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https://www.readbyqxmd.com/read/28813753/pre-guideline-trends-associated-with-chest-radiograph-usage-for-pediatric-community-acquired-pneumonia-in-emergency-department-settings
#1
Eric W Jones, Benjamin Meyer, Aaron M Berg, Benson S Hsu
BACKGROUND: Health care spending in the U.S. totaled $3 trillion in 2014 and continues to increase rapidly. Minimizing waste through clinical guidelines is a promising strategy to reduce spending without compromising patient care. In 2011, clinical guidelines recommended against the use of chest X-ray (CXR) for diagnosis of community-acquired pneumonia (CAP) in pediatric ambulatory settings. However, use of CXR has not changed post-guideline. Thus, understanding the drivers of CXR utilization prior to guideline implementation could improve guideline adherence...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28780309/clinical-and-microbiological-characteristics-of-pantoea-agglomerans-infection-in-children
#2
Ayşe Büyükcam, Özlem Tuncer, Deniz Gür, Banu Sancak, Mehmet Ceyhan, Ali Bülent Cengiz, Ateş Kara
Pantoea agglomerans is an environmental Gram-negative bacterium that rarely is responsible for the infections in humans but it is often a causative factor of a number of occupational diseases. This study evaluated the clinical and microbiological characteristics and pathogenicity of P. agglomerans in children. We retrospectively reviewed microbiological test results for all children (1 month old to 18 years old) who were admitted to our pediatric hospital between January 2000 to June 2015 and had positive clinical specimen cultures for P...
August 2, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28771405/pediatric-readmissions-after-hospitalizations-for-lower-respiratory-infections
#3
Mari M Nakamura, Alan M Zaslavsky, Sara L Toomey, Carter R Petty, Maria C Bryant, Alexandra T Geanacopoulos, Ashish K Jha, Mark A Schuster
BACKGROUND AND OBJECTIVE: Lower respiratory infections (LRIs) are among the most common reasons for pediatric hospitalization and among the diagnoses with the highest number of readmissions. Characterizing LRI readmissions would help guide efforts to prevent them. We assessed variation in pediatric LRI readmission rates, risk factors for readmission, and readmission diagnoses. METHODS: We analyzed 2008-2009 Medicaid Analytic eXtract data for patients <18 years of age in 26 states...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28756639/diagnosis-and-treatment-of-community-acquired-pneumonia-in-adults-2016-clinical-practice-guidelines-by-the-chinese-thoracic-society-chinese-medical-association
#4
REVIEW
Bin Cao, Yi Huang, Dan-Yang She, Qi-Jian Cheng, Fan Hong, Xin-Lun Tian, Jin-Fu Xu, Jing Zhang, Yu Chen, Ning Shen, Hui Wang, Mei Jiang, Xiang-Yan Zhang, Yi Shi, Bei He, Li-Xian He, You-Ning Liu, Jie-Ming Qu
Community-acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence...
July 29, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28745850/noninvasive-ventilation-for-patients-in-acute-respiratory-distress-an-update-digest
#5
Nikita Joshi, Molly K Estes, Kayla Shipley, Hyun-Chul Danny Lee, Milana Zaurova
Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema...
February 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28711128/care-of-respiratory-conditions-in-an-observation-unit
#6
REVIEW
Margarita E Pena, Viviane M Kazan, Michael N Helmreich, Sharon E Mace
In adults, respiratory disorders are the second most frequent diagnoses treated in emergency department observation units (EDOUs) and account for the most frequent indication for placement of pediatric patients into an EDOU. With appropriate patient selection, chronic obstructive pulmonary disease exacerbations, and community-acquired pneumonia can be managed in the EDOU. EDOU management results in equivalent or better outcomes than inpatient care with decreased length of stay, increased patient satisfaction, lower cost and in some studies decreased mortality...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28648309/economic-burden-of-community-acquired-pneumonia-among-pediatric-patients-aged-3-months-to-19-years-in-the-philippines
#7
Bernadette A Tumanan-Mendoza, Victor L Mendoza, Melchor Victor G Frias, Dolores D Bonzon
OBJECTIVE: 1) To determine the hospitalization, follow-up and total costs, and the economic burden of community-acquired pneumonia among pediatric patients aged 3 months to <19 years of age; 2) To compare the estimated cost of hospitalization to the pneumonia case rate payments of the Philippine Health Insurance Corporation (PhilHealth). METHODS: Using the societal perspective, both healthcare and non-healthcare costs were estimated. This was done through two tertiary private hospitals in the Philippines...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28583371/bacterial-infections-after-pediatric-heart-transplantation-epidemiology-risk-factors-and-outcomes
#8
Christina A Rostad, Karla Wehrheim, James K Kirklin, David Naftel, Elizabeth Pruitt, Timothy M Hoffman, Thomas L'Ecuyer, Katie Berkowitz, William T Mahle, Janet N Scheel
BACKGROUND: Bacterial infections represent a major cause of morbidity and mortality in heart transplant recipients. However, data describing the epidemiology and outcomes of these infections in children are limited. METHODS: We analyzed the Pediatric Heart Transplant Study database of patients transplanted between 1993 and 2014 to determine the etiologies, risk factors and outcomes of children with bacterial infections post-heart transplantation. RESULTS: Of 4,458 primary transplants in the database, there were 4,815 infections that required hospitalization or intravenous therapy, 2,047 (42...
May 11, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28562556/low-utility-of-blood-culture-in-pediatric-community-acquired-pneumonia-an-observational-study-on-2705-patients-admitted-to-the-emergency-department
#9
Jae Hyun Kwon, Jung Heon Kim, Jeong-Yong Lee, Youn-Jung Kim, Chang Hwan Sohn, Kyoung Soo Lim, Won Young Kim
To investigate the utility of blood cultures performed on previously healthy children and adolescents with community-acquired pneumonia (CAP) at a tertiary care hospital emergency department (ED).We reviewed 3235 patients with CAP aged 6 months to 18 years who underwent blood cultures at the ED from 2009 through 2016. CAP was defined according to the International Classification of Diseases, 10th Revision codes for pneumonia and the requirement of antibiotic treatment plus any of the following: radiologically confirmed, hospitalized, or moderate to severe disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28506958/enhancing-comparative-effectiveness-research-with-automated-pediatric-pneumonia-detection-in-a-multi-institutional-clinical-repository-a-phis-pilot-study
#10
Stephane Meystre, Ramkiran Gouripeddi, Joel Tieder, Jeffrey Simmons, Rajendu Srivastava, Samir Shah
BACKGROUND: Community-acquired pneumonia is a leading cause of pediatric morbidity. Administrative data are often used to conduct comparative effectiveness research (CER) with sufficient sample sizes to enhance detection of important outcomes. However, such studies are prone to misclassification errors because of the variable accuracy of discharge diagnosis codes. OBJECTIVE: The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports...
May 15, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28463942/diagnostic-practices-for-suspected-community-acquired-central-nervous-system-infection-in-the-post-conjugate-vaccine-era
#11
Natalie Banniettis, Saumya Joshi, Shubhi Kaushik, Stephan Kohlhoff, Margaret R Hammerschlag
OBJECTIVE: The aim of this study was to evaluate diagnostic practices for suspected community-acquired central nervous system (CNS) infection in an urban pediatric population. METHODS: This is an observational, retrospective single-center review of cerebrospinal fluid (CSF) studies in children, 1 month to 21 years old, evaluated for suspected CNS infection from 2004 to 2014. Cases of suspected nosocomial meningitis were excluded. The frequency of N-methyl-D-aspartate receptor antibody (NMDAR ab) encephalitis was analyzed from 2010 to 2014...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28403050/ceftaroline-activity-tested-against-bacterial-isolates-causing-community-acquired-respiratory-tract-infections-and-skin-and-skin-structure-infections-in-pediatric-patients-from-united-states-hospitals-2012-2014
#12
MULTICENTER STUDY
Michael A Pfaller, Rodrigo E Mendes, Mariana Castanheira, Robert K Flamm, Ronald N Jones, Helio S Sader
Ceftaroline fosamil has recently received US Food and Drug Administration approval for treatment of acute bacterial skin/skin structure infections (SSSIs), including those caused by methicillin-resistant Staphylococcus aureus and community-acquired bacterial pneumonia for pediatric patients ≥2 months old. We evaluated the potency and spectrum of ceftaroline and comparators when tested against community-acquired respiratory tract infection (CARTI) and SSSI pathogens from pediatric patients. A total of 3141 consecutive, unique pediatric patient isolates of clinical significance (1460 CARTI and 1681 SSSI isolates) were collected from 29 US medical centers and tested for susceptibility to ceftaroline and comparators by broth microdilution methods...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28397171/pediatric-antibiotic-stewardship-successful-interventions-to-reduce-broad-spectrum-antibiotic-use-on-general-pediatric-wards
#13
Katharina Kreitmeyr, Ulrich von Both, Alenka Pecar, Johannes P Borde, Rafael Mikolajczyk, Johannes Huebner
PURPOSE: Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. METHODS: We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy...
August 2017: Infection
https://www.readbyqxmd.com/read/28368491/viral-pathogen-detection-by-metagenomics-and-pan-viral-group-polymerase-chain-reaction-in-children-with-pneumonia-lacking-identifiable-etiology
#14
Robert Schlaberg, Krista Queen, Keith Simmon, Keith Tardif, Chris Stockmann, Steven Flygare, Brett Kennedy, Karl Voelkerding, Anna Bramley, Jing Zhang, Karen Eilbeck, Mark Yandell, Seema Jain, Andrew T Pavia, Suxiang Tong, Krow Ampofo
Background.: Community-acquired pneumonia (CAP) is a leading cause of pediatric hospitalization. Pathogen identification fails in approximately 20% of children but is critical for optimal treatment and prevention of hospital-acquired infections. We used two broad-spectrum detection strategies to identify pathogens in test-negative children with CAP and asymptomatic controls. Methods.: Nasopharyngeal/oropharyngeal (NP/OP) swabs from 70 children <5 years with CAP of unknown etiology and 90 asymptomatic controls were tested by next-generation sequencing (RNA-seq) and pan viral group (PVG) PCR for 19 viral families...
May 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28335406/factors-that-negatively-affect-the-prognosis-of-pediatric-community-acquired-pneumonia-in-district-hospital-in-tanzania
#15
Serena Caggiano, Nicola Ullmann, Elisa De Vitis, Marzia Trivelli, Chiara Mariani, Maria Podagrosi, Fabiana Ursitti, Chiara Bertolaso, Carolina Putotto, Marta Unolt, Andrea Pietravalle, Paola Pansa, Kajoro Mphayokulela, Maria Incoronata Lemmo, Michael Mkwambe, Joseph Kazaura, Marzia Duse, Francesco Nieddu, Chiara Azzari, Renato Cutrera
Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died...
March 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28277413/community-primary-care-provider-preferences-for-emergency-department-follow-up-recommendations-a-regional-study
#16
Marissa A Hendrickson, Eta Obeya, Andrew R Wey, Philippe R Gaillard
BACKGROUND: Children who present to emergency departments (EDs) for care are frequently advised to follow up with their primary care providers (PCPs) after discharge; little is known about whether PCPs agree that follow-up advised by EDs is appropriate for their patients. OBJECTIVES: The aims of this study were to determine PCP preferences for follow-up recommendations given to their pediatric patients at the time of ED visits and to compare these preferences to reported emergency medicine provider (EMP) practice...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28270546/variability-in-antibiotic-prescribing-for-community-acquired-pneumonia
#17
Lori K Handy, Matthew Bryan, Jeffrey S Gerber, Theoklis Zaoutis, Kristen A Feemster
BACKGROUND AND OBJECTIVES: Published guidelines recommend amoxicillin for most children with community-acquired pneumonia (CAP), yet macrolides and broad-spectrum antibiotics are more commonly prescribed. We aimed to determine the patient and clinician characteristics associated with the prescription of amoxicillin versus macrolide or broad-spectrum antibiotics for CAP. METHODS: Retrospective cohort study in an outpatient pediatric primary care network from July 1, 2009 to June 30, 2013...
April 2017: Pediatrics
https://www.readbyqxmd.com/read/28238680/pediatric-community-acquired-pneumonia-treated-with-a-three-day-course-of-tebipenem-pivoxil
#18
Hiroshi Sakata, Haruo Kuroki, Kazunobu Ouchi, Takeshi Tajima, Satoshi Iwata
We evaluated the efficacy and safety of a 3-day treatment regimen of tebipenem pivoxil for pediatric community-acquired pneumonia. Tebipenem pivoxil was administered to 49 patients, and its effectiveness was evaluated in 36 patients 2-4 days after initiation of treatment. Thirty-two patients were cured 7-15 days after initiation of treatment. Body temperature was significantly lower on the day following initial administration (median 38.8 to 37.0 °C, n = 33). Leukocyte counts and C-reactive protein levels were significantly reduced by Day 2-4 of treatment (median 16,100 to 7800 white blood cells/μL, and 5...
May 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#19
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
July 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28159006/the-potential-influence-of-human-parainfluenza-viruses-detected-during-hospitalization-among-critically-ill-patients-in-kuwait-2013-2015
#20
Sahar Essa, Haya Al-Tawalah, Sarah AlShamali, Widad Al-Nakib
BACKGROUND: The four types of human parainfluenza viruses (PIV) are important causes of community-acquired pneumonia, particularly in children; however, limited information exists about the incidence of PIV in critically ill patients. The aim of this study is to describe the spectrum, incidence and clinical features of PIV-associated infections diagnosed during the hospital stay of patients admitted to pediatric intensive care unit (PICU) and intensive care unit (ICU) of 5 medical centers across Kuwait...
February 3, 2017: Virology Journal
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