Australia’s active hospital-based surveillance for severe childhood disease
PAEDS has commenced surveillance on two new conditions – Kawasaki disease and Gram negative blood stream infections.
Kawasaki disease - Associate Professor Davinder Singh-Grewal and Dr Ryan Lucas, The Children’s Hospital at Westmead
Kawasaki disease (KD) is an inflammatory disease that predominantly affects children under the age of 5 years. It can cause a vasculitis of the coronary arteries, and is the leading cause of acquired heart disease in the developed world. KD management is centred on the use of intravenous immunoglobulin (IVIG), which has been shown to significantly reduce the incidence of coronary artery lesions. Other treatment modalities, such as aspirin and corticosteroids, are also used.
Recently a survey of paediatricians in Australia and New Zealand was conducted to describe treatment practices around KD. This showed significant variability in some areas of management, such as the dosing of aspirin and the indications for other agents. PAEDS has established a prospective surveillance study of KD in children’s hospitals around Australia. One of the goals of this study is to further describe variation in treatment practices as well as to help better understand the burden of disease from KD in Australia. Since surveillance started at the beginning of 2019, we have identified over 70 cases of KD at participating hospitals. Ongoing surveillance will help better describe KD in Australia, with the aim to improve KD management in Australia in the future.
Gram-negative blood stream infections - Dr Adam Irwin and Sonia Dougherty – Queensland Children’s Hospital
Gram-negative organisms cause almost one half of all bloodstream infections (BSI) in children with comorbidities and are associated with significant morbidity and mortality. Understanding the clinical and molecular epidemiology of Gram-negative BSI (GNBSI) and multi-drug GNBSI in children is necessary to facilitate the development and evaluation of the most effective antimicrobial treatment strategies in children. We have established prospective surveillance of GNBSI in tertiary children’s hospitals throughout Australia. This surveillance will augment data collected by the Australian Group on Antimicrobial Resistance (AGAR) Gram-negative Sepsis Outcome Program and will help explain transmission dynamics of both susceptible and resistant invasive Gram-negative organisms in Australian children.
Recruitment commenced in January 2019. Since the study commenced, more than 90 clinical episodes of GNBSI have been identified in tertiary children’s hospitals in Queensland, New South Wales, Victoria and Western Australia. These data provide detailed information on the clinical presentation, treatment and outcomes of children with GNBSI. Comprehensive microbiological characterisation, including whole genome sequencing of disease causing Gram-negative isolates, will be performed to relate molecular determinants of virulence and resistance to clinical outcomes. Laboratory analysis of clinical isolates will take place in the second half of 2019 and data will contribute to the annual AGAR report.
PAEDS receives fundingfrom the Australian government
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