scholarly journals Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

2020 ◽  
Vol 9 (4) ◽  
pp. 939
Author(s):  
Mădălina Adriana Bordea ◽  
Alexandru Pîrvan ◽  
Dan Gheban ◽  
Ciprian Silaghi ◽  
Iulia Lupan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Tract ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Post Mortem ◽  
Appetite Loss ◽  
Broad Spectrum Antibiotics ◽  
Prolonged Antibiotic Therapy

Objectives. The aim of this study is to provide information about prevalence, etiology, risk factors, clinical characteristics and endoscopic features of various types of infectious esophagitis in children. Methods. We performed a total of 520 upper gastrointestinal tract endoscopies in Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca. Indications for endoscopy in our cohort were gastrointestinal tract symptoms such as dysphagia, heartburn, or appetite loss. Results. The prevalence of infectious esophagitis in the study population was 2.11% (11 patients). Candida albicans (C. albicans) was the most frequent cause. Our data illustrates that herpes simplex virus (HSV)-induced esophagitis is common in immunocompromised patients and should be systematically suspected in cases of severe dysphagia, heartburn, or hematemesis. In the present study, all cytomegalovirus (CMV) esophagitis patients were immunocompromised. Immunodeficiency (81.8%) and prolonged antibiotic therapy with broad-spectrum antibiotics were by far the most important risk factors involved in the pathogenicity of the disease. Dysphagia, appetite loss, heartburn, epigastralgia, and hematemesis were the main clinical manifestations. Infectious esophagitis was associated with significant mortality. In four patients, endoscopy during life showed signs of infectious esophagitis; however, the precise etiology was only established post-mortem, in the pathological anatomy laboratory department. A risk factor involved in pathogenesis of post-mortem diagnosed infectious esophagitis is the DiGeorge syndrome for CMV and HSV patients. Conclusions. The study illustrates that infectious esophagitis should be considered in immunocompromised infants with prolonged antibiotic therapy with broad-spectrum antibiotics.

scholarly journals Incidence, risk factors, phathophisiology and modern aspects of therapy of feline pyometra

2019 ◽  
pp. 54-60
Author(s):  
Georgy Petrovich Dyulger ◽  
Yuliya Gennadievna Sibileva ◽  
Maria Aleksandrovna Yakovleva Maria ◽  
Peter Georgievich Dyulger ◽  
Evgeniya Sergeevna Sedletskaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Detection ◽  
Inflammatory Response ◽  
Broad Spectrum ◽  
Clinical Manifestations ◽  
Systemic Inflammatory Response ◽  
Clinical Forms ◽  
Broad Spectrum Antibiotics ◽  
Incidence Risk

The article provides an overview of the frequency of distribution of pyometra in cats. Risk factors, clinical manifestations and clinical forms of the disease are analyzed. Current methods of pyometra diagnostics and clinical and laboratory criteria for early detection of signs of sepsis (systemic inflammatory response) in cats with pyometra are considered. The methods of pyometra therapy are analyzed. It was emphasized that the most effective and safest method of treating any form of pyometra is a total ovariohisterectomy in combination with broad-spectrum antibiotics. Encouraging results in the treatment of an open uncomplicated form of pyometers in cats were obtained using, along with antibiotics, preparations based on PgF2alfa and aglepristone.

scholarly journals Pseudomonal breast infection

2010 ◽  
Vol 92 (3) ◽  
pp. e20-e22 ◽  
Author(s):  
DP Harji ◽  
S Rastall ◽  
C Catchpole ◽  
R Bright-Thomas ◽  
S Thrush
Keyword(s):  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Abscess Formation ◽  
Causative Organism ◽  
Breast Infection ◽  
Broad Spectrum Antibiotics

Breast infection and breast sepsis secondary to Pseudomonas aeruginosa is uncommon. We report two cases of pseudomonal breast infection leading to septic shock and abscess formation in women with non-responding breast infection. The management of breast infection is broad-spectrum antibiotics and ultrasound with aspiration of any collection. To treat breast infection effectively, the causative organism must be isolated to enable appropriate antibiotic therapy.

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Mycobacterium fortuitum abdominal wall abscesses following liposuction

2008 ◽  
Vol 41 (01) ◽  
pp. 58-61
Author(s):  
Hussam Al Soub ◽  
Eman Al-Maslamani ◽  
Mona Al-Maslamani
Keyword(s):  
Antibiotic Therapy ◽  
Abdominal Wall ◽  
Broad Spectrum ◽  
Mycobacterium Fortuitum ◽  
Surgical Drainage ◽  
Abdominal Abscesses ◽  
Broad Spectrum Antibiotics

ABSTRACTwe describe here a case of abdominal abscesses due to mycobacterium fortuitum following liposuction. the abscesses developed three months after the procedure and diagnosis was delayed for five months. the clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. this condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

EFFECTS OF PENICILLIN AND BROAD-SPECTRUM ANTIBIOTICS ON THE EMERGENCE OF A GRAM-NEGATIVE BACILLARY FLORA IN THE UPPER RESPIRATORY TRACT OF INFANTS

PEDIATRICS ◽  
1952 ◽  
Vol 9 (5) ◽  
pp. 572-576
Author(s):  
ROBERT S. MCCURDY ◽  
ERWIN NETER
Keyword(s):  
Respiratory Tract ◽  
Broad Spectrum ◽  
Clinical Manifestations ◽  
Upper Respiratory Tract ◽  
Broad Spectrum Antibiotic ◽  
Gram Negative ◽  
E Coli ◽  
Broad Spectrum Antibiotics ◽  
Upper Respiratory ◽  
Aerobic Flora

A study was undertaken on 107 infants to determine the effect of penicillin and broad-spectrum antibiotics (aureomycin, chloromycetin and terramycin), alone and in combination, on the emergence of a predominant gram-negative, bacillary flora of the upper respiratory tract. The following data were obtained: 1. Such a change of the flora took place in 4 out of 12 patients treated with penicillin, 15 out of 22 treated with penicillin and a broad-spectrum antibiotic, and in only 4 out of 21 infants who received a broad-spectrum antibiotic exclusively. 2. Of the 32 cases whose flora had thus changed, members of the E. coli-A. aerogenes group were found in 30 instances, members of the genus Proteus in 3; Ps. aeruginosa in 2; Paracolobactrum in 1; and combinations thereof in four cases. 3. This change of the flora took place in 18 out of 71 infants suffering from respiratory infection and in 14 out of 36 children suffering from other diseases. 4. Reappearance of clinical manifestations was observed in 6 out of 19 patients whose respiratory tract flora changed following the use of penicillin and in none of the four individuals who were treated with a broad-spectrum antibiotic alone. In view of the small number of cases this observation requires confirmation. 5. It is concluded that in infants the use of penicillin used in conjunction with a broad-spectrum antibiotic is followed rather frequently by the emergence in the upper respiratory tract of a predominant gram-negative, bacillary, aerobic flora; such a change occurs less frequently after the use of a broad-spectrum antibiotic alone. The clinical significance of these data is discussed.

Risk Factors for Clinical Manifestations in Patients with Factor V Leiden and Prothrombin Gene Mutations.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4090-4090
Author(s):  
Maria Teresa De Sancho ◽  
Nickisha Berlus ◽  
Jacob H. Rand
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Gene Mutations ◽  
Factor V Leiden ◽  
Factor V ◽  
Female Hormones ◽  
Significant Difference ◽  
History Of

Abstract Factor V Leiden (FVL) and prothrombin G20210A gene mutations are the most prevalent hereditary thrombophilias (HT). Carriers of these HT are at greater risk for developing thromboembolic events (TEE) and/or pregnancy complications (PC) compared to non-carriers, but not all carriers develop clinical manifestations. We retrospectively analyzed the risk factors (RF) for clinical manifestations of all subjects who tested positive for FVL and/or PG20210A gene mutations in our hematology clinic between January 2000 and July 2006. Symptomatic carriers (cases) and asymptomatic carriers (controls) were compared. Cases were defined as having had a TEE (venous and/or arterial) or a PC (pregnancy loss (PL), preeclampsia, abruption placenta and intrauterine growth restriction). Data analyzed included secondary RF for thrombosis, use of female hormones (FH), family history of thrombosis (FHT), and the presence of other thrombophilias. During the study period, 197 subjects were fully evaluable; 9 were excluded due to insufficient data. The clinical characteristics are shown in Table 1. Of the 85 venous thromboses (VT), 59 (69%) had DVT and/or PE, 10 (12%) had superficial thrombophlebitis, 9 (11%) intra-abdominal thrombosis, 2 (2%) cerebral VT, 2 (2%) had retinal VT and 3 (4%) had &gt; 1 site of VT. Of the 25 arterial thromboses (AT), 11 (44%) were CVA, 7 (28%) had TIA, 6 (24%) had other AT, and 1 (4%) had an MI. Of the 52 cases with PL, 27 (52%) were early recurrent 1st trimester PL, 8 (15%) were 2nd or 3rd trimester PL, 4 (8%) had infertility and 13 (25%) had both PL and infertility. Of the 5 PC, 3 were abruption placenta, 1 preeclampsia and 1 had &gt; 1 PC. The most common RF was the presence of &gt; 1 secondary RF (Table 2). There was no significant difference between cases and controls regarding the use of FH, FHT, and presence of other thrombophilias. Fertility medications were used by 12 (10%) of cases vs. 1 (2%) of controls. Antiphospholipid (aPL) antibody-positivity was the most prevalent concurrent thrombophilic factor and occurred in 18 of cases (12%) vs. 2 (4%) of controls. Cases and controls were similar regarding gender, age, family history of thrombosis, and presence of other thrombophilias. In summary, fertility medications and aPL antibodies appear to be significant risk factors for clinical manifestations in cases. Larger multicenter studies are warranted to identify additional RF in carriers of these HT. Clinical Characteristics Cases (n=145) Controls (n=52) *85 heterozygous, 6 homozygous, **29 heterozygous, 2 homozygous, ***37 heterozygous, 2 homozygous, ****100% heterozygous Mean Age, yr [+/−SD] 44+/−13 42+/−13 Gender, female 115 (79%) 42 (81%) FVL 91 (63%)* 31 (60%)** PG20210A 39 (27%)*** 18 (35%)**** FVL + PG20210A 15 (10%) 3 (6%) VT 85 (59%) --- AT 25 (17%) --- PC and infertility (female carriers, n=115) 57 (50%) --- Risk Factors Cases (n=145) Controls (n=52) p value Includes obesity, postoperative period, pregnancy, puerperium, long airplane flight, smoking, hypertension, hypercholesterolemia, and immobilization; **oral contraceptives, hormone replacement therapy, selective estrogen receptor modulators, progesterone OC, fertility medications Secondary RF* 74 (51%) 15 (29%) 0.265 NS Use of female hormones**, n=115 59 (51%) 21 (50%) 0.478 NS Family history of thrombosis 73 (50%) 34 (65%) 0.252 NS Other thrombophilias 60 (41%) 21 (40%) 0.232 NS

scholarly journals Outpatient Fluoroquinolone Use in Children, 2000–2018

2020 ◽  
Author(s):  
Rachael K Ross ◽  
Jeffrey S Gerber ◽  
Zachary I Willis ◽  
Adam L Hersh ◽  
Alan C Kinlaw
Keyword(s):  
Broad Spectrum ◽  
Clinical Characteristics ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Fill Rate ◽  
Outpatient Prescription ◽  
Broad Spectrum Antibiotics ◽  
Trends Over Time ◽  
Future Work ◽  
The Impact

Abstract Background While fluoroquinolones are commonly used in adults, the use in children has been low. Since 2000, there were 3 US Food and Drug Administration (FDA) Boxed warnings regarding fluoroquinolones (2008, 2013, and 2016). Our objective was to describe the use of fluoroquinolones in children and assess the impact of 3 recent FDA warnings on fluoroquinolone use. Methods From 2000 to 2018, we assessed claims for all outpatient prescription fills to measure the use of systemic fluoroquinolones and other broad-spectrum antibiotics in children  less than 18 years old in the MarketScan Commercial Claims and Encounters database. We describe demographics, indication for antibiotic, and clinical characteristics. To assess the impact of FDA warnings on fill rates, we conducted an interrupted time-series analysis. Results The cohort included 34.6 million unique beneficiaries less than 18 years old with 441 062 fluoroquinolone fills (5.5 fills per 1000 person-years). The fluoroquinolone fill rate was highest among children &gt; 11 years old. Urinary tract infection was the most common associated diagnosis (21.8%). Since 2008, the fluoroquinolone fill rate has declined. By the end of the study period in December 2018, in the (counterfactual) absence of the FDA warnings, fluoroquinolone fill rate would have been 7.5 (95% confidence interval [CI]: 5.2-9.7); however, the corresponding rate in observed data was 2.8 (95% CI: 1.7-3.9). Conclusions Fluoroquinolone use was low compared with other common broad-spectrum antibiotics and declining trends over time were associated with FDA warnings, even though these warnings were not pediatric specific. Future work should assess the adverse events at issue in these warnings in children.

scholarly journals A Decision Tree Using Patient Characteristics to Predict Resistance to Commonly Used Broad-Spectrum Antibiotics in Children With Gram-Negative Bloodstream Infections

2019 ◽  
Vol 9 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Anna C Sick-Samuels ◽  
Katherine E Goodman ◽  
Glenn Rapsinski ◽  
Elizabeth Colantouni ◽  
Aaron M Milstone ◽  
...  
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Intestinal Transplantation ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Broad Spectrum Antibiotics

Abstract Background As rates of multidrug-resistant gram-negative infections rise, it is critical to recognize children at high risk of bloodstream infections with organisms resistant to commonly used empiric broad-spectrum antibiotics. The objective of the current study was to develop a user-friendly clinical decision aid to predict the risk of resistance to commonly prescribed broad-spectrum empiric antibiotics for children with gram-negative bloodstream infections. Methods This was a longitudinal retrospective cohort study of children with gram-negative bacteria cared for at a tertiary care pediatric hospital from June 2009 to June 2015. The primary outcome was a bloodstream infection due to bacteria resistant to broad-spectrum antibiotics (ie, cefepime, piperacillin-tazobactam, meropenem, or imipenem-cilastatin). Recursive partitioning was used to develop the decision tree. Results Of 689 episodes of gram-negative bloodstream infections included, 31% were resistant to broad-spectrum antibiotics. The decision tree stratified patients into high- or low-risk groups based on prior carbapenem treatment, a previous culture with a broad-spectrum antibiotic resistant gram-negative organism in the preceding 6 months, intestinal transplantation, age ≥3 years, and ≥7 prior episodes of gram-negative bloodstream infections. The sensitivity for classifying high-risk patients was 46%, and the specificity was 91%. Conclusion A decision tree offers a novel approach to individualize patients’ risk of gram-negative bloodstream infections resistant to broad-spectrum antibiotics, distinguishing children who may warrant even broader antibiotic therapy (eg, combination therapy, newer β-lactam agents) from those for whom standard empiric antibiotic therapy is appropriate. The constructed tree needs to be validated more widely before incorporation into clinical practice.

scholarly journals Clinical Epidemiology and Risk Factors of Candida auris Bloodstream Infection in Trauma Patients

2020 ◽  
Vol 41 (S1) ◽  
pp. s168-s168
Author(s):  
Omika Katoch ◽  
Vijeta Bajpai ◽  
Surbhi Khurana ◽  
Sonal Katyal ◽  
Purva Mathur
Keyword(s):  
Risk Factors ◽  
Broad Spectrum ◽  
Clinical Epidemiology ◽  
Fungal Infections ◽  
Major Surgery ◽  
Trauma Patients ◽  
Candida Auris ◽  
Becton Dickinson ◽  
Broad Spectrum Antibiotics ◽  
Hospital Acquired

Background: Candidiasis caused by Candida auris is one of the most serious hospital-acquired infection. Initially, Candida auris was reported to cause local infections; later, invasive candidasis was also reported in which the bloodstream, the central nervous system, kidneys, liver eyes, etc, are invaded. In this study, we evaluated the clinical epidemiology and risk factors in patients hospitalized to trauma center. Methods: This study was conducted at JPN Apex Trauma Centre of All India Institute of Medical Sciences, New Delhi, which is a 169-bed hospital. All patients who were identified to have candidemia due to C. auris over a period of 5 years from January 2012 to December 2016 were included. Blood samples were collected in BAC-T-Alert bottles (Bio Merieux, Durham, NC) and isolates were identified up to the species level by the VITEK 2 (version 8.01, BioMerieux). Conventional identification was performed by observing color development on CHROMagar (Becton Dickinson, Franklin Lakes, NJ). The demographic and clinical data of patients were collected from the hospital information system. Results: Over a period of 5 years, 20 patients admitted to our trauma hospital developed candidemia due to Candida auris. Among them, men were predominant (95%), and the mean (SD) age of the patients was 33 (+15) years. Among these patients, 80% were in hospitalized and 20% were follow-up patients. The median of the total length of stay in the hospital was 34 days (range, 7–122). All of the patients were on mechanical ventilation; 65% patients were catheterized and 75% patients had central line placed. Head injury was the major cause of trauma followed by abdomen, chest, and spine. The overall mortality rate was 40%. Most of the patients (65%) who developed Candida auris infection were immunocompromised. The different comorbidities present were hypertension (35%), diabetes (15%), renal disease (10%), and hepatitis C (5%). Broad-spectrum antibiotics were given: amoxicillin-clavulanate was given to 65% of patients; cefoperazone sulbactam was given to 30% of patients; chloroamphenicol, amicillin-sulbactam, or clindamycin was given to 10% of patients. Antifungal agents like fluconazole or caspofungin were given to 5% of patients. Major surgeries like cranioplasty were performed in 58% of patients. Pancreatectomy, laparotomy, and endoscopic necrosectomy were performed in 42% of patients. Conclusions:Candida auris is one of the dreaded and most commonly spread hospital-acquired fungal infections, especially in immunocompromised patients. Broad-spectrum antibiotics use, major surgery, and invasive devices were the most common risk factors for acquiring Candida auris infection.Funding: NoneDisclosures: None

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