ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

During a 4-year period 4684 nosocomial infections occurred in a university pediatric hospital which admitted 78 120 patients (nosocomial infection rate (NIR) = 6.0). NIR varied from 0.17 to 14.0 on different wards or services; the highest rates (≥5.6) were found in the Neonatal Intensive Care Unit, infant neurosurgery, hematology/oncology, neonatal surgery, cardiology/cardiovascular surgery, Pediatric Intensive Care Unit and infant/toddler medicine areas. Infections were most common in patients ≤23 months (NIR = 11.5), were less common in the 2− to 4-year age group (NIR = 3.6) and occurred least frequently in patients ≥5 years (NIR = 2.6). The median day of onset of infections was 15.3 days. The proportional frequencies of infections were: 35% gastrointestinal; 21% bacteremia; 16% respiratory (10% upper, 6% lower); 7% postoperative wound; 6% urinary tract; 5% skin (32% of these skin infections were related to intravascular lines); 5% eye; 3% cerebrospinal fluid; and 2% other. A similar proportional frequency of 379 infections in patients hospitalized for more than 100 days was observed. The etiologic agents were Gram-positive bacteria (50%), viruses (23%), Gram-negative bacteria (18%), fungi (4%) and mixed/other (5%).

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Nosocomial infections in infants and children were prospectively studied in the general wards of a hospital serving a developing community. Of 1350 admissions in 5 months, 193 (14.3%) developed 302 infections (22.4/100 admissions). The major risk factors were malnutrition, age less than 2 years and prolonged hospitalization. The most common sites of infection were the lower respiratory and gastrointestinal tracts. The most frequently isolated organisms wereStaphylococcus aureusandKlebsiellaspecies and the site of most frequent isolation was the lower respiratory tract for which the method most commonly used was endotracheal aspiration. Seventy percent of isolated were resistantin vitroto conventional antibiotics. Thirty-one percent of infections developed while the patient was awaiting a diagnostic procedure or waiting to be sent home. During the study period 60 patients (4.4% of admissions) were admitted with a nosocomial infection acquired elsewhere (31 at this hospital and 29 from other hospitals). Measles and its complications accounted for 28 of these cases and 7 deaths. This study provides information on nosocomial infections in children from a developing community.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Acute phase and convalescent sera from 51 pediatric patients who had a documented viral infections and no obvious culture-confirmed bacterial infection such as meningitis, otitis media or urinary tract infection were tested by enzyme immunoassay for antibodies toHaemophilus influenzaeandBranhamella catarrhalisand by the latex agglutination test for pneumococcal antigens to evaluate the frequency of mixed bacterial and viral infections.A mixed bacterial and viral infection was documented in 19 patients (37%). Seven patients (14%) showed a diagnostic rise in antibodies toH. influenzaeand 8 patients (16%) showed an antibody elevation toB. catarrhalisin their

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Clinical and bacterial findings were prospectively studied in 90 children hospitalized because of middle or lower respiratory tract infection caused by respiratory syncytial virus (RSV) during a surveillance period of 12 months. The results were compared with those of RSV-negative children hospitalized with identical indications during the 3 peak months of the RSV epidemic (N =91) or for the 3 months after the outbreak (N= 99). A high frequency of pneumonia and acute otitis media were found in both RSV-positive and RSV-negative children during the epidemic, but not in control patients after the epidemic. Bacterial infection, based on a significant rise of antibody titer and/or on detection of pneumococcal antigen in serum or urine, was observed in 39% of the children with RSV-negative children hospitalized during the epidemic and 8% after the epidemic. Our observations stress the role of RSV as a predisposing agent for secondary bacterial infection in the airways of children. The most common bacteria involved in the mixed RSV-bacterial infections wereStreptococcus pneumoniaeandHaemophilus influenzae, the latter being found only in pneumonic patients. The presence or absence of pneumonic or acute otitis media was not significantly correlated with evidence of pneumococcal infection. We conclude that a bacterial pathogen should be actively sought when managing patients with lower respiratory tract syndromes, especially in those who have evidence of RSV infection.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Rotavirus vaccine could be administered most efficiently if it were incorporated into routine childhood immunizations and did not interfere with the immune response to the other vaccines, principally oral poliovirus vaccine (OPV). We conducted a placebo-controlled randomized trial giving oral rhesus rotavirus vaccine (RRV) (strain MMU 18006) alone and together with a child's first dose of OPV and diphtheria-tetanus toxoids-pertussis to examine the possible interaction of these vaccines. A total of 102 infants 2 to 3 months of age were randomized into 3 groups to receive (1) RRV with OPV, (2) placebo with OPV and (3) RRV 2 weeks after OPV. All infants were given diphtheria-tetanus toxoids-pertussis. Serum sample were collected at the time of OPV immunization and 3 to 5 weeks later. Three to 5 weeks after OPV immunization 60% of infants had a 4-fold rise in neutralization titer to at least one of the three poliovirus serotypes. The rate of antibody response to poliovirus did not differ by RRV groups but a lower rate was correlated with a shorter interval (3vs. 5 weeks) between OPV vaccination and antibody measurement. Fifty-six percent of infants had a 4-fold rise of IgA and 62% had a 4-fold rise of neutralizing antibody to RRV; this risc did not differ according to time of OPV immunization. RRV was not associated with side effects and may be safely given with OPV to infants 2 to 3 months of age.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

In a prospective, randomized, open study ceftriaxone was compared with chloramphenicol for treatment of 59 children who had bacteriologically confirmed acute typhoid fever. Ceftriaxone was administered intramuscularly in a once a day dose of approximately 80 mg/kg body weight for 5 days. Chloramphenicol was given orally for 3 weeks in a daily dosage of 50 to 100 mg/kg body weight divided into 4 doses. In the ceftriaxone group 23 of 29 patients were cured,

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A malformation syndrome has been proposed in infants with acquired immunoddeficiency syndrome or acquired immunodeficiency syndrome-related complex secondary to congenital infection with human immunodeficiency virus (HIV) in the United States and Europe. To determine whether embryopathy is detectable in HIV-exposed African infants, 85 infants of HIV-seropositive mothers and 98 infants of HIV-seronegative mothers in Nairobi, Kenya, were examined for minor and major anomalous features shortly after birth. No mother used intravenous drugs. With the exception of growth failture to anomalous feature was associated within uteroHIV exposure. No increase in the number of anomalous features per infant was correlated with HIV, nor did any infant have the reported malformation syndrome. Thus in this population of African infants examination for anomalous features during the neonatal period failed to identify those infants with fetal exposure to HIV.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

IgG subclass deficiency may be an important factor in the infection proneness of some IgA-deficient subjects. Although several studies on IgG subclass deficiency in IgA-deficient subjects have been reported, most have been unable to assess the incidence of IgG4 deficiency because the limitations of the assay methods used have often made a distinction between low normal and subnormal concentrations impossible. Having developed an enzyme-linked immunosorbent assay capable of measuring concentrations of all the IgG subclasses in healthy subjects of all ages and having established age-normal ranges for IgG subclasses using this assay, we measured IgG subcalss concentrations in 73 IgA-deficient patients, the majority of whom were children with recurrent respiratory infections. The results showed that IgG4 deficiency occurred in 26% of the patients and was the most common IgG subclass deficiency found. IgG1, IgG2 and IgG3 deficiencies occurred, respectively, in 10, 12 and 8% of the patients. IgA-IgG4 deficiency occurred in 16% of the patients; IgA-IgG2-IgG4 in 4%; and IgG1-IgG2-IgG4, IgA-IgG1 and IgA-IgG2-IgG3 each occurred in 3%. Other subclass deficiencies or combinations of deficiencies were less frequent. Our results suggest that IgG4 deficiency even in the absence of IgG2 deficiency may be an important but hitherto largely unrecognized factor in infection proneness in some IgA-deficient patients.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Recovery rates of Group A beta-hemolytic streptococci in throat cultures from 300 children were studied using three different methods. The swabs were streaked onto plates immediately, streaked from the same dry swabs held at room temperature for 3 to 6 hours and streaked from swabs held in transport media at room temperature for 3 to 6 hours. The cultures were processed in a pediatric office and interpreted by a microbiologist. The recovery rates were similar for the three methods, but the cultures were easier to interpret when the swzabs had been allowed to dry before streaking as a result of a decrease in the normal flora on these plates. In a separate study the recovery of Group A beta-hemolytic streptococci from 187 swabs was identical whether the swabs were streaked at 3 to 6 hours or at 18 to 24 hours.

ISSN:0891-3668    

出版商:OVID    

年代:1989

数据来源: OVID