ABSTRACT
Objective: To report an outbreak of Burkholderia (B.) cepacia related to contaminated surface cleaner in the pediatric ward of a tertiary hospital in Turkey. Methods: This study retrospectively reported the outbreak occurred between January 16, 2018 and January 23, 2018. Twelve immunocompetent patients who developed a bloodstream infection a few days after the hospitalization and who were positive for B. cepacia were included. Environmental samples were collected from various areas in the hospital to find the source of the outbreak. Results: All patients had clinical and biochemical evidence of sepsis. None of the patients had an underlying disease or had a central venous catheter as a risk factor. B. cepacia was isolated from the samples taken from the surface cleaners. The antibiotic susceptibilities of B. cepacia isolates were identical in the surface cleaners with the isolates from the patients' blood cultures. The outbreak was controlled after removing the surface cleaners from use. None of the infected patients died during the outbreak. Conclusions: Nosocomial B. cepacia outbreak may occur in immunocompetent children as well. Rapid identification of the outbreak, defining the source and taking appropriate measures to control the outbreak are the key points in the management.
ABSTRACT
Objective: To examine the effects of human bocavirus type 1 (HBoV1) on the course of lower respiratory tract infections in cases of monoinfection and coinfection, and the effects of HBoV1 viral load on the disease in children under six years old hospitalized with a diagnosis of HBoV1-associated lower respiratory tract infections. Methods: Children under six years of age, who were hospitalized with the diagnosis of lower respiratory tract infection due to HBoV1 between 1 January 2021 and 1 January 2022 were included in the study. Laboratory confirmation of the respiratory pathogens was performed using polymerase chain reaction (PCR). Results: Fifty-four (16.4%) children with HBoV1 among 329 children whose PCR was positive with bacterial/viral agent in nasopharyngeal swab samples were included in the study. There were 28 (51.9%) males and 26 (48.1%) females with a median age 23.4 months [interquartile range (IQR): 13.2, 30.0 months] (min-max:1 month-68 months). HBoV1 was detected as a monoinfecton in 26 (48.1%) children, and as a coinfection with other respiratory agents in 28 children (51.9%). In multiple regression analysis, coinfection (P=0.032) was associated with the length of hospitalization (P<0.001; R 2 =0.166). There was a negative correlation (r= 0.281, P=0.040) between cough and cycle threshold. Fever was found to be positively correlated with C-reactive protein (r=0.568, P<0.001) and procalcitonin (r=0.472; P=0.001). Conclusions: Although we found a higher HBoV1 viral load in children with more cough symptoms in our study, it had no effect on the severity of the disease, such as length of hospital stay and need for intensive care. Coinfection was found to affect the length of hospitalization.
ABSTRACT
@#Intracranial hypotension is a clinical syndrome characterized by orthostatic headache and low cerebrospinal fluid pressure. Noninvasive management is the usual first line treatment. Epidural blood patch is the treatment of choice if noninvasive treatments are ineffective. Cases with rebound intracranial hypertension after epidural blood patch treatment have been reported in the medical literature previously. We report here three patients with rebound intracranial hypertension who were treated noninvasively for intracranial hypotension. This phenomenon has not been reported previously. The underlying cause of intracranial hypotension was epidural anesthesia in the first, lumbar disc surgery in the second patient, and idiopathic in the third patient. They had been treated either with bed rest or with medical treatment not requiring epidural blood patch. After a short remission the patients were seen with a different headache pattern. They all had papilledema on examination. Automated perimetry revealed bilateral blind spot enlargement in Patient 1 and peripheral constriction in Patient 2. Cranial MRI and MRV in all three patients were normal. All the patients recovered very quickly with acetazolamide 1.5 or 2gm/day. In conclusion, rebound intracranial hypertension should be kept in mind in patients with intracranial hypotension who developed changes in the headache pattern, had new symptoms of nausea, vomiting, blurred or double vision during follow-up. Rebound intracranial hypertension can develop after conservative treatment of intracranial hypotension.