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  • 1
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    The intraperitoneal bacteriology and antimicrobial resistance in acute appendicitis among children: a retrospective cohort study between the years 2007–2017
    Springer Science and Business Media LLC ; 2021
    In:  European Journal of Pediatrics Vol. 180, No. 7 ( 2021-07), p. 2091-2098
    Details
    In: European Journal of Pediatrics, Springer Science and Business Media LLC, Vol. 180, No. 7 ( 2021-07), p. 2091-2098
    Type of Medium: Online Resource
    ISSN: 0340-6199 , 1432-1076
    URL: Article
    DOI: 10.1007/s00431-021-03994-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2647723-3
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  • 2
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    NonTuberculous Mycobacteria Blood Stream Infection in Pediatric and Adult Patients : 15 Years Surveillance
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Pediatric Infectious Disease Journal Vol. 41, No. 5 ( 2022-05), p. e216-e219
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 5 ( 2022-05), p. e216-e219
    Abstract: Nontuberculous Mycobacteria (NTM) are rare causes of bloodstream infection (BSI). This study addresses the management and prognosis of NTM BSI and the differences between adult and pediatric patients. Methods: We retrospectively reviewed the medical charts of patients at any age with NTM BSI, from January 1, 2005, to June 30, 2020. Data on demographics, underlying conditions, clinical manifestations, NTM species, antibiotic treatments and outcomes were retrieved. Results: Positive blood cultures for NTM were detected in 43 patients, 30 children and 13 adults. Median age: 10.37 years (IQR 6.692–39.864). Thirty-seven (86%) patients had an active malignant disease. Fever was the chief sign in 23 (53.5%) patients and pulmonary manifestations in 14 (32.6%). Rapidly growing NTM comprised 39 (90.7%) of the isolates. Central venous catheter (CVC) was documented in 39 (90.7%) cases, 31 (79.5%) of which were removed as part of treatment. Antibiotic treatment directed against NTM was documented in 26 (60.5%) patients. CVC was removed in 7/17 patients who were not treated with antibiotics. Relapse occurred in 3 cases; no 30-days mortality was reported. Children and adults had similar clinical characteristics. However, children had a higher rate of CVC at the time of bacteremia and a higher chance to receive treatment. Conclusion: NTM BSI was seen mainly in oncologic patients with CVC. Children and adults had a similar disease course and outcome. Relapse was rare and NTM-related mortality was not reported.
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/INF.0000000000003473
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2020216-7
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  • 3
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    SARS-CoV-2 and seasonal influenza: similarities and disparities
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Virology Vol. 167, No. 12 ( 2022-12), p. 2761-2765
    Details
    In: Archives of Virology, Springer Science and Business Media LLC, Vol. 167, No. 12 ( 2022-12), p. 2761-2765
    Type of Medium: Online Resource
    ISSN: 0304-8608 , 1432-8798
    URL: Article
    DOI: 10.1007/s00705-022-05615-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1458460-8
    SSG: 12
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  • 4
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    Pseudomonas Bacteremia in Children: Clinical and Microbiologic Features and Risk Factors of Mortality: A Retrospective Cohort Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Pediatric Infectious Disease Journal Vol. 42, No. 6 ( 2023-06), p. 479-484
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 6 ( 2023-06), p. 479-484
    Abstract: Pseudomonas bacteremia is most commonly acquired in hospital. The aim of this study was to investigate the clinical features and antibiotic susceptibility, mortality rate and risk factors of mortality in children with Pseudomonas bacteremia. Methods: A retrospective cohort study that included children 18 years of age or younger admitted to a tertiary hospital with Pseudomonas bacteremia between 2005 and 2020. Results: A total of 196 patients with Pseudomonas bacteremia were identified. The proportional rate of Pseudomonas bacteremia was 33.9/100,000 hospital days. Underlying disease was documented in 81.1% of patients, 61% had hemato-oncological disease. Pseudomonas bacteremia was healthcare related in 180 (91.8%) episodes. Multidrug-resistant (MDR) Pseudomonas accounted for 16 (8.2%) and difficult-to-treat organism to 3 (1.5%) of all isolates. Thirty-day mortality was reported in 27 (13.8%) patients, all had Pseudomonas aeruginosa . In multivariate regression analysis, the first model showed that younger age [ P = 0.038, odds ratio (OR) = 1.095, 95% confidence interval (CI): 1.005–1.192] and inappropriate empiric antibiotic treatment ( P = 0.004, OR = 3.584, 95% CI: 1.490–8.621) were significantly associated with higher mortality. The second model also showed higher morality in younger age ( P = 0.021, OR = 1.114, 95% CI: 1.016–1.221) and MDR isolates ( P = 0.001, OR = 9.725, 95% CI: 2.486–38.039). Conclusions: Significant morbidity and mortality due to Pseudomonas bacteremia, but relatively lower mortality than previously published. Although young age, MDR isolates and inappropriate antibiotic treatment have been associated with increased mortality, these factors, especially with low prevalence of MDR isolates, may reflect the baseline mortality rate in vulnerable hosts with continuous contact with healthcare facilities facing such severe infection, and more efforts should be made to emphasize infection control practices to prevent such severe infection.
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/INF.0000000000003891
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2020216-7
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  • 5
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    COVID-19 in a Subset of Hospitalized Children in Israel
    Oxford University Press (OUP) ; 2021
    In:  Journal of the Pediatric Infectious Diseases Society Vol. 10, No. 7 ( 2021-08-17), p. 757-765
    Details
    In: Journal of the Pediatric Infectious Diseases Society, Oxford University Press (OUP), Vol. 10, No. 7 ( 2021-08-17), p. 757-765
    Abstract: Most pediatric coronavirus disease 2019 (COVID-19) is mild. We assessed nationally severe COVID-19, including pediatric inflammatory multisystem syndrome (PIMS), in hospitalized children. Methods An ongoing, prospective, national surveillance was conducted from March 2020 through March 2021, at 20 hospitals treating children & lt;18 years across Israel (~75% of Israeli hospitals). Results Overall, 1007 cases (439 outpatients and 568 hospitalized) identified represent 0.35% of pediatric COVID-19 nationwide (n = 291 628). Of hospitalized cases, 464 (82%), 48 (8%), and 56 (10%) had mild, moderate/severe, and PIMS disease, respectively. The mean ± SD age was 5.6 ± 6.4 years. In mild, moderate/severe, and PIMS disease, 55%, 23%, and 4% of patients were & lt;1 year old, respectively. Obesity was reported in 1%, 4%, and 13% of patients, respectively (P & lt; .001). The most common symptom was fever in 67%, 60%, and 100%, respectively, whereas respiratory symptoms were documented in 33%, 41%, and 38% of patients, respectively. Lymphopenia was recorded in 25%, 60%, and 86% of cases, respectively. PIMS diagnosis was mainly serology-based (in 59%). Gastrointestinal symptoms, cardiovascular involvement, rash, and conjunctivitis were noted in 82%, 61%, 57%, and 34% of PIMS episodes, respectively. Elevated C-reactive protein (100%), ferritin, troponin, D-dimer, low albumin, and thrombocytopenia were common in PIMS. Echocardiography revealed pathological findings in 33% of patients. PIMS mainstay treatment included corticosteroids (77%) and intravenous immunoglobulin (53%). No mortality was recorded. Conclusions At a national level, pediatric COVID-19 is mild, even in hospitalized cases, with only a third presenting with respiratory involvement. PIMS is rare, but necessitates a high index of suspicion, and with suitable treatment prognosis is favorable.
    Type of Medium: Online Resource
    ISSN: 2048-7207
    URL: Article
    DOI: 10.1093/jpids/piab035
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2668791-4
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  • 6
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    Third BNT162b2 Vaccine Booster Dose against SARS-CoV-2-Induced Antibody Response among Healthcare Workers
    MDPI AG ; 2022
    In:  Vaccines Vol. 10, No. 10 ( 2022-10-18), p. 1741-
    Details
    In: Vaccines, MDPI AG, Vol. 10, No. 10 ( 2022-10-18), p. 1741-
    Abstract: This study assessed humoral response to the third BNT162b2 dose among healthcare workers (HCW). This prospective cohort study of HCW tested for anti-spike antibodies (LIAISON SARS-CoV-2 S1/S2 IgG assay) at 1, 3, 6, 9, and 12 months after receiving the second BNT162b2 vaccine dose (tests 1, 2, 3, 4, and 5, respectively). A third (booster) vaccination dose was introduced before test 4. Linear regression model was used to determine the humoral response following vaccine doses. For each serology test, changes in log-transformed antibody concentrations over time, adjusted for age, sex, underlying diseases, steroid treatment, and smoking were described using the general linear mix model. Serology tests were performed at 3, 6, 9, and 12 months after the second vaccine dose in 1113, 1058, 986, and 939 participants, respectively. The third dose was received by 964 participants before the 9-month tests, 797 of whom participated in the 9- and 12-month serology tests. A significant inverse correlation was noted between time from third dose and antibody concentrations (Spearman correlation −0.395; p 〈 0.001). Age (p 〈 0.0001; CI 95% −0.005–−0.004), heart disease (p 〈 0.0001; CI 95% −0.177–−0.052), immunodeficiency (p 〈 0.0001; CI 95% 0.251–−0.106), and smoking (p 〈 0.0001; CI 95% −0.122–−0.040) were significantly associated with decreased antibody concentrations. Female sex (p = 0.03; CI 95% 0.013–0.066) was associated with increased antibody concentrations. The third booster dose had a better effect on immunogenicity, with higher antibody concentrations among tested HCW. Heart disease, smoking, and other known risk factors were associated with decreased antibody concentrations.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines10101741
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2703319-3
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  • 7
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    Immunogenicity and SARS-CoV-2 Infection following the Fourth BNT162b2 Booster Dose among Health Care Workers
    MDPI AG ; 2023
    In:  Vaccines Vol. 11, No. 2 ( 2023-01-28), p. 283-
    Details
    In: Vaccines, MDPI AG, Vol. 11, No. 2 ( 2023-01-28), p. 283-
    Abstract: Introduction: The fourth SARS-CoV-2 vaccine dose was found to protect against infection and more importantly against severe disease and death. It was also shown that the risk of symptomatic or severe disease was related to the antibody levels after vaccination or infection, with lower protection against the BA.4 BA.5 Omicron variants. The aim of our study was to assess the impact of the fourth dose on infection and perception of illness seriousness among healthcare workers (HCWs) at a tertiary health care campus in Haifa, Israel, and to investigate the possible protective effect of antibody levels against infection. Methods: We conducted a prospective cohort study among fully vaccinated HCWs and retired employees at Rambam Healthcare Campus (RHCC), a tertiary hospital in northern Israel. Participants underwent serial serological tests at 1, 3, 6, 9, 12 and 18 months following the second BNT162b2 vaccine dose. Only a part of the participants chose to receive the fourth vaccine. A multivariable logistic regression was conducted to test the adjusted association between vaccination, and the risk of infection with SARS-CoV-2. Kaplan–Meier SARS-CoV-2 free “survival” analysis was conducted to compare the waning effect of the first and second, third and fourth vaccines. Receiver Operating Characteristic (ROC) curve was plotted for different values of the sixth serology to identify workers at risk for disease. Results: Disease occurrence was more frequent among females, people age 40-50 years old and those with background chronic lung disease. The fourth vaccine was found to have better protection against infection, compared to the third vaccine; however, it also had a faster waning immunity compared to the third vaccine dose. Antibody titer of 955 AU/mL was found as a cutoff protecting from infection. Conclusions: We found that the fourth vaccine dose had a protective effect, but shorter than the third vaccine dose. Cutoff point of 955 AU/mL was recognized for protection from illness. The decision to vaccinate the population with a booster dose should consider other factors, including the spread of disease at the point, chronic comorbidities and age, especially during shortage of vaccine supply.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines11020283
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2703319-3
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  • 8
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    COVID-19: Healthcare Workers May Be at Greater Risk Outside Their Work Environment—A Retrospective Observational Study
    Rambam Health Corporation ; 2022
    In:  Rambam Maimonides Medical Journal Vol. 13, No. 2 ( 2022-04-26), p. e0011-
    Details
    In: Rambam Maimonides Medical Journal, Rambam Health Corporation, Vol. 13, No. 2 ( 2022-04-26), p. e0011-
    Abstract: Background: With the availability of coronavirus disease 2019 (COVID-19) vaccine, concerns have been raised regarding pre-vaccination seroprevalence in healthcare workers (HCW). This study examines the seroprevalence of HCW at an Israeli tertiary medical center before first BNT162b2 vaccination. Methods: This was a retrospective observational study. Before vaccination, HCW at our center were offered serological testing. Data on their epidemiological, workplace, and quarantine history were collect¬ed. The SARS-CoV-2 IgG assay was performed pre-vaccination. Results: A total of 4,519 (82.5%) of the HCW were tested. Of these, 210 were seropositive; 101 had no known history of COVID-19. Of the 101 asymptomatic HCW, only 3 (3%) had worked at COVID-19 depart¬ments, and 70 (69.3%) had not been previously quarantined. Positive serology was similarly distributed across age groups, and about 40% had no children. Nearly half of the HCW tested were administrative and service staff. Overall, seropositive tests were associated with having no children (OR 1.42, 95% CI 1.06–1.89; P=0.0218), history of having been quarantined without proof of disease (OR 6.04, 95% CI 4.55–8.01; P 〈 0.001), and Arab ethnicity (OR 3.36, 95% CI 2.54–4.43; P 〈 0.001). Seropositivity was also more prevalent in members of the administration compared to other sectors, medical and paramedical, who are exposed to patients in their daily work (OR 1.365, 95% CI 1.02–1.82; P=0.04). Conclusions: The low percentage of asymptomatic COVID-19 among our HCW may reflect the high compliance to personal protective equipment use despite treating hundreds of COVID-19 patients. The relatively high number of childless seropositive HCW could reflect misconceptions regarding children as a main source of infection, leading to carelessness regarding the need for appropriate out-of-hospital protection.
    Type of Medium: Online Resource
    ISSN: 2076-9172
    URL: Journal
    URL: Article
    DOI: 10.5041/RMMJ.20769172
    DOI: 10.5041/RMMJ.10469
    Language: Unknown
    Publisher: Rambam Health Corporation
    Publication Date: 2022
    detail.hit.zdb_id: 2573657-7
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  • 9
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    Characterization of respiratory illness surge (April–June 2021) post‐COVID‐19 lockdown
    Wiley ; 2022
    In:  Pediatric Pulmonology Vol. 57, No. 3 ( 2022-03), p. 667-673
    Details
    In: Pediatric Pulmonology, Wiley, Vol. 57, No. 3 ( 2022-03), p. 667-673
    Abstract: Following the opening of lockdown and relaxation of public health restrictions, an unusual surge of respiratory illness occurred during the spring/summer (Q2) 2021 season. We aimed to characterize this surge compared to previous years. Methods Children discharged from a single tertiary hospital for respiratory illness or selected noncommunicable diseases (NCDs) between 2015 and 2021 were included, and hospitalization rates were compared. To evaluate whether the current respiratory surge resembles a typical winter, characteristics of the second quarter (Q2, April–June) of 2021 were compared to parallel seasons and to autumn/winter (Q4, October–December) of the previous years. Results Respiratory illness showed a seasonal peak, while the pattern of NCD was consistent throughout the study period. Respiratory illnesses showed a delayed surge in Q2 2021 (389 patients), with a missing seasonal peak in Q2 and Q4 2020 (135 and 119 patients, respectively). There were more cases of croup in Q2 2021 compared to Q2 and Q4 2015–2019 (26.2 vs. 12.5% and 15.8%, p   〈  0.001), fewer cases of pneumonia (5.9 vs. 15.9% and 11.7%, p   〈  0.001), lower admission rates (22.4 vs. 36.3% and 31.5%, p   〈  0.001), and fewer hypoxemia during hospitalization (6.3 vs. 11.7% and 10%, p   〈  0.001). Additionally, lower use of antibiotics (6.2 vs. 12.3% and 10.3%, p  = 0.001 and 0.012, respectively) and higher use of steroids (33.7 vs. 24.8% and 28.3%, p   〈  0.001 and 0.034, respectively). Conclusions The postponed increase in respiratory morbidity after lockdown had unique characteristics, with upper respiratory illness predominating and fewer hospitalizations. Follow‐up is needed to assess the altered epidemiological patterns of respiratory diseases in the post‐COVID era.
    Type of Medium: Online Resource
    ISSN: 8755-6863 , 1099-0496
    URL: Issue
    URL: Article
    DOI: 10.1002/ppul.v57.3
    DOI: 10.1002/ppul.25792
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1491904-7
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  • 10
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    A high percentage of hospital‐acquired neonatal bacteraemia but rare resistance to standard antibiotic regimens
    Wiley ; 2022
    In:  Acta Paediatrica Vol. 111, No. 5 ( 2022-05), p. 992-1001
    Details
    In: Acta Paediatrica, Wiley, Vol. 111, No. 5 ( 2022-05), p. 992-1001
    Abstract: We examined community and hospital‐acquired bacteraemia, namely bloodstream infections or meningitis, and looked at the clinical features and outcomes of cases. Methods The study comprised infants under 3 months of age, who were admitted to a tertiary referral centre in northern Israel with bacteraemia from 2010–2019. Causative pathogens, antibiotic susceptibility and mortality were retrospectively recorded. Results We identified 314 infants, 325 episodes of bacteraemia and 344 pathogens. Meningitis was identified in 22 (7.0%) infants. Hospital‐acquired bacteraemia accounted for 84.8% of the 325 episodes. Coagulase‐negative staphylococci (33.9%) was the most prevalent pathogen in the hospital‐acquired cases, while Escherichia coli (37.2%) dominated the community‐acquired cases. The susceptibility of Gram‐negative early‐onset sepsis cases to ampicillin–gentamicin or ampicillin–cefotaxime was 96% and 94.7% for hospital‐acquired cases and 91.7% and 88% for community‐acquired cases, respectively. Susceptibility to piperacillin–tazobactam or amikacin in late‐onset sepsis were 92.8% and 98%, respectively, in hospital‐acquired cases. The 30‐day mortality was 5.7% in infants with hospital‐acquired cases. Risk factors were Arab ethnicity ( p   〈  0.028), haemodynamic instability ( 〈 0.001) and Gram‐negative sepsis (0.043). Conclusion Most cases of bacteraemia were acquired during hospitalisation and these accounted for the majority of the deaths. Resistance to standard antibiotic regimens was rare.
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    URL: Article
    DOI: 10.1111/apa.v111.5
    DOI: 10.1111/apa.16291
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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