Delayed antibiotic treatment for antecedent AOM is not associated with an increase in severity parameters in subsequent acute mastoiditis admission.

Cryptosporidium is a parasite that causes watery diarrhea among both children and adults. However, because many physicians do not routinely ask for Cryptosporidium diagnostic test, cryptosporidiosis prevalence is likely underestimated. The current study investigated the prevalence of cryptosporidiosis among children admitted to the hospital with gastrointestinal symptoms. Stool sample was collected from each child and subjected to routine microbiological culture. Cryptosporidium presence was tested by three different methods: real-time PCR (RT-PCR), quick antigen, and microscopic examination with acid-fast staining. Each positive specimen was further tested with BioFire FilmArray Multiplex PCR (bioMérieux SA, Marcy-l'Etoile, France) to determine that Cryptosporidium is the only pathogen in the sample. Demographic and epidemiological data were collected from the patients' medical records. Of 291 patient stool samples, nine were positive for Cryptosporidium hominis or Cryptosporidium parvum. The average age of the nine Cryptosporidium-positive cases was 2.3 years, lower than the average age of the study population (4.2 years). Of the positive cases, 66.7% were Arabs and 33.3% were Jews. The main complaint of children with Cryptosporidium was diarrhea. Regarding the laboratory methods for Cryptosporidium identification, of the positive samples, 100% (9/9) were identified by RT-PCR, 88% (8/9) were positive by antigen test, and only 67% (6/9) were positive by microscopic examination with acid-fast staining. Because of the low incidence of Cryptosporidium among patients in our facility, the prevalence of cryptosporidiosis still cannot be established. Nevertheless, among the other pathogens found in stool samples, Cryptosporidium is the second leading cause of hospitalization due to gastrointestinal disease in children in our area.

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Objectives: To identify the changing trends of uropathogens over the years 2010-2017 and examine the incidence of both antibiotic resistance and extended spectrum beta lactamases (ESBL)-producing Enterobacteriaceae in urine cultures from pediatric patients. Study Design: Electronic medical records of 1,056 children, admitted to the Poriya Medical Center in Israel, between 2010 and 2017 with positive urine cultures, were reviewed for bacterial species and antibiotics resistance. Results: The leading pathogen was Escherichia coli (76%), followed by Klebsiella (7%), Enterococcus (5.8%), and Proteus (4%). Statistically significant gender-specific and ethnicity-specific differences in the distribution of uropathogens were found. E. coli was more common in females compared to males. Escherichia coli constituted most (92.3%) of the ESBL-positive cultures, while only 4.6% isolates carried Klebsiella, 1.5% carried Enterobacter spp., and 1.5% carried Morganella. Prevalence of ESBL-producing E. coli increased throughout the study period. Increasing prevalence over time was noted for ceftriaxone, cefuroxime, amoxicillin/clavulanate, and ampicillin resistance. Conclusions: Gender and ethnic background should be taken into consideration when choosing empiric antibiotic therapy for urinary tract infections in children. Similarly, the continuous increase in resistance to cefuroxime and amoxicillin/clavulanate should be considered when prescribing therapy in Israel. Ceftriaxone and gentamicin are still the antibiotics of choice for inpatient parenteral empiric treatment.

Emergency Department analgesia for children with acute appendicitis in Israeli government hospitals is markedly low. Patient-provider ethnic discordance may negatively influence the provision of analgesia. Significant efforts should be undertaken in order to increase analgesia provision rates and reduce social inequality.

Oro-facial infections are common pathologies comprising a substantial health concern in the pediatric population. Incorrect or late treatment may lead to serious and possibly lifethreatening complications. The aim of this study is to analyze variables associated with prolonged length of hospital stays (LOS) due to odontogenic infections in children. Study design: Data was collected from the records of patients (age <15 years) hospitalized due to odontogenic infections at Poriya Medical Center during the period of 1/2010-12/2015. Patients with oro-facial infections originating from other organs were excluded from the study as well as children with underlying systemic medical conditions that may affect recovery. Results: A total of 411 patients (mean age 6.5 ± 2 years) were included in this study, with 58.4% being male. There were significantly higher (p < 0.05) values of white blood cell (WBC) counts in patients with >3 days LOS. Patients with >3 days LOS were also significantly older (8.4 vs. 6.3 years). There were no significant differences in sex distribution or other clinical or laboratory parameters between the groups. Conclusion: Older child age and higher WBC counts on admission are indicators for prolonged LOS.

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