scholarly journals Paediatric critical illness associated with respiratory infection: a single-centre, retrospective cohort study

2020 ◽  
Vol 4 (1) ◽  
pp. e000640
Author(s):  
Haifa Alfaraidi ◽  
Kathy Luinstra ◽  
Alireza Eshaghi ◽  
Marek Smieja ◽  
Jonathan B Gubbay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critically Ill ◽  
Respiratory Infection ◽  
Chlamydia Pneumoniae ◽  
Respiratory Infections ◽  
Diagnostic Testing ◽  
Respiratory Viruses ◽  
Clinical Syndrome ◽  
Critically Ill Children ◽  
Single Centre

ObjectivesTo describe critically ill children with respiratory infections, classify them by infection syndrome type and determine the prevalence of Mycoplasma pneumoniae detection.Study designA retrospective, single-centre cohort study. All children aged 2 months–18 years with presumed respiratory infection who were admitted to a tertiary hospital paediatric intensive care unit (PICU) between September 2015 and October 2016 were eligible. Subjects were grouped by clinical syndrome (viral respiratory infection, asthma exacerbation, undifferentiated/uncomplicated pneumonia, pneumonia complicated by effusion/empyema and ‘other’). All subjects had nasopharyngeal swabs tested for respiratory viruses, M. pneumoniae and Chlamydia pneumoniae.ResultsThere were 221 subjects; the median age was 3.1 years; 44% were female; and 78% had medical comorbidities. The majority (75%) was treated with antibiotics, most often ceftriaxone (90% of treated children). Those with any pneumonia were significantly less likely to have a respiratory virus identified in their nasopharynges and had significantly higher C reactive protein (CRP) values than those in the viral infection and asthma groups. There were 10 subjects in whom M. pneumoniae was detected (4.5%, 95% CI 2.2% to 8.2%). Mycoplasma-positive children were older (difference 3.5 years, 95% CI 0.66 to 6.4 years) and had fewer viral coinfections (30% compared with 69%, p=0.02). The prevalence of Mycoplasma infection in children aged >5 years with any pneumonia was 13.2% (95%CI 4.4% to 28%).ConclusionsThe majority of participants had respiratory viruses detected and were treated with broad-spectrum antibiotics. Differences in CRP and viral prevalence were observed between children with different infection syndrome types. M. pneumoniae infection was not rare in school-aged children with pneumonia admitted to the PICU. Attention to antibiotic treatment and rapid diagnostic testing for Mycoplasma in older, critically ill children should be considered to optimise management and avert morbidity and mortality from respiratory infection.

scholarly journals Rapid Assay for Sick Children with Acute Lung infection Study (RASCALS): diagnostic cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e056197
Author(s):  
John Alexander Clark ◽  
Iain Robert Louis Kean ◽  
Martin D Curran ◽  
Fahad Khokhar ◽  
Deborah White ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critically Ill ◽  
Clinical Decision Making ◽  
16S Rrna Gene Sequencing ◽  
Critically Ill Children ◽  
Molecular Testing ◽  
Rrna Gene ◽  
Single Centre ◽  
Blood Draw ◽  
Wide Range

IntroductionLower respiratory tract infection (LRTI) is the most commonly treated infection in critically ill children. Pathogens are infrequently identified on routine respiratory culture, and this is a time-consuming process. A syndromic approach to rapid molecular testing that includes a wide range of bacterial and fungal targets has the potential to aid clinical decision making and reduce unnecessary broad spectrum antimicrobial prescribing. Here, we describe a single-centre prospective cohort study investigating the use of a 52-pathogen TaqMan array card (TAC) for LRTI in the paediatric intensive care unit (PICU).Methods and analysisCritically ill children with suspected LRTI will be enrolled to this 100 patient single-centre prospective observational study in a PICU in the East of England. Samples will be obtained via routine non-bronchoscopic bronchoalveolar lavage which will be sent for standard microbiology culture in addition to TAC. A blood draw will be obtained via any existing vascular access device. The primary outcomes of the study will be (1) concordance of TAC result with routine culture and 16S rRNA gene sequencing and (2) time of diagnostic result from TAC versus routine culture. Secondary outcomes will include impact of the test on total antimicrobial prescriptions, a description of the inflammatory profile of the lung and blood in response to pneumonia and a description of the clinical experience of medical and nursing staff using TAC.Ethics and disseminationThis study has been approved by the Yorkshire and the Humber-Bradford Leeds Research Ethics Committee (REC reference 20/YH/0089). Informed consent will be obtained from all participants. Results will be published in peer-reviewed publications and international conferences.Trial registration numberNCT04233268.

Clinical Outcomes in Critically Ill Children With Excess Weight: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Caroline Abud Drumond Costa ◽  
Rita Mattiello ◽  
Gabriele Carra Forte ◽  
Gabriela Rupp Hanzen Andrades ◽  
Francielly Crestani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Excess Weight ◽  
Critically Ill Children

scholarly journals Serum cystatin is a useful marker for the diagnosis of acute kidney injury in critically ill children: prospective cohort study

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Osama Y. Safdar ◽  
Mohammed Shalaby ◽  
Norah Khathlan ◽  
Bassem Elattal ◽  
Mohammed Bin Joubah ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Critically Ill ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum Cystatin

scholarly journals Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

2019 ◽  
Vol 6 (5) ◽  
pp. 1981
Author(s):  
Hawwa M.S. Siddiqua ◽  
Mathew John ◽  
V. C. Manoj ◽  
Rati Santhakumar
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Critically Ill ◽  
Cystatin C ◽  
Prospective Cohort ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum And Urine

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

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