Bacillus Calmette–Guérin vaccine related lymphadenitis in children: Management guidelines endorsed by the Saudi Pediatric Infectious Diseases Society (SPIDS)

AbstractThe Bacillus Calmette–Guérin (BCG) vaccine contains live attenuated Mycobacterium bovis; was first used in humans to prevent tuberculosis (TB) in 1921. The World Health Organization (WHO) established the Expanded Program on Immunization in 1974 to ensure that all children have access to routinely recommended vaccines including BCG. Each year 120 million doses of BCG vaccine are administered worldwide. Intradermal BCG vaccine gives rise to a classic primary complex that consists of a cutaneous nodule at the site of injection and subclinical involvement of the regional lymph nodes, which is self-limiting and requires no treatment.However, ipsilateral regional lymph node enlargement may follow BCG vaccine and is considered as the most common complication, some progress to suppuration. Rarely a disseminated BCG infection may develop in immunocompromised individuals resulting in a devastating outcome. Within the last decades, variable strategies have been applied in treating lymphadenitis related to BCG vaccine, ranging from observation, anti-mycobacterial therapy, aspiration, incision and drainage to lymph node surgical excision.We are presenting these guidelines that intended to optimize and standardize management of various types of BCG related lymph adenitis in children. They are based upon the best available evidence in literature beside our experience in this field

Increased prevalence of rotavirus among children associated gastroenteritis in Riyadh Saudi Arabia

The aim of this study is to assess the epidemiology along with the molecular structure of rotavirus causing pediatric diarrhea among Saudi patients. However, in this report we sited the epidemiological reflect coming from our project

Seasonal variations of respiratory viruses detected from children with respiratory tract infections in Riyadh, Saudi Arabia

ARTIs have a huge impact in health systems in which 20–30% of all hospital admissions and 30–60% of practitioner visits are related to respiratory tract infections. The aim of this study is to determine the prevalence, age distribution, and seasonal variation of respiratory viruses. This study was descriptive retrospective study in which all patients 14 years of age and below who presented with signs and symptoms of ARTIs between January 2013 and December 2014 and had respiratory specimen tested by direct immunofluorescence assays for viruses identification were included in the study. During that period, a total of 4611 patients who presented with ARTIs from January 2013 to December 2014 were investigated, viruses were detected in 1115 (24%). RSV was associated with 97.4% of the total viral pathogens. Viruses were detected throughout all the two years with a peak in winter; Dec (n: 265), Jan (n: 418), Feb (n: 218), and Mar (n: 109). Viral pathogens are very important cause of ARTIs in our region. RSV was the most common virus detected with the highest detection rate in children who are two years old and below. A multi-center surveillance with more sensitive detection methods like PCR may help to provide a comprehensive understanding of virus distribution in our area, which may contribute implant an effective prevention approach for each virus. Keywords: Pediatrics, Infectious diseases, Respiratory infections, Respiratory syncytial virus, Saudi Arabi

2. Central line associated blood stream infection in a pediatric cardiac intensive care unit: Incidence, risk factors, and outcome

Clinical research. Presentation Type: Oral presentation. Introduction: Central Line Associated Blood Stream Infection (CLABSI) is a serious infection associated with 28,000 deaths and expenses from $296 million to$2.3 billion yearly. There is scarcity of data on CLABSI in pediatric cardiac intensive care units (PCICU). The aim of the study is to describe the risk factors, causative organisms and outcome of CLABSI in a PCICU. Methodology: The study was retrospective cohort in which all charts of patients admitted to the PCICU from January 2012 to September 2012 were reviewed. Patients who had central line were followed to see if they develop CLABSI from the central line insertion date until discharge. Results: Two hundred and sixty-one patients were included in the study. There were 2275 central line days and 19 CLABSI episodes (8.35 CLABSIs per 1000 central line days). Most common causative pathogens isolated were gram negative bacteria (N = 10, 50%) with Klebsiella pneumoniae and coagulase negative Staphylococcus were the leading causative organisms (N = 4, 20% each). Patients who developed the infection had a longer stay at the PCICU with a mean of 27.1 days compared to 8.20 days for non CLABSI Patients (P 7 days were independent risk factors. Conclusion: CLABSI increased the length of PCICU stay and mortality, yet it has recognizable associated risk factors. Infection control measures should be carefully implemented with special attention given to patients with CLABSI risk factors