ABSTRACT
The implementation of managed protocols contributes to a systematized approach to the patient and continuous evaluation of results, focusing on improving clinical practice, early diagnosis, treatment, and outcomes. Advantages to the adoption of a pediatric sepsis recognition and treatment protocol include: a reduction in time to start fluid and antibiotic administration, decreased kidney dysfunction and organ dysfunction, reduction in length of stay, and even a decrease on mortality. Barriers are: absence of a written protocol, parental knowledge, early diagnosis by healthcare professionals, venous access, availability of antimicrobials and vasoactive drugs, conditions of work, engagement of healthcare professionals. There are challenges in low-middle-income countries (LMIC). The causes of sepsis and resources differ from high-income countries. Viral agent such as dengue, malaria are common in LMIC and initial approach differ from bacterial infections. Some authors found increased or no impact in mortality or increased length of stay associated with the implementation of the SCC sepsis bundle which reinforces the importance of adapting it to most frequent diseases, disposable resources, and characteristics of healthcare professionals. Conclusions: (1) be simple; (2) be precise; (3) education; (5) improve communication; (5) work as a team; (6) share and celebrate results.
Subject(s)
Shock, Septic , Child , Critical Care , Hemodynamics , Humans , Infant, Newborn , United StatesSubject(s)
Shock, Septic , Child , Critical Care , Hemodynamics , Humans , Infant, Newborn , United StatesABSTRACT
Com o declínio da taxa de infecções causadas pelo Haemophilus influenzae tipo b após a ampla introdução da vacina, sorotipos não-b devem ser considerados agentes patogênicos potenciais em crianças menores de 5 anos com doença invasiva. Relatamos um caso de meningite por Haemophilus influenzae tipo f em um lactente imunocompetente de 1 ano. O agente foi identificado em líquido cefalorraquidiano e hemocultura. A sorotipagem foi realizada por testes com soros policlonais e confirmada por reação em cadeia de polimerase. Todas as cepas de Haemophilus influenzae associadas à doença invasiva deveriam ser sorotipadas e notificadas, a fim de possibilitar uma análise adequada das mudanças e tendências na distribuição de sorotipos desta doença.
With the decline in the rate of infections caused by Haemophilus influenzae serotype b since the widespread vaccination, non-b serotypes should be considered as potential pathogenic agents in children with invasive disease younger than 5 years old. We report the case of an immunocompetent 1-year-old boy with Haemophilus influenzae type f meningitis. The agent was identified in cerebrospinal fluid and blood cultures. Serotyping was performed by tests using polyclonal sera and confirmed by polymerase chain reaction. All Haemophilus influenzae isolates associated with invasive disease should be serotyped and notified as a way to evaluate the changes and trends in serotype distribution of this disease.
Subject(s)
Humans , Infant , Male , Haemophilus influenzae/classification , Meningitis, Haemophilus/microbiology , Haemophilus influenzae/isolation & purification , Meningitis, Haemophilus/diagnosis , Polymerase Chain Reaction , SerotypingABSTRACT
With the decline in the rate of infections caused by Haemophilus influenzae serotype b since the widespread vaccination, non-b serotypes should be considered as potential pathogenic agents in children with invasive disease younger than 5 years old. We report the case of an immunocompetent 1-year-old boy with Haemophilus influenzae type f meningitis. The agent was identified in cerebrospinal fluid and blood cultures. Serotyping was performed by tests using polyclonal sera and confirmed by polymerase chain reaction. All Haemophilus influenzae isolates associated with invasive disease should be serotyped and notified as a way to evaluate the changes and trends in serotype distribution of this disease.
