فهرست مطالب

Archives of Pediatric Infectious Diseases - Volume:7 Issue: 2, 2019
  • Volume:7 Issue: 2, 2019
  • تاریخ انتشار: 1398/02/20
  • تعداد عناوین: 9
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  • Homa Sadri *, Mohammad Javad Gharavi , Reza Arjmand , Mohammad Zibaei , Nasrin Elahimehr , Yasaman Shaker Page 1
    Background
    It has been proposed that the migration of Toxocara canis larvae through the lungs is a contributing factor in the development of asthma and association of asthma and toxocariasis has been reported. The seroprevalence of toxocariasis varies widely among children living in different countries and even in different regions of a single country.
    Objectives
    The aim of this study is to compare seroprevalence of anti-Toxocara antibodies in asthmatic and healthy children in Karaj, Iran.
    Methods
    A serological study was conducted in children aged 1 to 15 years old for detection of antibodies to Toxocara canis in two groups (92 asthmatic children and 100 non-asthmatic children as control group), using commercial ELISA method for determination of IgG antibodies against Toxocara.
    Results
    Only one patient (1.09%) had positive levels of anti-Toxocara antibodies in the case group, while no one had them in the control group. The results showed that there was no significant correlation between IgG antibodies against Toxocara canis and asthma. More than 90% of children in both case and control groups were residents of urban areas.
    Conclusions
    We did not find any association between Toxocara infection and childhood asthma, suggesting that it may not be a common risk factor for childhood asthma in our urban area.
    Keywords: Asthma, Child, Toxocara, Iran
  • Samaneh Mozafari , Mohsen Shamsi , Nasrin Roozbahani *, Mehdi Ranjbaran Page 2
    Self-medication is one of the basic problems in the health system of Iran. The purpose of the present study is to determine the effect of theory-based education on the promotion of preventive behavior among mothers, concerning the self-medication for children. This study is an educational randomized controlled trial research that was designed and implemented for the first time in Iran. The samples consisted of 112 mothers with children under age six who referred to health centers of AzadShahr (a city in the north of Iran) from July 2015 to March 2016. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups. Data collection instrument was a researcher-made questionnaire. Then educational program was performed for the intervention group through four educational sessions. After three months, data collection was repeated for the two groups and the data were analyzed using the SPSS-20 software with inferential statistics (independent t-test, paired t-test, and chi-square). The findings showed that based on T-test, after the educational program, the mean score ± standard deviation (SD) of knowledge between the intervention and control groups was 66.07 ± 16.58 and 70.45 ± 15.33, respectively (P = 0.149). Moreover, the mean score ± SD of performance was 86.88 ± 14.84 and 93.81 ± 10.36, respectively that there was a significant difference (P = 0.005). Three months after the educational program, based on the chi-square test, the prevalence of self-medication between intervention and control groups was 8.92% and 21.42%, respectively that there was a significant difference (P = 0.02). The educational interventions based on the theory of planned behavior reduced self-medication for children. Therefore, due to the high cost of drug production and the side effects of self-medication, especially in vulnerable periods such as in childhood, it is recommended that educational programs, based on this model, should be carried out in other health care centers in order to provide children health.
    Keywords: Self-Medication, Education, Health Promotion, Preventive Behavior, Children
  • Abolfazl Mahyar *, Parviz Ayazi , Moloud Saffari Rad , Reza Dalirani , Amir Javadi , Shiva Esmaeily Page 3
    Background
    Acute diarrhea is the most common gastrointestinal disease among children. Identification of factors involved in the pathogenesis of acute bacterial diarrhea is highly critical.
    Objectives
    This study was conducted to investigate the correlation between serum 25-hydroxyvitamin D (25 (OH) Vit. D) and acute bacterial diarrhea in children.
    Methods
    The present study compared 60 children with acute bacterial diarrhea (the case group) and 60 healthy children (the control group) for serum 25 (OH) Vit. D concentrations. The children age ranged from two months to 12 years. The serum 25-hydroxyvitamin D level was measured using ELISA method.
    Results
    Among 60 children with acute bacterial diarrhea, 38 (63.3%) were males and 22 (36.7%) females. In the control group, 31 (51.6%) were males and 29 (48.4%) females (P = 0.26). The median (IQR) of age in case and control groups were 16 (29) and 16 (24) months, respectively (P = 0.75). The mean ± SD of serum 25 (OH) Vit. D levels in case and control groups were 19.3 ± 7.8 and 22.4 ± 7.3 ng/mL, respectively. There was a significant difference between groups regarding the serum 25 (OH) Vit. D concentrations (P = 0.02).
    Conclusions
    This study revealed a significant correlation between serum 25 (OH) Vit. D level and acute bacterial diarrhea. It is likely that vitamin D plays a role in the pathogenesis of diarrhea.
    Keywords: 25-Hydroxyvitamin D, Bacterial Diarrhea, Children
  • Mehdi Goudarzi *, Anis Mohammadi , Hossein Goudarzi , Maryam Fazeli , Fattaneh Sabzehali Page 4
    Background
    Treatment for infections caused by Methicillin-Resistant Staphylococcus aureus (S. aureus) is one of the main concerns of public health.
    Objectives
    The aim of this study was to investigate the prevalence of toxin, enterotoxin, and resistant encoding genes and analyze the distribution of different SCCmec types. The prevalence of integron was also determined in S. aureus isolates obtained from patients with urinary tract infections (UTIs).
    Methods
    In the present study, 126 MRSA isolates obtained from patients with UTI were examined for susceptibility to antimicrobial agents. Genes encoding integrase, resistance, toxin, and SEs were detected by the polymerase chain reaction (PCR) screening. The SCCmec types were determined using the multiplex PCR. Integrase positive strains were evaluated for determination of integron classes using PCR-restriction fragment length polymorphism assay.
    Results
    From 126 MRSA isolates studied, 107 isolates (84.9%) were multi-drug resistant. The most prevalent genes in isolates under study was aac (6΄)-Ie/aph (2˝) (50%) followed by tet (M) (47.6%), msr (A) (38.1%), aph (3΄)-IIIa (25.4%), erm (A) (23%), ant (4΄)-Ia (16.7%), erm (B) (14.3%), msr (B) (9.5%), and erm (C) (7.1%). Staphylococcal enterotoxins sea, sec, see, sed, seg, seb, and sei were detected in 27%, 20.6%, 16.7%, 14.3%, 11.1%, 7.1%, and 5.6% of the isolates, respectively. The results revealed that 126 MRSA isolates fell in the SCCmec type III (37.3%), SCCmec type I (23%), SCCmec type II (14.3%), SCCmec type IV (13.5%), and SCCmec type V (11.9%). Class 1 and 2 integrons were commonly found in 34.1% and 14.3% of the isolates, respectively. Seven isolates (5.6%) were observed to carry class 1 and 2 integrons, simultaneously.
    Conclusions
    The current findings showed that identification and screening of integrons and SCCmec elements as reservoirs that should be considered for various resistance genes to consume proper antibiotic and perform a systematic surveillance.
    Keywords: Methicillin-Resistant, Staphylococcus aureus, Integrons, Urinary Tract Infection
  • Reza Arjmand , Mehri Golami , Fariba Shirvani *, Kumars Pourrostami , Omid Safari , Nasrin Elahimehr , Saeed Nikkhah , Ehsan Zahmatkesh , Mostafa Qorbani , Esfandiar Najafi Tavana Page 5
    Background
    Since November 2014, pentavalent vaccine is available in Iran. This vaccine should be injected into all Iranian children at two, four, and six months after birth.
    Objectives
    There is little information on the immunogenicity of this vaccine against hepatitis B (HB) in Iranian children; therefore, the current study aimed at investigating the vaccine efficacy six months after administration of the last dose.
    Methods
    A total of 400 blood samples were collected from one-year-old children referred to Karaj healthcare centers, Alborz province, Iran. After sampling, checklists of demographic information were completed. Blood samples were sent to the laboratory to determine antibody titer by CMIA (chemiluminescent microparticle immunoassay). Statistical analysis was conducted by Stata and SVY software.
    Results
    Overall, 393 (98.3%) children (95% confidence interval (CI): 96.03% - 99.57%) had a protective IgG titer of > 10 mIU/mL, while it was < 10 mIU/mL in seven (95% CI: 0.5% - 3.1%) subjects. Geometric mean titer was 419.66 mIU/mL (95% CI: 380.52 - 462.82). Anti-HBsAb titer was not associated with gender and the type of milk feeding.
    Conclusions
    The seroprotection of HB vaccine in a pentavalent combination vaccine in Iran, six months after three doses of vaccination, was acceptable.
    Keywords: Hepatitis B, Pentavalent Vaccine, Children
  • Azam Elahi , Alisha Akya , Roya Chegene Lorestani , Keyghobad Ghadiri , Shokofe Baakhshii * Page 6
    Background
    Klebsiella pneumoniae is one of the important opportunistic pathogens causing serious infections, both community and hospital-acquired, with high resistance to antibiotics.
    Objectives
    We aimed to determine the molecular typing of K. pneumoniae isolates using pulse field gel electrophoresis (PFGE).
    Methods
    Sixty-two consecutive non-duplicate K. pneumoniae isolates were isolated from clinical specimens in three hospitals of Kermanshah, west of Iran. A total of K. pneumoniae was confirmed by API-20E kit. Antibiotic susceptibility testing and ESBL screening were performed following the genotyping of isolates using PFGE. The pattern of DNA bands was examined by the 6.6 version of the Gelcompar II (Applied Maths, Belgium). The calculation of similarities was done by the Dice coefficient, and the unweighted paired group method was used for cluster analysis (UPGMA).
    Results
    Fifty-eight percent of isolates were phenotypically ESBL positive. Twenty-nine pulsotypes (X1-29) were determined with various genotype patterns. Four clones (including 18 isolates) showed a close genetic relationship and were from ICU, burn and infectious wards in one hospital. Pulsotypes X15 to X29, each presented a unique genotype and the majority of these strains (> 50%) were from the emergency ward. Four isolates were non-typable.
    Conclusions
    Our results indicate the genotypic variation of K. pneumoniae isolates, which may suggest the different origins for isolates, as well as ongoing changes of bacterial genome. However, the presence of the isolates with similar genotype may show a common origin and consequently, the dissemination of strains in hospital wards, especially in ICU and burn wards. Therefore, Kermanshah hospitals need to establish an effective infectious control system to manage and monitor the spread of resistant strains.
    Keywords: Klebsiella pneumoniae, Molecular Typing, Pulsed-Field Gel Electrophoresis
  • Arezu Naemabadi , Heidar Sharafi, Paniz Shirmast , Hamidreza Karimi, Sari, Seyed Hoda Alavian , Farzaneh Padami , Mahdi Safiabadi , Seyed Ehsan Alavian , Seyed Moayed Alavian * Page 7
    Background
    Due to the increasing number of immigrations worldwide, the immigrants’ health assessment is a major issue especially in the working children of immigrants.
    Objectives
    In the current study, hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections were tested in working children of Afghan immigrants in Iran.
    Methods
    The current cross sectional study was conducted on working children of Afghan immigrants in Sarasiab (Tehran province) and Agh-Tappeh (Alborz province) supporting centers for HBsAg (hepatitis B surface antigen), HCVAb (hepatitis C virus antibody), and HIVAb (HIV antibody) using rapid diagnostic test. For each child, a questionnaire including demographics, life style, and risky behaviors items was filled.
    Results
    In the current study, 339 (54% male) working children of Afghan immigrants with mean ± SD age of 12.83 ± 2.83 years were tested. Two (0.59%; 95% confidence interval (Cl) = 0.16% - 2.13%) of the children were positive for HBsAg, while none were positive for HCVAb and HIVAb (0%, 95% Cl = 0% - 1.12%).
    Conclusions
    The implementation of neonatal HBV vaccination and prevention of mother-to-child transmission of HBV should be considered in Afghan immigrants in Iran.
    Keywords: Hepatitis B, Hepatitis C, Human Immunodeficiency Virus, Afghanistan, Iran
  • Elnaz Abbasi, Ehsanollah Ghaznavi, Rad * Page 8
    Introduction
    Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) are the most common campylobacter species related to human gastroenteritis. Due to their large similarity, these two species are not differentiated in laboratories. In this report, the coinfection with C. jejuni and C. coli was studied in two pediatric patients. The aim of the present report was to determine if simultaneous coinfection with C. jejuni and C. coli, with different antibiotic profiles, could happen.
    Case Presentation
    In the present report, two patients clinically diagnosed with bacillary dysentery, showing fever and pus in their stool and undergoing treatment with cotrimoxazole, were microbiologically investigated through the modified Gram stain, culture and duplex PCR for diagnosing C. jejuni and C. coli. Based on microbiological and molecular results, coinfection with C. jejuni and C. coli were determined in both patients. Campylobacters isolated from patients were resistant to erythromycin, tetracycline, ciprofloxacin, ampicillin, gentamicin, and nalidixic acid. Also, in both patients, C. jejuni was sensitive to cotrimoxazole and ceftriaxone. In contrast, isolated C. coli were resistant to cotrimoxazole and sensitive to ceftriaxone.
    Conclusions
    The two patients were simultaneously infected with C. jejuni and C. coli and both were carried all the antibiotic resistant genes under study. In spite of the sensitivity of C. jejuni to cotrimoxazole, no improvement was observed for C. coli due to its resistance to this antibiotic. This finding emphasizes on the important role of microbiology investigation once empirical therapy is needed. This issue must be taken seriously in pediatric hospitals.
    Keywords: Pediatric, Coinfection, Campylobacter jejuni, Campylobacter coli, Dysentery, Iran
  • Fariba Jahangiri , Shirin Sayyahfar, Elham Zarei *, Rozita Hoseini , Seyed Javad Nasiri Page 9
    Hydatid disease is a parasitic infection mainly caused by Echinococcus granulosus and is endemic in many parts of the world. Although hydatid disease can be found anywhere in the human body, the liver and lungs are the most commonly involved organs. Urinary tract involvement has been seen in about 2% - 4% of the cases; however, the isolated renal cyst is extremely rare. Here, we report a 5-year-old boy with an isolated huge renal hydatid cyst with no scolices or hooklets in aspirated fluid mimicking a simple renal cyst. The clinicians and radiologists should consider hydatid disease in the differential diagnosis of cystic lesions found in any part of the body especially in endemic countries since earlier diagnosis is crucial for appropriate treatment.
    Keywords: Echinococcosis, Hydatid Cyst, Hydatid Disease, Pediatrics, Renal Cyst