Browsing by Author "Mena, Patricia"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Evaluation of antimicrobial consumption in a Neonatology Unit: a team work to promote the rational use of antibiotics
    (SOC CHILENA INFECTOLOGIA, 2017) Jimenez, Elisa; Valls, Nicolas; Astudillo, Patricio; Valls, Cristian; Cavada, Gabriel; Sandoval, Alejandra; Alegria, Angelica; Ortega, Gabriela; Nunez, Daniela; Mena, Patricia
    Background: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. Aim: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr. Sotero del Rio Hospital, in order to objectify the changes in the usual practice of the ATM indication. A secondary objective was to assess its impact on antimicrobial resistance. Methods: Cohort, observational, prospective unicenter study which included all hospitalized patients between January 2011 and December 2014. Birth weight, hospitalization days, ATB indication and days of ATB use were recorded for each patient. The use of ATB was quantified by means of different rates; days of indication of one or more ATBs for global consumption (RUA), total sum of days of use (TSUA) and for the most frequently used ATBs. Each calculated rate for 100 days hospitalized. In addition, the antimicrobial susceptibility of the most frequently isolated bacteria in our service: coagulase-negative Staphylococcus (SCN) and Gram-negative bacilli (BGN) were recorded continuously. Results: The 34.7% of the hospitalized patients received some type of antimicrobial agent. ATBs were 32.3% of medicines used. The most widely used was ampicillin (with 20.2% of the total) and cefadroxyl (with 11.6%). The RUA did not change during the study time, but STUA decreased by 10.7% between 2011 and 2014 with p < 0.05. When subgroup analyzes were divided by weight ranges, in the < 750 g group, the use of vancomycin decreased in use by 9.9% and an increase of 18.8% for metronidazole was observed. On the other hand, there was an increase in the use of the piperacillin-tazobactam regimen in the range > 1,500 g. When evaluating antimicrobial susceptibility, there was a decrease in susceptibility for oxacillin in SCN between 2011 and 2014 from 27% to 10.3% respectively. In addition, for Gram negative there was a decrease from 76.9% to 40.5% in susceptibility to third generation cephalosporins, mainly due to Klebsiella pneumoniae, which became the predominantly isolated BGN with an increase of 6.7% to 50% between 2011 and 2014, respectively. For K. pneumoniae the loss of susceptibility to third generation cephalosporins decreased from 77% to 22%. Finally, amikacin showed an activity over 85% in all BGNs between 2011 and 2014. Conclusions: It is advisable to plan and to maintain a continuous record of ATB consumption, as well as therapy and prophylaxis, being categorized by ATB type and range of newborn weight. It is of considerable importance to analyze and to evaluate the susceptibility of microorganisms. It is essential that an interdisciplinary team prepare this recording, and to continuously provide feedback to professionals who maintain the functioning of neonatal care units.
  • Thumbnail Image
    Item
    Growth of Very Low Birth Weight Infants Who Received a Liquid Human Milk Fortifier: A Randomized, Controlled Multicenter Trial
    (2022) Masoli, Daniela; Mena, Patricia; Domínguez, Angélica; Ramolfo, Pamela; Vernal, Patricia; Pantoja, Miguel Angel; Esparza, Ruth; Hübner, Maria Eugenia; Ríos, Antonio; Faunes, Miriam; Uauy, Ricardo; Tapia, Jose L.; Neocosur Network
    Objectives: To evaluate growth (weight, length, head circumference, and knee–heel length [KHL]) in very low birth weight (VLBW) infants (500–1500 g) who received human milk with a liquid fortifier (LHMF) with high protein and fatty acid content versus a traditional powder fortifier (PHMF) for 45 days or until discharge. Methods: This was a multicenter, randomized, controlled trial. An intention-to-treat analysis was performed to determine adverse events and withdrawal causes. We also performed an efficacy analysis involving the infants who completed at least 2 weeks of study. Results: Of the 158 infants enrolled in the study, 146 completed at least 2 weeks, and 125 completed the entire study. The biodemographic characteristics were similar between groups, with no differences in increments of weight (22.9 vs 22.7 g kg−1 day−1), length (1.03 vs 1.09 cm/week), head circumference (0.91 vs 0.90 cm/week), or KHL (3.6 vs 3.3 mm/week). The KHL increment was greater in infants weighing >1 kg receiving LHMF (3.7 vs 3.2 mm/week, P = 0.027). Although there were no significant differences in serious adverse events, the incidence difference of the composite outcome death/necrotizing enterocolitis between groups warrants attention (1.3% with LHMF and 8.1% with PHMF). Conclusion: There were no differences in the overall growth between VLBW infants receiving either fortifier.
  • No Thumbnail Available
    Item
    Mode of delivery and antenatal steroids and their association with survival and severe intraventricular hemorrhage in very low birth weight infants
    (2016) Hubner, M. E.; Ramirez, R.; Burgos, J.; Dominguez, A.; Tapia, J. L.; Colantonio, Guillermo; Zapata, Jorge; Perez, Gaston; Ana Pedraza, Susana Garcia; Kurlat, Isabel; Di Siervi, Oscar; Escarate, Adriana; Mariani, Gonzalo; Maria Ceriani, Jose; Fernandez, Silvia; Fustinana, Carlos; Brener, Pablo; Edwards, Eleonora; Tavosnaska, Jorge; Roldan, Liliana; Sexer, Hector; Saa, Gladys; Sabatelli, Debora; Laura Gendra, Maria; Fernanda Buraschi, Maria; Molina, Paula; Daniel, Agost; Morganti, Federico; Fontana, Adriana; Chandias, Daniela; Rinaldi, Monica; Grandi, Carlos; Rojas, Elio; Solana, Claudio; Nieto, Ricardo; Meritano, Javier; Larguia, Miguel; Kasten, Laura; Cuneo, Lucrecia; Decaro, Marcelo; Cracco, Lionel; Bassi, Gustavo; Jacobi, Noemi; Brum, Andrea; Vain, Nestor; Aguilar, Adriana; Guerrero, Miriam; Szyld, Edgardo; Escandar, Alcira; Abdala, Daniel; Guida, Martin; Ferrin, Lucila; Roge, Horacio; Musante, Gabriel; Capelli, Maria C.; Pablo Berazategui, Juan; de Elizalde, Magdalena; Ignacio Fraga, Juan; Keller, Rodolfo; Ahumada, Luis; Ferreyra, Mirta; Ferreira, Vanda; Borges, Roberta; Do Vale, Marynea; Cavalcante, Silvia; Gusmao, Joama; Franco, Patricia; Jose Silva, Maria; Fabres, Jorge; Estay, Alberto; Gonzalez, Alvaro; Kattan, Javier; Quezada, Mariela; Urzua, Soledad; Campos, Lilia; Cifuentes, Lilian; Leon, Jorge; Aguilar, Roxana; Treuer, Sergio; Giaconi, Jimena; Bancalari, Aldo; Standen, Jane; Escobar, Marisol; Veas, Viviana; Sandino, Daniela; Gonzalez, Agustina; Avila, Claudia; Guzman, Carla; Toro, Claudia; Mena, Patricia; Milet, Beatriz; Pittaluga, Enrica; Pena, Veronica; Mendizabal, Rafael; Pizarro, Dagoberto; D'Apremont, Ivonne; Tapia, Jose L.; Marshall, Guillermo; Villarroel, Luis; Quezada, Mariela; Dominguez, Angelica; Lacarruba, Jose; Cespedes, Elizabeth; Mir, Ramon; Mendieta, Elvira; Genes, Larissa; Caballero, Carlos; Webb, Veronica; Rivera, Fabiola; Llontop, Margarita; Bellomo, Sicilia; Zegarra, Jaime; Chumbes, Oscar; Castaneda, Anne; Cabrera, Walter; Llanos, Raul; Mucha, Jorge; Garcia, Gustavo; Ceruti, Beatriz; Borbonet, Daniel; Gugliucci, Sandra; Lain, Ana; Martinez, Mariza; Bazan, Gabriela; Piffaretti, Susana; Cuna, Isabel; Bermudez, Patricia
    OBJECTIVE: To determine whether CS delivery and receipt of antenatal steroids (ANS) in vertex-presenting singletons with a gestational age (GA) between 24 and 30 weeks is associated with improved survival and improved severe intraventricular hemorrhage (sIVH)-free survival.