A predictive model to estimate the risk of serious bacterial infections in febrile infants.

Unlabelled: Low risk criteria have been defined to identify febrile infants unlikely to have serious bacterial infection (SBI). Using these criteria approximately 40% of all febrile infants can be defined as being at low risk. Of the remaining infants (60%) only 10%-20% have an SBI.

[Problems in the use, cleaning and maintenance of nebulization equipment in the home situation].

Objective: To determine whether jet nebulizers used at home for the treatment of children with asthma are used optimally.

Design: Descriptive.

Setting: Outpatient clinic for child pulmonary diseases of the Academic Hospital/Sophia Children's Hospital Rotterdam and outpatient clinic for child diseases of the Baronie Hospital Breda, the Netherlands.

Staphylococcal pneumonia in childhood: will early surgical intervention lower mortality?

Staphylococcus aureus pneumonia (SAP) continues to be a serious bacterial infection which is associated with a high incidence of complications. We retrospectively reviewed the case records of 36 infants and children admitted with SAP to the Sophia Children's Hospital between 1970 and 1992 to analyse changes over time in the clinical presentation, diagnostic work-up, management and complications. Fifteen of these 36 children (42%) were less than 1 year old.

[Gram staining and bacterial culture of stomach contents of the full-term neonate in prolonged status of ruptured membranes is not useful].

In an effort to evaluate the management of full-term neonates born after prolonged rupture of the membranes, we studied 159 full-term newborn infants born 24 hours or more after rupture of the membranes retrospectively. Gram stain and bacterial culture of a gastric aspirate of the neonates were significantly related; however, the predictive value of the Gram stain was low, both for a positive test (46%) and for a negative test (70%). A significant relation was not found between the Gram stain (presence of bacteria or greater than or equal to 4 leucocytes per high power field) or the bacterial culture on the one hand and the occurrence of clinical symptoms of infection on the other.

Childhood meningitis caused by enterococci and viridans streptococci.

Selected clinical and laboratory parameters were studied respectively in patients with meningitis caused by enterococci and viridans streptococci in an academic children's hospital. During a nine-year period (1981-1989), enterococci or viridans streptococci were isolated from the cerobrospinal fluid (CSF) of 48 patients. In nine of these 48 patients, enterococci or viridans streptococci were the causative agents of meningitis.

Antibiotic resistance in Haemophilus influenzae: mechanisms, clinical importance and consequences for therapy.

Invasive and non-invasive infections caused by Haemophilus influenzae are frequently diagnosed in children below the age of 5 years. The treatment of choice for these infections was ampicillin. However, since the early 1970s the increasing prevalence of resistance to ampicillin and other antibiotics has necessitated major changes in antibiotic therapy.

[Lung infections with atypical features].

The clinical difference between a lobar pneumonia caused by pneumococci or other bacterial agents and lower respiratory tract infections presenting with atypical symptoms is important. Mycoplasma pneumoniae, chlamydia species, Coxiella burnetii and several viruses amongst others are micro-organisms which cause atypical symptoms. All the time new types of micro-organisms like Ureaplasma urealyticum are found as a cause of pneumonia with atypical symptoms.

Disinfecting effect of a disposable lubricant during cystoscopy.

To study the disinfecting effect of the lubricant Instillagel for the urethra in children, bacteriologic tests of the urethra were performed immediately before and after cystoscopy in 100 children. In addition urine cultures were taken during and after cystoscopy. The culture of the urethra before cystoscopy was positive in 75 children.

Tobramycin in patients with cystic fibrosis. Adjustment in dosing interval for effective treatment.

The efficacy of the dosing regimen of tobramycin was investigated in 28 patients with cystic fibrosis who had an acute exacerbation of chronic pulmonary infection with Pseudomonas aeruginosa. The initial dose of tobramycin was 3.3 mg/kg of body weight three times daily (ie, 10 mg/kg/day).

[Is juvenile seborrheic dermatitis a candidiasis? Studies of a possible link with microbial infections].

Infantile seborrheic dermatitis (ISD), a disease occurring in the first months of life, is an erythematosquamous skin disease of unknown origin. This article presents results of microbial studies in 20 patients with ISD. Isolation of candida in a high percentage may indicate a primary role of this micro-organism in the etiology of this disease.

Chequerboard titrations: the influence of the composition of serial dilutions of antibiotics on the fractional inhibitory concentration index and fractional bactericidal concentration index.

Chequerboard titrations carried out with modified serial dilutions of antibiotics such that consecutive concentrations in these series were four times smaller than those in two-fold serial dilutions enable MICs and MBCs to be determined with greater accuracy. Interaction indices calculated by this method can differ markedly from those calculated on the basis of two-fold serial dilutions. The differences calculated in this study ranged from -0.

The efficacy of the combination of Timentin and tobramycin in the treatment of patients with bacteraemia.

Twenty-eight patients with bacteraemia were treated with Timentin, a combination of ticarcillin and clavulanic acid, and tobramycin. According to a simple physiological classification scheme 20 patients were moderately and eight severely ill. Clinical cure was achieved in 15 of 20 moderately ill and in four of eight severely ill patients.

Infantile seborrheic dermatitis. Morphological and immunopathological study.

The pathomechanisms of infantile seborrheic dermatitis (ISD) are unknown. An allergic reaction to candidal antigens is one of the hypotheses. The skin of 6 patients suffering from ISD was studied by immunostaining techniques.

Pharmacokinetics of tobramycin in patients with cystic fibrosis. Implications for the dosing interval.

The pharmacokinetics of tobramycin were evaluated in 15 patients (8 to 22 years of age) with cystic fibrosis (CF). A dose of 3.0 to 3.

Quantitative study of the aerobic and anaerobic faecal flora in neonatal necrotising enterocolitis.

Faeces from 24 neonates with proved necrotising enterocolitis (NEC), from 12 with clinically suspected NEC, and from 41 control infants were quantitatively cultured under aerobic and anaerobic conditions. An important difference in colonisation with Klebsiella was found between the NEC groups and the control group. Although the cause of NEC is unknown, colonisation with Klebsiella seems to increase the risk.

Plasma prekallikrein and endotoxemia in liver cirrhosis.

In liver disease low prekallikrein levels may be found which has been suggested to be due to diminished synthesis. However, it may also be due to endotoxemia accompanying liver disease. To study the last possiblity prekallikrein, endotoxins and Normotest were determined in 18 cirrhosis patients.