Procalcitonin was a more robust predictor compared with C-reactive protein or white blood cell count for selectively identifying children who had APN during the early stages of UTI, as well as those with late scarring.

We concluded that a rapid determination of PCT concentration could be useful for the management of children with febrile UTI in the emergency room.

No abstract

Background: Urinary tract infections are always treated empirically before the results of bacteriological cultures are obtained. The choice of antibiotics depends upon the causative organism and its expected local antibiotic susceptibility pattern. Objectives: We analyzed the spectrum and resistance patterns of uropathogens against common antimicrobial agents in Ahvaz Abuzar Children's Hospital, a tertiary care pediatric unit in southwest of Iran. Patients and Methods: In this retrospective study, all urine samples of children hospitalized with urinary tract infection (288 patients, aged 1mon -14.5 years) during October 2008 to May 2011 were included in the study. After bacteria were identified by standard methods, antimicrobial susceptibility testing was performed using a panel of antimicrobial agents. Results: The most of patients were girls (n = 226, 78.5%), and the median age was 13 months. The most common pathogens were Escherichia coli (84%), Klebsiella spp. (10.1%), Enterococcus spp. (2.4%), Proteus spp. (1.7%), and Pseudomonas spp. (1.7%). Overall bacterial resistance spectrum was the highest for co-trimoxazole (64.8%), followed by gentamicin (44.6%), amikacin (40.5%), nalidixic acid (37.3%), cefotaxime (28.9%), cefixime (27.5%), ceftriaxone (27.4%), and nitrofurantoin (10.2%). The female:male ratio was 2:1 (67.1% versus 32.9%) in infants aged < 1 year and 8:1 in those aged > 1 year (89.4% vs. 10.6%). Vesicoureteral reflux and abnormal sonography findings were associated with high resistance to cefotaxime (P = 0.017), ceftriaxone (P = 0.004), nitrofurantoin (P = 0.014), and nalidixic acid (P < 0.001). Conclusions: Increasing resistance to third-generation cephalosporins changed our opinion for using them as a single empiric intravenous therapy in hospitalized and very ill patients with acute pyelonephritis; the success will be achieved by concomitant use of an aminoglycoside or using other potent antibiotics.

Although pertussis is a vaccine-preventable infection, vaccine-induced immunity is not lifelong and booster doses are recommended according to national disease epidemiology. The aim of this study was to evaluate pertussis-IgG levels in school-aged students in Ahvaz, south-west Islamic Republic of Iran. In a descriptive, crosssectional study, blood samples were obtained from 640 students (382 boys and 258 girls) aged 6-17 years during 2010-2011. All students had received a full course of pertussis whole-cell vaccination at ages 2, 4, 6 and 18 months and 4-6 years. Using a Bordetella IgG ELISA kit, pertussis-IgG was detected in 301 (47.0%) students. No statistically significant differences in pertussis-IgG levels were found between girls and boys or across different age groups. The findings show that the overall level of pertussis-IgG seropositivity was unacceptable. Booster vaccination with an acellular pertussis vaccine should be considered in adolescents and/or adults in our region. ‫اإلسالمية‬ ‫إيران‬ ‫مجهورية‬ ‫غرب‬ ‫بجنوب‬ ‫األهواز،‬ ‫يف‬