Development and validation of a multiplex real-time PCR assay for detection and quantification of in pediatric respiratory samples.

() is the world's leading cause of lower respiratory tract infection morbidity and mortality in children. However, current clinical microbiological methods have disadvantages. can be difficult to grow in laboratory conditions if a patient is pre-treated, and antigen testing has unclear clinical utility in children.

Pediatric Swine Model of Methicillin-Resistant Sepsis-Induced Coagulopathy, Disseminated Microvascular Thrombosis, and Organ Injuries.

Unlabelled: Sepsis-induced coagulopathy leading to disseminated microvascular thrombosis is associated with high mortality and has no existing therapy. Despite the high prevalence of Gram-positive bacterial sepsis, especially methicillin-resistant (MRSA), there is a paucity of published Gram-positive pediatric sepsis models. Large animal models replicating sepsis-induced coagulopathy are needed to test new therapeutics before human clinical trials.

A point-of-need platform for rapid measurement of a host-protein score that differentiates bacterial from viral infection: Analytical evaluation.

The objective was to evaluate the analytical performance of a new point-of-need platform for rapid and accurate measurement of a host-protein score that differentiates between bacterial and viral infection. The system comprises a dedicated test cartridge (MeMed BV®) and an analyzer (MeMed Key®). In each run, three host proteins (TRAIL, IP-10 and CRP) are measured quantitatively and a combinational score (0-100) computed that indicates the likelihood of Bacterial versus Viral infection (BV score).

Adhesin genes and biofilm formation among pediatric Staphylococcus aureus isolates from implant-associated infections.

Background: Microbial surface component recognizing adhesive matrix molecules (MSCRAMMs) facilitate Staphylococcus aureus adherence to host tissue. We hypothesized that S. aureus isolates from implant-associated infections (IAIs) would differ in MSCRAMM profile and biofilm formation in vitro compared to skin and soft tissue infection (SSTI) isolates.

Increasing Numbers of Staphylococcal Scalded Skin Syndrome Cases Caused by ST121 in Houston, Texas.

Background: The molecular epidemiology of Staphylococcus aureus strains causing staphylococcal scalded skin syndrome (SSSS) in the United States has not been described. We analyzed patient and S. aureus isolate characteristics associated with SSSS in children at Texas Children's Hospital.

Clinical Characteristics and Outcomes of Staphylococcus aureus Implant-associated Infections in Children.

Background: Staphylococcus aureus is a significant cause of implant-associated infections (IAIs). Data detailing the optimal treatment of IAIs are lacking in children. We describe the clinical features and outcomes of pediatric patients with S.

Analysis of Invasive Community-Acquired Methicillin-Susceptible Staphylococcus aureus Infections During a Period of Declining Community Acquired Methicillin-Resistant Staphylococcus aureus Infections at a Large Children's Hospital.

Background: The epidemiology of community acquired (CA) Staphylococcus aureus infections is changing in the United States. We investigated the current epidemiology of S. aureus infections at Texas Children's Hospital.

Healthcare-associated Staphylococcus aureus Bacteremia in Children: Evidence for Reverse Vancomycin Creep and Impact of Vancomycin Trough Values on Outcome.

Introduction: Elevated vancomycin minimum inhibitory concentrations (MICs) in Staphylococcus aureus have been associated with worse clinical outcomes in adults. For invasive meticillin-resistant S. aureus (MRSA) infections in adults, the Infectious Diseases Society of America recommends targeting vancomycin serum trough concentrations between 15 and 20 μg/mL.

Impact of the 13-valent pneumococcal conjugate vaccine on chronic sinusitis associated with Streptococcus pneumoniae in children.

Background: The widespread use of the 7-valent pneumococcal conjugate vaccine has been associated with epidemiologic changes of mucosal and invasive pneumococcal disease. No study describes the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on chronic sinusitis in children. We describe changes in epidemiology of Streptococcus pneumoniae chronic sinusitis after the introduction of PCV13 at Texas Children's Hospital.

Randomized trial of "bleach baths" plus routine hygienic measures vs. routine hygienic measures alone for prevention of recurrent infections.

Children with probable community-associated Staphylococcus aureus skin and soft tissue or invasive infections were randomized to routine daily hygienic measures with or without "bleach baths" twice a week for 3 months. Within 12 months, a medically attended recurrence occurred in 84 of 495 (17%) children using bleach baths compared to 103 of 492 (21%) of control participants (P = .15).

Changes in Streptococcus pneumoniae serotype 19A invasive infections in children from 1993 to 2011.

Among 594 Streptococcus pneumoniae serotype 19A invasive pneumococcal disease (IPD) isolates collected from 1993 to 2011, we identified 85 sequence types by multilocus sequence typing. 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.

Staphylococcus aureus infections in pediatric patients with diabetes mellitus.

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

Methods: Children with DM (cases) and S. aureus infections (2/02-6/10) were identified from a surveillance database.

Characterization of nontypeable and atypical Streptococcus pneumoniae pediatric isolates from 1994 to 2010.

Streptococcus pneumoniae is a major cause of bacteremia, meningitis, pneumonia, sinusitis, and acute otitis media in children. Although optochin susceptibility, bile solubility, and Quellung testing are the standards for identifying and differentiating pneumococci, there are several reports of nontypeable pneumococci that give inconsistent results with one or more of these tests. We characterized 52 isolates previously labeled as nontypeable pneumococci.

Increase in prevalence of Streptococcus pneumoniae serotype 6C at Eight Children's Hospitals in the United States from 1993 to 2009.

Streptococcus pneumoniae serotype 6C, which was described in 2007, causes invasive disease in adults and children. We investigated the prevalence of 6C among pediatric isolates obtained from eight children's hospitals in the United States. S.

Staphylococcus aureus pneumonia in children in the era of community-acquired methicillin-resistance at Texas Children's Hospital.

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

Methods: Patients with SA pneumonia (not ventilator-associated) were identified from our surveillance database. Medical records were reviewed; isolates were genotyped by PFGE and Panton-Valentine leukocidin genes detected by polymerase chain reaction.

Staphylococcus aureus sinus infections in children.

Objective: Staphylococcus aureus can cause sinusitis in children. The predominant MRSA clone in the United States, USA300, has been associated with skin and soft tissue as well as invasive diseases. USA300 has increased among CA methicillin-susceptible S.

Nasal Staphylococcus aureus colonization among mothers of term and late preterm previously healthy neonates with community-acquired Staphylococcus aureus infections.

We enrolled 35 case neonates with community-acquired Staphylococcus aureus infection and their mothers and 19 control mother-neonate pairs. We obtained neonatal and maternal anterior nasal cultures, and clinical isolates. S.

Hospital-acquired Staphylococcus aureus infections at Texas Children's Hospital, 2001-2007.

Objective: To document the introduction of the methicillin-resistant Staphylococcus aureus (MRSA) USA300 clone into a children's hospital. Current molecular epidemiology of infections due to the USA300 strain of MRSA in the pediatric healthcare setting remains obscure.

Design: Retrospective study of patients with hospital-acquired S.

Vancomycin MICs for Staphylococcus aureus vary by detection method and have subtly increased in a pediatric population since 2005.

Vancomycin MICs for Staphylococcus aureus isolates in a pediatric hospital with a high rate of staphylococcal infections were examined for any increase over a 7-year period. A broth microdilution scheme allowed direct comparison of the MICs generated by this method to MICs generated by Etest. MICs generated by both methods were determined with the same inoculum suspension.

Increase of the USA300 clone among community-acquired methicillin-susceptible Staphylococcus aureus causing invasive infections.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a predominant cause of community-acquired (CA) infection in the United States. 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).

Venous thrombosis associated with staphylococcal osteomyelitis in children.

Background: Venous thrombosis (VT) in children with Staphylococcus aureus osteomyelitis occurs rarely. We describe clinical features of infections and molecular characterization of isolates of children at Texas Children's Hospital with S aureus osteomyelitis and VT.

Methods: We reviewed records and imaging studies (chest radiographs, ultrasound, computed tomography, and MRI) of 9 patients at Texas Children's Hospital with acute S aureus osteomyelitis and new onset VT between August 1999 and December 2004.

Three-year surveillance of community onset health care-associated staphylococcus aureus infections in children.

Background: 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).

Methods: Prospective community-acquired S. aureus infection surveillance at Texas Children's Hospital was initiated on August 1, 2001.

Streptococcus pneumoniae serogroups 15 and 33: an increasing cause of pneumococcal infections in children in the United States after the introduction of the pneumococcal 7-valent conjugate vaccine.

Background: After the widespread use of the 7-valent pneumococcal conjugate vaccine, replacement serotypes have emerged. Serogroups 15 and 33 have emerged as nonvaccine serotypes causing invasive disease. We describe the clinical characteristics of children with infections caused by these serogroups and determined the genetic relationship of the strains.

Pulmonary manifestations in children with invasive community-acquired Staphylococcus aureus infection.

Background: Primary pneumonia and metastatic pulmonary infection have become more common in patients with invasive community-acquired Staphylococcus aureus disease at Texas Children's Hospital (TCH; Houston).

Methods: In this study, we sought to describe pulmonary involvement in children with community-acquired S. aureus invasive infection and to determine whether the presence of genes encoding Panton-Valentine leukocidin (PVL) (luk-S-PV and luk-F-PV) and collagen adhesin (cna) is correlated with pulmonary manifestations.