Archives of Pediatric Infectious Diseases
Volume:1 Issue: 2, Jan 2013

Acute respiratory infections (ARIs) continue as the leading cause of mortality in under 5-year-old children worldwide. We decided to review available data about the incidence and prevalence of all diseases included in this category in Iran.. A systematic review was designed to obtain related data from English and Farsi sources, published or unpublished. An internet search of known data sources and websites of Iranian medical universities was conducted. In addition, we reviewed abstract books of related Persian seminars and prevalence reports of ARI in children from different departments in the Ministry of Health and Medical Education of Iran. After deleting duplicates obtained material was evaluated by two epidemiologists and selected documents underwent quality assessment through data extraction checklists. We have included the most valid studies in this review.. Only 19 out of 98 documents reported frequency of a disease in a defined population, a group of outpatients, or hospitalized patients. Almost all of the studies had some limitations. In addition, there were no similarities in methods or place/time to make a summary on any ARIs’ frequency. So, we discussed each study, separately.. Available data about frequency of ARIs in Iran were not beneficial enough to calculate burden of related diseases and make decision analysis for suggested interventions. Valid and large longitudinal population-based studies should be designed in different regions of the country supported by the Ministry and research centers..

Studies revealed that severity of atopic dermatitis correlates with colonization by S.aureus and the density of bacteria and antibiotic resistance is one of the factors in S.aureus recolonization.. We aimed to determine the pattern of colonization with different subtypes of S.aureus in patients with atopic dermatitis and its correlation with SCORAD (Scoring Atopic Dermatitis) index.. We studied 114 sample cultures from normal skin, nose and active lesions of 38 patients with atopic dermatitis to detection of Staphylococcus aureus colonization and MRSA (methicilin resistance Staphylococcus aureus) subtypes with E test. The severity of the disease was identified by the SCORAD criteria. Logistic regression analysis was used for the evaluation of the coexistence between MRSA colonization and SCORAD index in these patients.. We studied 114 sample cultures from 38 children (73% boys, 27% girls) with atopic dermatitis. Mean age of the patients was 19 ± 22.7 months. Mean objective SCORAD was 37.8 + 16.4 (range: 15-80). Twelve patients (31.6%) had mild, 18 patients (47.4%) had moderate and 8 patients (21%) had severe SCORAD. Seventeen patients (44%) were colonized by S. aureus in the nose, 14 (36%) on skin lesions, and 8 (21%) on healthy skin. Among all the cultures, MSSA was noted in 26 (22%) and MRSA was noted in 13 (11%). There was a significant relationship between SCORAD index and colonization of nose and active lesions with Staphylococcus aureus (P value = 0.001). We found MRSA only in patients with moderate SCORAD.. This study shows lower rate of S. aureus colonization in atopic dermatitis cases but similar rate of MRSA colonization in comparison with previous studies. A higher rate of MRSA colonization was found in patients with moderate SCORAD..

Noroviruses are one of the major viral pathogens responsible for gastroenteritis. Outbreaks of diarrhea due to Norovirus have been reported frequently. This study is performed to determine the prevalence of Norovirus in fecal specimens of children with gastroenteritis. Many viruses can cause gastroenteritis, including Rotaviruses; Adenoviruses types 40 and 41; Sapoviruses; and Noroviruses. Current techniques used for detection of Noroviruses in stool samples include multi-step viral RNA extraction and purification followed by reverse transcriptase-polymerase chain reaction (Rt-PCR).. The purpose of this study is to detect Norovirus in stool samples by Rt-PCR in 5 different centers in Iran..Patients and In this study, 2,170 stool samples were collected from children less than five years old from five different cities, all of whom had acute gastroenteritis. Detection of Noroviruses was performed through Rt-PCR. The mean age of the studied population was 48 months. Fecal specimens were collected within 24 hours of admission. The specimens were frozen, sent to the laboratory, and then stored at -70° C until being tested for Norovirus.. Rt-PCR was performed for 2,170 stool samples containing 90 (4.14%) Norovirus positive (0.97% Tehran, 0.64% Tabriz, 0.18% Mashhad, 1.57% Shiraz, 0.78% Bandar Abbas). The RT-PCR was validated with published primers for Norovirus (JV12/JV13). In both retrospective and prospective settings, the Rt-PCR was equally sensitive (95%) and specific (95%) in detecting Norovirus.. Noroviruses, which are important human pathogens, may cause epidemic acute viral gastroenteritis which in turn can be easily detected by molecular methods..

Neonatal sepsis is a serious problem in neonatal intensive care units, as it causes high rates of morbidity and mortality.. The purpose of this study is to evaluate various etiologic agents, antimicrobial susceptibility, clinical manifestations and the mortality rate in an intensive care unit in Kashan, Iran..Patients and One hundred and four neonates with documented early onset sepsis in a 2 year period from 2006 to 2008 were enrolled in this descriptive study. The results of blood cultures and antimicrobial susceptibility and clinical manifestations and outcome were collected in questionnaires and subsequently analyzed.. We evaluated 104 cases including 63 (61%) males and 41 (39%) females. The most common clinical presentations were respiratory distress in 28 (26.9%), poor feeding in 18 (17.3%), lethargy in 15 (14.5%), fever in 15 (14.5%) and jaundice in 13 cases (12.5%). The most common organisms isolated from blood cultures were Flavobacterium (43.3%), Pseudomonas (17.3%) and coagulase positive Staphylococcus (17.3%). All Flavobacterium were resistant to Ampicillin and 100% were susceptible to Amikacin.. The most common isolated organism from blood cultures was Flavobacterium. Water was causative source of Flavobacterium. Later on we found that an outbreak had occurred during our study and these results may not be seen in an ordinary situation..

Nosocomial infections increase mortality rate in neonates. Studies have attributed the use of H2 blockers as one of the various factors that increase the risk of nosocomial infections.. To define the relationship between nosocomial infection and Ranitidine in very low birth weight (VLBW) infants admitted in the NICU of a tertiary care hospital..Patients and All VLBW infants admitted during the study period of 3 years from April 2008 to March 2011 were included. All relevant pre-and peri-natal data including all administered medications was collected from the case notes and documented on a pre-designed questionnaire. Rate of nosocomial infection (NI) had been compared between patients who were administered Ranitidine and those who did not receive this medication.. During the study period, 564 VLBW infants were admitted in the NICU; 157, (27.8%) contracted nosocomial infections, 130 (82.8%) developed pneumonia, 21, (13.4%) had sepsis with positive blood cultures and 6 infants (1.1%) developed necrotizing enterocolitis. Factors remaining independently significant for development of NI after adjustment were as follows: RDS (P = 0.001. OR = 3.29; 95%CI = 1.64–6.6); CLD (P < 0.001. OR = 3.83; 95%CI = 2.06–7.11); anemia (P = 0.005. OR = 1.96; 95% CI = 1.23-3.13); use of Ibuprofen (P = 0.03. OR = 1.99; 95%CI = 1.06-3.74), and treatment with Ranitidine (P = 0.009, OR = 1.92, 95%CI = 1.18-3.12).. Use of Ranitidine was associated with a significantly increased risk of nosocomial infections in VLBW infant..

Disability is a relatively common problem in children. The pattern of admission in these children and their common infections may differ from other children because of their special disabilities.. We aimed to determine common infectious diseases resulting in admission of these children to our hospital..Patients and Between September 2006 and September 2007, 60 disabled children aged between 4 months and 15 years were admitted to infectious ward of Mofid children hospital Tehran, Iran. A questionnaire was filled at the time of admission, containing particular details of their recent complaint. They were completely examined and the final diagnosis was established at the time of discharge.. In this study 25 (42%) boys and 35 (58%) girls aged from 4 to168 months were included. The patients were divided practically into three groups: 21 patients (35%) with physical or developmental disabilities, 8 (13%) patients with mental or behavioral disabilities, and 31 (52%) patients with both developmental and mental disabilities. The common diseases among these children were lower respiratory tract infections (LRTI) in 24 patients (40%), urinary tract infections (UTI) in 8 patients (13.3%), and nonspecific infections in 9 patients (15%). Dental caries and periodontal problems were significantly higher in children having both mental and developmental disabilities this correlation was similar between different types of disability and skeletal deformity (P = 0.006). Children having both mental and developmental disabilities were admitted more than children with either of those disabilities (P = 0.08).. Lower respiratory tract infections were the most common reasons for admission of these children in our study, but we found no significant correlation between the type of disability and one special infectious disease. We need more prospective studies to complete our findings..

Uropathogenic Escherichia coli (UPEC) is a causative agent of most of urinary tract infections (UTIs), which expresses a multitude of virulence factors.. The aim of this study was to investigate virulence associated characteristics characteristics in UPEC isolates derived from urine specimens, and to investigate the distribution of the pathogenicity islands virulence markers (PAIs) among the isolates in relation to their antibiotic susceptibility pattern..Patients and A total of 50 E.coli isolates were collected from patients with UTI during 2009 to August 2010. Biochemical and standard microbiological techniques were used to identify E.coli followed by screening for islands by polymerase chain reaction (PCR).. We found a high number of PAI markers such as PAI ICFT073, PAI IICFT073, PAI I536, PAI IV536, PAI II J96, and PAI II536 significantly associated with UPEC. High level of resistance to Aztreonam, Co-trimoxazole, Cefpodoxime, and Cefotaxime was found among the UPEC isolates.. This observation is of special value considering that the UPEC pathotype constitutes an emerging group of enteropathogens, particularly, in our county. Knowledge of the molecular details of Uropathogenic E.coli is useful to develop successful strategies for the treatment of urinary tract infection and complications associated with UTIs in human..

Pandemic flu is a concerning problem with potentially high mortality and morbidity rates, so needs a proper health system response in each country..

To evaluate the nationwide health system response in Iran after declaration of H1N1/Swine flu pandemic in June 2009..Patients and

A surveillance system in all regions of country was implemented upon declaration of pandemic flu by the World Health Organization; RT-PCR methods in National influenza reference laboratory in the capital were used to diagnose all types of circulating influenza viruses. Epidemiological data as well as laboratory response, performances of 40 medical universities all over the country concerning case detection and timing of admission were analyzed..

3847 confirmed cases of H1N1/Swine flu were detected up to November 2009, which 140 cases died (i.e.; 3.8% mortality rate), highest mortality rates were observed in infants (7.4%) and those older than 50 years (9%). For about 78% of confirmed cases of Swine flu, the result had been notified within 3 days after sample submission, despite the fact, most of mortalities had occurred in this group of “short result gap”..

Although overall mortality rate in such a pandemic was comparable or better than other developing countries, it was shown that late hospital admission and late laboratory diagnosis were associated with higher mortality rates. Better case detection and earlier admission with more available and equipped laboratories seems necessary to improve the health system response for future pandemics in Iran..

TNF-α is one of the most potent cytokines in proinflammatory reactions.. This article contributes to evaluate the correlation between urinary TNF-α and inflammatory response markers in children with acute pyelonephritis..Patients and This cross sectional study, was performed on children with acute pyelonephritis. Fresh random urine samples were obtained before treatment of pyelonephritis. Urine samples were tested for TNF-α and creatinine. We also evaluated our patients with routine biochemical studies.. One hundred and twenty children with acute pyelonephritis were evaluated. Urinary TNF-α/Cr was 0.0051 ± 0.00083 Pg/g creatinine. The authors found out a significant difference in urinary TNF-α/Cr between patients who have normal and abnormal levels of urine leukocytes, urine protein, urine culture, erythrocyte sedimentation rate and C- reactive protein. This study revealed a significant correlation between urinary TNF-alpha and urine WBC (r = 0.36, P value = 0.02), ESR (r = 0.75, P value = 0.03) and CRP (r = 0.58, P value = 0.02).. We concluded that urinary TNF-α/Cr might be a good indicator for inflammatory response in children with acute pyelonephritis..

When a child presented with decreased level of consciousness in the emergency room, taking the right approach is one of the most important skills that every emergency physician should have. Ideally, there should be a defined diagnostic and therapeutic algorithm in the emergency room for managing these children in order to minimize difficulties diagnostically and maximize time spent helping the child. This article describes the history-taking, and physical and neurologic exams the affected child should be assessed with and explains the potential etiologies of a decreased level of consciousness. These factors are classified into traumatic and non-traumatic agents. Infectious causes of encephalopathy and the applied classification of them has been emphasized..

Hydatid cyst of heart is uncommon. We are reporting a case of 14 years old male with liver, lung and heart hydatidosis. Diagnosis was confirmed by imaging studies and histological evaluation of surgical specimens..