Publications by authors named "Toltzis P"
Background: Community-associated infection is a major public health hazard to adults and older children. Infants frequently excrete toxigenic asymptomatically in their stool, but their importance as a community reservoir of is uncertain.
Methods: Families of healthy infants were recruited at the baby's 4-month well child visit and were followed longitudinally until the baby was approximately 9 months old.
Introduction: Respiratory tract infections (RTIs) are common in children with tracheostomy tubes. Anecdotally, inhaled antibiotics are commonly prescribed, although to date there are no studies describing their use in this patient population. The objective of this study was to assess the variability of this practice at a single tertiary care children's hospital.
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- Blood culture overuse in pediatric intensive care can lead to unnecessary antibiotic use, which contributes to antibiotic resistance, making it crucial to optimize blood culture practices.
- A study evaluated a quality improvement initiative across 14 PICUs that aimed to reduce blood culture rates, antibiotic use, and improve patient outcomes from 2017 to 2020.
- Results showed a significant 33% reduction in blood culture rates and a 13% decrease in broad-spectrum antibiotic use, indicating that the collaborative initiative was effective in promoting better antibiotic stewardship in these units.
Tracheobronchitis is common in children with tracheostomy tubes. These children are predisposed to respiratory infections due to the bypassing of normal upper airway defense mechanisms by the tracheostomy, bacterial colonization of the tracheostomy tube itself, and underlying medical conditions. Diagnosis of bacterial tracheobronchitis is challenging due to the difficulty in differentiating between bacterial colonization and infection, as well as between viral and bacterial etiologies.
View Article and Find Full Text PDFCurrent guidelines recommend sampling each central-access lumen during the initial evaluation of febrile pediatric oncology patients. We investigated this recommendation's validity at centers implementing a diagnostic stewardship program to reduce blood cultures in critically ill children. Among 146 oncology patients admitted to the intensive care unit, there were 34 eligible blood culture-sets.
View Article and Find Full Text PDFBackground: Infants asymptomatically excrete Clostridioides difficile during their first year of life, suggesting that they may represent a source of infection for adults who acquire community-associated C. difficile infection (CA-CDI). The genetic relationship of C.
View Article and Find Full Text PDFObjectives: To describe antibiotic prescribing practices during the first 2 days of mechanical ventilation among previously healthy young children with respiratory syncytial virus-associated lower respiratory tract infection and evaluate associations between the prescription of antibiotics at onset of mechanical ventilation with clinical outcomes.
Design: Retrospective cohort study.
Setting: Forty-six children's hospitals in the United States.