Subject(s)
Serogroup , Humans , Infant , Pneumococcal Infections , Pneumococcal Vaccines , Serotyping , Streptococcus pneumoniae/immunologyABSTRACT
During 5 months in 2014, three Amish children in Missouri, USA, were diagnosed with invasive Haemophilus influenzae type b infection. Two were rural neighbors infected with a genetically similar rare strain, sequence type 45. One child had recently traveled, raising the possibility of maintenance of this strain among unvaccinated carriers in Amish communities.
Subject(s)
Amish/psychology , Haemophilus Infections/ethnology , Haemophilus Infections/epidemiology , Haemophilus influenzae type b/pathogenicity , Child, Preschool , Female , Haemophilus Infections/prevention & control , Haemophilus Infections/transmission , Haemophilus Vaccines/administration & dosage , Haemophilus influenzae type b/classification , Haemophilus influenzae type b/genetics , Haemophilus influenzae type b/isolation & purification , Humans , Infant , Male , Missouri/epidemiology , Multilocus Sequence Typing , Vaccination/psychologyABSTRACT
The challenge of diagnosing childhood tuberculosis (TB) results from its paucibacillary nature and the difficulties of sputum collection in children. Mycobacterial culture, the diagnostic gold standard, provides microbiological confirmation in only 30% to 40% of childhood pulmonary TB cases and takes up to 6 weeks to result. Conventional drug susceptibility testing requires an additional 2 to 4 weeks after culture confirmation. In response to the low sensitivity and long wait time of the traditional diagnostic approach, many new assays have been developed. These new tools have shortened time to result; however, none of them offer greater sensitivity than culture.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Pulmonary/diagnosis , Tuberculosis/diagnosis , Antitubercular Agents/pharmacology , Child , Drug Resistance, Bacterial , HIV Infections/complications , HIV Infections/diagnosis , Humans , Interferon-gamma Release Tests , Microbial Sensitivity Tests , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/immunology , Mycobacterium tuberculosis/isolation & purification , Reagent Kits, Diagnostic/standards , Reference Standards , Sensitivity and Specificity , Tuberculin Test , Tuberculosis/complications , Tuberculosis, Pulmonary/complicationsABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) infections are an emerging problem in both children and adults throughout the United States. Skin and soft tissue infections are most common, however serious invasive disease can occur and may involve any anatomic site. The initial empiric therapy of suspected S. aureus infections will be influenced by the regional antimicrobial susceptibility patterns for the organism as well as the severity of the infection being treated. This article will review the epidemiology, clinical features, and treatment considerations for MRSA infections in children.
Subject(s)
Methicillin Resistance , Skin Diseases, Bacterial/drug therapy , Soft Tissue Infections/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Incidence , Male , Microbial Sensitivity Tests , Middle Aged , Missouri/epidemiology , Risk Assessment , Severity of Illness Index , Skin Diseases, Bacterial/diagnosis , Skin Diseases, Bacterial/epidemiology , Soft Tissue Infections/epidemiology , Soft Tissue Infections/microbiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Treatment OutcomeABSTRACT
OBJECTIVE: To examine the association between mass media attention regarding invasive group A streptococcal (GAS) disease and testing for GAS in a pediatric emergency department (ED). DESIGN, SETTING, AND PARTICIPANTS: An observational analysis was performed of patients who had GAS tests done in a pediatric ED between December 1, 1999, and November 30, 2001. Data were analyzed by dividing each of the 2 years into 4 consecutive 90-day intervals. Data including age, date of the visit, presenting complaint, primary discharge diagnosis, whether a GAS test was obtained, and the results were collected from an electronic data repository. The date of the news stories, the station, and the duration of the broadcast were collected from electronic archives of the local newspaper and a broadcast monitoring service. MAIN OUTCOME MEASURE: The rate of GAS tests done per 1000 ED visits and the rate of positive tests per 1000 ED visits. RESULTS: An average of 103 GAS tests were performed per 1000 ED visits in the December through February period in year 2 compared with 55 GAS tests per 1000 ED visits in a similar period in year 1. This difference was statistically significant (difference, 48 tests; 95% confidence interval, 24-72 tests; P<.001). There were no significant differences in the proportion of positive tests (32% in year 1 vs 20% in year 2; mean difference, -11%; 95% confidence interval, -23% to 1%; P =.07). There were a total of 16 newspaper articles and 34 television stories on GAS during the 2-year study period. The peak in GAS tests and the peak in media events were concomitant. CONCLUSION: A surge in news stories regarding GAS disease was associated with an increase in testing for GAS in a pediatric ED.
