Hospital-acquired infections in children

Article Abstract:

In the December 27, 1990 issue of The New England Journal of Medicine, the authors describe the rapid transmission of Enterococcus faecalis among the workers and patients in an infant and toddler ward. This case provides a salient reminder of the ease with which infections can spread in hospitals and the degree to which many young patients are especially susceptible. The newborn is an immunocompromized host; furthermore, infants' skin is not fully keratinized and their mucosa do not provide a fully developed barrier to infection. Many children with congenital abnormalities require repeated surgery, and are therefore at repeated risk for nosocomial infection. Infection can be transmitted by mothers and hospital staff; contact is especially close since hospitalized children are repeatedly kissed and snuggled. Respiratory infections may spread very rapidly among toddlers, since crowded playrooms with communal toys are common. Prevention is the most important measure in the control of nosocomial infection among children, but the problem is not simple. While isolation may be biologically effective, the psychological consequences of isolation for a sick child may not be tolerable. Visitors should be encouraged, particularly young siblings, but a history should be taken by the physician or nurse to make sure that new pathogens are not unwittingly brought onto the ward. Some pediatric wards allow visiting pets, but this is to be avoided absolutely. Pediatric wards pose a special problem for the control of infectious disease, since children are more susceptible, their infections are more difficult to combat, and the possibility for long-term adverse consequences is greater in the developmentally immature. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Pediatric diseases, Disease transmission, Bacterial infections, Nosocomial infections, Cross infection, Infection in children, editorial, Nosocomial infections in children

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Management of hyperglycemia in the hospital setting

Article Abstract:

A case study of a 53-year-old woman admitted with respiratory failure having asthma and multilobar pneumonia without any history of diabetes is presented. Although data from trials of glucose control in medical and surgical inpatients that are not critically ill are lacking, the premeal targets of 90 to 150 mg per deciliter are recommended to circumvent concern about hyperglycemia and to minimize the risk of hypoglycemia.

Case studies, Hyperglycemia, Case study

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