ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Methicillin-resistantStaphylococcus aureus(MRSA) is an important cause of nosocomial infection. Outbreaks of infection caused by these pathogens are generally considered to be traceable to introduction of single strains into a hospital population. A large outbreak of bacteremic disease that recently occurred in our neonatal intensive care unit (11 episodes in 10 patients) involved 9 low birth weight infants and was associated with serious infection (4 episodes of meningitis). To determine the role of a single point source in this outbreak, isolates were characterized based on phenotypic and genotypic analyses. Phenotypic analysis included assessing hemolytic activity, phage typing, antimicrobial susceptibility testing and methicillin resistance population analysis. Genotypic analysis included assessment of plasmid profiles, dotblot hybridization, restriction enzyme fragment pattern analysis and hybridization analysis of chromosomal DNA using a panel of staphylococcal gene probes. This analysis established that at least two distinct strains of MRSA were responsible for disease during this outbreak. This experience demonstrates the potential for MRSA to cause severe disease in the neonatal intensive care unit and indicates that the epidemiology of MRSA outbreaks is more complex than the spread of a single strain of bacteria.

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In an open randomized multicenter study 190 culture-positive pediatric ambulatory pertussis patients were treated for 14 days with either erythromycin estolate (EST) (n= 93; 40 mg/kg/ day divided in 2 doses) or erythromycin ethylsuccinate (ETH) (n= 97; 60 mg/kg/day divided in 3 doses). On day 14Bordetella pertussiswas recovered from cultures of 2 patients (2.2%) treated with EST and 1 patient (1.0%) treated with ETH. Despite the fact that 151 patients (79.4%) had reached the early paroxysmal stage at initiation of antimicrobial therapy, clinical improvement was seen in the majority (reduced frequency and severity of coughing; EST, 77.4 and 67.7%; ETH, 74.2 and 63.9%, respectively). Drug-related side effects were noted in 11 patients (11.8%) treated with EST and 16 patients (16.5%) treated with ETH (P< 0.05) and consisted mainly of minor gastrointestinal complaints. Erythromycin estolate in a lower dose administered only twice a day was equivalent to erythromycin ethylsuccinate in all aspects and proved to be adequate antimicrobial treatment for pertussis patients.

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This nonrandomized, open clinical investigation of tubereulous meningitis evaluated 53 children with Stage I (n= 8), Stage II (n= 29) and Stage III (n= 16) disease. The overall mortality was 20.8% (11 of 53) with a rate of sequelae of 35.7% (15 of 42) in survivors reflecting the advanced stages of children at diagnosis. Various combinations of standard antituberculous drugs including isoniazid, rifampin, pyrazinamide, streptomyein and ethambutol were given. Three treatment durations used during various time periods were evaluated: 12, 9 and 6 months with only the 6-month regimen receiving pyrazinamide (PZA). This prospective evaluation demonstrated that: (1) severe disease at presentation is highly associated with early mortality (P< 0.05), regardless of drug regimen; and (2) intensive short course chemotherapy (6 months) with PZA, regardless of stage of disease at presentation, is more efficacious than longer course therapy (9 or 12 months) without PZA in preventing total negative outcomes and sequelae (P< 0.05). This study demonstrates that a 6-month regimen containing PZA can be used in treating children with tuberculous meningitis.

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We conducted a randomized prospective multicenter study to compare the safety and efficacy of once daily oral cefixime (8 mg/kg) to twice daily oral trimethoprim/sulfamethoxazole (TMP/SMX) (8/10 mg/kg/day) for the treatment of acute urinary traet infection in children ages 6 months to 13 years. Seventy-six patients (38 in each group) were studied. Thirty-seven percent were younger than 3 years of age.Escherichia coliwas the most common isolate in both groups (85%). Eighty-five percent of all Gramnegative organisms were susceptible to TMP/SMX and all were susceptible to cefixime. Seventy-two percent of all patients were febrile at the time of diagnosis. Both groups were treated for 7 to 10 days. Peripheral white blood cell

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The effect of vitamin A supplementation on selected factors of immunity was tested in African children (ages 4 to 24 months with complicated measles) during a randomized doubleblind intervention trial. Placebo (n= 31) and treated groups (n= 29) had similar baseline characteristics. The supplemented group had significant reductions in morbidity (expressed as integrated morbidity scores) during the acute (Day 8,P= 0.006) and chronic (Day 42,P= 0.02; 6 months;P= 0.002) phases. In the treated group there was an increase in total number of lymphocytes (Day 42,P= 0.05) and measles IgG antibody concentrations (Day 8,P= 0.02), both of which have consistently been previously shown to correlate more closely with outcome in measles than other immunologic, clinical and radiologic factors. Interleukin 2 and plasma complement values were unaffected by vitamin A supplementation. These findings reinforce results from animal studies that show that the pathways of vitamin A activity in decreasing morbidity and mortality are partly founded on selective immunopotentiation.

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Hepatitis B virus (HBV) DNA was detected by polymerase chain reaction in the serum of 87 and liver tissue of 40 children with chronic hepatitis B, negative for HBV DNA by dot blot and Southern blot hybridization, respectively. In sera HBV DNA could be detected in 73 hepatitis B surface antigen carriers; 14 were hepatitis B e antigen (HBeAg), 56 were anti-HBe-seropositive and 3 had neither HBcAg nor positive anti-HBe. In 14 anti-HBe-positive patients no HBV DNA could be found. Viral sequences in liver tissue were present in 33 specimens; 20 were HBeAg and 13 were anti-HBe-seropositive. All of the 7 negative children had anti-HBe. Our results confirm polymerase chain reaction to be a more sensitive method to detect HBV DNA in the liver compared with conventional hybridization techniques. Every HBeAg. positive carrier as well as the majority of antiHBe-positive patients show ongoing viral rep-

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Two hundred thirty cases of shigellosis in children managed at Chulalongkorn Hospital from 1984 to 1988 were reviewed. The most common presentation included diarrhea, most frequently with mucus and blood, and fever. There were no deaths. The most common species wasShigella flexneri(83.5%) which showed increasing resistance to trimethoprim-sulfamethoxazole.

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In this study 234 children with shigellosis were evaluated during a 6-year period. The ages ranged from 2 days to 13 years (mean, 3.4 years). Sixty percent of the children were in the 1− to 4-year age group. One hundred four children were hospitalized and 130 were outpatients. Most cases of shigellosis presented during the months of April-May and September-November.Shigella flexneriaccounted for 44% andShigella sonneifor 43% of the isolates. Susceptibility testing showed that 54% were resist-

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1992

数据来源: OVID