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Original Article
Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes
Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi
Background: The widespread dissemination of carbapenem-resistant Gram-negative bacteria poses a significant threat to global public health.
Purpose: This study aimed to investigate the prevalence of carbapenem resistance in Gram-negative bacteria isolated from patients at the Children's Medical Center Hospital, Tehran, Iran, to understand the molecular mechanisms underlying this resistance. Methods: During the period spanning from June 2019 to June 2020, 777...
Review Article
Infection
Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad Shieb, Rand Hasanain, Zara Arshad, Faisal A. Nawaz, Rahul Kashyap, Eric J. Stern
Clin Exp Pediatr. 2024;67(9):427-434.   Published online April 5, 2024
The overall incidence of bloodstream infections was 23.5%. Gram-negative organisms occur at a much higher rate in pediatric liver transplant recipients then that the general pediatric population. However, when comparing pediatric and adult liver transplant recipients Gram-positive organisms occur with a much higher rate in the pediatric population highlighting the importance of early and broad spectrum antimicrobial coverage when bloodstream infections are suspected.
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition.
· SIBO is prevalent in children and adolescents with functional abdominal pain disorders.
· Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria.
· Breath tests are safe and noninvasive.
· Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics.
Original Article
Nephrology (Genitourinary)
Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children
Ji Hyun Moon, Kee Hwan Yoo, Hyung Eun Yim
Clin Exp Pediatr. 2021;64(7):347-354.   Published online October 17, 2020
Question: Reliably diagnosing urinary tract infection (UTI) in febrile children is often difficult. Can urinary neutrophil gelatinase-associated lipocalin (uNGAL) better predict UTI and acute pyelonephritis (APN) than serum C-reactive protein (CRP) and white blood cell (WBC) count?
Finding: uNGAL better facilitated the prediction of UTI and APN, than serum CRP and WBC counts in febrile children.
Meaning: uNGAL is a suitable biomarker for UTI and APN in febrile children.
Cardiology
Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children
Na Hyun Lee, Hee Joung Choi, Yeo Hyang Kim
Clin Exp Pediatr. 2017;60(4):112-117.   Published online April 25, 2017
Purpose

The aims of this study were to compare serum procalcitonin (PCT) levels between febrile children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical usefulness of PCT level in predicting KD.

Methods

Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 and August 2014. The patients were divided into 3 groups as...

Applying the bacterial meningitis score in children with cerebrospinal fluid pleocytosis: a single center's experience
Jungpyo Lee, Hyeeun Kwon, Joon Soo Lee, Heung Dong Kim, Hoon-Chul Kang
Clin Exp Pediatr. 2015;58(7):251-255.   Published online July 22, 2015
Purpose

The widespread introduction of bacterial conjugate vaccines has decreased the risk of cerebrospinal fluid (CSF) pleocytosis due to bacterial meningitis (BM) in children. However, most patients with CSF pleocytosis are hospitalized and treated with parenteral antibiotics for several days. The bacterial meningitis score (BMS) is a validated multivariate model derived from a pediatric population in the postconjugate vaccine era and...

Analysis of neonatal sepsis in one neonatal intensive care unit for 6 years
Peter Chun, Seom Gim Kong, Shin Yun Byun, Su Eun Park, Hyung Du Lee
Clin Exp Pediatr. 2010;53(4):495-502.   Published online April 15, 2010
Purpose : Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm. The objective of this study was to analyze the incidence rate, causative pathogens and clinical features of neonatal sepsis in one neonatal intensive care unit (NICU) for 6 years. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics including sex, gestational age,...
Review Article
Antibiotics for bacterial pneumonia in children
Hye-yung Yum
Clin Exp Pediatr. 2009;52(3):283-288.   Published online March 15, 2009
Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia...
Original Article
Bacterial meningitis in children experienced at a university hospital, 1993-2006
Sung Yoon Cho, Tae Yeon Kim, Hyunju Lee, Kyung Hyo Kim, Eun Sun Yoo, Hae Soon Kim, Eun Ae Park, Kyung Ha Ryu, Jeong Wan Seo, Sejung Sohn, Seung Joo Lee
Clin Exp Pediatr. 2008;51(10):1077-1084.   Published online October 15, 2008
Purpose : Despite the seriousness of bacterial meningitis in children, there is little information on the incidence, causative organisms, mortality rate and age distribution. We studied the frequency by age group and causal pathogens, and clinical characteristics in children with bacterial meningitis in the private sector in Korea. Methods : The medical records containing the data on bacterial meningitis patients...
A clinical study of child bacterial meningitis in Daejeon and Chungcheong area : 2001-2005
Yong Joo Lee, Soo Jin Lee, Ho Jin Park, Young Hyuk Lee, So Young Kang, Young Chang Kim, In Kyu Lee, Kyung Yeon Lee, Keon Su Lee, Won Seop Kim
Clin Exp Pediatr. 2007;50(2):157-162.   Published online February 15, 2007
Purpose : The purpose of this study was to analyze the epidemiology, causative organism, clinical manifestation and prognosis of bacterial meningitis for children after the introduction of Haemophilus influenzae type b (Hib) vaccine in Daejeon and Chungcheong area. Methods : We analyzed retrospectively 53 medical records who had been diagnosed with bacterial meningitis at 10 general or university hospitals...
Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children
Joon Ho Lee, Eun Kyoung Song, Jin A Lee, Nam Hee Kim, Dong Ho Kim, Ki Won Park, Eun Hwa Choi, Hoan Jong Lee
Clin Exp Pediatr. 2005;48(11):1193-1200.   Published online November 15, 2005
ilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants ≤3 months. Among the infants and children aged 3 months to 2 years and children of 2-5 years, S. pneumoniae(57%, 52%, respectively, in each group) was the most common isolates followed by S....
Bacteremia in Pediatric Cancer Patients : Causative Organisms and Antibiotic Sensitivities
Yong-Han Kim, Hyun-Dong Lee, Jeong-Ok Hah
Clin Exp Pediatr. 2005;48(6):619-623.   Published online June 15, 2005
Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess...
Protein C as a Differential Marker for Bacterial Infection among Pediatric Patients with Fever
Eun Ha Mo, In Hae Nam, Kyung Duk Park
Clin Exp Pediatr. 2004;47(8):839-843.   Published online August 15, 2004
Purpose : This study was performed to find the clinical significance in protein C as a differential marker in the beginning stage of infection and prognosis factor in severe infection among pediatric patients who were admitted due to fever. Methods : A total of 40 pediatric patients who had temperatures higher than 37.5℃ on admission at the Department of Pediatrics,...
Causative Organisms in Children with Bacterial Meningitis(1992-2002)
Hyun-Jung Kim, JI-Won Lee, Kyung-Yil Lee, Hyung-Shin Lee, Ja-Hyun Hong, Seung-Hoon Hahn, Kyung-Tai Whang
Clin Exp Pediatr. 2003;46(11):1085-1088.   Published online November 15, 2003
Purpose : This study was performed to assess the difference of organisms causing bacterial meningitis according to time. Methods : We analyzed retrospectively 40 medical records of bacteriologically proven meningitis from 1992 to 2002. We divided them into two groups; neonate's group(14 cases), and children's group(26 cases). The results of the neonate's group were compared with those of previously reported articles...
Lumbar Puncture in Patients Who Experienced First Seizure with Fever
Jung Kim, Jun Su Lee, Sang Eun Lee, Wan Suk Choi, Sung Ryoung Han, Kyunglae Cho
Clin Exp Pediatr. 2003;46(10):1008-1012.   Published online October 15, 2003
Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and...
Case Report
A Case of Herpetic Whitlow with Bacterial Superinfection
Ju-Young Chung, Sang-Woo Kim
Clin Exp Pediatr. 2003;46(9):918-920.   Published online September 15, 2003
Herpes simplex virus infection of the hand in children occurs after auto-inoculation from herpetic gingivostomatitis or herpes labialis. Herpetic whitlow should be suspected based on clinical signs. Diagnosis can be made by PCR or virus culture. Many misdiagnosed cases suggests that this disease is not sufficiently known. Surgical interventions may be harmful and should be avoided. We report a case...
Original Article
Predictors of Clinically Non Specific Bacterial Infection in Febrile Children Less than 3 Years of Age : WBC, ESR and CRP
Jeong A Nho, Young Il Rho, Eun Seuk Yang, Eun Young Kim, Yeong Bong Park, Kyung Rye Moon
Clin Exp Pediatr. 2003;46(8):758-762.   Published online August 15, 2003
Purpose : Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. Methods : We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no...
A Clinical and Radiologic Study of Acute Focal Bacterial Nephritis in Children
Kum Ho Song, Kwon Hoe Huh, Ok Yeon Cho, Jae Hoon Sim, Do Jun Cho, Dug Ha Kim, Ki Sik Min, Ki Yang Yoo, Kwan Seop Lee
Clin Exp Pediatr. 2003;46(4):351-357.   Published online April 15, 2003
Purpose : To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. Methods : From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a...
Prognostic Value of Repeated Cerebrospinal Latex Agglutination Testing in Bacterial Meningitis
Soo Jeong Lee, So Hyun Ahn, Su Jin Cho, Hae Soon Kim, Seung Joo Lee
Clin Exp Pediatr. 2003;46(4):345-350.   Published online April 15, 2003
Purpose : Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing. Methods : We retrospectively evaluated 19...
Usefulness of Low Risk Criteria for Serious Bacterial Infection Among Febrile Infants Younger than Three Months of Age
So Hyun Kim, Ji Ah Jung, Hae-Soon Kim, Eun Sun Yoo, Sejung Sohn, Jeong Wan Seo, Seung Joo Lee
Clin Exp Pediatr. 2002;45(8):967-972.   Published online August 15, 2002
Purpose : A retrospective study was undertaken to evaluate the usefulness of low risk criteria for identifying febrile infants younger than three months unlikely to have serious bacterial infection. Methods : We conducted a retrospective study of 527 infants younger than three month with a axillary temperature ≥37.4℃. If they met the following all four criteria, appear well, WBC 5,000- 20,000/mm3,...
A Clinical Characteristics of Systemic Candidiasis in Neonatal Intensive Care Unit : Comparison with Systemic Bacterial Infection
Jung Hwa Lim, Kyung Pil Park, Jin Kyung Kim, Heng Mi Kim
Clin Exp Pediatr. 2002;45(7):847-854.   Published online July 15, 2002
Purpose : Long term hospitalized infants in neonatal intensive care units(NICUs) are prone to systemic infection. It is important to differentiate systemic candidiasis from systemic bacterial infection early in the course. Thus, in this study, we have compared clinical characteristics of systemic candidiasis and systemic bacterial infection, in premature low birth weight infants. Methods : Retrospective chart review of the medical...
Change of Cerebrospinal Fluid Ferritin in Children with Meningitis
Mee Hee Youm, Eun Young Kim, Young Jong Woo, Hyun Ju Park, Chan Jong Kim
Clin Exp Pediatr. 2000;43(8):1068-1073.   Published online August 15, 2000
Purpose : Despite the advent of new and more potent antibiotics, mortality and morbidity rates due to bacterial meningitis remain stagnant. Rapid detection of microorganism and early antibiotics treatment are the most important prognostic factors of bacterial meningitis. For early diagnosis of bacterial meningitis biochemical markers such as lactic dehydrogenase, lactic acid, C-reactive proteia have been measured in cerebrospinal fluid....
Isolation of Causative Microorganism and Antimicrobial Susceptibility Test in Impetigo Developed in the Past Four Years
Hyun Jeong Lee, Sang Jung Lee, Seog Jun Ha, Chang Kyu Oh, Jin Wou Kim
Clin Exp Pediatr. 2000;43(5):632-637.   Published online May 15, 2000
Purpose : Recently, Staphylococcus aureus has been reported as the principal microorganism isolated from impetigo, showing variable degrees of antimicrobial resistance. The aim of this work was to study the causative organism of impetigo the their antimicrobial susceptibility developed in impetigo in the past four years. Methods : We performed bacterial cultures and antimicrobial susceptibility tests in 73 patients with impetigo...
Diagnostic Value of Urine Latex Test In Bacterial Meningitis
Seung Min Lee, Eun Ae Park, Seung Joo Lee
Clin Exp Pediatr. 2000;43(1):55-59.   Published online January 15, 2000
Purpose : Bacterial meningitis in childhood carries significant mortality and morbidity, so accurate and rapid diagnosis is important. Cerebrospinal fluid(CSF) latex agglutination test has been used for rapid diagnosis of bacterial meningitis. However, urine may be the best specimen for a latex test, because bacterial antigens are concentrated in the urine. The study tried to determine the diagnostic value of urine latex test in...
Clinical Evaluation of Diagnostic Criteria for Early Prediction of Bacterial Infection in Febrile Neonates
Jai Il Cho, Sang Chun Lee, Hwan Il Kim, Cheol Am Kim, Kil Seo Kim
Clin Exp Pediatr. 1999;42(12):1661-1667.   Published online December 15, 1999
Purpose : A retrospective study was undertaken to test the hypothesis that febrile neonates, who have bacterial infections, can be accurately predicted early by diagnostic criteria. Methods : We conducted a retrospective study of 152 infants, 28 days or less of age, whose rectal temperature was at least 38℃. Past history, family history, finding on physical examinations and results of CBC,...
Case Report
Three Cases of Acute Focal Bacterial Nephritis
Yeon Soo Lim, Jae Kook Cha, Kon Hee Lee, Kwan Seop Le
Clin Exp Pediatr. 1999;42(1):138-142.   Published online January 15, 1999
Acute focal bacterial nephritis(AFBN) is an unusual form of localized renal infection, which has various imaging findings and should be distinguished from abscess or other renal masses. Clinical symptoms are similar to other urinary tract infections but the diagnosis needs a CT or sonographic confirmation. Treatment, which is nonoperative, consists of intensive antibiotic therapy. We report three cases of AFBN...
Original Article
Significance of Acute Phase Reactants(APR) Score for the Early Detection of Neonatal Bacterial Infection
Seong Woo Kim, Myung Ho Oh, Kee Hyuk Kim, Jay G. Sim
Clin Exp Pediatr. 1998;41(11):1491-1497.   Published online November 15, 1998
Purpose : We performed acute phase reactants(APR) test to evaluate as an appropriate screening test for the early detection of neonatal bacterial infection. Methods : We selected 174 neonates and divided into two groups; sepsis group and well-baby group. We performed APR test. Results : There are no significant difference in total leukocyte count, immature to mature rentrophil ratio, toxic granules, and...
The Diagnostic Value of CSF Tumor Necrosis Factor-α for Early Diagnosis of Bacterial Meningitis
So Young Park, Soo Ja Hwang, Eun Ae Park, Jung Wan Seo, Seung Joo Lee
Clin Exp Pediatr. 1998;41(8):1078-1083.   Published online August 15, 1998
Purpose : During the course of bacterial meningitis, TNF-α produced by macrophages and monocytes in response to LPS and other inflammatory and immune stimulation, is now recognized as a primary mediator in the pathogenesis of infection, injury and inflammation and in the process of host defence. TNF-α was increased vascular permeability by inducing morphologic and structural changes of endothelial cells...
C-Reactive Protein and Duration of Antibiotic Therapy in Neonatal Bacterial Infection
Jae Il Yoo, Jin Hwa Jeong, Jeong Ho Lee, Jong Dae Cho
Clin Exp Pediatr. 1998;41(7):901-908.   Published online July 15, 1998
Purpose : To determine whether C-reactive protein(CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection. Methods : We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial...
Prognosis of Bacterial Meningitis based on Cerebrospinal Fluid Culture
Yun Ju Lee, Won Sung Lee, Kyoung Sim Kim, Ki Bok Kim
Clin Exp Pediatr. 1998;41(5):614-621.   Published online May 15, 1998
Purpose : The present study was undertaken to assess whether the results of cerebrospinal fluid (CSF) culture are related to prognosis. Methods : Subjected to this study were 51 cases admitted to our department who had been diagnosed as bacterial meningitis. They were divided into two groups, Group Ⅰ(20) with positive CSF culture and Group Ⅱ(31) with negative outcome, then both...