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HEALTHCARE-ASSOCIATED INFECTIONS IN PAEDIATRIC AND NEONATAL INTENSIVE CARE UNITS: IMPACT OF UNDERLYING RISK FACTORS AND ANTIMICROBIAL RESISTANCE ON 30-DAY CASE-FATALITY
Objectives.
Our aims were (i) to describe trends in the epidemiology of Healthcare-associated Infections (HAIs) in paediatric/neonatal ICUs and (ii) to evaluate risk factors and impact of Multidrug-Resistance (MDR) in children admitted to ICUs.
Design.
Multicentre, retrospective, cohort study
with a nested case-control study conducted between January 2010 and December 2014.
Setting.
Three tertiary-care paediatric hospitals in Italy and Brazil with a total of 97 ICU beds.
Patients.
Inclusion criteria were (i) admission to ICU during the study period (ii) age at onset <18 years and (iii) microbiologically-confirmed HAI.
Results.
538 HAIs in 454 children were included. 93.3% of patients had comorbidities. Bloodstream infections (BSIs) were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU-admission and the crude 30-day fatality rate was 5.7/1,000-admission. The most frequently
isolated pathogens were Enterobacteriaceae, followed by
Pseudomonas aeruginosa and Staphylococcus aureus.44% of isolates were MDR. Two multivariate logistic regressions were performed. Factors independently associated with an MDR
-HAI were Country, previous antibiotics, transplantation, major surgery, and colonisation by an MDR strain. Factors independently associated with 30-day case-fatality were Country, previous transplantation, fungal infection, BSI, LRTI, and infection caused by MDR strains.
Conclusions.
Infection control and prevention should be a primary focus to limit the spread of MDR strains and improve the outcome of hospitalised patients. Targeted surveillance programmes
collecting neonatal and paediatric HAI/BSI data and outcomes would allow global benchmarking between centres. The next step is to identify simple methods to monitor key HAIs and integrate these into affordable intervention programmes
Doses of Crotalaria juncea: Residual effect on zucchini and maize crop in sequence to broccoli
Rapidity and Centrality Dependence of Proton and Anti-proton Production from Au+Au Collisions at sqrt(sNN) = 130GeV
We report on the rapidity and centrality dependence of proton and anti-proton
transverse mass distributions from Au+Au collisions at sqrt(sNN) = 130GeV as
measured by the STAR experiment at RHIC. Our results are from the rapidity and
transverse momentum range of |y|<0.5 and 0.35 <p_t<1.00GeV/c. For both protons
and anti-protons, transverse mass distributions become more convex from
peripheral to central collisions demonstrating characteristics of collective
expansion. The measured rapidity distributions and the mean transverse momenta
versus rapidity are flat within |y|<0.5. Comparisons of our data with results
from model calculations indicate that in order to obtain a consistent picture
of the proton(anti-proton) yields and transverse mass distributions the
possibility of pre-hadronic collective expansion may have to be taken into
account.Comment: 4 pages, 3 figures, 1 table, submitted to PR
Performance of the CMS Cathode Strip Chambers with Cosmic Rays
The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device
in the CMS endcaps. Their performance has been evaluated using data taken
during a cosmic ray run in fall 2008. Measured noise levels are low, with the
number of noisy channels well below 1%. Coordinate resolution was measured for
all types of chambers, and fall in the range 47 microns to 243 microns. The
efficiencies for local charged track triggers, for hit and for segments
reconstruction were measured, and are above 99%. The timing resolution per
layer is approximately 5 ns
Disappearance of back-to-back high-p(T) hadron correlations in central Au+Au collisions at root s(NN)=200 GeV
Azimuthal correlations for large transverse momentum charged hadrons have been measured over a wide pseudorapidity range and full azimuth in Au+Au and p+p collisions at roots(NN)=200 GeV. The small-angle correlations observed in p+p collisions and at all centralities of Au+Au collisions are characteristic of hard-scattering processes previously observed in high-energy collisions. A strong back-to-back correlation exists for p+p and peripheral Au+Au. In contrast, the back-to-back correlations are reduced considerably in the most central Au+Au collisions, indicating substantial interaction as the hard-scattered partons or their fragmentation products traverse the medium
Azimuthal anisotropy and correlations in the hard scattering regime at RHIC
Azimuthal anisotropy (v(2)) and two-particle angular correlations of high p(T) charged hadrons have been measured in Au+Au collisions at roots(NN) = 130 GeV for transverse momenta up to 6 GeV/c, where hard processes are expected to contribute significantly. The two-particle angular correlations exhibit elliptic flow and a structure suggestive of fragmentation of high p(T) partons. The monotonic rise of v(2)(p(T)) for p(T) 3 GeV/c, a saturation of v(2) is observed which persists up to p(T) = 6 GeV/c
Transverse-momentum and collision-energy dependence of high-p(T) hadron suppression in Au+Au collisions at ultrarelativistic energies
We report high statistics measurements of inclusive charged hadron production in Au+Au and p+p collisions at rootS(NN)=200 GeV. A large, approximately constant hadron suppression is observed in central Au+Au collisions for 5<p(T)<12 GeV/c. The collision energy dependence of the yields and the centrality and p(T) dependence of the suppression provide stringent constraints on theoretical models of suppression. Models incorporating initial-state gluon saturation or partonic energy loss in dense matter are largely consistent with observations. We observe no evidence of p(T)-dependent suppression, which may be expected from models incorporating jet attenuation in cold nuclear matter or scattering of fragmentation hadrons
Evidence from d+Au measurements for final-state suppression of high-p(T) hadrons in Au plus Au collisions at RHIC
We report measurements of single-particle inclusive spectra and two-particle azimuthal distributions of charged hadrons at high transverse momentum (high p(T)) in minimum bias and central d+Au collisions at roots(NN)=200 GeV. The inclusive yield is enhanced in d+Au collisions relative to binary-scaled p+p collisions, while the two-particle azimuthal distributions are very similar to those observed in p+p collisions. These results demonstrate that the strong suppression of the inclusive yield and back-to-back correlations at high p(T) previously observed in central Au+Au collisions are due to final-state interactions with the dense medium generated in such collisions
Cross sections and transverse single-spin asymmetries in forward neutral-pion production from proton collisions at root s=200 GeV
Measurements of the production of forward high-energy pi(0) mesons from transversely polarized proton collisions at root200 GeV are reported. The cross section is generally consistent with next-to-leading order perturbative QCD calculations. The analyzing power is small at x(F) below about 0.3, and becomes positive and large at higher x(F), similar to the trend in data at roots less than or equal to20 GeV. The analyzing power is in qualitative agreement with perturbative QCD model expectations. This is the first significant spin result seen for particles produced with p(T)>1 GeV/c at a polarized proton collider
Azimuthal anisotropy at the relativistic heavy ion collider: The first and fourth harmonics
We report the first observations of the first harmonic (directed flow, v(1)) and the fourth harmonic (v(4)), in the azimuthal distribution of particles with respect to the reaction plane in Au+Au collisions at the BNL Relativistic Heavy Ion Collider (RHIC). Both measurements were done taking advantage of the large elliptic flow (v(2)) generated at RHIC. From the correlation of v(2) with v(1) it is determined that v(2) is positive, or in-plane. The integrated v(4) is about a factor of 10 smaller than v(2). For the sixth (v(6)) and eighth (v(8)) harmonics upper limits on the magnitudes are reported
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