Journal of the Pediatric Infectious Diseases Society最新文献

{"title":"Survey response rates: Reassessing expectations.","authors":"Marie E Heffernan, Michelle L Macy","doi":"10.1093/jpids/piaf031","DOIUrl":"10.1093/jpids/piaf031","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","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":"Pharmacokinetics and Safety of Single-Dose Sotrovimab in High-Risk Children and Adolescents With Mild-to-Moderate COVID-19.","authors":"Jennifer Moore, Daren Austin, Alicia Aylott, Jerzy Daniluk, Leah A Gaffney, Marjan Hezareh, Ahmed Nader, Nadia Noormohamed, Charlene Parado, Amanda Peppercorn, Yessica Sachdeva, Scott Segal, Klaudia Steplewski, Phillip J Yates, Jill Walker, Andrew Skingsley","doi":"10.1093/jpids/piaf027","DOIUrl":"10.1093/jpids/piaf027","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729955","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":"Cytomegalovirus Saliva Shedding Kinetics in Children with Congenital CMV Infection.","authors":"Swetha Pinninti, Sunil Pati, Zdenek Novak, Karen Fowler, Suresh Boppana, Shannon Ross","doi":"10.1093/jpids/piaf040","DOIUrl":"10.1093/jpids/piaf040","url":null,"abstract":"<p><strong>Background: </strong>Congenital CMV (cCMV) is a common congenital viral infection worldwide and the most common cause of childhood non-genetic sensorineural hearing loss (SNHL). The kinetics of CMV detection (shedding) from mucosal surfaces have not been extensively described in children with cCMV due to a lack of systematic newborn CMV screening and follow-up protocols. The aim of this study is to describe the natural history of saliva CMV shedding in a cCMV cohort, which was identified through universal newborn screening.</p><p><strong>Methods: </strong>As part of the CMV and Hearing Multicenter Screening study (CHIMES), 100 332 newborns were screened, and those confirmed to have cCMV were followed prospectively every six months for four years to determine hearing outcomes. Saliva CMV DNA shedding kinetics, including duration, viral load (VL), and intermittent shedding are described and compared between groups with and without newborn symptoms and hearing loss in children with ≥5 visits.</p><p><strong>Results: </strong>The 197 children with confirmed cCMV shed CMV DNA in saliva for a median of 20 months with CMV shedding frequency decreasing from 100% at cCMV confirmation to 9.5% four years after enrollment. Similarly, median CMV DNA VL levels decreased from 8.89 × 106 IU/mL at the confirmation visit to 1.64 × 103 IU/mL at the 4-year follow-up visit. Saliva CMV shedding duration was similar between children with or without newborn symptoms (median 20 months for both groups; P = .57) or between those with SNHL vs normal hearing (P = .8). A third of the cohort intermittently shed CMV DNA in saliva (64/197, 32.5%).</p><p><strong>Conclusions: </strong>In this large cohort of children with cCMV identified by universal CMV newborn screening, CMV DNA was detectable in saliva for a median of 20 months, irrespective of newborn symptoms or hearing outcomes. Intermittent shedding was noted in a third of the cohort.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978885","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":"Population Pharmacokinetic Analysis and Pharmacodynamic Evaluation of Sulbactam in Pediatric Patients: Dosing Suggestions for Acinetobacter baumannii Infections.","authors":"Tetsushu Onita, Yui Sano, Kazuro Ikawa, Noriyuki Ishihara, Hiroki Tamaki, Takahisa Yano","doi":"10.1093/jpids/piaf043","DOIUrl":"10.1093/jpids/piaf043","url":null,"abstract":"<p><strong>Background: </strong>This study aims to develop a population pharmacokinetic (PK) model of sulbactam in pediatric patients using pooled data analysis, and to optimize dosing regimens against Acinetobacter baumannii infections.</p><p><strong>Methods: </strong>Publications were systematically identified with MEDLINE for collecting sulbactam PK data in pediatric patients. Sulbactam PK model was developed using plasma concentration-time data gained from identified literature works. Based on the model, we estimated the probability of attaining the pharmacodynamic (PD) target against A. baumannii.</p><p><strong>Results: </strong>The data were adequately described by 2-compartment model. Age was a statistically significant covariate in clearance. Aiming for the PD target of 60% of time above minimum inhibitory concentration in free drug concentrations (fT > MIC), the breakpoint MICs were increased by extending infusion time from 0.5 to 4 hours. The breakpoint MICs for 4-hour infusion regimens of 25 mg/kg 4 times daily (100 mg/kg/day) achieved 4 μg/mL in infants (4 weeks to 11 months), children (1-6 years old) and pediatrics (7-16 years old). The breakpoint values for 4-hour infusions of 50 mg/kg 4 times daily (200 mg/kg/day) achieved 8 μg/mL (intermediate range of Clinical and Laboratory Standards Institute criteria) in all age groups.</p><p><strong>Conclusions: </strong>This population PK analysis and PD evaluation suggest that higher dosing regimen, especially with extended infusion time, should be reasonable for treating A. baumannii infections in pediatric patients.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111299","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":"Survey of Pediatric Infectious Diseases Providers on Healthcare Sustainability and Climate Change.","authors":"Shreya M Doshi, Allyson Dalby, Preeti Jaggi","doi":"10.1093/jpids/piaf038","DOIUrl":"https://doi.org/10.1093/jpids/piaf038","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 5","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159886","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 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":"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 3 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, cutoff ≤ -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, cutoff ≤ -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], cutoff ≤ -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, cutoff ≤ -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":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117649/pdf/","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":"OA","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":"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":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123188/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric and Adolescent Hepatitis C Care Cascade and Real-World Treatment Outcomes Utilizing an Integrated Health System Specialty Pharmacy Model.","authors":"Alicia B Carver, Cori Edmonds, Kristen Whelchel, Ryan Moore, Leena Choi, Lynette A Gillis","doi":"10.1093/jpids/piaf042","DOIUrl":"10.1093/jpids/piaf042","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the Cascade of Care (CoC) and real-world efficacy of direct-acting antivirals (DAAs) for hepatitis C treatment in pediatric and adolescent patients utilizing an integrated health system specialty pharmacy (HSSP) to assist with medication selection, insurance approval, swallowing practice, initiation, and monitoring.</p><p><strong>Methods: </strong>This single-center, retrospective, observational cohort study included chronic hepatitis C patients <18 years old evaluated by pediatric hepatologists at an academic health system between January 1, 2017 and September 30, 2022. The primary endpoint was sustained virologic response (SVR) ≥12 weeks following treatment completion in patients initiating DAAs. Secondary endpoints were CoC advancement, variables impacting DAA initiation, patient-reported side effects, and adherence. An ordinal logistic regression model assessed whether initiation time was associated with a patient's ability to swallow, prior authorization outcome, and medication availability to HSSP at referral. The odds ratio reflects the likelihood of a shift in time to initiation for a given group relative to its respective reference group.</p><p><strong>Results: </strong>Of 98 patients evaluated by a hepatologist, 73 (75%) were referred to the HSSP. Loss to follow-up was the primary reason (88%; 22/25) for nonreferral, most commonly (73%; 16/22) in those aged ≤5 years. Following HSSP referral, 88% (64/73) initiated DAA and 92% (59/64) of those achieved SVR. Time from HSSP referral to medication initiation was impacted by DAA availability (OR = 41.47; 95% CI, 9.51-180.87; P <.001) and inability to swallow the dosage form at evaluation (OR = 3.94; 95% CI, 1.56-9.98; P =.004). Over half (53%; 34/64) of patients initiating DAA reported ≥1 adverse event; none discontinued treatment. Most (69%; 44/64) reported no missed doses.</p><p><strong>Conclusions: </strong>The largest CoC drop-off occurred following initial clinic evaluation, primarily in children aged ≤5 years. Enhanced linkage to care efforts is needed in these patients. Conversely, nearly all patients referred to the HSSP were initiated on DAA, completed therapy, and achieved SVR.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013378","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":"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":"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}