Objectives: To study the clinicomicrobiological profile and evaluate cartridge-based nucleic acid amplification test (CBNAAT) positivity in presumptive pulmonary and extrapulmonary tuberculosis (EPTB) in pediatric patients. Materials and methods: It was a descriptive observational study done in pediatric presumptive pulmonary tuberculosis (PTB) and EPTB patients in a tertiary care institute of northern India. Pulmonary as well as extrapulmonary samples were collected as per clinical signs and symptoms and subjected to Ziehl–Neelsen (ZN) staining, Xpert MTB/RIF, and Lowenstein–Jensen (LJ) culture simultaneously. Results: Total 100 children were enrolled during the study period. About 57 children were diagnosed with tuberculosis (TB) during the study period. PTB, EPTB, and disseminated TB were detected in 26, 21, and 10 patients, respectively. The male to female ratio was 1:1.4, with a slight female preponderance. The most common presenting symptoms were fever (88%), cough (63%), and weight loss (38%). In the EPTB group, 43% had pleural effusion, followed by central nervous system (CNS) TB and abdominal TB in 28 and 24%, respectively. Among the cohort of diagnosed patients, 50.87% of cases were confirmed microbiologically, and 49.13% were confirmed clinically. The sensitivity and specificity of CBNAAT were revealed to be 90.91% (95% CI: 70.84–98.88%) and 88.46% (95% CI: 79.22–94.59%), respectively. The sensitivity and specificity of CBNAAT in PTB were 91.67 and 66.67%, and in EPTB, they were 50 and 100%, respectively. No rifampicin resistance was detected among diagnosed cases. Conclusion: Detailed history and examination are required for diagnosing TB in the pediatric population. GeneXpert is a high-utility tool that provides rapid diagnosis and information on rifampicin resistance in the pediatric population. Hence, it helps in the early initiation of therapy in children.

Aims and background: In uncomplicated acute bronchiolitis, chest radiography (CR) is not routinely recommended, yet it is still frequently done. This study seeks to evaluate the use of chest X-ray (CXR) in children with acute bronchiolitis and the influence of CXR on patient's treatment. Materials and methods: The pediatric department of SCL General Hospital (NHL Municipal Medical College), a tertiary care center in Saraspur, Ahmedabad, conducted a prospective observational study from 1st January to 29th February, 2024. All patients aged between 1 and 24 months who were clinically diagnosed with acute bronchiolitis admitted to the pediatric ward within 72 hours of symptoms were included in the study with informed consent obtained from relatives of patients. Detailed history in the form of age, sex, medical history and data of prematurity, clinical presentation, and detailed physical examination with heart rate, respiratory rate, temperature, oxygen saturation, respiratory distress, tachypnea, intercostal retractions, nasal flaring, wheezing, and crackles were included. The data was tabulated in an Excel sheet and appropriate statistical analysis using percentage calculation was done. Results: Our study was conducted from January to February 2024 with a sample size of 120 patients, all of them with a clinical diagnosis of acute bronchiolitis. Of which 62% were male patients. 95.8% of patients had no significant change in the 1st CXR, while only 4.2% of patients had significant changes. Out of 115 patients, 68 patients had mild, 24 patients had moderate, and 23 patients had severe bronchiolitis. Out of these, 30% of patients required 2nd CXR after 72 hours of admission owing to high-grade fever, complete blood count (CBC) with high neutrophilic leukocytosis, worsening of respiratory severity score, and C-reactive protein (CRP) >40. Conclusion: Chest X-ray yields nonspecific information and does not help in differentiating between viral and bacterial infection. CXR has practically no value in the case of children of bronchiolitis. The radiographic abnormalities may result in a non-indicated prescription of antibiotics.

Introduction: This study aims to address the issue of hospital-acquired infections (HAIs), which pose a significant threat to patient well-being. Citing Centers for Disease Control and Prevention (CDC) definitions, the prevalence of HAIs ranges from 10 to 20%, particularly impacting intensive care units. The study focuses on educating and sensitizing healthcare workers to improve knowledge, enhance infection prevention practices, and reduce HAI incidence. Material and Methodology: Objectives include assessing the impact of educational interventions on healthcare workers’ knowledge, studying the influence on daily clinical practices, and comparing HAI incidence before and after the intervention. The prospective interventional study involves neonatal intensive care unit (NICU) nursing staff and doctors. The methodology comprises: preintervention assessment, educational intervention, blind observational study, and retrospective data analysis. The educational intervention was conducted through a lecture, followed by group training and one-on-one doubt solving. All educational material and test questionnaires were validated by different topic experts apart from the investigators. Safety considerations are noted as not applicable, and outcome measures include knowledge assessment, hand hygiene compliance, and HAI reduction. Statistical analysis was conducted. Results and conclusion: A total of 42 participants were included, comprising nursing staff and doctors, at 64.3 and 35.7%, respectively. Twenty-two participants had previously attended an HAI prevention workshop elsewhere. Knowledge scores rose significantly postintervention, maintaining levels for 1 month. Hospitalized patient data revealed a marginal reduction in infections (22.4–20.8%) after the educational intervention. The study concludes that educating and sensitizing healthcare workers is vital for preventing hospital-acquired infections. While a one-time intervention showed marginal improvement, continuous motivation is necessary for sustained adherence.

Aim and background: Urinary tract infections (UTI) are among the most common infections requiring antibiotics in the pediatric population. There have been reports of increasing resistance of uropathogens to the common antibiotics used in UTI. Guidelines by the Indian Society of Pediatric Nephrology recommend third-generation cephalosporins, aminoglycosides, amoxicillin-clavulanate, or quinolones as first-line treatment for UTI. We aimed to evaluate the resistance pattern of the uropathogens isolated from patients with community-acquired UTI against the first-line antibiotics recommended for treatment. The secondary objective was to analyze whether there was an increase in resistance between the two halves of the study period. Materials and methods: A retrospective analysis was conducted among pediatric inpatients with a diagnosis of UTI and a positive urine culture during the period from January 2009 to December 2019 in a tertiary care hospital in South India. Details of their urine culture with the resistance pattern were analyzed. A comparison of the resistance pattern was made between the first and second halves of the study period. Results: Among 245 patients who met the inclusion criteria, the predominant organism isolated was E. coli, which constituted 64.5%, followed by Klebsiella (17%). E. coli showed 70% resistance to ceftriaxone, 56% to co-trimoxazole, and 53% to quinolones. Similarly, Klebsiella also showed 66.4% resistance to ceftriaxone, 51.9% to co-trimoxazole, and 10% to ofloxacin. The overall rate of extended spectrum beta-lactamase (ESBL) producers among Enterobacterales was 65.2%. A significant increase in resistance was noted among Enterobacterales to piperacillin-tazobactam, cefoperazone-sulbactam, and amikacin between the two study periods. Conclusion: Uropathogens causing community-acquired UTI in children are increasingly becoming resistant to the common first-line antibiotics recommended for their treatment. Clinical significance: With nearly two-thirds of the common uropathogens isolated in community-acquired UTI being ESBL producers, treatment recommendations should be revisited. Antibiotic stewardship measures in primary care should be strengthened.

Seasonal influenza cases are one of the most common infections in the pediatric age-group, affecting millions globally each year. Around 10% of all seasonal influenza cases occur in children younger than 5 years of age. The morbidity and mortality rate in children <2 years is very high compared to older children due to an immature immune system. This article highlights the current influenza strains that commonly affect the pediatric age-group, the peak seasons, morbidity and mortality rates, common clinical features, prevention strategies, and current influenza infections in India.

Tuberculosis (TB) and COVID-19 are both primarily respiratory illnesses that can be prevented. This article aims to compare and contrast the transmission of both illnesses. We also study the differences in public health approaches to help prevent their transmission and spread. While COVID-19 can be prevented by lockdowns and quarantine, these may not be feasible to prevent the spread of TB. Contact tracing, treating contacts of TB patients with TB preventive therapy in children below 5 years as well as in the immunocompromised population, can help prevent the spread of the illness.

To report a case of a 1-year-old female with intestinal tuberculosis (TB) causing transverse colon perforation and peritonitis.

Aims and background: Leptospirosis is caused by spirochetes of the genus Leptospira. In most patients, it is a very mild illness. However, some patients develop complications due to the involvement of multiple organ systems. Hemophagocytic lymphohistiocytosis (HLH) is characterized by prolonged fever, hepatosplenomegaly and cytopenias, hyperferritinemia and hypertriglyceridemia, hypofibrinogenemia, and hemophagocytosis in lymphoreticular system. It may occur primarily as a result of some genetic predisposition or secondarily associated with certain infections, autoimmune, and malignant conditions [secondary hemophagocytic lymphohistiocytosis (sHLH)]. Case description: We report a 9-year-old girl with secondary HLH associated with Leptospira infection treated successfully with appropriate antibiotics and intravenous immunoglobulin. Conclusion: Progressive cytopenia associated with deteriorating clinical condition with recurrence or nonabatement of fever should lead the clinician to suspect sHLH. Clinical significance: Leptospirosis precipitating HLH has rarely been reported.