Pediatrics Commons^™

Increased Red Cell Distribution Width (Rdw) Is Associated With Culture Positive Sepsis And With Increased Need Of Escalation In Respiratory Support In Very Low Birth Weight Infants More Than Seven Days Of Life Undergoing Sepsis Workup Secondary To Vitals Instability In The Form Of Multiple Episodes Of True Apneas Or Bradycardia And Desaturations Associated With Apnea, Kedar Tilak, Aashka Patel, Anna Zylak

Posters

Background Apnea of prematurity is nearly universal among very low birth weight infants (VLBW). In VLBW infants, changes in clinical status usually occur due to sepsis or non-infectious causes and it is challenging to differentiate between the two. We as clinicians use irregularities in vital signs as an early warning sign of sepsis to facilitate early treatment and improve patient outcomes. Adults have used RDW as a marker of worsening respiratory status and mortality from acute respiratory distress syndrome (ARDS). In this study, we seek to investigate elevations in Red Cell Distribution Width (RDW) as markers for culture positive sepsis …

Relative Effectiveness And Immunogenicity Of Quadrivalent Recombinant Influenza Vaccine Versus Egg-Based Inactivated Influenza Vaccine Among Adults Aged 18-64 Years: Results And Experience From A Randomized, Double-Blind Trial, Lauren Grant, Jennifer A Whitaker, Sarang K Yoon, Karen Lutrick, Shivam Bhargava, C Perry Brown, Emily Zaragoza, Rebecca V Fink, Jennifer Meece, Kristina Wielgosz, Hana El Sahly, Kurt T Hegmann, Ashley A Lowe, Alia Southworth, Tanya Tatum, Sarah W Ball, Min Z Levine, Matthew S Thiese, Steph Battan-Wraith, John Barnes, Andrew L Phillips, Alicia M Fry, Fatimah S Dawood, Randomized Assessment Of Influenza Vaccine Efficacy Network (Raiven)

Faculty, Staff and Students Publications

BACKGROUND: Immunogenicity studies suggest that recombinant influenza vaccine (RIV) may provide better protection against influenza than standard-dose inactivated influenza vaccines (SD IIV). This randomized trial evaluated the relative vaccine effectiveness (VE) and immunogenicity of RIV versus SD IIV in frontline workers and students aged 18-64 years.

METHODS: Participants were randomized to receive RIV or SD IIV and followed for reverse-transcription polymerase chain reaction (RT-PCR)-confirmed influenza during the 2022-2023 influenza season. Sera were collected from a subset of participants before and at 1 and 6 months postvaccination and tested by hemagglutination inhibition for A/H1N1, A/H3N2, B/Yamagata, and B/Victoria and against cell-grown …

Atypical Hemolytic Uremic Syndrome Following Influenza B: A Case Report, Kathryn E. Mcgraw, Amanda P. Porter, Alyssa M. Moffitt, Marina E M Golden, Heather Stewart

HCA Healthcare Journal of Medicine

Background

Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy that presents with a triad of hemolytic anemia, thrombocytopenia, and acute kidney impairment. It can be attributed to mutations in an array of different complement proteins leading to the overactivation of the complement system, the most impacted being the alternative pathway. Though rare, influenza B has been documented as a potential trigger to the development of aHUS.

Case Presentation

We discuss a 10-year-old girl with a history of aHUS who was found to have a repeat episode of aHUS following an influenza B infection. There have only been a few …

Infant And Adult Human Intestinal Enteroids Are Morphologically And Functionally Distinct, Grace O Adeniyi-Ipadeola, Julia D Hankins, Amal Kambal, Xi-Lei Zeng, Ketki Patil, Victoria Poplaski, Carolyn Bomidi, Hoa Nguyen-Phuc, Sandra L Grimm, Cristian Coarfa, Fabio Stossi, Sue E Crawford, Sarah E Blutt, Allison L Speer, Mary K Estes, Sasirekha Ramani

Faculty, Staff and Students Publications

UNLABELLED: Human intestinal enteroids (HIEs) are gaining recognition as physiologically relevant models of the intestinal epithelium. While HIEs from adults are used extensively in biomedical research, few studies have used HIEs from infants. Considering the dramatic developmental changes that occur during infancy, it is important to establish models that represent infant intestinal characteristics and physiological responses. We established jejunal HIEs from infant surgical samples and performed comparisons to jejunal HIEs from adults using RNA sequencing (RNA-Seq) and morphologic analyses. We then validated differences in key pathways through functional studies and determined whether these cultures recapitulate known features of the infant …

Trends Of Methicillin-Resistant Staphylococcus Aureus Infections Among Thai Pediatric Patients, Pintip Suchartlikitwong, Nopphon Wuthinantiwong, Watsamon Jantarabenjakul, Noppadol Wacharachaisurapol, Jiratchaya Sophonphan, Tanittha Chatsuwan, Thanyawee Puthanakit

Chulalongkorn Medical Journal

Background While reductions in methicillin-resistant Staphylococcus aureus (MRSA) infections have been reported, vancomycin prescription rates have remained high.

Objectives We aimed to update trends in pediatric prevalence and antibiotic susceptibilities of MRSA infections.

Methods We conducted a retrospective study in patients aged S. aureus infections during 2016-2022 at a Thai tertiary-care hospital. MRSA was defined when resistant to cefoxitin or oxacillin MIC of >4 µg/mL. Patients with MRSA infections and their first isolates were classified into HA-MRSA or CA-MRSA based on surveillance definitions. Antibiotic susceptibilities were tested using the VITEK 2XL automated system and disk diffusion. The annual prevalence of …

School Knowledge Of Infectious Diseases In Schools: Conducting Surveillance And On-Demand, Symptomatic Respiratory Viral Testing In A Large Pre-Kindergarten-12th Grade School District., Jennifer E. Schuster, Tamoor T Chohdry, Chris T. Young, Brian R. Lee, Dithi Banerjee, Anjana Sasidharan, Olivia M Almendares, Hannah L Kirking, Janelle Porter, Anila Deliu, Shannon Tilsworth, Rangaraj Selvarangan, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Limited data about acute respiratory illness (ARI) and respiratory virus circulation are available in congregate community settings, specifically schools. To better characterize the epidemiology of ARI and respiratory viruses in schools, we developed School Knowledge of Infectious Diseases in Schools (School KIDS).

METHODS: School KIDS is a prospective, respiratory viral testing program in a large metropolitan school district (pre-kindergarten-12th grade) in Kansas City, Missouri. During the 2022-2023 school year, all students and staff were eligible to participate in surveillance respiratory viral testing at school by submitting observed self-administered nasal swabs monthly. Participants could also submit a nasal swab for …

Multicenter Analysis Of Valganciclovir Prophylaxis In Pediatric Solid Organ Transplant Recipients, Marc Foca, Salih Demirhan, Flor M Munoz, Kristen G Valencia Deray, Claire E Bocchini, Tanvi S Sharma, Gilad Sherman, William J Muller, Taylor Heald-Sargent, Lara Danziger-Isakov, Samantha Blum, Juri Boguniewicz, Samantha Bacon, Tuhina Joseph, Jodi Smith, Monica I Ardura, Yin Su, Gabriela M Maron, Jose Ferrolino, Betsy C Herold

Faculty, Staff and Students Publications

BACKGROUND: Valganciclovir is the only approved antiviral for cytomegalovirus (CMV) prevention in pediatric solid organ transplantation (SOT). Additional approaches may be needed to improve outcomes.

METHODS: A multicenter retrospective study from 2016 to 2019 was conducted of pediatric SOT recipients in whom at least 3 months of valganciclovir prophylaxis was planned. Episodes of CMV DNA in blood (DNAemia), CMV disease, drug-related toxicities, as well as other infections in the first year posttransplant and demographic and clinical data were collected. CMV DNAemia in the first year after prophylaxis or during prophylaxis (breakthrough) was analyzed by multivariate hazard models.

RESULTS: Among the …

Characterizing New Invasive Infections In Children’S Mercy Extracorporeal Membrane Oxygenation And And Continuous Renal Replacement Therapy Patients, Samantha M. Davidson, Jay F. Rilinger, Jenna O. Miller, Caroline Holten, Josh Herigon

Research Days

This abstract characterizes the patients at Children's Mercy who developed a new serious bacterial infection while on extracorporeal support.

Seasonality, Clinical Characteristics, And Outcomes Of Respiratory Syncytial Virus Disease By Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016-2020., Ariana P. Toepfer, Justin Z. Amarin, Andrew J. Spieker, Laura S. Stewart, Mary Allen Staat, Elizabeth P. Schlaudecker, Geoffrey A. Weinberg, Peter G. Szilagyi, Janet A. Englund, Eileen J. Klein, Marian G. Michaels, John V. Williams, Rangaraj Selvarangan, Christopher J. Harrison, Joana Y. Lively, Pedro A. Piedra, Vasanthi Avadhanula, Brian Rha, James Chappell, Meredith Mcmorrow, Heidi Moline, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illnesses in children. RSV can be broadly categorized into 2 major subtypes: A and B. RSV subtypes have been known to cocirculate with variability in different regions of the world. Clinical associations with viral subtype have been studied among children with conflicting findings such that no conclusive relationships between RSV subtype and severity have been established.

METHODS: During 2016-2020, children aged/guardian interviews, chart reviews, and collection of midturbinate nasal plus/minus throat swabs for RSV (RSV-A, RSV-B, and untyped) using reverse transcription polymerase chain reaction.

RESULTS: Among 6398 RSV-positive …

A Quality Improvement Project To Improve Antibiotic Choice For Children Admitted With Urinary Tract Infections (Utis), Philip Jurasinski Do, Pgy-3, Adrienne Deporre Md, Kathleen Berg Md, Allison Hadley Md, Viktoriya Stoycheva Mha, Rn, Cpn, Rana El Feghaly Md

Research Days

This is an antibiotic stewardship quality improvement project focused on improving antibiotic choices for children with urinary tract infections who are in the Children's Mercy Kansas City system. This project aims to improve the rates of cefazolin or cephalexin for treatment from 27% to 60%. 96% of urinary tract infections in our system are caused by E. Coli that are susceptible to these first generation cephalosporins.

Impact Of Nutritional Status And Placental Malaria Infection On Pregnancy Outcome In A Population Of Nigerian Maternal-Infant Dyads, Shirley F. Delair

Theses & Dissertations

Nigeria is the most populous country in Africa and accounts for one-quarter of the newborn mortality on the continent. Most newborn deaths are from prematurity (33%), infections (33%), and intrapartum complications (31%). Using an adapted analytical framework for the study of child survival in developing countries, this dissertation aimed to look at the pregnancy outcome of a population of Nigerian women and their offspring by looking at proximate determinants of health from nutritional status and environmental conditions. In Chapter 1, we characterized the micronutrients of the mother-infant dyads, looking specifically at concentrations of vitamin D and its metabolites. In Chapter …

Determinants Of Vaccine Hesitancy Among Parents And Caregivers, Priya Srivastava

Rowan-Virtua Research Day

•Vaccination efforts in the United States and globally are one of the largest contributors to pediatric preventative health

•Routine immunizations in the U.S for children ≤ 10 years old cover 14 vaccine-preventable diseases. As a result, an estimated 732,000 deaths, 21 million hospitalizations, and 322 diagnosed cases of diseases have been prevented between 1993 and 2013.

•Vaccines remain a point of contention with pediatricians and their patients' caregivers

•Many parents maintain hesitancy to give vaccines; to a number of reasons. Perceived risk and fear of side effects from vaccines more than the disease itself, can cause out-of-proportion concern

•Misinformation spread …

Approach For Defining Human Adenovirus Infection And Disease For Central Review Adjudication In Clinical Studies., Brian T. Fisher, Jesse Blumenstock, Craig L K Boge, Sydney Shuster, Alix E. Seif, Michael Green, Marian G. Michaels, Jessie L. Alexander, Monica I. Ardura, Tamara P. Miller, Diego R. Hijano, William J. Muller, Jennifer E. Schuster, Abby M. Green, Daniel E. Dulek, Adriana E. Kajon, Lara Danziger-Isakov

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pediatric allogeneic hematopoietic cell transplant (allo-HCT) recipients are at risk for morbidity and mortality from human adenovirus (HAdV). HAdV can be detected in an asymptomatic state, referred to as infection or with signs or symptoms of illness, referred to as disease. Standardized case definitions are needed to distinguish infection from disease and allow for consistent reporting in both observational cohort studies and therapeutic clinical trials.

METHODS: A working group of experts in virology, transplant infectious disease, and HCT was assembled to develop HAdV infection and disease definitions with the degree of certainty (i.e., possible, probable, and proven). Definitions were …

Sars-Cov-2 Viral Load In The Nasopharynx At Time Of First Infection Among Unvaccinated Individuals: A Secondary Cross-Protocol Analysis Of 4 Randomized Trials, Leigh H Fisher, Jia Jin Kee, Albert Liu, Claudia M Espinosa, April K Randhawa, James Ludwig, Craig A Magaret, Samuel T Robinson, Peter B Gilbert, Ollivier Hyrien, James G Kublin, Nadine Rouphael, Ann R Falsey, Magdalena E Sobieszczyk, Hana M El Sahly, Beatriz Grinsztejn, Glenda E Gray, Karen L Kotloff, Cynthia L Gay, Brett Leav, Ian Hirsch, Frank Struyf, Lisa M Dunkle, Kathleen M Neuzil, Lawrence Corey, Yunda Huang, Paul A Goepfert, Stephen R Walsh, Lindsey R Baden, Holly Janes, Covid-19 Prevention Network (Covpn)

Faculty, Staff and Students Publications

IMPORTANCE: SARS-CoV-2 viral load (VL) in the nasopharynx is difficult to quantify and standardize across settings, but it may inform transmission potential and disease severity.

OBJECTIVE: To characterize VL at COVID-19 diagnosis among previously uninfected and unvaccinated individuals by evaluating the association of demographic and clinical characteristics, viral variant, and trial with VL, as well as the ability of VL to predict severe disease.

DESIGN, SETTING, AND PARTICIPANTS: This secondary cross-protocol analysis used individual-level data from placebo recipients from 4 harmonized, phase 3 COVID-19 vaccine efficacy trials sponsored by Moderna, AstraZeneca, Janssen, and Novavax. Participants were SARS-CoV-2 negative at baseline …

Durability Of Original Monovalent Mrna Vaccine Effectiveness Against Covid-19 Omicron-Associated Hospitalization In Children And Adolescents - United States, 2021-2023., Laura D. Zambrano, Margaret M. Newhams, Regina M. Simeone, Amanda B. Payne, Michael Wu, Amber O. Orzel-Lockwood, Natasha B. Halasa, Jemima M. Calixte, Pia S. Pannaraj, Kanokporn Mongkolrattanothai, Julie A Boom, Leila C Sahni, Satoshi Kamidani, Kathleen Chiotos, Melissa A Cameron, Aline B Maddux, Katherine Irby, Jennifer E. Schuster, Elizabeth H. Mack, Austin Biggs, Bria M. Coates, Kelly N. Michelson, Katherine E. Bline, Ryan A. Nofziger, Hillary Crandall, Charlotte V. Hobbs, Shira J. Gertz, Sabrina M. Heidemann, Tamara T. Bradford, Tracie C. Walker, Stephanie P. Schwartz, Mary Allen Staat, Samina S. Bhumbra, Janet R. Hume, Michele Kong, Melissa S. Stockwell, Thomas J. Connors, Melissa L. Cullimore, Heidi R. Flori, Emily R. Levy, Natalie Z. Cvijanovich, Matt S. Zinter, Mia Maamari, Cindy Bowens, Danielle M. Zerr, Judith A. Guzman-Cottrill, Ivan Gonzalez, Angela P. Campbell, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Pediatric COVID-19 vaccination is effective in preventing COVID-19-related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021-October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19-related hospitalization and critical illness among U.S. children and adolescents aged 5-18 years, using a case-control design. Too few children and adolescents received bivalent or updated monovalent vaccines to separately evaluate their effectiveness. Most case-patients (persons with a positive SARS-CoV-2 test result) were unvaccinated, despite …

Chronic Pneumonia In A 1-Year-Old Male, Saritha Beauchamp, Irene Chern, Emily Souder

Tower Health Research Day

No abstract provided.

Antibiotic Treatment For Well-Appearing Infants Born At ≥35 Weeks’ Gestation To Mothers With Chorioamnionitis Before And After Implementation Of Neonatal Early-Onset Sepsis Calculator, Surichhya Bajracharya, Preetha Prazad, Catherine Bennett, Nahren Asado

Journal of Patient-Centered Research and Reviews

Purpose

Our quality improvement study aimed to determine whether application of a neonatal early-onset sepsis calculator (NSC) among well-appearing infants born at ≥ 35 weeks’ gestation to mothers with chorioamnionitis decreases the number of lab evaluations (LEs) and antibiotic treatments (Abxs) without missing early-onset sepsis.

Methods

We compared 2 years (January 1, 2019–January 3, 2021) of data from a historical-control group before implementation of the NSC to 1 year (January 4, 2021–December 31, 2021) of data from a calculator group after implementation of the NSC to evaluate whether LE and Abx decreased following implementation of the NSC on January 4, …

Accuracy Of Influenza Icd-10 Diagnosis Codes In Identifying Influenza Illness In Children., James W. Antoon, Tess Stopczynski, Justin Z. Amarin, Laura S. Stewart, Julie A. Boom, Leila C. Sahni, Marian G. Michaels, John V. Williams, Janet A. Englund, Eileen J. Klein, Mary A. Staat, Elizabeth P. Schlaudecker, Rangaraj Selvarangan, Jennifer E. Schuster, Geoffrey A. Weinberg, Peter G. Szilagyi, Ariana Perez, Heidi L. Moline, Andrew J. Spieker, Carlos G. Grijalva, Samantha M. Olson, Natasha B. Halasa

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Studies of influenza in children commonly rely on coded diagnoses, yet the ability of International Classification of Diseases, Ninth Revision codes to identify influenza in the emergency department (ED) and hospital is highly variable. The accuracy of newer International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes to identify influenza in children is unknown.

OBJECTIVE: To determine the accuracy of ICD-10 influenza discharge diagnosis codes in the pediatric ED and inpatient settings.

DESIGN, SETTING, AND PARTICIPANTS: Children younger than 18 years presenting to the ED or inpatient settings with fever and/or respiratory symptoms at 7 …

The Koolungar Moorditj Healthy Skin Project: Elder And Community Led Resources Strengthen Aboriginal Voice For Skin Health, Bernadette M. Ricciardo, Jacinta Walton, Noel Nannup, Dale Tilbrook, Heather-Lynn Kessaris, Carol Michie, Brad Farrant, Roni Forrest, Annette Garlett, Joanne Hill, Larissa Jones, Natasha Kickett, Sally Smith, Delys Walton, Taleah Ugle, Nadia Rind, Richelle Douglas, Jodie Ingrey, Brenda Carter, Ainslie Poore, Ingrid Amgarth-Duff, Hannah Thomas, Prasad S. Kumarasinghe, Jonathan R. Carapetis, Asha C. Bowen

Journal of the Australian Indigenous HealthInfoNet

In partnership with local Aboriginal Community Controlled Health Organisations, the Elder-led co-designed Koolungar Moorditj Healthy Skin project is guided by principles of reciprocity, capacity building, respect, and community involvement. Through this work, the team of Elders, community members, clinicians and research staff have gained insight into the skin health needs of urban-living Aboriginal koolungar (children); and having identified a lack of targeted and culturally appropriate health literacy and health promotion resources on moorditj (strong) skin, prioritised development of community-created healthy skin resources. Community members self-appointed to Aboriginal Community Advisory Groups (CAG) on Whadjuk (Perth) …

Maternal And Perinatal Health Research During Emerging And Ongoing Epidemic Threats: A Landscape Analysis And Expert Consultation, Mercedes Bonet, Magdalena Babinska, Pierre Buekens, Shivaprasad S Goudar, Beate Kampmann, Marian Knight, Dana Meaney-Delman, Smaragda Lamprianou, Flor Muñoz Rivas, Andy Stergachis, Cristiana M Toscano, Joycelyn Bhatia, Sarah Chamberlain, Usman Chaudhry, Jacqueline Mills, Emily Serazin, Hannah Short, Asher Steene, Michael Wahlen, Olufemi T Oladapo

Faculty, Staff and Students Publications

INTRODUCTION: Pregnant women and their offspring are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is paramount to ensure that this group is offered at least the same level of disease prevention, diagnosis, and care as the general population. We conducted a landscape analysis and held expert consultations to identify research efforts relevant to pregnant women affected by disease outbreaks, highlight gaps and challenges, and propose solutions to addressing them in a coordinated manner.

METHODS: Literature searches were conducted from 1 January 2015 to 22 March 2022 using Web of …

Vaccine Hesitancy Among Youth Living With Hiv In Detroit, Madeline B. Simone

Medical Student Research Symposium

Vaccine hesitancy among youth with human immunodeficiency virus (HIV) was evaluated to determine if the pandemic affected vaccine acceptance. A retrospective chart review was conducted to analyze vaccine rates over a five-year (pre-post COVID) in one university-based clinic. Results indicated a variation in acceptance rates between vaccines, with the MenACWY, MenB, tetanus, and HPV having the highest acceptance rates and COVID-19 and annual flu vaccine having the lowest acceptance rates. Vaccine hesitancy did not correlate with HIV treatment hesitancy nor with aversion to needles. Negative messaging around vaccines from a variety of sources appeared to be the primary factor in …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Current And Emerging Antiviral Agents In The Prevention And Treatment Of Cytomegalovirus In Pediatric Transplant Recipients, Kristen G Valencia Deray, Lara A Danziger-Isakov, Kevin J Downes

Faculty, Staff and Students Publications

Despite current prophylaxis regimens, cytomegalovirus (CMV) is common in hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) and remains a significant cause of morbidity and mortality. Newer antiviral medications are reshaping the landscape for prevention and treatment of CMV DNAemia, infection, and disease. Letermovir is approved for CMV prevention in adult HCT patients and is attractive due to the absence of marrow suppression seen with ganciclovir/valganciclovir. Letermovir should not be routinely used for CMV treatment due to its low threshold for resistance. Maribavir is approved for the treatment of refractory or resistant CMV disease in HCT and SOT recipients …

Notes From The Field: Reemergence Of Mycoplasma Pneumoniae Infections In Children And Adolescents After The Covid-19 Pandemic, United States, 2018-2024., Chris Edens, Benjamin R. Clopper, Jourdan Devies, Alvaro Benitez, Erin R. Mckeever, Dylan Johns, Bernard Wolff, Rangaraj Selvarangan, Jennifer E. Schuster, Geoffrey A. Weinberg, Peter G. Szilagyi, Fatimah S. Dawood, Lakshmi Radhakrishnan, Christina Quigley, Leila C. Sahni, Natasha Halasa, Laura S. Stewart, Meredith L. Mcmorrow, Brett Whitaker, Danielle M. Zerr, Vasanthi Avadhanula, John V. Williams, Marian G. Michaels, Aaron Kite-Powell, Janet A. Englund, Mary Allen Staat, Kathleen Hartnett, Heidi L. Moline, Adam L. Cohen, Maureen Diaz

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

A Case Of Streptococcus Constellatus Bacteremia Secondary To Respiratory Syncytial Virus Bronchiolitis In A Neonate, Ronald G. Lott Iii, Samantha M. Lavertue, Xavier Zonna, Samuel Wlasowicz, Roland Zhang, Ravi Kavuda

Advances in Clinical Medical Research and Healthcare Delivery

Common causes of bacteremia in the neonatal period include group B streptococcus, listeria, and E. coli. We report a rare case of neonatal bacteremia with culture-positive Streptococcus constellatus. Streptococcus constellatus is part of the normal flora of the orogenital regions of the body; when found elsewhere, it causes pyogenic abscesses in the brain and digestive tract. In this case, the Streptococcus constellatus bacteremia was secondary to prolonged hospitalization in a patient with respiratory syncytial virus (RSV) bronchiolitis. This report serves to make physicians aware of and to define treatment options for Streptococcus constellatus as a rarely isolated organism that …

Design, Synthesis, X-Ray Crystallography, And Biological Activities Of Covalent, Non-Peptidic Inhibitors Of Sars-Cov-2 Main Protease, Md Ashraf-Uz-Zaman, Teck Khiang Chua, Xin Li, Yuan Yao, Bala Krishna Moku, Chandra Bhushan Mishra, Vasanthi Avadhanula, Pedro A Piedra, Yongcheng Song

Faculty, Staff and Students Publications

Highly contagious SARS-CoV-2 coronavirus has infected billions of people worldwide with flu-like symptoms since its emergence in 2019. It has caused deaths of several million people. The viral main protease (Mpro) is essential for SARS-CoV-2 replication and therefore a drug target. Several series of covalent inhibitors of Mpro were designed and synthesized. Structure-activity relationship studies show that 1) several chloroacetamide- and epoxide-based compounds targeting Cys145 are potent inhibitors with IC50 values as low as 0.49 μM, and 2) Cys44 of Mpro is not nucleophilic for covalent inhibitor design. High resolution X-ray studies revealed the protein-inhibitor interactions and mechanisms of inhibition. …

Assessing Pattern Of The Pediatric Multisystem Inflammatory Syndrome (Pmis) In Children During The Covid-19 Pandemic: Experience From The Emergency Department Of Tertiary Care Center Of A Low-Middle-Income Country, Saleem Akhtar, Iqra Anis, Kumar Nirdosh, Muhammad Ihsan Tayyab Ihsan, Ahmed Raheem Buksh, Surraiya Bano

Department of Paediatrics and Child Health

Background: Pediatric Multisystem Inflammatory Syndrome (PMIS) is a hyperinflammatory condition affecting multiple organs in children, often resembling incomplete Kawasaki Disease during later phases of COVID-19 infection. Data on PMIS in low-middle-income countries, particularly in emergency department settings, is limited.
Objectives: This prospective observational study at Aga Khan University Hospital, Karachi, aimed to determine the frequency, clinical presentation patterns, and laboratory parameters of children with PMIS visiting the emergency department during the COVID-19 pandemic. Secondary objectives included assessing factors associated with in-hospital mortality.
Methods: From March 2020 to September 2021, patients meeting World Health Organization PMIS criteria were enrolled. COVID-19 testing …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Maternal Vaccine Effectiveness Against Influenza-Associated Hospitalizations And Emergency Department Visits In Infants, Leila C Sahni, Samantha M Olson, Natasha B Halasa, Laura S Stewart, Marian G Michaels, John V Williams, Janet A Englund, Eileen J Klein, Mary A Staat, Elizabeth P Schlaudecker, Rangaraj Selvarangan, Jennifer E Schuster, Geoffrey A Weinberg, Peter G Szilagyi, Julie A Boom, Manish M Patel, Flor M Muñoz, New Vaccine Surveillance Network Collaborators

Faculty, Staff and Students Publications

IMPORTANCE: Influenza virus infection during pregnancy is associated with severe maternal disease and may be associated with adverse birth outcomes. Inactivated influenza vaccine during pregnancy is safe and effective and can protect young infants, but recent evidence, particularly after the 2009 novel influenza A (H1N1) pandemic, is limited.

OBJECTIVE: To evaluate the effectiveness of influenza vaccination during pregnancy against laboratory-confirmed influenza-associated hospitalizations and emergency department (ED) visits in infants younger than 6 months.

DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, test-negative case-control study using data from the New Vaccine Surveillance Network from the 2016 to 2017 through 2019 to …

The Durability Of Antibody Responses Of Two Doses Of High-Dose Relative To Two Doses Of Standard-Dose Inactivated Influenza Vaccine In Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial., Jennifer E. Schuster, Lubna Hamdan, Daniel E. Dulek, Carrie L. Kitko, Einas Batarseh, Zaid Haddadin, Laura S. Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Spyros A. Kalams, Claire E. Bocchini, Elizabeth A. Moulton, Susan E. Coffin, Monica I. Ardura, Rachel L. Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Christopher J. Harrison, Jason L. Freedman, Paul A. Carpenter, Janet A. Englund, Flor M. Munoz, Lara Danziger-Isakov, Andrew J. Spieker, Natasha B. Halasa, Pediatric Hct Flu Study

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Our previous study established a 2-dose regimen of high-dose trivalent influenza vaccine (HD-TIV) to be immunogenically superior compared to a 2-dose regimen of standard-dose quadrivalent influenza vaccine (SD-QIV) in pediatric allogeneic hematopoietic cell transplant (HCT) recipients. However, the durability of immunogenicity and the role of time post-HCT at immunization as an effect modifier are unknown.

METHODS: This phase II, multi-center, double-blinded, randomized controlled trial compared HD-TIV to SD-QIV in children 3-17 years old who were 3-35 months post-allogeneic HCT, with each formulation administered twice, 28-42 days apart. Hemagglutination inhibition (HAI) titers were measured at baseline, 28-42 days following each …