Subject(s)
Acinetobacter Infections , Cross Infection/microbiology , Meningitis, Bacterial/microbiology , Ventriculoperitoneal Shunt/adverse effects , Acinetobacter , Acinetobacter Infections/mortality , Child, Preschool , Cross Infection/mortality , Humans , Infant , Meningitis, Bacterial/mortalityABSTRACT
Twelve cases of neonatal and infant nosocomial meningitis treated with intravenous ciprofloxacin in doses of 10 to 60 mg/kg/day are described. Four neonates were 21 to 28 days old and eight infants were 2 to 6 months old. Six presented with Gram-negative meningitis: Escherichia coli (2), Salmonella enteritidis (1), Acinetobacter calcoaceticus (1), two with two organisms, and (H. influenzae plus Staphylococcus epidermidis, Acinetobacter spp. plus S. epidermidis), and six were attributable to Gram-positive cocci (four S. aureus and two Enterococcus faecalis). Ten cases were cured. In two cases, reversible hydrocephalus appeared that responded to intraventricular punctures. In seven children, no neurologic sequellae appeared after a 2- to 4-year follow-up. One neonate had relapse of meningitis 3 months later and was ultimately cured, but developed a sequellae of psychomotoric retardation. Follow-up varied from 27 months to 10 years. Current published case reports from Medline on quinolone use in meningitis in neonates and infants are reviewed.
Subject(s)
Anti-Infective Agents/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/drug therapy , Meningitis, Bacterial/drug therapy , Anti-Infective Agents/administration & dosage , Ciprofloxacin/administration & dosage , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Injections, Intravenous , MaleABSTRACT
This study reviews 33 cases of ventriculoperitoneal shunt (VPS) meningitis among 415 children after 540 shunt insertions within 8 y, in 9 paediatric intensive care units from 5 centres in Slovakia. The incidence of VPS meningitis was 6.3% per insertion. The most common organisms isolated from cerebrospinal fluid (CSF) and shunt were coagulase-negative staphylococci (52.8%), followed by Staphylococcus aureus (13.1%) and Pseudomonas aeruginosa (7.5%). Seven of 15 assessed risk factors were significantly associated with VPS meningitis, compared with non-VPS meningitis: prior meningitis with hydrocephalus (15.1 vs 1.5%, p < 0.015), perinatal pathology (51.1 vs 1.5%, p < 0.001), very low birthweight (66.6 vs 16.2%, p < 0.001), polymicrobial nosocomial meningitis (30.3 vs 5.9%, p < 0.002), S. aureus (21.2 vs 7.3%, p < 0.05), coagulase-negative staphylococci (84.8 vs 30.9%, p < 0.001) and P. aeruginosa and Acinetobacter calcoaceticus (30.3 vs 4.5%, p < 0.001) in aetiology.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/therapeutic use , Ceftazidime/therapeutic use , Cephalosporins/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/complications , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/microbiology , Postoperative Complications/drug therapy , Vancomycin/therapeutic use , Ventriculoperitoneal Shunt , Humans , Infant , Infant, Newborn , Retrospective Studies , Risk FactorsABSTRACT
Early screening of subjects liable to develop cardiovascular diseases is one of the main tasks of preventive cardiology of child age. The authors present a rational programme for the screening and diagnostic of hypertension in children, its aim being to differentiate primary and the most frequent secondary forms of hypertension; this will create prerequisites for its adequate treatment (non-pharmacological and pharmacological) as well as for dispensarization. Review.
