Alireza Nateghian; Gholamreza Irajian; Fatemeh Faraji
Volume 6, Issue 2 , April 2011, , Pages 79-85
Abstract
Background and Objectives: The aim of the study was to determine the role and characteristics of nosocomial and community acquired Staphylococcus sepsis in admitted children in tertiary centers in Iran. Patients and Methods: A cross sectional descriptive-analytic study was performed since March ...
Read More
Background and Objectives: The aim of the study was to determine the role and characteristics of nosocomial and community acquired Staphylococcus sepsis in admitted children in tertiary centers in Iran. Patients and Methods: A cross sectional descriptive-analytic study was performed since March 2008 to March 2009 in which all blood cultures from various admitted patients were checked for Staphylococcu aurues in Aliasghar Children Hospital, Tehran, Iran. Upon diagnosis by appropriate microbiologic tests, antimicrobial testing was done according to CLSI methods. Results: Overall, 2647 blood culture samples from 5197 admitted children were sent from which, 25 cases of S. aurues septicemia were isolated; the rate was 4.8 in 1000 admissions;1.3 in 1000 admissions were nosocomial and 3.5 in 1000 admissions were community acquired sepsis. Ten cases were neonates and remainder was older. Eighteen cases were CA and 28% were NI septicemia with mean age of 38.8 months and 8.2 months, respectively. Mean duration of admission in NI group was 20.5 days, however it was 12.6 days in CA group; they also had higher mortality rate. Conclusion: The rate of Staphylococcus sepsis in this study was higher than developed countries for both CA and NI cases, both groups had high rate of resistance. Although most cases were CA in which significant proportion had underlying malignancy, NI group had a longer duration of admission and mortality.
Alireza Nateghian; Joan L. Robinson; Simin Rezaii; Mahnaz Kefayati; Naser Rakhshani; Safa Sianati
Volume 2, Issue 1 , January 2007, , Pages 23-28
Abstract
Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged ...
Read More
Background and Objective: The diagnosis of typhoid fever in children is a challenge due to the non-specific clinical picture. The current role of the Widal test for diagnosis in developing countries has not been clear. Materials and Methods: Charts were reviewed on all children ≤ 15 years of age discharged from 5 pediatric teaching hospitals in Tehran from 1991 to 2004 with a diagnosis of typhoid fever. The Widal test was performed on 58 children with confirmed and 40 children with probable typhoid fever and as control groups, 40 febrile children admitted with infections other than typhoid fever, and 40 afebrile children admitted for elective surgery. Results: For the confirmed cases of typhoid fever, 33 (57%) were male and the mean age was 7.5 ± 3.5 years. Fever was present in 56 cases (97%) and the mean duration of fever before admission was 14 ± 8 days. Other symptoms included tachycardia (60%), anorexia (60%), vomiting (60%), diarrhea (57%), abdominal pain (48%), and headache (34%). Hepatomegaly was present in 55% of cases, splenomegaly in 44%, and Rose spots in 14% of them. Positive cultures were from blood (45/58), stool (18/58), and bone marrow (12/17) with 4 cases having only positive bone marrow cultures. Positive titers of at least 1:40 for anti “O” and/or anti “H” agglutinins were found in 78% of confirmed cases, 65% of possible cases, 12.5% of febrile controls, and no afebrile controls. Conclusion: The Widal test remains a useful test for diagnosis of typhoid fever in developing countries where blood cultures may not be available or may be negative because of prior antibiotic therapy. A titer of at least 1:40 for anti “O” and/or anti “H” agglutinin should be considered a positive titer in Iranian children.