Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study

Nosocomial urinary tract infection [UTI] increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit [PCICU] in 2012, and we divided the patients into two groups: the UTI [UTI group] and the non-UTI [control group]. We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 [7%] had UTIs after cardiac surgery [UTI group], and 384 [93%] were free from UTIs [control group]. All UTI cases were catheter-associated UTIs [CAUTIs]. A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement [p < 0.001], presence of congenital abnormalities of kidney and urinary tract [CAKUT] [p < 0.0041] and the presence of certain syndromes [Down, William, and Noonan] [p < 0.02]. Gram-negative bacteria accounted for 63% of the CAUTI. The main causes of CAUTI were Klebsiella [27%], Candida [24%] and Escherichia coli [21%]. Resistant organisms caused 34% of CAUTI. Two patients [7%] died in the UTI group compared with the one patient [0.3%] who died in the control group [p < 0.05]. Based on these findings, we concluded that an increased duration of the urinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study

Effect of different blood sources on the feeding time of sand fly, Phlebotomus Papatasi

The feeding time for sand fly females was determined experimentally by feeding of thirty females [3-5 days-old] sand fly Phlebotomus papatasi on different blood sources [human, pigeon, hamster and blab C mice]. Mean feeding time was longest on blab C mice, 8.55 minutes, followed by hamster, 7.05 minutes, then pigeon, 4.84minutes, and finally human, 4.69 minutes. Significant difference was observed in the feeding time between females fed on hamster and balb c mice but there is no significant difference between females fed on human and pigeon

Isolation and biochemical identification of pathogenic burkholderia cepacia front human sources and related reactivity to different antibiotics

The aim of the present work is to isolate and identify Burkholderia species from different chest hospitalized patients .throat swap and sputum samples were considered. Reactivity of isolates to different antibiotics was considered using both Double Disc Synergy Test and Combined ESBL Test. Data revealed that 21/200 [10.5%] isolated from cystic flbrosis patients; samples were positive as Burkholderia isolation was more prevalent from sputum samples [55%] than throat swapping [45%]. Among the 21 bacterial isolates; 2/21[9.5%] children, 8/21[38.09%] females and 11/21[52.38%] males. The No of isolate was location related; El Sadr hospital [41%], Abbassia Chest hospital [24%], Al-Mattaria teaching hospital [21%] and health institute hospital [14%]. Also, isolation was gender related as male was more susceptible more than the other genders for infection by Burkholderia cepacia recording the highest value [52%] followed by female [38%] and children [10%]. Combined infection was recorded. Burkholderia cepacia was sensitive to Amlkacin, Gentamicin, Kanamycin, Neomycin, Ceftazidime, Ciprofloxacin and Amoxicillin/clavulanic acid, while it were resistant to; Paromomycin, Spectinomycin, Fosfomycin, Cefixime, Levofloxacin, Ofloxacin and Cefazolin. The most active antibiotic was Amoxicillin/clavulanic acid with mean diameter of inhibition zone 38.50 mm

Phylogenetic identification ofburkholderia cepacia isolates from human chest infection from different hospitals

Phylogenetic analysis of Burkholderia cepacia was achieved based on the variation of p-Lactamases production and antibacterial reactivity to different antibiotics. Sub inhibitory concentrations of augmentin down-regulates the production and/or release of exoprotein and this effect increase with increasing of the tested concentration. ESBLs was detected using double disc synergy test and combined ESBL test. Effect of reactivity of B. cepacia spp was influenced by antibiotic where Amoxicillin/ clavulanic acid showed the highest inhibitory effect and in turn clear zone dimension. Also, TEM-1 and SHV-1 genes electrophoretic pattern detected by both PFGE and RAPD. Different isolates showed a similarity to standard B. cepacia ranging from 94-95 %. Data recorded revealed the p-Lactamases genes showed a variable protein bands pattern revealing reactivity to antibiotics

Assessment of the prevalence of iodine deficiency disorders among primary school children in Cairo

This study was done to assess the prevalence of iodine deficiency [ID] among primary schoolchildren in Cairo. A stratified random sampling technique covering the five geographic zones of Cairo was used. Data revealed that the goitre rate was 13.5%; being 10.8% among males and 16.2% among females. Prevalence among females was higher than that of males in all categories. Based on the data found by this study, it can be concluded that ID constitutes a mild public health problem among Cairo primary schoolchildren, and a salt iodization programme is highly recommended

Nutrition and health beliefs of mothers during pregnancy and labour

Rapid assessment procedures were used to study women's knowledge, attitudes and practices regarding antenatal care during pregnancy, care during labor, nutrition and health knowledge in the presence of different kinds of health facilities. 100 mothers whose last child did not exceed 2 years of age from Menial Shiha Village, Giza Governorate were chosen for this study. 58 said that pregnant women do not need care during pregnancy because it is a normal event and so no interference should be done. Only 6 mothers mentioned that immunization is essential for their children to maintain their health. 63 mothers preferred delivery at home and are accustomed to be attended by traditional birth attendant [TBA] or [daya] because they fell comfortable and secure. In 47 cases, sister-in-law or mother in- law usually attends delivery because they live in the same home. Any sharp unsterilized household tool was used to cut umbilical cord in 61 cases. 60 mothers delayed breast feeding until the 3rd day after delivery. 71 mothers believed that there was no need for special food during pregnancy, but 77 of them mentioned that large quantities of food should be eaten during pregnancy irrespective of its quality. On the other hand, 37 mothers believed that some foods; e.g., fried onion, meat, tea, coffee, pickles should not be eaten or drunk during pregnancy because it was bad for health. Boiled egg was given during labor in 32 cases because it leads to more frequent uterine contraction. Protein foods such as meat and poultry [especially chicken] was offered to 76 mothers immediately after delivery because they believed that the uterus felt sorrow from losing its baby and there must be immediate replacement by chicken

Study of umbilical and uterine arteries doppler velocimetry, biophysical profile, placental grading and maternal plasma fibronectin level in pre-eclampsia

The present study was conducted on 30 preeclamptic patients and 20 well matched normotensive pregnant women. All studied cases were subjected to the study of umbilical and uterine arteries Doppler velocimetry, biophysical profile, placental grading, and maternal plasma fibronectin estimation. All these studied parameters with exception of placental grading, showed abnormal findings in pre- eclampsia. The umbilical artery Doppler velocimetry, fetal biophysical profile and maternal plasma fibronectin levels were significantly correlated with the severity of preeclampsia. The correlation between the different studied parameters and fetal outcome using Apgar scoring has been evaluated where fetal biophysical scoring proved to have the best accuracy. No significant results could be detected between the studied groups concerning placental grading and uterine artery velocimetry