Most Read Articles
01 Apr 2013
Aspergillus colonization may lead to an increase in the risk of bronchiolitis obliterans syndrome. This study determined the impact of colonization of conidia Aspergillus species after post lung transplantation.
5 days ago
No standard currently exists for the growing number of patients with multidrug-resistant strains of Helicobacter pylori, but a recent study has shown the safety and reliability of a 12-day low-dose rifabutin/high-dose proton pump inhibitor (PPI) regimen in patients infected with triple-resistant strains.
Roshini Claire Anthony, 10 Jan 2018

Adding rifampicin to standard antibiotic therapy does not improve outcomes in individuals with Staphylococcus aureus (S. aureus) bacteraemia, the ARREST* trial shows. However, rifampicin may contribute towards a minor reduction in bacteraemia recurrence.

14 Jan 2018
Patients with a first episode of Clostridium difficile infection (CDI) are likely to respond to treatment with fidaxomicin with no recurrences, a recent study has shown. On the other hand, those with prior CDI episodes are less likely to respond, especially with >1 prior episode, and more likely to recur, which suggests a greater clinical benefit of fidaxomicin earlier in the course of CDI.

Guidelines lack capacity to predict serious infections in febrile infants

10 Jan 2018
Newborn infant baby boy receiving phototherapy for jaundice at the hospital.

For febrile infants younger than 3 months old, current heart rate guidelines have variable performances, a recent Singapore study has found. Particularly, while the Advanced Paediatric Life Support (APLS) guideline had the greatest sensitivity, no individual guideline could satisfactorily predict serious infections (SIs).

A retrospective review of 1,057 infants (mean age 1.1±1.0 months), recruited from the KK Women’s and Children’s Hospital in Singapore, showed that the rate of SIs was 30.8 percent (n=326). A larger proportion of infants with SIs were administered ampicillin and gentamicin after admission (p<0.001 for both).

Univariate analysis identified temperature (p<0.001), heart rate (p=0.006), triage category (p=0.019), and Severity Index Score (SIS) category (p=0.005), total white blood cell count (p<0.001), absolute neutrophil count (p<0.001), platelet count (p=0.001) and C-reactive protein concentrations (p<0.001) as significantly predictive of SIs.

The most common SI was urinary tract infection, observed in 178 infants. The most common pathogens associated with this infection were Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis. Meningitis (n=112), septicaemia (n=21), and lobar pneumonia (n=7) were also commonly observed, with E. coli as a common cause.

Aside from the APLS, the Fleming normal reference values also resulted in a high sensitivity for abnormal heart rate (66.0 and 62.6 percent, respectively). Both also had the highest negative predictive values (73.3 and 71.4 percent, respectively).

In contrast, the Paediatric Canadian Triage and Acuity Scale yielded corresponding values of 23.0 and 69.5 percent. None of the guidelines examined reached a sensitivity of >70 percent.

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Most Read Articles
01 Apr 2013
Aspergillus colonization may lead to an increase in the risk of bronchiolitis obliterans syndrome. This study determined the impact of colonization of conidia Aspergillus species after post lung transplantation.
5 days ago
No standard currently exists for the growing number of patients with multidrug-resistant strains of Helicobacter pylori, but a recent study has shown the safety and reliability of a 12-day low-dose rifabutin/high-dose proton pump inhibitor (PPI) regimen in patients infected with triple-resistant strains.
Roshini Claire Anthony, 10 Jan 2018

Adding rifampicin to standard antibiotic therapy does not improve outcomes in individuals with Staphylococcus aureus (S. aureus) bacteraemia, the ARREST* trial shows. However, rifampicin may contribute towards a minor reduction in bacteraemia recurrence.

14 Jan 2018
Patients with a first episode of Clostridium difficile infection (CDI) are likely to respond to treatment with fidaxomicin with no recurrences, a recent study has shown. On the other hand, those with prior CDI episodes are less likely to respond, especially with >1 prior episode, and more likely to recur, which suggests a greater clinical benefit of fidaxomicin earlier in the course of CDI.