The role of antimicrobial therapy for treatment of uncomplicated skin and soft tissue infections from community-acquired methicillin-resistant Staphylococcus aureus in children.

Background And Purpose: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in skin and soft tissues are increasing in children in Taiwan. This study investigated the outcomes of therapy with or without appropriate antibiotics among children with CA-MRSA skin and soft tissue infections (SSTIs), and analyzed the outcomes of management among children with Panton-Valentine leukocidin (PVL)-positive strains and PVL-negative strains.

Methods: In this retrospective study, data for CA-MRSA SSTIs from 107 children younger than 18 years were analyzed.

Changing trend in antimicrobial resistance of pediatric uropathogens in Taiwan.

Background: There is growing concern regarding antimicrobial resistance worldwide, particularly of Escherichia coli, and the first choice of an antimicrobial agent for empiric treatment of pediatric urinary tract infection (UTI) is not well established.

Methods: The medical records from January 1991 to December 2005 for all children under 18 years of age admitted to Tri-Service General Hospital, Taipei for their first UTI were reviewed. Two study periods, early (1991-2000) and late (2001-2005), were chosen during the 15 year period for evaluating the trend of antimicrobial resistance.

Risk factors and molecular analysis of panton-valentine leukocidin-positive methicillin-resistant Staphylococcus aureus colonization in healthy children.

Background: Nasal carriage of Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is associated with community associated disease. The risk factors for and characteristics of PVL-positive MRSA colonization in the healthy pediatric population are not well understood.

Methods: Anterior nares cultures were obtained from healthy children < or =14 years of age presenting for health maintenance visits or attending 1 of 8 kindergartens during a 3-year period.

Low rate of nasopharyngeal carriage and high rate of ampicillin resistance for Haemophilus influenzae among healthy children younger than 5 years old in northern Taiwan.

Background And Purpose: Surveillance data of colonization by Haemophilus influenzae in Taiwan are lacking. This study aimed to define the nasopharyngeal carriage rate of H. influenzae among children younger than 5 years in northern Taiwan, and to determine the antibiotic susceptibility, serotype and the clonal relationship of these isolates.

Nasal carriage of a single clone of community-acquired methicillin-resistant Staphylococcus aureus among kindergarten attendees in northern Taiwan.

Background: To evaluate the prevalence and microbiological characterization of community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in a kindergarten.

Methods: Point prevalence study. Nasal swabs were collected from healthy children younger than 7 years of age who were attending a kindergarten in Taipei, Taiwan.

Does a normal DMSA obviate the performance of voiding cystourethrography in evaluation of young children after their first urinary tract infection?

Objective: To determine whether a normal technetium-99m-labeled dimercaptosuccinic acid (DMSA) renal scan obviates the need for voiding cystourethrography (VCUG) in evaluating young children after their first urinary tract infection (UTI).

Study Design: This was a 10-year retrospective review of 142 children (age < or = 2 years, 77 boys and 65 girls) who had their first UTI and were admitted to a tertiary care general hospital. The association between DMSA renal scan results and VCUG results performed 48 hours and 1 month after diagnosis was evaluated.

Safety monitoring in vaccine development and immunization.

The development of vaccines has been one of the most important achievement in preventive medicine. As the incidence of vaccine-preventable diseases is reduced by immunization, general public becomes increasingly concerned about the safety associated with vaccine. Vaccine safety is extensively evaluated through animal safety studies, clinical trials, during manufacturing processes, and postlicensure surveillance.

Methicillin-resistant Staphylococcus aureus in children, Taiwan.

Highly virulent community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) with Panton-Valentine leukocidin (PVL) is common worldwide. Using antimicrobial drug susceptibility testing, staphylococcal cassette chromosome mec typing, exotoxin profiling, and pulsed-field gel electrophoresis typing, we provide evidence that supports the relationship between nasal strains of PVL-positive MRSA and community-acquired disease.

Bacteriology and antibiotic susceptibility of community-acquired intra-abdominal infection in children.

Background And Purpose: Intra-abdominal infection can be a life-threatening condition in children, and aggressive treatment is usually needed. The treatment should include surgical correction and drainage, and administration of antimicrobials that are effective against both aerobic and anaerobic microorganisms. This study investigated the microbiological characteristics of intra-abdominal infection of children in Taiwan.

Antimicrobial resistance patterns and serotype distribution of invasive Streptococcus pneumoniae isolates from children in Taiwan from 1999 to 2004.

Streptococcus pneumoniae causes substantial morbidity and mortality worldwide. Because only limited data are available for the antibiotic resistance patterns and seroepidemiology of invasive S. pneumoniae isolates in Taiwanese children, this national surveillance of invasive pneumococcal infections in children was conducted during a 5-year period.

Kinetic Th1/Th2 responses of transgenic mice with bacterial meningitis induced by Haemophilus influenzae.

To investigate the kinetic Th1/Th2 immunopathogenic mechanisms of Haemophilus influenzae meningitis, we established a murine experimental model of meningitis and elucidated the Th1/Th2 immune responses in T1/T2 doubly transgenic mice based on a BALB/c background under the control of the IFN-gamma (interferon-gamma)/IL-4 (interleukin-4) promoters respectively. NTHi (non-typeable Haemophilus influenzae) meningitis was induced in these mice by inoculation with either a colonized (CNTHi) or invasive (INTHi) strain of NTHi. Mice inoculated with CNTHi displayed a less severe degree of disease in terms of clinical symptoms, mortality rate and brain histopathology.

Kinetics of adaptive immunity to Haemophilus influenzae type b meningitis in transgenic mice: evidence from diverse expression of double T1/T2 transgenes and Th1/Th2-related cytokines.

To investigate the kinetic changes in adaptive immunity during experimental Haemophilus influenzae type b (Hib) meningitis, we established a murine meningitis model based on T1/T2 doubly transgenic mice. These mice carry two transgenes that express two distinct cell-surface markers: a human Thy1 transgene (hThy1) under the control of the murine IFN-gamma promoter, and a murine Thy1.1 transgene (mThy1.

Dizygotic twins discordant for early-onset Citrobacter koseri and group B streptococcal sepsis.

Early-onset neonatal sepsis is usually a multisystem fulminant illness with prominent respiratory symptoms, and typically the infant has acquired the organism from the maternal genital tract during the intrapartum period. In this article, we report a rare case of dizygotic twins where each individual suffered early-onset sepsis caused by a different pathogen. Group B streptococcal (GBS) sepsis was diagnosed in twin A 1 day after birth; sepsis and meningitis caused by Citrobacter koseri was diagnosed in twin B at the age of the 4 days.

Cat-scratch disease in children at a medical center.

Background: Cat-scratch disease (CSD) is a well-recognized, benign, self-limited regional lymphadenopathy occurring in immunocompetent patients. Several retrospective studies have demonstrated that CSD occurs at all ages, however, the disease appears to be more common in children. We conducted a retrospective case study of CSD in children presenting at our hospital, and reviewed the relevant literature.

Epidemiological typing of community-acquired methicillin-resistant Staphylococcus aureus isolates from children in Taiwan.

Background: A 1400-bed tertiary medical center in northern Taiwan was used to conduct an epidemiological study of children hospitalized with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection during a 5-year period.

Methods: Nineteen previously healthy children with predominantly skin and soft-tissue CA-MRSA infections were enrolled into the study. Seventeen CA-MRSA isolates were examined for antimicrobial susceptibility and molecular typing.

Enterotoxin B is the predominant toxin involved in staphylococcal scarlet fever in Taiwan.

This study retrospectively reviewed all pediatric cases of staphylococcal scarlet fever (SSF) that occurred during a 10-year period in a 1400-bed tertiary medical center in northern Taiwan. All 20 cases of SSF occurred in previously healthy individuals. Skin and soft-tissue infections predominated among children from whom Staphylococcus aureus was isolated.

Rate of nasopharyngeal carriage, antimicrobial resistance and serotype of Streptococcus pneumoniae among children in northern Taiwan.

Multiple-antibiotic-resistant strains of Streptococcus pneumoniae are isolated from clinical specimens in Taiwan with increasing frequency. This study aimed to define the carriage rate of S. pneumoniae among children in northern Taiwan, and to determine the antibiotic susceptibility and the serotype incidence of these isolates.

Early onset neonatal infection with Neisseria meningitidis serogroup C: case report and literature review.

Although Neisseria meningitidis is one of the major causes of meningitis in children and adolescents, meningococcal disease should also be considered as part of the differential diagnoses in the newborn period.

Acute septicaemic acalculous cholecystitis complicated by empyema caused by Salmonella group D in a previously healthy child.

Unlabelled: We describe a rare case of acute acalculous cholecystitis (AC) due to Salmonella group D infection in a previously healthy child who developed gall bladder empyema and bacteraemia. Salmonella group D was recovered from blood culture, as well as cultures of stool, bile and gall bladder wall samples. The patient was successfully treated using cholecystectomy in combination with ceftriaxone therapy.

Epidemiology of invasive pneumococcal infection in Taiwan: antibiotic resistance, serogroup distribution, and ribotypes analyses.

From July, 1998, to June, 1999, pneumococcal isolates from 288 patients with invasive disease in Taiwan were serogrouped and tested for their susceptibility to various antibiotics. Automated ribotyping was used to study their molecular epidemiology. The mortality rate among those > or = 65 years was higher than those 18 or 19-64 years (p < 0.

Clinical characteristics of Staphylococcal pyomyositis.

Pyomyositis is common in the tropics but rarely reported in temperate climates. This disease may give rise to obscure, non-specific, or misleading signs and symptoms. Delayed diagnosis and treatment may lead to death.

A nursery outbreak of Staphylococcus aureus pyoderma originating from a nurse with paronychia.

An outbreak of methicillin-susceptible Staphylococcus aureus pyoderma occurred in the nursery of a tertiary-care referral center. All strains retrieved from the outbreak, including one from a nurse's infected finger, were typed by arbitrarily primed polymerase chain reaction and automated ribotyping. The results indicated that the spread of the outbreak was probably facilitated by contamination of the nurse with paronychia.