Tract Infections In Children Research Articles

Biomarkers for febrile urinary tract infection in children.

The current reference standard for pediatric urinary tract infection (UTI) screening, the leukocyte esterase (LE) dipstick test, has suboptimal accuracy. The objective of this study was to compare the accuracy of novel urinary biomarkers to that of the LE test. We prospectively enrolled febrile children who were evaluated for UTI based on their presenting symptoms. We compared the accuracy of urinary biomarkers to that of the test. We included 374 children (50 with UTI, 324 without UTI, ages 1-35 months) and examined 35 urinary biomarkers. The urinary biomarkers that best discriminated between febrile children with and without UTI were urinary neutrophil gelatinase-associated lipocalin (NGAL), IL-1β, CXCL1, and IL-8. Of all examined urinary biomarkers, the urinary NGAL had the highest accuracy with a sensitivity of 90% (CI: 82-98) and a specificity of 96% (CI: 93-98). Because the sensitivity of the urinary NGAL test is slightly higher than that of the LE test, it can potentially reduce missed UTI cases. Limitations of using urinary NGAL over LE include increased cost and complexity. Further investigation is warranted to determine the cost-effectiveness of urinary NGAL as a screening test for UTI.

Assessing the burden of bronchiolitis and lower respiratory tract infections in children ≤24 months of age in Italy, 2012-2019.

Bronchiolitis is the most common lower respiratory tract infection (LRTI) in children and is mainly caused by the Respiratory Syncytial Virus (RSV). Bronchiolitis presents seasonally and lasts about five months, usually between October to March, with peaks of hospitalizations between December and February, in the Northern Hemisphere. The burden of bronchiolitis and RSV in primary care is not well understood. This retrospective analysis used data from Pedianet, a comprehensive paediatric primary care database of 161 family paediatricians in Italy. We evaluated the incidence rates (IR) of all-cause bronchiolitis (ICD9-CM codes 466.1, 466.11 or 466.19), all-cause LRTIs, RSV-bronchiolitis and RSV-LRTIs in children from 0 to 24 months of age, between January 2012 to December 2019. The role of prematurity (<37 weeks of gestational age) as a bronchiolitis risk factor was evaluated and expressed as odds ratio. Of the 108,960 children included in the study cohort, 7,956 episodes of bronchiolitis and 37,827 episodes of LRTIs were recorded for an IR of 47 and 221 × 1,000 person-years, respectively. IRs did not vary significantly throughout the eight years of RSV seasons considered, showing a seasonality usually lasting five months, between October and March, while the peak of incidence was between December and February. Bronchiolitis and LRTI IRs were higher during the RSV season, between October and March, regardless of the month of birth, with bronchiolitis IR being higher in children aged ≤12 months. Only 2.3% of bronchiolitis and LRTI were coded as RSV-related. Prematurity and comorbidity increased the risk of bronchiolitis; however, 92% of cases happened in children born at term, and 97% happened in children with no comorbidities or otherwise healthy. Our results confirm that all children aged ≤24 months are at risk of bronchiolitis and LRTI during the RSV season, regardless of the month of birth, gestational age or underlying health conditions. The IRs of bronchiolitis and LRTI RSV-related are underestimated due to the poor outpatient epidemiological and virological surveillance. Strengthening the surveillance system at the paediatric outpatient level, as well as at the inpatient level, is needed to unveil the actual burden of RSV-bronchiolitis and RSV-LRTI, as well as to evaluate the effectiveness of new preventive strategies for anti-RSV.

Virological profile of upper respiratory tract infections in children under 5 years of age- a cross sectional study in a tertiary care hospital in North India

Objective: To study the virological profile of URI among children under 5 years of age. Since, it is very difficult to distinguish between various viral etiologies solely on the basis of symptoms, this study was attempted to generate evidence that majority of URI are caused due to viral illness and no antibiotics should be prescribed in the management of the same. Methods: This observational study was conducted over a period of one year (June 2021–May 2022) in a tertiary care teaching hospital in New Delhi. A total of 180 children between the age of 0–5 years with symptoms of URI were included. Nasopharyngeal swabs were taken and processed for detection of viruses using multiplex RT PCR. Results: Presence of viruses were detected in 136 (75.6%) samples. A single virus was identified in 113 samples, whereas 21 were found to harbour two viruses and 2 were carrying three viruses. The most common virus isolated was Human Rhinovirus (HRV- 55.8%) followed by Respiratory Syncytial Virus (RSV- 23.5%). In samples showing coinfection with two viruses, most common was Human Corona Virus (HCoV)- NL63, 229E, OC43, HKU1. None of the patients were given antibiotics. None of the patients required any hospital admission for severe respiratory illness. Conclusions: Viruses are a major cause of URI in children under five years of age, with the most prevalent organisms being HRV and RSV. Antibiotic prescriptions in URI are not warranted.

Frequency of urinary tract infection in children with nephrotic syndrome.

Objective: To Determine the Frequency of Urinary Tract Infection in Children Presenting With Nephrotic Syndrome. Study Design: Descriptive Cross Sectional Study. Setting: Department of Pediatrics, Lady Reading Hospital (LRH), Peshawar. Period: 16th July 2019 to 15th July 2020. Material &amp; Methods: All children presenting with nephrotic syndrome were evaluated, detailed history was obtained and complete detailed examination were performed to exclude the confounders and possible bias in the results of this study. From all these children, mid-stream clean urine catch urine was obtained with strict sterile technique and the sample was to hospital laboratory to diagnose UTI. Data was analyzed by SPSS. Results: Of these 106 study cases, 69 (65.1%) were male patients while 37 (34.9%) were female patients. The mean age of this study population was 7.71±3.11 years. Mean Duration of Illness was 5.25±4.38 months and 52.8% had duration of illness up to 6 months. Of these 106 study cases, 70 (66.00%) mothers were illiterate and 36(34.00%) mothers were literate. Urinary Tract Infection (UTI) was diagnosed in 27 (25.5%). Conclusion: Our Study results concludes that the frequency of urinary tract infection is very high (25.5%) in children with Nephrotic syndrome.

Extended-Spectrum β-Lactamase-Producing Escherichia coli and Virulence Genes in Pediatric Patients with Health-Care Urinary Tract Infections.

Healthcare-associated urinary tract infection (UTI) represents a significant health problem, especially in infants and young children. The most common pathogen associated with this infection is Escherichia coli (E. coli). The present study aimed to detect the frequency of virulence genes among clinical isolates of E. coli isolated from healthcare-associated urinary tract infections in children and the correlation between these virulence genes and the presence of the blaCTX gene. The study included one hundred clinical isolates of E. coli isolated from healthcareassociated urinary tract infections in children in intensive care units. The isolates were subjected to antibiotics sensitivity by disc diffusion method and detection of extended-spectrum beta-lactamase by double disc diffusion method. In addition, multiplex polymerase chain reaction (PCR) was used to detect some virulence genes, and PCR was used to detect the blaCTX-M gene. E. coli producing ESBL by double discs method was identified in 74 isolates. blaCTX-M gene detection by PCR was identified among 38 isolates representing 51.4% of ESBL-producing E. coli. There was a significant association between ESBL and blaCTX-M Gene, P = 0.0001. The frequency of the studied virulence genes by multiplex PCR in the isolated E. coli was 66% for the Fim gene, 75% for the Aer gene, 68% for the FliC gene, 53% for each of IucD gene and Usp gene, 40% for pap gene, 35% for each of AFA and ironN genes and 17% for sfa gene. None of the isolated E. coli had the Cdt gene. There was a significant association between the presence of the FimH gene (P = 0.0001), Pap gene (P = 0.05), sfa (P = 0.026), Afa gene (P = 0.018), and aer gene (P = 0.035) and the presence of the blaCTX-M gene in the isolated E. coli. The present study highlights the presence of virulence genes and blaCTX-M gene in uropathogenic E. coli isolated from pediatric patients with healthcare-associated urinary tract infections. There was an association between the blaCTX-M gene and virulence genes FimH, pap, sfa, Afa, and aer. Various distributions of the studied genes with a high frequency of fimbria are flic genes. Moreover, the ESBL had high frequency in E. coli with the presence of blaCTX-M in about one-third of the isolates.

Imaging investigation after urinary tract infection in childhood: narrative review of current recommendations

Imaging investigation after urinary tract infection in childhood: narrative review of current recommendations

Antimicrobial Sensitivity Pattern of Causative Agents of Urinary Tract Infection in Children Between 1 to 15 Years

Background: The presence of actively multiplying organisms in the urinary tract implies urinary tract infection. Although it is infrequently associated with mortality, it is still an important cause of morbidity in the pediatric age group. Prompt diagnosis and early initiation of appropriate antibiotics in children reduce the morbidities associated with urinary tract infection. The objective of the study was to find out the causative agents of urinary tract infections and their antibiotic sensitivity pattern in pediatric patients.&#x0D; Methods: This was a cross-sectional study conducted in the department of pediatrics over a period of 12 months and 80 patients fulfilled the inclusion criteria. The modes of presentation, laboratory investigation reports which included urine routine microscopy, bacterial isolates with colony count from the urine culture, and antibiotic sensitivity pattern were documented. Descriptive statistics were used for analysis of data.&#x0D; Result: Escherichia coli was the most common organism isolated (55.9%). Most of them were sensitive to amikacin.The highest degree of resistance was noticed with ampicillin.&#x0D; Conclusion: Aminoglycosides like amikacin can be considered as first-line drugs in urinary tract infection. &#x0D; Keywords: antibiotics, children, urinary tract infections.

Do We Have Enough Evidence to Lower the Urinary Bacterial Colony Counts for the Diagnosis of Urinary Tract Infection in Children?

Do We Have Enough Evidence to Lower the Urinary Bacterial Colony Counts for the Diagnosis of Urinary Tract Infection in Children?

Urinary Tract Infection in Children Presenting with Nephrotic Syndrome

Background: Nephrotic syndrome, or nephrosis, is defined by the1presence of nephrotic-range1 proteinuria, edema, hypoalbuminemia &amp; hyperlipidemia. Nephrotic syndrome remains the common manifestation of glomerular disease in childhood. UTI is a common infection accompanying nephrotic syndrome. But there is no local evidence available. Aim: To assess the frequency of urinary tract infection in children presenting with nephrotic syndrome in a tertiary1care hospital. Study design: Cross sectional study. Methodology: Total 280 children fulfilled the inclusion criteria were included through non-probability convenience sampling. Urine sample was obtained in sterile container &amp; was sent to the pathology1laboratory of the hospital. Then reports were assessed &amp; if pathogen was present, then UTI was labeled. Data was evaluated by using SPSS v.24. Quantitative data was presented as mean±SD. Qualitative data was presented as frequency and percentage. Chi-square test was applied with P-value ≤0.05 taken as significant. Results: The mean age was 7.07±3.09years. There were 152(54.3%) males and 128(45.7%) females. The mean weight of patients was 24.30±7.75kg. The mean duration of nephrotic syndrome was 9.66±5.37months. There were 147(52.5%) patients who had UTI while 133(47.5%) patients did not have UTI. Practical Implication: As there is a high incidence of UTI among nephritic children and there is lack of local data that specifically addresses this health issue thus current study was planned. Results regarding precise estimate of UTI frequency in nephrotic syndrome patients helped to formulate recommendations for early screening to initiate early management of UTI. This information also helped in reducing morbidity and mortality in children with nephrotic syndrome. Conclusion: It was concluded that frequency of UTI was high in children with nephrotic syndrome hence screening of UTI is necessary on regular intervals in children with1nephrotic syndrome. Keywords: Urinary Tract Infection, Nephrotic Syndrome, Children, Proteinuria and Albuminuria.

ПАТОЛОГИЯ МОЧЕВЫДЕЛИТЕЛЬНОЙ СИСТЕМЫ И ЕЕ ЧАСТОТА У ДЕТЕЙ НА ФОНЕ COVID-19

This review presents data on endothelial dysfunction and the mechanisms of its development in coro-navirus disease. The possible pathology of the urinary system and its frequency in children against the background of COVID-19, which is mainly due to endothelial dysfunction, is described. Displayed studies on the frequency of urinary tract infections in children and adolescents during a pandemic, which depended on the level of quarantine measures, which in turn affect the neuro-psychological causes of bladder dysfunction, limited timely access to medical care, etc. A systematic review of stud-ies published in English from 2000 to 2019 was performed (with predominant inclusion (84,6 %) of data for the last 2 years) using PubMed, ScienceDirect, ProQuest, GoogleScholar, Cochrane, Medline, AMED databases., EMBASE, CINHAL, SportDiscus, Scopus and PEDro. The review included review articles, meta-analyses, qualitative studies, retrospective and prospective studies.

Urinary Tract Infection in Children

Infeksi saluran kemih merupakan infeksi yang sering ditemukan pada anak-anak, dimana infeksi dapat mengenai bagian atas maupun bawah dari traktus urinarius. Infeksi saluran kemih merupakan salah satu penyebab demam tersering yang dialami oleh anak-anak, terutama anak perempuan. Infeksi saluran kemih digolongkan ke dalam infeksi saluran kemih atas (pielonefritis), saluran bawah (sistitis) dan bakteriuria asimtomatik. Penelitian ini bertujuan mengeksplorasi gejala, diagnosis dan penatalaksanaan infeksi saluran kemih pada anak. Ditemukan bahwa dalam menegakkan diagnosis infeksi saluran kemih, dibutuhkan analisis urin dan pemeriksaan kultur urin, dengan memperhatikan pengambilan sampel urin. Pemeriksaan urinalisis dapat digunakan untuk menegakkan diagnosis dari infeksi saluran kemih jika ditemukan adanya leukosit esterase atau nitrit yang positif dan kultur urine. Penatalaksanaan infeksi saluran kemih pada anak dapat menjadi tantangan karena gejala yang muncul secara samar dan tidak spesifik, namun penatalaksanaan infeksi saluran kemih harus memperhatikan tingkat resistensi, usia anak, lokasi infeksi saluran kemih, tingkat keparahan, dan antibiotik yang diberikan, sedangkan pengobatan terhadap infeksi saluran kemih dilakukan untuk mencegah terjadinya sepsis pada anak, dimana penggunaan antibiotik masih merupakan salah satu terapi utama untuk mengatasi infeksi saluran kemih pada anak. Penggunaan antibiotik pada anak dengan Vesicoureteral Reflux (VUR) bertujuan untuk mengurangi kekambuhan infeksi saluran kemih, sehingga direkomendasikan antimikroba dengan dosis yang rendah.

Mayer‐Rokitansky‐Küster‐Hauser syndrome presented as recurrent urinary tract infection in childhood (case report)

AbstractBackgroundMayer‐Rokitansky‐Küster‐Hauser syndrome (MRKH) is characterized by the absence of the uterus and upper two‐thirds of the vagina, normal secondary sexual development, and 46XX karyotype is one of the rare types of Mullerian agenesis. There may be associated congenital anomalies in other organ systems especially those with the same embryogenesis such as the urinary tract mostly in its upper parts present in 40% of cases including renal agenesis, ectopic kidney (unilateral or bilateral), renal hypoplasia, horseshoe kidneys, and hydronephrosis. Other organ systems also may be affected such as skeletal and auditory systems. MRKH is diagnosed mostly during or after adolescence because of unexpected amenorrhea or disturbed sexual experiences.Case reportWe present a 3‐year‐old girl coming with recurrent bouts of urinary tract infections diagnosed as having MRKH syndrome established by imaging and genetic studies. Our case is very rare and interesting because it presents itself as a recurrent urinary tract infection in early childhood which is rare and unusual. In this case, early detection helped us to prevent chronic kidney disease and also planning to perform necessary minimal but very important surgical procedures before initiation of sexual activities to relieve the psychosocial aspect of the syndrome both for the child and parents.ConclusionHealth givers should keep in mind that rare syndromes may present as a repeated quite common problem or have confusing or conceiving presentations. This point will assist us in the early detection of rare diseases at an earlier age or stage.

Accelerated bacteriological examination of urine and dialysate in the diagnosis of urinary tract infections in children

Aim. To evaluate the feasibility of an accelerated method for determining the etiology of infections in urine, dialysate and residual antimicrobial activity by using laser light scattering technology.Materials and methods. From January to September 2019, 106 urine samples and 42 dialysate samples from children aged 1–16 with various urinary pathologies and those on peritoneal dialysis underwent culture-based examination on an ALIFAX HB&amp;L LIGHT analyzer (Alifax, Italy) using laser light scattering technology.Results. Three hours after inoculation, 81 samples (76.4%) appeared to be negative and 25 samples (23.6%) proved to be positive. No microorganisms were detected in 38 dialysate samples (90.5%), two samples had Staphylococcus aureus (104 CFU/ml), and one dialysate sample had Corynebacterium sp. and associations of Escherichia coli + Candida albicans + Staphylococcus haemolyticus, associated with peritoneal catheter colonization. Bacteriuria was caused by Enterobacterales in 39.3% (E. coli, Morganella morganii, Citrobacter amalonaticus, Enterobacter cloacae), non-fermenting gram-negative bacteria – in 14.3% (Pseudomonas aeruginosa, Ralstonia picketii, Oligella sp., Acinetobacter baumannii), Enterococcus sp. – 21.4%, S. haemolyticus, Staphylococcus epidermidis – 10.7%, Candida albicans – 3.6%, contamination: Streptococcus viridians, Corynebacterium sp. – 7.1%. Residual antimicrobial activity in urine was detected in 30.1% of patients.Conclusion. The laser light scattering technology enables a minimal concentration of microorganisms to be detected in a smaller amount of urine or dialysate, which is very important for accelerated diagnosis of urinary tract infections and complications of peritoneal dialysis in children.

Bacterial profile, their antibiotic susceptibility pattern, and associated factors of urinary tract infections in children at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Urinary tract infections (UTIs) are common pediatric infections and contribute to high morbidity and mortality. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. However, there have been few studies on UTIs in children in Ethiopia, particularly in the east. This study aimed to assess the bacterial profile of urinary tract infections, their susceptibility to antimicrobial agents, and associated factors in under-five children at Hiwot Fana Specialized University Hospital, eastern Ethiopia. We conducted hospital-based quantitative study on 332 consecutively selected under-five children from March 20 to June 10, 2021. Parents and guardians were interviewed to collect data using a structured questionnaire. Random urine samples were collected aseptically, and standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into Epi Info version 7 and exported to Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive analysis, bivariate, and multivariable logistic regression analysis. The crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CI) were used to determine the significance of the predictors. A p-value at a 95% confidence interval of less than 0.05 was considered statistically significant. The overall prevalence of bacterial urinary tract infections was 80 (24.1%) 95% CI:19.40-29.00%). Most of the bacterial isolates 55 (68.75%) were gram-negative bacteria, predominantly E. coli 23 (28.75%) and K. pneumoniae 10 (12.50%). Being a rural resident (AOR: 4.10, 95%CI: 1.45 11.54), uncircumcised male (AOR: 3.52, 95%CI: 1.33, 9.39), previous history of antibiotic usage (AOR: 7.32, 95%CI: 2.11, 25.37), indwelling catheterization (AOR: 10.35, 95%CI: 3.74, 28.63), previous history of urinary tract infections (AOR: 5.64, 95% CI: 1.36, 23.38), and urinary frequency (AOR: 5.56, 95%CI: 2.03, 15.25) had higher odds of culture positive result. The majority of the isolates have shown high levels of antibiotic resistance. Meropenem, ciprofloxacin, and amoxicillin-clavulanic acid were effective against gram-negative uropathogens, whereas rifampin and ciprofloxacin were the most sensitive drugs for gram-positive isolates. From the tested bacterial isolates, 53/86 (61.6%), 11/86 (11.6%), and 2/86 (2.3%) were found to have multidrug resistance (MDR), extreme drug resistance (XDR), and pan drug resistance (PDR), respectively. About one-fourth of the children were culture-positive for many types of bacterial uropathogens; this is higher compared with most of the previous studies in Africa. Rural dwellers, uncircumcised males, indwelling catheterization, a history of antibiotic use and urinary tract infection, and frequent urination all had a higher risk of bacterial infections. Many isolates were resistant to multiple drugs, primarily beta-lactams. Urinary tract infections as well as the growth and spread of resistant bacterial pathogens should be monitor regularly.

Retrospective analysis of cefpodoxime proxetil dispersible tablets in the treatment of respiratory tract infection in children and study of the antibacterial effect of cefpodoxime proxetil nanoemulsion

A study was conducted to determine the efficacy and safety of cefpodoxime proxetil (CFP) dispersible tablets in the treatment of respiratory tract infection in children and to analyze the antibacterial effect of cefpodoxime proxetil nanoemulsion (CFP-NE). A retrospective analysis was conducted on 118 children with upper respiratory tract infection who received antibiotic treatment between March 2018 and March 2021. The control group was treated with cefradine and the CFP group was treated with CFP dispersible tablets. The serum indexes and bacteriological test results of the two groups were collected before and after treatment, and the bacterial clearance rate, infection control, and occurrence of adverse reactions were observed and compared between the two groups. Cefpodoxime proxetil nanoemulsion (CFP-NE) was prepared and its surface characteristics were observed. CFP-NE and CFP were used to treat infections by multiple strains of bacteria and the antibacterial effect and minimum inhibitory concentration (MIC) of CFP-NE were observed. The bacterial strain clearance rate of the CFP group was 96.2% and the total infection control rate was 94.92%. The bacterial strain clearance rate of the control group was 88.9% and the total infection control rate was 81.36%. Serum index detection showed that antibiotic treatment could reduce serum indexes of amyloid A, C-reactive protein, procalcitonin, and other indexes and CFP had better efficacy. There were only four cases of adverse reactions after treatment with CFP, a result similar to that of other antibiotics. The prepared CFP-NE system was stable, the particles were uniform, and the diameter of the inhibitory zone against pathogenic Escherichia coli and Salmonella was larger than that of the CFP group. The MIC of CFP-NE was significantly lower than the MIC of the CFP group (P &lt; 0.05). CFP dispersible tablets are safe and effective for the treatment of respiratory tract infection in children and the antibacterial effect of CFP-NE is greater than that of CFP.

Constipation as a Risk for Urinary Tract Infection in Children

Constipation as a Risk for Urinary Tract Infection in Children

Clinical, uropathogenic, and radiological profile of culture-positive urinary tract infections in children below 18 months of age

Background: Urinary tract infections (UTIs) are common in children and have the risk of renal scarring. To better identify this at risk group, the following study was carried out to analyze the clinical profile of children below 18 months of age with culture-positive UTI and the outcome of radiological investigations. The primary objective was to assess the clinical profile of culture-positive UTI children and diagnostic yield and correlation between radiological tests. The secondary objectives were to assess the prevalent uropathogens and their antibiogram. Materials and Methods: For this retrospective study, clinical details regarding radiological investigations, prevalent uropathogens and antibiograms, common antibiotics used in treatment, and uroprophylaxis were obtained through electronic medical records in children &lt;18 months of age admitted with culture-positive UTI. Results: In 225 children seen over a period of 36 months, a slight male predominance (56%) was observed. Ultrasonography (USG) was done in nearly all children, micturating cystourethrography (MCU) was performed in only 40% of patients, dimercaptosuccinic acid (DMSA), performed after 6 months of the index UTI, in one-fifths of the patients. All three investigations were performed in one out of six children. USG and MCU used in combination detected the highest number of significant abnormalities (39%) compared to USG and DMSA (32%). Escherichia coli was the predominant uropathogen identified. Significant meropenem resistance (52%) was observed in the community-acquired UTI. Conclusion: The evaluation and follow-up of infants and young children with UTI show inadequate radiological evaluation, which could increase the risk of undetected and untreated renal sequelae.

Impact of the bacterial nasopharyngeal microbiota on the severity of genus enterovirus lower respiratory tract infection in children: A case-control study.

Rhinoviruses (RV) and enteroviruses (EV) are among the main causative etiologies of lower respiratory tract infection (LRTI) in children. The clinical spectrum of RV/EV infection is wide, which could be explained by diverse environmental, pathogen-, and host-related factors. Little is known about the nasopharyngeal microbiota as a risk factor or disease modifier for RV/EV infection in pediatric patients. This study describes distinct nasopharyngeal microbiota profiles according to RV/EV LRTI status in children. Cross-sectional case-control study, conducted at Hospital Sant de Déu (Barcelona, Spain) from 2017 to 2020. Three groups of children <5 years were included: healthy controls without viral detection (Group A), mild or asymptomatic controls with RV/EV infection (Group B), and cases with severe RV/EV infection admitted to the pediatric intensive care unit (PICU) (Group C). Nasopharyngeal samples were collected from participants for viral DNA/RNA detection by multiplex-polymerase chainreaction andbacterial microbiota characterization by 16S rRNA gene sequencing. A total of 104 subjects were recruited (A = 17, B = 34, C = 53). Children's nasopharyngeal microbiota composition varied according to their RV/EV infection status. Richness and diversity were decreased among children with severe infection. Nasopharyngeal microbiota profiles enriched in genus Dolosigranulum were related to respiratory health, while genus Haemophiluswas specifically predominant in children with severe RV/EV LRTI. Children with mild or asymptomatic RV/EV infection showed an intermediate profile. These results suggest a close relationship between the nasopharyngeal microbiota and different clinical presentations of RV/EV infection.

Epidemiology and clinical course of bronchiolitis in hospitalized children in tertiary care hospital in Kashmir

Background: Bronchiolitis is the commonest lower respiratory tract infection in children &lt; 2 years of age and is responsible for the majority of their pediatrician visits and hospital admission during the winter season. The aim of this study was to describe the epidemiological data, seasonal trends, clinical characteristics, and outcomes of children admitted with bronchiolitis in pediatric hospital GMC Srinagar. Methods: This was a retrospective observational study in children less than 2 years of age admitted in department of pediatrics in GMC Srinagar. Data were collected through review of the medical records of patients with a diagnosis of bronchiolitis on discharge and analyzed through SPSS 20. Results: A total of 228 infants were enrolled in the study. The majority were males (60.08%). The median age on admission was 5.5 months, exclusive breastfeeding was the mode of feeding in majority and 8.77% were ex-preterm. Respiratory syncytial virus (RSV) was identified in majority (103) and admission peak was from October to March. Most of the patients presented on day 3 of the illness. Most patients 45.17% were having feeding difficulties and chest auscultation was normal in about 22% of the children. Oxygen supplementation was administered to 85.52% of the children. The 32 children (14.03%) required admission to PICU. Mechanical ventilation was required in 6 children (18.75%). No death occurred in infants while in the hospital. Conclusions: RSV has been found to be the main responsible virus. Management of bronchiolitis is usually symptomatic as recommended by most of the guidelines.

Detection of Respiratory Syncytial Virus in Suspected Asthmatic Children by Conventional RT-PCR Assays in Kathmandu

Respiratory Syncytial Virus (RSV) is the most common causative agent for lower respiratory tract infections in children particularly in infants. At least 50% of children are infected with RSV by the age of 2 to 3 years of age. However, the diagnosis of the RSV infection and its association with risk factors for asthma in asthmatic children is not studied in Nepal. The objectives of this study were to determine the prevalence of RSV in asthmatic children. This work was a hospital based cross-sectional prospective study and conducted from September 2017 to February 2018. Ethical approval was obtained from the Institutional Review Committee (IRC) of Kanti Children’s Hospital, Maharajgunj. Suspected asthmatic children visiting the Special Asthma OPD of Kanti Children’s Hospital, Maharajgunj were selected with the help of asthma specialist using a set of inclusion criteria for asthma. A total of 32 nasal swab samples were obtained from suspected asthmatic children. Initially, samples were processed for RNA extraction. The extracted RNA was then used for cDNA synthesis followed by PCR using primers for the Nucleocapsid (N) gene of RSV. Out of total 32 samples, 9 (28%) samples were positive for the N gene of RSV. There was no significant association of different variables including age (P=0.187), sex (P=0.264), family history of asthma (P=0.115), passive smoking (P=0.88), birth weight (P=0.954), seasonality (P=0.298) and history of pneumonia (P=0.457) with the RSV infection in this study.