Prevention of infections by direct contact Children are particularly prone to infections acquired by direct contact. Frequently, children engage in behaviors that place them at risk, such as placing their hands in their nose or mouth and then touching surfaces,…
General principles Children with deficient immune mechanisms, immunologic disorders, or those receiving immunosuppressive therapy (e.g., radiation, cytotoxic chemotherapy, antirejection medication, and steroids) are identified as high-risk patients with the greatest risk of acquiring healthcare-associated infections. Patients in this subset include…
Antimicrobial stewardship refers to the appropriate selection, dosing, route, and duration of antimicrobial therapy to optimize patient outcomes and minimize toxicity and the development of resistant pathogens. Over the past decade, the number of pediatric antimicrobial stewardship programs (ASPs) has…
At birth, infants become colonized with trillions of commensal microbes that play important roles in health and disease. The majority of these microbes reside in the gastrointestinal tract, reaching densities of 10 12 bacteria per gram of intestinal content in…
Vaccination has repeatedly been acknowledged as one of the most important tools for reduction of mortality worldwide and one of the most cost-effective ways to decrease health care–related costs. Immunocompromised children are at higher risk of complications caused by vaccine-preventable…
Chemotherapy agents have been the cornerstone of cancer treatments since the 1960s when the first concerted attempts were made to treat cancer. Although these agents are effective at destroying cancer cells, they often indiscriminately destroy other healthy cells, such as…
Solid organ transplantation (SOT) has transformed the prognosis of many children with organ failure. An estimated 135,860 SOTs were performed worldwide in 2016. A total of 33,610 SOTs were performed in the United States, with children, the majority of whom…
Patients who undergo hematopoietic stem cell transplantation (HSCT) are at risk for developing bacterial, fungal, viral, and/or parasitic infections, particularly those who receive allogeneic transplants. Infections in these patients are associated with high rates of morbidity and mortality; therefore preventative…
Donors of cells or organs are important potential sources of infection in children undergoing hematopoietic stem cell (HSCT) or solid organ transplantation (SOT). In both settings, the donor may be a source of anticipated or unanticipated transmission of pathogens to…
Basic principles of the infectious disease pretransplant evaluation The pretransplant infectious disease evaluation represents the first step in a long continuum of infection prevention that extends into the posttransplant period. This evaluation is a critical element in the pretransplant process…