Detection of human metapneumovirus and respiratory syncytial virus by real-time polymerase chain reaction among hospitalized young children in Iran

Background: Acute respiratory infection plays an important role in hospitalization of children in developing countries; detection of viral causes in such infections is very important. The respiratory syncytial virus (RSV) is the most common etiological agent of viral lower respiratory tract infection in children, and human metapneumovirus (hMPV) is associated with both upper and lower respiratory tract infections among infants and children. Objectives: This study evaluated the frequency and seasonal prevalence of hMPV and RSV in hospitalized children under the age of five, who were admitted to Aliasghar children�s hospital of Iran University of Medical Sciences from March 2010 until March 2013. Patients and Methods: Nasopharyngeal or throat swabs from 158 hospitalized children with fever and respiratory distress were evaluated for RSV and hMPV RNA by the real-time polymerase chain reaction (PCR) method. Results: Among the 158 children evaluated in this study, 49 individuals (31.1) had RSV infection while nine individuals (5.7) had hMPV infection. Five (55.5) of the hMPV-infected children were male while four (44.5) were female and 27 (55.2) of the RSV-infected patients were females and 22 (44.8) were males. The RSV infections were detected in mainly one year old children. Both RSV and hMPV infections had occurred mainly during winter and spring seasons. Conclusions: Respiratory syncytial virus was the major cause of acute respiratory infection in children under one-year of age while human metapneumovirus had a low prevalence in this group. The seasonal occurrence of both viruses was the same. © 2016, Ahvaz Jundishapur University of Medical Sciences

Comparison of antimicrobial sensitivity to older and newer quinolones versus piperacillin-tazobactam, cefepime and meropenem in febrile patients with cancer in two referral pediatric centers in Tehran, Iran

Background: Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if there was significant resistance to quinolones. Methods: Children with cancer who were admitted with or developed fever during admission to Aliasghar Children's Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained. Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic. Results: Blood cultures were positive for 38 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated, yielding a bacteremia rate of 29/160 (18). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97) with cefepime having the lowest coverage rate (21). Quinolone coverage ranged from 63 to 76. Conclusion. Quinolones may not be suitable for use as empiric therapy in febrile pediatric oncology patients in Iran

Transplacental transmission of SARS-CoV-2 infection: A case report from Iran

We report a case of SARS-CoV-2 vertical transmission through the placenta in a neonate whose mother had non-M3 acute myeloid leukemia (AML) that was complicated with Covid-19 in the last trimester. Viral load in nasopharyngeal swabs from mother and neonate were high. Real-time PCR of the fetal side of the placenta was positive for SARS-CoV-2, which makes it possible to consider this case as a congenital case of SARS-CoV-2 infection that is transmitted through vertical transmission. © 2020, Author(s)

Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis

BACKGROUND: The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery. METHODS: Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables. RESULTS: 179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p=0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p=0.02 and p=0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p=0.02). The length of the intensive care unit stay (p<0.001) was significantly longer in the infection group compared to the control group. CONCLUSIONS: Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts

COMPARISON OF ANTIMICROBIAL SENSITIVITY TO OLDER AND NEWER QUINOLONES VERSUS PIPERACILLIN-TAZOBACTAM, CEFEPIME AND MEROPENEM IN FEBRILE PATIENTS WITH CANCER IN TWO REFERRAL PEDIATRIC CENTERS IN TEHRAN, IRAN

Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if quinolones are appropriate for empiric therapy. Methods Children with cancer who were admitted with or developed fever during admission to Aliasghar Children’s Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained.  Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic. Results Blood cultures were positive for 39 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated,  yielding a bacteremia rate of 29/160 (18%). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97%) with cefepime having the lowest coverage rate (21%). Quinolone coverage ranged from 63%  to 76%. Conclusion Quinolones are not suitable for use as empiric therapy in febrile pediatric oncology patients 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

Demographic, clinical, and virological characteristics of patients with a laboratory-confirmed diagnosis of influenza during three consecutive seasons, 2015/2016�2017/18, in the Islamic Republic of Iran

Background: There are minimal data on the differences in demographics, clinical presentations and outcomes for patients with different types and sub-types of influenza in the Middle East. Objectives: To use population-based data from Iran to investigate factors associated with unfavorable disease outcome. Study design: Clinical data were compiled from the Iranian Ministry of Health for patients of all ages who fulfilled the severe acute respiratory infections (SARI) definition according to World Health Organization criteriatested for any reason and found to have and had laboratory proven influenza September 21, 2015 through March 20, 2018. Pulmonary, cardiac, renal, hematologic and neurologic complications were recorded. Results were compared by type, age, gender and health status. Multivariate analysis was used to analyze risk factors for complications and death. Results: Of 11,080 enrolled patients, 10,046 (90.7 ) were inpatients, 2254 (20.4 ) were children, 8403 (75.8 ) had influenza A, 2599 (23.5 ) had influenza B, and 78 (0.7 ) had unidentified types. Fever was less common in older patients (OR 0.99; 95 CI 0.98�0.99, p < 0.001 and in those with comorbidity (OR 0.87; 95 CI 0.77�0.97, p = 0.013). Although the rate of complications was lower with A(H1N1) pdm09 influenza than with A(H3N2) infection (12.8 versus 15.6 , p = 0.001), the mortality rate was higher (7.0 versus 3.0 , p < 0.001). Complications occurred more often during late versus early influenza season (OR 1.22; 95 CI 1.08�1.37, p = 0.002). Patients with type B influenza (OR 0.85; 95 CI 0.74�0.98, p = 0.025), or who presented with sore throat (OR 0.74; 95 CI 0.65�0.84, p < 0.001) were less likely to develop complications. The risk of developing complications was increased in patients who had chronic heart disease (OR 1.51; 95 CI 1.29�1.76, p < 0.001), chronic pulmonary disease (OR 1.62; 95 CI 1.37�1.91, p < 0.001), diabetes (OR 1.24; 95 CI 1.03�1.50, p = 022), or epilepsy (OR 1.55; 95 CI 1.17�2.05). Older age and male gender increased the risk of death but not of complications. Conclusions: The clinical features, complications and outcomes of influenza vary by age and by viral type and sub-type. Comorbidites appear to be more important than age in predicting complications. © 2020 Elsevier B.V

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

Genetic Analysis of 13 Iranian Families With Leukocyte Adhesion Deficiency Type 1

Background and Aim: Leukocyte adhesion deficiency type 1 is a rare, autosomal recessive disorder that results from mutations in the ITGB2 gene. This gene encodes the CD18 subunit of β2 integrin leukocyte adhesion cell molecules. Leukocyte adhesion deficiency type 1 is characterized by recurrent bacterial infections, impaired wound healing, inadequate pus formation, and delayed separation of the umbilical cord. Materials and Methods: Blood samples were taken from 13 patients after written consent had been obtained. Genomic DNA was extracted, and ITGB2 exons and exon-intron boundaries were amplified by polymerase chain reaction. The products were examined by Sanger sequencing. Results: In this study, 8 different previously reported mutations (intron7+1G>A, c.715G>A, c.1777 C>T, c.843del C, c.1768T>C, c.1821C>A, Intron7+1G>A, c.1885G>A) and 2 novel mutations (c.1821C>A; p.Tyr607Ter and c.1822C>T; p.Gln608Ter) were found. Conclusions: c.1821C>A (p.Tyr607Ter) and c.1822C>T (p.Gln608Ter) mutations should be included in the panel of carrier detection and prenatal diagnosis. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved