Pediatric Infectious Disease Journal最新文献

{"title":"Chikungunya: Unpronounceable, But Important.","authors":"Stanley A Plotkin","doi":"10.1097/INF.0000000000005273","DOIUrl":"10.1097/INF.0000000000005273","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"971-972"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841321","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 Respiratory Syncytial Virus Subtype and Viral Load on the Clinical Course and Disease Severity of Acute Respiratory Tract Infection in Hospitalized Children.","authors":"Julia Gsenger, Britta Manuel, Clara Marie Ihling, Paul Schnitzler, Julia Tabatabai","doi":"10.1097/INF.0000000000005268","DOIUrl":"10.1097/INF.0000000000005268","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a leading cause of hospitalization in children. The impact of viral factors like RSV subtype and viral load (VL) on disease severity remains unclear.</p><p><strong>Methods: </strong>We screened 1171 hospitalized children ≤3 years of age with respiratory symptoms in winter seasons (2017-2020) for RSV infection by Reverse Transcription Polymerase Chain reaction. Disease severity was assessed using length of hospital stay and a previously validated disease severity score (RSV-CLASS, range 0-4, higher scores indicating more severe disease). Univariate/multivariate analyses were performed to identify predictors of VL.</p><p><strong>Results: </strong>In total, n = 351/1171 children were tested RSV positive (RSV A: n = 146/351 [41.6%], RSV B: n = 205/351 [58.4%]) with a median VL of 4.7 × 10 8 (interquartile range [IQR] 5.6 × 10 7 to 1.3 × 10 9 ). The median age was 3.5 months (IQR 1.5-11.0), and most children were <6 months (n = 223/351 [63.5%]). Bronchiolitis was the leading admission diagnosis, and children were hospitalized for a median duration of 3 days (IQR 2-5), and the median RSV-CLASS disease severity score value was 2 (IQR 1-3). Higher clinical severity scores were observed in children with lower respiratory tract infections ( P < 0.01) and were associated with longer hospital stay (ρ = 0.14, 95% confidence interval [CI]: 0.04-0.25). Clinical symptoms did not differ between RSV subtypes. However, younger age, shorter symptom duration, lower weight and reduced blood leukocyte count were associated with higher VL. In multivariate linear regression analysis adjusted for age and sex, weight and leukocyte count remained significant.</p><p><strong>Conclusions: </strong>This study highlights that RSV subtype and VL are not associated with disease severity in hospitalized children.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"947-956"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841428","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 Wild West: A Case of Bubonic Plague.","authors":"Grace E Thompson, Elizabeth J McFarland, Michael L Wittkamp, Patrick J Cripe, Molly A Slate, Jaimee M Hall","doi":"10.1097/INF.0000000000005279","DOIUrl":"10.1097/INF.0000000000005279","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e480-e481"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988494","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":"Effectiveness and Safety of Contemporary Drug Regimens for Multidrug- and Extensively Drug-resistant Tuberculosis in Children and Adolescents: A Global Systematic Review and Meta-analysis.","authors":"Wamaka Kaminyoge, Reuben Simfukwe, Mwiza Singini, Norman Sitali, Felix P Chilunga","doi":"10.1097/INF.0000000000005269","DOIUrl":"10.1097/INF.0000000000005269","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents with multidrug-resistant (MDR) or extensively drug-resistant (XDR) tuberculosis (TB) face major treatment challenges. Although newer all-oral regimens have transformed adult TB care, their use in younger populations has largely been extrapolated from adult studies, despite important biologic and clinical differences. Systematic and up-to-date evidence on the effectiveness and safety of contemporary regimens in children and adolescents is lacking. We conducted a global systematic review and meta-analysis to address this gap.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library and Google Scholar for studies published between January 1, 2015, and September 1, 2025. Eligible studies included children 0-19 years old with confirmed or presumed MDR/XDR-TB or rifampicin-TB receiving pharmacologic treatment. Outcomes were pooled using a random-effects meta-analysis. The primary outcome was treatment success (cure or completion); severe (grade 3/4) adverse events were assessed as secondary outcomes.</p><p><strong>Results: </strong>We included 14 studies comprising 490 children across 13 countries. Overall pooled treatment success was 89% (95% confidence interval: 84%-93%; I2 = 51.9%). Newer all-oral regimens achieved slightly higher success (91%) than injectable-containing regimens (83%). Severe grade 3/4 adverse event were sparse (7 of 14 studies); events occurred in 21% (95% confidence interval: 13%-33%), most commonly QT prolongation and anemia, with limited specific drug attribution.</p><p><strong>Conclusions: </strong>Newer, all-oral bedaquiline- and delamanid-based regimens for pediatric MDR/XDR-TB are effective and generally well tolerated, though the full safety profile remains incompletely characterized. In pediatric MDR/XDR-TB, where studies are rare, our findings provide the best available evidence and a foundation for improved treatment guidelines and future research.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"1003-1012"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982540","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":"Bacterial Bloodstream Infections in Pediatric Intensive Care Units: A Multicenter Cohort Study to Investigate the Epidemiology and Risk Factors for Mortality.","authors":"Patrícia de Oliveira Costa, Shelley Ehrlich, Ianick Souto Martins","doi":"10.1097/INF.0000000000005290","DOIUrl":"10.1097/INF.0000000000005290","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSIs) are associated with a high mortality ratio among critically ill children. BSIs caused by multidrug-resistant (MDR) bacteria are a challenge due to limited therapeutic options. In this multicenter cohort study, factors associated with death of children with bacterial laboratory-confirmed BSI (LC-BSI) admitted to the intensive care unit (ICU) were analyzed, with a focus on MDR bacterial infection and appropriateness of therapy.</p><p><strong>Methods: </strong>A prospective cohort of children ≤18 years of age with LC-BSI, and admitted to 9 ICUs, was conducted from January 1, 2016, to December 31, 2018, in Rio de Janeiro, Brazil. Risk factors of 30- and 7-day death of LC-BSI were identified using multivariable logistic regression analyses.</p><p><strong>Results: </strong>Two hundred thirty-eight LC-BSI episodes occurred in 215 patients; 31.1% were caused by MDR bacteria. Inappropriate initial antibiotic therapy and definitive antibiotic therapy were administered in 50.4% and 8.4% of the episodes, respectively. The 30- and 7-day mortality ratios were 18.5% and 8.8%, respectively. Hematologic disease as primary condition, pediatric risk of mortality score ≥20 on date of LC-BSI, use of vasopressors, ICU-acquired BSI and LC-BSI from hospital B were independently associated with 30-day death. Inappropriate definitive antibiotic therapy; infectious disease, congenital heart disease and hematologic disease as primary conditions; PRISM score ≥20 at the time of LC-BSI; use of/vasopressors and LC-BSI secondary to respiratory tract or intra-abdominal infection were independently associated with 7-day death.</p><p><strong>Conclusions: </strong>Key clinical and healthcare-related factors associated with mortality in LC-BSI were identified.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e434-e441"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982163","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":"Intravenous-to-Oral Antibiotic Switch in Childhood Pleural Empyema: Insights From a Multicenter Service Evaluation.","authors":"Max Tagg, Sonal Kansra, Jemma Shanley, Simone Paulson, Callum Tipton, Sam Ensor, Louisa Pollock, Stéphane Paulus, Mildred A Iro","doi":"10.1097/INF.0000000000005254","DOIUrl":"10.1097/INF.0000000000005254","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e476-e477"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778212","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":"Community-acquired Pneumonia in Bangladeshi Children Under Five: Pathogen Prevalence, Resistance Trends, and Diagnostic Biomarkers.","authors":"Sanchita Kar, Sharmin Aktar Mukta, Zannat Kawser, Most Arifa Akter, Raisa Tasnia Khan, Sushmita Sridhar, Abu Bakar Siddik, Damien M Slater, Md Moniruzzaman, Md Shaidur Rahman, S M Shamsuzzaman, Valentina Sanchez Picot, Firdausi Qadri, Jason B Harris, Regina C LaRocque","doi":"10.1097/INF.0000000000005267","DOIUrl":"10.1097/INF.0000000000005267","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) is a leading cause of childhood mortality, with diverse etiologies. This study aimed to generate region-specific data to inform treatment and vaccination strategies for childhood CAP.</p><p><strong>Methods: </strong>We enrolled 226 CAP cases and 201 controls (<5 years) at Dhaka Medical College & Hospital (March 2022-April 2023) in Dhaka, Bangladesh. Blood and nasopharyngeal swabs were collected for pathogen detection. Bacterial isolates were tested for antibiotic susceptibility, pneumococcal isolates were serotyped, and inflammatory markers (C-reactive protein, procalcitonin) were measured.</p><p><strong>Results: </strong>No bacteremic cases of CAP were identified. Streptococcus pneumoniae [odds ratio (OR) = 2.26, 95% confidence interval (CI): 1.5-3.4], respiratory syncytial virus (OR = 6.16, 95% CI: 2.54-14.9), SARS-CoV-2, and influenza A/B were significantly associated with CAP, with SARS-CoV-2 and influenza A/B detected only in cases. Co-identification of pathogenic bacteria and viruses occurred in 14% (33/226) of cases. Over 90% of pneumococcal isolates were non-pneumococcal conjugate vaccine-10 serotypes, and serotype 19A was predominant (19%, 19/101 in cases and 6%, 3/53 in controls). Multidrug resistance was frequent in S. pneumoniae (40%, 71/178) and Haemophilus influenzae (38%, 20/52); 86% of pneumococci were macrolide nonsusceptible. Among Staphylococcus aureus , 76% (31/41) were methicillin-resistant. C-reactive protein and procalcitonin were elevated in severe CAP cases; however, no definitive cutoff threshold distinguished bacterial from viral causes.</p><p><strong>Conclusions: </strong>Our findings highlight the current epidemiology of childhood CAP in Dhaka, Bangladesh, identifying high antimicrobial resistance and predominance of non-pneumococcal conjugate vaccine-10 serotypes. These results underscore the need for continued pneumococcal surveillance to guide vaccine and treatment strategies and strengthened approaches for addressing antimicrobial resistance.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"935-941"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869051","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 Pseudomonas aeruginosa Bone and Joint Infection at Queensland Children's Hospital 2014-2024 : Retrospective Case Series.","authors":"Rebecca M Ward, Sarah Metz, Anne Bernard, Julia E Clark","doi":"10.1097/INF.0000000000005261","DOIUrl":"10.1097/INF.0000000000005261","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa is responsible for approximately 2% of pediatric bone and joint infections globally, and with its wide range of virulence factors, can be challenging to manage. Contemporary descriptions are minimal, and optimal management is poorly described. This single-center review and literature review aims to characterize this further.</p><p><strong>Methods: </strong>Retrospective observational study of all children with P. aeruginosa isolated in bone or joint fluid at Queensland Children's Hospital, 2014-2024.</p><p><strong>Results: </strong>Thirty-four children with P. aeruginosa osteomyelitis and/or septic arthritis were identified over a 10-year period, with a median of 3 cases per year. Median age was 7 years 1 month; 61.8% were male, and 14.7% identified as Aboriginal. Most infections were non-hematogenous (67.6%). Polymicrobial infection occurred in 41.2% of cases and exclusively in non-hematogenous infections ( P < 0.001). Staphylococcus aureus (6/14; 42.9%) was the most common co-pathogen. The lower limb was most affected (70.6%), with 52.9% involving the foot. There were no cases with classic \"puncture wound\" injuries. Fever and bacteremia were rare (8.8% and 2.9%, respectively). Median hospital stay was 11 days. The median intravenous antibiotic duration was 8 days, with a total antibiotic duration of 42 days. All patients had surgical debridement.</p><p><strong>Conclusions: </strong>Pediatric P. aeruginosa bone and joint infections are uncommon, typically involve the lower limbs, particularly the foot, and are usually non-hematogenous without classic puncture-wound exposure. Systemic features and bacteremia are rare. Early surgical debridement with prolonged targeted therapy appears to be important for diagnostic and clinical outcomes.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"929-934"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841378","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":"SARS-CoV-2 Reinfection and Risk of Multisystem Inflammatory Syndrome in Children: A Case-control Study.","authors":"Noémie Schiever, Lea Lenglart, Corinne Levy, Pierre-Alex Crisinel, Arnaud G L'Huillier, Johan N Siebert, Margherita Plebani, Yves Fougere, Alain Lefevre-Utile, Alexis Rybak, Eloise Burdet, Axelle Dupont, Olivier Brissaud, Jeanne Bordet, Lucas Percheron, Camille Brehin, Noémie Vanel, Caroline Ovaert, Alexandre Belot, Aurélie Morand, Julie Toubiana, Marion Grimaud, Stéphane Dauger, Julien Baleine, Stéphane Bechet, Alain Burtscher, Alain Wollner, Robert Cohen, Pierre-Louis Leger, Caroline Galeotti, Romain Basmaci, Camille Aupiais, Naïm Ouldali, François Angoulvant","doi":"10.1097/INF.0000000000005278","DOIUrl":"10.1097/INF.0000000000005278","url":null,"abstract":"<p><strong>Background: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, primarily affecting children 6-12 years of age. Although MIS-C was prominent during the early pandemic waves, recent studies suggest a declining incidence concurrent with increasing reinfection rates. The objective was to determine whether the risk of MIS-C differs following a primary SARS-CoV-2 infection versus reinfection.</p><p><strong>Methods: </strong>A retrospective, multicenter, international, matched case-control study was conducted from September 1, 2021, to April 30, 2022. MIS-C cases were recruited from 14 French and Swiss hospitals. Eligible cases included children younger than 18 years meeting the 2020 World Health Organization case MIS-C definition with laboratory evidence of SARS-CoV-2 infection. Cases were matched 1:1 by age, sex and epidemic period to controls with laboratory-confirmed acute SARS-CoV-2 infection. Vaccinated patients and those without consent were excluded. The primary outcome compared the association of reinfection with MIS-C versus acute infection using McNemar's test to estimate matched odds ratios (ORs). Prespecified sensitivity analyses used conditional logistic regression.</p><p><strong>Results: </strong>The matched cohort included 180 MIS-C cases (median [IQR] age, 106 [62-136] months) and 180 controls (median [interquartile range] age, 72 [48-108] months). No MIS-C cases had a documented reinfection, whereas 3.9% (7/180) of controls did (McNemar χ 2 = 5.142; P = 0.023; matched OR, 0.067; 95% confidence interval [0.004-1.167]; P = 0.064). Sensitivity analysis also suggested a lower odds of MIS-C after reinfection without reaching statistical significance (adjusted OR, 0.183; 95% [0.027-1.234]; P = 0.093).</p><p><strong>Conclusion: </strong>MIS-C occurred predominantly after first SARS-CoV-2 infections; while evidence for a lower risk following reinfection was suggestive but not conclusive.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"986-991"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974536","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":"Lack of Specificity of Catarrhalis Identification Disks.","authors":"Andrew Bischer, Jean Campbell, Roberto Vargas, Michael Pichichero","doi":"10.1097/INF.0000000000005260","DOIUrl":"10.1097/INF.0000000000005260","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e474-e475"},"PeriodicalIF":2.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778226","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}