فهرست مطالب

Archives of Pediatric Infectious Diseases - Volume:6 Issue: 1, 2018
  • Volume:6 Issue: 1, 2018
  • تاریخ انتشار: 1396/11/11
  • تعداد عناوین: 9
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  • Arezoo Charsizadeh, Bahram Nikmanesh, Bahram Ahmadi, Nilufar Jalalizand, Zahra Jafari, Maryam Rahmani, Parivash Kordbacheh, Hossein Mirhendi * Page 1
    Background
    Candida species originating from either endogenous or exogenous sources are one of the main causes of opportunistic infections. Colonization is an important independent risk factor for invasive candidiasis, and many patients admitted to neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) are colonized with Candida species that may result in invasive candidiasis. Awareness among clinicians about various aspects of colonization is critical to optimal management. The aim of this study was to determine the frequency and species distribution of Candida strains isolated from predisposed patients hospitalized at Children’s Medical Center (CMC), Tehran, Iran.
    Methods
    From June 2014 to June 2016, 347 Candida isolates were collected from 341 patients either hospitalized in different wards or referred as outpatients. The yeasts were identified by colony color characteristics using CHROMagar Candida medium and by amplification of the ITS1-5.8S rDNA-ITS2 region in DNA extracted from each isolate followed by analysis of species specific electrophoretic patterns of PCR products digested with the restriction enzyme MspI.
    Results
    Of the 341 patients, 213 were males and 128 were females. Most samples were obtained from the 1 – 12-month age group, and the majority of samples represented urine (n = 182), throat swabs (n = 57), and stool samples (n = 53), respectively. The samples were mostly from patients in general wards. The most commonly isolated species was C. albicans (77%), followed by C. tropicalis (8.4%), C. parapsilosis (7.5%), C. glabrata (2.3%), C. kefyr (1.7%), C. krusei (1.1%), C. lusitaniae (0.6%), C. guilliermondii (0.3%), C. albicans C. parapsilosis (1.4%), and C. albicans C. glabrata (0.3%).
    Conclusions
    C. albicans is the most common species isolated from children in Iran, followed by C. tropicalis and C. parapsilosis, a prevalence pattern that is relatively different from studies in other countries. Neonates and infants 1 - 12 months of age hospitalized in ICU, were more colonized by Candida species than other groups.
    Keywords: Pediatric, Candida Species, Colonization
  • Farideh Shiva, Roxana Ghanaie *, Fariba Shirvani, Shahnaz Armin, Sedigheh Rafiei Tabatabaei, Sayed Alireza Fahimzad, Fatemeh Fallah, Hassan Pourmoshtagh, Abdollah Karimi Page 2
    Background
    Antibiotic misuse is a major cause of antimicrobial resistance.
    Objectives
    The present study aimed at determining the pattern of antibiotic usage in previously healthy children hospitalized for common infectious diseases in a tertiary care children’s hospital.
    Methods
    This study was the second part of a previous study in which inpatient charts of children hospitalized from October 2013 to September 2014 were reviewed to determine the rationality of drug use. Data from the first study were analyzed to define the antibiotic usage pattern in urinary tract infection, acute meningitis, community acquired pneumonia, fever without a localized source and acute gastro-enteritis. The data were checked independently by two pediatric infectious disease specialists to assess the appropriateness of prescribed antibiotics and in case of disagreement, rechecked by a third member.
    Results
    Hospital charts of 140 children were reviewed; 47 had been treated for urinary tract infection, 31 for pneumonia, 25 for acute meningitis, 24 for acute gastroenteritis and 13 for fever without a localized source. One-hundred and fourteen children (81.42%) received 208 prescriptions for antibiotics (1.82 antibiotics/patient). Nineteen different antibacterial drugs and 2 antivirals (acyclovir and oseltamivir) were prescribed. Most frequently prescribed antibiotic was ceftriaxone. More than 25% of prescriptions for antibiotics were needless. In 91.6% of the prescriptions the medications had been prescribed by generic names. Dosing errors were observed in less than 7% and patients received the medication for prolonged duration, 25.6% of times.
    Conclusions
    Nonuniformity of antibiotic usage, a high rate of needless antibiotic prescriptions, and prolonged administration found in this study call for stringent antibiotic stewardship.
    Keywords: Antibiotics, Antibiotic Stewardship, Antimicrobial Resistance, Infections, Prescriptions
  • Reza Ranjbar, Davoud Afshar * Page 3
    Background
    As a major pathogen, Streptococcus pneumoniae is responsible for fatal diseases and is deemed to be a major public health problem in the developing countries. Due to its high mortality rate, rapid detection of pneumococci is necessary in medical centers with limited equipment. Loop-mediated isothermal amplification (LAMP) assay is a rapid method to detect bacterial pathogens. Herein, the current study developed a LAMP assay based on the choline-binding protein M (cbpM) gene to detect pneumococci isolates.
    Methods
    A set of 4 primers was designed using the sequence of cbpM, and a LAMP assay was conducted using a different ratio of inner primers to outer primers, dNTPs, and MgSO4 concentrations. The sensitivity of assays was calculated according to 30 clinical isolates of S. pneumoniae. The specificity of primers was also evaluated using 7 non-pneumococcal species. The detection limits of the LAMP assay were also compared with those of the polymerase chain reaction (PCR) assay using a 10-fold serial dilution of the DNA.
    Results
    Optimal temperature and time for the LAMP assay were 62°C and 1 hour, respectively. Its detection limit was only 5 copies of DNA, compared to 50 copies for PCR. When LAMP was tested on 7 non-pneumococcal species, no amplification was observed. Similar to PCR, all 30 S. pneumoniae isolates were detected using the LAMP assay, which showed 100% sensitivity.
    Conclusions
    The LAMP assay is a favorable tool for the rapid detection of pneumococci, and can be employed in medical centers with limited equipment.
    Keywords: Choline, Binding Protein M, Loop, Mediated Isothermal Amplification Assay, Streptococcus pneumoniae
  • Jasashree Choudhury *, Debasmita Rath Page 4
    Background And Objectives
    Thrombocytosis is a marker of inflammatory reaction with various clinical outcomes. The current study aimed at evaluating the incidence and significance of degree of thrombocytosis in relation to severity of the pneumonia in children less than 5 years old with lower respiratory tract infection.
    Methods
    The current prospective observational study was conducted over a period of 12 months on 230 children aged 2 to 60 months, hospitalized for lower respiratory tract infection. Patients were classified into 2 groups of patients with or without thrombocytosis. Demographic profile, clinical severity, radiological findings, complications and outcomes of the 2 groups were analyzed and compared.
    Results
    Out of 230 children, 122 (53.04%) had thrombocytosis and 108 (46.96%) not had thrombocytosis. Among children with thrombocytosis, 12 (9.83%) had pneumonia, 48 (39.34%) had severe pneumonia, and 62 (50.8%) had very severe pneumonia. Out of 108 children without thrombocytosis, 58 (53.7%) had pneumonia, 16 (14.8%) had severe pneumonia, and 34 (31.4%) had very severe pneumonia. Thrombocytosis was found in 82% of pneumonia cases with pleural effusion. Prolonged hospitalization was significantly associated with thrombocytosis. Leukocytosis had also significant association with pneumonia severity.
    Conclusions
    The current study indicated that children with lower respiratory tract infection frequently had associated thrombocytosis. The duration of hospital stay and severity of pneumonia were clearly higher in the group with high thrombocyte count. Thrombocyte count can be used as a predictor for the severity of the disease in children less than 5 year old with pneumonia to prioritize them.
    Keywords: Pneumonia, Lower Respiratory Tract Infection, Children, Thrombocytosis
  • Mohammad Javad Gharavi, Mona Roozbehani, Abolfazl Miahipour, Mojgan Oshaghi, Behnaz Gharegozlou, Enayatollh Kalantar, Shervin Ghaffari Hoseini, Nasser Mostafavi, Ramin Heshmat, Abdolhossien Naseri, Mostafa Qorbani *, Roya Kelishadi Page 5
    Background
    Toxoplasmosis is a worldwide neglected tropical and sub-tropical infection caused by Toxoplasma gondii (T. gondii). Most of the previous studies on the seroprevalence of T. gondii in Iran have been done at provincial level and on specific populations, including pregnant females. Socioeconomic parameters are associated with the prevalence of this disease. In this study, the authors evaluated the presence of anti-T. gondii antibodies and the related risk factors in Iranian adolescents.
    Methods
    This was a cross-sectional study on serum samples from the third Iranian national school-based survey (the CASPIAN III study), which included 10- to 18-year-old students. Participants were selected by multistage sampling from 27 Iranian provinces. In this study, serum samples of 882 adolescents from 16 provinces were randomly selected and examined for IgG and IgM antibodies against T. gondii by the Enzyme Linked Fluorescent Assay (ELFA). Demographic and socioeconomic factors related to T. gondii infection were gathered using the global school-based health survey (GSHS) questionnaire.
    Results
    The overall T. gondii IgG and IgM seropositivity was 56.3% (95% CI: 53.4 to 59.2) and 3.7% (95%CI: 2.7 to 4.9), respectively. In multivariate logistic regression model, family size was statistically associated with seroprevalence of anti T. gondii IgG. Living in crowded households (households with more than 4 people vs. households with less than 4 people) increased the risk of seropositivity of T. gondii (OR: 1.40, 95% CI: 1.10 to 1.99).
    Conclusions
    The results of this study indicate that about 40% of Iranian adolescents have not had contact with the T. gondii, thus the risk of congenital toxoplasmosis might be high in young females. Also, household size was the main factor associated with T. gondii infection. Preventive strategies and health education in Iranian adolescents are recommended.
    Keywords: Toxoplasmosis, Seroprevalence, Risk Factor, Iran
  • Mohammad Ali Mohaghegh, Mojtaba Azimi Resketi, Mehdi Azami, Seyed Hossein Hejazi, Hamed Kalani, Mohsen Ghomashlooyan Page 6
    Background
    Ectoparasitic infections are very important in poor countries. On the other hand, comprehensive information on the epidemiology of these parasites, especially in the North of Iran, remains scarce.
    Objectives
    The aim of this study was to assess soil contamination with mites, geohelminths, and bugs in residential areas of Sari city, north of Iran.
    Methods
    A total of 90 soil samples from 3 areas were collected via multistage, cluster, and random sampling in order to examine their contamination with mites, geohelminths, and bugs during summer, 2014. The results were analyzed using the SPSS 16 software.
    Results
    Of the 90 soil samples that were studied in different environmental areas of Sari, 30 (33.3%) were observed to be contaminated with mites, 10 (11.1%) had bugs, and 21 (23.3%) contained geohelminths. Mites were the most commonly seen parasite among the 3 studied region.
    Conclusions
    Based on the literature, North of Iran accounts for a high rate of allergic disorders. The current results showed high contamination rate of soil with ectoparasites in Sari. Thus, these organisms could be potential causes of allergic disorders and further studies on the subject is needed.
    Keywords: Soil, Contamination, Mites, Bugs, Geohelminth, Iran, Allergic Disorders
  • Leila Asadi, Tala Pourlak, Behrooz Ahmadi, Mina Aghamali, Mohammad Asgharzadeh, Mohammad Aghazadeh, Elham Zeinalzadeh, Hossein Samadi Kafil * Page 7
    Background
    Gastroenteritis is known as the leading cause of morbidity and mortality in children worldwide. Diarrhea is the second leading cause of infant death in the developing countries. Identification of gastroenteritis-causing pathogens helps to control fecal-oral transmission and prevents further outbreaks.
    Objectives
    The current study aimed at evaluating the prevalence of bacterial, viral, and parasitic pathogens associated with children’s diarrhea in Ardebil, Iran.
    Methods
    A total of 400 stool specimens were collected from children within the age range of 2 months to 12 years from December 2015 to June 2016 in Bu-Ali hospital in Ardebil, Iran. The samples were tested for bacterial, viral, and parasitic agents.
    Results
    The results showed that parasites had the largest proportion of pathogens in the collected samples, followed by bacteria and viruses. The most commonly detected pathogens were: rotavirus, Escherichia coli, and Entamoeba histolytica, respectively. Protozoan parasites showed higher prevalence compared with helminthic infections.
    Conclusions
    Rotavirus, E. coli and E. histolytica were the most prevalent agents of diarrhea in children’s aged 2 month to 12 years in this study. Although detection of few micro organisms were considered in our study, the results indicate importance of hygiene improvement in this area. More specified molecular epidemiology studies with evaluating the most common etiologies will be helpful for a better understanding of the frequency of common infections and their transmission in this area.
    Keywords: Gastroenteritis, Acute Diarrhea, Pediatric, Children Diarrhea, Infectious Diarrhea
  • Alireza Fahimzad, Mahdi Nouri, Farideh Shiva, Ahmad Reza Shamshiri, Zari Gholinejad, Abdollah Karimi * Page 8
    Background
    Varicella zoster virus (VZV) is responsible for chickenpox, which is generally a mild self-limited disease in healthy children. However, this disease may progress to a complicated and even life-threatening disease in adolescents, young adults, and immunocompromised patients in particular. The present study was conducted to investigate the seroprevalence of VZV in different age groups, selected among residents of Tehran, Iran.
    Methods
    We performed varicella serological tests (IgG) on the serum specimens of healthy people, collected from 3 main laboratories in Tehran. VZV IgG was measured with the ELISA method. We divided the subjects into 6 subgroups: below 2 years, 2 - 5 years, 5 - 12 years, 12 - 19 years, 19 - 25 years, and above 25 years. We tested almost 95 specimens from each age group.
    Results
    Samples were collected from 570 individuals, including 231 males. The VZV IgG was positive in 393 subjects; cumulatively, 81.3% of the population were immune to VZV. The seroprevalence rate was 43.2% in infants below 2 years, 32.6% in children aged 2 - 5 years, 47.2% in children aged 5 - 12 years, 74.7% in adolescents aged 12 - 19 years, 83.2% in young adults up to 25 years, and 90.5% in adults > 25 years.
    Conclusions
    Although the cumulative seroprevalence was estimated at 81.3% for all age groups, this rate was only 43% in children below 12 years; therefore, adolescents and young adults (high-risk age groups) are prone to chickenpox infection. In order to protect individuals against this infection, we suggest well-designed studies to address the need for routine chickenpox immunization programs in young children.
    Keywords: Varicella Zoster, Seroprevalence, Vaccination
  • Fariba Shirvani, Anahita Sannai Dashti, Kimia Seifi Page 9