Journal of the Pediatric Infectious Diseases Society最新文献

{"title":"Pediatric Dengue in Buenos Aires During the 2024 Outbreak: Clinical Presentation, Laboratory Findings, Viral Load, and Preexisting Immunity.","authors":"Sofía S Carril, Florencia A Bonnin, Maria S Tineo, Antonella S Antonelli Sanz, Agustina Denardi, Andrea Marin, Laura B Talarico, Eduardo L López","doi":"10.1093/jpids/piag009","DOIUrl":"https://doi.org/10.1093/jpids/piag009","url":null,"abstract":"<p><strong>Background: </strong>In 2024, dengue cases reached unprecedented levels worldwide, with the Americas accounting for most cases. This study describes clinical and laboratory characteristics of dengue, comparing children and adolescents, and explores the associations between preexisting anti-dengue virus (DENV) antibodies, clinical manifestations, laboratory parameters, and viremia.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study at the Ricardo Gutiérrez Children's Hospital in Buenos Aires, Argentina, between January and April 2024. Patients under 18 years with laboratory-confirmed dengue were included and classified as dengue with or without warning signs according to Pan American Health Organization criteria. Comparative analyses were performed between children (<10 years) and adolescents (≥10 years).</p><p><strong>Results: </strong>Of 971 suspected cases, 506 (52%) were confirmed (median age 11 years, IQR 8-14; 67% adolescents). Headache, musculoskeletal, and abdominal pain occurred more frequently in adolescents. Leukopenia and thrombocytopenia were significantly more frequent among adolescents, whereas elevated transaminases were significantly more common in children under 10 years of age. The median platelet and white blood cell counts were also significantly lower in the adolescent group. Warning signs occurred in 34%, mainly mucosal bleeding, persistent vomiting, and severe abdominal pain. Fifteen percent required hospitalization. Secondary infections were linked to elevated transaminases but not severe disease. No significant associations were observed between viremia and age, immune status, or serotype. An association between higher viremia and dengue without warning signs was likely due to earlier sample collection in this patient group. DENV-2 predominated (54%). Five patients developed severe dengue; no deaths occurred.</p><p><strong>Conclusions: </strong>Pediatric dengue shows age-related heterogeneity. The surge of cases in large urban centers of a previously non-endemic country reflects the changing dynamics of dengue in Latin America, emphasizing the urgent need for strengthened surveillance, prevention, and early risk stratification.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"15 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775164","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":"Early Transition From Parenteral to Oral Antibiotics for Neonates With Bacteremic Urinary Tract Infections.","authors":"Tara L Greenhow, Kritika Amanjee, Okezi Obrutu, Miranda Ritterman Weintraub, Diana Caro","doi":"10.1093/jpids/piag021","DOIUrl":"10.1093/jpids/piag021","url":null,"abstract":"<p><p>We conducted a retrospective cohort study of 49 neonates with bacteremic urinary tract infections (UTIs) to assess the efficacy of transition to oral antibiotics. Forty-one received oral step-down therapy after parenteral antibiotics; 2 had relapsed UTIs. No cases of bacteremia or meningitis occurred within 30 days post-treatment, suggesting transition to oral antibiotics as effective.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574821","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":"Impact of Clinical Decision Support Tools on Antibiotic Prescribing for Pediatric Acute Otitis Media in Emergency and Urgent Care Settings.","authors":"Joana Dimo, Andrew T Krack, Lori J Silveira, Leigh Anne Bakel, Irina Topoz, Nicole M Poole","doi":"10.1093/jpids/piag020","DOIUrl":"10.1093/jpids/piag020","url":null,"abstract":"<p><strong>Background: </strong>Acute otitis media (AOM) is the leading cause of pediatric antibiotic prescribing, often with unnecessarily long treatment durations. This study evaluates the impact of clinical decision support (CDS) tools on pediatric AOM prescribing in ambulatory care settings.</p><p><strong>Methods: </strong>This retrospective, quasi-experimental study evaluated the impact of (1) an electronic health record (EHR) order set with a preselected 5-day antibiotic duration for patients 2 years and older, and (2) an AOM clinical pathway on antibiotic prescribing for AOM. Review of patients 61 days to 18 years old presenting to emergency departments and urgent care centers within our institution between January 2019 and December 2023 was conducted. The primary outcome was the proportion of AOM encounters of children aged 2 to 18 years prescribed 5 days of antibiotics. The secondary outcome was the proportion of AOM encounters of children aged 61 days to 18 years prescribed enteral antibiotics or given ceftriaxone. Balancing measures included AOM-related revisits or complications. Interrupted time series segmented regression was used to analyze outcomes and balancing measures. Pathway use was assessed with a run chart, and order-set use was summarized descriptively.</p><p><strong>Results: </strong>A total of 31 929 patients were included. The proportion of AOM encounters for patients aged 2 to 18 years old prescribed a 5-day antibiotic duration increased from 1% to 85% during the study period, with a significant immediate level increase of 55.21% (95% CI 48.82 to 61.6) after order set implementation. Antibiotic prescriptions remained high (88% to 93%). There were no increases in AOM-related revisits or complications.</p><p><strong>Conclusion: </strong>Implementation of an EHR order set with preselected antibiotic durations substantially reduced antibiotic exposure for pediatric AOM without an increase in complications or revisits.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513240","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":"Evaluations and Treatment Among Infants Exposed to Syphilis in Utero, Six U.S. States, 2018-2021.","authors":"Mundayi V Nlandu, Elizabeth L Lewis, Jeffrey M Carlson, Ellen Martinson, Keivon Hobeheidar, Abigael Gardere, Teri' Willabus, Deborah Mbotha, Nicole D Longcore, Heather Marshall, Kevin P O'Callaghan, Van T Tong, Kate R Woodworth","doi":"10.1093/jpids/piag011","DOIUrl":"10.1093/jpids/piag011","url":null,"abstract":"<p><p>Contemporary data on evaluations and treatment of infants exposed to syphilis in utero are limited. This study analyzed population-based surveillance data to describe the management of exposed infants. Findings indicate inconsistent implementation of recommended guidelines for evaluations and treatment of infants exposed to syphilis in utero.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194930","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":"Management of Young Infants With Incomplete Evaluation for Meningitis.","authors":"Zachary I Willis, Danilo Buonsenso","doi":"10.1093/jpids/piag010","DOIUrl":"10.1093/jpids/piag010","url":null,"abstract":"<p><p>Evaluation of neonates and young infants with fever is a common problem in pediatrics. Lumbar puncture is frequently indicated, but results are often difficult to interpret due to dry tap, blood contamination, and/or antibiotic pretreatment. Pediatric infectious diseases clinicians are often called upon to determine the risk of meningitis requiring definitive treatment in the absence of optimal data. Pediatric clinicians can use clinical data, such as age, physical exam, and lab values to estimate the pre-test probability of meningitis and may be able to use ancillary testing, such as imaging and molecular microbiology, to refine the estimate. The goal of this review is to provide an evidence-based approach to this common scenario.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157569","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":"Plasma Microbial Cell-free DNA in Well-appearing Preterm Neonates.","authors":"Jason Sauberan, David Kaegi, Alice Pong","doi":"10.1093/jpids/piag014","DOIUrl":"10.1093/jpids/piag014","url":null,"abstract":"<p><p>Ten of 20 well-appearing hospitalized preterm neonates had an organism detected using plasma microbial cell-free DNA testing. The potential for false positive results should be considered when using this technology to evaluate culture-negative sepsis in the neonatal intensive care unit.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365704","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":"Epidemiology and Characteristics of Bacterial Meningitis of Children with Cerebrospinal Fluid Leakage or Cochlear Implant.","authors":"Corinne Levy, Etienne Bizot, Karen Milcent, André Birgy, Stéphane Béchet, Emmanuelle Varon, Robert Cohen","doi":"10.1093/jpids/piag015","DOIUrl":"10.1093/jpids/piag015","url":null,"abstract":"<p><strong>Background: </strong>Cerebrospinal fluid (CSF) leakage is a recognized risk factor for bacterial meningitis. Few data are published concerning bacterial meningitis in children with CSF leakage, and the impact of 13 valent pneumococcal conjugate vaccination (PCV13) in this population is not well known. The aim of this study was to describe the epidemiology of bacterial meningitis in children with known CSF leakage.</p><p><strong>Methods: </strong>Among all bacterial meningitis in children >3 months old, we analyzed those with known CSF leakage (meningeal breach and/or cochlear implant resulting in meningitis) in a nationwide prospective cohort between 2001 and 2024 in France, with 227 pediatric wards and 168 microbiology departments.</p><p><strong>Results: </strong>Of 5879 cases of bacterial meningitis in children over 3 months old, 251 (4.3%) were associated with known CSF leakage. In this population, Streptococcus pneumoniae (78.9%) was the most frequent bacteria involved, followed by Haemophilus influenzae (10%), mainly non typeable strains. Two cases of Neisseria meningitidis were recorded and only in children with cochlear implant. For children with known CSF leakage, in late PCV13 period, PCV13, PCV15, PCV20, PCV21, and 23-valent polysaccharide vaccine serotypes accounted for 14%, 16.3%, 37.2%, 79.1%, and 27.9%, respectively. In this population, serotype 23B was the most frequent (18.6%), followed by 11A (9.3%), 15A (9.3%), 19F (7%), 3 (4.7%), and 19A (2.3%).</p><p><strong>Conclusion: </strong>Bacterial meningitis in children with known CSF leakage is largely due to pneumococci and now mainly due to serotypes not included in PCV13. Only two cases of meningococcal meningitis were found and only for children with cochlear implant.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377921","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":"Where Did this Come From: Lumbar Puncture for All Infants with Suspected Tuberculosis Disease?","authors":"Collin Dubick, Marcos C Schechter, Frank Berkowitz, Andi L Shane","doi":"10.1093/jpids/piag013","DOIUrl":"10.1093/jpids/piag013","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325722","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":"Characteristics Associated With Positive Bacterial Blood Cultures in Pediatrics.","authors":"Pratik A Patel, Lydia Lu, Miguel A Locsin, Allyson Dalby, Preeti Jaggi","doi":"10.1093/jpids/piag016","DOIUrl":"10.1093/jpids/piag016","url":null,"abstract":"<p><strong>Background: </strong>Evaluation for bacterial bloodstream infections (BSIs) is commonly associated with prescribing empiric antibiotics while awaiting blood culture results. In an effort to identify opportunities for diagnostic and antibiotic stewardship, we examined clinical characteristics associated with positive cultures treated as BSI vs contaminant and BSI time-to-positivity (TTP).</p><p><strong>Methods: </strong>A retrospective review was conducted of all positive bacterial blood cultures collected from patients at a pediatric healthcare system between March 2021 and June 2022. Cultures were classified as BSIs or contaminants based on management by treating clinicians. Demographics, clinical characteristics, and culture data were analyzed to identify factors associated with BSIs vs contaminations and prolonged TTP (>24 hours).</p><p><strong>Results: </strong>Among 1068 positive cultures, 71% (n = 756) were treated as BSIs. The median age of patients with positive blood cultures was 3.7 years (IQR 0.5-12.4 years). Among those with BSI (n = 756), 734 (97.1%) had one of the following characteristics: age <90 days, fever or hypothermia, hypotension, a central line, or severe neutropenia. Most BSIs (93%) showed positivity within 36 hours, and prolonged TTP was most associated with peripheral draws, single positive cultures, and absence of fever (P < .01). Isolation of a priori defined high-likelihood pathogenic organisms was less likely to be associated with prolonged TTP (P < .01).</p><p><strong>Conclusions: </strong>We defined clinical characteristics associated with children who had clinically significant BSI. These data should be considered when developing guidance for which children warrant blood culture collection for BSI evaluation. The majority of BSIs are identified within 36 hours of collection.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377931","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":"VancObituary: A Summary of a Life Well Lived and a Death Well Timed.","authors":"Victoria J L Konold, Adam W Brothers, Matthew P Kronman, Daniel J Pak, Derry McDonald, Scott J Weissman","doi":"10.1093/jpids/piag030","DOIUrl":"10.1093/jpids/piag030","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618862","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}