Implementation of a guideline for diagnosing UTI in febrile children at the ED has led to a significantly better compliance, especially in children aged 3-24 months. However, this study also underlines the need for a well-defined implementation strategy after launching an (inter)national guideline, taking determinants influencing implementation into account.

Abstracts count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinical indication. EV or HPeV DNA was detected by PCR in plasma and/or CSF. Urine cultures were performed when urine screening was positive. 10 children with urinary tract infection were excluded. Data of the remaining 148 children were analysed. Results EV/HPeV PCR was performed in 122/148 children: 45 (37%) were EV positive and 22 (18%) HPeV positive. The most prominent difference between children with EV and HPeV was age. HPeV was solely diagnosed in children under 126 days of age. Clinical characteristics at presentation did not differ. Children with HPeV had lower leukocyte counts and lower CRP values. No difference in clinical management was found between EV and HPeV positive children. Conclusion Sepsis-like illness due to EV and HPeV infection is common in young children, and appeared in 37% and 18% of cases respectively. HPeV occurs in younger children and causes less elevation of infectious parameters than EV infection. All other clinical characteristics are similar. Clinical management does not differ. Background and Aim To evaluate the association between respiratory tract Ureaplasma urealyticum (Uu) colonization and development of retinopathy of prematurity (ROP) requiring treatment. Methods The infants with birthweight ≤1250 g born in a third level neonatal intensive care unit between March 2009 and May 2010 were prospectively identified. Nasopharyngeal swabs for Uu colonization were taken in postnatal first 3 days. Culture positive patients were reevaluated on the 12 th day by nasopharyngeal swabs for Uu. The primary outcome was to define whether there was an association between respiratory tract Uu colonization and severe ROP requiring treatment. Independent samples t-test or Mann whitney U test was used to compare continuous variables and Chi square test or Fisher's exact test for categorical variables. Multivariate (backward) logistic regression analysis was performed to simultaneously measure the influence of the independent variables with ROP as the dependent variable. Results Twenty-five (12.1%) infants developed severe ROP requiring treatment among 206 infants who underwent ROP screening. Mean birthweight and gestational age of total cohort were 1013±159 g and 27.9±1.6 weeks, respectively. Multivariate analysis demonstrated that birthweight (OR: 0.64 (95% Cl 0.47-0.88); p=0.006), duration of mechanical ventilation (OR: 1.17 (95% Cl 1.06-1.28); p=0.001), premature rupture of membrane >18 h (OR: 3.83 (95% Cl 1.2-12.2); p=0.02) and Uu positivity in both cultures (OR: 5.02 (95% Cl 1.8-13.9); p=0.002) were independent risk factors for the development of severe ROP requiring treatment. Conclusions Respiratory tract colonization with Uu was independently associated with severe ROP requiring treatment. THE ASSOCIATION BETWEEN RESPIRATORY TRACT

BACKGROUND AND AIMSTo date, little is known about the hemodynamic consequences caused by liver cirrhosis, especially at the microlevel. To gain more insight in the vascular deterioration during cirrhogenesis, accurate 3D reconstructions of the hepatic circulation are a necessity. We have optimized two complementary techniques to acquire detailed 3D geometrical data of the rat liver circulation, covering the entire length scale of the hepatic vasculature, and applied it to an established rat model of cirrhosis. METHODSCirrhosis was induced in rats according to the thioacetamide (TAA) protocol [1]. Prolonged TAA intoxication induces centrilobular necrosis and eventually homogenous macronodular cirrhosis after 18 weeks. Rats (n=36) were sacrificed at 0, 6, 12 and 18 weeks. At each time point, 5 rats were assigned to the vascular corrosion casting (VCC) technique and 4 rats to immunohistochemistry (IHC).VCC entails injecting the casting resin PU4ii in the portal vein and hepatic artery. Lipiodol was added to the arterial mixture as a contrast agent to ensure a clear distinction between the vascular trees after high resolution micro-CT-scanning. The resulting datasets enabled reconstructing detailed 3D geometries of the hepatic macro-and microcirculation.The IHC method includes staining 350 µm thick liver slices with a generic endothelial marker antibody (RECA). To increase the liver slices' transparency and microscopic penetration depth, an adapted version of the clearing protocol CUBIC was applied [2]. Image stacks were subsequently recorded with a confocal microscope, and automatically segmented and 3D analysed using in-house developed software (DeLiver) allowing quantification of the microcirculation. RESULTSWe were able to analyse and compare morphological parameters (radius, tortuosity, length, etc.) during cirrhogenesis. Our IHC results suggest that microcirculatory alterations deteriorate hepatic perfusion as the porosity (i.e. the number of sinusoids per unit of volume) steadily declines from 20.8 ± 2.3% (normal) to 11.4 ± 3.1 % (cirrhosis), and the mean sinusoidal radius significantly decreases (p<0.05) for cirrhosis (3.9 ± 0.4 µm) compared to normal liver tissue (4.4 ± 0.3 µm).