Aim and background: The COVID-19 pandemic has been studied extensively in the adult population; however, information regarding epidemiological and clinical characteristics in pediatric patients is meager. The study presented in this research article aims to analyze some clinical features of COVID-19-positive children in eastern Uttar Pradesh, India. Materials and methods: An observational study was carried out involving 97 children admitted at BRD Medical College, Gorakhpur, Uttar Pradesh, India. The basic parameters involved in the study included age, gender, presence and number of symptoms, oxygen saturation levels at the time of admission, and geographic origin of the patients. Results: The study revealed that a considerable proportion of pediatric patients were asymptomatic (30.93%). Cases reported from rural populations were higher (54.64%) compared to urban regions (45.36%) of the study area. The majority of children (71.13%) maintained oxygen saturation levels above 95% at the time of admission, suggesting mild respiratory involvement. Conclusion: The study highlighted the varied clinical presentations of COVID-19 in children, necessitating targeted public health measures and surveillance across different geographical settings in eastern Uttar Pradesh.

Aims and background: Most studies related to bacterial infections and their profiles in pediatric patients focus only on the pediatric intensive care unit (PICU) setup. Therefore, we undertook this study to review data on positive culture isolates in patients from all pediatric areas of our center, excluding the neonatal unit, for their profiles and antibiotic sensitivity patterns. Materials and methods: This was a retrospective study (5 years: 2017–2021) from hospital records including indoor patients (1 month to 18 years) from the PICU and pediatric ward. A total of 1,380 cultures (from any site) were sent, of which 706 were positive, excluding contaminations. Pertinent details were entered into Microsoft Excel and analyzed. Results: A total of 706 positive isolates were found in 468 patients, and the mean [interquartile range (IQR)] age was 63 (18, 144) months. Males were 65%. Among positive culture isolates, 30.9, 24.8, 17.3, 16.1, 1.6, and 8.9% were from blood, pus, urine, endotracheal tube/tracheostomy tube (ET/TT), cerebrospinal fluid (CSF), and others, respectively. The median (IQR) hospital stay was 10 (4, 22) days. Total deaths were 17 (3.6%). Among positive culture isolates, gram-negative organisms in 205 (43.8%), Staphylococcus aureus was found in 135 (28.8%), Salmonella typhi in 53 (11.3%), and Candida in 24 (5.1%) cultures. Gram-negative organisms showed variable sensitivity to β-lactam/β-lactamase inhibitors and carbapenems. Among S. aureus isolates, 74 (39%) were oxacillin-sensitive. Almost all Salmonella were sensitive to ceftriaxone. Conclusion: S. aureus was the single top isolate, with oxacillin resistance in almost two-thirds of isolates, whereas other gram-negative organisms were common nosocomial isolates with variable sensitivity to β-lactamase inhibitors and carbapenems. Clinical significance: It includes recent data on microorganism profiles and their antibiograms from the western part of India.

Background: Enteric fever continues to impact millions of children who lack adequate access to clean water and sanitation. Enteric fever remains a major concern in India with an estimated incidence from hospital surveillance ranging from 12 to 1,622 cases per 100,000 child-years among children between the ages of 6 months and 14 years, and from 108 to 970 cases per 100,000 person-years among those who are 15 years of age or older. With the inappropriate use of antibiotics and rising trends of multidrug-resistant (MDR) and extensively drug-resistant (XDR) typhoid, it is becoming a public health emergency. This study evaluated the current trends in antibiotic susceptibilities to Salmonella typhi and paratyphi A and B in North Delhi. Materials and methods: We undertook a retrospective, cross-sectional multicentric study by reviewing hospital-based laboratory records of pediatric patients (up to age 18 years) whose blood culture samples were submitted from the outpatient and inpatient departments to the laboratories of Jaipur Golden Hospital in Rohini and Fortis Hospital in Shalimar Bagh, Delhi, India from September 2022 to September 2023. Results: There were 121 (75.15%) children with S. typhi and 40 (24.84%) with S. paratyphi isolates. The median age of patients was 8 years with male and female patients constituting 61.4 and 38.5%, respectively. The disease was prevalent throughout the year with high prevalence between March and May. There were four cases of MDR typhoid (2.4%) and two cases of XDR typhoid (1.2%). Conclusion: S. typhi was the predominant serotype. The study also shows that infection with S. paratyphi is not distant second as it contributes for significant 25% of total enteric fever infection. Alarming multiple drug resistance patterns were not observed. Third-generation cephalosporins as monotherapy are quite effective, and there is no need of adding azithromycin in combination form. Effective mass vaccination strategy against typhoid and water and safe hygiene (WASH) practices can decrease the burden of this disease. Broad-spectrum vaccine to cover both S. typhi and S. paratyphi is need of the hour.

Zoonotic diseases are on the rise globally as well as in India. Out of 1,407 human pathogens, 816 were zoonotic. Out of them, 538 were bacterial and Rickettsial, 317 fungi, 208 viruses, 287 helminths, and 57 protozoal. Thirteen percent of total pathogens were emerging or reemerging, and 75% of these were classified as zoonoses. Usually, emerging infections are more challenging and threatening to humans as little knowledge is acquired about them. Examples of some of these in recent times include COVID-19, Ebola hemorrhagic fever, Zika virus, and Nipah virus. Emerging infections have a chance to spread across countries due to international travel. India is primarily an agriculture-dependent country. Animals play an important role in boosting the economy of India. It is a developing country with poor resources. Some of the key factors that play a crucial role in the surge of zoonotic diseases are: dense population, industrialization, urbanization, deforestation, and domestication of animals. These factors lead to increased animal and human contacts. Besides, factors like poor sanitation, insufficient health infrastructure, and lack of health education are also responsible. The recent COVID-19 pandemic was a big challenge to our healthcare system.

Infections caused by nontuberculous mycobacteria (NTM) are increasing globally and are notoriously difficult to treat due to their intrinsic resistance to many commonly used antibiotics. NTM are diverse and ubiquitous in the environment, with only a few species causing serious and often opportunistic infections in humans, including Mycobacterium abscessus. It is one of the commonly identified NTM species responsible for severe respiratory, skin, and mucosal infections in humans and is often regarded one of the most antibiotic-resistant mycobacteria, leaving us with few therapeutic options. Although historically known to cause infections in immunocompromised individuals, the incidence of infections in immunocompetent humans is on the rise, giving it the status of a true pathogen. This is a case report of an 18-month-old child diagnosed in an urban secondary care center with M. abscessus soft tissue infection, which was acquired postimmunization. Microbiological evidence was consistent with multidrug-resistant strains of M. abscessus. The child was evaluated for primary and secondary immunodeficiencies and was started on appropriate treatment based on culture and sensitivity, that is, linezolid and amikacin, which led to the resolution of the infection. Prevention of these infections at the source level is of utmost importance. Since the organisms are frequently found on hospital instruments, water sources, and surfaces, timely and regular sterilization and microbiological quality checks should be carried out.

Aims and background: Necrotizing fasciitis is a rare, severe, fulminating disorder infecting all the layers of skin and extending to the fascial planes and muscular layer. It is an unusual presentation of septicemia in neonates and is, to a larger extent, a disease of immunocompromised adults. Thus, there is a lack of reported neonatal cases. It could be misdiagnosed as cellulitis or myonecrosis due to its nonspecific presentations. It becomes essential to diagnose in a timely manner and culminate in a multidisciplinary approach with antimicrobial treatments and surgical aid to prevent its fulminating course. Thus, we aim to report three cases of necrotizing fasciitis presented in neonatal age, presented to us within a short span of 6 months, and sensitize its neonatal presentation with distinct clinical features. Case description: We report three cases of necrotizing fasciitis presented in neonatal age with varied clinical features, presenting as deep ulcers with fasciitis and scalp abscesses with no history of perinatal infections. The wound culture may not necessarily be septic. However, a multidisciplinary approach involving broad-spectrum intravenous antimicrobial therapy with advanced plastic surgical methodologies can help attenuate its fulminant course. Timely diagnosis and prompt intervention may aid in complete recovery, as in our cases, and thus prevent fatality. Conclusion: Neonatal necrotizing fasciitis is a progressive, fulminating infection of the skin, subcutaneous tissues, and fascial planes and may extend to muscular levels. We aim to sensitize the presence of necrotizing fasciitis as an unusual presentation of neonatal septicemia, encourage prompt diagnosis, and adopt a multidisciplinary approach. Clinical significance: Neonatal necrotizing fasciitis, though infrequent, carries a fatal, fulminating course. It is primarily a polymicrobial infection involving deep skin layers with extension to muscular planes. The diagnosis is usually clinical. Timely diagnosis with prompt antimicrobial treatment and surgical intervention helps reduce grave complications and mortality rates.