Human adenoviruses in children with gastroenteritis: a systematic review and meta-analysis.

PURPOSE: Human adenoviruses (HAdVs) have always been suggested as one of the main causes of gastroenteritis in children. However, no comprehensive report on the global epidemiology of these viruses in pediatric gastroenteritis is available. METHODS: A systematic search was conducted to obtain published papers from 2003 to 2023 in three main databases PubMed, Scopus, and Web of Science. RESULTS: The estimated global pooled prevalence of HAdV infection in children with gastroenteritis was 10% (95% CI: 9-11%), with a growing trend after 2010. The highest prevalence was observed in Africa (20%, 95% CI: 14-26%). The prevalence was higher in inpatients (11%; 95% CI: 8-13%) and patients aged 5 years old and younger (9%; 95% CI: 7-10%). However, no significant difference was observed between male and female patients (P = 0.63). The most prevalent species was found to be the species F (57%; 95% CI: 41-72%). The most common HAdVs observed in children with gastroenteritis were types 40/41, 38, and 2. Analysis of case-control studies showed an association between HAdV and gastroenteritis in children (OR: 2.28, 95% CI; 1.51-3.44). CONCLUSION: This study provided valuable insights into the importance of HAdVs in children with gastroenteritis, especially in hospitalized and younger children. The results can be used in future preventive measurements and the development of effective vaccines.

Global prevalence and genotype distribution of norovirus infection in children with gastroenteritis: A meta-analysis on 6 years of research from 2015 to 2020.

In the post rotavirus vaccine era, norovirus (NoV) plays an increasingly important role in epidemic and sporadic gastroenteritis among children. This study was designed to provide an updated meta-analytic review of the prevalence of NoV among paediatric patients with gastroenteritis and to clarify the relationship between NoV infection and gastroenteritis. Systematic searches of the literature for potentially relevant studies were carried out from 1 January 2015 to 29 May 2020. The inverse variance method was chosen for weighting of the studies, and the random-effects model was used to analyse data. To determine the association between NoV infection and gastroenteritis in children, pooled odds ratio (OR) and its 95% confidence interval (CI) were computed for case-control studies. The pooled prevalence of NoV infection among 12,0531 children with gastroenteritis from 45 countries across the world was 17.7% (95% CI: 16.3%-19.2%). There were 28 studies with a case-control design, and the pooled prevalence of NoV infection among 11,954 control subjects was 6.7% (95% CI: 5.1%-8.8%). The pooled OR of the association of NoV infection and gastroenteritis was 2.7 (95% CI: 2.2-3.4). The most common NoV genotypes were GII.4 (59.3%) and GII.3 (14.9%). The highest frequency of NoV was found in the age group below 1 year. Our findings indicated a substantial burden of gastroenteritis caused by NoV globally, with GII.4 and GII.3 the major genotypes responsible for the majority of NoV-associated gastroenteritis cases among children. Younger age and male sex can be considered risk factors for NoV-associated gastroenteritis among children.

Etiology and Antimicrobial Susceptibility Pattern of Urinary Tract Infection in the First Year after Pediatric Renal Transplantation: A Preliminary Study.

Background: Urinary tract infection (UTI) is common after pediatric renal transplantation, and the emergence of multidrug-resistant (MDR) bacteria causing UTI is a therapeutic challenge in this regard. The main purpose of this study was to determine the UTI frequency, its etiologic agents, and the antibiotic susceptibility pattern in the first year following renal transplantation in Iranian pediatric recipients. Methods: In a retrospective cohort study, all of the 81 children who had undergone renal transplantation in Hazrat Rasoul Akram Hospital between 2012 and 2017 were enrolled. Confirmed episodes of UTI during the first year following renal transplantation were analyzed. The pattern of antibiotic resistance was determined for the causative agents of UTI. The data were analyzed using the IBM SPSS Statistics software (version 20). and the P < 0.05 was considered significant. Results: Totally, from 81 enrolled cases, 37(44.7%) cases were in the age group of 11-15 years. Overall, 19, 10, and 3 UTI episodes had occurred in the first month, from the first to sixth month, and between the sixth month and one year after transplantation, respectively. The four most common isolated bacteria were Escherichia coli (E. coli; 31.2%), Pseudomonas aeruginosa (P. aeruginosa; 25%), Enterococci (21.9%) and Klebsiella pneumoniae (K. pneumoniae; 12.5%). The highest rate of resistance was reported to trimethoprim/sulfamethoxazole (TMP/SMX), cephalosporins, and fluoroquinolones among gram-negative bacteria. However, none of the Enterococci isolates were resistant to linezolid and nitrofurantoin. Conclusion: Resistance to antibiotics is increasing among the pathogens causing UTI in pediatric renal transplanted cases. It is suggested to stop the administration of TMP/SMX and third-generation cephalosporins for empiric treatment of UTI in Iranian pediatric renal transplant recipients. Ciprofloxacin might be administered cautiously secondary to the increasing rate of antibiotic resistance in this group.

Prevalence and Clinical Relevance of cagA and oipA Genotypes of Helicobacter pylori in Children and Adults with Gastrointestinal Diseases in Tehran, Iran.

Background: Helicobacter pylori isa universal pathogen that causes gastric diseases and cancers in humans. In recent years, several virulence genes have been detected in this microorganism. Thus, we aimed to investigate the frequency of Helicobacterpylori strainswith cytotoxin-associated gene A(cagA) and outer membrane inflammatory protein A(oipA) genotypes among children and adult patients in Tehran, Iran, and evaluatetheir relation to themanifestations of different clinical symptoms. Methods: In this cross-sectional study, biopsy specimens were obtained from patients with gastrointestinal symptomsand evaluated for Helicobacter pylori infectionand its genotypes (cagA/oipA) througha polymerase chain reaction PCR assay. Clinical findings and demographic data of patients were documented and analyzed. Results: A total of 80 patients with Helicobacter pylori infectionwere included in the study (34 children and 46 adults). The cagA and oipA genotypes of Helicobacter pylori wereidentified in 22 (64.7%) and 24 (70.5%) children and in 31 (67.3%) and 34 (73.9%) adults, respectively. These differences were not statistically significant between the 2 studied groups. In addition, the frequency of cagA-positive strains of Helicobacterpylori wasfound more among patients with gastric ulcers rather than other clinical outcomes. Conclusion: Our findings demonstrate a highfrequency of Helicobacter pylori strains with oipA and cagA genotypes among children and adults in this region. Although we could not find a significant relationship between virulence genes and clinical outcomes in the patients, further studies are suggested to evaluate these factors in patients and assess their potential roles in the presence of antibiotic-resistant strains.

Tropheryma whipplei in the stool samples of children with acute diarrhea: a study from Tehran, Iran.

BACKGROUND: Recently, Tropheryma whipplei has been suggested as one of the causative agents of diarrhea among children worldwide. Limited data is available on the prevalence of T. whipplei among children with diarrhea in most countries such as Iran. This study was conducted to evaluate the prevalence of T. whipplei in children with acute diarrhea in Iran. METHODS: In this study, the stool samples were collected from 130 children under 10 years old with acute diarrhea from children's hospitals in Tehran city. Genomic DNA was extracted from stool samples and was tested for the presence of DNA of T. whipplei using the SYBR Green Real-time PCR method. Positive T. whipplei samples were finally confirmed by PCR Product sequencing. RESULTS: The mean age of participants was 32.5 months, and 54.6% of children were female. Using the SYBR Green Real-time PCR, 9.23% (12/130) of samples were positive for T. whipplei, which were confirmed by sequencing. 66.67% of positive cases were males. The duration of diarrhea in infected children with T. whipplei (83.3%) was significantly longer (OR: 5.93, 95% CI 1.24-28.22) compared to children with negative results (45.8%). Other demographic factors and clinical signs had not a statistically significant relationship with T. whipplei infection. CONCLUSIONS: In this study, T. whipplei was detected in stool samples of children with acute diarrhea. The results indicated that T. whipplei could be associated with childhood diarrhea in Iran. The health care system and physicians should be aware of the presence of T. whipplei infection in Iran, especially in childhood diarrhea.

Molecular Characterization of Streptococcus Pneumoniae from Patients Diagnosed with Pneumonia: Recommendation for Vaccination Program.

Background: Infections caused by Streptococcus pneumoniae (S. pneumoniae) have remained a significant public health concern worldwide. In developed countries, the highest prevalence of S. pneumonia has been reported among the elderly. The aim of this study was to evaluate the coverage of genotypes in the 13-valent pneumococcal conjugate vaccine (PCV-13) in the Iranian elderly population. Methods: A total of 41 isolates of S. pneumoniae were collected in the current retrospective cross-sectional study. The samples comprised 33 inpatients hospitalized for pneumococcal pneumonia and 8 outpatients. Multiplex polymerase chain reaction assay was performed to categorize the bacteria isolated into specific genotypes. Statistical analyses were performed using SPSS software, and the chi-square test was used to assess the statistical significance in percentages. Results: A total of 68 genotypes were identified in this study, in which 39 isolates (57.3%) were associated with invasive infections. The most common genotypes were 6A/B [8 (19.5%)], 1 [7 (17.5%)], 14 [5 (12.2%)], and 19A [4 (9.75%)], respectively. The coverage rates of PCV-7, PCV-10, and PCV-13 vaccines were 51.17%, 70.7%, and 99.9%, respectively. According to our results, the pneumococcal coverage rate of PCV-7, PCV-10, and PCV-13 vaccine types is estimated to be 51.2%, 70.7%, and 99.9%, respectively. Furthermore, the trend of pneumococcal serotypes included in the PCV-13 was steadily increasing during the study period. Conclusion: It can be concluded that the most circulating pneumococcal serotypes were in accordance with specific serotypes included in the PCV-13 vaccine types. Therefore, including PCV-13 vaccines in immunization programs against pneumococcus in the elderly can effectively reduce the rate of infections.

The effect of calcium on the duration of acute gastroenteritis in children: A randomized clinical trial.

Background: Currently, the role of calcium in reducing the duration and severity of diarrhea and its consequences has been considered as a topic of concern. The aim of this study was to evaluate the effect of oral calcium on the duration of acute gastroenteritis in children. Methods: This single-blind randomized clinical trial was performed from 2014 to 2016 at Ali Asghar Children's Hospital, Tehran, Iran. Totally, 124 patients (one month to twelve years old) with acute gastroenteritis were enrolled in this study. The patients were divided equally into intervention and placebo groups and received the calcium gluconate 10%, 0.5cc/kg/day and distinct water, respectively. Data analysis was performed using the statistical software SPSS version 20.0 for windows (SPSS Inc., Chicago, IL) and p<0.05 was considered significant. Results: The mean age of the intervention and placebo groups was 26.43±3.74 and 20.84±2.70 months, respectively, and the difference was not significant (p=0.228). The duration of diarrhea in the intervention and placebo groups was 5.27±2.01 and 6.71 ± 2.44 days respectively (p=0.001). In the placebo group, the plasma calcium level was less than 8mg/dl in 1 (1.6%), 8 - 10 mg/dl in 55 (88.7%) and more than 10mg/dl in 6 cases (9. 7%). In the intervention group, there were 7 (11.3%), 55 (88.7%) and 0 (0%) cases in three groups, respectively (p=0.005). Conclusion: The oral calcium gluconate might shorten the duration of acute gastroenteritis. Therefore, it could be considered as an adjunctive therapy. Whether the formulation of the oral rehydration solution (ORS) will be updated in the future with adding the calcium salts remains to be defined and needs more investigations.

Correction to: Serotype distribution of Streptococcus pneumoniae among healthy carriers and clinical patients: a systematic review from Iran.

A correction to this paper has been published: https://doi.org/10.1007/s10096-020-04084-3.

Serotype distribution of Streptococcus pneumoniae among healthy carriers and clinical patients: a systematic review from Iran.

Streptococcus pneumoniae is associated with high morbidity and mortality in the world. Commercially licensed and available pneumococcal conjugate vaccines (PCVs) contain 10 (PCV10) and 13 (PCV13) pneumococcal serotypes. The most common serotypes of S. pneumoniae causing clinical diseases and carriers of S. pneumoniae in Iran are not yet known. Reviewing and reporting trends in the distribution of pneumococcal serotypes in Iran will be useful for policy-making as PCV is being introduced into Iran's routine immunization program. Here, we report a systematic literature review of studies regarding S. pneumoniae serotype distribution in clinical and carrier patients in Iran. MEDLINE (via PubMed), Scopus, Embase, Ovid, Google Scholar, Web of Science, and the Iranian Database were used to identify relevant papers published from 1 January 2000 to 21 August 2019. The search returned 8 relevant articles. Among serotypes causing invasive pneumococcal diseases (IPD), serotype 23F (16.4%) was the most circulating serotype followed by 19F (15.2%), 19A (11.3%), 6A/B (9.2%), 9 V (5.8%), and 11A (5.14%). In carrier patients, the most common serotypes were, in rank order, 6A/B (10%), 19F (9%), 14(6.2%), 17F (4.8%), and 20(4.5%). Vaccine coverage among IPD patients would be 67.1% for PCV10-TT and 73.8% for PCV13. The present review demonstrates that the serotypes which were most responsible for disease in Iran are included in PCV10-TT and PCV13. However, sentinel surveillance must be continued in representative parts of the country to assess changing trends in the distribution of pneumococcal serotypes and their implications for vaccine selection and rollout in Iran.

Comparison of serologic status of Toxoplasma gondii infection in pre- and post-heart transplantation in a pediatric population: A preliminary study.

BACKGROUND: Toxoplasmosis is an important opportunistic infection in immunocompromised children, especially in heart transplant recipients. This study aimed to investigate pre- and post-transplant serology for toxoplasmosis along with post-transplant PCR in pediatric heart transplant patients. METHODS: This cross-sectional study was performed on 38 heart transplant recipients aged 1-17 years, by the end of 2018. Pre- and post-transplant IgM and IgG titrations were measured using ELISA method. Nested PCR of B1 gene was performed to identify Toxoplasma gondii (T gondii) infection after transplant. RESULTS: Totally, 11.4% of patients had positive IgG and 91.4% had negative IgM for toxoplasmosis before heart transplantation. The mean of pre-transplant IgG titration for seropositive and seronegative patients was 22.32 ± 15.30 IU/mL and 1.49 ± 1.15 IU/mL, respectively (P < .001). All cases were on chemoprophylaxis with trimethoprim-sulfamethoxazole (TMP/SMX). The mean of post-transplant IgG titration was 1.62 ± 1.87 IU/mL, which was negative for all cases. Investigating pre-transplant, IgM titration, 5.7% were positive, 91.4% were negative, and 2.9% were borderline. All cases were post-transplant IgM negative. The mean of post-transplant IgG titrations was significantly higher in the first 6 months (3.26 ± 2.68 IU/mL) compared to 6-12 (1.30 ± 1.34 IU/mL; P = .039) and > 12 months (1.07 ± 1.27 IU/mL; P = .004) time periods. The result of PCR for B1 gene in all cases was negative. CONCLUSIONS: Chemoprophylaxis with TMP/SMX seems to be effective in prevention of T gondii infection or reactivation among pediatric heart transplantation population. Anti-T. gondii-IgG level alone may not be sensitive enough for evaluation of the infection at least after 6 months post-transplantation.

Comparison of tuberculin skin test and interferon gamma release assay in pediatric candidates of heart transplantation and a 2-year follow-up.

BACKGROUND: Currently, tuberculin skin test (TST) and interferon gamma release assay (IGRA) are used to find the latent tuberculosis infection (LTBI) cases in the candidates of heart transplantation. Therefore, this study aimed to compare TST and IGRA to diagnose LTBI in pediatric heart transplant candidates. METHODS: This cross-sectional study was performed on 50 children, who were candidates for heart transplantation, of whom 42 cases underwent heart transplantation in Shahid Rajaie Cardiovascular, Medical, and Research center, Tehran, Iran, from 2016 to 2017. RESULTS: Participants of the study included 24 male patients (%48) (p-value = 0.67). The mean age of the patients was 8.18 ± 4.27 years (1-16 years). According to the results, IGRA was negative in all patients, and no indeterminate result was reported, while the purified derivative test (PPD) was positive in three (6%) cases. In comparison with QFT, an accuracy of 94% was achieved for TST to diagnose Mycobacterium tuberculosis infection. CONCLUSIONS: It seems that TST can still be used as an accurate test for screening LTBI in pediatric candidates for heart transplantation.

Incidence of intussusception in children less than five years of age: a pre-rotavirus vaccine survey from Iran, 2010-2015.

Background: The aim of this study was to determine the baseline statistics of intussusception in the under-five- year age group in Iran to facilitate the monitoring of potential side effects after administration of rotavirus vaccine. Methods: This hospital-based historical cohort study reviewed children under 60 months of age with the final diagnosis of intussusception, ICD-10 code K56.1, using census in all hospitals of Tehran, Iran from March 2010-2015. Demographic (sex, age, hospital stay duration), clinical manifestations (such as currant jelly stool, abdominal pain, vomiting, and fever),diagnostic and treatment methods (contrast enema, ultrasonography, laparotomy, and laparoscopy), and outcome data of patients aged less than 5 years with the diagnosis of intussusception were collected and analyzed using SPSS Version 16.0 (SPSS Inc., Chicago, IL, USA) Results: In this study, 759 patients were diagnosed with intussusception; 309 (40.7%) cases were less than 12 months old. The annual incidence of intussusception was 66.54 cases per 100.000 in children less than one-year-old and 31.61 cases per 100.000 in children less than five years old. The most common symptoms and signs were abdominal pain/irritability (94.2%) and tenderness (24.2%), respectively. The diagnostic method was ultrasound in 75.9% of cases. The most frequent anatomic location was the ileocolic region (87.87%) and the most common treatment method was barium enema. Conclusion: This research has provided a baseline statistic for childhood intussusception in Tehran prior to the administration of the rotavirus vaccine to provide a better comparison with post-introduction data.

Genetic Analysis of 13 Iranian Families With Leukocyte Adhesion Deficiency Type 1.

BACKGROUND AND AIM: Leukocyte adhesion deficiency type 1 is a rare, autosomal recessive disorder that results from mutations in the ITGB2 gene. This gene encodes the CD18 subunit of ß2 integrin leukocyte adhesion cell molecules. Leukocyte adhesion deficiency type 1 is characterized by recurrent bacterial infections, impaired wound healing, inadequate pus formation, and delayed separation of the umbilical cord. MATERIALS AND METHODS: Blood samples were taken from 13 patients after written consent had been obtained. Genomic DNA was extracted, and ITGB2 exons and exon-intron boundaries were amplified by polymerase chain reaction. The products were examined by Sanger sequencing. RESULTS: In this study, 8 different previously reported mutations (intron7+1G>A, c.715G>A, c.1777 C>T, c.843del C, c.1768T>C, c.1821C>A, Intron7+1G>A, c.1885G>A) and 2 novel mutations (c.1821C>A; p.Tyr607Ter and c.1822C>T; p.Gln608Ter) were found. CONCLUSIONS: c.1821C>A (p.Tyr607Ter) and c.1822C>T (p.Gln608Ter) mutations should be included in the panel of carrier detection and prenatal diagnosis.

Comparison of tuberculin skin test and interferon gamma release assay for diagnosis of latent tuberculosis infection in pediatric candidates of renal transplantation.

IGRA has been approved as an alternative in vitro test to diagnose Mycobacterium TB infection. This study aimed to assess the diagnostic value of TST in comparison with QFT assay to detect LTBI among Iranian children candidate for renal transplantation. This cross-sectional study was performed on 31 children who were candidate for renal transplantation admitted to Ali Asghar Children's Hospital and Rasoul Akram Hospital, Tehran, Iran, from 2013 to 2014. TST and QFT were performed for all patients. QFT was negative in all patients, while TST was positive only in one case. Both tests results were negative in 30 patients, yielding an accuracy rate of 96.7% for TST to diagnose LTBI when compared to QFT. In conclusion, compared to QFT, TST is still a valuable diagnostic tool with high accuracy rate for diagnosis of LTBI in children candidates for renal transplantation and can still be used as an accurate test for screening Mycobacterium TB infection.

A Case of Congenital Insensitivity to Pain With Anhidrosis Comorbid With Attention Deficit Hyperactivity Disorder: Clinical Implications for Pathophysiology and Treatment.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive genetic disorder caused by a mutation in the neurotrophic tyrosine kinase receptor (NTRK1) gene. CIPA is accompanied by abnormal catecholamine metabolism and decreased blood concentration of dopamine and norepinephrine. Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder of heterogeneous etiology and presentation, and recent reports have suggested a pathophysiological role of neurotrophins in ADHD. Furthermore, dopamine and norepinephrine are known to play major roles in the pathophysiology of ADHD, and the imbalance of monoaminergic and cholinergic systems as an underlying cause of ADHD has recently been studied. Here, we report the case of an 11-year-old boy with CIPA and comorbid ADHD. Our observations have important clinical implications for patients with CIPA. Because of deficiencies in self-control, proper management of these patients necessitates a highly structured and monitored environment, made dually important by possible comorbidity of ADHD.

Visceral leishmaniasis without fever in an 11-month-old infant: a rare clinical feature of Kala-azar.

Visceral leishmaniasis or kala-azar is an endemic parasitic disease in some parts of the world which is characterized by fever, splenomegaly, and pancytopenia in most of the cases. Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. Surprisingly, fever started after beginning of meglumine antimoniate treatment in this patient. As far as we are aware of, this is a rare presentation of visceral leishmaniasis. Therefore, clinicians especially in endemic areas are highly recommended to include kala-azar among differential diagnosis of unexplained anemia without fever to prevent misdiagnosis of this potentially fatal, but treatable condition.

An unusual imaging presentation of pediatric bacterial meningoencephalitis: a case-report study.

Background: Bacterial meningoencephalitis is a serious infection affecting the brain and its surrounding membranes. While imaging studies play a crucial role in diagnosing this condition, the typical radiological findings are well-documented. However, this case report describes an unusual imaging presentation that deviates from the expected patterns, emphasizing the need for awareness of such variations. Case presentation: A 7-year-old female with no prior medical history was referred to our hospital with fever, seizure, and loss of Consciousness. She had mild flu a week before admission. The duration of seizure episodes were 2-3 min, with tonic-clonic uncontrollable jerky movements. Brudzinski and Kernig signs were positive and plantar reflex was upward bilaterally in the physical examination. The computed tomography (CT) scan showed brain ventriculomegaly/hydrocephalus, and MRI findings indicated multiple foci located at cerebellum, basal ganglia, and thalamus alongside intensely restricted diffusion of the layering debris, suggesting pyogenic ventriculitis. Cerebrospinal fluid (CSF) analysis showed severe hypoglycorrhachia, despite non-significant increase of protein. The patient was undergone antibiotic therapy with ceftriaxone, vancomycin and rifampin, resulting in normalization of CSF values. Conclusion: This case report highlights the importance of recognizing and interpreting unusual imaging presentations of bacterial meningoencephalitis in paediatric patients. It emphasizes the need for a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, and imaging studies, to ensure accurate diagnosis and appropriate management of this potentially life-threatening condition. Further research and awareness of atypical imaging findings are warranted to enhance our understanding and improve patient outcomes.

Congenital insensitivity to pain with anhidrosis presenting with palmoplantar keratoderma.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal-recessive disease caused by mutations in the NTRK1 gene. The disease is characterized by insensitivity to pain and absence of thermal perception. Herein a 6-year-old boy is presented with a large ulcer on the sole of his right foot and a thick, hyperkeratotic appearance of his palms and soles; there was also a medical history of hyperthermia, anhidrosis, recurrent bone fractures, osteomyelitis, injuries, mental retardation, dry and exfoliative skin, insensitivity to pain, and lack of thermal sensation. Genetic studies revealed a homozygote mutation in the NTRK1 gene. Although the patient initially presented with palmoplantar keratoderma, genetic studies confirmed the diagnosis of CIPA.

General Principles of Vaccination of Pediatric Candidates of Kidney Transplant in Iran.

Pediatric organ transplantation, specifically kidney transplant, has improved considerably in recent decades in Iran. Since infections are the most common cause of morbidity and mortality among transplanted children, pre-transplant vaccination is an effective preventive tool in this regard. In addition, administration of some vaccines is contraindicated in post- transplant period and the efficacy and immunogenicity of authorized vaccines may also be suboptimal in comparison to normal population. Therefore, pre-transplant period offers an outstanding chance to boost the immunization of this population. With regard to this population, it is imperative to establish a localized vaccination guideline, which can be used by nephrologists and other clinicians who are part of the transplant team, in Iran. Currently, such a local guideline for Iranian pediatric kidney transplant candidates is not available. The aim of this study is to provide a comprehensive overview of the existing vaccines recommended for these cases regarding the Expanded Program on Immunization (EPI) and available vaccines in Iran. In addition, general principles of vaccination, the use of specific vaccines as well as accelerated vaccination in this population are discussed in this article. This review could be a preliminary guide for preparing a comprehensive guideline for vaccination of this population in Iran.  DOI: 10.52547/ijkd.7660.