Jasjit Singh

Jasjit Singh
Children's Hospital of Orange County | CHOC · Pediatric Infectious Diseases

MD

About

74
Publications
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519
Citations

Publications

Publications (74)
Article
Background: CDI is the single most common cause of nosocomial diarrhea in both adults and children. Available data regarding treatment outcomes in hospitalized children remain limited. CDI recurrence in children has been reported in 20%–30% of cases. Consensus regarding the best testing method for CDI is lacking. The 2018 IDSA guideline recommends...
Article
Background: Respiratory syncytial virus (RSV) and influenza infections are a major cause of hospitalization and intensive care unit (ICU) admission to children's hospitals and are closely tracked. We compared data over 6 seasons of human metapneumovirus (hMPV), RSV and influenza infections. Methods: During the 2014-2019 winter viral seasons, hMP...
Article
Full-text available
Background In a typical winter respiratory season, Influenza A, Influenza B, Respiratory Syncytial Virus (RSV) and human Metapneumovirus (hMPV) infections are common in pediatrics. During the COVID-19 pandemic, we noted a marked decrease in all except for Rhinovirus/Enterovirus at our free-standing quaternary level children’s hospital. Methods We...
Article
Pseudomonas aeruginosa ( P. aeruginosa ) is an aerobic Gram-negative bacterium that is implicated in the development of severe systemic infections among pediatric patients. It is identified in hospitalized chronically ill pediatric patients in association with genitourinary, respiratory tract, and skin or soft tissue infections as well as severe an...
Article
Pseudomonas aeruginosa ( P. aeruginosa ) is an aerobic Gram-negative bacterium that is implicated in the development of severe systemic infections among pediatric patients. It is identified in hospitalized chronically ill pediatric patients in association with genitourinary, respiratory tract, and skin or soft tissue infections as well as severe an...
Article
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Background: Healthcare-associated infections (HAIs) affect patient health and are tracked closely by infection prevention. Patients in a pediatric intensive care unit (PICU) acquired viral respiratory infections had longer use of respiratory support. We sought to determine the types of viral respiratory HAIs (VR-HAIs) acquired in the PICU and the c...
Article
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Background: Therapies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its life-threatening respiratory infection coronavirus disease 2019 (COVID-19) have been evaluated, including COVID-19 convalescent plasma (CCP). Multiple large reports of CCP treatment in adults exist. Pediatric data on CCP safety and efficacy are limit...
Article
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Background Mycobacterium species, specifically M. abscessus and M. chelonae (MABs), known to contaminate water systems, and are uncommon causes of healthcare associated infection, but morbidity can be significant and treatment complex. Methods Odontogenic MAB infections occurred in patients following pulpotomy procedures at Dental Clinic A from Ja...
Presentation
Full-text available
Abstract INTRODUCTION: A novel Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the pathogen responsible for a serious, life threatening respiratory infection (COVID-19) initially reported in Wuhan, China which rapidly spread worldwide resulting in global pandemic. Multiple immunological and pharmacological therapies h...
Article
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Newborn screening efforts focusing on the quantification of T cell receptor excision circles (TRECs), as a biomarker for abnormal thymic production of T cells, have allowed for the identification and definitive treatment of severe combined immunodeficiency (SCID) in asymptomatic neonates. With the adoption of TREC quantification in Guthrie cards ac...
Article
As the nation implements SARS-CoV-2 vaccination in adults at an unprecedented scale, it is now essential to focus on the prospect of SARS-CoV-2 vaccinations in pediatric populations. To date, no children younger than 12 years have been enrolled in clinical trials. Key challenges and knowledge gaps that must be addressed include (1) rationale for va...
Article
Background: Central-line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) definitions continue to be refined to ensure accuracy. As facilities decrease CLABSI and CAUTI, and as midline catheters become more widely utilized, we sought to understand our non–central-line bloodstream infections (NCLBSI)...
Article
In 2016, water lines at a children's dental clinic in Orange County, California were contaminated with Mycobacterium abscessus (MA), a non-tuberculosis rapidly-growing mycobacterium, leading to the largest MA outbreak ever reported. Mandatory reporting and active case finding directed by the Public Health Department was conducted in collaboration w...
Article
A 6-month-old girl whose parents had recently received a diagnosis of syphilis was referred for evaluation after testing suggested that she also had syphilis. Physical examination revealed frontal bossing and a soft-tissue perirectal mass. A biopsy specimen was positive for spirochetes on immunostaining.
Article
Introduction: Since 2014, the American Academy of Pediatrics has recommended that patients over two years with diabetes mellitus (DM) receive the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Methods: Retrospective chart review was initiated by a quality improvement (QI) project to determine PPSV23 administration rates for inpatients with...
Article
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Background Viral respiratory infections are a major cause of hospitalization and intensive care unit (ICU) admission to children’s hospitals. Rates of respiratory syncytial virus (RSV) and influenza are closely tracked due to their known morbidity. We had previously observed over one season that human metapneumovirus (hMPV)-infected children have h...
Article
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Background Many emergency departments and urgent care settings use the commonly available Respiratory Syncytial Virus Rapid Antigen Detection Test (RSV RADT) to diagnose children with RSV. We noted discordant results between RADT and definitive testing. Our study looked at the positive predictive value (PPV) and the false discovery rate (FDR) of th...
Article
Mycobacterium abscessus infections can be challenging to treat. Clofazimine has excellent in vitro activity against M abscessus, but reports of its use, particularly in children, have been limited. In this study, clofazimine was given to 27 children during an outbreak of odontogenic mycobacterial infections and seemed to be well tolerated as part o...
Article
No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment. We conducted a retrospective cohort study of patients discharg...
Article
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The association of immunodeficiency-related vaccine-derived rubella virus (iVDRV) with cutaneous and visceral granulomatous disease has been reported in patients with primary immunodeficiency disorders (PIDs). The majority of these PID patients with rubella-positive granulomas had DNA repair disorders. To support this line of inquiry, we provide ad...
Article
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Background AMK exhibits concentration-dependent bactericidal activity where larger intermittent doses with higher peaks (Cmax) may be less toxic than more frequent dosing while achieving similar efficacy. An AMK containing regimen was used for treatment of M. abscessus odontogenic outbreak infections in children. Additionally, synergy has been obse...
Article
Full-text available
Background In 2016, an Orange County, California, pediatric dental clinic’s contaminated water system led to the largest outbreak of odontogenic NTM infections yet described. Methods Mandatory reporting and active case finding directed by County Public Health were conducted in collaboration with community Pediatric Infectious Disease physicians fo...
Article
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Background Hospitalization and hospital-based clinics confer an opportunity to target high-risk patients and their families who would benefit from vaccination. Methods CHOC Children’s Hospital is a tertiary-care hospital in Southern California with 11,995 admissions in 2016, including 1,580 hematology/oncology (HO) admissions. We examined the tren...
Article
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Background Mycobacterium abscessus infections are increasingly common and can be challenging to treat due to antimicrobial resistance. Clofazimine (CFZ), which is commonly used for treatment of leprosy, comes as a 50 mg capsule that must be swallowed whole. It has excellent in vitro activity against M. abscessus but there are limited reports of its...
Conference Paper
Background: Treatment of acute hematogenous osteomyelitis (AHO) is controversial with regard to length of therapy and intravenous to oral therapy switch. Previous studies have reported changing from intravenous to oral therapy after only 3 days in patients with an identified pathogen. However, there is little data on the treatment and outcomes for...
Conference Paper
Background: Viral respiratory infections are a major cause of hospitalization and Intensive Care Unit (ICU) admission. At childrens' hospitals, Infection Prevention closely tracks Respiratory Syncytial Virus (RSV) and Influenza, including rates of healthcare associated infections (HAI). There is conflicting data on the contribution of human Metap...
Article
After exposure to a teacher with multidrug-resistant pulmonary tuberculosis, 31 children developed latent infection. Twenty-six were treated with levofloxacin and pyrazinamide. Twelve required a change in therapy secondary to adverse effects. The most common adverse effects included abdominal pain, arthralgias/myalgias, and elevated transaminases....
Conference Paper
Background: We have noted an increased number of children at our institution with infection due to gram-negative bacteria producing extended-spectrum beta-lactamases (ESBLs). We sought to characterize these children over a twelve year period in order to better understand the changing epidemiology of these infections. Methods: We identified all pa...
Article
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Conclusion: We observed an extremely low RSV pneumonia fatality rate in contrast to that reported in the literature. Perhaps due to strict control of nosocomial transmission, our cohort tended to contract RSV late, which might account for better outcomes. Our low incidence of NIPCs is intriguing, and could be biased by the fact that 66% of our coho...
Article
In February 2007, we experienced an abrupt 8-fold increase in vancomycin-resistant Enterococcus (VRE)-positive pediatric hematology/oncology patients in isolation per day, peaking at 12 patients in isolation per day in June 2007. We enforced and expanded infection prevention practices and initiated a rigorous 6-month clearance process. After noting...
Article
We report clinical characteristics and outcome of infants <3 months of age hospitalized with pertussis compared with viral respiratory infection (respiratory syncytial virus and influenza). Patients with pertussis more often were afebrile, had more visits before admission, and had longer hospital stays. Household coughing contacts were common.
Article
Murine typhus is typically a mild febrile illness caused by Rickettsia typhi, generally confined to Texas and Southern California. Clinicians should consider early treatment with doxycycline when presented with a child having protracted fever, rash, and headache.We present 5 pediatric cases and a literature review highlighting the changing epidemiol...
Article
The introduction of Streptococcus pneumoniae 7-valent conjugate vaccine has decreased pneumococcal infections in children. Recently a resurgence of invasive pneumococcal infections has been reported. Delineating populations at risk and microbiological changes responsible for this is important to develop new preventive strategies. We conducted a ret...
Conference Paper
Background: CHOC Children’s Hospital is a 238 bed free standing pediatric hospital with a 12 bed Oncology ICU; 34 bed Oncology unit, 31 bone marrow transplants annually and 1,324 cancer institute patients; 245 on active chemotherapy. The average length of stay is 34 days in OICU and 5.5 days in Oncology with a range of 4-231 days. Our five year bas...
Article
This study was conducted to evaluate once-weekly liposomal amphotericin B (L-AmB) for Candida prophylaxis in very low birth weight (VLBW) neonates. This prospective, randomized, open-label, placebo-controlled study included neonates who were <32 weeks' gestational age, <7 days old, and weighing <1500 g at birth. Subjects were randomized to receive...
Article
Infective endocarditis (IE) is a known complication of Staphylococcus aureus bacteremia in pediatric patients. We sought to evaluate the impact of prolonged bacteremia associated with a retained central venous catheter (CVC) in the diagnosis of IE using Duke criteria. We conducted a 13-year retrospective review of hospitalized patients with blood c...
Article
Micafungin is one of three FDA-approved echinocandins, a novel class of antifungal agents that target 1,3-beta-D-glucan in the fungal cell wall. Its spectrum of activity and favorable safety profile have made it an attractive option in the treatment of invasive Candida and Aspergillus infections. Since its approval in 2005 in the US, a variety of s...
Article
Bloodstream infections (BSIs) are prevalent in the critical care setting and have high attributable morbidity and mortality. The purpose of this study was to identify factors that significantly contribute to immediate as well as eventual mortality in patients with bloodstream infections at a pediatric intensive care unit (PICU). Retrospective revie...
Article
Meningococcemia causes substantial morbidity and mortality worldwide, usually in the term of fulminant disease. This paper reviews the background, pathophysiology, clinical manifestations, and treatment of this entity, along with prevention measures and public health issues to be considered. The authors present updated information on breakthroughs...
Article
We report a case of life-threatening lactic acidosis in a 10-year-old male with HIV stage B2 infection, presumed to be vertically acquired. This occurred after several months of therapy with d4t, ddl, and nevirapine. His most recent CD4 count was 347 cells per microliter and viral load 16,000 copies per milliliter 3 weeks prior to admission. The pe...
Article
Recurrent and persistent acute otitis media (AOM) is a common problem, affecting close to 20% of children in their first years of life. It presents a therapeutic challenge to physicians, particularly as beta-lactamase-producing Haemophilus influenzae, as well as penicillin- and, more recently, macrolide-resistant Streptococcus pneumoniae are often...
Article
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This pilot study was designed to determine the serum cytokine profile of acute otitis media (AOM) due to Streptococcus pneumoniae and the impact of clarithromycin (Abbott Laboratories, Inc). Serum levels of interleukin-1β (IL-1β), tumor necrosis factor alpha (TNF-α), IL-6, and IL-8 were measured at diagnosis and 3 to 5 days after start of antibioti...
Article
The management of fever in infants younger than 1 month is guided by clinical and laboratory yardsticks indicating risk for serious bacterial infection. The presence of pyuria (more than 10 white blood cells per high-power field) suggests urinary tract infection (UTI), and an aggressive workup including lumbar puncture and prolonged intravenous ant...
Article
Full-text available
Urinary tract infections are common in infants and children. Pyelonephritis may result in serious complications, such as renal scarring, hypertension, and renal failure. Identification of the timing of release of inflammatory cytokines in relation to pyelonephritis and its treatment is essential for designing interventions that would minimize tissu...
Article
A 6-month-old infant presented with preauricular swelling that did not respond to antibiotic therapy. A purified protein derivative tuberculin test and family history of tuberculosis led to the correct diagnosis.
Article
Due to normal growth and development, hospitalised paediatric patients with infection require unique consideration of immune function and drug disposition. Specifically, antibacterial and antifungal pharmacokinetics are influenced by volume of distribution, drug binding and elimination, which are a reflection of changing extracellular fluid volume,...
Article
Due to normal growth and development, hospitalised paediatric patients with infection require unique consideration of immune function and drug disposition. Specifically, antibacterial and antifungal pharmacokinetics are influenced by volume of distribution, drug binding and elimination, which are a reflection of changing extracellular fluid volume,...
Article
Choosing appropriate antimicrobial therapy is no longer a simple process. Even for the common problems of respiratory tract disease in children and adults, selection is complicated by both increasing microbial resistance and the daunting number of extended-spectrum antibiotics now on the market. In this article, Drs Singh and Arrieta look at the pr...
Article
Respiratory tract infections are a common reason for physician visits and antibiotic prescriptions. Worldwide problems of drug resistance and proliferation of new antimicrobials mandate that clinicians use all antibiotics judiciously. This entails a pathogen-directed approach that optimizes treatment strategies.
Article
The broad antimicrobial spectrum, clinical efficacy, and favorable safety profile of the cephalosporin class of antibiotics have contributed to their popularity in the treatment of outpatients and hospitalized patients with severe infections. In recent years, a surge in the number of new products being developed, each with particular characteristic...
Article
The infant with cyanosis is a distressing medical presentation. The emergency room physician must be familiar with the diverse causes that may be underlying the event. An understanding of the pathophysiology along with a thorough history and physical examination will guide the physician toward appropriate intervention and management.

Projects

Project (1)
Project
Understanding the immune response to SARS-CoV2 infection in pediatric patients. Understand and identify factors that can lead to MIS-C