Staphylococcus aureus is the main pathogen responsible for bone and joint infections worldwide and is also capable of causing pneumonia and other invasive severe diseases. Panton-Valentine leukocidin (PVL) and methicillin-resistant S. aureus (MRSA) have been studied as factors related with severity in these infections. The aims of this study were to describe invasive community-acquired S. aureus (CA-SA) infections and to analyse factors related to severity of disease. Paediatric patients (aged 0-16 years) who had a CA-SA invasive infection were prospectively recruited from 13 centres in 7 European countries. Demographic, clinical and microbiological data were collected. Severe infection was defined as invasive infection leading to death or admission to intensive care due to haemodynamic instability or respiratory failure. A total of 152 children (88 boys) were included. The median age was 7.2 years (interquartile range, 1.3-11.9). Twenty-six (17%) of the 152 patients had a severe infection, including 3 deaths (2%). Prevalence of PVL-positive CA-SA infections was 18.6%, and 7.8% of the isolates were MRSA. The multivariate analysis identified pneumonia (adjusted odds ratio (aOR) 13.39 (95% confidence interval (CI) 4.11-43.56); p 0.008), leukopenia at admission (<3000/mm(3)) (aOR 18.3 (95% CI 1.3-259.9); p 0.03) and PVL-positive infections (aOR 4.69 (95% CI 1.39-15.81); p 0.01) as the only factors independently associated with severe outcome. There were no differences in MRSA prevalence between severe and nonsevere cases (aOR 4.30 (95% CI 0.68- 28.95); p 0.13). Our results show that in European children, PVL is associated with more severe infections, regardless of methicillin resistance.
MEF and NP-CAAP S. pneumoniae isolates were similar in regard to serotype distribution and antibiotic resistance. S. pneumoniae antibiotic resistance rates were extremely high. Thirteen-valent PCV has the potential to reduce both the burden of disease as well as the rates of antibiotic-resistant S. pneumoniae in both diseases.
Scop:Scopul studiului a fost stabilirea evaluarea corelațiilor dintre febră, analizele de laborator și prescrip-ția de antibiotice.Metodă:Am efectuat un studiu prospectiv pe perioada unui an, incluzând copiii diagnosticați cu convulsii febrile.Rezultate:Am inclus 70 de copii care s-au prezentat cu convulsii febrile la Spitalul Clinic de Copii din Brașov, cu o vârstă medie de 4,32 de ani, 56,2% provenind din mediul urban. 42% au avut leucocite sub 12000/mm3, 24% au avut leucocite peste 15000/mm3. 78,26% au avut o proteină C Reactivă (CRP) sub 1 mg/dl, iar 70,58% au avut o viteză de sedimentare a hematiilor sub 10 mm/h. Culturile au fost pozitive la 1,42% dintre pacienți. Un procent de 54,27 a primit monoterapie, iar restul biterapie cu antibiotice.Concluzie:Convulsiile febrile reprezintă una dintre cele mai frecvente cauze de prezentare în serviciul de urgență. Majoritatea convulsiilor febrile nu sunt de etiologie bacteriană. Există o prescripție excesivă de antibioti-ce pentru convulsiile febrile.
Abstracts amoxicillin-clavulanate, cefixim, cefuroxim, cefotaxim, cefpodoxim and imipenem. The β-lactamase production was performed using the nitrocefin test. We determined the resistance genes (bla TEM-1 , bla ROB-1 and ftsI) by PCR. Results Isolates were identified as non capsulated and were classified into 3 groups according to their β-lactam resistance mechanisms: β-lactamase positive ampicillin-resistant (BLPAR: 50%); β-lactamase negative ampicillin-resistant (BLNAR: 40.32%) and β-lactamase positive amoxicillin-clavulanate-resistant (BLPACR: 9.68%). All strains showed high amoxicillin, amoxicillin-clavulanate, cefuroxim and imipenem MICs. Among these, the less active one was imipenem with MIC 50 >32mg/l in all strains. The highest MICs of cefuroxim were in BLPACR strains (2-4mg/l). MICs ranges of this antibiotic were 0.5-6 mg/l in BLNAR and 0.125-4 mg/l in BLPAR. Cefotaxim, cefixim and cefpodoxim were the most active agents tested against our strains. Conclusion This study indicates that many β-lactams are ineffective among some Hi strains. So, it's important to have an appropriate usage of antibiotics to stop these phenomena. We must make other investigations to know if these strains belonged to the same clone or if it's a question of an outbreak in our hospital.
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