All You Need Is Evidence: What We Know About Pneumonia in Children With Neuromuscular Diseases

Cherchi, Claudio; Testa, Maria Beatrice Chiarini; Deriu, Daniele; Schiavino, Alessandra; Petreschi, Francesca; Ullmann, Nicola; Paglietti, Maria Giovanna; Cutrera, Renato

doi:10.3389/fped.2021.625751

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…Data in the literature regarding MDRO/XDRO infection in patients suffering with NMD and requiring hospitalisation, in particular, in a semi-intensive/sub-intensive care setting are scarce, with only a few studies describing pneumonia as one of the most common complications of this group of diseases [ 23 , 24 ]. Indeed, mortality due to pneumonia in amyotrophic lateral sclerosis and adult-onset myotonic dystrophy is shown to be near 30% [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of MDR/XDR Bacterial Infections in a Neuromuscular Semi-Intensive/Sub-Intensive Care Unit

et al. 2022

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(1) Background: The aim of this study was to assess the clinical and microbiological characteristics of multidrug-resistant infections in a neuromuscular semi-intensive/sub-intensive care unit; (2) Methods: Retrospective analysis on data from 18 patients with NMD with proven MDRO/XDRO colonisation/infection from August 2021 to March 2022 was carried out; (3) Results: Ten patients were males (55.6%), with a median age of 54 years, and there were fourteen patients (77.8%) with amyotrophic lateral sclerosis. All patients had at least one invasive device. Ten (55.6%) patients developed MDRO/XDRO infection (with a median time of 24 days) while six (33.3%) were colonised. The Charlson comorbidity index was >2 in both groups but higher in the infected compared with the colonised (4.5 vs. 3). Infected patients were mostly females (seven patients) with a median age of 62 years. The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa, infecting four (28.6%) patients each. Of eighteen infectious episodes, nine were pneumonia (hospital-acquired in seven cases). Colistin was the most commonly active antibiotic while carbapenems were largely inactive. Eradication of infection occurred in seven infectious episodes (38.9%). None of those with infection died; (4) Conclusions: MDRO/XDRO infections are common in patients with neuromuscular diseases, with carbapenem-resistant non-fermenting Gram-negative bacilli prevailing. These infections were numerically associated with the female sex, greater age, and comorbidities. Both eradication and infection-related mortality appeared low. We highlight the importance of infection prevention in this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of MDR/XDR Bacterial Infections in a Neuromuscular Semi-Intensive/Sub-Intensive Care Unit

et al. 2022

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“…Recurrent, chronic, and severe acute respiratory infections are frequently seen in children with SMA type 1 and 2 and engender a high morbidity and mortality ( 17 ). Several factors contribute to this increased risk of lower respiratory tract infections.…”

Section: The Multifactorial Origin Of Respiratory Problems In Smamentioning

confidence: 99%

Respiratory morbidity in patients with spinal muscular atrophy—a changing world in the light of disease-modifying therapies

Lagae,

Proesmans,

Van den Hauwe

et al. 2024

Front. Pediatr.

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Respiratory complications are common in spinal muscular atrophy (SMA) and significantly contribute to morbidity and mortality in these patients. Generalized respiratory and bulbar muscle weakness translates into diverse and complex clinical consequences necessitating strict follow-up and specialized care. The natural history of SMA has evolved drastically in recent years as a result of the introduction of novel, disease-modifying therapies. While the impact of these therapies on motor function is well described in literature, its consequence for respiratory management has not been extensively studied. In this review we aim to provide a comprehensive overview of the respiratory morbidities, their follow-up, management, and the impact of novel therapies in SMA.

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“…percutaneous endoscopic gastrostomy (PEG) tube, central venous catheter, tracheal cannula) 3,4 are the most evident reasons for colonisation with MDRO. On the other hand, colonisation with MDRO in these children could lead to serious negative effects; for example, any acute infection of the respiratory tract can be life‐threatening 5,6 . In this regard, efforts should be made to prevent the nosocomial transmission of MDRO in these children.…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

“…On the other hand, colonisation with MDRO in these children could lead to serious negative effects; for example, any acute infection of the respiratory tract can be life-threatening. 5,6 In this regard, efforts should be made to prevent the nosocomial transmission of MDRO in these children.…”

Section: What This Paper Addsmentioning

confidence: 99%

Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

Schmidt

Hasan

Mauritz

et al. 2022

J Paediatrics Child Health

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Aim Multidrug‐resistant organisms (MDRO) deserve special attention in health‐care facilities for children with life‐limiting conditions because these children have an increased risk for colonisation. To avoid nosocomial transmissions to other inpatients, single‐room isolation is usually recommended. In the context of paediatric palliative care (PPC), such isolation counters the aim of participation in social activities for the patients. This study aimed to determine the prevalence of MDRO, the predictive value of risk factors and the incidence of nosocomial infections and nosocomial colonisations on a PPC inpatient unit applying a special hygiene concept that enables participation in social activities through risk‐adaption and barrier nursing. Methods Two‐year surveillance with MDRO screening of all intakes (N = 386) of a PPC unit on the day of admission and discharge. To determine the predictive value of pre‐defined risk factors, logistic regression analyses were calculated. Receiver operating characteristic analyses were performed to determine the predictive power of the number of risk factors on the presence of MDRO. Results The rate of MDRO colonisation at admission was 12.7%; previous positive MDRO screening was the only significant individual risk factor. Over the 2‐year period, no MDRO‐related nosocomial infections occurred; nosocomial colonisation incidence density was 0.6. Conclusion Results demonstrate that patients with at least one risk factor have to be cared for by barrier nursing until MDRO screening results are negative. Following these guidelines prevents nosocomial MDRO transmission.

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All You Need Is Evidence: What We Know About Pneumonia in Children With Neuromuscular Diseases

Cited by 6 publications

References 19 publications

Clinical Characteristics and Outcome of MDR/XDR Bacterial Infections in a Neuromuscular Semi-Intensive/Sub-Intensive Care Unit

Clinical Characteristics and Outcome of MDR/XDR Bacterial Infections in a Neuromuscular Semi-Intensive/Sub-Intensive Care Unit

Respiratory morbidity in patients with spinal muscular atrophy—a changing world in the light of disease-modifying therapies

Multidrug‐resistant organisms in paediatric palliative care patients – Prevalence, risk factors and the impact of a liberal hygiene concept

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