Archives of Pediatric Infectious Diseases
Volume:2 Issue: 4, Oct 2014

Acute viral respiratory infection (ARVI) is a common cause of morbidity and mortality especially in pediatric patients. Among important respiratory pathogens, adenovirus is a most prevalent cause of upper and lower respiratory tract infection.. The aim of the present study was to determine the prevalence of adenovirus infection in pediatric patients with respiratory symptoms..Patients and This cross-sectional study was carried out from November 2010 to February 2012. An in-house nested-PCR was used to detect adenovirus in nasopharyngeal swabs from 328 children, aged 19 years or younger, with acute upper respiratory tract symptoms referred to the hospitals affiliated with Shiraz University of Medical Sciences.. Adenovirus was detected in 22% of 328 nasopharyngeal swabs and the highest rate of hospitalization (74%) due to ARVI associated with fever, cough and muscular ache was found in children older than five years.. The results of this study showed that acute respiratory infection due to adenovirus in Shiraz mostly occur during November to February. In contrast to other studies, adenovirus infection was more prevalent in children aged older than 5 years..

Integrons are frequently detected in clinical isolates of Enterobacteriaceae. These elements are able to capture and express gene cassettes encoding antibiotic resistance. Numerous studies have examined the distribution of integrons in Escherichia coli. Despite this, there is a paucity of epidemiological data on the occurrence of integrons as well as extended spectrum β-lactamases (ESBLs) among enteropathogenic E. coli isolates.. The main aim of this study was to investigate the prevalence of integrons as well as ESBLs among enteropathogenic E. coli isolates obtained from children with diarrhea in Tehran, Iran..Patients and In total, 42 enteropathogenic E. coli strains were isolated from children with diarrhea and examined for the presence of class 1 and 2 integrons. The combined disk method was also performed to detect ESBL production. Statistical analysis was used for the comparison of the categorical data.. Class 1 integron was identified in 24 (57.1%) isolates, while only 2 (4.8%) isolates harbored class 2 integron. Integrons were significantly associated with resistance to certain antibiotics, including; co-trimoxazole (P = 0.016) and tetracycline (P = 0.006). Of the 42 enteropathogenic E. coli isolates, 9 (21.4%) isolates were ESBL producers. However, no significant association was observed between the existence of integrons and ESBL production (P = 0.26).. Class 1 integrons are prevalent among enteropathogenic E. coli isolates, regardless of whether or not they produce ESBLs. This study emphasizes the alarming role of integrons in antibiotic resistance within diarrheagenic E. coli strains..

Vancomycin-resistant Enterococcus (VRE) has been established as a significant health-care associated problem, and caused significant morbidity and mortality.. This study was aimed to determine prevalence of VRE colonization in severely ill patients admitted to Pediatric Intensive Care Unit (PICU), and identify potential risk factors for colonization, and in vitro susceptibility of VRE to linezolid..Patients and Rectal swabs were taken from 71 children 18 years old or younger who were admitted with serious systemic illness, including malignancy, chronic kidney, lung or liver diseases, treatment with chemotherapeutic agents, immunodeficiency, treatment with high-dose corticosteroids, malnutrition, previous treatment with 2nd or 3rd generation cephalosporin, aminoglycoside, and broad-spectrum β-lactam antibiotics within the past 3 months. Demographics and known risk factors were retrieved and assessed by statistical methods.. A total of 71 patients with a mean age of 29.1 ± 38.5 months were enrolled in this study. The prevalence of VRE rectal colonization was 66.2%. None of the potential risk factors including age, gender, comorbidities, previous admission into ICU, length of stay in ICU, presence of invasive devices were significantly associated with VRE colonization. Linezolid-susceptible isolated strains accounted 97.9%.. The prevalence of VRE was higher compared to previous reports from local and international studies. In order to control the spread of VRE, appropriate use of antibiotics, adherence to infection control measures, and shortening the duration of ICU stay is highly recommended..

Staphylococcus aureus (S. aureus) especially those with methicillin resistance are human pathogens capable of causing a wide variety of diseases, ranging from mild skin lesions to systemic and fatal infections.. The aim of this study was to detect the accessory gene regulator (agr) specificity groups among methicillin resistant and susceptible S. aureus isolated from children.. During July 2012 to January 2013, 22 S. aureusc linical isolates were collected from children aged between 2 to 11, in Loghman Hospital of Tehran. Antibiogram test was performed using disc diffusion method. Polymerase chain reaction (PCR) was conducted to detect mecA gene and agr specificity groups.. Among 22 S. aureus clinical isolates collected from children, five isolates (22.7 %) were resistant to methicillin. fourteen isolates (63.6%) were resistant to amoxicillin and all were susceptible to vancomycin and linezolid. Agr specificity group I was detected in 12 (54.5%) isolates (in 2 MRSA and 10 MSSA isolates), agr group II in four (18%, in 3 MSSA and 1 MRSA), group III in 3 (9%, 2 in MSSA and one in MRSA), while agr specificity group IV was found in three (13.6%, 2 MSSA and 1 MRSA) isolates.. The agr specific group I had the highest rate of detection among pathogens isolated from hospitalized children in Tehran..

Hospital acquired infections lead to significant morbidity and mortality in hospitalized patients. Proper implementation of hand hygiene by health care personnel (HCP) prevents nosocomial infections.. To monitor hand hygiene compliance by the medical and nursing staff in different wards of a children’s hospital..Patients and Four wards were selected for surveillance. In observation periods of 20 minutes each, a trained Pediatric resident observed four patient beds and hand hygiene behavior of health care professionals, physicians (house staff) and nurses, before and after touching the patients. The contacts were classified as ‘high-risk’ if the person came in contact with body fluids or ‘low-risk’ if there was no such contact. Findings were documented on a predesigned Hand Hygiene Observation Tool.. Overall, 510 patient contacts were observed and 1020 hand hygiene opportunities before and after patient contact were recorded. In total, 302 contacts (59.2%) were low risk and 208 (40.7%) were high risk. The HCP used disposable and surgical gloves before 87, (41.82%) high risk and 27, (8.94%), low risk contacts; however, no hand washing or the use of alcohol hand rubs before contact was recorded by the observer stationed by the patients’ bed-side. The observer could not ascertain if the HCP washed their hands before entering the 3-6 bedded rooms.. Serious lack of adherence to standard protocols for hand hygiene by the HCP together with inappropriate glove use, calls for an urgent strategic planning to educate, train and motivate the health care personnel in all aspects of hand hygiene practices..

Group B Streptococcus (GBS) (Streptococcus agalactiae) is the leading cause of morbidity and mortality of newborn infants considered a leading factor causing septicemia after birth. The standard method for the diagnosis of GBS colonization is culture in a selective medium, but PCR has a high sensitivity and specificity.. The goal of this study was to estimate the colonization of GBS in rectum of neonates of high-risk mothers by culture and PCR method..Patients and Samples were taken from rectal mucosa of 154 neonatesof high-risk mothers for GBS by swabs. Samples were tested by standard culture using Todd Hewitt broth and blood agar and also by PCR using primers specific for cfb gene.. Of 154 neonates, Culture identified 17 (11%) neonates as colonized by GBS; and the PCR assay could identify 27 (17%) neonates with positive results for GBS. Mothers age range was 17-40 years (mean = 26.1 ± 5.1). Maternal age was significantly lower in PCR positive group (P = 0.038) and in culture positive group (P = 0.015). Using culture as the gold standard, sensitivity, NPV, specificity, and PPV of PCR were 100%, 100%, 92%, and 62%, respectively. The time required for PCR assay and culture were 2hours and 36hours, respectively.. This study showed that the incidence of GBS in Iranian high-risk neonates is high, so we strongly recommend screening of high-risk neonates for detection of GBS..

Diarrhea is the most common pediatric disease. The leading cause of death from acute diarrhea is the loss of water and essential minerals, which can be compensated by oral rehydration solution (ORS). The role of mothers is vital in health promotion, disease prevention and patient care.. The present research aimed to investigate the knowledge and performance of the mothers of diarrheic children referring to the Children''s Hospital, Tabriz, Iran..Patients and Predesigned questionnaires were used to collect data from the mothers of diarrheic children aged younger than 12 years, referring to the outpatient clinic of the Children''s Teaching Hospital in Tabriz. Demographic information of the mother and child, mothers’ knowledge about pediatric diarrheal disease, and their performance in the case of pediatric diarrheal disease, were investigated.. A questionnaire was administered to 956 mothers, of whom 3.03%, 21.75% and 75.22% were uneducated, had a university education, high school diploma or less, respectively. Furthermore, 95.5% of the mothers referred to a doctor after the first day following an episode of diarrhea. The knowledge of 37.23%, 44.24%, and 18.53% of the mothers was poor, medium and good, respectively. Moreover, the performance of 51.98%, 30.03% and 17.99% of the mothers was poor, medium and good, respectively. A significant relationship was found between maternal education and knowledge (P = 0.000), but no relationship was observed between maternal age and knowledge (P = 0.36). There was also a direct relationship between maternal education and performance, which was significant (P = 0.001). There was no relationship found between any other variables.. The knowledge and performance of the majority of mothers were medium or poor. Training programs are recommended for mothers, medical students, pediatric, internal and infectious residents, in addition, retraining programs are recommended for GPs and related specialists..

Context: High levels of interleukin-1 have been implicated in uncontrolled inflammation and fever in inflammatory diseases, including; familial Mediterranean fever, cryopyrin associated periodic syndrome, Behcet''s disease and systemic onset juvenile idiopathic arthritis. The underlying specific genetic causes for these diseases have not yet been elucidated due to inferring factors, such as high levels of interleukin-1 beta (IL-1β) in the blood and etiology, as well as the disease manifestations.. This review discusses the role of interleukin-1 beta and interleukin-18 production pathways in the development of systemic onset juvenile idiopathic arthritis and familial Mediterranean fever disease..

Disseminated cryptococcosis mainly occurs in patients with impaired cell mediated immunity.. We present a case of disseminated cryptococcosis, in a non-HIV patient with steroid resistant nephrotic syndrome (focal segmental glomerulosclerosis), who was given various immunosuppressive agents.. BACTEC blood culture, cerebrospinal fluid analysis, and chest x-rays, were consistent with a Cryptococcus neoformans infection. Treatment with liposomal amphotericin B, combined with flucytosine, followed by fluconazole, was successful..

Enterococci are considered as the third most common cause of nosocomial infections and their antimicrobial resistance has been a concerning issue.. In this study, we looked for resistance genes of vanA and vanB in vancomycin-resistant Enterococcus (VRE) isolated from intestinal colonization of children admitted to the pediatric intensive care unit (PICU) and neonatal ICU (NICU) of Ali-Asghar Children''s Hospital..Patients and In this descriptive study, 71 rectal swab samples were collected from the intestines of children admitted to the PICU and NICU of Ali-Asghar Children''s Hospital. Enterococci were diagnosed in samples by appropriate microbiological tests. Antimicrobial resistance and VRE detection was performed by the Kirby-Bauer disk diffusion method on Mueller-Hinton agar based on Clinical and Laboratory Standards Institute (CLSI) criteria. vanA and vanB genes were detected by PCR.. Enterococcus was detected in 64 (90.1%) rectal swab samples. The frequency rate of VRE strains was 47 (73.4%) and vancomycin-intermediate Enterococcus (VIE) strains was 6 (9.4%). PCR analysis of VRE samples showed that 42 samples had vanA gene (89.3%) but vanB gene was not identified in remaining five samples. VIR was detected in 4 cases with vanA gene (66.7%). Again, we did not d vanB gene in remaining samples.. VRE colonization was very high among studied cases. Most important mechanism for high level of resistance to vancomycin is presence of van genes, which can be potentially transmittable to other enterococci and gram-positive organisms. More molecular studies are needed to clarify the trend of VRE colonization and the role of preventive measures in this setting..