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Archives of Pediatric Infectious Diseases - Volume:4 Issue: 2, Apr 2016

Archives of Pediatric Infectious Diseases
Volume:4 Issue: 2, Apr 2016

  • تاریخ انتشار: 1395/02/18
  • تعداد عناوین: 10
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  • Amir Nasimfar, Anahita Sanaei Dashti *, Hossein Haghbin Page 1
    Introduction
    H syndrome (OMIM 612391) is an autosomal recessive disease with some features such as hyperpigmentation, hypertrichosis, heart anomalies, hepatosplenomegaly, hearing deficit, hypogonadism, short stature, flexion contracture of fingers and toes and hypertriglyceridemia..
    Case Presentation
    A 17-year-old boy with hyperpigmented, hypertrichotic and indurated seborrheic keratosis-like cutaneous patches mainly involving the extremities referred to Namazi hospital, an academic center affiliated to Shiraz university of medical sciences. The patient belonged to a consanguineous family with Arab origin..
    Conclusions
    We described a case with many clinical manifestations of H syndrome in addition to new characteristics such as microphallus. H syndrome should be considered in individuals with a constellation of symptoms as hyperpigmentation, hypertrichosis, heart anomalies, hepatosplenomegaly, hearing deficit, hypogonadism, short stature, flexion contracture of fingers and toes and hypertriglyceridemia..
    Keywords: H syndrome, Hyperpigmentation, Hypertrichosis, Hearing Loss, Hypogonadism
  • Mohammad Ahangarzadeh Rezaee, Seyed Foad Mirkarimi, Alka Hasani, Vajihe Sheikhalizadeh, Mohammad Hossein Soroush, Babak Abdinia* Page 2
    Background
    Antibiotic resistant Staphylococcus aureus is a serious public health problem worldwide..
    Objectives
    This study aimed to investigate the susceptibility pattern and molecular typing of S. aureus isolated from clinical specimens of hospitalized patients during eight years, from 2005 to 2012..
    Materials And Methods
    A total of 151 randomly selected S. aureus isolates, identified with phenotypic tests and detection of nuc gene, were subjected to antimicrobial susceptibility testing using the disk diffusion method. Moreover, molecular typing of the isolates was carried out by PCR-RFLP based on coa and spa genes..
    Results
    All isolates were susceptible to vancomycin and teicoplanin. High rates of susceptibility were also observed with rifampin (98.1%), imipenem (94.7%), and linezolid (94.1%). On the other hand, most of the isolates were resistant against penicillin (95.4%), erythromycin (68.9%) and clindamycin (57.6%). Four types of spa and coa were distinguished among the isolates based on PCR results; however, the HaeII digestion resulted in a total of sixteen and nine RFLP patterns for spa and coa genes, respectively..
    Conclusions
    The outcome of this study indicates a higher discriminatory power of the RFLP analysis based on the spa gene compared to the coa gene. Moreover, the results of our study reveal that the resistance rate of S. aureus to some antimicrobial agents including linezolid is a growing concern..
    Keywords: Antimicrobial Resistance, Spa Typing, Coa Typing, Staphylococcus aureus
  • Homayoon Behmadi, Abasalt Borji, Azadeh Taghavi, Rad, Leyla Soghandi, Reza Behmadi* Page 3
    Background
    Neonatal sepsis is a systemic inflammatory response syndrome that is secondary to infection. It is a major cause of neonatal mortality in the world, particularly in developing countries. A definitive diagnosis requires the isolation of pathogens from a normally sterile body site, including blood, cerebrospinal fluid and urine. Empirical antibiotic therapy is based on the physician’s knowledge of the anticipated bacterial species and their expected antibiotic susceptibilities..
    Objectives
    The aim of this study was to determine the prevalence and evaluate the antimicrobial susceptibility patterns of bacterial infections at a neonatal unit..
    Patients and
    Methods
    This study was conducted at the neonatal intensive care unit and neonatal ward of Hakim hospital, Neyshabour, Iran. Blood, cerebrospinal fluid (CSF) and urine specimens were collected before institution of empirical antibiotic therapy. Antibiotic resistance pattern of the isolates was studied by the disc diffusion technique..
    Results
    Coagulase-negative staphylococci (CoNS) were the most prevalent pathogens isolated from blood specimens in early and late-onset disease. Escherichia coli and Klebsiella were the most causative pathogens in early and late-onset urinary tract infections. They had high resistance to our empirical antibiotic regimens. Prevalence of bacterial meningitis was low in our study..
    Conclusions
    Due to the increasing resistance of pathogens to usual empirical antibiotics, it is reasonable to stress upon preventive measures, so that a minimum number of neonates develop sepsis..
    Keywords: Newborn, Sepsis, Drug Resistance, Microbial Sensitivity Tests
  • Mostafa Sharifian*, Mohammad Reza Shiva, Mohsen Akhavan Sepahi, Shirin Shohadaee, Nasrin Esfandiar, Fatemeh Fallah Page 5
    Background
    Urinary tract infections (UTIs) are common in children. They can lead to hypertension and end stage renal disease (ESRD). Ghrelin is a regulatory hormone that maintains fat tissues and body composition. Ghrelin is mainly produced in the stomach and in smaller amounts in kidneys. It stimulates release of growth hormone (GH), increases food intake, and causes weight gain..
    Objectives
    The aim of this study was to examine weather urinary Ghrelin concentration is involved in anorexia in patients with UTI and its urinary concentration changes with treatment..
    Patients and
    Methods
    This study was performed on 40 hospitalized children with UTI at Mofid children’s hospital during years 2013 to 2014. Ghrelin and Creatinine were measured before and after treatment. statistical analyzes were performed using the SPSS software version 18 by student t test, Wilcoxon test and Spearman coefficient and differences were considered as significant if P
    Results
    Mean age was 4.5 ± 3.8 years and 34 (85%) were females; 14 children (35%) had proteinuria, nine patients (29%) had Vesicoureteral Reflux (VUR), eight (20%) scare, five (12.5%) hydronephrosis and 33 (82.5%) anorexia. Mean urinary acylated Ghrelin before and after treatment were 138.4 ± 70.9 and 147.2 ± 72.6, respectively (P
    Conclusions
    Urinary Ghrelin concentration was lower before treatment of UTI and significantly increased after cessation of inflammation. Further studies are required for more definite results..
    Keywords: Urinary Ghrelin, Urinary Tract Infection, Anorexia, Children
  • Fariba Shirvani, Abdollah Karimi, Maryam Rajabnejad* Page 6
    Context: Tuberculosis is still one of the deadliest communicable diseases..
    Objectives
    Nine million people worldwide developed TB in 2013, and 1.5 million people died from it, 360000 of which were HIV positive. Although the disease is controllable by means of diagnostic and treatment measures, the death toll from the disease is still high, and efforts to combat it must be accelerated..
    Data Sources: Data compiled from 202 countries in the Global Tuberculosis Report 2014 showed that TB is present in all regions of the world..
    Study Selection: Higher numbers of tuberculosis cases were diagnosed in 2013 in comparison with previous reports, indicating that diagnoses and reports of new cases may be improved by stringent data collection..
    Data Extraction: A special note to the 2014 report highlighted the progress of drug resistant TB during the last two decades..
    Results
    Worldwide, a proportion of new cases with multidrug-resistant TB (MDR-TB) were reported at 3.5% in 2013 without a significant change compared with recent years. Interestingly, higher levels of resistance and poor treatment outcomes are of major concern in some parts of the world. Due to this concern, special attention is focused on prevention rather than treatment. On the other hand, the effectiveness of an existing vaccine (BCG) is increasingly questionable..
    Conclusions
    It has the potential to cause disseminated infection, and an increasing number of immunocompromised patients prone to disease and the suboptimal preventive potency of this vaccine suggest the need for a global attempt to review its benefits and disadvantages..
    Keywords: Tuberculosis, BCG Vaccine, Strategy
  • Farshad Nojoomi, Abdolmajid Ghasemian* Page 7
    Context: The composition and function of the gut microbiota develop with their host from birth. The human microbiome, especially the gut microbiota, plays a critical role in a myriad of health and normal activities. However, the increase or decrease in number of gut bacteria may cause several disorders. This review aimed to assess the importance of human gut microflora and their roles in the health and possible diseases caused by fluctuations in the number of these bacteria..
    Evidence Acquisition: For the current review, we searched for the terms “bacterial gut flora”, “role,” “number,” and “increase” and “decrease” on the Google scholar, PubMed, Science Direct, SciVerse, and Scopus search engines and databases. The exclusion criteria were “genetic factors,” “veterinary flora,” “protozoal flora,” “mold,” “fungal,” and “yeast flora”..
    Results
    The gut microbiota is accompanied by the regulation of several host metabolic pathways, giving rise to interactive host-microbiota signaling, metabolic, and immune-inflammatory responses that physiologically connect the gut, muscle, liver, and brain. A more thorough understanding of these axes is an early essential for reaching therapeutic strategies to use the gut microbiota for combating disease and improving health. Bacterial species of Bacteroides, Clostridia, and Bifidobacterium consist of a large proportion of the gut bacterial flora. Increase in the proportion of these genera in the gut could cause abscess formation, sepsis, inflammatory bowel disease (IBD), Crohn’s disease, toxicity, infection, and malnutrition. However, the decrease in the proportion of these species is accompanied by allergies in infants, inflammation, malabsorption syndrome, carbohydrate/fiber intolerance, atopic eczema, and IBD..
    Conclusions
    The results showed that although the human gut microbiome plays a pivotal role in health in a normal concentration, fluctuation in their number (increase or decrease) is a possible factor in the appearance of major diseases..
    Keywords: Gut Flora, Health, Clinical Disorders
  • Ferial Lotfian, Payam Mehrian* Page 8
    Background
    Cavitary pulmonary tuberculosis (TB) is rare in children..
    Objectives
    The aim of this study was to evaluate the characteristics of cavitary pulmonary TB in children..
    Patients and
    Methods
    This retrospective study was conducted on 97 children less than 15 years old with pulmonary TB to assess the clinical characteristics and radiographic findings of patients with cavitary lesions..
    Results
    Seven (7%) out of 97 children had cavitary pulmonary TB. All patients were between 13 and 14 years old with a female/male ratio of 2.5/1. The most common symptom was cough. All patients had positive sputum smear results. Cavitary lesions were seen in the right upper lobe in six cases and multiple cavities were observed in two cases..
    Conclusions
    This finding strongly suggests that older children with pulmonary TB can be more at risk than younger ages. Special attention must be paid to the prevention and treatment of TB in older children, particularly females..
    Keywords: Children, Cavitary Tuberculosis, Smear Positivity
  • Pablo Mesa Del, Castillo B.*, Paula Alcaniz Rodiguez, Ana Blazquez, Marta Castellon Perez, Carme Salvador Garcia, Ana Menasalvas Ruiz, Santiago Alfayate Minguelez, Encarna Mira Requena, Lourdes Gimeno Arias Page 9
    The current paper presents a three-year-old toddler with an acute and severe osteoarticular infection of her left hip and proximal thigh. In the first 24 hours she underwent an arthrotomy and during the intravenous phase of antibiotic treatment multiple teeth were removed because of an extensive periodontal disease. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was identified in her blood culture samples. The paper discusses the clinical spectrum of the disease caused by this pathogen and briefly reviews the literature. To the authors’ best knowledge, this is the first case of septic osteomyelitis and arthritis caused by SDSE in a child..
    Keywords: Septic Arthritis, Osteomyelitis, Children, Streptococcus dysgalactiae
  • Atmaram Pawar, Asawari Raut*, Vijay Kalrao, John Jacob, Isha Godha, Ritty Thomas Page 10
    Background
    Sepsis can be defined as the body’s response to an infection. Sepsis in children remains a significant cause of morbidity and mortality worldwide..
    Objectives
    This study focuses on the etiological factors, risk factors, and clinical characteristics of sepsis in neonate and pediatric patients..
    Patients and
    Methods
    A prospective study was conducted over a six-month period in the pediatric and neonatal intensive care units of Bharati hospital and research centre, Pune. Fifty-two patients aged 0 - 12 years who were diagnosed with sepsis were included in the study. Data collected from the cases included demography, history, etiology, and diagnosis. Air contamination was assessed using the settle plate method..
    Results
    The incidence rate of sepsis was found to be 2.04%. Children aged 0 - 3 months accounted for the greatest percentage of admissions (57.6%). The male to female ratio was 1.7:1. Common etiologies that presented as risk factors included pneumonia, meningitis associated with catheterization, and very low birth weight. The most commonly seen organisms were gram-negative (Klebsiella, Enterococcus) and (Methicillin-resistant Staphylococcus aureus) MRSA. Microbiological testing was conducted in different wards of the hospital to determine the risk of developing sepsis, and it was found that the highest colony count was present in the labor rooms. On the basis of the onset of sepsis, patients were classified into early onset sepsis (3.84%) and late onset sepsis (9.61%). SIRS (systemic inflammatory response syndrome) with severe sepsis (51%) was the most prominent clinical characteristic of sepsis. There was a significant relationship between the severity of sepsis and mortality (P
    Conclusions
    Sepsis remains the most common cause of mortality, with gram-negative infection and catheterization being the most significant risk factors. The more severe the sepsis, the greater the chances of mortality..
    Keywords: Sepsis, Organ Dysfunction, Catheterization, Systemic Inflammatory Response Syndrome