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Kerur B, Fiedler K, Stahl M, Hyams J, Stephens M, Lu Y, Pfefferkorn M, Alkhouri R, Strople J, Kelsen J, Siebold L, Goyal A, Rosh JR, LeLeiko N, Van Limbergen J, Guerrerio AL, Maltz RM, Karam L, Crowley E, Griffiths AM, Heyman MB, Deneau M, Benkov K, Noe J, Moulton D, Pappa H, Galanko J, Snapper S, Muise AM, Kappelman MD, Benchimol EI. Utilization of Antitumor Necrosis Factor Biologics in Very Early Onset Inflammatory Bowel Disease: A Multicenter Retrospective Cohort Study From North America. J Pediatr Gastroenterol Nutr 2022; 75:64-69. [PMID: 35622080 DOI: 10.1097/mpg.0000000000003464] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Research on the utilization and effectiveness of antitumor necrosis factor (TNF) biologics in children with very early onset inflammatory bowel disease (VEOIBD) is urgently needed. Here we describe anti-TNF use and durability in a multicenter cohort. METHODS We performed a retrospective cohort study of patients diagnosed with VEOIBD (<6 years) between 2008 and 2013 at 25 North American centers. We performed chart abstraction at diagnosis and 1, 3, and 5 years after diagnosis. We examined the rate of initiation and durability of infliximab and adalimumab and evaluated associations between treatment durability and the following covariates with multivariate Cox proportional hazard regression: age at diagnosis, sex, disease duration, disease classification, and presence of combined immunomodulatory treatment versus monotherapy. RESULTS Of 294 children with VEOIBD, 120 initiated treatment with anti-TNF therapy and 101 had follow-up data recorded [50% Crohn disease (CD), 31% ulcerative colitis (UC), and 19% IBD unclassified (IBD-U)]. The cumulative probability of anti-TNF treatment was 15% at 1 year, 30% at 3 years, and 45% at 5 years from diagnosis; 56 (55%) were treated between 0 and 6 years old. Anti-TNF durability was 90% at 1 year, 75% at 3 years, and 55% at 5 years. The most common reason for discontinuation of anti-TNF were loss of response in 24 (57%) children. Children with UC/IBD-U had lower durability than those with CD (hazard ratio [HR] 0.17; 95% confidence interval [CI], 0.06-0.51; P = 0.001). CONCLUSIONS Utilization and durability of anti-TNF in VEOIBD is relatively high and comparable with older children. Having Crohn disease (compared with UC/IBD-U) is associated with greater durability.
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Affiliation(s)
- Basavaraj Kerur
- From the University of Massachusetts Medical School (UMMS), Worcester, MA
| | - Karoline Fiedler
- the The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Jeffrey Hyams
- the Connecticut Children's Medical Center, Hartford, CT
| | - Michael Stephens
- the Center for Individualized Medicine, Mayo Clinic, Rochester, MN
| | - Ying Lu
- the Cohen Children's Medical Center of New York, New Hyde Park, NY
| | | | | | - Jennifer Strople
- the Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Judith Kelsen
- the Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Leah Siebold
- the UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Alka Goyal
- the Stanford University School of Medicine, Palo Alto, CA
| | - Joel R Rosh
- the Goryeb Children's Hospital/Atlantic Health System, Morristown, NJ
| | - Neal LeLeiko
- the Morgan Stanley Children's Hospital of NewYork, Columbia University, New York, NY
| | - Johan Van Limbergen
- the Amsterdam University Medical Centres, Emma Children's Hospital, Amsterdam, Netherlands
| | | | - Ross M Maltz
- the Nationwide Children's Hospital, Columbus, OH
| | - Lina Karam
- the Texas Children's Hospital, Houston, TX
| | - Eileen Crowley
- the Children's Hospital, London Health Science Centre, University of Western Ontario, London, Ontario, Canada
| | - Anne M Griffiths
- the The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Mark Deneau
- the University of Utah/Intermountain Primary Children's Hospital, Salt Lake City, UT
| | - Keith Benkov
- the Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joshua Noe
- the Medical College of Wisconsin, Milwaukee, WI
| | - Dedrick Moulton
- the Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
| | - Helen Pappa
- the Cardinal Glennon Children's Hospital, St Louis, MO
| | - Joseph Galanko
- the University of North Carolina in Chapel Hill, Chapel Hill, NC
| | - Scott Snapper
- the Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Aleixo M Muise
- the The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Eric I Benchimol
- the Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa
- the The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Kerur B, Benchimol EI, Fiedler K, Stahl M, Hyams J, Stephens M, Lu Y, Pfefferkorn M, Alkhouri R, Strople J, Kelsen J, Siebold L, Goyal A, Rosh JR, LeLeiko N, Van Limbergen J, Guerrerio AL, Maltz R, Karam L, Crowley E, Griffiths A, Heyman MB, Deneau M, Benkov K, Noe J, Mouton D, Pappa H, Galanko JA, Snapper S, Muise AM, Kappelman MD. Natural History of Very Early Onset Inflammatory Bowel Disease in North America: A Retrospective Cohort Study. Inflamm Bowel Dis 2020; 27:295-302. [PMID: 32386060 PMCID: PMC8177809 DOI: 10.1093/ibd/izaa080] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The incidence of very early onset inflammatory bowel disease (VEOIBD) is increasing, yet the phenotype and natural history of VEOIBD are not well described. METHODS We performed a retrospective cohort study of patients diagnosed with VEOIBD (6 years of age and younger) between 2008 and 2013 at 25 North American centers. Eligible patients at each center were randomly selected for chart review. We abstracted data at diagnosis and at 1, 3, and 5 years after diagnosis. We compared the clinical features and outcomes with VEOIBD diagnosed younger than 3 years of age with children diagnosed with VEOIBD at age 3 to 6 years. RESULTS The study population included 269 children (105 [39%] Crohn's disease, 106 [39%] ulcerative colitis, and 58 [22%] IBD unclassified). The median age of diagnosis was 4.2 years (interquartile range 2.9-5.2). Most (94%) Crohn's disease patients had inflammatory disease behavior (B1). Isolated colitis (L2) was the most common disease location (70% of children diagnosed younger than 3 years vs 43% of children diagnosed 3 years and older; P = 0.10). By the end of follow-up, stricturing/penetrating occurred in 7 (6.6%) children. The risk of any bowel surgery in Crohn's disease was 3% by 1 year, 12% by 3 years, and 15% by 5 years and did not differ by age at diagnosis. Most ulcerative colitis patients had pancolitis (57% of children diagnosed younger than 3 years vs 45% of children diagnosed 3 years and older; P = 0.18). The risk of colectomy in ulcerative colitis/IBD unclassified was 0% by 1 year, 3% by 3 years, and 14% by 5 years and did not differ by age of diagnosis. CONCLUSIONS Very early onset inflammatory bowel disease has a distinct phenotype with predominantly colonic involvement and infrequent stricturing/penetrating disease. The cumulative risk of bowel surgery in children with VEOIBD was approximately 14%-15% by 5 years. These data can be used to provide anticipatory guidance in this emerging patient population.
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Affiliation(s)
- Basavaraj Kerur
- University of Massachusetts Medical School (UMMS), Worcester, MA, United States,Address correspondence to: Basavaraj Kerur, MD, University of Massachusetts Medical School, UMass Memorial Medical Center, 55 Lake Avenue North Worcester, MA 01655, USA. E-mail:
| | | | | | - Marisa Stahl
- Children’s Hospital Colorado, Denver, CO, United States
| | - Jeffrey Hyams
- Connecticut Children’s Medical Center, Hartford, CT, United States
| | - Michael Stephens
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ying Lu
- Cohen Children’s Medical Center of New York, New York, NY, United States
| | | | | | - Jennifer Strople
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States
| | - Judith Kelsen
- Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Leah Siebold
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Alka Goyal
- Children’s Mercy, Kansas City, MO, United States
| | - Joel R Rosh
- Goryeb Children’s Hospital/Atlantic Health System, Morristown, NJ, United States
| | - Neal LeLeiko
- Hasbro Children’s Hospital, Providence, RI, United States
| | - Johan Van Limbergen
- Amsterdam University Medical Centres, Emma Children’s Hospital, Amsterdam, Netherlands
| | | | - Ross Maltz
- Nationwide Children’s Medical Center, Columbus, OH, United States
| | - Lina Karam
- Texas Children’s Hospital, Houston, TX, United States
| | - Eileen Crowley
- Children’s Hospital, London Health Science Centre, University of Western Ontario, London, Ontario, Canada
| | | | - Melvin B Heyman
- UCSF Benioff Children’s Hospital, San Francisco, CA, United States
| | - Mark Deneau
- University of Utah/Intermountain Primary Children’s Hospital, Salt Lake City, UT, United States
| | - Keith Benkov
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Joshua Noe
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Dedrick Mouton
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, United States
| | - Helen Pappa
- Cardinal Glennon Children’s Hospital, St. Louis, MO, United States
| | - Joseph A Galanko
- University of North Carolina in Chapel Hill, Chapel Hill, NC, United States
| | - Scott Snapper
- Children’s Hospital Boston, Boston, MA, United States
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Kerur B, Machan JT, Shapiro JM, Cerezo CS, Markowitz J, Mack DR, Griffiths AM, Otley AR, Pfefferkorn MD, Rosh JR, Keljo DJ, Boyle B, Oliva-Hemker M, Kay MH, Saeed SA, Grossman AB, Sudel B, Kappelman MD, Schaefer M, Tomer G, Bousvaros A, Lerer T, Hyams JS, LeLeiko NS. Biologics Delay Progression of Crohn's Disease, but Not Early Surgery, in Children. Clin Gastroenterol Hepatol 2018; 16:1467-1473. [PMID: 29486253 DOI: 10.1016/j.cgh.2018.02.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 02/09/2018] [Accepted: 02/16/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Up to 30% of patients with Crohn's disease (CD) require surgery within the first 5 years from diagnosis. We investigated the recent risk of bowel surgery in an inception cohort of pediatric patients with CD and whether early use of biologics (tumor necrosis factor antagonists) alters later disease course. METHODS We collected data from the Pediatric Inflammatory Bowel Disease Collaborative Research Group registry on 1442 children (age, ≤16 y) diagnosed with CD from January 2002 through December 2014. Data were collected at diagnosis, 30 days following diagnosis, and then quarterly and during hospitalizations for up to 12 years. Our primary aim was to determine the 10-year risk for surgery in children with CD. Our secondary aim was to determine whether early use of biologics (<3 mo of diagnosis) affected risk of disease progression. RESULTS The 10-year risk of first bowel surgery was 26%. The 5-year risk of bowel surgery did not change from 2002 through 2014, and remained between 13% and 14%. Most surgeries occurred within 3 years from diagnosis. The only predictor of surgery was disease behavior at diagnosis. CD with inflammatory behavior had the lowest risk of surgery compared to stricturing disease, penetrating disease, or both. We associated slowing of disease progression to stricturing or penetrating disease (but not surgery) with early use of biologics, but this effect only became evident after 5 years of disease. Our results indicate that biologics slow disease progression over time (hazard ratio, 0.85; 95% CI, 0.76-0.95). CONCLUSIONS In an analysis of data from a registry of pediatric patients with CD, we found that among those with significant and progressing disease at or shortly after presentation, early surgery is difficult to prevent, even with early use of biologics. Early use of biologics (<3 mo of diagnosis) can delay later disease progression to stricturing and/or penetrating disease, but this affect could become evident only years after initial management decisions are made.
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Affiliation(s)
- Basavaraj Kerur
- Pediatric Gastroenterology and Nutrition, Hasbro Children Hospital, Providence, Rhode Island; The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jason T Machan
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island; Lifespan Biostatistics Core, Rhode Island Hospital, Providence, Rhode Island
| | - Jason M Shapiro
- Pediatric Gastroenterology and Nutrition, Hasbro Children Hospital, Providence, Rhode Island; The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Carolina S Cerezo
- Pediatric Gastroenterology and Nutrition, Hasbro Children Hospital, Providence, Rhode Island; The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - James Markowitz
- Steven & Alexandra Cohen Children's Medical Center, Lake Success, New York
| | - David R Mack
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | | | | | - Joel R Rosh
- Goryeb Children's Hospital/Atlantic Health, Morristown, New Jersey
| | - David J Keljo
- Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | - Marsha H Kay
- The Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Boris Sudel
- University of Minnesota, Minneapolis, Minnesota
| | | | - Marc Schaefer
- Penn State Hershey Children's Hospital, Hershey, Pennsylvania
| | - Gitit Tomer
- Children's Hospital at Montefiore, Bronx, New York
| | | | - Trudy Lerer
- Connecticut Children's Medical Center, Hartford, Connecticut
| | - Jeffrey S Hyams
- Connecticut Children's Medical Center, Hartford, Connecticut
| | - Neal S LeLeiko
- Pediatric Gastroenterology and Nutrition, Hasbro Children Hospital, Providence, Rhode Island; The Warren Alpert Medical School, Brown University, Providence, Rhode Island.
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Balasubramanian S, Harrild DM, Kerur B, Marcus E, del Nido P, Geva T, Powell AJ. Impact of surgical pulmonary valve replacement on ventricular strain and synchrony in patients with repaired tetralogy of Fallot: a cardiovascular magnetic resonance feature tracking study. J Cardiovasc Magn Reson 2018; 20:37. [PMID: 29909772 PMCID: PMC6004693 DOI: 10.1186/s12968-018-0460-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/22/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In patients with repaired tetralogy of Fallot (TOF), a better understanding of the impact of surgical pulmonary valve replacement (PVR) on ventricular mechanics may lead to improved indications and outcomes. Therefore, we used cardiovascular magnetic resonance (CMR) feature tracking analysis to quantify ventricular strain and synchrony in repaired TOF patients before and after PVR. METHODS Thirty-six repaired TOF patients (median age 22.4 years) prospectively underwent CMR a mean of 4.5 ± 3.8 months before PVR surgery and 7.3 ± 2.1 months after PVR surgery. Feature tracking analysis on cine steady-state free precession images was used to measure right ventricular (RV) and left ventricular (LV) circumferential strain from short-axis views at basal, mid-ventricular, and apical levels; and longitudinal strain from 4-chamber views. Intraventricular synchrony was quantified using the maximum difference in time-to-peak strain, the standard deviation of the time-to-peak, and cross correlation delay (CCD) metrics; interventricular synchrony was assessed using the CCD metric. RESULTS Following PVR, RV end-diastolic volume, end-systolic volume, and ejection fraction declined, and LV end-diastolic volume and end-systolic volume both increased with no significant change in the LV ejection fraction. LV global basal and apical circumferential strains, and basal synchrony improved. RV global circumferential and longitudinal strains were unchanged, and there was a varied impact on synchrony across the locations. Interventricular synchrony worsened at the midventricular level but was unchanged at the base and apex, and on 4-chamber views. CONCLUSIONS Surgical PVR in repaired TOF patients led to improved LV global strain and no change in RV global strain. LV and RV synchrony parameters improved or were unchanged, and interventricular synchrony worsened at the midventricular level.
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MESH Headings
- Adolescent
- Adult
- Cardiac Surgical Procedures/adverse effects
- Child
- Databases, Factual
- Female
- Heart Valve Prosthesis Implantation/adverse effects
- Humans
- Magnetic Resonance Imaging, Cine
- Male
- Middle Aged
- Myocardial Contraction
- Observer Variation
- Predictive Value of Tests
- Pulmonary Valve/diagnostic imaging
- Pulmonary Valve/physiopathology
- Pulmonary Valve/surgery
- Pulmonary Valve Insufficiency/diagnostic imaging
- Pulmonary Valve Insufficiency/etiology
- Pulmonary Valve Insufficiency/physiopathology
- Pulmonary Valve Insufficiency/surgery
- Randomized Controlled Trials as Topic
- Recovery of Function
- Reproducibility of Results
- Stroke Volume
- Tetralogy of Fallot/complications
- Tetralogy of Fallot/diagnostic imaging
- Tetralogy of Fallot/physiopathology
- Tetralogy of Fallot/surgery
- Time Factors
- Treatment Outcome
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/diagnostic imaging
- Ventricular Dysfunction, Right/etiology
- Ventricular Dysfunction, Right/physiopathology
- Ventricular Function, Left
- Ventricular Function, Right
- Young Adult
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Affiliation(s)
- Sowmya Balasubramanian
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - David M. Harrild
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Basavaraj Kerur
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
| | - Edward Marcus
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Pedro del Nido
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, USA
- Department of Surgery, Boston Children’s Hospital, Boston, USA
| | - Tal Geva
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Andrew J. Powell
- Department of Cardiology, Boston Children’s Hospital, Boston, USA
- Department of Pediatrics, Harvard Medical School, Boston, USA
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Kerur B, Litman HJ, Stern JB, Weber S, Lightdale JR, Rufo PA, Bousvaros A. Correlation of endoscopic disease severity with pediatric ulcerative colitis activity index score in children and young adults with ulcerative colitis. World J Gastroenterol 2017; 23:3322-3329. [PMID: 28566893 PMCID: PMC5434439 DOI: 10.3748/wjg.v23.i18.3322] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/10/2017] [Accepted: 04/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate of pediatric ulcerative colitis activity index (PUCAI) in ulcerative colitis correlate with mucosal inflammation and endoscopic assessment of disease activity (Mayo endoscopic score).
METHODS We reviewed charts from ulcerative colitis patients who had undergone both colonoscopy over 3 years. Clinical assessment of disease severity within 35 d (either before or after) the colonoscopy were included. Patients were excluded if they had significant therapeutic interventions (such as the start of corticosteroids or immunosuppressive agents) between the colonoscopy and the clinical assessment. Mayo endoscopic score of the rectum and sigmoid were done by two gastroenterologists. Inter-observer variability in Mayo score was assessed.
RESULTS We identified 99 patients (53% female, 74% pancolitis) that met inclusion criteria. The indications for colonoscopy included ongoing disease activity (62%), consideration of medication change (10%), assessment of medication efficacy (14%), and cancer screening (14%). Based on PUCAI scores, 33% of patients were in remission, 39% had mild disease, 23% had moderate disease, and 4% had severe disease. There was “moderate-substantial” agreement between the two reviewers in assessing rectal Mayo scores (kappa = 0.54, 95%CI: 0.41-0.68).
CONCLUSION Endoscopic disease severity (Mayo score) assessed by reviewing photographs of pediatric colonoscopy has moderate inter-rater reliability, and agreement was less robust in assessing patients with mild disease activity. Endoscopic disease severity generally correlates with clinical disease severity as measured by PUCAI score. However, children with inflamed colons can have significant variation in their reported clinical symptoms. Thus, assessment of both clinical symptoms and endoscopic disease severity may be required in future clinical studies.
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Shapiro JM, Kerur B. Do Orally Administered Immunoglobulin-Based Agents Represent the Future of IBD Therapeutics? Dig Dis Sci 2015; 60:3155-7. [PMID: 26182902 DOI: 10.1007/s10620-015-3802-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 07/06/2015] [Indexed: 12/09/2022]
Affiliation(s)
- Jason M Shapiro
- Division of Pediatric Gastroenterology, Nutrition and Liver Diseases, Department of Pediatrics, Hasbro Children's Hospital/Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA. .,The Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Basavaraj Kerur
- Division of Pediatric Gastroenterology, Nutrition and Liver Diseases, Department of Pediatrics, Hasbro Children's Hospital/Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.,The Warren Alpert School of Medicine, Brown University, Providence, RI, USA
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Kerur B, Salvador A, Arbeter A, Schutzman DL. Neonatal blood cultures: survey of neonatologists' practices. World J Pediatr 2012; 8:260-2. [PMID: 22886201 DOI: 10.1007/s12519-012-0368-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 11/09/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are currently no standard recommendations regarding the optimal method to obtain a blood culture in neonates. METHODS We performed an online survey of the membership of the Section on Perinatal Pediatrics of the American Academy of Pediatrics regarding their practices when drawing blood cultures. The survey included questions regarding the type of antisepsis used in preparing the site for sampling, the amount of blood drawn and preferred site for obtaining the culture. RESULTS Overall 715 of 2955 (24%) members responded to the survey. There was wide variability in responses to all of the questions. However, virtually all providers washed their hands and wore gloves while performing the procedure, and virtually all providers obtained ≥0.5 mL of blood for the sample. CONCLUSIONS Given the wide variability of practices among the members of the Section, evidence-based standards are needed to guide clinical practice for this procedure.
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Affiliation(s)
- Basavaraj Kerur
- Division of Pediatrics, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA
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8
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Affiliation(s)
- B Kerur
- Royal Albert Edward Infirmary, Wigan, UK.
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