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Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?

The objective was to investigate the prevalence of Pseudomonas aeruginosa (PA) in patients with complex neurodisability and current treatment practice in our centre in order to inform future guidelines. A retrospective case note review was undertaken at a tertiary children’s hospital. One hundred si...

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Autores principales: Gregson, Elizabeth, Thomas, Lowri, Elphick, Heather E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346391/
https://www.ncbi.nlm.nih.gov/pubmed/33822245
http://dx.doi.org/10.1007/s00431-021-04025-y
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author Gregson, Elizabeth
Thomas, Lowri
Elphick, Heather E
author_facet Gregson, Elizabeth
Thomas, Lowri
Elphick, Heather E
author_sort Gregson, Elizabeth
collection PubMed
description The objective was to investigate the prevalence of Pseudomonas aeruginosa (PA) in patients with complex neurodisability and current treatment practice in our centre in order to inform future guidelines. A retrospective case note review was undertaken at a tertiary children’s hospital. One hundred sixty-two patients (mean age 11.7 years) with a primary diagnosis of neuromuscular disease (NMD) or severe cerebral palsy (CP) and a respiratory sample sent for analysis during the study period were studied. Associations between PA in respiratory samples and diagnosis, long-term ventilation, presence of a gastrostomy or a tracheostomy, antibiotic choice, clinical deterioration and adverse events were analysed. Twenty-five (15%) had one or more PA isolate in respiratory samples. There was a significant association between PA in respiratory samples and tracheostomy (p<0.05). In 52% samples, multiple pathogens co-existed. There was no significant association between choice of antibiotic and clinical outcome but when antibiotics were changed to specific PA antibiotics during the course of the illness, all resulted in clinical improvement. Twenty-six episodes involving 8 patients with recurrent admissions involved PA organisms that were resistant to one or more antibiotics. Conclusions: A larger prospective study may establish clearer criteria for guideline development. Techniques such as point-of-care testing to identify virulent strains of PA may improve patient outcomes and prevent the development of antibiotic resistance in the future.
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spelling pubmed-83463912021-08-20 Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat? Gregson, Elizabeth Thomas, Lowri Elphick, Heather E Eur J Pediatr Original Article The objective was to investigate the prevalence of Pseudomonas aeruginosa (PA) in patients with complex neurodisability and current treatment practice in our centre in order to inform future guidelines. A retrospective case note review was undertaken at a tertiary children’s hospital. One hundred sixty-two patients (mean age 11.7 years) with a primary diagnosis of neuromuscular disease (NMD) or severe cerebral palsy (CP) and a respiratory sample sent for analysis during the study period were studied. Associations between PA in respiratory samples and diagnosis, long-term ventilation, presence of a gastrostomy or a tracheostomy, antibiotic choice, clinical deterioration and adverse events were analysed. Twenty-five (15%) had one or more PA isolate in respiratory samples. There was a significant association between PA in respiratory samples and tracheostomy (p<0.05). In 52% samples, multiple pathogens co-existed. There was no significant association between choice of antibiotic and clinical outcome but when antibiotics were changed to specific PA antibiotics during the course of the illness, all resulted in clinical improvement. Twenty-six episodes involving 8 patients with recurrent admissions involved PA organisms that were resistant to one or more antibiotics. Conclusions: A larger prospective study may establish clearer criteria for guideline development. Techniques such as point-of-care testing to identify virulent strains of PA may improve patient outcomes and prevent the development of antibiotic resistance in the future. Springer Berlin Heidelberg 2021-04-06 2021 /pmc/articles/PMC8346391/ /pubmed/33822245 http://dx.doi.org/10.1007/s00431-021-04025-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Gregson, Elizabeth
Thomas, Lowri
Elphick, Heather E
Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title_full Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title_fullStr Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title_full_unstemmed Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title_short Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
title_sort pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346391/
https://www.ncbi.nlm.nih.gov/pubmed/33822245
http://dx.doi.org/10.1007/s00431-021-04025-y
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