The Pediatric Infectious Disease Journal最新文献

{"title":"Clinical Presentation, Investigation and Control of an Outbreak of Adenoviral Conjunctivitis in a Neonatal Unit at a Tertiary Hospital.","authors":"Anchal Thakur,&nbsp;Kapil Goyal,&nbsp;Poonam Chauhan,&nbsp;Bhawna Sharma,&nbsp;Shashi Kant Dhir,&nbsp;Deeksha Katoch,&nbsp;Manisha Biswal,&nbsp;Shweta Talati,&nbsp;Ranjitpal Singh Bhogal,&nbsp;Lalit Mohan,&nbsp;Monika Sapra,&nbsp;Amit Gupta,&nbsp;Venkataseshan Sundaram,&nbsp;Sourabh Dutta,&nbsp;Praveen Kumar,&nbsp;Mini P Singh","doi":"10.1097/INF.0000000000003347","DOIUrl":"https://doi.org/10.1097/INF.0000000000003347","url":null,"abstract":"<p><strong>Background: </strong>Nosocomial spread of adenovirus infection has been reported in neonatal, pediatric and adult medical units. This nonenveloped and hardy virus is resistant to numerous disinfectants thus posing a challenge for control and prevention of adenovirus infections in health care settings.</p><p><strong>Methods: </strong>An epidemiologic outbreak investigation revealed an adenoviral outbreak in the neonatal nursery as well as in the neonatal screening outpatient department for Retinopathy of Prematurity (ROP). All suspected cases (94 neonates) underwent adenoviral conventional polymerase chain reaction (PCR) and representative samples underwent sequencing by Sanger's method. The clinical features and disease course were studied. Infected babies were started on tobramycin eye drops. Topical steroid eye drops were added for those who developed pseudomembranes.</p><p><strong>Results: </strong>We found 58 cases of laboratory-confirmed neonatal adenovirus conjunctivitis (between July 10 and October 24, 2019). Redness (96%) was the most common presentation followed by discharge (68.9%) and lid edema (51.7%). Pseudomembrane were seen in 77.5% of the infected neonates. Prior ROP examination was carried out in 38 (65.5%) neonates. Respiratory symptoms were present in 7 (12.06%) neonates. Sequencing revealed serotype 8 as the cause of the outbreak. Control measures were strictly implemented. Standard Operating Procedures (SOPs) for ROP screening were revisited, revised and reinforced to prevent future outbreaks.</p><p><strong>Conclusions: </strong>We observed ROP screening as a risk factor for the development of adenoviral conjunctivitis in neonatal care units. Neonates present with different clinical manifestations as compared with adults. Prompt control measures were implemented to control the adenoviral outbreak.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"243-247"},"PeriodicalIF":3.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39783469","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":"Respiratory Tract Infection Management and Antibiotic Prescription in Children: A Unique Study Comparing Three Levels of Healthcare in The Netherlands: ERRATUM.","authors":"","doi":"10.1097/INF.0000000000003427","DOIUrl":"https://doi.org/10.1097/INF.0000000000003427","url":null,"abstract":"","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"274"},"PeriodicalIF":3.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39783472","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":"Stenotrophomonas maltophilia External Ventricular Drain Infections: A Case Series.","authors":"Caitlin Naureckas Li,&nbsp;Avika Dixit","doi":"10.1097/INF.0000000000003387","DOIUrl":"https://doi.org/10.1097/INF.0000000000003387","url":null,"abstract":"","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e106-e108"},"PeriodicalIF":3.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39783471","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":"Do Not Act Fast and Furious.","authors":"Arne Simon,&nbsp;Marika Schöndorf,&nbsp;Dominik Schöndorf,&nbsp;Sascha Meyer","doi":"10.1097/INF.0000000000003363","DOIUrl":"https://doi.org/10.1097/INF.0000000000003363","url":null,"abstract":"","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e65-e66"},"PeriodicalIF":3.6,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39673226","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":"A Case of Congenital Human Parechovirus Type 3 Meningoencephalitis.","authors":"Selina Mei Jy Lim,&nbsp;David Anthony Foley,&nbsp;Rahul Lakshmanan,&nbsp;Leon Caly,&nbsp;Sanjay Gehlot,&nbsp;Jonathan Davis","doi":"10.1097/INF.0000000000003369","DOIUrl":"https://doi.org/10.1097/INF.0000000000003369","url":null,"abstract":"","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e67-e68"},"PeriodicalIF":3.6,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39673227","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":"A Tool to Distinguish Viral From Bacterial Pneumonia.","authors":"Alfredo Tagarro,&nbsp;Cinta Moraleda,&nbsp;Sara Domínguez-Rodríguez,&nbsp;Mario Rodríguez,&nbsp;María Dolores Martín,&nbsp;María Luisa Herreros,&nbsp;Julia Jensen,&nbsp;Agustín López,&nbsp;Juan Carlos Galán,&nbsp;Enrique Otheo","doi":"10.1097/INF.0000000000003340","DOIUrl":"https://doi.org/10.1097/INF.0000000000003340","url":null,"abstract":"<p><strong>Background: </strong>Establishing the etiology of community-acquired pneumonia (CAP) in children at admission is challenging. Most of the admitted children with CAP receive antibiotics. We aimed to build and validate a diagnostic tool combining clinical, analytical and radiographic features to differentiate viral from bacterial CAP, and among bacterial CAP, typical from atypical bacteria.</p><p><strong>Methods: </strong>Design-observational, multi-center, prospective cohort study was conducted in 2 phases. Settings: 24 secondary and tertiary hospitals in Spain. Patients-A total of 495 consecutive hospitalized children between 1 month and 16 years of age with CAP were enrolled. Interventions-A score with 2 sequential steps was built (training set, 70% patients, and validation set 30%). Step 1 differentiates between viral and bacterial CAP and step 2 between typical and atypical bacterial CAP. Optimal cutoff points were selected to maximize specificity setting a high sensitivity (80%). Weights of each variable were calculated with a multivariable logistic regression. Main outcome measures-Viral or bacterial etiology.</p><p><strong>Results: </strong>In total, 262 (53%) children (median age: 2 years, 52.3% male) had an etiologic diagnosis. In step 1, bacterial CAPs were classified with a sensitivity = 97%, a specificity = 48%, and a ROC's area under the curve = 0.81. If a patient with CAP was classified as bacterial, he/she was assessed with step 2. Typical bacteria were classified with a sensitivity = 100%, a specificity = 64% and area under the curve = 0.90. We implemented the score into a mobile app named Pneumonia Etiology Predictor, freely available at usual app stores, that provides the probability of each etiology.</p><p><strong>Conclusions: </strong>This 2-steps tool can facilitate the physician's decision to prescribe antibiotics without compromising patient safety.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"31-36"},"PeriodicalIF":3.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39418146","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":"A Case of Aseptic Meningitis Without Skin Rash Caused by Oka Varicella Vaccine.","authors":"Yoshiki Kawamura,&nbsp;Daijiro Suzuki,&nbsp;Toya Kono,&nbsp;Hiroki Miura,&nbsp;Kei Kozawa,&nbsp;Haruo Mizuno,&nbsp;Tetsushi Yoshikawa","doi":"10.1097/INF.0000000000003316","DOIUrl":"https://doi.org/10.1097/INF.0000000000003316","url":null,"abstract":"<p><p>Here, we present a previously healthy adolescent with aseptic meningitis without skin rash caused by varicella vaccine derived from the Oka/Biken strain; the patient received a single dose of varicella vaccine at 1 year of age. Pediatricians should be aware of the potential for reactivation of varicella vaccine derived from the Oka/Biken strain, which can cause aseptic meningitis in vaccinated children even in the absence of a skin rash.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"78-79"},"PeriodicalIF":3.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39472408","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":"Chronic Osteomyelitis With Proliferative Periostitis of the Mandible in a Child: Report of a Case Managed by Immunosuppressive Treatment.","authors":"Maria Georgaki,&nbsp;Konstantina Delli,&nbsp;Polytimi Paschalidi,&nbsp;Sotiria Gkizani,&nbsp;Konstantinos Tsiklakis,&nbsp;Nikolaos G Nikitakis","doi":"10.1097/INF.0000000000003368","DOIUrl":"https://doi.org/10.1097/INF.0000000000003368","url":null,"abstract":"<p><strong>Background: </strong>Osteomyelitis with proliferative periostitis is a relatively uncommon inflammatory condition of the jaws, mainly characterized by periosteal formation of reactive bone. It primarily affects children and adolescences, also referred to as Garre's osteomyelitis, more frequently involving the molar region of the mandible. Cases lacking an obvious source of infection may have an immunologically mediated etiopathogenesis, falling under the spectrum of primary chronic osteomyelitis or chronic recurrent multifocal osteomyelitis (CRMO).</p><p><strong>Case report: </strong>Herein, we present a case of chronic osteomyelitis in a 6.5-year-old girl, who suffered from recurrent painful episodes of swelling of the mandible for the last 2 years, previously requiring hospitalization and administration of intravenous (IV) antibiotics and NSAIDs with limited responsiveness. The biopsy showed features consistent with osteomyelitis with proliferative periostitis. The patient was initially managed with an IV combination antibiotic regimen with only partial improvement. The possibility of an autoimmune mechanism in the context of primary chronic osteomyelitis or CRMO was considered, and immunosuppressive therapy (TNF inhibitor etanercept along with corticosteroids and methotrexate) was administered, resulting in clinical resolution.</p><p><strong>Conclusions: </strong>Osteomyelitis and its childhood variants are relatively rare and their management presents several challenges. Although typically treated with administration of antibiotics, possibly along with surgical intervention, other treatment modalities may be necessary for resilient and persistent cases. In a subset of cases, especially in the absence of local infectious factors, immunologically mediated mechanisms may play an important role and appropriate immunosuppressive therapy may be effective.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"e10-e15"},"PeriodicalIF":3.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39571703","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 and Bacteriologic Characteristics of Six Cases of Bifidobacterium breve Bacteremia Due to Probiotic Administration in the Neonatal Intensive Care Unit.","authors":"Yoshie Sakurai,&nbsp;Tatsuya Watanabe,&nbsp;Yuichiro Miura,&nbsp;Toshihiko Uchida,&nbsp;Natsumi Suda,&nbsp;Marie Yoshida,&nbsp;Tatsuro Nawa","doi":"10.1097/INF.0000000000003232","DOIUrl":"https://doi.org/10.1097/INF.0000000000003232","url":null,"abstract":"<p><strong>Background: </strong>Bifidobacterium breve is widely used as a probiotic in preterm infants and children with congenital surgical conditions, however, some cases of probiotics-induced bacteremia have been reported recently.</p><p><strong>Objectives: </strong>To examine the clinical and bacteriologic features of Bifidobacterium breve bacteremia caused by a probiotic (BBG-01) in term and preterm infants.</p><p><strong>Methods: </strong>We included 298 patients who were admitted to the neonatal intensive care unit of Miyagi Children's Hospital and were given BBG-01 as a probiotic within the period June 2014 to February 2019. We experienced six cases of B. breve bacteremia and assessed their features retrospectively.</p><p><strong>Results: </strong>The incidence rate of B. breve bacteremia in our hospital was 2% (6/298), higher than reported previously. The median age at onset, corrected age, and weight of the patients was 8 days (range: 5-27 days), 35 weeks (range: 26-39 weeks), and 1,940 g (range: 369-2734 g), respectively. The bacteremia triggers were gastrointestinal perforations in two cases, food protein-induced enterocolitis syndrome in two cases, adhesive ileus in one case, ileal volvulus in one case, and aspiration pneumonia following esophageal atresia repair in one case. B. breve was detected on blood cultures after a median of 5 days 13 hours (range: 4 days 18 hours-9 days 13 hours). No patient demonstrated serious symptoms, such as septic shock. All patients received antibiotics and recovered without any sequelae.</p><p><strong>Conclusions: </strong>Ileus and intestinal mucosal damage, such as enteritis, can cause B. breve bacteremia. The incidence of B. breve bacteremia may be higher than reported previously and detection via culture may require a longer time than typically needed for more common bacteria. It is associated with a good prognosis.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"62-65"},"PeriodicalIF":3.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39823802","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":"Development of the Novel Pneumonia Risk Score to Predict Radiographic Pneumonia in Children.","authors":"Susan C Lipsett,&nbsp;Alexander W Hirsch,&nbsp;Michael C Monuteaux,&nbsp;Richard G Bachur,&nbsp;Mark I Neuman","doi":"10.1097/INF.0000000000003361","DOIUrl":"https://doi.org/10.1097/INF.0000000000003361","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of pneumonia in children is challenging, given the wide overlap of many of the symptoms and physical examination findings with other common respiratory illnesses. We sought to derive and validate the novel Pneumonia Risk Score (PRS), a clinical tool utilizing signs and symptoms available to clinicians to determine a child's risk of radiographic pneumonia.</p><p><strong>Methods: </strong>We prospectively enrolled children 3 months to 18 years in whom a chest radiograph (CXR) was obtained in the emergency department to evaluate for pneumonia. Before CXR, we collected information regarding symptoms, physical examination findings, and the physician-estimated probability of radiographic pneumonia. Logistic regression was used to predict the presence of radiographic pneumonia, and the PRS was validated in a distinct cohort of children with suspected pneumonia.</p><p><strong>Results: </strong>Among 1181 children included in the study, 206 (17%) had radiographic pneumonia. The PRS included age in years, triage oxygen saturation, presence of fever, presence of rales, and presence of wheeze. The area under the curve (AUC) of the PRS was 0.71 (95% confidence interval [CI]: 0.68-0.75), while the AUC of clinician judgment was 0.61 (95% CI: 0.56-0.66) (P < 0.001). Among 2132 children included in the validation cohort, the PRS demonstrated an AUC of 0.69 (95% CI: 0.65-0.73).</p><p><strong>Conclusions: </strong>In children with suspected pneumonia, the PRS is superior to clinician judgment in predicting the presence of radiographic pneumonia. Use of the PRS may help efforts to support the judicious use of antibiotics and chest radiography among children with suspected pneumonia.</p>","PeriodicalId":118937,"journal":{"name":"The Pediatric Infectious Disease Journal","volume":" ","pages":"24-30"},"PeriodicalIF":3.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39569277","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}