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Biomedical subjects

D Burgner

Publications and source records attributed to D Burgner.

17 recordsLinked to original sources
PubMed1999

Epidemiology of Cryptosporidium parvum in symptomatic paediatric oncology patients.

BACKGROUND: Although Cryptosporidium parvum is known to cause significant morbidity in immunocompromised individuals, including adults with cancer, the epidemiology of this pathogen in paediatric oncology patients is not known. OBJECTIVE: We prospectively investigated the incidence of symptomatic C. parvum infection in children receiving treatment for malignancy. METHODOLOGY: Over a 9 month period, all oncology inpatients with diarrhoea had stool analysis for C. parvum oocysts. The incidence of cryptosporidiosis was also recorded in non-oncology patients who had a stool analysed for C. parvum during the 6 years of the study period. RESULTS: None of the 149 stool samples from 60 oncology patients analysed contained C. parvum oocysts. Thirteen per cent of 173 samples from non-oncology patients were positive for C. parvum oocysts. CONCLUSIONS: In contrast to studies of adult oncology patients, paediatric oncology patients in our institution appear at low risk of cryptosporidiosis.

Animals↗
PubMed1998

Disseminated invasive infection due to Metarrhizium anisopliae in an immunocompromised child.

The first reported human case of possible disseminated infection with the insect pathogen Metarrhizium anisopliae var. anisopliae, a fungus which has been used commercially for biocontrol of insects, is described. The patient, a 9-year-old boy, had a 5-year history of pre-B-cell acute lymphoblastic leukemia and had been on chemotherapy throughout this period. After 10 days of profound neutropenia, lesions consistent with ecthyma gangrenosum appeared on his arms and legs. M. anisopliae was grown from specimens from three separate sites, collected at different times over a period of 1 month: a skin biopsy, a swab from the base of a lesion, and the core of another skin lesion which spontaneously discharged. The initial skin biopsy also showed histological evidence of epidermal necrosis and dermal invasion with fungal hyphae. A computed-tomography (CT) scan of the chest demonstrated a lesion in the superior segment of the lower lobe of the left lung. A CT scan of the brain revealed a lesion in the left temporoparietal region of the brain, consistent with an abscess. Despite antifungal treatment including liposomal amphotericin and 5-flucytosine, the patient eventually died. The initial portal of entry is unknown, but hematogenous dissemination to the skin appears likely because of the multiple ecthymic lesions, and the appearances of the brain lesion on the CT scan are consistent with a hematogenous fungal abscess.

Child↗
PubMed1997

A prospective study of Clostridium difficile infection and colonization in pediatric oncology patients.

BACKGROUND: Patients with cancer often receive broad spectrum antibiotics in addition to antineoplastic chemotherapy. Both treatments predispose adult oncology patients to infection and colonization with Clostridium difficile, but the role of this pathogen in pediatric oncology patients is poorly defined. METHODS: A prospective study of 149 fecal samples from symptomatic pediatric oncology patients and 58 samples from asymptomatic patients was performed. Each sample was analyzed for the presence of C. difficile and its toxins A and B. RESULTS: In 8.7% of the symptomatic samples and 19% of the asymptomatic samples toxigenic C. difficile was found. No association was found between either the use of antibiotics and/or the administration of chemotherapy and the presence of toxigenic C. difficile. Younger children were more likely to be infected or colonized with C. difficile, and there was no evidence of nosocomial transmission of C. difficile within the study population. CONCLUSIONS: As toxigenic C. difficile may form part of the normal flora in young children, this study indicates that in the absence of a defined outbreak, C. difficile does not appear to be an important pathogen in pediatric oncology patients.

Adolescent↗
PubMed1996

Repeated prevalence surveys of paediatric hospital-acquired infection.

Hospital-acquired infection (HAI) results in an enormous burden of excess morbidity, mortality and cost in both adults and children. Monitoring HAI is difficult, especially with limited resources, but it is vital if infection control measures are to be appropriately implemented and assessed. Cross-sectional prevalence surveys, repeated every six months, have been used effectively to monitor HAI in adults, but this technique has not been previously employed in the paediatric population. We performed prevalence surveys of HAI on a single day once every six months for five years, using a standardized questionnaire. Of the 1623 inpatients surveyed, 125 (7.7%) had HAI and 352 (21%) had community-acquired infection. In those with HAI, central-line infections, pneumonia, and wound infections predominated. A hospital stay of greater than seven days was associated with a sixfold increase in the risk of HAI. In addition, admission to a paediatric or neonatal intensive care unit, the presence of a urinary or vascular catheter, the presence of an endotracheal tube, immunosuppression and recent surgery were all associated with a significantly increased risk of HAI. In contrast to other studies, younger children were not at increased risk of HAI; admission to the neonatal unit, rather than age per se, was associated with increased risk. We conclude that repeated prevalence surveys enable simple and cost-effective assessment of HAI, facilitating appropriate infection control interventions. They should be used more widely in the paediatric setting.

Age Factors↗
PubMed1996

New rapid microbiological diagnostic techniques.

OBJECTIVE: To briefly and critically review the role of new, rapid techniques, especially PCR, in the diagnosis of infectious diseases. METHODOLOGY: Review of the literature. RESULTS: New diagnostic techniques show great promise but many techniques are still in their infancy and the relative roles of the various methods remain uncertain. CONCLUSIONS: It seems likely that different techniques will continue to be useful in a number of different contexts. No one technique is likely to become 'diagnostically dominant' in the foreseeable future.

Enzyme-Linked Immunosorbent Assay↗