Staphylococcal Pneumonia In Children Research Articles

Empyema thoracis complicating acute chest syndrome

Literature on the incidence of empyema thoracis complicating chest infection in developing countries is scanty; though it may occur in pneumococcal, Staphylococcal pneumonia in children. However its association with acute chest syndrome is a rare event. Hence we report, a case of a 10-year-old child with sickle cell anemia with empyema thoracis complicating acute chest syndrome.

An evaluation of the emerging vaccines and immunotherapy against staphylococcal pneumonia in children

BackgroundStaphylococcus aureus is a commensal of human skin and nares. It is also one of the leading nosocomial pathogens in both developed and developing countries and is responsible for a wide range of life threatening infections, especially in patients who are immunocompromised, post-surgery, undergoing haemodialysis and those who are treated with catheters and ventilators. Over the past two decades, the incidence of nosocomial staphylococcal infections has increased dramatically. Currently there are at least seven vaccine and immunotherapy candidates against S. aureus in the developmental phase targeting both active and passive immunization.MethodsWe used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging vaccines against Staphylococcus aureus relevant to several criteria of interest: answerability; cost of development, production and implementation; efficacy and effectiveness; deliverability, affordability and sustainability; maximum potential impact on disease burden reduction; acceptability to the end users and health workers; and effect on equity. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies) to participate. The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to sensitive nature of their involvement in such exercises. They answered questions from CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%.ResultsThe panel of experts expressed low levels of optimism (score around or below 50%) on the criteria of answerability, efficacy, maximum disease burden reduction potential, low cost of production, low cost of implementation and affordability; moderate levels of optimism (scores around 60 to 80%) that these vaccines could be developed at a low cost, and thus on the deliverability, sustainability and impact on equity; and high levels of optimism (scores above 80%) regarding acceptable of such a product to both the end-users and health workers. While assessing the candidates for passive immunization against S.aureus, the experts were poorly optimistic regarding low production cost, low implementation cost, efficacy, deliverability, sustainability, affordability and equity; moderately optimistic regarding answerability and acceptability to health workers and end-users. They were of the opinion that these interventions would have only a modest impact (3 to 5%) on the burden of childhood pneumonia. .ConclusionIn order to provide an effective vaccine against S. aureus, a number of unresolved issues in vaccine development relating to optimal antigenic target identification, criteria for acceptable efficacy, identification of target population, commercial development limitations, optimal timing of immunization strategy, storage, cold chain requirements and cost need to be addressed properly. There is still a great deal unknown about the complex interaction between S. aureus and the human host. However, given the nature of S. aureus and the lessons learned from the recent failure of two emerging vaccines, it is clear that a multi-component vaccine is essential. Combating only one virulence factor is not sufficient in the human host but finding the right combination of factors will be very challenging.

Linezolid dosing for staphylococcal pneumonia in children.

Linezolid dosing for staphylococcal pneumonia in children.

50 Years Ago in The Journal of Pediatrics: Staphylococcal Pneumonia in Children—A Review of 83 Cases

Koch R, Carson MJ, Donnell G. J Pediatr 1959;55:473-480 Koch et al published a review on staphylococcal pneumonia in children that covered a period between 1944 and 1958, during which a total of 83 patients were diagnosed on the basis of clinical and radiologic evidence of pneumonia together with pyopneumothorax or isolation of the organism from blood or empyema fluid. The authors noted an increase in incidence over the study period, the reason for which was unknown. The highest “hit” rate was among those younger than 12 months, and the mortality rate was significant at 12% with all fatality but 1 occurring in infants younger than 4 months. The combination of chloramphenicol and erythromycin was the most frequently prescribed therapy in those days. Staphylococcus aureus remains an important pathogen that frequently causes clinical disease in children, although staphylococcal pneumonia accounts for only 1% to 5% of all cases of community-acquired pneumonias. Classically patients present with an acute and severe illness. Destruction of bronchial walls leads to air-trapping and pneumatocele formation in approximately half of the cases. Pleural effusion and empyema are found in as many as 90% of the cases, with pneumothorax and pyopneumothorax remain as common and important complications. Methicillin-resistant S. aureus (MRSA) has become an increasing problem in pediatric patients over the past decade. MRSA commonly causes nosocomial pneumonia, but relatively few cases of MRSA community-acquired pneumonia have also been reported. Nowadays treatment regimen that includes vancomycin will be used if MRSA is the suspected culprit. Predisposition to pneumonia after previous influenza virus infection of the upper respiratory tract is another characteristic of S. aureus that has caught our attention lately. It is believed that influenza induces an increase in S. aureus–specific adhesion throughout the respiratory tract and S. aureus–specific proteases, which may increase influenza viral replication. This latter mechanism points to a synergistic relationship in which S. aureus increases influenza disease severity whereas influenza increases S. aureus infection and severity. Some strains of influenza A virus also decrease phagocytic killing of S. aureus, leading to increased host susceptibility to bacterial superinfection. Many studies have demonstrated that vaccination against influenza cuts down overall pneumonia risk; therefore one can rightly assume that influenza vaccination would prevent secondary bacterial infections, including MRSA.

Pneumonies staphylococciques graves de l'enfant

Between 1986 and 1999, 8 cases of severe pneumonia due Staphylococcus aureus strains producing the Panton and Valentine leucotoxin (PVL) were referred to the French reference centre for staphylococcal toxaemia. All but one patient were children and to determine the clinical features of these pneumonia we conducted a prospective surveillance during 1999. Staphylococcal pneumonia was defined according to usual standards. All the strains were tested for the gene coding PVL, the cases associated with PVL positive strains were considered as study group. Nosocomial pneumonia were excluded. 52 cases were referred and 16 were PVL positive. These pneumonia occurred in younger patients (median age = 14.8 vs. 70.1) which were previously healthy (40% of underlying disease in control) Remarkable features were the presence of viral infection in the preceding day (75% vs. 9%), the frequency of shock (81% vs. 53%), respiratory distress (75% vs. 53%) and hemoptysia (38% vs. 3%). Leucopenia was present in 79% of cases. Mortality was higher in the PVL group (75% vs. 47%). Severe staphylococcal pneumonia with shock, leucopenia, hemoptysia and high mortality rate have been previously described in children and young adults. We established the relationship between this syndrom and the PVL production by S. aureus. We believe that viral infection constitue the prerequisite altering the respiratory epithelium which secondary allows S. aureus invasion. The necrotizing action of the PVL leads to the massive haemorragic necrotic pneumonia. Staphyloccocal necrotizing pneumonia is a new entity which frequency is probably underestimated. Further studies are needed to determinate the prognosis factors, the role of S. aureus carriage and of viral infections. The description of this new syndrome could lead to changes in the management of staphylococcal pneumonia in children.

Plain chest film findings of staphylococcal pneumonia in children

Plain chest film findings of staphylococcal pneumonia in children

Pulmonary function following staphylococcal pneumonia in children.

Twenty three subjects with proven staphylococcal pneumonia (19 with empyema) were studied 12-25 years after the original infection. Clinical radiological, and lung function status and airway response to histamine inhalation was assessed. No clinical or radiological changes resulted from the original staphylococcal infection. No subject had physiological evidence of chronic lung disease and there was no evidence of an increased incidence of airways hyperreactivity.

Surgical management of pericarditis in Zaria, Nigeria.

Over eight years, 58 rural Nigerians with pericarditis were treated surgically in Zaria using basic surgical facilities. Eighteen patients had purulent pericarditis, associated with staphylococcal pneumonia in children, or pneumococcal pneumonia in adults. Treatment with antibiotics and prompt pericardiectomy appeared to be superior to drainage, since a quarter of those initially treated with surgical drainage developed early constriction and required pericardiectomy soon after. Thirteen patients had chronic pericardial effusions, of whom one had epicardial constriction and two had cardiomyopathy. Twenty-seven patients had chronic constrictive pericarditis but tuberculosis was confirmed histologically in three only. Echocardiographic findings remained unchanged in five patients evaluated before and after pericardiectomy. Eight of the 13 patients who died had already developed myocardial or hepatic insufficiency before operation, because of late presentation or diagnosis. Greater awareness of the significance of precordial pain in this rural population where ischaemic heart disease is rare would help in making an earlier diagnosis.

Staphylococcal pneumonia in children. An analysis of 30 cases.

24 cases of primary and 6 secondary staphylococcal pulmonary infection have been reviewed. There were 5 deaths. Late recognition, resistant organisms and inadequate treatment of various complications add to the mortality.

Staphylococcal Pneumonia in Childhood

We studied the long-term prognosis of staphylococcal pneumonia in childhood by examining 36 children 22 to 49 months after the acute episode. We evaluated pulmonary function at rest and during exercise, the incidence of recurrent respiratory tract infections, the progress of growth, and the occurrence of residual roentgenographic abnormalities. Only one patient had chronic bronchitis and localized cylindrical bronchiectasis; the remaining 35 were free from respiratory symptoms or abnormal physical signs. Six children showed moderate decrease in weight in relation to age, but they all had a history of low caloric intake. Lung roentgenograms showed complete resolution of the pneumonia in almost all children. Pulmonary function was normal at rest and during exercise. This study confirms the excellent long-term prognosis of adequately treated staphylococcal pneumonia in children.

Empyema in Childhood

The introduction of antibiotics two decades ago made it appear that empyema would pass into history as a surgical and medical problem. However, there has been an increase in the incidence of childhood empyema in recent years. 1-3 Today, childhood empyema is a common complication of staphylococcal pneumonia; Koch and coworkers reported a 74% incidence of empyema in 83 cases of staphylococcal pneumonia in children. 4 Kevy and Lowe reported empyema associated with 10 of 11 cases of streptococcal pneumonia. 5 In spite of this increase in the incidence of childhood empyema, many surgeons who treat adult empyema are not familiar with the course of this disease in children. Empyema in children is almost always seen following a primary pulmonary infection. Since the introduction of antibiotics, empyema in adults is most often associated with malignancy or an operative procedure. In addition, the management and prognosis of childhood empyema differ from

Staphylococcal pneumonia in children: A review of 83 cases

Staphylococcal pneumonia in children: A review of 83 cases

Staphylococcal pneumonia in children and adults.

Since 1950, 76 proved cases of pneumonia due to Staphylococcus aureus have been seen at the Los Angeles County Hospital. There has been a considerable increase in the incidence of this type of pneumonia beginning in 1954 and reaching a peak in 1956, with 21 cases. Nineteen cases were seen in the first half of 1958.