Browsing by Author "Alireza Nateghian"

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    Detection of Human Metapneumovirus and Respiratory Syncytial Virus by Real-Time Polymerase Chain Reaction Among Hospitalized Young Children in Iran
    (Brieflands, 2016-03-01) Masoud Parsania; Behzad Poopak; Mohammad Hassan Pouriayevali; Sama Haghighi; Aref Amirkhani; Alireza Nateghian
    Background: Acute respiratory infection plays an important role in hospitalization of children in developing countries; detection of viral causes in such infections is very important. The respiratory syncytial virus (RSV) is the most common etiological agent of viral lower respiratory tract infection in children, and human metapneumovirus (hMPV) is associated with both upper and lower respiratory tract infections among infants and children. Objectives: This study evaluated the frequency and seasonal prevalence of hMPV and RSV in hospitalized children under the age of five, who were admitted to Aliasghar children’s hospital of Iran University of Medical Sciences from March 2010 until March 2013. Patients and Methods: Nasopharyngeal or throat swabs from 158 hospitalized children with fever and respiratory distress were evaluated for RSV and hMPV RNA by the real-time polymerase chain reaction (PCR) method. Results: Among the 158 children evaluated in this study, 49 individuals (31.1%) had RSV infection while nine individuals (5.7%) had hMPV infection. Five (55.5%) of the hMPV-infected children were male while four (44.5%) were female and 27 (55.2%) of the RSV-infected patients were females and 22 (44.8%) were males. The RSV infections were detected in mainly < one year old children and hMPV infections were detected mainly in > one year old children. Both RSV and hMPV infections had occurred mainly during winter and spring seasons. Conclusions: Respiratory syncytial virus was the major cause of acute respiratory infection in children under one-year of age while human metapneumovirus had a low prevalence in this group. The seasonal occurrence of both viruses was the same.
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    Epidemiological Aspects and Main Determinants of Prognosis in Children with Acinetobacter Infections Admitted to Intensive Care Units at Aliasghar Children's Hospital, Tehran, Iran
    (Brieflands, 2018-10-31) Alireza Nateghian; Hanieh Radkhah; Niyosha Masalegooyan; Masoumeh Moradkhani; Masoumeh Miradi
    Background: There is not enough information about the prevalence of Acinetobacter infection as well as its risk factors, especially in neonatal intensive care units. The present research aimed at conducting a five-year study on Acinetobacter infection and its main factors in neonatal and pediatric intensive care units in Iran. Methods: This cross-sectional survey was conducted on 89 children with positive culture for hospital-acquired Acinetobacter, admitted to intensive care units of Aliasghar Children's Hospital in Tehran, between 2010 and 2015. Besides, 97 patients with similar baseline characteristics without Acinetobacter positivity were enrolled as the control group. Epidemiological information and clinical data were collected by reviewing the hospital recorded files. Results: In the group with positive Acinetobacter culture, complete and partial improvement was observed in 62.9% and 11.2%, respectively, while 25.8% died due to treatment failure. In this regard, complete and partial improvement in the control group was revealed in 85.6% and 11.3% with an overall death rate of 3.1%, indicating significantly higher failure rate in the case group (P = 0.001). To determine the main factors for in-hospital death, all variables with a significant association with positive culture in univariate analysis (considering P < 0.2) were entered in a backward multivariable logistic regression model. In this regard, venous access (OR = 7.80, 95% CI: 1.06 to 57.19, P = 0.043), carbapenem use (OR = 27.03, 95% CI: 1.93 to 377.780, P = 0.014), and ampicillin use (OR = 0.12, 95% CI: 0.019 to 0.739, P = 0.022) were shown as the main determinants for Acinetobacter-related death. Conclusions: Although the study was not a prognostic study and determination of the main determinants of prognosis in children with Acinetobacter infections was not possible yet it seems that the mortality rate due to Acinetobacter infection in the population was about 25.8% in the global range reported in the literature. The main factors for Acinetobacter infection-related death are central venous catheters related to TPN, carbapenem use, and ampicillin use.
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    Leptospirosis Mimicking Collagen Vascular Disease in a Thirteen-Year-Old Iranian Girl
    (Brieflands, 2012-04-28) Alireza Nateghian; Soudabeh Hoseini; Amin Lavasani
    A thirteen-year-old girl from Dezfoul, Iran was referred to our hospital with a history of eight days of high fever, headache, odynophagia, diffuse abdominal and body pain especially limb pain. She then developed conjunctival erythema, transient maculopapular rash on the trunk and also diplopia. No obvious or specific point was shown in the history. In the lab studies, she had very high sedimentation rate (ESR), bandemia and leukocytosis and thrombocytosis with negative results for an array of infectious diseases. Before making a vasculitis diagnosis a microscopic agglutination test for leptospira and then PCR test in blood and stool were requested and revealed to be positive for leptospira. She responded to doxycycline and remained well after one year of follow-up. Leptospirosis should be considered in differential diagnosis of vasculitic syndromes in Iran even for patients from seemingly non-enzootic areas.
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    Molecular Detection of vanA and vanB Genes in Vancomycin-Resistant Enterococcus Isolated by Polymerase Chain Reaction From the Intestines of Children Admitted to the Intensive Care Units
    (Brieflands, 2014-10-01) Zahra Daghighi; Saeed Tajbakhsh; Hossein Goudarzi; Abdollah Karimi; Alireza Nateghian
    Background: Enterococci are considered as the third most common cause of nosocomial infections and their antimicrobial resistance has been a concerning issue. Objectives: In this study, we looked for resistance genes of vanA and vanB in vancomycin-resistant Enterococcus (VRE) isolated from intestinal colonization of children admitted to the pediatric intensive care unit (PICU) and neonatal ICU (NICU) of Ali-Asghar Children's Hospital. Patients and Methods: In this descriptive study, 71 rectal swab samples were collected from the intestines of children admitted to the PICU and NICU of Ali-Asghar Children's Hospital. Enterococci were diagnosed in samples by appropriate microbiological tests. Antimicrobial resistance and VRE detection was performed by the Kirby-Bauer disk diffusion method on Mueller-Hinton agar based on Clinical and Laboratory Standards Institute (CLSI) criteria. vanA and vanB genes were detected by PCR. Results: Enterococcus was detected in 64 (90.1%) rectal swab samples. The frequency rate of VRE strains was 47 (73.4%) and vancomycin-intermediate Enterococcus (VIE) strains was 6 (9.4%). PCR analysis of VRE samples showed that 42 samples had vanA gene (89.3%) but vanB gene was not identified in remaining five samples. VIR was detected in 4 cases with vanA gene (66.7%). Again, we did not d vanB gene in remaining samples. Conclusions: VRE colonization was very high among studied cases. Most important mechanism for high level of resistance to vancomycin is presence of van genes, which can be potentially transmittable to other enterococci and gram-positive organisms. More molecular studies are needed to clarify the trend of VRE colonization and the role of preventive measures in this setting.
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    Molecular investigation of Campylobacter spp. and salmonella infection in children with community acquired diarrhea
    (Brieflands, 2022-10-31) Haniyeh Ahadi; Bahareh Attaran; Roxana Mansour Ghanaiee; Leila Ganji; Fatemeh Fallah; Abdollah Karimi; Iraj Sedighi; Marjan Tariverdi; Alireza Nateghian; Negin Nahan-Moghadam; Masoud Alebouyeh
    Introduction: Acute gastroenteritis is a typical disorder that accounts for 8-12% of pediatric outpatient visits. Campylobacter and Salmonella infections account for about 8.4% and 11% of global diarrhea cases. Due to the importance of these bacteria in pediatric diseases, the aim of this study was to determine the infectious rate of Salmonella and Campylobacter species and also the frequency of the gene encoding Cytholethal distending toxin in children with community-acquired diarrhea. Materials and Methods: Stool samples of children under 5 years of age with diarrhea were collected. The samples were related to children referred to hospitals in Hamadan, Ardabil, Bandar Abbas and two hospitals in Tehran. DNA was extracted from the samples using a DNA extraction kit from stool. The presence of Campylobacter in the studied samples was detected by polymerase chain reaction using specific primers. A control stool sample was spiked with 10-fold dilution of C. jejuni suspension for LOD (detection limit determination) measurement. Results: In this study, PCR results showed a LOD of 100 CFU per gram in the spiked feces sample. Accordingly, out of 144 fecal samples of children with acute diarrhea, one case was positive for Campylobacter jejuni; this sample was also positive for the presence of cdtB gene. Presence of Salmonella was confirmed in two samples of the patients (1.4%). Conclusion: Low prevalence of Campylobacter and Salmonella was detected in symptomatic children under 5 years of age during the Covid-19 pandemic. Examination of these samples for viruses and other microbial agents can clarify the etiology of diarrhea in children referred to the hospitals.
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    Pandemic Flu in Islamic Republic of Iran; A Review of Health System Response From July to November
    (Brieflands, 2013-07-31) Alireza Nateghian; Mohammadnasr Dadras; Mohammad Mehdi Gouya; Mahmood Nabavi; Mahmood Soroush; Nakysa Hooman; Mehrtash Mehrparvar; Peyman Hemmati; Farah Abazari; Abolghasem Omidvarnia
    Background: Pandemic flu is a concerning problem with potentially high mortality and morbidity rates, so needs a proper health system response in each country.
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    Prevalence of Vancomycin-resistant Enterococci Colonization, and Susceptibility to linezolid in Pediatric Intensive Care Units of a Referral Pediatric Center in Tehran, Iran
    (Brieflands, 2014-10-01) Alireza Nateghian; Seyed Mohammad Ghasemi Ahari; Arash Lahouti Harahdashti; Masoumeh Navidnia; Mitra Mehrazma
    Background:: Vancomycin-resistant Enterococcus (VRE) has been established as a significant health-care associated problem, and caused significant morbidity and mortality. Objectives:: This study was aimed to determine prevalence of VRE colonization in severely ill patients admitted to Pediatric Intensive Care Unit (PICU), and identify potential risk factors for colonization, and in vitro susceptibility of VRE to linezolid. Patients and Methods:: Rectal swabs were taken from 71 children 18 years old or younger who were admitted with serious systemic illness, including malignancy, chronic kidney, lung or liver diseases, treatment with chemotherapeutic agents, immunodeficiency, treatment with high-dose corticosteroids, malnutrition, previous treatment with 2nd or 3rd generation cephalosporin, aminoglycoside, and broad-spectrum β-lactam antibiotics within the past 3 months. Demographics and known risk factors were retrieved and assessed by statistical methods. Results:: A total of 71 patients with a mean age of 29.1 ± 38.5 months were enrolled in this study. The prevalence of VRE rectal colonization was 66.2%. None of the potential risk factors including age, gender, comorbidities, previous admission into ICU, length of stay in ICU, presence of invasive devices were significantly associated with VRE colonization. Linezolid-susceptible isolated strains accounted 97.9%. Conclusions:: The prevalence of VRE was higher compared to previous reports from local and international studies. In order to control the spread of VRE, appropriate use of antibiotics, adherence to infection control measures, and shortening the duration of ICU stay is highly recommended.
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    Transplacental Transmission of SARS-CoV-2 Infection: A Case Report from Iran
    (Brieflands, 2020-11-29) Farhad Abolhasan Choobdar; Maral Ghassemzadeh; Mohammad Attarian; Ezzat Abbariki; Alireza Nateghian; Behrooz Ghanbari; Samira Shah Hamzehi; Melika Razavi Hashemi; Zahra Azarbin
    We report a case of SARS-CoV-2 vertical transmission through the placenta in a neonate whose mother had non-M3 acute myeloid leukemia (AML) that was complicated with Covid-19 in the last trimester. Viral load in nasopharyngeal swabs from mother and neonate were high. Real-time PCR of the fetal side of the placenta was positive for SARS-CoV-2, which makes it possible to consider this case as a congenital case of SARS-CoV-2 infection that is transmitted through vertical transmission.
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    The Validity of a Scoring System in Predicting Intravenous Immunoglobulin Treatment Failure in Children With Kawasaki Disease
    (Brieflands, 2016-01-01) Alireza Nateghian; Roya Isa Tafreshi; Arezoo Najari; Atefeh Vaezi
    Background: Between 10 and 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment, and are prone to coronary abnormalities. A variety of predicting scoring systems, including the Kobayashi system, have been proposed, but have not yet been evaluated using Iranian patients. Objectives: To evaluate the Kobayashi scoring system with regard to predicting response to IVIG treatment in Iranian children. Patients and Methods: All patients who received a final diagnosis of KD at Aliasghar children’s hospital between 1982 and 2013, and who met the inclusion criteria, were enrolled in this retrospective cohort study. We excluded patients with missing data, abnormal echocardiographic finding on admission, late admission, atypical or afebrile cases, and those who had received an insufficient amount of IVIG. We compared demographic and echocardiographic data before IVIG, and within 7 days of treatment, as well as C reactive protein (CRP), sodium, aspartate aminotransferase, platelet levels, neutrophil percentage, age of patients, and duration of fever before IVIG administration, in treatment responders and non-responders. Results: Of the 141 cases, 97 patients met the criteria and were enrolled. Of these, 19 (19.6%) did not respond to IVIG. A total of 61.8% of patients were male, and the mean patient age was 36.9 months (SD = 32.1 months). Echocardiographic evaluation revealed early coronary involvement in 15.3% of patients, and coronary abnormalities were diagnosed in 10% of patients within the first 10 days of presentation and concurrent with their IVIG treatment. A between-groups comparison of quantitative CRP, absolute neutrophil count, and platelet count showed that platelet count alone was significantly higher in nonresponders (P = 0.04). With regard to items of Kobayashi scoring system, data were present for just 41 cases, but a significant difference between the two groups was shown, with the treatment-refractory group having a significantly higher score (P = 0.002). Receiver-operating characteristic curve analysis revealed that the optimum cut-off point for our population would be 2, which makes the sensitivity of the test equal to 75%, with a specificity of 60%. Conclusions: This preliminary study showed that patients with KD and a high Kobayashi score are at greater risk of being unresponsive to IVIG treatment. Further studies, preferably multicenter evaluations, are required in order to understand the exact application of various scoring systems in the management of people with KD in Iran.