Prevalence of nosocomial urinary tract infection in PICU of referral children hospital in Iran

To determine the prevalence of the occurrence, risk factors and microbiology for acquiring UTIs in the PICU of one of the main referral children hospital in Iran. A surveillance study was conducted among all children admitted to PICU in the Mofid children hospital in Tehran between July 2007 and July 2008. During the one year, 428 patients were admitted to PICU for 48 hours or more and a total of 31 [7.2%] acquired UTIs, yielding an overall incidence density, of 11 per 1000 PICU days. One bacteremic [4.3%] ICU-acquired UTIs occurred. Mean hospital staying in UTI patients was 22 days comparing with 7 days in other patients [P value<0.001] but mortality rate difference was not significant [P value=0.2]. The most common organisms isolated were Escherichia coli [30.4%], Kelebsiellapneumoniae[30.4%] and Candida a/b/cans[21.7%]. Monitoring of a PICU-acquired UTI is important in critically ill patients. The results of this study offer a reliable measure of the prevalence of nosocomial UTIs at hospitals in Iran and provide a baseline for future studies

[Evaluation of neonatal sepsis by BACTEC system in Mahdie hospital]

The signs and symptoms of neonatal sepsis are often non-specific and can make the diagnosis of infection more difficult. This leads to treat majority of neonates with antibiotics without bacterial infections. The aim of this study was to determine the incidence of positive bacterial cultures and isolating the etiologic agents from neonates with suspected sepsis. This cross-sectional study was conducted on 120 neonates with suspected bacterial sepsis admitted in Mahdieh hospital, Tehran, Iran. Blood culture was performed by BACTEC 9120 system, as a more sensitive method compared to current blood culture techniques. Sepsis was classified as definite, probable, or possible based on clinical findings of sepsis, hematologic data, blood culture and CRP. Among 120 neonates, 11 cases had positive blood culture. Seven of them were positive by staphylococcus epidermidis and the rest by entrococcus, lactobacillus, diphtheroid and gram positive bacillus. Definite, probable, and possible sepsis was found in 1.7%, 9.2% and 89.1% of neonates, respectively. Early onset sepsis was determined in 90.8% of patients. The most common clinical manifestations were respiratory distress and apnea. It is beneficial to use an automated blood culture system such as BACTEC which is a sensitive method and lead to earlier detection of bacterial growth

[Evaluation of hepatitis in children]

The causes of hepatitis or increased liver enzymes which follow liver cells [hepatocytes] are numerous. They vary from a temporary asymptomatic viral disease to a serious chronic liver disease that needs more attention and follow up. In a child with hepatitis, primary lab data including CBC, U/A, ALT, AST and PT are needed. According to the early clinical and paraclinical evaluation, hepatitis can be divided to cytotoxic and cholestatic types. In this paper, we suggest the appropriate approach for diagnosis and treatment of each type of hepatitis. Paying attention to this suggested approach will help physicians to do best in the management of their patients

Prevalence of oropharyngeal colonization by Haemophilus influenzae type b in Iranian children

Healthy carriers of Haemophilus influenzae type b [Hib] play an important role in the spread of invasive disease. The aim of this study was to assess the need for Hib vaccination in Iranian children by estimating the prevalence of Hib oropharyngeal colonization among children in Tehran. Cultures were prepared from oropharyngeal swabs of 1000 children in 25 day-care centres in Tehran from October 2005 to March 2006. The prevalence of Hib carriers was 7.6%, similar to other developing countries prior to inoculation with the conjugate Hib vaccine. We recommend Hib vaccination be included in the Iranian national programme of immunization

Aseptic meningitis in pediatrics: Epidemiologic evaluation and cerebrospinal fluid changes

This study aimed at investigating seasonal variation, clinical symptoms, and cerebrospinal fluid [CSF] changes in patients with aseptic meningitis admitted in Mofid hospital between 1995 and 1996. A total of 63 children with aseptic meningitis were enrolled in the study. Their age, gender, season of the disease, etiology, clinical symptoms, CSF changes, and treatment were evaluated and documented. Data were analyzed using SPSS 11.5. The male to female ratio of the patients was 2.5 to 1, mean age being 6.5 years. The disease occurrence was most common in spring and summer, and the most common symptoms observed were fever [92.6%], followed by nausea and vomiting [88.88% and 68.25%], neck stiffness, neck stiffness [54%], seizure [19%], kernig sign [14.28%], Brudzinski's sign [11.11%], and 1.58% of the patients had history of head injury. Mean white blood cell count for CSF was 165/mm3 [range, 6 to 850/mm3], the common cells being mononuclear cells; mean red blood cell count was 538 [range, 0 to 8100/mm3]; protein and glucose levels were within the normal ranges. Blood and CSF culture and CSF smear were negative. Prognosis was excellent and mean duration of recovery was 5 days [range, 2 to 18 days]. Although the clinical symptoms of aseptic meningitis are similar to those of bacterial meningitis, its prognosis is excellent. The CSF features can be used to diagnose the disease

Febrile Convulsion

Febrile convulsion [FC] is the most common type of seizure in childhood. This benign seizure does not usually result in serious neuro-developmental complications, but it may recur in one third. 25-40% of patients with FC have a positive family history but the possibility of a seizure disorder is low in their future. Early evaluation must be performed to find the etiology of fever after stopping the seizure attack and prevent any unnecessary para-clinical work up. The possibility of a bacterial infection like bacteremia or its serious complications such as meningitis must be the important aim of FC evaluation study. The essential education and providing the necessary information for parents with enough treatment could decrease their anxiety. The disease is worked up and treated with the help of different specialists in medicine, from general physician to pediatric sub-specialists. Therefore, sufficient knowledge is needed by different groups of physicians

[Acute childern pneumonia]

After performance of successful program for control and treatment of acute gastroenteritis, acute respiratory infections [ARI] especially pneumonia, are the most important infectious etiology of children's mortality in developing countries nowadays. Diagnosis of pneumoma is made on clinical grounds it is based on four sets of data including Clinic, epidemiology, Radiology and routine laboratory tests. Then, pneumonia itself can be divided to three categories including bacterial, viral and atypical pneumonia. Each type of pneumonia is treated after possible diagnosis with its criteria. Correct and accurate knowledge of physicians of diagnosis and therapy of this important disease in children could prevent unnecessary costs and decrease its morbidity and mortality