Journal of the Pediatric Infectious Diseases Society最新文献

{"title":"Molecular analysis of AmpC-producing Escherichia coli isolated from pediatric patients.","authors":"Eiki Ogawa, Masahiro Suzuki, Aki Sakurai, Yohei Doi","doi":"10.1093/jpids/piaf008","DOIUrl":"10.1093/jpids/piaf008","url":null,"abstract":"<p><strong>Background: </strong>AmpC-mediated cephalosporin resistance occurs in 1.0% to 3.3% of Escherichia coli isolates due to the production of either plasmid-mediated AmpC (p-AmpC) or chromosomal AmpC (c-AmpC). Data on the prevalence and molecular characteristics of AmpC-producing E. coli in pediatric patients are limited.</p><p><strong>Methods: </strong>We analyzed E. coli clinical strains with resistance phenotype consistent with AmpC production isolated from patients at a pediatric hospital in Japan between 2015 and 2022. Sequence types, resistance genes, and relevant mutations were identified through whole genome sequencing. Promoter and attenuator regions of the chromosomal ampC gene were examined, and the presence of plasmid-mediated ampC genes was determined.</p><p><strong>Results: </strong>Among 2081 E. coli strains, 80 (3.8%) from 27 patients demonstrated the AmpC phenotype. The median patient age was 55 months, with 92.6% having underlying diseases, mainly renal and urinary tract abnormalities. Of the 27 strains, p-AmpC was found in 9 strains including 6 strains belonging to ST131, while c-AmpC was identified in 18 strains including 9 ST73 strains and 4 ST12 strains.ST131 and ST73 were the major AmpC-E. coli lineages isolated from children with underlying diseases.</p><p><strong>Conclusions: </strong>Most ST131 strains harbored p-ampC, while all ST73 strains acquired cephalosporin resistance by c-AmpC production through promoter and attenuator mutations, suggesting the presence of both AmpC mechanisms in a lineage-specific manner in E. coli identified among hospitalized children.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189267","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":"Receipt of Fluoroquinolone Prophylaxis is not Associated With Development of Vancomycin-Resistant Enterococcus Colonization During Pediatric Hematopoietic Cell Transplantation.","authors":"Catherine R Murphy, Chunyan Liu, Joshua Courter, Cameron Griffin, Felicia Scaggs Huang, Hilary Miller-Handley, Michael S Grimley, Lara Danziger-Isakov, William R Otto","doi":"10.1093/jpids/piaf010","DOIUrl":"10.1093/jpids/piaf010","url":null,"abstract":"<p><p>Fluoroquinolones are used to prevent bloodstream infections in pediatric hematopoietic cell transplant (HCT) recipients. We performed a retrospective cohort study in 799 pediatric HCT patients to evaluate the association between fluoroquinolone prophylaxis and VRE colonization. Propensity score analyses were performed. Fluoroquinolone prophylaxis was not associated with VRE colonization.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189271","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 Pneumococcal Conjugate Vaccines on Otitis Media among American Indian/Alaska Native Children in the Southwest United States.","authors":"Victoria M Sergent, Catherine G Sutcliffe, Del Yazzie, George Brasinikas, Laura B Brown, Loretta Christensen, Demetria Clichee, Shawnell Damon, Sheri L Dixon, Lindsay R Grant, Marcella Harker-Jones, James B McAuley, Pierrette Montanez, Dennie Parker Riley, Alisa Reasonover, Amy Rice, Eugene Romancito, Charis Salabye, Brenna Simons-Petrusa, Valerie L Tenequer, Polly Thompson, Minnie Tsingine, Carol Tso, Robert C Weatherholtz, Laura L Hammitt","doi":"10.1093/jpids/piaf013","DOIUrl":"10.1093/jpids/piaf013","url":null,"abstract":"<p><p>We assessed the impact of pneumococcal conjugate vaccines on pneumococcal otitis media (OM) among children living in Navajo and White Mountain Apache Tribal lands. During the PCV7 era (2000-2009), the proportion of vaccine-type OM declined. However, vaccine-type OM (predominantly 3, 19A, and 19F) persisted in the PCV13 era (2010-2019).</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433053","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":"Utility and Safety of Bronchoalveolar Lavage for Diagnosis and Management of Respiratory Illnesses in Immunocompromised Children.","authors":"Afreen Abraham, Amanda Green, Jose Ferrolino, Tim Flerlage, Ashleigh Gowen, Kim J Allison, Ali Y Suliman, Nickhill Bhakta, Jennifer McArthur, Saumini Srinivasan, Randall T Hayden, Diego R Hijano","doi":"10.1093/jpids/piaf015","DOIUrl":"10.1093/jpids/piaf015","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory illnesses (ARIs) in immunocompromised children have diverse causes, which can obscure accurate diagnosis and lead to unnecessary antimicrobial use. The risk-benefit ratio of bronchoalveolar lavage (BAL) in these patients is debated. This study aimed to evaluate the safety, yield, and utility of BAL in managing ARIs in immunocompromised children.</p><p><strong>Methods: </strong>This retrospective review examined BALs performed on immunocompromised children with ARI at St. Jude Children's Research Hospital between 2016 and 2021. Microbiological and molecular test results were reviewed from BAL, respiratory tract, and blood within 7 days of the BAL. The final ARI diagnosis was determined by the primary team, changes in antimicrobial management and adverse events were assessed.</p><p><strong>Results: </strong>BAL identified a potential pathogen in 84/137 (61.3%) of ARI episodes. BAL results contributed to changes in antimicrobial management in 120 (87.6%) cases and contributed to the ARI diagnosis in 106 (77.3%) cases. In 81 (59.1%) cases, ARI diagnosis was established solely from BAL results (infectious [33.3%], noninfectious [63%], multifactorial [3.7%]). BAL results usually agreed with the ARI diagnosis, but 31/137 (22.6%) were not concordant. Post-BAL, only 5 (3.6%) had increased supplemental oxygen > 24 hours, and 3 (3.4%) required new, persistent intubation. Consolidative or nodular pulmonary lesions and post-hematopoietic cell transplant had the highest BAL yields, with no significant differences based on the diffuseness of lesions.</p><p><strong>Conclusions: </strong>BAL is a safe, high-yield diagnostic procedure in immunocompromised children, with results leading to changes in clinical management of ARI. Prospective studies are needed to generate BAL guidelines for ARI in this population.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 3","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700737","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":"Retrospective Investigation of Pediatric Histoplasmosis Diagnosed at a Tertiary Children's Hospital in an Endemic Area Over 11 Years.","authors":"Lina Al-Tahhan, Christopher J Harrison, Brian R Lee, Rana E El Feghaly","doi":"10.1093/jpids/piaf007","DOIUrl":"10.1093/jpids/piaf007","url":null,"abstract":"<p><strong>Background: </strong>Most histoplasmosis data are from adults. We describe pediatric histoplasmosis diagnosed at a tertiary pediatric care center in an endemic area.</p><p><strong>Methods: </strong>We performed a retrospective chart review of patients birth-18 years seen in our institution (January 1, 2010 to August 15, 2022) with histoplasmosis identified by International Classification of Disease codes. We performed descriptive and univariate analyses of demographic, historical, clinical, laboratory, and treatment data.</p><p><strong>Results: </strong>Of 122 patients, 26 had disseminated histoplasmosis (DH), 71 pulmonary/thoracic (P/T) disease, 21 had histoplasmosis as an incidental finding, and 4 were classified as other. Median age was 14 years (range 0.3-18.7 years); most were non-Hispanic White (70.5%) and city dwellers (77.1%). We noted neither seasonality nor disease category differences for age, race and ethnicity, residence, or environmental factors. Compared to P/T, DH more frequently had complex chronic conditions (73.1% vs 12.7%, P < .001), fever (88.5% vs 52.1%, P < .001), fatigue (76.9% vs 46.5%, P = .01), vomiting (53.8% vs 25.3%, P = .01), anemia (hemoglobin median 10.05 vs 12.5 g/dL, P < .001), elevated sedimentation rate values (median 31 vs 29 mm/h, P = .02), blood and urine Histoplasma antigen detection (63.6/84.6% vs 20.0/14.8%, P < .001), and antifungal treatment (100% vs 70.4%, P < .001). Patients with DH had longer antifungal treatment courses (399 vs 84 days, P < .001). Exposures were rarely recorded, but the most common was chickens. Chest radiographs were less likely to show adenopathy in DH compared to P/T (8.7% vs 55%, P < .001).</p><p><strong>Conclusions: </strong>Presentations, risk factors, diagnostics use/results, and therapy for pediatric histoplasmosis most often parallel those in adults.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408957","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":"Utility of Bronchoalveolar Lavage in Immunocompromised Children: Is the Bronch Result in the Eye of the Beholder or Is It a Wash?","authors":"Joshua Wolf, Monica I Ardura","doi":"10.1093/jpids/piaf018","DOIUrl":"https://doi.org/10.1093/jpids/piaf018","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 3","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700740","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":"Breaks in the Cascade of Care: Evidence to Shift From Facility-Based Screening of Household Contacts of People With Tuberculosis in Rural Tanzania.","authors":"Ghassan Ilaiwy, Scott K Heysell, Saning'o Lukumay, Domitila Agustino, Paulo Mejan, Kusulla Simeon, Estomih Mduma, Tania A Thomas","doi":"10.1093/jpids/piaf016","DOIUrl":"10.1093/jpids/piaf016","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458391","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":"Mixing of Tecovirimat in Water to Support Oral Dosing of Infants and Children With Mpox.","authors":"Zixuan Wei, Kristina M Brooks, Sharon Nachman, Grace Aldrovandi, Timothy Wilkin, William Fischer, Jennifer J Kiser, Jason Zucker","doi":"10.1093/jpids/piaf014","DOIUrl":"10.1093/jpids/piaf014","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425729","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":"Neurological Disorders and Use of Healthcare Services After Enteroviral Meningitis in Childhood: A Nationwide, Population-Based Cohort Study.","authors":"Emma E Graham, Malte M Tetens, Jacob Bodilsen, Nanna S Andersen, Ram Dessau, Svend Ellermann-Eriksen, Kristina Franck, Sofie Midgley, Jens Kjølseth Møller, Alex Christian Nielsen, Lene Nielsen, Kirstine K Søgaard, Christian Østergaard, Anne-Mette Lebech, Ulrikka Nygaard, Lars H Omland, Niels Obel","doi":"10.1093/jpids/piae125","DOIUrl":"10.1093/jpids/piae125","url":null,"abstract":"<p><strong>Background: </strong>Nervous system infections are associated with long-term risks of neurological disorders and healthcare service utilization, but little data exist on the long-term risks of enteroviral meningitis in childhood.</p><p><strong>Methods: </strong>We performed a population-based, nationwide registry-based matched cohort study (1997-2021). We included 925 children with enteroviral meningitis aged <17 years, a comparison cohort, and a cohort of siblings of all individuals. To illustrate short- and long-term risks of neurological disorders, we calculated 1-year cumulative incidences and age- and sex-adjusted hazard ratios (aHRs) with 95% confidence intervals (95% CIs) during years 1-20 of follow-up. We further calculated the annual proportion of individuals using antiepileptic medication and healthcare services.</p><p><strong>Results: </strong>Young infants (0 to <90 days) and older children (≥90 days to <17 years) had slightly increased short- and long-term risks of neurological disorders after enteroviral meningitis compared to comparison cohort members (1-year cumulative incidence: 1.4% vs 0.6%, and 1.5% vs 0.4%, 1-20-year adjusted hazard ratio: 2.0 [95% CI: 1.2-3.2] and 1.7 [95% CI: 1.0-2.8]). Older children had increased use of antiepileptic medication, as well as the use of health care services both before and after enteroviral meningitis, with a similar trend among their siblings.</p><p><strong>Conclusions: </strong>Enteroviral meningitis in childhood appears to be associated with increased risk of short- and long-term neurological morbidity, though our estimates in older children may be confounded by prior neurological morbidity or increased healthcare-seeking behavior. Our findings suggest a generally good prognosis after enteroviral meningitis, though clinicians should be aware of the risk of neurological disorders in selected patients.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":"14 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391150","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":"Walking (Pneumonia) Down Memory Lane: Mycoplasma pneumoniae Returns.","authors":"Rebecca G Same, Jeffrey S Gerber","doi":"10.1093/jpids/piaf006","DOIUrl":"10.1093/jpids/piaf006","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047178","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}