儿童菌血症蜡样芽孢杆菌的分离及耐药性分析

目的了解儿童菌血症蜡样芽孢杆菌的感染状况、耐药性与耐药趋势。方法对临床送检标本进行分离培养,采用API 50 CH试验条进行菌株鉴定,采用K-B法测定细菌药物敏感性。结果 2006年1月—2010年3月从血液标本中分离蜡样芽孢杆菌共83株,其中儿童患者61株,占73.5%,61株中配方奶喂养新生儿为49例,占80.3%。蜡样芽孢杆菌对13种临床常见药物抗菌活性较好,对除青霉素、氨苄西林、一二代头孢菌素以外的抗菌药物耐药率均低于25%。结论蜡样芽孢杆菌引起人工喂养的儿童菌血症发病率较高,需严防漏检而贻误治疗时机,尤其应重视准确分离、鉴定菌株,测定其耐药谱,可为临床合理应用抗生素提供理论依据。     

Isolation and drug resistance analysis of Bacillus cereus in children with sepsis

目的 了解儿童菌血症蜡样芽孢杆菌的感染状况、耐药性与耐药趋势.方法 对临床送检标本进行分离培养,采用API 50 CH试验条进行菌株鉴定,采用K-B法测定细菌药物敏感性.结果 2006年1月 - 2010年3月从血液标本中分离蜡样芽孢杆菌共83株,其中儿童患者61株,占73.5%,61株中配方奶喂养新生儿为49例,占80.3%.蜡样芽孢杆菌对13种临床常见药物抗菌活性较好,对除青霉素、氨苄西林、一二代头孢菌素以外的抗菌药物耐药率均低于25%.结论 蜡样芽孢杆菌引起人工喂养的儿童菌血症发病率较高,需严防漏检而贻误治疗时机,尤其应重视准确分离、鉴定菌株,测定其耐药谱,可为临床合理应用抗生素提供理论依据.     

重症监护病房氧气湿化瓶污染细菌与下呼吸道细菌感染及耐药率的探讨

目的探讨重症监护病房氧气湿化瓶污染细菌与住院患儿呼吸道感染的关系,为防治医院感染的吸氧途径提供证据。方法采集47例重症监护病房住院患儿痰标本及其使用的湿化瓶,进行细菌分离鉴定,重点分析铜绿假单胞菌耐药率。结果从湿化瓶分离细菌79株,革兰阴性杆菌58株(73%),其中铜绿假单胞菌38株(48%);痰培养细菌170株,革兰阴性杆菌139株(82%),铜绿假单胞菌42株(30%)。患者痰培养的铜绿假单胞菌对15种抗生素耐药率为38%～84%,湿化瓶分离的铜绿假单胞菌耐药率为10%～86%。结论氧气湿化瓶污染细菌与呼吸道感染关系密切。     

呼吸道感染的免疫应答

呼吸道感染是多样的。从解剖上来说,有上、下呼吸道感染;从感染时期来分,有急性、迁延性和慢性呼吸道感染;从病原上来看,有细菌、病毒、支原体感染等.机体对感染的免疫应答是不尽相同的.这里我们谈谈4种类型感染的免疫应答.     

单核细胞增生性李斯特菌脑膜炎二例

单核细胞增生性李斯特菌是一种短小的革兰阳性无芽孢杆菌,儿童感染此种细菌可引起脓毒症、细菌性脑膜炎,近年来发病率明显增多.本文报道我院新生儿病房及重症监护病房各1例单核细胞增生性李斯特菌脑膜炎,以此帮助临床医生了解李斯特菌及其感染后引起脑膜炎的特点,加深对本病的认识.     

嗜酸性粒细胞对呼吸道感染性疾病的调节作用

嗜酸性粒细胞是参与寄生虫感染和过敏性疾病发生的重要细胞。近年来研究发现嗜酸性粒细胞参与宿主对细菌、病毒和真菌等感染的免疫反应, 通过模式识别受体去识别病原体, 利用多种机制发挥免疫防御作用。国内外有关嗜酸性粒细胞在呼吸道感染方面的研究取得了许多进展。该综述对嗜酸性粒细胞对呼吸道感染性疾病的调节作用进行总结, 阐述嗜酸性粒细胞活化过程及与呼吸道病原体直接和间接的相互作用, 旨在提高临床医生对嗜酸性粒细胞在呼吸道感染性疾病中作用的认识, 为临床诊疗提供新思路。     

新生儿感染T淋巴细胞亚群及细胞因子变化分析

目的探讨新生儿感染不同病原体后体内相关免疫细胞及其细胞因子的变化。方法入选20例新生儿细菌性肺炎患儿(细菌组),15例新生儿轮状病毒腹泻患儿(病毒组),20例新生儿高胆红素血症患儿(对照组),采用流式细胞仪检测外周血CD4+T淋巴细胞因子、淋巴细胞亚群。结果细菌组、病毒组和对照组间,IL-4水平的差异有统计学意义(F=3.39,P=0.041),IFN-γ、IL-17水平在三组间的差异均无统计学意义(F=0.28、1.24,P均0.05);经两两比较发现,细菌组IL-4水平高于病毒组和对照组,差异有统计学意义(P均0.05)。除CD8+细胞外,CD3+、CD4+、CD19+、NK细胞阳性率以及CD4+/CD8+,在细菌组、病毒组和对照组三组间的差异均有统计学意义(F=3.30~26.69,P均0.05)。经两两比较发现,CD3+和CD4+细胞阳性率以及CD4+/CD8+,细菌组和病毒组均低于对照组;细菌组和病毒组CD19+细胞阳性率均高于对照组,差异均有统计学意义(P均0.05)。病毒组NK细胞阳性率低于对照组和细菌组,差异均有统计学意义(P0.05)。结论不同病原体感染后体内相关细胞因子水平变化不同,免疫功能紊乱,体内存在Th1/Th2失衡,以Th2型占主导地位。T淋巴细胞亚群水平较低,提示机体感染后细胞免疫功能减低,也可能是新生儿易感及感染后病情隐匿、病程长的原因之一。     

白血病患儿的口腔护理

白血病常因并发感染而死亡。而口腔感染又往往是细菌侵入机体、导致败血症的门户,因此作好白血病病人的口腔护理非常重要。一、白血病易发生口腔感染的原因1.机体缺乏成熟的粒细胞,使机体的免疫力下降。2.白血病细胞广泛浸润,牙龈增殖肿大,口腔粘膜出血,有利于细菌滋生。3.     

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1呼吸道感染性疾病1.1病原学病原学监测是制订小儿呼吸道感染防治策略的必要基础。1.1.1细菌越来越多儿科工作者对小儿急性呼吸道感染(ARTIs)的细菌学方面做了研究,从鼻咽分泌物中分离的主要细菌有流感嗜血杆菌(HI)、肺炎链球菌(SP)、金黄色葡萄球菌(SA)、卡他莫拉菌(MC)、大肠埃希菌(E.coli)及肺炎克雷伯菌(K.pn)等,在一些地区革兰阴性菌占优势、耐药性较高。显然,不同地区、不同时间和年龄对象以及细菌培养方法和抗生素使用与否等均可能影响结果。要指出两点:一是鼻咽部取材如何防止污染仍是难题,严格讲目前取材方法所得结果是细菌…     

感染相关噬血细胞淋巴组织增生症研究进展

噬血细胞淋巴组织增生症(HLH)是儿童期常见的免疫性疾病之一。细菌、EB病毒、原虫、真菌、衣原体等感染是HLH的常见病因。目前认为感染相关HLH的发病机制是由于NK细胞和细胞毒T细胞(CTL)介导的穿孔素依赖的细胞毒作用缺陷所导致的多系统炎症反应,感染激活巨噬细胞、树突状细胞、NK细胞和CTL,导致细胞因子风暴形成。不同的感染类型可针对其病因控制。研究证实4周内积极应用依托泊苷在内的化疗方案能够改善预后,化疗诱导阶段适当短期应用环孢素A有利于粒细胞减少症恢复。预后不良的因素包括高血清铁蛋白和乳酸脱氢酶、IL-2R和IFN-γ升高,EB病毒感染引起的HLH、年龄过小或年龄>30岁可能增加病死率。     

Lifesaving liver transplantation for multi‐organ failure caused by Bacillus cereus food poisoning

Bacillus cereus is a spore‐forming, gram‐positive bacterium that causes food poisoning presenting with either emesis or diarrhea. Diarrhea is caused by proteinaceous enterotoxin complexes, mainly hemolysin BL, non‐hemolytic enterotoxin (NHE), and cytotoxin K. In contrast, emesis is caused by the ingestion of the depsipeptide toxin cereulide, which is produced in B. cereus contaminated food, particularly in pasta or rice. In general, the illness is mild and self‐limiting. However, due to cereulide intoxication, nine severe cases with rhabdomyolysis and/or liver failure, five of them lethal, are reported in literature. Here we report the first case of life‐threatening liver failure and severe rhabdomyolysis in this context that could not be survived without emergency hepatectomy and consecutive liver transplantation.     

Food poisoning as a cause of acute liver failure

We report a 9-year-old girl with cereulide-producing Bacillus cereus food poisoning, who developed fulminant hepatitis, renal and pancreatic insufficiency, shock, and prolonged seizures. She was transferred to our institution for hepatic transplantation before her diagnosis was established. As a result of rapid identification of the microorganism and supportive care, liver transplantation was avoided, and she recovered fully.     

Children and genetically engineered food: potentials and problems

Changes in food production and dietary practices are occurring faster than our understanding of their potential impact on children's health. Traditionally, pediatric gastroenterologists have studied food with respect to its nutritive value and digestibility, its influence on metabolism, its growth-promoting characteristics, and its relationship to risk and severity of disease. Biotechnology is now expanding the science of food to include disease prevention and treatment, as well as the feeding of children on a global scale. Bioengineered ("genetically modified", or "transgenic") plants were initially developed to enhance the food supply by increasing crop yields. Such previously developed transgenic plants are now prevalent worldwide and appear in many processed food products. The implementation of the technology of genetic modulation of food plants has led to considerable fear, controversy, and confusion as the understanding of the technology is poor in the general population. This review presents an overview of genetically modified food crops and their potential unique benefits and risks to children's health. Political, economical, and ecological issues related to transgenic crops are not discussed.     

Hazard analysis and critical control points of weaning foods

Hazards and critical control points were identified during the preparation, feeding and storage of weaning foods fed to the children (6–24 months) belonging to low income group (LIG) families using survey methods, spot and indepth observations and microbial analysis. High microbial counts were obtained for the weaning food samples procured from the families that were rated as poor for both personal hygiene and environmental sanitation. Food samples that were held at ambient temperature (25–35°C) showed high counts of coliforms, AMCC, yeast and mold,Staphylococcus aureus andBacillus cereus. Spice mixtures and mop samples also revealed high counts for all these organisms. Coliforms were not isolated from the water samples of all the 10 households. However, a high count ofBacillus cereus (10^3–5/ml) was observed in water samples of two selected households. The hazards and critical control points identified were high initial contamination of raw foods, poor environmental sanitation and personal hygiene, feeding of overmight moist foods stored at ambient temperature and insufficient steaming of these foods.     

‘The second mother’: How the baby food industry captures science,health professions and civil society in France

Most babies in France are fed with infant formula and then commercial complementary foods, many of which are ultra‐processed and harmful to health. Internationally, there is opposition by the baby food industry to the introduction of public health policies that would limit the marketing and consumption of such products. Our aim was to identify the key baby food industry actors, describe their history and corporate political activity (CPA) in France. We sourced publicly available information, which we triangulated with data from 10 semi‐structured interviews. Qualitative thematic analysis was undertaken simultaneously to data collection, guided by an existing classification of the CPA of the food industry. The baby food industry in France has shaped the science on infant and young child nutrition and nurtured long‐established relationships with health professionals. This corporate science and these relationships helped baby food companies to portray themselves as experts on child‐related topics. The baby food industry has also engaged with a broad range of civil society organisations, particularly through the concept of the first 1000 days of life, and during the covid‐19 pandemic. We found evidence, although limited, that the baby food industry directly lobbied the French government. Since its early development in France in the 19th century, the baby food industry used its CPA to promote its products and protect and sustain its market. Our findings can be used to recognise, anticipate and address the CPA of this industry, and to minimise any negative influence it may have on babies'' and mother''s health.     

Bacillus species isolates from cerebrospinal fluid in patients without shunts

Of 849 CSF cultures done at Hartford Hospital, nine were positive for nonanthrax Bacillus species. Differentiation of true nonanthrax Bacillus species infection from contamination requires careful consideration of the clinical findings, the clinical course, and the laboratory data. In seven patients the nonanthrax Bacillus species represented contamination. In two patients the nonanthrax Bacillus species represented true infection. In one of these infected patients, nonanthrax Bacillus species complicated a cranial gun shot wound. Bacillus cereus meningitis developed in the second patient, a premature infant, following sepsis from a contaminated IV catheter. Nonanthrax Bacillus species, especially B cereus, can be resistant to penicillins and cephalosporins when nonanthrax Bacillus species infections are being treated, susceptibility testing should always be performed.     

Food allergy in children—the current status and the way forward

Food allergy in children is a major health concern, and its prevalence is rising. It is often over-diagnosed by parents, resulting occasionally in unnecessary exclusion of some important food. It also causes stress, anxiety, and even depression in parents and affects the family’s quality of life. Current diagnostic tests are useful when interpreted in the context of the clinical history, although cross-sensitivity and inability to predict the severity of the allergic reactions remain major limitations. Although the oral food challenge is the current gold standard for making the diagnosis, it is only available to a small number of patients because of its requirement in time and medical personnel. New diagnostic methods have recently emerged, such as the Component Resolved Diagnostics and the Basophil Activation Test, but their use is still limited, and the latter lacks standardisation. Currently, there is no definite treatment available to induce life-long natural tolerance and cure for food allergy. Presently available treatments only aim to decrease the occurrence of anaphylaxis by enabling the child to tolerate small amounts of the offending food, usually taken by accident. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy. If standardised and widely implemented, this may result in decreasing the prevalence of food allergy.     

Impact du régime d''éviction sur la néophobie dans le cadre d''une allergie alimentaire chez l''enfant : étude exploratoire

OBJECTIVES: This study was designed to analyse the impact of an elimination diet in children with food allergy, and its perception by their parents on the later reticence of children to test unknown foods, food neophobia. METHODS: The degree of food neophobia of children having outgrown their allergy (mean age, 7 years 2 months) was compared to that of a sibling (9 years 5 months) using a standardized scale and a questionnaire of food friendliness. Parents were also asked to fill in a questionnaire on the disease and its burden on the family. RESULTS: Children having outgrown their allergy are more reluctant to test new foods than their non-allergic brother or sister, as shown by their scoring on the food neophobia scale and the number of unknown foods following the cure of the disease. Two factors increase the level of food neophobia, the distressing effect and the duration of the period elapsed until the diagnosis was made, as well as the distressing effect and the lack of variety in the meal preparation. CONCLUSION: Food neophobia, a normal phase between 2 and 10 years, is worsened by the elimination diet required by food allergy, especially in case of late diagnosis and when the time elapsed before diagnosis and the preparation of meals were perceived as difficult to bear.     

Food choices at lunch during the third year of life: high selection of animal and starchy foods but avoidance of vegetables

AIM: The objective was to show patterns of food selection by 2- to 3-y-old children for a wide variety of foods in a self-service cafeteria and to assess the effect of individual variables (gender, BMI, mode of feeding after birth and rank in sibship). METHODS: In a nursery self-service canteen, food choices at lunch made by children (n=418, 24-36 mo; 109 observations per child on average) were recorded by trained assistants who monitored portion size. An offer of eight dishes (animal products, starchy foods, combination dishes, vegetables and dairy products), excluding dessert-type foods, was proposed. Choice level was calculated for each food. Analysis of variance was used to compare choices for the various foods and to assess the effect of the individual variables. RESULTS: The choice of a food largely depended upon its nature: animal products, starchy foods and their combinations were widely chosen, whereas vegetables were not often selected; the choice for dairy products depended upon the type. The mode of preparation of the food influenced its choice. Segmenting products were identified; however, except for cheeses, a given child did not refuse an entire food category. Children's characteristics did not explain the choice variability. CONCLUSION: At the age of 2 to 3 y, children preferentially choose animal products and starchy foods and avoid vegetables; the high individual variability of their food choices could be related to previous food experiences.