NEWS SCAN: MRSA in the NICU, immunization reminders, polio campaign in China, drop in antibiotic prescribing

Oct 18, 2011

Study finds MRSA colonization patterns in NICU
A study of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection patterns in a neonatal intensive care unit (NICU) found that patients were at higher risk based on the types of physical contacts they had, a research group from Boston reported yesterday in Pediatrics. Their analysis included 2,620 babies who were screened for MRSA at least once at Beth Israel-Deaconess Medical Center's NICU between Jun 1, 2002, and Dec 31, 2007. Researchers used hospital information to determine patients' room assignments and transfers and the electronic health record to determine nurse assignments. They found that MRSA-negative infants were more likely to become colonized when exposed to a colonized sibling than a colonized patient who wasn't related. Though contact precautions used when caring for colonized infants decreased the colonization rate of other patients, having a nurse in common increased the odds of infection by 43% [95% confidence interval, 14% to 80%). MRSA transmission between colonized and noncolonized siblings might be related to the effects of multiple gestation or the practice of siblings sharing the same bed, the authors hypothesized. They also suggested that parents may play a role or that healthcare providers may practice different infection control measures when working with siblings. Researchers concluded that strategies to reduce the frequency of staff members caring for both colonized and noncolonized infants may help reduce the spread of MRSA.
Oct 17 Pediatrics abstract

Online survey shows desire for vaccine messages via cell, e-mail
 Only 2% of respondents said they had received immunization reminders for their children via e-mail, cell phone call, or text message, but more than one-fourth said they would prefer an alert via such newer technologies, according to the results of a nationwide online survey published yesterday in Pediatrics. Researchers from the University of Michigan and the US Centers for Disease Control and Prevention conducted the survey in January 2010 as part of the C.S. Mott Children's Hospital National Poll on Children's Health. Of the 1,575 who completed the survey and had their children vaccinated, 35% said they would prefer a reminder notice via the following channels: home phone, 35%; mail, 33%; e-mail, 16%; cell phone call, 8%; and text message, 3%. Five percent said they would rather not receive a reminder. Of the 477 parents who said they had received a reminder about childhood vaccines, the breakdown of delivery systems was: mail, 76%; home phone, 16%; in person, 6%; cell phone call, 1%; e-mail, 1%; and text message, 0%. The researchers said that more than half of parents were willing to register their cell phone numbers for immunization messages via phone or text. They conclude, "Research and implementation efforts might benefit from focusing on this willing population."
Oct 17 Pediatrics abstract

China vaccinates 4.5 million against polio
China has vaccinated 4.5 million children and young adults against polio in 5 weeks in its western province of Xinjiang after 17 people contracted the disease, Reuters reported today. All 17 cases occurred in Hotan prefecture in Xinjiang from early July to mid September, and one of the patients died, the Reuters story said. Starting in early September, health workers vaccinated 4.5 million people in the province with three doses of polio vaccine each, according to the World Health Organization (WHO). "Even if they [polio carriers] don't come down with any symptoms, by giving them polio vaccine we make that person less infectious," said Oliver Rosenbauer, WHO spokesman for the agency's Global Polio Eradication Initiative. In addition, said Rosenbauer, "We are sensitising disease surveillance in large hospitals to look for any child or adult displaying polio-like symptoms." China had been free of polio since 1999, and the latest outbreak was caused by a strain originating in Pakistan, according to Reuters.
Oct 18 Reuters report

Study: French guidelines led to drop in ER antibiotics for respiratory infections
Antibiotic prescriptions for acute respiratory infections (ARIs) dropped from 32% to 21% in a Paris pediatric emergency department after the country published guidelines to minimize inappropriate prescribing, according to a new study. French researchers analyzed data from November 2005, when guidelines from the French Drug Agency were implemented, to October 2009. During that time, 53,055 children were diagnosed with ARIs in that facility, and 59% of the 22,198 antibiotic prescriptions written were for ARI. The percentage of patients who were given antibiotic prescriptions fell from 32.1% during the first year to 21% in the fourth year, a significant difference. Amoxicillin–clavulanic acid and amoxicillin were the most-prescribed drugs for ARI, accounting for 50% and 34% of all antibiotic prescriptions, respectively.
Oct 16 Eur J Clin Microbiol Infect Dis abstract

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