Enterobacter aerogenes Primary Bacteremia in Pediatric Patients

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 304-306
Author(s):  
Kathryn E. Edwards ◽  
James R. Allen ◽  
Marilyn J. Miller ◽  
Ram Yogev ◽  
Philip C. Hoffman ◽  
...  
Keyword(s):  
Hospital Pharmacy ◽  
Pediatric Patients ◽  
Control Measure ◽  
Enterobacter Aerogenes ◽  
Primary Control ◽  
Pediatric Hospital ◽  
Temporal Clustering ◽  
Clinical Illness

Enterobacter aerogenes bacteremia associated with the infusion of contaminated admixed intravenous (IV) fluid occurred in seven patients in a pediatric hospital over a five-day period. Clinical illness was characterized by spiking fever in all patients. The temporal clustering of cases allowed for rapid recognition of the problem. The primary control measure was the prompt replacement of the IV fluids, although IV antibiotics were also administered. Hospital pharmacy practices for admixing IV solutions should follow published recommendations to minimize this source of potential contamination of fluids.

scholarly journals Update to the Minimum Requirements for Core Competency in Pediatric Hospital Pharmacy Practice

2021 ◽  
Vol 26 (7) ◽  
pp. 762-766
Author(s):  
Elizabeth A. Boucher ◽  
Margaret M. Burke ◽  
Kristin C. Klein ◽  
Jamie L. Miller
Keyword(s):  
Hospital Pharmacy ◽  
Pediatric Patients ◽  
Core Competencies ◽  
Pharmacy Practice ◽  
Core Competency ◽  
Position Statement ◽  
Pediatric Hospital ◽  
New Graduates ◽  
Minimum Requirements ◽  
Pharmacist Role

Colleges of pharmacy provide varying amounts of didactic and clinical experiential hours in pediatrics therapeutics, resulting in variability in the knowledge, skills, and perceptions of new graduates toward the pharmacist role in providing care to pediatric patients. The Pediatric Pharmacy Association continues to endorse a minimum set of core competencies for all pharmacists involved in the care of hospitalized pediatric patients of all ages. To that end, we have updated our 2015 Position Statement.

Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital

2011 ◽  
Vol 22 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Natascha J. Cuper ◽  
Jurgen C. de Graaff ◽  
Atty T. H. van Dijk ◽  
Rudolf M. Verdaasdonk ◽  
Desirée B. M. van der Werff ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Pediatric Patients ◽  
Pediatric Hospital

scholarly journals Mutation of Influenza A Virus PA-X Decreases Pathogenicity in Chicken Embryos and Can Increase the Yield of Reassortant Candidate Vaccine Viruses

2018 ◽  
Vol 93 (2) ◽  
Author(s):  
Saira Hussain ◽  
Matthew L. Turnbull ◽  
Helen M. Wise ◽  
Brett W. Jagger ◽  
Philippa M. Beard ◽  
...  
Keyword(s):  
Host Cell ◽  
Influenza A Virus ◽  
Influenza A ◽  
Control Measure ◽  
Virus Titer ◽  
Virus Antigen ◽  
Economic Consequences ◽  
Primary Control ◽  
X Protein ◽  
X Gene

ABSTRACTThe PA-X protein of influenza A virus has roles in host cell shutoff and viral pathogenesis. While most strains are predicted to encode PA-X, strain-dependent variations in activity have been noted. We found that PA-X protein from the A/PR/8/34 (PR8) strain had significantly lower repressive activity against cellular gene expression than PA-X proteins from the avian strains A/turkey/England/50-92/91 (H5N1) (T/E) and A/chicken/Rostock/34 (H7N1). Loss of normal PA-X expression, either by mutation of the frameshift site or by truncating the X open reading frame (ORF), had little effect on the infectious virus titer of PR8 or PR8 7:1 reassortants with T/E segment 3 grown in embryonated hens’ eggs. However, in both virus backgrounds, mutation of PA-X led to decreased embryo mortality and lower overall pathology, effects that were more pronounced in the PR8 strain than in the T/E reassortant, despite the low shutoff activity of the PR8 PA-X. Purified PA-X mutant virus particles displayed an increased ratio of hemagglutinin (HA) to nucleoprotein (NP) and M1 compared to values for their wild-type (WT) counterparts, suggesting altered virion composition. When the PA-X gene was mutated in the background of poorly growing PR8 6:2 vaccine reassortant analogues containing the HA and neuraminidase (NA) segments from H1N1 2009 pandemic viruses or from an avian H7N3 strain, HA yield increased up to 2-fold. This suggests that the PR8 PA-X protein may harbor a function unrelated to host cell shutoff and that disruption of the PA-X gene has the potential to improve the HA yield of vaccine viruses.IMPORTANCEInfluenza A virus is a widespread pathogen that affects both humans and a variety of animal species, causing regular epidemics and sporadic pandemics, with major public health and economic consequences. A better understanding of virus biology is therefore important. The primary control measure is vaccination, which for humans mostly relies on antigens produced in eggs from PR8-based viruses bearing the glycoprotein genes of interest. However, not all reassortants replicate well enough to supply sufficient virus antigen for demand. The significance of our research lies in identifying that mutation of the PA-X gene in the PR8 strain of virus can improve antigen yield, potentially by decreasing the pathogenicity of the virus in embryonated eggs.

Traditional Versus Room Service Menu Styles For Pediatric Patients

2006 ◽  
Vol 67 (2) ◽  
pp. 92-94 ◽  
Author(s):  
Krista Wadden ◽  
Bernice Wolf ◽  
Alain Mayhew
Keyword(s):  
Patient Satisfaction ◽  
Pediatric Oncology ◽  
Pediatric Patients ◽  
Hemodialysis Patients ◽  
Pediatric Hospital ◽  
Group A ◽  
Quality Of Food ◽  
Room Service ◽  
Group B

Purpose: To compare patient satisfaction with a room service (RS) menu style versus a traditional menu (TM) in a Canadian pediatric hospital. Methods: A sample of 20 subjects (Group A) was surveyed before implementation of the RS menu and a second sample of 20 subjects (Group B) was surveyed after implementation. Results: All subjects in Group B rated overall satisfaction with meals as greatly exceeding or exceeding expectations after implementing the new menu style. Also, 65% of Group B subjects rated quality of food as greatly exceeding or exceeding their expectations after the intervention. Conclusions: To improve meal satisfaction for pediatric oncology and hemodialysis patients, the RS menu style is a worthwhile option.

Bridging Familiarity with Unfamiliarity: The Use of Music Therapy to Normalize the Pediatric Hospital Environment

2015 ◽  
Vol 7 (3) ◽  
pp. 26
Author(s):  
Shawna N. Vernisie
Keyword(s):  
Music Therapy ◽  
Pediatric Patients ◽  
Hospital Environment ◽  
Pediatric Hospital ◽  
Main Concept ◽  
Case Examples ◽  
Case Vignettes ◽  
The Many

This article explores how music therapy can help to normalize the hospital environment for pediatric patients regardless of their acute or long-term status. Many different facets of how normalization can be utilized through music therapy are explained, as well as some case examples to further demonstrate these circumstances. The main concept of this article is to reflect upon how normalization of the hospital environment, via music therapy, may provide pediatric patients with an opportunity to explore their healthy selves rather than focusing on their illness or medical ailments. Case vignettes are also provided to enlighten the many facets of normalization and show how music therapy may offer unique ways of accessing feelings of normalization.

scholarly journals Clostridium Difficile-Associated Diarrhea in 200 Canadian Children

2005 ◽  
Vol 19 (8) ◽  
pp. 497-501 ◽  
Author(s):  
Véronique Morinville ◽  
Jane McDonald
Keyword(s):  
Clostridium Difficile ◽  
Pediatric Patients ◽  
Single Agent ◽  
Hirschsprung Disease ◽  
Pediatric Hospital ◽  
Recurrence Rates ◽  
Treatment Data ◽  
Prior Literature ◽  
Clostridium Difficile Associated Diarrhea ◽  
Bloody Stools

OBJECTIVE: Clostridium difficile-associated diarrhea is a major problem in adults. The present study was conducted to assess risk factors and outcomes in children with C difficile-associated diarrhea.METHODS: Laboratory records at a university-affiliated pediatric hospital were reviewed for all C difficile toxin-positive stools (cell culture cytotoxin assay) between 2000 and 2003. Charts on identified patients were reviewed.RESULTS: Two hundred patients with a diagnosis of C difficile-associated diarrhea were identified between February 2000 and November 2003. There were 107 males and 93 females (mean age 5.4 years; median age 2.6 years). Underlying factors were identified in 19% (12 patients underwent chemotherapy; seven patients had Crohn's disease; six were transplantation recipients; seven an immunodeficiency; four with Hirschsprung disease; two diagnoses of 'other'). Of the 200 identified patients, 149 (74.5%) had documentation of antibiotics in the previous two months (32 penicillins; 38 cephalosporins; three clindamycin, nine other single-agent, 59 multiple; eight not specified), and 111 (55.5%) had been hospitalized in the previous month. The symptoms of C difficile-associated diarrhea included bloody stools in 12.5% and frequent watery stools in 79%. Hospitalization was required in 27 of 116 outpatients; stay was prolonged in seven of the 84 patients already hospitalized. Fifty-five per cent received metronidazole, 34% were not treated, and treatment data were not available for the remainder. Recurrence occurred in 31% of those treated and retreatment consisted of vancomycin (15%), probiotics (15%) and cholestyramine (6%). No colectomies were required but two deaths occurred.CONCLUSIONS: The majority of pediatric patients developing symptomatic C difficile-associated diarrhea had antibiotic exposure or hospitalization within the previous one to two months. This is higher than previously reported. One-third had spontaneous symptom resolution. For those treated, recurrence rates were high. Mortality was significantly lower than described in adults, in agreement with prior literature.

Summary of 11 Years of Enteric Outbreak Investigations and Criteria To Initiate an Investigation, Province of Quebec, 2002 through 2012

2014 ◽  
Vol 77 (9) ◽  
pp. 1563-1570 ◽  
Author(s):  
COLETTE GAULIN ◽  
ANDREA CURRIE ◽  
GENEVIÈVE GRAVEL ◽  
MEGHAN HAMEL ◽  
MARIE-ANDREE LEBLANC ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Control Measure ◽  
Descriptive Analysis ◽  
Disease Outbreaks ◽  
Disease Outbreak ◽  
Control Measures ◽  
Primary Control ◽  
Enteric Disease ◽  
Health Authorities ◽  
Outbreak Investigations

This article presents a retrospective analysis of enteric disease outbreak investigations led by or conducted in collaboration with provincial health authorities in the Province of Quebec from 2002 through 2012. Objectives were to characterize enteric disease outbreaks, quantify and describe those for which a source was identified (including the control measures implemented), identify factors that contributed to or impeded identification of the source, and recommend areas for improvement in outbreak investigations (including establishment of criteria to initiate investigations). A descriptive analysis of enteric disease outbreak summaries recorded in a provincial database since 2002 was conducted, and corresponding outbreak reports were reviewed. Among 61 enteric disease outbreaks investigated, primary pathogens involved were Salmonella (46%), Escherichia coli O157:H7 (25%), and Listeria monocytogenes (13%). Sources were identified for 37 (61%) of 61 of the outbreaks, and descriptive studies were sufficient to identify the source for 26 (70%) of these. During the descriptive phase of the investigation, the causes of 21 (81%) of 26 outbreaks were identified by promptly collecting samples of suspected foods based on case interviews. Causes of outbreaks were more likely to be detected by weekly surveillance or alert systems (odds ratio = 6.0, P = 0.04) than by serotyping or molecular typing surveillance and were more likely to be associated with a common event or location (odds ratio = 11.0, P = 0.023). Among the 37 outbreaks for which causes were identified, 24 (65%) were associated with contaminated food, and recalls were the primary control measure implemented (54%). Review of enteric outbreaks investigated at the provincial level in Québec has increased the province's ability to quantify success and identify factors that can promote success. Multiple criteria should be taken into account to identify case clusters that are more likely to be resolved.

scholarly journals Proof of concept for the reduction of classical swine fever infection in pigs by a novel viral polymerase inhibitor

2009 ◽  
Vol 90 (6) ◽  
pp. 1335-1342 ◽  
Author(s):  
Robert Vrancken ◽  
Andy Haegeman ◽  
Jan Paeshuyse ◽  
Gerhard Puerstinger ◽  
Jef Rozenski ◽  
...  
Keyword(s):  
Virus Replication ◽  
Infectious Virus ◽  
Control Measure ◽  
Field Isolate ◽  
Classical Swine Fever ◽  
Primary Control ◽  
Lead Compound ◽  
Proof Of Concept ◽  
Specific Pathogen

5-[(4-Bromophenyl)methyl]-2-phenyl-5H-imidazo[4,5-c]pyridine (BPIP) is a representative of a class of imidazopyridines with potent in vitro antiviral activity against pestiviruses including classical swine fever virus (CSFV). This study analysed whether the lead compound, BPIP, was able to reduce virus replication in infected piglets. The compound, administered in feed, was readily bioavailable and was well tolerated. Eight specific-pathogen-free pigs received a daily dose of 75 mg kg−1 (mixed in feed) for a period of 15 consecutive days, starting 1 day before infection with the CSFV field isolate Wingene. BPIP-treated pigs developed a short, transient viraemia (one animal remained negative) and leukopenia (three animals did not develop leukopenia). Virus titres at peak viraemia (7 days post-infection) were markedly lower (∼1000-fold) than in untreated animals (P=0.00005) and the viral genome load in blood was also significantly lower (P≤0.001) in drug-treated animals than in untreated animals over the entire experiment. At the end of the experiment (day 33), no infectious virus was detectable in the tonsils of BPIP-treated animals, although low levels of viral RNA were detected. The inability to isolate infectious virus from the tonsils indicates that the risk of a persistent CSFV infection is negligible. Further optimization of the antiviral potency and bioavailability of this lead compound may result in molecules completely suppressing virus replication. A potent antiviral could potentially be used as a primary control measure against virus spread in case of an outbreak, in addition to present countermeasures. This study provides the first proof of concept for the prophylaxis/treatment of CSFV infection in pigs.

scholarly journals Evaluation of an Alternative Intravenous N-Acetylcysteine Regimen in Pediatric Patients

2015 ◽  
Vol 20 (3) ◽  
pp. 178-185
Author(s):  
Kathryn A. Pauley ◽  
Tracy L. Sandritter ◽  
Jennifer A. Lowry ◽  
D. Adam Algren
Keyword(s):  
Clinical Outcomes ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Pediatric Hospital ◽  
Exclusion Criteria ◽  
Maintenance Infusion ◽  
Diagnostic Codes ◽  
Termination Criteria ◽  
Anaphylactoid Reactions ◽  
Disease Initiation

OBJECTIVE: Conventionally, intravenous N-acetylcysteine (IV-NAC) administration is a 3-bag regimen administered over the course of 21 hours, which increases the risk of reconstitution and administration errors. To minimize errors, an alternative IV-NAC regimen consists of a loading dose (150 mg/kg) followed by a maintenance infusion (15 mg/kg/hr) until termination criteria are met. The aim was to determine the clinical outcomes of an alternative IV-NAC regimen in pediatric patients. METHODS: A retrospective review of pharmacy dispensing records and diagnostic codes at a pediatric hospital identified patients who received alternative IV-NAC dosing from March 1, 2008, to September 10, 2012, for acetaminophen overdoses. Exclusion criteria included chronic liver disease, initiation of oral or other IV-NAC regimens, and initiation of standard IV-NAC infusion prior to facility transfer. Clinical and laboratory data were abstracted from the electronic medical record. Descriptive statistics were utilized. Clinical outcomes and adverse drug reaction incidences were compared between the alternative and Food and Drug Administration (FDA)–approved IV-NAC regimens. RESULTS: Fifty-nine patients (mean age 13.4 ± 4.3 years; range: 2 months-18 years) with acetaminophen overdoses were identified. Upon IV-NAC discontinuation, 45 patients had normal alanine transaminase (ALT) concentrations, while 14 patients' ALT concentrations remained elevated (median 140 units/L) but were trending downward. Two patients (3.4%) developed hepatotoxicity (aspartate transaminase/ALT > 1000 units/L). No patients developed hepatic failure, were listed for a liver transplant, were intubated, underwent hemodialysis, or died. Two patients (3.4%) developed anaphylactoid reactions. No known medication or administration errors occurred. Clinical outcome incidences of the studied endpoints with the alternative IV-NAC regimen are at the lower end of published incidence ranges compared to the FDA IV-NAC regimen for acetaminophen overdoses. CONCLUSIONS: This alternative IV-NAC regimen appears to be effective and well tolerated among pediatric patients when compared to the FDA-approved regimen. It may also result in fewer reconstitution and administration errors, leading to improved patient safety.

scholarly journals Rapid Implementation of Telerehabilitation for Pediatric Patients During COVID-19

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rachel Bican ◽  
Catie Christensen ◽  
Kristin Fallieras ◽  
Grace Sagester ◽  
Sara O'Rourke ◽  
...  
Keyword(s):  
United States ◽  
Physical Therapy ◽  
Occupational Therapy ◽  
Pediatric Patients ◽  
Demographic Characteristics ◽  
Pediatric Hospital ◽  
Midwest United States ◽  
Serial Casting ◽  
Therapy Services ◽  
Occupational And Physical Therapy

The COVID-19 pandemic necessitated a sudden limitation of in-person outpatient occupational and physical therapy services for most patients at a large, multisite pediatric hospital located in the Midwest, United States.  To ensure patient and staff safety, the hospital rapidly shifted to deliver most of these services via telerehabilitation. The purposes of this study were to (1) describe the rapid implementation of telerehabilitation during the COVID-19 pandemic, (2) describe the demographic characteristics of patients who continued in-person services and those who received telerehabilitation, and (3) evaluate the therapists’ perceptions of telerehabilitation for physical and occupational therapy. Most of the children (83.4% of n=1352) received telerehabilitation services. A family was more likely to choose to continue in-person visits if their child was <1-year-old, had a diagnosis of torticollis, received serial casting, or was post-surgical. Occupational and physical therapy therapists (n=9) completed surveys to discern their perceptions of the acceptability of telerehabilitation, with most reporting that telerehabilitation was as effective as in-person care.  

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