e26014th International Congress on Infectious Diseases (ICID) Abstracts four percent (12/49) of patients received inappropriate initial antibiotics and 83% (10/12) of these were patients who had RGN. Mortality trended higher in patients with RGN infection compared to other GN bacilli (3/10, 30% vs. 3/39, 7.7%; p = 0.06).Conclusion: Most patients diagnosed with GN-CRBSI did not meet our strict criteria for diagnosis, a fact that suggests that GN-CRBSI is misdiagnosed. However, the true diagnosis of GN-CRBSI does not clearly impact mortality or median length of stay. There was a nonsignificant trend towards increased mortality in patients with RGN infection. Antibiotics active against RGN should be considered as part of initial empiric coverage.

Background and aims The PI3K pathway is frequently activated during tumourigenesis through deletion of the tumour suppressor PTEN. In contrast, increased PTEN expression in adipose tissue results in an increase in UCP1 expression and provides metabolic protection from tumourigenesis. This intrinsic protection normally arises from interscapular brown adipose tissue (iBAT) but may also arise from 'beiging' of inguinal white adipose tissue (iWAT). The aim of this study was to see if an association existed between UCP1 expression in adipose tissue and paediatric brain tumour growth through elevated PTEN levels. Methods Two types of medulloblastoma (WNT and group 4) and ependymoma tumour cells were orthotopically xenografted into mice. iBAT and iWAT samples were extracted from tumour and non-tumour bearing mice to examine UCP1 and PTEN expression through QRT-PCR and Western blotting. Haematoxylin and eosin staining and UCP1 antibody immunohistochemistry (IHC) was also used to determine BAT activity in adipose tissue. Thermogenic activity of the adipose tissue was indirectly measured by thermal imaging of mice. Results iWAT from ependymoma tumour-bearing mice had evidence of beiging and increased UCP1 expression through histology and IHC, while UCP1 expression in iBAT remained high in all mice. An increase in UCP1 gene expression and thermogenesis was observed with spinal metastasis. PTEN expression did not relate to UCP1 expression. Conclusion Our data indicated mice implanted with aggressive tumours had increased UCP1 expression in iWAT. In conclusion, this pilot study suggests rapidly growing and metastatic brain tumours stimulate metabolic protection via an increase UCP1 expression in iWAT. Background and aims To evaluate the diagnostic usefulness of biomarkers in the management of children with fever at risk of serious bacterial infections (SBI) at the emergency department (ED). Paediatric Emergency Medicine IIMethods In this prospective observational study previously healthy children with fever, aged 1 month to 16 years, attending the EDs of a university hospital and a teaching hospital (Rotterdam, the Netherlands) between 2009 and 2012 were included. Standardised information on clinical signs and symptoms, Creactive protein (CRP), procalcitonin (PCT), neutrophil CD64 expression and urinalysis were collected prospectively. Logistic multivariable regression analysis was used to assess diagnostic performance.Results 1,084 children were included, median age was 1.6 years (interquartile range: 0.8-3.5), 170 children (16%) had SBI. CRP (receiver operating characteristic curve (ROC-area) 0.77 (95% confidence interval (CI) 0.69-0.85)) and PCT (ROC-area 0.75 (95% CI 0.67-0.83)) were both strong predictors of SBI. CD64 lacked diagnostic strength (ROC-area 0.62 (95% CI 0.54-0.70)). A score containing PCT and CRP together with urinalysis, the Lab-score, performed well (ROC-area 0.79 (95% CI 0.72-0.87)), but thresholds performed similar to often used cut-offs of single biomarkers. Combined with clinical signs and symptoms b...

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Aims To examine whether bilevel positive airway pressure (BiPAP) for children with acute asthma exacerbations not approaching respiratory failure (not meeting NIH and GINA guidelines for noninvasive ventilation) is associated with improved clinical outcomes. Methods We prospectively enrolled children 5-17 years with exacerbations not meeting respiratory failure guidelines for BiPAP use in a paediatric emergency department. We modelled propensity scores for BiPAP treatment then used propensity score matching to estimate the associations of BiPAP treatment with hospital admission; PICU admission; hospital length-of-stay; and time to Q4 hr albuterol as a metric of clinical improvement. Results Amongst 933 participants, median [IQR] age was 8.8 [6.9,11.2] years, male 61%, and African-American 59%. BiPAPtreated participants (n = 45) had similar demographic characteristics to BiPAP-untreated participants in the matched analysis and significantly greater likelihood of hospital and PICU admission (Table). Conclusions BiPAP treatment for paediatric patients with asthma exacerbations not meeting respiratory failure guidelines may be associated with greater resource utilisation without evidence of improved outcomes. Background and aims Inadequate physical activity (PA) is a common thread running through most public health problems across the world. PA declines during the lifespan, especially during adolescence. We studied the current status of PA of children in Anand, India in the age group 11-19 years. Methods Cross-sectional study using a self-reported Physical Activity Questionnaire (PAQ-A) which has consistently high validity and moderate reliability. It comprehensively captures the PA in last 7 days. Self-reported anthropometric data and sociodemographic data were also recorded. Of 3337 participants, anthropometric data was not reported in 784. Results Mean physical activity level (n = 3337) amongst adolescents was 2.62 (0.72 SD). In females it was 2.5670 (0 . 71 SD) and in males was 2.66 (0.73 SD). Correlating their PA with age, in females (n = 1410) correlation was -0.204 and in males (n = 1927) it was -.095. PA declines with age but in males not statistically significant. Lowest PA of 1.93 was reported from school (n = 231) where most students were appearing for boards within a year. Correlating PA with BMI (n = 2553), overall correlation was -0.116 showing insignificant correlation. Correlation of BMI with PA was -0.314 for an affluent school (n = 328). Most common physical activity was BICYCLING in males 55.9% and in females 51.7%. Swimming was practiced by 5.8%. Overall (n = 2617) 15.7% were overweight/obese (BMI > 23 for Indian population) In which 16.5% male and 14.8% female.