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Community-acquired pneumonia in paediatric

Anil Gautam, Gregory G Wiseman, Marika L Goodman, Simon Ahmedpour, Daniel Lindsay, Adele Heyer, Harry Stalewski, Robert E Norton, Andrew V White
AIM: The Townsville Hospital and Health Service is the regional referral centre for children in the north of Queensland. Aboriginal and Torres Strait Islander (ATSI) people make up 7-10% of the population. Increasing numbers of children with paediatric thoracic empyema (pTE) are being referred to Townsville Hospital and Health Service for management. This study aims to describe the incidence rates, epidemiology, microbiology and trends of this disease in North Queensland over a 10-year period...
February 14, 2018: Journal of Paediatrics and Child Health
H Crichton, N O'Connell, H Rabie, A C Whitelaw, A Dramowski
BACKGROUND: The epidemiology of neonatal and paediatric community-acquired and healthcare-associated bloodstream infections (BSI) at South African (SA) district hospitals is under-researched. OBJECTIVE: Retrospective review of neonatal and paediatric BSI (0 - 13 years) at Khayelitsha District Hospital, Cape Town, SA, over 3 years (1 March 2012 - 28 February 2015). METHODS: We used laboratory, hospital, patient and prescription data to determine BSI rates, blood culture yield and contamination rates, pathogen profile, antimicrobial resistance, patient demographics, BSI outcome and antibiotic prescribing practice...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Jeffrey Pernica, Stuart Harman, April Kam, Jacob Bailey, Redjana Carciumaru, Sarah Khan, Martha Fulford, Lehana Thabane, Robert Slinger, Cheryl Main, Marek Smieja, Mark Loeb
BACKGROUND: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients. Minimizing exposure to antimicrobials is desirable to avoid harms including diarrhoea, rashes, severe allergic reactions, increased circulating antimicrobial resistance, and microbiome disruption...
February 1, 2018: Trials
Nicola Principi, Andrea Esposito, Caterina Giannitto, Susanna Esposito
BACKGROUND: Early diagnosis of community-acquired pneumonia (CAP) is essential to reduce the total burden of this disease. Traditionally, chest radiography (CR) is used to identify true CAP. However, CR is not a perfect diagnostic test for CAP. The use of lung ultrasonography (LUS) has been suggested as an alternative to overcome the problems associated with CR and increase the feasibility and accuracy of CAP diagnosis. LUS has largely been used for the diagnosis of several lung problems, including CAP, in adult patients with satisfactory results...
December 19, 2017: BMC Pulmonary Medicine
C M C Rodrigues, H Groves
Community-acquired pneumonia (CAP) is the leading cause of mortality in children under five years of age, globally. To improve the management of CAP, we must distinguish CAP from other common paediatric conditions and develop better diagnostic methods to detect the causative organism, so to best direct appropriate resources in both industrialised and developing countries. Here, we review the diagnostic modalities available for identifying viruses and bacteria in the upper and lower respiratory tract of children, with a discussion of their utility and limitations in diagnosing CAP in children...
December 13, 2017: Journal of Clinical Microbiology
Lekha Saha, Sharonjeet Kaur, Pratibha Khosla, Sweta Kumari, Alka Rani
AIMS AND OBJECTIVES: The cost of antibiotic therapy for the treatment of pneumonia in the inpatient paediatric population can have a major impact on the healthcare expenditure. We planned to assess the direct and indirect costs of diagnosis and medical treatment of paediatric patients with community acquired pneumonia who are hospitalized in a tertiary care hospital in India. METHODS: 125 children with a diagnosis of pneumonia who were admitted to the inpatient department of a paediatric hospital receiving antibiotic treatment were observed...
December 11, 2017: Medical Sciences: Open Access Journal
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
Harsha Lochan, Vashini Pillay, Colleen Bamford, James Nuttall, Brian Eley
BACKGROUND: Bloodstream infection (BSI) in children causes significant morbidity and mortality. There are few studies describing the epidemiology of BSI in South African children. METHODS: A retrospective descriptive cohort study was conducted at a paediatric referral hospital in Cape Town, South Africa. The National Health Laboratory Service (NHLS) microbiology database was accessed to identify positive blood culture specimens during the period 2011-2012. Demographic and clinical details, antimicrobial management and patient outcome information were extracted from medical and laboratory records...
December 6, 2017: BMC Infectious Diseases
I Chkhaidze, N Kapanadze
In spite of many attempts to differentiate bacterial from viral disease and predict severity and outcome, the etiologic diagnosis of paediatric community acquired pneumonia and the estimation of potential outcomes remain unsolved problems in most cases. Mycoplasma pneumoniae is one of the major pathogens causing CAP in children. Although MP infection was traditionally thought to be a self-limited process, more and more severe cases even fatal cases of MP infections were reported in recent years. So it is essential for pediatricians to recognize severe or refractory or severe MP early, treat it promptly and prevent the progress of the disease...
June 2017: Georgian Medical News
Borja Croche Santander, Elena Campos Alonso, Adela Sánchez Carrión, Laura Marcos Fuentes, Isabel Diaz Flores, Juan Carlos Vargas, Bárbara Fernández Domínguez, Cristóbal Toro Ibañez
INTRODUCTION: Antibiotics represent one of the most widely prescribed therapeutic agents in children. It has been estimated that 30-50% of antibiotic prescriptions for this population are inappropriate. In this scenario, analysis of prescription data provides an invaluable source of information as a basis for implementing strategies for improvement in this field. OBJECTIVE: To assess the appropriateness of antibiotic prescriptions in a paediatric population at an emergency department...
July 12, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Jermaine Khumalo, Mark Nicol, Diana Hardie, Rudzani Muloiwa, Phindile Mteshana, Colleen Bamford
INTRODUCTION: Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. METHODS: We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H...
2017: PloS One
Chand Wattal, Neeraj Goel, S P Byotra
CONTEXT: Currently, majority of studies on antibiotic resistance and serotype prevalence in Streptococcus pneumoniae are in paediatric population and there is limited epidemiologic data pertaining to elderly Indian population. AIMS: This study was undertaken to assess antibiotic resistance pattern and the coverage of the polysaccharide vaccine 23 (PPV23) in the elderly population. SETTINGS AND DESIGN: This was a prospective 2-year pneumococcal surveillance study in patients with community-acquired pneumococcal infections of ≥50 years' age group on fifty isolates of S...
January 2017: Indian Journal of Medical Microbiology
Jie Zhou, Lei Ren, Dapeng Chen, Xue Lin, Shifeng Huang, Yibing Yin, Ju Cao
The role of IL-17B in regulating pulmonary immunity and inflammation is unknown. In this study, we found that IL-17B concentrations were significantly elevated in adult and paediatric patients with community-acquired pneumonia relative to their corresponding healthy adult and paediatric controls. The increased concentrations of IL-17B significantly and positively correlated with chemokine IL-8 concentrations in clinical pneumonia. In vitro studies demonstrated that IL-17B could induce gene and protein expression of IL-8 in human bronchial epithelial cells, but not lung fibroblasts, which was regulated by the activation of Akt, p38 mitogen-activated protein kinase (MAPK), extracellular signal-regulated kinase (ERK) and nuclear factor-kappaB (NF-κB) signaling pathways...
February 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
David King, Noreen West, Charlotte Elder
The teaching and training of doctors-in-training in paediatrics has become increasingly challenging in recent times. All too often there is a perception that training must come second to service provision. In this article, the case of a child with community-acquired pneumonia is considered and used to illustrate how a culture of teaching can be embedded in everyday clinical practice.
April 2017: Archives of Disease in Childhood. Education and Practice Edition
Lesley J Scott
Intravenous ceftaroline fosamil (Zinforo™), a prodrug that is rapidly converted to its active metabolite ceftaroline, is approved for use in adults and children (from 2 months of age) with complicated skin and soft tissue infections (cSSTIs) or community-acquired pneumonia (CAP). In several multinational trials, ceftaroline fosamil was an effective and generally well tolerated treatment in adult and paediatric patients with cSSTIs or CAP. In the phase 3 CANVAS trials, ceftaroline fosamil treatment was noninferior to vancomycin plus aztreonam in adults with cSSTIs...
November 2016: Drugs
Francesco Blasi, Murat Akova, Paolo Bonanni, Nathalie Dartois, Evelyne Sauty, Chris Webber, Antoni Torres
Pneumococcal pneumonia remains a clear unmet medical need for adults worldwide. Despite advances in vaccine technology, vaccination coverage remains low, putting many people at risk of significant morbidity and mortality. The herd effect seen with paediatric vaccination is not enough to protect all older and vulnerable people in the community, and more needs to be done to increase the uptake of pneumococcal vaccination in adults. Several key groups are at increased risk of contracting pneumococcal pneumonia, and eligible patients are being missed in clinical practice...
January 2017: European Journal of Internal Medicine
Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Tessa R Davis, Hannah R Evans, Jennifer Murtas, Aimee Weisman, J Lynn Francis, Ahmed Khan
AIM: The aim of the study was to assess the utility of blood cultures in children admitted to hospital with community-acquired pneumonia. The primary outcome was the number of positive blood culture results, and secondary outcomes included the effect of positive blood culture results on management, and the identification of other clinical/biochemical variables that could predict blood culture results or the course of illness. METHODS: A retrospective data analysis was carried out on all children admitted to Gosford Hospital during the 2-year period from July 2013 to June 2015...
March 2017: Journal of Paediatrics and Child Health
Elise Launay, Karine Levieux, Corinne Levy, François Dubos, Alain Martinot, Bénédicte Vrignaud, Flora Lepage, Robert Cohen, Emmanuel Grimprel, Matthieu Hanf, François Angoulvant, Christèle Gras-Le Guen
BACKGROUND: Lower respiratory tract infection is a common cause of consultation and antibiotic prescription in paediatric practice. The misuse of antibiotics is a major cause of the emergence of multidrug-resistant bacteria. The aim of this study was to evaluate the frequency, changes over time, and determinants of non-compliance with antibiotic prescription recommendations for children admitted in paediatric emergency department (PED) with community-acquired pneumonia (CAP). METHODS: We conducted a prospective two-period study using data from the French pneumonia network that included all children with CAP, aged one month to 15 years old, admitted to one of the ten participating paediatric emergency departments...
August 12, 2016: BMC Pediatrics
A Nor Azizah, M N Fadzilah, M Mariam, Z A Anis Siham, A Ariza, M N Noor Shafina, A Anita Kaur
INTRODUCTION: bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens. METHOD: A retrospective study was conducted by analysing clinical details, blood cultures and antimicrobial susceptibility testing results in children between the ages of 0 to 13 years old, who were admitted to selayang Hospital over an 11-year period from 2001 until 2011...
June 2016: Medical Journal of Malaysia
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