Shigatoxin E. coli (STEC) in Public Park at Different Seasons of the Year

BACKGROUND: In the U.S. STEC HUS is the most common cause of acute renal failure in children. In TN from 1996-2017 there were 2008 STEC cases were reported. Every year in the U.S, there 36 reported mortality each year. At our local children’s hospital, 4-5 children are hospitalized with STEC infection each year. Some of these children had no history of ingesting food items that could have placed them at risk to develop STEC infection; however, there are other ways that humans could get infected, such as exposure to contaminated water from cattle farms. GOALS: To determine if there are differences in the presence of STEC at a local park at different seasons of the year. METHODS: Fifty (50) ml of water samples were collected from a creek in 2 areas of public park in Johnson City, TN. Samples were inoculated to Sorbitol McConkey Agar (SMAC) plates under sterile techniques & incubated at 36C for 18 hours under aerobic conditions. RESULTS: Table demonstrating presence of STEC from water samples at different seasons of the year. SEASON OF THE YEAR # COLONIES FOUNDERS PARK # COLONIES LIBRARY PARK SUMMER JUNE 2018 A:1 B:1 C:2 TOTAL: 4 A: 3 B: 2 C: 1 TOTAL: 6 FALL SEPT 2018 A: 1 B: 3 C: 2 TOTAL: 6 A: 1 B:2 C:4 TOTAL: 7 WINTER DEC 2018 A: 1 B: 0 C: 1 TOTAL: 2 A: 0 B: 1 C: 1 TOTAL: 2 SPRING MARCH 2019 A: 2 B: 2 C:1 TOTAL: 5 A: 0 B: 0 C: 0 TOTAL: 0 DISCUSSION/ CONCLUSION: STEC was present at almost every season of the year. Public health measures should be undertaken to inform the community that these waters around public parks are contaminated with STEC to prevent STEC infection. References: TN Dept of Health CEDEP report CDC websit

Streptococcus Pneumoniae Bacteremia in a Late Preterm Infant

Neonatal sepsis is an important cause of neonatal morbidity and mortality. There are two distinct types of sepsis- early and late onset. Group B streptococcus and Listeria are the most common causes of early onset neonatal sepsis historically. Physicians select antibiotics for neonates with fever based on historically common bacterial pathogens such as GBS, Ecoli, Listeria, and Staphylococcal aureus. However, the landscape of bacterial pathogens causing sepsis and fever in neonates seems to be changing. This could potentially change the first choice of antibiotics for this susceptible population. In this case study, we will present early-onset sepsis in a late preterm infant due to Streptococcus pneumoniae as confirmed by blood culture. The only maternal risk factors present in this case for septicemia were delivery less than 37 weeks. Patient initially had respiratory distress at delivery and required CPAP for 3 days. On day 2 of life, cultures were taken due to acute deterioration. Ampicillin and Gentamycin were given to the patient for empiric coverage initially. On day 2 of antibiotics, cultures were reported positive. Patient’s antibiotics had to be altered at that time to cover the isolated organism. The patient was inadequately treated up until cultures were positive. This case raises the question if Ampicillin and Gentamycin remain the best choice for broad antibiotic coverage in neonates with possible sepsis

Treatment of CMV Vitritis in a Preterm Newborn

Title: Treatment of CMV Vitritis in a Preterm Newborn Author’s Section: Remil Simon1, Darshan Shah1, Peter Blosser1, Demetrio Macariola1, Jeffrey Carlsen2 1.Department of Pediatrics, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 2.Johnson City Eye Clinic, Johnson City, TN Body: Cytomegalovirus (CMV) infection in the neonate is an infrequent occurrence in the developing world, and observing the symptoms of ocular CMV infection such as vitritis is rare. Treating CMV infection promptly is necessary to prevent mortality and potential neurological deficits including blindness and hearing loss. We encountered a preterm infant presenting with CMV sepsis immediately after birth. Our question was: will the current standard of treatment for CMV sepsis prevent CMV ocular infection? With our method of treatment, we followed the current standard of treatment for CMV infection by administering intravenous Gancyclovir for 6 weeks and oral Valgancyclovir for 6 months. Despite using the standard treatment to prevent neurological sequelae, the patient developed CMV vitritis and retinitis bilaterally. Although the treatment did not prevent CMV ocular infection, the severity of CMV retinitis and vitritis improved with treatment, and full resolution of vitritis was noted by day of life 61