Screens for infants and preschool children: Assessment of medical prevention with parents and assessment of exposure.

BACKGROUND: Regarding the massive increase of interactive mobile screen household equipment and the omnipresence of television, many recommendations are in favor of a limitation of use, especially among the youngest. OBJECTIVE: We aimed to evaluate the proportion of parents who report having discussed the subject of their child's exposure to screens during a consultation with a health professional. We also aimed to assess preschool exposure to television and mobile media devices, and to explore parents' views on the benefits and risks of exposing their children under 3 years old. METHODS: A questionnaire was administered to parents of children aged 6 months to 3 years in a pediatric emergency ward and several nurseries. This observational, cross-sectional and multicenter study was conducted from January to May 2019. RESULTS: We included 451 responses in the analyses. Only 99 (22.7%; 95% CI: 18.7-26.6) parents reported having discussed their child's exposure to screens with a doctor, on the initiative of the parents themselves for 52 households (53.1%; 95% CI: 43.2-62.9). Feelings of a benefit of screens on child learning concerned 134 (34.5%; 95% CI: 29.8-39.3) parents; 300 (68.5%; 95% CI: 64.1-72.8) said they were sufficiently informed about benefits and risks. In a typical week, 240 (53.7%; 95% CI: 49.1-58.3), 160 (35.8%; 95% CI: 31.3-40.2), and 58 (13.0%; 95% CI: 9.9-16.1) children were exposed at least once a week to television, smartphones, and tablets, respectively. CONCLUSIONS: Our study showed that the theme of exposure to screens was hardly addressed by physicians in consultation. Our findings help target prevention messages, including fighting the widespread belief that media are beneficial to child development, emphasizing the importance of screen-free time (eating, going to bed, after waking up) and encouraging support and interaction during exposure in families who choose to expose their children.

Recurrence of group B streptococcal meningitis.

Group B Streptococcus is the most frequent cause of neonatal sepsis. However, recurrences are rare. We report a case of recurrent meningitis due to Streptococcus B in a 2-month-old infant. Streptococcus B identified was hypervirulent clone ST-17 serotype III, which is known for its neurotropism. We found five other cases of recurrent group B streptococcal meningitis in the literature, which we report here. Many reports have identified breastfeeding and persistent colonization as the mode of transmission in recurrent Streptococcus B infections. We also discuss different ways to prevent recurrent group B streptococcal infections. Oral antibiotic therapy against carriage does not seem to be effective and there is no consensus on management of breastfeeding.

Spondylodiscitis in a healthy 12-year-old girl with Extraintestinal pathogenic Escherichia coli (ExPEC) bacteraemia.

BACKGROUND: Escherichia coli (E. coli) is rarely implicated in bone or joint infections in children. CASE PRESENTATION: We discuss the case of a healthy 12-year-old girl with an E. coli bacteraemia and a T11-T12 spondylodiscitis revealed by magnetic resonance imaging. The strain harboured serogroup O1:K1 and virulence factors common to highly virulent extra intestinal pathogenic E. coli (ExPEC). Immunological work-up was normal. CONCLUSION: The identification of E. coli in a spondylodiscitis should lead to the search for immunosuppression of the host and virulence factors of the strain, particularly those of ExPEC.

[Cefepime-amikacin combination in febrile neutropenic children with malignant hemopathy or tumor]. / Association céfépime-amikacine chez les enfants neutropéniques fébriles atteints d'hémopathies ou de tumeurs malignes.

UNLABELLED: Our aim was to evaluate retrospectively the efficacy of a therapeutic strategy with a first line combination based on cefepime-amikacin in febrile neutropenic children treated with chemotherapy. PATIENTS AND METHODS: Sixty-five neutropenic febrile episodes in 43 children treated by the association cefepime-amikacin, were evaluated according to the clinical status, the depth and duration of neutropenia, the underlying disease and the initial treatment. RESULTS: Thirty-nine (60%) episodes were successfully treated by the association cefepime-amikacin. Among the 26 persisting febrile episodes, adjunction of vancomycin and amphotericin B was effective in 11 (76% of total rate success) and 5 (84% of total rate success) cases respectively. The efficacy of the first line antibiotherapy was not different as regards to the duration and the depth of neutropenia. Otherwise, febrile episodes after chemotherapy against solid tumours were rapidly controlled by the first and second line of the anti-microbial strategy. Children treated for haematological malignancies presented a lower response rate (P = 0.03). CONCLUSION: In febrile and neutropenic children treated with chemotherapy, the association cefepime-amikacin appeared to be a safe empirical treatment. In a neutropenic child, the immunodeficiency and possibly the clinical status should be the major factors of the infectious prognosis more than the duration of aplasia.

Identification of TogMNAB, an ABC transporter which mediates the uptake of pectic oligomers in Erwinia chrysanthemi 3937.

The bacterium Erwinia chrysanthemi, which causes soft rot disease on various plants, is able to use pectin as a carbon source for growth. Knowledge of the critical step in pectin catabolism which allows the entry of pectic oligomers into the cells is scarce. We report here the first example of a transport system involved in the uptake of pectic oligomers. The TogMNAB transporter of E. chrysanthemi is a member of the ATP-binding cassette (ABC) superfamily. TogM and TogN are homologous to the inner membrane components, TogA exhibits the signature of ABC ATPases and TogB shows similarity with periplasmic ligand-binding proteins. The TogMNAB transporter is a new member of the carbohydrate uptake transporter-1 family (CUT1, TC no. 3.1.1), which is specialized in the transport of complex sugars. The four genes, togM, togN, togA and togB, are apparently co-transcribed in a large operon which also includes the pectate lyase gene pelW. The transcription of the tog operon is induced in the presence of pectic derivatives and is affected by catabolite repression. It is controlled by the KdgR repressor and the CRP activator. The TogMNAB system is able to provide Escherichia coli with the ability to transport oligogalacturonides. In E. chrysanthemi, the TogMNAB system seems to play a major role in switching on the induction of pectin catabolism. TogB also acts as a specific receptor for chemotaxis towards oligogalacturonides. The decreased capacity of maceration of a togM mutant indicates the importance of transport and/or attraction of oligogalacturonides for E. chrysanthemi pathogenicity.

Treatment of an acyclovir and foscarnet-resistant herpes simplex virus infection with cidofovir in a child after an unrelated bone marrow transplant.

Herpes simplex virus (HSV) causes serious problems in immuno-compromised patients such as those receiving a bone marrow transplant (BMT) for a hematological malignancy. Resistance to acyclovir (ACV) is a growing major concern. Foscarnet is a non-thymidine kinase-dependent agent, but the emergence of ACV and foscarnet-resistant HSV requires a new therapeutic approach. We describe a girl treated with cidofovir for a life-threatening ACV-resistant HSV infection after an unrelated BMT for a relapse of an acute myeloblastic leukemia (AML).