Abstract：
OBJECTIVE:Infections with multidrug-resistant organisms (MDROs) such as Gram-negative bacteria have high morbidity and mortality with limited treatment options. Colistin, an antibiotic active against MDRO, was rarely used due to frequent adverse effects, but its use has now been recommended among adults. In this study, we determined the efficacy of colistin for the treatment of sepsis in neonates. DESIGN/SETTING/PATIENTS/OUTCOMES:We conducted a retrospective record review of all neonates admitted to the neonatal intensive care unit of Aga Khan University Hospital, Karachi, Pakistan, between June 2015 and June 2018, who had sepsis and received colistin by intravenous, inhalation and/or intrathecal routes. Predictors of colistin efficacy, for neonatal survival and microbial clearance, were assessed using multiple logistic regression. RESULTS:153 neonates received colistin; 120 had culture-proven sepsis; and 93 had MDR-GNB (84 colistin-sensitive). 111 (72.5%) neonates survived and were discharged from hospital; 82.6% had microbial clearance. Neonates with colistin-sensitive bacteria (adjusted OR (AOR)=3.2, 95% CI 2.8 to 4.0), and those in which colistin therapy started early (AOR=7.2, 95% CI 3.5 to 13.6) were more likely to survive. Neonates with increased gestational age (AOR=1.9, 95% CI 1.5 to 3.0), higher weight (AOR=5.4, 95% CI 3.3 to 11.8) and later onset of sepsis (AOR=4.3, 95% CI 2.0 to 9.0) had higher survival. Adverse events included nephrotoxicity in 5.2%; 13.7% developed seizures and 18.3% had electrolyte imbalance. CONCLUSIONS:Colistin therapy was associated with survival among neonates suffering from MDR-GNB sepsis. The frequency of side effects was moderate.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Ambreen G,Salat MS,Hussain K,Raza SS,Ali U,Azam I,Iqbal J,Fatmi Zdoi
10.1136/archdischild-2019-318067subject
Has Abstractpub_date
2020-09-01 00:00:00pages
830-836issue
9eissn
0003-9888issn
1468-2044pii
archdischild-2019-318067journal_volume
105pub_type
杂志文章abstract：:National trends in the survival of low birthweight infants for the years 1953 to 1979 were examined. While stillbirth and day 1-28 mortality rates improved steadily throughout this period, day 0 mortality did not start to fall until the mid-1960s and then it improved in all birthweight groups. This suggests that speci...
journal_title：Archives of disease in childhood
pub_type： 历史文章,杂志文章
doi：10.1136/adc.56.2.86
更新日期：1981-02-01 00:00:00
abstract：BACKGROUND:Long term growth hormone (GH) treatment in children with idiopathic short stature (ISS) results in a relatively small mean gain in final height of 3-9 cm, which may not justify the cost of treatment. As it is unknown whether GH treatment during puberty adds to final height gain, we sought to improve the cost...
journal_title：Archives of disease in childhood
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1136/adc.87.3.215
更新日期：2002-09-01 00:00:00
abstract：:Dubowitz et al. have offered a scoring system for estimating the gestational age of newborn babies. If the system is applied to twin pairs, the heavier twin is generally estimated to have a greater gestational age than the lighter one. Previously this has been interpreted as a flaw in the scoring system. However, it m...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.55.4.281
更新日期：1980-04-01 00:00:00
abstract：OBJECTIVES:To evaluate the outcome of percutaneous transluminal angioplasty (PTA) in children with renovascular hypertension (RVH) treated at a single centre over 29 years. METHODS:A retrospective study of the medical charts of all children with RVH who underwent PTA between 1984 and 2012. The primary outcome measurem...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/archdischild-2013-305886
更新日期：2015-05-01 00:00:00
abstract：:Early postnatal malnutrition produces delay in growth and developmental processes, and children from a low socioeconomical level where undernutrition is prevalent are shorter than those from higher socioeconomic levels. We examined the effects of severe and early protein energy malnutrition on growth and bone maturati...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.61.3.257
更新日期：1986-03-01 00:00:00
abstract：:Two neonates with spontaneous rupture of the bladder and an otherwise normal genitourinary tract are described. Conservative management resulted in complete resolution of the lesion in one but the other child died from a coliform septicaemia. Necropsy showed a discrete ischaemic lesion in the fundus of the bladder. ...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.60.7.676
更新日期：1985-07-01 00:00:00
abstract：:The response of desamino-D-arginine vasopressin (DDAVP) was investigated in 32 enuretic children in a double-blind clinical study. The 15 children treated with DDAVP showed a significant reduction in the incidence of bed wetting--from 18.7 +/- 6.5 to 6.5 +/- 9.2 wet nights per 30 days. In 6 children bed wetting stoppe...
journal_title：Archives of disease in childhood
pub_type： 临床试验,杂志文章
doi：10.1136/adc.57.2.137
更新日期：1982-02-01 00:00:00
abstract：:The past year has produced several new clinical guidelines germane to paediatric dermatology, as well as important work related to rheumatologic overlap disorders, psoriasis comorbidities, pigmented lesions and quality of life impact. This review highlights common diagnoses and treatments useful for the practicing pae...
journal_title：Archives of disease in childhood
pub_type： 杂志文章,评审
doi：10.1136/archdischild-2013-304398
更新日期：2014-10-01 00:00:00
abstract：AIMS:To investigate a population of individuals with 22q11 deletion syndrome for hypocalcaemia. METHODS:A detailed clinical history enquiring into symptoms of hypocalcaemia and blood sampling to assess for hypocalcaemia and hypoparathyroidism, of patients outside the neonatal period known to have the 22q11 microdeleti...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.88.6.520
更新日期：2003-06-01 00:00:00
abstract：AIM:To identify the experiences of patients, parents or carers when a child/young person is prescribed a new long-term medicine. METHOD:Patients' prescribed a new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy.A semi-structured questionnaire was administered to p...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/archdischild-2016-311535.58
更新日期：2016-09-01 00:00:00
abstract：SITUATION:Patient I is a 15 year old female with ornithine transcarbamylase deficiency prescribed L-arginine 1.5 g three times daily and sodium benzoate 4.2 g three times daily. By taking her medication and controlling her diet she is able to lead a normal life and does well at school. However she struggles with the pa...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/archdischild-2016-311535.8
更新日期：2016-09-01 00:00:00
abstract：:An intravenous urogram and micturating cystourethrogram were carried out in 100 infants presenting with documented urinary tract infections. Ninety three cases were identified by suprapubic aspiration and 7 by culture of two voided urine samples containing greater than 100 X 10(6) organisms per litre. The urinary trac...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.59.7.620
更新日期：1984-07-01 00:00:00
abstract：OBJECTIVE:To examine the policy, administration, and supervision of medicine administration in primary schools within the Greater London area (GLA). DESIGN:A prospective survey using postal questionnaires sent to 172 randomly selected primary schools within the GLA. PARTICIPANTS:Head teachers of primary schools. RES...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.2003.047258
更新日期：2004-11-01 00:00:00
abstract：:Delayed puberty (DP) is defined as the lack of pubertal development by an age that is 2-2.5 SDs beyond the population mean. Although it generally represents a normal variant in pubertal timing, concern that DP could be the initial presentation of a serious underlying disorder has led to a diagnostic approach that is v...
journal_title：Archives of disease in childhood
pub_type： 杂志文章,评审
doi：10.1136/archdischild-2015-310375
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:To investigate whether meningococcal C conjugate vaccine (MCCV) caused relapse in children with steroid-responsive nephrotic syndrome. DESIGN:A population-based study was conducted using an active surveillance system, developed to assess adverse events following vaccination, which linked hospital record inf...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.2006.105247
更新日期：2007-10-01 00:00:00
abstract：OBJECTIVE:Assays based on interferon gamma (IFNgamma) are an exciting new development for screening for latent tuberculosis infection (LTBI) in adults, but there are limited data on their effectiveness in children. Nevertheless new National Institute for Health and Clinical Excellence (NICE) guidelines recommend their ...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.2006.106617
更新日期：2008-03-01 00:00:00
abstract：:Serial small intestinal biopsies related to withdrawal and challenge with cows' milk are described in 5 infants with cows' milk protein intolerenace. On the basis of these serial observations the existence of a cows' milk-sensitive enteropathy in infancy is clearly established. The cows' milk-sensitive mucosal lesion ...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.53.5.375
更新日期：1978-05-01 00:00:00
abstract：:The auditory function of 370 infants, drawn from both low and high risk groups, was tested before postnatal discharge using three tests: standard auditory brain stem responses (ABR), automated analysis of ABR, and automated analysis of evoked otoacoustic emissions (OAE). All infants failing any neonatal test had furth...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.66.10_spec_no.1124
更新日期：1991-10-01 00:00:00
abstract：:Over 15 years, 42 children aged 2-14 years were diagnosed as having acquired aplastic anaemia. Adequate clinical details were available for 38 children who were categorised as very severe (n = 13), severe (n = 16), or nonsevere (n = 9) by the modified Camitta criteria. Treatment varied over the study period. Seven chi...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.66.7.858
更新日期：1991-07-01 00:00:00
abstract：:Anomalies of the bronchial cilia were studied in 5 children with recurrent pulmonary infections. Case 1 had Kartagener's syndrome and an absence of the inner and outer dynein arms in most cilia, although a few shortened and even some normal arms could be seen. Cases 2 and 3 had unilateral bronchiectasis without family...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.56.12.929
更新日期：1981-12-01 00:00:00
abstract：:Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environmental enteropathy, ...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/archdischild-2014-306026
更新日期：2015-03-01 00:00:00
abstract：:Infant feeding methods used by mothers who smoke and by mothers who do not, who delivered in one maternity hospital, were compared to determine if smoking affected breast feeding. Significantly more of the smoking group chose either to bottle feed from delivery or, having been discharged from the hospital breast feedi...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.58.5.378
更新日期：1983-05-01 00:00:00
abstract：:A questionnaire study regarding airway morbidity in children and environmental factors was performed in April 1985. The parents of 5301 children, aged 6 months to 16 years, from different rural areas in mid Sweden were sent a validated questionnaire and 4990 (94%) responded. The cumulative prevalence of bronchial hype...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.63.5.473
更新日期：1988-05-01 00:00:00
abstract：:Of 80 children with proved coeliac disease, 2 presented with an associated disease of the distal portion of the large intestine. In one child the family history and the extension, localisation, and characteristics of intestinal lesions made us suspect ulcerative colitis; in the other we made a diagnosis of milk-induce...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.53.8.645
更新日期：1978-08-01 00:00:00
abstract：AIM:To describe the nature and causes of reported patient safety incidents relating to care in the community for children dependent on long-term ventilation with the further aim of improving safety. METHODS:We undertook an analysis of patient safety incident data relating to long-term ventilation in the community usin...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/archdischild-2019-317965
更新日期：2020-05-01 00:00:00
abstract：:Post-thrombotic syndrome (PTS) is a potentially disabling complication occurring in up to 67% of adult patients following deep venous thrombosis (DVT). PTS has recently been recognised in children. We present three cases of symptomatic PTS in children, which occurred following the use of central venous lines (CVLs). I...
journal_title：Archives of disease in childhood
pub_type： 杂志文章,评审
doi：10.1136/adc.86.3.212
更新日期：2002-03-01 00:00:00
abstract：:A cohort of 164 children born within the defined boundaries of greater Manchester during the years 1981 to 1984 inclusive were identified as having bilateral sensorineural hearing loss, giving a prevalence of 1.2/1000 population of 1/817 births. Ninety three children developed an additional conductive hearing loss sec...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.65.7.757
更新日期：1990-07-01 00:00:00
abstract：:Cellobiose and mannitol absorption were studied in patients with suspected abnormal function of the small bowel mucosa. The urinary cellobiose:mannitol ratio was increased in subtotal villous atrophy, iron deficiency anaemia, and small intestinal Crohn's disease. The test seems a sensitive indicator of the integrity o...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.64.6.853
更新日期：1989-06-01 00:00:00
abstract：:Forty-seven cases of prune belly syndrome in children born between 1948 and 1977 are described. They have been classified into three groups according to the state of the urinary tract in the neonatal period. The results achieved in these cases form the basis of our present management. In group I, the most severely aff...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.57.11.856
更新日期：1982-11-01 00:00:00
abstract：AIMS:To compare the respiratory health and function at 8 to 9 years of age of a total population based cohort of 300 very low birthweight (VLBW) children with that of two classroom controls (n = 590) matched for age and sex. STUDY DESIGN:Cohort study with controls. SETTING:Schools throughout Scotland. RESULTS:The VL...
journal_title：Archives of disease in childhood
pub_type： 杂志文章
doi：10.1136/adc.74.3.188
更新日期：1996-03-01 00:00:00
