Introduction
Infections caused by Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) are a serious therapeutic and clinical problem. An increasing role of ESBL(+) pathogens is observed in both community- and hospital-acquired infections. The aim of the study was to assess the incidence and the risk factors for ESBL(+) bacteria infection in a pediatric ward during a 5-year period.
Material and methods
The medical documentation data of patients hospitalized in the Department of Pediatrics, Pediatric Nephrology and Allergology between 2011 and 2015 were subjected to a retrospective analysis. Cases of ESBL(+) bacterial infections were analyzed in detail.
Results
0.57% (46) of all the hospitalizations (8015) during the 5-year observation period in our department were caused by ESBL (+) pathogens. It constituted 8.5% of all positive microbiological cultures obtained. The analysis revealed an increasing trend in the number of ESBL (+) infections throughout the observed period. 43.5% of patients were only asymptomatic carriers. In 71.7% urinary tract structural and functional abnormalities were present. 76.1% of patients had been hospitalized previously and 60.9% had undergone urinary tract invasive procedures.
Conclusions
The results confirm the rising trend of ESBL (+) infections during the observed period. ESBL (+) bacteria were isolated primarily in previously hospitalized children with particular reference to urinary tract invasive procedures during hospitalizations. Moreover, the study showed that patients with urogenital disorders and non-urinary chronic diseases are more susceptible to these priority pathogen infections.
Food allergy is an important problem in the paediatric population. Food products that are most likely to induce allergic reactions include cow’s milk, wheat, peanuts, hen’s eggs, fish and seafood. Food-allergy-related diseases include, among other things, atopic dermatitis, urticaria and asthma. Anaphylactic shock is the most severe form of allergic reaction. Intramuscular adrenalin at a dose of 0.01 mg/kg body weight (maximum dose 0.3–0.5 mg) is the primary treatment for anaphylaxis. An elimination diet is the treatment of choice in food allergy. If symptoms persist despite dietary intervention, extended diagnosis using skin prick tests and/or specific IgE measurements should be performed. We present a clinical case of a 2.5-year-old boy with erythroderma secondary to atopic dermatitis, who was referred to our Department due to the lack of improvement after outpatient treatment. It was found during hospital stay that the symptoms were caused by potato allergens.
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