Journal of Pediatric Infectious Diseases - Volume 4, issue 1

Authors: Brook, Itzhak

Article Type: Research Article

DOI: 10.3233/JPI-2009-0144

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 1-1, 2009

Authors: Brook, Itzhak

Article Type: Research Article

Abstract: Anaerobic infections are common in children yet difficult to diagnose. Anaerobes are the most predominant components of the skin and mucous membranes bacterial flora, and are therefore a common cause of endogenous infections. Because of their fastidiousness, they are difficult to isolate and are often overlooked. Anaerobic infections can occur in all body sites, including the central nervous system, head and neck, chest, abdomen, pelvis, skin, and soft tissues. They can occur at any age and …have a unique role in newborns. Therapy inadequate against these organisms may lead to clinical failures. Their isolation requires appropriate methods of collection, transportation and cultivation of specimens. Treatment is complicated by the slow growth of anaerobes, by their growing resistance to antimicrobials, and by the polymicrobial nature of the infection. Antimicrobial therapy is often the only form of therapy required, whereas in others it is an adjunct to a surgical approach. Because anaerobic bacteria generally are recovered mixed with aerobic organisms, the choice of appropriate antimicrobial agents should provide for adequate coverage of both types of pathogens. Show more

Keywords: Anaerobes, Bacteroides fragilis, Clostridium spp., children

DOI: 10.3233/JPI-2009-0145

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 3-9, 2009

Authors: Wong, Kelli A. | Steele, Russell W.

Article Type: Research Article

Abstract: Clinical practice guidelines for the management of acute sinusitis in children have been published by the American Academy of Pediatrics. Of note is that in this document, a brief discussion of chronic disease concluded that the bacterial pathogens causing disease, pathogenesis and management are essentially unknown. Although there are insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of the literature and clinical experience of experts who manage pediatric chronic sinusitis is …presented in an effort to develop specific recommendations and to offer practical treatment options. It is apparent that anaerobic bacteria play a major role in this infection thereby influencing the natural history of disease and directing, to a great degree, medical management. Show more

Keywords: Sinusitis, chronic sinusitis, immunodeficiency, allergy, gastroesophageal reflux

DOI: 10.3233/JPI-2009-0146

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 11-16, 2009

Authors: Brook, Itzhak

Article Type: Research Article

Abstract: Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck in children. This review summarizes the aerobic and anaerobic microbiology and antimicrobial therapy of acute and chronic upper respiratory tract infection and other head and neck infections. These infections include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal …and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Show more

Keywords: Upper respiratory tract infection, anaerobes, Haemophilus influenzae, abscess, antimicrobials

DOI: 10.3233/JPI-2009-0147

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 17-26, 2009

Authors: Alsubie, Haya | Fitzgerald, Dominic A.

Article Type: Research Article

Abstract: Lung abscess is an uncommon but challenging condition to manage. Predisposing factors including pulmonary aspiration and impaired mucociliary defense mechanisms increase the likelihood of developing a secondary lung abscess. Aspirating anaerobic organisms from the mouth leading to pneumonia and a secondary lung abscess is more likely to be seen in children with neuro-cognitive impairment. The more likely anaerobic organisms include Peptostreptococcus species, Fusobacterium nucleatum and Prevotella melaninogenica. These organisms may be …difficult to isolate without specific anaerobic transport vials and culture media. The rise of interventional radiology, higher positive culture results, better targeted antibiotic regimes and a greater awareness of hospital acquired pathogens have been significant is decreasing the length of hospitalization for children with lung abscesses. The morbidity and mortality for lung abscess in children is vastly superior to that in adult patients because of the lack of co-morbidities in the pediatric population. Show more

Keywords: Lung abscess, pathophysiology, microbiology, anaerobes, interventional radiology, antibiotic therapy

DOI: 10.3233/JPI-2009-0148

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 27-35, 2009

Authors: Hamilton, Nicholas A. | Mazuski, John E.

Article Type: Research Article

Abstract: Complicated intra-abdominal infections are a common problem in children. The etiology of these infections varies by age, with necrotizing enterocolitis being the most common cause in neonates, and appendicitis the most common cause in children. Diagnosis is based on clinical and laboratory findings as well as appropriate imaging studies. These infections are generally the result of mixed gastrointestinal flora, most commonly Escherichia coli and Bacteroides spp. The basic treatment principles for complicated …intra-abdominal infections include adequate hemodynamic resuscitation, appropriate antimicrobial therapy, and source control. Antibiotic regimens should include agents effective against common Gram-negative facultative/aerobic bacilli as well as anaerobes. Increased antibiotic resistance has developed among several of the pathogens involved in these infections, which may need to be taken into consideration when selecting empiric therapy. In addition to appropriate antimicrobial therapy, adequate source control has been considered essential in the management of these infections. However, the need for definitive source control procedures in all patients has been challenged, and it has been demonstrated that deferral of these procedures or use of drainage instead of definitive procedures may suffice in selected children and neonates. The advent of laparoscopic procedures has also allowed less invasive approaches to be used in managing the nidus of infection. In this review, some aspects of the etiology, diagnosis and treatment of pediatric intra-abdominal infections will be addressed, particularly with regard to controversies in the use of antimicrobial therapy and source control procedures for these infections. Show more

Keywords: Intra-abdominal infection, secondary peritonitis, intra-abdominal abscess, appendicitis, necrotizing enterocolitis, antimicrobial therapy

DOI: 10.3233/JPI-2009-0149

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 37-45, 2009

Authors: Pandey, Anand | Gangopadhyay, Ajay N. | Sharma, Shiv P. | Kumar, Vijayendra | Upadhyaya, Vijai D.

Article Type: Research Article

Abstract: Necrotizing fasciitis is a rapidly progressive and potentially fatal infection. It is a rare infectious entity that posses challenging diagnostic and therapeutic management for a pediatric surgeon. Anaerobic bacteria are the predominant flora in the normal human skin and mucous membranes and are, therefore, a common cause of endogenous infections. Infections due to anaerobes are often polymicrobial, and include aerobic and facultative bacteria. Some predisposing conditions are found to be associated with the recovery of certain …anaerobe organisms. This review aims to give a better understanding of the etiology, pathology, diagnosis and treatment of necrotizing fasciitis in children with special emphasis on the role of anaerobes. Show more

Keywords: Necrotizing fasciitis, children, anaerobes, anaerobic infection

DOI: 10.3233/JPI-2009-0150

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 47-52, 2009

Authors: Goldstein, Ellie J.C. | Stein, Gary E.

Article Type: Research Article

Abstract: Anaerobes are opportunistic pathogens that are the predominant indigenous normal flora of the skin and mucous membranes in humans. Anaerobic infections are common, often found in proximity to their anatomical locations, and may be difficult to treat. Anaerobes are usually found in mixed culture along with aerobes. This article reviews the activity of various classes of antimicrobials used against anaerobes, along with their pharmacodynamics, and the susceptibility patterns and resistance mechanisms of important anaerobic …pathogens such as Bacteroides fragilis. It is hoped that the reader will be able to use this information and synthesize it into an approach on how to select antimicrobials for anaerobic therapy. Show more

Keywords: Anaerobic bacteria, B. fragilis, carbapenems, antimicrobial resistance, pharmacokinetics

DOI: 10.3233/JPI-2009-0151

Citation: Journal of Pediatric Infectious Diseases, vol. 4, no. 1, pp. 53-65, 2009