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Healthcare-associated infections in the pediatric intensive care unit: A 6-year evaluation

Aim: Identifying local determinants of the Healthcare-associated infections(HCAI) burden and improving reporting and surveillance systems is the first step to

find active action programs against HCAI. The aim of this study was to evaluate and describe the results of surveillance of HCAIs in a Leve lIII intensive care

unit( ICU ) between January 2011 and December 2016. Material and Method: Children aged between 28 days and 18 years with HCAI in the ICU were included

in the study. The definition of HCAI was based on the 2008 CDC diagnostic criteria. Results: During 6 years7211 patients were admitted in the ICU. Infection

rate was 12.6 infections per 1000 resident days. Between2011 and 2016, %60.3 reduction in the central line-associated bloodstream infections (CLABSI),

61.1% reduction in ventilatory-associated pneumonia (VAP) was observed.Prior to implementation of VAP bundle in 2013, the incidence of VAP was 10.7/1000

ventilator days. After the implementation of VAP bundle, 71.7% reduction was reported in VAP between 2013 and 2016. Of 342 infections, the most common

infections were pneumonia (n=182, 53.2%), bloodstream infections(n=86, 25.2%) and urinary tract infections (n=62, 18.1%). A total of 435 infectious agents

were isolated. Acinetobacter baumanni was the most commonly reported pathogen(25.05%) followed secondly by Klebsiella pneumoniae (17.01% ). Discussion:

Surveillance data are useful to identify interventions needed and to assess the interventions to improve infection rates.Education of the health care providers,

multidisciplinary team approach and strict criteria to define appropriate indications for the use of indwelling catheters, devices and strict adherence to bundles

are vital to decrease the HCAI rates.

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Umbilical discharge in neonates: A case-based management protocol performed from a different perspective

Aim: This study aimed to retrospectively investigate causes of umbilical discharge (UD), its clinical course, treatment modalities and follow-up in infants with
UD complaints in a major teaching hospital in Turkey. Material and Method: Infants with an UD complaint who were referred to our clinic by a pediatrician or
a family physician from January 2013 to June 2014 were investigated. Results: The study included 291 infants between the ages of 3 and 114 days. Of these
infants, 194 (67%) had an umbilical granuloma, 83 (28.3%) had an umbilical polyp, and 14 (4.8%) had omphalitis. Among 14 infants with omphalitis who were
treated with topical antibiotics, six infants had refractory or recurrent discharge and ultrasonography (US) was performed which revealed a 1-3 mm sized cystic
appearance with no connection to the peritoneum or other tissues. These infants received systemic antibiotics in addition to topical antibiotics. During the
follow-up period, cystic appearance was not present in US in three of these six patients and in the remaining three patients who did not present for follow-up
we learned via phone calls that their complaints had not recurred. Discussion: Cauterization using a silver nitrate pencil was sufficient in the umbilical granuloma.
Ligating, excising and cauterizing the base of the lesions was sufficient in an umbilical polyp. In cases with persistent or recurrent UD, high-resolution
US should be primarily performed, which may direct the subsequent management.

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Efficacy of low-concentration hypochlorous acid spray in acute sore throat relief

Aim: Sore throat is one of the most predominant symptoms of the human population. The aim of the study was to define the efficacy of low-concentration
hypochlorous acid (HOCl) in patients with sore throat. Low-concentration hypochlorous acid (HOCl) is an antiviral and antibacterial agent which is produced
endogenously. Material and Method: 50 patients over the age of 18 were included in this study. The patients were randomly chosen to receive oropharyngeal
mouthwash with either low-concentration HOCl (n= 24) or placebo saline solution (n= 26) for 4 days. We evaluated the sore throat relief using the 7-point
Sore Throat Relief Scale (STRS). Results: The STRS scores were significantly lower in the HOCl group than in the placebo group after 4 days of treatment
(p<0.05). Discussion: This study showed that low-concentration HOCl spray provided better improvement in sore throat symptoms when compared to placebo
saline spray.

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