Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Vancomycin and teicoplanin are glycopeptidic antibiotics that are used for many years in infections due to methicillin-resistant Staphylococcus aureus (MRSA). Nephrotoxicity of vancomycin and a slow clinical efficacy lead to discuss alternatives. Glycopeptides are less active than oxacillin against staphylococci susceptible to methicillin and should be reserved for infections due to MRSA. ⋯ Glycopeptide resistance is rare in Staphylococcus aureus, but not that to teicoplanin in coagulase-negative staphylococci. MRSA remain currently susceptible to several antibiotics in addition to glycopeptides. Linezolid and daptomycin, recently introduced in therapy, have no indication in children but may have an interest.
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Infant botulism is caused by the ingestion of spores of Clostridium botulinum and affects newborns and infants under 12 months of age. Ingested spores multiply and produce botulinum toxin in the digestive tract, which then induces clinical symptoms. A single French case was described in the literature prior to 1991. ⋯ Infant botulism, a form of botulism that was previously rarely recognized in France, has been reported more frequently during the last 6 years. This disease remains rare but nonetheless severe. In light of recent epidemiological data, efforts to raise awareness among parents of infants and health professionals on the danger of infant botulism and particularly, its association with honey consumption seems necessary.
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Hypoxic-ischemic encephalopathy (HIE) is an important cause of acute neurologic injury at birth, affecting approximately two to three cases per 1000 full-term live births. Despite advancements in many aspects of neonatal intensive care, the outcome for infants with HIE remains poor. Interventions to improve outcomes in this population have been disappointing. ⋯ However, national guidelines concerning regional organization and supportive care are necessary. A developmental follow-up must be organized. Neonatologists involved in this procedure must be encouraged joining a national data collection and registry.
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Pylephlebitis or septic thrombophlebitis of the portomesenteric veins is a complication of intra-abdominal infections. The disease is rare in children and the diagnosis is often delayed. The morbidity of pylephlebitis is relatively low, although there is a risk of residual thrombosis. ⋯ An appendectomy is always performed either at the time of diagnosis or later. The need for anticoagulation therapy in children is controversial. However, most pediatricians recommend its use, beginning as soon as possible, to be continued until normalization of portal vein flow.