Pediatric Infectious Disease Journal最新文献

{"title":"Pediatric Clinical Outcomes of Nasal Methicillin-resistant Staphylococcus aureus Polymerase Chain Reaction Utilization.","authors":"Salih Demirhan, Kevin Burgos, Kiriam Escobar Lee, Philip Lee, Sharlene Sy, Betsy C Herold, Brenda I Anosike","doi":"10.1097/INF.0000000000004533","DOIUrl":"10.1097/INF.0000000000004533","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) is a clinical challenge in selecting empiric antimicrobials for pediatric infections. We implemented nasal MRSA polymerase chain reaction (nMRSA PCR) screening as a diagnostic tool and evaluated its impact on empiric antibiotic use and clinical outcomes.</p><p><strong>Methods: </strong>A retrospective single-center study of patients hospitalized with infections who were empirically prescribed anti-MRSA antibiotics was conducted prior to and following the initiation of nMRSA PCR screening. Electronic medical records, pharmacy data and bacterial cultures results were reviewed. Predictive values of nMRSA PCR testing were calculated and the duration of anti-MRSA empiric therapy and clinical outcomes preimplementation and postimplementation were compared.</p><p><strong>Results: </strong>During the preimplementation period, there were 382 distinct episodes (294 unique patients) that met the inclusion criteria and during post-nMRSA PCR implementation, 394 episodes (360 unique patients) were identified. The median time to discontinuation of anti-MRSA antibiotics and proportion of patients prescribed anti-MRSA antibiotics at discharge were significantly lower in postimplementation compared with preimplementation period; 48 versus 56 hours, P < 0.001 and 20.1% versus 40.3%, P < 0.001, respectively. The negative and positive predictive values of nMRSA PCR compared to clinical culture results were 95.6% and 51.2%, respectively. Predefined adverse outcomes were documented in 11 patients who had early anti-MRSA discontinuation with negative nMRSA PCR results but only 3 were restarted on anti-MRSA treatment and none grew MRSA in clinical cultures.</p><p><strong>Conclusions: </strong>Shortened anti-MRSA antibiotic duration, high negative predictive value and low adverse events provide promising evidence that nMRSA PCR is an effective, rapid antimicrobial stewardship tool for hospitalized children.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"33-39"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126356","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":"An Update on Treatment Options for Resistant Kawasaki Disease.","authors":"Shu Ki Tsoi, David Burgner, Rolando Ulloa-Gutierrez, Linny K Phuong","doi":"10.1097/INF.0000000000004561","DOIUrl":"10.1097/INF.0000000000004561","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e11-e15"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351671","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":"Invasive Candidiasis in Pediatric Hematologic Malignancy: Increased Risk of Dissemination With Candida tropicalis.","authors":"Amira M Said, Faraz Afridi, Michele S Redell, Chelsea Vrana, Candelaria O'Farrell, Michael E Scheurer, Natalie J Dailey Garnes, Maria Monica Gramatges, Ankhi Dutta","doi":"10.1097/INF.0000000000004502","DOIUrl":"10.1097/INF.0000000000004502","url":null,"abstract":"<p><strong>Background: </strong>Candida species are the most common cause of invasive fungal disease, and children with hematologic malignancy are at increased risk. Non- albicans Candida (NAC) now account for more than half of all invasive candidiasis (IC) and carry a worse prognosis. We aimed to compare the epidemiology, risk factors, organ dissemination, biomarkers and outcomes in IC based on the species implicated and evaluate trends in antifungal resistance over time.</p><p><strong>Methods: </strong>Patients 0-18 years of age with hematologic malignancy and IC at 2 centers were included. Fifty-three patients from 2011 to 2022 were identified. Information related to demographics, host and risk factors, Candida species and antifungal susceptibilities, treatment and outcomes was collected via retrospective chart review. Data were analyzed at the species level.</p><p><strong>Results: </strong>The incidence rate of IC was 29 per 1000 patients with leukemia and lymphoma. The median time to infection from diagnosis of malignancy was 38 days. Candida tropicalis (n = 17; 30%) was the most identified species followed by Candida albicans (n = 14; 25%). Patients with C. tropicalis infection were more likely to have dissemination to the eyes ( P = 0.035), spleen ( P = 0.001) and skin ( P = 0.003) than patients with C. albicans or other NAC. Of the 34 patients who underwent dilated retinal examination, 24% (n = 8) had evidence of intraocular candidiasis. Seven of the 8 patients with intraocular disease had prolonged candidemia (3 or more days; P = 0.003). The 12-week crude mortality rate was 16.9%.</p><p><strong>Conclusions: </strong>NAC, specifically C. tropicalis , accounted for most of the IC in children with hematological malignancies. Screening for intraocular candidiasis continues to play an important role in patients with IC, and future studies are needed to determine if screening can be limited to patients with select risk factors.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"58-63"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392376","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":"Do We Need a Lyme Disease Vaccine?","authors":"Stanley A Plotkin","doi":"10.1097/INF.0000000000004537","DOIUrl":"10.1097/INF.0000000000004537","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":"44 1","pages":"32"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869535","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 Rare Case of Aspergillus Involvement in a Kidney Transplant Recipient: Thyroiditis.","authors":"Tuğçe Tural Kara, Hatice Burcu Çağlar Kizil, Hafize Selma Çetin, Ayşe Kübra Açik, Onur Tekeli, Gülşah Kaya Aksoy, Mennan Yiğitcan Çelik, Kağan Çeken","doi":"10.1097/INF.0000000000004519","DOIUrl":"10.1097/INF.0000000000004519","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e30-e31"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009238","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":"Fatal Neonatal Influenza A Myocarditis.","authors":"Elisabeth Ralser, Christina Edwards, Michaela Höck, Susanne Sprung, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1097/INF.0000000000004516","DOIUrl":"10.1097/INF.0000000000004516","url":null,"abstract":"<p><p>A term baby underwent unexpected, fatal resuscitation in the delivery room. The mother suffered from a common cold during her last trimester of pregnancy. All other examinations throughout gestation were normal. Despite immediate, extended and effective resuscitation, heart rate did not exceed 15-20 beats/minute. In the autopsy, fetal myocarditis due to influenza A infection was detected.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e4-e6"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009243","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":"Urinary Tract Infection in Children and the Potential Role of Pivmecillinam as a Treatment Option.","authors":"Naja Lyhne Andersen, Valeria Antsupova, Jonas Bredtoft Boel, Mette Marie Christensen, Ulrikka Nygaard, Lisbeth Samsø Schmidt","doi":"10.1097/INF.0000000000004524","DOIUrl":"https://doi.org/10.1097/INF.0000000000004524","url":null,"abstract":"<p><p>We investigated the potential role of pivmecillinam in the treatment of urinary tract infections in children. Among 351 children (0-6 years) with urinary tract infections, 83% could be treated with pivmecillinam following urine culture. Resistance was highest in infants (0-3 months) caused by the high prevalence of Enterococcus faecalis. This result emphasizes the necessity for developing a pediatric oral form of pivmecillinam.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":"44 1","pages":"e1-e3"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869545","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":"Prevalence of SARS-CoV-2 in Children Identified by Preprocedural Testing at 5 US Children's Hospital Systems.","authors":"Anna F Wang-Erickson, Xueyan Zhang, Klancie Dauer, Danielle M Zerr, Amanda Adler, Janet A Englund, Brian Lee, Jennifer E Schuster, Rangaraj Selvarangan, Chelsea Rohlfs, Mary A Staat, Leila C Sahni, Julie A Boom, G K Balasubramani, John V Williams, Marian G Michaels","doi":"10.1097/INF.0000000000004547","DOIUrl":"10.1097/INF.0000000000004547","url":null,"abstract":"<p><strong>Background: </strong>The burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic children was initially presumed to be high, which influenced hospital, school and childcare policies. Before vaccines were widely available, some hospitals implemented universal preprocedural SARS-CoV-2 polymerase chain reaction testing on asymptomatic patients. Understanding SARS-CoV-2 prevalence in asymptomatic children is needed to illuminate the diversity of viral characteristics and inform policies implemented during future pandemics.</p><p><strong>Methods: </strong>Data were extracted from patient records of outpatient children who were preprocedurally tested for SARS-CoV-2 from 5 US hospital systems between March 1, 2020, and February 28, 2021. Prevalence was determined from positive test results. Adjusted odds ratios (AORs) were calculated using mixed logistic regression with the site as a random effect.</p><p><strong>Results: </strong>This study analyzed 93,760 preprocedural SARS-CoV-2 test results from 74,382 patients and found 2693 infections (3.6%) from 2889 positive tests (3.1%). Site-specific prevalence varied across sites. Factors modestly associated with infection included being uninsured [AOR, 1.76 (95% confidence interval [CI], 1.45-2.13)], publicly insured [AOR, 1.17 (95% CI, 1.05-1.30)], Hispanic [AOR, 1.78 (95% CI, 1.59-1.99)], Black [AOR, 1.22 (95% CI, 1.06-1.39)], elementary school age [5-11 years; AOR, 1.15 (95% CI, 1.03-1.28)], or adolescent [12-17 years; AOR, 1.26 (95% CI, 1.13-1.41)].</p><p><strong>Conclusions: </strong>SARS-CoV-2 prevalence was low in outpatient children undergoing preprocedural testing, a population that was predominantly asymptomatic at the time of testing. This study contributes evidence that suggests that undetected infection in children likely did not play a predominant role in SARS-CoV-2 transmission during the early prevaccine pandemic period when the general population was naive to the virus.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"47-53"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292989","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":"Pathologic Findings of Sepsis-associated Disseminated Intravascular Coagulation in a Neonate.","authors":"Yuichi Kubo, Takuya Tokuhisa, Masanori Kambara, Kensuke Fujishiro, Kazuyoshi Sueyoshi","doi":"10.1097/INF.0000000000004680","DOIUrl":"https://doi.org/10.1097/INF.0000000000004680","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877727","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":"Dengue Encephalitis in a Pediatric Patient: An Unusual Presentation of a Common Disease in Endemic Areas.","authors":"Juan Jose Londono-Aranzazu, Ivan Felipe Tobar-Gutierrez, Juan Pablo Londono-Ruiz","doi":"10.1097/INF.0000000000004662","DOIUrl":"https://doi.org/10.1097/INF.0000000000004662","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877652","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}