Antimicrobial resistance pattern and uropathogens distribution in children visiting a referral hospital in Mogadishu.

Aim: Studies concerning epidemiology and drug susceptibility patterns of pediatric urinary tract infection in developing countries are scarce. This study aimed to evaluate the antimicrobial resistance pattern and uropathogens distribution in children. Method: Four-year retrospective study included 840 participants in all pediatric age groups whose urine had been cultured. Results: The prevalence of culture-proven pediatric UTIs was 17.6% (148/840). Escherichia coli was the most common pathogen isolated from the cultures, accounting for (48%, 71/148), followed by Klebsiella pneumoniae (16.2%, 24/148). About 27% of the pathogens had a multidrug-resistant (MDR) pattern. A resistance rate against nitrofurantoin at 24.6%, fosfomycin at 15.2% and trimethoprim-sulfamethoxazole (SMX-TMP) at 79.7% was noted. Conclusion: E. coli and Klebsiella pneumoniae were the most common pathogens isolated.

Embryonal rhabdomyosarcoma of the testis in a 17-year-old male.

Primary rhabdomyosarcoma of the testis is an exceptionally rare and highly malignant sarcoma. To date, there are only 23 reported cases in the literature. We report a 17-year-old male patient presented with massive scrotal swelling that had been progressively enlarging over seven-months. Scrotal ultrasound and contrast-enhanced CT revealed a 10 × 10cm left testicular heterogeneously enhancing mass that extends into the spermatic cord. A left inguinal orchiectomy was performed, and histopathological examinations showed findings consistent with Rhabdomyosarcoma, Embryonic-type. Primary embryonal testicular rhabdomyosarcoma has poor prognosis, particularly for adolescents, and tumour size greater than 10cm. Early diagnosis and radical orchiectomy improve the prognosis.

Bilateral supernumerary kidney with an obstructive calculus: An extremely rare case report and literature review.

Bilateral supernumerary kidneys and associated urinary stone disease are rarely seen in clinical practice, and only three cases have been reported in the literature to date. We report a 15-year-old male patient having a bilateral supernumerary kidney with an obstructive left ureteric stone successfully managed with retrograde intrarenal surgery. Stones in such anomalous kidneys pose a challenge for the urologist, and imaging is essential for surgical intervention planning. RIRS with holmium laser lithotripsy is a safe and effective treatment with a high single-stage stone-free rate and low complication rate in experienced hands.

Spinal cord Schistosomiasis: A child's case with an unsatisfactory outcome that mimicked an intramedullary neoplasm. A rare case report.

Neuroshcistosomiasis is a life-threatening complication of schistosomiasis. Its prevalence in endemic populations is believed to be underreported at 1-4%. We report a four-year-old child who came to our hospital relatively late since the presentation of weakness and incontinence. MRI revealed long segment (T12-L1) ill-defined intramedullary lesions with cord extension having patchy enhancements. Despite the administration of both praziquantel and pulse prednisolone treatment, there was no convincing result. We thus question the role of steroids and praziquantel in individuals with late-diagnosed spinal schistosomiasis.

Prevalence, Clinical Profile and Risk Factors of Nosocomial Infection in Ayder Pediatric Intensive Care Unit, Tigray, Ethiopia.

Background: Hospital-acquired infection (HAI) is a significant cause of increased morbidity and mortality amongst hospitalized patients and represents a considerable health and economic burden worldwide. However, evidence about HAI in pediatric ICU is limited. Objective: To identify the prevalence of hospital-acquired infection (HAI), clinical profile, and its risk factors for nosocomial infection in patients admitted to the pediatric intensive care unit (PICU). Methodology: From a two-year retrospective chart review admitted from 2019 to 2020 to the PICU, 223 patients were selected by systematic random sampling. Data were analyzed in SPSS version 23.0. P-values <0.05 were considered significant for all tests. Results: Forty-five (20.2%) patients developed nosocomial infection (NI). The median age was 4 years with 25-50th IQR of (0.6-9). About invasive procedures done, the most common was nasogastric tube (57%), followed by mechanical ventilation (17.9%) and urinary catheter (13.9%). The main focus of the infection was chest (53.3%), followed by bloodstream infection (22%) and gastrointestinal infection (9%). The odds of HAI were 3.3 times higher among under-five compared to those aged between 5 and 18 years (AOR: 3.3, 95% CI = 1.4-8.0, p = 0.008). The odds of HAI were also 4.1 times higher in those who stayed for more than two weeks compared to those who stayed in the pediatric ICU 2 to 14 days (AOR: 4.1, 95% CI = 2.0-8.6, p < 0.001). The mean duration of mechanical ventilation in those patients with and without NI was 1.65 days and 13.96 days, respectively (AOR = 3.46, 95% CI = 1.44-9.81, p = 0.02). Patients who started antibiotics at admission and patients who were on nasogastric tube feeding were also statistically significant risk factors for developing NI (AOR = 2.67, 95% CI = 1.37-9.64, p = 0.02; AOR = 2.45, 95% CI = 1.64-6.53, p = 0.03). Conclusion: The rate of infection in this study was higher compared to some developing countries. Younger age and prolonged length of hospital stay were found to be significant risk factors for HAI.