Antimicrobial surgical prophylaxis: Still an issue in paediatrics

Objectives: Antimicrobial prophylaxis (AP) is an important means of reducing surgical site infections. The goal of this study was to evaluate the perioperative AP in paediatric practice and its compliance with surgical prophylaxis guidelines. Methods: A prospective study was conducted at Gazi University Faculty of Medicine, between September 2015 and April 2016. Paediatric patients who underwent surgical procedures were included in the study. Surgical AP was evaluated. Results: During the entire study period, 466 children underwent surgery at our centre; 433 (92.7\%) received antimicrobial prophylaxis. Overall adherence to the guidelines regarding surgical prophylaxis was 22.1\%. The rate of administration of surgical prophylaxis was significantly lower, and the duration was shorter when the surgical procedure was clean (P = 0.002). When the duration of the procedure was longer, the rate of administration of prophylaxis was higher (P = 0.000). The duration of postoperative prophylaxis was longer than recommended in 72.2\% of the patients. In the multivariate analysis, application errors increased with longer surgical time (P = 0.01, OR 2.18, 95\% CI 1.19-4.03). Conclusions: High rates of misapplication of antimicrobial surgical prophylaxis were observed in this study. Awareness and usage of guidelines should be encouraged. The education of clinicians should be supported by studies regarding surgical prophylaxis in children. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy

Vaccine failures in pediatric cases caused by streptococcus pneumoniae serotype 19A.

Community-acquired pneumonia (CAP) is a leading cause of childhood mortality and morbidity worldwide. PCV-13 has implemented incidence of CAP undoubtedly in a very good way but continuous surveillance for vaccine failures is still very important for future vaccination programs. To support this opinion we report seven children (age of the seven patients ranged between 10 months and 5 y, 10 months old patients were vaccinated 3 times with PCV13 whereas others were fully vaccinated as 3 + 1) infected with Streptococcus pneumoniae Serotype 19A in last 4 y (2015-2018)

Influenza Epidemiology And Influenza Vaccine Effectiveness During The 2016-2017 Season In The Global Influenza Hospital Surveillance Network (Gihsn)

BackgroundThe Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hospital-based epidemiological study to collect epidemiological data in the GIHSN. In the 2016-2017 influenza season, 15 sites in 14 countries participated in the GIHSN, although the analyses could not be performed in 2 sites. A common core protocol was used in order to make results comparable. Here we present the results of the GIHSN 2016-2017 influenza season.MethodsA RT-PCR test was performed to all patients that accomplished the requirements detailed on a common core protocol. Patients admitted were included in the study after signing the informed consent, if they were residents, not institutionalised, not discharged in the previous 30days from other hospitalisation with symptoms onset within the 7days prior to admission. Patients 5years old or more must also complied the Influenza-Like Illness definition. A test negative-design was implemented to perform IVE analysis. IVE was estimated using a logistic regression model, with the formula IVE=(1-aOR)x100, where aOR is the adjusted Odds Ratio comparing cases and controls.ResultsAmong 21,967 screened patients, 10,140 (46.16%) were included, as they accomplished the inclusion criteria, and tested, and therefore 11,827 (53.84%) patients were excluded. Around 60% of all patients included with laboratory results were recruited at 3 sites. The predominant strain was A(H3N2), detected in 63.6% of the cases (1840 patients), followed by B/Victoria, in 21.3% of the cases (618 patients). There were 2895 influenza positive patients (28.6% of the included patients). A(H1N1)pdm09 strain was mainly found in Mexico. IVE could only be performed in 6 sites separately. Overall IVE was 27.24 (95% CI 15.62-37.27. Vaccination seemed to confer better protection against influenza B and in people 2-4years, or 85years old or older. The aOR for hospitalized and testing positive for influenza was 3.02 (95% CI 1.59-5.76) comparing pregnant with non-pregnant women.ConclusionsVaccination prevented around 1 in 4 hospitalisations with influenza. Sparse numbers didn't allow estimating IVE in all sites separately. Pregnancy was found a risk factor for influenza, having 3 times more risk of being admitted with influenza for pregnant women.Wo