Pub Date : 2023-04-30DOI: 10.5812/pedinfect-135494
H. Hashemian, Seyyed Shams, Soodeh Salehi, N. Dara, S. Maroufizadeh, Afagh Hassanzadehrad, Mohammad Ali Esfandiari, Setila Dalili
Background: Some studies have shown that low vitamin D is a risk factor for infectious diarrhea, but some have rejected it. Objectives: Considering the high prevalence of infectious diarrhea among children, the high prevalence of vitamin D deficiency, and the possible mutual effect of these two, the present study aimed to measure vitamin D in children with acute diarrhea. Methods: This study enrolled 222 children aged 2 - 14 in healthy control and acute diarrhea groups. The 25-hydroxyvitamin D (25(OH)D) level was measured in all samples by the Chemiluminescent Immunoassays (CLIA) method. Results: The mean age of the participants was 5 ± 2.7 years. Patients with acute diarrhea had lower vitamin D than healthy controls (P = 0.04). The frequency of deficient and insufficient vitamin D levels was higher in the acute diarrhea group than in the healthy control group, but insignificantly (P = 0.146). Conclusions: The present study revealed an association between insufficient vitamin D and acute diarrhea. Hence, low vitamin D is a risk factor for acute diarrhea.
{"title":"Is There a Correlation Between Vitamin D Levels and Acute Diarrhea in Children?","authors":"H. Hashemian, Seyyed Shams, Soodeh Salehi, N. Dara, S. Maroufizadeh, Afagh Hassanzadehrad, Mohammad Ali Esfandiari, Setila Dalili","doi":"10.5812/pedinfect-135494","DOIUrl":"https://doi.org/10.5812/pedinfect-135494","url":null,"abstract":"Background: Some studies have shown that low vitamin D is a risk factor for infectious diarrhea, but some have rejected it. Objectives: Considering the high prevalence of infectious diarrhea among children, the high prevalence of vitamin D deficiency, and the possible mutual effect of these two, the present study aimed to measure vitamin D in children with acute diarrhea. Methods: This study enrolled 222 children aged 2 - 14 in healthy control and acute diarrhea groups. The 25-hydroxyvitamin D (25(OH)D) level was measured in all samples by the Chemiluminescent Immunoassays (CLIA) method. Results: The mean age of the participants was 5 ± 2.7 years. Patients with acute diarrhea had lower vitamin D than healthy controls (P = 0.04). The frequency of deficient and insufficient vitamin D levels was higher in the acute diarrhea group than in the healthy control group, but insignificantly (P = 0.146). Conclusions: The present study revealed an association between insufficient vitamin D and acute diarrhea. Hence, low vitamin D is a risk factor for acute diarrhea.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47151805","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}
Pub Date : 2023-04-09DOI: 10.5812/pedinfect-135011
A. Nasser, M. M. Soltan Dallal, A. Rahimi Foroushani, J. Yavarian
Objectives: The purpose of this study is to determine the viability of enterotoxigenic Escherichia coli (ETEC) in a sample of diarrhea. The investigation focuses specifically on the lt gene and utilizes propidium monoazide (PMA) and quantitative real-time polymerase chain reaction (qPCR) to differentiate between live and dead bacteria. Methods: Propidium monoazide is a chemical that can bind to and inhibit the amplification of free DNA during qPCR analysis. In this study, in addition to analyzing diarrhea samples, artificially spiked samples were used to assess the sensitivity and accuracy of the PMA treatment. The qPCR results were compared to the gold standard of culture-based methods both with and without PMA treatment. Results: The method’s limit of detection was 8 CFU/mL, and it exhibited linearity from a 10-1 to a 10-9 dilution. The qPCR approach revealed a higher bacterial count than the culture method due to the detection of DNA released from dead bacteria. However, when PMA was employed, the bacterial count was similar to that obtained using colony count agar, which is attributed to the elimination of free DNA during investigation. Conclusions: The present study developed a PMA-based qPCR approach that enables the detection of live bacterial DNA. This method involves PMA and real-time PCR and offers several advantages, including faster detection times (a few hours vs. several days with the traditional culture method) and the ability to exclusively detect live bacteria without interference from free DNA released by dead bacteria. Additionally, the use of real-time PCR enables precise quantification of the live bacterial load. Overall, this approach is cost-effective, rapid, highly sensitive, and specific, making it a valuable tool for various applications.
{"title":"Effect of Propidium Monoazide in the Detection of Enterotoxigenic Escherichia coli in the Pediatric","authors":"A. Nasser, M. M. Soltan Dallal, A. Rahimi Foroushani, J. Yavarian","doi":"10.5812/pedinfect-135011","DOIUrl":"https://doi.org/10.5812/pedinfect-135011","url":null,"abstract":"Objectives: The purpose of this study is to determine the viability of enterotoxigenic Escherichia coli (ETEC) in a sample of diarrhea. The investigation focuses specifically on the lt gene and utilizes propidium monoazide (PMA) and quantitative real-time polymerase chain reaction (qPCR) to differentiate between live and dead bacteria. Methods: Propidium monoazide is a chemical that can bind to and inhibit the amplification of free DNA during qPCR analysis. In this study, in addition to analyzing diarrhea samples, artificially spiked samples were used to assess the sensitivity and accuracy of the PMA treatment. The qPCR results were compared to the gold standard of culture-based methods both with and without PMA treatment. Results: The method’s limit of detection was 8 CFU/mL, and it exhibited linearity from a 10-1 to a 10-9 dilution. The qPCR approach revealed a higher bacterial count than the culture method due to the detection of DNA released from dead bacteria. However, when PMA was employed, the bacterial count was similar to that obtained using colony count agar, which is attributed to the elimination of free DNA during investigation. Conclusions: The present study developed a PMA-based qPCR approach that enables the detection of live bacterial DNA. This method involves PMA and real-time PCR and offers several advantages, including faster detection times (a few hours vs. several days with the traditional culture method) and the ability to exclusively detect live bacteria without interference from free DNA released by dead bacteria. Additionally, the use of real-time PCR enables precise quantification of the live bacterial load. Overall, this approach is cost-effective, rapid, highly sensitive, and specific, making it a valuable tool for various applications.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49443649","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}
Pub Date : 2023-04-08DOI: 10.5812/pedinfect-132673
Maryam Mollaie, A. Mirahmadizadeh, Anahita Sanaei Dashti, Amir Hossein Jalalpour, Khoubyar Jafari
Background: Of all teenage deaths caused by coronavirus disease 2019 (COVID-19), 47% occurred in children aged 0 - 9. Like many other infectious diseases, reducing mortality in children requires widespread vaccination. Despite the availability of the COVID-19 vaccine, a large percentage of children have not received the vaccine. Objectives: This survey aimed to study parents’ reluctance to receive the COVID-19 vaccine for their children in Shiraz, Iran. Methods: An online questionnaire was sent to parents whose 5 to 11-year-old children had received no COVID-9 vaccine through the health educators of primary schools in Shiraz, Iran. The questionnaire contained demographic questions and 16 beliefs about COVID-19 vaccination that were answered as yes/no. Results: We assessed 1093 respondents, including 49.5% (n = 542) male and 50.5% female students’ parents. The mean number of wrong beliefs was 7.21 ± 2.80 in parents who had boys and 7.78 ± 2.95 in girls’ parents. Also, 78.6% of participants had at least five wrong beliefs or excuses for not vaccinating their children. Notably, 82.8% of mothers and 84.3% of fathers were vaccinated with 2 - 3 doses against COVID-19. The most common wrong beliefs were probable vaccines’ side effects in the future, the undesirable effect of vaccination on children’s growth, and the awful effect of the vaccine on fertility, with a prevalence of 82.7%, 81.2%, and 76.7%, respectively. Conclusions: This study identified that most participants believed that COVID-19 vaccines have side effects for their children and unfavorable effects on children’s growth and infertility.
{"title":"COVID-19 Vaccination Hesitancy Among 5 - 11-year-old Iranian Children’s Parents: What Are Underlying Beliefs?","authors":"Maryam Mollaie, A. Mirahmadizadeh, Anahita Sanaei Dashti, Amir Hossein Jalalpour, Khoubyar Jafari","doi":"10.5812/pedinfect-132673","DOIUrl":"https://doi.org/10.5812/pedinfect-132673","url":null,"abstract":"Background: Of all teenage deaths caused by coronavirus disease 2019 (COVID-19), 47% occurred in children aged 0 - 9. Like many other infectious diseases, reducing mortality in children requires widespread vaccination. Despite the availability of the COVID-19 vaccine, a large percentage of children have not received the vaccine. Objectives: This survey aimed to study parents’ reluctance to receive the COVID-19 vaccine for their children in Shiraz, Iran. Methods: An online questionnaire was sent to parents whose 5 to 11-year-old children had received no COVID-9 vaccine through the health educators of primary schools in Shiraz, Iran. The questionnaire contained demographic questions and 16 beliefs about COVID-19 vaccination that were answered as yes/no. Results: We assessed 1093 respondents, including 49.5% (n = 542) male and 50.5% female students’ parents. The mean number of wrong beliefs was 7.21 ± 2.80 in parents who had boys and 7.78 ± 2.95 in girls’ parents. Also, 78.6% of participants had at least five wrong beliefs or excuses for not vaccinating their children. Notably, 82.8% of mothers and 84.3% of fathers were vaccinated with 2 - 3 doses against COVID-19. The most common wrong beliefs were probable vaccines’ side effects in the future, the undesirable effect of vaccination on children’s growth, and the awful effect of the vaccine on fertility, with a prevalence of 82.7%, 81.2%, and 76.7%, respectively. Conclusions: This study identified that most participants believed that COVID-19 vaccines have side effects for their children and unfavorable effects on children’s growth and infertility.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45636302","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}
Pub Date : 2023-04-06DOI: 10.5812/pedinfect-134518
S. Armin, L. Azimi, G. Shariatpanahi, A. Shirvani, Nasim Almasian Tehrani
Background: Carbapenems are broad-spectrum antibiotics used to treat the family of gram-negative Enterobacteriaceae, especially those that are resistant to first-line antibiotics. Because these drugs are usually prescribed as the last line of treatment, resistance to these antibiotics carries irreparable risks to treatment systems, and screening high-risk individuals in medical centers and using infection control measures are critical strategies for eliminating them. Objectives: We investigated the prevalence of colonization of different strains of Enterobacteriaceae, Klebsiella, Enterobacter, and Escherichia coli and their risk factors in hospitalized children. Methods: In this descriptive cross-sectional study, stool samples were taken from patients during the first 48 hours of hospitalization in a tertiary children’s hospital and were cultured on Makcanki culture medium or EMB. Cultured Enterobacteriaceae samples were transferred to Müller-Hinton agar medium, and their antibiotic susceptibility was evaluated with meropenem and imipenem discs by disc diffusion method. In the next step, five common carbapenemase genes, including (VIM, IMP, OXA-48, NDM-1, and SPM-1) were examined by PCR method and reported accordingly. Results: Two hundred and ninety-five stool samples were examined, of which 242 (82%) samples were cultured positively with Enterobacteriaceae. The prevalence of carbapenem resistance was reported to be 37% among 295 samples using the phenotypic method. Resistance rates were high in patients with a history of antibiotic use, with frequent hospitalizations (more than two episodes in the last six months), and in patients with an underlying disease) malignancy, GI diseases, immunodeficiency, neurologic diseases such as cerebral palsy and epilepsy, endocrine diseases. Most of the genes found were OXA-48, followed by IMP and VIM. NDM-1 was found in 3 samples, and SPM was not found in any of the samples. In 13% of resistant samples, more than one carbapenemase gene was found. Conclusions: The results of this study showed that the frequency of carbapenem resistance in stools colonized with Enterobacteriaceae is high in our patients. On the other hand, the presence of carbapenemase genes in these bacteria, which are located on the plasmids that can be rapidly spread in the hospital environment, is an alarm for the hospital infection control committee to take preventive measures in order to prevent the spread of these bacteria in the hospital.
{"title":"The Prevalence of Colonization with Carbapenem-resistant Enterobacteriaceae, E. coli, Klebsiella and Enterobacter, and Related Risk Factors in Children","authors":"S. Armin, L. Azimi, G. Shariatpanahi, A. Shirvani, Nasim Almasian Tehrani","doi":"10.5812/pedinfect-134518","DOIUrl":"https://doi.org/10.5812/pedinfect-134518","url":null,"abstract":"Background: Carbapenems are broad-spectrum antibiotics used to treat the family of gram-negative Enterobacteriaceae, especially those that are resistant to first-line antibiotics. Because these drugs are usually prescribed as the last line of treatment, resistance to these antibiotics carries irreparable risks to treatment systems, and screening high-risk individuals in medical centers and using infection control measures are critical strategies for eliminating them. Objectives: We investigated the prevalence of colonization of different strains of Enterobacteriaceae, Klebsiella, Enterobacter, and Escherichia coli and their risk factors in hospitalized children. Methods: In this descriptive cross-sectional study, stool samples were taken from patients during the first 48 hours of hospitalization in a tertiary children’s hospital and were cultured on Makcanki culture medium or EMB. Cultured Enterobacteriaceae samples were transferred to Müller-Hinton agar medium, and their antibiotic susceptibility was evaluated with meropenem and imipenem discs by disc diffusion method. In the next step, five common carbapenemase genes, including (VIM, IMP, OXA-48, NDM-1, and SPM-1) were examined by PCR method and reported accordingly. Results: Two hundred and ninety-five stool samples were examined, of which 242 (82%) samples were cultured positively with Enterobacteriaceae. The prevalence of carbapenem resistance was reported to be 37% among 295 samples using the phenotypic method. Resistance rates were high in patients with a history of antibiotic use, with frequent hospitalizations (more than two episodes in the last six months), and in patients with an underlying disease) malignancy, GI diseases, immunodeficiency, neurologic diseases such as cerebral palsy and epilepsy, endocrine diseases. Most of the genes found were OXA-48, followed by IMP and VIM. NDM-1 was found in 3 samples, and SPM was not found in any of the samples. In 13% of resistant samples, more than one carbapenemase gene was found. Conclusions: The results of this study showed that the frequency of carbapenem resistance in stools colonized with Enterobacteriaceae is high in our patients. On the other hand, the presence of carbapenemase genes in these bacteria, which are located on the plasmids that can be rapidly spread in the hospital environment, is an alarm for the hospital infection control committee to take preventive measures in order to prevent the spread of these bacteria in the hospital.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44538668","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}
Pub Date : 2023-02-04DOI: 10.5812/pedinfect-126995
F. Arcelia, W. Pratita, A. Pasaribu
Background: Nutritional status is believed to affect the immune system and parasite density in children diagnosed with malaria from Plasmodium vivax infection. It is known that nutritional status could facilitate the growth of protective immune response towards malaria antigen, but some studies have shown that poor nutrition could cause clinical complications and lead to severe malaria. There have also been different reports on the relationship between nutritional status and parasite density. Objectives: This study aimed to examine the association between nutritional status and parasite density in children with vivax malaria in Kualuh Leidong area. Methods: This cross-sectional study was conducted from October 2019 to January 2020 in Kualuh Leidong to investigate 48 children aged between 2 - 18 and diagnosed with vivax malaria. The nutritional status of children with fever and positive Plasmodium vivax confirmed by microscopic examination were evaluated. Parasite density was determined in order to assess the severity of the infection. A non-parametric test was performed to examine the association between these two conditions. Results: There was a significant association (P = 0.032) between sexual parasite density and nutritional status. A post hoc test showed that overweight or mild malnutrition significantly correlated (P = 0.029) with high sexual parasite density. However, no significant association was found between nutritional status and asexual parasite density (P = 0.222).
{"title":"The Association between Nutritional Status and Parasite Density in Children with Vivax Malaria in Kualuh Leidong, Indonesia","authors":"F. Arcelia, W. Pratita, A. Pasaribu","doi":"10.5812/pedinfect-126995","DOIUrl":"https://doi.org/10.5812/pedinfect-126995","url":null,"abstract":"Background: Nutritional status is believed to affect the immune system and parasite density in children diagnosed with malaria from Plasmodium vivax infection. It is known that nutritional status could facilitate the growth of protective immune response towards malaria antigen, but some studies have shown that poor nutrition could cause clinical complications and lead to severe malaria. There have also been different reports on the relationship between nutritional status and parasite density. Objectives: This study aimed to examine the association between nutritional status and parasite density in children with vivax malaria in Kualuh Leidong area. Methods: This cross-sectional study was conducted from October 2019 to January 2020 in Kualuh Leidong to investigate 48 children aged between 2 - 18 and diagnosed with vivax malaria. The nutritional status of children with fever and positive Plasmodium vivax confirmed by microscopic examination were evaluated. Parasite density was determined in order to assess the severity of the infection. A non-parametric test was performed to examine the association between these two conditions. Results: There was a significant association (P = 0.032) between sexual parasite density and nutritional status. A post hoc test showed that overweight or mild malnutrition significantly correlated (P = 0.029) with high sexual parasite density. However, no significant association was found between nutritional status and asexual parasite density (P = 0.222).","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45907538","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}
Pub Date : 2023-01-28DOI: 10.5812/pedinfect-129829
T. Nazari, A. Karimi, M. Alebouyeh, Roxana Mansour Ghanaiee
Background: Rotavirus (RV) is associated with diarrhea in children under 5 years old. It leads to severe dehydration. RV infection is the third cause of hospitalization and death in children under 5 years old. Objectives: This study aimed to assess the frequency of RV infection in hospitalized children under 5 years old with diarrhea during 2021-2022. Methods: In this cross-sectional observational study, a total of 190 stool samples from hospitalized children with diarrhea were collected in Mofid Children’s Hospital in Tehran from December 2020 to March 2021. RV infection was detected by an enzyme-linked immunosorbent assay (ELISA). Chi-square tests were performed to determine the difference in age and gender group, time, and symptoms. Results: The overall prevalence of RV infection was 28.5% and higher in boys (68.5%), children aged ≤ 12 months (44.4%), and children with mixed feeding (33.3%); it is more common in winter. Vomiting (79.6%), fever (87.03%), and non-exudative stool (88.8%) were observed in most children with RV, but there were no significant differences in children with and without RV. Conclusions: Due to the prevalence of RV among children under 5 years of age, establishing a national RV registration system and control programs, like vaccination, seems to be considered.
{"title":"Assessment of Rotavirus Infection in Hospitalized Children with Diarrhea","authors":"T. Nazari, A. Karimi, M. Alebouyeh, Roxana Mansour Ghanaiee","doi":"10.5812/pedinfect-129829","DOIUrl":"https://doi.org/10.5812/pedinfect-129829","url":null,"abstract":"Background: Rotavirus (RV) is associated with diarrhea in children under 5 years old. It leads to severe dehydration. RV infection is the third cause of hospitalization and death in children under 5 years old. Objectives: This study aimed to assess the frequency of RV infection in hospitalized children under 5 years old with diarrhea during 2021-2022. Methods: In this cross-sectional observational study, a total of 190 stool samples from hospitalized children with diarrhea were collected in Mofid Children’s Hospital in Tehran from December 2020 to March 2021. RV infection was detected by an enzyme-linked immunosorbent assay (ELISA). Chi-square tests were performed to determine the difference in age and gender group, time, and symptoms. Results: The overall prevalence of RV infection was 28.5% and higher in boys (68.5%), children aged ≤ 12 months (44.4%), and children with mixed feeding (33.3%); it is more common in winter. Vomiting (79.6%), fever (87.03%), and non-exudative stool (88.8%) were observed in most children with RV, but there were no significant differences in children with and without RV. Conclusions: Due to the prevalence of RV among children under 5 years of age, establishing a national RV registration system and control programs, like vaccination, seems to be considered.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41932520","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}
Ghazal Zahed, P. Karimzadeh, L. Wissow, S. Arman, M. Babaee, Reza Shervin Badv, Vahide Zeinali, Hadi Zarafshan, S. Armin, S. Nasiri, Narges Hashemi, A. Moayedi
Background: The large proportion of coronavirus disease 2019 (COVID-19) patients has been associated with a large number of neuropsychiatric manifestations. Despite the high prevalence of COVID-19, few studies have examined such manifestations, especially in children and adolescents. Objectives: This study investigated neuropsychiatric manifestations in hospitalized children and adolescents admitted for COVID-19 infection in Iran. Methods: This prospective observational study included admitted children and adolescents (4 - 18 years old) diagnosed with COVID-19 infection, pediatric neurologists, child and adolescent psychiatrists, and infectious disease specialists, and assessed 375 infected patients during August and December 2021. Results: Of the 375 patients, 176 (47%) were female, with a mean age of 9.0 ± 3.39 years. Psychiatric and neurological manifestations were reported in 58 (15.5%) and 58 (15.5%) patients, respectively. The most prevalent psychiatric disorders were separation anxiety disorder (SAD) (5.1%), major depressive disorder (MDD) (3.5%), generalized anxiety disorder (GAD) (2.7%), insomnia (2.4%), and oppositional defiant disorder (ODD) (2.4%). Regarding neurological complications, seizures were the most prevalent (13.1%), followed by encephalitis (1.9%), transverse myelitis (0.3%), acute ischemic stroke (0.3%), and Guillain-Barre syndrome (0.3%). There was no significant relationship between the duration of COVID-19 infection (P = 0.54) and ICU admission (P = 0.44) with the emergence of psychiatric symptoms. Conclusions: The most prevalent neurologic and psychiatric complications among children and adolescents with COVID-19 infection were seizures and the symptoms of anxiety/mood disorders, respectively.
{"title":"Neuropsychiatric Manifestations of COVID-19 in Hospitalized Pediatrics: A Multicenter Cross-sectional Study","authors":"Ghazal Zahed, P. Karimzadeh, L. Wissow, S. Arman, M. Babaee, Reza Shervin Badv, Vahide Zeinali, Hadi Zarafshan, S. Armin, S. Nasiri, Narges Hashemi, A. Moayedi","doi":"10.5812/apid-131511","DOIUrl":"https://doi.org/10.5812/apid-131511","url":null,"abstract":"Background: The large proportion of coronavirus disease 2019 (COVID-19) patients has been associated with a large number of neuropsychiatric manifestations. Despite the high prevalence of COVID-19, few studies have examined such manifestations, especially in children and adolescents. Objectives: This study investigated neuropsychiatric manifestations in hospitalized children and adolescents admitted for COVID-19 infection in Iran. Methods: This prospective observational study included admitted children and adolescents (4 - 18 years old) diagnosed with COVID-19 infection, pediatric neurologists, child and adolescent psychiatrists, and infectious disease specialists, and assessed 375 infected patients during August and December 2021. Results: Of the 375 patients, 176 (47%) were female, with a mean age of 9.0 ± 3.39 years. Psychiatric and neurological manifestations were reported in 58 (15.5%) and 58 (15.5%) patients, respectively. The most prevalent psychiatric disorders were separation anxiety disorder (SAD) (5.1%), major depressive disorder (MDD) (3.5%), generalized anxiety disorder (GAD) (2.7%), insomnia (2.4%), and oppositional defiant disorder (ODD) (2.4%). Regarding neurological complications, seizures were the most prevalent (13.1%), followed by encephalitis (1.9%), transverse myelitis (0.3%), acute ischemic stroke (0.3%), and Guillain-Barre syndrome (0.3%). There was no significant relationship between the duration of COVID-19 infection (P = 0.54) and ICU admission (P = 0.44) with the emergence of psychiatric symptoms. Conclusions: The most prevalent neurologic and psychiatric complications among children and adolescents with COVID-19 infection were seizures and the symptoms of anxiety/mood disorders, respectively.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46528447","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}
Pub Date : 2023-01-02DOI: 10.5812/pedinfect-129629
S. Armin, F. Fallah, A. Karimi, Fariba Shirvani, L. Azimi, Nasim Almasian Tehrani, Nafiseh Abdollahi, P. Mobasseri, Maryam Rajabnejad, Roxana Mansour Ghanaiee, S. Hoseini-Alfatemi, S. Fahimzad, N. Karami, M. Tajbakhsh, G. Ghandchi, Sedigheh Rafiei Tabatabaei
Background: The spread of resistant bacteria has caused serious concern worldwide. The spread of multidrug-resistant (MDR) and extensive drug-resistant (XDR) limits the choice of antibiotics, making available antibiotics less effective. Objectives: This study aimed to investigate resistance patterns to seven global threatening organisms announced by the Centers for Disease Control and Prevention (CDC) for one year in Iran, called ESKAPE bacteria (Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). Methods: Clinical isolates were collected from 10 selective hospitals in nine provinces. Antibiotic susceptibility testing was performed according to the Clinical and Laboratory Standards Institute for each bacterium. Results: A total of 5522 bacterial species were considered, of which 30% were ESKAPE. Multidrug-resistant A. baumannii and Staphylococcus aureus methicillin-resistant Staphylococcus aureus (MRSA) were the most identified in Gram-negative and -positive bacteria, with the frequency of 44% and 39%, respectively. The remaining bacteria, including E. coli, K. pneumoniae, Enterobacter spp. P. aeruginosa, and Enterococcus spp., had the frequency of 30%, 32%, 21%, 20%, and 22%, respectively. Conclusions: The determined patterns for the antibiotic resistance of the ESKAPE bacteria can help determine antibiotic stewardship. Also, the high rates of the ESKAPE bacteria in Iran could be alarming for healthcare centers not to misuse broad-spectrum antibiotics.
{"title":"Prevalence and Antimicrobial Resistance Patterns in ESKAPE Pathogens in Iran","authors":"S. Armin, F. Fallah, A. Karimi, Fariba Shirvani, L. Azimi, Nasim Almasian Tehrani, Nafiseh Abdollahi, P. Mobasseri, Maryam Rajabnejad, Roxana Mansour Ghanaiee, S. Hoseini-Alfatemi, S. Fahimzad, N. Karami, M. Tajbakhsh, G. Ghandchi, Sedigheh Rafiei Tabatabaei","doi":"10.5812/pedinfect-129629","DOIUrl":"https://doi.org/10.5812/pedinfect-129629","url":null,"abstract":"Background: The spread of resistant bacteria has caused serious concern worldwide. The spread of multidrug-resistant (MDR) and extensive drug-resistant (XDR) limits the choice of antibiotics, making available antibiotics less effective. Objectives: This study aimed to investigate resistance patterns to seven global threatening organisms announced by the Centers for Disease Control and Prevention (CDC) for one year in Iran, called ESKAPE bacteria (Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). Methods: Clinical isolates were collected from 10 selective hospitals in nine provinces. Antibiotic susceptibility testing was performed according to the Clinical and Laboratory Standards Institute for each bacterium. Results: A total of 5522 bacterial species were considered, of which 30% were ESKAPE. Multidrug-resistant A. baumannii and Staphylococcus aureus methicillin-resistant Staphylococcus aureus (MRSA) were the most identified in Gram-negative and -positive bacteria, with the frequency of 44% and 39%, respectively. The remaining bacteria, including E. coli, K. pneumoniae, Enterobacter spp. P. aeruginosa, and Enterococcus spp., had the frequency of 30%, 32%, 21%, 20%, and 22%, respectively. Conclusions: The determined patterns for the antibiotic resistance of the ESKAPE bacteria can help determine antibiotic stewardship. Also, the high rates of the ESKAPE bacteria in Iran could be alarming for healthcare centers not to misuse broad-spectrum antibiotics.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42378093","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}
Pub Date : 2023-01-02DOI: 10.5812/pedinfect-127183
Nasim Almasian Tehrani, M. Alebouyeh, S. Armin, N. Soleimani, A. Karimi, B. Shamsian, S. Nazari, L. Azimi
Background: Hospital-acquired infection with carbapenem-resistant Enterobacteriaceae (CRE) is a global concern. The administration of antibiotics among the infected and non-infected immunocompromised children with SARS-CoV-2 is associated with an increased risk of intestinal CRE colonization and bacteremia during hospitalization. Objectives: The present study aimed to detect the correlation between the intestinal colonization of carbapenemase encoding Enterobacteriaceae with SARS-CoV-2 infection and antibiotic prescription among immunocompromised children admitted to the oncology and Bone Marrow Transplantation (BMT) wards. Methods: Stool samples were collected from the immunocompromised children, and the members of Enterobacteriaceae were isolated using standard microbiological laboratory methods. Carbapenem resistance isolates were initially characterized by the disc diffusion method according to CLSI 2021 and further confirmed by the PCR assay. SARS-CoV-2 infection was also recorded according to documented real-time PCR results. Results: In this study, 102 Enterobacteriaceae isolates were collected from the stool samples. The isolates were from Escherichia spp. (59/102, 57.8%), Klebsiella spp. (34/102, 33.3%), Enterobacter spp. (5/102, 4.9%), Citrobacter spp. (2/102, 1.9%), and Serratia spp. (2/102, 1.9%). The carbapenem resistance phenotype was detected among 42.37%, 73.52%, 40%, 50%, and 100% of Escherichia spp., Klebsiella spp., Enterobacter spp., Citrobacter spp., and Serratia spp., respectively. Moreover, blaOXA-48 (49.1%) and blaNDM-1 (29.4%), as well as blaVIM (19.6%) and blaKPC (17.6%) were common in the CRE isolates. SARS-CoV-2 infection was detected in 50% of the participants; however, it was confirmed in 65.45% (36/55) of the intestinal CRE carriers. The administration of antibiotics, mainly broad-spectrum antibiotics, had a significant correlation with the CRE colonization in both the infected and non-infected children with SARS-CoV-2 infection. Conclusions: Regardless of the COVID-19 status, prolonged hospitalization and antibiotic prescription are major risk factors associated with the CRE intestinal colonization in immunocompromised children.
{"title":"Intestinal Carriage of Carbapenemase-Producing Enterobacteriaceae Members in Immunocompromised Children During COVID-19 Pandemic","authors":"Nasim Almasian Tehrani, M. Alebouyeh, S. Armin, N. Soleimani, A. Karimi, B. Shamsian, S. Nazari, L. Azimi","doi":"10.5812/pedinfect-127183","DOIUrl":"https://doi.org/10.5812/pedinfect-127183","url":null,"abstract":"Background: Hospital-acquired infection with carbapenem-resistant Enterobacteriaceae (CRE) is a global concern. The administration of antibiotics among the infected and non-infected immunocompromised children with SARS-CoV-2 is associated with an increased risk of intestinal CRE colonization and bacteremia during hospitalization. Objectives: The present study aimed to detect the correlation between the intestinal colonization of carbapenemase encoding Enterobacteriaceae with SARS-CoV-2 infection and antibiotic prescription among immunocompromised children admitted to the oncology and Bone Marrow Transplantation (BMT) wards. Methods: Stool samples were collected from the immunocompromised children, and the members of Enterobacteriaceae were isolated using standard microbiological laboratory methods. Carbapenem resistance isolates were initially characterized by the disc diffusion method according to CLSI 2021 and further confirmed by the PCR assay. SARS-CoV-2 infection was also recorded according to documented real-time PCR results. Results: In this study, 102 Enterobacteriaceae isolates were collected from the stool samples. The isolates were from Escherichia spp. (59/102, 57.8%), Klebsiella spp. (34/102, 33.3%), Enterobacter spp. (5/102, 4.9%), Citrobacter spp. (2/102, 1.9%), and Serratia spp. (2/102, 1.9%). The carbapenem resistance phenotype was detected among 42.37%, 73.52%, 40%, 50%, and 100% of Escherichia spp., Klebsiella spp., Enterobacter spp., Citrobacter spp., and Serratia spp., respectively. Moreover, blaOXA-48 (49.1%) and blaNDM-1 (29.4%), as well as blaVIM (19.6%) and blaKPC (17.6%) were common in the CRE isolates. SARS-CoV-2 infection was detected in 50% of the participants; however, it was confirmed in 65.45% (36/55) of the intestinal CRE carriers. The administration of antibiotics, mainly broad-spectrum antibiotics, had a significant correlation with the CRE colonization in both the infected and non-infected children with SARS-CoV-2 infection. Conclusions: Regardless of the COVID-19 status, prolonged hospitalization and antibiotic prescription are major risk factors associated with the CRE intestinal colonization in immunocompromised children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47558108","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}
Pub Date : 2023-01-01DOI: 10.5812/pedinfect-129026
L. Mohajerzadeh, M. Ebrahimian, M. Sarafi, Gholamreza Ebrahimisaraj, Sedigheh Rafiei Tabatabaei, S. Noorbakhsh, Ali Kaveh, Hossein Taheri, L. Azimi, M. Alebouyeh
Background: The clinical course of acute appendicitis, one of the most common diseases needing surgical intervention in children, was affected by the coronavirus disease 2019 (COVID-19) pandemic. The global fear and panic about the outbreak and governmental decisions on lockdowns and restrictions led to an increasing number of complicated forms of appendicitis. Objectives: This study aimed to compare different aspects of appendicitis and its complications between the pre-pandemic and pandemic periods. Methods: In a retrospective cross-sectional analytical study, we enrolled all patients with a diagnosis of acute appendicitis for two consecutive years. Only children under 14 years of age were included in the study. The patients were divided into two groups based on the time of disease presentation, the pre-pandemic and pandemic periods. Demographic features, as well as clinical, laboratory, and imaging findings, were compared between the two groups. Results: Out of 369 patients included in the study, 173 were placed in the pre-pandemic group. There was no significant change in the incidence of appendicitis between the two periods (P = 0.232). However, the incidence of complicated appendicitis increased remarkably during the pandemic (27% vs. 11%, P < 0.001). No substantial differences were found in parameters like age, sex, laboratory findings, and the length of hospital stay between the two groups (P > 0.005). The patients who tested positive for COVID-19 had a significantly higher hospitalization duration (P < 0.001). Conclusions: Our results suggested that the rate of complicated appendicitis was substantially higher during the pandemic compared to the pre-pandemic time. Also, the proportion of midline laparotomy was significantly higher after the outbreak. These findings suggested that delays in care provision during the COVID-19 outbreak could have probably contributed to the rise in the incidence of complicated appendicitis in children.
{"title":"Effects of COVID-19 Pandemic on the Frequency of Complicated Appendicitis in Pediatric Populations","authors":"L. Mohajerzadeh, M. Ebrahimian, M. Sarafi, Gholamreza Ebrahimisaraj, Sedigheh Rafiei Tabatabaei, S. Noorbakhsh, Ali Kaveh, Hossein Taheri, L. Azimi, M. Alebouyeh","doi":"10.5812/pedinfect-129026","DOIUrl":"https://doi.org/10.5812/pedinfect-129026","url":null,"abstract":"Background: The clinical course of acute appendicitis, one of the most common diseases needing surgical intervention in children, was affected by the coronavirus disease 2019 (COVID-19) pandemic. The global fear and panic about the outbreak and governmental decisions on lockdowns and restrictions led to an increasing number of complicated forms of appendicitis. Objectives: This study aimed to compare different aspects of appendicitis and its complications between the pre-pandemic and pandemic periods. Methods: In a retrospective cross-sectional analytical study, we enrolled all patients with a diagnosis of acute appendicitis for two consecutive years. Only children under 14 years of age were included in the study. The patients were divided into two groups based on the time of disease presentation, the pre-pandemic and pandemic periods. Demographic features, as well as clinical, laboratory, and imaging findings, were compared between the two groups. Results: Out of 369 patients included in the study, 173 were placed in the pre-pandemic group. There was no significant change in the incidence of appendicitis between the two periods (P = 0.232). However, the incidence of complicated appendicitis increased remarkably during the pandemic (27% vs. 11%, P < 0.001). No substantial differences were found in parameters like age, sex, laboratory findings, and the length of hospital stay between the two groups (P > 0.005). The patients who tested positive for COVID-19 had a significantly higher hospitalization duration (P < 0.001). Conclusions: Our results suggested that the rate of complicated appendicitis was substantially higher during the pandemic compared to the pre-pandemic time. Also, the proportion of midline laparotomy was significantly higher after the outbreak. These findings suggested that delays in care provision during the COVID-19 outbreak could have probably contributed to the rise in the incidence of complicated appendicitis in children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48829317","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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