2.2 retos para controlar infecc. en noenatologia

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  • 1.Preventing Nosocomial infections in Neonatal Intensive Care UnitsCongresoInternacional de Prevention de InfeccionesIntrahospitalarias
    Alan Picarillo, MD, FAAP
    Neonatologist
    UMassMemorial Healthcare
    Assistant Professor in Pediatrics
    University of Massachusetts Medical School
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2. Disclosures
I have no financial interests to disclose for this lecture
I will be speaking about off-label use of a medication (chlorhexidine) during this lecture
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3. Introduction
Why are our smallest infants so vulnerable to hospital-acquired infections?
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5. Liberian Observer Chinese doctor performs miracle surgery at JFK Hospital
Liberian Observer January 2010, online edition
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9. Introduction
Why are our smallest infants so vulnerable to hospital-acquired infections?
Very immature infants
Immature immune systems
Poor skin integrity
Surgical procedures
Central line placement
Long length of stay
Overcrowding
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10. Overall burden of nosocomial infections
In the US it is estimated that 5-10% of all hospitalized patients will have a nosocomial infection
>90,000 deaths attributable each year to nosocomial infections in the United States
39,788 deaths from auto/motorcycle accidents
16,605 deaths from HIV/AIDS (2008)
138 deaths from airline accidents
Can this be stopped?
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http://www.cdc.gov/ncidod/dhqp/pdf/hicpac/infections_deaths.pdf
DOT data (1999-2003)
CDC data http://www.cdc.gov/hiv/topics/surveillance/basic.htm#ddaids
11. Burden of nosocomial infections in neonates
Late onset (>72 hours of age) sepsis occurs in 4.2% of all neonatal ICU admissions and 17.1% of infants