----:: Super antigens (Sags) are some part of virus or bacteria proteins which stimulate T cells and antigen-presenting cells leading to systemic immune repose and inflammation. ---SAgs might have possible role in in various inflammatory childhood diseases (eg Kawasaki disease, atopic dermatitis, and chronic rhinosinusitis). ----Worldwide studies had done to determine the role of staphylococcal SAgs (TSST-1 ) in various inflammatory diseases. The SAgs (TSST-1) not only induce sepsis and septic shock (even in negative blood culture for S.aureus) ,but also might have significant role in various childhood inflammatory diseases ( eg KD, OMS, Polyp, dermatitis, psoriasis ) . In proven SAgs induced inflammatory diseases, inhibition the cell-destructive process by SAgs suppressants might be helpful. ----In toxic shock or sepsis like presentation even in cases with negative blood cultures immediate use pf anti staphylococcal drugs is required. . ---Occasionaly, clinical presentation of some human viruses (eg coronavirus and adenovirus) mimic KD. ----- In addition ,coinfection with adenovirus, coronavirus, and para-influenza virus type 3 were observed with KD. -- Bacterial Sags induced increasement of acute-phase reactants and number of white blood cell, and neutrophil counts In developed KD. ----Multisystem inflammatory syndrome in children (MISC) and KS observed during the recent COVID-19 pandemia. This study summarized the relation between viral and bacterial SAgs and childhood inflammatory diseases.

Background: There is not enough information about the prevalence of Acinetobacter infection as well as its risk factors, especially in neonatal intensive care units. The present research aimed at conducting a five-year study on Acinetobacter infection and its main factors in neonatal and pediatric intensive care units in Iran. Methods: This cross-sectional survey was conducted on 89 children with positive culture for hospital-acquired Acinetobacter, admitted to intensive care units of Aliasghar Children's Hospital in Tehran, between 2010 and 2015. Besides, 97 patients with similar baseline characteristics without Acinetobacter positivity were enrolled as the control group. Epidemiological information and clinical data were collected by reviewing the hospital recorded files. Results: In the group with positive Acinetobacter culture, complete and partial improvement was observed in 62.9% and 11.2%, respectively, while 25.8% died due to treatment failure. In this regard, complete and partial improvement in the control group was revealed in 85.6% and 11.3% with an overall death rate of 3.1%, indicating significantly higher failure rate in the case group (P = 0.001). To determine the main factors for in-hospital death, all variables with a significant association with positive culture in univariate analysis (considering P < 0.2) were entered in a backward multivariable logistic regression model. In this regard, venous access (OR = 7.80, 95% CI: 1.06 to 57.19, P = 0.043), carbapenem use (OR = 27.03, 95% CI: 1.93 to 377.780, P = 0.014), and ampicillin use (OR = 0.12, 95% CI: 0.019 to 0.739, P = 0.022) were shown as the main determinants for Acinetobacter-related death. Conclusions: Although the study was not a prognostic study and determination of the main determinants of prognosis in children with Acinetobacter infections was not possible yet it seems that the mortality rate due to Acinetobacter infection in the population was about 25.8% in the global range reported in the literature. The main factors for Acinetobacter infection-related death are central venous catheters related to TPN, carbapenem use, and ampicillin use.