Background: Enteric fever, commonly known as typhoid fever is a global public health problem. It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by faecooral route and common in the areas with poor sanitation. Globally, majority of the Typhoid fever is caused by Salmonella enterica var typhi, one fifth of the infection is caused by Salmonella enterica var paratyphi. This study was conducted to describe clinical and laboratory parameters among children with enteric fever. Methods: It was a descriptive cross-sectional study conducted in the Pediatric ward and Pediatric Intensive Care Unit (PICU) of Nepal Medical College Teaching Hospital (NMCTH), Atterkhel, Kathmandu, Nepal from 2015 January to 2015 December. Inclusion criteria: clinical details and laboratory parameters of children aged 13 months to 15 years old with diagnosis of enteric fever was obtained in the proforma and descriptive statistics were calculated. Result: A total of 1,020 children with the sign and symptom suggestive of enteric fever were admitted in the inpatient department (Pediatrics) during the study period. All the enteric fever suspected children were tested for blood culture, Widal test and complete blood count, out of them 80 children were diagnosed as enteric fever. Male female ratio is 1.6:1. Fever was the most common clinical feature observed in 95% cases and other common features were loose motion (37.5%), vomiting (33.8%) and abdominal pain (27.5%). Hepato-splenomegaly is common finding of Enteric fever reported in 85.0% and 43.7%. Majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%. Conclusion: Fever and hepato-splenomegaly were the major clinical presentation of typhoid fever in our study. Other less common features were loose motion, vomiting and abdominal pain. This finding may be useful for the pediatrician and other health professionals for the early diagnosis of enteric fever.

Recurrent pneumonia usually occurs due to an underlying disorder that negatively affects local or systemic defence mechanisms. The aim of this study was to find out the prevalence and risk factors associated with recurrent pneumonia in children and to determine possible strategic plan needed for better clinical outcome. Children between 2 months to 15 years old who had a history of 2 or more episodes of pneumonia per year, or 3 or more episodes in a life time were investigated prospectively at Nepal Medical College Teaching Hospital. Out of 653 children admitted for pneumonia, 74 (11.3 %%) met the criteria for recurrent pneumonia. Among 74 children with recurrent pneumonia, underlying risk factors was demonstrated in 65 patients (87.8%). Most common underlying diseases were aspiration syndrome in 21.6% patients, congenital heart disease in 13.5% patients and bronchial asthma in 12.1% children. No predisposing illness could be demonstrated in 12.1% patients. Approximately 1 in 9 children with pneumonia in our hospital had recurrent pneumonia. Aspiration syndrome was the most common underlying illnesses for undiagnosed recurrent pneumonia in children.

objeCtives: The prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) is emerging in the intensive care units (ICUs) in Taiwan. Pneumonia is a common site of CRAB infection and associated with high mortality in critically ill patients. The aims of this study were to study the epidemiology and treatment outcomes associated with different treatment strategies of CRAB pneumonia. Methods: We conducted a multicenter retrospective study on adults (≥ 20 years) patients with CRAB pneumonia in the medical ICUs of three hospitals, including a medical center and two regional hospitals in Southern Taiwan during 2010-2015. The data were collected for patient characteristics, prescribing patterns, drug resistant patterns, and treatment outcomes. Results: A. baumannii accounted for about 13% of all isolates in the MICUs, and up to 86% of them were CRAB. The prevalence of CRAB was continuously increasing during the study period. More than 94% of the CRAB were susceptible to tigecycline and colistin. Of the 215 patients with CRAB pneumonia included in the analyses for treatment effectiveness, 84 (39%) were treated with tigecycline monotherapy, 42 (20%) with tigecycline combined with colistin, 34 (16%) with colistin monotherapy, 28 (13%) with colistin combination, and 27 (13%) with tigecycline combination. Patients treated with tigecycline monotherapy had significantly higher mortality rate than colistin monotherapy (p = 0.04). ConClusions: CRAB was emerging in the MICUs in Taiwan. Tigecycline was the most common antibiotic prescribed for CRAB pneumonia patients; however, tigecycline monotherapy was associated with significantly higher mortality rate than colistin monotherapy.

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