RESUMO
BACKGROUND: Salmonellosis continues to be a major public health issue and high rates of infection are reported among young children. The contemporary clinical epidemiology of pediatric Salmonella spp. infections in the US is not well characterized. METHODS: We performed a retrospective observational study in a large hospital network in Houston, TX. We included all patients 18 years or younger identified as having a positive culture for Salmonella spp. from any body site during the years 2016-2021. The patient's medical record was accessed and detailed demographic, clinical and microbiologic information were collected. RESULTS: We identified a total of 110 pediatric patients with Salmonella spp. infections between 2016 and 2021. The highest frequency (69%) of infections was observed among children 0-5 years old. Bloody diarrhea was most frequently reported for children 0-1 years old. Although the highest number of salmonellosis was among infants smaller than 1 year, the percentage of bacteremia in this age group was the lowest (15%). Serotype Infantis was the most common (21%) and was less likely to cause Salmonella bacteremia. Among the Salmonella spp. isolates that had antimicrobial susceptibility performed 5 showed resistance to one or more antibiotics including 1 extensively drug-resistant S . ser. Typhi originating from Pakistan. CONCLUSION: Our findings suggest distinct clinical characteristics of Salmonella infections in the pediatric population. Consistent identification of isolates to the sub-species level along with serotyping seems critical to identify emerging lineages with increased virulence. Special consideration should be given to empiric treatment for patients who have recently returned from the Indian subcontinent.
Assuntos
Bacteriemia , Infecções por Salmonella , Lactente , Criança , Humanos , Pré-Escolar , Recém-Nascido , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Farmacorresistência Bacteriana , Salmonella , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/tratamento farmacológico , Bacteriemia/microbiologia , Testes de Sensibilidade MicrobianaRESUMO
OBJECTIVE: To determine the frequency and effects of nosocomial respiratory viral infections (RVIs) in premature neonates, including those who may be asymptomatic. STUDY DESIGN: We performed a year-long surveillance for RVIs in infants <33 weeks gestational age admitted to 2 Syracuse neonatal intensive care units. Infants were enrolled within 3 days of neonatal intensive care unit admission and were sampled for RVIs until discharge using a multiplex polymerase chain reaction assay capable of detecting 17 different respiratory viruses or subtypes. RESULTS: Twenty-six of 50 prematurely born infants (52%) tested positive for a respiratory virus at least once during their birth hospitalization. Testing positive for a respiratory virus was significantly associated with longer length of stay (70 days vs 35 days, P = .002) and prolonged ventilatory support (51 vs 13 days, P = .002). Infants who tested positive for a respiratory virus during their birth hospitalization had more than twice the rate of developing bronchopulmonary dysplasia (P < .05). CONCLUSION: Nosocomial RVIs were frequent in our study population, despite the absence of clinical indicators of illness. Length of hospital stay was significantly longer and a diagnosis of bronchopulmonary dysplasia was more common in infants who had respiratory viruses detected.
Assuntos
Terapia Intensiva Neonatal/métodos , Infecções Respiratórias/diagnóstico , Viroses/diagnóstico , Feminino , Idade Gestacional , Hospitalização , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Masculino , Staphylococcus aureus Resistente à Meticilina/metabolismo , Reação em Cadeia da Polimerase/métodos , Estudos Prospectivos , Respiração Artificial , Vírus Sinciciais Respiratórios/metabolismo , Infecções Respiratórias/virologia , Respirovirus/metabolismoRESUMO
Pseudomonas aeruginosa is a rare cause of early-onset sepsis in neonates, even among infants with identifiable risk factors. Herein we describe the first case, to our knowledge, of P. aeruginosa early-onset sepsis in a term infant with no identifiable risk factor and propose that maternal healthcare occupation could predispose to gastrointestinal/genital colonization with this potential pathogen.
Assuntos
Sepse Neonatal , Sepse , Atenção à Saúde , Humanos , Lactente , Recém-Nascido , Sepse Neonatal/epidemiologia , Ocupações , Pseudomonas aeruginosa , Fatores de Risco , Sepse/etiologiaRESUMO
An infant had a subdural empyema caused by the rare Salmonella species enterica subspecies houtenae (IV) serotype 44:z4,z23:- after only indirect exposure to exotic reptiles in her foster home. Infants recovering from preexisting subdural hematoma are at risk for development of empyema.
Assuntos
Reservatórios de Doenças , Empiema/microbiologia , Hematoma Subdural Crônico/microbiologia , Lagartos/microbiologia , Infecções por Salmonella/etiologia , Salmonella enterica , Animais , Austrália , Empiema/patologia , Empiema/cirurgia , Feminino , Cuidados no Lar de Adoção , Hematoma Subdural Crônico/patologia , Hematoma Subdural Crônico/cirurgia , Humanos , Iguanas/microbiologia , Lactente , Imageamento por Ressonância Magnética , New York , Infecções por Salmonella/patologia , Infecções por Salmonella/cirurgiaAssuntos
Encéfalo/diagnóstico por imagem , COVID-19/complicações , Infecções por Haemophilus/complicações , Pandemias , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Feminino , Infecções por Haemophilus/patologia , Haemophilus influenzae tipo b , Humanos , Lactente , Influenza Humana , SARS-CoV-2Assuntos
Surtos de Doenças/prevenção & controle , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Promoção da Saúde/métodos , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cooperação do Paciente , Estados UnidosRESUMO
BACKGROUND: Virus-induced inflammation contributes to respiratory syncytial virus (RSV) pathogenesis. We sought to determine the specific mediators that are associated with more severe illness in young children. METHODS: Children ≤ 5 years of age seen in our emergency department for respiratory symptoms from September 1998 to May 2008 were eligible for enrollment. Nasopharyngeal wash samples were collected from all eligible patients, and clinical data were recorded. Individuals were included in this study if nasopharyngeal wash samples were positive for RSV only. Patients enrolled in the study were stratified by disease severity, defined as mild (not hospitalized), moderate (hospitalized) or severe (requiring intensive care unit stay). Concentrations of individual inflammatory biomarkers in nasopharyngeal wash fluids were determined using the Luminex human 30-plex assay. RESULTS: Eight hundred fifty-one patients met study criteria: 268 (31.5%) with mild, 503 (59.1%) with moderate and 80 (9.4%) with severe illness. As expected, illness severity was directly associated with young age, prematurity, heart or lung disease, infection with RSV group A and elevated concentrations of interleukin (IL)-2R, IL-6, CXCL8, tumor necrosis factor-α, interferon-α, CCL3, CCL4 and CCL2. In addition, we report several novel and mechanistically important inflammatory biomarkers of severe RSV disease, including IL-1ß, IL1-RA, IL-7, epidermal growth factor and hepatocyte growth factor. CONCLUSIONS: In a large, longitudinal study (10 years, 851 enrolled patients) limited to RSV infection only, in which well-known risk factors are confirmed, we identified 5 novel biomarkers specifically of severe disease. These markers may ultimately serve to elucidate disease mechanisms.
Assuntos
Citocinas/sangue , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/virologia , Biomarcadores/sangue , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Cavidade Nasal/virologia , Infecções por Vírus Respiratório Sincicial/sangue , Vírus Sinciciais Respiratórios/classificação , Vírus Sinciciais Respiratórios/isolamento & purificação , Fatores de RiscoRESUMO
BACKGROUND: Although fever is common in neutropenic children, a microbiological etiology is determined in only 15% to 30% of cases. The authors investigated the frequency of respiratory virus detection in the upper airways of febrile neutropenic children with negative bacterial cultures. METHODS: This is a 3-year prospective study of children younger than 19 years, hospitalized with febrile neutropenia and negative bacterial cultures. Respiratory samples were obtained for amplification of viral nucleic acids via Luminex xTAG technology. RESULTS: There were 50 febrile neutropenic episodes among 42 patients. Respiratory viruses were detected in 26 (52%) febrile episodes. A single virus was detected in 22 febrile episodes; multiple viruses were detected in the remaining 4. Rhinovirus/Enterovirus was most frequently detected. CONCLUSION: Respiratory viruses were detected frequently in nasopharyngeal samples from febrile neutropenic patients with negative bacterial cultures, thus providing an impetus to determine the relationship between virus detection, infection, and pathology in this unique patient population.