Outbreak of Pseudomonas aeruginosa infections in a neonatal care unit associated with feeding bottles heaters.

This report describes an outbreak caused by Pseudomonas aeruginosa in a neonatal care unit possibly linked to feeding bottles heaters. Infection control measures were undertaken such as reinforcement of contact isolation precautions, environmental microbiologic sampling, educational sessions on hand hygiene, and use of sterilized water to refill feeding bottles heaters. The sustained eradication of P aeruginosa isolates after implementing control measures on feeding bottles heaters strongly suggests those as the source of the outbreak.

Congenital acute lymphoblastic leukemia: a two-case report and a review of the literature.

Congenital leukemia is a rare disease with particular biological and clinical characteristics which differs from those of older children and adults. Here, we describe two cases of congenital acute lymphoblastic leukemia in two newborns with different clinical presentations (leukemia cutis vs. splenomegaly and respiratory distress) and fatal outcome. Both cases shared the expression of myeloid antigens (CD65) and cytogenetic disorders involving the MLL gene (location 11q23) which are associated to extremely poor prognosis.

[Incidence of nosocomial infections at a neonatal intensive care unit: a six-year surveillance study]. / Incidencia de infecciones en una unidad de cuidados intensivos neonatales: estudio de vigilancia de 6 años.

INTRODUCTION: Nosocomial infection is a frequent complication in neonatal intensive care units (NICUs) attending patients who require lengthy hospitalization and frequent invasive techniques. PATIENTS AND METHODS: This study is part of a prospective surveillance program for nosocomial infection in Spain. All patients admitted to NICUs between June 1999 and March 2005 were observed. CDC criteria were used as the standard definition for nosocomial infection. RESULTS: A total of 1236 neonates (58% male) were admitted during the surveillance period, involving 19,420 days in the NICU. The average birth weight was 1947.6 +/- 1009.5 g and average gestational age was 32.9 +/- 5.4 weeks. The most frequent associated pathology was respiratory distress (23.06%). A total of 316 nosocomial infections were diagnosed in 226 neonates, 76.7% affecting premature neonates (< 1500 g). The most frequent location was bacteremia (56.3%), and there was a predominance of coagulase-negative staphylococci (46.05%). Gram-negative microorganisms were isolated in 32.1% of the cases (Escherichia coli and Pseudomonas aeruginosa were the most frequent pathogens). Overall incidence of nosocomial infection was 25.6%. Overall mortality was 6.6%, with higher mortality in the group with nosocomial infections (8.7%). CONCLUSIONS: Nosocomial infection rates are acceptable, with a typical epidemiological pattern for these units. Presence of a central catheter increased the risk. A program to promote proper hand washing should be considered. We do not recommend a continuing surveillance strategy in these units.

Incidencia de infecciones en una unidad de cuidados intensivos neonatales: estudio de vigilancia de 6 años / Incidence of nosocomial infections at a neonatal intensive care unit: a six-year surveillance study

Introducción. La infección nosocomial (IN) es una complicación frecuente en unidades de cuidados intensivos neonatales (UCIN), que atienden a pacientes con largas estancias hospitalarias y sometidos a frecuentes técnicas invasivas. Pacientes y métodos. Este trabajo forma parte de un estudio prospectivo multicéntrico nacional de vigilancia de IN. Se observan todos los ingresos en UCIN entre junio de 1999 y marzo de 2005. Se vigila la aparición de infecciones siguiendo los criterios diagnósticos de los Centers for Disease Control and Prevention (CDC). Resultados. En el período de estudio ingresaron 1.236 neonatos (58% varones), con un total de 19.420 días de estancias. El peso medio al nacimiento fue de 1.947,6 6 1.009,5 g y la edad gestacional media fue de 32,9 6 5,4 semanas. La patología más frecuente fue la dificultad respiratoria neonatal (23,06%). Se diagnosticaron 316 IN en 226 neonatos, el 76,7% de los cuales afectaron a prematuros de menos de 1.500 g. La localización más frecuente fue la bacteriemia (56,3%), con claro predominio del Staphylococcus coagulasa-negativo como responsable (46,05%). Los gramnegativos fueron aislados en el 32,1% de los casos (Escherichia coli y Pseudomonas aeruginosa, los más frecuentes). La incidencia acumulada de IN fue de 25,6% y la densidad de incidencia del 16,3 ‰. La mortalidad global afectó al 6,6% de los neonatos, mayor en el subgrupo de infectados (8,7%) que en los que no se infectaron (6,2%). Conclusiones. Se detectaron cifras de IN aceptables, con un patrón epidemiológico típico de estas unidades. Se debe considerar cuidadosamente el cateterismo central e intensificar los programas de higiene de las manos. No recomendamos la estrategia de vigilancia ininterrumpida en estas unidades (AU)

Introduction. Nosocomial infection is a frequent complication in neonatal intensive care units (NICUs) attending patients who require lengthy hospitalization and frequent invasive techniques. Patients and methods. This study is part of a prospective surveillance program for nosocomial infection in Spain. All patients admitted to NICUs between June 1999 and March 2005 were observed. CDC criteria were used as the standard definition for nosocomial infection. Results. A total of 1236 neonates (58% male) were admitted during the surveillance period, involving 19,420 days in the NICU. The average birth weight was 1947.6 6 1009.5 g and average gestational age was 32.9 6 5.4 weeks. The most frequent associated pathology was respiratory distress (23.06%). A total of 316 nosocomial infections were diagnosed in 226 neonates, 76.7% affecting premature neonates (< 1500 g). The most frequent location was bacteremia (56.3%), and there was a predominance of coagulase-negative staphylococci (46.05%). Gram-negative microorganisms were isolated in 32.1% of the cases (Escherichia coli and Pseudomonas aeruginosa were the most frequent pathogens). Overall incidence of nosocomial infection was 25.6%. Overall mortality was 6.6%, with higher mortality in the group with nosocomial infections (8.7%). Conclusions. Nosocomial infection rates are acceptable, with a typical epidemiological pattern for these units. Presence of a central catheter increased the risk. A program to promote proper hand washing should be considered. We do not recommend a continuing surveillance strategy in these units (AU)