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paediatric sepsis

Mona Noureldein, Roxana Mardare, Jack Pickard, Hoi Lun Shing, Michael Eisenhut
BACKGROUND: It has been estimated that paediatric meningitis without elevated CSF white cell count (pleocytosis) accounts for 0.5-12% of all cases of bacterial meningitis. CSF protein and glucose measurements are therefore essential in management but may be neglected in clinical practice. In order to improve recognition of bacterial meningitis in neonates and to enable adequate management and audit, we investigated whether a systemic inflammatory response in the absence of meningitis is associated with elevated CSF protein and reduced CSF glucose levels...
March 14, 2018: Fluids and Barriers of the CNS
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
Carolin Fleischmann-Struzek, David M Goldfarb, Peter Schlattmann, Luregn J Schlapbach, Konrad Reinhart, Niranjan Kissoon
The incidence of sepsis is highest in neonates and children, yet the global burden of sepsis in these age groups has not been assessed. We reviewed available evidence from observational epidemiological studies to estimate the global burden and mortality of sepsis in neonates and children. We did a systematic review and meta-analysis of studies reporting population-based sepsis incidence in neonates and children, published between 1979 and 2016. Our search yielded 1270 studies, 23 of which met the inclusion criteria; 16 were from high-income countries and seven from middle-income countries...
March 2018: Lancet Respiratory Medicine
Santiago Mintegi, Borja Gomez, Alba Carro, Haydee Diaz, Javier Benito
OBJECTIVE: To determine the prevalence of invasive bacterial infections (IBI, pathogenic bacteria in blood or cerebrospinal fluid) in infants less than 90 days old with fever without a source related to the presence or absence of fever on arrival to the emergency department (ED). DESIGN: Prospective registry-based cohort study. SETTING: Paediatric ED of a tertiary teaching hospital. PATIENTS: We included infants less than 90 days old with a history of fever evaluated in the ED from 2003 to 2016...
February 15, 2018: Archives of Disease in Childhood
Andreia Ribeiro, Diana Moreira, Cristina Costa, Isabel Pinto Pais
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity triggered by food proteins. It may present acutely, with repetitive vomiting, diarrhoea and lethargy leading to dehydration and eventually shock or insidiously with intermittent emesis, chronic diarrhoea or failure to thrive. We describe a paediatric male patient with recurrent sepsis-like episodes of fever, lethargy, ashen-grey skin colouration and vomiting followed by diarrhoea. These episodes were triggered by cow's milk formula and grains...
February 8, 2018: BMJ Case Reports
Roshan Ramasamy, Louise Willis, Seilesh Kadambari, Dominic F Kelly, Paul T Heath, Simon Nadel, Andrew J Pollard, Manish Sadarangani
OBJECTIVE: To quantify delays during management of children with suspected meningitis. DESIGN: Multicentre prospective cohort study. SETTING: Three UK tertiary paediatric centres; June 2011-June 2012 PATIENTS: 388 children aged <16 years hospitalised with suspected meningitis or undergoing lumbar puncture (LP) during sepsis evaluation. MAIN OUTCOME MEASURES: Time of prehospital and in-hospital assessments, LP, antibiotic treatment and discharge; types of prehospital medical assessment and microbiological results...
February 7, 2018: Archives of Disease in Childhood
Peter Alarcon Manchego, Michael Cheung, Diana Zanino, Russell Nunn, Yves D'Udekem, Christian Brizard
OBJECTIVE: The burden of disease associated with cardiac surgery in preterm and low birth weight infants is increasing. This retrospective study aimed to compare the mortality and morbidity of cardiac surgery in low birth weight and preterm infants with that of a case-matched normal population. METHODS: This was a single-centre audit of cardiac surgery interventions at a tertiary paediatric centre in Melbourne, Australia. Subjects underwent intervention in the first three months of life and were preterm (< 37 weeks gestation) and/or <2,500 grams at birth...
February 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Chia-Hung Yo, Tzu-Chun Hsu, Meng-Tse Gabriel Lee, Lorenzo Porta, Po-Yang Tsou, Yu-Hsun Wang, Wan-Chien Lee, Szu-Ta Chen, Chien-Chang Lee
AIM: The aim of this study was to investigate the trend of incidence and outcome of paediatric sepsis in a population-based database. METHODS: Children with sepsis were identified from the 23 million nationwide health insurance claims database of Taiwan. Sepsis was defined by the presence of single ICD-9 code for severe sepsis or septic shock or a combination of ICD-9 codes for infection and organ dysfunction. We analysed the trend of incidence, mortality and source of infection in three age groups: infant (28 days to 1 year), child (1-9 years) and adolescent (10-18 years)...
February 9, 2018: Journal of Paediatrics and Child Health
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
Girish Deshpande, Gayatri Jape, Shripada Rao, Sanjay Patole
OBJECTIVE: Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates...
December 7, 2017: BMJ Open
M Guadalupe Perez, Soledad Martiren, Florencia Escarra, Vanesa Reijtman, Alejandra Mastroianni, Ana Varela-Baino, Carola Cedillo, M Eva Garcia, Moira Taicz, Rosa Bologna
INTRODUCTION: Community-acquired Staphylococcus aureus (SA) bacteraemia is a common cause of hospitalisation in children. The occurrence of secondary foci (SF) of SA infection is associated with higher morbidity and mortality. OBJECTIVES: To identify risk factors for SF of infection in children with community-acquired SA bacteraemia. MATERIAL AND METHODS: Prospective cohort. All children aged from 30 days to 16 years admitted to a paediatric referral hospital between January 2010 and December 2016 for community-acquired infections, with SA isolated in blood cultures, were included...
December 4, 2017: Enfermedades Infecciosas y Microbiología Clínica
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
Maria José Santiago-Lozano, Marta Lucía Barquín-Conde, Lucía Fuentes-Moreno, Roberto Manuel León-Vela, Lucas Madrid-Vázquez, Amelia Sánchez-Galindo, Jesús López-Herce Cid
INTRODUCTION: The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. METHODS: A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. RESULTS: One hundred patients with a median age of 11 months were analysed...
December 1, 2017: Enfermedades Infecciosas y Microbiología Clínica
Bing-Shao Liang, Yan-Mei Huang, Yin-Shuang Chen, Hui Dong, Jia-Liang Mai, Yong-Qiang Xie, Hua-Min Zhong, Qiu-Lian Deng, Yan Long, Yi-Yu Yang, Si-Tang Gong, Zhen-Wen Zhou
Staphylococcus aureus ( S. aureus ) is one of the most frequently isolated pathogens in neonatal cases of early and late-onset sepsis. Drug resistance profiles and carriage of toxin genes may affect the treatment and outcome of an infection. The present study aimed to determine the antimicrobial resistance patterns and frequencies of the toxin-associated genes conserved virulence factor B (CvfB), staphylococcal enterotoxin Q (SEQ) and staphylococcal enterotoxin K (SEK) among S. aureus isolates recovered from paediatric patients with bloodstream infections (BSIs) in Guangzhou (China)...
November 2017: Experimental and Therapeutic Medicine
Georgina Corbet Burcher, Maria D Picouto, Lorraine C Als, Mehrengise Cooper, Christine M Pierce, Simon Nadel, M Elena Garralda
AIM: To examine the association between corticosteroid use in paediatric intensive care units (PICU) and subsequent symptoms of post-traumatic stress disorder (PTSD). METHODS: The subjects were children aged 8-16 years admitted to PICU with sepsis, meningoencephalitis (ME) and other disorders. Illness information was extracted from case notes; 3-6 months post discharge children completed a PTSD symptom questionnaire (eight-item Impact of Events Scale (IES-8)) assessing intrusion and avoidance symptoms...
November 25, 2017: Archives of Disease in Childhood
Per-Arne Lönnqvist
I would like to reply to the issues raised by the letter from Dr Barrington (1) on my Different View article on disability-free survival and number needed to suffer (2). However, first of all I would like to provide some important background on my interest in this area.First, I worked in NICU care for more than 10 years before focusing on paediatric anaesthesia and I am the proud father of premature triplets born at 31+4 weeks. As such, I have also been a parent who has witnessed NICU care three times for three months, including surfactant replacement, mechanical ventilation, surgical ductus ligation, sepsis and necrotising entercolitis treated by nil-by-mouth, total parenteral nutrition and antibiotics...
November 23, 2017: Acta Paediatrica
Kine Nordheim, Ingunn Holmefoss Hovland, Bjørn Erik Kristiansen, Per Ivar Kaaresen, Trond Flaegstad
AIM: We examined children hospitalised for invasive meningococcal disease, a leading cause of paediatric sepsis, in Troms County, North Norway, from 1973 to 2016, including the epidemic in the 1970s and 1980s. METHODS: This study was a retrospective review of children under the age of 15 years who were hospitalised for meningococcal disease at the University Hospital of North Norway and Harstad Hospital. We studied hospital and bacteriological records to determine the incidence rates and phenotypes involved...
October 28, 2017: Acta Paediatrica
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
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