scholarly journals Prevalence and Molecular Characterization of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in a Pediatric Patient Population

2012 ◽  
Vol 56 (9) ◽  
pp. 4765-4770 ◽  
Author(s):  
Lakshmi Chandramohan ◽  
Paula A. Revell
Keyword(s):  
Pediatric Patient ◽  
Patient Population ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Content Type ◽  
Extended Spectrum ◽  
Pediatric Patient Population ◽  
Pediatric Infections ◽  
Relative Prevalence

ABSTRACTVery little is known about the prevalence and composition of various types of extended-spectrum β-lactamases (ESBL) in pediatric patients. The aims of this study were the following: (i) to determine the prevalence of ESBLs amongEnterobacteriaceaein a tertiary-care pediatric population; (ii) to characterize the genetic composition of the identified ESBL enzymes; and (iii) to determine the relative prevalence of CTX-M enzymes andEscherichia coliST131 strains among ESBL-producing isolates in the same pediatric patient population. Among the 1,430Enterobacteriaceaeisolates screened for elevated MICs to cefotaxime and/or ceftazidime from pediatric patients during a 1-year period, 94 isolates possessed at least one ESBL gene. CTX-M was the most commonly isolated ESBL type, consisting of 74% of all ESBLs versus 27% TEM and 24% SHV enzymes. Sequence analysis and probe-specific real-time PCR revealed that the majority (80%) of the CTX-M-type ESBLs were CTX-M-15 enzymes, followed by CTX-M-14 (17%) and CTX-M-27(2.8%). Multilocus sequence typing (MLST) and repetitive PCR analyses revealed that the relative prevalence of ST131 among ESBL-producingE. coliisolates is 10.2%. This study highlights the growing problem of ESBL resistance in pediatricEnterobacteriaceaeisolates and demonstrates a transition toward the predominance of CTX-M-type enzymes among ESBL-producingEnterobacteriaceaeorganisms causing pediatric infections.

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.

scholarly journals Thromboembolic Complications in a Pediatric Patient Population: Treatment with Direct Oral Anticoagulants. Monitoring of Treatment Efficiency with D-Dimer Levels and Safety Profile By Thromboelastogram

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4270-4270
Author(s):  
Afshin Ameri ◽  
Courtney M Anderson ◽  
Joetta H Smith ◽  
Julisa Patel
Keyword(s):  
Pediatric Patient ◽  
Patient Population ◽  
Conflicts Of Interest ◽  
Pediatric Population ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Coagulation Factor ◽  
Thrombin Inhibitor ◽  
Pediatric Patient Population ◽  
D Dimer

Abstract Direct oral anticoagulants (DOAC) such as the thrombin inhibitor Dabigatran and the coagulation factor Xa inhibitors Apixaban and Rivaroxaban have been in clinical use for the past 5-6 years. Familiarity with their use in the general pediatric population with thrombosis secondary to inflammatory disorders and rheumatologic disease is currently not as prevalent due to the widespread more conventional anticoagulation practice with the fractionated heparins in particular Lovenox. In this report we would like to summarize our experience in a pediatric patient population ranging from 3- 17 years with thrombotic disease. Of 55 patients with various thrombotic events 16 patients were treated with DOAC. There were 5 patients who had underlying inflammatory disease including COVID. Thrombotic complications included arterial as well as venous thrombotic events. All patients had elevated D-Dimer levels ranging from 360-4000 mcg/ml on diagnosis and normalized with successful anticoagulation. All patients had resolution of thrombosis. Thrombelastogram (TEG) were obtained on isolated patients during therapy and were useful to balance anticoagulation to prevent hemorrhagic complications. In conclusion, DOAC are a safe and effective alternative to LMW Heparin in pediatric patients with arterial or venous thrombosis. Monitoring should include determination of D-Dimer levels for efficacy of treatment and TEG in cases with arterial disease where bleeding may be a secondary complication of therapy. Disclosures No relevant conflicts of interest to declare.

Investigation of High-Risk ST131 Clone in Extended Spectrum β-Lactamase–Producing Escherichia coli Isolates in Children

2021 ◽  
Author(s):  
Mehmet E. Bulut ◽  
Gülen Hürkal ◽  
Nazan Dalgıç
Keyword(s):  
Escherichia Coli ◽  
High Risk ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Maldi Tof Ms ◽  
E Coli ◽  
Maldi Tof ◽  
Extended Spectrum ◽  
St131 Clone ◽  
Tof Ms

Abstract Objective Antimicrobial resistance poses a serious threat to children's health. In recent years, high-risk Escherichia coli ST131 has become an important target for global surveillance studies. The E.coli ST131 clone is associated with extended spectrum β-lactamase (ESBL) production, as well as multidrug resistance and treatment failure. Studies on this clone in the pediatric age group are limited. We aim to investigate the rate of high-risk E. coli ST131 clone in ESBL-positive E. coli isolates obtained from pediatric patients. Methods A total of 292 ESBL-positive E. coli isolates from clinical samples of pediatric patients was included in the study. MALDI-TOF MS system was used for bacterial identification. Susceptibility tests were performed using BD Phoenix automated system. ST131 detection was done by MALDI-TOF-MS. Fisher's exact test was used to compare the groups (significance <0.05). Results A total of 292 isolates was analyzed. The high-risk ST131 clone was detected in 117 (40%) of the 292 ESBL-positive isolates. ST131 rates were found to be significantly higher in children under the age of 5 years compared with children over the age of 5 years (49.3 vs. 31.1%, p = 0.0019). Ciprofloxacin resistance was higher in ST131 isolates (45.6 vs. 31.7%; p < 0.05). Conclusion The rate of the ST131 clone was found to be high in the pediatric population. The significantly high rate of resistance to ciprofloxacin, which is not commonly used in the pediatric population, in ST131 isolates reveals the importance of the spread of high-risk clones for the development of resistance.

MR Imaging of Meningioangiomatosis in a Pediatric Population

Neurographics ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. 325-329
Author(s):  
A. Bhatia ◽  
S. Saade-Lemus ◽  
J.M. Ndolo ◽  
W. Chow ◽  
E.S. Schwartz
Keyword(s):  
Mr Imaging ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Brain Lesion ◽  
Solitary Lesion ◽  
Leptomeningeal Enhancement ◽  
Histopathologic Diagnosis

Meningioangiomatosis (MA) is a rare intracranial hamartomatous lesion. We retrospectively reviewed the MRIs in 6 pediatric patients with a histopathologic diagnosis of MA. Patients with MA demonstrated a solitary lesion in the frontotemporal regions, with FLAIR hyperintensity and leptomeningeal enhancement. A solitary brain lesion in the frontotemporal lobes associated with leptomeningeal enhancement and T2/FLAIR hyperintensity should include the possibility of MA in a pediatric patient who presents with seizures or headaches.

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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