To describe the epidemiology, clinical and laboratory features, and outcome of children hospitalized with coronavirus disease 2019 (COVID-19) in the Middle East. A multicenter retrospective study of children hospitalized with COVID-19 in 7 centers across Oman between February and July 2020. In total, 56 children <14 years old required hospitalization in 7 Omani centers over 5 months (February – July 2020). Thirty-seven (68%) children were admitted with uncomplicated COVID-19, 13 (23%) with pneumonia and 5 (9%) with multisystem inflammatory syndrome in children. Infants constituted 41% of cases (23/56), approximately half of whom (12/23, 52%) were <2-months old. Fever was the most common symptom (46, 82%), followed by respiratory symptoms (33, 59%), and gastrointestinal symptoms (31, 55%). Twenty-two (39%) children had underlying medical conditions: sickle cell disease (7, 13%), chronic respiratory disease (4, 7%) and severe neurological impairment (4, 7%). Leukocytosis, elevated inflammatory markers and anemia were independently associated with intensive care admission. There were no mortalities related to admission with COVID-19 in this cohort. Most of the children hospitalized with COVID-19 had a mild course and a satisfactory outcome. Sickle cell disease is the most common comorbidity associated with pediatric admission of COVID-19 in Oman.

Objectives: Group B streptococcus (GBS) infection is a serious disease that continues to cause high morbidity and mortality. It is one of the leading cause of sepsis; particularly meningitis, in infants and young children all around the world. In this study, we aim to identify the incidence of GBS sepsis in Omani infants less than 3 months of age who were born at Royal Hospital and who presented with clinical sepsis and positive culture. In addition, we aim to describe the clinical presentation and complications noted on admission and then on follow-up visit. Methods: This is an observational retrospective chart review study. It included all Omani infants (0–3 months) who were diagnosed to have GBS sepsis/meningitis from 2006 to 2016 at the Royal Hospital, Muscat, Sultanate of Oman. Results: There were 83,000 live births in the Royal Hospital over a period of 10 years. Thirty-eight babies had culture proven GBS infection, with an overall incidence rate of neonatal GBS of 0.46 per 1000 live births with 95% confidence intervals. There were no significant variations in the annual rates of infection during the study period, ranging from around 1–7 cases per year. Additional 5 cases of GBS sepsis presented to Royal Hospital are either through Emergency Department or as referrals from other hospitals, giving us a total of 43 cases of proven GBS infections. Out of the 43 cases, 8 were born prematurely (19%), either before (<34 weeks, n = 2) or during (34–36 weeks, n = 6). Term babies were 35 out of 43 with percentage of 81% of the total. Three died, resulting in a case mortality of 7.0%. Conclusion: Our GBS incidence is comparable to that of screened population internationally. At the time being, with the best available results, maternal screening might not seem cost effective in our current settings. A cost effective study is required before implemented a national screening programme in the Country. However, this research will definitely help in the process of any future plans of implantation of new guidelines, as it can be used as leading point for future prospective studies.

Invasive fungal disease (IFD) is a common and serious consequence of leukemia in children and the incidence of these infections has increased due to chemotherapy. This study aimed to present the epidemiology of IFD in a cohort of children with leukemia from a tertiary reference institution in Oman. A retrospective study of IFDs in pediatric patients below 13 years of age with newly diagnosed or relapsed leukemia was conducted at the Royal Hospital in Muscat, Oman. From 2010 to 2017, IFD episodes in children with leukemia were evaluated retrospectively, considering age, gender, type of leukemia, chemotherapy regimen, IFD detection phase, neutropenia, prevention, diagnostic method, and treatment. Between 2010 and 2017, 198 children with leukemia were admitted and treated at Royal Hospital. Invasive fungal infection (IFI) was diagnosed in 32 patients out of 198 (16.1%), and IFI was defined as probable and proven in 53% (n=17) and 47% (n=15) of the cases, respectively. At 1.1:1, the male-to-female ratio was roughly equal. According to chest computed tomography scans, 65.6% of patients had radiological features of fungal infections. Positive fungal cultures were found in the bronchoalveolar lavage of three patients, 37.5% of whom had positive blood cultures, and 3% had positive urine cultures as a neonatal invasive candidiasis. In three patients, invasive aspergillosis caused pulmonary IFD, accounting for 9.3% of all infection sites. Candidaemia was found in 28% of IFD patients, and the most common organism was Candida tropicalis (15.6%), followed by Candida parapsilosis (6.25%). Furthermore, the major risk factor was febrile neutropenia. In children with leukemia, invasive fungal infection is common and serious. Despite aggressive treatment, mortality among these high-risk patients remains high.

Comamonas testosteroni initially has been considered as a nonpathogenic microorganism until 1987; after which year, it has being recognized as a human pathogen with spectrum of infections both in adult and children. We report the first case of a healthy child who is 12 months old Omani girl presented with features of acute gastroenteritis with Comamonas testosteroni sepsis, that was treated successfully with two weeks course of intravenous ceftriaxone with excellent outcome. Most of the reported cases of Comamonas testosterone infection were sensitive to antibiotics with favorable outcome.

A five years old Yemeni boy presented with a 5 months history of progressive neurological deterioration in picture of progressive cognitive decline , seizures and hyperkinetic movements. Patient came from an area with political instability and low socio-economic status. There was history suggestive of measles at 2 years of age. He never received measles vaccination. Diagnosis of sub acute sclerosing pan encephalitis (SSPE) was made based on clinical symptoms, serum and CSF findings of high measles IgG, neuroradiological findings as well as neurophysiological findings. We report this case to highlight the role of intravenous immunoglobulin and steroid in improving his symptoms.

Background: One of the well-known causes of morbidity and mortality in the neonatal population is neonatal invasive candidiasis. In neonatal critical care units, candida sepsis is now the third most frequent cause of late-onset sepsis. The objective of this research was to determine the prevalence of related risk factors, clinical traits, and results related to invasive candidiasis in the neonatal intensive care unit (NICU) at the Royal Hospital in Oman. Methods: A case-control retrospective analysis of 20 newborns admitted between January 2006 and December 2020 to the neonatal intensive care unit at Royal Hospital. In terms of gestational age, birth weight, and day of birth, cases and controls were matched. Results: There were 60 infants in all-20 cases and 40 controls. The two groups' demographics, including age, sex, and weight, were comparable. The case group compared to the control group had a mean gestational age of 32.2±6.1 weeks and a mean birth weight of 1978±1202 grammes against 1930±1040 grammes, respectively. Seventy-five percent of the isolated species were Candida albicans. Sixty-five percent of the instances happened in the second and third week of life. Compared to the control group, the case group's mean NICU stay was longer. Several risk factors, including maternal age, the presence of a central line, invasive mechanical ventilation, total parenteral nutrition, necrotizing enterocolitis, surgery, and an extended hospital stay, were found to be related with an elevated risk for invasive candidiasis using univariate analysis. In the case group, the overall mortality rate was 45%, but in the control group, there was no death in the cohort. Conclusion: The following factors were linked to an elevated risk of invasive candidiasis in this case series: complete parenteral feeding, prolonged hospital stay, central line presence, preterm, and abdominal surgery. Those with risk characteristics should be highly suspected for neonatal candidiasis, particularly if their stay in the NICU is longer than seven days. Antifungal prophylaxis should be taken into consideration for these newborns, and presumed antifungal medication should be started as soon as possible.