Pediatric Infectious Disease Journal最新文献

{"title":"Serial Biomarker Monitoring Reveals Progressive Cardiac Injury in Pediatric Dengue Shock Syndrome.","authors":"Truyen Le Phuoc, Nguyen The Nguyen Phung","doi":"10.1097/INF.0000000000005256","DOIUrl":"10.1097/INF.0000000000005256","url":null,"abstract":"<p><strong>Background: </strong>Dengue shock syndrome (DSS) is a life-threatening complication of dengue infection, marked by plasma leakage and hemodynamic collapse. Cardiac dysfunction contributes to poor outcomes, but its dynamic progression remains unclear. We investigated temporal changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin I (troponin I) levels in pediatric DSS and their associations with clinical outcomes.</p><p><strong>Methods: </strong>In this longitudinal study, 113 children with DSS were enrolled. NT-proBNP and troponin I were measured at 2 standardized time points: T1 (approximately 6 hours after initial fluid resuscitation) and T2 (12 hours after T1). A third sample at 30 hours after T1 (T3) was obtained in a subset of patients. Mortality was the primary outcome; secondary outcomes included inotropic support, mechanical ventilation and length of stay.</p><p><strong>Results: </strong>Both biomarkers rose significantly from T1 to T2, indicating progressive myocardial stress and injury. At T1, elevated NT-proBNP and troponin I levels were found in 30.1% and 21.2% of patients, respectively, increasing to 73.5% and 42.5% at T2. Elevated biomarker levels were strongly associated with mortality ( P < 0.01). NT-proBNP also predicted inotropic requirement and mechanical ventilation, with good discriminative performance at T1 (area under the curve 0.813). Elevated biomarkers further correlated with multiorgan dysfunction and prolonged pediatric intensive care unit stay.</p><p><strong>Conclusions: </strong>Serial NT-proBNP and troponin I measurements reveal progressive cardiac involvement in pediatric DSS. These biomarkers offer distinct yet complementary insights into disease severity and may assist early risk stratification and guide fluid and hemodynamic management in critical care.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"899-904"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778253","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":"Health and Economic Impact of Seasonal Maternal Vaccination With Bivalent Respiratory Syncytial Virus Prefusion F Vaccine in Belgium.","authors":"Machteld De Bock, Sophie Marbaix, Hannah Goovaerts, Frédéric Debiève, Marijke Proesmans, Marc Raes","doi":"10.1097/INF.0000000000005226","DOIUrl":"10.1097/INF.0000000000005226","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is the leading cause of potentially severe lower respiratory tract viral infection in infants. Hospitals may encounter challenges during the RSV season following the increased number of pediatric patients' admissions. Maternal vaccination can help address this healthcare threat. This study aimed to analyze the cost-effectiveness of the bivalent respiratory syncytial virus prefusion F-protein-based (RSVpreF) vaccine versus no immunization.</p><p><strong>Methods: </strong>A static model was developed to assess the impact of RSV-lower respiratory tract infections immunization via maternal vaccination on hospitalization, life expectancy and quality of life in an annual newborn population, from the perspective of the public healthcare payer. Key input data were derived from an independent Belgian observational study and the latest available clinical data on the bivalent RSVpreF vaccine. The targeted infants were defined based on the recommendations of the Superior Health Council for maternal vaccination.</p><p><strong>Results: </strong>Maternal vaccination against RSV is a cost-saving option compared to no immunization against RSV, up to a cost of €183.67 (including 1 dose of vaccine and administration fee). The protection of 46,542 newborns with maternal vaccination prevented 1 infant death and 2242 pediatric hospital admissions while saving €8.57 million. These hospital savings will more than offset the cost of vaccination, resulting in incremental healthcare savings of €102,873. Moreover, in this target population, 80 QALYs will be gained over the lifetime horizon.</p><p><strong>Conclusions: </strong>The bivalent RSVpreF vaccine, administered in line with the recommendations of the Superior Health Council, is a dominant option compared with no immunization.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"905-910"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513701","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":"A Case of Monomorphic Ventricular Tachycardia in an Immunocompetent Pediatric Patient With Histoplasmosis.","authors":"Saja Al Falahi, Siddharth Mahajan, Ryan Jones, Patricia Pichilingue","doi":"10.1097/INF.0000000000005224","DOIUrl":"10.1097/INF.0000000000005224","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e432-e433"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581775","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 Varicella Vaccination in Children and Adolescents Living With HIV: A Systematic Review.","authors":"Mona Marin, Likhita Raparti, Jessica Leung, Sara E Oliver, Myron J Levin","doi":"10.1097/INF.0000000000005264","DOIUrl":"10.1097/INF.0000000000005264","url":null,"abstract":"<p><strong>Introduction: </strong>Preventing varicella-zoster virus infection is important in the management of human immunodeficiency virus (HIV)-positive persons. Varicella remains endemic worldwide, and HIV-positive persons can experience greater morbidity than the general population. We summarized the global literature on the safety and immunogenicity of the varicella vaccine in HIV-positive children.</p><p><strong>Methods: </strong>Systematic review of original reports on varicella vaccination of HIV-positive children, published through December 31, 2024, including assessment of safety, immunologic responses and effectiveness after vaccination.</p><p><strong>Results: </strong>Eighteen articles were analyzed. Local reactions were the most common adverse events, albeit infrequent (<21% and <10% of vaccinees after dose 1 and 2, respectively). Systemic reactions were also infrequent, consisting mostly of low-grade fever. A vaccine-related rash, reported in <5% of vaccinees, had fewer lesions and a shorter duration than typical varicella. Serious adverse events were reported only when the vaccine was inadvertently administered to children with severe HIV immunosuppression. Varicella vaccination had no clinically significant impact on plasma HIV RNA or CD4+ T-cell count after either dose. An antibody response was reported in 60%-79% of HIV-positive vaccinees after dose 2 and often declined more rapidly than in uninfected children. Cell-mediated immunity was detected in 67%-83% after dose 2. No significant differences in adverse events or short-term immune response after vaccination correlated with past or current CD4+ T-cell status.</p><p><strong>Conclusions: </strong>The varicella vaccine had a favorable safety profile and induced specific immune responses in most nonseverely immunocompromised HIV-positive children. The vaccine remains contraindicated for persons with severe HIV infection. Robust data on the durability of immune response and long-term effectiveness are needed.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"916-924"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869054","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":"Beyond Traditional Pathogens: Clinical and Microbiologic Insights Into Atypical Pediatric Otitis Media.","authors":"Din Haim Ben Hayoun, Danielle Keidar-Friedman, Ori Cohen Michael, Sharon Ovnat Tamir, Tal Brosh-Nissimov, Ofir Fogel, Amos Cahan, Anka Tsur, Tal Marom","doi":"10.1097/INF.0000000000005216","DOIUrl":"10.1097/INF.0000000000005216","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced microbiologic diagnostics have expanded the spectrum of bacterial species identified in otitis media (OM). The clinical significance of atypical otopathogens remains unclear. This study compares characteristics and outcomes of pediatric OM caused by atypical versus typical pathogens.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study of children (0-18 years) with culture-positive monomicrobial OM at a secondary care center (2021-2024), we assigned Streptococcus pneumoniae , Haemophilus influenzae , Streptococcus pyogenes , Staphylococcus aureus , Moraxella catarrhalis and Pseudomonas aeruginosa from chronic suppurative OM (CSOM) cases to the typical group; other isolates were atypical. Clinical outcomes were compared using 1:1 matched cohorts and propensity scores.</p><p><strong>Results: </strong>Thirty-one children were included in both the atypical and typical groups. Six typical cases involving P. aeruginosa from CSOM were included in a supplementary analysis. Turicella otitidis predominated among atypical isolates (n = 13, 42%). Following 1:1 matching, atypical otopathogens were significantly associated with older age (5.41 ± 5.08 vs. 2.7 ± 3.7 years, P = 0.006) and prior otologic surgery (42% vs. 10%, P = 0.008). Acute OM was more associated with typical otopathogens (87% vs. 61%, P = 0.016). CSOM was associated with atypical otopathogens (48% vs. 30%, P = 0.034). These differences remained significant after applying the inverse propensity score-weighted approach. No statistically significant differences were observed in clinical outcomes, complication rates or inflammatory biomarkers. Atypical otopathogens demonstrated markedly elevated quinolone resistance (53% vs. 7%).</p><p><strong>Conclusions: </strong>Atypical otopathogens predominantly affect older children and are associated with distinct disease phenotypes but comparable outcomes to typical pathogens. Current management appears appropriate; however, elevated quinolone resistance warrants consideration in selecting empirical therapy.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"879-884"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474863","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":"Describing the Utility of Fungal Blood Cultures in Patients Hospitalized at a Large Pediatric Academic Center.","authors":"Lorenzo Chiusaroli, Mickael Boustany, Jean K Millimono, Jesse Blumenstock, Craig L K Boge, Morgan A Zalot, Brian T Fisher","doi":"10.1097/INF.0000000000005282","DOIUrl":"10.1097/INF.0000000000005282","url":null,"abstract":"<p><strong>Background: </strong>Routine blood cultures (BCs) are frequently obtained in hospitalized children with suspected infection. Although bacterial pathogens are the primary concern, fungal infections remain a consideration in high-risk populations, prompting clinicians to order fungal blood cultures (FBCs) in addition to routine BCs. However, given the prolonged incubation time and labor-intensive nature of FBCs, their incremental diagnostic value beyond routine BCs is uncertain.</p><p><strong>Methods: </strong>We performed a retrospective, single-center study of hospitalized children 0-18 of age years at the Children's Hospital of Philadelphia between October 2015 and December 2022. Electronic health record data were used to identify all FBCs and associated BCs obtained during hospitalizations lasting ≥24 hours. Demographic and clinical characteristics, including admitting service, neutropenia status and presence of a central venous catheter, were collected. Culture results were grouped into diagnostic episodes by hospitalization. FBC results were compared with BCs obtained within 5 days to assess diagnostic yield and clinical utility, defined as identification of a unique organism leading to a change in clinical management.</p><p><strong>Results: </strong>A total of 540 FBCs were ordered for 244 patients across 159,563 inpatient admissions, representing 296 diagnostic episodes. Patients were predominantly male, non-Hispanic, and White, with 28.7% younger than 1 year. Most diagnostic episodes occurred in oncology, hematology, transplant, critical care or surgical settings; 25.3% involved patients with central venous catheters and 17.2% with neutropenia. Fifty-four FBCs were positive, corresponding to 22 diagnostic episodes (7.4%). Most positive cultures grew fungal pathogens, commonly Candida parapsilosis , Trichosporon asahii and Candida albicans . Only 1 FBC identified an organism not detected on routine BCs, and this finding did not alter the management.</p><p><strong>Conclusions: </strong>Over 7 years, FBCs provided no additional clinically actionable information beyond routine BCs. These findings support diagnostic stewardship efforts to limit routine FBC use and clarify scenarios in which they may be beneficial.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e392-e395"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875257","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":"Fungal Osteomyelitis of the Calcaneus Caused by Exophiala spp. in an Immunocompetent Child.","authors":"José Yagoh Saraiva Rolim, Izabel Athayde da Silva Cruz Salgado, Leônidas Braga Junior, Daniel Wagner de Castro Lima Santos, Sirlei Garcia Marques, Fabrício Silva Pessoa","doi":"10.1097/INF.0000000000005239","DOIUrl":"10.1097/INF.0000000000005239","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e427-e428"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623454","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":"Influenza-related Deaths in Young Children: Observations From a German Case Series.","authors":"Julian A F Klein, Marianne Wedde, Ralf Dürrwald, Katharina Feld, Gerrit Dunke, Hans-Georg Kräusslich, Julia Gsenger, Julia Tabatabai","doi":"10.1097/INF.0000000000005297","DOIUrl":"10.1097/INF.0000000000005297","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza virus infections remain a major public health burden. During the last years, several case reports of severe influenza infections in children have been published.</p><p><strong>Cases: </strong>We report 4 fatal influenza cases in young children (2-6 years old) which occurred in Southwest Germany in the seasons 2022/23 and 2023/24. All 4 children were previously healthy; a forensic autopsy was conducted due to an unknown cause of death. Postmortem samples from the respiratory tract and organ tissues were tested for respiratory viruses via real-time polymerase chain reaction (RT-PCR) and analyzed by whole-genome sequencing.</p><p><strong>Results: </strong>In 1 child, RT-PCR revealed influenza B virus, and 3 children died with influenza A (H1N1)pdm09 infection. No mutations associated with high virulence were detected. In 1 case, influenza A(H1N1)pdm09 could be cultivated in cell culture from brain tissue.</p><p><strong>Conclusions: </strong>This case series underlines the potential risk of fatal outcomes of influenza infections in children. This should be considered when re-evaluating the vaccination recommendations for healthy children.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e420-e426"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164191","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":"Burden of COVID-19 in Korean Children: A Retrospective Observational Study Using Real-world Data.","authors":"Young Hwa Lee, Eunseon Gwak, Young June Choe","doi":"10.1097/INF.0000000000005271","DOIUrl":"10.1097/INF.0000000000005271","url":null,"abstract":"<p><strong>Background: </strong>While children were initially less susceptible to coronavirus disease 2019 (COVID-19), emerging variants and eased public health measures shifted the burden to younger populations. This study characterizes pediatric COVID-19 features in South Korea across 7 epidemic waves, evaluating vaccination and comorbidities on disease severity.</p><p><strong>Methods: </strong>This retrospective study used the national K-COV-N database, integrating surveillance and health insurance claims data. Children 1-17 years old with confirmed COVID-19 from January 2020 to August 2023 were included. Participants were stratified by age and dominant variant waves. Logistic regression assessed demographic and clinical risk factors for severity.</p><p><strong>Results: </strong>Among 239,334 cases, the Omicron-dominant era (waves 5-7) accounted for 97.88% of the total burden. Although the mean hospital stay decreased from 12.6 days (wave 1) to 3.7 days (wave 5), mortality and multisystem inflammatory syndrome in children were concentrated during Omicron waves. Children 1-4 years of age experienced the most severe outcomes. Multivariate analysis identified cardiovascular disease (adjusted odds ratio [AOR]: 3.97), neurologic disorders (AOR: 2.88) and obesity (AOR: 2.68) as significant independent risk factors for severity. After adjusting for age and sex, vaccination showed limited protective effects against severe outcomes in this cohort.</p><p><strong>Conclusions: </strong>The pediatric COVID-19 landscape in South Korea shifted to massive community transmission during the Omicron era. While individual clinical severity declined, the absolute burden remained significant due to high prevalence. Future outbreak mitigation requires targeted protection for high-risk groups and scalable healthcare planning.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e406-e411"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265472","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 of Rotavirus Vaccination in a Growing Care Unit (Intermediate-care Neonatal Unit) in Japan.","authors":"Hiroki Miura, Masahiko Manabe, Masaru Ihira, Kei Kozawa, Masafumi Miyata, Yoshiki Kawamura, Yotaro Kondo, Jun-Ichi Kawada, Satoshi Komoto, Tetsushi Yoshikawa","doi":"10.1097/INF.0000000000005251","DOIUrl":"10.1097/INF.0000000000005251","url":null,"abstract":"<p><strong>Background: </strong>Rotavirus vaccination effectively prevents severe rotavirus gastroenteritis; however, administration during neonatal hospitalization is often avoided because of theoretical concerns regarding vaccine-virus transmission. Data on the safety of in-hospital rotavirus vaccination in neonatal step-down care settings remain limited.</p><p><strong>Methods: </strong>We conducted a 1-year prospective cohort study in a Japanese growing care unit, a step-down neonatal unit comparable to Level II-III neonatal intensive care units in the United States. Hospitalized infants were monitored for adverse events and vaccine-strain shedding after administration of monovalent rotavirus vaccine (RV1). Stool samples were collected weekly and analyzed using RV1 strain-specific real-time quantitative reverse transcription polymerase chain reaction targeting the NSP2 gene. Routine contact precautions, including gown and glove use for all patient care activities and environmental cleaning, were consistently implemented.</p><p><strong>Results: </strong>Among 237 infants included in the analysis, 15 received a total of 19 doses of RV1 during hospitalization. RV1 vaccine-strain RNA was detected in 26 of 38 postvaccination stool samples (68.4%). No RV1 strain RNA was detected in unvaccinated infants or in samples collected before vaccination. No serious adverse events were observed, and no evidence of horizontal transmission was identified. Six vaccinated infants exceeded the upper age limit for vaccine initiation at discharge and would have missed vaccination opportunities without in-hospital vaccination.</p><p><strong>Conclusions: </strong>RV1 vaccination was not associated with detectable transmission or serious adverse events in a neonatal step-down care setting under routine contact precautions, supporting its potential safety and role in preventing missed vaccination opportunities among high-risk infants.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"911-915"},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778233","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}