Determinants of vaccination coverage and adherence to the Greek national immunization program among infants aged 2-24 months at the beginning of the economic crisis (2009-2011).

Background: Childhood immunization has significantly reduced the incidence of vaccine preventable diseases. Parental mistrust over vaccine safety has been associated with vaccine refusal creating barriers on vaccine coverage. Recently, economic crisis has imposed additional impediment.

Burden of rotavirus gastroenteritis in children <5 years of age in Greece: hospital-based prospective surveillance (2008-2010).

Objectives: This study describes the epidemiology of rotavirus (RV) gastroenteritis (GE) disease following the introduction of RV vaccination in Greece in 2006.

Design: A prospective hospital-based surveillance.

Setting: A multicentre study was conducted at six hospitals in Greece between July 2008 and March 2010.

Oseltamivir pharmacokinetics and clinical experience in neonates and infants during an outbreak of H1N1 influenza A virus infection in a neonatal intensive care unit.

Detailed oseltamivir pharmacokinetics have yet to be reported in neonates and infants; this group is at high risk of serious influenza-associated complications. Extrapolation of doses from older patients is complicated by rapid organ and drug-metabolizing enzyme maturation. A pharmacokinetic study has been conducted during an influenza A(H1N1) outbreak in a neonatal intensive care unit.

Hospital-based surveillance of rotavirus gastroenteritis in the era of limited vaccine uptake through the private sector.

To investigate possible impact of limited vaccine uptake by the private sector since 2007, a prospective observational study included all children <5 years hospitalized for acute gastroenteritis (AGE) in a Tertiary Care Hospital between 09/2006 and 08/2010. Rotavirus (RV) antigen was detected in stools by a rapid immunochromatographic test and genotype analysis was performed on positive samples by RT-PCR. Compared to 2006-2008, the likelihood of rotavirus infection was significantly reduced among children hospitalized for AGE in 2008-2010 (OR 0.

The impact of the heptavalent pneumococcal conjugate vaccine on the epidemiology of acute otitis media complicated by otorrhea.

Background: The heptavalent pneumococcal conjugate vaccine (PCV7) has a considerable effect on the epidemiology of pneumococcal disease. The aim of this observational hospital-based study was to examine the effect of the PCV7 (introduced in our settings in 2004) on the epidemiology of spontaneously draining acute otitis media.

Methods: Results of all middle ear fluid cultures (n = 3446) obtained from children with acute otitis media complicated with otorrhea before the introduction of immunization (between 2000 and 2003) were compared with those (n = 2134) obtained during a similar post-PCV7 period (between 2005 and 2008).

Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis.

Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (two children), and as adjunctive therapy for necrotizing pneumonia (one child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens.

Hepatitis B-specific T helper cell responses in uninfected infants born to HBsAg+/HBeAg- mothers.

Vertically transmitted hepatitis B virus (HBV) usually causes chronic infection. While combined active-passive immunoprophylaxis in neonates of hepatitis B surface antigen-positive (HBsAg(+)) mothers at birth prevents vertical transmission, it is not yet clear whether neonates encounter the virus or its products in the absence of hepatitis B e antigen (HBeAg). This study was undertaken to investigate HBV antigen-specific T-cell responses in vaccinated neonates of HBsAg(+)/HBeAg(-) mothers.

Dendritic cells in uninfected infants born to hepatitis B virus-positive mothers.

Plasmacytoid dendritic cells (pDCs) play a central role in antiviral immunity, detecting viruses via Toll-like receptors (TLR) and producing in response vast amounts of type I interferons (IFNs). Hepatitis B virus (HBV) causes chronic infection after vertical transmission. This study investigated whether an HBV-infected maternal environment might influence DC numbers and pDC function in uninfected infants.

Investigation of serum bactericidal activity in childhood and adolescence 3-6 years after vaccination with a single dose of serogroup C meningococcal conjugate vaccine.

Serogroup C meningococcal conjugate vaccines were introduced in Greece in 2001, and although no cases of serogroup C meningococcal disease were recorded in 2004, a steady increase was observed since 2005. In this study, serum bactericidal activity was assessed in sera of 269 vaccinated children at a mean time of about 5 years after vaccination. Non-protective antibody titers were observed in most children vaccinated at age <6 years (85.

Intravenous colistimethate (colistin) use in critically ill children without cystic fibrosis.

Introduction: The increasing frequency of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has led to the reappraisal of colistimethate use.

Methods: We present a case series of critically ill pediatric patients without cystic fibrosis who received intravenous colistimethate treatment. All available relevant medical records were reviewed.

Kawasaki disease: an overview.

Purpose Of Review: Kawasaki disease is an acute, self-limited vasculitis of childhood. The increasing frequency of the disease as well as the deficiency of specific diagnostic means renders its diagnosis and treatment an area of intense investigation. The purpose of this review is to summarize all the known features of Kawasaki disease and also give an insight to the latest findings.

Liposomal amphotericin B for the treatment of visceral leishmaniasis.

During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphotericin B is widely used to treat VL.

The significance of Ureaplasma urealyticum as a pathogenic agent in the paediatric population.

Purpose Of Review: Ureaplasma urealyticum is a frequent commensal in the lower genital tract of sexually active women. It may be transmitted perinatally from the colonized mother to her offspring, often resulting in prematurity and neonatal disease. The microorganism also sustains a causative role for infectious diseases in older children.

Intrauterine infection with parvovirus B19 and CMV: implications in early and late gestation fetal demise.

In utero viral infections have been associated with an adverse pregnancy outcome and may have a causative role in the unexplained fetal death file. Parvovirus B19 and cytomegalovirus are among the most common pathogens implicated in fetal loss cases. Parvovirus B19 has been reported to account for cases of spontaneous abortions, intrauterine fetal death and nonimmune hydrops fetalis, whereas cytomegalovirus accounts for nonimmune hydrops fetalis, intrauterine growth retardation and congenital anomalies.

Immunologic markers in the neonatal period: diagnostic value and accuracy in infection.

Diagnosis of early-onset neonatal infection has led to the development of several screening tests including C-reactive protein, a very commonly used marker, and cytokines (mainly interleukin-6 and -8), alone or in combination with C-reactive protein, based on the premise that their increases in response to infection may precede that of C-reactive protein. In recent years the search for diagnostic tests has turned to procalcitonin, a propeptide of calcitonin, which appears to be a promising marker of infection in newborn infants. Additionally, specific leukocyte cell surface antigens (mainly CD11b and CD64), detected by flow cytometry, are evaluated as markers of neonatal infection, since their expression on the cell membrane increases in substantial quantities after leukocyte activation by bacteria or their cellular products.

Otitis media with effusion: an effort to understand and clarify the uncertainties.

Otitis media with effusion--defined as the accumulation of middle-ear effusion behind an intact tympanic membrane without signs or symptoms of acute infection--is one of the most common causes of hearing loss in children in developed countries, potentially leading to language deficits. Although treatment of chronic or relapsing otitis media with effusion is considered imperative, none of the preventative or nonsurgical management measures currently available have proven effective. Tympanostomy tube placement remains the recommended treatment option for high-risk children or for cases of unresponsive otitis media with effusion.

Maternal genital colonization with Ureaplasma urealyticum promotes preterm delivery: association of the respiratory colonization of premature infants with chronic lung disease and increased mortality.

Background: Infection of the chorioamnion with Ureaplasma urealyticum has been associated with low birth weight. Respiratory tract colonization in preterm infants has been associated with the development of chronic lung disease (CLD). The purpose of the present study was to determine the frequency of colonization of the mother's vagina and the preterm infant's respiratory tract and to associate U.

Chronic cough in children: recent advances.

Recurrent cough in children is a very common symptom of respiratory disease. Most children who cough, however, have normal pulmonary function. This article presents a diagnostic framework for chronic cough and a recommended management plan in order to avoid over investigation and over treatment of a generally benign and self-remitting condition.

Rhinovirus infections and adenoidal hypertrophy: do they interact with atopy in children?

Modern diagnostic methods allow the evaluation of the connection between rhinoviruses and atopy. Recent studies suggest that rhinoviruses are present in the adenoids at higher titers than in other specific sites, after inoculation of nasal mucosa or conjunctiva in volunteers. Therefore, it is possible that they might be responsible for specific local changes, while such changes may be influenced by atopy.

Ureaplasma urealyticum airway colonization and pulmonary outcome in neonates.

Ureaplasma urealyticum genital tract colonization of pregnant women has been associated with an adverse pregnancy outcome, while its consequent perinatal transmission has been implicated in the development of respiratory disease of the neonate. Clinical manifestations or contributions of ureaplasmal airway colonization in newborns mainly include pneumonia, precocious dysplastic changes and chronic lung disease; although systemic disease has also been documented. This review aims to summarize current diagnostic techniques, pathogenetic mechanisms and pathological data in an attempt to establish an optimal therapeutic approach regarding neonatal U.

Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR.

Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI). Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections. The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI.

Q fever in children in Greece.

The aim of this study was to investigate the incidence, epidemiology, and clinical manifestations of Q fever among hospitalized children in Greece. During a two-year period, 1,200 children with various clinical manifestations were prospectively tested for Coxiella burnetii infection by indirect immunofluorescence. Acute Q fever was diagnosed in eight (0.

Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae causing invasive infections and acute otitis media in children.

Unlabelled: A prospective study was conducted to determine the serotypes and antibiotic resistance patterns of pneumococcal isolates from children with invasive pneumococcal disease (IPD) and acute otitis media (AOM). From October 2001 to May 2002, 65 children with IPD (28 bacteraemic pneumonia, 24 bacteraemia without focus, 7 meningitis, 6 other infections) and 78 with AOM were identified. The most common serotypes causing IPD were 14 (32.