Nosocomial infections in the pediatric intensive care units in Lithuania

Objective. The aim of the study was to collect the data on incidence rates, pathogens of nosocomial infections, and antimicrobials for treatment of nosocomial infections. Material and methods. Data were collected between March 2003 and December 2005 in five pediatric intensive care units using a modified patient-based HELICS protocol. Nosocomial infection was identified using the Centers for Disease Control definitions. All patients aged between 1 month and 18 years that stayed in the units for more than 48 hours were eligible for inclusion in this study. Results. A total of 1239 patient admissions and 7601 patient-days were evaluated. In 169 children (13.6%), 186 nosocomial infections occurred. The incidence density was 24.5 per 1000 patient-days, the incidence rate – 15.0 per 100 admissions. The highest incidence density was observed in the 6–12-year age group (31.2 per 1000 bed-days). Nosocomial infection rates per 1000 device-days were 28.8 for ventilator-associated pneumonia, 7.7 – for bloodstream infection, and 3.4 – for urinary tract infection. The most common site of infection was respiratory tract (58.8%). Secondary bacteremia developed in 18 (10.6%) patients. Haemophilus influenzae (20.1%), Acinetobacter spp. (14.2%), and Staphylococcus aureus (17.6%) were the most frequently isolated microorganisms. The most common antimicrobials used were first- and second-generation cephalosporins 74 (31.0%) and broad-spectrum penicillins 70 (29.3%). Conclusions. In Lithuanian pediatric intensive care units, the incidence rates of nosocomial infections were comparable to the available data from other countries, except for the ventilatorassociated pneumonia rate, which was relatively high. H. influenzae, Acinetobacter spp., and S. aureus were the most prevalent pathogens. The first- and second-generation cephalosporins and broad-spectrum penicillins were the most common antimicrobials in the treatment of nosocomial infection

Stakeholders’ attitudes towards intersectoral collaboration in the area of health inequalities

This article focuses on inter-sectoral collaboration in the area of health inequalities by implementing health in all policies approach. The aim of the study was to assess the attitudes of the specialists of different ministries and institutions subordinated to the Ministry of Health towards inter-sectoral collaboration in health inequalities. A cross sectional questionnaire survey was performed in March–April, 2015. Based on the results, the most of specialists of the health and non-health sectors noted about close collaboration with institutions operating in the same and different areas in order to implement institutional actions, however, specialists of both sectors rarely reported institutional collaboration in the area of health inequalities. Specialists of the health sector emphasized strong institutional collaboration within the health sector in health inequalities, besides, they collaborated with social, education and environmental sectors. Non-health sector institutions were involved in strong collaboration with social sector moreover they collaborated with justice and education sectors. The main forms of intersectoral collaboration in reducing health inequalities were participation in working groups, commissions or committees and development of strategic documents or legislation.Straipsnyje analizuojamas tarpsektorinis bendradarbiavimas sveikatos netolygumų srityje, įgyvendinant „Sveikata visose politikose“ principą. Šio straipsnio tikslas – įvertinti ministerijų ir Sveikatos apsaugos ministerijai pavaldžių įstaigų specialistų požiūrį į tarpsektorinį bendradarbiavimą sveikatos netolygumų srityje. 2015 m. kovo – balandžio mėn. atliktas kiekybinis tyrimas, taikant anketinės apklausos metodą. Tyrimo duomenimis, didžioji dalis sveikatos sektoriaus ir kitų sektorių specialistų pažymėjo apie aktyvų bendradarbiavimą su savo ir ne savo veiklos srityse veikiančiomis įstaigomis, įgyvendinant veiklos krytis, tačiau šių sektorių specialistai rečiau nurodė apie įstaigų bendradarbiavimą sveikatos netolygumų srityje. Sveikatos sektoriaus specialistai pažymėjo, kad jų įstaigos sveikatos netolygumų srityje aktyviai bendradarbiauja su sveikatos sektoriumi, be to, bendradarbiavimas vystomas su socialiu, švietimo bei aplinkos sektoriais. Kitų sektorių specialistai nurodė, kad aktyvus bendradarbiavimas sveikatos netolygumų srityje vyksta su socialiniu sektoriumi, taip pat bendradarbiaujama su teisėsaugos bei švietimo sektoriais. Pagrindinėmis tarpsektorinio bendradarbiavimo formos sveikatos netolygumų srityje išlieka dalyvavimas darbo grupių, komisijų arba komitetų veikloje ir strateginių dokumentų arba teisės aktų rengimas