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    New Fever in PICU

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    Mohamed Elgayar
    The document discusses nosocomial infections that can cause new fever in the pediatric intensive care unit (PICU). It describes three main types of infections: ventilator-acquired pneumonia, catheter-related bloodstream infections, and urinary tract infections. For each type of infection, it provides details on clinical signs, common organisms, diagnosis, prevention strategies, and treatment approach.

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    New Fever in PICU

    Uploaded by

    Mohamed Elgayar
    13 views11 pages
    The document discusses nosocomial infections that can cause new fever in the pediatric intensive care unit (PICU). It describes three main types of infections: ventilator-acquired pneumonia, catheter-related bloodstream infections, and urinary tract infections. For each type of infection, it provides details on clinical signs, common organisms, diagnosis, prevention strategies, and treatment approach.

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    New fever in PICU

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    The document discusses nosocomial infections that can cause new fever in the pediatric intensive care unit (PICU). It describes three main types of infections: ventilator-acquired pneumonia, catheter-related bloodstream infections, and urinary tract infections. For each type of infection, it provides details on clinical signs, common organisms, diagnosis, prevention strategies, and treatment approach.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    13 views11 pages

    New Fever in PICU

    Uploaded by

    Mohamed Elgayar
    The document discusses nosocomial infections that can cause new fever in the pediatric intensive care unit (PICU). It describes three main types of infections: ventilator-acquired pneumonia, catheter-related bloodstream infections, and urinary tract infections. For each type of infection, it provides details on clinical signs, common organisms, diagnosis, prevention strategies, and treatment approach.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 11

     New Fever in PICU

     Infection in PICU
     Serious Focal infection
     Isolation
     Antimicrobial drugs
    New Fever in PICU
    Nosocomial Infection

    Mohamed Abdallah
    )2018(
    Fever in PICU
    1. Ventilator acquired Pneumonia
    2. Catheter related blood stream infection
    3. Urinary tract infection
    4. CNS Infection
    1.Ventilator acquired Pneumonia
     Clinical Signs:
    • New/increased production of purulent sputum
    • Chest rales/bronchial breath sounds/dullness
    • Radiographic infiltrations, consolidations, pleural effusion,
    cavitations not attributable to any other etiology
     Usual Organisms:
    • Pseudomonas aeruginosa
    • Staph aureus (MRSA)
    • Klebsiella
    • E Coli
    • Enterococci
    • Fungus
    1.Ventilator acquired Pneumonia con.
    Laboratory Diagnosis:
    • Leukocytosis
    • Suggestive CXR
    • Positive cultures of ET aspirate
     Prevention:
    • Use disposable ventilator tubing
    • Strict sterile precautions during suctioning
    • Postural drainage/ chest physiotherapy
    • Early extubation
     Treatment: Appropriate Ab (as guided by C/S results) for adequate duration
    Additions
    • Prevention of Aspiration of pathogenic organisms from the oropharynx (The instances of VAP that
    appear within 4 days of intubation are most likely caused by pathogens that have been dragged into
    the airways during the intubation procedure.)
    • Oral decontamination (usually with antiseptic agent chlorhexidine) is now a standard measure in all
    ventilator-dependent patients.
    • Routine Airway Care: Endotracheal suctioning can disrupt the biofilms and dislodge microbes colonizing
    the inner surface of tracheal tubes, which introduces pathogens into the lower airways. For this reason,
    endotracheal suctioning is not recommended as a routine procedure, but only when necessary to clear
    secretions from the airways.
    • Clearance of Subglottic Secretions: significant reduction in the incidence of VAP when subglottic
    secretions are cleared using specialized endotracheal tubes ((e.g. Mallinckrodt TaperGuard Evac Tube,
    Covidien, Boulder, CO)
    2. Catheter related blood stream infection
    Clinical Signs:
    •Recrudescence of fever after afebrile period
    •Redness/Thrombophlebities at local site
    Usual Organisms:
    •CONS
    •Enterococci
    •Fungi
    •Staph aureus
    •Pseudomonas
    Laboratory Diagnosis:
    •Leukocytosis
    •+ blood culture from blood draw from catheter and simultaneously from peripheral site
    2. Catheter related blood stream infection
    con.
    Prevention:
    • Strict enforcement of hand washing protocol
    • Use chlorhexidine and alcohol for cleaning at time of insertion
    • Prefer subclavian > internal jugular >femoral line
    • Avoid use of transparent dressing for fixation (moisture retention)
    • Handling by experienced healthcare staff
     Treatment:
    Appropriate Ab (as guided by C/S results) for adequate duration
    3. Urinary tract infection
     Clinical Signs:
    • Recrudescence of fever after afebrile period
     Usual Organisms:
    • Gram negative enterics
    • Fungi
    • Enterococci
     Laboratory Diagnosis:
    • Without an idwelling catheter:
    1.Clean catch midstream urine growth > 100,000 CFU/ml
    2.Any growth from suprapubic specimen
    • With an idwelling catheter: Bacterial counts >100 from the urine from catheter port
    3. Urinary tract infection
    Prevention:
    • Strict enforcement of hand washing protocol
    • Use of urinary catheter for shortest possible period
    • Use of Abs.before any invasive urological procedure
    • Development of catheter material that prevent bacterial growth
     Treatment:
    Appropriate Ab (as guided by C/S results) for adequate duration

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