Background The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD. Methods This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire. Results The median age of the affected children (43.8% male) was 26 months (18.25–36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41–5.90, P = 0.00) were independently associated with an increased risk. Conclusions This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.

We tested whether interleukin-6 (IL-6) in tracheal aspirate (TA) at birth, as a marker of fetal pulmonary inflammation, can be a predictor of bronchopulmonary dysplasia (BPD) in preterm infants. A total of 75 preterm (< or = 32 wk) infants who were intubated in the delivery room were prospectively enrolled. Multivariate logistic regression analysis was done to determine whether IL-6 in TA at birth is an independent risk factor for BPD, and a receiver-operating characteristic curve was constructed to determine the accuracy of IL-6 in TA for predicting the risk of BPD. IL-6 in TA at birth was an independent risk factor for BPD. Fetal pulmonary inflammation defined as IL-6 in TA at birth > or = 316 pg/ml together with patent ductus arteriosus (PDA) additively predicted the risk of BPD. The sensitivity, specificity, and positive and negative predictive values of fetal pulmonary inflammation for the identification of BPD were 73%, 71%, 58% and 83%, respectively. IL-6 in TA at birth can be used as a predictor of BPD in combination with the presence of PDA.

Objective: The recent development of fetal ultrasonography has allowed for an increasing number of prenatal diagnoses for congenital cystic adenomatoi

This study investigated the clinical details and epidemiology of the imipenem-resistant Acinetobacter baumannii (IRAB) outbreak that occurred at a pediatric intensive care unit (PICU), and describes successful outcome of the implemented infection control measures. With the recognition of 3 clustered cases with IRAB bacteremia at the PICU of Seoul National University Children’s Hospital, Korea, from August to September 2010, the following outbreak control strategies were implemented: reinforcement of hand hygiene and contact precautions, investigation of environmental contamination, disinfection of the contaminated environment and medical equipment, active surveillance culture upon PICU admission and isolation of IRAB-positive patients. The clinical and microbiological data were reviewed for A. baumannii positive cases in the PICU from April 2001 to June 2011. Multilocus sequence typing was also performed. Twenty IRAB-positive cases (bacteremia in 10, pneumonia in 3 and colonizers in 7) were detected from January 2010 to February 2011. Thirteen IRAB-infected patients were all placed on a mechanical ventilator, had central venous catheters, received broad-spectrum antimicrobial treatment and had underlying diseases. Eleven (85%) IRAB-infected patients died probably due to IRAB infection. IRAB grew in 4 samples obtained from sinks and water taps from 38 environmental samples. Multilocus sequence typing analysis revealed 2 sequence types: ST138 (n = 16) and its single-locus variant ST92 (n = 4). Eleven weeks after the initiation of active surveillance, no further IRAB isolates were identified. This study identifies the environmental source of an IRAB outbreak in a PICU and describes successful control of the outbreak with a multicomponent intervention program.

Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide (PTCy) was performed previously in adults using a nonmyeloablative conditioning regimen and bone marrow as a graft source. In an effort to reduce relapse rates, myeloablative conditioning regimens with higher intensities are now used. We used an intensive daily pharmacokinetic monitoring method for busulfan dosing in children for effective myeloablation and to reduce toxicity. Here, we report the retrospective results of 34 patients (median age 11.1 years) who underwent haplo-HSCT with PTCy using a targeted busulfan-based myeloablative conditioning regimen and peripheral blood as a stem cell source. The donor-type neutrophil engraftment rate was 97.1%, and the cumulative incidence rates of grade II to IV and grade III to IV acute and extensive chronic graft-versus-host disease were 38.2%, 5.9%, and 9.1%, respectively. The overall survival and event-free survival rates, and treatment-related mortality were 85.0%, 79.4%, and 2.9%, respectively. Based on the subgroup analysis of patients with malignancies (n = 23), the relapse incidence rate was 21.7%. Haplo-HSCT using PTCy with targeted busulfan-based myeloablative conditioning and peripheral blood as a stem cell source was a safe and promising therapeutic option for children.