Pediatrics Commons^™

Detection Of Enterotoxin Gene Cluster In Staphylococcus Epidermidis Recovered From Neonatal Liver Abscess, Bishara J. Freij, Barbara E. Robinson-Dunn, Patrick M. Schlievert

Posters

• Neonatal pyogenic liver abscesses are rare • Potential routes of hepatic infection include: portal vein, biliary ducts, hepatic artery during sepsis, or direct spread from infected contiguous structures • Risk factors may include bloodstream infection, abdominal surgery, umbilical vein catheterization, total parenteral nutrition, necrotizing enterocolitis, and/or immune deficiencies • More common in premature infants at present • Variety of etiologic agents for neonatal liver abscess: Staphylococcus aureus (methicillin-susceptible and resistant), coagulase-negative staphylococci (CONS), streptococci, Escherichia coli, Klebsiella, Pseudomonas, Enterobacter, Serratia, and Candida • Umbilical stump and catheter exit site hub often colonized with CONS • CONS colonize nearly all …

Vampirism For The Microbiologist, Joudeh B. Freij, Bishara J. Freij

Posters

Vampirism has been a means to explain the cause of communicable diseases throughout the centuries.

Cross-Reactive Immunity Against The Sars-Cov-2 Omicron Variant Is Low In Pediatric Patients With Prior Covid-19 Or Mis-C., Juanjie Tang, Tanya Novak, Julian Hecker, Gabrielle Grubbs, Fatema Tuz Zahra, Lorenza Bellusci, Sara Pourhashemi, Janet Chou, Kristin Moffitt, Natasha B. Halasa, Stephanie P. Schwartz, Tracie C. Walker, Keiko M. Tarquinio, Matt S. Zinter, Mary A. Staat, Shira J. Gertz, Natalie Z. Cvijanovich, Jennifer E. Schuster, Laura L. Loftis, Bria M. Coates, Elizabeth H. Mack, Katherine Irby, Julie C. Fitzgerald, Courtney M. Rowan, Michele Kong, Heidi R. Flori, Aline B. Maddux, Steven L. Shein, Hillary Crandall, Janet R. Hume, Charlotte V. Hobbs, Adriana H. Tremoulet, Chisato Shimizu, Jane C. Burns, Sabrina R. Chen, Hye Kyung Moon, Christoph Lange, Adrienne G. Randolph, Surender Khurana

Manuscripts, Articles, Book Chapters and Other Papers

Neutralization capacity of antibodies against Omicron after a prior SARS-CoV-2 infection in children and adolescents is not well studied. Therefore, we evaluated virus-neutralizing capacity against SARS-CoV-2 Alpha, Beta, Gamma, Delta and Omicron variants by age-stratified analyses (5 years of age. As expected, convalescent pediatric COVID-19 and MIS-C cohorts demonstrate higher neutralization titers than hospitalized acute COVID-19 patients. Overall, children and adolescents show some loss of cross-neutralization against all variants, with the most pronounced loss against Omicron. In contrast to SARS-CoV-2 infection, children vaccinated twice demonstrated higher titers against Alpha, Beta, Gamma, Delta and Omicron. These findings can influence transmission, re-infection …

Effect Of Bovine Lactoferrin On Seroconversion Following Polio Vaccine Administration In Children: Protocol For A Double-Blinded Randomised Controlled Trial, Atif Habib, Sidrah Nausheen, Shanila Nooruddin, Tooba Javed, Tariq Samejo, Amjad Hussain, Suneeta Namdave, Sehrish Amirali, Muhammad Umer, Lumaan Sheikh

Department of Paediatrics and Child Health

Introduction: The oral polio vaccine (OPV) has substantial results in eliminating wild poliovirus and the vaccine of choice in polio eradication. However, the mucosal immunity induced by the OPV is still uncertain. Literature has shown that bovine lactoferrin (BLF) is a safe and useful protein found in cow's milk with extraordinary antimicrobial, antiviral, antiinflammatory and immune-modulatory functions that help children's gut to fight against micro-organisms like poliovirus. However, limited data exist regarding the effect of BLF on polio vaccine immune response. The primary objective is to evaluate the effect of BLF in enhancing mucosal and humoral immunity in children following …

Cathelicidin Anti-Microbial Peptide (Camp) Is Toxic During Neonatal Influenza Virus Infection, Nneka Ugwu

St. Chris Research Day

No abstract provided.

Burden, Clinical Characteristics, Risk Factors, And Seasonality Of Adenovirus 40/41 Diarrhea In Children In Eight Low-Resource Settings, Godfrey Guga, Sarah Elwood, Caroline Kimathi, Gagandeep Kang, Margaret N. Kosek, Aldo A M Lima, Pascal O. Bessong, Amidou Samie, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Biological & Biomedical Sciences

Background: The application of molecular diagnostics has identified enteric group adenovirus serotypes 40 and 41 as important causes of diarrhea in children. However, many aspects of the epidemiology of adenovirus 40/41 diarrhea have not been described.
Methods: We used data from the 8-site Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project birth cohort study to describe site- and age-specific incidence, risk factors, clinical characteristics, and seasonality.
Results: The incidence of adenovirus 40/41 diarrhea was substantially higher by quantitative polymerase chain reaction than enzyme immunoassay and peaked at ∼30 episodes …

A Case Of Intracranial Empyema After Bacterial Sinusitis, Eric Doane, Bhumi Shah, Robert Belfer

Rowan-Virtua Research Day

Acute sinusitis in the pediatric population is a common presentation in the emergency department. Most cases are viral and can be managed conservatively and will resolve spontaneously in 7-10 days. Even in cases of bacterial sinusitis, patients can typically be discharged with oral antibiotics and close follow up with the pediatrician.

There is however a small subset of patients who will develop a rare lethal complication, an intracranial empyema. While the incidence in the developed world has decreased as antibiotics become more available, it is still estimated to occur in up to 5% of severe cases requiring hospitalization (1) . …

Improving Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner

Research Days

Watch recording of live event

Problem Statement/Question: Although national guidelines recommend 5-7 days of oral antibiotics for most skin and soft tissue infections (SSTIs), in 2019, CMH urgent care clinics (UCCs) prescribed > 7-day courses for 42% of patients diagnosed with SSTIs. Prolonged antibiotic courses result in increased patient burden, cost and adverse events which could be prevented by prescribing shorter courses.

Background/Project Intent (Aim Statement): To increase the percentage of patients receiving 5- 7 days of oral antibiotics for SSTIs from 58% to 75% by December 31st, 2021, in CMH UCCs.

Methods (include PDSA cycles): We formed a multidisciplinary team …

Maternal Antepartum Administration Of Lactoferrin Ameliorates Neonatal Infection By Bacteremia-Producing Escherichia Coli In Mice, Charity Dunlop

Research Days

Background: E. coli is a major cause of neonatal sepsis. Vaginal pathogenic E. coli strains ascend into the pregnant uterus infecting the offspring of colonized mothers. Lactoferrin (LF) is an antibacterial and immunomodulatory glycoprotein that has been given to preterm newborns to prevent lateonset sepsis. However, the effects of maternal LF administration to prevent neonatal E. coli invasive infection have not been studied.

Objectives/Goal: Our goal was to test the hypothesis that LF pre-treatment of pregnant mice administered prenatally will significantly reduce the bacterial load in their embryos following infection with E. coli.

Methods/Design: Human LF 100 mcg/mL or placebo …

Repeat Tracheal Aspirates In Pediatric Intensive Care Patients: Understanding Clinical Application, Edward Lyon

Research Days

Background: Tracheal aspirate cultures (TA) are regularly obtained in the pediatric intensive care unit (PICU) when clinical changes in intubated or tracheostomy dependent children occur. Positive TA results are often unable to distinguish infection from colonization. There is no data describing the frequency and impact of repeated TAs on patients in the PICU.

Goal: Our objectives were to describe the frequency of repeated TAs in PICU children and emergence of multidrug resistant organisms (MDRO), identify bacterial profile of TAs, and examine antibiotic prescribing patterns related to these cultures.

Methods: A retrospective chart review occurred on 15 patients in the PICU …

Family’S Sufferings From Asymptomatic Covid: Clinicians’ Perspective, Neha Joshi Dr, Jitender Nagpal Dr, Anand Sinha Dr

Patient Experience Journal

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot …

The Who Global Tuberculosis 2021 Report - Not So Good News And Turning The Tide Back To End Tb, Chakaya Jeremiah, Eskild Petersen, Rebecca Nantanda, Brenda N. Mungai, Giovanni Battista Migliori, Farhana Amanullah, Patrick Lungu, Francine Ntoumi, Nagalingeswaran Kumarasamy

Department of Paediatrics and Child Health

Objective: To review the data presented in the 2021 WHO global TB report and discuss the current constraints in the global response.
Introduction and methods: The WHO global TB reports, consolidate TB data from countries and provide up to date assessment of the global TB epidemic. We reviewed the data presented in the 2021 report.
Results: We noted that the 2021 WHO global TB report presents a rather grim picture on the trajectory of the global epidemic of TB including a stagnation in the annual decline in TB incidence, a decline in TB notifications and an increase in estimated TB …

Knowledge And Practices On The Prevention And Management Of Diarrhea In Children Under-2 Years Among Women Dwelling In Urban Slums Of Karachi, Pakistan, Asif Khaliq, Amreen 1, Nazia Jameel, Stefanie J. Krauth

Department of Paediatrics and Child Health

Background: Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps …

Influenza Clinical Testing And Oseltamivir Treatment In Hospitalized Children With Acute Respiratory Illness, 2015-2016., Lubna Hamdan, Varvara Probst, Zaid Haddadin, Herdi Rahman, Andrew J. Spieker, Simon Vandekar, Laura S. Stewart, John V. Williams, Julie A. Boom, Flor Munoz, Janet A. Englund, Rangaraj Selvarangan, Mary A. Staat, Geoffrey A. Weinberg, Parvin H. Azimi, Eileen J. Klein, Monica Mcneal, Leila C. Sahni, Monica N. Singer, Peter G. Szilagyi, Christopher J. Harrison, Manish Patel, Angela P. Campbell, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Antiviral treatment is recommended for all hospitalized children with suspected or confirmed influenza, regardless of their risk profile. Few data exist on adherence to these recommendations, so we sought to determine factors associated with influenza testing and antiviral treatment in children.

METHODS: Hospitalized children(ARI) were enrolled through active surveillance at pediatric medical centers in seven cities between 11/1/2015 and 6/30/2016; clinical information was obtained from parent interview and chart review. We used generalized linear mixed-effects models to identify factors associated with influenza testing and antiviral treatment.

RESULTS: Of the 2299 hospitalized children with ARI enrolled during one influenza season, …

Kaposiform Lymphangiomatosis Presenting With A Group A Streptococcus Pericardial Effusion, Taylor Koerner, Mehul D Patel, Vinay Pai, Gitanjali Indramohan

Faculty, Staff and Student Publications

A 4-year-old child was transferred to the paediatric intensive care unit with acute respiratory failure following 4 days of fever, nausea and vomiting. Chest X-ray on admission had an enlarged cardiac silhouette and transthoracic echo confirmed a large pericardial effusion. An emergent pericardiocentesis was performed at bedside which drained nearly 1000 mL of purulent fluid. Postdrainage course was complicated by acute systolic and diastolic heart failure, thrombocytopenia and acute renal failure. A chest CT and MRI were concerning for a diffuse mediastinal soft-tissue density, so the patient underwent interventional radiology-guided biopsy complicated by haemorrhage requiring mediastinal exploration and subtotal thymectomy. …

Factors Associated With Penicillin Allergy Labels In Electronic Health Records Of Children In 2 Large Us Pediatric Primary Care Networks, Margaret G Taylor, Torsten Joerger, Yun Li, Michael E Scheurer, Michael E Russo, Jeffrey S Gerber, Debra L Palazzi

Faculty, Staff and Students Publications

IMPORTANCE: Penicillin allergy labels influence clinical decision-making, yet most children who are labeled do not have type 1 hypersensitivity allergic reactions and instead have a history of predictable adverse reactions or unspecified illness symptoms while receiving penicillin for viral infections. Studies describing penicillin allergy labeling in the pediatric outpatient setting are lacking.

OBJECTIVE: To describe the epidemiology and factors associated with penicillin allergy labels across 2 large US pediatric primary care networks.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, longitudinal birth cohort study was conducted in 90 primary care pediatric practices serving a diverse population of children across Houston, Texas, Austin, …

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …

Contact Dermatitis Due To Personal Protective Equipment Use And Hygiene Practices During The Covid-19 Pandemic: A Systematic Review Of Case Reports, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Miguel Felix, Jonathan A. Bernstein, Luz Fonacier, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Prolonged use of personal protective equipment (PPE) may lead to contact dermatitis during the coronavirus disease 19 (COVID-19) pandemic. This paper aims to identify the causative factors of contact dermatitis from PPE and hygiene practices.
Methods: The search was conducted adhering to PRISMA 2020 guidelines. A Delphi process was employed to ensure that the aims of this study were met. PubMed and Web of Science databases were systematically searched through September 12, 2021, using search terms: Contact dermatitis, case report, covid-19. The findings were tabulated as author/year, gender, age, presentation, cause, dermatological diagnosis, testing modality, provided treatment, symptom resolution …

Clinical Influenza Testing Practices In Hospitalized Children At United States Medical Centers, 2015-2018., Mark W. Tenforde, Angela P. Campbell, Marian G. Michaels, Christopher J. Harrison, Eileen J. Klein, Janet A. Englund, Rangaraj Selvarangan, Natasha B. Halasa, Laura S. Stewart, Geoffrey A. Weinberg, John V. Williams, Peter G. Szilagyi, Mary A. Staat, Julie A. Boom, Leila C. Sahni, Monica N. Singer, Parvin H. Azimi, Richard K. Zimmerman, Monica M. Mcneal, H Keipp Talbot, Arnold S. Monto, Emily T. Martin, Manjusha Gaglani, Fernanda P. Silveira, Donald B. Middleton, Jill M. Ferdinands, Melissa A. Rolfes

Manuscripts, Articles, Book Chapters and Other Papers

At nine US hospitals that enrolled children hospitalized with acute respiratory illness (ARI) during 2015-2016 through 2017-2018 influenza seasons, 50% of children with ARI received clinician-initiated testing for influenza and 35% of cases went undiagnosed due to lack of clinician-initiated testing. Marked heterogeneity in testing practice was observed across sites.

Effectiveness Of Bnt162b2 (Pfizer-Biontech) Mrna Vaccination Against Multisystem Inflammatory Syndrome In Children Among Persons Aged 12-18 Years - United States, July-December 2021., Laura D. Zambrano, Margaret M. Newhams, Samantha M. Olson, Natasha B. Halasa, Ashley M. Price, Julie A. Boom, Leila C. Sahni, Satoshi Kamidani, Keiko M. Tarquinio, Aline B. Maddux, Sabrina M. Heidemann, Samina S. Bhumbra, Katherine E. Bline, Ryan A. Nofziger, Charlotte V. Hobbs, Tamara T. Bradford, Natalie Z. Cvijanovich, Katherine Irby, Elizabeth H. Mack, Melissa L. Cullimore, Pia S. Pannaraj, Michele Kong, Tracie C. Walker, Shira J. Gertz, Kelly N. Michelson, Melissa A. Cameron, Kathleen Chiotos, Mia Maamari, Jennifer E. Schuster, Amber O. Orzel, Manish M. Patel, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious hyperinflammatory condition, which generally occurs 2-6 weeks after a typically mild or asymptomatic infection with SARS-CoV-2, the virus that causes COVID-19 (1-3). In the United States, the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine is currently authorized for use in children and adolescents aged 5-15 years under an Emergency Use Authorization and is fully licensed by the Food and Drug Administration for persons aged ≥16 years (4). Prelicensure randomized trials in persons aged ≥5 years documented high vaccine efficacy and immunogenicity (5),§ and real-world studies in persons aged 12-18 years demonstrated high vaccine …

Implementation Of The Comprehensive Unit-Based Safety Program To Improve Infection Prevention And Control Practices In Four Neonatal Intensive Care Units In Pune, India, Julia Johnson, Asad Latif, Bharat Randive, Abhay Kadam, Uday Rajput, Aarti Kinikar, Nandini Malshe, Sanjay Lalwani, Tushar B. Parikh, Umesh Vaidya

Department of Anaesthesia

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.
Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate …

Effectiveness Of Stricter Vaccine Mandates In Public Schools And Childcare Centers, Anna Ferentinos

Emerging Writers

Vaccines have been a controversial and frequently discussed topic the last two years due to the COVID-19 pandemic. The amount of readily available information on the internet - accurate or not – has led to many theories and opinions on whether to vaccinate and why, or why not. This article discusses these theories, as well as the benefits and consequences of vaccine mandates, with the help of examples from other countries. The author argues that a federal vaccine mandate should be implemented in the United States of America so as to encourage parents to protect children through scheduled immunizations.

Central Line Associated Bloodstream Infection Caused By Kodamaea Ohmeri In A Young Child, Amier Haidar, Farhana Khaja, Brian Simms, Amr Issam Elgehiny, Tracy Omoegbele, Nikita Khetan

Faculty, Staff and Student Publications

INTRODUCTION:

CASE REPORT: The patient is a 5-year-old male with a history of short gut syndrome, and total parenteral nutrition (TPN) dependence who presented to the emergency room with a two-day history of productive-cough, rhinorrhea, and fever. Antibiotic therapy was initiated with cefepime and vancomycin for suspected CLABSI. However, within the first twenty-four hours of his admission, his initial blood culture from his central venous catheter became positive for yeast so fluconazole was added due to suspicion of candidemia. During his admission, his initial central line and peripheral blood culture were later speciated as

CONCLUSIONS: This case report further acknowledges …

Multiplex Pcr Pathogen Detection In Acute Gastroenteritis Among Hospitalized Us Children Compared With Healthy Controls During 2011-2016 In The Post-Rotavirus Vaccine Era., Christopher J. Harrison, Ferdaus Hassan, Brian R. Lee, Julie Boom, Leila C. Sahni, Coreen Johnson, James Dunn, Daniel C. Payne, Mary E. Wikswo, Umesh Parashar, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

Background: Despite vaccine-induced decreases in US rotavirus (RV) disease, acute gastroenteritis (AGE) remains relatively common. We evaluated AGE pathogen distribution in hospitalized US children in the post-RV vaccine era.

Methods: From December 2011 to June 2016, the New Vaccine Surveillance Network (NVSN) conducted prospective, active, population-based surveillance in hospitalized children with AGE. We tested stools from 2 NVSN sites (Kansas City, Houston) with Luminex x-TAG Gastrointestinal Pathogen Panels (Luminex GPP) and analyzed selected signs and symptoms.

Results: For 660 pediatric AGE inpatients and 624 age-matched healthy controls (HCs), overall organism detection was 51.2% and 20.6%, respectively (P < .001). Among AGE subjects, GPP polymerase chain reaction detected >1 virus …

Rotavirus Genotype Trends And Gastrointestinal Pathogen Detection In The United States, 2014-2016: Results From The New Vaccine Surveillance Network., Mathew D. Esona, M Leanne Ward, Mary E. Wikswo, Slavica M. Rustempasic, Rashi Gautam, Charity Perkins, Rangaraj Selvarangan, Christopher J. Harrison, Julie A. Boom, Janet A. Englund, Eileen J. Klein, Mary Allen Staat, Monica M. Mcneal, Natasha Halasa, James Chappell, Geoffrey A. Weinberg, Daniel C. Payne, Umesh D. Parashar, Michael D. Bowen

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Following the implementation of rotavirus vaccination in 2006, severe acute gastroenteritis (AGE) due to group A rotavirus (RVA) has substantially declined in US children. We report the RVA genotype prevalence as well as coinfection data from 7 US New Vaccine Surveillance Network sites during 3 consecutive RVA seasons, 2014-2016.

METHODS: A total of 1041 stool samples that tested positive for RVA by Rotaclone enzyme immunoassay were submitted to the Centers for Disease Control and Prevention (CDC) for RVA genotyping and multipathogen testing.

RESULTS: A total of 795 (76%) samples contained detectable RVA when tested at the CDC. Rotavirus disease …

Effectiveness Of Pfizer-Biontech Mrna Vaccination Against Covid-19 Hospitalization Among Persons Aged 12-18 Years - United States, June-September 2021., Samantha M. Olson, Margaret M. Newhams, Natasha B. Halasa, Ashley M. Price, Julie A. Boom, Leila C. Sahni, Katherine Irby, Tracie C. Walker, Stephanie P. Schwartz, Pia S. Pannaraj, Aline B. Maddux, Tamara T. Bradford, Ryan A. Nofziger, Benjamin J. Boutselis, Melissa L. Cullimore, Elizabeth H. Mack, Jennifer E. Schuster, Shira J. Gertz, Natalie Z. Cvijanovich, Michele Kong, Melissa A. Cameron, Mary A. Staat, Emily R. Levy, Brandon M. Chatani, Kathleen Chiotos, Laura D. Zambrano, Angela P. Campbell, Manish M. Patel, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Pfizer-BioNTech COVID-19 vaccine is authorized for use in children and adolescents aged 12-15 years and is licensed by the Food and Drug Administration (FDA) for persons aged ≥16 (1). A randomized placebo-controlled trial demonstrated an efficacy of 100% (95% confidence interval [CI] = 75.3%-100%) in preventing outpatient COVID-19 in persons aged 12-15 years (2); however, data among adolescents on vaccine effectiveness (VE) against COVID-19 in real-world settings are limited, especially among hospitalized patients. In early September 2021, U.S. pediatric COVID-19 hospitalizations reached the highest level during the pandemic (3,4). In a test-negative, case-control study at 19 pediatric hospitals in 16 …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Data-Driven Clustering Identifies Features Distinguishing Multisystem Inflammatory Syndrome From Acute Covid-19 In Children And Adolescents., Alon Geva, Manish M. Patel, Margaret M. Newhams, Cameron C. Young, Mary Beth F. Son, Michele Kong, Aline B. Maddux, Mark W. Hall, Becky J. Riggs, Aalok R. Singh, John S. Giuliano, Charlotte V. Hobbs, Laura L. Loftis, Gwenn E. Mclaughlin, Stephanie P. Schwartz, Jennifer E. Schuster, Christopher J. Babbitt, Natasha B. Halasa, Shira J. Gertz, Sule Doymaz, Janet R. Hume, Tamara T. Bradford, Katherine Irby, Christopher L. Carroll, John K. Mcguire, Keiko M. Tarquinio, Courtney M. Rowan, Elizabeth H. Mack, Natalie Z. Cvijanovich, Julie C. Fitzgerald, Philip C. Spinella, Mary A. Staat, Katharine N. Clouser, Vijaya L. Soma, Heda Dapul, Mia Maamari, Cindy Bowens, Kevin M. Havlin, Peter M. Mourani, Sabrina M. Heidemann, Steven M. Horwitz, Leora R. Feldstein, Mark W. Tenforde, Jane W. Newburger, Kenneth D. Mandl, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Multisystem inflammatory syndrome in children (MIS-C) consensus criteria were designed for maximal sensitivity and therefore capture patients with acute COVID-19 pneumonia.

Methods: We performed unsupervised clustering on data from 1,526 patients (684 labeled MIS-C by clinicians)clusters, followed by recursive feature elimination to identify characteristics of potentially misclassified MIS-C-labeled patients.

Findings: Of 94 clinical features tested, 46 were retained for clustering. Cluster 1 patients (N = 498; 92% labeled MIS-C) were mostly previously healthy (71%), with mean age 7·2 ± 0·4 years, predominant cardiovascular (77%) and/or mucocutaneous (82%) involvement, high inflammatory biomarkers, and mostly SARS-CoV-2 PCR negative (60%). Cluster …

Mid-Upper Arm Circumference Assessment And Comparison With Weight For Length Z-Score In Infants ≤6 Months As An Indicator Of Severe Acute Malnutrition, Mahjabeen Zehra, Ali Faisal Saleem, Zaubina Kazi, Sadia Parkar

Department of Paediatrics and Child Health

Objective: To assess the frequency of severe acute malnutrition (SAM) and to determine the validity of mid-upper arm circumference (MUAC) as compared to weight for length z-score (WLZ-score) as an indicator of the nutritional status in this age group.
Methods: A cross-sectional study, with a purposive sampling was conducted from March 2018 to November 2018 to enroll 540 infants ≤6 months of age from three different sites in Karachi, Pakistan. The anthropometric measurements (MUAC, length and weight) were taken by experienced community health workers. The data were analyzed using SPSS. MUAC was compared with WLZ-score for sensitivity and specificity to …

Impact Of Pulse Oximetry On Hospital Referral Acceptance In Children Under 5 With Severe Pneumonia In Rural Pakistan (District Jamshoro): Protocol For A Cluster Randomised Trial, Fatima Mir, Apsara Ali, Suhail Chanar, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Pneumonia is a leading cause of death among children under 5 specifically in South Asia and sub-Saharan Africa. Hypoxaemia is a life-threatening complication among children under 5 with pneumonia. Hypoxaemia increases risk of mortality by 4.3 times in children with pneumonia than those without hypoxaemia. Prevalence of hypoxaemia varies with geography, altitude and severity (9%-39% Asia, 3%-10% African countries). In this protocol paper, we describe research methods for assessing impact of Lady Health Workers (LHWs) identifying hypoxaemia in children with signs of pneumonia during household visits on acceptance of hospital referral in district Jamshoro, Sindh.
Methods and analysis: A …