ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We reviewed retrospectively 31 cases of candidemia in children with central venous catheters. Infection rate was significantly higher in 1− to 4-year-old children than in other age groups (8.4%vs.2.2%;P< 0.05). Serious sequelae occurred in 11 (35%) cases and included fatal outcome (5 instances),Candidaendocarditis (2), renal abscesses, meningitis, arthritis and osteomyelitis (1 each). Complications were significantly more common in infants than in older children (P< 0.05) and appeared 3 to 52 days after the first positive blood culture (mean, 16 days). In fatal cases catheters were left in place a significantly greater number of days than in nonfatal cases (P< 0.05). A literature review identified 43 additional cases of catheter-related candidemia described in 11 series. The rate ofCandidainfection in the group as a whole was 2.7%. Patients treated with catheter removal plus amphotericin B had a significantly higher cure rate then patients treated with catheter retention plus amphoteriein B (P= 0.009). Prompt catheter removal remains crucial in the treatment of catheter-related candidemia.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We conducted a 1-year prospective study in the Negev region of southern Israel to determine the epidemiologic and clinical patterns of rotavirus diarrhea. A total of 605 patients were studied, 392 Bedouins and 213 Jews, 441 of whom had diarrhea (449 episodes) and 164 did not. Rotavirus was the most common organism detected in children with diarrhea (63 of 444; 14%) but was rarely found in controls (3 of 163; 2%) (P< 0.001). In 22% (12 of 54) of the rotavirus-positive patients, at least one other organism was also detected. The rate of rotavirus detection decreased as age increased, from 18% in the first year to 8% in the third year of life. Hospitalization with rotavirus diarrhea occurred more frequently in the summer. However, during winter, when diarrhea was less prevalent in the community, the proportion of cases associated with rotavirus was higher. Compared with controls, malnourished children were more likely to be hospitalized. However, rotavirus was detected in similar proportions among well-nourished and malnourished cases with diarrhea. The most prevalent rotavirus serotype was type 1 (in 69%), followed by types 4 and 2 (18 and 13%, respectively). We estimated that during the study period, approximately 2% of all Bedouin infantsvs.only 0.2% of Jewish infants were hospitalized with rotavirus disease in their first year of life. Clinical signs and symptoms and stool appearance were

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We report the epidemiology of invasiveHaemophilus influenzaetype b disease requiring hospital intervention in Southern Israel, an area that contains two ethnic populations, Bedouins and Jews. The study is based on 107 blood or cerebrospinal fluid culture-positive cases during the years 1984 to 1988. The annual incidence rate among children younger than 5 years of age was 51/100 000 (48/100 000 for Jews and 58/100 000 for Bedouins). Thirty-nine percent of patients had meningitis, 32% had pneumonia and 31% had otitis media. Epiglottitis was present in only one case (<1%). The median age was 8 months. Twenty-six percent of the cases were 6 months old or younger, 75% were 1 year old or younger and 87% were 18 months old or younger. Ninety-five percent of all meningitis cases occurred during the first 18 months of life. A projected number of 2938 hospitalization days and 9.8 deaths/year for a population in which 100 000 births occur yearly was calculated. The major impact of invasiveH. influenzaetype b infections and the very young age involved justify initiation ofH. influenzaevaccine studies in our region.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Three cases ofHaemophilus influenzaetype b (Hib) meningitis in a Swedish day care center prompted the investigation of the nasopharyngeal carriage in attendees of that day care center (I), and among children in another day center (II) in the same city, but without meningitis cases. Because the evaluation of the spread ofHaemophilus influenzae(Hi) isolates through a population, such as children in day care centers, requires stable identification markers for the bacteria, this study used multilocus enzyme electrophoresis to separate Hib carried by day care attendees from the disease-associated Hib clone. The three meningitis episodes were caused by the same clone of Hib (ET14). This and other Hib clones occurred in the healthy carriers. The frequency ofH. influenzaecarriage and composition of theH. influenzaeflora differed between the two day care centers. Center I with the meningitis cases had a lower overall frequency ofH. influenzaecarriage, 11 of 40 (28%) compared with both the control day care center (57%) and previous studies. The main difference between the two day care centers was in the nontypableH. influenzae(HiNT) flora. The frequency of HiNT was higher in the center without Hib disease, and there was a higher degree of sharing of HiNT isolates among the children in Center II. This raised the question of an inverse relationship between carriage of HiNT and Hib infection. The results emphasized the importance of accurate identification of the disease isolate in order to estimate the risk of acquisition and dissemination to secondary cases.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

We monitored the development of serum bactericidal antibody in eight children with acute nontypableHaemophilus influenzaeotitis media and correlated its development with the appearance of antibody against lipooligosaccharide and surface-exposed outer membrane proteins of the infecting strains. Complement-dependent bactericidal activity was absent in acute sera but increased to titers of 1:4 to 1:32 in sera obtained 4 to 6 weeks later. Absorption of anti-lipooligosaccharide antibodies from convalescent sera had no effect on bactericidal titers of five patients and resulted in small decreases in titer in three patients. Lipooligosaccharide-absorbed samples had persisting bactericidal titers of 1:4 to 1:16. Four of eight acute samples lacked antibodies to surface-exposed outer membrane proteins whereas four had low concentrations of antibody directed against one or moreM*** 100 000 to 250 000 outer membrane proteins. Convalescent samples from all eight children showed substantial increases in antibodies directed primarily againstM*** 100 000 to 250 000 proteins. Thus, both surface-exposedM*** 100 000 to 250 000 outer membrane proteins and lipooligosaccharide are immunogenic duringHaemophilusotitis media and are potential targets of bactericidal antibody.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Ninety-six healthy infants ages 2 to 5 months received rhesus rotavirus vaccine serotype 3 (RRV) as a single dose of 103, 104or 105plaque-forming units (pfu) in this double-blinded, placebo-controlled study. Half of the infants in each dose group were also randomized to receive either 30 ml of infant formula as buffer before vaccination or were vaccinated on an empty stomach. The incidence of fever, increased stool frequency and decreased activity level was consistently higher among infants who received RRV than those who received placebo. There was no consistent increase in incidence of symptoms as the dose of RRV was increased. Possible vaccine-related side effects were increased in older vaccinees and in those with higher prevaccination antibody titers. The serocon version rate and pre to postvaccination antibody rise, evaluated by enzyme-linked immunosorbent assay and by plaque reduction neutralization, correlated well. The 105and 104pfu RRV dose produced significantly higher rates of seroconversion and higher antibody rises than did placebo (P< 0.001 for 105andP= 0.005 for 104). The 103pfu dose was no more immunogenic than placebo. In the 104pfu dose group 73% of infants receiving formula as a “buffer” seroconverted compared with 36% of those not receiving formula; 63% of infants partially breast-fed or formula-fed seroconverted compared with 17% of those exclusively breast-fed. These differences in seroconversion rate were largely overcome by increasing the RRV dose to 105pfu. Stool (copro IgA) antibody responses were examined; of six infants showing a copro IgA response only

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID