Age and sex‐specific prevalence of serious bacterial infections in febrile infants ≤60 days, in Sweden

Abstract Background Infectious complications in children treated for cancer contribute to their morbidity and mortality. There is a paucity of studies on the incidence, microbiological etiology, risk factors, and outcome of serious bacterial infections in African children treated for cancer. Aim The aim of the study was to delineate the epidemiology of infectious morbidity and mortality in South African children with cancer. Methods This prospective, single-center, longitudinal-cohort study enrolled children one-19 years old hospitalized for cancer treatment at the Paediatric Oncology Unit, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa. Children were investigated for infection as part of the standard of care. Results In total, 169 children were enrolled, 82 with hematological malignancy (HM), 87 with a solid tumor (ST), median age was 68.5 months and 10.7% were living with HIV. The incidence (per 100 child-years) of septic episodes (SE) and microbiologically confirmed SE (MSCE) was 101 (138 vs. 70, P < 0.001) and 70.9 (99.1 vs. 47.3; P < 0.001), respectively; higher in children with HM than ST. The incidence of MCSE in children with high-risk HM (137.7) was 4.32-fold greater compared with those with medium-risk HM (30.3; P < 0.001). Children with metastatic ST had a higher incidence (84.4) of MSCE than those with localized ST (33.6; aOR: 2.52; P < 0.001). The presence of an indwelling catheter was 3-fold (P < 0.001) more likely to be associated with MCSE compared with those without. There was no association for age group, nutritional status or HIV-status, and incidence of MCSE. The incidence of gram-positive (GPB) and gram-negative (GNB) SEs was 48.5 and 37.6, respectively, and higher in children with an HM. The most commonly identified GPB were Coagulase-negative Staphylococci, Streptococcus viridans and Enterococcus faecium; while the most common GNB were Escherichia coli, Acinetobacter baumannii, and Pseudomonas species. The median CRP was higher in children with MSCE compared with those with culture-negative SE (CNSE) (116.5 vs. 92; P < 0.001) in both HM (132.5 vs. 117; P < 0.001) and ST (87.5 vs. 46; P < 0.001). The procalcitonin was higher in those with MSCE compared with those with CNSE (2.30 vs. 1.40; P < 0.001) in both HM (2.95 vs. 1.60; P = 0.002) and ST (2.10 vs. 1.20; P < 0.001). The case fatality risk was 40.4%; 80% was attributed to sepsis. Of these, 35 (72.92%) had HM and 34 of the 35 (97.14%) had HR-HM. Children with HM had an overall sepsis CFR of 42.68%. Four (30.77%) of the 13 sepsis-related deaths in STs had metastatic disease and 8 (16.67%) of the total number of sepsis-related deaths were in children living with HIV. There was no association between malnutrition or HIV-positivity and death. The odds of dying from sepsis were higher in children with profound (aOR 3.96; P = 0.004) and prolonged (aOR 3.71; P = 0.011) neutropenia. Pneumonia (58.85% vs. 29.23%; aOR 2.38; P = 0.025) and tuberculosis (70.83% vs. 34.91%; aOR 4.3; P = 0.005) were independently associated with a higher CFR. Conclusion The current study emphasizes the high burden of sepsis in African children treated for cancer, and especially HM, and highlights the association of tuberculosis and pneumonia as independent predictors of death in children with cancer.

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Assessment of the microbiome during bacteriophage therapy in combination with systemic antibiotics to treat a case of staphylococcal device infection

Microbiome ◽

10.1186/s40168-021-01026-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Andre Mu ◽

Daniel McDonald ◽

Alan K. Jarmusch ◽

Cameron Martino ◽

Caitriona Brennan ◽

...

Keyword(s):

Bacterial Infections ◽

Phage Therapy ◽

Ecological Impacts ◽

Skin Microbiome ◽

Bacteriophage Therapy ◽

Bacterial Diseases ◽

Device Infection ◽

Global Health Issue ◽

Serious Bacterial Infections ◽

Systemic Antibiotics

Abstract Background Infectious bacterial diseases exhibiting increasing resistance to antibiotics are a serious global health issue. Bacteriophage therapy is an anti-microbial alternative to treat patients with serious bacterial infections. However, the impacts to the host microbiome in response to clinical use of phage therapy are not well understood. Results Our paper demonstrates a largely unchanged microbiota profile during 4 weeks of phage therapy when added to systemic antibiotics in a single patient with Staphylococcus aureus device infection. Metabolomic analyses suggest potential indirect cascading ecological impacts to the host (skin) microbiome. We did not detect genomes of the three phages used to treat the patient in metagenomic samples taken from saliva, stool, and skin; however, phages were detected using endpoint-PCR in patient serum. Conclusion Results from our proof-of-principal study supports the use of bacteriophages as a microbiome-sparing approach to treat bacterial infections.

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Identifying Serious Bacterial Infections in Febrile Young Infants

Indian Pediatrics ◽

10.1007/s13312-021-2089-6 ◽

2021 ◽

Vol 58 (1) ◽

pp. 15-19

Author(s):

Vikram Bhaskar ◽

Prerna Batra ◽

Prashant Mahajan

Keyword(s):

Bacterial Infections ◽

Young Infants ◽

Serious Bacterial Infections

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Bacterial Infection and Splenic Reticuloendothelial Function in Children with Hemoglobin SC Disease

PEDIATRICS ◽

10.1542/peds.72.1.93 ◽

1983 ◽

Vol 72 (1) ◽

pp. 93-98

Author(s):

George R. Buchanan ◽

Susan J. Smith ◽

Christine A. Holtkamp ◽

John P. Fuseler

Keyword(s):

Bacterial Infection ◽

Bacterial Infections ◽

Infection Risk ◽

Bacterial Disease ◽

Normal Children ◽

Splenic Function ◽

Focus Of Infection ◽

Serious Bacterial Infections ◽

Primary Focus ◽

Hemoglobin Sc Disease

Although the epidemiology and pathophysiology of serious bacterial infection in homozygous sickle cell anemia (SS disease) have become increasingly well understood, information about infection risk and splenic reticuloendothelial function in hemoglobin SC disease is quite limited. Therefore, the type and frequency of invasive bacterial disease were examined in 51 children with SC disease followed for 370 person-years and splenic function was assessed in 31 patients by quantitation of pitted erythrocytes. Seven serious bacterial infections occurred in four of the patients, five due to Streptococcus pneumoniae and two to Haemophilus influenzae. A primary focus of infection was present in all episodes, none of which proved fatal. Although 30 episodes of pneumonia or chest syndrome occurred in 20 of the patients, a bacterial etiology was proven in only three instances. Splenic function was usually impaired, with a mean pit count of 7.1% ± 8.2% (range 0% to 22.9%). This is significantly greater than normal, but less than pit counts in patients with SS disease or asplenic subjects. Children with SC disease may have a greater risk of bacterial infection than normal children, but their infection rate is not nearly as high as that in patients with SS disease.

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Serious bacterial infections in neonates: improving reporting and case definitions

International Health ◽

10.1093/inthealth/ihx011 ◽

2017 ◽

Vol 9 (3) ◽

pp. 148-155 ◽

Cited By ~ 3

Author(s):

Stefania Vergnano ◽

Anna C. Seale ◽

Elizabeth J.A. Fitchett ◽

Mike Sharland ◽

Paul T. Heath

Keyword(s):

Bacterial Infections ◽

Case Definitions ◽

Serious Bacterial Infections

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Increased Mortality Associated With a Clonal Outbreak of Ceftazidime-ResistantKlebsiella pneumoniae: A Case–Control Study

Infection Control and Hospital Epidemiology ◽

10.1086/502488 ◽

2005 ◽

Vol 26 (1) ◽

pp. 63-68 ◽

Cited By ~ 12

Author(s):

Abdul Qavi ◽

Sorana Segal-Maurer ◽

Noriel Mariano ◽

Carl Urban ◽

Carl Rosenberg ◽

...

Keyword(s):

Infection Control ◽

Bacterial Infections ◽

Case Control Study ◽

Community Hospital ◽

Case Control ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Environmental Cleaning ◽

Serious Bacterial Infections ◽

Control Study

AbstractObjectives:To determine risk factors for ceftazidime-resistantKlebsiella pneumoniaeinfection and the effect of cef-tazidime-resistantK. pneumoniaeinfection on mortality during an isolated outbreak.Design:Case–control investigation using clinical and molecular epidemiology and prospective analysis of infection control interventions.Setting:Surgical intensive care unit of a university-affiliated community hospital.Patients:Fourteen case-patients infected with ceftazidime-resistantK. pneumoniaeand 14 control-patients.Results:Ten of 14 case-patients had identical strains by pulsed-field gel electrophoresis. Broad-spectrum antibiotic therapy before admission to the unit was strongly predictive of subsequent ceftazidime-resistantK. pneumoniaeinfection. In addition, patients with ceftazidime-resistantK. pneumoniaeinfection experienced increased mortality (odds ratio, 3.77).Conclusions:Cephalosporin restriction has been shown to decrease the incidence of nosocomial ceftazidime-resistantK. pneumoniae. However, isolated clonal outbreaks may occur due to lapses in infection control practices. Reinstatement of strict handwashing, thorough environmental cleaning, and repeat education led to termination of the outbreak. A distinct correlation between ceftazidime-resistantK. pneumoniaeinfection and mortality supports the important influence of antibiotic resistance on the outcome of serious bacterial infections.

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Diagnostic Value of PCT and CRP for Detecting Serious Bacterial Infections in Patients With Fever of Unknown Origin

Applied Immunohistochemistry & Molecular Morphology ◽

10.1097/pai.0000000000000552 ◽

2017 ◽

Vol 25 (8) ◽

pp. e61-e69 ◽

Cited By ~ 14

Author(s):

Lan Hu ◽

Qiuping Shi ◽

Miao Shi ◽

Ruixia Liu ◽

Chao Wang

Keyword(s):

Bacterial Infections ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Diagnostic Value ◽

Serious Bacterial Infections

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Renal transplantation outcomes in obese patients: a French cohort-based study

10.21203/rs.3.rs-41397/v2 ◽

2021 ◽

Author(s):

Yohann Foucher ◽

Marine Lorent ◽

Laetitia Albano ◽

Solène Roux ◽

Moglie Le Quintrec ◽

...

Keyword(s):

Kidney Transplant ◽

Graft Survival ◽

Surgical Complications ◽

Bacterial Infections ◽

Study Patient ◽

Cardiac Complications ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Risk Of Death ◽

Serious Bacterial Infections

Abstract Background. Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort. Methods. In this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function. Results. Among the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m². We observed a higher mortality for obese recipients (HR=1.37, p=0.0086) and higher risks of serious bacterial infections (HR=1.24, p=0.0006) and cardiac complications (HR=1.45, p<0.0001). We observed a trend towards death censored graft survival (HR=1.22, p=0.0666) and no significant increased risk of early surgical complications. Conclusions. We showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.

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Efficacy, safety, and tolerability of Kedrion 10% IVIG in primary immunodeficiency

LymphoSign Journal ◽

10.14785/lymphosign-2016-0004 ◽

2016 ◽

Vol 3 (3) ◽

pp. 99-109 ◽

Cited By ~ 1

Author(s):

Mark Stein ◽

Agnes Nemet ◽

Santhosh Kumar ◽

William Lumry ◽

Hartwig Gajek ◽

...

Keyword(s):

Primary Immunodeficiency ◽

Confidence Limit ◽

Bacterial Infections ◽

Phase Iii ◽

Open Label ◽

Safety Endpoint ◽

Ivig Preparation ◽

Phase Iii Study ◽

Serious Bacterial Infections ◽

Primary Safety Endpoint

Background: Primary immunodeficiency involving defective antibody formation requires antibody replacement therapy with immunoglobulin products to prevent and reduce infections. Immunoglobulin for intravenous use (IVIG) is a processed blood product with limited availability, and the various marketed IVIG products may have different tolerability among patients. New IVIG products are therefore necessary to offer options to patients and to reduce the risk of a product shortage. Methods: Forty-five adult and pediatric patients with primary immunodeficiency, documented agammaglobulinemia or hypogammaglobulinemia, and antibody deficiency were enrolled in a prospective, multi-centre, open-label, single-arm historically controlled Phase III study to evaluate the safety, efficacy, and pharmacokinetics of a new 10% IVIG produced by Kedrion. Results: Forty-four patients completed the study while one withdrew consent. Over the 12-month study period, only 2 episodes of acute serious bacterial infections (both bacterial pneumonias) were recorded, for a mean annual event rate of 0.04 per subject, with an upper one-sided 99% confidence limit of 0.11. Values for all secondary efficacy endpoints were comparable with those in similar studies. The primary safety endpoint was met as the rate of infusions temporally associated (i.e., within 72 hours) with ≥1 adverse event was 16% (upper 95% confidence limit 20.4%). Pharmacokinetics were assessed in 31 patients and found to be comparable with those published for other IVIG products. Conclusion: Kedrion IVIG 10% is safe, efficacious, and well tolerated by patients with primary immunodeficiency. Statement of novelty: This report describes the safety, efficacy, and pharmacokinetics of a new IVIG preparation.

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