Minimum Duration of Antibiotic Treatment Based on Blood Culture in Rule Out Neonatal Sepsis

by Ur Rehman Durrani, Naveed, MD, FCPS, MRCP; Rochow, Niels, MD; Alghamdi, Jameel, MD; Pelc, Anna, MSc; Fusch, Christoph, MD, PhD; Dutta, Sourabh, MD, PhD

To be published in The Pediatric Infectious Disease Journal, May 2019.

 

 

Neonatologists usually wait 48 hours for blood culture results before deciding to discontinue antibiotics. The objective of the study was to analyze time to positive blood culture in rule out sepsis and estimate the minimum duration of antibiotics.

Continue reading
4 Hits
0 Comments

Point-of-care Ultrasound for Pulmonary and Extrapulmonary Tuberculosis in Children

by Bélard, Sabine, MD; Heuvelings, Charlotte C., MD; Heller, Tom, MD; Andronikou, Savvas, PhD; Grobusch, Martin P., FRCP; Zar, Heather J., PhD

To be published in The Pediatric Infectious Disease Journal, May 2019. 

 

 

Childhood pulmonary tuberculosis (PTB) is difficult to diagnose because clinical presentation is nonspecific, and microbiologic confirmation is only achieved in a minority of children. Imaging therefore plays an important diagnostic role. However, current imaging tools are limited by sensitivity and specificity, as well as availability and/or feasibility in children. The standard radiologic study in childhood tuberculosis (TB) is chest radiograph, which can show parenchymal disease or pleural effusion but may not accurately detect mediastinal lymphadenopathy, has poor interreader agreement and may not be affordable in resource-poor, highly endemic settings. Computed tomography (CT) may certainly demonstrate lymphadenopathy more often and may be more accurate for parenchymal disease, but it is not the “standard” technique because of radiation exposure and cost. CT or magnetic resonance imaging is even less accessible and require sedation in young children. New imaging approaches are urgently needed to improve diagnosis of childhood TB, and ultrasound emerges as promising noninvasive and cheap point-of-care tool. Authors focused on point-of-care ultrasound (POCUS) for detection of extra-pulmonary tuberculosis (EPTB) because children are vulnerable to develop disseminated forms of TB.

Continue reading
3 Hits
0 Comments

Combination of clinical symptoms and blood biomarkers can improve discrimination between bacterial or viral community-acquired pneumonia in children

by Bhuiyan MU, Blyth CC, West R, Lang J, Rahman T, Granland C, de Gier C, Borland ML, Thornton RB, Kirkham LS, Martin A, Richmond PC, Smith DW, Jaffe A, Snelling TL

Published in BMC Pulmonary Medicine, 02 April 2019. 

 

 

Differentiating bacterial from viral pneumonia is important for guiding targeted management and judicious use of antibiotics. Researchers assessed if clinical characteristics and blood inflammatory biomarkers could be used to distinguish bacterial from viral pneumonia. 

Continue reading
7 Hits
0 Comments

Pediatric community-acquired pneumonia: diagnosis and management in the emergency department

by Cooper-Sood J, Wallihan R, Naprawa J

Published in Pediatric Emergency Medical Practice, April 2019. 

 

Worldwide, pneumonia is the most common cause of death in children aged < 5 years. Distinguishing viral from bacterial causes of pneumonia is paramount to providing effective treatment but remains a significant challenge. For patients who can be managed with outpatient treatment, the utility of laboratory tests and radiographic studies, as well as the need for empiric antibiotics, remains questionable. This issue reviews viral and bacterial etiologies of community-acquired pneumonia in pediatric patients, offers guidance for obtaining historical information and interpreting physical examination findings, discusses the utility of various diagnostic techniques, and provides recommendations for the treatment of previously healthy and medically fragile children.

 

Continue reading
15 Hits
0 Comments

Identification of potential diagnostic biomarkers for pneumonia caused by adenovirus infection in children by screening serum exosomal microRNAs

by Huang F, Bai J, Zhang J, Yang D, Fan H, Huang L, Shi T, Lu G

Published in Molecular Medicine Reports, 29 March 2019.

 

Human adenovirus (HAdV) infection causes serious pneumonia in children, leading to significant morbidity and mortality rates. However, diagnostic biomarkers for HAdV‑associated pneumonia are unavailable. Serum microRNAs (miRNAs/miRs) have been recently reported as diagnostic biomarkers for several diseases. The present study performed microRNA sequencing to identify potential biomarkers among serum exosomal miRNAs, with the aim of identifying candidate biomarkers for the diagnosis of pneumonia in adenovirus‑infected children. To validate the biomarker candidates, reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) was performed to determine the relative expression levels of miRNAs. As there is no endogenous reference RNA for serum miRNAs, pairwise analysis of RT‑qPCR was used in the present study to narrow down the number of biomarker candidates among all the serum exosomal miRNAs to a set of four miRNAs. As a result, the identified miRNAs (namely, miR‑450a‑5p‑miR‑103a‑3p and miR‑103b‑5p‑miR‑98‑5p) from 59 samples were considered as potential diagnostic biomarkers in adenovirus‑infected children. The results indicated that this four miRNA set could distinguish adenovirus‑infected patients from healthy controls. In conclusion, the four exosomal miRNAs identified in the present study could be considered as candidate diagnostic biomarkers for pneumonia in adenovirus‑infected children.

 

Continue reading
8 Hits
0 Comments