[ACUTE OTITIS MEDIA BACTERIOLOGY IN CHILDREN YOUNGER THAN THREE MONTHS IN THE LAST 16 YEARS].

Background: Only scant information is available regarding the bacteriology of acute otitis media (AOM) in neonates.

Objectives: To investigate the bacteriology of AOM post the introduction of Pneumococcal Conjugate Vaccine (PCV13) in children younger than 3 months and its relation to the mode of delivery.

Methods: Retrospective bacteriological analysis of middle ear fluids taken from children younger than 60 months suffering from AOM.

High Rates of ESBL-producing and Gentamycin-resistant Gram-negative Bacteria During the First Week of Life: A Multicenter Cross-sectional Study Among Infants Younger Than 2 Months With Urinary Tract Infection.

Introduction: Reducing the risk of renal scarring in infants with urinary tract infection (UTI) necessitates timely and effective administration of antimicrobial treatment. The Israeli Medical Association recommends the empirical use of gentamicin and ampicillin for febrile infants younger than 2 months with suspected UTI. We aimed to assess the prevalence of Extended Spectrum Beta-Lactamase (ESBL)-producing and gentamicin-resistant Gram-negative UTI among infants younger than 2 months.

Compared perinatal outcomes of two prophylactic antibiotic regimens for preterm premature rupture of membranes: a randomized controlled trial.

Background: Prophylactic antibiotic use in preterm premature rupture of membranes is associated with significantly reduced intra-amniotic infection and improved neonatal outcome, although data are insufficient to determine the optimal antibiotic regimen. Ampicillin resistance has changed the epidemiology of neonatal sepsis.

Objective: This study aimed to determine the efficacy of two antibiotic regimens in prolonging the latency period in women with preterm premature rupture of membranes.

Two decades of otitis media in northern Israel: Changing trends in the offending bacteria and antibiotic susceptibility.

Objective: Bacteriology and antibiotic resistance trends changed considerably following introduction of the pneumococcal conjugate vaccines (PCV) 7 and 13, with differences between geographic regions. The objective of this study was to evaluate changes in acute otitis media (AOM) bacteriology and antibiotic susceptibility from the pre-vaccination period (2002-2008) to after the introduction of PCV13 (2010-2019) in northern Israel.

Methods: Data were collected from 3277 middle ear fluid (MEF) cultures and 4822 common AOM-generating pathogens of children aged <5 years with otitis media, taken during 2002-2019.

The Yield of Targeted Examination for the Detection of Symptomatic Congenital Cytomegalovirus Infection.

Background: The incidence of congenital cytomegalovirus (CMV) infection in Israel is 0.7%. Only 10-15% are symptomatic.

Risk Factors for Mortality among Newborns with Neonatal Seizures.

Objective: The aim of the study is to examine the incidence and risk factors for death among neonates who developed neonatal seizures (NS) in an ethnically distinctive community with high consanguinity rate in Israel.

Methods: Retrospective study was conducted at a single institution on data between January 2001 and January 2016. All neonates diagnosed with NS developed up to age 28 days were included.

A novel extended prophylactic antibiotic regimen in preterm pre-labor rupture of membranes: A randomized trial.

Objectives: Prophylactic antibiotic use in preterm pre-labor rupture of membranes (PPROM) is associated with a significant reduction in intra-amniotic infection and improved neonatal outcome. However, data is insufficient to determine the optimal antibiotic regimen. Considering the rise in Escherichia coli and Klebsiella pneumonia early-onset sepsis rate and the emergence of ampicillin resistance, our aim is to compare the efficiency of two antibiotic regimens in prolonging pregnancy and reducing infectious morbidity.

Characteristics of hospitalised patients with influenza in 2015-2016 in northern Israel: three circulating strains and continued fear of 2009 A/H1N1.

This study aimed to characterise children and adults diagnosed with influenza who were admitted to three medical centres in northern Israel in the winter of 2015-2016, a unique season due to infection with three types of influenza strains: A/H1N1, A/non-H1N1 and B. Data were collected retrospectively from medical records. Influenza A/H1N1 infected mainly adults (61% vs.

Validation of a Novel Assay to Distinguish Bacterial and Viral Infections.

Background: Reliably distinguishing bacterial from viral infections is often challenging, leading to antibiotic misuse. A novel assay that integrates measurements of blood-borne host-proteins (tumor necrosis factor-related apoptosis-inducing ligand, interferon γ-induced protein-10, and C-reactive protein [CRP]) was developed to assist in differentiation between bacterial and viral disease.

Methods: We performed double-blind, multicenter assay evaluation using serum remnants collected at 5 pediatric emergency departments and 2 wards from children ≥3 months to ≤18 years without ( = 68) and with ( = 529) suspicion of acute infection.

The herd effects of infant PCV7/PCV13 sequential implementation on adult invasive pneumococcal disease, six years post implementation; a nationwide study in Israel.

Background: Introduction of pneumococcal conjugate vaccine (PCV) has nearly eliminated vaccine-type (VT) invasive pneumococcal disease (IPD) in children, yet the reported resulting reduction of adult IPD is variable. We present the indirect impact of sequential PCV7/PCV13 implementation in Israel on adult IPD.

Methods: An ongoing nationwide active surveillance was initiated on July 2009 when PCV7 was implemented (with Catch-up).

Topical Minocycline Foam for the Treatment of Impetigo in Children: Results of a Randomized, Double-Blind, Phase 2 Study.

Background: Currently available treatment options for impetigo are limited by either systemic side effects (for oral therapy) or lack of ease of use (for topical ointment). A novel foam formulation of minocycline for topical use may improve convenience and treatment utilization for pediatric patients with impetigo.

Objective: To evaluate the safety and efficacy of topically applied minocycline foam (FMX-102 1% and 4%) in the treatment of impetigo and to determine the optimal therapeutic active ingredient concentration.

Bronchiolitis in young infants: is it a risk factor for recurrent wheezing in childhood?

Background: Acute bronchiolitis in infancy is considered a risk factor for recurrent wheezing episodes in childhood. The present study assessed prevalence, clinical manifestations and risk factors for recurrent wheezing events during the first 3 years of life and persistent wheezing events beyond this age in children hospitalized as young infants with acute bronchiolitis.

Methods: Two groups of children aged 6 years were included.

Brucellosis Outbreak in Children and Adults in Two Areas in Israel.

Two parallel outbreaks of Brucella melitensis infection occurred in 2014 in two geographical areas in Israel. In two medical centers in northern Israel and one medical center in Jerusalem, 102 patients (58 children, 47 adults) were diagnosed with brucellosis. Most patients (N = 76, 72%) were Muslim Arabs, 28 (27%) were Druze, and one was Jewish.

[THE PREVALENCE OF SUBCLINICAL MYOCARDITIS AMONG YOUNG CHILDREN WITH ACUTE VIRAL INFECTION].

Background: Viruses are the most prevalent ausative agents of myocarditis in young children. Studies have shown acute myocarditis in post mortem examinations during viral disease outbreaks. The aims of this study are to assess the prevalence of and risk factors for subclinical acute myocarditis in young children hospitalized with an acute viral disease.

Severe Acute Mastoiditis Admission is Not Related to Delayed Antibiotic Treatment for Antecedent Acute Otitis Media.

Background: Delayed antibiotic treatment for acute otitis media (AOM) is recommended for children >6 months with nonsevere illness, no risk factors for complications or history of recurrent AOM. This study evaluates relationship between delayed antibiotic treatment for antecedent AOM and severity of subsequent acute mastoiditis admission.

Methods: A prospective observational study of children aged 0-14 years admitted with acute mastoiditis to 8 hospitals between 2007 and 2012 calculates rates of severe acute mastoiditis admission [defined by ≥1 of the following: complication (mastoid subperiosteal abscess, brain abscess and sagittal vein thrombosis), need for surgical procedure and duration of admission >6 days].

Reconsidering the Current Preterm Premature Rupture of Membranes Antibiotic Prophylactic Protocol.

Objective: The purpose of our study was to determine whether the current antibiotic regimen for preterm premature rupture of membranes (PPROM) is adequate for covering the current causative agents and sensitivities of chorioamnionitis and early-onset neonatal sepsis.

Study Design: During a 3-year period, we retrieved the results from placental and amniotic membrane cultures obtained at delivery in cases of maternal fever, chorioamnionitis, and PPROM, and from blood cultures obtained from neonates with early-onset sepsis (EOS) in three participating hospitals. Sensitivity of pathogens to antimicrobial agents was performed using routine microbiologic techniques.

Early impact of PCV7/PCV13 sequential introduction to the national pediatric immunization plan, on adult invasive pneumococcal disease: A nationwide surveillance study.

Background: PCV7 was introduced as a universal childhood vaccination in Israel on July 2009 and was gradually replaced by PCV13 from November 2010. We report data on adult invasive pneumococcal disease (IPD), two years post PCV13 implementation.

Methods: An ongoing nationwide active surveillance (all 27 laboratories performing blood/CSF cultures nationwide), initiated in 2009, providing all blood/CSF Streptococcus pneumoniae isolated from persons ≥18 years.

Early impact of sequential introduction of 7-valent and 13-valent pneumococcal conjugate vaccine on IPD in Israeli children <5 years: an active prospective nationwide surveillance.

Background: The 7-valent pneumococcal conjugated vaccine (PCV7) was introduced to the Israeli national immunization plan (NIP) in July 2009 (administered at age 2, 4 and 12 months), with a fast reduction of invasive pneumococcal disease (IPD) caused by PCV7 serotypes. Starting in November 2010, PCV13 gradually replaced PCV7.

Aim: To report the impact of PCV7/PCV13 sequential introduction on IPD in Israeli children <5 years.

Thoracic empyema in children: clinical presentation, microbiology analysis and therapeutic options.

Thoracic empyema is an accumulation of purulent fluid in the pleural space presenting as a complication of bacterial pneumonia. The aims of the study were to present the incidence, demographic results, clinical presentation, laboratory and microbiology results, imaging and the therapeutic options. From January 1992 until December 2009 we collected data of children hospitalized with empyema in our medical center in north of Israel.

[Tuberculosis in pregnancy and puerperium].

According to the World HeaLth Organization, tuberculosis (TB) is the third leading cause of death worldwide among women at child bearing age. However, in Israel, a low TB prevalence country, TB in pregnant women is infrequent and infectious pulmonary TB at puerperium is rare. Early diagnosis of TB in pregnancy is challenging because the non-specific symptoms of early TB such as weakness, excess perspiration and tachycardia will usually be attributed to pregnancy.

Midazolam for urethral catheterisation in female infants with suspected urinary tract infection: a case-control study.

Objectives: Based on the 2010 Israeli Medical Association recommendations, young children with suspected urinary tract infection (UTI) are mildly sedated with oral or intranasal midazolam to reduce the distress associated with urethral catheterisation (UC). The primary objective of this study was to examine the rate of urine culture contamination (UCC) in infants who underwent UC with and without sedation. Other objectives were to evaluate serious adverse events and emergency department (ED) length of stay.

Bordetella pertussis infection attenuates clinical course of acute bronchiolitis.

Background: Bordetella pertussis (BP) was detected in hospitalized children with various lower respiratory tract infections. The aim of this study was to assess clinical characteristics of BP infection, and its effect on disease severity in young children hospitalized with acute bronchiolitis.

Methods: Included were previously healthy children ≤2 years of age who were hospitalized with acute bronchiolitis.

Physician specialty is associated with adherence to treatment guidelines for acute otitis media in children.

Aim: To identify physician and visit characteristics affecting adherence to guidelines recommending delayed antibiotic therapy for acute otitis media (AOM).

Methods: We used physician visit data from an Israeli health maintenance organization to identify children ages 0-15 diagnosed with AOM. We defined early antibiotic treatment as purchase, within 3 days of diagnosis, of antibiotics prescribed by the diagnosing physician.