S L Kaplan

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..The role of newer antibiotics such as linezolid and daptomycin for the treatment of CA-MRSA musculoskeletal infections in children needs further study...

..The objective of this study was to collect demographic, clinical, laboratory, and outcome information for infants and children who had Neisseria meningitidis infections of various serogroups and were cared for in 10 pediatric hospitals...

..Monitor clinical and microbiologic features including antimicrobial susceptibility of invasive pneumococcal infections among children...

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..To determine the safety, tolerance, pharmacokinetics and efficacy of linezolid, a new oxazolidinone antibiotic in the treatment of community-acquired pneumonia in hospitalized children...

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..This article discusses epidemiology, clinical manifestations, laboratory diagnosis, treatment, and prevention...

..To determine the impact of antibiotic resistance on the frequency, clinical features, and management/outcome of mastoiditis attributable to Streptococcus pneumoniae...

..Otitis media represents the single most common infection due to S. pneumoniae. Recommendations for treatment of acute otitis media due to drug-resistant strains and the rationale for these recommendations are discussed...

..Methicillin-resistant Staphylococcus aureus (MRSA) isolates are increasingly frequent causes of skin and soft-tissue infections or invasive infections in many communities...

..Pediatric infections caused by resistant Gram-positive infections are an increasing concern with limited treatment options. Linezolid, a new oxazolidinone, is active against staphylococci, streptococci and enterococci...

..Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are becoming increasingly prevalent. Linezolid is effective and well-tolerated in the treatment of adults with MRSA infections...

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..The antimicrobial susceptibilities and outcome of infections with S. pneumoniae in patients who have undergone transplantation are similar to those in the general pediatric population...

..To review the epidemiology and clinical course of facial cellulitis attributable to Streptococcus pneumoniae in children...

..CONCLUSIONS: One CA-MRSA clone, TCH clone A, has become the predominant cause of CA S. aureus infections among children in the Houston area. It causes a wide spectrum of diseases, including complicated pneumonia...

..ICAM-1 deficiency may be protective early in Hib infection but has a detrimental effect in S. pneumoniae infection...

..CONCLUSIONS: MRSA is an established, community-acquired pathogen in our area. This necessitates a change in empiric therapy of infections suspected to be caused by...

..We compared clinical characteristics of children with USA300 versus non-USA300 CA-methicillin-susceptible S. aureus (CA-MSSA) invasive infections at Texas Children's Hospital (TCH)...

..CA MRSA and clonally related CA MSSA characterized as USA300 and sequence type 8 have been isolated from these patients...

..Recurrent systemic pneumococcal infection usually occurs in immunocompromised patients and patients with underlying conditions...

..The use of VATS for initial therapy of empyema results in decreased duration of fever and length of hospitalization...

..LFA-1(-/-) mice had increased incidence of otitis media and meningitis/encephalitis vs WT at 72 and 96 h. Both Mac-1 and LFA-1 play important but distinct roles in host defense to S. pneumoniae...

..This work suggests that the loss of ICAM-1 significantly impairs host defense against C. albicans, by impairing either neutrophil migration or phagocyte activation or both...

..CONCLUSIONS: Osteomyelitis caused by pvl+ S aureus strains were associated with more severe local disease and a greater systemic inflammatory response compared with osteomyelitis caused by pvl- S aureus...

..These results demonstrate a definitive phenotypic abnormality in E-selectin-deficient mice, and suggest that E- and P-selectin are important in the host defense against S. pneumoniae infection...

..In this study, sinus cultures which grew Streptococcus pneumoniae at Texas Children's Hospital were evaluated with regard to pneumococcal serotype, antimicrobial susceptibility, and frequency of coinfecting organisms...

..3) was not different. We conclude that MICs for pediatric isolates have increased slightly since 2005 and therapeutic decisions based on vancomycin MICs need to be made by considering the methodology used...

..The USA300 clone increasingly causes healthcare associated infections. We compared children with SA-CRB due to USA300 versus non-USA300 isolates and identified risk factors for complications...

..We review the impact of pneumococcal conjugate vaccine on pneumococcal mastoiditis in children at Texas Children's Hospital...

..aureus infections. Community-acquired MRSA may cause primary community-acquired pneumonia, as well as metastatic pulmonary disease. The presence of genes encoding PVL is highly associated with pulmonary involvement by S. aureus...

..Furthermore macrolide resistant organisms are not more likely to be recovered after a macrolide treatment failure than a penicillin-nonsusceptible isolate being recovered after a beta-lactam treatment failure (P = 1.0)...

..Clinicians should consider replacement serotypes when encountered with invasive pneumococcal disease in vaccinated children...

..Community-acquired MRSA (CA-MRSA) infections have changed several aspects of staphylococcal infections in children including the epidemiology, clinical manifestations, laboratory approach, antibiotic management, and prevention...

..pneumoniae increased during the 6-year study. The proportion of M phenotype remained constant at 75%, meaning that these isolates remain susceptible to clindamycin. Continued surveillance to document potential changes is essential...

..Management of the venous thrombosis in this setting may be complicated by the rapid evolution of septic emboli...

..It is likely that many of these cases remain undiagnosed because of the HPS's rapidly fatal course...

..The ketolides appear to be active antimicrobials against penicillin- and macrolide-resistant pneumococci...

..The increase appears to correlate with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA)...

..We describe the evaluation and treatment of neonatal community-acquired Staphylococcus aureus disease in the era of community-acquired methicillin-resistant S. aureus...

..Epidemiological studies suggest that USA300 is more virulent than other CA-MRSA. The genetic determinants that render virulence and dominance to USA300 remain unclear...

..The data show that patients infected with Panton-Valentine leukocidin (PVL)-positive strains developed a dominant immunoglobulin G anti-PVL antibody response that correlates with markers of inflammation...

..Staphylococcus aureus is the most common cause of septic arthritis (SA) in children. USA300 is the predominant community methicillin-resistant (MRSA) clone. Panton-Valentine leukocidin genes (pvl) have been associated with severe disease...

..Current molecular epidemiology of infections due to the USA300 strain of MRSA in the pediatric healthcare setting remains obscure...

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..At 2 years after discharge, the results of psychologic tests (Bayley Scales of Infant Development or McCarthy Scales of Children's Abilities) were also equivalent between the two treatment groups for patients remaining in the study...

..No significant differences were observed in the percentage of patients who returned to the emergency center or clinics because of worsening or incomplete resolution of the infected site...

..Male infants 7 to 12 days of age are affected most often. Neonatal community-acquired S aureus infection may be associated with concurrent maternal infection. USA300 is the predominant clone among these neonatal isolates in our region...

..Pneumococcal endocarditis in children is unusual but often has serious complications...

..The aim of this study was to review the current epidemiology and clinical course of SPIN...

..Although the inflammatory responses were similar histologically in ICAM-1-deficient and normal mice, differences in site- and stimulus-specific susceptibilities were noted...

..Multilocus sequence type characterization was performed on selected isolates. Four different genomic banding patterns were identified by Rep-PCR. One profile (clone 1) was predominant and matched sequence type 227...

..Imaging is frequently requested in these children for diagnosis and planning of therapeutic interventions...

..Asplenia is associated with an increased risk of infections caused by Streptococcus pneumoniae. Overwhelming infection can be fulminate and lead to a fatal outcome...

..Dexamethasone remains the only adjunctive antiinflammatory therapy to consider. The empiric approach to the child with suspected bacterial meningitis who has received the pneumococcal conjugate vaccine currently remains unchanged...

..We describe the clinical and laboratory features of two children with HPS after KD and review the three previously reported pediatric cases of recrudescence of HD leading to HPS...

..Case 3 was a 13-year-old male adolescent with adenitis of the neck and thigh. All three patients were treated with rifampin with improvement of their symptoms...

..Cidofovir allows for directed therapy but can result in nephrotoxicity. We report our experience with cidofovir for the treatment of adenovirus pneumonia in pediatric lung transplant recipients...

..CONCLUSIONS: This study of the pharmacokinetics of beta-lactam antibiotics in children with bacterial pneumonia may help in the development of therapeutic guidelines for the treatment of pneumococcal pneumonia...

..More than 90 immunologically distinct pneumococcal serotypes have been identified, but limited information is available regarding their relative importance in AOM...

..The impact of the 7-valent pneumococcal conjugate vaccine (PCV7 [Prevnar]) on penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) recovered from children with acute otitis media (AOM) is unclear...

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..In adults linezolid treatment for >/=2 weeks has been associated with reversible hematopoietic suppression, primarily thrombocytopenia...

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..CONCLUSIONS: Linezolid given iv or orally was well-tolerated and safe. It was as effective as vancomycin in treating children with Gram-positive CSSSIs...

..Data for regimens begun at 12-23 months were inconclusive. These data support the use of the 2-dose and 3-dose infant PCV7 regimens when the full series cannot be delivered and detail the limitations of abbreviated dosing regimens...

..Hematologic abnormalities were consistent with mild, reversible, duration-dependent myelosuppression. Appropriate monitoring is warranted with linezolid use...