ABSTRACT
In the period 1989-1999, Bacillus sphaericus was demonstrated to cause 12 out of 469 (2%) episodes of bacteraemia in children with cancer or receiving bone marrow transplant at G. Gaslini Children's Hospital, Genoa, Italy. Neutropenia was present in five episodes, six episodes, (all without neutropenia) were related to the presence of a central venous catheter, and one episode occurred in a patient with intestinal graft vs. host disease and gut colonization. All patients survived. Ciprofloxacin was the only drug active against all the isolated strains.Bacillus sphaericus represents a new cause of infection in the immunocompromised host, with low aggressiveness, but a peculiar pattern of antibiotic susceptibility.
Subject(s)
Bacillaceae Infections/etiology , Bacillus , Bacteremia/etiology , Immunocompromised Host , Neoplasms/microbiology , Bacillaceae Infections/drug therapy , Bacillaceae Infections/mortality , Bacillus/drug effects , Bacteremia/drug therapy , Bacteremia/mortality , Child , Drug Resistance, Microbial , Humans , Italy/epidemiology , Neoplasms/immunology , Neoplasms/therapy , Risk FactorsABSTRACT
Among 102 episodes of intravenous catheter related bacteraemias documented between January 1989 and July 1996 in children receiving antineoplastic chemotherapy or bone marrow transplantation at G. Gaslini Children's Hospital, Genoa, Italy, were identified seven episodes due to unusual pathogens: Bacillus circulans, Bacillus licheniformis, Brevibacterium casei, Flavimonas oryzihabitans, Porphyromonas asaccharolytica, Comamonas acidovorans and Agrobacterium radiobacter. Susceptibility to different antibiotics of all strains are reported. In all cases catheter removal was required for culture negativization. All episodes were diagnosed in absence of granulocytopenia.
Subject(s)
Bacteremia/etiology , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/adverse effects , Neoplasms/complications , Child , HumansABSTRACT
Sinusitis is a common complication of non-allergic and allergic rhinitis, and can trigger lower respiratory diseases, such as bronchitis and asthma. Standard radiography is unable to give any data about the underlying pathological mechanisms (infectious or allergic) involved and infectious rhinosinusitis is very common in pediatric age, even in allergic patients. We investigated the possibility of obtaining more useful diagnostic information, performing nasal brushing (NB) on 117 children with recurrent respiratory symptoms. The following hypothesis were evaluated: (1) whether NB neutrophil/eosinophil percentages and/or NB culture could predict the radiological evidence of maxillary sinusitis; and (2) whether differences between nonallergic and allergic patients could be detected. In the total patient group and in the nonallergic group, the comparison of NB neutrophil percentages in patients with and without maxillary sinusitis showed a statistically significant difference (median 2 and 18%, respectively; P < 0.001). In the nonallergic group, a NB neutrophil rate > or = 5% was chosen as a cut-off between positive and negative NB diagnosis of rhinosinusitis and NB data were compared with radiological investigations. The results obtained showed that NB was fairly sensitive (91%) and predictive (84%). In allergic patients, neither neutrophil nor eosinophil percentages significantly correlated with the presence of sinusitis. Microbiological studies showed that, even if the presence of bacteria in NB resulted associated with sinusitis, a negative culture was not predictive of the absence of the disease. We therefore suggest that NB describes the present inflammatory status of the upper airways, hence, it is more suitable to describe the inflammation related to ongoing upper respiratory tract infections rather than chronic inflammation due to allergic rhinitis, characterized by relapsing episodes of acute inflammation. In conclusion, we propose to consider NB a reliable tool in the diagnosis of rhinosinusitis, particularly in nonallergic pediatric patients. Compared to standard radiological techniques, NB makes it possible to avoid radiation exposure and gives information about the pathological mechanisms involved in the single patient.
Subject(s)
Nasal Lavage Fluid/immunology , Nasal Mucosa/immunology , Rhinitis, Allergic, Perennial/immunology , Adolescent , Child , Child, Preschool , Chronic Disease , Eosinophils/immunology , Female , Humans , Immunoglobulin E/immunology , Inflammation , Male , Maxillary Sinusitis/diagnosis , Maxillary Sinusitis/diagnostic imaging , Maxillary Sinusitis/immunology , Neutrophils/immunology , Paranasal Sinuses/diagnostic imaging , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
This paper reports the results of blood cultures of a great children Hospital during the last three years. It regards 2164 blood cultures, 140 of which positive, and analyses the reasons that probably determinate the detected deficencies and defects.
Subject(s)
Bacteria/isolation & purification , Blood/microbiology , Child , HumansABSTRACT
In this paper we report and make short comments on data concerning 237 strains of Staphylococci isolated from 8820 samples of various pathologic material we tested when normal working in the Laboratory of our pediatric Institute. We noticed that 34.1% of cases were St. epidermidis or St. saprophyticus and we think that the frequency of such a results is related to the special conditions of subjects, all children or newborn children, so that also so called saprophytic Staphylococci may have etiological meaning.
Subject(s)
Staphylococcal Infections/microbiology , Anti-Bacterial Agents/pharmacology , Child, Preschool , Humans , Infant , Infant, Newborn , Micrococcus/isolation & purification , Species Specificity , Staphylococcus/drug effects , Staphylococcus/isolation & purification , Staphylococcus/pathogenicity , Staphylococcus aureus/isolation & purification , Streptococcaceae/isolation & purificationABSTRACT
The authors report on a newborn admitted to the Intensive Care Unit of Gaslini Institute for serious respiratory insufficiency who died on the third day of life because of a sepsis due to Listeria monocytogenes. The authors focus on the patient's history and clinical picture and on the histological evaluation of the lesions observed. The importance of infection in pregnancy and the possible severe consequences of listeriosis on the foetus are underlined, stressing the need for early diagnosis and adequate treatment.
Subject(s)
Cheese/microbiology , Infectious Disease Transmission, Vertical , Listeriosis/transmission , Adult , Fatal Outcome , Female , Humans , Infant, Newborn , Listeriosis/pathology , Male , PregnancyABSTRACT
The serum concentrations and safety of single daily dosing of amikacin were studied in 16 episodes of fever and granulocytopenia in children undergoing bone marrow transplantation. Amikacin (20 mg/kg) was administered as a 20 min iv infusion once daily for 7 to 19 days; all patients received concomitant therapy with ceftazidime. Peak amikacin concentrations measured immediately after infusion on day 1 and 4 of therapy averaged 72.29 +/- 11.6 mg/l and 74.02 +/- 19.29 mg/l respectively. A slight but statistically significant increase 30 minute post-infusion concentrations was observed in most patients during therapy. Serum amikacin were less than 3 mg/l in all trough samples and within 6 h post-infusion in most patients. A significant increase in serum creatinine was observed in one patient, who was also receiving cyclosporin A. Auditory function was evaluated in 10 patients and showed no changes. Although other drugs were added to cover Gram-positive or fungal pathogens, all patients survived. These data combined with the recent experience of single daily dose amikacin in adults supports further evaluation of novel dosage regimens of aminoglycosides in children.