Isolation of Kawasaki disease-associated with bacterial sequence from peripheral blood leukocytes

The clinical and epidemiologic features of Kawasaki disease [KD] suggest an infectious etiology; however, the agent[s] remain unknown. Our purpose was to isolate the causative bacterial gene from peripheral blood leukocytes of patients with acute KD, by Universal polymerase chain reaction [UPCR], in Tehran Children's Medical Center. Universal polymerase chain reaction [UPCR] assay was used to amplify the bacterial 16S ribosomal RNA gene [rDNA]. Forty three [28 boys and 15 girls] were diagnosed with acute Kawasaki disease included in this study. The median age at diagnosis was 3.5 years [range: 0.5-9 years]. Twenty Nine [29] cases had typical KD criteria and 14 patients had atypical KD at diagnosis. Two of the 43 KD patients were positive for the Universal PCR assay for 16S rRNA, prior to intravenous g-globulin therapy [IVGT], while all specimens were negative by conventional blood culture. In our study, there was fever in 100%, conjunctivitis in 62.7%, rash in 83.72%, oral mucosal changes in 76.74%, peripheral changes in 37.20%, and cervical lymphadenopathy in 39.53% cases. The 16S rDNA sequence was positive in 4.65% of acute KD patients; this data shows that an infectious KD agent is traced in peripheral leukocytes. The question remains as to what true frequency of the16S rDNA sequence in KD is

Study of antibiotics resistance in pediatric acute bacterial meningitis with E test method

Appropriate treatment of bacterial meningitis especially in children is a important problem due to multiple drug resistance. The determination MIC of conventional antibiotics for bacterial meningitis with quantitative E. test is exactly practical and essential. We studied MIC of conventional antibiotics in pediatric acute bacterial meningitis older than two months, center children hospital, 1382-1384. In this prospective and cross sectional process research we measured MIC of antibiotics in 30 positive bacterial culture in CSF or blood with quantitative E. test and compared with qualitative disk diffusion test. Antibiotic resistance of 10 Haemophilus influenzae type b patient was: ampicillin resistance in 90%, co- Amoxiclave R. in 10%, chlorampheicol R. in 40%, third gerenation cephlosporins R.[ceftriaxone and cefotaxime] in 0% and cotrimoxazole R. in 100% and antibiotic resistance of 20 streptococcous pneumoniae patient was: penicillin R. in 35%, chloramphenical R. in 10%, third generation cephalosporins R. in 5%,rifampin R. in 10% and cotrimoxazole R. in 60% .In comparison of two methods E-Test and Disk Diffusion we found insignificant difference. Antibiotic Resistance of our study is compatible with other studies. Therefore it seems that composition of ampicillin and chloramphenicol as empiric therapy for bacterial meningitis for many years ago,aren't appropriate today and third generation cephalosporins alone or with vancomycin is a suitable therapy

Sensory hearing loss in children with mumps infection

Mumps infection is endemic in Iran and mumps parotiditis is a common disease in Iranian children. There has been a dramatic decrease in the worldwide incidence of mumps since the introduction and use in 1968 of the very effective and inexpensive mumps vaccine. In Iran probably due to a higher percentage of unvaccinated young persons <15yr, the incidence rate of mumps infection and its sequel are higher in comparison to corresponding data from developed countries prior to comprehensive vaccination programs. The aim of the study was to investigate the effects of the mumps virus on cochlear function and to determine the frequency of related Sensory Neural Hearing Loss [SNHL] in children. This descriptive case-series study was conducted in 94children, aged less than 14 years, hospitalized between 1999 and 2001, in the pediatric ward of the Hazrat Rasool Hospital in Tehran. All patients with documented mumps infection [specific mumps-IgM antibody] were evaluated twice for audiometeric function on the basis of diagnostic parameters for sensory neural hearing loss; the first evaluation was done on admission and the second three weeks later. 54 patients [age range 1-14y, mean age 4.83 +/- 3.93, male: female ratio30:24] were studied in two years. The highest incidence of mumps was seen in winter [37%] and spring [28%] and the lowest in summer [13%]. Specific IgM antibody for mumps virus was detected in 74 children. Comprehensive audiologic evaluation was done in 54 patients at admission and again 3 weeks later. SNHL was detected in 7.2% of patients; the 4.4% incidence of SNHL in this study was higher than in other studies in developed countries prior to comprehensive vaccination programs. Implementation of comprehensive vaccination programs in young Iranians could dramatically reduce the burden and costs imposed by the infection and its sequelae