Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study

© 2022 by The Korean Pediatric Society.Background: Infantile colic has a multifactorial etiology; although various treatments have been attempted to manage and alleviate its symptoms, a solution is lacking, adversely affecting mothers and their babies. Recent studies have suggested that dysbiosis may play a role in the pathogenesis of infantile colic and that modulating the gut microbiota, including the use of probiotics, may aid its management. Purpose: This single-blind randomized controlled study evaluated the effect of probiotics (Actiregularis, 5×106) added to the diet of mothers on infantile colic symptoms and neonatal gut microbiota content. Methods: A probiotic drink containing the Actiregularis (5× 106) strain was added to the diet of mothers in the experimental group once daily for 15 consecutive days. Stool samples were collected from each infant twice, on days 0 and 15, and fecal 16s rRNA gene sequencing and compositional-based metabolomic analyses were performed. The mothers recorded the babies’ crying frequency and severity for 15 days using a daily form created by the researchers. This study was registered at ClinicalTrials.gov (ID: NCT04374955). Results: Infants whose mothers were supplemented with Actiregularis for 15 days showed a decreased frequency (P= 0.00) and intensity (P<0.001) of crying as well as a significantly increased bacterial diversity in the stools (P=0.017). This variety was substantially affected by the addition of probiotic products. The greatest species diversity was observed in the group treated with probiotics, while the least diversity was observed in the control group (Shannon, P=0.0043; Simpson, P=0.017). Conclusion: Babies treated with Actiregularis added to their mother’s diet for 15 days showed decreased crying frequency and intensity and increased bacterial diversity and density

Visceral leishmaniasis with splenic nodules: Case report

Copyright © 2016 by Tür ki ye Kli nik le ri.Visceral leishmaniasis (VL) is transmitted to humans by the bite of sandflies. VL is an endemic parasitic disease which is characterized by fever, splenomegaly and pancytopenia in most of the cases. Delays in diagnosis of VL are common because of nonspecific symptoms and variable incubation time. Specific serology and polymerase chain reaction are useful for the diagnosis. Anti-K39 strip test is highly sensitive. Splenic multifocal hypoechoic nodules should be evaluated for VL with clinical and laboratory features in patient. Herein we report a twenty-two month-old female infant with diagnosis of VL who presented with recurrent fever, pancytopenia and ultrasonography revealed enlarged spleen with multifocal hypoechoic nodules. We considered that splenic nodules can help to diagnosis of VL in children as literature case reports support to this situation

Evaluation of the intestinal parasitic infections in children patients with cancer

Amaç: Bu çalışmada sağlıklı, kanserli ve kanser tedavisi sonrası hayatta kalan çocuklardaki bağırsak parazitlerinin prevalansını ve cinsini tespit edilmesi, ayrıca nötropenik dönemde parazitlerin insidansı ve cinsinde değişikliğin araştırılması amaçlanmıştır. Yöntemler: Çalışmada üç farklı hasta grubu oluşturulmuştur. Birinci grup hematolojik maligniteli veya solid tümörlü yoğun kemoterapi alan ve mutlak nötrofil sayısı 1000/mm3’ün altında olan immün yetmezlikli seksen hastadan oluşurken, ikinci grup hematolojik maligniteli veya solid tümörlü mutlak nötrofil sayısı normal ve ayaktan idame kemoterapi alan seksen beş hastadan, üçüncü grup ise çeşitli sebepler nedeni ile pediatri hematoloji polikliniğine başvurmuş immün yetmezliği olmayan ve kronik immün baskılayıcı tedavi almamış yüz yetmiş iki hastadan oluşmuştur. Hastalardan üç gün üst üste dışkıda parazit incelemesi yapılmıştır. Bulgular: Birinci gruba dahil edilen hastalarda parazit prevalansı diğer gruplara göre istatistiksel olarak anlamlı derecede yüksek bulunmuştur. Çalışmaya alınan bütün gruplarda en sık rastlanan parazit Giardia intestinalis olmuştur. Mutlak nötrofil sayısı 1000/mm3’ün altında olan hastalarda parazit varlığı, mutlak nötrofil sayısı 1000/mm3’ün üzerinde olan hastalara göre istatistiksel olarak anlamlı yüksek tespit edilmiştir. Sonuç: İmmün yetmezlikli hastalarda bağırsak paraziti prevalansının diğer gruplara göre yüksek bulunmuştur. Bu tür hastalarda enfeksiyon bulguları olduğunda, parazitik enfeksiyon olasılığının gözardı edilmemesi gerektiği kanaatine varılmıştır.Objective: We aimed to determine the prevalence and type of the intestinal parasites in healthy, cancer and survivor children after cancer therapy, and to evaluate whether there are any differences in incidence and types of parasites during their neutropenic period. Methods: Three different patient groups were formed. Group I and Group II were immune deficient patients with hematologic malignancy or solid tumors, and Group I were receiving intensive chemotherapy and had absolute neutrophil count less than 1000/mm3. Group II were receiving maintenance chemotherapy and had normal absolute neutrophil counts. One hundred and seventy two patients, who did not receive chronic immune suppressant treatment and who did not have immune deficiency were chosen among the patients admitted to pediatric hematology outpatient clinic. Parasitic evaluation of stools was performed on three consequtive days. Results: Prevalence of parasite in Group I patients was significantly higher than other groups. The most commonly detected parasite in all groups was Giardia intestinalis. The presence of parasite in patients with absolute neutrophil counts below 1000/mm3 was found to be significantly higher than in patients with absolute neutrophil counts above 1000/mm3. Conclusion: Parasitic infections should not be ignored when these types of patients present with infection finding

Beneficial Effects of Limosilactobacillus fermentum CECT 5716 Administration to Infants Delivered by Cesarean Section.

Cesarean section (CS) disrupts the natural microbiota colonization process in infants, which might compromise immune system maturation, leading to a higher risk of infections. We evaluated the effect of the probiotic Limosilactobacillus (L.) fermentum CECT 5716 on the incidence of gastrointestinal and respiratory infections in the CS infant subgroups (n = 173) of three randomized clinical trials in which this probiotic strain was demonstrated to be safe and effective for preventing infections. Therefore, the data for the CS infants were extracted to obtain the incidence rate ratio (IRR) and 95% CI for gastrointestinal and respiratory infections for each study and were then combined to obtain a pooled IRR and 95% CI using the generic inverse variance method. There was a significant reduction of 73% in the incidence of gastrointestinal infections in CS infants receiving L. fermentum CECT 5716 compared with those receiving the control formula [n = 173, IRR: 0.27 (0.13, 0.53), p = 0.0002]. Regarding respiratory infections, although pooled results showed a reduction of 14% in the probiotic group, the difference was not statistically significant [n = 173, IRR (95% CI): 0.86 (0.67, 1.11), p = 0.25]. In conclusion, the administration of L. fermentum CECT 5716 to CS-born infants protects them from gastrointestinal infections by reducing the risk by up to 73% in this population

Children with breakthrough varicella infection requiring hospitalization in Turkey (VARICOMP Study 2008-2013)

Introduction: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition

Evaluation of group A beta hemolytic streptococci macrolide resistance in Turkey : Pilot study results

Amaç: Bu çalışma ile Türkiye genelindeki 8 merkezden tonsillofarenjit etkeni olan A grubu beta hemolitik streptokok izolatı toplanarak makrolid duyarlılığı çalışılarak ülke genelinde grup A streptokok makrolid duyarlılığı ile ilgili genel bir bilgi edinilmesi ve makrolid direnç prevalansının belirlenmesi amaçlanmıştır. Bu yazıda ilk elde edilen örneklerin makrolid direnci açısından sonuçları açıklanmıştır.Gereç ve Yöntemler: İlk örneklerin alındığı merkezlerden, toplanan grup A beta hemolitik streptokok izolatlarının ait oldukları 5-15 yaş arası hastaların klasik yöntemlerle, boğaz kültüründe grup A beta hemolitik streptokok üremeleri (kanlı agar- basitrasin) transport besi yeriyle Hacettepe Üniversitesi Tıp Fakültesi Hastanesi'ne nakledilmiş ve burada disk difüzyon tekniğiyle eritromisin, klaritromisin, klindamisin, azitromisin direnci çalışılmıştır.Bulgular: Hacettepe Üniversitesi Tıp Fakültesi Hastanesi'nden 75, Ankara Üniversitesi Tıp Fakültesi Hastanesi'nden 18, T.C Sağlık Bakanlığı Ankara Hematoloji ve Onkoloji Eğitim ve Araştırma Hastanesi'nden 31, Selçuk Üniversitesi Tıp Fakültesi Hastanesi'nden 51, Süleyman Demirel Üniversitesi Hastanesi'nden 69, Mustafa Kemal Üniversitesi Hastanesi'nden 14, T.C. Sağlık Bakanlığı Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi'nden 9, Ankara Özel Akay Hastanesi'nden 20 olmak üzere toplamda 287 adet grup A beta hemolitik streptokok çalışılmıştır. Suşların eritromisine orta derecede direncinin %2, klindamisine orta derecede direncinin %1.1, azitromisine orta derecede direncinin %1.8 ve klaritromisine orta derecede direncinin %1.8 olduğu saptanmıştır. Grup A beta hemolitik streptokokların %1.3'ünün eritromisine dirençli, %2.8'inin azitromisine dirençli, %1.3'ünün klaritromisine dirençli olduğu belirlenmiştir. Sonuç: Bu çalışma sonuçlarıyla ülkemizde bu dönemde tonsillofarenjit etkeni olan A grubu beta hemolitik streptokoklarda yüksek olduğundan endişe duyulan makrolid direncinin sorun olmadığı ancak aralıklı olarak ülke genelinde ve merkez temelinde de izlenmesi gerektiği görülmüş, buna yönelik mevcut veriler bir an önce paylaşılmak istenmiştir. Çalışma katılan 20 merkezden gelen örneklerle devam etmektedir.Objective: In this study, it is aimed to attain a general opinion about macrolide resistance and its prevalance in group A beta hemolytic Streptococci all over the country by studying isolates of group A beta hemolytic Streptoccocci causing tonsillopharyngitis from 8 centers in Turkey. In this study, the first results of macrolide resistance in a continuing study are reported. Material and Methods: From the first centers, isolates of group A beta hemolytic Streptococci from patients 5-15 years of age, throat cultures were carried via transport medium (blood agar-bacitracin) to Hacettepe University Medical Faculty Hospital and with disc diffusion technique erythromycin, clarithromycin, azithromycine and clindamycin resistance was studied. Results: From Hacettepe University Hospital 75 isolates, from Ankara University Hospital18 isolates, from Ankara Hematology andOncology Hospital 31 isolates, from Sel&ccedil;uk University Hospital 51 isolates, from S&uuml;leyman Demirel University Hospital 69 isolates, from Mustafa Kemal University Hospital 14 isolates, from Bakırk&ouml;y Sadi Konuk Research Hospital 9 isolates and from Ankara Akay Hospital 20 isolates were obtained which yielded 287 group A beta hemolytic Streptococci. Intermediate erythromycin resistance of the strains was 2%, intermediate clindamycin resistance of the strains was 1.1%, intermediate azithromycin resistance of the strains was 1.8% and intermediate clarihtromycin resistance of the strains was 1.8%. Erythromycin resistance of group A beta hemolytic Streptococci was 1.3%, azithromycin resistance of group a beta hemolytic Streptococci was 2.8%, clarithromycin resistance of group A beta hemolytic Streptococci was 1.3%. Conclusion: In this study the anxiety that macrolide resistance of group A beta hemolytic Streptococci in our country is high should not be a serious problem. However macrolide resistance should be followed up intermittently with national and regional studies. Our study is continuing with the isolates from 20 centers and this study is presented to demonstrate pilot findings. (J Pediatr Inf 2011; 5: 96-9

Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy

Background: Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods: The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. Results: A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect. Conclusion: This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region