The Pediatric Infectious Disease Journal最新文献

{"title":"A Diagnostic Challenge Is it Tuberculosis?","authors":"Elif Böncüoğlu, Aybüke Akaslan Kara, Nuri Bayram, İlker Devrim, Elif Kiymet, İlknur Çağlar, Bengü Demirağ, Cenk Eraslan, Elif Bolat, Yeşim Ertan, Serra Kamer, Aycan Ünalp","doi":"10.1097/INF.0000000000003485","DOIUrl":"https://doi.org/10.1097/INF.0000000000003485","url":null,"abstract":"Auto-brewery syndrome is defined as intestinal distillation syndrome and is probably caused by an overgrowth of microorganisms which metabolize carbohydrates to ethanol. In this report, we describe the case of a patient with classical symptoms of auto-brewery syndrome, with no prior alcohol ingestion and clinical improvement after medical treatment was instituted. It is a very rare case and, due to its inadequate description in the medical literature, we attempt to describe the essentials of the disease and the diagnostic challenge it represents. (Acta Med Colomb 2022; 48. DOI: https://doi.org/10.36104/amc.2023.2565).","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e254"},"PeriodicalIF":3.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39639851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Hematologic Outcomes in HIV1-Exposed Infants Receiving Nevirapine Compared With Zidovudine for Postnatal Prophylaxis in a High Resource Setting.","authors":"Catherine Dollfus,&nbsp;Jérome Le Chenadec,&nbsp;Laurent Mandelbrot,&nbsp;Roland Tubiana,&nbsp;Albert Faye,&nbsp;Maud Brossard,&nbsp;Pierre Frange,&nbsp;Stéphane Blanche,&nbsp;Josiane Warszawski","doi":"10.1097/INF.0000000000003478","DOIUrl":"https://doi.org/10.1097/INF.0000000000003478","url":null,"abstract":"<p><p>In the ANRS French Perinatal Cohort, we compared outcomes in 830 HIV1-exposed infants who received either nevirapine (NVP) or zidovudine postnatal prophylaxis. At 1 month, anemia grade ≥2 was less frequent on NVP than zidovudine (2.9% vs. 8.0%; P = 0.01), favoring the use of NVP as a first choice prophylaxis in infants at low risk of HIV acquisition.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"420-423"},"PeriodicalIF":3.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Etiology of Community-acquired Pneumonia in US Children, 2015-2018.","authors":"Ki Wook Yun,&nbsp;Rebecca Wallihan,&nbsp;Ankita Desai,&nbsp;Sherman Alter,&nbsp;Lilliam Ambroggio,&nbsp;Daniel M Cohen,&nbsp;Ossama El-Assal,&nbsp;Sarah Marzec,&nbsp;Todd A Florin,&nbsp;Meghan Keaton,&nbsp;Samir S Shah,&nbsp;Richard M Ruddy,&nbsp;Samantha Sharpe,&nbsp;Amy L Leber,&nbsp;Kathy Everhart,&nbsp;Asuncion Mejias,&nbsp;Octavio Ramilo","doi":"10.1097/INF.0000000000003475","DOIUrl":"https://doi.org/10.1097/INF.0000000000003475","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia has a major impact on childhood health and health care costs. This study was designed to obtain contemporary information on the clinical characteristics and etiology of community-acquired pneumonia (CAP) in children from both inpatient and outpatient settings in the USA.</p><p><strong>Methods: </strong>We conducted a prospective, multicenter, observational study of CAP among previously healthy children 2 months to 18 years of age in 6 children's hospitals in Ohio from 2015 to 2018. For pathogen detection, nasopharyngeal swabs were collected from all subjects. Blood and pleural fluid cultures were available per standard of care.</p><p><strong>Results: </strong>We enrolled a convenience sample of 441 patients: 380 hospitalized and 61 outpatients. Tachypnea and radiologic findings of consolidation and pleural effusion were more frequent among inpatients than outpatients. A pathogen was detected in 64.6% of patients: viruses in 55.6%, atypical bacteria in 8.8% and pyogenic bacteria in 4.3%. Eighteen (4.1%) patients had both viruses and bacteria detected. Rhinovirus/enterovirus (RV; 18.6%) and respiratory syncytial virus (RSV; 16.8%) were the viruses most frequently detected, and Mycoplasma pneumoniae (8.2%) and Streptococcus pneumoniae (2.3%) were the most common bacteria. Except for S. pneumoniae, which was identified more frequently in inpatients, there were no significant differences between inpatients and outpatients in the proportions of children with specific pathogens detected.</p><p><strong>Conclusions: </strong>Rhinovirus/enterovirus and RSV among viruses and M. pneumoniae and S. pneumoniae among bacteria were the most common pathogens detected in children with CAP. Tachypnea and chest radiographs with consolidation and/or pleural effusion were associated with hospitalization.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"381-387"},"PeriodicalIF":3.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39906706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elizabethkingia anophelis: An Important Emerging Cause of Neonatal Sepsis and Meningitis in China.","authors":"Beibei Wang,&nbsp;Rui Cheng,&nbsp;Yun Feng,&nbsp;Yan Guo,&nbsp;Qing Kan,&nbsp;Aimin Qian,&nbsp;Li Zhao","doi":"10.1097/INF.0000000000003464","DOIUrl":"https://doi.org/10.1097/INF.0000000000003464","url":null,"abstract":"<p><p>Elizabethkingia anophelis, originally isolated from the midgut of Anopheles gambiae in 2011, is an important cause of sepsis in adults and children and meningitis in newborns, with several reported outbreaks worldwide. Accumulating molecular biological and whole-genome sequencing (WGS) evidence suggests that E. anophelis is the major human pathogen belonging to the genus Elizabethkingia. The source of infection, routes of transmission and pathogenicity of E. anophelis are unclear and should be better understood as the bacterium is capable of causing sepsis and meningitis in newborns, with complications and high mortality rates. Here, we describe two healthy neonates who developed meningitis caused by Elizabethkingia infection. Initial conventional laboratory results revealed that the pathogen was E. meningoseptica; metagenomic findings later confirmed it as E. anophelis. We also summarize reported E. anophelis infections among newborns in China and elsewhere and describe the clinical, pathogenic and genetic characteristics of this bacillus.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e228-e232"},"PeriodicalIF":3.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39850890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal Cytomegalovirus Infection of Preterm and Very-low-birth-weight Infants Through Maternal Breast Milk: Does It Matter?","authors":"Patricia Bimboese,&nbsp;Seilesh Kadambari,&nbsp;Sepehr N Tabrizi,&nbsp;Suzanne M Garland,&nbsp;Alison Tigg,&nbsp;Rosalind Lau,&nbsp;Colin J Morley,&nbsp;Nigel Curtis","doi":"10.1097/INF.0000000000003400","DOIUrl":"https://doi.org/10.1097/INF.0000000000003400","url":null,"abstract":"<p><strong>Background: </strong>Postnatal infection with cytomegalovirus (CMV) in very-preterm and very-low-birth-weight infants, transmitted through breast milk (BM), is potentially associated with adverse outcomes. This study aimed to investigate the incidence and clinical significance of postnatal CMV infection in a tertiary neonatal intensive care unit.</p><p><strong>Methods: </strong>Infants of CMV-seropositive mothers born in a neonatal intensive care unit in Melbourne, Australia, were observed for 14 weeks from birth in a prospective cohort study. Maternal BM and infant urine were tested weekly for CMV by culture and polymerase chain reaction, respectively. Clinical and laboratory data were collected and analyzed in relation to the infants' CMV infection status.</p><p><strong>Results: </strong>Data from 65 infants of 56 CMV-seropositive mothers were available for analysis. Of these mothers, 88% (49/56) shed CMV in their BM. Of the 58 infants exposed to CMV-positive BM, 27 (47%) became urine polymerase chain reaction CMV-positive. There was no significant difference in gestational age, birth weight, incidence of bronchopulmonary dysplasia, or necrotizing enterocolitis between the CMV-positive and CMV-negative groups. However, CMV-positive infants had a longer length of hospital stay and more episodes of prolonged neutropenia. Of the CMV-positive infants, 30% (8/27) remained asymptomatic, 48% (13/27) had symptoms categorized as mild and 22% (6/27) as severe.</p><p><strong>Conclusions: </strong>About half of preterm and very-low-birth-weight infants exposed to CMV-positive BM become infected, and a fifth develop significant clinical symptoms. Future studies should address the maternal and neonatal factors that determine the risk of mother-to-infant CMV transmission, as well as those leading to clinical deterioration and long-term sequelae.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"343-351"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39785878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Reinfection, and Discrepancy Between Sexual Practice and Anatomic Site Positivity of Sexually Transmitted Infections in Youth With HIV.","authors":"Leah Loerinc,&nbsp;Amy Scheel,&nbsp;Sierra Jordan-Thompson,&nbsp;Scott Gillespie,&nbsp;Andres Camacho-Gonzalez","doi":"10.1097/INF.0000000000003399","DOIUrl":"https://doi.org/10.1097/INF.0000000000003399","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the overall incidence and reinfection rates of sexually transmitted infections (STIs) and the discrepancy between self-reported exposure history and anatomic site positivity of STIs among adolescents and young adults (AYAs) with HIV in Atlanta, GA.</p><p><strong>Methods: </strong>Retrospective chart review was conducted on all patients 13-24 years of age at the Grady Ponce and Family Youth Clinic from January 1, 2009 to December 31, 2018. Data were collected on patient demographics, self-reported sexual history and STI events. First STI incidence and incidence of reinfections were calculated by dividing new cases over corresponding person follow-up time.</p><p><strong>Results: </strong>A total of 626 sexually active AYAs with HIV were included in analysis. The mean age at first observation was 18.9 (SD: ±2.8) years; 72% were male, 92% were Black and 80% were horizontally infected. The cumulative first STI incidence rate was 45.49 cases per 100 person-years, and the recurrent STI incidence rate was 119.86 cases per 100 person-years. Among all Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) cases, the most common site of infection was the rectum (48.6% and 49.6%, respectively). Disagreement between exposure history and presence of GC or CT infection was statistically significant for nearly all anatomic sites and types of intercourse.</p><p><strong>Conclusions: </strong>AYAs with HIV in Atlanta have disproportionately high first and recurrent incidence rates of STIs, with many patients not reporting exposure at their site of infection. There is considerable need to increase screening for STIs, including routine extragenital testing for GC and CT, among AYAs with HIV regardless of self-reported exposure history.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"306-311"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39887651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Metapneumovirus Infection in a Children's Hospital - It Should Get More Attention.","authors":"Nellie Hani,&nbsp;Wendi Gornick,&nbsp;Beth Huff,&nbsp;Jamie Atienza,&nbsp;Jasjit Singh","doi":"10.1097/INF.0000000000003416","DOIUrl":"https://doi.org/10.1097/INF.0000000000003416","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) and influenza infections are a major cause of hospitalization and intensive care unit (ICU) admission to children's hospitals and are closely tracked. We compared data over 6 seasons of human metapneumovirus (hMPV), RSV and influenza infections.</p><p><strong>Methods: </strong>During the 2014-2019 winter viral seasons, hMPV, RSV and influenza infections were tracked. For hMPV admissions, rates of hospitalizations, ICU admissions, hospital-acquired infections (HAIs) and mortalities were assessed and compared with RSV and influenza admissions. Retrospective data was used to study patients infected with hMPV.</p><p><strong>Results: </strong>During the winter seasons of 2014-2019, the rates of hospitalization due to hMPV were significantly higher than both RSV and influenza. ICU admissions, deaths and HAIs for hMPV were similar to RSV and influenza.Of the 471 total cases with hMPV, 58 (12.3%) had chronic lung disease (CLD) and 23 (4.9%) were tracheostomy dependent. Among 104 hMPV ICU admissions from 2013 to 2019, 86 (82%) had an underlying medical diagnosis, 30 (29%) had CLD, 21 (20%) had tracheostomies and 33 (32%) required mechanical ventilation. The average age of hMPV infected children in our ICU is 3 years and 10 months.</p><p><strong>Conclusions: </strong>Our large descriptive study of hMPV infected children over 6 seasons showed higher rates of hospitalization compared with RSV and influenza, similar ICU and HAI rates, and deaths. ICU admitted children often had associated co-morbidities, including CLD. Further studies for focused disease surveillance and potential vaccine development for high-risk children are needed.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"284-289"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Novel Culture System for Rapid Pathogen Identification and Detection of Cephalosporin Resistance in Neonatal Gram-negative Sepsis at a Tertiary Referral Unit in Harare, Zimbabwe: ERRATUM.","authors":"","doi":"10.1097/INF.0000000000003492","DOIUrl":"https://doi.org/10.1097/INF.0000000000003492","url":null,"abstract":"","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"360"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Viral-associated Hemophagocytic Lymphohistiocytosis at a Tertiary Hospital.","authors":"Hanan F Nazir,&nbsp;Nehad Hassanein,&nbsp;Yasser Wali,&nbsp;Laila S Al Yazidi","doi":"10.1097/INF.0000000000003401","DOIUrl":"https://doi.org/10.1097/INF.0000000000003401","url":null,"abstract":"<p><strong>Background: </strong>Little is known about viral-associated hemophagocytic lymphohistiocytosis (HLH) in Oman. This study was done to assess the epidemiology, clinical features and outcome of viral-associated HLH in our setting.</p><p><strong>Methods: </strong>We retrospectively reviewed children (0-18 years) managed for viral-associated HLH at the Sultan Qaboos University Hospital, Oman, over a 15-year period (2006-2020). Patients' medical records were used to describe their demographic, clinical and laboratory features, management and outcome.</p><p><strong>Results: </strong>Fifty-six children were managed for HLH at Sultan Qaboos University Hospital over the last 15 years (2006-2020) of whom a third (19; 34%) had a viral trigger. The median age at the time of diagnosis of viral-associated HLH was 83 (13-96) months. Fever, cytopenia, hyperferritinemia and evidence of hemophagocytosis in bone marrow were the most consistent findings. Most of these children had either genetic predisposition to HLH (8/19; 42%) or underlying immunodeficiency secondary to malignant conditions or chemotherapy/hematopoietic stem cell transplantation (6/19; 32%). Epstein-Barr virus (9; 47%) followed by cytomegalovirus (6; 31%) was the most common viral trigger in our setting. Treatment included antivirals (8; 42%), HLH 2004 protocol (4; 21%), rituximab (4; 21%) and hematopoietic stem cell transplantation (3; 16%). Fourteen children (74%) had full recovery.</p><p><strong>Conclusions: </strong>In our small cohort, viral-associated HLH was more frequently encountered in children with genetic predisposition to HLH or children with underlying immunodeficiency. In addition, we found that the outcome is overall good for children who have no genetic predisposition to HLH and children with genetic predisposition who underwent hematopoietic stem cell transplantation.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"330-334"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39677795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molds and More: Rare Fungal Infections in Preterm Infants <24 Weeks of Gestation.","authors":"Katrin Mehler,&nbsp;Oliver Cornely,&nbsp;Harald Seifert,&nbsp;Janine Zweigner,&nbsp;Saskia Janssen,&nbsp;André Oberthuer","doi":"10.1097/INF.0000000000003407","DOIUrl":"https://doi.org/10.1097/INF.0000000000003407","url":null,"abstract":"<p><strong>Background: </strong>Extreme immature infants are at an increased risk of fungal infection due to immaturity of the skin barrier and the immune system. Besides Candida infections, in particular, Aspergillus may cause life-threatening diseases in preterm infants. Frequently, Aspergillus primarily affects the skin and may cause extensive damage.</p><p><strong>Methods: </strong>We searched our hospital database for fungal infections other than Candida in preterm infants treated between 2015 and 2020 at our level III neonatal intensive care unit of the University Hospital of Cologne.</p><p><strong>Results: </strong>In total, 13 preterm infants were identified. Of these, 11 had cutaneous Aspergillosis, one infant had severe enterocolitis caused by Aspergillus and Rhizopus and one had invasive intraabdominal Trichosporon mucoides infection. All infants were born <24 weeks of gestation, were delivered due to premature labor or chorioamnionitis, and had received prenatal steroids and/or hydrocortisone. Voriconazole and liposomal Amphotericin B were first-line treatments and the length of treatment varied between 3 and 148 days. Two infants died associated with severe infection. Liver toxicity was observed in six infants treated with Voriconazole. Therapeutic drug management for Voriconazole was performed in four infants. Target levels were not achieved by the doses that are recommended.</p><p><strong>Conclusions: </strong>Rare fungal infections, predominantly cutaneous Aspergillosis affects the most immature preterm infants and may cause severe disease. Treatment with Voriconazole has a high rate of liver toxicity and target levels are difficult to achieve in extremely immature infants.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"352-357"},"PeriodicalIF":3.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39654766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}