Discordant antibiotic therapy and length of stay in children hospitalized for urinary tract infection

BACKGROUND: Urinary tract infections (UTIs) are a common reason for pediatric hospitalizations. OBJECTIVE: To determine the effect of discordant antibiotic therapy (in vitro nonsusceptibility of the uropathogen to initial antibiotic) on clinical outcomes for children hospitalized for UTI. DESIGN/SETTING: Multicenter retrospective cohort study in children aged 3 days to 18 years, hospitalized at 5 children's hospitals with a laboratory‐confirmed UTI. Data were obtained from medical records and the Pediatric Hospital Information System (PHIS) database. PARTICIPANTS: Patients with laboratory‐confirmed UTI. MAIN EXPOSURE: Discordant antibiotic therapy. MEASUREMENTS: Length of stay and fever duration. Covariates included age, sex, insurance, race, vesicoureteral reflux, antibiotic prophylaxis, genitourinary abnormality, and chronic care conditions. RESULTS: The median age of the 216 patients was 2.46 years (interquartile range [IQR]: 0.27, 8.89) and 25% were male. The most common causative organisms were E. coli and Klebsiella species. Discordant therapy occurred in 10% of cases and most commonly in cultures positive for Klebsiella species, Enterobacter species, and mixed organisms. In adjusted analyses, discordant therapy was associated with a 1.8 day (95% confidence interval [CI]: 1.5, 2.1) longer length of stay [LOS], but not with fever duration. CONCLUSIONS: Discordant antibiotic therapy for UTI is common and associated with longer hospitalizations. Further research is needed to understand the clinical factors contributing to the increased LOS and to inform decisions for empiric antibiotic selection in children with UTIs. Journal of Hospital Medicine 2012; © 2012 Society of Hospital MedicinePeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94298/1/1960_ftp.pd

The COP software for development and testing of the ExoMars instrument MicroMED

We present a dedicated software for assessing the performances of an Optical Particle Counter, the most common sensor used to monitor the atmospheric dust. The software is called COP and has been developed in the frame of the MicroMED project, the first OPC designed for extraterrestrial environment and selected for the ExoMars space mission. We describe its functioning and compare its result to the laboratory data acquired during the validation and calibration process of the instrument. COP has proven its usefulness along the whole instrument development and integration chain and can be adapted to the study of any Optical Particle Counter

Performance analysis of the "microMED" optical particle counter in windy conditions

The Optical Particle Counter 'MicroMED' will be part of the ExoMars 2022 mission and aims to provide the first ever direct measurement of airborne Martian dust. The instrument has been tested at the INAF - OAC premises, where a Martian chamber is present, simulating the Martian environment in terms of pressure, instrument temperature, atmosphere composition and the presence of dust. However, tests in the presence of wind are also needed for the instrument characterization. To this purpose, a test campaign at the AWTS II simulator at the Aarhus University (Denmark) was performed, testing the instrument in the presence of winds up to 15 m/s. Such tests are important since wind is the main agent of landscape modification on Mars. The present work describes the results of such tests, showing the variation of the instrument detecting ability with the wind speed, as well as the influence of temperature on performances

CFD Analysis of the unpredicted bimodal size distribution histograms for the ExoMars MicroMED sensor

The sensor "MicroMED", which is scheduled to reach Mars in the framework of the ExoMars mission, is an Optical Particle Counter (OPC) that aims at performing the first ever direct measurement at the surface of airborne Martian dust. MicroMED has been mostly developed and integrated at the Astronomical Observatory of Capodimonte (INAF-OAC) premises and will provide size distribution and concentration of airborne dust on Mars. During performance and calibration tests with monodispersed grain samples, some unexpected bimodal size distributions have been obtained, highlighting the need for a verification of MicroMED's precision in size retrieving. This paper provides an overview of the analysis performed to individuate the causes of this behavior, and the verification of the impact on performances. Such analysis could be of interest to whoever is implied in the design of an OPC