Immune Reconstitution and Need for Booster Vaccinations Among Non-Transplant Childhood Cancer Survivors: A Single-Center Experience.

Background: Waning immunity from childhood vaccines can be more profound in pediatric patients following chemo/immunotherapy. Moreover, childhood cancer survivors (CCS) are at significantly increased risk for life-threatening infections. We implemented an institutional standard of practice (SOP) to assess immune reconstitution and provide recommendations for re-vaccination for non-transplant CCS.

Challenges in the Diagnosis and Management of Recurrent and Severe Clostridioides difficile Infection in Children.

Children with Clostridioides difficile infection (CDI) can experience recurrent or severe disease. Recurrent CDI occurs in 20%-30% of children with an initial CDI episode. A careful clinical evaluation is important to distinguish recurrent CDI from other disorders that cause recurring gastrointestinal symptoms.

Recent advances in Clostridioides difficile infection epidemiology, diagnosis and treatment in children.

Purpose Of Review: The US Centers for Disease Control and Prevention (CDC) classified Clostridioides difficile as an 'urgent' public health threat that requires 'urgent and aggressive action'. This call to action has led to new discoveries that have advanced C. difficile infection (CDI) epidemiology, diagnosis and treatment, albeit predominantly in adults.

Hyperammonemic Encephalopathy due to Infection in an Immunocompromised Child.

Idiopathic hyperammonemia is a rare complication with a high mortality rate that occurs in persons with hematologic malignancies or hematopoietic stem cell or solid organ transplant. Patients present with encephalopathy and hyperammonemia in the absence of liver disease or inborn errors of metabolism. Several etiologies have been proposed, including chemotherapeutic agents, medications, and a catabolic state with an elevated nitrogen load in the setting of acute illness.

Risk Factors for Surgical Site Infections Following Vertical Expandable Prosthetic Titanium Rib (VEPTR) Surgery in Children.

Study Design: Case-control study.

Objectives: To identify risk factors for surgical site infections (SSIs) following vertical expandable prosthetic titanium rib (VEPTR) surgery in children.

Summary Of Background Data: VEPTR surgery is a growth-sparing approach for early-onset scoliosis and chest or rib abnormalities.

Recurrent Clostridium difficile Infection in Children: Patient Risk Factors and Markers of Intestinal Inflammation.

Background: The management of Clostridium difficile infection (CDI) in children is complicated by recurrence rates of 20%-30%. The identification of risk factors associated with recurrent disease might allow early recognition of those children at highest risk.

Methods: Pediatric patients with CDI were identified through clinical laboratory records at 2 tertiary-care children's hospitals from March 2013 through May 2014.

Dietary zinc alters the microbiota and decreases resistance to Clostridium difficile infection.

Clostridium difficile is the most commonly reported nosocomial pathogen in the United States and is an urgent public health concern worldwide. Over the past decade, incidence, severity and costs associated with C. difficile infection (CDI) have increased dramatically.

Risk Factors for Community-associated Clostridium difficile-associated Diarrhea in Children.

Background: Clostridium difficile-associated diarrhea (CDAD) is increasingly diagnosed in children in community settings. This study aims to assess recent antibiotic use and other risk factors in children with community-associated (CA-) CDAD compared with children with other diarrheal illnesses in a tertiary care setting.

Methods: Children with CA-CDAD evaluated at Texas Children's Hospital (Houston, TX) from January 1, 2012 to June 30, 2013 were identified.

A hospital-based study of the clinical characteristics of Clostridium difficile infection in children.

Background: Clostridium difficile infection (CDI) is an increasingly important cause of morbidity in hospitalized children. We describe the recent epidemiology of pediatric CDI at a children's hospital, compare community-associated (CA) and hospital-associated (HA) infections and identify risk factors for severe disease.

Methods: Children with CDI at Texas Children's Hospital were identified from February 1, 2011, to October 31, 2011.

Sustained improvement in hand hygiene at a children's hospital.

A quality improvement project was conducted to improve hand hygiene at a children's hospital. Interventions included education, performance feedback, an incentive program, and a marketing campaign. There were 9,322 observations performed over a 5-year period.

Clostridium difficile: an emerging pathogen in children.

Clostridium difficile is emerging as an important enteric pathogen in children. Historically considered as an asymptomatic colonizer of the gastrointestinal tract, C. difficile infection (CDI) has not been well-studied in pediatric populations.