Journal of the Pediatric Infectious Diseases Society最新文献

{"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}

{"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}

{"title":"Assessing the Use of Neonatal Sepsis Guidelines and Antibiotic Prescription With Large-Scale Prospective Data From Zimbabwe and Malawi.","authors":"Nushrat Khan, Gwendoline Chimhini, Som Kumar Shrestha, Mario Cortina-Borja, Simbarashe Chimhuya, Gloria Zailani, Hannah Gannon, Marcia Mangiza, Felicity Fitzgerald, Michelle Heys, Msandeni Chiume","doi":"10.1093/jpids/piaf017","DOIUrl":"10.1093/jpids/piaf017","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis is a major cause of mortality in low-resource settings. We assessed how neonatal sepsis guidelines were used in 2 Zimbabwean hospitals and 1 Malawian hospital.</p><p><strong>Methods: </strong>Using routine data collected with the digital health intervention, Neotree, we retrospectively reviewed doctors' and nurses' agreement with national and World Health Organization (WHO) guideline recommendations for antibiotic prescription for sepsis. We compared clinical features and outcomes of neonates who should have received antibiotics as per guideline with those who actually received them and fitted a logistic regression model to identify features associated with prescription.</p><p><strong>Results: </strong>Data were collected between January 2021 and June 2022 from 10 868 neonates: 6045 admitted to Sally Mugabe Central Hospital (SMCH), 1094 to Chinhoyi Provincial Hospital (CPH) and 3729 to Kamuzu Central Hospital (KCH). Complete implementation of national guidelines would increase antibiotics at admission: from 2188 (38%) to 3745 (64%) at SMCH, 472 (44%) to 852 (79%) at CPH, and 1519 (41%) to 3043 (82%) at KCH. Clinical features of sepsis were frequently not acted on, but the case fatality rate was lower in those not prescribed antibiotics despite guideline recommendation. Application of WHO guidelines would increase antibiotic prescription to 91% at SMCH, 88% at CPH, and 77% in KCH. Maternal risk factors for sepsis, male gender, low birth weight, older age at admission, and spontaneous vaginal delivery were associated with higher rate of antibiotic prescription.</p><p><strong>Conclusions: </strong>Guideline-recommended clinical signs for sepsis are inconsistently used, with clinicians using other features for antibiotic decision-making. Work is needed to revise clinical diagnostic algorithms in low-resource settings to ensure they are useful, usable and contextually appropriate.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468382","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":"Healthcare-Associated Gastroenteritis: Outbreak Report and Systematic Review of the Literature.","authors":"Nathan L'Etoile, Morgan A Zalot, Salma Sadaf, Nicole Wittmeyer, Anna Davis, Jordan Mick, Ericka Hayes, Kathleen A Gibbs, Susan E Coffin","doi":"10.1093/jpids/piaf019","DOIUrl":"10.1093/jpids/piaf019","url":null,"abstract":"<p><p>Healthcare-associated gastroenteritis continues to be associated with significant pediatric morbidity and mortality despite the introduction of rotavirus vaccines. Infection prevention (IP) measures are critical in mitigating outbreaks. We describe an outbreak of norovirus and effective IP strategies utilized and calculated the costs associated with the outbreak. To demonstrate the burden of these events, we conducted a systematic review of pediatric healthcare-associated gastroenteritis outbreaks since 1973 to describe changing epidemiologic trends. Twenty-four publications describing 27 outbreaks were included in the final analysis with 293 healthcare-associated cases. Rotavirus (14) and norovirus (7) outbreaks were most commonly described. Limitations include the retrospective nature of included reports, nonuniform data ascertainment and reporting among publications. Norovirus has replaced rotavirus as the most common etiology of healthcare-associated gastroenteritis outbreaks in North America, Europe, and Australia and New Zealand, since the introduction of rotavirus vaccines.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557105","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}