Abstract:
OBJECTIVE:The frequency of children who are hospitalized with pneumococcal pneumonia complicated by necrosis, empyema/complicated parapneumonic effusion, and lung abscess seems to be increasing. The factors that contribute to this increase are unclear; therefore, the objective of this study was to describe and compare the relative frequency, clinical characteristics, and outcome of hospitalized children with complicated pneumonia with those of children with uncomplicated pneumonia caused by Streptococcus pneumoniae in the era of antibiotic resistance. METHODS:A multicenter, retrospective study of 8 children's hospitals in the United States was undertaken. A total of 368 children who were hospitalized with pneumococcal pneumonia identified from patients enrolled in the US Pediatric Multicenter Pneumococcal Surveillance Study over the period from September 1, 1993, to January 31, 2000 were studied. Demographic and clinical variables, antibiotic susceptibility, pneumococcal serotypes, antimicrobial therapy, and clinical outcome in hospitalized children with complicated versus uncomplicated pneumococcal pneumonia were measured. RESULTS:A total of 368 patients with pneumococcal pneumonia were identified. Of the 368 isolates, 47 (12.8%) were intermediate and 37 (10.1%) were resistant to penicillin; 18 (5%) were intermediate to ceftriaxone, and 9 (2.5%) were resistant to ceftriaxone. A total of 133 patients met the criteria for complicated pneumonia and had a chest tube placed; 56 of these patients subsequently underwent decortication. The proportion of hospitalized patients with complicated pneumococcal pneumonia increased progressively over the study period from 22.6% in 1994 to 53% in 1999. Patients with complicated disease were older (median age: 45 vs 27 months) and significantly more likely to be of white race and have chest pain on presentation compared with patients with uncomplicated disease. Patients who had complicated disease and underwent decortication were more likely to have pleural fluid lactate dehydrogenase levels of >7500 IU/L compared with those patients who had chest tube placement alone. Fifty-three percent of children who were > or =61 months of age and were hospitalized had complicated pneumonia. This group of children accounted overall for 42% of the patients with complicated pneumonia, 48.2% of the patients who subsequently underwent decortication, and 44% of the patients who had received a course of antibiotics before diagnosis. Pneumococcal serotypes 1, 6, 14, and 19 were the most prevalent serotypes causing disease, with serotype 1 causing 24.4% of the complicated cases versus 3.6% of the uncomplicated cases. Ninety-eight percent of the patients in both groups recovered from their pneumonia. Antibiotic resistance was not found to be more prevalent in those patients with complicated disease. CONCLUSIONS:The relative frequency of complicated disease in hospitalized children with pneumococcal pneumonia is increasing. Patients with complicated pneumococcal disease were older and significantly more likely to be of white race compared with those patients with uncomplicated disease. Pneumococcal serotype 1 caused significantly more disease in patients with complicated versus uncomplicated pneumonia. Patients with complicated disease were not more likely to be infected with an antibiotic-resistant isolate.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Tan TQ,Mason EO Jr,Wald ER,Barson WJ,Schutze GE,Bradley JS,Givner LB,Yogev R,Kim KS,Kaplan SLdoi
10.1542/peds.110.1.1subject
Has Abstractpub_date
2002-07-01 00:00:00pages
1-6issue
1 Pt 1eissn
0031-4005issn
1098-4275journal_volume
110pub_type
杂志文章,多中心研究相关文献
PEDIATRICS文献大全abstract:OBJECTIVE:Despite new treatments, congenital diaphragmatic hernia (CDH) still has high mortality. The aim of this study was to identify echocardiographic predictors of outcome in newborns with an isolated CDH. METHODS:We reviewed medical charts and echocardiograms of 40 newborns who presented with CDH in the first 24 ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.5.1106
更新日期:2000-05-01 00:00:00
abstract::Diabetic retinopathy (DR) is the leading cause of blindness in young adults in the United States. Early identification and treatment of DR can decrease the risk of vision loss in affected patients. This clinical report reviews the risk factors for the development of DR and screening guidance for pediatric patients wit...
journal_title:Pediatrics
pub_type: 杂志文章,实务指引
doi:10.1542/peds.2005-0875
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Our purpose with this work was to examine the relationship between negative comments about weight, shape, and eating and social adjustment, social support, self-esteem, and perceived childhood abuse and neglect. METHODS:A retrospective study was conducted with 455 college women with high weight and shape con...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-1806
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between specific television-viewing habits and both sleep habits and sleep disturbances in school children. METHODS:The parents of 495 children in grades kindergarten through fourth grade in three public elementary schools completed two retrospective survey questionnaires, one...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.104.3.e27
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. DESIGN:Randomized, multicenter, investigator-blinded. SETTING:Outpatient. PATIENTS:A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxim...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prevalence of severe fatigue in adolescent boys and girls, to explore the role of lifestyle factors in fatigue, and to investigate whether severe fatigue in a healthy population is associated with depression, anxiety, and comorbid factors also observed in chronic...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-2575
更新日期:2006-06-01 00:00:00
abstract::We describe here the case of an adolescent who developed eosinophilic hepatitis during treatment for attention-deficit/hyperactivity disorder with lisdexamfetamine dimesylate (Vyvanse [Shire US Inc, Wayne, PA]). A 14-year-old boy presented to his primary care provider with abdominal pain and worsening jaundice. A diag...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1835
更新日期:2010-06-01 00:00:00
abstract::The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscita...
journal_title:Pediatrics
pub_type:
doi:10.1542/peds.2014-1246
更新日期:2014-07-01 00:00:00
abstract::A program that calculates a value of clearance for an individual patient prior to reaching steady state in the early stages of aminophylline therapy is presented. The program is written for the Texas Instruments TI-59 programmable calculator and may be used with or without the PC-100C printer. The program can provide ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVES:To describe the developmental trajectories of mobility performance and daily activities in children and young adults with cerebral palsy (CP). To explore the influence of gross motor function and intellectual disability on these trajectories. METHODS:Four hundred and twenty-four Dutch participants with CP (...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2013-0499
更新日期:2013-10-01 00:00:00
abstract::A patient with homozygous sickle cell anemia is the youngest known to have died from acute splenic sequestration crisis. A cord blood screening program might have prevented this infant's death. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::Two patients with idiopathic Fanconi syndrome and glucose intolerance were studied from a metabolic perspective. They had fasting hyperglycemia, massive glucosuria, insulinopenia, ketosis, and elevated serum free fatty acids. There was a markedly blunted insulin secretory response to glucagon, tolbutamide, glucose, an...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVES:Pain in children with cerebral palsy (CP) is underrecognized, undertreated, and negatively affects quality of life. Communication challenges and multiple pain etiologies complicate diagnosis and treatment. The primary objectives of this study were to determine the impact of pain on activities and to identify...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-0224
更新日期:2013-08-01 00:00:00
abstract::Intestinal lymphangiectasia is characterized by obstruction of lymph drainage from the small intestine and lacteal dilation that distorts the villus architecture. Lymphatic vessel obstruction and elevated intestinal lymphatic pressure in turn cause lymphatic leakage into the intestinal lumen, thus resulting in malabso...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.107.2.416
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:Pulmonary vein stenosis is a rare, although often lethal, anomaly. Risk factors for the diagnosis of pulmonary vein stenosis are poorly characterized. In this study we sought to identify factors associated with pulmonary vein stenosis, paying particular attention to preterm birth. METHODS:By review of the ca...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-0075
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:To determine the frequency of symptomatic congenital cytomegalovirus (CMV) infection in the offspring of women with a recurrent maternal CMV infection and to characterize the demographic and newborn findings. METHODS:Study subjects consisted of infants with symptomatic congenital CMV infection identified by...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.104.1.55
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:To determine whether the incidence of neurosonographic and neurologic abnormalities is higher in cocaine-exposed infants at birth. METHODS:In utero exposure to cocaine was investigated in 39 term and near-term infants with positive urine screens for cocaine only and 39 matched control infants without drug ex...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::A family is presented in which three of four siblings had truncus arteriosus and other anomalies compatible with the third and fourth pharyngeal pouch syndrome (DiGeorge syndrome). The syndrome is uncommon and most of the reported cases have been solitary. In this family an autosomal recessive inheritance is possible....
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract::The Immunization Practices Advisory Committee ( ACIP ) has devised noninvasive, historical criteria for determining individuals who are susceptible to measles. These criteria, which involve proof of vaccination, are incorporated into school entrance regulations and are used to indicate people who require vaccination d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:In 1995, the Children's Medical Services (CMS) of the State of Georgia contracted with the Department of Pediatrics of the Medical College of Georgia (MCG) and the MCG Telemedicine Center to develop telemedicine programs to provide subspecialty care for children with special health care needs. This article pr...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.4.843
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:We hypothesized that maternal diabetes mellitus (DM) increases the risk for mortality, respiratory distress syndrome (RDS), and major complications of prematurity. METHODS:Analysis of prospectively collected (1995-2007) Israel National Very Low Birth Weight Infant Database. Maternal DM was recorded as preges...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-3443
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epilepsy affects 0.5% to 1% of children and is the most frequent chronic neurologic condition in childhood. Incidence rates appear to be declining in high-income countries. The validity of epilepsy diagnoses from different data sources varies, and contemporary population-based incidence studie...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-3908
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:The primary aim of this study was to identify interventions used by pediatric health care providers in treatment of overweight children and adolescents to identify provider educational needs. A secondary aim was to examine the association of certain provider characteristics with recommended evaluation practic...
journal_title:Pediatrics
pub_type: 评论,杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To determine the primary caretakers of children born to women with human immunodeficiency virus (HIV) infection. METHODS:We interviewed women at least 18 years of age who have been reported with HIV infection or acquired immunodeficiency syndrome to local health departments in 10 cities and states regarding ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVES:The long-acting beta2-adrenergic agonist salmeterol prevents exercise-induced asthma, but tolerance may develop to its bronchoprotective effect. We wanted to ascertain if the development of tolerance could be prevented by using a low-dose treatment regimen of 50 microg once daily, instead of the usual dose o...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.99.5.655
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To determine clinical characteristics in children with osteogenesis imperfecta (OI) regarding impairment (range of joint motion and muscle strength) and disability (functional skills) in relation to the different types of the disease, and to study the correlation between characteristics of impairment and disa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.99.2.e3
更新日期:1997-02-01 00:00:00
abstract::Ifosfamide is widely used in the treatment of pediatric solid tumors. Its main adverse effects are various forms of renal tubular and glomerular damage. Many risk factors have been proposed to play a role in the development and severity of nephrotoxicity in children receiving ifosfamide, among which are 1) patient's a...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.101.6.e8
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:We have used the combination of midazolam, a short-acting benzodiazepine, and ketamine, a "dissociative anesthetic," to provide conscious sedation for invasive or lengthy procedures. METHODS:A total of 350 procedures (74 lumbar punctures, 97 bone marrow aspirations or biopsies, 84 radiotherapy sessions, and ...
journal_title:Pediatrics
pub_type: 临床试验,评论,杂志文章
doi:10.1542/peds.99.3.427
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:To update clinical practice guidelines to assist primary care (PC) clinicians in the management of adolescent depression. This part of the updated guidelines is used to address practice preparation, identification, assessment, and initial management of adolescent depression in PC settings. METHODS:By using ...
journal_title:Pediatrics
pub_type: 杂志文章,实务指引
doi:10.1542/peds.2017-4081
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:This study evaluated age- and sedative agent-related differences in bispectral index across observed sedation levels in a large sample of children < 18 years of age. PATIENTS AND METHODS:With institutional review board approval and waiver of consent, data from 4 independently conducted studies were combined ...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.2006-2577
更新日期:2007-09-01 00:00:00