Neisseria meningitidis and cytomegalovirus simultaneous detection in the filmarray meningitis/encephalitis panel and its clinical relevance

A BioFire FilmArray Meningitis/Encephalitis test was performed on a 7-month old child suspected for bacterial meningitis. Two pathogens were detected, Neisseria meningitidis and cytomegalovirus (CMV). We verified the filmarray meningitis/encephalitis test by pan-bacterial assay to test for Neisseria meningitidis and CMV viral load test for the CMV detection. Pan-bacterial confirmed presence of N. meningitidis, but CMV was not detected by the CMV viral load test. Together with the manifestations of high fever, vomiting, diffuse petechial rash, bulging fontanel, and leukocytosis, it is a clear case of meningococcal meningitis, while CMV detection had no clinical relevance

Unstable Vancomycin Heteroresistance Is Common among Clinical Isolates of Methiciliin-Resistant Staphylococcus aureus

We tested 109 unique, vancomycin-susceptible, methicillin-resistant Staphylococcus aureus (MRSA) strains for vancomycin heteroresistance by a selection method, i.e., step-wise exposure of large inoculums to increasing concentrations of vancomycin. Although no strains demonstrated stable heteroresistance, 81 strains (74%) demonstrated unstable heteroresistance. Unstable heteroresistance is common among clinical isolates of MRSA and may represent a cause of therapeutic failure

Medical And Surgical Management Of Orbital Cellulitis In Children

Objective: The purpose of this study was to identify features of orbital cellulitis that predict response to conservative treatment without surgical intervention and factors associated with a decision for surgery

The Burden of COVID-19 in Children and Its Prevention by Vaccination: A Joint Statement of the Israeli Pediatric Association and the Israeli Society for Pediatric Infectious Diseases

As of October 2021, SARS-CoV-2 infections were reported among 512,613 children and adolescents in Israel (~33% of all COVID-19 cases). The 5–11-year age group accounted for about 43% (223,850) of affected children and adolescents. In light of the availability of the Pfizer-BioNTech BNT162b2 vaccine against COVID-19 for children aged 5–11 years, we aimed to write a position paper for pediatricians, policymakers and families regarding the clinical aspects of COVID-19 and the vaccination of children against COVID-19. The first objective of this review was to describe the diverse facets of the burden of COVID-19 in children, including the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the indirect effects of social isolation and interruption in education. In addition, we aimed to provide an update regarding the efficacy and safety of childhood mRNA COVID-19 vaccination and to instill confidence in pediatricians regarding the benefits of vaccinating children against COVID-19. We reviewed up-to-date Israeli and international epidemiological data and literature regarding COVID-19 morbidity and its sequelae in children, vaccine efficacy in reducing COVID-19-related morbidity and SARS-CoV-2 transmission and vaccine safety data. We conducted a risk–benefit analysis regarding the vaccination of children and adolescents. We concluded that vaccines are safe and effective and are recommended for all children aged 5 to 11 years to protect them from COVID-19 and its complications and to reduce community transmissions. Based on these data, after weighing the benefits of vaccination versus the harm, the Israeli Ministry of Health decided to recommend vaccination for children aged 5–11 years

Performance of BV in secondary (bacterial/viral/suspected) analysis cohort (n = 253).

(DOCX)</p

Diagnostic accuracy rate of etiological suspicion at the time of patient examination.

The calculations and assumptions are explained in Methods. Error bars indicate 95% confidence intervals. P-values were computed using a one-sided Fisher-exact test; significant p-values appear in red text. Data are shown for the primary (reference standard bacterial/viral) cohort that had completed questionnaires; n = 208.</p

S1 File -

(XLSX)</p

Distribution of BV scores according to reference standard diagnosis.

Each circle represents a patient in the study population (n = 287). Red line corresponds to group median and red circle corresponds to group average. (DOCX)</p

Patient enrollment flow.

Summary of patients enrolled in the study. Primary (bacterial/viral) cohort (n = 214) includes reference standard bacterial (n = 18) and reference standard viral (n = 196). Secondary (bacterial/viral/suspected) cohort (n = 253) includes the reference standard bacterial/viral (n = 214) as well as the reference standard suspected bacterial (n = 10) and reference standard suspected viral (n = 29). RTI, respiratory tract infection and FWS, fever without source were based on the suspected clinical syndrome as recorded by the physician in the questionnaire.</p

Standards for the reporting of diagnostic accuracy studies (STARD) checklist.

(DOCX)</p