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

Do urine collection techniques affect contamination?

The aim of the microbiology laboratory in the management of urinary tract infection [UTI] is to reduce morbidity and mortality through accurate and timely diagnosis with appropriate antimicrobial sensitivity testing. Although optimal specimen collection, processing, and interpretation should provide the clinician with a precise answer, no single evaluation method is fool proof and applicable to all patient groups. So this study aimed at validating 3 different urine sampling techniques, clean catch midstream [CCMS], midstream [MSJ, and nothing techniques, regarding bacterial contamination. The study involved 300 urine samples taken from females, who were attending either the out patients clinics at the Main University Hospital or the Sporting Students Hospital in Alexandria. All urine samples were subjected to quantitative and qualitative cultures on blood agar and MacConkey's agar. Contamination was found in 66% of the studied specimens. CCMS, MS, and nothing techniques have approximately identical contamination rates and the difference between their results were not statistically significant [76% 80%, and 90%, respectively]. It can be recommended that midstream or nothing techniques could be used in collecting urine specimens instead of the tedious CCMS

Risk factors for acute and recurrent urinary tract infection in children

Urinary tract infection [UTI] is a common problem in infants and children. This infection is mostly ascending Recurrent U.T.I. is mainly caused by bad hygiene and poor health education, and its incidence increased with enuretic children. Cases with episodes of U.T.I. must be followed up by urine culture monthly because may have a new episode without symptoms. The aim of this work it to identify the possible risk factors that may lead to acute and recurrent U.T.I. among children. This study included 100 children suffered from U.T.I. aged from 2-14 years and attended our pediatric clinic. No 29 cases of them had urinary symptoms, 28 cases were a symptomatic and proved to have infections during routine urine investigations, and 43 cases had one episode of U.T.I. and came for follow up which was monthly based on urine culture and during follow up they had recurrent U.T.I. These patients subjected to urine analysis and culture, stool analysis, renal function test, complete blood picture, erythrocyte sedimentation rate, C-reactive protein and ultra sonography for abdomen and pelvis to detect any abnormality, stones and to measure post voided bladder capacity. Our study showed no sex difference in U.T.I. 18% of boys were uncircumcised;. 21% with postponement of the start of potty-training, 61% had pinworm infection, 2% had bladder stones, 3% had bilharzial ova and 16% had enuresis. Urine cultures were positive for E-coli, Klebsiella, Staph. Aureus and Staph. Epidermidis. No, mixed infection was found. With measurement of post-voided bladder volume, we found 11% had voiding dysfuctions. These results proved the presence of multi-factorial risk factors for occurrence of U.T.I. U.T.I. is mainly affected by had hygiene, poor health education and negligence from doctors to follow up patients if they have no symptoms. We recommend routine follow up for U.T.I. cases based on urine culture to enhance early detection of recurrence and early proper treatment. Pediatricians should take urinary symptoms very seriously into account and should do routine wine workup to detect asymptomatic U.T.I

Prevalence of urinary tract infections in febrile infants and children

Urinary tract infection [UTI] is relatively a common cause of fever in infants and young children. False negative diagnosis will leave UTI patients at risk for serious complications, while false positive one may lead to unnecessary invasive testing and expensive treatment. In order to find UTI prevalence in febrile Egyptian infants and children and to evaluate the role of urine analysis and culture and renal sonography in UTI diagnosis, we studied 200 cases with fever for <48hs after excluding those with clinically detectable cause, other than UTI, for the fever. The overall UTI prevalence in febrile infants and children was 7.5%. It was higher in females than in males and in uncircumcised than in circumcised males. UTI symptoms in neonates and infants were not specific and older children had urinary symptoms highly associated with UTI. E.coli was the commonest causative organism for UTI. Our work showed that UTI is an important cause in febrile Egyptian infants and children so that we strongly recommend further studies on best cost - effective management of these patients

Antigen detection for rapid diagnosis of acute bacterial pneumonia in children

In a study carried out during the period from May to December 1997, blood and urine samples were collected from 100 children who had clinical manifestations and radiological evidences suggestive of pneumonia and were admitted to El-Shatby Children's University Hospital. Sputum samples were collected from 26 children, their ages ranged from 5-12 years, out of the examined cases, 65% were definitely diagnosed as bacterial pneumonia cases. S. aureus and St. pneumoniae were the most frequently isolated bacterial agents from blood and sputum cultures, 19.4% and 30.9% respectively. 38.3%, 30.7% and 30.9% of cases were diagnosed by Ag detection in urine, serum and sputum respectively by the latex agglutination test

Frequency of bacteruria among primary health care patients in Abu Dhabi

In this study, a sample of 1588 urine culture results was taken including allages and both sexes. From Mafraq Hospital, the results of 660 urine cultures referred for the primary health care centers in the last 4 months in the year1997 were taken. It was shown that most of the symptomatic patients who were tested were females [86.2%] and adults [87.3%]. The females constituted 92.5%of the positive significant growth. Out of 1588 samples, only 16.8% had a significant bacterial growth and another 12% had an insignificant growth. Pyuria and hematuria were present in 77.9% and 33.7% of the significant bacterial growth, respectively. The most frequent cultured organism was E.Coli, followed by Staph. aureus. Mafraq Hospital showed a similar predominance of female patients and pyuria was present in 41.3% and only 9.5% of the patients had a significant bacterial growth. The commonest organism was E. coli

study of antithrombin III level in healthy and septic neonates

Antihtrombin III level was studied in 48 neonates admitted to the neonatal care unit of Benha University hospital. They were classitied into 4 groups: Group I : 9 full term healthy neonates. Group II 9 full term septic neonates. Group III : 10 preterm healthy neonates, Group IV : 10 preterm septic neonates. Our study revealed that antithrombin III [AT III] level was significantly reduced in septic full term neonates compared to healthy full term neonates. Mean level was [45.2 +/- 7.57] and [50.6 +/- 7.6] in septic full term and healthy full term respectively with [P<0.01]. It was also significantly reduced in septic preterm neonates compared to healthy preterm neonates. Mean level was [21.6 +/- 4.19] and [39.7 +/- 4.41] with [P<0.001] in septic preterm and healthy pattern respectively. Finally antithrorithin III level is significantly reduced in preterm whether healthy or septic compared to full term neonates whether healthy or septic. Thus we conclude that neonates especially if they are preterm and septic will have marked reduction in antithrombin III level this creates a state of hypercoagulability with great risk of thrombotic complication varying from superficial vein thrombosis, to cerebral thrombosis or in its severe form to disseminated intravascular coagulation [DIC]

Infectious diseases among food handlers

This study was carried out to find the prevalence and associated factors of communicable diseases especially parasitic infections among food handlers in King Fahd Hospital, Jeddah, Saudi Arabia, for early detection and proper management. This study was conducted as a preemployment examination on 52 new kitchen male workers with a mean age of 26.77 +/- 5.03 years. They were subjected to complete medical examination as well as some general and specific laboratory investigations as a food handler. Results of throat swab showed that 12% of the studied group were positive for group A beta haemolytic streptococci. Parasitological examination showed that seven subjects [13.5%] were infected. Out of them 3 only had single parasitic infections and 4 had double infections. Trichuris trichiura was the most common infection in the studied group. Continuous follow up and health education of food handlers have led to avoidance of outbreaks of infections among food consumers in the hospital