Puerperal fever and neonatal pleural empyema and bacteremia caused by group A streptococcus

A term neonate developed early onset of sepsis and pleural empyema with group A streptococcus. Her mother also became septic with group A streptococcus in the early postpartum period. The infant required initial chest tube drainage. After reaccumulation of pleural fluid after removal of the chest tube, a thoracotomy with decortication was performed. The isolates of group A streptococcus were analyzed and found to be identical serotypes of the same bacterium. The serotyping revealed both to be M type 1, T pattern 1. Polymerase chain reaction detected the genomic sequence for streptococcal pyrogenic exotoxin A and B in both isolates. With the increase in invasive streptococcal infections in the community, serious perinatal infections may become more frequent

Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

IntroductionContinuous renal replacement therapy (CRRT) is used for the symptomatic management of acute kidney injury (AKI) and fluid overload (FO). Contemporary reports on pediatric CRRT are small and single center in design. Large international studies evaluating CRRT practice and outcomes are lacking. Herein, we describe the design of a multinational collaborative.MethodsThe Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) is an international collaborative of pediatric specialists whose mission is to improve short- and long-term outcomes of children treated with CRRT. The aims of this multicenter retrospective study are to describe the epidemiology, liberation patterns, association of fluid balance and timing of CRRT initiation, and CRRT prescription with outcomes.ResultsWe included children (n = 996, 0-25 years) admitted to an intensive care unit (ICU) and treated with CRRT for AKI or FO at 32 centers (in 7 countries) from 2018 to 2021. Demographics and clinical characteristics before CRRT initiation, during the first 7 days of both CRRT, and liberation were collected. Outcomes include the following: (i) major adverse kidney events at 90 days (mortality, dialysis dependence, and persistent kidney dysfunction), and (ii) functional outcomes (functional stats scale).ConclusionThe retrospective WE-ROCK study represents the largest international registry of children receiving CRRT for AKI or FO. It will serve as a broad and invaluable resource for the field of pediatric critical care nephrology that will improve our understanding of practice heterogeneity and the association of CRRT with clinical and patient-centered outcomes. This will generate preliminary data for future interventional trials in this area