The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Sep 2014
Randomized Controlled Trial Multicenter StudyA prospective multicenter study of microbiologically defined infections in pediatric cancer patients with fever and neutropenia: Swiss Pediatric Oncology Group 2003 fever and neutropenia study.
Fever and neutropenia (FN) often complicate anticancer treatment and can be caused by potentially fatal infections. Knowledge of pathogen distribution is paramount for optimal patient management. ⋯ MDI were identified in a minority of FN episodes but they significantly affected management and the clinical course of pediatric cancer patients. Compliance with published guidelines was associated with effectiveness of empiric antibiotic therapy in FN episodes with bacteremia.
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Pediatr. Infect. Dis. J. · Sep 2014
Frequency of apnea and respiratory viruses in infants with bronchiolitis.
The frequency of apnea in infants <12 months of age admitted with acute bronchiolitis was 5.16% (95% confidence interval: 3.94-6.72). Most commonly detected viruses in the 51 apneic infants were respiratory syncytial virus (33.3%), rhinovirus (13.7%) and viral coinfections (23.5%). Young age and prematurity were the main risk factors for apnea independent of the respiratory syncytial virus status. Non-respiratory syncytial virus infants had a higher rate of prematurity.
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Pediatr. Infect. Dis. J. · Sep 2014
Observational StudyEpidemiology and clinical outcomes of multidrug-resistant, gram-negative bloodstream infections in a European tertiary pediatric hospital during a 12-month period.
Bloodstream infections caused by multidrug-resistant, Gram-negative (MDRGN) bacteria represent a significant cause of morbidity and mortality. Prompt diagnosis and appropriate empiric treatment are the most important determinants of patient outcome. The objective of our study was to assess the epidemiology and clinical outcome of MDRGN sepsis in a tertiary-care pediatric hospital during a 12-month period. ⋯ This study demonstrates the high mortality of hospital-acquired MDRGN bacteremia in children. International networks focusing on clinical management and outcomes of MDRGN in children are required. Study of novel antibiotics active against Gram-negative bacteria should include children early in the clinical trial development programs.
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We evaluated whether procalcitonin (PCT) might aid diagnosing serious bacterial infections in a general pediatric intensive care unit population. Two-hundred and one patients accounted for 332 PCT samples. A PCT ≥1.45 ng/mL had a positive predictive value of 30%, a negative predictive value of 93% and a sensitivity of 72% and a specificity of 75%. These data suggest PCT can assist in identifying patients without serious bacterial infections and limit antimicrobial use.