Urinary antigene and PCR can both be used to detect Legionella pneumophila in childrens hospital-acquired pneumonia

Legionella pneumophila is the causative agent of more than 95 cases of severe Legionella pneumonia. Nosocomial pneumonias in different hospital wards is an important medical and pharmaceutical concern. This study aimed to detect Legionella with two methods: polymerase chain reaction PCR and detection of urine antigenic test UAT in patients suffering from nosocomial pneumonia admitted to pediatric intensive care unit PICU of children hospitals. This study was conducted in PICU wards of Rasool Akram and Bahrami children hospitals, Tehran, Iran during 2013- 2014. In patients diagnosed with hospital-acquired pneumonia, intratracheal secretion samples for PCR and urine sample for urinary antigen test UTA were taken. Simultaneously, PCR and urinary antigen test were conducted using commercial kits. The results of urinary antigen test and PCR were analyzed by SPSS v.19 for statistical comparison. In this study, 96 patients aging 2.77 years on average with two age peaks of less than 1 year and 7-8 year were enrolled. More than half of the patients were under 1 year old. The most common underlying diseases were seizure, Acute Lymphoblastic Lymphoma, Down syndrome and metabolic syndromes. The positivity rate of Legionella urinary antigen test was 16.7% and positivity rate of PCR test was 19.8%. There were no significant associations between the results obtained by both assays with age, gender or underlying diseases. In conclusion, PCR is a better detection method for Legionella infection than urinary antigen test, but the difference between the two methods was not significant. © 2019 PAGEPress Publications. All rights reserved

Sepsis risk factors in children: a brief report

Background: Sepsis is a leading cause of death in infants and children. In this study, we determined sepsis risk factors in children admitted in Bahrami Hospital. Methods: Medical records of 94 patients with septicemia and a positive blood culture were reviewed in this study. The patients had been admitted during 2010-2011 in different wards of Bahrami Pediatric Hospital. Variables including age, gender, underlying diseases, causative agents and use of medical devices were extracted from the medical records and analyzed statistically. Results: 54.3% of the cases were male and 51% were below 1 year of age. 54.3% had underlying diseases including malignancy (18.1%) and renal disease (11.7%), which were the most common causes. Failure to thrive (FTT) was detected in 34% of the cases. 82% of the causative bacterial agents were gram positive bacteria and the most common organisms were coagulase negative staphylococci (63.8%) and staphylococcus aureus (10.6%). IV-catheters (100%), NG tubes (9.6%), urinary catheters (4.3%) had been used in the patients. The mortality rate was 6.3%. Conclusion: This study showed that septicemia was more prevalent in infants and the most common underlying diseases were malignancy and renal disease, respectively. Gram positive bacteria were the most common cause of septicemia

Vitamin A, D & zinc serum levels in children with acute gastroentritis: A case control study: Tehran, Iran

Background and Objective: Diarrhea (as one of the main manifestations of parasitic or microbial infections in gastrointestinal tract) is still a leading cause of mortality and morbidity in children younger than 5 years old in developing countries such as Iran. Objective: Identify and compare the relationship between serum levels of zinc, vitamin A and D in children with acute gastroenteritis (AGE) and the control group to demonstrate that those who need hospitalization due to infection have lower levels of said elements. Materials and Methods: This was a cross sectional study on 25 patients with AGE in pediatric ward of Rasul Akram hospital and Bahrami Hospital during a year (2011-2012), were compared to 40 other patients who were admitted to surgical wards for elective surgery. 72 of all the patients were male and 28 were female. All patients were older than 6 months years; mean age of cases was 2.17 years. Serum levels of vitamins A and D and zinc were measured using HPLC; Radioimmunoassay; atomic methods in 2 groups. Findings: Despite the lower levels of vitamins A in cases than controls, serum levels were not significantly different (p=0.5). Serum levels of zinc were considerably but not significantly lower in cases than the controls (p=0.06). However, serum levels of vitamin D were significantly lower in AGE cases (p=0.003). Conclusion: We found lower serum levels of vitamin D in AGE cases but no difference had found in serum levels of vitamin A and zinc between the two groups probably is the end result of various effects of vitamin A and zinc on diarrhea in different age groups and AGE. This trial emphasizes therapeutic effects of vitamin D supplementation on AGE in children especially in those with malnutrition and in developing countries. Therefore, other trials on a larger scale designed to investigate discriminating different etiologies for AGE and in different age groups is performed. © 2016 Bentham Science Publishers

The Genetic Diversity and Phylogenetic Characteritics of Rotavirus VP4(P) Genotypes in Children With Acute Diarrhea

Background: Acute gastroenteritis is a major cause of morbidity and mortality among children in developing countries. Rotaviruses are recognized as the most common etiologic factors of gastroenteritis. In this study, we determined the epidemiologic features, clinical symptoms and molecular structure of rotavirus VP4(P) genotypes in children with acute diarrhea in Bahrami Hospital in Tehran Iran, during 2009 for justifying the routine use of rotavirus vaccines in children. Methods: One hundred fifty fecal samples from 150 children with acute diarrhea in Bahrami Pediatric Hospital in Tehran, Iran were collected from January to December 2009. The patients’ mean age was 20.90+18.19 years (ranging from 1 month to 14 years). Fecal samples were transported on ice to the laboratory of virology department of Pasture Institute of Iran. The demographic and clinical data for each case were entered in an author-devised questionnaire. Group A rotavirus was detected by dsRNA-PAGE. Subsequently, rotavirus genotyping (VP4) was performed by semi-nested multiple RT-PCR and the phylogenetic tree of the Rotavirus nucleotides was constructed. The data were analyzed by statistical tests including Wilcoxon signed and Mann-Whitney U. Results: Rotavirus was isolated in 19.3% of the samples, more than 90% of which had long RNA patterns. The predominant genotype (VP4) was P[8] (86%) and other genotypes respectively were P[6] (6.9%) and P[4] (6.9%). Conclusion: A high prevalence of the P[8] genotype was found to be the cause of acute diarrhea. The analysis of P[8] genotype sequence showed a high level of similarity of the virus in this study with those of other Asian countries

Final 3.indd

Abstract Background: Human rotavirus genotypes G1-G4, G9, P[4] and P Methods: A total of 700 stool specimens were collected from children and assessed for the presence of rotaviruses by the dsRNA-PAGE technique. G and P typing of the positive samples were performed by semi-nested multiplex RT-PCR. Results: Rotaviruses were isolated in 19% of samples. A total of 14 rotavirus dsRNA different electrophoretypes were detected. The predominant genotype was G1 (76.3%), followed by G4 (11.5%), G8 (0.8%), P[4] (9.2%) and P[8] (66.4%), respectively. In mixed type samples, the majority were of genotype G1P[8] (53.4%), followed by G1P[4] (9.2%) and G4P[8] (4.6%). Mixed types consisted of 3.1% of the total sample followed by G1G2/-P (1.5%), G1G4P[4] (0.8%) and G1G4P[8] (0.8%). Conclusion: In this study, a high prevalence of the G1P[8] genotype was determined to be the cause of childhood gastroenteritis in Tehran, Iran. The sequence of G and P genotypes showed high levels of similarity to strains from other Asian countries. Our data will be useful for future vaccine formulation in Iran

Prevalence and genetic diversity of norovirus genogroup II in children less than 5 years of age with acute gastroenteritis in Tehran, Iran

Viral gastroenteritis is a major public health problem worldwide. In Iran, very limited studies have been performed with regard to the epidemiology of noroviruses. This study aimed to evaluate the prevalence and molecular epidemiology of GII noroviruses in hospitalized children less than 5 years of age with acute gastroenteritis (AGE). A total of 210 stool specimens were collected from Ali Asghar Childrenâ��s Hospital and Bahrami Childrenâ��s Hospital in Tehran, from June 2015 to June 2016. The samples were screened by real-time RT-PCR for genogroup II (GII). Positive samples were genotyped by semi-nested PCR followed by Sanger sequencing and phylogenetic analysis. Norovirus was identified in 36 (17.1) of 210 specimens. Based on genetic analysis of RdRp and capsid sequences, the strains were clustered into eight RdRpâ��capsid genotypes: GII.P4â��GII.4 Sydney₂₀₁₂ (41.7), GII.Peâ��GII.4 Sydney₂₀₁₂ (30.6), GII.P21â��GII.3 (13.9), GII.P16â��GII.4 Sydney₂₀₁₂ (2.8), GII.P16â��GII.12 (2.8), GII.P2â��GII.4 Sydney₂₀₁₂ (2.8), GII.P7â��GII.7 (2.8) and GII.P2â��GII.2 (2.8). We determined several different co-circulating norovirus genotypes in children < 5 years of age with AGE in our hospital in Tehran, Iran. Continued molecular surveillance of noroviruses, including typing of both RdRp and capsid genes, is important for monitoring emerging strains in our continued efforts to reduce the overall burden of norovirus disease. © 2018 Springer-Verlag GmbH Germany, part of Springer Natur

Cytomegalovirus Disease in Children with Acute Lymphoblastic Leukemia in the Nontransplant Setting: Case Series and Review of the Literature

Cytomegalovirus (CMV) disease in pediatric acute lymphoblastic leukemia in the nontransplant setting is very rare. We report our experience with 4 such cases, and review the literature (n=12). The median age at diagnosis was 10 years and 50 of patients were males. Among the 11 cases with available information at the time of diagnosis, CMV disease occurred during maintenance therapy in 10 patients. Fever was present in 9 cases. CMV disease manifested as retinitis in 6, hepatosplenic disease in 3, pneumonitis in 1, and hemophagocytic lymphohistiocytosis in 1 patient. One patient had both CMV retinitis and CMV-related hemophagocytic lymphohistiocytosis. Four of the 7 patients with retinitis complained of visual disturbance at diagnosis. CMV viremia was present in 10 patients. Three patients had at least 1 relapse and developed permanent visual defects, and 1 patient developed recurrent retinal detachment. In conclusion, prolonged immunosuppression is the major etiology and retinitis is the most common manifestation of CMV disease. As a significant number of patients with retinitis are asymptomatic, early diagnosis and treatment is important to prevent permanent visual loss. © Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved

Prevalence and genetic diversity of norovirus genogroup II in children less than 5Â years of age with acute gastroenteritis in Tehran, Iran

Viral gastroenteritis is a major public health problem worldwide. In Iran, very limited studies have been performed with regard to the epidemiology of noroviruses. This study aimed to evaluate the prevalence and molecular epidemiology of GII noroviruses in hospitalized children less than 5 years of age with acute gastroenteritis (AGE). A total of 210 stool specimens were collected from Ali Asghar Childrenâ��s Hospital and Bahrami Childrenâ��s Hospital in Tehran, from June 2015 to June 2016. The samples were screened by real-time RT-PCR for genogroup II (GII). Positive samples were genotyped by semi-nested PCR followed by Sanger sequencing and phylogenetic analysis. Norovirus was identified in 36 (17.1) of 210 specimens. Based on genetic analysis of RdRp and capsid sequences, the strains were clustered into eight RdRpâ��capsid genotypes: GII.P4â��GII.4 Sydney₂₀₁₂ (41.7), GII.Peâ��GII.4 Sydney₂₀₁₂ (30.6), GII.P21â��GII.3 (13.9), GII.P16â��GII.4 Sydney₂₀₁₂ (2.8), GII.P16â��GII.12 (2.8), GII.P2â��GII.4 Sydney₂₀₁₂ (2.8), GII.P7â��GII.7 (2.8) and GII.P2â��GII.2 (2.8). We determined several different co-circulating norovirus genotypes in children < 5 years of age with AGE in our hospital in Tehran, Iran. Continued molecular surveillance of noroviruses, including typing of both RdRp and capsid genes, is important for monitoring emerging strains in our continued efforts to reduce the overall burden of norovirus disease. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Surveillance of antibiotic consumption point prevalence survey 2014: Antimicrobial prescribing in pediatrics wards of 16 Iranian hospitals

Background: Antibiotics are among the most commonly prescribed drugs in pediatrics. Due to lack of uniformity in pediatric antimicrobial prescribing and the emergence of antibiotic resistance, appropriate drug utilization studies have been found to be crucial to evaluate whether these drugs are properly used. Methods: Data were collected between January 2014 and February 2014 in 16 Iranian pediatric hospitals using a standardized method. The point prevalence survey included all inpatient beds. Results: Of 858 children, 571 (66.6) received one or more antimicrobials. The indications were therapeutic in 60.6. The parenteral route was used in 92.5 of therapeutic indications. Ceftriaxone was the most prescribed antimicrobials for therapeutic indications (32.4) and combination-therapy was the most type of therapy in pediatric intelligent care unit (PICU). Conclusion: According to results of this study, antibiotics� prescribing in pediatrics wards of Iranian hospitals is empirical. Therefore, for quality improvement of antimicrobial use in children continuous audit process and antibiotic prescriptions require further investigation. © 2016, Academy of Medical Sciences of I.R. Iran. All right resvrved