Pediatric Infectious Disease Journal最新文献

{"title":"Fusobacterium on the Rise: A Decade of Otogenic and Beyond.","authors":"Sraya Kraus, Goni Peleg, Maayan Shachor, Yotam Dizitzer Hillel, Haim Ben Zvi, Ori Snapiri, David Levy, Efraim Bilavsky, Nimrod Sachs","doi":"10.1097/INF.0000000000004982","DOIUrl":"https://doi.org/10.1097/INF.0000000000004982","url":null,"abstract":"<p><strong>Background: </strong>Fusobacterium has become increasingly recognized pediatric pathogen, responsible for a wide spectrum of infections, including otogenic, oropharyngeal, intra-abdominal and soft tissue infections. However, large-scale studies remain limited.</p><p><strong>Objective: </strong>This study aimed to assess the incidence, clinical features, complications and outcomes of pediatric Fusobacterium infections.</p><p><strong>Methods: </strong>Retrospective cohort study of children (0-18 years) diagnosed with Fusobacterium infections at a tertiary pediatric hospital between 2010 and 2023.</p><p><strong>Results: </strong>A total of 195 cases were identified, with a 10-fold increase in incidence over 13 years. Linear regression demonstrated a significant annual rise in Fusobacterium isolations [β = 2.25, 95% confidence interval (CI): 1.99-2.60, P < 0.01], affecting both otologic (β = 0.65, 95% CI: 0.19-1.11, P < 0.01) and nonotologic sources (β = 1.58, 95% CI: 1.23-1.94, P < 0.001). Infections were primarily otogenic (50.2%), followed by skin and soft tissue, intra-abdominal and pharyngeal infections. Patients with otogenic infections were significantly younger (mean 2.6 vs. 10.3 years, P < 0.001). Hospitalization was required in 80.5%, and complications occurred in 37%. No mortality was observed.</p><p><strong>Conclusions: </strong>Pediatric Fusobacterium infections are rising, with significant clinical complexity and complications. While often otogenic, these infections affect multiple body systems. Awareness of their evolving epidemiology is crucial for optimizing diagnosis and management.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086787","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":"Comparison of Noninvasive Methods for the Evaluation of Liver Fibrosis in Children With Chronic Hepatitis C Virus Infection.","authors":"Maria Pokorska-Śpiewak, Anna Dobrzeniecka, Ewa Talarek, Małgorzata Aniszewska, Magdalena Marczyńska","doi":"10.1097/INF.0000000000004978","DOIUrl":"https://doi.org/10.1097/INF.0000000000004978","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to analyze liver fibrosis using transient elastography (TE) and serum biomarkers [aspartate transaminase-to-platelet ratio index (APRI) and the fibrosis-4 index (FIB-4)] in children with chronic hepatitis C before antiviral treatment and to compare the results of these noninvasive methods.</p><p><strong>Methods: </strong>All consecutive patients 3-17 years old treated with direct-acting antivirals for hepatitis C virus infection between August 2019 and July 2024 were included. Evaluation of liver stiffness measurement (LSM) was performed before starting treatment with TE. Liver fibrosis was considered significant if the median LSM was >7 kPa, corresponding to a METAVIR F score of ≥2 points. Simultaneously, TE, APRI and FIB-4 evaluations were performed, and their accuracy in the detection of significant fibrosis and cirrhosis was determined by calculating areas under the receiver operating characteristic curve (AUROC) using the LSM results as a reference.</p><p><strong>Results: </strong>One hundred fifty patients with a median age of 11 years were included. TE evaluation revealed that 139/150 (92.7%) of the participants presented with normal LSMs (≤7.0 kPa), whereas in the remaining 11/150 (7.3%) participants, significant fibrosis was confirmed, correlating to a score of F2 on the METAVIR scale in 6 (4%), F3 in 2 (1.3%) and F4 in 3 (2%). Among the independent predictors of significant fibrosis were age >10 years and duration of infection >10 years. The median APRI and FIB-4 values were significantly greater in children with significant liver fibrosis on TE evaluation. For detecting significant fibrosis, the AUROC was 0.706 for the APRI and 0.802 for the FIB-4, with cutoff values >0.53 for the APRI and >0.24 for the FIB-4. When the accuracies of the APRI and the FIB-4 for detecting cirrhosis were analyzed, the AUROCs were greater: 0.879 for the APRI, with a cutoff >0.53, and 0.96 for the FIB-4, with a cutoff >0.40.</p><p><strong>Conclusion: </strong>There is some agreement between the results of biomarker (APRI and FIB-4) and TE evaluation, but with the assumption of lower cutoff thresholds indicating significant fibrosis/cirrhosis than previously validated in adults.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086745","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 Cohort Study of Hepatitis B Virus Vaccination in Pediatric Heart Transplant Recipients: Cellular and Humoral Immune Responses and the Role of Innate Immunity.","authors":"Beatriz Lazaro-Martin, Laura Tarancon-Diez, Manuela Camino Lopez, Roberto Alonso, Nuria Gil Villanueva, Mª Ángeles Muñoz-Fernández, Alicia Hernanz-Lobo, María Luisa Navarro Gomez","doi":"10.1097/INF.0000000000004958","DOIUrl":"https://doi.org/10.1097/INF.0000000000004958","url":null,"abstract":"<p><strong>Background: </strong>Vaccination is a key strategy to reduce infectious disease mortality. In pediatric heart transplant recipients (HTRs), the use of immunosuppressive therapy weakens immune responses, increasing the risk of viral infections. This study aimed to evaluate the immunogenicity of hepatitis B virus (HBV) revaccination in this vulnerable population.</p><p><strong>Methods: </strong>A prospective longitudinal study was conducted in HTRs under 18 years of age who received HBV revaccination. Blood samples were collected at study inclusion (baseline) and after the final vaccine dose post-solid organ transplant (SOT; follow-up). Seroprotection was measured by quantifying plasma antibodies to hepatitis B surface antigen (anti-HBs) IgG. Cellular responses were assessed by flow cytometry, evaluating HBV-specific T-cell and natural killer (NK) cell activity following in vitro stimulation with HBV peptides.</p><p><strong>Results: </strong>Twenty-three patients (median age, 9 years; 70% male) were included, with a median posttransplant time of 13 months. All received tacrolimus; most received mycophenolate (87%) and corticosteroids (39%). Post-SOT seroprotection was achieved in 48% of patients, and 82% showed HBV-specific CD4+ and CD8+ T-cell responses. Higher vaccine doses (3-4 doses) were associated with stronger immune responses. NK cell responses were observed in 56% (total NK cells) and 61% (NK T cells). NK responders showed higher expression of the activating receptor NKG2C. Baseline monocyte, dendritic cell and memory T-cell frequencies were positively correlated with post-SOT vaccination response.</p><p><strong>Conclusions: </strong>Pediatric HTRs showed a generally good immune response to HBV revaccination, especially with higher vaccine doses. The immune profile at the time of vaccination appears to influence outcomes, supporting personalized vaccination approaches in immunosuppressed populations.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030209","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":"INFECTIOUS COMPLICATIONS OF Staphylococcus aureus BACTEREMIA: Reconsidering the Need for a Systematic Approach.","authors":"Laura Roig-Soria, Beatriz Alvarez-Vallejo, Elena Castilla-Cuevas, Berta Fernandez-Ledesma, Susana Melendo-Pérez, Natalia Mendoza-Palomar, Saúl Levy-Blitchtein, Belén Viñado-Pérez, Nieves Larrosa-Escartín, Pere Soler-Palacín","doi":"10.1097/INF.0000000000004980","DOIUrl":"https://doi.org/10.1097/INF.0000000000004980","url":null,"abstract":"<p><p>Staphylococcus aureus bacteremia (SAB) metastatic complications are uncommon in children. Systematic screening entails additional diagnostic tests with higher costs. Our retrospective single-center study included 114 episodes of SAB and supports limiting systematic screening to patients with persistent bacteremia or congenital heart disease and considering it on a case-by-case basis in patients with methicillin-resistant SAB or an intravascular catheter.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086818","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":"Acute Necrotizing Encephalopathy and Cerebral Infarction Triggered by Mycoplasma pneumoniae Infection in a Pediatric Patient: A Rare Clinical Association.","authors":"Yue Wang, Fei Li, Lijuan Wang, Kechun Li, Zheng Li, Suyun Qian, Chaonan Fan, Quan Wang","doi":"10.1097/INF.0000000000004987","DOIUrl":"https://doi.org/10.1097/INF.0000000000004987","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086697","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":"Tricuspid Valve Vegetation in Neonatal Candida Endocarditis.","authors":"Rupendra Nath Saha, Bhanu Duggal, Raghuraj Chawla","doi":"10.1097/INF.0000000000004996","DOIUrl":"https://doi.org/10.1097/INF.0000000000004996","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086833","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":"Mycoplasma pneumoniae Infection Mimicking Pediatric Tuberculosis: A Case Report.","authors":"Damla Sel Coban, Hincal Ozbakir, Berna Avci Yavuz, Berna Kahraman Cetin, Ozgul Gulaslan Erdogan, Aybuke Akaslan Kara","doi":"10.1097/INF.0000000000004981","DOIUrl":"https://doi.org/10.1097/INF.0000000000004981","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029698","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":"Trends in Antibiotic Resistance in Community-acquired Urinary Tract Infections Among Children: Nationwide Survey.","authors":"Michal Stein Yeshurun, Michal Stein, Sharon Amit, Shirley Shapiro Ben David","doi":"10.1097/INF.0000000000004991","DOIUrl":"https://doi.org/10.1097/INF.0000000000004991","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infection (UTI) is one of the most common bacterial infections in children. Early antibiotic treatment may prevent complications. Empirical treatment requires up-to-date knowledge of the local epidemiology. This study aims to describe trends in resistance rates in community-acquired UTI between 2017 and 2023, assess whether current recommendations for empirical treatment are valid and identify risk factors for resistance.</p><p><strong>Methods: </strong>Data were collected retrospectively from the computerized system of Maccabi Health Services for all children under 18 years old diagnosed with a UTI in 2017, 2022 and 2023. Data was evaluated using chi-square tests and regression models to identify resistance trends and associated risk factors.</p><p><strong>Results: </strong>A total of 24,592 urinary samples were included in the study. Escherichia coli was the most frequently isolated pathogen (76%-78%), with higher prevalence among females than males (78.3% vs. 59.3%, P < 0.001). Sensitivity to first-generation cephalosporins improved significantly (73% in 2017 to 82% in 2022, P < 0.001), while second- and third-generation cephalosporins showed minor fluctuations. Resistance to fluoroquinolones increased markedly, from 7% to 20% (P < 0.001). Female gender, older age, prior antibiotic use and urinary tract abnormalities were significant risk factors for resistance.</p><p><strong>Conclusions: </strong>The increased resistance rate observed for most pathogens and antibiotics was statistically significant. Nevertheless, due to small absolute changes, the recommendations for empirical antibiotic treatment in Israel are still valid. Fluoroquinolones, which are not recommended as empirical treatment, should be avoided due to high levels of resistance.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086835","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":"Black Hairy Tongue on Second Line Antituberculous Therapy: Don't Forget Linezolid Induced Lingua Villosa Nigra.","authors":"Suhani Jain, Reepa Agrawal, Ira Shah","doi":"10.1097/INF.0000000000004974","DOIUrl":"https://doi.org/10.1097/INF.0000000000004974","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030285","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 Clinical Characteristics of Kawasaki Disease Patients With Sterile Pyuria.","authors":"Miku Shono, Zenpei Kano, Wataru Tanaka, Noriko Kuga, Akiko Hiraoka, Michiko Torio, Nobutaka Harada, Hikaru Kanemasa, Sagano Onoyama, Takayuki Hoshina","doi":"10.1097/INF.0000000000004988","DOIUrl":"https://doi.org/10.1097/INF.0000000000004988","url":null,"abstract":"<p><strong>Background: </strong>Sterile pyuria is a common manifestation of Kawasaki disease (KD). We investigated the characteristics of KD patients with sterile pyuria.</p><p><strong>Methods: </strong>This retrospective study included 345 KD patients who had not received antimicrobial therapy before the diagnosis. These patients were divided into 2 groups based on the presence or absence of sterile pyuria, and the clinical characteristics were compared between the 2 groups.</p><p><strong>Results: </strong>Of the 345 patients, 151 (43.8%) had sterile pyuria. The peripheral neutrophil counts and serum levels of aspartate aminotransferase and C-reactive protein were significantly higher in KD patients with sterile pyuria than in those without sterile pyuria (P < 0.001, P = 0.003, P < 0.001, respectively). The serum sodium levels were significantly lower in the patients with sterile pyuria (P < 0.001). The proportion of KD patients that were resistant to initial high-dose intravenous immunoglobulin (IVIG) therapy was significantly higher in the patients with sterile pyuria (26.5%) than in those without sterile pyuria (10.8%) (P < 0.001). There was no significant difference in the incidence of coronary artery abnormalities between the 2 groups. In the prediction of the patients who were resistant to initial IVIG therapy, the sensitivity of positivity for sterile pyuria (66%) was superior to that of the Gunma score (52%).</p><p><strong>Conclusion: </strong>KD patients with sterile pyuria are likely to be resistant to initial IVIG therapy. Performing examinations of sterile pyuria may be useful to complement the scoring systems in order to predict the patients who may be resistant to initial IVIG therapy.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030124","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}