Try a new search

Format these results:

Searched for:



Total Results:


Poor Uptake of MMR Vaccine 1-year Post-Measles Outbreak: New York City and Israel

Paret, Michal; Trillo, Rebecca; Lighter, Jennifer; Youngster, Ilan; Ratner, Adam J; Pellett Madan, Rebecca
BACKGROUND:In 2018-2019, large outbreaks of measles occurred in Israel and in New York City, driven in part by travel of unimmunized children between the 2 communities. METHODS:A retrospective chart review was conducted for children tested for measles (March 2018-September 2019) at NYU Langone Health in New York, NY, and in Ramla subdistrict, Israel. Vaccination records were reviewed to determine vaccination status for measles, mumps, and rubella (MMR) at the time of measles testing and 1-year post-testing. RESULTS:A total of 264 children were tested for measles, and 102 (38.6%) had confirmed measles. Only 20 (19.6%) of measles-positive cases received a full 2-dose course of vitamin A. 82.4% of children with measles were ≥1 year at the time of diagnosis and fully eligible for MMR vaccine. Of the 100 measles-positive cases with available vaccine records, 63 were unvaccinated at testing, and 27 remained unimmunized against MMR 1 year later. At testing, measles-negative children were significantly more likely to have received MMR than measles-positive children (65.4% vs 37%, P < .01). One year later, 70.4% of measles-negative cases and only 57.1% of measles-positive cases had received MMR vaccine (P = .18). CONCLUSIONS:The majority of measles cases occurred in unimmunized children eligible for vaccination, and >25% of children in both measles-positive and -negative groups remained unimmunized for MMR 1-year post-outbreak. Our results suggest the need for novel, longitudinal vaccination strategies and increased awareness of the role of vitamin A.
PMID: 35477779
ISSN: 2048-7207
CID: 5217512

50 Years Ago in TheJournalofPediatrics: Same Bug, Different Drugs: The Persistent Threat of Escherichia coli Neonatal Sepsis

Popofsky, Stephanie; Pellett Madan, Rebecca
PMID: 34030838
ISSN: 1097-6833
CID: 4887632

Impact of Pre-transplant Carbapenem-resistant Enterobacterales Colonization and/or Infection on Solid Organ Transplant Outcomes

Taimur, Sarah; Pouch, Stephanie M; Zubizarreta, Nicole; Mazumdar, Madhu; Rana, Meenakshi; Patel, Gopi; Freire, Maristela Pinnheiro; Pellett Madan, Rebecca; Kwak, Eun Jeong; Blumberg, Emily; Satlin, Michael J; Pisney, Larissa; Clemente, Wanessa Trindade; Zervos, Marcus J; La Hoz, Ricardo M; Huprikar, Shirish
The impact of pre-transplant (SOT) carbapenem-resistant Enterobacterales (CRE) colonization or infection on post-SOT outcomes is unclear. We conducted a multi-center, international, cohort study of SOT recipients, with microbiologically diagnosed CRE colonization and/or infection pre-SOT. Sixty adult SOT recipients were included (liver n=30, hearts n=17). Klebsiella pneumoniae (n=47, 78%) was the most common pre-SOT CRE species. Median time from CRE detection to SOT was 2.32 months (IQR 0.33-10.13). Post-SOT CRE infection occurred in 40% (n=24/60), at a median of 9 days (IQR 7-17), and most commonly due to K. pneumoniae (n=20/24, 83%). Of those infected, 62% had a surgical site infection, and 46% had bloodstream infection. Patients with post-SOT CRE infection more commonly had a liver transplant (16, 67% vs. 14, 39%; P=0.0350) or pre-SOT CRE BSI (11, 46% vs. 7, 19%; P=0.03). One-year post-SOT survival was 77%, and those with post-SOT CRE infection had a 50% less chance of survival vs. uninfected (0.86, 95% CI, 0.76-0.97 vs. 0.34, 95% CI 0.08-1.0, P=0.0204). Pre-SOT CRE infection or colonization is not an absolute contraindication to SOT, and is more common among abdominal SOT recipients, those with pre-SOT CRE BSI, and those with early post-SOT medical and surgical complications.
PMID: 33527453
ISSN: 1399-0012
CID: 4776142

SARS-CoV-2 infection (COVID-19) in febrile infants without respiratory distress

Paret, Michal; Lighter, Jennifer; Pellett Madan, Rebecca; Raabe, Vanessa N; Shust, Gail F; Ratner, Adam J
We report two cases of SARS-CoV-2 infection (COVID-19) in infants presenting with fever in the absence of respiratory distress who required hospitalization for evaluation of possible invasive bacterial infections. The diagnoses resulted from routine isolation and real-time RT-PCR-based testing for SARS-CoV-2 for febrile infants in an outbreak setting.
PMID: 32301967
ISSN: 1537-6591
CID: 4383852

CMV as culprit or bystander: The debate continues [Letter]

Yamada, Masaki; Pellett Madan, Rebecca
PMID: 33044777
ISSN: 1399-3046
CID: 4631602

Persistent hypogammaglobulinemia in pediatric solid organ transplant recipients

Pellett Madan, Rebecca; Penkert, Rhiannon R; Surman, Sherri L; Jones, Bart G; Houston, James; Lamour, Jacqueline M; Del Rio, Marcela; Herold, Betsy C; Hurwitz, Julia L
INTRODUCTION/BACKGROUND:Hypogammaglobulinemia has not been well studied in transplanted children. We quantified plasma immunoglobulin (Ig) and lymphocyte phenotypes among 31 pediatric heart and kidney recipients for two years post-transplant and from 10 non-transplanted children. METHODS:Plasma IgM, IgG, and IgA were quantified by immunoturbidimetric assays, IgG subclasses were quantified by bead-based multiplex immunoassay, and lymphocyte phenotypes were assessed by flow cytometry. RESULTS:Median age at transplant for SOT recipients was similar to that of the control cohort (15 vs. 12.5 years, respectively; p=0.61). Mean plasma IgG and IgM levels for SOT recipients fell significantly below the control cohort means by 1 month post-transplant (p<0.001 for both) and remained lower than control levels at 12-18 months post-transplant. Heart recipients had lower frequencies of CD45RA+CD4+ naïve T lymphocytes relative to kidney recipients. CONCLUSIONS:Hypogammaglobulinemia was prevalent and persistent among pediatric SOT recipients and may be secondary to immunosuppressive medications, as well as loss of thymus tissue and CD45RA+CD4+ T cells in heart recipients. Limitations of our study include but are not limited to small sample size from a single center, lack of samples for all participants at every time point, and lack of peripheral blood mononuclear cell samples for the non-transplanted cohort.
PMID: 32575155
ISSN: 1399-0012
CID: 4505102

Neutrophilic panniculitis arising from hematogenous spread of methicillin-resistant Staphylococcus aureus [Case Report]

Young, Trevor K; Gutierrez, Daniel; Meehan, Shane A; Pellett Madan, Rebecca; Oza, Vikash S
Infectious panniculitis from hematogenous spread is uncommon and usually occurs in immunocompromised patients. Dissemination of gram-positive organisms to the subcutaneous tissue is rare with only several reports of disseminated panniculitis caused by Streptococcal species. We report a case of an immunocompetent 2-year-old boy presenting with diffuse neutrophilic panniculitis arising from methicillin-resistant Staphylococcus aureus septicemia. This case represents a highly atypical manifestation of severe MRSA infection and serves as a reminder to consider MRSA as a cause of disseminated neutrophilic panniculitis, particularly in high-risk populations.
PMID: 32124476
ISSN: 1525-1470
CID: 4338412

50 Years Ago in TheJournalofPediatrics: Neonatal HSV: Many Advances and the Elusive Promise of an Effective Vaccine

Paret, Michal; Madan, Rebecca Pellett
PMID: 32089180
ISSN: 1097-6833
CID: 4324122

Isolation of antibiotic-resistant gram-negative organisms from donor respiratory culture does not impact non-lung solid organ recipient management

Benamu, Esther; Pereira, Marcus R; Taimur, Sarah; Jacobs, Samantha E; Friedman, Amy L; Jenkins, Stephen G; Herold, Betsy C; Madan, Rebecca Pellett
BACKGROUND:Multidrug-resistant (MDR) and extensively drug-resistant (XDR) gram-negative bacteria may be transmitted from organ donors to solid organ transplant recipients and are associated with poor outcomes post-transplant. METHODS:We reported the prevalence of MDR/XDR gram-negative respiratory colonization among 702 deceased organ donors in the New York City area from 2011-2014 and performed chart reviews for a subset of recipients to determine if donor respiratory culture results were predictive of subsequent recipient infection or used to guide post-transplant antimicrobial therapy. RESULTS:50 donors (7% of the cohort) had MDR or XDR gram-negative bacteria isolated from endotracheal aspirate or bronchoalveolar lavage culture. Organs from these 50 donors were transplanted into 120 recipients; chart review was performed for 89 of these recipients (38 kidney, 32 liver, 11 heart, 6 kidney/pancreas, 1 liver/kidney, 1 lung). None of the 89 recipients of organs from donors with MDR/XDR gram-negative respiratory colonization were reported to have a donor-derived infection post-transplant, and chart review for the 88 non-lung recipients indicated that peri-transplant antibiotics were not adjusted specifically for donor respiratory culture results. CONCLUSION/CONCLUSIONS:These results suggest that donor respiratory culture results are not predictive of post-transplant infection in non-lung recipients and are unlikely to impact post- transplant management. This article is protected by copyright. All rights reserved.
PMID: 31230392
ISSN: 1399-0012
CID: 3954922

Human herpesvirus 6, 7, and 8 in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Pellett Madan, Rebecca; Hand, Jonathan
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of HHV-6A, HHV-6B, HHV-7, and HHV-8 in the pre- and post-transplant period. The majority of HHV-6 (A and B) and HHV-7 infections in transplant recipients are asymptomatic; symptomatic disease is reported infrequently across organs. Routine screening for HHV-6 and 7 DNAemia is not recommended in asymptomatic patients, nor is prophylaxis or preemptive therapy. Detection of viral nucleic acid by quantitative PCR in blood or CSF is the preferred method for diagnosis of HHV-6 and HHV-7 infection. The possibility of chromosomally integrated HHV-6 DNA should be considered in individuals with persistently high viral loads. Antiviral therapy should be initiated for HHV-6 encephalitis and should be considered for other manifestations of disease. HHV-8 causes Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman disease and is also associated with hemophagocytic syndrome and bone marrow failure. HHV-8 screening and monitoring may be indicated to prevent disease. Treatment of HHV-8 related disease centers on reduction of immunosuppression and conversion to sirolimus, while chemotherapy may be needed for unresponsive disease. The role of antiviral therapy for HHV-8 infection has not yet been defined.
PMID: 30844089
ISSN: 1399-0012
CID: 3814872