Welcome to the WSPID 2022 Virtual Congress Calendar

Background

Unregulated antimicrobial use, lack of clinical microbiology laboratories and trained personnel are driving antimicrobial resistance in developing countries. .

Aims

The objective of the study was to compare antimicrobial prescription days recommended by pediatric residents and pediatricians in Addis Ababa, Ethiopia with guidelines published by internationally recognized bodies.

Methods

This descriptive cross-sectional study was conducted from February - July, 2020. Data on recommendations on length of antimicrobial prescription were collected from pediatricians and pediatric residents in Addis Ababa, Ethiopia. Responses were summarized using descriptive quantitative analysis and their conformity to recommendations of internationally recognized guidelines was evaluated. Differences between sub-groups was determined by the Mann-Whitney U test. Analyses were done using Statistical package for the social sciences (SPSS) version 20.0 and significant differences ascertained at p-value < 0.05.

Results

A total of 88 respondents participated in the stud. Many respondents suggested prescription days exceeding recommendations for common pediatric infections; notably for conjunctivitis, cystitis, cellulitis and lower respiratory infections. Antimicrobial durations often came short of standard recommendations for tonsillopharyngitis, amebiasis and pyomyositis. Pediatricians favored less prescription days for endocarditis, hospital acquired pneumonia, cystitis and conjunctivitis. Inter-group differences were significant when prescribing for meningococcal meningitis, otitis media, Candida central line infections and non-gonococcal septic arthritis. Overall, respondents suggested 11,828.6 prescription days exceeding guideline recommendations.

Conclusions

Prescription days offered by pediatric residents and pediatricians practicing in Addis Ababa, Ethiopia differed from those recommended by guidelines for most childhood infections. Observance of evidence-based antimicrobial guidelines leads to favorable patient outcomes, fewer drug-related toxicities and prevention of antimicrobial resistance.

Background

Cellular phones of healthcare workers are carriers of pathogenic organisms, yet are rarely disinfected. These devices may become reservoirs to infect susceptible patients. Isopropyl alcohol-based disinfection of the phone has been advocated, but newer devices using ultraviolet C (UVC) light to disinfect cellular phones are now available. Level one evidence does not exist comparing the efficacy of UVC light with isopropyl alcohol-based swabs disinfection.

Aims

This study aims to compare the efficacy of the UVC light to 70% isopropyl alcohol-based swabs in disinfecting cellular phones.

Methods

A randomised controlled study in a paediatric ICU setting was conducted. Cellular phones of HCW or other personnel entering ICU were swabbed prior to and after decontaminating with either 70% isopropyl alcohol-based swabs or UVC light method. The reduction ratio of colony-forming units (CFU) pre-and post-intervention was analysed using the Mann-Whitney U test. In addition, the effectiveness of the decontaminant method was individually analysed using the Wilcoxon signed-rank paired test.

Results

A total of 74 cellular phones were sampled, 34 in the 70% isopropyl alcohol-based group, 35 in the UVC light group, with five exclusions. Disinfection with 70% isopropyl alcohol-based (z= 5,16; p < 0.000001) and UVC light (z = 3,28; p< 0.005) were individually statistically significant in reducing CFU of common skin commensals. When comparing isopropyl alcohol-based to UVC, isopropyl alcohol-based disinfection was superior to the UVC disinfection (p<0.001), effect size 0.67.

Conclusions

Disinfecting cellular phones with 70% isopropyl alcohol is superior to using UVC light.

Background

Despite vaccination being one of the great global public health successes, uptake amongst children and young people (CYP) remains below WHO targets for many diseases. UK guidance recommends vaccination status be checked routinely in all healthcare settings, e.g. the Paediatric Emergency Department (PED). This is most commonly done via a basic question such as “Is this child up-to-date?”.

Aims

The aim of this work was to estimate the accuracy of parent/carer recall (the routine source of data during a PED consultation). It is part of a project exploring the potential for PED-based vaccination interventions, with an initial focus on ways of reliably identifying those at higher risk of being under-immunised.

Methods

Full ethics approval was obtained. Participants were recruited from attendees (< 16 years old) at one PED in England. Parents/carers were asked if the attendee was up-to-date with vaccinations (yes/no/not sure) and consent was requested to access community-held vaccination records (assumed to be correct as vaccines are mostly given in the community).

Results

Only 4% of CYP were reported by parents/carers as not being fully immunised, however community-held records showed this figure to be 14%. Nearly one in five (18%) of parents/carers inaccurately reported their child’s status, with the majority over-estimating vaccination coverage.

Conclusions

CYP attending the PED may benefit from targeted interventions to improve their vaccination coverage. However, parent/carer recall is not sufficiently reliable as a source of accurate vaccination data. More work needs to be done to look at alternative sources of data for identifying under-vaccinated CYP during a PED visit.

Background

India has been significantly progressed in full immunization care over the last few decades. Existing literature has not been unaddressed the potential spatial variations in relationships between full immunization coverage and its influence on socio-economic factors.

Aims

This study aims to explore place-specific spatially varying relationships between district-level complete immunization coverage and socio-economic and healthcare factors in India using the 4th wave of the National Family Health Survey, 2015–16.

Methods

Univariate Moran’s I and LISA maps were used to confirm the spatial autocorrelation and geographical hotspots of the district-level full immunization coverage. Multivariate Ordinary Least Squares and Geographically Weighted Regression models were employed to examine spatial relationships and to decrypt location-based district-level analysis.

Results

The prevalence of full immunization care was 62% as per the national figure. The GWR results revealed that the relationships between outcome and set of cofactors were significantly place-specific and spatially clustering in terms of their respective magnitude, direction, and differences in due to local characteristics across India. In terms of model performance and prediction accuracy, the GWR model was performing better over OLS estimates through comparisons of R2 and Akaike Information Criterion (AICC) in both models.

Conclusions

Thus, the findings suggest that the local GWR model has the potential to explain complexities in place-specific variations that could be ignored by OLS on the local causes of immunization coverage. Highlighting the socio-economic importance of spatial dependence and heterogeneity, appropriate intervention should be devised to safeguard the child from vaccine-preventable diseases reduce the geographical heterogeneity of full immunization coverage across India.

Background

Fleas (Siphonaptera) are important vectors of several animal and human disease pathogens, while rodents are considered as reservoirs of most pathogens, including Yersinia pestis Factors that influence the parasitism rate of fleas, ecological aspects that modulate their distribution, and host-flea relationship in Eastern Zambia remain unknown. Furthermore, there is little information on the biodiversity and abundance of rodents and fleas in the study area.

Aims

The was to determine the close association of fleas, rodents and the plague disease

Methods

The rodents were trapped using the live traps. The captures were taken to the mobile laboratory where fleas, blood and organs were collected. The fleas were also collected from the domestic animals. The fleas were identified and the sera were tested for the IgG antibodies of the F1 antigen of the Yersinia pestis using ELISA technique. The Organs and fleas were processed following the protocal. The DNA was extracted using DNA extraction kit. The PCR was run to detect the pla gene of Yersinia pestis.

Results

The results showed that 27(8.2%) and 19(5.8%) rodents and 8(7.0%) and 2(1.8%) Crocidura were positive for antibodies and pla gene for Y. pestis, respectively. Echidnophaga larina were the most mean abundant (MA=8.58), while Xenopsylla cheopis had the least mean abundant (MA=0.14), nevertheless it was the most infected with Y.pestis. Mastomys. natalensis was highest in plague positivity 31/56, followed by Crocidura spp 10/56 and Rattus rattus 6/56.

Conclusions

It’s established that rodents were more biodiversity than fleas while both were unevenly distributed

Background

Real time PCR (RT-PCR) is an alternative approach for the identification and quantification of pneumococci directly from samples.

Aims

To compare pneumococcal detection rates using culture and RT-PCR and to compare pneumococcal colonization density in healthy children and hospitalized children with respiratory symptoms.

Methods

284 nasopharyngeal swabs (NPSs) obtained from children between 2 months to 2 years of age were included; 101 were from healthy children while 183 were from children with respiratory symptoms. An RT-PCR assay targeting lytA was done alongside with culture based methods.

A standard curve was plotted using DNA from ATCC 49619 strain of Streptococcus pneumoniae with a 10-fold dilution series. RT-PCR positivity as defined by a Cq value of =< 35

Results

The overall colonization rate detected by conventional culture was 41.2% (n=117) while RT-PCR detection rate was 43.7% (n=124). The colonization rate detected by RT-PCR in the healthy cohort was 33.7% (n=34) and it was 49.2% (n=90) in the hospitalized cohort. It was 37.6% (n=38) and 43.2% (n=79) for the two cohorts by culture. The mean Cq value for the healthy cohort was 29.61±2.85 and 28.93±3.62 for the hospitalized cohort.

The mean genomic DNA copy numbers detected in children with respiratory symptoms was log10 7.49 (SD 1.07) while it was log10 7.30 (SD 0.23) in healthy children.

Conclusions

There was a higher detection of pneumococcal colonization using RT-PCR.

A higher pneumococcal colonization density was detected in hospitalized children with respiratory symptoms.

Acknowledgements

Research grant WI216479 through Pfizer for financial assistance.

Background

Campylobacter species have been recognized as the leading cause of bacterial enteritis in both developed and developing countries, and the prevalence of Campylobacter infection in children under five years has been reported to be higher than in adults

Aims

This study aimed to determine the prevalence and risk factors for Campylobacter infection in children with diarrhea and those without diarrhea in Dar es Salaam Tanzania.

Methods

A hospital based cross sectional comparative study was conducted from October 2016 to April 2017. A total of 617 children (312 with diarrhea and 305 without diarrhea) at the main hospitals and their respective Reproductive and Child Health (RCH-1) clinics were enrolled. Stool samples were collected and tested for Campylobacter infection, while blood samples were collected and tested for malaria and HIV.

Results

We found no significant difference in the prevalence of Campylobacter infection among children with diarrhea (16.7%) and those without diarrhea (16.4%) (p-value = 0.927). Drinking unboiled water was significantly associated with Campylobacter infection among children with diarrhea (p-value=0.045), while chicken keeping and HIV infection were significantly associated with Campylobacter infection in children without diarrhea (p-value=0.025 and 0.001 respectively)

Conclusions

Campylobacter infection is prevalent in both children with and without diarrhea. Consumption of unboiled water increases the risk of developing diarrhea in children with Campylobacter infection.

Background

Since the beginning of the year 2020, the Coronavirus Disease-19 (COVID-19) pandemic has affected the world and thus, the Healthcare Systems around the world in an unprecedented way. It has been reported that the pandemic has implied an increase in the numbers of the Healthcare Associated Infections (HAIs), therefore we decided to explore the impact of the pandemic in a Third Level Pediatric Hospital in Mexico City.

Aims

Determine the prevalence of the HAIs before and after the beginning of the COVID-19 pandemic.

Methods

We realized a retrospective study from November 2018 until June 2021 using the medical records of pediatric patients with HAIs in our hospital. We included demographic data, type of infection and the microorganisms found in these HAIs. Data was analyzed in quarters of a year comparing pre-pandemic and pandemic data.

Results

Our pre-pandemic data shows a total of 825 HAIs with a rate of 8.1 per 1,000 patient-days comparing to a total of 625 HAIs with a rate of 7.3 per 1,000 patient-days. Comparison shows a 17.6% reduction in total HAIs and 10% reduction in HAIs rate per 1,00 patient-days between both time periods.

Conclusions

There is a decrease in total and rate per 1,000 patient-days of HAIs contrary to what is documented in other reports. The increase in the prevention measures and the high compliance of the Healthcare Personnel regarding these preventive measures, may have contributed to the reduction of the HAIs in our Hospital.

Background

About one million pregnant women (PW) are infected with syphilis globally, leading to an estimated 350,000 adverse pregnancy outcomes annually. In Ethiopia, 45% and 90% of PW are tested for syphilis and HIV respectively during ANC, with testing rates at 16% and 66% in Nigeria. The ‘testing gap’ between HIV and syphilis represents a missed opportunity to screen and treat maternal syphilis.

Aims

CHAI supported the Governments to conduct pilots, introducing dual HIV/syphilis RDTs in ANC across 40 and 31 Health Facilities (HF) in Ethiopia and Nigeria respectively, demonstrating the dual RDT’s operational feasibility and establishing impact driving congenital syphilis elimination.

Methods

HFs with the highest first ANC attendance volume, based on a three-year retrospective DHIS data, were selected for the pilot per region/state. 1,678 health care workers in Nigeria and 159 in Ethiopia were trained to use dual RDTs and administer Benzathine Penicillin G for syphilis treatment over the 6-month and 18-month respective pilot periods in Ethiopia and Nigeria.

Results

45,413 pregnant women were tested for HIV and syphilis in Nigeria, representing 100% syphilis testing coverage. Syphilis positivity rate was 0.2%, treatment uptake 90% and partner testing 42%. In Ethiopia, 97% of the 14,568 ANC attendees were tested with the dual RDT. Syphilis positivity rate was 0.6%, treatment uptake 98%, and partner testing 75%.

Conclusions

Dual HIV/syphilis RDTs have the potential to rapidly scale up access to HIV and syphilis diagnosis for pregnant women, a key strategy and pathway towards achieving dual elimination of mother-to-child transmission of both diseases.

Background

Time to positivity(TTP) is the time between the beginning of incubation and detection of growth in an automated system for blood culture. Some studies have found that TTP are related to prognosis in bacteremia. The diagnostic and prognostic value of TPP in pediatrics are related with high inoculum and small TTP, but few studies describe it.

Aims

To describe the TTP of 6 years of blood cultures in a Pediatric Hospital in Bogotá, Colombia.

Methods

We conducted a retrospective descriptive study of TTP in 6 years(2015-2020) in a Pediatric Hospital in Colombia. We obtained information of time to positivity using BD-Epicenter. We analyzed it with R4.0.3.

Results

We included 1258 blood cultures. Most frequent pathogen was coagulase-negative Staphylococci(CoNS) (409–32,5%), followed by S. aureus (264–20,9%), E. coli (176–14%), K. pneumoniae (68–5,4%), Streptococcus viridans (64-5,1%) and pneumococcus (29–2,3%). CoNS was most common in newborns and infants, and S. aureus in children and adolescents. Median TTP for S. aureus was 15 hours(IQR 12.3–18.6), E. coli 10.1 hours(IQR8.6–11.5), K. pneumoniae 9.5 hours (IQR8.3–10.9), Streptococcus viridans 14.1 hours (IQR12.1–16.1) and pneumococcus was 10.7 hours(IQR8.5-11.6). CoNS have a delayed growth (median 19.6h IQR17.1–23.2) related with contamination. TTP change the proportion of different organisms; <15 hours are frequent for pneumococcus and K. pneumoniae, >50 hours another pathogens (ie.Yeast) and contamination with CoNS are frequent.

Conclusions

TTP in pediatrics related to pathogenic isolates are practically always less that one day and common pathogens in Pediatrics usually growth in the first 14 hours. The TTP could change the probability of obtaining different pathogens.

Background

Chikungunya is a re-emerging infectious disease in Thailand.

Aims

We conducted this study to describe the epidemiological data of chikungunya infection in Thailand.

Methods

Analysis of the data of chikungunya patients reported to Center of Epidemiological Information, Bureau of Epidemiology, Ministry of Public Health, Thailand from January 2008 to December 2019 was done. Diagnosis of chikungunya fever adhered to clinical and laboratory criteria.

Results

From October 2008 onward, chikungunya cases were again reported in Thailand. The disease is more common in rainy season with all age groups affected. The strain in the current outbreak is African strain which is different from Asian strain in the past. The sudden onset of very high fever along with rash, and severe arthralgia especially in the small joints of hands and toes are characteristics of the disease. There was no mortality, however the high morbidity with severe arthralgia persisted for several months made the patient mentally and physically weak.

Conclusions

The implementation of effectively sustainable vector control is a key to success for prevention and control of this disease.

Background

Previous epidemiological studies have documented the household factors associated with childhood lower respiratory tract infections (LRTI), but only very few studies have explored the dose-response relationship between residential microbial diversity and childhood LRTI.

Aims

This study aimed to investigate the association between exposure to diverse indoor fungal aerosols and LRTI among under-five children in Ibadan, Nigeria.

Methods

In-home visits were conducted among 178 under-five children with LRTI matched by age (±3months), sex, and geographical location with 180 community-based under-five children without LRTI in Ibadan, Nigeria. Trained study staff sampled the indoor environment for fungal exposures using active sampling approach. Indoor total fungal count (TFC) was estimated and dichotomized into high (>median) and low (≤median) exposures. Alpha diversity measures including richness (R), Shannon (H), and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor fungal aerosols and LRTI risk among under-five children.

Results

The mean (SD) age of participants was 7.3 (1.35) months with a male preponderance (61.0%). Median TFC was higher in homes of cases (66 cfu/m³) than controls (49cfu/m³). Higher fungal diversities were found in homes of cases (R=2.56; H=0.82; D=2.33) than controls (R=1.89; H=0.55; D=1.88). In the multivariate models, higher categories of exposure to indoor TFC (OR=2.75, 95%CI=1.54–4.89), fungal richness (OR=3.17, 95%CI=1.65–6.07), and fungal diversity (OR=3.00, 95%CI=1.55–5.79) were independently associated with childhood LRTI risk.

Conclusions

Our study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor fungal aerosols.