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https://www.readbyqxmd.com/read/27923247/patterns-of-empiric-antibiotic-administration-for-presumed-early-onset-neonatal-sepsis-in-neonatal-intensive-care-units-in-the-united-states
#1
Emily A Oliver, Patricia B Reagan, Jonathan L Slaughter, Catalin S Buhimschi, Irina A Buhimschi
Objective To evaluate current patterns in empiric antibiotic use for early-onset neonatal sepsis (EONS). Study Design Retrospective population-based cohort study of newborns admitted on postnatal day 0 to 1 and discharged from NICUs participating in the Pediatric Health Information System (PHIS 2006-2013). Analyses included frequency of antibiotic initiation within 3 days of birth, duration of first course, and variation among hospitals. Results Of 158,907 newborns, 118,624 (74.7%) received antibiotics on or before postnatal day 3...
December 6, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27922234/long-term-azithromycin-therapy-in-patients-with-cystic-fibrosis
#2
Nagehan Emiralioğlu, Zeynelabidin Öztürk, Ebru Yalçın, Deniz Doğru, Uğur Özçelik, Nural Kiper
Inflammation is a central contributor to the pathogenesis of cystic fibrosis (CF) pulmonary disease; so limiting the excessive production of inflammatory mediators represents a major therapeutic strategy for slowing the decline in lung function and improving survival. The macrolide antibiotic azithromycin (AZM) has anti-inflammatory properties and immunomodulatory effects that may be beneficial in CF. The aim of this study was to document the long term use of AZM effect on pulmonary function, nutritional status and number of pulmonary exacerbations in patients with CF...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#3
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916349/pediatric-pyoderma-gangrenosum-is-it-just-big-wounds-on-little-adults
#4
Tahereh Soleimani, Sarah E Sasor, Leigh Spera, Barry E Eppley, Juan Socas, Michael W Chu, Sunil S Tholpady
BACKGROUND: Pyoderma gangrenosum (PG) is an uncommon, ulcerative, cutaneous condition, often caused by surgical trauma that can masquerade as a pyogenic disease process requiring debridement and antibiotics. Treatment is, however, medical, with delay leading to significant morbidity. In addition, medical workup for coincident disorders has been suggested. The purpose of this study was to test the hypothesis that pediatric PG has differing disease associations and therefore requires a differing medical workup...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27915986/molecular-analysis-of-pseudomonas-aeruginosa-metallo-beta-lactamase-a-first-report-of-an-iranian-referral-pediatric-hospital
#5
Shima Mahmoudi, Babak Pourakbari, Mansoure Hosseini, Amir Esmaeil Alyari, Mohammad Taghi Haghi Ashtiani, Setareh Mamishi
INTRODUCTION: Pseudomonas aerouginosa is an important opportunistic pathogen causes clinical infections among ill patients. Metallo- Beta- lactamases (MBLs) are important mechanisms of carbapenem (drug of choice) resistance among Pseudomonas aerouginosa isolates. The aim of this study was to determine B- lactamases genes (bla-genes) in P. aerouginosa isolates and to detect percentage of MBLs among P. aerouginosa isolates in different wards. MATERIAL AND METHODS: Clinical isolates of P...
December 2, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27912925/cardiac-arrest-in-pediatric-patients-receiving-azithromycin
#6
Santiago O Valdés, Jeffrey J Kim, Mary C Niu, Caridad M de la Uz, Christina Y Miyake, Brady S Moffett
OBJECTIVE: To compare outcomes of pediatric patients treated with azithromycin compared with penicillin or cephalosporin. We hypothesized that azithromycin use would not be associated with increased cardiac mortality in the pediatric population. STUDY DESIGN: Retrospective cohort study from the Pediatric Health Information System database between 2008 and 2012. Patients <19 years of age with a principal diagnosis of community-acquired pneumonia who received an antibiotic were included...
November 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27903852/topical-honey-in-the-management-of-pediatric-peritoneal-dialysis-exit-sites
#7
Thomas A Forbes, Loren Shaw, Catherine Quinlan
International guidelines in peritoneal dialysis (PD) advocate for regular application of topical mupirocin in chronic PD exit-site care. A strong evidence base links this treatment to reduced rates of exit-site infections and peritonitis. However, emerging reports of increasing mupirocin resistance and gram-negative infections are threatening the long-term viability of topical antibiotic ointments as a prophylactic treatment. Medical grade honey has multiple proven antibacterial and wound healing properties...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27902365/the-oral-cavities-of-healthy-infants-harbor-high-proportions-of-streptococcus-salivarius-strains-with-phenotypic-and-genotypic-resistance-to-multiple-classes-of-antibiotics
#8
Thaís H Palma, Erika Harth-Chú, Jodie Scott, Rafael N Stipp, Heike Boisvert, Mariana F Salomão, Jéssica D Theobaldo, Rosana F Possobon, Leandro C Nascimento, Jonathan W McCafferty, Lina Faller, Margaret J Duncan, Renata O Mattos-Graner
Emerging antibiotic resistance in the oropharyngeal microbiota, of which Streptococcus salivarius is a prominent species, represents a challenge for treating pediatric populations. In this study, we investigated the role of S. salivarius as a reservoir for antibiotic resistance genes (ARG) in the oral microbiota by analyzing 95 S. salivarius isolates from 22 healthy infants (2 to 16 months of age). Minimum inhibitory concentrations (MIC) of penicillin G, amoxicillin, erythromycin, tetracycline, doxycycline and streptomycin were determined...
October 24, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#9
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#10
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27895635/molecular-characteristic-and-virulence-gene-profiles-of-community-associated-methicillin-resistant-staphylococcus-aureus-isolates-from-pediatric-patients-in-shanghai-china
#11
Xing Wang, Xia Li, Wei Liu, Weichun Huang, Qihua Fu, Min Li
Staphylococcus aureus is a globally important human pathogen, especially among children and immunocompromised patients. The emergence and spread of community-associated methicillin-resistant S. aureus (CA-MRSA) has become a serious public health problem worldwide. The aim of this study was to investigate the prevalence, molecular characteristics and virulence profiles of CA-MRSA infections from pediatric patients in a university hospital in Shanghai, China. A total of 80 CA-MRSA isolates were collected from July 2012 to December 2013 in Shanghai Children's Medical Center and analyzed by multilocus sequence typing, staphylococcus chromosomal cassette mec (SCCmec) typing, and spa typing...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27894763/extended-spectrum-beta-lactamase-esbl-producing-bacteria-urinary-tract-infections-and-complex-pediatric-urology
#12
Ruth Wragg, Anna Harris, Mitul Patel, Andrew Robb, Harish Chandran, Liam McCarthy
AIM OF THE STUDY: Extended spectrum beta lactamase (ESBL) producing bacteria are resistant to most beta-lactam antibiotics including third-generation cephalosporins, quinolones and aminoglycosides. This resistance is plasmid-borne and can spread between species. Management of ESBL is challenging in children with recurrent urinary tract infections (UTIs) and complex urological abnormalities. We aim to quantify the risk in children and specifically in urological patients. METHODS: Retrospective review of a microbiology database (April 2014 to November 2015)...
November 13, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27893516/caregiver-expectations-and-satisfaction-of-urgent-care-in-a-pediatric-emergency-department
#13
Greg P Marconi, Phung K Pham, Alan L Nager
Health care delivery expectations that may affect patient and caregiver satisfaction are not clearly understood. This study examined caregiver expectations and satisfaction with urgent care in a pediatric emergency department. Of 201 caregivers surveyed, we found that caregivers have specific expectations regarding clinical care of their child in terms of radiographic imaging, blood testing, antibiotics, pain management, and subspecialty consultation. Caregivers were generally less dissatisfied with the actual care provided than the urgent care physicians expected...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27888411/to-screen-or-not-to-screen-for-vesicoureteral-reflux-in-children-with-ureteropelvic-junction-obstruction-a-systematic-review
#14
REVIEW
Marcus Weitz, Maria Schmidt
: Ureteropelvic junction obstruction (UPJO) and vesicoureteral reflux (VUR) are the most common uropathies. The co-occurrence of both anomalies has led to the practice of screening for VUR in children with UPJO to prevent deterioration of kidney function due to renal scarring following urinary tract infections (UTIs). We determined the prevalence of VUR in children with UPJO for a critical assessment of VUR screening by voiding cystourethrography (VCUG). A systematic search strategy in MEDLINE, EMBASE, and CENTRAL was carried out for all articles that included VCUG, and renal scintigraphy or any other appropriate imaging technique for the diagnosis of UPJO...
November 25, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27885442/patterns-and-trends-of-pediatric-bloodstream-infections-a-7-year-surveillance-study
#15
N Buetti, A Atkinson, L Kottanattu, J Bielicki, J Marschall, A Kronenberg
We characterize the epidemiology of pediatric bloodstream infections (BSIs) in Switzerland. We analyzed pathogen distribution and resistance patterns in monomicrobial and polymicrobial BSIs in children from 2008 to 2014 using data from the Swiss antibiotic resistance centre (ANRESIS). A confirmatory statistical analysis was performed comparing pathogens and resistance across 20 acute care hospitals. We identified 3,067 bacteremia episodes, of which 1,823 (59 %) were considered true BSI episodes. Overall, S...
November 24, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27884536/-chest-x-ray-and-acute-bronchiolitis-are-these-indications-decreasing
#16
V Arnoux, A Carsin, E Bosdure, K Retornaz, B Chabrol, G Gorincour, J Mancini, A Dabadie, J-C Dubus
OBJECTIVE: A management protocol for infants hospitalized for acute bronchiolitis, established after the study conducted in our unit in 2012, recommends a chest X-ray when the clinical course is unusual or if a differential diagnosis is suspected. The goal of this study was to evaluate professional practices after the introduction of this new management protocol. STUDY DESIGN: Retrospective descriptive study in two pediatric units from October 2013 to March 2015, including infants (0-23 months) hospitalized for their first episode of acute bronchiolitis without any underlying chronic condition...
November 21, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27882804/a-comparison-of-high-frequency-chest-wall-oscillation-and-intrapulmonary-percussive-ventilation-for-airway-clearance-in-pediatric-patients-with-tracheostomy
#17
Aneela Bidiwala, Linda Volpe, Claudia Halaby, Melissa Fazzari, Christina Valsamis, Melodi Pirzada
OBJECTIVES: The aim of this study was to compare two modes of airway clearance, the intrapulmonary percussive ventilation system (IPV) to high frequency chest wall oscillation system (HFCWO) in medically complex pediatric patients with tracheostomy requiring long term care. METHODS: This was a single center, retrospective study comparing the number of respiratory illnesses, lower respiratory tract infections (LRTI), utilization of bronchodilator and systemic steroids, and respiratory illnesses requiring acute care hospitalizations...
November 24, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27878110/discontinuation-of-antimicrobial-prophylaxis-ap-in-children-with-spina-bifida-a-case-series-analysis
#18
Kevin G Couloures, Michael Anderson, Michael Machiorlatti, Olivera Marsenic, Lawrence Opas
BACKGROUND: Spina bifida increases the risk for urinary tract infections (UTI). Antimicrobial prophylaxis (AP) reduces symptomatic UTI's but selects resistant organisms. Measures to ensure regular and complete emptying of the bladder combined with treatment of constipation reduce the risk for UTI. OBJECTIVES: Demonstrate that close adherence to a catheterization regimen in children with spina bifida (Selective Treatment - ST) reduces the need for antimicrobial prophylaxis...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27877097/preoperative-antibiotic-orders-protocol-initiated-pharmacist-order-entry
#19
Ben B Hyde, Richard K Ogden, Ron D Berger, Brad W VanBrimmer, Leslie M Stach
OBJECTIVE: To evaluate the antibiotic selection of preoperative orders before and after a pharmacist order entry protocol for patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization. METHODS: A retrospective chart review of orthopedic surgery procedures on patients with MRSA colonization at a free-standing, academic pediatric hospital, between February 2010 and February 2012. RESULTS: Procedures that were performed pre protocol (n = 27) implementation had a 63% rate of appropriate antibiotic selection compared to 81% in the postprotocol group (n = 32; p = 0...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27876028/clinical-assessment-of-children-with-renal-abscesses-presenting-to-the-pediatric-emergency-department
#20
Chun-Yu Chen, Huang-Tsung Kuo, Yu-Jun Chang, Kang-Hsi Wu, Wen-Chieh Yang, Han-Ping Wu
BACKGROUND: Renal abscesses are relatively uncommon in children but may result in prolonged hospital stays and life-threatening events. We undertook this study to analyze the clinical spectrum of renal abscesses in children admitted to the pediatric emergency department (ED) and to find helpful clinical characteristics that can potentially aid emergency physicians for detecting renal abscesses in children earlier. METHODS: From 2004 to 2011, we retrospectively analyzed 17 patients, aged 18 years or younger, with a definite diagnosis of renal abscess admitted to the ED...
November 22, 2016: BMC Pediatrics
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