Background:Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions.Objectives:In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined.Patients and Methods:In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected.Results:The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04).Conclusions:The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.

Background: Nasal colonization of healthy children with Staphylococcus aureus is an important risk factor for different infections. Detection of colonized individuals with methicillin resistant S. aureus (MRSA) and its eradication is the proper prevention strategy for infection spread in the community and health-care centers. Objectives: The aim of this study was to determine the prevalence, associated risk factors and antibiotic resistance pattern among healthy children who were nasal carriers of S. aureus. Patients and Methods:This cross-sectional study was conducted on 350 one month to 14-year-old healthy children living in Kashan/Iran. The nasal specimens were cultured in blood agar medium for S. aureus. Positive cultures were evaluated for cephalothin, co-trimoxazole, clindamycin, ciprofloxacin, oxacillin and vancomycin susceptibility by the disc diffusion method and E-test. Risk factors for nasal carriage of S. aureus and MRSA were evaluated. Results: Frequency of S. aureus nasal carriage was 92 from 350 cases (26.2%), amongst which 33 (35.9%) were MRSA. Isolates indicated an overall resistance of 52.2% to cephalothin, 33.7% to co-trimoxazol, 26.1% to ciprofloxacin, 26.1% to clindamycin, 35.9% to oxacillin and 4.3% to vancomycin. Factors associated with MRSA nasal carriage included gender (P value 0.001), age of less than four years (P value 0.016), number of individuals in the family (P value < 0.001), antibiotic use (P value < 0.001) and admission (P value < 0.001) during the previous three months, parental smoking (P value < 0.001) and sleeping with parents (P value 0.022). Conclusions: Age of less than four years, male sex, family size being more than four, antibiotic use and admission during the previous three months, parental smoking and sleeping with parents were independent risk factors for nasal colonization with MRSA.

Overall, melatonin supplementation had beneficial effects on disease severity, serum total IgE levels, and CSHQ among children diagnosed with AD.

A probiotic is a living micro-organism administered to promote the health of the host by treating or preventing infections owing to strains of pathogens. Saccharomyces boulardii is a nonpathogen yeast that has a direct inhibitory effect on the growth of many pathogens, an anti-secretory effect and a trophic effect on enterocytes. The aim of this study was to determine the effect of S. boulardii on diarrhea in children. The children from 6 months to 6 years of age with acute watery diarrhea admitted in pediatric clinic in Kashan in 2012 were included in this trial. Exclusion criteria were high fever (T > 38.5 °C), severe dehydration, bloody diarrhea, severe malnutrition, using of antibiotics, anti-diarrheal or antifungal drugs and children with more than one complain. Two hundred patients were assigned into two groups: A total of 100 patients were treated with S. boulardii in addition to ORS (case group) and 100 patients were given placebo in addition to ORS (control group). The duration of diarrhea and frequency of stools were recorded by asking the mothers of the children every day. The results showed that the defecation frequency after second day of treatment in the case group was significantly less than the control group (P = 0.001) and the mean numbers of days of diarrhea was significantly lower in the case group (P = 0.001). The result of this study confirms that S. boulardii reduces the frequency of stool and duration of illness in children.

Background:Nasal carriage of Staphylococcus aureus is a substantial source of human infections. Detection and treatment of nasal carriage in children with methicillin-resistant and multidrug resistant S. aureus (MRSA and MDRSA, respectively) may be an important modality in prevention of infections.Objectives:This study determined the prevalence, antibiotic resistance patterns and risk factors for nasal carriage of MDRSA among healthy children.Patients and Methods:This cross-sectional study was carried out on 350 one-month to 14-year-old healthy children in Kashan city, Iran. From all health-care centers, four were chosen by simple random sampling. Nasal samples were cultured in blood agar medium for S. aureus and antibiotic susceptibility profile was determined by disc diffusion and E-test. Risk factors for nasal carriage of MDRSA were also determined.Results:A total of 92 (26.3%) S. aureus isolates were obtained, of which 33 (35.9%) were MRSA and 27 (29.3%) were MDRSA. Of MRSA strains, 19 (70.4%) were MDRSA. S. aureus isolates showed 52.2% resistance to cephalothin, 33.7% to co-trimoxazole, 26.1% to clindamycin, 26.1% to ciprofloxacin, 4.3% to vancomycin, and 35.9% to oxacillin. The risk factors for nasal carriage of MDRSA were antibiotic usage during the last three months (P = 0.006), family size of more than four members (P = 0.044), and parental smoking (P = 0.045).Conclusions:MDRSA was not uncommon among healthy children in Kashan and prevention of its spread in the population is judicious.