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      Hospital-acquired enterobacteriaceae Bloodstream Infections in Children Translated title: Szpitalne zakażenia krwi pałeczkami enterobacteriaceae u dzieci

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          Abstract

          Among the different age groups of children, newborns are most exposed to hospital-acquired bloodstream infection (HA-BS1), especially those who are burdened with additional risk factors, such as low birth weight, immaturity or exposition to medical procedures .

          The aim of this study was to analyze the aetiology of HA-BS1 among children at high risk, including incidence and drug resistance .

          The data was obtained from the PubMed database and included medico/ articles as welI as UNICEF and WHO reports published from 2002 to 2017. The study focused on newborns and older children (under 18 years old) with BS1. The main eligibility criteria, aport from age, were Enterobacteriaceae HA-BS1, and the use of invasive medico/ procedures. It was demonstrated that the main risk factors of infection were age and medico/ procedures. Due to non-specific symptoms, sepsis is difficult to diagnose, a fact which leads to a high mortality rate in newborns .

          The existence of such mufti-drug resistant strains as Extended-Spectrum β-Lactamases (ESBLs) or Carbapenem-Resistant Enterobacteriaceae (CRE) phenotypes is a grave couse for concern .

          Streszczenie

          Wśród różnych grup wiekowych u dzieci, noworodki należą do grupy najbardziej narażonej na zakażenia krwi (BSI), szczególnie te obciążone dodatkowymi czynnikami ryzyka, takimi jak mola urodzeniowa masa ciała, niedojrzałość lub poddanie procedurom medycznym .

          Celem opracowania była analiza etiologii zakażeń krwi u dzieci z uwzględnieniem zapadalności i oporności na leki .

          Dane uzyskane z bazy PubMed obejmowały publikacje medyczne oraz doniesienia UNICEF i WHO ogłoszone w latach 2002-2017. Badaniami objęto noworodki i starsze dzieci (poniżej 18 lat) z BS/. Głównymi kryteriami kwalifikacji, poza wiekiem, było zakażenie krwi poleczkami Enterobacteriaceae oraz stosowanie inwazyjnych procedur medycznych .

          Przedstawione czynniki ryzyka zakażenia wskazują na szczególne znaczenie wieku oraz procedur medycznych .

          Zwraca również uwagę wysoka śmiertelność noworodków z powodu posocznicy ze względu na trudności diagnostyczne, spowodowane jej nieswoistymi objawami .

          Niepokojącyjest fakt występowania także wielu szczepów wielolekoopornych, a wśród nich między innymi fenotypów β-laktamaz o rozszerzonym spektrum działania (ESBL) lub opornych na karbapenemy (CRE) .

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          Most cited references35

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          Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis.

          Trend data for causes of child death are crucial to inform priorities for improving child survival by and beyond 2015. We report child mortality by cause estimates in 2000-13, and cause-specific mortality scenarios to 2030 and 2035. We estimated the distributions of causes of child mortality separately for neonates and children aged 1-59 months. To generate cause-specific mortality fractions, we included new vital registration and verbal autopsy data. We used vital registration data in countries with adequate registration systems. We applied vital registration-based multicause models for countries with low under-5 mortality but inadequate vital registration, and updated verbal autopsy-based multicause models for high mortality countries. We used updated numbers of child deaths to derive numbers of deaths by causes. We applied two scenarios to derive cause-specific mortality in 2030 and 2035. Of the 6·3 million children who died before age 5 years in 2013, 51·8% (3·257 million) died of infectious causes and 44% (2·761 million) died in the neonatal period. The three leading causes are preterm birth complications (0·965 million [15·4%, uncertainty range (UR) 9·8-24·5]; UR 0·615-1·537 million), pneumonia (0·935 million [14·9%, 13·0-16·8]; 0·817-1·057 million), and intrapartum-related complications (0·662 million [10·5%, 6·7-16·8]; 0·421-1·054 million). Reductions in pneumonia, diarrhoea, and measles collectively were responsible for half of the 3·6 million fewer deaths recorded in 2013 versus 2000. Causes with the slowest progress were congenital, preterm, neonatal sepsis, injury, and other causes. If present trends continue, 4·4 million children younger than 5 years will still die in 2030. Furthermore, sub-Saharan Africa will have 33% of the births and 60% of the deaths in 2030, compared with 25% and 50% in 2013, respectively. Our projection results provide concrete examples of how the distribution of child causes of deaths could look in 15-20 years to inform priority setting in the post-2015 era. More evidence is needed about shifts in timing, causes, and places of under-5 deaths to inform child survival agendas by and beyond 2015, to end preventable child deaths in a generation, and to count and account for every newborn and every child. Bill & Melinda Gates Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.
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            Genome-based phylogeny and taxonomy of the 'Enterobacteriales': proposal for Enterobacterales ord. nov. divided into the families Enterobacteriaceae, Erwiniaceae fam. nov., Pectobacteriaceae fam. nov., Yersiniaceae fam. nov., Hafniaceae fam. nov., Morganellaceae fam. nov., and Budviciaceae fam. nov.

            Understanding of the phylogeny and interrelationships of the genera within the order 'Enterobacteriales' has proven difficult using the 16S rRNA gene and other single-gene or limited multi-gene approaches. In this work, we have completed comprehensive comparative genomic analyses of the members of the order 'Enterobacteriales' which includes phylogenetic reconstructions based on 1548 core proteins, 53 ribosomal proteins and four multilocus sequence analysis proteins, as well as examining the overall genome similarity amongst the members of this order. The results of these analyses all support the existence of seven distinct monophyletic groups of genera within the order 'Enterobacteriales'. In parallel, our analyses of protein sequences from the 'Enterobacteriales' genomes have identified numerous molecular characteristics in the forms of conserved signature insertions/deletions, which are specifically shared by the members of the identified clades and independently support their monophyly and distinctness. Many of these groupings, either in part or in whole, have been recognized in previous evolutionary studies, but have not been consistently resolved as monophyletic entities in 16S rRNA gene trees. The work presented here represents the first comprehensive, genome-scale taxonomic analysis of the entirety of the order 'Enterobacteriales'. On the basis of phylogenetic analyses and the numerous identified conserved molecular characteristics, which clearly distinguish members of the order 'Enterobacteriales' and the seven reported clades within this order, a proposal is made here for the order Enterobacterales ord. nov. which consists of seven families: Enterobacteriaceae, Erwiniaceae fam. nov., Pectobacteriaceae fam. nov., Yersiniaceae fam. nov., Hafniaceae fam. nov., Morganellaceae fam. nov., and Budviciaceae fam. nov.
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              Global, regional, and national causes of child mortality in 2008: a systematic analysis

              The Lancet, 375(9730), 1969-1987
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                Author and article information

                Journal
                Dev Period Med
                Dev Period Med
                jmotherandchild
                jmotherandchild
                Developmental Period Medicine
                Sciendo
                1428-345X
                2354-0060
                June 2019
                08 July 2019
                : 23
                : 2
                : 131-136
                Affiliations
                [1 ]Department of Microbiology, Jagiellonian University, Collegium Medicum , Kraków, Poland
                Author notes
                [* ] Marta Kłos Department of Microbiology, Jagiellonian University, Collegium Medicum, Czysta 18,31-121 Kraków, Poland tel. 694-380-057 klosmartha@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-2482-2944
                https://orcid.org/0000-0003-0756-1639
                Article
                devperiodmed.20192302.131136
                10.34763/devperiodmed.20192302.131136
                8522371
                31280250
                2e8d6f58-d8b8-4812-97d1-75630f49470b
                © 2019 Marta Kłos, Jadwiga Wójkowska-Mach, published by Sciendo

                This work is licensed under the Creative Commons Attribution 4.0 International License.

                History
                : 14 November 2018
                : 22 March 2018
                Page count
                Pages: 6
                Categories
                Review article/Praca poglądowa

                bsi,incidence,risk factors,drug resistance,zakażenie krwi,zapadalność,czynniki ryzyka,oporność na antybiotyki

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