In recent years, the pathogenic role and antibiotic resistance of methicillin-resistant Staphylococcus aureus (MRSA) strains causing severe community-acquired pneumonia (CAP) have received increasing attention in clinical practice. The aim of this study was to determine the rate of isolates of MRSA strains causing severe CAP in children and to assess their level of antibiotic resistance. The study design was cross-sectional. Children with severe CAP were sampled by nasopharyngeal aspiration for the culture, isolation, and identification of MRSA. Antimicrobial susceptibility testing was performed using the gradient diffusion method to determine the minimum inhibitory concentration (MIC) of antibiotics. Results: MRSA was identified as the second leading cause of severe CAP in Vietnamese children. The rate of isolates of S. aureus was 41/239 (17.5%), of which most were MRSA, at 32/41 (78.0%). MRSA strains were completely non-susceptible to penicillin (100%), more resistant to clindamycin and erythromycin, less sensitive to ciprofloxacin and levofloxacin, and fully susceptible to vancomycin and linezolid, with a 32-fold decreased MIC₉₀ for vancomycin (0.5 mg/L) and a 2-fold decreased MIC₉₀ for linezolid (4 mg/L). Therefore, vancomycin and linezolid may be appropriate options for severe CAP identified by MRSA.

Introduction: After the Coronavirus Disease 2019 pandemic, a high number of cases and severe dengue in children were reported in some provinces in the south of Vietnam. This study aimed to determine the distribution of dengue virus serotypes and their correlation with demographic factors, disease severity, clinical manifestations, and laboratory findings. Methodology: This study employed a cross-sectional design. Ninety-six dengue-infected children admitted to Can Tho Children's Hospital between October 2022 and March 2023 were included. Confirmation of dengue infection was achieved through the real-time polymerase chain reaction (RT-PCR). Results: Among the identified serotypes, DENV-2 accounted for the highest proportion (71.87%), followed by DENV-1 (23.96%), and DENV-4 (4.17%). DENV-3 was not detected. No significant demographic, disease severity, or laboratory differences were observed among the identified dengue serotypes. However, DENV-2 was associated with a higher occurrence of mucous membrane hemorrhages and gastrointestinal bleeding compared to other serotypes. Conclusions: Although DENV-2 was the most prevalent serotype responsible for dengue in children in southern Vietnam, it did not lead to more severe cases compared to other serotypes. This finding is crucial for evaluating the illness’s prognosis.

Objective: This study aims to determine the frequency of pathogen detection by real-time polymerase chain reaction (PCR), the frequency of pathogen isolation by culture; and compare the value of real-time PCR and culture of nasopharyngeal aspiration samples in patients with severe community-acquired pneumonia (sCAP). Materials and Methods: It was a prospective and descriptive study. All pediatric patients diagnosed with sCAP were performed real-time PCR and culture of nasopharyngeal aspiration samples. Results: A total of 336 patient samples were obtained from children with sCAP. Real-time PCR detected pathogens in 312 patients (92.9%), while culture isolated bacteria in 228 patients (67.9%). Coinfections were reported in 279 cases (83.0%) through real-time PCR. The frequency of agreement between culture and real-time PCR was quite high (P < .001). Conclusion: Real-time PCR demonstrated more ability for detecting microorganisms than culture. This finding highlighted the value of real-time PCR for targeting pathogens in children with sCAP, particularly in cases involving complex pathogens or those requiring timely identification. Cite this article as: Quang Tran K, Hung Pham V, Minh Vo C, Minh Pham Q, Minh Nguyen P. Comparison of real-time PCR and culture for targeting pathogens in pediatric severe community-acquired pneumonia. Turk Arch Pediatr. 2024;59(4):383-389.

(1) Background: Exhaled nitric oxide (NO) has been considered as a biomarker of airway inflammation. The measurement of fractional exhaled NO (FENO) is a valuable test for assessing local inflammation in subjects with allergic rhinitis (AR). (2) Objective: To evaluate (a) the correlation between nasal FENO with anthropometric characteristics, symptoms of AR and nasal peak flows in children without and with AR; and (b) the cut-off of nasal FENO for diagnosis of AR in symptomatic children. (3) Methods: The study was a descriptive and cross-sectional study in subjects with and without AR < 18 years old. All clinical and functional characteristics of the study subjects were recorded for analysis. They were divided into healthy subjects for the control group and subjects with AR who met all inclusion criteria. (4) Results: 100 subjects (14 ± 3 years) were included, including 32 control subjects and 68 patients with AR. Nasal FENO in AR patients was significantly higher than in control subjects: 985 ± 232 ppb vs. 229 ± 65 ppb (p < 0.001). In control subjects, nasal FENO was not correlated with anthropometric characteristics and nasal inspiratory or expiratory peak flows (IPF or EPF) (p > 0.05). There was a correlation between nasal FENO and AR symptoms in AR patients and nasal IPF and EPF (p = 0.001 and 0.0001, respectively). The cut-off of nasal FENO for positive AR diagnosis with the highest specificity and sensitivity was ≥794 ppb (96.7% and 92.6%, respectively). (5) Conclusion: The use of nasal FENO as a biomarker of AR provides a useful tool and additional armamentarium in the management of allergic rhinitis.

Background: Acute diarrhea is a worldwide health concern with a high mortality rate among children under five. Dehydration, a potentially fatal consequence of this illness, must be promptly identified. A scoring system is necessary to predict the degree of dehydration. Objectives: This study aims to identify risk factors and develop a scoring system with an appropriate cutoff to estimate the likelihood of dehydration in children with acute diarrhea. Methods: In this case-control study, the patient group comprised 34 children with acute diarrhea and dehydration, while the control group included 137 children with acute diarrhea without dehydration, admitted to the Gastroenterology Department of Can Tho Children's Hospital, Can Tho city, Vietnam, from November 2022 to October 2023. Results: Acute diarrhea with dehydration was associated with the following factors: Fever (OR 1.802, 95% CI 1.703 - 3.024, P = 0.026), frequency of diarrhea per day (OR 1.744, 95% CI 1.432 - 2.125, P < 0.001), frequency of vomiting per day (OR 1.242, 95% CI 1.102 - 1.399, P < 0.001), and weight-for-age > +2SD (OR 3.293, 95% CI 1.151 - 9.422, P = 0.026). Based on these four parameters and an area under the ROC curve of 0.889, a new scoring system known as the KVAD (K: Kelvin, V: Vomit, A: Avoirdupois, D: Diarrhea) score has been developed. A score of 21 was determined as the optimal cutoff point for identifying dehydration in children with acute diarrhea, with a sensitivity of 79.4% and specificity of 85.4%. Conclusions: The KVAD score represents the initial step in developing an effective and reliable screening tool for estimating the risk of dehydration in children with acute diarrhea.

Objective: The purpose of this research is to (1) determine the frequency of viral acute diarrheal disease in 2 months to 5 years of aged children admitted to the hospital; (2) describe the clinical and laboratory characteristics among children diagnosed with viral acute diarrheal disease; and (3) evaluate patterns of antibiotic utilization in treating pediatric acute diarrheal disease. Materials and Methods: A cross-sectional study involved 232 pediatric inpatients at the Department of Gastroenterology, Can Tho Children’s Hospital from March 2023 to February 2024. This study utilized real-time polymerase chain reaction (PCR) to identify etiological pathogens responsible for infection. Results: Real-time PCR detected viruses in 140/232 (60.3%) of acute diarrhea cases, with 85/232 (36.6%) being only virus infections. Age, sex, and nutritional status showed no significant differences between the viral infection only and other case groups (P > .05). Vomiting predominated in viral infections only (P < .05), while mucoid-bloody stools and elevated C-reactive protein marked other cases (P < .05). Antibiotics were used in 52.9% of viral and 60.3% of total cases. The study found no differences in hospitalization time, fever length, or duration of diarrhea between the antibiotic use and non-antibiotic use groups (P > .05). Conclusion: Viruses were the predominant cause of acute diarrhea in children, yet antibiotics were frequently used without clinical benefit. Among children with confirmed viral infections, antibiotic use showed no advantage in reducing hospitalization duration, fever length, or diarrhea resolution. These findings support the need to limit unnecessary antibiotic use in pediatric diarrhea management. Cite this article as: Tran KQ, Nguyen PM, Nguyen UTP, Nguyen HHT, Bui NQ. High frequency of viral etiology and antibiotic utilization patterns in pediatric acute diarrhea: A cross-sectional study at a tertiary hospital in Vietnam. Turk Arch Pediatr. 2025;60(5):536-542.