Roya Oboodi, Zahra Hashemi, Elham Jaafarzadeh, Negar Yazdani, H. Barzegar
Background: Sepsis is a leading cause of morbidity and mortality in neonates. Objectives: This study aimed to investigate the bacterial profile and antibiotic sensitivity in infants with sepsis. Methods: This cross-sectional study was conducted on 90 neonates with sepsis admitted to the neonatal intensive care unit of Namazi Hospital, a tertiary-level hospital, in Shiraz, Iran, from 2020 to 2021. Demographic and clinical data including gestational age, previous diseases, maternal infectious, underlying diseases, history and duration of premature rupture of the membrane and delivery, clinical symptoms (fever, reduced breastfeeding, and lethargy), laboratory results (complete blood cell and C-reactive protein), and results of blood and urine cultures were recorded and analyzed. Results: Among 90 neonates with sepsis, the average age was 6.7 ± 7.6 days; 54 were male (60.0%), and 36 were female (40.0%). Fifty (55.5%) neonates had early sepsis. Gram-negative organisms were grown in 61% of positive blood cultures; the most common was Klebsiella. Among Gram-positive organisms, Staphylococcus epidermidis was the most common. Most organisms were sensitive to colistin, and most were resistant to cefotaxime. There was a significant relationship between the age of onset of sepsis symptoms and birth weight in infants with positive blood cultures (P = 0.004) (r = 0.3). Conclusions: Gram-negative bacteria are the most common causes of sepsis, mainly resistant to aminoglycosides and cefotaxime. Therefore, increasing awareness about the optimal use of antibiotics is necessary to curb the increase in resistance levels.
{"title":"Bacterial Etiology and Antibiotic Susceptibility Profile in Neonatal Sepsis","authors":"Roya Oboodi, Zahra Hashemi, Elham Jaafarzadeh, Negar Yazdani, H. Barzegar","doi":"10.5812/apid-136487","DOIUrl":"https://doi.org/10.5812/apid-136487","url":null,"abstract":"Background: Sepsis is a leading cause of morbidity and mortality in neonates. Objectives: This study aimed to investigate the bacterial profile and antibiotic sensitivity in infants with sepsis. Methods: This cross-sectional study was conducted on 90 neonates with sepsis admitted to the neonatal intensive care unit of Namazi Hospital, a tertiary-level hospital, in Shiraz, Iran, from 2020 to 2021. Demographic and clinical data including gestational age, previous diseases, maternal infectious, underlying diseases, history and duration of premature rupture of the membrane and delivery, clinical symptoms (fever, reduced breastfeeding, and lethargy), laboratory results (complete blood cell and C-reactive protein), and results of blood and urine cultures were recorded and analyzed. Results: Among 90 neonates with sepsis, the average age was 6.7 ± 7.6 days; 54 were male (60.0%), and 36 were female (40.0%). Fifty (55.5%) neonates had early sepsis. Gram-negative organisms were grown in 61% of positive blood cultures; the most common was Klebsiella. Among Gram-positive organisms, Staphylococcus epidermidis was the most common. Most organisms were sensitive to colistin, and most were resistant to cefotaxime. There was a significant relationship between the age of onset of sepsis symptoms and birth weight in infants with positive blood cultures (P = 0.004) (r = 0.3). Conclusions: Gram-negative bacteria are the most common causes of sepsis, mainly resistant to aminoglycosides and cefotaxime. Therefore, increasing awareness about the optimal use of antibiotics is necessary to curb the increase in resistance levels.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"24 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The sudden spread of COVID-19 raised significant concerns about the potential impact of the pandemic on healthcare systems in low- and middle-income nations. The length of hospital stay is a critical health metric with far-reaching implications in healthcare systems and a matter of resource allocation. Hospital beds, ventilators, medications, and the invaluable time and expertise of medical professionals are all finite resources. Understanding the factors influencing the length of hospitalization is essential for the efficient allocation of these resources and the provision of high-quality care. Objectives: To explore the demographic features and clinical presentations of COVID-19 patients and investigate the relationship between patient characteristics and hospitalization length by employing advanced statistical models. Methods: This was a retrospective study in Bam City, Kerman province, on 2096 patients who were admitted to the Pastor Hospital of Bam City with the diagnosis of COVID-19 between March and September 2021. The criterion for inclusion was either laboratory confirmation of SARS-CoV-2 infection by swab sampling or clinical diagnosis. No exclusion criteria were applied. Several variables, including age, gender, history of drug abuse, comorbid diseases, chronic illnesses, and clinical symptoms were gathered. A univariate analysis was performed, and significant parameters were subsequently included in the final multivariable model. We used SPSS 22, STATA 13, and R 4.1.3 software for statistical analysis. Results: A total of 2096 patients admitted to the Pastor Hospital of Bam City from March to September 2021 diagnosed with COVID-19 were included in this study. The results of a negative binomial regression model showed that the factors affecting hospitalization length in COVID-19 patients were advanced age, male gender, contact with COVID-19 patients, PO2, body temperature, cancer, fever, heart disease, coughing severity, and respiratory distress. Conclusions: Elder COVID-19 patients had relatively longer hospitalization periods. Moreover, hospitalization duration was longer in males, those who had contact with a COVID-19 patient, and patients with PO2 below 93 %, higher body temperature and fever, coughing, respiratory distress, heart diseases, and cancer compared to others. Therefore, it is recommended to monitor COVID-19 patients with heart disease and cancer more cautiously. Investigating the factors associated with long hospitalization is important for the suitable management of available resources and demands for hospital beds.
{"title":"Factors Affecting the Length of Hospital Stay in COVID-19 Patients: A Retrospective Study in Bam City, Iran","authors":"Seyed Mojtaba Mortazavi, Maryam Jalali, Rezvan Bagheri, Faezeh Rezaei Fard, Ali Radfar, Samane Nematolahi","doi":"10.5812/apid-140944","DOIUrl":"https://doi.org/10.5812/apid-140944","url":null,"abstract":"Background: The sudden spread of COVID-19 raised significant concerns about the potential impact of the pandemic on healthcare systems in low- and middle-income nations. The length of hospital stay is a critical health metric with far-reaching implications in healthcare systems and a matter of resource allocation. Hospital beds, ventilators, medications, and the invaluable time and expertise of medical professionals are all finite resources. Understanding the factors influencing the length of hospitalization is essential for the efficient allocation of these resources and the provision of high-quality care. Objectives: To explore the demographic features and clinical presentations of COVID-19 patients and investigate the relationship between patient characteristics and hospitalization length by employing advanced statistical models. Methods: This was a retrospective study in Bam City, Kerman province, on 2096 patients who were admitted to the Pastor Hospital of Bam City with the diagnosis of COVID-19 between March and September 2021. The criterion for inclusion was either laboratory confirmation of SARS-CoV-2 infection by swab sampling or clinical diagnosis. No exclusion criteria were applied. Several variables, including age, gender, history of drug abuse, comorbid diseases, chronic illnesses, and clinical symptoms were gathered. A univariate analysis was performed, and significant parameters were subsequently included in the final multivariable model. We used SPSS 22, STATA 13, and R 4.1.3 software for statistical analysis. Results: A total of 2096 patients admitted to the Pastor Hospital of Bam City from March to September 2021 diagnosed with COVID-19 were included in this study. The results of a negative binomial regression model showed that the factors affecting hospitalization length in COVID-19 patients were advanced age, male gender, contact with COVID-19 patients, PO2, body temperature, cancer, fever, heart disease, coughing severity, and respiratory distress. Conclusions: Elder COVID-19 patients had relatively longer hospitalization periods. Moreover, hospitalization duration was longer in males, those who had contact with a COVID-19 patient, and patients with PO2 below 93 %, higher body temperature and fever, coughing, respiratory distress, heart diseases, and cancer compared to others. Therefore, it is recommended to monitor COVID-19 patients with heart disease and cancer more cautiously. Investigating the factors associated with long hospitalization is important for the suitable management of available resources and demands for hospital beds.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"6 2","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farinaz Saeidi, Atousa Kialashaki, Ali Sadighi, Ali Bahadori, S. Valizadeh, Mohammadbagher Hosseini, Mohammad Taha Saadati Rad, Mina Owrang
Background: Sepsis is one of the most dangerous neonatal infections. Bacterial causes of neonatal septicemia are different. Objectives: This study aimed to investigate the prevalence and antibiotic resistance pattern of microbial agents causing preterm neonatal sepsis. Methods: This descriptive study was performed on 1000 infants admitted to neonatal intensive care units 1 and 2 and the neonatal ward of Al-Zahra Medical Center in Tabriz, Iran, from March 2019 to June 2020. Sampling was completed through the convenience sampling method. Data were collected using a researcher-made questionnaire after evaluating its validity and reliability. The questionnaire included personal information of neonates, causes of infection, antibiotic use, hospitalization time, and medication resistance pattern. Antibiotic susceptibility testing was performed by disk diffusion technique according to the Clinical and Laboratory Standards Institute guidelines. SPSS software version 22 was used for data analysis. Results: Among all studied neonates, 78 cases (7.8%) had positive blood cultures. The most common cause of neonatal infection was preterm birth (80.8%), and the most common bacterial causes of sepsis were coagulase-negative Staphylococcus (46.15) and Klebsiella pneumonia (28.2%). The highest antibiotic susceptibility of Gram-positive (coagulase-negative Staphylococcus) and Gram-negative bacteria was to ceftriaxone (47.3%) and piperacillin/tazobactam (100%), respectively, and the highest antibiotic resistance was to ampicillin and gentamicin (nearly 100%). Conclusions: Resistance to antibiotics used to treat sepsis has increased, which will cause irreparable problems in the treatment of preterm neonates if not addressed. Due to different microbial agents and drug resistance patterns in distinct regions, annual surveys should be conducted to determine drug resistance patterns, emphasizing preventive measures.
{"title":"A Survey of the Prevalence Rate and Antibiotic Resistance Pattern of Microbial Agents in Preterm Neonatal Sepsis","authors":"Farinaz Saeidi, Atousa Kialashaki, Ali Sadighi, Ali Bahadori, S. Valizadeh, Mohammadbagher Hosseini, Mohammad Taha Saadati Rad, Mina Owrang","doi":"10.5812/apid-137546","DOIUrl":"https://doi.org/10.5812/apid-137546","url":null,"abstract":"Background: Sepsis is one of the most dangerous neonatal infections. Bacterial causes of neonatal septicemia are different. Objectives: This study aimed to investigate the prevalence and antibiotic resistance pattern of microbial agents causing preterm neonatal sepsis. Methods: This descriptive study was performed on 1000 infants admitted to neonatal intensive care units 1 and 2 and the neonatal ward of Al-Zahra Medical Center in Tabriz, Iran, from March 2019 to June 2020. Sampling was completed through the convenience sampling method. Data were collected using a researcher-made questionnaire after evaluating its validity and reliability. The questionnaire included personal information of neonates, causes of infection, antibiotic use, hospitalization time, and medication resistance pattern. Antibiotic susceptibility testing was performed by disk diffusion technique according to the Clinical and Laboratory Standards Institute guidelines. SPSS software version 22 was used for data analysis. Results: Among all studied neonates, 78 cases (7.8%) had positive blood cultures. The most common cause of neonatal infection was preterm birth (80.8%), and the most common bacterial causes of sepsis were coagulase-negative Staphylococcus (46.15) and Klebsiella pneumonia (28.2%). The highest antibiotic susceptibility of Gram-positive (coagulase-negative Staphylococcus) and Gram-negative bacteria was to ceftriaxone (47.3%) and piperacillin/tazobactam (100%), respectively, and the highest antibiotic resistance was to ampicillin and gentamicin (nearly 100%). Conclusions: Resistance to antibiotics used to treat sepsis has increased, which will cause irreparable problems in the treatment of preterm neonates if not addressed. Due to different microbial agents and drug resistance patterns in distinct regions, annual surveys should be conducted to determine drug resistance patterns, emphasizing preventive measures.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"117 46","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138607563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There is a lack of conclusive evidence regarding thyroid function test (TFT) abnormalities in COVID-19, especially among children. Objectives: This study aimed to investigate TFT abnormalities in COVID-19 pediatric patients compared to healthy children. Methods: This study was conducted on 37 COVID-19-positive children who were admitted to Namazi Hospital from January 21 to March 1, 2022, compared with 37 healthy children. Within 48 h of positive real-time polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2, a blood sample was taken to measure serum levels of thyroid-stimulating hormone (TSH) and total thyroxine (tT4) in the two groups. Additional tests, including free and total triiodothyronine, free T4, and thyroperoxidase antibodies, were also conducted on cases. The chi-square, Pearson correlation coefficient, and analysis of variance tests were used for data analysis. Results: Twenty-five patients were male, and 49 were female, with a mean age of 7.99 ± 5.02. The abnormal TFT and TSH frequency was significantly higher in the case group than in the control group. Nevertheless, there was no significant difference between the case and control groups regarding tT4 abnormalities. We could not establish an association between the mean of TSH and tT4 and age groups in the two groups and between abnormalities of TFTs and COVID-19 severity. Conclusions: Although abnormalities of TFT were significantly more common among COVID-19 children, they were not associated with the disease severity. However, studies with larger sample sizes are recommended to evaluate thyroid abnormalities and their clinical course in COVID-19 children.
{"title":"Thyroid Function Test Abnormalities in Children and Adolescents with COVID-19: A Case-Control Study","authors":"Zhila Afshar, Keivan Sahebi, Hassan Foroozand, Negar Yazdani, Sedighe Hamzavi, Hossein Moravej, Homa Ilkhanipoor, Anis Amirhakim","doi":"10.5812/apid-136044","DOIUrl":"https://doi.org/10.5812/apid-136044","url":null,"abstract":"Background: There is a lack of conclusive evidence regarding thyroid function test (TFT) abnormalities in COVID-19, especially among children. Objectives: This study aimed to investigate TFT abnormalities in COVID-19 pediatric patients compared to healthy children. Methods: This study was conducted on 37 COVID-19-positive children who were admitted to Namazi Hospital from January 21 to March 1, 2022, compared with 37 healthy children. Within 48 h of positive real-time polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus 2, a blood sample was taken to measure serum levels of thyroid-stimulating hormone (TSH) and total thyroxine (tT4) in the two groups. Additional tests, including free and total triiodothyronine, free T4, and thyroperoxidase antibodies, were also conducted on cases. The chi-square, Pearson correlation coefficient, and analysis of variance tests were used for data analysis. Results: Twenty-five patients were male, and 49 were female, with a mean age of 7.99 ± 5.02. The abnormal TFT and TSH frequency was significantly higher in the case group than in the control group. Nevertheless, there was no significant difference between the case and control groups regarding tT4 abnormalities. We could not establish an association between the mean of TSH and tT4 and age groups in the two groups and between abnormalities of TFTs and COVID-19 severity. Conclusions: Although abnormalities of TFT were significantly more common among COVID-19 children, they were not associated with the disease severity. However, studies with larger sample sizes are recommended to evaluate thyroid abnormalities and their clinical course in COVID-19 children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"33 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The urachus is a duct that connects the allantois to the urinary bladder in the fetus. Partial or total obliteration failure of the urachus leads to various anomalies, which can be discovered in children and adults. Case Presentation: A 12-year-old boy presented with recurrent fever and abdominal pain two years ago. In the physical examination, he had tenderness in the lumbosacral area and Achilles tendons. Enthesitis-related arthritis (ERA), inflammatory bowel disease (IBD), and familial Mediterranean fever (FMF) were considered differential diagnoses. The patient was treated with a naproxen anti-inflammatory dose. After 15 months, his mother reported a bad odor discharge from his umbilical area. Investigations revealed patent urachus, and he underwent an operation that confirmed the diagnosis and resolved the patient's complaints.
{"title":"Recurrent Fever and Abdominal Pain: Periodic Fever Syndrome, Inflammatory Bowel Disease or Patent Urachus; A Case Report","authors":"Khosro Rhmani, Mohsen Jari, Reza Shiari, Mehrnoush Hassas Yeganeh, Vadood Javadi","doi":"10.5812/apid-139427","DOIUrl":"https://doi.org/10.5812/apid-139427","url":null,"abstract":"Introduction: The urachus is a duct that connects the allantois to the urinary bladder in the fetus. Partial or total obliteration failure of the urachus leads to various anomalies, which can be discovered in children and adults. Case Presentation: A 12-year-old boy presented with recurrent fever and abdominal pain two years ago. In the physical examination, he had tenderness in the lumbosacral area and Achilles tendons. Enthesitis-related arthritis (ERA), inflammatory bowel disease (IBD), and familial Mediterranean fever (FMF) were considered differential diagnoses. The patient was treated with a naproxen anti-inflammatory dose. After 15 months, his mother reported a bad odor discharge from his umbilical area. Investigations revealed patent urachus, and he underwent an operation that confirmed the diagnosis and resolved the patient's complaints.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"3 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135774082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The widespread use of carbapenems increased the prevalence of Carbapenem-resistant Enterobacteriaceae with subsequent increases in mortality due to extremely limited treatment options. Following neurosurgical procedures, carbapenem-resistant Klebsiella pneumoniae (CRKP) is the main cause of central nervous system (CNS) infections. The optimal antimicrobial treatment of such infections has not yet been defined. Case Presentation: We present a 4-month-old boy with an extra-ventricular drain-related central nervous system (CNS) infection with CRKP. Although meropenem minimum inhibitory concentration (MIC) for the bacterial isolate was ≥ 16 mg/L and it harbored blaNDM, blaVIM, and blaOXA-48-like Carbapenemase genes, this infection was effectively treated with a combination therapy of intravenous (IV) double dose extended infusion of meropenem in addition to amikacin. Conclusions: This successful treatment regimen for CRKP-causing meningitis may pave the way to manage severe CNS infections with extensive-drug-resistant bacteria in infants and children without inserting an external drain or intra-thecal antibiotic administration.
{"title":"Successful Treatment of Carbapenem-Resistant Klebsiella pneumoniae Meningitis with Combination Therapy of Meropenem and Amikacin","authors":"Eman Hamza, Shahinda Rezk, Hassan Eshra, Heba Selim, Mohamed Samir Turkey","doi":"10.5812/apid-140658","DOIUrl":"https://doi.org/10.5812/apid-140658","url":null,"abstract":"Introduction: The widespread use of carbapenems increased the prevalence of Carbapenem-resistant Enterobacteriaceae with subsequent increases in mortality due to extremely limited treatment options. Following neurosurgical procedures, carbapenem-resistant Klebsiella pneumoniae (CRKP) is the main cause of central nervous system (CNS) infections. The optimal antimicrobial treatment of such infections has not yet been defined. Case Presentation: We present a 4-month-old boy with an extra-ventricular drain-related central nervous system (CNS) infection with CRKP. Although meropenem minimum inhibitory concentration (MIC) for the bacterial isolate was ≥ 16 mg/L and it harbored blaNDM, blaVIM, and blaOXA-48-like Carbapenemase genes, this infection was effectively treated with a combination therapy of intravenous (IV) double dose extended infusion of meropenem in addition to amikacin. Conclusions: This successful treatment regimen for CRKP-causing meningitis may pave the way to manage severe CNS infections with extensive-drug-resistant bacteria in infants and children without inserting an external drain or intra-thecal antibiotic administration.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"7 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135868385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salimeh Noorbakhsh, Fahimeh Ehsanipour, Behnam Sobouti, Behzad Haghighi Aski, Mohammad Faranoush, Ashraf Mousavi, Amir Ghadipasha, Zahra Sadr
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the recent pandemic. According to published reports, respiratory symptoms, such as pneumonia and inflammatory conditions, are common in this disease. Objectives: The current study aimed to investigate the level of antiphospholipid (aPL) antibodies in children with and without coronavirus disease 2019 (COVID-19). Methods: This descriptive-analytic cross-sectional study was conducted on patients under 16 years of age with and without COVID-19 admitted to Ali Asghar Hospital between December 2021 and February 2022. Patient information was collected by the researcher in a checklist. The checklist included demographic information, clinical findings, and information on laboratory and ultrasound results. Results: In this study, 99 patients were evaluated in three groups: control (without COVID-19), moderate, and severe. The means (standard deviation [SD]) of C-reactive protein (CRP) and D-dimer were significantly higher in the severe group. The Pearson correlation coefficient test was used to examine the relationship between aPL and anticardiolipin (aCL) antibodies with laboratory results. The only significant and direct relationship was observed between aCL antibody and D-dimer. Conclusions: Increased CRP and D-dimer in children with COVID-19 are associated with the severe form of this serious disease. However, there was no significant association between the severity of the disease and the levels of aCL and aPL antibodies and anti-beta 2-glycoprotein I antibodies (aβ2GPI) in children.
{"title":"Comparison of Antiphospholipid Antibody Levels in Children with and Without COVID-19","authors":"Salimeh Noorbakhsh, Fahimeh Ehsanipour, Behnam Sobouti, Behzad Haghighi Aski, Mohammad Faranoush, Ashraf Mousavi, Amir Ghadipasha, Zahra Sadr","doi":"10.5812/apid-133851","DOIUrl":"https://doi.org/10.5812/apid-133851","url":null,"abstract":"Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the recent pandemic. According to published reports, respiratory symptoms, such as pneumonia and inflammatory conditions, are common in this disease. Objectives: The current study aimed to investigate the level of antiphospholipid (aPL) antibodies in children with and without coronavirus disease 2019 (COVID-19). Methods: This descriptive-analytic cross-sectional study was conducted on patients under 16 years of age with and without COVID-19 admitted to Ali Asghar Hospital between December 2021 and February 2022. Patient information was collected by the researcher in a checklist. The checklist included demographic information, clinical findings, and information on laboratory and ultrasound results. Results: In this study, 99 patients were evaluated in three groups: control (without COVID-19), moderate, and severe. The means (standard deviation [SD]) of C-reactive protein (CRP) and D-dimer were significantly higher in the severe group. The Pearson correlation coefficient test was used to examine the relationship between aPL and anticardiolipin (aCL) antibodies with laboratory results. The only significant and direct relationship was observed between aCL antibody and D-dimer. Conclusions: Increased CRP and D-dimer in children with COVID-19 are associated with the severe form of this serious disease. However, there was no significant association between the severity of the disease and the levels of aCL and aPL antibodies and anti-beta 2-glycoprotein I antibodies (aβ2GPI) in children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136157142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Antibiotics should be used to treat bacterial infections, while prescribing antibiotics for viral infections is ineffective. Sometimes, physicians do not diagnose diseases correctly and misdiagnose viral infections as bacterial. Objectives: In this study, we aimed to evaluate the appropriateness of prescribed antibiotics in the Children’s Emergency Department of Mofid Hospital, Tehran, Iran. Methods: This cross-sectional study was conducted in the Emergency Department of Mofid Children's Hospital during January-December 2019. All children younger than 16 years who were hospitalized and received antibiotics were included in this study. The degree of fever, diagnosis of disease, and laboratory findings were assessed. Results: We found 12.6% (38/301) inappropriate antibiotic prescriptions in the studied cases. The causes of antibiotic inappropriateness were incorrect diagnosis in 4.31% of patients (13/301), incorrect medication dose in 1.99% (6/301) patients, and no indication for the prescribed medicine in 6.31% (19/301) patients. Erythrocyte sedimentation rate, C-reactive protein, and neutrophil count were not significantly different between the two groups (P > 0.05). Conclusions: According to our results, incorrect antibiotic prescription is common in Mofid Hospital. Therefore, it is an urgent need to monitor and train the treatment system.
{"title":"Appropriateness of Antibiotic Prescribing in the Emergency Department of Mofid Children's Hospital: A Retrospective Cross-Sectional Study","authors":"Fereshteh Karbasian, Anahita Dorrani Bakhsh, Bahador Mirrahimi, Shahnaz Armin","doi":"10.5812/apid-136149","DOIUrl":"https://doi.org/10.5812/apid-136149","url":null,"abstract":"Background: Antibiotics should be used to treat bacterial infections, while prescribing antibiotics for viral infections is ineffective. Sometimes, physicians do not diagnose diseases correctly and misdiagnose viral infections as bacterial. Objectives: In this study, we aimed to evaluate the appropriateness of prescribed antibiotics in the Children’s Emergency Department of Mofid Hospital, Tehran, Iran. Methods: This cross-sectional study was conducted in the Emergency Department of Mofid Children's Hospital during January-December 2019. All children younger than 16 years who were hospitalized and received antibiotics were included in this study. The degree of fever, diagnosis of disease, and laboratory findings were assessed. Results: We found 12.6% (38/301) inappropriate antibiotic prescriptions in the studied cases. The causes of antibiotic inappropriateness were incorrect diagnosis in 4.31% of patients (13/301), incorrect medication dose in 1.99% (6/301) patients, and no indication for the prescribed medicine in 6.31% (19/301) patients. Erythrocyte sedimentation rate, C-reactive protein, and neutrophil count were not significantly different between the two groups (P > 0.05). Conclusions: According to our results, incorrect antibiotic prescription is common in Mofid Hospital. Therefore, it is an urgent need to monitor and train the treatment system.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"24 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136233721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study aimed to examine the correlation between the pediatric assessment triangle (PAT) and the rate of hospitalization among pediatric patients. Patients presenting to the pediatric emergency department were categorized based on PAT criteria during the study period, and retrospective data analysis was conducted. The primary outcome measure was the percentage of patients with PAT findings who required hospital admission; however, the secondary outcome measure focused on the association between PAT findings and admission to the pediatric intensive care unit (PICU) and the comparison between hospitalization rates with disrupted PAT versus blood testing as the initial diagnostic step. Methods: In this study, 622 patients were enrolled, and among them, 246 patients (39.5%) had normal findings in the peripheral arterial tonometry (PAT) test. The researchers conducted both univariate and multivariate analyses to investigate the relationship between PAT results and hospitalization. They also examined the association between hospitalization and abnormal findings in more than one component of PAT, presentation at the emergency department, performance of blood tests showing abnormalities in more than one component, and appearance while accounting for potential confounding factors. By adjusting for these confounders, the researchers aimed to assess the independent impact of PAT on hospitalization risk and identify any significant associations. Results: The study revealed a strong association between impaired PAT findings and hospitalization, both in univariate and multivariate analyses. Abnormal findings in >1 component of PAT, appearance in the emergency department, and abnormal findings in >1 component of blood tests were the most significant factors related to hospitalization, even after adjusting for confounders. Conversely, normal PAT findings showed no association with either the primary or secondary outcomes. Furthermore, hospitalization rates differed significantly between patients with impaired PAT and those with normal PAT. Conclusions: Impaired PAT findings, when utilized by pediatricians, are associated with increased hospitalization rates, even during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Moreover, it is crucial to emphasize physician training in utilizing PAT effectively as the initial step in evaluating pediatric patients in the emergency room, potentially reducing the need for additional costly testing and enabling physicians to make more confident decisions.
{"title":"Assessment of the Value of the PAT as the First Step in the Triage Process in a Pediatric Emergency Room","authors":"Masoumeh Ahmadi, Hojjat Derakhshanfar, Shamila Noori","doi":"10.5812/apid-128551","DOIUrl":"https://doi.org/10.5812/apid-128551","url":null,"abstract":"Background: This study aimed to examine the correlation between the pediatric assessment triangle (PAT) and the rate of hospitalization among pediatric patients. Patients presenting to the pediatric emergency department were categorized based on PAT criteria during the study period, and retrospective data analysis was conducted. The primary outcome measure was the percentage of patients with PAT findings who required hospital admission; however, the secondary outcome measure focused on the association between PAT findings and admission to the pediatric intensive care unit (PICU) and the comparison between hospitalization rates with disrupted PAT versus blood testing as the initial diagnostic step. Methods: In this study, 622 patients were enrolled, and among them, 246 patients (39.5%) had normal findings in the peripheral arterial tonometry (PAT) test. The researchers conducted both univariate and multivariate analyses to investigate the relationship between PAT results and hospitalization. They also examined the association between hospitalization and abnormal findings in more than one component of PAT, presentation at the emergency department, performance of blood tests showing abnormalities in more than one component, and appearance while accounting for potential confounding factors. By adjusting for these confounders, the researchers aimed to assess the independent impact of PAT on hospitalization risk and identify any significant associations. Results: The study revealed a strong association between impaired PAT findings and hospitalization, both in univariate and multivariate analyses. Abnormal findings in >1 component of PAT, appearance in the emergency department, and abnormal findings in >1 component of blood tests were the most significant factors related to hospitalization, even after adjusting for confounders. Conversely, normal PAT findings showed no association with either the primary or secondary outcomes. Furthermore, hospitalization rates differed significantly between patients with impaired PAT and those with normal PAT. Conclusions: Impaired PAT findings, when utilized by pediatricians, are associated with increased hospitalization rates, even during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Moreover, it is crucial to emphasize physician training in utilizing PAT effectively as the initial step in evaluating pediatric patients in the emergency room, potentially reducing the need for additional costly testing and enabling physicians to make more confident decisions.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"39 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136158472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Enterobacter sakazakii is considered a rare yet extremely important cause of enterocolitis and may lead to a necrotizing condition. Central nervous system and blood infections with this type of organism will be fatal, with a mortality rate of as much as 40 - 80%. Case Presentation: Our case report is a 31-month-old boy with a history of posterior urethral valves surgery presented to the emergency department with a history of dysuria, dribbling, and a 24-hour history of fever, chill, and anorexia. The case had a urinary tract infection diagnosis with E. sakazakii. Conclusions: E. sakazakii can cause bacteremia, meningitis, and necrotizing enterocolitis, but E. sakazakii causes rare literature about urinary tract infection (UTI). We have reported a rare Enterobacter sakazakii infection in the present study.
{"title":"Urinary Tract Infection by Enterobacter sakazakii: A Case Report","authors":"Masoud Rezagholizamenjany, Parsa Yousefichaijan","doi":"10.5812/apid-131390","DOIUrl":"https://doi.org/10.5812/apid-131390","url":null,"abstract":"Introduction: Enterobacter sakazakii is considered a rare yet extremely important cause of enterocolitis and may lead to a necrotizing condition. Central nervous system and blood infections with this type of organism will be fatal, with a mortality rate of as much as 40 - 80%. Case Presentation: Our case report is a 31-month-old boy with a history of posterior urethral valves surgery presented to the emergency department with a history of dysuria, dribbling, and a 24-hour history of fever, chill, and anorexia. The case had a urinary tract infection diagnosis with E. sakazakii. Conclusions: E. sakazakii can cause bacteremia, meningitis, and necrotizing enterocolitis, but E. sakazakii causes rare literature about urinary tract infection (UTI). We have reported a rare Enterobacter sakazakii infection in the present study.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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