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https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#1
Dipanwita Saha, Jimisha Patel, Don Buckingham, David Thornton, Terry Barber, Joshua R Watson
BACKGROUND AND OBJECTIVES: Empiric antibiotic therapy for presumed urinary tract infection (UTI) leads to unnecessary antibiotic exposure in many children whose urine culture results fail to confirm the diagnosis. The objective of this quality improvement study was to improve follow-up management of negative urine culture results in the off-campus urgent care network of Nationwide Children's Hospital to reduce inappropriate antibiotic exposure in children. METHODS: A multidisciplinary task force developed and implemented a protocol for routine nurse and clinician follow-up of urine culture results, discontinuation of unnecessary antibiotics, and documentation in the electronic medical record...
March 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28298206/burden-and-spectrum-of-bacterial-infections-among-sickle-cell-disease-children-living-in-cameroon
#2
Anastasie Nicole Alima Yanda, Jobert Richie N Nansseu, Hubert Désiré Mbassi Awa, Sandra A Tatah, Judith Seungue, Charlotte Eposse, Paul Olivier N Koki
BACKGROUND: Although sickle cell disease (SCD) children are highly susceptible to bacterial infections (BIs), there is a dreadful lack of data related to the burden and spectrum of BIs in sub-Saharan Africa (SSA), the highest affected region with SCD. This study aimed to determine the burden and spectrum of BIs among SCD children hospitalized in a pediatric reference hospital in Cameroon, a SSA country. METHODS: We conducted a retrospective analysis of records of children hospitalized from November 2012 to August 2015 in the SCD unit of the Mother and Child Centre of the Chantal Biya Foundation, Cameroon...
March 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28284733/utility-of-a-routine-urinalysis-in-children-who-require-clean-intermittent-catheterization
#3
C S Forster, D B Haslam, E Jackson, S L Goldstein
BACKGROUND: Children who require clean intermittent catheterization (CIC) frequently have positive urine cultures. However, diagnosing a urinary tract infection (UTI) can be difficult, as there are no standardized criteria. Routine urinalysis (UA) has good predictive accuracy for UTI in the general pediatric population, but data are limited on the utility of routine UA in the population of children who require CIC. OBJECTIVE: To determine the utility of UA parameters (e...
February 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28277411/testing-for-urinary-tract-infection-in-the-influenza-respiratory-syncytial-virus-positive-febrile-infant-aged-2-to-12-months
#4
Anna Kathleen Schlechter Salinas, David S Hains, Tamekia Jones, Camden Harrell, Mark Meredith
OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28265323/bladder-and-bowel-dysfunction-in-children-an-update-on-the-diagnosis-and-treatment-of-a-common-but-underdiagnosed-pediatric-problem
#5
REVIEW
Joana Dos Santos, Roberto I Lopes, Martin A Koyle
Bladder and bowel dysfunction (BBD) describes a spectrum of lower urinary symptoms (LUTS) accompanied by fecal elimination issues that manifest primarily by constipation and/or encopresis. This increasingly common entity is a potential cause of significant physical and psychosocial burden for children and families. BBD is commonly associated with vesicoureteral reflux (VUR) and recurrent urinary tract infections (UTIs), which at its extreme may lead to renal scarring and kidney failure. Additionally, BBD is frequently seen in children diagnosed with behavioural and neuropsychiatric disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD)...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28265307/antibiotic-prophylaxis-for-prevention-of-urinary-tract-infections-in-prenatal-hydronephrosis-an-updated-systematic-review
#6
REVIEW
Bethany Easterbrook, John-Paul Capolicchio, Luis H Braga
INTRODUCTION: While continuous antibiotic prophylaxis (CAP) is currently recommended to prevent urinary tract infections (UTIs) in infants with prenatal hydronephrosis (HN), this recommendation is not evidence-based. The objective of this study was to systematically determine whether CAP reduces UTIs in the HN population. METHODS: Applicable trials were identified through an electronic search of MEDLINE (1946-2015), EMBASE (1980-2016), CINAHL (1982-2016), and CENTRAL (1993-2016) and through a hand search of American Urological Association (AUA) (2012-2015) and European Society for Pediatric Urology (ESPU) (2012-2015) abstracts, as well as reference lists of included trials...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28260444/pediatric-kidney-transplant-experience-at-an-algerian-nephrology-department
#7
Ali Benziane, Saliha Boutennoune
OBJECTIVES: To evaluate the outcomes, complications, causes of graft loss, and patient and graft survival in pediatric renal transplant. MATERIALS AND METHODS: We conducted a retrospective study using the records of 32 children who had a renal transplant between February 2007 and October 2014. RESULTS: All donations were intrafamily, and all patients had a living donor: the patient's mother in 56.3%, the father in 40.6%, and a brother in 3...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28224100/early-infant-male-circumcision-systematic-review-risk-benefit-analysis-and-progress-in-policy
#8
Brian J Morris, Sean E Kennedy, Alex D Wodak, Adrian Mindel, David Golovsky, Leslie Schrieber, Eugenie R Lumbers, David J Handelsman, John B Ziegler
AIM: To determine whether recent evidence-based United States policies on male circumcision (MC) apply to comparable Anglophone countries, Australia and New Zealand. METHODS: Articles in 2005 through 2015 were retrieved from PubMed using the keyword "circumcision" together with 36 relevant subtopics. A further PubMed search was performed for articles published in 2016. Searches of the EMBASE and Cochrane databases did not yield additional citable articles. Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28224087/fragmentation-of-severely-encrusted-ureteral-stent-indwelled-for-4%C3%A2-years-in-a-boy
#9
Guangjing Tao, Guojun Wu, Lijun Yang, Fuli Wang, Chao Han, Fei Liu, Jianlin Yuan
Four years ago, a 9-year-old boy received percutaneous nephrolithotomy (PCNL) and a 5F DJS was placed thereafter. The DJS was neglected until it caused serious complications including encrustation involving the whole stent, a 5-cm-diameter vesical stone, fragmentation of DJS, and serious urinary tract infection. For this rare and complex case of pediatric lithotomy, we combined PCNL with the suprapubic cystolithotomy for complete removal of the encrusted stent and associated stones without any complications and the patient was rendered stone- and stent-free safely...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28203336/a-5-fr-externalized-nephroureteral-catheter-as-the-sole-protective-device-for-pediatric-pyeloplasty-the-experiences-of-142-patients
#10
Mansour Mollaeian, Maryam Ghavami-Adel, Farid Eskandari, Arash Mollaeian
BACKGROUND: Pyeloplasty for ureteropelvic junction obstruction correction is a common procedure, but the optimal method for protective diversion after pyeloplasty is still a matter of debate. OBJECTIVES: Here, we present our clinical trial experience using a single percutaneous externalized nephroureteral (NU) 5-Fr catheter (infant feeding tube) with multiple side holes as the sole instrument of drainage to provide a protective mechanism. MATERIALS AND METHODS: In this prospective study, we analyzed the charts of 142 patients who underwent pyeloplasty from August 2001 through October 2008...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28185802/infection-in-burn-patients-in-a-referral-center-in-colombia
#11
Carlos Enrique Ramirez-Blanco, Carlos Enrique Ramirez-Rivero, Luis Alfonso Diaz-Martinez, Luis Miguel Sosa-Avila
INTRODUCTION: Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. OBJECTIVES: To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS)...
February 6, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28169050/the-importance-of-urine-concentration-on-the-diagnostic-performance-of-the-urinalysis-for-pediatric-urinary-tract-infection
#12
Pradip P Chaudhari, Michael C Monuteaux, Pinkey Shah, Richard G Bachur
STUDY OBJECTIVE: The presence of leukocyte esterase by urine dipstick and microscopic pyuria are both indicators of possible urinary tract infection. The effect of urine concentration on the diagnostic performance of the urinalysis for pediatric urinary tract infection has not been studied. Our objective is to determine whether the urinalysis performance for detecting urinary tract infection varies by urine concentration as measured by specific gravity. METHODS: This was a retrospective cross-sectional study of the urine laboratory results of children younger than 13 years who presented to the emergency department during 68 months and had a paired urinalysis and urine culture obtained...
February 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28131557/-profile-of-bacterial-resistance-in-pediatric-urinary-tract-infections-in-2014
#13
A Flammang, R Morello, M Vergnaud, J Brouard, P Eckart
In pediatric units, bacteria-producing extended-spectrum-betalactamase (ESBL) have an increasing prevalence among bacteria causing febrile urinary tract infections (UTIs). The purpose of this study was to evaluate the epidemiology of bacteria resistance patterns observed in UTIs, in order to assess the current antibiotic treatment protocols. This study is based upon a single-center retrospective chart review of the cytobacteriological urine cultures performed in UTIs between 1 January and 31 December 2014, in the medical pediatric unit of the Caen University Hospital...
January 25, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28126219/imaging-of-the-pediatric-urinary-system
#14
REVIEW
Ellen M Chung, Karl A Soderlund, Kimberly E Fagen
Recent advances in pediatric urinary tract imaging include development of alternative imaging methods without use of ionizing radiation; evolving understanding of the relationship of urinary tract infection, vesicoureteral reflux, and renal scarring, including the important role of dysfunctional voiding; development of a consensus nomenclature and risk-based classification for fetal and antenatal urinary tract dilation; advances in the understanding of sporadic and inherited renal cystic disease; and a proposed modification of the Bosniak criteria for distinguishing complex renal cysts from cystic renal tumors in children...
March 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28096977/high-rates-of-multidrug-resistance-among-uropathogenic-escherichia-coli-in-children-and-analyses-of-esbl-producers-from-nepal
#15
Narayan Prasad Parajuli, Pooja Maharjan, Hridaya Parajuli, Govardhan Joshi, Deliya Paudel, Sujan Sayami, Puspa Raj Khanal
BACKGROUND: Emergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28087926/urinary-tract-infections-in-infants-and-children
#16
Theresa A Schlager
Urinary tract infections (UTI) are one of the most common infections in children and symptoms may be nonspecific. The risk of renal scarring is highest in children under 1 year of age with febrile UTI and high-grade vesicoureteral reflux (VUR). Although treatment of UTI is usually straightforward, given increased rates of antimicrobial resistance worldwide, the choice of treatment for pediatric UTI should be guided by community resistance patterns whenever feasible. The benefit of antimicrobial prophylaxis after first UTI and/or in the presence of VUR remains controversial, but a recent meta-analysis supports continuous antimicrobial prophylaxis in children with VUR, indicating a need for more research in this area...
October 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/28051222/contribution-of-ultrasound-scans-in-the-first-episode-of-urinary-tract-infection-in-children
#17
Manel Jellouli, Asma Ben Mansour, Kamel Abidi, Meriem Ferjani, Ouns Naija, Yousra Hammi, Chokri Zarrouk, Tahar Gargah
Background - Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (US) and voiding cystourethrography (VCUG). We propose to determine whether abnormalities found on US can help indicate the necessity of VCUG in children after the first urinary tract infection. Methods - A retrospective study included all children admitted with their first episode of urinary tract infection from January 2007 to December 2012...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27994915/intravenous-colistin-use-for-multidrug-resistant-gram-negative-infections-in-pediatric-patients
#18
Ayşe Karaaslan, Eren Çağan, Eda Kepenekli Kadayifci, Serkan Atıcı, Gülşen Akkoç, Nurhayat Yakut, Sevliya Öcal Demir, Ahmet Soysal, Mustafa Bakır
BACKGROUND: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce. AIMS: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients. STUDY DESIGN: This study has a retrospective study design. METHODS: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27974897/process-mapping-in-a-pediatric-emergency-department-to-minimize-missed-urinary-tract-infections
#19
Morgan Black, Valene Singh, Vladimir Belostotsky, Madan Roy, Deborah Yamamura, Kathryn Gambarotto, Keith Lau, April J Kam
Urinary tract infections (UTIs) are common in young children and are seen in emergency departments (EDs) frequently. Left untreated, UTIs can lead to more severe conditions. Our goal was to undertake a quality improvement (QI) initiative to help minimize the number of children with missed UTIs in a newly established tertiary care pediatric emergency department (PED). A retrospective chart review was undertaken to identify missed UTIs in children < 3 years old who presented to a children's hospital's ED with positive urine cultures...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27974258/parental-preference-assessment-for-vesicoureteral-reflux-management-in-children
#20
Geraldine N Tran, Anand V Bodapati, Jonathan C Routh, Christopher S Saigal, Hillary L Copp
PURPOSE: Parents of children with vesicoureteral reflux are presented with a variety of management options, which in many cases offer a similar risk-benefit ratio. To facilitate shared decision making, parental preferences regarding vesicoureteral reflux treatment options need to be acknowledged. We aimed to characterize the clinical experience of parents and elicit core themes affecting decision making in regard to managing vesicoureteral reflux in their child. MATERIALS AND METHODS: A semistructured, qualitative interview script was developed and vetted by 25 pediatric urologists to discuss treatment options for vesicoureteral reflux...
March 2017: Journal of Urology
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