Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
| Autor: | Heather Elphick, Elizabeth Gregson, Lowri Thomas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neuromuscular disease medicine.drug_class Antibiotic resistance Antibiotics medicine.disease_cause Cerebral palsy 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine medicine Neurodisability Humans Pseudomonas Infections Prospective Studies Adverse effect Prospective cohort study Child Retrospective Studies Pseudomonas aeruginosa business.industry medicine.disease Anti-Bacterial Agents Point-of-care testing 030228 respiratory system Pediatrics Perinatology and Child Health Original Article business |
| Zdroj: | European Journal of Pediatrics |
| ISSN: | 1432-1076 0340-6199 |
| Popis: | The objective was to investigate the prevalence of Pseudomonas aeruginosa (PA) in patients with complex neurodisability and current treatment practice in our centre in order to inform future guidelines. A retrospective case note review was undertaken at a tertiary children’s hospital. One hundred sixty-two patients (mean age 11.7 years) with a primary diagnosis of neuromuscular disease (NMD) or severe cerebral palsy (CP) and a respiratory sample sent for analysis during the study period were studied. Associations between PA in respiratory samples and diagnosis, long-term ventilation, presence of a gastrostomy or a tracheostomy, antibiotic choice, clinical deterioration and adverse events were analysed. Twenty-five (15%) had one or more PA isolate in respiratory samples. There was a significant association between PA in respiratory samples and tracheostomy (pConclusions: A larger prospective study may establish clearer criteria for guideline development. Techniques such as point-of-care testing to identify virulent strains of PA may improve patient outcomes and prevent the development of antibiotic resistance in the future. What is Known:•Children with complex neurodisability are at increased risk of respiratory morbidity and of infection with gram-negative organisms such as Pseudomonas aeruginosa.•There are currently no guidelines to inform treatment choices in this group of vulnerable children. What is New:•15% children in this study population had Pseudomonas aeruginosa in respiratory samples during a 12-month period, the majority of whom did not require critical care treatment. Thirteen of these children had a tracheostomy in situ and 12 did not. •In those that deteriorated clinically or developed antibiotic resistant organisms, earlier detection and targeted treatment of Pseudomonas aeruginosa may have prevented deterioration. |
| Databáze: | OpenAIRE |
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