Pub Date : 2020-06-01DOI: 10.33590/emjmicrobiolinfectdis/20-00001
S. Uwaezuoke, A. Ayuk, U. Muoneke
Urinary tract infection (UTI) is a significant cause of morbidity in children. Delayed treatment is associated with complications that may result in chronic kidney disease and, subsequently, end-stage kidney disease. Over the years, clinical practice guidelines have advanced to ensure the best global practices in treating the infection and preventing its progression to chronic kidney disease. The established practice guidelines address five main questions: 1) which children should have their urine tested; 2) how the sample should be obtained; 3) which radiological tests are recommended after a diagnosis of UTI; 4) how the infection should be treated; 5) and how affected children should be followed up. There is a substantial overlap in the recommendations of the American Academy of Pediatrics (AAP) guidelines and the UK’s National Institute for Health and Clinical Excellence (NICE) guidelines. Subtle differences, however, exist between the two established guidelines. An evidence-based paradigm shift of some traditional concepts about UTI in children has contributed to the revision and update of these guidelines. Further research is needed to clarify the role of host and genetic factors in renal scarring, as well as the diagnostic criteria for UTI. This narrative review aims to discuss the current recommendations of these established practice guidelines with an emphasis on the diagnosis, radiological investigation, treatment, and follow-up of UTI in children.
{"title":"Urinary Tract Infection in Children: A Review of the \u0000Established Practice Guidelines","authors":"S. Uwaezuoke, A. Ayuk, U. Muoneke","doi":"10.33590/emjmicrobiolinfectdis/20-00001","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20-00001","url":null,"abstract":"Urinary tract infection (UTI) is a significant cause of morbidity in children. Delayed treatment is associated with complications that may result in chronic kidney disease and, subsequently, end-stage kidney disease. Over the years, clinical practice guidelines have advanced to ensure the best global practices in treating the infection and preventing its progression to chronic kidney disease. The established practice guidelines address five main questions: 1) which children should have their urine tested; 2) how the sample should be obtained; 3) which radiological tests are recommended after a diagnosis of UTI; 4) how the infection should be treated; 5) and how affected children should be followed up. There is a substantial overlap in the recommendations of the American Academy of Pediatrics (AAP) guidelines and the UK’s National Institute for Health and Clinical Excellence (NICE) guidelines. Subtle differences, however, exist between the two established guidelines. An evidence-based paradigm shift of some traditional concepts about UTI in children has contributed to the revision and update of these guidelines. Further research is needed to clarify the role of host and genetic factors in renal scarring, as well as the diagnostic criteria for UTI. This narrative review aims to discuss the current recommendations of these established practice guidelines with an emphasis on the diagnosis, radiological investigation, treatment, and follow-up of UTI in children.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41575068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.33590/emjmicrobiolinfectdis/20-00034
K. Diba, K. Makhdoomi, Shima Aboutalebian
Background: There is an increasing incidence of life-threatening systemic mycoses, specifically fulminant infections by the Candida species in hospitalised patients and in those who are immunocompromised. Management of the limited number of antifungal drugs currently available requires the identification of infections containing drug-resistant isolates. Objectives: The aim of this study was to identify the non-albicans Candida species as azole-resistant fungi, isolated from sputum and bronchoalveolar lavage specimens of hospitalised cases. Methods: The subjects included hospital-acquired infection (HAI) cases, with a primary diagnosis using a direct microscopic examination, performed for the detection of probable fungi. The molecular tests of PCR-restriction fragment length polymorphism (RFLP) and real-time PCR were performed to confirm the identity and molecular typing of the Candida isolates. Antifungal susceptibility testing (AFST), by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) minimum inhibitory concentration (MIC) (M27-A2) method, was performed on the hospital-isolated Candida species. Results: During 24 months, from August 2014 to September 2016, a total of 198 samples were obtained from cases with proven HAI. The results of experimental studies on the specimens showed 93 (47%) positive cases for a fungal or bacterial infection, of which 54 (58%) had a fungal infection. It was hypothesised that all of the isolated organisms were causative agents of the HAI. Conclusions: The results showed that the medium CHROMagar™ Candida is an accessible and easy-to-use method for the identification of infection, but not as accurate and reliable as PCR-RFLP and real-time PCR methods. Results also showed decreasing susceptibility to azoles (itraconazole in this study) of the Candida species.
{"title":"Molecular Identification and Antifungal \u0000Susceptibility Profiles of Non-albicans Candida\u0000Species Clinical Isolates","authors":"K. Diba, K. Makhdoomi, Shima Aboutalebian","doi":"10.33590/emjmicrobiolinfectdis/20-00034","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20-00034","url":null,"abstract":"Background: There is an increasing incidence of life-threatening systemic mycoses, specifically fulminant infections by the Candida species in hospitalised patients and in those who are immunocompromised. Management of the limited number of antifungal drugs currently available requires the identification of infections containing drug-resistant isolates.\u0000\u0000Objectives: The aim of this study was to identify the non-albicans Candida species as azole-resistant fungi, isolated from sputum and bronchoalveolar lavage specimens of hospitalised cases.\u0000\u0000Methods: The subjects included hospital-acquired infection (HAI) cases, with a primary diagnosis using a direct microscopic examination, performed for the detection of probable fungi. The molecular tests of PCR-restriction fragment length polymorphism (RFLP) and real-time PCR were performed to confirm the identity and molecular typing of the Candida isolates. Antifungal susceptibility testing (AFST), by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution (BMD) minimum inhibitory concentration (MIC) (M27-A2) method, was performed on the hospital-isolated\u0000Candida species.\u0000\u0000Results: During 24 months, from August 2014 to September 2016, a total of 198 samples were obtained from cases with proven HAI. The results of experimental studies on the specimens showed 93 (47%) positive cases for a fungal or bacterial infection, of which 54 (58%) had a fungal infection. It was hypothesised that all of the isolated organisms were causative agents of the HAI.\u0000\u0000Conclusions: The results showed that the medium CHROMagar™ Candida is an accessible and easy-to-use method for the identification of infection, but not as accurate and reliable as PCR-RFLP and real-time PCR methods. Results also showed decreasing susceptibility to azoles (itraconazole in this study) of the Candida species.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48060122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.33590/emjmicrobiolinfectdis/20f20601
Lenos Archer-Diaby
PANDEMIC: the term making headlines across the world, instilling fear in many, and urging scientists across the world to unite and find a cure. For as long as the global population has exploited freedom of travel, so too have infectious diseases spread. Outbreaks have been nearly constant since the dawn of mankind; however, not all escalate to global levels. There have been many pandemics in history, the most recent being COVID-19 declared as such by the World Health Organization (WHO) on March 12th, 2020.1 As the COVID-19 pandemic continues to disrupt our everyday lives, it is important to look back in history and reflect on what previous pandemics have taught us.
{"title":"Lessons Learned from a Global History of Pandemics","authors":"Lenos Archer-Diaby","doi":"10.33590/emjmicrobiolinfectdis/20f20601","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20f20601","url":null,"abstract":"PANDEMIC: the term making headlines across the world, instilling fear in many, and urging scientists across the world to unite and find a cure. For as long as the global population has exploited freedom of travel, so too have infectious diseases spread. Outbreaks have been nearly constant since the dawn of mankind; however, not all escalate to global levels. There have been many pandemics in history, the most recent being COVID-19 declared as such by the World Health Organization (WHO) on March 12th, 2020.1 As the COVID-19 pandemic continues to disrupt our everyday lives, it is important to look back in history and reflect on what previous pandemics have taught us.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47276126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.33590/emjmicrobiolinfectdis/20f10601
K. Colvin
CONTAINING a viral outbreak with public health measures firstly requires identification of the causative virus, followed by more detailed understanding of viral features. Genomic sequencing provides exhaustive insight into viral features that may help predict outbreak behaviours, assist in diagnosis and tracking, and shape treatment and vaccination strategies. When coupled with epidemiologic study of outbreak data, viral genomic sequencing can be used to direct public health measures and increase the speed of understanding compared to epidemiology alone. Community spread of cases can be used to guide mathematic models and contact tracing of viral outbreaks for public health response. However, epidemiologic data alone better suits responses to low-prevalence and less-widespread outbreaks. Where pathogens have a longer latency period or spread affects rural and remote communities, features of the virus itself must be considered in determining the response. Genotypic and phenotypic characteristics, identified using molecular biology tools, can clarify the type and strain of a virus responsible for an outbreak, and inform and improve case diagnosis, treatment options, and vaccine development, as well as improve tracing accuracy.1
{"title":"Know Thine Enemy: Viral Genome Sequencing in Outbreaks","authors":"K. Colvin","doi":"10.33590/emjmicrobiolinfectdis/20f10601","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20f10601","url":null,"abstract":"CONTAINING a viral outbreak with public health measures firstly requires identification of the causative virus, followed by more detailed understanding of viral features. Genomic sequencing provides exhaustive insight into viral features that may help predict outbreak behaviours, assist in diagnosis and tracking, and shape treatment and vaccination strategies. When coupled with epidemiologic study of outbreak data, viral genomic sequencing can be used to direct public health measures and increase the speed of understanding compared to epidemiology alone.\u0000\u0000Community spread of cases can be used to guide mathematic models and contact tracing of viral outbreaks for public health response. However, epidemiologic data alone better suits responses to low-prevalence and less-widespread outbreaks. Where pathogens have a longer latency period or spread affects rural and remote communities, features of the virus itself must be considered in determining the response. Genotypic and phenotypic characteristics, identified using molecular biology tools, can clarify the type and strain of a virus responsible for an outbreak, and inform and improve case diagnosis, treatment options, and vaccine development, as well as improve tracing accuracy.1","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45488125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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