Invasive fungal disease in PICU: epidemiology and risk factors

Candida and Aspergillus spp. are the most common agents responsible for invasive fungal infections in children. They are associated with a high mortality and morbidity rate as well as high health care costs. An important increase in their incidence has been observed during the past two decades. In infants and children, invasive candidiasis is five times more frequent than invasive aspergillosis. Candida sp. represents the third most common agent found in healthcare-associated bloodstream infections in children. Invasive aspergillosis is more often associated with hematological malignancies and solid tumors. Recommendations concerning prophylactic treatment for invasive aspergillosis have been recently published by the Infectious Diseases Society of America. Candida albicans is the main Candida sp. associated with invasive candidiasis in children, even if a strong trend toward the emergence of Candida non-albicans has been observed. The epidemiology and the risk factors for invasive fungal infections are quite different if considering previously healthy children hospitalized in the pediatric intensive care unit, or children with a malignancy or a severe hematological disease (leukemia). In children, the mortality rate for invasive aspergillosis is 2.5 to 3.5 higher than for invasive candidiasis (respectively 70% vs. 20% and 30%)

Multiple Erythematous Nodules and Ecthyma Gangrenosum as a Manifestation of Pseudomonas aeruginosa Sepsis in a Previously Healthy Infant

Pseudomonas aeruginosa septicemia is rare in healthy infants and children. Also not common, dermatologic manifestations such as ecthyma gangrenosum and indurated erythematous nodular lesions may be the first signs of pseudomonas infection, or may appear later in the course of the disease. Peripheral facial paralysis and mastoiditis are also rare and serious complications of acute otitis media caused by P. aeruginosa. We report a previously healthy 6-month-old boy who had an uncommon presentation and rare complications during the course of P. aeruginosa sepsis

Variant analysis from bacterial isolates affirms DnaK crucial for multidrug resistance

Next-generation sequencing and associated computational analyses have become powerful tools for comparing the whole genomes and detecting the single nucleotide polymorphisms (SNPs) within the genes. In our study, we have identified specific mutations within the plausible drug resistant genes of eight multidrug resistant (MDR) bacterial species. Essentially, we have unearthed few proteins, involved in folding and enabling survival under stress, to be the most crucial ones from the network of the whole genome protein interactome (PIN) of these species. To confirm the relevance of these proteins to antibiotic resistance, variant analyses were performed on all the selected MDR species, isolated from patients’ samples in PATRIC database, against their respective reference genomes. The SNPs found in the patient isolates revealed the nucleotide changes from C to A on DnaK, thereby altering a single amino acid change that might lead to misfolding of proteins. Thus, we propose DnaK to be the best characterized bacterial chaperone having implications in multidrug resistance. To this end, to provide an alternative solution to tackle MDR, docking studies were performed with a phenaleno-furanone derivative which revealed the highest binding energy and inhibition against DnaK