A decade of trends in the distribution and antimicrobial susceptibility of prevalent uropathogens among pediatric patients from Tehran,Iran during 2005-2016

Objectives:To determine changes in the distribution of uropathogens and their antimicrobial resistance in pediatric patients in a children's hospital from 2005 to 2016.Methods:A cross-sectional analysis of uropathogens and their antimicrobial resistance within inpatient children was performed over the 11-year period,2005 to 2016,in Ali Asghar children's hospital.The rate of antibiotic resistance among patients was evaluated according to demographic data including age,sex,urinary tract abnormities and history of antibiotic consumption.Results:In total,958 female and 349 male positive cultures were analyzed.Escherichia coli(E.coli)(77.6%)was the most common causative agent of urinary tract infection(UTI)in children and Klebsiella pneumoniae(10.4%),Pseudomonas aeruginosa(2.4%),and Enterococcus spp(2.4%)were less frequent isolated bacteria.The resistance rates of E.coli isolates were increased against amikacin,ceftriaxone,ceftazidime,ciprofloxacin,cotrimoxazole and imipenem from 2005 to 2010.However,we observed a decreasing trend for some of antibiotics including amikacin,gentamicin,imipenem,ceftazidime and cotrimoxazole during 2014-2016.The rate of antibiotic resistance was greater in boys than in girls against many antibiotics.The rate of resistance to amikacin,gentamicin,nitrofurantoin and cotrimoxazole in patients aged<1 year was higher than other age groups(p<0.001).A higher antibiotic resistance rate was observed in patients with anatomical abnormality and those who have had a history of antibiotic consumption.Conclusion:The study indicated the significant decrease in E.coli antibiotic resistance in the last 3 years.An effective empirical treatment regime should be based on local epidemiology and antimicrobial susceptibility testing.

Information technology and artificial intelligence support in management experiences of the pediatric designated hospital during the COVID-19 epidemic in 2022 in Shanghai

Objective:To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai.Methods:We retrospectively concluded the management experiences at the largest pediatric designated hospital from March 1st to May 11th in 2022 in Shanghai.We summarized the application of Internet hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward and the structed electronic medical record in the inpatient system.We illustrated the role of the information system through the number and prognosis of patients treated.Results:The COVID-19 designated hospitals were built particularly for critical patients requiring high-level medical care,responded quickly and scientifically to prevent and control the epidemic situation.From March 1st to May 11th,2022,we received and treated 768 children confirmed by positive RT-PCR and treated at our center.In our management,we use Internet Information on the Internet Hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward,structed electronic medical record in the inpatient system.No deaths or nosocomial infections occurred.The number of offline outpatient visits dropped,from March to May 2022,146,106,48,379,57,686 respectively.But the outpatient volume on the internet hospital increased significantly(3,347 in March 2022 vs.372 in March 2021;4,465 in April 2022 vs.409 in April 2021;4,677 in May 2022 vs.538 in May 2021).Conclusions:Information technology and artificial intelligence has provided significant supports in the management.The system might optimize the admission screening process,increases the communication inside and outside the ward,achieves early detection and diagnosis,timely isolates patients,and timely treatment of various types of children.