Effect of UV-C disinfection and copper plating on healthcare-associated infections in a NICU with high ESBL infections.

INTRODUCTION: Healthcare-associated infections (HCAIs) in neonates are frequent and highly lethal, in particular those caused by extended spectrum beta-lactamase (ESBL) producing bacteria. We evaluated the beneficial effects of ultraviolet C (UV-C) disinfection and copper adhesive plating on HCAIs in the Neonatal Intensive Care Unit (NICU) of a third level paediatric hospital in Mexico City, both in combination of hand-hygiene (HH) and prevention bundles. METHODS: All NICU patients were included. There were 4 periods (P): P1: HH monitoring and prevention bundles; P2: P1+UV-C disinfection; P3: P2+Copper adhesive plating on frequent-contact surfaces and P4: Monitoring of P3 actions. RESULTS: 552 neonates were monitored during 15,467 patient days (PD). HCAI rates decreased from 11.03/1000 PD in P1 to 5.35/1000 PD in P4 (p=0.006). HCAIs with bacterial isolates dropped from 5.39/1000 PD in PI to 1.79/1000 PD in P4 (p=0.011). UV-C and copper were associated with significant HCAI prevention (RR 0.49, CI95% 0.30-0.81, p=0.005) and with lesser HCAIs with bacterial isolates (RR 0.33, CI95% 0.14-0.77, p=0.011). CONCLUSIONS: Copper adhesive plating combined with UV-C disinfection were associated with a drop in HCAI rates and with the elimination of ESBL-caused HCAIs. Hence, we propose that these strategies be considered in MDRO proliferation preventions.

Allowing access to parents/caregivers into COVID-19 hospitalization areas does not increase infections among health personnel in a pediatric hospital.

Background: At the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. Isolating children has a negative effect on both, them and their parents/caregivers. Nevertheless isolation was mandatory because of the potential risk that visitation might have on COVID-19 dissemination mostly among health personnel. Methods: From the starting of the COVID-19 pandemic in our pediatric hospital visits were forbidden. This 2 months period (April-May) was called P1. In June parents were allowed to visit (P2), under a visiting protocol previously published. Hospital workers were monitored for the presence of COVID-19 symptoms and tested for the infection when clinically justified. The positivity proportion and the relative risk (RR) of COVID-19 among the health personnel between periods were calculated. The caregivers were also followed up by phone calls. Results: Since April 2020 to November 2020, 2,884 health personnel were studied for 234 days, (318,146 workers days). Although the COVID-19/1,000 health personnel days rate decreased from one period to another (1.43 vs 1.23), no statistically significant differences were found. During P1, 16 patients with COVID-19 were treated. During the follow up none of the family members were infected/symptomatic in P1, while in P2, 6/129 (4.65%) were symptomatic or had a positive test. All of them initiated between 2 and 4 days after the patient's admission. As they also had some other infected family members it was not possible to ensure the source of infection. There were no statistically significant differences in the RR of COVID-19 in health personnel, (RR 1, 95% CI 0.69-1.06, p = 0.162). Conclusions: When safely implemented, allowing parents/caregivers to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers or among themselves.

Tracing COVID-19 Source of Infection Among Health Personnel in a Pediatric Hospital.

Health personnel (HP) have been universally recognized as especially susceptible to COVID-19. In Mexico, our home country, HP has one of the highest death rates from the disease. From the beginning of the SARS-CoV-2 pandemic, an office for initial attention for HP and a call center were established at a COVID-19 national reference pediatric hospital, aimed at early detection of COVID-19 cases and stopping local transmission. The detection and call center implementation and operation, and tracing methodology are described here. A total of 1,042 HP were evaluated, with 221 positive cases identified (7.7% of all HP currently working and 26% of the HP tested). Community contagion was most prevalent (46%), followed by other HP (27%), household (14%), and hospitalized patients (13%). Clusters and contact network analysis are discussed. This is one of the first reports that address the details of the implementation process of contact tracing in a pediatric hospital from the perspective of a hybrid hospital with COVID-19 and non-COVID-19 areas.

Performance of LDL-C calculated with Martin's formula compared to the Friedewald equation in familial combined hyperlipidemia.

BACKGROUND AND AIMS: A novel method to estimate low density lipoprotein cholesterol (LDL-C) has been proposed by Martin et al. This may permit a more accurate estimation of cardiovascular risk, however, external validation is needed. Here, the performance of LDL-C using this new method (LDL-N) is compared with LDL-C estimated with Friedewald equation (LDL-F) in familial combined hyperlipidemia (FCHL), a common primary dyslipidemia in which apolipoprotein B containing particle composition is abnormal and interferes with LDL-C estimation. METHODS: A total of 410 FCHL subjects were included. LDL-C was estimated with both the Friedewald equation (LDL-F) and the novel formula (LDL-N). Apolipoprotein B levels and non- HDL-C were recorded. The correlation and concordance between LDL-F and LDL-N and both Apolipoprotein B and non-HDL-C levels were calculated. Analysis stratifying for triglyceride tertiles and FCHL lipid phenotypes was also carried out. RESULTS: The correlations between LDL-N and Apo B and non-HDL-C were ρ = 0.777 (95%CI 0.718-0.825) and ρ = 0.735 (95%CI 0.648-0.816), respectively. The corresponding correlations for LDL-F were ρ = 0.551(95%CI 0.454-0.637) and ρ = 0.394 (95%CI 0.253-0.537), respectively. In mixed dyslipidemia or isolated hypertriglyceridemia, these correlations were significantly better using LDL-N. With respect to concordance, LDL-N performed significantly better than LDL-F when considering apoB <90 mg/dL (κLDL-N = 0.495 vs. κLDL-F = 0.165) and non-HDL-C <130 (κLDL-N = 0.724 vs. κLDL-F = 0.253). CONCLUSIONS: In FCHL, LDL-C estimation using Martin's formula showed greater correlation and concordance with non-HDL-C and Apo B compared with the Friedewald equation.

Evaluación de aptitudes por sexo para el aprendizaje de las técnicas quirúrgicas: ¿Hombres o mujeres? / Assessment of aptitudes according to gender for the learning of surgical techniques: Men or women?

Objetivo: Evaluar las aptitudes de los hombres y las mujeres estudiantes de medicina para establecer si hay alguna limitante de capacidad por el tipo de sexo en el aprendizaje de las técnicas quirúrgicas. Sede: Facultad de Ciencias de la Salud de la Universidad Anáhuac México Norte. Diseño: Análisis retrospectivo, comparativo, observacional, de investigación educativa. Análisis estadístico: Prueba t. Material y métodos: Se revisaron los resultados obtenidos por el tipo de sexo en 261 estudiantes en ocho cursos de técnicas quirúrgicas impartidos desde julio de 2006 a junio de 2010. Se definió la aptitud como el rasgo general y propio de cada individuo, que le facilita el aprendizaje de tareas específicas y le distingue de los demás. Fueron nueve las experiencias educativas evaluadas, integradas en seis categorías: 1) evaluaciones escritas, 2) ejecución de prácticas en quirófano, 3) ejecución de tareas y trabajos, 4) participaciones en clase, 5) empleo de tecnologías de información y comunicación y 6) calificación final integradora. Resultados: En cinco de las nueve experiencias educativas analizadas, las mujeres obtuvieron una calificación mayor y estadísticamente significativa. Conclusión: En un curso de técnicas quirúrgicas de pregrado, las mujeres no tuvieron ninguna limitante de aptitud, capacidad o comportamiento, comparadas con los varones.

Objective: To assess the aptitudes of male and female students of Medicine to establish if there is a limited capacity per gender in the learning of surgical techniques. Setting: School of Health Sciences, Anahuac University North, Mexico City. Design: Retrospective, comparative, observational analysis of educational research. Statistical analysis: Student's t test. Material and Methods: We reviewed the results obtained according to gender in 261 students regarding eight surgical techniques courses taught from July 2006 to June 2010. Aptitude was defined as a general feature pertaining to each individual that eases learning of specific tasks and differs him/her from other individuals. We evaluated nine educational experiences, integrated in six categories: 1) written examinations, 2) practices in the operating room, execution, 3) execution of homeworks and projects, 4) participation in classes, 5) use of informatics and communication tools, and 6) final integrating score. Results: In five of the nine analyzed experiences, women attained statistically significant higher scores. Conclusion: In an undergraduate surgical techniques course, women had no limits in their aptitude, capacity, or behavior as compared to male students.