Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study.

Background: For microbiological confirmation of diagnosis of pulmonary tuberculosis in young children, sequential gastric lavages are recommended; sputum induction has not been regarded as feasible or useful. We aimed to compare the yield of Mycobacterium tuberculosis from repeated induced sputum with that from gastric lavage in young children from an area with a high rate of HIV and tuberculosis.

Methods: We studied 250 children aged 1 month to 5 years who were admitted for suspected pulmonary tuberculosis in Cape Town, South Africa.

The etiology and outcome of pneumonia in human immunodeficiency virus-infected children admitted to intensive care in a developing country.

In developing countries, many human immunodeficiency virus (HIV)-infected children require intensive care unit (ICU) resources for pneumonia, but there is little information on the etiology of pneumonia or the impact of ICU intervention. OBJECTIVE: To compare the etiology and outcome of pneumonia in HIV-positive and seronegative children admitted to ICU. DESIGN: Prospective study.

Sputum induction as a diagnostic tool for community-acquired pneumonia in infants and young children from a high HIV prevalence area.

Sputum induction is a standard diagnostic procedure to identify pathogens in lower respiratory tract secretions in adults with pneumonia, but has rarely been studied or used in infants and young children. Our aim was to determine the usefulness of induced sputum (IS) as a diagnostic method for infants and children hospitalized with community-acquired pneumonia (CAP) in a high HIV prevalence area. Children hospitalized for CAP were prospectively enrolled over a year.

The impact of HIV infection and trimethoprim-sulphamethoxazole prophylaxis on bacterial isolates from children with community-acquired pneumonia in South Africa.

The aim of this study was to compare the type and antimicrobial resistance patterns of bacteria cultured from blood or respiratory tract secretions by HIV status and the use of trimethoprim-sulphamethoxazole (TMP-SMX) prophylaxis in children hospitalized with community-acquired pneumonia. During a 1-year prospective study in Cape Town, South Africa, 250 children [median aged 6 (3-16) months] hospitalized with pneumonia were enrolled; 151 (60.4 per cent) were HIV-infected.

The relationship between Helicobacter pylori infection, the virulence genotypes of the infecting strain and gastric cancer in the African setting.

Background: The relationship between Helicobacter pylori infection and gastric carcinoma remains controversial, especially in the African setting where infection is common, while gastric cancer is perceived to be uncommon, the basis of the so called 'African enigma'. This discrepancy between infection and the development of disease is commonly attributed to differences in host, environment and bacterial factors. Interest in the bacterial factors has focused on heterogeneity in the so-called 'virulence genes'.

Aetiology and outcome of pneumonia in human immunodeficiency virus-infected children hospitalized in South Africa.

Unlabelled: To determine the aetiology and outcome of pneumonia in human immunodeficiency virus (HIV)-infected children, we prospectively investigated 250 children hospitalized with pneumonia who were known or clinically suspected to be HIV-positive, or who required intensive care support in Cape Town, South Africa. Blood culture, induced sputum or bronchoalveolar lavage, nasopharyngeal aspirate and gastric lavage were performed. Of the total, 151 children (60.

Bacterial infection in children with HIV: a prospective study from Cape Town, South Africa.

Invasive bacterial infection in children infected with the human immunodeficiency virus (HIV) is common. South African data on this problem are limited. Over 1 year we prospectively studied 108 HIV-infected children hospitalized for 136 presumed infective episodes.

Pneumocystis carinii pneumonia in South African children infected with human immunodeficiency virus.

Background: Pneumocystis carinii pneumonia (PCP) has been regarded as uncommon in HIV-infected patients in Africa, but diagnostic difficulties and geographic variability may partly account for this. There is little information on the incidence of PCP in HIV-infected children in Africa.

Aim: To investigate (1) the incidence and associated features of PCP in African HIV-infected children and (2) the usefulness of sputum induction and nasopharyngeal aspirates (NPAs) for diagnosis of PCP.

Sputum induction for the diagnosis of pulmonary tuberculosis in infants and young children in an urban setting in South Africa.

Background: Bacteriological confirmation of pulmonary tuberculosis is difficult in infants and young children. In adults and older children, sputum induction has been successfully used; this technique has not been tested in younger children.

Aims: To investigate whether sputum induction can be successfully performed in infants and young children and to determine the utility of induced sputum compared to gastric lavage (GL) for the diagnosis of pulmonary tuberculosis in HIV infected and uninfected children.

Chlamydia trachomatis lower respiratory tract infection in infants.

Chlamydia trachomatis may be an important cause of lower respiratory tract infection (LRTI) in infants born to mothers amongst whom there is a high prevalence of sexually transmitted disease. A study of 100 ambulatory infants with signs of LRTI in South Africa showed that 6% had C. trachomatis infection.

Primary staphylococcal pneumonia in young children: a review of 100 cases.

Staphylococcus aureus (S. aureus) is responsible for a small proportion of acute respiratory infections in children. Nevertheless a high index of suspicion is required because of the potential for rapid progression, the need for antibiotics different to those routinely administered in the treatment of pneumonia, and the high incidence of complications.

Two-week course of pantoprazole combined with 1 week of amoxycillin and clarithromycin is effective in Helicobacter pylori eradication and duodenal ulcer healing.

Background: Experience with proton pump inhibitor-based triple therapy is predominantly with omeprazole-containing regimens.

Aim: To investigate the efficacy of a pantoprazole-based regimen, with either a 1 or 2-week course of antibiotic co-therapy, in eradicating H. pylori, healing duodenal ulcers and to assess the antibiotic sensitivity profiles of isolated H.

Epidemiology of post-neonatal bacterial meningitis in Cape Town children.

Bacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from 1 August 1991 to 31 July 1992, was to define the magnitude of the problem of childhood bacterial meningitis in Cape Town.

Identification of the tetracycline resistance gene, tet(O), in Streptococcus pneumoniae.

Five isolates of Streptococcus pneumoniae resistant to tetracycline but lacking tet(M) were studied. The tetracycline resistance gene, tet(O), was detected for the first time in the pneumococcus. The gene was amplified and sequenced and found to share 99% nucleotide sequence identity and 99, 99, and 98% deduced amino acid sequence identity with the tet(O) resistance genes of Streptococcus mutans, Campylobacter coli, and Campylobacter jejuni, respectively.

Sexually transmitted diseases in children and evidence of sexual abuse.

During the period June 1989 to March 1991, laboratory evidence of sexually transmitted diseases (STDs) was found in 107 patients at the Red Cross War Memorial Children's Hospital in Cape Town. Data was available on 96 patients aged 23 months to 14 years (mean 75.9 months).

The etiology and antimicrobial susceptibility patterns of microorganisms in acute community-acquired lung abscess.

Objective: To determine the spectrum and antibiotic susceptibility patterns of microorganisms causing acute community-acquired lung abscess.

Design: A prospective survey.

Setting: Medical emergency department and wards of a tertiary teaching hospital.

Serotypes and antimicrobial susceptibility of Haemophilus influenzae.

During a one year prospective study of Haemophilus influenzae infections in patients treated in hospitals in the metropolitan area of Cape Town. H. influenzae type b accounted for 81.

Epidemiology of invasive Haemophilus influenzae infections in Cape Town, South Africa.

The full spectrum of invasive Haemophilus influenzae disease has not been documented previously in Africa. This 1-year prospective study was designed to determine the epidemiology of invasive Haemophilus influenzae disease in Cape Town children. During this period, 142 children with invasive disease were hospitalized; 85 (59.

An outbreak of whooping cough in a highly vaccinated urban community.

In 1950 a whole-cell pertussis vaccine was introduced in Cape Town and was followed by a marked decline in reported whooping cough mortality and morbidity. This resulted in reduced awareness of whooping cough as a clinical problem and, in recent years, no routine diagnostic tests for Bordetella pertussis have been performed. An outbreak of whooping cough occurred in Cape Town between 1 June 1988, and 31 May 1989, with 292 children admitted to hospital for whooping cough during this period (hospital admission rate in children under 5 years of age = 187 per 100,000).

Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection.

Methicillin-resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as nosocomial pathogens, especially in burn wounds. MRSA constituted 38% of all S. aureus isolates in our 25-bed burns unit despite the utilization of a combination of 1% silver sulfadiazine and 0.

Dipstick screening for urinary tract infection.

In screening for urinary tract infection the leucocyte esterase test will detect almost all samples with significant pyuria and bacteriuria, but is relatively nonspecific. The nitrite test is more specific but less sensitive and about one-third of the urinary tract infections in a large group of children were missed. The combination of screening tests results in greater overall accuracy both in the diagnosis and exclusion of urinary tract infection.

Ringworm of the scalp in children.

Scalp scrapings were collected from 651 children in the Cape Peninsula and along the Western Cape coast to determine which dermatophytic fungi occur in these areas. Fungi were isolated from 61% of specimens, by far the commonest being Trichophyton violaceum. Only half of these specimens showed fungal elements on direct microscopy.