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Lundberg, Fredrik
Publications (2 of 2) Show all publications
Rybczynska, H., Melander, E., Johansson, H. & Lundberg, F. (2014). Efficacy of a once-a-week screening programme to control extended-spectrum beta-lactamase-producing bacteria in a neonatal intensive care unit. Scandinavian Journal of Infectious Diseases, 46(6), 426-432
Open this publication in new window or tab >>Efficacy of a once-a-week screening programme to control extended-spectrum beta-lactamase-producing bacteria in a neonatal intensive care unit
2014 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 46, no 6, p. 426-432Article in journal (Refereed) Published
Abstract [en]

Background: Extended-spectrum beta-lactamase (ESBL)-producing bacteria are an escalating problem threatening health. Devastating consequences can result in neonatal intensive care units (NICU) due to these bacteria. The aim of this study was to investigate the efficacy of once-a-week screening (July 2010 to September 2012) versus screening on demand (April 2008 to June 2010).

Materials and methods: The investigation was an open retrospective descriptive study comparing 2 unpaired groups, the first exposed to screening on demand and the second to screening once a week. All other infection control measures were unchanged. Both groups were cared for in the NICU of Skåne University Hospital. Parameters compared were the proportion of cultured neonates, prevalence, time before detection, number of secondary cases, and clinical infections due to ESBL-producing bacteria.

Results: The proportion of cultured neonates increased from 28% to 49% (p < 0.05) in period 2. The time from admission to detection was 8 days shorter in period 2 (p < 0.05). Secondary cases decreased from 44% to 9% (p < 0.05), and clinical infections from 4 to 0 cases (p < 0.05). During period 2, the prevalence of colonization was 1.77%.

Conclusions: Once-a-week screening is a strategy to control the epidemiology of unwanted pathogens among newborn infants. It provides the opportunity for early intervention, thereby avoiding secondary cases and infections. Premature neonates in particular benefit from this approach. The prevalence of ESBL of 1.77% is low from an international perspective. ESBL appear to be introduced onto the ward by mothers colonized with ESBL.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
National Category
Anesthesiology and Intensive Care Pediatrics
Identifiers
urn:nbn:se:liu:diva-106255 (URN)10.3109/00365548.2014.896027 (DOI)000336454800004 ()24689959 (PubMedID)
Available from: 2014-04-30 Created: 2014-04-30 Last updated: 2017-12-05Bibliographically approved
Verder, H., Ebbesen, F., Fenger-Grøn, J., Henriksen, T. B., Andreasson, B., Bender, L., . . . Stanchev, H. (2013). Early surfactant guided by lamellar body counts on gastric aspirate in very preterm infants. Neonatology, 104(2), 116-22
Open this publication in new window or tab >>Early surfactant guided by lamellar body counts on gastric aspirate in very preterm infants
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2013 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 104, no 2, p. 116-22Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: We have developed a rapid method, based on lamellar body counts (LBC) on gastric aspirate, for identifying newborns who will develop respiratory distress syndrome with a need for surfactant supplementation. Objective: We set out to test whether it was possible to improve the outcome when used in a clinical trial.

METHODS: We randomly assigned 380 infants born at 24-29 weeks' gestation and supported with nasal continuous positive airway pressure (nCPAP) to receive surfactant guided either by LBC (intervention group) or increasing need for oxygen (control group). The primary outcome was mechanical ventilation or death within 5 days. Secondary outcomes included need for oxygen expressed by arterial to alveolar oxygen tension ratio (a/APO2) at the age of 6 h and need for oxygen at day 28.

RESULTS: The primary outcomes were equal (25%) in the two groups. The intervention group had higher a/APO2 than the control group at 6 h, median 0.64 versus 0.52 (p < 0.01), and the subgroup with gestational age 26-29 weeks needed fewer days of oxygen supplementation than the controls, median 2 vs. 9 days (p = 0.01), and fewer infants needed oxygen at day 28 (p = 0.04). Furthermore, there was a tendency in the intervention group towards a shorter duration of nCPAP. Too little or viscose aspirate in 23% of the cases was a limitation of the method.

CONCLUSION: Using LBC test as indicator of lung maturity and early surfactant therapy in very preterm newborns, it is possible to reduce the need for oxygen supplementation.

Place, publisher, year, edition, pages
S. Karger, 2013
Keywords
Continuous positive airway pressure; Nasal CPAP; Premature infants; Respiratory distress syndrome; Pulmonary surfactant; Lamellar bodies
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-104751 (URN)10.1159/000351638 (DOI)000322733700007 ()23942627 (PubMedID)
Available from: 2014-02-25 Created: 2014-02-25 Last updated: 2017-12-05Bibliographically approved
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