Document Detail

Do pacifiers increase the risk of nosocomial diarrhoea? A cohort study.
MedLine Citation:
PMID:  22508955     Owner:  NLM     Status:  PubMed-not-MEDLINE    
DESIGN: Prospective cohort study.
SETTING: Teaching paediatric hospital-Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast Brazil.
PARTICIPANTS: 378 of 536 infants admitted in paediatric wards from April to October 2009 were daily assessed during hospital stay until the first episode of nosocomial diarrhoea (ND), death or discharge. Infants with community-acquired diarrhoea, respiratory or haemodynamic instability and who stayed in hospital for <24 h were excluded.
PRIMARY AND SECONDARY OUTCOME MEASURES: Incidence and risk factors for ND and rates of pacifier faecal contamination.
RESULTS: 33 ND episodes occurred in 378 infants, with a cumulative incidence of 8.7% and density of 11.25/1000 patients-day. ND occurred in 8.2% (16/194) of pacifier users compared with 9.2% (17/184) in non-users (adjusted OR=0.88, 95% CI 0.43 to 1.80). In multivariate logistic regression analysis, duration of oxygen use (OR=1.61; 95% CI 1.18 to 2.20) and days of antimicrobial use (OR=1.62, 95% CI 1.34 to 1.94) were associated with higher risk of ND, whereas being breast fed (OR=0.40, 95% CI 0.17 to 0.93) and each day of hospital stay (OR=0.65, 95% CI 0.53 to 0.80) were protective factors. Faecal coliforms were isolated in 16% (27/169) of tested pacifiers, 77.8% of which had more than 100 000 CFU/ml. The probability of a child remaining free of an episode of diarrhoea up to the seventh day of hospitalisation in the ward was 91.2% (95% CI 87.7% to 94.9%). The log-rank test showed no statistical difference between pacifier users and non-users.
CONCLUSIONS: ND is a frequent healthcare-associated infection in paediatric wards, but the use of pacifiers during the stay in hospital does not seem to affect the incidence of ND in infants in many settings where the burden of diarrhoea is still high.
Gabriela Cunha Schechtman Sette; Maria Júlia Gonçalves Mello; Jailson Barros Correia; Ioram Schechtman Sette; Gisélia Alves Pontes da Silva; Luciane Soares de Lima
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Publication Detail:
Type:  Journal Article     Date:  2012-04-16
Journal Detail:
Title:  BMJ open     Volume:  2     ISSN:  2044-6055     ISO Abbreviation:  BMJ Open     Publication Date:  2012  
Date Detail:
Created Date:  2012-04-17     Completed Date:  2012-10-02     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101552874     Medline TA:  BMJ Open     Country:  England    
Other Details:
Languages:  eng     Pagination:  e000427     Citation Subset:  -    
Universidade Federal de Pernambuco, Recife, Brazil.
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