Pediatric Infectious Disease Journal最新文献

{"title":"Invasive Meningococcal Disease in Hospitalized Children in Argentina, 2020-2024: Clinical, Epidemiologic and Molecular Findings From a Multicenter Active Surveillance Study.","authors":"Angela Gentile, Julia Bakir, Mara Noemí Maydana, Juan Carlos Morales, Gabriela Ensinck, Adriana Ernst, Luciana J Moreira, Pablo Andrés Melonari, Alejandro Santillán Iturres, Adriana Efron","doi":"10.1097/INF.0000000000005453","DOIUrl":"https://doi.org/10.1097/INF.0000000000005453","url":null,"abstract":"<p><strong>Background: </strong>Invasive meningococcal disease (IMD) is a low-incidence but high-impact infection associated with substantial mortality and sequelae. Following MenACWY vaccine introduction into Argentina's National Immunization Program in 2017, updated data on residual disease burden are needed.</p><p><strong>Methods: </strong>A multicenter active hospital-based surveillance study was conducted in 6 pediatric sentinel units in Argentina (January 2020-December 2024) in children younger than 15 years with suspected IMD. Cases were confirmed by culture and/or polymerase chain reaction from a normally sterile body site. Hospital discharge rates were calculated per 10,000 discharges. Whole-genome sequencing and genetic Meningococcal Antigen Typing System were used to characterize strains and estimate theoretical 4CMenB coverage.</p><p><strong>Results: </strong>Among 234,264 pediatric hospital discharges, 27 confirmed IMD cases were identified (overall rate: 1.2 per 10,000; 95% confidence interval, 0.8-1.7). Annual rates showed no consistent pattern between children younger than 2 years and those 2 years or older. The case-fatality rate was 14.8% (4/27); all deaths occurred in previously healthy children younger than 5 years and were associated with sepsis and a fulminant course (hospital stay ≤1 day). Of 20 cases with a determined capsular group, 19 (95%) were B and 1 (5%) was C; no capsular group Y or W cases were identified. Theoretical 4CMenB coverage by genetic Meningococcal Antigen Typing System was 77.3%, driven by ST-162 clonal complex predominance.</p><p><strong>Conclusions: </strong>IMD in Argentina continues to predominantly affect young children and is associated with elevated case-fatality amid fulminant sepsis. Serogroup B predominates in the post-MenACWY era, and high estimated 4CMenB coverage supports evaluation of serogroup B vaccination as a complementary prevention strategy.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245897","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":"Proportion of Colonized Person-time With Streptococcus pneumoniae and Duration of Colonization With Individual Serotypes in Young Peruvian Children.","authors":"Leigh M Howard, Xiang Huang, Kathryn M Edwards, Yuwei Zhu, Marie R Griffin, Jorge E Vidal, Keith P Klugman, Ana I Gil, Nicole R Soper, Isaac P Thomsen, Katherine Gould, Jason Hinds, Claudio F Lanata, Carlos G Grijalva","doi":"10.1097/INF.0000000000005456","DOIUrl":"https://doi.org/10.1097/INF.0000000000005456","url":null,"abstract":"<p><p>Few studies have characterized the proportion of time a child spends with nasopharyngeal pneumococcal colonization, thus at risk for pneumococcal disease. In this prospective study conducted in the early 7-valent pneumococcal conjugate vaccine implementation period, young Peruvian children exhibited pneumococcal colonization during half of the observed person-time. Specific serotypes exhibited variable colonization duration, ranging from 17.5 to 100.3 days.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245955","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":"Long-term Sequelae in Children With Invasive Meningococcal Disease, Chile 2009-2023.","authors":"Rodolfo Villena, Cindy Arteta-Acosta, Salomé Bahamondes, Romina Valenzuela, Belén Sepúlveda-Aliaga, Eduardo Cifuentes-Silva, Jimena Alvarado, Karla Mascaró, Juan Francisco Falconi, Ali Mohammad, Jamie Findlow, María E Santolaya","doi":"10.1097/INF.0000000000005442","DOIUrl":"https://doi.org/10.1097/INF.0000000000005442","url":null,"abstract":"<p><strong>Background: </strong>Around 30% of survivors of invasive meningococcal disease (IMD) may develop long-term sequelae; data from Latin America remain scarce. This study aimed to estimate the proportion of long-term sequelae in pediatric IMD survivors and associated factors.</p><p><strong>Methods: </strong>A retrospective cohort study with cross-sectional outcome evaluation included children diagnosed with IMD (2009-2019) in 2 hospitals in Santiago, Chile. Between October 2022 and April 2023, 40 IMD survivors and 42 age- and sex-matched children without IMD or central nervous system infection underwent standardized physical, neurocognitive, audiologic and functional assessments conducted independently. Prevalence ratio (PR) and adjusted PR (aPR) were estimated with modified Poisson regression with standard errors.</p><p><strong>Results: </strong>Median ages were 10 (interquartile range [IQR] 9-13) and 11 (IQR 9-14) years in the exposed and unexposed groups; 70% and 64.3% were male. Sequelae occurred in 70% of exposed; the corresponding clinical findings were present in 16.7% of unexposed children (PR, 4.20; 95% confidence interval [CI]: 2.07-8.51). Neurologic (55%), dermatologic (25.0%) and hearing (20.5%) sequelae predominated. This association remained significant after adjusting for age, sex, caregiver education and socioeconomic status (aPR, 3.75; 95% CI: 1.83-7.69). Children with sequelae had a lower quality of life than those without sequelae (62% and 8%, P = 0.004).</p><p><strong>Conclusion: </strong>Pediatric survivors of IMD in Chile face a high burden of long-term sequelae. Sustained multidisciplinary follow-up and preventive strategies, including vaccination, are essential to reduce disability and improve quality of life.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245878","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":"Respiratory Infections in Patients Eligible for Pediatric Palliative Care: An Ongoing Challenge.","authors":"Daniele Zama, Enrico Valerio, Anna Sandoni, Chiara Secchiaroli, Fiorentina Guida, Elisa Manieri, Eleonora Battelli, Alessandro Rocca, Monia Gennari, Emanuela Di Palmo, Duccio Maria Cordelli, Franca Benini, Marcello Lanari","doi":"10.1097/INF.0000000000005441","DOIUrl":"https://doi.org/10.1097/INF.0000000000005441","url":null,"abstract":"<p><strong>Background: </strong>Advances in pediatric care have increased the survival of children with life-limiting conditions, leading to a growing population requiring pediatric palliative care (PPC). Respiratory tract infections are among the leading causes of hospitalization in these patients. This study aimed to describe the features of respiratory infections in children eligible for PPC.</p><p><strong>Methods: </strong>The present study is a monocentric retrospective study including pediatric patients eligible for PPC with an Assessment of Complex Clinical-Care Needs in Pediatrics (ACCAPED) score ≥30 who were followed by a third-level hospital in Bologna, Italy. Hospitalizations for respiratory infections occurring between January 2019 and February 2025 were analyzed. Clinical, microbiologic, laboratory and therapeutic data were collected.</p><p><strong>Results: </strong>Among 319 eligible PPC patients, 99 experienced at least 1 infectious hospitalization, accounting for 117 admissions due to respiratory infections in 56 children. Lower respiratory tract infections predominated (86.3%), with viral pathogens identified in most cases. Respiratory support required escalation in 76.9% of admissions, while 6% required pediatric intensive care, and mortality was 1.7%. Pseudomonas aeruginosa was the most frequently isolated bacterial pathogen, especially among tracheostomized patients. Multivariate analysis identified an Assessment of Complex Clinical-Care Needs in Pediatrics score ≥75 [odds ratio (OR): 2.43; 95% confidence interval (CI): 1.04-5.68; P = 0.041] and C-reactive protein ≥8 mg/dL (OR: 3.85; 95% CI: 1.48-10.00; P = 0.0058) as independent predictors of respiratory support escalation.</p><p><strong>Conclusions: </strong>Respiratory infections represent a major cause of hospitalization in children receiving PPC. High clinical complexity and elevated inflammatory markers independently predict worsening respiratory status, supporting their use for early risk stratification and individualized management.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245892","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":"Pharmacokinetic Modeling and Dosing Simulations of Temocillin in Children With Urinary Tract Infections.","authors":"Xin Liu, Perrin Ngougni Pokem, Marc Hainaut, Christine Ferreiro, Catherine Adler, Jason A Roberts, Françoise Van Bambeke","doi":"10.1097/INF.0000000000005458","DOIUrl":"https://doi.org/10.1097/INF.0000000000005458","url":null,"abstract":"<p><strong>Background: </strong>Temocillin, active against most extended-spectrum β-lactamases (ESBL)-producing Enterobacterales, is increasingly considered a carbapenem-sparing option for Gram-negative infections. Despite a recommended pediatric dose of 25-50 mg/kg/d in 2 administrations, its pharmacokinetics in children remain ill characterized. This study aimed to characterize temocillin pharmacokinetics in young children with urinary tract infections using population pharmacokinetic modeling and to evaluate target attainment using Monte Carlo simulations.</p><p><strong>Methods: </strong>Eligible patients contributed 1-2 blood samples collected at different time points, providing coverage of the dosing interval through an ethically acceptable sparse sampling strategy. Total and unbound temocillin plasma concentrations were quantified using high-performance liquid chromatography-tandem mass spectrometry, and data were used for pharmacokinetic modeling. Probabilities of target attainment were calculated using Monte Carlo simulation.</p><p><strong>Results: </strong>Pediatric patients (6-34 months) hospitalized with urinary tract infection received temocillin at a dose of 25 mg/kg twice daily. Thirty unbound and 33 total plasma concentrations collected from 30 patients were available for analysis. A 1-compartment structural model including nonlinear protein binding was supported. Population pharmacokinetic estimates fell within the corresponding 95% confidence intervals and were consistent with bootstrap medians, supporting model stability. Clearance and volume of distribution were estimated at 2.81 L/h and 10.3 L, respectively. Interindividual variability of clearance was determined to be 21.2% in the population. Modeling predicted that the studied regimen would provide a >90% probability of target attainment against organisms with minimum inhibitory concentration (MIC) ≤2 mg/L when targeting 40% of the dosing interval with free-drug concentrations above the MIC (40% fT>MIC).</p><p><strong>Conclusion: </strong>Although sparse sampling limits parameter precision, characterization of interindividual variability, and covariate evaluation, these data may serve as an exploratory reference to inform preliminary dosing considerations in this pediatric population.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239189","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":"Group A Streptococcus in an Unexpected Site: Temporal Pyomyositis in 2 Children.","authors":"Ana Carolina Alves, Maria Limbert, Ana Pereira Lemos, Inês Soares Cunha, Catarina Gouveia","doi":"10.1097/INF.0000000000005450","DOIUrl":"https://doi.org/10.1097/INF.0000000000005450","url":null,"abstract":"<p><strong>Background: </strong>Pyomyositis is an uncommon bacterial infection of skeletal muscle. Group A Streptococcus (GAS) accounts for a smaller proportion of pediatric cases, and temporal muscle involvement is exceptionally rare.</p><p><strong>Case description: </strong>We report 2 previously healthy children, a 7-year-old boy and a 6-year-old girl, who presented with acute otitis media (AOM) and painful unilateral temporomandibular swelling. Computed tomography revealed AOM with temporal myositis, complicated by mastoiditis in the first case. Both were treated with intravenous antibiotics, and the first case required drainage and mastoidectomy, with full recovery. GAS was isolated in both cases.</p><p><strong>Conclusions: </strong>GAS temporal pyomyositis should be considered in children presenting with AOM and painful temporal swelling. Imaging is crucial for diagnosis and assessment of disease extent. Surgical management should be individualized.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239125","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":"After 2 Nirsevimab Seasons, the Decline in RSV Deepens While Human Metapneumovirus Remains an Unaddressed Cause of Severe Bronchiolitis in Young Italian Children.","authors":"Alessandra Chiara Ferrari, Andrea Enzo Scaramuzza, Giulia Chiopris, Lorenzo Zanola, Elena Benedettucci, Enrico Antodaro, Domenico Sestito, Gloria Fumagalli, Antonella Scarda, Valentina Todescato, Christian Steuber, Claudio Cavalli","doi":"10.1097/INF.0000000000005447","DOIUrl":"https://doi.org/10.1097/INF.0000000000005447","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239179","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":"Toxic Megacolon and Secondary Acinetobacter lwoffii Bacteremia: An Unusual Presentation of Serogroup B Meningococcemia in a Toddler.","authors":"Aslihan Arslan Maden, İrem Ceren Erbaş, Tuğçe Aybek, Fatih Durak, Dilek Yilmaz","doi":"10.1097/INF.0000000000005440","DOIUrl":"https://doi.org/10.1097/INF.0000000000005440","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220224","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":"Diagnostic Challenges in Pediatric Infectious Encephalitis: Applicability of the International Encephalitis Consortium Criteria and Prognostic Factors in a Multicenter Study.","authors":"Celia García Bailo, José Antonio Alonso-Cadenas, Verónica Cantarín, Klaudia Irati Bidaurrazaga García, Roberto Velasco, Alicia Calvo Cillán, Ana María Borrull Senra, Cristina López Fernández, Izaskun Olaciregui Echenique, Alejandra Méndez Sánchez, Nathalie Campo Fernández, Iris Collazo Vallduriola, María José González Abad, Celia García Blanco, Ana de la Iglesia Rivaya, Laura Escolà Morales, Sara Figueroa Jiménez, Inés Valle T-Figueras, Borja Gómez","doi":"10.1097/INF.0000000000005444","DOIUrl":"https://doi.org/10.1097/INF.0000000000005444","url":null,"abstract":"<p><strong>Background: </strong>The International Encephalitis Consortium (IEC) criteria are widely used to diagnose pediatric encephalitis, although their performance has not been evaluated.</p><p><strong>Objective: </strong>To evaluate IEC criteria in children with suspected encephalitis and identify prognostic factors associated with adverse outcomes.</p><p><strong>Methods: </strong>Secondary analysis of a retrospective multicenter study including children aged <18 years undergoing cerebrospinal fluid polymerase chain reaction testing for suspected encephalitis in 10 Spanish Pediatric Emergency Departments between 2017 and 2023. Patients were classified according to the IEC criteria. Children fulfilling the major criterion and 1 minor criterion plus pathogen confirmation were classified as subthreshold encephalitis. Multivariable logistic regression was used to identify prognostic factors for adverse outcomes.</p><p><strong>Results: </strong>Of 446 children, 118 met IEC criteria (60 confirmed, 15 probable, 43 possible encephalitis). Twenty additional cases were classified as subthreshold encephalitis. Rates of adverse outcomes were similar in both groups (31.4% vs. 30.0%). Independent predictors of adverse outcomes were abnormal neuroimaging (adjusted odds ratio [aOR], 3.2; 95% confidence interval [CI], 1.6-6.4; P < 0.001), focal neurologic deficits (aOR, 2.6; 95% CI, 1.3-5.2; P = 0.01), bacterial etiology (aOR, 2.7; 95% CI, 1.05-6.8; P = 0.03), seizures (aOR, 2.1; 95% CI, 1.0-4.5; P = 0.04) and microbiologic confirmation (aOR, 1.9; 95% CI, 1.0-3.6; P = 0.048).</p><p><strong>Conclusions: </strong>Children with altered mental status and an encephalitis-associated pathogen but only 1 minor IEC criterion may represent missed encephalitis cases. Microbiologic confirmation, particularly bacterial etiology, and 3 minor IEC criteria were independently associated with worse outcomes, with abnormal neuroimaging being the strongest predictor.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220292","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":"First Do No Harm: When Can and Should We Withhold Antibiotics in Neonates?","authors":"Liesanne E J van Veen, Niek B Achten, Gerdien A Tramper-Stranders","doi":"10.1097/INF.0000000000005446","DOIUrl":"https://doi.org/10.1097/INF.0000000000005446","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220274","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}