Journal of the Pediatric Infectious Diseases Society最新文献

{"title":"A prospective evaluation of a three-gene host response signature to classify tuberculosis severity in children.","authors":"Brittney Sweetser, Esin Nkereuwem, Jascent Nakafeero, Marie Gomez, Peter Wambi, Moses Nsereko, Alfred Andama, Joel D Ernst, Adithya Cattamanchi, Beate Kampmann, Devan Jaganath, Eric Wobudeya","doi":"10.1093/jpids/piaf041","DOIUrl":"https://doi.org/10.1093/jpids/piaf041","url":null,"abstract":"<p><strong>Background: </strong>Children with non-severe TB may benefit from short-course treatment, but point-of-care tools are needed to stratify disease severity. We prospectively evaluated the Cepheid Xpert MTB-Host Response (HR) prototype cartridge for distinguishing TB severity in children with pulmonary TB (PTB) in The Gambia and Uganda.</p><p><strong>Methods: </strong>We included children <15 with microbiologically confirmed or clinically diagnosed unconfirmed PTB. Severity was defined using the World Health Organization (WHO) guidelines for a four-month, drug-susceptible regimen. Capillary or venous blood was tested with the HR cartridge for PCR-based detection of three mRNA genes and calculation of a TB score from cycle thresholds. We generated receiver operating characteristic curves with the TB score to classify severe TB and assessed if Xpert-HR could achieve the WHO target accuracy for treatment optimization (≥90% sensitivity, ≥70% specificity).</p><p><strong>Results: </strong>Among 106 children, the median age was 4 years (IQR 1-7), 56.6% were female, and 13.2% were living with HIV. In all children with PTB, Xpert-HR achieved an AUC of 0.67 (95% CI 0.55-0.78), with 89.3% sensitivity (95% CI 71.8-97.7) and 29.5% specificity (95% CI 19.7-40.9, cut-off≤-0.60). By confirmation status, Xpert-HR approached the target accuracy in children with Confirmed TB, with 62.5% specificity (95% CI 24.5-91.5) at 91.7% sensitivity (95% CI 61.5-99.8, cut-off≤-1.349). Among children with Unconfirmed TB, specificity was lower (24.3% 95% CI 14.8-36.0) at 93.8% sensitivity (95% CI 69.8-99.8, cut-off≤-0.450). Target accuracy was almost achieved in children 5-9 regardless of confirmation status (100% sensitivity [95% CI 71.5-100], 66.7% specificity [95% CI 43.0-85.4], cut-off≤-1.35), but specificity (28.2%, 95% CI 18.6-39.5) was lower for children <5 (92.9% sensitivity [95% CI 76.5-99.1], cut-off≤-0.550).</p><p><strong>Conclusions: </strong>Xpert-HR approached the target accuracy to stratify PTB severity in older children and those with Confirmed TB but had lower specificity in children with Unconfirmed TB. Child-specific signatures may be needed to improve performance in younger children with paucibacillary disease.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971119","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":"Readmission Following Respiratory Syncytial Virus Hospitalization among Children < 5 Years of Age.","authors":"Yoonyoung Choi, Evan Heller, Linda Amoafo, Yue Zhang, Kaleb Miller, Abbey Loveridge, Madelyn Ruggieri, Per Gesteland, Krow Ampofo","doi":"10.1093/jpids/piaf036","DOIUrl":"https://doi.org/10.1093/jpids/piaf036","url":null,"abstract":"<p><strong>Background: </strong>Hospitalization with lower respiratory infection (LRI) by Respiratory Syncytial Virus (RSV) and other respiratory viruses is common in young children. However, the likelihood of readmission following RSV LRI compared to other common respiratory viral infections is unknown.</p><p><strong>Methods: </strong>This prospective study included children <5 years and hospitalized with laboratory-confirmed RSV LRI at two hospitals in Salt Lake City, Utah, from October 31, 2019, to April 30, 2022. For comparison, we retrospectively identified children < 5 years, hospitalized during the same period with Influenza virus (IV) or human metapneumovirus (hMPV) LRI. Readmissions were tracked for 1.5 years post-discharge. We calculated the incidence proportion of readmissions and estimated hazard ratios using Cox proportional hazards model with Covariate Balancing Propensity Score.</p><p><strong>Results: </strong>Among children hospitalized with RSV, IV and hMPV LRI, all-cause hospital readmission was common, with 30-day readmission proportions ranging between 5% and 9% and increasing to between 19% and 30%, 1.5 years post-discharge. Respiratory-related readmission varied by virus, with RSV having higher proportions, increasing to 16.8% 1.5 years post-discharge, compared to 6-7% with IV and hMPV. After adjusting for confounders, RSV hospitalization was associated with an increased hazard of respiratory-related readmission within 1.5-years after hospitalization compared to IV (HR 3.62, 95% CI 1.13-11.64) or hMPV (HR 3.56, 95% CI 1.14-11.06).</p><p><strong>Conclusion: </strong>Respiratory-related readmission proportion was higher and progressive over time among children <5 years with an index RSV admission compared to IV and hMPV. This underscores the critical need for prevention of RSV infection in infants and young children through RSV immunization strategies.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008738","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":"Risk of Highly Pathogenic Avian Influenza A/H5N1 Virus in Pediatrics.","authors":"C Mary Healy","doi":"10.1093/jpids/piaf035","DOIUrl":"https://doi.org/10.1093/jpids/piaf035","url":null,"abstract":"<p><p>Highly Pathogenic Avian Influenza A/H5N1 Virus has been found in multiple US states since 2024. While human infection risk is currently low, children are a high-risk group for severe infection as the virus evolves. Preventive efforts should prioritize children in vaccine and therapeutic clinical trials and vaccine implementation strategies.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999378","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":"Pharmacokinetics and Safety of Ceftazidime-Avibactam in Neonates and Young Infants: a Phase 2a, Multicenter Prospective Trial.","authors":"John Bradley, Emmanuel Roilides, Margaret Tawadrous, Jean Li Yan, Elena Soto, Gregory G Stone, Shweta Kamat, Paurus Irani, Richard England","doi":"10.1093/jpids/piaf028","DOIUrl":"https://doi.org/10.1093/jpids/piaf028","url":null,"abstract":"<p><strong>Background: </strong>This phase 2a study evaluated pharmacokinetics and safety of ceftazidime-avibactam (CAZ/AVI; combination dosed as fixed 4:1 ratio) in neonates and young infants with suspected/confirmed infections due to Gram-negative pathogens requiring intravenous antibiotics.</p><p><strong>Methods: </strong>Hospitalized neonates and infants (gestational age ≥26 weeks to <3 months), enrolled sequentially into three age cohorts, received CAZ/AVI single dose (Part A) or multiple dose every 8 hours (Part B) by 2-hour intravenous infusions. Infants >28 days (Cohort 1) received CAZ/AVI 37.5 mg/kg/dose (CAZ 30 mg/kg and AVI 7.5 mg/kg). Full-term neonates ≤28 days (Cohort 2) and preterm neonates ≤28 days (Cohort 3) received 25 mg/kg/dose (CAZ 20 mg/kg and AVI 5 mg/kg). Pharmacokinetics, safety, and clinical and microbiological outcomes (Part B only) were assessed descriptively.</p><p><strong>Results: </strong>Forty-six patients received CAZ/AVI, 25 in Part A and 21 in Part B. Sepsis (39.1%) and urinary tract infection (15.2%) were the predominant diagnoses. Observed drug plasma-concentration time profiles were generally similar across cohorts. Overall, 23 patients (50%) had ≥1 adverse event (AE), 8 patients (17.4%) had ≥1 serious AE (SAE), and 2 patients (4.3%) died; no SAE or death was treatment related. In Part B, ≥80% patients had favorable clinical and microbiological responses.</p><p><strong>Conclusions: </strong>Plasma exposures after single and multiple CAZ/AVI doses in neonates and young infants <3 months old (37.5 [30/7.5] mg/kg/dose for >28 days; 25 [20/5] mg/kg/dose for ≤28 days) were similar to approved doses for older children. The safety profile of CAZ/AVI was as expected based on previous observations.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979148","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":"Survey response rates: Reassessing expectations.","authors":"Marie E Heffernan, Michelle L Macy","doi":"10.1093/jpids/piaf031","DOIUrl":"https://doi.org/10.1093/jpids/piaf031","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989291","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":"Scientific Integrity Under Threat: The Role of the IDSA, PIDS, and SHEA Journals in an Evolving Political Landscape.","authors":"","doi":"10.1093/jpids/piaf039","DOIUrl":"https://doi.org/10.1093/jpids/piaf039","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032810","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":"Macaque Models of Prenatal and Postnatal Zika Virus Exposure and Developmental Outcomes.","authors":"Jake Gutkes, Nicholas P Krabbe, Karla Ausderau, Emma L Mohr","doi":"10.1093/jpids/piaf024","DOIUrl":"10.1093/jpids/piaf024","url":null,"abstract":"<p><p>Prenatal and postnatal Zika virus (ZIKV) exposure can result in a constellation of developmental deficits in human infants that present during early childhood. Translational rhesus macaque models have been developed to interrogate these deficits. Here, we summarize and interpret the developmental findings from rhesus macaque studies of prenatal or postnatal ZIKV exposure. We looked for potential biomarkers that could be used to identify infants at risk for developmental deficits. Visual orientation and motor deficits were the most common developmental deficits across the studies. We identified a potential association between prolonged maternal RNAemia and worse infant developmental outcomes in prenatal exposure studies. Therefore, longitudinal screening of maternal blood for ZIKV RNA may help identify human infants at risk for visual orientation and motor deficits in early childhood; however, the diversity of research protocols across the groups made it challenging to make definitive associations.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586132","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":"Contact Precautions for Preventing Methicillin-Resistant Staphylococcus Aureus in Pediatric Healthcare Settings: Pros, Cons, and Future Actions.","authors":"Stephanie Mayoryk, Xiaoyan Song","doi":"10.1093/jpids/piaf023","DOIUrl":"10.1093/jpids/piaf023","url":null,"abstract":"<p><p>Although contact precautions (CP) have proven effective in protecting patients and healthcare providers and preventing the transmission of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities, pediatric patients under CP may experience unintended effects, including psychosocial stress and limited access to developmentally appropriate activities. Modifying or discontinuing the routine use of CP based on risk assessment results may enhance their overall benefits. Facilities that opt to modify or cease the routine use of CP should base their decisions on (1) compliance with the local regulations related to MRSA; (2) institutional compliance with CP for patients with MRSA infection and/or colonization, and (3) assessment of local MRSA data. Irrespective of any changes, all pediatric facilities should conduct ongoing assessments of MRSA-specific risks and monitor compliance with infection control practices. The results of these activities should guide the optimal use of CP to prevent MRSA infections among hospitalized pediatric patients.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557104","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":"The Epidemiology and Burden of Human Parainfluenza Virus Hospitalizations in US Children.","authors":"Geoffrey A Weinberg, Annabelle M de St Maurice, Yasmeen Z Qwaider, Tess Stopczynski, Justin Z Amarin, Laura S Stewart, John V Williams, Marian G Michaels, Leila C Sahni, Julie A Boom, Andrew J Spieker, Eileen J Klein, Janet A Englund, Mary A Staat, Elizabeth P Schlaudecker, Rangaraj Selvarangan, Jennifer E Schuster, Christopher J Harrison, Gordana Derado, Ariana P Toepfer, Heidi L Moline, Natasha B Halasa, Peter G Szilagyi","doi":"10.1093/jpids/piaf026","DOIUrl":"10.1093/jpids/piaf026","url":null,"abstract":"<p><strong>Background: </strong>Human parainfluenza viruses (PIV) are a major cause of acute respiratory infection (ARI) leading to hospitalization in young children. In order to quantify the burden of PIV hospitalizations and to evaluate the characteristics of children hospitalized with PIV by virus type, we used data from the New Vaccine Surveillance Network, a multicenter, active, prospective population-based surveillance network, enrolling children hospitalized for ARI (defined as fever and/or respiratory symptoms) at 7 U.S. children's hospitals.</p><p><strong>Methods: </strong>The study period included December 1, 2016 through March 31, 2020. Data captured included demographic characteristics, clinical presentation, underlying medical conditions, discharge diagnoses, and virus detection by RT-PCR. Linear and logistic regression were used to compare descriptive and clinical characteristics among children. Population-based PIV-associated hospitalization rates were calculated by age group and PIV-type.</p><p><strong>Results: </strong>Of the 16,971 enrolled children with PIV virologic testing, 10,488 had only one respiratory virus detected, among whom 702 (7%) had positive testing for PIV without a co-detected virus (mean age [SD], 2.2 [3.2] years). Of these 702 children, 340 (48%) had underlying comorbidities, 139 (20%) had a history of prematurity, 121 (17%) were admitted to the ICU, and 23 (3%) required intubation. Overall, PIV hospitalization rates were highest in children aged 0-5 months, 1.91 hospitalizations per 1,000 children per year [95% CI, 1.61-2.23]; PIV-3 contributed to the highest rates in that age group, followed by PIV-1 and PIV-4: 1.08 [0.84-1.21], 0.42 [0.28-0.58] and 0.25 [0.15-0.37] per 1,000 children per year, respectively. Seasonal distribution of PIV-associated hospitalizations varied by type.</p><p><strong>Conclusions: </strong>PIV infection was associated with a substantial number of ARI hospitalizations in children aged 0-5 months. Results suggest that future PIV prevention strategies in the US that focus on younger children and protection against PIV-3, PIV-1, and PIV-4 might have the greatest impact on reducing PIV hospitalization burden.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692669","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":"Effects of Cytomegalovirus-Induced Neuroinflammation on Central Nervous System Development.","authors":"Veronica Sanchez, Matthew D Smith, Scott H James","doi":"10.1093/jpids/piaf021","DOIUrl":"https://doi.org/10.1093/jpids/piaf021","url":null,"abstract":"<p><p>Congenital cytomegalovirus (cCMV) infection is associated with long-term central nervous system sequelae, including sensorineural hearing loss and neurodevelopmental delay, but mechanisms of neuropathogenesis in the developing fetal brain are incompletely understood. Animal models biologically representative of congenital infection have been used to characterize the effects of cCMV on neurogenesis, brain development, and cochlear development. Murine models utilizing host transcriptional analyses have been helpful in understanding the inflammatory response to cCMV infection and have demonstrated a correlation between elevation of proinflammatory mediators and altered brain and cochlear morphology during development. In this article, we review mechanisms of neuropathogenesis in cCMV animal models, with particular focus on the role of CMV-induced neuroinflammation in the impairment of fetal brain development.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016736","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}