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

PEDIATRICS ◽  
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.

scholarly journals Fever without a focus in children 0-36 months of age

2006 ◽  
Vol 59 (3-4) ◽  
pp. 187-191 ◽  
Author(s):  
Svetlana Kuzmanovic ◽  
Nevenka Roncevic ◽  
Aleksandra Stojadinovic
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Medical Care ◽  
Bacterial Infections ◽  
Clinical Presentation ◽  
Febrile Illness ◽  
Empirical Antibiotic Therapy ◽  
Focus Of Infection ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

Introduction. About 20% of fevers in childhood have no apparent cause. A small, but significant number of these children may have a seroius bacterial infection. Fever without a focus of infection is an acute febrile illness with rectal temperature of 38?C or higher in children younger than 36 months, without localizing signs or symptoms. Practice Guidelines for Medical Care. In this article, practical recommendations for medical care of febrile children 0-36 months of age are given, bearing in mind children's age, clinical presentation (toxic manifestations) and risk for serious bacterial infection (sepsis, meningitis, pneumonia, urinary tract infection...). Toxic appearance is a clinical presentation characterized by lethargy, poor perfusion, marked hypo/hyperventilation and cyanosis. All febrile children under 36 months of age, who are appearing toxic, require hospitalization, evaluation for sepsis and administration of empirical antibiotic therapy. All febrile neonates, however, must be hospitalized: cultures of blood, urine and spinal fluid should be taken and empirical antibiotic therapy administered immediately. Febrile infants, 28 to 90 days of age, need to be evaluated in order to determine whether they are in the low-risk group for serious bacterial infections (Rochester Criteria). Yale Observation Scale is recommended to assess febrile children aged 3-36 months, and the risk of occult bacteriemia. Febrile children, 3-36 months of age who appear well, with temperature of less than 39?C without focus, should be closely followed up without laboratory tests and antibiotics and 2-3 days later reexamined. In febrile children, 3-36 months old, with temperature of 39?C and above, without toxic manifestations, blood culture should be taken and ceftriaxone 50 mg/kg/in a single dose should be given, if leukocyte count is 15000/mm? or absolute neutrophil count is over 10.000/mm? .

scholarly journals Fever and laboratory profiles as predictors of serious bacterial infection in children

2012 ◽  
Vol 52 (6) ◽  
pp. 313
Author(s):  
Ni Putu Veny Kartika Yantie ◽  
BNP Arhana ◽  
Purnomo Suryantoro
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Controlled Study ◽  
Control Group ◽  
Case Group ◽  
Bacterial Gastroenteritis ◽  
Leukocyte Counts ◽  
Serious Bacterial Infections ◽  
Tract Infections

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3􀁉15% of children with fever of 2: 39°C.Various laboratory parameters including increased C􀁉reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 month􀁉 18 years.Methods A case􀁉controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (non􀁉SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively].Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

A CONTROLLED TRIAL OF INTRAVENOUS IMMUNE GLOBULIN FOR THE PREVENTION OF SERIOUS BACTERIAL INFECTIONS IN CHILDREN RECEIVING ZIDOVUDINE FOR ADVANCED HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 408-408
Author(s):  
David Fuentes ◽  
William T. Shearer
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Bacterial Infection ◽  
Immune Globulin ◽  
Bacterial Infections ◽  
Controlled Trial ◽  
Immunodeficiency Virus ◽  
Aids Related Complex ◽  
Serious Bacterial Infections

Children with AIDS or AIDS-related complex receiving zidovudine have a decreased risk of bacterial infection when given IVIG. In this study, the benefit is most apparent in those not receiving trimethoprim- sulfamethoxazole prophylaxis.

scholarly journals Population-based trends in hospitalizations due to injection drug use-related serious bacterial infections, Oregon, 2008 to 2018

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242165
Author(s):  
Jeffrey Capizzi ◽  
Judith Leahy ◽  
Haven Wheelock ◽  
Jonathan Garcia ◽  
Luke Strnad ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Bacterial Infection ◽  
Injection Drug Use ◽  
Bacterial Infections ◽  
Fold Increase ◽  
Population Based ◽  
Injection Drug ◽  
Discharge Data ◽  
Serious Bacterial Infections

Background Injection drug use has far-reaching social, economic, and health consequences. Serious bacterial infections, including skin/soft tissue infections, osteomyelitis, bacteremia, and endocarditis, are particularly morbid and mortal consequences of injection drug use. Methods We conducted a population-based retrospective cohort analysis of hospitalizations among patients with a diagnosis code for substance use and a serious bacterial infection during the same hospital admission using Oregon Hospital Discharge Data. We examined trends in hospitalizations and costs of hospitalizations attributable to injection drug use-related serious bacterial infections from January 1, 2008 through December 31, 2018. Results From 2008 to 2018, Oregon hospital discharge data included 4,084,743 hospitalizations among 2,090,359 patients. During the study period, hospitalizations for injection drug use-related serious bacterial infection increased from 980 to 6,265 per year, or from 0.26% to 1.68% of all hospitalizations (P<0.001). The number of unique patients with an injection drug use-related serious bacterial infection increased from 839 to 5,055, or from 2.52% to 8.46% of all patients (P<0.001). While hospitalizations for all injection drug use-related serious bacterial infections increased over the study period, bacteremia/sepsis hospitalizations rose most rapidly with an 18-fold increase. Opioid use diagnoses accounted for the largest percentage of hospitalizations for injection drug use-related serious bacterial infections, but hospitalizations for amphetamine-type stimulant-related serious bacterial infections rose most rapidly with a 15-fold increase. People living with HIV and HCV experienced increases in hospitalizations for injection drug use-related serious bacterial infection during the study period. Overall, the total cost of hospitalizations for injection drug use-related serious bacterial infections increased from $16,305,129 in 2008 to $150,879,237 in 2018 (P<0.001). Conclusions In Oregon, hospitalizations for injection drug use-related serious bacterial infections increased dramatically and exacted a substantial cost on the health care system from 2008 to 2018. This increase in hospitalizations represents an opportunity to initiate substance use disorder treatment and harm reduction services to improve outcomes for people who inject drugs.

scholarly journals Seeking diagnostic and prognostic biomarkers for childhood bacterial pneumonia in sub-Saharan Africa: study protocol for an observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046590
Author(s):  
Clarissa Valim ◽  
Yekin Ajauoi Olatunji ◽  
Yasir Shitu Isa ◽  
Rasheed Salaudeen ◽  
Sarwar Golam ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
High Sensitivity ◽  
The Gambia ◽  
Sub Saharan Africa ◽  
Support Vector ◽  
Bacterial Disease ◽  
Blood Proteins ◽  
Study Results ◽  
Bacterial Aetiology

IntroductionClinically diagnosed pneumonia in children is a leading cause of paediatric hospitalisation and mortality. The aetiology is usually bacterial or viral, but malaria can cause a syndrome indistinguishable from clinical pneumonia. There is no method with high sensitivity to detect a bacterial infection in these patients and, as result, antibiotics are frequently overprescribed. Conversely, unrecognised concomitant bacterial infection in patients with malarial infections occur with omission of antibiotic therapy from patients with bacterial infections. Previously, we identified two combinations of blood proteins with 96% sensitivity and 86% specificity for detecting bacterial disease. The current project aimed to validate and improve these combinations by evaluating additional biomarkers in paediatric patients with clinical pneumonia. Our goal was to describe combinations of a limited number of proteins with high sensitivity and specificity for bacterial infection to be incorporated in future point-of-care tests. Furthermore, we seek to explore signatures to prognosticate clinical pneumonia.Methods and analysisPatients (n=900) aged 2–59 months presenting with clinical pneumonia at two Gambian hospitals will be enrolled and classified according to criteria for definitive bacterial aetiology (based on microbiological tests and chest radiographs). We will measure proteins at admission using Luminex-based immunoassays in 90 children with definitive and 160 with probable bacterial aetiology, and 160 children classified according to the prognosis of their disease. Previously identified diagnostic signatures will be assessed through accuracy measures. Moreover, we will seek new diagnostic and prognostic signatures through machine learning methods, including support vector machine, penalised regression and classification trees.Ethics and disseminationEthics approval has been obtained from the Gambia Government/Medical Research Council Unit The Gambia Joint Ethics Committee (protocol 1616) and the institutional review board of Boston University Medical Centre (STUDY00000958). Study results will be disseminated to the staff of the study hospitals, in scientific seminars and meetings, and in publications.Trial registration numberH-38462.

Abnormalities of Neutrophil Adherence in Newborns

PEDIATRICS ◽  
1982 ◽  
Vol 69 (2) ◽  
pp. 184-187
Author(s):  
Peter J. Krause ◽  
Eufronio C. Maderazo ◽  
Mark Scroggs
Keyword(s):  
Whole Blood ◽  
Bacterial Infections ◽  
Good Health ◽  
Polymorphonuclear Neutrophil ◽  
Normal Children ◽  
Term Newborns ◽  
Neutrophil Adherence ◽  
Serious Bacterial Infections ◽  
Increased Susceptibility ◽  
Nylon Wool

Polymorphonuclear neutrophil (PMN) adherence to glass and nylon wool was examined in 19 healthy term newborns, 19 normal children aged 2 weeks to 17 years, and 33 adults in good health who were taking no medication. Using a whole blood glass adherence assay, neonatal PMN adherence (0.18 ± 0.16%) was significantly less than PMN adherence in children (7.4 ± 4.0%, P &lt; .0001) and in adults (16.0 ± 4.5%, P &lt; .0001). Similar results were obtained when separated neonatal and adult PMNs were used with both glass and nylon wool column adherence assays, indicating that decreased neonatal PMN adherence is due to a cellular defect. In other experiments there was significantly greater reduction in adherence of separated PMNs with addition of neonatal serum than with adult serum, indicating that a humoral inhibitor also contributes to decreased adherence of neonatal PMNs. Decreased neonatal PMN adherence may be one cause of the increased susceptibility of neonates to serious bacterial infections.

Clinical Picture, Outcome, and Risk of Serious Bacterial Infections in Immunocompetent Previously Healthy Neutropenic Children

2021 ◽  
Author(s):  
Esra Arslantaş ◽  
Ali Ayçiçek ◽  
Recep Türkoğlu ◽  
Tuba Nur Tahtakesen ◽  
Ezgi Paslı Uysalol ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Clinical Picture ◽  
Bacterial Infections ◽  
Age Groups ◽  
Healthy Children ◽  
Aggressive Therapy ◽  
Serious Bacterial Infections ◽  
Low Incidence ◽  
New Onset

Abstract Objective In childhood, the cause of neutropenia is a challenging diagnosis with a spectrum of underlying etiologies. This study was performed to investigate the clinical picture and the outcomes associated with the new onset neutropenia in previously healthy children, and to determine the risk of serious bacterial infection (SBI) in those patients. Methods Patients presenting between January 2018 and September 2018 with an absolute neutrophil count (ANC) <1,500/μL were retrospectively evaluated. Patients with known underlying chronic disease or immunosuppressive conditions were excluded. Neutropenia was categorized into three groups: mild, 1,000–1,500/μL; moderate, 500 to <1,000/μL; and severe <500/μL. Results A total of 423 patients were investigated. There were 156 (36.9%), 193 (45.6%), and 74 (17.5%) patients in the mild, moderate, and severe groups, respectively. Bacteremia was detected in one (0.02%) patient and SBI in 21 (4.9%) patients. No significant correlation was found between the incidence of SBI and bacterial infection rate among different age groups (p > 0.05). The incidence of SBI varied significantly according to the severity of the neutropenia (p = 0.012) and as the neutropenia became more severe, the incidence of SBI increased (p = 0.015). Conclusion The clinical outcome of neutropenia in previously healthy and immunocompetent children is generally good with a relatively low incidence of SBI. We suggest that aggressive therapy and frequent follow-up should be reserved for previously healthy neutropenic children with SBI.

scholarly journals Sensitivity and Specificity of Procalcitonin in Predicting Bacterial Infections in Patients With Renal Impairment

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Dena El-sayed ◽  
Jonathan Grotts ◽  
William A. Golgert ◽  
Alan M. Sugar
Keyword(s):  
Renal Impairment ◽  
Bacterial Infection ◽  
Sensitivity And Specificity ◽  
Bacterial Infections ◽  
Severe Renal Impairment ◽  
Predictive Values ◽  
Patients Âgés ◽  
Focus Of Infection ◽  
Sensitivity Specificity ◽  
Community Teaching

Abstract Background.  It is unclear whether procalcitonin is an accurate predictor of bacterial infections in patients with renal impairment, although it is used as a biomarker for early diagnosis of sepsis. We determined the sensitivity, specificity, positive and negative predictive values, accuracy and best predictive value of procalcitonin for predicting bacterial infection in adult patients with severe renal impairment. Methods.  Retrospective study at a single-center community teaching hospital involving 473 patients, ages 18–65, with Modification of Diet in Renal Disease eGFR ≤30 ml/min per 1.73 m2, admitted between January 2009 and June 2012, with 660 independent hospital visits. A positive or negative culture (blood or ide.jpegiable focus of infection) was paired to the highest procalcitonin result performed 48 hours before or after collecting the culture. Results.  The sensitivity and specificity to predict bacterial infection, using a procalcitonin level threshold of 0.5 ng/mL, was 0.80 and 0.35 respectively. When isolating for presence of bacteremia, the sensitivity and specificity were 0.89 and 0.35 respectively. An equation adjusting for optimum thresholds of procalcitonin levels for predicting bacterial infection at different levels of eGFR had a sensitivity and specificity of 0.55 and 0.80 respectively. Conclusions.  Procalcitonin is not a reliably sensitive or specific predictor of bacterial infection in patients with renal impairment when using a single threshold. Perhaps two thresholds should be employed, where below the lower threshold (i.e. 0.5 ng/mL) bacterial infection is unlikely with a sensitivity of 0.80, and above the higher threshold (i.e. 3.2 ng/mL) bacterial infection is very likely with a specificity of 0.75.

scholarly journals Antibody-Dependent Enhancement of Bacterial Disease: Prevalence, Mechanisms, and Treatment

2021 ◽  
Vol 89 (4) ◽  
Author(s):  
Von Vergel L. Torres ◽  
Carrie F. Coggon ◽  
Timothy J. Wells
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Molecular Mechanisms ◽  
Vaccine Development ◽  
Viral Disease ◽  
Influenza Viruses ◽  
Bacterial Disease ◽  
Antibody Dependent Enhancement ◽  
Current Vaccine ◽  
Current Therapies

ABSTRACT Antibody-dependent enhancement (ADE) of viral disease has been demonstrated for infections caused by flaviviruses and influenza viruses; however, antibodies that enhance bacterial disease are relatively unknown. In recent years, a few studies have directly linked antibodies with exacerbation of bacterial disease. This ADE of bacterial disease has been observed in mouse models and human patients with bacterial infections. This antibody-mediated enhancement of bacterial infection is driven by various mechanisms that are disparate from those found in viral ADE. This review aims to highlight and discuss historic evidence, potential molecular mechanisms, and current therapies for ADE of bacterial infection. Based on specific case studies, we report how plasmapheresis has been successfully used in patients to ameliorate infection-related symptomatology associated with bacterial ADE. A greater understanding and appreciation of bacterial ADE of infection and disease could lead to better management of infections and inform current vaccine development efforts.

scholarly journals The Significance of Clinical and Laboratory Findings in Predicting Serious Bacterial Infections in Children With Acute Fever Without a Focus

2020 ◽  
Vol 54 (4) ◽  
pp. 195-203
Author(s):  
Hasan Demir ◽  
Medine Ayşin Taşar
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Blood Count ◽  
Biochemical Indicators ◽  
Clinical Scales ◽  
Severe Bacterial Infection ◽  
Observation Scale ◽  
Erythrocyte Sedimentation ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

Objective: Fever is among most common causes of admission to hospital in childhood. In 20% of febrile infants and children, no focus can be identified by physical examination and this group is defined as “acute fever without a focus” (AFWF). Bacteremia (5%), and serious bacterial infection (15%) is determined in of children with AFWF. Clinical scales and laboratory tests are used to detect the risk of occult bacteremia and serious bacterial infection in children with AFWF This study aimed to determine relation between biochemical indicators and YALE Observation Scale, besides, rates of clinical scales and biochemical indicators predicting serious bacterial infections, in 3-36 months children with AFWF. Material and Methods: This study was performed prospectively, in 77 cases, between 3-36 months of AFWF. Low risk criteria was evaluated by performing YALE Observation Scale in children. Complete blood count, absolute neutrophil count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin 6, procalcitonin, urine analysis, chest x-ray, cerebrospinal fluid (CSF) examination; blood, urine and CSF cultures were obtained. Results: The mean age of the patients was 11.0 (4-36) months, 64.9% (n= 50) were boys. Most commonly AFWF recovered in patients (35.0%), and urinary tract infection was diagnosed (32.5%). Severe bacterial infection was determined in 44.2%. When patient groups with and without severe bacterial infection were compared, white blood count, ESH, CRP, and procalcitonin were significantly higher in severe bacterial infection (p< 0.05). Erythrocyte sedimentation rate had highest specificity (87.5%) in discriminating between groups with and without severe bacterial infection. Conclusion: In conclusion, AFWF mostly recovered in children at 3-36 months, and urinary tract infection was common cause. White cell count, ESR, CRP and procalcitonin were found valuable in predicting serious bacterial infection. Further studies are needed to predict interleukin-6 value relevant to serious bacterial infection.

Sign in / Sign up

Export Citation Format

Share Document