ABSTRACT
Group A Streptococcus causes a variety of clinical manifestations, including pharyngitis and skin and soft tissue infections as well as more invasive disease. There are also multiple nonsuppurative complications of group A Streptococcus infection, including acute rheumatic fever and poststreptococcal glomerulonephritis. Pediatricians should be able to diagnose and treat the various presentations of the infection.
Subject(s)
Glomerulonephritis , Pharyngitis , Rheumatic Fever , Streptococcal Infections , Humans , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Rheumatic Fever/complications , Rheumatic Fever/diagnosis , Rheumatic Fever/therapy , Streptococcus pyogenes , Glomerulonephritis/complications , Glomerulonephritis/diagnosis , Pharyngitis/diagnosis , Pharyngitis/etiologyABSTRACT
Aerococcus urinae has been found to cause urinary tract infection in elderly patients and has been reported as a rare cause of infective endocarditis associated with significant morbidity and death in adults. However, information regarding its occurrence in children is lacking. We report here the case of a pediatric patient with subacute A urinae infective endocarditis with mycotic aneurysms.
Subject(s)
Aerococcus/isolation & purification , Aneurysm, Infected/diagnostic imaging , Aneurysm, Infected/microbiology , Endocarditis, Subacute Bacterial/diagnostic imaging , Gram-Positive Bacterial Infections/diagnostic imaging , Aneurysm, Infected/surgery , Anti-Bacterial Agents/therapeutic use , Child , Computed Tomography Angiography , Endocarditis, Subacute Bacterial/drug therapy , Gram-Positive Bacterial Infections/drug therapy , Humans , Male , Penicillin G/therapeutic use , Pulmonary Artery/microbiology , Pulmonary Artery/surgery , Thoracotomy , Treatment OutcomeABSTRACT
OBJECTIVE: To assess the impact of MALDI-TOF MS coupled with antimicrobial stewardship on clinical outcomes for pediatric inpatients with bloodstream infections. METHODS: Outcomes of pediatric inpatients were compared before and after MALDI-TOF MS implementation. Outcomes measured included time until organism identification and susceptibility, duration of antibiotics, patient length of stay (LOS), mortality and hospital costs. RESULTS: 210 and 135 patient events were compared pre- and post-intervention. Average time to organism identification decreased from 41 to 11â¯hours (Pâ¯=â¯<0.0001). Time to i) susceptibilities decreased from 50.8 to 37.7â¯hours (Pâ¯=â¯<0.0001), ii) de-escalation of antibiotics decreased from 58 to 23â¯hours (Pâ¯=â¯<0.0001), iii) discontinuation of unnecessary antibiotics decreased from 49 to 20â¯hours (Pâ¯=â¯<0.0001). Infection-related LOS decreased from 10.5 to 8.37â¯days (Pâ¯=â¯0.006). No significant differences were seen for other outcomes. CONCLUSIONS: MALDI-TOF MS identification of bacteria from blood culture broth improves time to appropriate antibiotic treatment for pediatric inpatients.
Subject(s)
Blood Culture , Infections/epidemiology , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Adolescent , Age Factors , Anti-Infective Agents/pharmacology , Anti-Infective Agents/therapeutic use , Antimicrobial Stewardship , Blood Culture/methods , Child , Child, Preschool , Comorbidity , Disease Management , Female , Health Care Costs , Humans , Infant , Infant, Newborn , Infections/diagnosis , Infections/drug therapy , Infections/microbiology , Length of Stay , Male , Microbial Sensitivity Tests , Outcome Assessment, Health Care , Referral and Consultation , Sepsis/diagnosis , Sepsis/drug therapy , Sepsis/microbiologyABSTRACT
We present a paediatric case of group G streptococcal bacteraemia and vertebral osteomyelitis. The patient is a 14-year-old girl with Gaucher disease type 1 who presented with severe thoracolumbar pain. She was treated with a 4-week course of antibiotics for presumed osteomyelitis with clinical improvement.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Osteomyelitis/microbiology , Spinal Diseases/microbiology , Streptococcal Infections/microbiology , Streptococcus agalactiae/isolation & purification , Adolescent , Female , Humans , Lumbar Vertebrae , Magnetic Resonance Imaging , Osteomyelitis/diagnosis , Osteomyelitis/drug therapy , Spinal Diseases/diagnosis , Spinal Diseases/drug therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Thoracic VertebraeABSTRACT
INTRODUCTION: Species of the genus Kocuria are Gram-positive cocci of the family Micrococcacceae that are ubiquitous in the environment and part of the normal skin and oral flora in humans. A paucity of cases have been reported of Kocuria as human pathogens and there are currently no evidence-based guidelines for managing these uncommon infections. CASE PRESENTATION: We present two paediatric cases of central line infections with species of the genus Kocuria that required line removal despite antimicrobial therapy. CONCLUSION: Species of the genus Kocuria are uncommon human pathogens that have rarely been reported to cause opportunistic infections in both adult and paediatric populations. The cases presented here add to the growing body of literature documenting the pathogenicity of these organisms and the possible need for line removal to achieve clinical cure in central line-associated bacteraemia caused by species of the genus Kocuria.
