RESUMEN
BACKGROUND: In contrast to the adult population, limited information is currently available on risk factors for ventilator-associated pneumonia (VAP) in children. Therapeutic hypothermia has been identified as a risk factor for the early onset of VAP in adults; however, the relationship between VAP and normothermia remains unclear. The present study investigated risk factors for VAP in children, with a focus on the deleterious effects of therapeutic normothermia on VAP. METHODS: We retrospectively investigated the clinical characteristics of children treated with mechanical ventilation for more than 48 h and analyzed risk factors for VAP. The endpoint was the onset of VAP by the seventh day after the initiation of mechanical ventilation. RESULTS: Among the 288 patients enrolled, seven (2.4%) developed VAP. No significant differences were observed in clinical backgrounds between the VAP and non-VAP groups. A univariate analysis identified target temperature management (TTM) at 36°C (p < 0.0001) and methylprednisolone (mPSL) pulse therapy (p = 0.02) as risk factors for VAP. An analysis of the time to the onset of VAP by the Kaplan-Meier plot and log-rank test revealed a significantly higher incidence of VAP in the TTM group (p < 0.0001) and mPSL pulse group (p = 0.001). CONCLUSION: TTM at 36°C and mPSL pulse therapy may be risk factors for VAP in the pediatric population.
Asunto(s)
Hipotermia Inducida , Neumonía Asociada al Ventilador , Adulto , Humanos , Niño , Neumonía Asociada al Ventilador/epidemiología , Neumonía Asociada al Ventilador/etiología , Neumonía Asociada al Ventilador/tratamiento farmacológico , Estudios Retrospectivos , Respiración Artificial/efectos adversos , Factores de Riesgo , Hipotermia Inducida/efectos adversosRESUMEN
BACKGROUND: Encephalitis due to vaccination for mumps is a rare complication that occurs in 0.00004% of recipients, and there has been no report of serious neurological sequelae. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) has been reported as the most frequent type among acute encephalopathy syndromes in the pediatric population in Japan. There has been no report of AESD caused by vaccinations. Case presentation We present the clinical course of a 1-year and 10-month-old boy who had no preexisting condition, and developed mumps vaccine-induced severe primary encephalitis. Refractory status epilepticus due to encephalitis persisted for 16 h and resulted in secondary encephalopathy as a form of AESD mimic. He had serious neurological sequelae, such as West syndrome, transient spastic tetraplegia, and intellectual disability, despite intensive treatments. DISCUSSION: The presented boy is the first patient to develop mumps vaccine-induced primary encephalitis with severe central nervous system (CNS) damage. Screening of the immunological background in the presented patient revealed no abnormalities; therefore, it is unclear why he developed such severe adverse events. In patients with acute encephalitis caused by the herpes simplex virus 1, inborn immune errors in CNS based on mutations in single genes are involved in its pathophysiology. Consequently, some immunogenetic alterations could be found by further analysis in the presented patient.
Asunto(s)
Encefalopatías , Encefalitis Viral , Encefalitis , Encefalomielitis Aguda Diseminada , Paperas , Estado Epiléptico , Masculino , Humanos , Niño , Lactante , Vacuna contra la Parotiditis , Paperas/complicaciones , Encefalopatías/etiología , Encefalopatías/complicaciones , Convulsiones/etiología , Estado Epiléptico/etiología , Estado Epiléptico/complicaciones , Encefalitis/etiología , Encefalitis/complicaciones , Encefalomielitis Aguda Diseminada/complicaciones , Fiebre/complicacionesRESUMEN
Bacillus cereus is known to cause two types of food poisoning: emetic and diarrhoeal. Both diseases are usually self-limiting; however, severe cases have been reported, presenting with acute liver failure and encephalopathy, including rarely fatal cases of vomiting. Clinical laboratories do not routinely test for B. cereus in patients with gastrointestinal disease. Therefore, B. cereus causing food poisoning goes undetected. We report a successful isolation of emetic B. cereus from a patient with food poisoning who presented with severe vomiting, fulminant hepatic failure, and acute encephalopathy, by a non-conventional method. Initially, stool specimens from the patients were routinely cultured to identify the causative organisms of food poisoning. No foodborne pathogens were detected in this study. In contrast, additional clinical and epidemiological information strongly suggested food poisoning by emetic B. cereus. Consequently, we allowed Drigalski agar medium smeared with patient stool specimens to stand at room temperature (approximately 25 °C) for 9 days. After 9 days, mixed bacteria grown on the medium were inoculated onto mannitol egg yolk polymyxin (MYP) agar plates, a selective medium for B. cereus. Typical colonies of B. cereus developed on MYP agar plates. The isolated B. cereus had a cereulide-producing genetic locus (ces) gene encoding the emetic toxin cereulide. The method used in this case study was unique. This method is easy to apply after obtaining an additional clinical and epidemiological information, and this method will improve the diagnostic rate of severe B. cereus food poisoning. This will contribute to the advancement of therapeutics in the future.
Asunto(s)
Encefalopatías , Enfermedades Transmitidas por los Alimentos , Agar , Bacillus cereus/genética , Eméticos , Enfermedades Transmitidas por los Alimentos/diagnóstico , Humanos , VómitosAsunto(s)
Bacteriemia , Infecciones por Klebsiella , Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Niño , Hospitales Pediátricos , Humanos , Klebsiella , Infecciones por Klebsiella/diagnóstico , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella oxytocaRESUMEN
BACKGROUND: Prophylactic antibiotics decrease mortality and morbidity in patients with hematological malignancies following intensive chemotherapy. However, the efficacy of prophylactic antibiotics for pediatric patients with solid tumors remains unclear. METHODS: We retrospectively assessed 103 neutropenic periods from 26 patients with neuroblastoma or brain tumors following three different intensity chemotherapy regimens (05A3, A, and B). While piperacillin was intravenously administered as prophylaxis (PIPC prophylaxis group), the historical control group received no prophylaxis. As patients exhibited a variable degree of myelosuppression based on the intensity of the chemotherapy regimen, we separately evaluated the frequency and severity of febrile neutropenia (FN) in each regimen. RESULTS: Following intensive chemotherapy, we observed a significantly lower frequency of FN in the PIPC prophylaxis group compared with the historical control group in both regimen 05A3 (20% vs 65%; P = 0.01) and regimen A (56% vs 93%; P = 0.02). We also observed a shorter duration of fever, lower maximum fever, and lower C-reactive protein levels in the PIPC prophylaxis group compared with the historical control group after regimens 05A3 and A. Conversely, the frequency and severity of FN were not different between the two groups after moderate-intensity chemotherapy (regimen B). However, a longitudinal routine surveillance study of Pseudomonas aeruginosa also indicated a reduction in the susceptibility to PIPC throughout the study period. CONCLUSIONS: Although PIPC prophylaxis might provide an advantage for severe neutropenia in pediatric patients with solid tumors, there is concern regarding bacterial resistance to antibiotics. Therefore, further careful examination is necessary for adaptation.
Asunto(s)
Antibacterianos/uso terapéutico , Fiebre/prevención & control , Neutropenia/prevención & control , Piperacilina/uso terapéutico , Profilaxis Antibiótica , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Carboplatino/uso terapéutico , Niño , Preescolar , Farmacorresistencia Microbiana , Femenino , Fluorouracilo/uso terapéutico , Humanos , Lactante , Leucovorina/uso terapéutico , Masculino , Metotrexato/uso terapéutico , Neuroblastoma/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
BACKGROUND: Development of neurological complications of varicella zoster virus reactivation is relatively uncommon, particularly in an immunocompetent child. CASE PRESENTATION: An 11-year-old Asian girl presented with headache and skin rash on her left chest. She was diagnosed with meningitis, and herpes zoster was confirmed by polymerase chain reaction using cerebrospinal fluid. Acyclovir was administered intravenously. Given the favorable evolution of the clinical course, she was discharged from the hospital on day 8 of her illness. She had no apparent sequelae or comorbidities at the time of the 6-week follow-up. CONCLUSIONS: Neurological complications such as meningitis due to varicella zoster virus reactivation are uncommon, especially in an immunocompetent child; no specific immune deficiency was identified in our patient. We conclude that, although rare, varicella zoster virus should be recognized as a potential cause of viral meningitis in immunocompetent children.
Asunto(s)
Aciclovir/administración & dosificación , Líquido Cefalorraquídeo/virología , Herpes Zóster , Herpesvirus Humano 3/aislamiento & purificación , Meningitis Viral , Administración Intravenosa , Antivirales , Niño , Exantema/diagnóstico , Exantema/etiología , Femenino , Cefalea/diagnóstico , Cefalea/etiología , Herpes Zóster/complicaciones , Herpes Zóster/diagnóstico , Herpes Zóster/tratamiento farmacológico , Herpes Zóster/fisiopatología , Humanos , Inmunocompetencia , Meningitis Viral/diagnóstico , Meningitis Viral/tratamiento farmacológico , Meningitis Viral/etiología , Meningitis Viral/fisiopatología , Resultado del TratamientoRESUMEN
BACKGROUND: The risk factors of multidrug-resistant (MDR) Gram-negative bacilli (GNB) bloodstream infection (BSI) are not yet known in children. Our aim was to evaluate risk factors and outcomes associated with MDR GNB BSI in children. METHODS: Patients with GNB BSI were enrolled between April 2010 and March 2017 at 8 children's hospitals in Japan. Clinical and microbiologic data were collected retrospectively. The risk factors and outcomes of MDR and non-MDR GNB BSI were compared. RESULTS: In total, 629 GNB BSI episodes met the case definition. The median age and proportion of males were 2 years (interquartile range, 0.3-8.7) and 50.7%, respectively. An underlying disease was found in 94% of patients. The proportion of BSI cases that developed >48 hours after admission was 76.2%. MDR comprised 24.5% of BSI cases. The MDR rate did not change over time (P = 0.540). The effective coverage rate of the initial empiric therapy for the MDR and non-MDR BSI cases was 60.4% and 83.4%, respectively (P < 0.001). The all-cause mortality rate at 28 days for all BSI, MDR-BSI and non-MDR BSI cases was 10.7%, 13.6% and 9.7%, respectively (P = 0.167). MDR BSI was independently associated with cancer chemotherapy within 30 days (odds ratio [OR] 43.90), older age (OR 1.05) and admission to the neonatal ward (OR 0.019). CONCLUSIONS: One-fourth of GNB BSI cases were MDR. Cancer chemotherapy and older age were risk factors for MDR GNB BSI in children's hospitals. MDR did not increase the all-cause mortality rate.
Asunto(s)
Bacteriemia/epidemiología , Bacteriemia/microbiología , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Adolescente , Niño , Preescolar , Femenino , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/aislamiento & purificación , Hospitales Pediátricos , Humanos , Lactante , Recién Nacido , Japón/epidemiología , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia , Resultado del TratamientoAsunto(s)
Proteínas Bacterianas/genética , Proteínas Bacterianas/aislamiento & purificación , Infección Hospitalaria/microbiología , Staphylococcus aureus Resistente a Meticilina/genética , Proteínas de Unión a las Penicilinas/genética , Proteínas de Unión a las Penicilinas/aislamiento & purificación , Staphylococcus aureus/genética , Antibacterianos/uso terapéutico , Proteínas Bacterianas/efectos de los fármacos , Infección Hospitalaria/tratamiento farmacológico , Brotes de Enfermedades , Hospitales Pediátricos , Humanos , Japón , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Proteínas de Unión a las Penicilinas/efectos de los fármacos , Penicilinas/uso terapéutico , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificaciónAsunto(s)
Actinomicosis/diagnóstico , Enfermedades Faríngeas/diagnóstico , Seno Piriforme , Fístula del Sistema Respiratorio/diagnóstico , Actinomicosis/complicaciones , Enfermedades Asintomáticas , Preescolar , Humanos , Masculino , Cuello , Enfermedades Faríngeas/complicaciones , Enfermedades Faríngeas/microbiología , Seno Piriforme/microbiología , Fístula del Sistema Respiratorio/complicaciones , Fístula del Sistema Respiratorio/microbiologíaRESUMEN
Mycoplasma hominis is a rare causative pathogen for surgical site infections after neurosurgical procedures. This organism lacks a cell wall, rendering it undetectable by Gram staining and making it resistant to beta-lactam antibiotics. In addition, some special techniques are required to identify this organism. Thus, it is very difficult to diagnose infections caused by this pathogen. Here, the authors report a pediatric case of M. hominis ventriculoperitoneal shunt (VPS) infection with central nervous system involvement for which beta-lactam antibiotics were not effective and Gram staining revealed no pathogens. Because few cases have been described that involve the treatment of M. hominis infection after neurosurgery, in this case the patient's serum and CSF were monitored for antibiotic drug concentrations. Successful treatment of the infection was achieved after approximately 6 weeks of administration of clindamycin and ciprofloxacin antibiotics in addition to external ventricular drain revision and subsequent VPS replacement. When beta-lactam antibiotics are ineffective and when Gram staining cannot detect the responsible pathogens, it is important to consider M. hominis as the atypical pathogen.
Asunto(s)
Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/terapia , Mycoplasma hominis , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/terapia , Derivación Ventriculoperitoneal/efectos adversos , Niño , Diagnóstico Diferencial , Femenino , Humanos , Hidrocefalia/cirugía , Infecciones por Mycoplasma/líquido cefalorraquídeo , Infecciones por Mycoplasma/patología , Procedimientos Neuroquirúrgicos/efectos adversos , Infecciones Relacionadas con Prótesis/líquido cefalorraquídeo , Infecciones Relacionadas con Prótesis/patologíaRESUMEN
PURPOSE: This study aimed to describe the epidemiology of childhood group B streptococcus (GBS) disease including late late-onset disease (LLOD) and to clinically characterize recurrent cases and twin-sibling cases in Japan. METHODS: We collected information on infants (<1 year of age) with invasive GBS disease and institutional information about births and transfers through a nationwide questionnaire between 2011 and 2015. RESULTS: We identified 133 infants with early-onset disease (EOD), 274 late-onset disease (LOD), and 38 LLOD from 149 institutes. The case fatality rate (CFR) of EOD, LOD, and LLOD was 4.5, 4.4, and 0%, respectively. CFR in EOD was significantly (P < 0.001) associated with preterm birth, but not that in LOD and LLOD. Twenty-nine percent of infants with meningitis (49/169) had neurologic sequelae. We showed clinical details of 12 recurrent cases that accounted for 2.8% of the total patients, and 4 sets of both twins affected; 4 of 12 recurrent cases and 3 of 4 twin-sibling sets were also associated with preterm birth. Based on the livebirth number of 581,488, the instituted-based incidence of EOD, LOD, and LLOD was estimated as 0.09 (95% CI 0.06-0.11), 0.12 (95% CI 0.11-0.14), and 0.01 (95% CI 0.01-0.02) per 1000 livebirths, respectively. CONCLUSIONS: CFR of EOD and LOD in Japan is comparable with that in high-income European countries or the United States, and their incidence is much lower. Our findings also describe the clinical details of LLOD, recurrent infections, and infections in twin siblings. This study is the largest among Asian childhood GBS studies ever reported.
Asunto(s)
Enfermedades en Gemelos/epidemiología , Meningitis/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/fisiología , Enfermedades en Gemelos/microbiología , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Japón/epidemiología , Masculino , Meningitis/complicaciones , Meningitis/microbiología , Enfermedades del Sistema Nervioso/microbiología , Recurrencia , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/microbiologíaRESUMEN
This study examined the pathogenesis of early-onset sarcoidosis (EOS) in a patient with a rare NOD2 mutation and surveyed the literature to identify the hallmark features for early diagnosis. An infant girl suffering from prolonged fever and skin rash of multiple pinkish papules and subsequent erythema nodosum was referred to our institution. Skin biopsy and DNA sequencing were performed along with cytokine profiling of the patient's serum and stimulated mononuclear cells. NF-κB activation was analyzed using transfected cells. Multiple non-caseating granuloma inclusions were recognized in biopsy specimens obtained from the patient's rash. DNA sequencing revealed a very rare heterozygous Met513Thr (M513T) mutation in NOD2. Mononuclear cells produced a low amount of IL-1ß upon stimulation as compared with normal control cells. Mutated NOD2 transfection enhanced NF-κB activation. We suspected that the M513T mutation in NOD2 decreased IL-1ß production and enhanced NF-κB activation, which was likely responsible for the patient's granuloma involvement. A comprehensive review of the literature on 30 cases of sporadic type of EOS revealed that all patients had cutaneous manifestations, with all but one displaying granulation. A majority of EOS patients have R334W/Q. But about half of sporadic EOS had NOD2 mutations other than R334W/Q, as in the present case. Accordingly, skin rash with granuloma formation and specific NOD2 mutations may represent early diagnostic hallmarks of EOS in infants with persistent inflammation.
Asunto(s)
ADN/genética , Diagnóstico Precoz , Mutación , Proteína Adaptadora de Señalización NOD2/genética , Sarcoidosis/diagnóstico , Piel/patología , Artritis , Biomarcadores/metabolismo , Biopsia , Análisis Mutacional de ADN , Femenino , Humanos , Lactante , Proteína Adaptadora de Señalización NOD2/metabolismo , Sarcoidosis/genética , Sarcoidosis/fisiopatología , Sinovitis , UveítisRESUMEN
In the spring of 2015, we experienced a cluster of 4 sporadic cases of yersiniosis in children in Nagano prefecture, a rural area of Japan. Two patients developed appendicitis-like episodes; one had acute gastroenteritis, and the other had bacteremia associated with liver abscess. The causative agent of these infections was Yersinia enterocolitica serogroup O:8. None of the patients had an underlying illness, and all have recovered completely. The patients were neither socially nor geographically related to each other. These 4 consecutive cases suggest that Y. enterocolitica O:8 has spread substantially in the middle part of Japan, and that this virulent strain might be more common than previously reported in our country.
Asunto(s)
Antígenos O/análisis , Serogrupo , Yersiniosis/diagnóstico , Yersiniosis/microbiología , Yersinia enterocolitica/clasificación , Yersinia enterocolitica/aislamiento & purificación , Adolescente , Niño , Preescolar , Análisis por Conglomerados , Femenino , Humanos , Japón/epidemiología , Masculino , Población Rural , Yersiniosis/epidemiología , Yersiniosis/patologíaAsunto(s)
Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/microbiología , Endocarditis/tratamiento farmacológico , Endocarditis/microbiología , Válvula Tricúspide/microbiología , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Bacterias Anaerobias/efectos de los fármacos , Bacterias Anaerobias/patogenicidad , Bacteroides fragilis/efectos de los fármacos , Bacteroides fragilis/patogenicidad , Endocarditis/cirugía , Endocarditis Bacteriana/cirugía , Femenino , Humanos , Pruebas de Sensibilidad Microbiana , Mortalidad , Peptostreptococcus/efectos de los fármacos , Peptostreptococcus/patogenicidad , Factores de Riesgo , Válvula Tricúspide/cirugía , Veillonella/efectos de los fármacos , Veillonella/patogenicidad , Adulto JovenRESUMEN
Although the effectiveness of subarachnoid continuous drug infusion has been established in cancer pain management, its clinical use in children is rare. A 14-year-old girl with neurofibromatosis type I complained of right leg pain stemming from a growing tumor on her right buttock. Continuous and breakthrough right leg pain were unbearable, even at high doses of systemic opioids that caused severe constipation and deep sedation. Subsequent continuous infusion of bupivacaine and morphine through a subarachnoid catheter effectively relieved the girl's pain. The corresponding decrease in systemic opioid also improved her activities of daily living. The patient eventually died of cachexia due to the rapidly growing buttock lesion that was pathologically confirmed post-mortem as a malignant peripheral nerve sheath tumor. Subarachnoid continuous drug infusion may be very useful in controlling severe pain with few side-effects, even in the field of pediatric palliative care.
Asunto(s)
Analgésicos Opioides/administración & dosificación , Dolor en Cáncer/tratamiento farmacológico , Neoplasias Pélvicas/complicaciones , Adolescente , Dolor en Cáncer/diagnóstico , Dolor en Cáncer/etiología , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Espinales , Dimensión del Dolor , Espacio SubaracnoideoRESUMEN
In the treatment of Kawasaki disease, resistance to high-dose immunoglobulin intravenous (IGIV) can occur. The neutrophil morphology analyses in 17 patients revealed that transient pseudo-Pelger-Huët anomaly was more frequently detected in the IGIV-resistant group. This finding may aid the prediction of IGIV resistance.
Asunto(s)
Resistencia a Medicamentos , Inmunoglobulinas Intravenosas/uso terapéutico , Síndrome Mucocutáneo Linfonodular/tratamiento farmacológico , Anomalía de Pelger-Huët/diagnóstico , Preescolar , Femenino , Humanos , Masculino , Anomalía de Pelger-Huët/complicaciones , Estudios RetrospectivosRESUMEN
BACKGROUND: Staphylococcus lugdunensis (S. lugdunensis) is known as a common cause of clinically significant infections in adults although the clinical importance of S. lugdunensis isolates from pediatric samples is less known. The aim of this study is to assess the incidence, characteristics, and outcomes of S. lugdunensis bacteremia (SLB) in children. METHODS: From January 2009 to March 2014, all blood culture isolates were retrospectively screened for S. lugdunensis. We analyzed the isolates for antimicrobial susceptibility and patients who had developed SLB by reviewing the electronic medical records. Additionally, we identified mecA and blaZ for available isolates by polymerase chain reaction (PCR). RESULTS: Of the 647 positive blood cultures during the period, 277 (42.8%) yielded coagulase negative Staphylococcus (CoNS), and 10 of 277 CoNS were S. lugdunensis (3.6% of all CoNS isolates). Of eight SLB episodes identified, seven (87.5%) were considered to have clinically significant bacteremia. All patients had underlying diseases, and all SLB were either healthcare-associated or hospital acquired. There was no infectious endocarditis (IE) development. All patients were treated with antibiotics and recovered without sequelae. We found that the isolates in our study showed higher antibiotic resistance to penicillin (8/8: 100%) and oxacillin (6/8: 75.0%) than previously reported. Among isolates available, we detected mecA in all four isolates resistant to oxacillin and blaZ in 5 of 6 isolates resistant to penicillin. CONCLUSIONS: S. lugdunensis is a rare but an important cause of bacteremia in children.
Asunto(s)
Bacteriemia , Infecciones Estafilocócicas , Staphylococcus lugdunensis , Antibacterianos/farmacología , Bacteriemia/diagnóstico , Bacteriemia/epidemiología , Bacteriemia/microbiología , Proteínas Bacterianas , Niño , Preescolar , Coagulasa , Farmacorresistencia Bacteriana , Femenino , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/enzimología , Staphylococcus lugdunensis/aislamiento & purificaciónRESUMEN
We encountered a pediatric case of bacteremia and possible cholecystitis due to Moraxella osloensis that was treated successfully. We confirmed the diagnosis with the presence of a high serum titer of the antibody to the organism. Furthermore, 16S rRNA sequencing was performed to identify the bacteria.
Asunto(s)
Bacteriemia/diagnóstico , Colecistitis/complicaciones , Colecistitis/diagnóstico , Moraxella/aislamiento & purificación , Infecciones por Moraxellaceae/diagnóstico , Anticuerpos Antibacterianos/sangre , Bacteriemia/patología , Niño , Colecistitis/patología , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Humanos , Masculino , Moraxella/inmunología , Infecciones por Moraxellaceae/patología , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADNRESUMEN
Chronic granulomatous disease (CGD) often presents with infectious illness, such as repeating bacterial and fungal infections, due to the inability to generate superoxide, which would destroy certain infectious pathogens, and is usually diagnosed in childhood. We describe a CGD case diagnosed in neonatal period, who initially presented with invasive aspergillosis. Neonatal invasive pulmonary aspergillosis is very rare and, to the best of our knowledge, this might be the youngest case in Japan.
Asunto(s)
Enfermedad Granulomatosa Crónica/diagnóstico , Aspergilosis Pulmonar Invasiva/diagnóstico , Factores de Edad , Antifúngicos/uso terapéutico , Diagnóstico Diferencial , Femenino , Enfermedad Granulomatosa Crónica/microbiología , Humanos , Recién Nacido , Aspergilosis Pulmonar Invasiva/tratamiento farmacológicoRESUMEN
Extended-spectrum ß-lactamase (ESBL)-producing-Enterobacteriaceae strains were detected in 12% (6 out of 50) of fecal samples collected from the inpatients of a Japanese pediatric hospital. All the ESBLs belonged to the CTX-M-1 group. The proportion of carriage of ESBL producers was higher among patients who had received antibiotics within the past 3 months and among those who had cardiologic diseases.