Pediatric Infectious Disease Journal最新文献

{"title":"The Association Between Obesity and COVID-19 Severity in Children Differed Between SARS-CoV-2 Variants: A Multicountry Hospital-based Observational Study.","authors":"Yanshan Zhu, Petra Zimmermann, Daniel K Yeoh, Yao Xia, Marco Aurélio Palazzi Sáfadi, Malcolm G Semple, Christoph Saner, Fernanda Rodrigues, Nicole Ritz, Srivatsan Padmanabhan, Daniel Jarovsky, Charles F Gilks, Stephania A Cormier, Kulkanya Chokephaibulkit, Keng Yih Chew, David Burgner, Danilo Buonsenso, Martin Eduardo Brizuela, Philip N Britton, Asha C Bowen, Flávia Jacqueline Almeida, Kirsty R Short","doi":"10.1097/INF.0000000000004956","DOIUrl":"10.1097/INF.0000000000004956","url":null,"abstract":"<p><strong>Background: </strong>Obesity was a risk factor for severe COVID-19 in children during early outbreaks of ancestral SARS-CoV-2 and the Delta variant. However, the relationship between obesity and COVID-19 severity during the Omicron wave remains unclear.</p><p><strong>Methods: </strong>This multicenter, observational study included polymerase chain r eaction-confirmed SARS-CoV-2-infected children and adolescents from Australia, Brazil, Italy, Portugal, Switzerland, Thailand, the United Kingdom and the United States hospitalized between January 1, 2020, and March 31, 2022. Data were collected across 3 time periods representing dominant SARS-CoV-2 variants: the ancestral strain (T1), pre-Omicron variants (Alpha and Delta; T2) and Omicron (T3). The primary outcome was the need for supplemental oxygen therapy and/or ventilatory support (respiratory support).</p><p><strong>Results: </strong>This study included 6176 hospitalized children and adolescents of 2 to <18 years of age. The median age was 11.0 (interquartile range, 6.0-14.0) years, and 2989 (48.4%) were female. Obesity status was available for 5460 (88.4%), of whom 213 (3.9%) met the criteria for having obesity. Obesity was positively associated with the need for respiratory support during T1 [risk ratio (RR), 3.45 (95% CI: 2.02-5.88)] and T2 [RR, 3.24 (95% CI: 1.57-6.67], but this association was lost during T3 [RR, 3.08 (95% CI: 0.85-11.15)]. These findings were similar for unvaccinated children.</p><p><strong>Conclusions: </strong>Obesity was associated with more severe COVID-19 during the ancestral and pre-Omicron waves but not during the Omicron wave. Importantly, the same phenomenon was observed in unvaccinated children, suggesting that differences in vaccination did not account for the observed changes in the need for respiratory support over time.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"1084-1093"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030154","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":"In Memoriam: George H. McCracken.","authors":"","doi":"10.1097/INF.0000000000004957","DOIUrl":"10.1097/INF.0000000000004957","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":"44 11","pages":"1017"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252003","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":"Blood And Pharyngeal Swab Polymerase Chain Reaction Testing: Diagnostic and Therapeutic Implications in Children With Acute Nonbacterial Encephalitis.","authors":"Roberto Privato, Sandra Trapani, Elisabetta Venturini, Maria Moriondo, Francesco Nieddu, Chiara Azzari, Luisa Galli, Giuseppe Indolfi","doi":"10.1097/INF.0000000000004898","DOIUrl":"10.1097/INF.0000000000004898","url":null,"abstract":"<p><strong>Background: </strong>Children with acute nonbacterial encephalitis are often treated with extended antimicrobial therapies. Negative results from cerebrospinal fluid (CSF) examinations frequently lead to unnecessary prolongation of empirical treatments due to uncertain etiology. To enhance the identification rate of infectious causative agents, additional tests are increasingly performed on non-CSF specimens, including viral polymerase chain reaction (PCR) testing on blood or pharyngeal swabs. This study aimed to evaluate the impact of blood and pharyngeal swab PCR testing on the duration of empirical intravenous (IV) therapy in children with acute nonbacterial encephalitis, as well as its usefulness in identifying viral etiologies.</p><p><strong>Methods: </strong>A single-center, retrospective observational study was conducted on children aged 28 days to 18 years hospitalized with acute, nonbacterial encephalitis from January 2019 to August 2024. Data on age, sex, clinical presentation, laboratory features, instrumental investigations, administered therapy, results of PCR testing on different specimens and identified etiology were collected.</p><p><strong>Results: </strong>Among 52 encephalitis cases, viruses were detected via PCR in CSF in 9 cases (17%), pharyngeal swabs in 8 (15%) and blood in 5 (10%). Herpetic infections were more frequently found on CSF ( P < 0.001), while nonherpetic viruses were detected in non-CSF specimens in most cases. The duration of IV antibiotics was shorter in patients with positive viral PCR results from blood or pharyngeal swabs ( P = 0.009). Prolonged antibiotic therapy despite negative bacterial CSF tests was inversely associated with positive PCR in blood/pharyngeal swabs [adjusted odds ratio (aOR), 0.14; P = 0.031) and directly associated with sepsis-like presentation (aOR, 5.08; P = 0.028). No difference in IV acyclovir duration was found between those with nonherpetic viral infections and those with unidentified etiology ( P = 0.12).</p><p><strong>Conclusions: </strong>Performing viral PCR on both CSF and non-CSF specimens is associated with a higher detection rate of viral etiology and may positively impact the duration of empirical antimicrobial therapy in children with nonbacterial encephalitis.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"1120-1125"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317597","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":"Recent Global Trends of Macrolide-resistant Mycoplasma Pneumoniae: Why Has the Macrolide-resistant Rate Decreased in Japan?","authors":"Kazunobu Ouchi, Tomohiro Oishi","doi":"10.1097/INF.0000000000005019","DOIUrl":"https://doi.org/10.1097/INF.0000000000005019","url":null,"abstract":"<p><p>Mycoplasma pneumoniae pneumonia incidence was much decreased worldwide from 2020 to 2023 due to global infection control measures against the novel coronavirus epidemic. However, it resurfaced in the second half of 2023 following the relaxation of infection control measures, and the threat of macrolide-resistant M. pneumoniae has reemerged, especially in East Asian countries. A reduction of the rate of macrolide-resistant M. pneumoniae was seen in Japan and a part of Taiwan during the pandemic, so it is important to minimize selection pressure favoring macrolide-resistant M. pneumoniae by avoiding overuse of macrolides.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293330","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":"Severe Presentations and Outcomes in Hospitalized Pediatric Patients With Parvovirus B19 Infection During the 2024 Outbreak: A Multicenter Prospective Study in Italy.","authors":"Elisabetta Venturini, Agnese Maria Tamborino, Giusy Arrichiello, Federica Attaianese, Francesca Ippolita Calò Carducci, Claudio Cafagno, Désirée Caselli, Maia De Luca, Valeria Garbo, Vania Giacomet, Cecilia Liberati, Laura Lancella, Amelia Licari, Marco Maglione, Fabio Midulla, Cristina Moracas, Maria Moriondo, Marco Poeta, Claudia Rossini, Alfredo Guarino, Luisa Galli","doi":"10.1097/INF.0000000000005014","DOIUrl":"https://doi.org/10.1097/INF.0000000000005014","url":null,"abstract":"<p><strong>Background: </strong>Since March 2024, the European Center for Disease Prevention and Control has reported increased Parvovirus B19 (B19V) infections across 14 European countries. While often self-limiting in healthy children, B19V may cause severe disease in vulnerable populations.</p><p><strong>Methods: </strong>This multicenter prospective study aimed to characterize the clinical presentation of B19V infection in hospitalized children and identify risk factors for severe outcomes. Data were collected through the INF-ACT pediatric surveillance system, as part of the National Recovery and Resilience Plan. Children hospitalized with confirmed B19V infection were enrolled from January to December 2024 in 10 Italian INF-ACT centers.</p><p><strong>Results: </strong>A total of 135 children were included (median age 7.6 years, interquartile range 4.4-9.9), with 78.5% of cases occurring between April and July 2024. Acute myocarditis (20.7%) and neurological complications (17.8%) were the most frequent severe manifestations. Myocarditis was significantly associated with younger age (P < 0.001), longer hospital stays (median 19.5 vs. 6.5 days; P = 0.0018) and higher intensive care unit (ICU) admission rates (71.4% vs. 20.8%; P < 0.001). Multivariate analysis showed myocardial involvement increased the risk of ICU admission over 20-fold (P < 0.001).</p><p><strong>Conclusions: </strong>Although often mild, B19V infection can cause severe complications in children, particularly myocarditis and neurological involvement. Prompt recognition is essential, even in the absence of classic features like erythema infectiosum, to ensure timely monitoring and management of potentially life-threatening outcomes.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293376","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":"Orthopedic Device-related Infections in Children: Characteristics, Treatment and Outcomes.","authors":"Marie Raphalen, Léa Domitien Payet, Joana Pissara, Caroline Mollevi, Sarah Dutron, Eric Jeziorski","doi":"10.1097/INF.0000000000005017","DOIUrl":"https://doi.org/10.1097/INF.0000000000005017","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic device-related infection (ODRI) is a major postoperative complication encompassing a broad spectrum of clinical situations depending on the anatomical site, type of implanted material, and patient-specific factors. Despite their clinical significance, data on ODRIs in children are scarce and standardized management guidelines are lacking. Our aim was to characterize the clinical presentation, laboratory findings, microbiological characteristics, therapeutic management and outcomes of ODRIs in children.</p><p><strong>Methods: </strong>We conducted a retrospective, observational study at Montpellier University Hospital from January 2015 to June 2023. All children under 16 years with an ODRI diagnosis, defined as the presence of clinical signs requiring surgical revision, were included.</p><p><strong>Results: </strong>Sixty-nine ODRI cases were analyzed. Initial surgical indications were: 25 fractures, 16 cases of nonidiopathic scoliosis (NIS), 12 of idiopathic scoliosis (IS) and 16 other orthopedic anomalies. Infections were polymicrobial in 35% of cases. Staphylococcus aureus (SA) was isolated in 39/69 cases, gram-negative bacteria (GNB) in 13/69 cases and anaerobic bacteria in 9/69 cases (none on fracture cases). SA was involved in 72% of fracture-related ODRI. 50% of NIS were affected by GNB and 58% of IS by anaerobic bacteria. Empirical antibiotic treatment was mainly piperacillin/tazobactam and vancomycin (n = 38). Median duration of intravenously antibiotic therapy was 15 days [interquartile range (IQR) 10-18.5]. Median duration of total antibiotic therapy was 60 days (IQR 44.5-92), 46.5 days (IQR 42-61.75) with implant removal and 63.5 days (IQR 42.25-96.5) with implant retention. The cure rate in our cohort was 85%.</p><p><strong>Conclusions: </strong>SA is the first cause of ODRIs in children. GNB predominates in the case of NIS and anaerobic bacteria in the case of IS. Surgical indications and comorbidities are essential to determine antibiotic prophylaxis, antibiotic therapy and optimize their duration.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293321","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":"Evaluation of Adherence to HIV Postexposure Prophylaxis and Follow-up in Pediatric Sexual Assault Victims in Turkey: A Tertiary Center Experience.","authors":"İlknur Çağlar, Özlem Bağ, Miray Yilmaz Çelebi, Elif Kiymet, Elif Böncüoğlu, Şahika Şahinkaya, Ela Cem, Mustafa Gülderen, Pelin Kaçar, Deniz Ergün, İlker Devrim","doi":"10.1097/INF.0000000000004984","DOIUrl":"https://doi.org/10.1097/INF.0000000000004984","url":null,"abstract":"<p><strong>Background: </strong>Postexposure prophylaxis (PEP) is critical in preventing HIV acquisition after risky exposures, particularly in pediatric sexual assault victims. Despite its importance, adherence and follow-up remain significant challenges.</p><p><strong>Objectives: </strong>This study evaluates PEP and follow-up adherence and efficacy among pediatric sexual assault victims treated at a tertiary care hospital in Turkey.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 119 pediatric patients aged 1 month to 18 years, treated between September 2017 and September 2022. Data were collected on demographics, PEP initiation and completion, follow-up rates and serological testing for HIV. PEP compliance, follow-up adherence and outcomes were analyzed.</p><p><strong>Results: </strong>PEP was initiated in 97% of the eligible 119 patients, with 70% completing the regimen. Compliance showed no significant differences by sex or age. Follow-up adherence decreased progressively, from 55% at the first month to 30% by the sixth month. Nausea and vomiting occurred in one case, indicating a low incidence of side effects. None of the patients seroconverted to HIV.</p><p><strong>Conclusion: </strong>A structured care system involving multidisciplinary collaboration, pioneered by pediatric infectious diseases, can lead to high PEP initiation and completion rates in children. Single-pill PEP regimens may enhance adherence. However, the decline in follow-up rates underscores the need for improved follow-up mechanisms and future interventions.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251963","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":"Disseminated Fusariosis in a Pediatric Patient With Acute Lymphoblastic Leukemia.","authors":"Irem Kubilay, Seval Ozen, Ikbal Ok Bozkaya, Bedia Dinc, Ayşe Kalkanci, Nilgün Karabicak, Belgin Gulhan, Turan Bayhan","doi":"10.1097/INF.0000000000004870","DOIUrl":"10.1097/INF.0000000000004870","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e386-e388"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317600","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":"Optimizing Voriconazole Dosing in Extremely Premature Infants With Aspergillus Infections.","authors":"Adam Lee, M Tuan Tran, Jasjit Singh, Antonio Arrieta","doi":"10.1097/INF.0000000000004868","DOIUrl":"10.1097/INF.0000000000004868","url":null,"abstract":"<p><strong>Background: </strong>Primary cutaneous aspergillosis can disseminate in premature infants. Voriconazole, dosed every 12 hours, is the preferred antifungal agent. Prior studies show difficulty achieving therapeutic targets with this regimen. We report the safety and attainment of therapeutic targets with voriconazole dosed q8h with careful therapeutic drug monitoring.</p><p><strong>Methods: </strong>Retrospective review of 4 extremely premature infants with primary cutaneous aspergillosis given voriconazole divided every 8 hours with therapeutic drug monitoring. Demographics, voriconazole administration, treatment duration, need for debridement and patient outcomes were analyzed.</p><p><strong>Results: </strong>All patients survived with complete healing of affected skin. Median voriconazole duration was 69.5 days (min-max 36-84); 69% of voriconazole troughs on intravenous therapy were within the targeted range (1-5 mcg/mL). Troughs on enteral voriconazole were consistently under the targeted range. Few mild, transient adverse effects attributable to therapy were noted.</p><p><strong>Conclusions: </strong>Intravenous voriconazole every 8 hours was safe and consistently met therapeutic targets. Enteral administration consistently failed to achieve therapeutic concentrations.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"955-961"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182702","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":"Safety and Immunogenicity of a Pneumococcal Conjugate Vaccine When Administered Concomitantly With Routine Pediatric Vaccines in Healthy Toddlers and Infants.","authors":"Sylvie Pichon, Gary M Ullery, Luis Cousin, Manish Sadarangani, Ji Hwa Ryu, Céline Monfredo, Karine Mari, Aseem Pandey, Sarah Personnic, Catherine Pouzet, Christine Manson, Widad Silhadi, Ada-Maria Minutello","doi":"10.1097/INF.0000000000004913","DOIUrl":"10.1097/INF.0000000000004913","url":null,"abstract":"<p><strong>Background: </strong>A 21-valent pneumococcal conjugate vaccine, PCV21, was developed to provide broader coverage against Streptococcus pneumoniae serotypes. PCV21 comprises 13 serotypes common to a licensed 13-valent pneumococcal conjugate vaccine (PCV13) and 8 additional serotypes. This study evaluated 3 PCV21 formulations with differences in antigen content for some serotypes, compared with PCV13, administered concomitantly with routine pediatric vaccines.</p><p><strong>Methods: </strong>This was a randomized, modified double-blind, multicenter, active-controlled phase 2 study enrolling toddlers previously vaccinated with 3 doses of PCV13 (cohort 1) and unvaccinated infants (cohort 2). Toddlers/infants were randomized 1:1:1:1 to 1 of 3 PCV21 formulations or PCV13, administered at ages 12-15 months (cohort 1) and 2, 4, 6 and 12-15 months (cohort 2). Safety was assessed throughout the study. Immunogenicity was assessed 30 days after dose 1 (cohort 1) or doses 3 and 4 (cohort 2).</p><p><strong>Results: </strong>Overall, 140 toddlers (cohort 1) and 712 infants (cohort 2) were randomized. All PCV21 formulations showed acceptable safety profiles comparable with PCV13. In both cohorts, serotype-specific immunoglobulin G concentrations showed that PCV21 elicited a robust immune response for all serotypes. PCV21 and PCV13 showed generally comparable immunogenicity for shared serotypes, with numerically greater immunogenicity in the PCV21 groups than in the PCV13 group for the additional serotypes. Increased antigen content for selected serotypes appeared to be associated with greater immunogenicity.</p><p><strong>Conclusion: </strong>PCV21 demonstrated favorable immunogenicity, with no safety concerns identified. This study supports the evaluation of the PCV21 formulation that had the highest antigen content for selected serotypes for phase 3 assessment.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"995-1008"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964398","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}