Mamdoh M. Meqdam

Bacteremia in Children: Etiologic Agents, Focal Sites, and Risk Factors

A prospective study was carried out on 210 cases of children under 10 years of age with fever. Cases of gastroenteritis, respiratory tract infections, and suspected sepsis in children seen or admitted to the pediatric hospital were studied. Clinical and microbiological data were recorded in a questionnaire or obtained from patient medical records. Most of the children with septicemia (71.3 per cent) were less than 1 year old. Focal source of bacteremia was gastroenteritis (40.4 per cent), pneumonia or bronchopneumonia (20 per cent), meningitis (7.4 per cent), and urinary tract infections (7.4 per cent). The predominant pathogens isolated from blood or stool specimens were gram-positive bacteria (53.3 per cent), mainly Streptococcus pneumoniae and coagulase-negative Staphylococcus spp. The gram-negative bacteria (45.6 per cent) were mainly Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Yersinia spp. One case of Candida albicans (1.1 per cent) was reported. Pasteurella pneumotropica was reported in two cases for the first time. The mortality rate was 4 per cent, mostly from septicemia cases. Long duration of hospitalization (> 10 days) and parenteral feeding were identified as risk factors. Resistance of the isolated pathogens to several commonly used antibiotics was observed. Empirical treatment with antibiotics is recommended only in life-threatening cases.

Viral Gastroenteritis Among Young Children in Northern Jordan

During the summer months of 1992 and 1993, a total of 439 diarrhoeatic fecal specimens from infants and young children less than 3 years of age admitted to the pediatric ward of Princess Basma Teaching Hospital, northern Jordan were tested for the presence of viruses using direct electron microscopy (EM) and enzyme-linked immunosorbent assay (ELISA) for rotavirus. EM revealed rotaviruses in 83 (18.9 per cent) of cases, adenoviruses in five (1.1 per cent) cases, and small round viruses in three (0.68 per cent) cases. In contrast, the ELISA assay detected rotaviruses in 174 (39.6 per cent) of cases. In an evaluation of the collected diarrhoeatic fecal samples for rotavirus detected by ELISA, a sensitivity of 95.2 per cent and a specificity of 73.3 per cent was demonstrated.

Assessment of toxic potential of local Jordanian Bacillus thuringiensis strains on Drosophila melanogaster and Culex sp. (Diptera)

I. SAADOUN, F. AL‐MOMANI, M. OBEIDAT, M. MEQDAM AND A. ELBETIEHA. 2001.

Enhanced detection of respiratory syncytial virus by shell vial in children hospitalised with respiratory illnesses in Northern Jordan

During the period between November 1997 and May 1998, a total of 350 nasopharyngeal aspirates were obtained from children admitted to the Respiratory Disease Unit at Princess Rahma Hospital, northern Jordan, and diagnosed clinically as suffering from respiratory tract infections. Nasopharyngeal aspirates were investigated for the presence of respiratory syncycial virus (RSV) by using shell vial (SV) culture assay, conventional culture assay, and direct immunofluorescence assay. Out of 350 nasopharyngeal aspirates, 101(28.9%) were found positive by any of SV, conventional culture, and immunofluorescence; 91 (90.1%) by SV, 87(86.1%) by culture, and 83(82.2%) by immunofluorescence. The maximum number of virus isolations was noted in children below the age of 1 year and was associated with bronchiolitis. SV assay showed the highest sensitivity (94.3%) and specificity (96.9%) for detecting RSV from nasopharyngeal aspirates. These results emphasise the importance of SV culture assay for diagnosis of RSV, although immunofluorescence is a valuable, rapid diagnostic assay. J. Med. Virol. 62:518–523, 2000.

Detection of adenovirus infection in children in Jordan

Summary Between November 1997 and May 1998, 350 nasopharyngeal aspirates (NPA) were obtained from children admitted to the Respiratory Disease Unit at Princess Rahma Hospital, northern Jordan who were clinically diagnosed as suffering from respiratory tract infections. NPA were investigated for the presence of adenovirus using shell vial (SV) culture assay, conventional culture (CC) assay, and direct immunofluorescence assay (DFA). Of the 350 NPA, adenoviruses were detected in 54 (15.4%) by the combined techniques used. SV identified 34 (63%), CC 48 (89%) and DFA 30 (56%). Most virus isolations were in children aged 1–<5 years old and were associated with pneumonia in 39% and bronchopneumonia in 32%. SV assay showed a sensitivity and specificity of 68.8% and 99.7%, respectively, for detecting adenovirus from NPA. These results emphasize that CC assay is still important for the diagnosis of adenovirus, although SV and DFA are superior diagnostic assays.