Ammarah Jamal, Sharmeen Nasir, Faiza Hayee, Y. Yahya
Abstract Objective A nationwide measles–rubella (MR) vaccination campaign was executed in Pakistan in November 2021. Despite that, there was a persistence of new measles cases. Thus, we designed this study to determine the measles vaccination status in patients with measles and to determine the reasons of missed vaccination during the campaign. Methods We reviewed medical records of measles patients >1 month to 12 years of age, presenting to the pediatric emergency of a tertiary care hospital of Karachi, Pakistan, during January to June 2022. We recorded patients' demographics and vaccination status. Measles patients who were hospitalized were reviewed to see if the child has or has not received vaccination during the MR campaign and what were the reasons for missed vaccination. Results A total of 1,058 children presented with measles out of which 52.9% were male. The mean age of the patients was 2.2 years. Excluding 24.3% of the patients because of age <9 months, 800 (75.6%) patients were eligible for measles vaccine. Out of these, 80% received the vaccine (94.6% had one dose and only 5.3% had two doses). Among the 98 admitted patients, 68 (69.3%) were eligible for vaccination during the MR campaign, out of which 88.2% did not get the vaccine. Common reasons of missed vaccination were: lack of knowledge of the campaign (36.6%), impossibility to find vaccination facility (23.3%), and lack of trust in vaccines (15%). Conclusion Most of the hospitalized measles patients had missed the vaccine during the MR campaign, mostly because of lack of knowledge of the campaign. This calls for devising strategies to improve coverage of vaccination services.
{"title":"Frequency and Reasons for Vaccination Failure against Measles among Pediatric Cases at a Tertiary Care Hospital of Karachi","authors":"Ammarah Jamal, Sharmeen Nasir, Faiza Hayee, Y. Yahya","doi":"10.1055/s-0043-1770988","DOIUrl":"https://doi.org/10.1055/s-0043-1770988","url":null,"abstract":"Abstract Objective A nationwide measles–rubella (MR) vaccination campaign was executed in Pakistan in November 2021. Despite that, there was a persistence of new measles cases. Thus, we designed this study to determine the measles vaccination status in patients with measles and to determine the reasons of missed vaccination during the campaign. Methods We reviewed medical records of measles patients >1 month to 12 years of age, presenting to the pediatric emergency of a tertiary care hospital of Karachi, Pakistan, during January to June 2022. We recorded patients' demographics and vaccination status. Measles patients who were hospitalized were reviewed to see if the child has or has not received vaccination during the MR campaign and what were the reasons for missed vaccination. Results A total of 1,058 children presented with measles out of which 52.9% were male. The mean age of the patients was 2.2 years. Excluding 24.3% of the patients because of age <9 months, 800 (75.6%) patients were eligible for measles vaccine. Out of these, 80% received the vaccine (94.6% had one dose and only 5.3% had two doses). Among the 98 admitted patients, 68 (69.3%) were eligible for vaccination during the MR campaign, out of which 88.2% did not get the vaccine. Common reasons of missed vaccination were: lack of knowledge of the campaign (36.6%), impossibility to find vaccination facility (23.3%), and lack of trust in vaccines (15%). Conclusion Most of the hospitalized measles patients had missed the vaccine during the MR campaign, mostly because of lack of knowledge of the campaign. This calls for devising strategies to improve coverage of vaccination services.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"256 - 260"},"PeriodicalIF":0.3,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43640927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Şahin, Emine Kaya-Guner, Yıldız Ekemen-Keles, Eda Karadag-Oncel, Ahu Kara-Aksay, Dilek Yılmaz
Abstract Objective Multisystem inflammatory syndrome (MIS-C) in children is associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and can be mortal with the involvement of multiple organ systems. However, long-term effects on all organs and organ systems involvement are still unclear or even whether this condition may still occur in which organs. This report aims to identify ocular findings in children with MIS-C on the follow-up. Methods This is a prospective cross-sectional study. Cases diagnosed with MIS-C between May 2020 and February 2021 in our hospital (e.g., cases aged 1 month–18 years old) were included in the study. The same ophthalmologist followed up with the patients after discharge. Patients underwent detailed ophthalmic examinations, including slit lamp biomicroscopy and fundoscopy, best-corrected visual acuity, and Schirmer's 2 test. Results Our study included 22 patients treated with the MIS-C. Twelve (54.5%) were girls, and 10 (45.5%) were boys. Their mean age was 8.7 ± 4.9 years. Pathological ocular findings were found in six (27.2%) patients in the follow-up. The most common finding was punctate epitheliopathy in four (18.2%) patients. The cause of punctate epitheliopathy was dry eye. All patients recovered with treatment. Conclusion Our study is the first to evaluate ocular findings in MIS-C in the long term. Regardless of the severity of the disease, the most common ocular finding in our study was punctate epitheliopathy, that is, dry eye. According to our results, we think patients should be followed up on pathological ocular findings after discharge.
{"title":"Evaluation of Ocular Findings Following Multisystem Inflammatory Syndrome in Children","authors":"A. Şahin, Emine Kaya-Guner, Yıldız Ekemen-Keles, Eda Karadag-Oncel, Ahu Kara-Aksay, Dilek Yılmaz","doi":"10.1055/s-0043-1769121","DOIUrl":"https://doi.org/10.1055/s-0043-1769121","url":null,"abstract":"Abstract Objective Multisystem inflammatory syndrome (MIS-C) in children is associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and can be mortal with the involvement of multiple organ systems. However, long-term effects on all organs and organ systems involvement are still unclear or even whether this condition may still occur in which organs. This report aims to identify ocular findings in children with MIS-C on the follow-up. Methods This is a prospective cross-sectional study. Cases diagnosed with MIS-C between May 2020 and February 2021 in our hospital (e.g., cases aged 1 month–18 years old) were included in the study. The same ophthalmologist followed up with the patients after discharge. Patients underwent detailed ophthalmic examinations, including slit lamp biomicroscopy and fundoscopy, best-corrected visual acuity, and Schirmer's 2 test. Results Our study included 22 patients treated with the MIS-C. Twelve (54.5%) were girls, and 10 (45.5%) were boys. Their mean age was 8.7 ± 4.9 years. Pathological ocular findings were found in six (27.2%) patients in the follow-up. The most common finding was punctate epitheliopathy in four (18.2%) patients. The cause of punctate epitheliopathy was dry eye. All patients recovered with treatment. Conclusion Our study is the first to evaluate ocular findings in MIS-C in the long term. Regardless of the severity of the disease, the most common ocular finding in our study was punctate epitheliopathy, that is, dry eye. According to our results, we think patients should be followed up on pathological ocular findings after discharge.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"240 - 244"},"PeriodicalIF":0.3,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41907835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alper Divarci, A. Bulbul, Evrim Kıray Baş, Gülen Hürkal Yiğitler, Alev Aydın, Hasan Avsar, Emel Celebi Congur, H. S. Uslu, Ebru Turkoglu Unal
Abstract Objective The COVID-19 pandemic was declared a pandemic and a global health emergency by the World Health Organization (WHO) on March 11, 2020. COVID-19 infection is the most common cause of life-threatening acute respiratory tract infection in adults and older people but more mildly in the childhood age group. While the pandemic continues, there is no clear information about the vertical transmission of COVID-19 infection from the mother to the baby. Methods In our study, we aimed to examine vertical virus transmission (breast milk, amniotic fluid, placenta) in pregnant women with COVID-19 infection and to examine the demographic, clinical, and laboratory characteristics of these infants. Our prospective and observational study was conducted in our hospital between March 1, 2020 and July 31, 2021. Results During the study period, a total of 24 infants were included. All infants were admitted to the neonatal intensive care unit for postnatal follow-up. The virus was not detected in breast milk or amniotic fluids by the SARS-COV-2 reverse transcription polymerase chain reaction (RT-PCR) test, and no evidence of vertical transmission was found. Conclusion In our study, no life-threatening complication was found in the babies of mothers infected with COVID-19 at birth. Babies born to mothers with COVID-19 infection did not develop any system findings that required specific treatment.
{"title":"Evaluation of SARS-CoV-2 Mother-to-Child Vertical Transmission: Prospective and Observational Study","authors":"Alper Divarci, A. Bulbul, Evrim Kıray Baş, Gülen Hürkal Yiğitler, Alev Aydın, Hasan Avsar, Emel Celebi Congur, H. S. Uslu, Ebru Turkoglu Unal","doi":"10.1055/s-0043-1771349","DOIUrl":"https://doi.org/10.1055/s-0043-1771349","url":null,"abstract":"Abstract Objective The COVID-19 pandemic was declared a pandemic and a global health emergency by the World Health Organization (WHO) on March 11, 2020. COVID-19 infection is the most common cause of life-threatening acute respiratory tract infection in adults and older people but more mildly in the childhood age group. While the pandemic continues, there is no clear information about the vertical transmission of COVID-19 infection from the mother to the baby. Methods In our study, we aimed to examine vertical virus transmission (breast milk, amniotic fluid, placenta) in pregnant women with COVID-19 infection and to examine the demographic, clinical, and laboratory characteristics of these infants. Our prospective and observational study was conducted in our hospital between March 1, 2020 and July 31, 2021. Results During the study period, a total of 24 infants were included. All infants were admitted to the neonatal intensive care unit for postnatal follow-up. The virus was not detected in breast milk or amniotic fluids by the SARS-COV-2 reverse transcription polymerase chain reaction (RT-PCR) test, and no evidence of vertical transmission was found. Conclusion In our study, no life-threatening complication was found in the babies of mothers infected with COVID-19 at birth. Babies born to mothers with COVID-19 infection did not develop any system findings that required specific treatment.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"261 - 265"},"PeriodicalIF":0.3,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49025802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Potes, Iván Darío Benavides, Nelson Rivera-Franco, C. A. Portilla, Oscar Ramírez, Andrés Castillo, Eduardo López-Medina
Abstract Objective To describe the association between antibiotic use, gut microbiota composition, and the development of sepsis in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) to treat acute lymphoblastic leukemia. Methods A cohort of pediatric patients was followed up between days −30 (pre-HSCT) and +30 (post-HSCT), and sequential stool samples were collected for analysis of the taxonomic composition of bacterial communities by comparing the sequences of the 16s ribosomal RNA gene. Clinically, patients were divided into those with or without sepsis according to their clinical and laboratory data. Gut microbiota was categorized as potentially pathogenic or commensal and was described according to antibiotic use in patients with and without sepsis. Results A cohort of eight patients provided 34 stool samples at different time points during their pre- and post-HSCT periods. There was a greater diversity in the microbial composition in patients who did not develop sepsis. In contrast, patients who developed sepsis had low microbiota diversity, a slight dominance of the genus Bacteroides and order Enterobacterales, and a low abundance of the genus Akkermansia . The use of antibiotics was associated with a low relative abundance of commensal bacteria, a high relative abundance of potentially pathogenic microbiota, and a risk of sepsis. Conclusion Our results suggest that gut microbiota sequencing in pediatric HSCT recipients could predict the clinical course and guide direct interventions to improve patient outcomes. Accordingly, short-spectrum, tailored antibiotic therapy could be provided to patients with fever pre- and post-HSCT to prevent dysbiosis and reduce the risk of sepsis.
{"title":"Effect of Antibiotics and Gut Microbiota on the Development of Sepsis in Children with Hematopoietic Stem Cell Transplants","authors":"Daniela Potes, Iván Darío Benavides, Nelson Rivera-Franco, C. A. Portilla, Oscar Ramírez, Andrés Castillo, Eduardo López-Medina","doi":"10.1055/s-0043-57249","DOIUrl":"https://doi.org/10.1055/s-0043-57249","url":null,"abstract":"Abstract Objective To describe the association between antibiotic use, gut microbiota composition, and the development of sepsis in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) to treat acute lymphoblastic leukemia. Methods A cohort of pediatric patients was followed up between days −30 (pre-HSCT) and +30 (post-HSCT), and sequential stool samples were collected for analysis of the taxonomic composition of bacterial communities by comparing the sequences of the 16s ribosomal RNA gene. Clinically, patients were divided into those with or without sepsis according to their clinical and laboratory data. Gut microbiota was categorized as potentially pathogenic or commensal and was described according to antibiotic use in patients with and without sepsis. Results A cohort of eight patients provided 34 stool samples at different time points during their pre- and post-HSCT periods. There was a greater diversity in the microbial composition in patients who did not develop sepsis. In contrast, patients who developed sepsis had low microbiota diversity, a slight dominance of the genus Bacteroides and order Enterobacterales, and a low abundance of the genus Akkermansia . The use of antibiotics was associated with a low relative abundance of commensal bacteria, a high relative abundance of potentially pathogenic microbiota, and a risk of sepsis. Conclusion Our results suggest that gut microbiota sequencing in pediatric HSCT recipients could predict the clinical course and guide direct interventions to improve patient outcomes. Accordingly, short-spectrum, tailored antibiotic therapy could be provided to patients with fever pre- and post-HSCT to prevent dysbiosis and reduce the risk of sepsis.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"186 - 192"},"PeriodicalIF":0.3,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42814591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Kara, M. C. Kizil, M. Arslanoglu, E. Kacmaz, Nidai Dalokay, Ezgi Pala, E. Kıral, G. Bozan, T. Us, O. Kilic, E. Dinleyici
Abstract Objective Acute respiratory tract infections are one of the leading causes of morbidity and mortality in children. Although human bocavirus (HBoV) infections are not as common as other seasonal respiratory viruses, children who are infected with HBoV are more likely to suffer from a variety of respiratory conditions, including the common cold, acute otitis media, asthma exacerbations, bronchiolitis pneumonia, some of the affected children require pediatric intensive care unit stay. Here, we aimed to evaluate pediatric bocavirus (HBoV) cases presenting with severe respiratory tract symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Methods This retrospective study evaluated the medical records of children diagnosed with respiratory infections, followed up at the Faculty of Medicine, Eskisehir Osmangazi University between September 2021 and March 2022. In this study, patients with HBoV identified using nasopharyngeal polymerase chain reaction (PCR) were considered positive. Cases were analyzed retrospectively for their clinical characteristics. Results This study included 54 children (29 girls and 25 boys) with HBoV in nasopharyngeal PCR samples. The cases ranged in age from 1 month to 72 months (median 25 months). At the time of presentation, cough, fever, and respiratory distress were the most prevalent symptoms. Hyperinflation (48%), pneumonic consolidation (42%), and pneumothorax–pneumomediastinum (7%) were observed on the chest X-ray; 54% of the children required intensive care unit stay. The median length of hospitalization was 6 days. Bacterial coinfection was detected in 7 (17%) children, while HBoV and other viruses were present in 20 (37%) children; 57% of children received supplemental oxygen by mask, 24% high-flow nasal oxygen, 7% continuous positive airway pressure, and 9% invasive mechanical ventilation support. Antibiotics were given to 34 (63%) cases, and systemic steroid treatment was given to 41 (76%) cases. Chest tubes were inserted in three out of the four cases with pneumothorax–pneumomediastinum. All patients were recovered and were discharged from the hospital. Conclusion The COVID-19 pandemic changed the epidemiology of seasonal respiratory viruses and the clinical course of the diseases. Although it usually causes mild symptoms, severe respiratory symptoms can lead to life-threatening illnesses requiring intensive care admission.
{"title":"Unexpected Severe Bocavirus Infections among Hospitalized Children during the COVID-19 Pandemic","authors":"Y. Kara, M. C. Kizil, M. Arslanoglu, E. Kacmaz, Nidai Dalokay, Ezgi Pala, E. Kıral, G. Bozan, T. Us, O. Kilic, E. Dinleyici","doi":"10.1055/s-0043-1767738","DOIUrl":"https://doi.org/10.1055/s-0043-1767738","url":null,"abstract":"Abstract Objective Acute respiratory tract infections are one of the leading causes of morbidity and mortality in children. Although human bocavirus (HBoV) infections are not as common as other seasonal respiratory viruses, children who are infected with HBoV are more likely to suffer from a variety of respiratory conditions, including the common cold, acute otitis media, asthma exacerbations, bronchiolitis pneumonia, some of the affected children require pediatric intensive care unit stay. Here, we aimed to evaluate pediatric bocavirus (HBoV) cases presenting with severe respiratory tract symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Methods This retrospective study evaluated the medical records of children diagnosed with respiratory infections, followed up at the Faculty of Medicine, Eskisehir Osmangazi University between September 2021 and March 2022. In this study, patients with HBoV identified using nasopharyngeal polymerase chain reaction (PCR) were considered positive. Cases were analyzed retrospectively for their clinical characteristics. Results This study included 54 children (29 girls and 25 boys) with HBoV in nasopharyngeal PCR samples. The cases ranged in age from 1 month to 72 months (median 25 months). At the time of presentation, cough, fever, and respiratory distress were the most prevalent symptoms. Hyperinflation (48%), pneumonic consolidation (42%), and pneumothorax–pneumomediastinum (7%) were observed on the chest X-ray; 54% of the children required intensive care unit stay. The median length of hospitalization was 6 days. Bacterial coinfection was detected in 7 (17%) children, while HBoV and other viruses were present in 20 (37%) children; 57% of children received supplemental oxygen by mask, 24% high-flow nasal oxygen, 7% continuous positive airway pressure, and 9% invasive mechanical ventilation support. Antibiotics were given to 34 (63%) cases, and systemic steroid treatment was given to 41 (76%) cases. Chest tubes were inserted in three out of the four cases with pneumothorax–pneumomediastinum. All patients were recovered and were discharged from the hospital. Conclusion The COVID-19 pandemic changed the epidemiology of seasonal respiratory viruses and the clinical course of the diseases. Although it usually causes mild symptoms, severe respiratory symptoms can lead to life-threatening illnesses requiring intensive care admission.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"199 - 205"},"PeriodicalIF":0.3,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46127681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Yılmaz, A. Copur, H. Parlatan, H. T. Çağlar, Gökçe Ünal, Fatih Ercan, A. Yazar, M. Özdemir, S. Pekcan
Abstract This study aims to investigate and analyze the clinical features of coexisting human bocavirus (HBoV) positivity and plastic bronchitis (PB). We present three cases with no known history of cardiac surgery who presented with cough, progressive dyspnea, and atelectasis. They tested positive for HBoV in a real-time polymerase chain reaction of both nasal lavage fluids. They were diagnosed with PB as a result of bronchoscopy and pathology. PB is a rare disease characterized by forming thick rigid casts in the tracheobronchial tree, which can progress to respiratory failure. While asthma or atopy-related type 1 PB was observed in one patient, two patients were diagnosed with PB, which was thought to have developed secondary to viral infections of unknown etiology. As far as we know, HBoV-associated PB cases are rare in the literature. Besides the commonly known infectious agents, we identified a relationship with HBoV in all the presented cases.
{"title":"Plastic Bronchitis and Human Bocavirus: A Report of Three Cases","authors":"A. Yılmaz, A. Copur, H. Parlatan, H. T. Çağlar, Gökçe Ünal, Fatih Ercan, A. Yazar, M. Özdemir, S. Pekcan","doi":"10.1055/s-0043-1769120","DOIUrl":"https://doi.org/10.1055/s-0043-1769120","url":null,"abstract":"Abstract This study aims to investigate and analyze the clinical features of coexisting human bocavirus (HBoV) positivity and plastic bronchitis (PB). We present three cases with no known history of cardiac surgery who presented with cough, progressive dyspnea, and atelectasis. They tested positive for HBoV in a real-time polymerase chain reaction of both nasal lavage fluids. They were diagnosed with PB as a result of bronchoscopy and pathology. PB is a rare disease characterized by forming thick rigid casts in the tracheobronchial tree, which can progress to respiratory failure. While asthma or atopy-related type 1 PB was observed in one patient, two patients were diagnosed with PB, which was thought to have developed secondary to viral infections of unknown etiology. As far as we know, HBoV-associated PB cases are rare in the literature. Besides the commonly known infectious agents, we identified a relationship with HBoV in all the presented cases.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"266 - 271"},"PeriodicalIF":0.3,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47760050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evyatar Hubara, Irena Serencev, O. Kriger, Shatzman Steuerman Rachel, Eitan Keizman, M. Nellis, D. Mishali, R. Lerner, U. Katz, Yelena Skorchin, G. Barkai, Itai M. Pessach
Abstract Objective Delayed sternal closure (DSC) is a frequent strategy for optimizing hemodynamics for patients after complicated cardiac surgery. However, this practice is associated with increased risk for infection and mortality. Despite the importance of antibiotic prophylaxis during open chest management, no clear recommendations are available. We sought to describe our practice with single-agent prophylactic antibiotic treatment for children with DSC. Methods We retrospectively reviewed the electronic medical record of children with delayed chest closure after stage 1 palliative surgery, between January 2009 and December 2020. Demographics, antibiotic treatment, and data regarding postoperative infection occurrence were collected. The primary outcomes were surgical site infection (SSI) and blood stream infection (BSI) rates within 28 days of repair. Results Sixty-eight patients were identified with single ventricle physiology, who underwent Damus–Kaye–Stansel or a modified Norwood procedure, remained with an open chest postoperatively, and were treated with prophylactic cefazolin. Sixty-three percent (43/68) of the children were male with a median (interquartile range) age of 9 (6–16) days. Eleven patients (16%) had an SSI or BSI identified postoperatively. Those with infections were significantly older (8 vs. 14 months, p = 0.037), had longer central line time (11 vs. 7 days, p = 0.004), had a central line location other than internal jugular ( p = 0.022), and had a dialysis line ( p = 0.022). Conclusion Our study demonstrates a relatively low occurrence rate of postoperative SSIs and bacteremia with prophylactic cefazolin therapy among children with DSC suggesting that single-agent, narrow antimicrobial treatment may be sufficient in this high-risk population.
{"title":"Surgical Site and Blood Stream Infections in Children with Delayed Sternal Closure after Cardiopulmonary Bypass Surgery: A Single-Center Experience","authors":"Evyatar Hubara, Irena Serencev, O. Kriger, Shatzman Steuerman Rachel, Eitan Keizman, M. Nellis, D. Mishali, R. Lerner, U. Katz, Yelena Skorchin, G. Barkai, Itai M. Pessach","doi":"10.1055/s-0043-57236","DOIUrl":"https://doi.org/10.1055/s-0043-57236","url":null,"abstract":"Abstract Objective Delayed sternal closure (DSC) is a frequent strategy for optimizing hemodynamics for patients after complicated cardiac surgery. However, this practice is associated with increased risk for infection and mortality. Despite the importance of antibiotic prophylaxis during open chest management, no clear recommendations are available. We sought to describe our practice with single-agent prophylactic antibiotic treatment for children with DSC. Methods We retrospectively reviewed the electronic medical record of children with delayed chest closure after stage 1 palliative surgery, between January 2009 and December 2020. Demographics, antibiotic treatment, and data regarding postoperative infection occurrence were collected. The primary outcomes were surgical site infection (SSI) and blood stream infection (BSI) rates within 28 days of repair. Results Sixty-eight patients were identified with single ventricle physiology, who underwent Damus–Kaye–Stansel or a modified Norwood procedure, remained with an open chest postoperatively, and were treated with prophylactic cefazolin. Sixty-three percent (43/68) of the children were male with a median (interquartile range) age of 9 (6–16) days. Eleven patients (16%) had an SSI or BSI identified postoperatively. Those with infections were significantly older (8 vs. 14 months, p = 0.037), had longer central line time (11 vs. 7 days, p = 0.004), had a central line location other than internal jugular ( p = 0.022), and had a dialysis line ( p = 0.022). Conclusion Our study demonstrates a relatively low occurrence rate of postoperative SSIs and bacteremia with prophylactic cefazolin therapy among children with DSC suggesting that single-agent, narrow antimicrobial treatment may be sufficient in this high-risk population.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"206 - 210"},"PeriodicalIF":0.3,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41991745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Özaslan, H. Şenol, M. Barlık, Fevziye Çoksuer, Bahar Dindar, E. Demir, F. Gülen
Abstract Objective Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020, with millions of infected cases worldwide. Although the course is usually mild in the pediatric age group, there are unknown factors in patients with chronic lung diseases. The aim of this study was to determine the demographic characteristics and the clinical course of patients with cystic fibrosis who contracted COVID-19 infection. Methods A total of 128 patients with cystic fibrosis who were under follow-up in our clinic were separated into two groups: those who had been infected with COVID-19 and those who had not. The COVID-19-positive patients were then grouped as those who were hospitalized and those treated as outpatients. In the COVID-19 group, the spirometry values of the patients before the infection were compared with those measured at 3 and 6 months after the infection. Results The COVID-19 group comprised 34 (25.6%) cystic fibrosis patients with a mean age of 108.2 ± 60.8 months who contracted COVID-19 between April 2020 and October 2022. The rates of chronic bacterial colonization and allergic bronchopulmonary aspergillosis were significantly higher in the COVID-19 group ( p = 0.001 and 0.005). Eight of the 34 patients were hospitalized, and 26 were isolated at home. Five patients required oxygen, and the forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) values were lower. Conclusion A severe course of COVID-19 was not seen in any of the cystic fibrosis patients. A greater number of patients with chronic respiratory tract bacterial colonization and allergic bronchopulmonary aspergillosis were hospitalized.
{"title":"An Evaluation of the Risk Factors and Respiratory Function Test Change of Children with Cystic Fibrosis Who Contracted COVID-19 Infection","authors":"M. Özaslan, H. Şenol, M. Barlık, Fevziye Çoksuer, Bahar Dindar, E. Demir, F. Gülen","doi":"10.1055/s-0043-1769902","DOIUrl":"https://doi.org/10.1055/s-0043-1769902","url":null,"abstract":"Abstract Objective Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020, with millions of infected cases worldwide. Although the course is usually mild in the pediatric age group, there are unknown factors in patients with chronic lung diseases. The aim of this study was to determine the demographic characteristics and the clinical course of patients with cystic fibrosis who contracted COVID-19 infection. Methods A total of 128 patients with cystic fibrosis who were under follow-up in our clinic were separated into two groups: those who had been infected with COVID-19 and those who had not. The COVID-19-positive patients were then grouped as those who were hospitalized and those treated as outpatients. In the COVID-19 group, the spirometry values of the patients before the infection were compared with those measured at 3 and 6 months after the infection. Results The COVID-19 group comprised 34 (25.6%) cystic fibrosis patients with a mean age of 108.2 ± 60.8 months who contracted COVID-19 between April 2020 and October 2022. The rates of chronic bacterial colonization and allergic bronchopulmonary aspergillosis were significantly higher in the COVID-19 group ( p = 0.001 and 0.005). Eight of the 34 patients were hospitalized, and 26 were isolated at home. Five patients required oxygen, and the forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) values were lower. Conclusion A severe course of COVID-19 was not seen in any of the cystic fibrosis patients. A greater number of patients with chronic respiratory tract bacterial colonization and allergic bronchopulmonary aspergillosis were hospitalized.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"232 - 239"},"PeriodicalIF":0.3,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45808864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. K. Agrawal, Rewati Sharma, Arpita Mishra, Ashok Singh, R. Narayan, O. Mishra
Abstract Objective In the midst of the COVID-19 pandemic, many children presenting with persistent fever, rashes, conjunctivitis, abdominal pain, respiratory distress, and shock were reported and diagnosed with multisystem inflammatory syndrome in children (MIS-C). The aim of the study was to observe the clinical presentation and outcome of MIS-C treated at a tertiary care hospital. Methods Eighteen children, aged 24 days to 18 years, with suspected MIS-C were admitted. Their clinical presentation, laboratory parameters, radiological investigations, management, and outcomes were recorded. Results Median age was 8 years (interquartile range [IQR]: 0.5, 14), and the male-to-female ratio was 1:1. Fever, tachycardia, respiratory distress, hypotension, and seizures with altered sensorium were present in 94.4, 88.8, 83.3, 44.4, and 44.4% of the cases, respectively. Median erythrocyte sedimentation rate, C-reactive protein, serum ferritin, and d-Dimer levels were 21 mm/h, 151 mg/L (1,14.2, 319), 1,091 µg/L (737.4, 1,456), and 3,094 ng/mL (990, 4,300), respectively. Methylprednisolone was given to all patients. Low molecular weight heparin and intravenous immunoglobulin (IVIG) were instituted in 83.3 and 38.8% cases, respectively. Seventeen patients (94.4%) required oxygen therapy and 44.4% needed mechanical ventilation. Fourteen patients (77.7%) recovered completely and four cases (22.2%) expired during the hospital stay. The need for ventilation and the presence of shock adversely affected the outcome. Conclusion Chief clinical presentations in the patients of MIS-C were fever, respiratory distress, hypotension, and altered sensorium. Among admitted patients, 87.8% cases were managed successfully by systemic corticosteroids with or without IVIG. Need for mechanical ventilation, shock, and central nervous system symptoms at admission appear to be important factors that can lead to mortality.
{"title":"Multisystem Inflammatory Syndrome in Children Associated with COVID-19 Infection: Clinical Presentation and Outcome","authors":"R. K. Agrawal, Rewati Sharma, Arpita Mishra, Ashok Singh, R. Narayan, O. Mishra","doi":"10.1055/s-0043-1769122","DOIUrl":"https://doi.org/10.1055/s-0043-1769122","url":null,"abstract":"Abstract Objective In the midst of the COVID-19 pandemic, many children presenting with persistent fever, rashes, conjunctivitis, abdominal pain, respiratory distress, and shock were reported and diagnosed with multisystem inflammatory syndrome in children (MIS-C). The aim of the study was to observe the clinical presentation and outcome of MIS-C treated at a tertiary care hospital. Methods Eighteen children, aged 24 days to 18 years, with suspected MIS-C were admitted. Their clinical presentation, laboratory parameters, radiological investigations, management, and outcomes were recorded. Results Median age was 8 years (interquartile range [IQR]: 0.5, 14), and the male-to-female ratio was 1:1. Fever, tachycardia, respiratory distress, hypotension, and seizures with altered sensorium were present in 94.4, 88.8, 83.3, 44.4, and 44.4% of the cases, respectively. Median erythrocyte sedimentation rate, C-reactive protein, serum ferritin, and d-Dimer levels were 21 mm/h, 151 mg/L (1,14.2, 319), 1,091 µg/L (737.4, 1,456), and 3,094 ng/mL (990, 4,300), respectively. Methylprednisolone was given to all patients. Low molecular weight heparin and intravenous immunoglobulin (IVIG) were instituted in 83.3 and 38.8% cases, respectively. Seventeen patients (94.4%) required oxygen therapy and 44.4% needed mechanical ventilation. Fourteen patients (77.7%) recovered completely and four cases (22.2%) expired during the hospital stay. The need for ventilation and the presence of shock adversely affected the outcome. Conclusion Chief clinical presentations in the patients of MIS-C were fever, respiratory distress, hypotension, and altered sensorium. Among admitted patients, 87.8% cases were managed successfully by systemic corticosteroids with or without IVIG. Need for mechanical ventilation, shock, and central nervous system symptoms at admission appear to be important factors that can lead to mortality.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"171 - 177"},"PeriodicalIF":0.3,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44059040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selen Güler, B. Aksoy, Y. C. Appak, Sinem Kahveci, Şenay O. Karabağ, M. Baran
Abstract Objective Inflammatory bowel disease is a chronic inflammatory disease of the gastrointestinal tract. Some difficulties and differences were experienced during the coronavirus disease 2019 (COVID-19) pandemic period for monitoring of chronic diseases. In this study, the effect of the COVID-19 pandemic on the frequency and course of inflammatory bowel disease in children was evaluated. Methods The first severe acute respiratory syndrome coronavirus 2 case in Türkiye was diagnosed on March 11, 2020. The pandemic period was defined as the year following this date, and the pre-pandemic period as the preceding year. The number of patients newly diagnosed with inflammatory bowel disease and their clinical presentations during the pandemic period and pre-pandemic period was compared. In addition, the clinical features of previously diagnosed inflammatory bowel disease patients in the pandemic period and pre-pandemic period were compared. Results Eighty-six patients in a pediatric gastroenterology clinic between 2009 and 2021 were included. The number of newly diagnosed patients was higher during the pandemic period ( n = 14) compared with the pre-pandemic period ( n = 18; p = 0.017). Fifty-four patients were follow-up patients diagnosed before 2019: the mean number of outpatient clinic visits, disease attacks, and hospitalizations was lower pandemic period than pre-pandemic period ( p < 0.01). Conclusion The changes experienced during pandemic period may have triggered more cases of inflammatory bowel disease. However, we found no evidence that either less face-to-face follow-up of, or life changes in, existing inflammatory bowel disease patients during the pandemic period adversely affected their clinical outcomes.
{"title":"The Effect of the COVID-19 Pandemic on the Frequency and Course of Inflammatory Bowel Disease in Children","authors":"Selen Güler, B. Aksoy, Y. C. Appak, Sinem Kahveci, Şenay O. Karabağ, M. Baran","doi":"10.1055/s-0043-1769738","DOIUrl":"https://doi.org/10.1055/s-0043-1769738","url":null,"abstract":"Abstract Objective Inflammatory bowel disease is a chronic inflammatory disease of the gastrointestinal tract. Some difficulties and differences were experienced during the coronavirus disease 2019 (COVID-19) pandemic period for monitoring of chronic diseases. In this study, the effect of the COVID-19 pandemic on the frequency and course of inflammatory bowel disease in children was evaluated. Methods The first severe acute respiratory syndrome coronavirus 2 case in Türkiye was diagnosed on March 11, 2020. The pandemic period was defined as the year following this date, and the pre-pandemic period as the preceding year. The number of patients newly diagnosed with inflammatory bowel disease and their clinical presentations during the pandemic period and pre-pandemic period was compared. In addition, the clinical features of previously diagnosed inflammatory bowel disease patients in the pandemic period and pre-pandemic period were compared. Results Eighty-six patients in a pediatric gastroenterology clinic between 2009 and 2021 were included. The number of newly diagnosed patients was higher during the pandemic period ( n = 14) compared with the pre-pandemic period ( n = 18; p = 0.017). Fifty-four patients were follow-up patients diagnosed before 2019: the mean number of outpatient clinic visits, disease attacks, and hospitalizations was lower pandemic period than pre-pandemic period ( p < 0.01). Conclusion The changes experienced during pandemic period may have triggered more cases of inflammatory bowel disease. However, we found no evidence that either less face-to-face follow-up of, or life changes in, existing inflammatory bowel disease patients during the pandemic period adversely affected their clinical outcomes.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"227 - 231"},"PeriodicalIF":0.3,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49013289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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