Shiga-like toxin-producing Escherichia coli (STEC) infection causes diarrhea, which is often bloody and which can result in potentially life-threatening hemolytic-uremic syndrome (HUS). Urtoxazumab, a humanized monoclonal antibody directed against the Shiga-like toxin 2 (Stx2) produced by STEC, has been developed as a promising agent for the prevention of HUS. Single randomized, intravenous, double-blind, placebo-controlled doses of urtoxazumab were administered to assess its safety and pharmacokinetics in healthy adults (0.1 to 3.0 mg/kg of body weight) and STEC-infected pediatric patients (1.0 and 3.0 mg/kg). No dose-related safety trends were noted, nor were antiurtoxazumab antibodies detected. The disposition of urtoxazumab showed a biexponential decline, regardless of the dose. In healthy adults, the mean terminal elimination half-life was consistent across the dose groups and ranged from 24.6 days (3.0-mg/kg dose group) to 28.9 days (0.3-mg/kg dose group). The mean maximum serum drug concentration (C max ) ranged from 2.6 g/ml at 0.1 mg/kg to 71.7 g/ml at 3.0 mg/kg. The disposition of urtoxazumab following the administration of doses of 1.0 and 3.0 mg/kg in pediatric patients showed mean C max s of 19.6 and 56.1 g/ml, respectively. Urtoxazumab was well tolerated, appears to be safe at doses of up to 3.0 mg/kg, and is a potential candidate for the prevention of HUS in pediatric patients.

Results suggest that young STEC-positive children with bloody diarrhea and exhibiting neutrophilic leukocytosis in the early course of their diarrhea are at risk for HUS progression. The observation of measurable concentrations of Stx-2 levels in the early post-bloody-diarrhea period and rapid dissipation at the time of HUS onset requires further evaluation.

Rapid and significant decreases in the rates of hospitalization resulting from IPD and/or CAP during the first 2 years after PCV13 introduction were observed. A longer surveillance period is required to confirm these results and the effectiveness of the vaccination program.

The use of long-term central venous catheters (CVCs) has increased over the past decade. There is, however, a risk of complications associated with the use of these catheters. Catheter-related bloodstream infection (CRBSI) is a common complication with a mortality rate that can be in excess of 25%. Antibiotic-lock therapy consists of filling the catheter lumen with antibiotics and allows them to dwell for a period of time, to rid the lumen from the organisms that are there and allowing the life of the catheter to be extended. The objective of this study is to evaluate the treatment of uncomplicated long-term CRBSI using lock therapy associated with systemic antibiotics among a hematology-oncology pediatric population. This is a noncomparative retrospective and descriptive cohort study. CRBSIs in patients with long-term CVCs who were treated with antibiotic-lock therapy and systemic antibiotics in oncology ward at Hospital de Ni?os de C?rdoba between January 2005 and December 2011 were analyzed. A total of 174 noncomplicated CRBSIs were identified during this period. A total of 123 uncomplicated CRBSIs occurred in 90 patients; all of them were treated with both systemic and lock therapy. The CRBSI rate observed in 7 years was 0.57 episodes per 1000 days/catheter. Out of the 90 patients, 68 (75.56%) had acute lymphoblastic leukemia. A total of 118 episodes were monomicrobial. Gram-negative bacilli accounted for 76/123 (59%). All Klebsiella spp and Escherichia coli responded to conservative treatment. Total therapeutic success rate was achieved in 87.89%. This study suggests that antibiotic-lock therapy along with systemic therapy is an effective and reasonable alternative for the treatment of uncomplicated long-term CRBSIs in children with oncologic diseases.

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