Mary Anne Jackson

Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States

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Publications (68)215.97 Total impact

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    ABSTRACT: Background: Pediatric ASPs have demonstrated the ability to decrease antibiotic (ab) use. No data exists on the clinical impact of pediatric ASPs. We evaluated the impact of an ASP on LOS and readmission rates at a children's hospital. Methods: Outcome data from patients enrolled between 3/3/08 – 3/3/13 in a prospective-antibiotic audit ASP were analyzed. ASP recommendations included to discontinue, modify or optimize the ab or to consult the infectious diseases service. Patients in whom a recommendation was made were propensity score matched to non-intervention patients based on the patient's age, ASP year of implementation, ab and indication for ab use, and further analyzed based on if the recommendation was implemented. Patients were stratified into 3 groups: surgical, medical and medical with complex chronic care (CCC). Patients with >1 ASP review or admitted to the pediatric or neonatal intensive care unit, or the hematology/oncology unit were excluded. Results: The ASP intervened on 17% (1191) of the 7051 reviewed patients. Interventions were most likely in patients receiving ceftriaxone/cefotaxime (62%), vancomycin (11%), and meropenem (5%); pneumonia (22%), urinary tract infections (19%), and rule out sepsis (9%) were the most common diagnoses. The most common intervention was stop followed by modify the ab. When ASP recommendations were followed, length of stay was shorter and there were no 30-day readmissions for surgery or patients with non CCC medical conditions.(Fig 1&2) Conclusion: An ASP at a freestanding childrens hospital decreased LOS and readmission rates among patients not requiring critical care. Future work is needed to better demonstrate the clinical impact of ASPs.
    IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
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    ABSTRACT: Background: ASPs are growing in pediatrics. Many programs function by reviewing a large number of antimicrobial prescriptions on a daily basis to identify opportunities to improve or modify prescribing, thus leading to an intervention or recommendation. Little is known about the frequency with which reviewed prescriptions lead to an intervention and the patient and clinical factors most strongly associated with an intervention. A better understanding of these factors could lead to more targeted ASP reviews and more efficient use of resources. Objectives: Identify the antibiotics and clinical diagnoses most strongly associated with a pediatric ASP. Methods: We reviewed the frequency and types of interventions made by a pediatric ASP across 5 years, from 3/2008 to 3/2013. Our program uses a prospective audit and feedback structure where prescriptions for any of 18 selected antibiotics are reviewed daily for potential interventions. Interventions were grouped into four categories: stop therapy, modify therapy (i.e. change antibiotic), optimize therapy (i.e. alter dosing or route of administration) and consult infectious diseases. We used a multinomial distribution model to determine the probability of each ASP intervention group, based on the specific antimicrobial agent or disease category. Results: A total of 14,407 ASP reviews were included in our analysis. Among these, a total of 2,318 (16%) prompted an ASP intervention. The most common types of ASP recommendations were stop or modify therapy. The clinical diagnoses with the highest predicted probability of an intervention were community acquired pneumonia (CAP, 0.26), ear/nose/throat (ENT, 0.25), genitourinary (0.23), and respiratory infections (0.21) (Figure 1). The antibiotics with the highest predictive probability of an intervention were ceftriaxone (0.20), clindamycin (0.20), and gentamicin (0.19) (Figure 2). Conclusion: We identified several clinical diagnoses and antimicrobials that are associated with higher than average likelihood of triggering an ASP intervention. This analysis will assist in enhancing our ASP to focus not only on specific antibiotics but to also target specific conditions for review and development of clinical practice guidelines.
    IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
  • Mary Anne Jackson
    IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014
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    ABSTRACT: On August 19, 2014, CDC was notified by Children's Mercy Hospital in Kansas City, Missouri, of an increase (relative to the same period in previous years) in patients examined and hospitalized with severe respiratory illness, including some admitted to the pediatric intensive care unit. An increase also was noted in detections of rhinovirus/enterovirus by a multiplex polymerase chain reaction assay in nasopharyngeal specimens obtained during August 5-19. On August 23, CDC was notified by the University of Chicago Medicine Comer Children's Hospital in Illinois of an increase in patients similar to those seen in Kansas City. To further characterize these two geographically distinct observations, nasopharyngeal specimens from most of the patients with recent onset of severe symptoms from both facilities were sequenced by the CDC Picornavirus Laboratory. Enterovirus D68 (EV-D68) was identified in 19 of 22 specimens from Kansas City and in 11 of 14 specimens from Chicago. Since these initial reports, admissions for severe respiratory illness have continued at both facilities at rates higher than expected for this time of year. Investigations into suspected clusters in other jurisdictions are ongoing.
    MMWR. Morbidity and mortality weekly report. 09/2014; 63(36):798-799.
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    ABSTRACT: To assess the performance of the QuantiFERON-TB Gold in-tube (QFT-GIT) assay for tuberculosis (TB) screening using a convenience sample from among a population of healthcare provider (HCP) employees of a hospital.
    Laboratory medicine. 01/2014; 45(3):207-210.
  • J Michael Klatte, Jason G Newland, Mary Anne Jackson
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    ABSTRACT: Objective. To identify risk factors for pediatric Candida central line-associated bloodstream infections (CLABSIs). Design. Retrospective case-control study. Setting. Freestanding tertiary care children's hospital. Patients. Patients with Candida CLABSI from January 31, 2000, through December 31, 2010, compared with age- and year-matched controls. Methods. Demographics, comorbidities, presence of indwelling foreign bodies, exposure to antibiotics or corticosteroids, total parenteral nutrition (TPN) or blood transfusions, complications, and outcome were evaluated. Bivariate and then logistic regression were used to compare temporal trends and risk factors. Results. A total of 160 Candida CLABSI patients (median age, 1.96 years) were compared with 457 controls. Those with Candida CLABSIs were more likely to have intestinal failure (adjusted odds ratio [aOR], 6.777 [95% confidence interval (CI), 2.315-19.839]; [Formula: see text]), to have a gastrostomy tube in place (aOR, 4.156 [95% CI, 2.317-7.456]; [Formula: see text]), and to receive TPN (aOR, 3.897 [95% CI, 2.403-6.319]; [Formula: see text]) or blood transfusions (aOR, 2.990 [95% CI, 1.841-4.856]; [Formula: see text]), and they had a 3-fold increase in mortality (aOR, 3.543 [95% CI, 1.501-8.364]; [Formula: see text]). Candida albicans was most common, but non-albicans strains resistant to amphotericin (C. lusitaniae) and fluconazole (C. glabrata and C. krusei) were also found. Conclusions. Those patients with intestinal failure, gastrostomy tube presence, and/or receipt of TPN and blood transfusions are at increased risk for development of Candida CLABSI.
    Infection Control and Hospital Epidemiology 12/2013; 34(12):1266-71. · 4.02 Impact Factor
  • Adam L Hersh, Mary Anne Jackson, Lauri A Hicks
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    ABSTRACT: Most upper respiratory tract infections are caused by viruses and require no antibiotics. This clinical report focuses on antibiotic prescribing strategies for bacterial upper respiratory tract infections, including acute otitis media, acute bacterial sinusitis, and streptococcal pharyngitis. The principles for judicious antibiotic prescribing that are outlined focus on applying stringent diagnostic criteria, weighing the benefits and harms of antibiotic therapy, and understanding situations when antibiotics may not be indicated. The principles can be used to amplify messages from recent clinical guidelines for local guideline development and for patient communication; they are broadly applicable to antibiotic prescribing in general.
    PEDIATRICS 11/2013; · 4.47 Impact Factor
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    ABSTRACT: Background: Human Parechoviruses (HPeVs) are recognized causes of infant sepsis-like illness and CNS infection. No studies have examined testing utility of non-CSF specimens for HPeV. Our aim was to evaluate non-CSF specimens in predicting HPeV or EV CNS infection in infants with sepsis-like illness. Methods: Hospitalized infants < 90 days old with CSF WBC counts <1000 and negative CSF gram stain were enrolled between 1/3/2011–12/31/2012. Stool, throat and nasal specimens were prospectively obtained. Scavenged CSF, blood and urine were collected when available. EasyMag® or Qiacube® was used to extract total nucleic acids, which were then tested by two-step real-time EV/HPeV RT-PCR. Diagnostic utility of non-CSF specimens to predict HPeV-CNS infection was determined by analyzing EV/HPeV results from paired CSF and non-CSF specimens in the same infants. Results: From 461 infants, 2001 specimens were obtained (432 CSF, 341 blood, 224 urine, 407 throat, 229 nasal, 368 stool). HPeV was detected in 164 specimens (46 subjects) and EV in 115 specimens (47 subjects). HPeV and EV were detected in 40 and 35 CSF samples, respectively. HPeV detection sensitivity in non-CSF specimens compared to CSF detection: blood (96%), stool (82%), throat (71%), nasal (63%) and urine (43%). HPeV detection specificity in all non-CSF specimens was 100%. EV detection sensitivity in non-CSF specimens: stool (94%), blood (64%), throat (41%), urine (6%) and nasal (5%). EV detection specificity for all non-CSF specimens was >95%. HPeV vs. EV blood and respiratory specimen testing showed HPeV blood testing outperformed EV blood testing in correctly predicting CNS disease presence/absence (p = 0.037), as did HPeV respiratory testing vs. EV respiratory testing (p = 0.015). Conclusion: HPeV can be detected from multiple anatomic sites outside CSF in HPeV-infected infants. Excluding stool, HPeV is detected at a higher frequency in non-CSF specimens than EV. Blood appears a useful non-CSF specimen for HPeV (96%) and EV (64%) detection in infants with sepsis-like illness. Stool appears suitable for both HPeV and EV detection, while respiratory specimens (nasal/ throat) are more reliable for infant HPeV detection. PCR testing of non-CSF specimens can be useful adjuncts in diagnosis of HPeV CNS disease in infants presenting with sepsis-like illness.
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013
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    ABSTRACT: We evaluated vancomycin minimum inhibitory concentration (MIC) trends by three methods (broth microdilution, Etest, Vitek 2®) in 208 S. aureus blood isolates from 2006-2009 and assessed for heteroresistance. Vancomycin MICs did not increase nor was heteroresistance identified. Etest yielded higher MIC results than the other two methods. No MIC was > 2 µg/ml by any testing method.
    The Pediatric Infectious Disease Journal 09/2013; · 3.57 Impact Factor
  • John D Lantos, Mary Anne Jackson
    The American Journal of Bioethics 09/2013; 13(9):1-2. · 4.00 Impact Factor
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    ABSTRACT: Bordetella parapertussis is widely recognized as a cause of a pertussis-like respiratory illness in children, but reports of invasive infection are rare. We review the literature and describe the clinical presentation and treatment of 2 children with B. parapertussis bacteremia, as well as the techniques used to isolate the organism.
    The Pediatric Infectious Disease Journal 07/2013; 32(7):796-798. · 3.57 Impact Factor
  • Gina Weddle, Mary Anne Jackson
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    ABSTRACT: OBJECTIVE: The goals of this study were to evaluate the effectiveness of an inpatient documentation system for identifying missed vaccine opportunities and to identify parental satisfaction with their vaccination services. METHODS: A prospective descriptive study compared inpatient documentation of vaccine history with actual vaccine records, and adherence with the Advisory Committee on Immunization Practices guidelines was assessed. A parental satisfaction survey was administered. RESULTS: One hundred sixty pediatric patients ages 2 months to 17 years (mean age 8 years) were enrolled. Seventy-six percent of patients had documentation of vaccine history, and 92% were documented as receiving all age-appropriate vaccines. Actual immunization records showed that 16% percent of patients were in compliance with Advisory Committee on Immunization Practices guidelines. The most commonly missed vaccine was influenza (67%) followed by meningococcal (57%), hepatitis A (48%), and varicella (38%). Ninety percent of parents were satisfied with the vaccination services their child had received. CONCLUSION: A review of vaccine records is recommended to accurately assess status. Inpatient hospitalization represents an opportunity to assess vaccination status, address parental concerns, and provide updated vaccinations.
    Journal of Pediatric Health Care 03/2013; · 1.76 Impact Factor
  • Gina Weddle, Barbara Pahud, Mary Anne Jackson
    New England Journal of Medicine 03/2013; 368(11):1066-7. · 54.42 Impact Factor
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    ABSTRACT: This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem.
    PEDIATRICS 03/2013; 131(3):e964-99. · 4.47 Impact Factor
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    ABSTRACT: Intravenous immunoglobulin (IVIG) is commonly used for a wide range of diagnoses, by multiple pediatric subspecialists. We report two cases of hepatitis B screening results post IVIG infusion, where positive anti-Hepatitis B core antigen serology tests indicated possible occult hepatitis infection, leading to a delay in care. However, serial antibody testing showed results consistent with the passive transfer of antibodies.
    F1000Research. 01/2013; 2:249.
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    ABSTRACT: OBJECTIVE:To examine temporal trends of adverse drug reactions (ADRs) associated with trimethoprim-sulfamethoxazole (TMP-SMX) use in children.METHODS:We performed a retrospective observational study to characterize TMP-SMX ADRs in children between 2000 and 2009. We completed a chart review at our institution by identifying children diagnosed with TMP-SMX ADRs. To compare local trends to comparable institutions, we estimated the frequency of hospitalizations for TMP-SMX ADRs at 25 tertiary pediatric hospitals utilizing the Pediatric Health Information System database. To determine whether changes in outpatient prescribing rates occurred, we used the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey.RESULTS:At our institution, 109 children were diagnosed with a TMP-SMX ADR (5 cases from 2000 to 2004 as compared with 104 cases from 2005 to 2009). Fifty-eight percent had been treated for a skin and soft tissue infection (SSTI). A similar trend was observed nationally, where the incidence of TMP-SMX ADRs more than doubled from 2004 to 2009 at comparable pediatric hospitals (P < .001). Although national outpatient data revealed no change in overall TMP-SMX prescribing, the percentage of children prescribed TMP-SMX for SSTI sharply increased during the study period (0%-2% [2000-2004]; 9%-17% [2005-2009]).CONCLUSIONS:The majority of TMP-SMX ADRs at our institution occurred in conjunction with SSTI treatment. TMP-SMX ADRs have occurred more frequently coincident with increased prescribing for SSTI. Increased usage alone may explain the increasing trend of TMP-SMX ADRs in children; however drug-disease interaction may play a role and requires further investigation.
    PEDIATRICS 12/2012; · 4.47 Impact Factor
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    ABSTRACT: Background: While influenza vaccine (IV) is recommended for all children annually, children with diabetes are at higher risk for complications and vaccine is underutilized in this population. This is the first study using order sets in the ambulatory setting to increase IV rates in diabetic children. Methods: A non-equivalent control group design was used to enroll 420 children and parents over 2 influenza seasons (2010-11, 2011-12) at 2 sites (A & B). No vaccine prompts were used for phase 1 which was considered a control season at both sites. An influenza vaccine order set was introduced in season 2 at site A and not B (phase 2), and phase 3 had the order set at both sites. Demographic data included: age, race, ethnicity, insurance, parental education, and parental IV status. Location of patient IV receipt and reason for non-receipt was recorded. Results: Majority of children were white 357/423 (84%), non-Hispanic 402/423 (95%), with private insurance 277/423 (65%); median age 152 mos (IQR: 115,180). 72% (297/414) of mothers and 69% (264/382) of fathers had some college. Vaccine rates for children during the 3 phases were 104/140 (74%), 97/140 (69%), and 114/143 (80%) respectively. Maternal vaccine rates were 37/134 (28%), 19/136 (14%), 43/139 (31%); and paternal rates were 37/116 (32%), 18/119 (15%), 40/114 (35%) during the 3 phases respectively. Table 1 shows the comparison of immunization rates of vaccine eligible (i.e. no previous vaccine) patients in endocrine clinic over the 3 study phases. Table 1. Children receiving vaccine in Endocrine Clinic # received vaccine in clinic/eligible patients p-value Comparison 1: p=0.04 Phase 1 A (%) 14/34 (41) Phase 2 A (%) 36/56 (64) Comparison 2: Phase 1 B (%) 14/30 (47) NS Phase 2 B (%) 42/65 (65) Comparison 3: Phase 2 B (%) 42/65 (65) NS Phase 3 B (%) 28/38 (74) Comparison 4: Phase 2 A (%) 36/56 (64) NS Phase 3 A (%) 15/34 (44) Conclusion: While use of the order set improved vaccine rates at site A, and was sustained over time; an increase was also seen at site B which may reflect increased provider awareness at both sites prompting an IV recommendation. We noted an IV rate above the national average for children, but remains sub-optimal. The provider’s strength of conviction to immunize may be key to improving IV rates for this population.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012
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    ABSTRACT: Background: Despite established guidelines, vaccination rates remain suboptimal. Screening of immunization status at each health care encounter is recommended but rarely done outside of primary care facilities. Our main objectives were to assess vaccine status of the inpatient population at a large pediatric tertiary care center and to assess the effectiveness of a pilot intervention requesting immunization records upon admission to increase immunization rates. Methods: This is a prospective pilot single-center intervention study. A request of immunization records was added to the automated admission notice routinely sent to the primary care providers (PCP). A daily list of admissions was generated for randomization after determining study eligibility. Patients >18 years, short stay, requiring critical care or immunocompromised were excluded. Immunization records were pursued for 5-10 random patients per day (M-F) from various sources. Vaccination status was ascertained as per the CDC’s online Catch-Up Immunization Scheduler tool. Results: We enrolled 250 children from 3/6- 5/3/12; 56% were male. Median age was 4.8 years (IQR .9 – 10.2). Race was white 64%, black 15%, Hispanic 8%, NA 6% and other 6%. Insurance was public 51%, private 41%, self-pay 6% and military 2%. Immunization records were obtained from PCP (phone call) 45%, public health department online website 16%, electronic medical record 15%, obtained via fax per admission notice intervention 14%, from parents 4%, school 1%, or a combination of methods 7%. Vaccination status was determined to be current as per ACIP guidelines on 67% (n-168) of our inpatient population. Catch up dose(s) were needed on 33% (n-82): 10/82 children received required doses prior to discharge and 3/82 after discharge. Catch up doses needed included HPV 40%, VZV 27%, MCV4 23%, Hep A 22%, IPV 16%, Hib 12%, PCV13 11%, DTaP 11%, Hep B 9%, MMR 6%, Rotavirus 5% and Tdap 5% (influenza excluded). Most children 73% (n-59) needed <2 vaccines to be current. The intervention increased vaccination rate to 73%. Conclusion: Under immunization is a common problem in hospitalized children and is not routinely recognized by parents or healthcare providers. The hospital admission may provide a unique opportunity to screen the immunization status of a child, educate parents and link with community vaccine providers.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012
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    ABSTRACT: Background: Fungal central line associated bloodstream infection (F-CLABSI) is a significant source of pediatric morbidity/mortality. No study to date has focused solely on incidence/risks for pediatric F-CLABSIs in all age groups. Objective: To determine risk factors associated with F-CLABSI in children. Methods: A case control study was performed on children 0-18 years with an indwelling central line and blood culture positive for fungus not due to infection at another site from 1/1/2000 to 12/31/2010. Eligible controls were chosen randomly from the hospital’s central line database and matched for number of infections/year and presence of central line without F-CLABSI. Demographic data and differences in exposure to prior antibiotics, TPN/lipids, steroids, blood products and indwelling foreign bodies were evaluated Results: 163 children with F-CLABSI (median age= 24 mos; 45% girls) were compared to 216 controls (median age= 74 mos; 50% girls). C. albicans and C. parapsilosis accounted for 75% of infections (76/163; 47% and 45:28% respectively, along with C. tropicalis 16;10%, C. glabrata 13;8%, C. lusitaniae 6;4%, C. krusei 4;2%. Those with tunneled catheters were more likely to develop F-CLABSI than those with non-tunneled lines (OR: 2.74, 95% CI 1.76, 4.27), though those with F-CLABSI were also more likely to have short bowel syndrome (OR: 26.14, 95% CI: 6.16, 110) or be a NICU patient (OR: 22.193, 95%CI: 5.20, 94.67). Blood cultures remained positive 3.7 + 2.9 days and ≥3 days of fungemia was associated with complications (OR: 2.93, 95% CI 1.02, 8.45). Significant risks that predicted F-CLABSI included prior TPN/lipids (OR: 1.92, 95% CI 1.25, 2.94), co-existing foreign body (OR: 6.13, 95% CI 3.91, 9.59) and receipt of blood transfusions (OR: 6.17, 95% CI 3.65, 10.44). Associated F-CLABSI complications included skin/soft tissue involvement in 6 (10%), and metastatic lesions were found in 13%, involving kidney (4), lung (4), meninges (8) or multiple sites (4). Mortality was higher in F-CLABSI subjects (OR: 5.90, 95% CI: 2.17, 16.09). Conclusion: Children with F-CLABSI were younger and more likely to have short bowel syndrome and/or be hospitalized in the NICU. Those with prior blood transfusions and TPN/lipids receipt through a tunneled catheter and those with another indwelling foreign body were most likely to have F-CLABSI. Prevention efforts should focus on these high risk groups.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012
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    ABSTRACT: Background: Human Parechoviruses(HPeVs) are increasingly recognized in infants presenting with sepsis and meningitis. Recent retrospective data from our institution noted different clinical characteristics in HPeV vs. Enterovirus (EV), but no prospective study has validated these findings or detailed infant exposure history. We are currently in year 2 of active CSF surveillance for EV and HPeV, expecting renewed activity in summer 2012. Methods: Hospitalized infants <90 days old, with CSF WBC counts <1000 and negative CSF gram stain are eligible. Mothers were asked about pregnancy history, infant exposures, and infant illness history. Mothers were asked for throat swabs and blood specimens. Infant throat swabs, nasal swabs and stools were obtained. Scavenged infant CSF, blood and urine were batch tested. Demographics, laboratory values, clinical course, and treatment modalities were collected from charts. Results: Among 281 subjects to date (Jan 2011 – April 2012), specimens tested were 236 CSF, 231 throat, 57 nasal swabs, 148 urine, 210 stool, 210 blood and 233 maternal throat swabs. EV was detected in 20 subjects and HPeV in 5 subjects. EV CSF WBC counts were higher than HPeV (Mn= 102.1/mm3 + 9.9/mm3 vs. 4.0/mm3 + 4.0/mm3, p < 0.0001), as were peripheral WBC counts (8929/mm3 + 1838/mm3 vs. 6118/mm3 + 2624/mm3, p = 0.0005) and CSF glucose values (46.2 mg/dL + 3.9 mg/dL vs. 40.9 mg/dL + 2 mg/dL, p = 0.0002). EV positives had an ill household contact more often than HPeV (p = 0.0403). Compared to controls with neither, HPeV and EV subjects trended to more ill contacts (p = 0.0698). Overall 19/32 (59%) specimens were positive from HPeV subjects and 57/112 (51%) from EV subjects. Permissive sites (throat, stool, nasal) had virus detected in 5/5 (100%) HPeV and 19/20 (95%) EV, while CSF and/or blood isolates were detected in 3/5 (60%) HPeV and 15/20 (75%) EV subjects. Conclusion: Active surveillance for HPeV and EV CNS infections is ongoing. Prospective analysis has confirmed that mean CSF and peripheral WBC counts and CSF glucose levels were significantly higher in EV vs. HPeV patients. EV subjects also had ill contacts more often than HPeV. We expect HPeV and EV infections to re-appear in summer 2012, permitting more complete 2-year EV to HPeV prospective comparisons.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012

Publication Stats

363 Citations
215.97 Total Impact Points

Institutions

  • 2008–2014
    • Children's Mercy Hospitals and Clinics
      Kansas City, Missouri, United States
    • University of Kansas
      • Department of Otolaryngology and Head and Neck Surgery
      Kansas City, KS, United States
    • Kansas City University of Medicine and Biosciences
      Kansas City, Missouri, United States
  • 2002–2013
    • University of Missouri - Kansas City
      • School of Medicine
      Kansas City, MO, United States
  • 2012
    • University of Missouri
      Columbia, Missouri, United States
  • 1999–2004
    • Children's Mercy Hospital
      Kansas City, Missouri, United States