The document discusses common bacterial infections in children. The most common bacterial infections in babies are skin, ear, and throat infections, while the most common viral infections are respiratory infections such as RSV. Over 44% of child deaths under age 5 occur during the neonatal period, with approximately 2.6 million neonatal deaths worldwide in 2015. Bacterial infections and sepsis are major causes of neonatal mortality. Prevention strategies discussed include immunization of mothers and children, breastfeeding, hygiene practices like chlorhexidine cord care, and education of health professionals in neonatal resuscitation. Prudent antibiotic use and stewardship programs are important to prevent antibiotic resistance.
Prospects for GBS prevention - current candidates & removing barriers to licensure of a GBS vaccine for pregnant women globally
https://www.meningitis.org/mrf-conference-2017
Dr. Laura Guay, the Foundation’s Vice President of Research, also conducted a journalist training today sponsored by the National Press Foundation, teaching reporters about some of the most misunderstood issues concerning HIV and children
Prospects for GBS prevention - current candidates & removing barriers to licensure of a GBS vaccine for pregnant women globally
https://www.meningitis.org/mrf-conference-2017
Dr. Laura Guay, the Foundation’s Vice President of Research, also conducted a journalist training today sponsored by the National Press Foundation, teaching reporters about some of the most misunderstood issues concerning HIV and children
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Rega...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Factors Influencing Immunization Coverage among Children 12- 23 Months of Age...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Vertical transmission is major contributor- HIV among children
No intervention – as high as 45%
With interventions – as low as less than 5%
Minimal manipulation
NVD vs. C-section
Anti retroviral prophylaxis vs. anti retroviral therapy
Exclusive breastfeeding vs. exclusive replacement feeding
Follow-up and care.
Sustained research successes during the first two decades of the AIDS epidemic, an unprecedented expansion of HIV prevention and treatment programs during the last decade, and recent global attention and leadership have set the stage for the virtual elimination of new HIV infections in infants in the next decade.
Dr. Benjamin Park - Antimicrobial Resistance in Humans and the Global Health ...John Blue
Antimicrobial Resistance in Humans and the Global Health Security Agenda - Dr. Benjamin Park, Senior Advisor for International Healthcare Quality, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), from the 2015 NIAA Antibiotic Symposium - Stewardship: From Metrics to Management, November 3-5, 2015, Atlanta, Georgia, USA.
More presentations at http://swinecast.com/2015-niaa-symposium-antibiotics-stewardship-from-metrics-to-management
Expanded Program of Immunization.
Objectives are:
To learn about EPI and the current situation of EPI in Pakistan
To understand the mechanism of the Cold Chain and the maintenance of vaccines
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Rega...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Factors Influencing Immunization Coverage among Children 12- 23 Months of Age...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Vertical transmission is major contributor- HIV among children
No intervention – as high as 45%
With interventions – as low as less than 5%
Minimal manipulation
NVD vs. C-section
Anti retroviral prophylaxis vs. anti retroviral therapy
Exclusive breastfeeding vs. exclusive replacement feeding
Follow-up and care.
Sustained research successes during the first two decades of the AIDS epidemic, an unprecedented expansion of HIV prevention and treatment programs during the last decade, and recent global attention and leadership have set the stage for the virtual elimination of new HIV infections in infants in the next decade.
Dr. Benjamin Park - Antimicrobial Resistance in Humans and the Global Health ...John Blue
Antimicrobial Resistance in Humans and the Global Health Security Agenda - Dr. Benjamin Park, Senior Advisor for International Healthcare Quality, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), from the 2015 NIAA Antibiotic Symposium - Stewardship: From Metrics to Management, November 3-5, 2015, Atlanta, Georgia, USA.
More presentations at http://swinecast.com/2015-niaa-symposium-antibiotics-stewardship-from-metrics-to-management
Expanded Program of Immunization.
Objectives are:
To learn about EPI and the current situation of EPI in Pakistan
To understand the mechanism of the Cold Chain and the maintenance of vaccines
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
2. Common bacterial infection in
children
The most common bacterial
infections in babies are skin, ear,
and throat. The most common
viral infections in babies are
respiratory, including respiratory
syncytial virus (RSV), rhinovirus
(RV), and influenza virus.
4. “… 44% of child deaths under the age of 5 take place during the
neonatal period…”
Weekly Epidemiological Record, no. 38, 19 SEPTEMBER 2014
Of the 5.8 million children who died before 5 years of age in 2015
worldwide, approximately 2.6 million died in the neonatal period
GBD 2015 Child Mortality Collaborators, Lancet 2016
5. Oza S et al., Bull World Health Organ 2015;93:19–2
8. Prevention
• Immunization maternal, childhood, general population
• Nutrition breast-feeding, weight, Kangaroo Mother Care
• Hygiene perinatal, use of chlorhexidine for cord care
• Education health professionals (neonatal resuscitation),
leaflets, trainings, workshops
9. Prevention
• Immunization maternal, childhood, general population
“immunologic immaturity”: ineffective clearing of intracellular
pathogens, only moderate antibody generation against bacterial
polysaccharides, …
Palmeira P et al., Clin Dev Immunol 2012
Neonates/ young babies:
1. Unprotected (insufficient maternal protection, e.g. pertussis)
2. More robust protection after several months of life (ca. 6 months)
3. Lack of vaccinations licensed for this young age group (e.g. influenza)
10. Increase in steroid hormones
Immune system: Shift TH1 to TH2
(„antiinflammatory“)
--I cytotox. T-lymphocytes
B-lymphocyte stimulation
Increase of diaplacental
IgG-transfer
Omer SB, NEJM 2017
12. World Health Organization. WHO vaccine-preventable diseases: monitoring
system. 2016 global summary [Internet]. 2016 [cited 2016 Feb 26]. Available from:
http://apps.who.int/immunization_monitoring/ globalsummary/schedules
Maternal Vaccination
13. Tetanus
• Propagated by WHO since 1974 to reduce the risk of
neonatal tetanus
• Vaccination against tetanus during pregnancy is safe!
“…Although this approach has decreased neonatal tetanus by 96%
compared to the late 1980s, the WHO estimated that 34,000 new-borns
still died from the disease in 2015 …”
Blencowe H et al., Int J Epidemiol 2010
WHO (2017) Tetanus vaccines: WHO position paper –
February 2017. Wkly Epidemiol Rec 92:53-76.
“… Transplacental antibody transfer can be significantly reduced by a
short interval between the last dose of TTCV before delivery (<14 days),
prematurity, and conditions such as maternal HIV infection,
hypergammaglobulinemia in the context of malaria and chronic placental
malaria infection …”
15. • California, US-cohort of 74.504 mother-child pairs
• Risk of symptomatic pertussis infection during the first 2 months of life
• Prenatal vs. postnatal vaccination
Vaccination during 27th–36th week of pregnancy improved
propability of childhood protection against pertussis by 85% as
compared to vaccination during 14 days postpartum!
Winter K et al., Clin Infect Dis 2017
16. Mothers vaccinated:
49 infants diseased 43% hospitalization rate
3 days average duration of hospitalization
no deaths
Mothers non-vaccinated:
371 infants diseased 73% hospitalization rate
6 days average duration of hospitalization
6 deaths
Winter K et al., Clin Infect Dis 2017
17. Prevention
• Immunization maternal, childhood, general population
• Nutrition breast-feeding, Kangaroo Mother Care
• Hygiene perinatal, use of chlorhexidine for cord care
• Education health professionals (neonatal resuscitation),
leaflets, trainings, workshops
18. Raihana S et al., PLoS Med 2019; 16(8): e1002904
• Study from Bangladesh
• Neonatal sepsis: 24% of neonatal deaths
• Only 50% of newborns in Bangladesh initiated breastfeeding
within 1 hour of birth
• Initiation of breastfeeding and severe illness
• the earlier the initiation of breastfeeding, the lower the risk
of having severe illnesses in the early newborn stage
19. Prevention
• Immunization maternal, childhood, general population
• Nutrition breast-feeding, Kangaroo Mother Care
• Hygiene perinatal, use of chlorhexidine for cord care
• Education health professionals (neonatal resuscitation),
leaflets, trainings, workshops
20. Awareness
• Public awareness neonatal care
• Easy access to medical care midwifes, community nurses
• Education red flags (outpatient/ inpatient)
Treatment
• Know your microbes (and your antimicrobial resistance)
• Empirical, promt treatment (right drug, dose, duration)
• Antibiotic Stewardship
21. Increased antibiotic consumption is associated with increasing
numbers of resistance against antibiotics
Goossens 2009
Up to 50% of all prescribed antibiotics in hospitals are unneccessary!
Dellit et al., Clin Inf Dis 2007
Antibiotics account for the most prescribed medications in children
(outpatient: up to 30%; inpatient: 30-72%)
Pakyz et al., Infect Hosp Epidemiol 2009
Gerber et al., Pediatrics 2010
Missuse of Antibiotics Increases Antimicrobial Resistance
22. Sir Alexander Fleming
(1881 – 1955)
Quelle: medienwerkstatt-online.de
„… the thoughtless person playing with penicillin is morally
responsible for the death of the man who finally succumbs to
infection with the penicillin-resistant organism. I hope this evil
can be averted.“
New York Times, 26 June 1945
SHEA / IDSA / PIDS policy statement,
Infect Control Hosp Epidemiol 2012
24. „rational use of antibiotics“
„optimal choice, dose and duration of antimicrobial therapy or
prophylaxis, with minimal toxicity for the patient as well as with the
lowest potential for developing resistance“
Gerding DN, Jt Comm J Qual Improv 2001
What are Antimicrobial Stewardship Programs?
25. 1. 4 D‘s Drug, Dose, De-escalation, Duration
Joseph and Rodvold, Expert Opin Pharmacother 2008
2. Stop overuse (wrong indication)
wrong use (missing adaptation)
missuse („favoured drug“)
3. Minimize development of resistance
antibiotics risk for colonization or infection with
resistant organisms
Dellit et al., Clin Infect Dis 2007
What are Antimicrobial Stewardship Programs?
26. Neonatal infections/ sepsis
• Antibiotic Stewardship
Diagnostics:
- blood culture(s) (1ml!) (low grade bacteremia)
- supportive role of biomarkers (CRP, IL-6, IL-8, PCT)
( good negative predictive value; can help to
reduce antobiotic consumption)
27. • Neonates with suspected bacterial infection:
Test: combination of CRP and IL-8 (vs. CRP and I/T neutrophil
ratio)
Outcome: Reduction of antibiotics by 73%!
• Neonates with suspected early onset sepsis (EOS):
Test: IL-8 and CRP (vs. CRP alone)
(IL-8 > 70 pg/mL and/ or CRP > 10 mg/L)
Outcome: 50% reduction (vs. 36%), without an increase in
missed infections
Franz et al., 2001
Franz et al., 2004
28. Neonatal infections/ sepsis
• Antibiotic Stewardship
Therapy:
- dosage and monitoring of antimicrobial levels
- e.g. gentamicin: higher doses at longer intervalls
- detect toxicity „trough levels“ and access potency
„peak levels“ (e.g. vancomycin 10-20 mg/l)
Gkentzi D and Dimitriou G, Current Pediatric Reviews, 2019, Vol. 15, No
29. Kearns GL et al., N Engl J Med 2003;349:1157-67.