scholarly journals 1355. Resistance in Gram-Negative Bacteria in the Pediatric Patient Population by Age and Sex

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S689-S689
Author(s):  
Benjamin J Malamet ◽  
Matthew Sims
Keyword(s):  
Antibiotic Resistance ◽  
Pediatric Patient ◽  
Patient Population ◽  
Sample Type ◽  
Adult Males ◽  
Gram Negative ◽  
Pediatric Age Group ◽  
Gender And Age ◽  
Early Peak ◽  
Pediatric Patient Population

Abstract Background Previous research within the Beaumont Infectious Diseases Research Program found an overall increase in antibiotic resistance in adult males versus females. Furthermore, there is a peak in resistance in 18-29-year-old males, not seen in females. The origin of this early peak of antibiotic resistance in adults is unclear. This study examines these trends in the pediatric patient population. Methods Resistance data for all Gram-negative bacterial clinical isolates from Beaumont Health System’s clinical microbiology lab between October 1st, 2010, and December 31st, 2014 was analyzed. The pediatric isolates were categorized into sextiles (0-2, 3-5, 6-8, 9-11, 12-14, 15-17) and the sensitivities for each antibiotic were compared based on gender and age and separated by urine isolates vs. non-urine isolates to account for potential bias based on an abundance of urine samples in females. Results There were 7878 pediatric Gram-negative bacterial isolates in the database, and 96 duplicate samples were removed, leaving 7782 isolates to be analyzed. There were more female isolates (n=6888) than male isolates (n=890) due to the preponderance of urine cultures in females. At most age ranges, antibiotic resistance was significantly higher in males than females. In males, antibiotic resistance was highest between 12-14 and 15-17 years old. When analyzing the cultures based on sample type, the peak in resistance in males is seen in urine isolates, but the patterns of resistance are chaotic in non-urine isolates. This is likely attributable to a low number of isolates. Conclusion Sex is an important factor in determining antibiotic resistance in the pediatric patient population, as males exhibit higher resistance. The peak in antibiotic resistance initially noted in 18-29-year-old males in previous research originates in the pediatric age group and appears to develop between 12-17 years old. Further research is needed to determine the cause of the observed gender bias, to ascertain if it is modifiable in order to reduce antibiotic resistance. Disclosures All Authors: No reported disclosures

Vestibular Testing in Children

1980 ◽  
Vol 89 (5_suppl) ◽  
pp. 63-69 ◽  
Author(s):  
David G. Cyr
Keyword(s):  
Young Child ◽  
Pediatric Patient ◽  
Patient Population ◽  
Closed Loop ◽  
Pediatric Population ◽  
Caloric Irrigation ◽  
The Past ◽  
Vestibular Testing ◽  
Ocular Movement ◽  
Pediatric Patient Population

Vestibular evaluation in the pediatric population has in the past taken several forms. For the most part, the pediatric vestibular evaluation has been more subjective than objective. One of the primary reasons for this has been the obvious difficulties encountered in trying to conduct a standard, adult electronystagmography (ENG) procedure on a pediatric patient population not capable of performing in a manner conducive to a good ENG recording. The purpose of this paper is to suggest certain modifications of the standard adult ENG battery for use with young children and infants. Discussion consists of modifications in the areas of various ocular movement tests including sinusoidal pursuit, calibration, optokinetics and gaze testing. In addition, procedures relative to peripheral vestibular output from perrotational and caloric stimulation are discussed. Topics also include the use of a closed-loop caloric irrigator and simultaneous caloric irrigation as viable alternatives to standard, alternate water irrigation when testing the vestibular output of a young child or infant.

Fluoroscopically guided, transoral, closed reduction, and halo vest immobilization for an atypical C-1 fracture

2011 ◽  
Vol 7 (4) ◽  
pp. 380-382 ◽  
Author(s):  
Matthew R. Sanborn ◽  
Michael L. DiLuna ◽  
Robert G. Whitmore ◽  
Phillip B. Storm
Keyword(s):  
Pediatric Patient ◽  
Conservative Management ◽  
Closed Reduction ◽  
Patient Population ◽  
Pediatric Population ◽  
Halo Vest ◽  
Anterior Arch ◽  
Pediatric Patient Population ◽  
Displaced Fracture

Fractures through the ring of the C-1 vertebrae are very rare in the pediatric patient population. In this report, the authors describe the case of a widely displaced fracture of the C-1 anterior arch in a 6-year-old boy. The fracture was initially treated using a fluoroscopy-guided, transoral, closed reduction with subsequent halo vest immobilization. Although conservative management of C-1 fractures is generally adequate and efficacious in the pediatric population, mechanistic and anatomical considerations in this case were concerning for potential instability in extension, and prompted an unusual method of closed reduction followed by treatment in a halo vest.

Hemodialysis access in the pediatric patient population

1994 ◽  
Vol 168 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Alan B. Lumsden ◽  
M. Julia MacDonald ◽  
Robert C. Allen ◽  
Thomas F. Dodson
Keyword(s):  
Pediatric Patient ◽  
Patient Population ◽  
Hemodialysis Access ◽  
Pediatric Patient Population
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