Journal of Pediatric Infectious Diseases - Volume 3, issue 4
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Journal of Pediatric Infectious Diseases is a peer-reviewed medical journal, publishing articles in the field of child infectious diseases. The journal provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques in diagnosis and treatment of childhood infectious diseases.
The following articles will be considered for publication: editorials, original and review articles, rapid communications, case reports, letters to the editor and book reviews.
The aim of the
Journal of Pediatric Infectious Diseases is to share and disseminate knowledge between all disciplines that work in the field of pediatric infectious diseases.
Abstract: Dengue infection has become one of the most important public health problems worldwide. It can be asymptomatic or cause illnesses ranging from a mild to a severe and sometimes fatal disease. The mechanism underlying disease severity is still not fully understood. Several studies, however, have suggested an immune-mediated process. There are three potential factors contributing to disease severity, including host genetic, virological and epidemiological factors. Recent studies have demonstrated host genetic factors…that correlate with susceptibility or resistance to severe dengue infection. Several human leukocyte antigen alleles and non-human leukocyte antigen alleles have been investigated and found to be associated with dengue infection and disease severity. Further studies of genetic risk factors will undoubtedly give important insights into the mechanism of dengue virus pathogenesis leading to the development of more effective strategies for risk assessment, immunotherapy as well as vaccine design.
Abstract: Infections with organisms producing extended-spectrum beta-lactamases are associated with well established risk factors and poor outcomes in adults, but these are less well defined in children. Our case-control analysis showed that infections with extended-spectrum beta-lactamases producing organisms are linked to prolonged antibiotic usage and are possibly associated with prolonged length of stay and worse overall outcomes in hospitalized children. Efforts to limit the duration and narrow the spectrum of antimicrobial therapy may…assist in controlling infections due to these organisms.
Keywords: ESBL, extended-spectrum beta-lactamases, antimicrobials, E. coli, K. pneumoniae, children, pediatrics
Abstract: Our aim is to study the demographic features, clinical presentations, laboratory and radiographic findings, management, and outcome of children with acute osteomyelitis in Kingdom of Saudi Arabia. A retrospective chart review study of children 14 years of age and younger, with acute osteomyelitis hospitalized in King Fahad National Guard Hospital, Riyadh during the 10-years period, and January 1997 through December 2006. Seventy-five patients (67% males), aged 9 days to 12 years of age, were studied. The…peak incidence rate of osteomyelitis was during the first year of life. Pain, fever and localized signs were the most frequent symptoms and signs. The white blood cell count and erythrocyte sedimentation rate were elevated in 27% and 87% of cases respectively. Cultures of blood and tissue were positive in 27% and 73% of patients respectively. Staphylococcus aureus was the commonest causative agent, isolated from 55% of patients. No methicillin-resistant S. aureus was recovered from these patients. Abnormal plain radiographs were seen in 54%, positive skeletal scintigraphy in 93%, and diagnostic magnetic resonance imaging in 100% of cases in whom these investigations were performed. The most commonly involved bones were those of the lower extremities (76%). The majority of patients (38%) were initially treated with either intravenous cloxacillin or cefuroxime. In all patients infected with S. aureus the intravenous therapy was followed by oral first generation cephalosporin's until the 3 weeks course was completed. In patients infected with other organisms appropriate antibiotic therapy directed by susceptibility testing was initiated. The infection resolved in 73 (97%) of children and persisted in two (3%). Our data indicate that acute osteomyelitis is as common in young infants of this series from Kingdom of Saudi Arabia as it is from other parts of the world. The early diagnosis and administration of appropriate antimicrobial therapy results in good outcome.
Keywords: Acute osteomyelitis, children, S. aureus, skeletal scintigraphy, MRI
Abstract: Infections are responsible for significant mortality and long-term morbidity for infants in the neonatal intensive care unit (NICU). We are reporting an outbreak of neonatal cellulites and sepsis caused by a unique species of Salmonella (Salmonella worthington). We also provide the steps that were initiated in order to control such an unusual epidemic. Our aim is to increase awareness of the community to this rare but serious infection with its unique presentation, and re-emphasize the importance…of hand hygiene in the control of infections. This is a retrospective observational study. Data on septicemia and cellulites were collected during January-October 2002 and January-October 2003 in the NICU at Dr. Soetomo hospital. A total of 24 infants with cellulites-septicemia were identified during the period of January-October 2002. Of them 12 cases died. Blood culture of all cases grew S. worthington. All infections occurred during the first 3 days of life. Only one case was identified in the period of January-October 2003; this infant survived. All of the isolates recovered were sensitive to amikacin, chloramphenicol, and meropenem, while resistant to ampicillin. Two third of the cases were sensitive to cefopime 66% Environmental cultures recovered S. worthington from hands of healthcare providers. Outbreaks of S. worthington in NICU have high case-fatality rate, but can be efficiently controlled with hand washing or hand spraying. Cellulites in the newborn are a warning sign for infection with S. worthington.
Keywords: NICU, sepsis, infants, alcohol-glycerin mixture, hand washing
Abstract: Urinary tract infection (UTI) is common among young infants. The diagnosis of UTI requires a better understanding of the clinical and laboratory presentations in this age group. This study describes the clinical and laboratory aspects of UTI in young infants who were born preterm compared with infants who were born full term. All infants aged less than 3 months who had their first episode of UTI (excluding infants with UTI that occurred during neonatal intensive care…unit stay) between July 2003 and June 2006 were retrospectively analyzed. A total of 73 infants (32 preterm and 41 term) were included. Clinical and laboratory presentations were compared between the two groups. Overall, 49.3% of patients had fever, 52% had poor feeding, 47.9% had vomiting, and 39.7% had apnea. There were no significant differences in clinical features of UTI between the two groups. Term infants had an elevated C-reactive protein in 45% of cases, leukocytosis in 30.8% and thrombocytosis in 61.5%, while preterm infants had elevated C-reactive protein in 21.9% of cases, leukocytosis in 3.6%, and thrombocytosis in 35.7%, (P = 0.041, P = 0.037, and P = 0.008, respectively). Urinary leukocytes were present in 40% of term and in 26% of preterm infants (P = 0.360). There was no difference in vesicoureteral reflux between the two groups. Clinical features of UTI of early infancy were similar in preterm and term infants. Both groups had similar vesicoureteral reflux. Symptomatic preterm infants with UTI were less likely to have abnormal laboratory findings.
Keywords: Urinary tract infection, young infants, term, preterm, CRP, thrombocytosis
Abstract: Several outbreaks of Pseudomonas aeruginosa have been published in neonatal and pediatric patients, but no systematic analysis is available. Medline and outbreak-database search, systematic analysis of outbreak reports (confirmed by genotyping). Twenty-four studies were included. Outbreaks caused by P. aeruginosa resulted in high morbidity (median clinical infection rate: 68%; range: 0–100%), mortality (median 27%; 0–100%) and resource consumption in neonatal and pediatric inpatient facilities. In most cases, these outbreaks indicate certain breaches…in basic hygienic practices or are due to the persistence of P. aeruginosa in environmental vectors and reservoirs (tap water, medical devices, and fomites). The majority of the reported isolates displayed multi-resistance to first-line antibiotics. The clinical observation of two or more temporally related cases of nosocomial P. aeruginosa infections should raise the suspicion of an outbreak particularly in high-risk pediatric patient populations (neonatal intensive care unit, pediatric intensive care unit, oncology) and when the isolate displays resistance to two or more first-line antibiotics. Strict hygienic barrier precautions should immediately be implemented, re-educated and supervised. Well-planned environmental culturing should be performed, paying special attention to water, water outlets, sinks and other wet areas, to identify environmental reservoirs. A water safety plan based on the WHO Guidelines for Drinking Water Quality must be introduced. The current strategy of empiric antibiotic treatment should be investigated by an infectious diseases' specialist. Genotyping of the isolates by pulse-field gel electrophoresis should be performed, but any interventions to interrupt further nosocomial spread should be carried out without waiting for the results.
Abstract: Sandfly fever (SF) viruses are known to spread in the Mideteranean basin and some species were shown to cause different forms of encephalitis. This case report describes an 8-year-old girl who was admitted to a rural hospital in Egypt with fever and myalgia. The clinical presentation included signs suggesting cerebrospinal infection. Cerebrospinal fluid aspects suggested viral infection. Virological diagnosis was obtained by serological tests, and reverse transcriptase-polymerase chain reaction and virus isolation cultures…against a panel of viruses. Enzyme-linked immunosorbent assay IgM antibodies and plaque reduction neutralization tests suggested that sandfly Scilian virus is the causing etiology.
Abstract: Myvobacterium marinum is an atypical Mycobacterium belonging to Runyon's classification group I. It is the most common atypical mycobacterium to cause infection in humans. However, the infection appears to be rare in the pediatric population. Clinically, patients may present a single cutaneous lesion, such as an erythematous papule, nodule, plaque, sporotrichoid lesions or ulcers at the inoculation site. We present an unusual case of multiple "swimming pool granulomas" in an immunocompetent child who had a…history of non-chloridrated water exposure. Our patient presented with lesions located in non-contiguous body sites, suggesting either systemic dissemination or multiple sites of inoculation as possible pathogenesis.
Abstract: An 18-month-old boy was hospitalized with left hand cellulitis and lymphangitis following a dog bite that was contaminated with soil. Cultures grew pink colonies of Gram-negative bacilli identified as Methylobacterium mesophilicum. He was treated with local debridement and intravenous ampicillin/sulbactam followed by oral amoxicillin/clavulanate with complete resolution of symptoms.
Keywords: Methylobacterium mesophilicum, cellulitis, lymphangitis, dog bite