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Epidemic to Different Strains of SERRATIA: Experience of neonatal intensive care unit: About 30 Cases

Open Journal of Pediatrics 2023年第2期13卷 253-261页

作者： Fatima-Ezzahra Tahiri Abdessamad Lalaoui Hasna Rafi Fatiha Bennaoui Nadia El Idrissi Slitine Nabila Soraa Fadl Marabih Rabou Maoulainine neonatal intensive care unit CHU Mohammed VI Marrakech Morocco Health Childhood and Development Faculty of Medicine Research Team Cadi Ayyad University Marrakech Morocco Microbiology Department CHU Mohammed VI Marrakech Morocco

Serratia is an opportunistic pathogenic bacterium of the Enterobacteriaceae family, occasionally responsible for epidemics of nosocomial infections in critical departments;in particular in neonatal intensive care units Enterobacteriaceae form a large family of Gram-negative bacteria, which cause diseases of highly variable severity, due to distinct pathogenic mechanisms. This family is heterogeneous as it consists of about 30 genera of bacteria and more than 100 species. However, all these germs have in common their preferential location in the digestive system, some being part of the normal flora although they are also present in the environment. Several metabolic processes characterize this bacterial family. These include the ability to reduce nitrate to nitrite (for energy generation), ferment glucose, lack cytochrome oxidase, be aerobic or anaerobic, motile or immobile, … Enterobacteriaceae constitute more than 80% of the germs isolated in the laboratory: Escherichia, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus, Morganella and Yersinia are the rods most often found. Regarding nosocomial infection to Serratia, this bacterium colonizes the respiratory, digestive and urinary systems of patients, mainly responsible for bacteremia, infections of the lower respiratory tract, urinary and skin infections. Through our work, we report the epidemic experienced in the neonatal intensive care unit MOHAMMED VI university hospital, mother-child hospital MARRAKECH MOROCCO for three months from December at February 2023 interesting 30 newborns whose clinical presentation was different, the positive diagnosis was based on blood and geographical samples taken by the bacteriology department to isolate the offending germs, the therapeutic management of our patients consisted essentially of various hygiene measures in association with dual antibiotic therapy based on meropenem and amikacin. The evolution was marked by the death of 21 patients (70%) and the recov

关键词： Epidemic neonatal Resuscitation Nosocomial Infection Serratiamarcesens Serratiaureitylica Serratia Nematodiphila Antibiotic Resistance

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Diarrhea in neonatal intensive care unit

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World Journal of Gastroenterology 2010年第21期16卷 2664-2668页

作者： Annalisa Passariello Gianluca Terrin Maria Elisabetta Baldassarre Mario De Curtis Roberto Paludetto Roberto Berni Canani Department of Pediatrics University of Naples "Federico Ⅱ"Naples80131Italy Department of Evolutive Age Biomedicine University of BariBari70124Italy neonatal care unit University La SapienzaRome00161Italy European Laboratory for Investigation on Food-Induced Diseases University of Naples "Federico Ⅱ"Naples80131Italy

AIM:To investigate the frequency,etiology,and current management strategies for diarrhea in ***:Retrospective,nationwide study involving 5801 subjects observed in neonatal intensive care units during 3 *** main anamnesis and demographic characteristics,etiology and characteristics of diarrhea,nutritional and therapeutic management,clinical outcomes were ***:Thirty-nine cases of diarrhea(36 acute,3 chronic) were *** occurrence rate of diarrhea was 6.72 per 1000 hospitalized *** was defined in 29 of 39 newborn(74.3%):food allergy(20.5%),gastrointestinal infections(17.9%),antibiotic-associated diarrhea(12.8%),congenital defects of ion transport(5.1%),withdrawal syndrome(5.1%),Hirschsprung's disease(2.5%),parenteral diarrhea(2.5%),cystic fibrosis(2.5%),and metabolic disorders(2.5%).Three patients died due to complications related to diarrhea(7.7%).In 19 of 39 patients(48.7%),rehydration was performed exclusively by the enteral ***:Diarrhea in neonates is a challenging clinical condition due to the possible heterogeneous etiologies and severe *** guidelines are advocated in order to optimize management of diarrhea in this particular setting.

关键词： Chronic diarrhea Congenital diarrhea Food allergy Oral rehydration solution Rotavirus

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Evaluation of a complex couplet care intervention in a neonatal intensive care unit:A mixed methods study protocol

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Pediatric Investigation 2024年第2期8卷 139-148页

作者： Michella Bjerregaard Anna Axelin Emma Louise Malchau Carlsen Hans Okkels Birk Ingrid Poulsen Patrick Palisz Thomas Kallemose Anne Brødsgaard Department of Paediatric and Adolescent Medicine Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Public Health Faculty of HealthResearch Unit for Nursing and HealthcareUniversity of AarhusAarhusDenmark Department of Nursing Science University of TurkuTurkuFinland Department of Clinical Medicine Faculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark Department of Public Health Section of Health Service ResearchUniversity of CopenhagenCopenhagenDenmark Department of People and Technology Roskilde UniversityRoskildeDenmark Department of Clinical Research Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Gynaecology and Obstetrics Copenhagen University Hospital Amager HvidovreHvidovreDenmark

Background:Families with an infant in need of intensive care most often experience a harmful separation after *** is due to a division of medical specialties into neonatal care and maternal ***,a couplet care intervention is implemented for mother-infant dyads in a neonatal intensive care *** study protocol provides a comprehensive evaluation of the *** aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and ***:The couplet care intervention is a family-centered model of care,where treatment-requiring mother-infant dyads will be admitted together and receive couplet care by neonatal *** study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi-experimental trial and a qualitative process ***,a health economic evaluation will be conducted to assess the cost-effectiveness of this complex couplet care ***:Separation of mother-infant dyads after birth has an adverse impact on family health and *** study protocol evaluates a complex couplet care *** this study,a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants.

关键词： Complex interventions Couplet care Family-centered care Neonatology Zero separation

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Earlier detection of late onset neonatal sepsis using temporal analysis of continuous physiological data streams in a Chinese neonatal intensive care unit

Earlier detection of late onset neonatal sepsis using tempor...

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2015年泛长三角围产医学学术年会暨浙江省围产医学学术年会

作者： Zhou Qi Christina Catley Carolyn McGregor Andrew James Cao Yun neonatal intensive unit Children's Hospital for Fudan University Health Informatics Research Laboratory University of Ontario Institute of Technology Department of Paediatrics University of Toronto

Objective:Late-onset neonatal sepsis(LONS)is an important cause of morbidity and mortality in *** clinical symptoms of LONS are often subtle and nonspecific and therefore early and accurate diagnosis is *** rate variability(HRV)may be decreased up to 24 hours before the diagnosis of *** aimed to test whether HRV and respiratory rate variability(RRV)behaviors present prior to the clinical suspicion of LONS within two North American cohorts were evident within a population of neonatal patients from China Method:We collected physiological data prospectively from a cohort of 43 infants born at less than 34 weeks gestational age at neonatal unit at Fudan University Children’s *** were 6 infants who developed LONS within this *** was defined as a blood culture positive infection or clinical infection occurring at more than 3 days of *** all infants in the cohort HRV and RRV were determined by a process of temporal abstraction of one second values of heart rate and respiratory rate captured from Phillips MP30 and MP50 ***:LONS was suspected in 6 out of 43 babies in the *** 6 episodes,4microbiologically confirmed sepsis from sterile sites,2 were clinical *** representative patient examples,we illustrate an analytics user interface design that shows the potential in using our HRV and RRV analytics for early identification of LONS with1 second spot readings Conclusion:Continuous HRV and RRV monitoring provides a valuable tool for early identification of *** work will expand this pilot study to increase the sample size and capture additional clinical practice data to provide greater insight into the relationship between the behaviours of continuous physiological data streams and the early identification of LONS.

关键词： sepsis infant late onset neonatal sepsis physiological data streams temporal analysis

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Analysis of In-hospital neonatal Death in the Tertiary neonatal intensive care unit in China： A Multicenter Retrospective Study

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Chinese Medical Journal 2016年第22期129卷 2652-2658页

作者： Chen-Hong Wang Li-Zhong Du Xiao-Lu Ma Li-Ping Shi Xiao-Mei Tong Hong Liu Guo-Fang Ding Bin Yi Xin-Nian Pan Dan-Ni Zhong Ling Liu Mei Li Cui-Qing Li Shi-Wen Xia Hong-Yun Wang Ling He Kun Liang Xiao-Yu Zhou Shu-Ping Han Qin Lyu Yin-Ping Qiu Ruo-Bing Shan De-Zhi Mu Xiao-Hong Liu Si-Qi Zhuang Jing Guo Li Liu Jia-Jun Zhu Hong Xiong Department of neonatal intensive care unit Children's Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310051 China Department of Pediatrics Peking University Third Hospital Beijing 100191 China Department of Neonatology Beijing Children's Hospital Capital Medical University Beijing 100045 China Department of Pediatrics Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China Department of Neonatology Gansu Provincial Maternity and Children-care Hospital Lanzhou Gansu 730050 China Department of Neonatology Guangxi Maternal and Child Health Hospital Nanning Guangxi 530003 China Department of Neonatology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi 530021 China Department of Neonatology Guiyang Maternal and Child Health Care Hospital Guiyang Guizhou 550003 China Department of Neonatology Harbin Children's Hospital Harbin Heilongjiang 150010 China Department of Neonatology Children's Hospital of Hebei Province Shijiazhuang Hebei 050031 China Department of Neonatology Hubei Maternity and Child Heath Hospital Wuhan Hubei 430070 China Department of neonatal intensive care unit Inner Mongolia Maternal and Child Health Hospital Huhhot Inner Mongolia 010030 China Department of Neonatology Jiangxi Provincial Children's Hospital Nanchang Jiangxi 330006 China Department of Pediatric First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650032 China Department of Neonatology Nanjing Children's Hospital of Nanjing Medical University Nanjing Jiangsu 320100 China Department of Neonatology Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Nanjing Jiangsu 210004 China DeDartment of neonatal intensive care unit Ningbo Women and Children's Hospital Ningbo Zhejiang 315012 China Department of Neonatology General Hospital of Ningxia Medical University Yinchuan Ningxia 750004 China Department of Neonatology Qingdao Women and

Background：Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%.Differences of cause in neonate death exist in different regions as well as in different economic development *** specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary neonatal intensive care unit （NICU） of ***：All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,*** the data were collected retrospectively from clinical records by a designed *** collected from each NICU were delivered to the leading institution where the results were ***：A total of 744 newborns died during the l-year survey,accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these *** neonate death accounted for 59.3% of all the *** leading causes of death in preterm and term infants were pulmonary disease and infection,*** early neonate period,pulmonary diseases （56.5%） occupied the largest proportion ofpreterm deaths while infection （27%） and neurologic diseases （22%） were the two main causes of term *** late neonate period,infection was the leading cause of both preterm and term neonate *** two-thirds of neonate death occurred after medical care *** the cases who might survive if receiving continuing treatment,parents＇ concern about the long-term outcomes was the main reason of medical care ***：Neonate death still accounts for a high proportion of all the deaths in children under 5 years of *** study showed the majority of neonate death occurred in preterm *** of death varied with the age of death and gestational *** and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

关键词： Cause-of-death Mortality Newbom Retrospective Survey

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High-risk phenotypes of genetic disease in a neonatal intensive care unit population

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Chinese Medical Journal 2022年第5期135卷 625-627页

作者： Tiantian Xiao Qi Ni Huiyao Chen Huijun Wang Lin Yang Bingbing Wu Yun Cao Guoqiang Cheng Laishuan Wang Liyuan Hu Hongfang Mei Yulan Lu Mengchun Gong Xinran Dong Wenhao Zhou Department of Neonatology Key Laboratory of Neonatal DiseasesMinistry of HealthChildren’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghai 201102China Center for Molecular Medicine Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghai 201102China Institute of Health Management Southern Medical UniversityGuangzhouGuangdong 510515China

To the Editor: Genetic diseases contribute to 35% of deaths during the first year of life and are a significant cause of intensive care.[1] A previous study based on the China neonatal Genomes Project investigated the genetic causes of early infant deaths and found that >25% of deceased neonates with genetic diagnoses can be cured if diagnosed in time.[2] Therefore, it is crucial to target and diagnose neonates with genetic diseases as early as possible. According to our experience, the typical phenotypes, such as special facial features or multiple congenital anomalies (MCAs), indicate a high risk of genetic disease and lead physicians to perform genetic testing in neonates as early as possible. However, in practice, infants without typical phenotypes typically undergo a long and costly diagnostic process before genetic diagnoses are confirmed. Moreover, a recent survey by the American College of Medical Genetics and Genomics (ACMG) and other national professional organizations indicated that there are insufficient numbers of qualified geneticists to fulfil genetic service needs.[3] The ACMG published the general clinical features for genetic testing indications. For example, patients with phenotypes or family history data that strongly implicate a genetic cause may undergo genetic testing.[1] However, the study indicated that many genetic conditions arise de novo or are inherited with no family history.[1] A previous study attempted to apply the non-phenotype-driven panel approach in neonates admitted to the neonate intensive care unit (NICU).[4] However, at present, the diagnostic yield is only 3.45% (1/29).[4] In addition, the economic and ethical issues associated with genomic screening remain challenging. Therefore, the available indications for genetic testing may improve the management of genetic diseases.

关键词： admitted apply fir

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Healthcare Associated Infection in the neonatal intensive care unit of King Abdl Aziz Specialist Hospital, Taif, KSA

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Advances in Infectious Diseases 2013年第4期3卷 300-305页

作者： A. K. Al-Zahrani E. M. Eed A. A. Alsulaimani S. H. Abbadi Associate Prof. Medical College Consultant Pediatrician & Neonatologist Taif University Taif KSA Department of Medical Microbiology and Immunology Faculty of Medicine Menoufia University Egypt and College of Applied Medical Sciences Taif University Taif KSA Department of Medical Microbiology and Immunology Faculty of Medicine Suez Canal University Egypt and College of Medicine Taif University KSA Department Pediatrics College of Medicine Taif University Neonatal Intensive Care Unit King Abdulaziz Specialist Hospital Taif KSA

Healthcare-associated infection is a common problem of newborn in neonatal intensive care units. It results in high mortality rate and serious complications. The Aim: to assess the incidence, etiology and the mortality of healthcareassociated infections of patients in neonatal intensive care unit at King Abdl Aziz Specialist Hospital (KAASH), Taif, Kingdom of Saudi Arabia. Material and Methods: This is a retrospective study including 8033 neonates admitted to neonatal intensive care unit during period between April, 2006 and December, 2012. The health-care associated infection rate, mortality rate, causative organism and risk factors were studied. Results: The prevalence of health-care associated infection was found to be 6.03%;the mortality rate was 27.1%. The highest prevalence was among children with the birth weight below 1000 g. The most frequent causative pathogen was klebseilla spp, followed by other gram negative bacilli. Conclusion: The rate of healthcare-associated infections in neonatal intensive care unit at KAASH was relatively high. In addition, the mortality rate was observed to be high (27.1%) owing to the high virulence of the causative organisms.

关键词： Healthcare-Associated Infection Newborn neonatal intensive care unit

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Prevalence and Spectrum of Complex Congenital Heart Disease in the neonatal intensive care unit at High Altitude in China

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Congenital Heart Disease 2021年第1期16卷 45-52页

作者： Jingjing Li Xiaorong Wang Yuan Liu Guodong Zhao Ting Dai Hong Chen Haiyan Liao Haiying Qi Jia Li Department of Obstetrics and Gynecology Xuanwu HospitalCapital Medical UniversityBeijingChina Department of Neonatology Women and Children’s Hospital of Qinghai ProvinceXiningChina Department of Echocardiography Women and Children’s Hospital of Qinghai ProvinceXiningChina intensive care unit Capital Institute of PediatricsBeijingChina Clinical Physiology Laboratory Institute of PediatricsGuangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina Clinical Physiology Laboratory Institute of PediatricsBeijingChina

Background:Previous studies from high altitudes have reported significantly higher prevalence of congenital heart disease(CHD),consisting almost solely of simple *** is known about the occurrence of complex *** with complex CHD are likely admitted to *** examined the prevalence and spectrum of complex CHD in NICU in order to depict a truer picture of CHD at high ***:We reviewed charts of 4,214 neonates admitted to NICU in Qinghai province(average altitude 3,000 m).Echocardiography was performed in 1,943 babies when CHD was suspected based on clinical ***:CHD was diagnosed in 1,093(56.3%of echoed babies).Mild CHD in 96.8%(1058 babies).Moderate CHD in 0.8%(9)included 1(0.1%)large secundum atrial septal defect,3(0.3%)moderate pulmonary stenosis,2(0.2%)aortic stenosis and 3(0.3%)partial anomalous pulmonary venous *** CHD in 2.4%(26)included 6(0.5%)complete atrioventricular septal defect,5(0.5%)complete transposition of the great arteries,5(0.5%)hypoplastic right heart,3(0.3%)hypoplastic left heart,3(0.3%)double outlet right ventricle,3(0.3%)tetralogy of Fallot,2(0.2%)truncus arteriosus,2(0.2%)total anomalous pulmonary venous connection,2(0.2%)severe aortic stenosis,2(0.2%)interrupted aortic arch and 2(0.2%)severe pulmonary stenosis and 1(0.1%)single-ventricle *** two-years follow-up in 737(67.4%)patients,18(90%)with severe CHD and 38(5.3%)with mild and moderate CHD died,and 15 underwent cardiac surgery with 1 early ***:At high altitude,a wide spectrum of CHD exists,with many heretofore unreported complex *** is urgent need for routine echocardiography and early interventions in newborns particularly in NICU.

关键词： Congenital heart disease neonatal intensive care unit high altitude

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Pantoea SPP: A New Nosocomial Infection in the neonatal intensive care unit

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Open Journal of Pediatrics 2023年第2期13卷 181-188页

作者： Soraya Hani Fatima Ezzahra Tahiri Abdessamad Lalaoui Fatiha Bennaoui Nabila Soraa Nadia El Idrissi Slitine Fadl Mrabih Rabou Maoulainine neonatal Resuscitation Service Mother and Child Hospital Mohamed VI University Hospital Marrakech Morocco Laboratory of Childhood Health and Development Faculty of Medicine and Pharmacy of Marrakech Cadi Ayyad University Marrakech Morocco Microbiology Laboratory Arrazi Hospital Mohammed VI University Hospital Marrakech Morocco

Pantoea SPP is a gram-negative bacillus, which usually colonizes plants, soil and water. This pathogen very rarely causes neonatal sepsis. The most common infections caused by Pantoea SPP are septic arthritis or synovitis, meningitis frequently complicated by brain abscess, upper respiratory infections, and peritonitis. We present the case of a premature infant who presented neonatal respiratory distress and whose evolution was complicated by the occurrence of a nosocomial infection for which a blood culture was performed isolating the germ Pantoea SPP. The patient’s management was initially centered on non-invasive ventilation with antibiotherapy based on carbapenem and aminoglycoside. Due to the clinical and biological worsening, the neonate was intubated and sedated and put on colymicin. The evolution was unfavorable marked by a death at 16th days of life. Considering the high pathogenicity of this germ and its multi-resistance to antibiotics, it is crucial to know the clinical spectrum of Panteoa SPP infections in neonatal intensive care units, in order to palliate the fulminant evolution of multifocal attacks due to this germ.

关键词： Newborn Premature Nosocomial Infection Pantoea SPP neonatal Resuscitation Antibiotic Therapy

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Successful elimination of extended-spectrum beta-lactamase (ESBL)-producing nosocomial bacteria at a neonatal intensive care unit

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World Journal of Pediatrics 2017年第3期13卷 210-216页

作者： Borbála Szél Zsolt Reiger Edit Urbán Andrea Lázár Krisztina Mader Ivelina Damjanova Kamilla Nagy Gyula Tálosi Infection Control unit University of SzegedHungary Department of Pediatrics University of SzegedHungary Institute of Clinical Microbiology University of SzegedHungary Department of Bacteriology National Center for EpidemiologyHungary

Background:Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are highly dangerous to *** our neonatal intensive care unit (NICU),the presence of these bacteria became so threatening in 2011 that immediate intervention was ***:This study was conducted during a nearly two-year period consisting of three phases:retrospective (9 months),educational (3 months) and prospective (9 months).Based on retrospective data analysis,a complex management plan was devised involving the introduction of the INSURE protocol,changes to the antibiotic regimen,microbiological screening at short intervals,progressive feeding,a safer bathing protocol,staff hand hygiene training and continuous monitoring of the number of newly infected and newly colonized *** these intervals,a total of 355 patients were ***:Both ESBL-producing Enterobacter cloaceae and Klebsiella pneumoniae were found (in both patients and environmental samples).In the prospective period a significant reduction could be seen in the average number of both colonized (26/167 patients;P=0.029) and infected (3/167 patients;P=0.033) patients compared to data from the retrospective period regarding colonized (72/188 patients) and infected (9/188 patients) *** was a decrease in the average number of patientdays (from 343.72 to 292.44 days per months),though this difference is not significant (P=0.058).During the prospective period,indirect hand hygiene compliance showed a significant increase (from the previous 26.02 to 33.6 hand hygiene procedures per patient per hospital day,P<0.001).Conclusion:Colonizations and infections were rolled back successfully in a multi-step effort that required an interdisciplinary approach.

关键词： hand hygiene INSURE protocol interdisciplinary approach neonates polyresistance

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