Clinical Findings, Bacterial Agents, and Antibiotic Resistance in Children with Spontaneous Peritonitis in Southern Iran: An Academic Tertiary Referral Center’s Experience

Background: Spontaneous bacterial peritonitis (SBP) is a fatal complication of ascites fluid infection. The causes of SBP in children differ from those in adults, and these bacteria are frequently resistant to antibiotics. Therefore, this study investigated the clinical findings, bacterial etiology, and antimicrobial resistance in children with SBP.Methods: This study was conducted on all new pediatric ascites patients, who were admitted to the Department of Pediatric Gastroenterology, Namazi Hospital, affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from 2021 to 2022. Required data such as demographic information, and clinical information such as complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Gram staining, blood culture by Automated Blood Culture System (BACTEC), and antibiogram of ascites fluids by disc diffusion method were all collected. Finally, the data were statistically analyzed using SPSS Software (version 26). Besides, the t test, Fisher’s exact, Mann-Whitney, and Chi square tests were used for data analysis. In all tests, P≤0.05 was considered statistically significant.Results: The present study examined 62 children with ascites of which 18 (29%) had SBP. The median (IQR) age was 2.5 (8.1) years. Thirty-four (54.8%) of the participants were girls. Abdominal pain was the most common clinical manifestation in patients (54%), and there was a significant association between abdominal pain and SBP (P=0.02). In 12 positive ascites fluid cultures, coagulase-negative staphylococci had the highest frequency (25%), followed by Escherichia coli (16.7%). Third-generation cephalosporins had a 25% sensitivity in the total positive cultures. This sensitivity was 33.3% for Gram-negative cultures and 16.6% for Gram-positive cultures.Conclusion: Although third-generation cephalosporins are recommended as the primary antibiotic for the empirical treatment of SBP, the present study found high bacterial resistance. Finally, empirical therapy should be tailored to each region’s bacterial resistance features

Train‑the‑trainers in hand hygiene in Iran

Abstract video clip description: Introduction Healthcare associated infections and antimicrobial resistance are two major treats to patient safety and have become more important during COVID-19 pandemic. Objectives Hand hygiene is the best way to prevent these ominous events. Methods We planned two courses of training of infection control Antimicrobial Resistance & Infection Control 2023, 12(Suppl 1):81 Page 198 of 200 nurses and physicians as a standardized approach to training, using a “Train-the-Trainers” (TTT) in Mashhad and Shiraz (two big cities in Iran) during 17–20 April 2017 and 30 October to November 1st 2019. Results During these two courses, we trained 95 IPC professionals in a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. Conclusion The TTT in hand hygiene proved to be effective in increasing knowledge of IPC professionals and to disseminate knowledge to other health care workers.peer-reviewe

The Prevalence of minor congenital anomalies and normal variations in neonates in Bushehr Port

Background: Congenital malformations are a major reason for medical interventions, long-term illness and death. Minor congenital anomaly is not important in appearance and surgical views, and its prevalence in general population is less than 4%, however a normal variation has a prevalence of more than 4% in general population. Methods: In a prospective study from Aug 2002 to Mar 2003, seven hundreds and fifteen (45.45% male and 59.54% female) consecutive newborns in random days were examined for the presence of minor congenital malformations in a university hospital. Results: The overall incidence of minor malformations was 5.03% (55.55% male and 44.46% female p>0.05). 0.28% of neonates had two minor anomalies. The musculoskeletal system (2.25%) was the most common involved system followed by genitourinary system (1.39%), skin (0.99%), ear (0.42%) and nose (0.14%). Mongolian spot (6.01%) and hydrocele (7.69%) were detected as normal variations. The positional clubfoot (1.82%) was the most common minor congenital anomaly followed by undescended tests (1.85% in males) and granular hypospadias (0.92% in males) and sacral dimpling (0.56%). Conclusion: The minor anomalies are detecting in a significant number of neonates in Bushehr Port. Mongolian spot and hydrocele are two normal variations among neonates in Bushehr port

The prevalence of recurrent abdominal pain and some relative factors among children beginning primary school in Bushehr port

Recurrent abdominal pain (RAP) is a common problem in children and adolescence. The functional abdominal pain is the most common cause of RAP. The conceptual models of RAP are multivariate and acknowledge the contributions of a variety of biological, psychological, and social factors. Among the 6-7 year-old population of Bushehr port, 485 (50.1% male, 49.9%female) children starting primary school were randomly selected. Questionnaires were completed by direct interview during the National Program of Health Surveillance of Schoolchildren in 2000. According to Apley's criteria, 49 children had RAP (9.1% male and 11.2% female). Abdominal pain pattern such as frequency, duration, location, radiation, associated symptoms was relatively similar to other investigations. The signs of environmental reinforcement of pain behavior such as specific attention and medication at time of pain were commonly observed (32.6% and 71.4%, respectively). Prolonged duration of involvement (73.5%, more than one year) and frequent referral to physician (30.6%, at least three referral) were detected. Some psychosocial stress such as father unemployment and history of irritable bowel syndrome (IBS) in parents were significantly more frequent in RAP group (p values= 0.038 and 0.01, respectively). History of RAP in siblings and appendectomy, peptic disease and migraine were mildly more frequent in RAP group. Separation of one of the parents, change of address, parent education and mother employment, sibling number and order and weight and height had not significant differences between two groups. Among 22 patients, giardia cyst was detected in the stool of 4 patients (18.2 %). In conclusion, RAP is a common problem in Bushehr port and its pattern was relatively similar to other regions. The father unemployment and the history of IBS in parents, two psychosocial stresses, were associated with RAP

Characterization and phylogenetic analysis of Iranian SARS‐CoV‐2 genomes: A phylogenomic study

Abstract Background and Aim Characterization of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) based on analyzing the evolution and mutations of viruses is crucial for tracking viral infections, potential mutants, and other pathogens. The purpose was to study the complete sequences of SARS‐CoV‐2 to reveal genetic distance and mutation rate among different provinces of Iran. Methods As of March 2020–April 2021, a total of 131 SARS‐CoV‐2 whole genome sequences submitted from Tehran and 133 SARS‐CoV‐2 full‐length sequences from 24 cities with high coverage submitted to EpiCoV GISAID database were analyzed to infer clades and mutation annotation compared with the wild‐type variant Wuhan‐Hu‐1. Results The results of variant annotation were revealed 11,204 and 9468 distinct genomes were identified among the samples from different cities and Tehran, respectively. The phylogenetic analysis of genomic sequences showed the presence of eight GISAID clades, namely GH, GR, O, GRY, G, GK, L, and GV, and six Nextstrain clades; that is, 19A, 20A, 20B, 20I (alpha, V1), 20H (Beta, V2), and 21I (Delta) in Iran. The GH (GISAID clade), 20A (Nextstrain clade), and B.1 (Pango lineage) were predominant in Iran. Notably, analysis of the spike protein revealed D614G mutation (S_D614G) in 56% of the sequences. Also, the delta variant of the coronavirus, the super‐infectious strain that was first identified among the sequences submitted from the southern cities of the country such as Zahedan, Yazd and Bushehr, and most likely from these places to other cities of Iran as well has expanded. Conclusions Our results indicate that most of the circulated viruses in Iran in the early time of the pandemic had collected in eight GISAID clades. Therefore, a continuous and extensive genome sequence analysis would be necessary to understand the genomic epidemiology of SARS‐CoV‐2 in Iran

Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review

Abstract Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence

Autoantibodies in a Three-Year-Old Girl with Visceral Leishmaniasis: A Potential Diagnostic Pitfall

Visceral leishmaniasis (VL), a life-threatening parasitic infection, is endemic in the Mediterranean region. Diagnosis of VL is based on epidemiologic, clinical, and laboratory findings. However, sometimes, clinical features and laboratory findings overlap with those of autoimmune diseases. In some cases, autoantibodies are detected in patients with VL and this could be a potential diagnostic pitfall. In this study, we have reported on a three-year-old girl from a VL-endemic area in Iran, who presented with prolonged fever and splenomegaly. Bone marrow examination, serologic tests, and the molecular PCR assay were performed; however, results were inconclusive. The levels of anti-double stranded DNA, cytoplasmic antineutrophil cytoplasmic autoantibody, and perinuclear antineutrophil cytoplasmic autoantibody were elevated and, at the end, splenic biopsy was performed. The splenic tissue PCR test detected the DNA of Leishmania infantum. The patient’s condition improved with anti-Leishmania therapy, and the autoantibodies disappeared within the following four months. Clinical presentations and laboratory findings of VL and autoimmune diseases may overlap in some patients