scholarly journals Prevalence, Clinical Features, and Outcome of Pseudomonas Bacteremia in Under-Five Diarrheal Children in Bangladesh

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Farhana Akram ◽  
Mark A.C. Pietroni ◽  
Pradip Kumar Bardhan ◽  
Samira Bibi ◽  
Mohammod Jobayer Chisti
Keyword(s):  
Chart Review ◽  
Case Fatality ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
Diarrhoeal Disease ◽  
Multidrug Resistant ◽  
Under Five ◽  
Disease Research ◽  
Resource Poor ◽  
Hospital Management System

We sought to evaluate the prevalence, associated factors, and outcome of under-five diarrheal children with either sex having Pseudomonas bacteremia. A retrospective chart review of under-five diarrheal children admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), from January 2011 to December 2011 was performed using an online hospital management system. Children with Pseudomonas bacteremia constituted the cases (n = 31), and the controls (n = 124), without Pseudomonas bacteremia, were randomly selected. The prevalence of Pseudomonas bacteremia was 1% (31/5,179). The Pseudomonas was multidrug resistant but was 84% sensitive to ceftazidime and 100% to imipenem. The case-fatality rate was significantly higher among the cases than the controls (26% versus 5%; P = 0.003). In logistic regression analysis, after adjusting for potential confounders such as severe wasting, severe underweight, severe pneumonia, and young age (11.71 (4.0, 18.0) months), the cases more often presented with absent peripheral pulses in absence of dehydration (95% CI = 2.31–24.45) on admission. This finding underscores the importance of early identification of this simple clinical sign to ensure prompt management including fluid resuscitation and broad spectrum antibiotics to help reduce morbidity and mortality in such children, especially in resource-poor settings.

scholarly journals G6PD deficiency and severity of COVID19 pneumonia and acute respiratory distress syndrome: tip of the iceberg?

2020 ◽  
Author(s):  
Jihad G. Youssef ◽  
Faisal Zahiruddin ◽  
George Youssef ◽  
Sriram Padmanabhan ◽  
Joe Ensor ◽  
...  
Keyword(s):  
G6pd Deficiency ◽  
Chart Review ◽  
Ventilatory Support ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Supplemental Oxygen ◽  
Redox Status ◽  
Clinical Series ◽  
Viral Proliferation

Abstract The severe pneumonia caused by human coronavirus (hCoV)-SARS-CoV-2 has inflicted heavy causalities, especially among the elderly and those with comorbid illnesses irrespective of age. The high mortality in African Americans and males, in general, raises concern for a possible X-linked mediated process that could affect viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X-linked enzyme deficiency associated with redox status, may have a role in the severity of pneumonia. A retrospective chart review was performed in hospitalized patients with COVID19 pneumonia needing supplemental oxygen. A total of 17 patients were evaluated: six with G6PD deficiency and 11 with normal levels. The two groups (normal and G6PD def) were comparable in terms of age, sex and comorbidities and laboratory parameters LDH, IL-6, CRP, and ferritin. Thirteen patients needed ventilatory support, with 6 in the G6PD group (83% vs. 72%). The main differences indicating increasing severity in the G6PD def group included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days before intubation (2.5 vs. 4.8 P= 0.03), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and hematocrit (32 vs. 26 P=0.015). Only one patient with G6PD deficiency died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PD deficiency in SARS-CoV2 viral proliferation. It is imperative that further studies be performed to understand the interplay between the viral and host factors in G6PD deficiency that may lead to disparity in outcomes.

scholarly journals Initial Therapy of Bacterial Meningitis with Cefuroxime: Experience in 167 Children

1992 ◽  
Vol 3 (4) ◽  
pp. 162-166
Author(s):  
Lissette Navas ◽  
Susan M King ◽  
Ronald Gold
Keyword(s):  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Case Fatality Rate ◽  
Chart Review ◽  
Case Fatality ◽  
Retrospective Chart Review ◽  
Initial Therapy ◽  
Fatality Rate ◽  
Sick Children ◽  
Previous Prospective Study

The morbidity and mortality of patients with bacterial meningitis treated initially with cefuroxime were studied and compared with the results of a previous prospective study of patients treated initially with ampicillin plus chloramphenicol in the same institution from 1979 to 1983. A retrospective chart review was completed in all cases of microbiologically confirmed bacterial meningitis admitted to the Hospital for Sick Children in Toronto, Ontario between January 1, 1984 and August 1, 1988. During this period all patients were treated initially with intravenous cefuroxime. The 167 children reviewed ranged in age from six weeks to 17.1 years (median 11.6 months). The case fatality rate was 7.8% and the rate of hearing deficit 13%. There were no statistically significant differences in abnormal neurological outcome (20 versus 20%, respectively), hearing loss (12.9 versus 13%, respectively), and case fatality rate (6.4 versus 7.8%, respectively) between the cohort of 1979–83 and the present study. The rate of hearing loss following meningitis caused byHaemophilus influenzaetype b increased from 7.3 to 11.7% (P=0.26).

scholarly journals Factors and outcomes related to the use of guideline-recommended antibiotics in patients with neutropenic fever at the Uganda Cancer Institute

2021 ◽  
Author(s):  
Elizabeth A Gulleen ◽  
Scott V Adams ◽  
Bickey Chang ◽  
Lauren Falk ◽  
Riley Hazard ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Chart Review ◽  
Case Fatality ◽  
Retrospective Chart Review ◽  
Neutropenic Fever ◽  
Sub Saharan Africa ◽  
Antibiotic Management ◽  
Delayed Initiation ◽  
Sub Saharan ◽  
Selection Of

Abstract Background Neutropenic fever (NF) is associated with significant morbidity and mortality for patients receiving cancer treatment in sub-Saharan Africa (sSA). However, the antibiotic management of NF in sSA has not been well described. We evaluated the timing and selection of antibiotics for patients with NF at the Uganda Cancer Institute (UCI). Methods We conducted a retrospective chart review of adults with acute leukemia admitted to UCI from January 1, 2016, to May 31, 2017, who developed NF. For each NF event, we evaluated the association of clinical presentation and demographics with antibiotic selection as well as time to both initial and guideline-recommended antibiotics. We also evaluated the association between ordered antibiotics and the in-hospital case fatality ratio (CFR). Results Forty-nine NF events occurred among 39 patients. The time to initial antibiotic order was <1 day. Guideline-recommended antibiotics were ordered for 37 (75%) NF events. The median time to guideline-recommended antibiotics was 3 days. Fever at admission, a documented physical examination, and abdominal abnormalities were associated with a shorter time to initial and guideline-recommended antibiotics. The in-hospital CFR was 43%. There was no difference in in-hospital mortality when guideline-recommended antibiotics were ordered as compared to when non-guideline or no antibiotics were ordered. (HR: 0.51, 95%CI: [0.10, 2.64] and 0.78, 95%CI: [0.20, 2.96], respectively). Conclusions Patients with acute leukemia and NF had delayed initiation of guideline-recommended antibiotics and a high CFR. Prospective studies are needed to determine optimal NF management in sSA, including choice of antibiotics and timing of antibiotic initiation.

scholarly journals 364. Baseline characteristics, comorbidities, and outcomes of COVID-19 patients hospitalized in Southwest Georgia, U.S. – an interim analysis of an early hot spot

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S251-S251
Author(s):  
Daniel B Chastain ◽  
Sharmon P Osae ◽  
Ashley M Burt ◽  
Kevin VanLandingham ◽  
Natalie Sibold ◽  
...  
Keyword(s):  
Chart Review ◽  
Hot Spot ◽  
Case Fatality ◽  
Retrospective Chart Review ◽  
Radiographic Findings ◽  
Mechanically Ventilated ◽  
Comorbidity Index ◽  
Baseline Characteristics ◽  
The U.S ◽  
Overall Mortality

Abstract Background Understanding the spectrum of disease severity and death are critical for identifying unrecognized risk factors associated with morbidity and mortality from coronavirus disease 19 (COVID-19). The purpose of this study was to describe the baseline characteristics, clinical presentation, and outcomes among patients hospitalized with COVID-19 in a major hotspot in the U.S. Southeast. Methods This multicenter retrospective chart review included adult patients hospitalized with COVID-19, defined by laboratory-detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, in Southwest Georgia. The primary outcome was mortality, which was assessed through discharge or June 14, 2020, whichever occurred first. Secondary outcomes included comorbidities, laboratory and radiographic findings, as well as clinical course. Results A total of 120 patients were included with a median age of 61 years (IQR 50–72). The majority were African American (73%) and female (56%). Comorbidities on admission were present in 88% of patients; most prevalent were hypertension (76%), diabetes mellitus (55%), and chronic pulmonary disease (27%). Median Charlson comorbidity index was 4 (IQR 2–6) and BMI was 32.8 kg/m2 (IQR 26.2–39.5). On presentation, patients most often complained of dyspnea (69%), fever (63%), and cough (53%), with a median SOFA score of 2 (IQR 2–4). Most patients were admitted to the general ward (71%), of which 17% were subsequently transferred to ICU. During hospitalization, 27% were mechanically ventilated for a median 11 days (IQR 5–13.5), 18% developed ARDS, and 43% developed AKI. Median length of stay was 9.5 days (IQR 3.75–14). Overall mortality was 20%, which was significantly higher among patients with comorbidities (p = 0.047), as well as those who developed ARDS (p < 0.001) or AKI (p = 0.027). Conclusion Most reports of COVID-19 have focused on large urban settings. However, early during the pandemic, we identified a large cluster of cases with a high-case fatality rate in a semirural setting in Southwest Georgia in the U.S. Disclosures All Authors: No reported disclosures

scholarly journals Characteristics of Multidrug Resistant Shigella and Vibrio cholerae O1 Infections in Patients Treated at an Urban and a Rural Hospital in Bangladesh

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Sumon Kumar Das ◽  
Erik H. Klontz ◽  
Ishrat J. Azmi ◽  
Abu I. M. S. Ud-Din ◽  
Mohammod Jobayer Chisti ◽  
...  
Keyword(s):  
Vibrio Cholerae ◽  
Clinical Features ◽  
Diarrhoeal Disease ◽  
Multidrug Resistant ◽  
Stool Frequency ◽  
Rural Hospital ◽  
Surveillance Data ◽  
Severe Illness ◽  
Disease Research ◽  
Vibrio Cholerae O1

We determined the frequency of multidrug resistant (MDR) infections with Shigella spp. and Vibrio cholerae O1 at an urban (Dhaka) and rural (Matlab) hospital in Bangladesh. We also compared sociodemographic and clinical features of patients with MDR infections to those with antibiotic-susceptible infections at both sites. Analyses were conducted using surveillance data from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), for the years 2000–2012. Compared to patients with antibiotic-susceptible for Shigella infections, those in Dhaka with MDR shigellosis were more likely to experience diarrhea for >24 hours, while, in Matlab, they were more likely to stay inhospital >24 hours. For MDR shigellosis, Dhaka patients were more likely than those in Matlab to have dehydration, stool frequency >10/day, and diarrheal duration >24 hours. Patients with MDR Vibrio cholerae O1 infections in Dhaka were more likely than those in Matlab to experience dehydration and stool frequency >10/day. Thus, patients with MDR shigellosis and Vibrio cholerae O1 infection exhibited features suggesting more severe illness than those with antibiotic-susceptible infections. Moreover, Dhaka patients with MDR shigellosis and Vibrio cholerae O1 infections exhibited features indicating more severe illness than patients in Matlab.

scholarly journals Patterns of diarrhoeal disease among under-five children in Plateau State, Nigeria, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Chikan Jiwok ◽  
Ayo Stephen Adebowale ◽  
Idongesit Wilson ◽  
Vijaya Kancherla ◽  
Chukwuma David Umeokonkwo
Keyword(s):  
Time Series ◽  
Seasonal Variation ◽  
Disease Surveillance ◽  
Case Fatality ◽  
Diarrhoeal Disease ◽  
Age Group ◽  
Quality Of Data ◽  
Under Five ◽  
Surveillance And Response ◽  
Plateau State

Abstract Background Diarrhoea is the second commonest cause of under-five mortality accounting for over half a million deaths annually. Although the prevalence of diarrhoea in Plateau State is lower than the national figure, the level remains high despite remarkable progress in the reduction of under-five mortality. This study seeks to determine the pattern of diarrhoea disease among under-fives in Plateau State. Methods We extracted data from the Integrated Disease Surveillance and Response platform between January 2013 and December 2017 and analysed the trends of diarrhoea, age-specific case fatality rate (ASCFR), and seasonal patterns. We modelled the quarterly pattern of diarrhoea cases using additive time series and predicted the expected cases for 2018–2020. Results We documented 60,935 cases of diarrhoea with age group 12–59 months having the highest number of cases (49.3%). The age group < 1 month had the highest ASCFR of 0.53%. Seasonal variation showed cases peaked in the first and third quarters of each year, except for the year 2016. The time series projection estimated 16,256, 17,645 and 19,034 cases in the year 2018, 2019 and 2020 respectively. Conclusion Seasonal variation exists, and trends show an increased pattern of diarrhoeal disease among under-fives. There is a need to strengthen the implementation of diarrhoeal preventive and control strategy in the state and to improve the quality of data reporting.

scholarly journals G6PD deficiency and severity of COVID19 pneumonia and acute respiratory distress syndrome: tip of the iceberg?

2020 ◽  
Author(s):  
Jihad G. Youssef ◽  
Faisal Zahiruddin ◽  
George Youssef ◽  
Sriram Padmanabhan ◽  
Joe Ensor ◽  
...  
Keyword(s):  
G6pd Deficiency ◽  
Chart Review ◽  
Ventilatory Support ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Supplemental Oxygen ◽  
Redox Status ◽  
Clinical Series ◽  
Viral Proliferation

Abstract The severe pneumonia caused by the human Coronavirus (hCoV)- SARS-CoV-2 has inflicted heavy casualties, especially among the elderly and those with co-morbid illnesses irrespective of their age. The high mortality in African-Americans and males, in general, raises the concern for a possible X-linked mediated process that could affect the viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X linked enzyme deficiency associated with redox status, may have a role in severity of pneumonia. Retrospective chart review was performed in hospitalized patients with COVID19 pneumonia needing supplemental oxygen. A total of 17 patients were evaluated; six with G6PD deficiency (G6PDd), and 11 with normal levels. The two groups (Normal and G6PDd) were comparable in terms of age, sex and co-morbidities, and laboratory parameters-LDH, IL-6, CRP, and Ferritin, respectively. Thirteen patients needed ventilatory support with 8 in the normal group and 5 in the G6PDd group (72% vs.83%). The main differences indicating increasing severity in normal vs. G6PDd groups included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and Hematocrit (32 vs. 26 P=0.015). Only one patient with G6PDd died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PDd in SARS-CoV2 viral proliferation. It is imperative that further studies are performed to understand the interplay between the viral and host factors in G6PDd that may lead to disparity in outcomes.

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