Neonatology Intensive Care Unit Research Articles

Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the Department of Neonatology Intensive Care Unit of Mohammed VI University Hospital

Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the Department of Neonatology Intensive Care Unit of Mohammed VI University Hospital

Proteomics-Based Mapping of Bronchopulmonary Dysplasia-Associated Changes in Noninvasively Accessible Oral Secretions

ObjectiveTo determine if oral secretions (OS) can be used as a non-invasively collected body fluid, in lieu of tracheal aspirates (TA), to track respiratory status and predict bronchopulmonary dysplasia (BPD) development in infants born <32 weeks. Study DesignThis was a retrospective, single-center cohort study that included data and convenience samples from week-of-life (WoL) 3 from two independent preterm infant cohorts. Using previously banked samples, we applied our sample-sparing, high-throughput proteomics technology to compare OS and TA proteomes in infants born <32 weeks admitted to the Neonatology Intensive Care Unit (NICU) (Cohort 1; N=23 infants). In a separate similar cohort, we mapped the BPD-associated changes in the OS proteome (Cohort 2; N=17 infants including 8 with BPD). ResultsIn samples collected during the first month of life, we identified 607 proteins unique to OS, 327 proteins unique to TA, and 687 overlapping proteins belonging to pathways involved in immune effector processes, neutrophil degranulation, leukocyte mediated immunity, and metabolic processes. Furthermore, we identified 37 OS proteins that showed significantly differential abundance between BPD cases and controls: 13 were associated with metabolic and immune dysregulation, 10 of which (eg, SERPINC1, CSTA, BPI) have been linked to BPD or other prematurity-related lung disease based on blood or TA investigations, but not OS. ConclusionOS are a noninvasive, easily accessible alternative to TA and amenable to high-throughput proteomic analysis in preterm newborns. OS samples hold promise to yield actionable biomarkers of BPD development, particularly for prospective categorization of at-risk infants for timely clinical trial enrollment with novel therapies.

Rare Case of Systemic Lupus Erythematosus with Multiorgan Involvement in A Young Pregnant Women – A Case Report

Systemic Lupus erythematosus (SLE) is an autoimmune disease that notoriously varies in presentation, course, andoutcome. Active Nephritis, especially if the neuropsychiatry component is involved, is associated with adverse pregnancy outcomessuch as Gestational hypertension, pre-eclampsia, and renal failure. Our aim is to elaborate on the case report of young pregnantwomen diagnosed with SLE with multiorgan involvement about its course and management and the need for a multidisciplinaryapproach. A 20-year-old primigravida at 33 weeks of gestation with no known co-morbidities previously came with a history offever for 2 days, abdominal pain, and bleeding per vagina. Given placental abruption, the patient underwent an emergency lowersegment cesarean section. The patient developed postpartum hemorrhage (PPH), which was managed medically. On POD#8(postoperative day 8), the patient had generalized tonic-clonic seizures (GTCS) and developed hematuria. On evaluation, itrevealed abnormal renal parameters suggestive of Pregnancy-related Acute Kidney Injury (PRAKI). The patient's condition did notimprove with conservative management. After immunological investigations, a renal biopsy was done, and the diagnosis wasconfirmed as SLE-LN III (Systemic lupus erythematosus-Lupus nephritis) with Neuropsychiatry component involvement. Hence,the patient was started on Hydroxychloroquine based on the National Institute of Health protocol, and her condition improved.Hence given the relatively high number of maternal and neonatal deaths, lupus pregnancies should be followed by a multidisciplinaryteam, including nephrologists, rheumatologists, and obstetricians experienced in high-risk pregnancies, and deliveries should beplanned in tertiary-care settings provided with neonatology intensive care units.

Estrategias de afrontamiento y nivel de estrés de las enfermeras en la Unidad de Cuidados Intensivos de Neonatología

The main purpose of the research study was to determine the association between coping strategies styles: problem-focused, emotion-focused and other strategies with the level of work stress in nurses of the Neonatology Intensive Care Unit of the Hospital Belén de Trujillo (HBT) and the Hospital Regional Docente de Trujillo (HRDT). The sample consisted of 36 nurses, to whom the following scales were applied: Coping styles (EVEA) and stress level (EVNE). Chi-Square was applied to the findings to determine the relationship of the study variables. Results: the most common level in problem-focused and emotion-focused strategy styles was high with a percentage of 69.4 and 44.4, respectively. In addition, the low level of stress was the most recurrent in nurses with a percentage of 47.2. Finally, the significance level is equal to 0.000, then, the association that exists between both problem-focused and emotion-focused coping strategy styles with the level of stress in nurses is significant.

Need for palliative care from birth to infancy in pediatric patients with neurological diseases.

Palliative care is a comprehensive treatment approach that guarantees comfort for pediatric patients and their families from diagnosis to death. The techniques used for neurological patients in the field of palliative care can enhance the quality of care provided to patients with neurological disorders and support their families. This study aimed to analyze the palliative care protocols in use in our department, describe the palliative course in the clinical setting, and propose the implementation of hospital palliative care for long-term prognosis of patients with neurological diseases. This retrospective observational study examined the application of palliative care from birth to early infancy in neurological patients. We studied 34 newborns with diseases affecting the nervous system impairing prognosis. The study was conducted from 2016 to 2020 at the Neonatology Intensive Care Unit and the Pediatric Unit of the San Marco University Hospital in Catania, Sicily, Italy. Despite current legislation in Italy, no palliative care network has been activated to meet the needs of the population. In our center, given the vast number of patients with neurological conditions requiring palliative care, we should activate a straightforward departmental unit for neurologic pediatric palliative care. The establishment of specialized reference centers that manage significant neurological illnesses is due to neuroscience research progress in recent decades. Integration with specialized palliative care is sparse but now seems essential.

Nosocomial outbreak caused by Serratia marcescens in a neonatology intensive care unit in a regional hospital. Analysis and improvement proposals

ObjectivesSerratia marcescens (SM) may cause nosocomial outbreaks in Neonatal Intensive Care Units (NICU). We describe an outbreak of SM in a NICU and propose additional prevention and control recommendations. MethodsBetween March 2019 and January 2020, samples were taken from patients in the NICU (rectal, pharyngeal, axillary and other locations) and from 15 taps and their sinks. Control measures were implemented including thorough cleaning of incubators, health education to staff and neonates’relatives, and use of single-dose containers. PFGE was performed in 19 isolates from patients and in 5 environmental samples. ResultsFrom the first case in March 2019 to the detection of the outbreak, a month elapsed. Finally, 20 patients were infected and 5 colonized. 80% of infected neonates had conjunctivitis, 25% bacteremia, 15% pneumonia, 5% wound infection, and 5% urinary tract infection. Six neonates had two foci of infection. Among the 19 isolates studied, 18 presented the same pulsotype and only one of the isolates from the sinkhole showed a clonal relationship with those of the outbreak. Initial measures established were ineffective to control de outbreak and were implemented with exhaustive cleaning, use of individual eye drops, environmental sampling and changing sinks. ConclusionThis outbreak presented a high number of neonates affected due to its late detection and torpid evolution. The microorganisms isolated from the neonates were related to an environmental isolate. Additional prevention and control measures are proposed, including routine weekly microbiological sampling.

BORN study: a multicenter randomized trial investigating cord blood red blood cell transfusions to reduce the severity of retinopathy of prematurity in extremely low gestational age neonates

BackgroundExtremely low gestational age neonates (ELGANs, i.e., neonates born before 28 weeks of gestation) are at high risk of developing retinopathy of prematurity (ROP), with potential long-life visual impairment. Due to concomitant anemia, ELGANs need repeated red blood cell (RBC) transfusions. These produce a progressive replacement of fetal hemoglobin (HbF) by adult hemoglobin (HbA). Furthermore, a close association exists between low levels of HbF and severe ROP, suggesting that a perturbation of the HbF-mediated oxygen release may derange retinal angiogenesis and promote ROP.Methods/designBORN (umBilical blOod to tRansfuse preterm Neonates) is a multicenter double-blinded randomized controlled trial in ELGANs, to assess the effect of allogeneic cord blood RBC transfusions (CB-RBCs) on severe ROP development. Recruitment, consent, and randomization take place at 10 neonatology intensive care units (NICUs) of 8 Italian tertiary hospitals. ELGANs with gestational age at birth comprised between 24+0 and 27+6 weeks are randomly allocated into two groups: (1) standard RBC transfusions (adult-RBCs) (control arm) and (2) CB-RBCs (intervention arm). In case of transfusion need, enrolled patients receive transfusions according to the allocation arm, unless an ABO/RhD CB-RBC is unavailable. Nine Italian public CB banks cooperate to make available a suitable amount of CB-RBC units for all participating NICUs. The primary outcome is the incidence of severe ROP (stage 3 or higher) at discharge or 40 weeks of postmenstrual age, which occurs first.DiscussionBORN is a groundbreaking trial, pioneering a new transfusion approach dedicated to ELGANs at high risk for severe ROP. In previous non-randomized trials, this transfusion approach was proven feasible and able to prevent the HbF decrease in patients requiring multiple transfusions. Should the BORN trial confirm the efficacy of CB-RBCs in reducing ROP severity, this transfusion strategy would become the preferential blood product to be used in severely preterm neonates.Trial registrationClinicalTrials.gov NCT05100212. Registered on October 29, 2021

Improving Compliance with a Rounding Checklist through Low- and High-technology Interventions: A Quality Improvement Initiative.

Introduction:Checklists aid in ensuring consistency and completeness in medical care delivery. However, using an improvement and safety checklist during rounds was variable in our neonatology intensive care unit (NICU), and completion was not tracked sustainably. This quality improvement (QI) initiative’s primary aim was to increase compliance with checklist completion from 31% to >75% within 1 year.Methods:A multidisciplinary QI team identified barriers to checklist completion and implemented a human factors-focused low-technology intervention (redesign of a hard-copy checklist) and later a high-technology clinical decision support tool within the electronic health record. The primary outcome measure was percent compliance with the use of the checklist. Process metrics included the duration of checklist completion. Balancing measures included staff perceptions of work burden and question relevance.Results:Major barriers to checklist utilization were inability to remember, rounding interruptions, and perceived lack of question relevance to patients. Average biweekly checklist compliance improved from 31% before interventions to 80% after interventions. Average checklist completion time decreased from 46 to 11 seconds. Follow-up surveys demonstrated more respondents found questions “completely relevant” (34% pre versus 43% post) but perceived increased work burden (26% pre versus 31% post).Conclusions:Using QI methodology, human factors-based interventions, and a novel clinical decision support tool, we significantly improved efficiency and checklist compliance and created an automated, sustainable method for monitoring completion and responses. This foundational project provides an infrastructure broadly applicable to QI work in other healthcare settings.

Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit

To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. Prospective observational study. Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13-24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205,000: implementation of a new nursery room and extra salaries cost US$30,350 and estimated productivity loss during 1 month cost US$175,000. Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.

The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia

Backgrounds: Neonatal sepsis is a significant cause of mortality and long-term morbidity. The preterm infant has high-risk sepsis and its sequelae. Low birth weight infants were more susceptible to sepsis. Initial infections in neonates may not be identified due to non-specific symptoms and sign with the limited laboratory criteria. This study aims to describe the characteristics of neonatal sepsis in low birth weight infants in the neonatology intensive care unit of Sanglah Hospital.Methods: A retrospective cross-sectional study was conducted among 168 infants aged zero to 28 days with birth weights &lt;2,500 grams from May 2017 – April 2018 at Sanglah General Hospital, Bali, Indonesia using a purposive sampling technique. The inclusion criteria were sepsis infants who were hospitalized in neonatology care rooms during the study period at Sanglah General Hospital. Variables assessed in this study were sex, location and mode of delivery, birth weight, gestational age, number of parity, length of stay, the onset of sepsis, as well as the outcome. Data were analysed using SPSS version 17 for Windows.Results: The mortality rate of sepsis in low birth weight infants was 29.8%. Most of the subjects were male (53%), location of delivery at Sanglah Hospital (60.7%), born spontaneously (51.2%), birth weight were 1500-2499 grams (58,3%) and the most gestational ages were 32-36 weeks (44,6%). Early-onset neonatal sepsis (EONS) dominates patients with neonatal sepsis, with a mean length of stay was 23.27±20.32 days. The major infection risk factor was premature rupture membrane (PRM) &gt;24 hours (14.9%), and minor infection risk factor was gestational age &lt;37 weeks (78%), very low birth weight (44.6%) and asphyxia (41.1%). The total blood culture positivity was 38 (22.6%) cases, and Enterococcus faecalis was the most common organism in this study.Conclusion: The incidence and mortality of neonatal sepsis in LBW infants were still high. The importance of knowledge and awareness of pregnant women about danger signs and the risk of infection can reduce the incidence of early-onset neonatal sepsis. Prevention of healthcare-associated infections can reduce the incidence of late-onset neonatal sepsis.

Transcranial Ultrasound in Comparison to MRI in Evaluation of Hypoxic Ischemic Injury in Neonates

Background: Hypoxic-ischemic injury is the most common cause of encephalopathy in newborns. Objectives: The goal of our study was to demonstrate the role of transcranial ultrasound (TCUS) compared to MRI in assessment of neonatal encephalopathy. Patients and methods: Consecutive thirty sex neonates with hypoxic-ischemic encephalopathy (HIE) were included. All cases had undergone MR imaging as well as transcranial ultrasound study of the brain. The study was conducted between May 2015 and September 2017. They were collected from the Neonatology Intensive Care Unit at Elsayed Galal and El-Demerdash University Hospitals. Results: Our study found that stages I and II showed mild to moderate HIE presented with peripheral pattern and white matter injuries while stage III revealed severe HIE presented with central pattern of injury (BGT). In addition, our study reported that all patients with stage III of HIE showed severe central pattern on MRI. Conclusion: MRI imaging is considered a sensitive technique in detecting different MR patterns of encephalopathy in newborns. MRI placed other imaging modalities in diagnostic assessment and early predictor of future development of neurological abnormalities in neonates with encephalopathy.

INICU \u2013 Integrated Neonatal Care Unit: Capturing Neonatal Journey in an Intelligent Data Way

Neonatal period represents first 28 days of life, which is the most vulnerable time for a child’s survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby. iNICU (integrated Neonatology Intensive Care Unit) leverages Beaglebone and Intel Edison based IoT integration with biomedical devices in NICU i.e. monitor, ventilator and blood gas machine. iNICU is hosted on IBM Softlayer based cloud computing infrastructure and map NICU workflow in Java based responsive web application to provide translational research informatics support to the clinicians. iNICU captures real time vital parameters i.e. respiration rate, heart rate, lab data and PACS amounting for millions of data points per day per child. Stream of data is sent to Apache Kafka layer which stores the same in Apache Cassandra NoSQL. iNICU also captures clinical data like feed intake, urine output, and daily assessment of child in PostgreSQL database. It acts as first Big Data hub (of both structured and unstructured data) of neonates across India offering temporal (longitudinal) data of their stay in NICU and allow clinicians in evaluating efficacy of their interventions. iNICU leverages drools based clinical rule based engine and deep learning based big data analytical model coded in R and PMML. iNICU solution aims to improve care time, fills skill gap, enable remote monitoring of neonates in rural regions, assists in identifying the early onset of disease, and reduction in neonatal mortality.

Extended-spectrum β-lactamase–producing Enterobacteriaceae in cell phones of health care workers from Peruvian pediatric and neonatal intensive care units

Health care workers (HCWs) use their mobile phones during working hours or medical care. There is evidence that the instruments are colonized with pathogenic microorganisms. Here, we describe levels of Enterobacteriaceae contamination (EC) in cell phones and the risk factors associated with EC in Peruvian intensive care units (ICUs). This was a 5-month cohort study among 114 HCWs of 3 pediatric and 2 neonatology ICUs from 3 Peruvian hospitals. A baseline survey collected data on risk factors associated with EC. Swabs were collected from HCWs' phones every other week. Three-quarters of HCWs never decontaminated their phones, and 47% reported using the phones in the ICU >5 times while working. EC was frequent across samplings and sites and was substantially higher in subjects with longer follow-up. Potential risk factors identified did not have strong associations with positive samples (relative risk, 0.7-1.5), regardless of significance. Half of the phones were colonized with an Enterobacteriaceae at least once during the 4 samplings attained on average during the study period. Half of the isolates were multidrug resistant (MDR), and 33% were extended-spectrum β-lactamase producers. EC on HCWs' phones was frequent and apparently randomly distributed through the hospitals without clear clustering or strongly associated risk factors for having a positive sample. Based on the level of EC, phones may be considered as potential bacterial reservoirs of MDR and ESBL bacteria.

Late onset perinatal sepsis in the neonatology intensive care unit – risk factors

The lowest-birth-weight premature is very susceptible for nosocomial infections. These infants require the most invasive therapeutic interventions and the longest exposure to environment conductive for microbial colonization. Incidence of no-socomial infection and risk factors in pre-mature has been compared over two years, 2010 and 2015. We examined the effects of common procedures on the incidence of nosocomial sepsis. Birth weight, distribu-tion of pathogens and the therapeutically procedures had been analysed. We tried to find strategies to minimise the risks for acquiring sepsis. Hospital documentation from neonatal intensive care unit (NICU) has been analysed retrospectively dur-ing two different years in the University Hospital Osijek. Incidence of nosocomial sepsis among hospitalised premature has been 8.9% in 2010, and 4.8% in 2015. The highest rate of affected infants weighed below 1,500 g in both periods. Statistically significance in these two periods has been found in the percentage of pre-term in-fants with umbilical vein catheter (UVC), and in the number of pre-term on invasive mechanical ventilation. The most common pathogen in 2010 was methicillin-resistant Staphylococcus epidermidis (MRSE), and in 2015 coagulase negative Staphylococci (CONS). The percentage of Candida para-psylosis was higher in 2015. Lowering the incidence of late-onset sepsis has been ac-complished by using peripherally inserted central catheters (PICCs) and non-invasive mechanical ventilation. Invasive proce-dures must be avoided as much as possible.

Infections and risk-adjusted length of stay and hospital mortality in Polish Neonatology Intensive Care Units

BackgroundThe objectives of this study were to analyze the impact of infections on prolonging hospital stay with consideration of underlying risk factors and determining the mortality rates and its association with infections. MethodsAn electronic database developed from a continuous prospective targeted infection surveillance program was used in the study. Data were collected from 2009 to 2012 in five Polish tertiary academic neonatal intensive care units (NICUs). The length of stay (LOS) of 2,003 very low birth weight (VLBW) neonates was calculated as the sum of the number of days since birth until death or until reaching a weight of 1,800g. ResultsThe median LOS for neonates with infections was twice as high as for neonates without infection. LOS was significantly affected by the overall general condition of the neonate, as expressed by both gestational age and birth weight as well as by the Clinical Risk Index for Babies (CRIB) score; another independent factor was presence of at least one infection. Risk of in-hospital mortality was significantly increased by male sex and vaginal birth and was lower among breastfed neonates. Deaths were significantly more frequent in neonates without infection. ConclusionsThe general condition of VLBW infants statistically increase both their risk of mortality and LOS; this is in contrast to the presence of infection, which significantly prolonged LOS only.

PS-262 Risk Profile To Prevent Re-admittance To The Neonatal Intensive Care Unit

<h3>Background and aims</h3> Infants at the Neonatology Intensive Care Unit (NICU) of the Emma Children’s Hospital/Academic Medical Centre Amsterdam are transferred to regional hospitals once they no longer need intensive care. Unfortunately, a number of these infants are re-admitted to the NICU. This study investigates the similarities between these hospitalised infants, in order to develop a way to limit the number of infants re-admitted to the NICU. <h3>Methods</h3> The first step in the process is to classify different diagnoses for re-admittance of infants to the NICU. By using these diagnoses, and adding parameters resulting from a search of literature, a set of risk parameters can be created. This set will be used to retrospectively analyse the nursing files of infants re-admitted to the NICU within 72 h after discharge. The exclusion criteria used were re-admittance for phototherapy, inserting an IV or planned surgical or treatment interventions. <h3>Results</h3> From July 2009 to July 2013, 44 infants were re-hospitalised at the NICU. Nineteen infants met the inclusion criteria. Of these 19 infants a (graphical) risk profile could be created showing the physiological (in)stability in the three days before discharge. <h3>Conclusions</h3> This study shows that infants have different early warning signs of physiological instability. However this instability can be expressed in a risk score, which might predict the chance that the infants are re-admitted to the NICU. The NICU may thus decide to not discharge the infant for a few more days. Further research on the utilisation of the risk score is needed.

Evaluation of GeneXpert vanA/vanB assay for the detection of vancomycin-resistant enterococci in patients newly admitted to intensive care units

The automated Cepheid GeneXpert system provides rapid PCR results and can be used for the identification of VRE. We aimed to evaluate the use of the Cepheid Xpert vanA/vanB real-time PCR assay for the detection of VRE from rectal swabs of patients newly admitted to intensive care units in a hospital setting. Materials and methods: Rectal swab samples of patients newly admitted to 6 intensive care units from March 2011 to February 2012 were obtained. The specimens were analyzed by the GeneXpert system. The results were reported for both vanA and vanB as negative or positive. Results: Comparing the number of inpatients, most of the samples were delivered from the neurosurgery (48.3%), pediatrics (33.3%), and neonatology (20.6%) intensive care units. The positive samples according to GeneXpert vanA/vanB method were 33 (7.3%) among 454 rectal samples. Of these positive samples 22 (4.9%) were vanA, 10 (2.2%) were vanB, and 1 sample (0.2%) was vanA and vanB-harboring, by PCR. Conclusion: As a rapid, easy to use, and labor-saving method GeneXpert vanA/vanB can detect VRE-positive patients, particularly in risk groups, as soon as they are admitted to hospital so that infection control policies can be applied immediately.

Évaluation de la concordance entre recommandations et pratiques transfusionnelles en unités de soins intensifs néonataux

ObjectiveTo assess the concordance rate between the prescriptions of blood products and Afssaps guidelines for transfusion practices in neonatology. Study designRetrospective monocentric study. Patients and methodsChildren transfused in the neonatology intensive care units in the Universitary Hospital of Rouen were included. Concordance rates between transfusion prescriptions, delivered and transfused products and the Afssaps guidelines were assessed. Any additional costs resulting from a theoretical discordance was also assessed. ResultsIn 2006, 380 PSL were administered to 168 newborn children (NBC). Packed red blood cells (PRBC) represented the most often transfused products (n=290, 76%). Fifty packed platelets (PP) were transfused (13% of the blood products) and 41 fresh frozen plasmas (11%). Overall concordance rate between the Afssaps guidelines and the prescriptions was 64.9%. In 35.1% of cases, the prescription was excessive, compared to the recommendations. Excessive transfusion represented a total of 27,307 euros. ConclusionGlobal concordance's rate between the guidelines and the prescriptions is fairly well. PRBC are the most blood product transfused. Excessive transfusions related to this concordance rate are leading to important theoretical costs. New informations to the guidelines are warranted to improve transfusional practices in this institution.

P07.01 Central line associated bloodstream infections in 2 Polish neonatology intensive care units: incidence, microbiology and antibiotic consumption

P07.01 Central line associated bloodstream infections in 2 Polish neonatology intensive care units: incidence, microbiology and antibiotic consumption

Hospitalization for Lower Respiratory Tract Disease in Preterm Infants: Effects of Prophylaxis with Palivizumab

To evaluate the effect of palivizumab prophylaxis on hospitalization for acute respiratory tract infections (RTI) in preterm infants, a prospective study was performed on a cohort of preterm infants [gestational age (GA) ≤32weeks], admitted at birth to a Neonatology Intensive Care Unit (NICU) (follow-up: 30-month after discharge). 154 palivizumab-recipients and 71 palivizumab-non-recipients were evaluated. During follow-up, a similar rate of hospitalization for RTI was found in the two groups (11.3% in palivizumab-non-recipients and 15.58% in palivizumab-recipients, P=0.39). However, when only infants hospitalized during their first respiratory syncytial virus (RSV) epidemic season and with a chronological age <6 months at admission were considered, the incidence rates for hospitalization was six-fold lower in the palivizumab-recipients (P=0.007). This study contributes to the definition of epidemiological data on RTI among preterm infants in Italy. These data support the usefulness of palivizumab prophylaxis for prevention of hospitalization for RTI in young preterm infants during the expected RSV epidemic season.