Journal of the Pediatric Infectious Diseases Society最新文献

{"title":"Using Minimally Invasive Tissue Sampling and Determination of Cause of Death to Establish Etiologies of Community Respiratory Deaths Among Zambian Infants and Children.","authors":"Alyse Wheelock, Mwelwa Chasaya, Natasha Namuziya, Emilia Jumbe Marsden, Monica Kapasa, Chibamba Mumba, Bwalya Mulenga, Lisa Nkole, Rachel Pieciak, Victor Mudenda, Chilufya Chikoti, Benard Ngoma, Charles Chimoga, Sarah Chirwa, Lilian Pemba, Diana Nzara, James Lungu, Leah Forman, William MacLeod, Crispin Moyo, Somwe Wa Somwe, Christopher Gill","doi":"10.1093/jpids/piae129","DOIUrl":"10.1093/jpids/piae129","url":null,"abstract":"<p><p>In low-to-middle-income countries, acute lower respiratory infection (ALRI) remains the leading infectious cause of death among infants and children under 5 years old. Case-control studies based on upper respiratory sampling have informed current understandings of ALRI etiologies; in contrast, minimally invasive tissue sampling (MITS) offers a method of directly interrogating lower respiratory tract pathogens to establish etiologic distributions. This study performed in the postmortem setting used MITS and a Determination of Cause of Death (DeCoDe) panel to elucidate the causes of fatal pneumonia in the community in Lusaka, Zambia. For deceased infants and children under age 5 years whose next-of-kin provided consent, a verbal autopsy was obtained and 6 lung tissue biopsies from each case were sent for histopathology and multiplex polymerase chain reaction testing. Subsequently, a multi-disciplinary DeCoDe panel met to review each case, determine if the child died of respiratory causes, construct a causal chain of diagnoses directly leading to the death, and determine if the death was preventable (i.e., if an identifiable intervention would have averted the death). Among 106 deaths, 49 were adjudicated as respiratory deaths, with etiologic causes including Klebsiella pneumoniae (13), Streptococcus pneumoniae (5), and Pneumocystis jirovecii (4), among others. Of note, for 21 respiratory deaths, a causative pathogen could not be identified despite clinical and histopathologic evidence of ALRI. A large majority of all deaths were considered preventable (90/106 or 85%). This study demonstrates the impact of certain respiratory pathogens through direct in situ tissue sampling with supportive pathologic data and presents a useful method of studying the etiologic distribution of fatal ALRIs in settings where many deaths occur in the community.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950587","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":"Alternative Antibiotic Selections During the 2022 Amoxicillin Shortage in the United States.","authors":"Sriram Ramgopal, Marc Rosenman, Lu Zhang, Jillian M Cotter, Laura F Sartori, Matthew J Lipshaw, Ashley R Banks, Alan R Schroeder, George Lales, Kenneth A Alexander, Kenneth A Michelson, Todd A Florin","doi":"10.1093/jpids/piae122","DOIUrl":"10.1093/jpids/piae122","url":null,"abstract":"<p><p>This study of 7 pediatric hospitals identified that the amoxicillin shortage in 2022 resulted in a decline in amoxicillin suspension prescribing by 30.8% with increases in use of amoxicillin nonsuspension (+7.9) and broad-spectrum antibiotics. Strategic planning and standardized guidelines are essential to address future shortages and ensure effective, guideline-based care.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813647","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":"Neurovirulent Pathogens Across the Human Lifespan: A Balancing Act.","authors":"Lisa N Akhtar, Anita McElroy","doi":"10.1093/jpids/piae118","DOIUrl":"10.1093/jpids/piae118","url":null,"abstract":"","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950597","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 Clinical Influenza Disease by Type and Subtype 2015-2020: A Multicenter, Prospective Study.","authors":"Hanna M Grioni, Erin Sullivan, Bonnie Strelitz, Kirsten Lacombe, Eileen J Klein, Julie A Boom, Leila C Sahni, Marian G Michaels, John V Williams, Natasha B Halasa, Laura S Stewart, Mary A Staat, Elizabeth P Schlaudecker, Rangaraj Selvarangan, Christopher J Harrison, Jennifer E Schuster, Geoffrey A Weinberg, Peter G Szilagyi, Monica N Singer, Parvin H Azimi, Benjamin R Clopper, Heidi L Moline, Angela P Campbell, Samantha M Olson, Janet A Englund","doi":"10.1093/jpids/piae108","DOIUrl":"10.1093/jpids/piae108","url":null,"abstract":"<p><strong>Background: </strong>Previous investigations into clinical signs and symptoms associated with influenza types and subtypes have not definitively established differences in the clinical presentation or severity of influenza disease.</p><p><strong>Methods: </strong>The study population included children 0-17 years old enrolled at 8 New Vaccine Surveillance Network sites between 2015 and 2020 who tested positive for influenza virus by molecular testing. Demographic and clinical data were collected for study participants via parent/guardian interviews and medical chart reviews. Descriptive statistics were used to summarize demographic and clinical characteristics by influenza subtype. Multivariable logistic regression and Cox proportional hazard models were used to assess the effects of age, sex, influenza subtype, and history of asthma on severity, including hospital admission, need for supplemental oxygen, and length of stay.</p><p><strong>Results: </strong>Retractions, cyanosis, and the need for supplemental oxygen were more frequently observed among patients with influenza A(H1N1)pdm09. Headaches and sore throat were more commonly reported among patients with influenza B. Children with influenza A(H1N1)pdm09 and children with asthma had significantly increased odds of hospital admission (adjusted odds ratio [AOR]: 1.39, 95% confidence interval [CI]: 1.14-1.69; AOR: 2.14, 95% CI: 1.72-2.67, respectively). During admission, children with influenza A(H1N1)pdm09 had significantly increased use of supplemental oxygen compared to children with A(H3N2) (AOR: 0.60, 95% CI: 0.44-0.82) or B (AOR: 0.56, 95% CI: 0.41-0.76).</p><p><strong>Conclusions: </strong>Among children presenting to the emergency department and admitted to the hospital, influenza A(H1N1)pdm09 caused more severe disease compared to influenza A(H3N2) and influenza B. Asthma also contributed to severe influenza disease regardless of subtype.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468698","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":"Resurgence of Pediatric Mycoplasma pneumoniae Infections in Southeast Texas, November 2023-June 2024.","authors":"Margaret Taylor Danner, Heather Colvin Binns, Khanh Nguyen, Coreen Johnson, Jim Dunn, Denver Niles, Diana K Nguyen","doi":"10.1093/jpids/piae119","DOIUrl":"10.1093/jpids/piae119","url":null,"abstract":"<p><p>We conducted a retrospective review of children tested for Mycoplasma pneumoniae from January 1, 2020 to June 30, 2024. M. pneumoniae polymerase chain reaction positivity increased starting in November 2023, peaking at 18.3% in June 2024. During the resurgence, children with laboratory-confirmed infection often had severe respiratory disease or extrapulmonary manifestations.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824154","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":"Primary Adjunctive Corticosteroids in the Acute Management of High-Risk Kawasaki Disease in a North American Cohort.","authors":"Alan P Wang, Huthaifah Khan, Siyuan Dong, Kwang-Youn A Kim, Pei-Ni Jone, Simon Lee, Stanford Shulman, Nancy Innocentini, Tresa Zielinski, Anne H Rowley","doi":"10.1093/jpids/piae112","DOIUrl":"10.1093/jpids/piae112","url":null,"abstract":"<p><strong>Background: </strong>Primary adjunctive therapy with corticosteroids has been shown to reduce coronary artery (CA) abnormalities in high-risk Kawasaki disease (KD) patients in Japan (the randomized control trial to assess immunoglobulin plus steroid efficacy [RAISE] study). We evaluated their effect on outcomes in North American patients with high-risk KD.</p><p><strong>Methods: </strong>We performed a single-center retrospective review of high-risk KD patients between 2010 and 2023. From 2017 to 2023, adjunctive corticosteroids in a modified RAISE regimen (mRAISE) were given to high-risk patients as primary adjunctive therapy with intravenous gammaglobulin (IVIG) and aspirin. We compared CA outcomes in these patients and those presenting from 2010 to 2016, when mRAISE therapy was not administered.</p><p><strong>Results: </strong>A total of 221 high-risk KD patients were treated at our institution between 2010 and 2023. Among these, 83 received the mRAISE regimen and 138 did not (no corticosteroid, n = 82, corticosteroid in a non-mRAISE regimen, n = 56). There were no significant differences in CA outcomes in the mRAISE and non-mRAISE groups. Patients receiving the mRAISE regimen were significantly less likely to receive more than one dose of IVIG when compared to those who did not receive this regimen (11% vs 33%, p < .001).</p><p><strong>Conclusions: </strong>Use of adjunctive primary therapy with corticosteroids in a mRAISE regimen in high-risk KD patients resulted in significantly decreased IVIG retreatment.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":"626-632"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502891","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":"Decreasing the Use of Cefdinir for Pediatric Urinary Tract Infections in a Rural Health Care System: A Quasi-experimental Study.","authors":"Kelly Berglund, Philip Logan Whitfield, Rachel M Gabor, Thomas G Boyce","doi":"10.1093/jpids/piae114","DOIUrl":"10.1093/jpids/piae114","url":null,"abstract":"<p><p>There are several antimicrobial options for treating urinary tract infections in children. Although cefdinir is commonly used, better options exist. We developed an intervention bundle to reduce the use of cefdinir in favor of cephalexin. The intervention bundle decreased cefdinir use by 19.1% (73% relative decrease) while the use of cephalexin increased by 19.8%.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":"643-646"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591035","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":"Antimicrobial Resistance in Enterobacterales, Acinetobacter spp. and Pseudomonas aeruginosa Isolates From Bloodstream Infections in Australian Children, 2013-2021.","authors":"Anita Williams, Geoffrey W Coombs, Jan M Bell, Denise A Daley, Shakeel Mowlaboccus, Penelope A Bryant, Anita J Campbell, Louise Cooley, Jon Iredell, Adam D Irwin, Alison Kesson, Brendan McMullan, Morgyn S Warner, Phoebe C M Williams, Christopher C Blyth","doi":"10.1093/jpids/piae111","DOIUrl":"10.1093/jpids/piae111","url":null,"abstract":"<p><strong>Background: </strong>Gram-negative bloodstream infections are associated with significant morbidity and mortality in children. Increasing antimicrobial resistance (AMR) is reported globally, yet efforts to track pediatric AMR at a national level over time are lacking.</p><p><strong>Methods: </strong>The Australian Group on Antimicrobial Resistance (AGAR) surveillance program captures clinical and microbiological data of isolates detected in blood cultures across Australia. EUCAST 2022 was used for MIC interpretation and the AMR package in R for data analysis.</p><p><strong>Results: </strong>Over a 9-year period, there were 3145 bloodstream infections with 3266 gram-negative isolates reported in hospitalized children aged <18 years; 21.0% were from neonates. The median length of stay was 9 days, and 30-day all-cause mortality was 5.2%. A greater odds of death was observed in those with a multi-drug resistant organism (aOR: 2.1, 95% CI: 1.3, 3.3, p: 0.001). Escherichia coli (44.5%) and Klebsiella pneumoniae complex (12.6%) were the two most frequently reported organisms. Overall resistance in Enterobacterales to gentamicin/tobramycin was 11.6%, to ceftazidime/ceftriaxone was 12.9%, and 13.2% to ciprofloxacin. Resistance increased over time. Of the 201 Pseudomonas aeruginosa isolates reported, 19.7% were resistant to piperacillin-tazobactam, 13.1% resistant to cefepime/ceftazidime, and 9.8% to ciprofloxacin. Of 108 Acinetobacter spp. isolates, one was resistant to meropenem, and two were resistant to ciprofloxacin. Resistance did not increase over time.</p><p><strong>Conclusions: </strong>AMR in gram-negative organisms causing bloodstream infections in Australian children is increasing, which should be considered when updating guidelines and empiric treatment regimens. Ongoing pediatric-specific national surveillance with pediatric reporting must remain a priority to strengthen antimicrobial stewardship and infection control programs.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":"617-625"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502890","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":"Angiostrongylus cantonensis Meningoencephalitis in Three Pediatric Patients in Florida, USA.","authors":"Melinda D Chance, Anniesha D Noel, Amelia B Thompson, Natalie Marrero, Fernando Bula-Rudas, Christopher M Horvat, Jerril Green, Jennifer E Armstrong, Fatma Levent, Robert A Dudas, Serena Shaffren, Aaron Samide, Katie Martinez, Kimberly Stockdale, Rebecca J Chancey","doi":"10.1093/jpids/piae113","DOIUrl":"10.1093/jpids/piae113","url":null,"abstract":"<p><p>Eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis has been reported in several southern U.S. states and Hawai'i. We present the first locally acquired human cases of A. cantonensis meningoencephalitis in three children in Florida, occurring between June 2021 and January 2022. Clinicians should be attuned to this possible diagnosis in this region.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":"639-642"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622965","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":"Transition to Enteral Triazole Antifungal Therapy for Pediatric Invasive Candidiasis: Secondary Analysis of a Multicenter Cohort Study Conducted by the Pediatric Fungal Network.","authors":"Robert F T Bucayu, Craig L K Boge, Inci Yildirim, Martha Avilés-Robles, Surabhi B Vora, David M Berman, Tanvi S Sharma, Lillian Sung, Elio Castagnola, Debra L Palazzi, Lara Danziger-Isakov, Dwight E Yin, Emmanuel Roilides, Gabriela Maron, Alison C Tribble, Pere Soler-Palacin, Eduardo López-Medina, José Romero, Kiran Belani, Antonio C Arrieta, Fabianne Carlesse, Dawn Nolt, Natasha Halasa, Daniel Dulek, Sujatha Rajan, William J Muller, Monica I Ardura, Alice Pong, Blanca E Gonzalez, Christine M Salvatore, Anna R Huppler, Catherine Aftandilian, Mark J Abzug, Arunaloke Chakrabarti, Michael Green, Irja Lutsar, Elizabeth D Knackstedt, Sarah K Johnson, William J Steinbach, Brian T Fisher, Rachel L Wattier","doi":"10.1093/jpids/piae116","DOIUrl":"10.1093/jpids/piae116","url":null,"abstract":"<p><p>Of 319 children with invasive candidiasis, 67 (21%) transitioned from intravenous to enteral antifungal therapy. Eight (12%) transitioned back to intravenous antifungal therapy, one due to perceived treatment failure defined by clinical progression or worsening. Global treatment response at study completion was successful in 66 participants who transitioned to enteral therapy.</p>","PeriodicalId":17374,"journal":{"name":"Journal of the Pediatric Infectious Diseases Society","volume":" ","pages":"633-638"},"PeriodicalIF":2.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605231","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}