Sheldon L Kaplan

....

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

..Continued surveillance is needed to monitor changes in serotype prevalence and possible emergence of antibiotic resistance in pediatric pneumococcal disease...

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

..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...

..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 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)...

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

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

..Staphylococcus aureus causes skin and soft tissue or invasive infections in children in the community, in the hospital or in other ways associated with the health care system (HCA)...

....

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

..Community-acquired Staphylococcus aureus (SA) pneumonia has increased in children, yet few studies have focused on this infection...

..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...

..aureus (CA-MSSA) isolates. We describe the clinical characteristics of pediatric patients with S. aureus cultured from sinus specimens, treated at Texas Children's Hospital (TCH), and characterized their isolates by molecular methods...

..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...

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

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

..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...

..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...

..Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted...

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

..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...

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

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

..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)...

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

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

..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...

..S. aureus nasal colonization was greater in case than control pairs. Neonates were more often infected with their nasal strain than their mother's nasal strain...

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

..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...

..The clinical characteristics and virulence factors related to musculoskeletal infections caused by community-acquired, methicillin-resistant Staphylococcus aureus (MRSA) in children are not well-defined...

..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...

..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...

..We compared the outcome of therapy for MRSA with that of methicillin-susceptible (MSSA) invasive infections in children treated with clindamycin, vancomycin or beta-lactam antibiotics...

..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...

..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...

..aureus (21.4%) than methicillin-resistant S. aureus (8.3%; P=0.03). Seven of 20 mupirocin-resistant isolates displayed clindamycin resistance...

..CC320 was associated with multidrug resistance and reduced susceptibility to penicillin and ceftriaxone and still predominated among declining serotype 19A IPD isolates following PCV13 introduction...

..These data suggest a potential defense function for constitutively produced catalytic antibodies to a putative superantigenic site of Efb, but an adaptive catalytic response appears to be proscribed...

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

..To describe Staphylococcus aureus infections in children with diabetes mellitus (DM)...

..In conclusion, few isolates were truly nontypeable by Quellung reaction, and MLST and the presence of psaA proved useful in distinguishing between atypical pneumococci and other streptococcal species...

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

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

..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...

..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...

..Case patients had more advanced HIV disease as measured by CD4 T-cell counts, log10 human immunodeficiency viral load, and Centers for Disease Control and Prevention category of disease, than controls...

..The study objective is to assess the diagnostic efficacy of contrast-enhanced and unenhanced MRI sequences for the diagnosis of community-acquired S. aureus extremity skeletal infection in infants and young children...

..Furthermore, we determined the prevalence of the chlorhexidine resistance gene qacA/B from isolates in this unique population...

..The purpose of this study was to determine the utility of needle aspiration in pediatric patients with cellulitis in the era of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)...

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

..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...

..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...

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

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

..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...

..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...

..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...

..Ecthyma gangrenosum can be the herald of severe sepsis in neutropenic children...

..Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted...

..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...

..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...

....

....

..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...

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

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

....

..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...