Neonatal mastitis-clinical profile and outcome: a hospital based study

Background: Neonatal mastitis may occur de novo due to infection by various organisms, most notably Staphylococcus aureus. This condition usually responds well to treatment, but may sometimes progress to breast abscess formation.Methods: This was a retrospective study. All the patients who were admitted in hospital with admission diagnosis of neonatal mastitis or breast abscess were included in this study. Various demographic, clinical and lab data were recorded and analyzed.Results: Total 11 patients fulfilled the inclusion criteria and were included in the study. (7 females: 4 males). Swollen and red breast area was the most common presenting complaint, seen in 10 patients. One patient came with complaint of pus draining from the swollen breast. 2 patients were febrile. The age at presentation varied from 7 days to 30 days (median age 14 days). 7 patients had undergone breast massage at hands of their family members to express the witch's milk. Pus culture from the 6 cases of breast abscesses grew Staphylococcus aureus in 3 cases and Coagulase negative staph (CONS) in 1 patient. Blood culture was sterile in 8 cases, grew CONS in two cases and MRSA in 1 patient. In all the cases where blood culture grew an organism, a lumbar puncture was also done but CSF analysis was normal in all the cases. Drainage of abscess and IV antibiotics led to resolution of disease in all patients and none of the patients developed any complications.Conclusions: Neonatal mastitis and breast abscess is not an uncommon condition. Complications are very rare and the condition responds well to IV antibiotics. People should be made aware about the ill effects of cultural practice of breast massage to express witch's milk in neonates. Early treatment of mastitis leads to better outcome and lesser chances of abscess formation.

Culture sensitivity and antibiotic profile in urinary tract infection in children between 1-15 years

Background: The aim was to study the antibiotic resistance in children with urinary tract infection and to observe any difference between antibiotic resistance rates.Methods: It was a prospective study carried out in SKIMS Medical College Hospital, Srinagar over a period of two years from January 2017 to January 2019. The study included 210 children between 1 year and 15 years who had presented with complaints of urinary tract infection and whose urine cultures were positive for the growth of an organism. These children were analyzed in order to find the frequency of organisms grown on culture, sensitivity of organisms isolated on culture and the rates of developed resistance to the antibiotics.Results: A total of 210 patients aged were included in the study, encompassing 66 (31.4) males and 144 (68.6%) females. Out of 144 female children 108 were under 6years of age while as out of 66 male children 48 were under 6years of age. As per the growth on urine culture,' the commonest organism that grew on culture were Escherichia coli (E. coli) was observed in 156 (74.3%), enterococcus in 18 (8.57%), Proteus mirabilis in 11 (5.2%), Acinetobacter spp. in 7 (3.3%), Pseudomonas spp. 5 (2.4%), Staphylococcus aureus in 4 (1.9%), Morganella spp. in 3 (1.4%) patients. Authors found imipenem, aminoglycosides and nitrofurantoin as the most effective antibiotics for urinary tract infections in pediatric age group.Conclusions: From this study, they concluded that parenteral antibiotics to be started empirically for the treatment of UTIs in all pediatric age groups are' aminoglycosides. In contrast for outpatient management of urinary tract infections, our results suggest that nitrofurantoin should be used for children aged beyond 1 year of age due to the low rate of resistance to nitrofurantoin in patients aged over 1 year.

Sonographic measurement of renal size in normal North Indian children.

Objective: To determine the renal size in normal North Indian children by renal sonography. Design: Hospital based (outpatient based) cross sectional observational study. Material and methods: Total 1198 normal children aged 1 month to 12 years were included in the study. Sonographic assessment of renal size (length, width and thickness) was performed using Philips, multi frequency (3.5, 5 and 7.5 Mhz) linear and convex probes in B-mode. The mean renal dimensions and volume were calculated for each age group with ± 2SD. The renal length and calculated renal volume were correlated with somatic parameters like age, weight, height, and body surface area (BSA). Linear Regression equations were derived for each variable. Results: A strong correlation was seen between renal size and renal volume with various somatic parameters (age, weight, height, BSA), (coefficient of correlation = 0.9). Conclusion: This study provides values of renal size (mean± 2SD) in normal North Indian children and its correlation with age, weight,height, and BSA. Renal size can be easily calculated by derived linear regression equation.