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In this article, a retrospective study was performed to describe the impact of merging two pediatric intensive care units on the overall and neurocognitive outcomes of children who required extracorporeal cardiopulmonary resuscitation (ECPR). Results from three cohorts were compared: 2008 to 2014: premerge, 2014 to 2017: initial time period postmerge, and 2018 to 2019: established merge. Survival to hospital discharge (and with good neurological outcome) was of 68% (61%), 46% (36%), and 79% (71%), respectively, for the three time periods. Merging two hospitals resulted in a nonsignificant trend toward temporary worse outcomes in pediatric patients requiring ECPR.
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IntroductionRapid, high throughput diagnostics are a valuable tool, allowing the detection of SARS-CoV-2 in populations, in order to identify and isolate people with asymptomatic and symptomatic infections. Reagent shortages and restricted access to high throughput testing solutions have limited the effectiveness of conventional assays such as reverse transcriptase quantitative PCR (RT-qPCR), particularly throughout the first months of the COVID-19 pandemic. We investigated the use of LamPORE, where loop mediated isothermal amplification (LAMP) is coupled to nanopore sequencing technology, for the detection of SARS-CoV-2 in symptomatic and asymptomatic populations. MethodsIn an asymptomatic prospective cohort, for three weeks in September 2020 health care workers across four sites (Birmingham, Southampton, Basingstoke and Manchester) self-swabbed with nasopharyngeal swabs weekly and supplied a saliva specimen daily. These samples were tested for SARS-CoV-2 RNA using the Oxford Nanopore LamPORE system and a reference RT-qPCR assay on extracted sample RNA. A second retrospective cohort of 848 patients with influenza like illness from March 2020 - June 2020, were similarly tested from nasopharyngeal swabs. ResultsIn the asymptomatic cohort a total of 1200 participants supplied 23,427 samples (3,966 swab, 19,461 saliva) over a three-week period. The incidence of SARS-CoV-2 detection using LamPORE was 0.95%. Diagnostic sensitivity and specificity of LamPORE was >99.5% in both swab and saliva asymptomatic samples when compared to the reference RT-qPCR test. In the retrospective symptomatic cohort, the incidence was 13.4% and the sensitivity and specificity were 100%. ConclusionsLamPORE is a highly accurate methodology for the detection of SARS-CoV-2 in both symptomatic and asymptomatic population settings and can be used as an alternative to RT-qPCR.
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To evaluate the intrafamilial oropharyngeal transmission of Kingella kingae, we conducted a prospective study among pairs of siblings. We found that 55% of children who suffered from osteoarticular infections due to K. kingae, and 40% of asymptomatic carriers of K. kingae had siblings with positive oropharyngeal carriage.
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Kingella kingae/aislamiento & purificación , Enfermedades de la Boca/microbiología , Infecciones por Neisseriaceae/microbiología , Infecciones por Neisseriaceae/transmisión , Orofaringe/microbiología , Enfermedades Faríngeas/microbiología , Portador Sano/epidemiología , Portador Sano/microbiología , Preescolar , Brotes de Enfermedades/estadística & datos numéricos , Femenino , Humanos , Lactante , Kingella kingae/clasificación , Kingella kingae/genética , Masculino , Enfermedades de la Boca/epidemiología , Infecciones por Neisseriaceae/epidemiología , Enfermedades Faríngeas/epidemiología , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Hermanos , Suiza/epidemiologíaRESUMEN
The course of the spondylodiscitis' infantile form is characterized by a mild-to-moderate clinical and biologic inflammatory response. Unfortunately, blood and disk/vertebral aspiration cultures show a high percentage of negative results. However, detecting Kingella kingae DNA in the oropharynx provided reasonable suspicion, to our opinion, that this microorganism is responsible for the spondylodiscitis.
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Discitis/microbiología , Kingella kingae/aislamiento & purificación , Infecciones por Neisseriaceae/microbiología , Preescolar , Discitis/diagnóstico , Femenino , Hospitalización , Humanos , Lactante , Imagen por Resonancia Magnética , Masculino , Infecciones por Neisseriaceae/diagnóstico , Orofaringe/microbiología , Estudios ProspectivosRESUMEN
Colonization of the oropharynx by Kingella kingae is currently considered to be a prerequisite for later development of invasive infections. However, the oropharyngeal K. kingae DNA bacterial load in children with osteoarticular infections caused by this microorganism is not different than that of asymptomatic carriers.
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Carga Bacteriana , Portador Sano/microbiología , Kingella kingae/aislamiento & purificación , Infecciones por Neisseriaceae/microbiología , Orofaringe/microbiología , Osteoartritis/microbiología , Preescolar , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , Femenino , Humanos , Lactante , MasculinoRESUMEN
INTRODUCTION: Strains of Panton-Valentine leukocidin-producing Staphylococcus aureus producing a new pattern of disease have emerged worldwide. Infection with these bacteria typically presents as a life-threatening infection of soft tissues and bones, and may cause potentially devastating consequences. CASE PRESENTATION: We report a case of osteoarticular infection caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. A 12-year-old Caucasian girl presented with acute osteomyelitis of the tibia associated with toxic shock syndrome, which was complicated by an unexpected spontaneous ankle arthrodesis. CONCLUSIONS: Osteoarticular infections due to Panton-Valentine leukocidin-producing Staphylococcus aureus appear to be severe, and are characterized by their tendency to evolve towards serious complications. This case highlights the need for early and aggressive surgical procedures in conjunction with appropriate antimicrobial therapy and regular long-term follow-up.