Global-PPS targets for antimicrobial stewardship in paediatric patients at hospitals in Sanandaj, Western Iran, compared with Southeast Asian and European hospitals.

OBJECTIVES: Point prevalence surveys (PPS) provide valuable data on patterns of hospital antimicrobial administration. To identify quality improvement indicators, we evaluated antimicrobial prescribing patterns in children and neonates admitted to three referral centres in Sanandaj, Western Iran, and compared these with Southeast Asian and European paediatric benchmark data. METHODS: The standardised Global-PPS was performed to assess antimicrobial use in Southeast Asia, including Sanandaj and European hospitals, in 2019. RESULTS: Of the 4118, 2915, and 443 paediatric patients enrolled in Southeast Asian, European and Sanandaj hospitals, 2342 (56.9%), 833 (28.6%) and 332 (74.9%), respectively, received at least one antimicrobial in 2019. The most administered antibiotics in neonates were ampicillin in Southeast Asia (30.3%) and Sanandaj (41.5%, often in combination with cefotaxime (29.0%)), compared with amoxicillin in Europe (20.0%). In children, ceftriaxone was most prescribed in Sanandaj (62.4%) and Southeast Asia (20.5%) as opposed to amoxicillin (11.8%) in Europe. Twice as many Watch antibiotics (83.0%) were prescribed on paediatric wards in Sanandaj compared with European paediatric wards (41.1%). All antimicrobials in Sanandaj hospitals were prescribed empirically, and prolonged surgical prophylaxis was common (75.5%). CONCLUSION: The high prevalence of antibiotic prescribing, high empirical therapies, and poor outcomes for antibiotic quality indicators strongly suggest the urgent need for an antibiotic stewardship program in Sanandaj hospitals, where improved diagnostic laboratory capacity and reconsideration of training may be good targets for intervention in their hospitals.

Evaluating Vertical Transmission of COVID-19 from Mothers to Neonates: An Iranian Case Series of 8 Patients.

The coronavirus epidemic first broke out in China in 2019 and spread around the world. Not only the signs, symptoms, and outcomes of the coronavirus in neonates, but also its vertical transmission risks are still unknown. This case series presents eight neonates born to mothers with COVID-19 and two neonates with this infection.

Stroke in a child with SARS-CoV-2 infection: A case report.

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Some patients with COVID-19 show widely neurological manifestations including stroke. We report a child who was hospitalized due to seizures and was later diagnosed with COVID-19. Acute infarction was seen in the right putamen, globus pallidus, and the posterior part of the insula. A small focal dilatation within M1 segment of the left middle cerebral artery (MCA) was also observed. According to the present case report, COVID-19 infection may contribute to the occurrence and development of ischemic stroke.

Griscelli Syndrome in a seven years old girl.

In this study, a case of Griscelli Syndrome (GS) in a 7 years old girl was reported. The patient initially presented with fever and pancytopenia in laboratory results; after ruling out the malignancies, she went under treatment with the diagnosis of infectious disease and was discharged after two weeks. Nevertheless, ten days after discharge, she developed new symptoms. Due to patient symptoms and general appearance, microscopic analysis of her hair shaft was done, and the abnormal distribution of pigments in the shaft was observed, indicating GS.