Browsing by Author "Jadavji, Taj"

Now showing 1 - 4 of 4
  • Thumbnail Image
    ItemOpen Access
    Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community-Acquired Paediatric Diarrhea
    (1999-01-01) Deorari, Savita; McConnell, Athena; Tan, Kah-Kee; Jadavji, Nadeem; Ma, Doreen; Church, Deirdre; Katzko, Gary; Gall, D Grant; Jadavji, Taj; Davies, H Dele
    OBJECTIVES: To evaluate the role of routine stool examination for all pathogens in paediatric nosocomial diarrhea (NAD) and community-acquired diarrhea (CAD) over a two-year period at Alberta Children’s Hospital and current practices in other Canadian hospitals. A secondary objective was to characterize features that may predict NAD or CAD etiology.STUDY DESIGN: Retrospective cohort study and telephone survey.SETTING: Alberta Children’s Hospital (retrospective review) and Canadian tertiary care paediatric centres (telephone survey).METHODS: The health and microbiological records of all children with an admission or discharge diagnosis of diarrhea were reviewed using a standardized data collection form. In addition, a telephone survey of laboratories serving all paediatric hospitals in Canada was conducted using a standard questionnaire to obtain information about practices for screening for pathogens related to NAD.RESULTS: Four hundred and thirty-four CAD episodes and 89 NAD episodes were identified. Overall, rotavirus and Clostridium difficile were the most commonly identified pathogens. Bacterial culture was positive in 10.6% CAD episodes tested, with Escherichia coli O157:H7 identified as the most common non-C difficile organism. In NAD, no bacteria were identified other than C difficile (toxin). Screening for ova and parasites had negligible yield. Viruses were more frequent in the winter months, while bacterial pathogens were more common in the summer and fall months. Over 50% of Canadian paediatric hospitals still routinely process NAD specimens similarly to CAD specimens.CONCLUSIONS: There is a need for the re-evaluation of routine ova and parasite screening, and bacterial culture in nonoutbreak episodes of NAD in children.
  • Thumbnail Image
    ItemOpen Access
    Evaluation of Potential Factors Contributing to Microbiological Treatment Failure in Streptococcus Pyogenes Pharyngitis
    (2001-01-01) Kuhn, Susan M; Preiksaitis, Jutta; Tyrrell, Gregory J; Jadavji, Taj; Church, Deirdre; Davies, H Dele
    BACKGROUND: A cohort study of children with pharyngitis aged two to 16 years was conducted to assess the role of microbial and host factors in group A beta-hemolytic streptococcus (GABHS) microbiological treatment failure. METHODS: GABHS-infected children had pharyngeal swabs repeated two to five days after completing a 10-day course of penicillin V. M and T typing, and pulsed field gel electrophoresis were performed on the isolates, and the isolates were evaluated for tolerance. Patient characteristics and clinical features were noted and nasopharyngeal swabs for respiratory viruses were taken at enrolment. RESULTS AND CONCLUSIONS: Of 286 patients enrolled, 248 (87%) could be evaluated. GABHS was cultured from 104 patients (41.9%), of whom 33 (33.7%) had microbiological treatment failures on follow-up. Although there was a trend toward failure for younger children (mean 6.5±2.4 years versus 7.3±2.4 years, P=0.07) and M type 12 (24% versus 10%, P=0.08), no factors were associated with treatment failure.
  • Thumbnail Image
    ItemOpen Access
    Meningitis Due to Ampicillin-and Chloramphenicol-Resistant Haemophilus influenzae Type B in Canada. Case Report and Review
    (1990-01-01) Kabani, Amin; Joffe, Ari; Cadrain, Gisele; Jadavji, Taj
    The first report of a case of ampicillin- and chloramphenicol-resistant Haemophilus influenzae type b invasive infection in Canada is described in a four-month-old male with meningitis. He was treated with cefotaxime 200 mg/kg/day divided every 6 h and dexamethasone 0.6 mg/kg/day divided every 6 h, eventually recovering after a complicated course. Follow-up at 21 months showed mild to moderate global developmental delay. While chloramphenicol resistance is rare in North America, a case of meningitis initially unresponsive to ampicillin and chloramphenicol must be considered suspect for resistance. Third generation cephalosporins should be used for resistant cases.
  • Thumbnail Image
    ItemOpen Access
    Population-Based Surveillance of HiB Invasive Infections in Children in British Columbia, Alberta and Ontario -- 1995 to 1997
    (2000-01-01) Scheifele, David; Bell, Alison; Jadavji, Taj; Vaudry, Wendy; Waters, John; Naus, Monika; Sciberras, Jill
    OBJECTIVE: To assess vaccine effectiveness through enhanced disease surveillance following the change in childhood immunization programs in 1995, when all provinces and territories chose to use polyribosyl ribitol phosphate-tetanus protein (PRP-T) Haemophilus influenzae type b (Hib) conjugate vaccine, generally in combination with diphtheria-pertussis-tetanus inactivated polio vaccine (DPT-IPV) (as PENTA vaccine) because the protective efficacy of this regimen had not been directly measured.DESIGN: Prospective, active, laboratory-based Hib case surveillance was implemented in British Columbia and Alberta, and enhanced, stimulated laboratory surveillance in Ontario during 1995 to 1997, centred on invasive infections in children. Case details and immunization histories were uniformly collected and centrally collated.MAIN RESULTS: Thirty-eight Hib cases were detected, but only 12 cases arose among PENTA-eligible children, an attack rate of 0.85 cases/100,000 child-years of observation. Annual case totals declined from 20 in 1995 to seven in 1997, when only one to three cases were encountered in each province and the incidence rate in children under age five years was 0.6/100,000. Only four cases occurred after primary immunization with PENTA, a failure rate of 0.28 cases/100,000 child-years of observation. Three cases among PENTA-eligible children reflected parental refusal of infant vaccinations, accounting for 25% of cases in eligible children.CONCLUSIONS: PRP-T conjugate vaccine was highly effective when given in combination with DPT-IPV vaccine. Provincial programs that used this regimen resulted in the near elimination of invasive Hib disease in children, but unimmunized children remain at risk.