Search Results (40)

Background/Objectives: Multidrug-resistant (MDR) bacterial colonization poses a significant risk for subsequent infections, especially within hospital environments. Healthcare workers can inadvertently transmit these MDR bacteria to vulnerable patients, exacerbating the problem. This study aimed to determine the colonization rates of MDR bacteria among patients and healthcare workers in a rural Ethiopian hospital with limited resources. Methods: Between 26 May and 6 June 2024, nasal, rectal, vagino-rectal exudate, and stool samples were collected from patients (n = 78) and healthcare workers (n = 11) at Gambo General Hospital (Oromia Region, Ethiopia). Samples were cultured on chromogenic media selective for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), and carbapenemase-producing Enterobacteriaceae (CPE). Bacterial identification was performed using MALDI-TOF mass spectrometry (Bruker), antimicrobial susceptibility testing using the MicroScan WalkAway system (Beckman Coulter), and genotypic characterization with the MDR Direct Flow Chip kit (Vitro). Results: MRSA nasal colonization was detected in 43.3% of patients (13/30; 95% CI: 27.4–60.8%) and 27.3% of healthcare workers (3/11; 95% CI: 6.0–61.0%) (p = 0.73). Rectal (or stool) colonization by MDR bacteria was significantly higher in pediatric patients (85.0%, 17/20; 95% CI: 62.1–96.8%) than in adults (14.3%, 4/28; 95% CI: 5.7–31.5%) (p < 0.001). Notably, a high proportion of pediatric patients harbored Escherichia coli strains co-producing NDM carbapenemase and CTX-M ESBL, and VRE strains were also predominantly isolated in this group. Conclusions: This study reveals a concerningly high prevalence of MRSA and MDR Enterobacteriaceae, especially among children at Gambo Hospital. The VRE prevalence was also substantially elevated compared to other studies. These findings underscore the urgent need for strengthened infection control measures and antimicrobial stewardship programs within the hospital setting. Full article

Background: Residency training is a formative and rigorous experience, with burnout rates reported at 76%. Formal peer support groups have shown improvement in burnout among healthcare workers with anxiety and depression. Objective: Implement a peer support program for emergency medicine (EM) residents and characterize utilization of metrics by demographics, burnout rates of participants, and overall session impact. Methods: An IRB-approved, longitudinal, prospective cohort study of 73 EM and EM/Pediatrics residents post-graduate year (PGY) 1–5 from July 2021–June 2022 was performed. Resident peer leaders were trained using a novel curriculum to lead peer support groups. Residents were invited to participate in biweekly sessions, with optional pre- and post-session surveys measuring demographics, burnout, themes discussed, and how they felt after sessions (Patients’ Global Impression of Change scale). Results: There were 134 attendances over 20 sessions, averaging 6 residents per session. Of 73 total residents, 37 (50%) participated at least once. All levels of training were represented, with half being female, 20% underrepresented in medicine, and 14% LGBTQ+. Overall burnout rates were unchanged for first-time attendances (49%, n = 18) vs. recurrent (50%, n = 11). Females had higher burnout at both baseline (60%, n = 15) and recurrent sessions (69%, n = 13). Following sessions, 94% of participants reported feeling immediately better and 100% of leaders felt prepared leading peer support sessions. Conclusions: This study demonstrates that residents utilize peer support, with many returning more than once. Despite stable burnout rates, 94% of participants felt immediately better after the session, suggesting that peer support is a valuable resource for residents actively experiencing burnout. Full article

Background/Objectives: The COVID-19 pandemic, caused by SARS-CoV-2, required the rapid development of diagnostic tests. SARS-CoV-2, part of the betacoronavirus genus, shares characteristics with SARS-CoV-1, including its ability to survive on surfaces, facilitating the spread of the infection. This study analyzes the technique of nasopharyngeal secretion collection for SARS-CoV-2 diagnosis and compares the accuracy of rapid antigen and molecular tests. Methods: This study had two components: study A assessed the healthcare personnel training in collecting nasopharyngeal secretions and the discomfort associated with applying a questionnaire. Study B compared rapid antigen test accuracy with RT-PCR among children, through a retrospective analysis. The data were statistically analyzed to assess compliance with the testing protocols. Results: In study A, 88 healthcare workers achieved an average compliance score of 7.60 out of 10 regarding the collection procedure. Over 70% of participants correctly followed the fundamental steps of the procedure. Many patients who underwent sample collection reported pain and symptoms such as coughing or sneezing. In study B, 198 pediatric patients were tested using rapid antigen tests, collected simultaneously with RT-PCR. The rapid tests showed a 50% sensitivity and 97.5% specificity. Conclusions: This study indicates that nasopharyngeal specimen collection techniques are based on international recommendations, but improvements could be made to reduce discomfort. Rapid antigen tests are helpful for screening due to their high specificity and negative predictive value. Continuous healthcare personnel training and the monitoring of diagnostic techniques remain essential in managing SARS-CoV-2 and other viral infections. Full article

Background and Objectives: Musculoskeletal disorders (MSDs) are a leading cause of absenteeism among healthcare workers (HCWs), impacting healthcare delivery. Pediatric HCWs face specific physical demands such as lifting and awkward postures. While absenteeism rose during the COVID-19 pandemic, its effects on pediatric MSD-related leave remain unclear. This study examined MSD-related absenteeism trends among pediatric HCWs in a Romanian hospital across the pre-pandemic (2017–2019), pandemic (2020–2021), and post-pandemic (2022–2023) periods. Materials and Methods: We conducted a retrospective observational study using records from the hospital’s occupational health database. We included all HCWs who took MSD-related leave during 2017–2023. Diagnoses included arthropathies, dorsopathies, other osteoarticular/connective tissue disorders, and acute trauma or fractures. We used chi-square tests, ANOVA, and regression models to identify trends and predictors. Results: A total of 3388 cases were analyzed. Post-pandemic absenteeism increased significantly (40.1%), especially among women (86.8%), nurses (46.7%), and workers aged ≥46 (62.7%). A seasonal shift was observed, with spring peaks (March 9.7% and May 9.9%) replacing the pre-pandemic autumn peaks (October 11.9% and November 12.8%). The regression models identified age, occupation, and diagnosis type as significant predictors of leave duration. Conclusions: MSD-related absenteeism rose post-pandemic and showed altered seasonal patterns. Occupational and demographic predictors identified through a multivariate analysis highlight the need for anticipatory, evidence-based strategies to support pediatric HCWs, enhance workforce resilience, and sustain healthcare performance. Full article

Clinical algorithms for child tuberculosis (TB) are a valuable guide for healthcare workers to initiate treatment. We evaluated the agreement of pediatric TB diagnosis using the current Indonesia diagnostic algorithms with the 2022 WHO treatment decision algorithm and developed a new Indonesia algorithm for child TB based upon our findings and expert opinion. We conducted a retrospective study at 10 hospitals in Indonesia, involving children (0–10 years), who were evaluated for TB diagnosis in 2022. A panel of child TB experts used participants’ records to make a diagnosis using the 2022 WHO algorithm and the 2016 Indonesian algorithm. We assessed agreement between the diagnosis made by the attending doctor and those determined by the expert panel. A new Indonesia guideline was developed based on the findings and consensus of various stakeholders. Of 523 eligible children, 371 (70.9%) were diagnosed with TB by the attending doctors, 295 (56.4%) by the WHO algorithm, and 246 (47%) by the Indonesia algorithm. The Cohen’s Kappa of TB diagnosis was: attending doctor vs. WHO algorithm (0.27), attending doctor vs. Indonesia algorithm (0.45), and WHO algorithm vs. Indonesia algorithm (0.42). A review of both algorithms revealed challenges for implementation. An algorithmic approach for child TB diagnosis may not be universally applicable or implementable due to variable access to diagnostic tests and the wide variety of clinical presentations. Full article

Healthcare professionals in pediatric oncology are at a high risk of burnout. Art therapy is being increasingly recognized as a potential tool for reducing stress and improving emotional well-being. The Art-Out pilot project aimed at nursing staff was initiated in a pediatric oncology unit. The staff members participating in the project were guided in a team-building course integrated with art and clay therapy, aiming to reduce burnout levels, improve emotional climate, and strengthen resilience. Methods: Burnout levels were assessed through the Maslach Burnout Inventory (MBI), alexithymia was measured with the Toronto Alexithymia Scale (TAS-20), and emotional regulation difficulties were evaluated through the Difficulties in Emotion Regulation Scale (DERS); these tests were assessed before (T0) and after (T1) the team-building course (Art-Out project). Results: Data analysis showed a significant reduction in burnout, alexithymia, and emotional dysregulation, highlighting the positive impact of this approach in improving team dynamics and emotional management. Conclusions: Our study confirms the high risk of burnout, alexithymia, and emotional dysregulation among pediatric oncology healthcare workers, underscoring the need for targeted interventions to prevent and mitigate these risks. Full article

Background: Respiratory infections pose a significant public health challenge, particularly among healthcare workers (HCWs). The COVID-19 pandemic exacerbated absenteeism due to respiratory illnesses, affecting healthcare workforce stability. Identifying factors influencing absenteeism is crucial for workforce resilience and effective care. Methods: This retrospective longitudinal study analyzed HCW absenteeism due to respiratory diseases from 2017 to 2023 at the “Sf. Maria” Children’s Emergency Hospital in Iași, Romania. Data from 3827 HCWs were examined, including demographic and occupational variables (age, gender, job role) and disease types. Statistical analyses (chi-square tests, ANOVA, and regression models) were conducted using SPSS to assess absenteeism trends and associated risk factors. Results: Sick leave peaked in 2020 (8322 days) and remained high in 2021 (8134 days), gradually decreasing in 2022–2023 but not returning to pre-pandemic levels (~5000 days/year). Nurses accounted for most leave days, while male staff and HCWs aged 41–50 were most affected. Seasonal variations showed higher absenteeism in transitional months and lower rates in summer. COVID-19 was the leading cause of absenteeism during the pandemic, with quarantine measures further increasing sick leave duration. Conclusions: Pediatric hospitals must strengthen infection control measures to protect HCWs and sustain care continuity. Preventive actions such as immunization, staff training, and health monitoring are critical in reducing absenteeism, maintaining a resilient workforce, and ensuring quality care during health crises. Full article

Background: Vaccines against COVID-19 target the spike protein. There is minimal information on longitudinal COVID-19 immune profiling in recovered versus naïve and vaccinated versus non-vaccinated healthcare workers (HCWs). Methods: This is a prospective longitudinal observational cohort of pediatric HCWs (pHCWs) conducted during 2020–2022 at an academic center, exploring the impact of COVID-19 vaccination on immunoglobulin G (IgG) antibody titers over time and cross-reactivity with other coronaviruses, including SARS-CoV-1, MERS-CoV, and seasonal coronaviruses (HCoV-HKU1 and HCoV-OC43). Results: A total of 642 pHCWs initially enrolled, and 337 participants had repeat IgG titers measured post-vaccine and post-booster. Most participants were female, median age range of 31–40 years. Anti-spike was higher in all vaccinated individuals versus non-vaccinated (p < 0.0001) and naïve versus infected (p < 0.0001). A single dose of vaccine was sufficient to attain maximum titers in recovered participants versus naïve who received both doses of vaccine. Anti-spike titers dropped significantly at 9 months after the primary series, whereas sustained anti-spike titers were observed at 9 months post-booster. Conclusions: All vaccinated pHCWs developed antibodies to spike. COVID-19 infection and/or vaccination yielded antibodies that cross-reacted to SARS-CoV-1, MERS-CoV, HCoV-HKU1, and HCoV-OC43. Anti-spike titers were more durable post-booster compared to the primary series. Longitudinal immune profiling of COVID-19 responses provides vital data to shape public health policies, optimize vaccine strategies, and strengthen pandemic preparedness. Full article

Background/Objectives: The COVID-19 pandemic has emphasized the importance of preparedness in preventing the spread of infectious diseases, especially in Emergency Departments (EDs), where initial patient assessments and triage occur. This study aims to evaluate the current practices and available tools for infection control in Pediatric EDs across Italy, focusing on the differences between various hospital types and regional settings. Methods: A cross-sectional national survey was conducted in February 2022, targeting healthcare workers in Pediatric EDs across Italy. The survey, distributed via the Italian Society for Pediatric Emergency and Urgent Medicine (SIMEUP) mailing list, collected data on infection control measures, including the availability of hand hygiene stations, personal protective equipment, disinfection protocols, and the use of rapid diagnostic tests. Results: A total of 80 questionnaires were completed from 119 (67.2%) different ERs. The majority of respondents were from Northern Italy (47.5%) and worked in hospitals with 24 h pediatric assistance (48.8%). Less than half of non-pediatric hospitals had separate access for children, potentially exposing them to adult pathogens. Across all settings, basic infection control measures, such as providing masks and hand gel, were widely implemented. However, significant differences were observed in the availability of social distancing, informational materials, and dedicated pediatric pathways, with I level assistance hospitals less likely to have these resources. Rapid diagnostic tests were available in most settings, but the focus was predominantly on SARS-CoV-2, despite other respiratory pathogens’ relevance in pediatric care. Conclusions: Strengthening preparations for future pandemics will be crucial in enhancing the resilience of healthcare systems and ensuring the safety of both patients and healthcare workers in the face of emerging infectious threats. Full article

Objectives: This study examines the recommendation behaviors and influencing factors for the 13-valent Pneumococcal Conjugate Vaccine (PCV13) among 3579 Chinese healthcare workers (HCWs), including 1775 pediatric care providers (Peds-PCPs) and 1804 primary care providers (PCPs). Data were collected from May to July 2023 through a national cross-sectional survey using a structured questionnaire, distributed across hospitals providing pediatric services in five provincial-level administrative divisions. Methods: The sociodemographic data, vaccine knowledge, and recommendation practices were analyzed using Pearson’s chi-square test, Wilcoxson rank-sum test, and multivariate logistic regression. Results show that while PCPs are more likely to recommend PCV13, vaccine hesitancy persists among Peds-PCPs. Logistic regression revealed that higher influenza vaccination intention, salary, vaccine consultation frequency, familiarity with immunization, work ethic, and flexible schedules positively impacted HCWs’ recommendation behavior. Results: Factors influencing Peds-PCPs’ recommendations include vaccine training (OR: 1.470, CI: 1.049–2.509), safety recognition (OR: 1.986, CI: 1.163–3.391), concern over rejection (OR = 1.274, CI: 1.076–1.508) and vaccine cost (OR = 1.203, CI: 1.023–1.414). For PCPs, influencing factors were the perceived susceptibility of children to pneumonia (OR = 2.185, CI: 1.074–4.445), acceptance of herd immunity (OR: 1.717, CI: 1.101–2.677), and belief that parents with better family conditions are more likely to accept vaccine recommendations (OR = 1.229, CI: 1.024–1.477).  Conclusion: This survey underscores the need for tailored interventions to address differing perceptions and enhance confidence in the safety and efficacy of vaccines among HCWs, particularly Peds-PCPs. Full article

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted healthcare systems worldwide. To assess the effects of the pandemic on pediatric emergency department (ED) visits in Taiwan, we conducted a study to evaluate changes in pediatric ED visits during the COVID-19 pandemic. Materials and Methods: This retrospective study included pediatric patients (age ≤ 18) who visited the ED between 21 January 2019 and 30 April 2019, at three hospitals of the Cathay Health System, and compared them with a corresponding period in 2020. Basic information, including mode of arrival, triage level, disposition, chief complaints, and incidence rates, were analyzed before and during the pandemic. Results: A total of 10,116 patients, with 6009 in the pre-pandemic group and 4107 in the pandemic group, were included in this study. The mean number of daily pediatric ED visits decreased from 60.09 before the pandemic to 40.66 during the pandemic, while ambulance use increased significantly by 2.56%. The percentage of patients with high acuity triage levels (levels 1 and 2) was significantly lower during the pandemic period (0.63% and 10.18%, respectively) than the pre-pandemic period (0.7% and 10.9%, respectively). Additionally, a significantly higher proportion of patients were discharged during the pandemic period (89.36%) than during the pre-pandemic period (88.33%). The proportion of COVID-19-related complaints, such as fever and respiratory tract infections, as well as other complaints including gastrointestinal issues, trauma, and psychological problems, significantly increased during the pandemic. Conclusions: In preparation for future pandemics, we recommend increasing emergency medical service capacity, establishing a non-contagious route for obtaining chronic medication prescriptions, optimizing staff allocation in pediatric emergency departments, and increasing the number of hospital social workers for enhanced support. Full article

Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child’s life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child’s death or a threat to a child’s life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master’s, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma. Full article

Antimicrobial-resistant bacterial infections are a known threat to the public health of low-income countries and are undercharacterized in Papua New Guinea. A scoping literature review of scientific peer-reviewed publications on antimicrobial resistance in Papua New Guinea was conducted, and their results were summarized. Many of the available data on resistant bacteria in Papua New Guinea have come from Port Moresby and Goroka and have been focused on Staphylococcus aureus, as well as important pediatric pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. Progressive resistance to the commonly used antibiotics penicillin and chloramphenicol among most clinically important bacterial pathogens has prompted healthcare workers to adopt expensive broad-spectrum antibiotics. There is already evidence of resistance to newly adopted antibiotics among several Gram-negative organisms. Drivers of antimicrobial resistance in Papua New Guinea include a high burden of infectious diseases, inappropriate antibiotic prescription practices, poor regulation of antibiotics, incomplete adherence, substandard drug quality, and overcrowding of healthcare facilities. There is a lack of information on antimicrobial resistance among priority pathogens and from several important regions of Papua New Guinea. Full article

The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from eight countries who participated—predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)—most of them felt that caring for NCCC patients during the pandemic presented unique difficulties, and they reported a significant decrease in the in-person NCCC clinic volume (p < 0.001), multidisciplinary appointments (p < 0.001), surgical cases (p = 0.008), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. The usage of telemedicine significantly increased for NCCC patient visits (p < 0.001). During the COVID-19 pandemic, many children with NCCCs lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and with the threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCCs. Full article

Background: Healthcare-associated infections (HAIs) present a formidable challenge for healthcare institutions, resulting in heightened mortality, morbidity, and economic burden. Within healthcare settings, various equipment and materials, including mobile phones, can potentially act as sources of infection. This study sought to examine the occurrence of bacterial contamination on mobile phones utilized by healthcare workers (HCWs) in intensive care units (ICUs), pediatric intensive care units (PICUs), neonatal intensive care units (NICUs), and cardiac care units (CCUs) within a central hospital (CH) and two peripheral hospitals (PHs) situated in the southwestern province of Saudi Arabia. Materials and methods: We collected a total of 157 samples from mobile phones utilized by HCWs across all ICUs in the CH and PHs. These samples underwent bacteriological analysis to evaluate the degree of bacterial contamination. Results: We found that 45 out of 55 samples from physicians (81.81%) and 58 out of 77 samples from nurses (75.32%) showed bacterial contamination. Contamination rates on HCWs’ mobile phones in the ICU, PICU, and NICU departments of the CH were observed at 69.56%, 80.95%, and 70.27%, respectively. Furthermore, the overall contamination rates in the ICUs, NICUs, and CCUs of the PHs were 78.26%, 88.88%, and 66.66%, respectively. The overall contamination rates of mobile phones in the CH and PHs were 72.11% and 81.13%, respectively. Conclusion: These findings underscore the necessity of routinely disinfecting the mobile phones of HCWs to mitigate the risk of cross-contamination. Implementing robust disinfection protocols can significantly contribute to curtailing the propagation of bacterial pathogens and reducing the incidence of HAIs in healthcare settings. Full article