Objective The aim of the present study was to investigate the bacterial pathogens and their resistance patterns in children presenting with their first admission for a urinary tract infection (UTI) in a large tertiary care center in Riyadh, Saudi Arabia. Methods A retrospective chart review was conducted of pediatric patients 0–14 years of age who were admitted for their first community-acquired UTI in a large tertiary care center in Riyadh, Saudi Arabia. The review covered a 6-year period (2006–2012). Results Data were obtained from 202 children, of which 162 (80.2%) were female. The most frequently isolated uropathogens were Escherichia coli (75.7%), followed by Klebsiella pneumoniae (9.4%), Pseudomonas aeruginosa (5.9%) and Enterococcus species (3.5%). Sixteen (7.9%) isolates were ESBLs. Among all uropathogens, 68% were resistant to ampicillin, 54% resistant to co-trimoxazole, and 30% resistant/intermediate sensitivity to amoxicillin/clavulinic acid. Overall, there was a low resistance rate to cefotaxime (4.4%). Conclusion E. coli is the predominant uropathogen causing UTIs in children, yet there is a high rate of multidrug-resistant organisms. For children admitted for a community-acquired UTI, a third-generation cephalosporin remains an appropriate empiric antibiotic. Our study and the work of others emphasize the importance of choosing empiric antibiotics for pediatric UTIs based on local resistance patterns.

Introduction: Antimicrobial resistance is a global health problem. The present study was carried out to determine the prevalence and antibiotic resistance of uropathogens in the outpatient departments (OPDs) at the clinics of Qassim University, Saudi Arabia. Methods: A cross-sectional study was conducted from January to December 2016. Nonrepetitive midstream urine samples (1273) were cultured on standard culture media. Identification and susceptibility testing of causative microorganisms was performed using the fully automated VITEK 2 Compact system. Results: Out of the 1273 nonrepetitive urine samples, 418 (32.8%) exhibited significant growth of UTI-causing microbes, 377 (90.2%) of which were Gram-negative bacilli. The commonly isolated microorganisms were Escherichia coli (157, 37.6%), Klebsiella pneumoniae (70, 16.7%), Proteus mirabilis (17, 4.1%), Pseudomonas aeruginosa (24, 5.8%), Enterobacter cloacae (11, 2.6%), Enterococcus faecalis (12, 2.9%), and Staphylococcus aureus (14, 3.3%). Overall, drug resistance was observed in 91.3% (n=381/418) of the samples, with a majority (80%) exhibiting resistance to at least 2 drugs. Drug resistance was commonly observed against ampicillin (89.9%), oxacillin (75.6%), piperacillin (85.4%), clindamycin (56.1%), amoxicillin/clavulanic acid (74.5%) and trimethoprim/sulfamethoxazole (50.4%). Conclusion: The uropathogens E. coli, K. pneumoniae and P. aeruginosa and multidrug resistance pose serious therapeutic threats in the setting of this study. A concerted and systematic effort is required to rapidly identify high-risk patients and to reduce the burden of antimicrobial resistance in this region.

Background: While Escherichia coli (E. coli) is the most common uropathogen implicated in urinary tract infections (UTIs) in children, some studies have found that there are different characteristics between different uropathogens in children. The aim of this study was to compare E. coli and non-E. coli UTIs in children with respect to their demographic data, predisposing factors, and imaging results. Methodology: A retrospective chart review was done in children during their first admission with urine culture confirmed UTI in a tertiary care center. We divided patients into E. coli and non-E. coli groups according to urine culture results. Results: Out of 202 children with their first admission for a culture-proven UTI, pathogens other than E. coli accounted for 24.3% of UTIs. Klebsiella pneumoniae was the most common non-E. coli pathogen, followed by Pseudomonas aeruginosa and Enterococcus species. Non-E. coli UTIs were significantly more common in male subjects, younger children, and children with a past history of UTI or who had received antibiotics prior to admission. In addition, higher rates of abnormalities on renal ultrasound and VCUG were found with non-E. coli organisms. Conclusion: There is a significant difference in demographic and imaging findings in children with non-E. coli UTIs. These findings may impact the work-up and treatment of UTIs in the pediatric population.

Objective To determine the cut‐off values for low birth weight (LBW) and high birth weight (HBW) of Sudanese newborns. Methods Data (maternal age, parity, birth weight, and gender of the newborn) from women (n = 2818) who delivered at Saad Abualila Hospital in Khartoum were retrieved from the medical files. Results The cut‐off for LBW (the 10th centile) was 2400 g and the 90th centile (HBW) was 3700 g. Out of 2818 newborns, 317 (11.2%) had birth weights below 2400 g. Using the WHO (traditional) cut‐off of 2500 g, the prevalence of LBW was 14.3%. The difference between the two prevalences of LBW was statistically significant (P < 0.001). However, the agreement rate between the two was high (κ = 0.86). The cut‐off to define HBW was 3700 g. In the study, 292 (10.4%) newborns had birth weights of at least 3700 g. Using the cut‐off of 4000 g, the prevalence of HBW was 9.5%. The difference between the two prevalences of HBW was statistically significant (P < 0.001). However, the agreement rate between the two was low (κ = 0.06). Conclusion The cut‐off values for low and high birth weight were 2400 and 3700 g, respectively.

Breastfeeding is indeed the foundation for life and gives growing children a once-ina-lifetime opportunity to grow and develop to their full potential. There are considerable studies on the role of maternal contribution to human milk components. It would be very important and interesting to explore the existence of a paternal contribution into the composition of human milk. Proceeding on this track, there is an abundant evidence that supports the hypothesis of paternal contribution in human milk composition. This evidence could be strengthened by the fact that a small population of the fetal cells migrate during pregnancy and stay for long time in the maternal body. This phenomenon is known as microchimerism. It has been well documented that some of these cells are of mature immunological and hematopoietic stem cells character. As the fetal parts contain 50% from each parent, any fetal parts in the maternal body (i.e., fetal microchimerism) should contain paternal components as well. The paternal genetic material is more responsible for the determination of the fetal sex (female XX or male XY). The variations