Journal of paediatrics and child health最新文献

{"title":"Perspective on the Potential Vertical Transmission of SARS-CoV-2 Through Breast Milk","authors":"Nam Phuong Le,&nbsp;Emma Cravo,&nbsp;Tyler Burke,&nbsp;Benjamin Brooks,&nbsp;Andrew Tucker","doi":"10.1111/jpc.16755","DOIUrl":"10.1111/jpc.16755","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>SARS-CoV-2 is highly transmissible, having infected ~16 million children in the United States. Symptom severity is higher in infants compared to older children, possibly due to their ineligibility for vaccination. Concerns persist that mothers transmit infectious viral loads of SARS-CoV-2 through breast milk. In this review, we discuss the mechanism by which viruses transmit through breast milk, weigh the specific virulence and infectivity of SARS-COV-2, and review current guidelines for minimizing transmission in neonates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through available literature, we propose a stepwise pathway for vertical transmission of SARS-CoV-2. The level of risk and probability of infection is assessed based on established mechanisms, reported viral loads, and presence of transmembrane receptors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>To successfully transmit viruses through breast milk, the virus must infect the mother's breast cells, replicate in the mammary gland, be secreted into breast milk, survive contact with the infant's oral mucosa and digestive tract, infect enterocytes, replicate while evading the infant's immune system, exit the gastrointestinal tract, and enter the bloodstream for systemic infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We conclude that SARS-CoV-2 infection through breast milk has limited transmission risk, and benefits for infants far outweigh the risks, aligning with current AAP/WHO/CDC guidelines. Though close contact during breastfeeding and exposure to respiratory droplets pose a higher transmission risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 2","pages":"148-152"},"PeriodicalIF":1.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Energy Nutrition in Hospitalised Paediatric Patients With Congenital Heart Disease: A Systematic Review and Meta-Analysis","authors":"Lorhayne Kerley Capuchinho Scalioni Galvao,&nbsp;Ana Clara Felix de Farias Santos,&nbsp;Fernanda Valeriano Zamora,&nbsp;Nicole dos Santos Pimenta,&nbsp;João Pedro Costa Esteves Almuinha Salles,&nbsp;Isabella Guzzardi Hable","doi":"10.1111/jpc.16767","DOIUrl":"10.1111/jpc.16767","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Congenital heart disease (CHD) is a significant cause of growth failure and neonatal mortality worldwide, and requirement-focused nutritional management can deeply impact the prognosis. Despite multiple trials, there is no published meta-analysis on the impact of high-energy nutrition in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Embase and Cochrane Central for RCTs comparing high-energy to standard formulas in hospitalised patients. We computed mean differences (MDs) for continuous outcomes and odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five studies comprising 276 patients were included, of whom 139 (50.4%) received the high-energy formula. Compared with the standard, they had higher weight gain (MD 276.37; 95% CI 56.29, 496.46). Despite no statistical significance, the length of hospital stay (MD −3.51; 95% CI −7.33, 0.3) tends to be shorter. There were no significant differences regarding the length of ICU stay (MD −10.32; 95% CI −58.04, 37.40) and mechanical ventilation (MD −19.54; 95% CI −47.81, 8.73). The presence of side effects (OR 1.82; 95% CI 0.58, 5.7; <i>p</i> = 0.3) was one of the outcomes most reported as better in the control group, but overall, there's no significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest the high-energy formula may be superior to control considering weight gain. In addition, the presence of side effects was not significantly different between groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"316-323"},"PeriodicalIF":1.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Call to Action: Healthcare Professionals to Become Independent of the Commercial Milk Formula Industry","authors":"Jamie Errico,&nbsp;Nicole Bando,&nbsp;Evelyn Volders,&nbsp;Kathleen Halliday","doi":"10.1111/jpc.16761","DOIUrl":"10.1111/jpc.16761","url":null,"abstract":"<p>Health-care professionals (HCP) have a responsibility to protect and promote maternal and infant health and breastfeeding is one of the most effective measures to support this. Increasing breastfeeding rates in Australia is crucial to improving population health, but the absence of robust policies, programmes and education for HCP undermines this effort. The pervasive marketing of commercial milk formulas (CMF), including sponsorship of HCP and their organisations, has introduced significant conflicts of interest that distort clinical practice, education, research and guidelines developed in the infant feeding domain. This paper calls on all HCP to seek independence from the CMF industry and to actively support breastfeeding in their practice.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 2","pages":"291-296"},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Central Nervous System Tumours: Symptomatology and Total Diagnostic Interval in a New Zealand Cohort","authors":"Cecilia M. Verryt,&nbsp;Siobhan Cross","doi":"10.1111/jpc.16763","DOIUrl":"https://doi.org/10.1111/jpc.16763","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Central nervous system (CNS) tumours are the leading cause of paediatric oncologic death and survivors face high rates of persistent disability. Timeframe from initial symptom to diagnostic radiography [total diagnostic interval (TDI)] is associated with increased morbidity and mortality. Interventions such as HeadSmart and Brain Pathways Guidelines UK have reduced TDI in the United Kingdom through public and professional education campaigns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The overarching aim of this project is to reduce TDI for brain tumours across New Zealand. As there are no local data for TDI in paediatric CNS tumours, we sought baseline data prior to local interventions, which would then inform interventions in the next project phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis of patients ≤ 18 years with a CNS tumour in the CHOC catchment between 2015 and 2020. Demographics, tumour type, presenting symptoms/signs, referral pathways and TDI were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 72 cases, median TDI was 9 weeks (0–156 weeks). This was lower in patients aged &lt; 4 years compared with &gt; 4 years (4 weeks vs. 13 weeks), in high grade tumours compared to low grade (4 weeks vs. 13 weeks), and in other ethnicities compared with Māori/Pasifika (6 weeks vs. 16.5 weeks) (<i>p</i> &lt; 0.05 for all comparisons). Symptomatology was similar to Brain Pathways, however, some signs including head circumference were poorly recorded and identify areas for improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Median TDI is higher than recommended targets, and there is ethnic disparity. This gives impetus for local intervention, using strategies comparable to Brain Pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"417-423"},"PeriodicalIF":1.6,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Message","authors":"Ju-Lee Oei","doi":"10.1111/jpc.16768","DOIUrl":"10.1111/jpc.16768","url":null,"abstract":"<p>It has now been almost a year since I had the honour of being appointed the acting Editor in Chief (EiC) of the Journal of Paediatrics and Child Health (JPCH). I am the 7th EiC since JPCH was established as the Australian Paediatric Journal in 1965. The last one and a half years was tumultuous, with three EiCs taking the helm within a few short months. The journal's recovery over the last 10 months would not have been possible without the rock-solid foundation built by the previous EiCs and the unrelenting and selfless efforts and support of a (entirely) voluntary editorial board, an army of reviewers the College Journal Committee and the Marketing and Communications team.</p><p>The editorial board underwent significant change in 2024. Senior editors were ‘re-classified’ as ‘Section Editors’ to align with their expertise. Some editors who had provided years of generous service to the journal stepped down. Seven section editors and 16 new associate editors were appointed, providing much needed complementary expertise to the editorial board. Currently, the editors cover almost all specialties in paediatrics and hail from 7 countries, including Singapore, Japan, India and China. They bring with them world-leading skills in rapidly developing fields of health care, including global health, evidence synthesis, economics, statistics and ethics.</p><p>March 2025 will be the 60th Anniversary of JPCH.</p><p>In the first issue in March 1965, Charlotte Anderson, the first editor with Peter Jones, hoped that ‘it (the journal) will help to promote understanding, cooperation and exchange of personnel between countries’ as the voice of Australian paediatricians and South-East Asia. In this issue (Jan 2025), there are manuscripts from 5 Australian states, New Zealand and 10 other countries, covering 12 different specialties, including artificial intelligence and law. Although much has changed in the world and in paediatrics since 1965, I'm proud to say that JPCH continues the aspirations of Dr Anderson and Dr Jones and hope that it's reach and diversity will continue to grow for the next 60 years.</p><p>The author declares no conflicts of interest.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 1","pages":"6"},"PeriodicalIF":1.6,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.16768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-economic disparities in the psychosocial and economic impacts of the COVID-19 pandemic on children and young people in Australia","authors":"Meredith O'Connor,&nbsp;Katherine Lange,&nbsp;Marnie Downes,&nbsp;Margarita Moreno-Betancur,&nbsp;David Burgner,&nbsp;Naomi Priest,&nbsp;Valerie Sung,&nbsp;Stephanie J Brown,&nbsp;Deirdre Gartland,&nbsp;Kirsten P Perrett,&nbsp;Sharon Goldfeld,&nbsp;Craig A Olsson","doi":"10.1111/jpc.16737","DOIUrl":"10.1111/jpc.16737","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>While COVID-19 no longer presents a global health emergency, the indirect (non-infection) impacts of the pandemic may exacerbate health inequalities in years to come. We examined the socio-economic distribution of the impacts of the pandemic on the psychosocial and economic well-being of children, young people and their families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The CoRonavIruS Health Impact Survey (CRISIS) was conducted in seven existing longitudinal cohorts, together involving <i>n</i> = 3072 participants aged 0–19 years. Online surveys were conducted from May 2020–April 2021, during periods of low infection but stringent public health measures in Victoria, Australia. Analysed CRISIS domains included: COVID-19-related worries, mood state, economic difficulties and positive life changes. Social disadvantage of each sample was characterised by pre-pandemic maternal education, unemployment, income and neighbourhood disadvantage, avoiding cross-sectional data limitations. The proportion of children experiencing each type of pandemic impact was estimated within each cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Substantial socio-economic disparities were observed. COVID-19-related worries were 22 percentage points higher in the most (24.2%, 95% confidence interval (CI) 19.4–29.1) versus least (2.9%, 95% CI 1–4.7) disadvantaged cohorts. Similar patterns were noted for negative mood state (19.4%, 95% CI 15–23.9 vs. 3.6%, 95% CI 1.6–5.6), economic difficulties (18.5%, 95% CI 14.2–22.9 vs. 5.7%, 95% CI 3.3–8.1) and lower levels of positive life changes (63.7%, 95% CI 58.3–69.1 vs. 83.2%, 95% CI 78.9–87.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Indirect consequences of the COVID-19 pandemic showed significant disparities across populations experiencing different socio-economic conditions. The pandemic offers a unique opportunity to rethink and redesign policies and services to achieve greater equity now and better preparedness for global crises in future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 2","pages":"267-276"},"PeriodicalIF":1.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Therapeutic Hypothermia During Transport of Newborns With Perinatal Hypoxic-Ischaemic Encephalopathy: Experience From Newborn and Paediatric Transport Service, New South Wales","authors":"Lucia McLean,&nbsp;Hannah Dalrymple,&nbsp;Lekshmi Sasidharan,&nbsp;Trish Grant,&nbsp;Kathryn Browning Carmo","doi":"10.1111/jpc.16758","DOIUrl":"10.1111/jpc.16758","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the efficacy of current non-servo-based cooling methods used by NETS NSW in treating hypoxic ischaemic encephalopathy (HIE) with therapeutic hypothermia (TH) in neonatal retrieval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study of infants treated with TH for HIE retrieved by NETS NSW from January 2017 to June 2020 inclusive. Primary outcomes were the proportion of neonates achieving TH within 6 h of life and maintaining temperature in a therapeutic range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>82 patients were included in analysis. Mean gestational age (GA) was 39 weeks (IQR 38–40) and mean birthweight (BW) 3297 g (SD 607 g). 68 infants (82.9%) were passively cooled while 14 (17.1%) were cooled with gel packs. 20 infants (21.4%) had rectal temperature monitoring before retrieval. 45 infants (55.6%) reached TH within 6 h of birth. Only 56 infants (68.3%) reached TH during retrieval. Of these infants, 45 (80.4%) had subsequent temperatures outside the therapeutic range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Infants receiving TH through non-servo-controlled methods are commonly exposed to temperature instability and overcooling. Introduction of servo-controlled cooling devices is required to improve care and management of perinatal HIE in retrieval.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"411-416"},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylactic Reactions During Bee Venom Immunotherapy in the Paediatric Population","authors":"Jessica W. S. Wong,&nbsp;Ashling Courtney,&nbsp;Tess O'Gorman,&nbsp;Elizabeth McKinnon,&nbsp;Valerie Noble,&nbsp;Benedicta Itotoh","doi":"10.1111/jpc.16757","DOIUrl":"10.1111/jpc.16757","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A retrospective study will review episodes of anaphylaxis during bee venom immunotherapy (BVIT) in children, any modifications made to the dosing schedule, and the subsequent outcomes over a nine-year period in Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient demographics, dose eliciting anaphylaxis during BVIT, modifications made to BVIT regimen following anaphylaxis (i.e., continuation, modification, or cessation), and the subsequent outcomes were collected for children commenced on BVIT from 1st September 2012 to 31st August 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 624 children were commenced on BVIT from 2012 to 2021. 12/624 (1.9%) did not complete the recommended duration of BVIT, the majority of which were due to poor compliance. 33 children (5.2%) developed anaphylaxis. 2/33 children (6.0%) experienced anaphylaxis on multiple occasions, resulting in 36 separate episodes of anaphylaxis. Most of the anaphylactic episodes occurred on Day 1 of BVIT (56%). 23/35 children (65.7%) developed anaphylaxis during the build-up phase and 12/35 children (34.3%) developed anaphylaxis during the maintenance phase. For those who experienced anaphylaxis in the build phase, 6/23 children (26.0%) continued with immunotherapy on the same day, and 5/6 of these children (83.3%) tolerated the same-day continuation of immunotherapy; 17/23 children (73.9%) ceased immunotherapy and restarted on another day, with 11/17 children (64.7%) tolerating cessation and recommencement of the regimen on another day. For those who developed anaphylaxis during the maintenance phase, 6/12 children (50.0%) tolerated ongoing immunotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children who experience anaphylaxis during the build-up phase of BVIT showed a low risk of further anaphylaxis with proceeding immunotherapy on the same day. Children who experience anaphylaxis during the maintenance phase of BVIT appear less likely to tolerate ongoing immunotherapy due to the recurrence of anaphylaxis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"404-410"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging bullous dermatosis in a child: Linear immunoglobulin-A bullous disease","authors":"Raquel da Costa Neves,&nbsp;Inês A Carvalho,&nbsp;Daniela Silva,&nbsp;Inês Silva,&nbsp;Ermelindo Tavares,&nbsp;Florbela Cunha","doi":"10.1111/jpc.16753","DOIUrl":"10.1111/jpc.16753","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 2","pages":"288-290"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-reactive protein diagnostic value for bacterial infections in the paediatric emergency department setting","authors":"Iben Hamad Adam MD,&nbsp;Inbal Kestenbom MD,&nbsp;Moshe Shmueli MPH,&nbsp;Lior Hassan,&nbsp;Idan Lendner MD,&nbsp;Shalom Ben-Shimol MD","doi":"10.1111/jpc.16752","DOIUrl":"10.1111/jpc.16752","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>C-reactive protein (CRP) is commonly used to assess the probability of bacterial infection and the need for empiric antibiotic treatment. We assessed the relationship between CRP levels and bacterial infection in the paediatric emergency room (PER) setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study. Relative risks (RRs) were calculated for the relation between CRP levels and various demographic, clinical and diagnosis parameters. Additionally, the sensitivity and specificity of different CRP levels (2, 5, 7 and 10 mg/dL) for bacterial infection diagnosis was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 13 092 cases were recorded. Fever, leucocytosis, hospitalisation and bacterial infection diagnosis were associated with elevated CRP levels, while lower CRP levels were associated with young age. Gender, ethnicity, hypoxemia and neutrophilia were not associated with CRP levels. The sensitivity of CRP ≥2 mg/dl for bacterial disease was 65%–70%, declining to &lt;50% in CRP ≥5 mg/dL. The specificity of CRP ≥2 mg/dL for bacterial disease was ~60%, increasing to &gt;80% in CRP ≥5 mg/dL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CRP levels of ≥5 mg/dl high specificity for bacterial disease, allow for its use as an indicator to start empiric antibiotic treatment, while the low sensitivity of various CRP levels probably excludes the possibility of withholding empiric antibiotic treatment, based only on CRP level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 3","pages":"396-403"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}