Risks for bacteremia and urinary tract infections in febrile young children with respiratory syncytial virus-bronchiolitis

This study was done to evaluate the risks of bacteremia and urinary tact infections [UTI] in febrile patients with respiratory syncytial virus [RSV] -bronchiolitis. One hundred infants and children were selected from emergency department [ED] and outpatient clinic of El-Minia University and El-Galaa Teaching Hospital. They were divided into three groups: bronchiolitis group [40 patients], group of febrile children without obvious cause for fever [30 patients], and control group of normal healthy non febrile children [30 infants and children]. Apart from thorough physical examination, they were investigated for respiratory syncytial virus [RSV] detection in nasal aspirate, bacterial infections by WBCs count, absolute neutrophil count [ANC] and absolute band count [ABC], bacteremia by blood culture, and UTI by urine culture and bacterial count. We found a significant difference on comparison, for temperature, WBCs count, ANC, and ABC, between group with bronchiolitis only and control group on one hand and between febrile group without bronchiolitis and control group on the other hand [p <0.0001]. While on comparison between group with bronchiolitis only and febrile group without bronchiolitis, the difference between them for the same risk factors was not statistically significant [p >0.05]. Also, patients in group with bronchiolitis had more abnormal X- ray chest findings than those in the other two groups. On the other hand, more positive cases for blood culture and bacterial cell count were found among patients in febrile group without bronchiolitis [46.6% and 40% respectively] than among those in group with bronchiolitis [32.5% and 20% respectively] and control group [0.00%]. We recorded high risk of bacteremia and UTI in febrile patients of RSV bronchiolitis but less than that of febrile patients without focal infections. Therefore, evaluation of RSV bronchiolitis for bacterial infections including bacteremia and UTI may be necessary especially in developing counties

Behavioral and physiologic response to pain in neonates

This study was done to assess the physiological and behavioral response to pain. Eighty healthy neonates [47 male, 33 female] less than 7 days of age, requiring bilirubin estimation, blood sugar etc. were randomly assigned for venous puncture. They were classified equally according to weight into Group I [<2.5 Kg] and Group II [> 2.5 Kg]. All pararneters were recorded 10 minutes prior, and during the procedure. Neonatal Infant Pain Scale [NIPS] score and Respiratory Rate [RR], Heart Rate [HR], Non-Invasive Blood Pressure [NIBP] and O2 saturation were observed on Nihon-Kohden multimonitor. During the venepuncture, heart rate [p<0.001] and blood pressure [p<0.001] were significantly in creased in both groups but more significant increase was present in Group I [<2.5kg] as compared to Group II [>2.5kg]. Respiratory rate was also increased in both groups but more significantly in Group II [p<0.001], whereas Oxygen saturation decreased in both groups but more significantly in Group I [p<0.001]. Median NIPS score was higher in both Groups [p<0.001]. These measures appear to be reliable indices of term neonates responses to painful stimulation. NIPS is a suitable method for neonatal pain evaluation