Tract Infections In Children Research Articles

Urinary Tract Infection in Children: A Narrative Review.

This study investigates the susceptibility of different age groups and genders to urinary tract infections (UTIs) in pediatric populations, focusing on anatomical and behavioural factors. A systematic review of clinical data explores manifestations, accurate diagnosis methods, and antibiotic treatment regimens. Escherichia coli is a prevalent uropathogen, and the study addresses concerns about antibiotic resistance. The research aims to close knowledge gaps, influence guidelines, and enhance public health initiatives. Factors influencing UTI prevalence, such as age, gender, and structural abnormalities, are discussed. The review follows a robust search methodology, presenting a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The included studies cover a wide range of topics related to pediatric UTIs, including aetiology, treatment, prevention, and diagnostic approaches. The study emphasizes the importance of understanding and addressing pediatric UTIs for effective management and prevention.

Risk Factors for Lower Respiratory Tract Infection and Recurrent Lower Respiratory Tract Infection in Children

Risk Factors for Lower Respiratory Tract Infection and Recurrent Lower Respiratory Tract Infection in Children

PEMETAAN DAN POLA PENYEBARAN KASUS PNEUMONIA PADA BALITA BERBASIS SISTEM INFORMASI GEOGRAFIS DI KOTA DENPASAR TAHUN 2022

Background: Pneumonia is part of respiratory tract infections in children and is one of the diseases that causes the most deaths in toddlers. According to data from the Ministry of Health of the Republic of Indonesia for 2021, based on 34 provinces of pneumonia in toddlers, Bali ranks ninth with the largest coverage of pneumonia in toddlers, namely 28.6% of cases with 23 cases of deaths in toddlers. The purpose of this research is to describe the mapping and patterns the spread of pneumonia in toddlers in Denpasar City in 2022 based on Geographic Information Systems (GIS Methods The design in this study uses descriptive quantitative with the research design used is cross sectional. Sampling of 260 samples was carried out using a purposive sampling technique. Data analysis using spatial classification analysis. Results: From the results of the study it was found that the spread of pneumonia in toddlers in Denpasar City in 2022 was classified into three categories namely high, medium and low. The pattern of distribution of pneumonia cases in Denpasar City in 2022 is the highest in West Denpasar District with 94 cases. Conclusion: The conclusion of this research is that the West Denpasar Subdistrict region has the highest cases and the lowest cases are found in the East Denpasar Subdistrict region. Age, gender and population density are risk factors that influence the high incidence of pneumonia in children under five in Denpasar City.

MANAGEMENT OF CROUP IN CHILDREN: A CASE REPORT

Background Croup is a viral respiratory disease in children that attacks the larynx and trachea causes obstruction or blockage of the upper respiratory tract which, if severe, can be life-threatening. Diagnosis of respiratory tract infection in children requires keen clinical vigilance to understand the risk of airway obstruction and the possible need for prompt intervention. Clinical symptoms in croup usually fever, runny nose, painful swallowing, and mild cough. This condition can develop into a loud, hoarse and harsh cough. Recognition of signs and symptoms is very important to prevent morbidity and mortality. Objective To describe diagnosis and management of croup in children. Case Description A 3-year-old boy, came to the emergency room with complaints of sudden shortness of breath this morning accompanied by fever and a barking cough. These complaints had been felt for 3 days before going to the hospital, but they can reduce on their own and according to the parents there were no danger signs for complaints in their children. Conclusion Croup is a self-limited disease, but sometimes it tends to be severe and even fatal. Prompt and appropriate management can prevent or reduce the risk of croup morbidity and mortality in children .

A cross-sectional study of clinical a nd microbiological profile of urinary tract infections in children from tertiary care centre in Maharashtra

Abstract Introduction: Urinary tract infections (UTIs) are common in children, often leading to renal damage if not promptly treated. Understanding the changing epidemiology, causative agents, and antibiotic resistance patterns is crucial for effective management. Methods: A cross-sectional study was conducted at a tertiary care hospital. 100 children aged 1 month to 18 years diagnosed with UTI based on symptoms, pyuria, and bacteriuria were enrolled. Data on demographics, clinical features, and antibiotic use were collected. Urine samples were cultured, and antimicrobial susceptibility testing was performed. Results: Infants (<1 year) showed a higher male prevalence (69.6%) compared to females (30.4%). Fever was the most common symptom (92%). Escherichia coli (E. coli) was the predominant pathogen (69%), followed by Klebsiella pneumoniae (10%) and Enterobacter spp. (6%). Antibiotic resistance was observed, with 20% sensitive to 4 or fewer antibiotics and 27% sensitive to 9-12 antibiotics. Prior urinary instrumentation, past UTI history, and recent antibiotic use were identified as risk factors for resistance. ESBL-producing organisms showed significant resistance to cephalosporins and ciprofloxacin compared to non-ESBL organisms. Conclusions: UTIs in children show age-specific gender variations and evolving bacterial profiles. E. coli remains the dominant pathogen, but resistance is rising. Prior interventions, past UTIs, and recent antibiotic use are associated with resistance. ESBL-producing organisms pose a particular challenge. These findings highlight the need for judicious antibiotic use and tailored management strategies based on age, bacterial profile, and resistance patterns.

Urinary tract infections in children in the era of growing antimicrobial resistance – recommendations of the Polish Society of Paediatric Nephrology

Introduction and objective: Urinary tract infections can recur in children, and due to their potential long-term consequences, they require appropriate diagnosis and prompt treatment. Although Escherichia coli is the most common aetiology, an increase in infections with drug-resistant strains has been observed. The aim of this study was to develop current diagnostic and treatment recommendations in the era of increasing microbial resistance. Materials and methods: The recommendations are based on updated guidelines developed by the experts of the Polish Society of Paediatric Nephrology and a literature review. Results: Because the symptoms of urinary tract infection are often non-specific, urinalysis and urine culture should be performed in children presenting with fever without an identifiable cause. Correct method of urine collection and interpretation of the results are crucial for therapeutic decisions. Treatment should be continued for 7–14 days for upper and 3–5 days for lower urinary tract infections; the choice of the narrowest-spectrum antimicrobial should be based on bacterial susceptibility. Antibiotic prophylaxis is limited and recommended in children with grade III–V vesicoureteral reflux. Non-pharmacological management should include treatment of bladder and bowel dysfunction. Ultrasound is recommended for all children up to 24 months of age. Indications for voiding cystourethrography are limited to cases with ultrasound abnormalities, recurrent and septic infections. Conclusion: The paper provides up-to-date, practical recommendations for the diagnosis and management of urinary tract infections in children in the era of increasing microbial resistance and restricted indications for invasive radiological investigations.

The Effect of Clean Intermittent Catheterization-Based Nursing Interventions on the Knowledge, Skill, Coping, Adaptation, Anxiety in Caregivers and Infection in Children: A Randomized Controlled Study Protocol

Objective: To explore the effect of clean intermittent catheterization training based on android application-supported Roy Adaptation Model (RAMTAKE) given by nurses to caregivers on their knowledge, skills, coping, adaptation and anxiety levels and the development of infection in the child. 
 Material and Method: The study is a single-center, single-blind, prospective, randomized controlled trial. This randomized controlled trial was reported according to SPRIT. The sample of the study consisted of 42 patients and their caregivers who underwent clean intermittent catheterization in a university hospital. Participants were divided into two separate groups, experimental and control, by simple random sampling method. Participants in the experimental group will be given RAMTAKE, and after being discharged from the hospital, home visits and telephone counseling will be applied by the researchers. The caregivers in the control group will not be subjected to any intervention by the researchers and will be provided with routine clean intermittent catheterization training in the hospital. Study data will be collected using The knowledge, skill level of the caregiver, The Roy Adaptation Model (RAM) psychosocial adaptation areas scale, Coping and Adaptation Scale, The State/Trait Anxiety Scale and UTI development in children. Knowledge, skills, coping, adaptation and anxiety levels of caregivers in both groups will be measured three times. In addition, after discharge from the hospital, children in both groups will be tested for urine culture three times with an interval of one month. Researchers will not interfere with caregivers during the data collection and urine culture analysis phase of the study.
 Results: How beneficial clean intermittent catheterization is for children who cannot urinate on their own is quite clear. However, the effect of RAMTAKE knowledge/skills, anxiety level and coping/adaptation of the caregivers and the development of infection in children is yet unknown. Within the scope of the study, it is aimed that the knowledge/skills, coping and adaptation levels of the caregivers who receive RAMTAKE will increase and their anxiety level will decrease. In addition, it is thought that the frequency of urinary tract infection will decrease in the children of caregivers who receive RAMTAKE.
 Conclusion: This study is expected to provide reliable evidence to increase the knowledge, skill, coping, adherence level of caregivers who apply clean intermittent catheterization to their children, and to reduce the anxiety level of caregivers with urinary tract infections in children.

Pediatric tuina for recurrent respiratory tract infection in children: A systematic review and meta-analysis.

To evaluate the effects and safety of pediatric tuina for recurrent respiratory tract infections (RRTIs). Web of Science, PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, VIP, and CBM databases were searched from inception to September 20 2023. Two authors independently selected studies, collected data, and evaluated methodological quality using the Cochrane Risk of Bias tool. Revman 5.4 was used for the meta-analysis. Fifteen randomized controlled trials involving 1420 pediatric patients were included in this meta-analysis. The meta-analysis indicated that pediatric tuina significantly reduced the incidence of RRTIs [MD -1.11, 95% confidence interval (CI) (-1.77, -0.46)], decreased infection duration (MD -1.16 days, 95% CI [- 1.66, - 0.66]), improved IgA (MD 0.25 g/L, 95% CI [0.09, 0.41]), IgG (MD 1.64 g/L; 95% CI [0.82, 2.45]), CD3+ (MD 3.33%, 95% CI [0.74, 5.92]), CD4+ (MD 4.78%, 95% CI [2.08, 7.48]), CD4+/CD8+ ratio (MD 0.27%, 95% CI [0.08, 0.47]), and total effective rate (RR 1.19, 95% CI [1.13, 1.25]). However, IgM levels (MD 0.26 g/L, 95% CI [-0.26, 0.81]) and CD8+ (MD -1.36%, 95% CI [- 3.12, 0.41]) were not significantly different between the groups. Moreover, no Tuina-linked adverse reactions were observed. Pediatric tuina has shown positive effects in RRTIs treatment. However, these results should be interpreted with caution owing to study quality. Further large-scale and high-quality randomized controlled trials are warranted to confirm these findings.

Mycoplasma Pneumoniae as a Causative Agent of Community-Acquired Lower Respiratory Tract Infections in Children

Mycoplasma pneumoniae (M. pneumoniae) causes respiratory tract infections in all age groups but older children and young adults are more affected than other age groups.

Impact of covid-19 pandemic on the epidemiology and etiology of lower respiratory tract infections in children

Purpose: Changes in the epidemiology of communicable diseases in children are one of the direct and measurable consequences of the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to evaluate the impact of the recent pandemic on the epidemiology of lower respiratory tract infections and the relevant causative pathogens other than severe acute respiratory syndrome coronavirus 2. 
 Methods: In this retrospective study, all children hospitalized due to lower respiratory tract infections in 2019 and 2021 were enrolled. The nasopharyngeal swab test was performed using polymerase chain reaction to identify prevalent respiratory viruses and atypical bacteria. 
 Results: A total of 356 children were hospitalized due to lower respiratory tract infections in 2019 and 250 children in 2021 (a reduction of 29.8%). The proportion of children hospitalized due to atypical pneumonia and bacterial pneumonia decreased from 10.1% and 21.9% in 2019 to 2.8% and 12.0% in 2021, respectively (P <0.01 for both). A complete disappearance of influenza viral infections was observed in 2021. Moreover, a profound decrease in the proportion of Mycoplasma pneumoniae–positive specimens from 9.0% in 2019 to 2.7% in 2021 was observed (P <0.01). However, the proportion of rhinovirus-positive specimens increased from 8.2% in 2019 to 41.2% in 2021 (P <0.01). 
 Conclusions: The COVID-19 pandemic affected the incidence and etiology of lower respiratory tract infections in children, resulting in a decrease in atypical and bacterial pneumonia, a complete disappearance of influenza, and a seasonal shift in the epidemiology of the respiratory syncytial virus. These observations are important for planning healthcare resources and preventive measures for future pandemics, which will undoubtedly occur.

New Insights on Respiratory Syncytial Virus Prevention.

Respiratory syncytial virus (RSV) is a well-known infant pathogen transmitted mainly by droplets. It is a leading cause of upper respiratory tract infections in children, usually with a mild course of illness. RSV has also been a threat to older people, especially those with underlying medical conditions. For a long time, prevention was limited to passive immunoprophylaxis with palivizumab for high-risk infants. There was a strong need to find other treatment or prevention methods against RSV infections. In addition, after the coronavirus disease 2019 (COVID-19) pandemic, some significant changes in RSV epidemiology have been observed. Researchers noticed the shift in RSV seasonality and age distribution and the increased number of cases in older infants and adults. All of these made the need to find other medical options even stronger. Fortunately, two protein-based vaccines against RSV have successfully passed all phases of clinical trials and have been approved for use by adults and older people. One of them is also approved for infants from birth to 6 months of age (after maternal immunisation during pregnancy) and for pregnant women between 24 and 36 weeks of pregnancy. Also, a new passive immunisation option named nirsevimab (a highly potent monoclonal antibody with a long half-life) is now available for the paediatric group. In this review, we will discuss the previous and current RSV prevention methods in the light of structural discoveries of RSV antigens.

Vitamin Supplementation and Urinary Tract Infection in Children: A Narrative Review

: Urinary tract infections (UTIs) are one of the most prevalent infections among pediatric patients. Recently, there has been growing interest in the use of vitamins as supplementary therapies. However, the existing research in this field appears to be fragmented and lacking coherence. Thus, this study aimed to provide a comprehensive overview of the current status of vitamin supplements' role in UTI treatment. We reviewed articles in PubMed and Google Scholar from 1950 to 2022. In conclusion, vitamins C, E, and A have shown promising results as adjuvant therapies in UTI.

Increase in complicated upper respiratory tract infection in children during the 2022/2023 winter season—a post coronavirus disease 2019 effect?

BackgroundUpper respiratory tract infections usually peak during winter months.ObjectiveThe purpose of this study was to evaluate whether imaging of complicated upper airway infection in children increased during the winter season of 2022/2023.Materials and methodsIn a retrospective study setting, pediatric magnetic resonance imaging (MRI) and computed tomography (CT) scans for evaluation of upper respiratory tract infection performed between October 2022 and April 2023 were analyzed regarding presence of the following complications: mastoiditis, abscess, phlegmon, meningitis, reactive vasculitis, and sinus vein thrombosis. Pathogen detection, surgery, and infection parameters were obtained. Data were compared with MRI and CT scans performed in the same months of the preceding five years, distinguishing between pandemic and pre-pandemic years.ResultsDuring the 2022/2023 winter season, the number of MRI and CT scans in children with upper airway infections, the complication rate, the rate of detected streptococcal infections, and the rate of surgery increased significantly compared to expectations based on the five prior winter seasons (all P<0.05). During the first complete pandemic winter season in Europe (2020/2021), the number of MRI and CT scans in children with upper airway infection, the complication rate, and the rates of streptococcal detection and surgery decreased significantly compared to expectations based on the pre-pandemic, the second pandemic, and the post-pandemic winter seasons (all P<0.05).ConclusionAfter a decline during the first pandemic winter season, there was a marked rebound in complicated upper airway infection in children, with a significant increase in cases during the 2022/2023 winter season compared to the pre-pandemic and pandemic years.Graphical

A Study on the Relationship Between Breastfeeding Type and Urinary Tract Infections in Children Under the Age of Two Years

This study aimed to investigate the relationship between breastfeeding practices and urinary tract infections (UTIs) in children under the age of two years. Data were obtained from Al-Rifai, Souq AlShuyukh, and Bint Al-Huda maternity hospitals, as well as private laboratories affiliated with outpatient clinics

Airway and Blood Monocyte Transcriptomic Profiling Reveals an Antiviral Phenotype in Infants With Severe Respiratory Syncytial Virus Infection.

Respiratory syncytial virus (RSV) infection is the primary cause of lower respiratory tract infections in children <5 years of age. Monocytes, especially in the respiratory tract, are suggested to contribute to RSV pathology, but their role is incompletely understood. With transcriptomic profiling of blood and airway monocytes, we describe the role of monocytes in severe RSV infection. Tracheobronchial aspirates and blood samples were collected from control patients (n = 9) and those infected with RSV (n = 14) who were admitted to the pediatric intensive care unit. Monocytes (CD14+) were sorted and analyzed by RNA sequencing for transcriptomic profiling. Peripheral blood and airway monocytes of patients with RSV demonstrated increased expression of antiviral and interferon-responsive genes as compared with controls. Cytokine signaling showed a shared response between blood and airway monocytes while displaying responses that were more pronounced according to the tissue of origin. Airway monocytes upregulated additional genes related to migration and inflammation. We found that the RSV-induced interferon response extends from the airways to the peripheral blood. Moreover, RSV induces a migration-promoting transcriptional program in monocytes. Unraveling the monocytic response and its role in the immune response to RSV infection could help the development of therapeutics to prevent severe disease.

Association between serum copper-zinc ratio and respiratory tract infection in children and adolescents.

The aim of this study was to explore the association between serum copper-zinc (Cu-Zn) ratio and the risk of respiratory tract infection in children and adolescents. This cross-sectional study collected the data of 1695 participants who aged 6-17 years with follow-up data on respiratory tract infection in 2011-2012, 2013-2014 and 2015-2016 cycles from the National Health and Nutrition Examination Survey (NHANES) database. Univariate logistic regression analysis was applied to explore the covariates. Each covariate was adjusted in multivariate logistic regression analysis to explore the correlation between serum Cu-Zn ratio and respiratory tract infection. Subgroup analysis was performed to stratify the data according to age, gender and BMI. Restricted cubic spline (RCS) curve was plotted to identify the association between serum Cu-Zn ratio and respiratory tract infection. The results of RCS curve depicted that the risk of respiratory tract infection was increased as the elevation of the serum Cu-Zn ratio. After adjusting for confounders, risk of respiratory tract infection in children and adolescents was elevated with the increase of serum copper-zinc ratio (OR = 1.38, 95%CI: 1.19-1.60). Compared with people with serum copper-zinc ratio <1.25, subjects who had serum copper-zinc ratio >1.52 was associated with increased risk of respiratory tract infection in children and adolescents (OR = 1.88, 95%CI: 1.19-2.98). Subgroup analysis demonstrated that the risk of respiratory tract infection was elevated as the increase of serum copper-zinc ratio in participants <12 years (OR = 1.65, 95%CI: 1.28-2.12), ≥12 years (OR = 1.27, 95%CI: 1.03-1.57), males (OR = 1.63, 95%CI: 1.29-2.06), females (OR = 1.26, 95%CI: 1.01-1.57), underweight and normal (OR = 1.35, 95%CI: 1.11-1.65), and overweight and obese participants (OR = 1.44, 95%CI: 1.15-1.80). Higher serum Cu-Zn ratio was associated with increased risk of respiratory tract infection in children and adolescents, which suggests the importance of Zn supplement and the balance of serum Cu-Zn ratio in children and adolescents.

A cross-sectional descriptive study of culture and urine dipstick methods for evaluation of urinary tract infection in children as a rapid screening tool

A cross-sectional descriptive study of culture and urine dipstick methods for evaluation of urinary tract infection in children as a rapid screening tool

Patterns of antibiotics sensitivity in culture positive cases of urinary tract infections in children.

Objective: To determine the effective narrow spectrum antibiotics for treatment of UTI in children in order to control the rapidly increasing antibiotic resistance to broad spectrum antibiotics. Study Design: Prospective Clinical study. Setting: Department of Pediatric, Akbar Niazi Teaching Hospital, Bhara Kahu-Pakistan. Period: January 2021 to December 2021. Material &amp; Methods: 361 children with clinical suspicion of UTI Urine samples were collected. Antimicrobial sensitivity test was applied on Samples on which bacterial growth was identified using Clinical Laboratory Standards Institute (CLSI) guidelines. The data was analyzed using SPSS version 25. Results: Total 361 patients were enrolled in the study according to inclusion criteria, out of which, 30 (8.3%) were infants (&lt;1 years old), 178 (49.3%) were aged 1 to 5 years and 153 (42.4%) were aged from 5 to 12 years of age. Out of 361 patients, 125 (34.6%) patients were males and 236 (65.4%) were females. Out of 124 patients, whose urine culture was positive, most common pathogen was E. coli that was observed in 92 (25.5%) cases, followed by Klebsialla in 9 (2.5%) and enterococcus in 9 (2.5%) patients, Pseudomonas in 5 (1.4%), Proteus in 4 (1.1%), Mirabilis in 4 (1.1%), Acinobacter in 2 (0.6%), and enterobacter in 2 (0.6%) cases. Spectrum of sensitivity of 17 drugs was studied. The most sensitive drug was Imipenem, (29.9%), followed by Nitrofurantoin, Fosfomycin (25.8%), Amikacin (24.1%), Piperacilin / Tazobactam (22.7%). Conclusion: Thus E. coli was the most common pathogen and the most sensitive drug was Imipenem, followed by Nitrofurantoin, Fosfomycin, Amikacin, and Piperacilin / Tazobactam.

Predicting Lead-Time RSV-Related Pediatric Hospitalizations From Historic Google Trend Search.

Respiratory syncytial virus (RSV) causes seasonal outbreaks of respiratory tract infections in children, leading to increased emergency department visits and hospitalizations. Although the risk of severe illnesses difficult to predict, the sudden surge in RSV may strain the health care system. Therefore, the objective of this study was to examine the utility of Google Trends search activity on RSV to predict changes in RSV-related hospitalizations in children in the United States in 2019. A retrospective cross-sectional analysis of pediatric hospitalization was conducted using the 2019 HCUP-Kids Inpatient Database. Google Trends search activity for "RSV" was abstracted as a monthly relative interest score for 2019. RSV-related hospitalizations were identified using International Classification of Diseases 9/10 codes. We applied finite distributed lag models to estimate the causal effect over time of historical relative search activity and long-run propensity to calculate the cumulative effect of changes in relative search activity on admission rate. Of the total 102 127 RSV-related pediatric hospitalizations, 90% were in those aged ≤2 years. Admissions were common in males (55%), non-Hispanic Whites (50%), and South region (39%). Across 2o successive months, the cumulative effect of a 1-unit score increase in relative interest was associated with an increase of 140.7 (95% confidence interval, 96.2-185.2; P < .05) RSV-related admissions. Historic Google Trends search activity for RSV predicts lead-time RSV-related pediatric hospitalization. Further studies are needed to validate these findings using regional health systems.

Evaluation of new generation systemic immune-inflammation markers to predict urine culture growth in urinary tract infection in children.

Systemic inflammation has been implicated in the development and progression of urinary tract infection (UTI). Accordingly, the aim of this study is to determine whether the white blood cell (WBC), C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are useful markers to predict of urine culture growth in children with UTI. The second aim of this study is to evaluate the prevalence of UTI pathogens, antibiotic resistance patterns, and empirical treatment options in children diagnosed with UTI based on laboratory and clinical findings. The study population comprised 413 cases (positive urine culture) and 318 cases (negative urine culture) of pediatric patients with UTI. There was no statistically significant difference observed in the median levels of hemoglobin, hematocrit, and platelet between the negative and positive culture groups. The median levels of monocytes, WBC, NLR, SII, and CRP of the patients with a positive urine culture were shown to be statistically significantly higher than the patients with a negative urine culture. The AUC value was 0.747 (0.710-0.784) for CRP with a cutoff value of 3.2, the sensitivity value was 56.4%, and the specificity value was 98.4% in terms of UTI. The AUC value was 0.733 (0.697-0.769) for SII with a cutoff value of 600, the sensitivity value was 58.4%, and the specificity value was 83.0%. The AUC value was 0.732 (0.697-0.769) for NLR with a cutoff value of 2, the sensitivity value was 57.4%, and the specificity value was 81.1%. WBC, CRP, NLR, PLR, and SII could potentially serve as useful independent diagnostic or complementary markers for disease in children diagnosed with UTI who exhibit a positive urine culture. Escherichia coli was found to be the most common causative agent, and the commonly prescribed antibiotic was cephalosporin. However, it was observed that all identified agents of pediatric UTIs in our center exhibited high resistance to cefuroxime, trimethoprim-sulfamethoxazole, cefixime, ampicillin, and ceftriaxone.