bs_bs_banner
Letters to the Editor
References 1 Raymond JMD, Yannick Aujard MD, the Group ES. Nosocomial infections in pediatric patients: a European, multicenter prospective study. Infect. Control Hosp. Epidemiol. 2000; 21: 260–3. doi: 10.1086/ 501755. 2 Brady R, Wasson A, Stirling I, McAllister C, Damani N. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on health care workers’ mobile phones. J. Hosp. Infect. 2006; 62: 123–5. 3 Visvanathan A, Rodrigues MA, Brady R, Gibb AP. Mobile phone usage in the clinical setting: evidence-based guidelines for all users is urgently required. Am. J. Infect. Control 2012; 40: 86–7. 4 Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leblebicioglu H. Are we aware how contaminated our mobile phones with nosocomial pathogens? Ann. Clin. Microbiol. Antimicrob. 2009; 8: 7.
Dear Editor,
As BPD is defined as the need for oxygen at 36 weeks’ postmenstrual age and >28 days of age, infants who die within this period are excluded when determining BPD rates. This may result in exclusion of a subgroup with high frequency of respiratory problems and high risk of developing BPD if they lived longer. Therefore, we believe that ‘survival free of BPD’ is a more rational outcome, and we showed that poractant is more efficacious in this regard. European Panel of expert neonatologists who developed consensus guidelines also reported updated recommendations on May 2013.3 They stated that poractant alfa in an initial dose of 200 mg/kg has a survival advantage compared with 100 mg/kg of poractant alfa or 100 mg/kg beractant for treatment of RDS. We propose that contradictory results in the study of Paul et al. and our study might be secondary to its retrospective nature and discrepancy of gestational ages in study groups as also stated by the authors.
PORACTANT ALFA VERSUS BERACTANT IN THE TREATMENT OF PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME We read with interest the paper by Paul et al. that aimed to compare the effects of poractant alfa versus beractant on mortality and other morbidities in preterm infants less than 32 weeks gestation retrospectively.1 They found no significant differences in the outcomes between two types of surfactants. Recently, we have prospectively evaluated the differences in clinical responses and short-term outcomes in 126 preterm infants with respiratory distress syndrome (RDS) randomised to treatment with poractant (n = 61) or beractant (n = 65).2 Patients were followed until 40 weeks of corrected gestational age or death. Significantly, more patients in the beractant group required two doses of surfactant compared with the poractant group (31% vs. 12%, P = 0.023). Extubation rate within the first 3 days after surfactant administration was higher in the poractant group than in the beractant group (81% vs. 55.9%, P = 0,004). Post-treatment FiO2 requirement in the poractant group was significantly lower than in the beractant group on days 1, 3 and 5. Overall mortality and morbidities were similar between groups. Survival free of bronchopulmonary dysplasia (BPD) at the end of study period was 78.7% and 58.5% in poractant and beractant groups, respectively (P = 0.015). Conflict of interest: None declared.
Dr Evrim Alyamaç Dizdar1 Dr Fatma Nur Sari1 Dr Serife Suna Oguz1 Dr Ugur Dilmen2 1 Division of Neonatology Zekai Tahir Burak Maternity Teaching Hospital Ankara, Turkey 2 Department of Pediatrics School of Medicine Yildirim Beyazit University Ankara, Turkey
References 1 Paul S, Rao S, Kohan R et al. Poractant alfa versus beractant for respiratory distress syndrome in preterm infants: a retrospective cohort study. J. Paediatr. Child Health 2013; 49: 839–44. 2 Dizdar EA, Sari FN, Aydemir C et al. Randomized, controlled trial of poractant alfa versus beractant in the treatment of preterm infants with respiratory distress syndrome. Am. J. Perinatol. 2012; 29: 95–100. 3 Sweet DG, Carnielli V, Greisen G et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants – 2013 update. Neonatology 2013; 103: 353–68. doi: 10.1159/000349928.
Image of the Month: Answer Tuberculin skin test (TST); induration 26 mm diameter. No acid- fast bacilli were identified on microscopy of a broncho-alveolar lavage specimen, but Mycobacterium tuberculosis complex DNA nucleic acid detection was subsequently positive. The child has been commenced on a multi-drug anti-tuberculous medication course (isoniazid, rifampicin, pyrazinamide and ethambutol). M. tuberculosis was later cultured, and the isolate was fully sensitive to the antimicrobials.
1084
Journal of Paediatrics and Child Health 49 (2013) 1082–1084 © 2013 The Authors Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Letters to the Editor
References 1 Raymond JMD, Yannick Aujard MD, the Group ES. Nosocomial infections in pediatric patients: a European, multicenter prospective study. Infect. Control Hosp. Epidemiol. 2000; 21: 260–3. doi: 10.1086/ 501755. 2 Brady R, Wasson A, Stirling I, McAllister C, Damani N. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on health care workers’ mobile phones. J. Hosp. Infect. 2006; 62: 123–5. 3 Visvanathan A, Rodrigues MA, Brady R, Gibb AP. Mobile phone usage in the clinical setting: evidence-based guidelines for all users is urgently required. Am. J. Infect. Control 2012; 40: 86–7. 4 Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leblebicioglu H. Are we aware how contaminated our mobile phones with nosocomial pathogens? Ann. Clin. Microbiol. Antimicrob. 2009; 8: 7.
Dear Editor,
As BPD is defined as the need for oxygen at 36 weeks’ postmenstrual age and >28 days of age, infants who die within this period are excluded when determining BPD rates. This may result in exclusion of a subgroup with high frequency of respiratory problems and high risk of developing BPD if they lived longer. Therefore, we believe that ‘survival free of BPD’ is a more rational outcome, and we showed that poractant is more efficacious in this regard. European Panel of expert neonatologists who developed consensus guidelines also reported updated recommendations on May 2013.3 They stated that poractant alfa in an initial dose of 200 mg/kg has a survival advantage compared with 100 mg/kg of poractant alfa or 100 mg/kg beractant for treatment of RDS. We propose that contradictory results in the study of Paul et al. and our study might be secondary to its retrospective nature and discrepancy of gestational ages in study groups as also stated by the authors.
PORACTANT ALFA VERSUS BERACTANT IN THE TREATMENT OF PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME We read with interest the paper by Paul et al. that aimed to compare the effects of poractant alfa versus beractant on mortality and other morbidities in preterm infants less than 32 weeks gestation retrospectively.1 They found no significant differences in the outcomes between two types of surfactants. Recently, we have prospectively evaluated the differences in clinical responses and short-term outcomes in 126 preterm infants with respiratory distress syndrome (RDS) randomised to treatment with poractant (n = 61) or beractant (n = 65).2 Patients were followed until 40 weeks of corrected gestational age or death. Significantly, more patients in the beractant group required two doses of surfactant compared with the poractant group (31% vs. 12%, P = 0.023). Extubation rate within the first 3 days after surfactant administration was higher in the poractant group than in the beractant group (81% vs. 55.9%, P = 0,004). Post-treatment FiO2 requirement in the poractant group was significantly lower than in the beractant group on days 1, 3 and 5. Overall mortality and morbidities were similar between groups. Survival free of bronchopulmonary dysplasia (BPD) at the end of study period was 78.7% and 58.5% in poractant and beractant groups, respectively (P = 0.015). Conflict of interest: None declared.
Dr Evrim Alyamaç Dizdar1 Dr Fatma Nur Sari1 Dr Serife Suna Oguz1 Dr Ugur Dilmen2 1 Division of Neonatology Zekai Tahir Burak Maternity Teaching Hospital Ankara, Turkey 2 Department of Pediatrics School of Medicine Yildirim Beyazit University Ankara, Turkey
References 1 Paul S, Rao S, Kohan R et al. Poractant alfa versus beractant for respiratory distress syndrome in preterm infants: a retrospective cohort study. J. Paediatr. Child Health 2013; 49: 839–44. 2 Dizdar EA, Sari FN, Aydemir C et al. Randomized, controlled trial of poractant alfa versus beractant in the treatment of preterm infants with respiratory distress syndrome. Am. J. Perinatol. 2012; 29: 95–100. 3 Sweet DG, Carnielli V, Greisen G et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants – 2013 update. Neonatology 2013; 103: 353–68. doi: 10.1159/000349928.
Image of the Month: Answer Tuberculin skin test (TST); induration 26 mm diameter. No acid- fast bacilli were identified on microscopy of a broncho-alveolar lavage specimen, but Mycobacterium tuberculosis complex DNA nucleic acid detection was subsequently positive. The child has been commenced on a multi-drug anti-tuberculous medication course (isoniazid, rifampicin, pyrazinamide and ethambutol). M. tuberculosis was later cultured, and the isolate was fully sensitive to the antimicrobials.
1084
Journal of Paediatrics and Child Health 49 (2013) 1082–1084 © 2013 The Authors Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
