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Background Of all blood stream infections (BSI), candidaemia poses the greatest threat with a high fatality rate among children. There has been an increase in the number of reports of non- C. albicans species and antifungal resistance has progressively emerge. Aim The present study aimed to demonstrate the prevalence of candidaemia among children and to characterize the involved species and their susceptibility to antifungal agents. Methodology Microbes were isolated from blood samples and identified via standard microbiological procedures. Chromogenic media was used to characterize the Candida species. The susceptibility of the isolates to the antifungal agents; caspofungin, amphotericin, itraconazole, and fluconazole was determined with the E-test. Statistical methods The data were analysed with Statistical Package for the Social Science SPSS; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows. Comparisons between the study groups were performed using the Chi square (χ 2 ) test. p -values less than 0.05 were considered significant. Results Candidaemia accounted for 17.3% of all BSIs. C. albicans and non- C. albicans species accounted for 36% and 64% of the cases of candidaemia, respectively. Caspofungin, amphotericin, itraconazole, and fluconazole antifungals had activities of 99%, 97%, 73% and 64%, respectively. In total, 64% of patients with candiaemia died. Conclusion The prevalence of candidaemia was high, the fatality rate was alarming and non- C. albicans species were predominant. Fluconazole was the least effective of the tested antifungal agents owing to the high level of resistance.

Background and Objectives. SAA is an acute-phase reactant detected during an FMF attack or other inflammatory conditions. High SAA levels may increase the risk of amyloidosis. The aim of the study is to measure the serum amyloid A (SAA) level in a group of Egyptian children with familial Mediterranean fever (FMF) and study its various correlates, if any. Methods. The study enrolled seventy-one children with FMF. Results. SAA level was high in 78.9% of the studied patients with a mean of 81.62 ± 31.6 mg/L, and CRP was positive in 31% of patients. There was no significant releation between SAA level and any demographic or clinical manifestation. High SAA was more frequent in V726A allele (16.9%) followed by M694V allele (12.3%). Elevated SAA levels were more frequent in patients on low colchicine doses. Forty-five percent (45%) of patients have low adherence to colchicine therapy. Interpretation and Conclusion. High SAA levels were detected two weeks after last FMF attack in a large percentage of Egyptian FMF children. This indicates that subclinical inflammation continues during attack-free periods, and SAA could be used as a marker of it.

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Background: Pediatric patients with end-stage renal disease undergoing hemodialysis (HD) are exposed to oxidative stress associated with an impairment of antioxidant defense and an overproduction of oxidative stress markers. Oxidative stress plays a significant role in the development of inflammation in these patients. Objectives: The high incidence of cardiovascular disease in HD pediatric patients is now well established and the involvement of oxidative stress has been hypothesized. This study focuses on a comparison of plasma total antioxidant capacity (TAC) and lipid peroxidation product and evaluates the relationship between these parameters and high-sensitivity C-reactive protein (hsCRP) in pediatric patients on HD. Subjects and Methods: Plasma TAC, lipid peroxidation products, malondialdehyde (MDA) as well as hsCRP were determined in 30 pediatric patients on HD and in 20 healthy controls (HC). Results: TAC and MDA levels were significantly higher in children on HD than in the HC (p < 0.001). The hsCRP values were also significantly higher in HD patients than in HC (p < 0.001). The percentage of HD pediatric patients with CRP >10 mg/l was 30%. The concentrations of TAC and MDA correlated positively with hsCRP in HD patients (TAC: r = 0.52, p < 0.08; MDA: r = 0.75, p < 0.04), but not in HC. Conclusion: Our study demonstrates an increase in oxidative stress in children on HD and that the susceptibility to oxidative stress is strongly related to the levels of MDA produced in plasma. hsCRP levels are higher in children on HD than in HC and this is indicative of a higher degree of inflammatory activity in the former patients. These profound disturbances in oxidative stress markers may provide an explanation for the cardiovascular complications in HD patients.