pediatrics | Acta Medica Marisiensis

The influence of the COVID-19 pandemic on pediatric hospitalizations for type 1 diabetes mellitus

Măriuca Mănescu¹, Ion-Bogdan Mănescu², Alina Grama^1,3

1. Department of Pediatrics, Emergency County Clinical Hospital of Targu Mures, Targu Mures, Romania
2. Department of Laboratory Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
3. Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania

DOI: 10.2478/amma-2024-0021

Objective: In this retrospective cohort study, we aimed to provide a snapshot of how the pandemic has affected pediatric type 1 diabetes mellitus (T1D) admissions in our hospital.
Methods: This study included 117 patients aged 0-18 classified based on period (pre-pandemic vs. pandemic period 2020-2022) and type of diagnosis at admission: new-onset T1D (nT1D) or diabetic ketoacidosis (DKA)-decompensated T1D. We investigated the effect of the COVID-19 pandemic on the demographic, clinical, and laboratory characteristics of these patients.
Results: Out of all T1D-related admissions, the proportion of admissions for nT1D increased compared to the pre-pandemic period: 71.6% vs 53.4%, p=0.048. Unrelated to the pandemic, the type of diagnosis at admission was associated with 1) the sex distribution (males – more nT1D admissions, females – more frequent DKA admissions, p=0.01), and 2) hospitalization duration (longer for nT1D admissions than for DKA-decompensated T1D admissions, p=0.001). Blood glucose and HbA1c levels were influenced neither by the pandemic period nor by the type of diagnosis. During the pandemic, a change in the T1D seasonality became apparent. A potential association pattern between new COVID-19 cases, number of T1D admissions, and stringency of restrictions was observed.
Conclusions: During the COVID-19 pandemic, the proportion of nT1D admissions increased, as well as the severity of DKA-decompensated T1D cases. In addition, the pandemic period brought about notable shifts in the seasonality of pediatric T1D.

An Outbreak of Achromobacter Bacteremia in Pediatric Clinic 1 Tîrgu Mureș in 2010

Man Lidia¹, Baghiu Despina^1,3, Székely Edit^2,4, Man A²

1 Pediatric Clinic I, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 Microbiology Department, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Pediatric Department I, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
4 Central Clinical Laboratory, Department of Bacteriology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

Introduction: Achromobacter is a less common pathogen, with implications in patients with immune deficiency. The purpose of this paper is to evaluate the Achromobacter spp. bacteremia outbreaks in the hematology department of Pediatric Clinic I Tîrgu Mureș and to establish the involvement of this species as an etiologic agent of bacteremia/septicemia or solely as a contaminant of blood culture samples.
Material and methods: We analyzed an outbreak of Achromobacter infection from 2010’s summer-autumn season in Pediatric Clinic I. Bacteriological (blood culture, antibiotic susceptibility), laboratory (white cells count, inflammatory tests) and clinical aspects (underlying disease, body temperature, treatments, age, sex) were followed.
Results: A total of 26 blood cultures collected from nine children admitted in this period were positive for Achromobacter spp., other 28 were negative. In febrile patients with positive blood cultures, the leukocyte and neutrophil count was increased. In non-febrile patients with positive blood cultures, changes in the total number of leukocytes and granulocytes did not show significant variations. The antibiotic susceptibility test for Achromobacter strains identified a 100% resistance to ticarcillin, gentamicin, and trimethoprim-sulfamethoxazole, sensitivity to most classes of antibiotics, but an OXA-114 β-lactamase producing phenotype.
Conclusions: An association between the inflammatory syndrome and Achromobacter spp. bacteremia was established. Achromobacter spp. isolated from blood sampled through catheters is most likely a contaminant. The antibiotic susceptibility testing of Achromobacter spp. revealed sensitivity to most classes of antibiotics.