ABSTRACT
Between March and May 2012, three neonates born at a regional maternity hospital developed Elizabethkingia meningoseptica (previously Chryseobacterium meningosepticum) sepsis with meningitis aged <10 days, and were treated successfully with intravenous ciprofloxacin plus vancomycin or piperacillin-tazobactam for three to six weeks. Four (16.6%) of 24 environmental specimens obtained from the nursery and delivery room were positive for this organism. All of the clinical isolates and two isolates from storage boxes for pacifiers and pacifier covers were genetically identical. After changing the storage boxes to stainless steel boxes that underwent regular autoclave sterilization, there were no further cases of infection with E. meningoseptica.
Subject(s)
Child Day Care Centers , Chryseobacterium/isolation & purification , Cross Infection/epidemiology , Disease Outbreaks , Flavobacteriaceae Infections/epidemiology , Meningitis, Bacterial/epidemiology , Sepsis/epidemiology , Anti-Bacterial Agents/therapeutic use , Chryseobacterium/classification , Chryseobacterium/genetics , Cross Infection/drug therapy , Cross Infection/microbiology , Environmental Microbiology , Female , Flavobacteriaceae Infections/complications , Flavobacteriaceae Infections/drug therapy , Flavobacteriaceae Infections/microbiology , Genotype , Humans , Infant, Newborn , Infection Control/methods , Male , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/microbiology , Molecular Epidemiology , Molecular Typing , Sepsis/complications , Sepsis/drug therapy , Sepsis/microbiology , Treatment OutcomeABSTRACT
The objectives of this study were to investigate the treatment effect and stability of fronto-facial monobloc distraction osteogenesis. Five consecutive patients who underwent monobloc distraction were included (aged 4.8-18.4 years). Three patients had Crouzon syndrome, one had Apert syndrome, and one had Pfeiffer syndrome. The evaluation included clinical records, serial cephalograms for at least 1-year follow up (average 24.6 months). The treatment and post-treatment changes were measured. The intracranial volume, upper airway volume and globe protrusion were calculated from CT before and after treatment. After distraction, the supraorbital region was advanced 15.3mm forward, the midface demonstrated forward advancement of 17.7 mm, 22.1mm and 23.1mm at orbitale, anterior nasal spine and A point, respectively. The downward movement was 2-3mm at maxillary level. The intracranial volume increased 11%; the upper airway volume increased 85% on average. Globe protrusion reduced 3.7 mm on average, which was 20% of underlying skeletal movement. Facial growth demonstrated forward remodelling of the supraorbital region, mild downward but no further forward growth of the midface. Monobloc distraction is effective for relieving related symptoms and signs through differential external distraction at different vertical levels of the face.
