Journal of Pediatric infectious diseases最新文献

Objective This study aimed to find the prevalence and clinico-demographic profile of cystic fibrosis (CF) children with allergic bronchopulmonary aspergillosis (ABPA).

Methods A cross-sectional study was conducted at a CF clinic of a tertiary care hospital. Participants included the diagnosed cases of children with CF, of both genders, from 4 to 18 years of age.

Results A total of 61 patients were enrolled. Sixteen patients (26.2%) had Aspergillus fumigatus sensitization—among these, 10 (16.4%) patients fulfilled the minimum diagnostic criteria for ABPA and 6 (9.8%) had A. fumigatus sensitization only. Two patients were below the age of 5 years, while eight patients were more than 6 years old. The female-to-male ratio was 6:4. High attenuated mucus was the specific finding in our study cohort on computed tomography (CT) chest. All patients with ABPA had significantly higher median (interquartile range [IQR]) levels of total IgE, specific IgE, and IgG for A. fumigatus, and total eosinophil count compared to patients without ABPA. There was also a significant decrease in forced exhalation volume in first second (FEV1) values (6 months apart) in ABPA patients.

Conclusion Our study found that ABPA affects 16.4% of our CF population, with 20% of cases occurring in children aged 4 to 5 years. We observed a higher prevalence of ABPA in patients from rural areas. Eosinophilia and serial decline in FEV1 values were observed as potential early markers for ABPA.

Objective Congenital intestinal atresia is one of the most common surgical pathologies in the neonatal period. This study aimed to compare the efficacy of preoperative neutrophil/lymphocyte ratio (NLR) and postoperative NLR in predicting early mortality in neonates with intestinal atresia.

Methods The data of 38 newborns with intestinal atresia operated on in our hospital between January 2016 and March 2023 were retrospectively analyzed. Patients' gestational age, gender, birth weight, other congenital anomalies, operative findings, length of hospital stay, sepsis, and mortality rates were recorded. NLR was calculated by analyzing preoperative and postoperative day 1 complete blood tests.

Results Of the patients included in the study, 60.5% were male and 39.5% were female. The median birth weight was 2,468 g (600–3,800 g), and the median gestational age was 36 weeks (28–40 weeks). Gender, number of areas of atresia in the gut, and development of sepsis were not associated with mortality. Mortality was observed at a lower rate in duodenal atresia when compared with the other types of atresia (p < 0.05). The mortality was higher in patients with prematurity, low birth weight, long duration of mechanical ventilation, and severe congenital anomalies (p < 0.05). Preoperative lymphocyte and neutrophil counts were not found to be predictive of mortality. The mortality rate increased as the postoperative lymphocyte count decreased and as the neutrophil count increased (p < 0.05). The preoperative and postoperative NLR was not useful in predicting mortality, the development of sepsis, or the need for reoperation.

Conclusion It is possible to predict early mortality in newborns with intestinal atresia who underwent surgery with neutrophil and lymphocyte counts on the first day after surgery. However, early NLR is not useful in predicting prognosis after surgery in newborns.

Objective This study aims to investigate the intricate interactions between viral infections, specifically within the context of community-acquired pneumonia. We seek to shed light on the underestimation of viral pneumonia cases, utilizing advancements in molecular diagnostic testing.

Methods The investigation involves a comprehensive review of existing literature to explore the prevalence and impact of various viruses causing pneumonia in both children and adults. Our focus spans parainfluenza virus, respiratory syncytial virus, human bocavirus, human metapneumovirus, and rhinoviruses in children and coronaviruses, rhinoviruses, and influenza viruses in adults. The study further delves into the host's innate immune response, emphasizing the roles of pattern recognition receptors (PRRs), type I interferons (IFNs), proinflammatory cytokines, and other immune cells during viral infections.

Results The analysis reveals a substantial global burden of viral community-acquired pneumonia, estimating approximately 200 million cases annually in children and adults combined. This study underscores viruses' significant, previously underestimated role in causing pneumonia. Insights into specific viruses affecting different age groups and their prevalence in various geographical settings are provided.

Conclusion In conclusion, this review emphasizes the necessity of recognizing the substantial contribution of viral infections to community-acquired pneumonia cases. The host's innate immune response, mediated by PRRs, type I IFNs, and other immune mediators, is pivotal in preventing viral invasion and replication. The study accentuates the importance of continued research into understanding the innate immune mechanisms involved in viral infections and the resulting inflammation.

Objective Our objective was to investigate soluble angiotensin-converting enzyme (sACE) levels in pediatric patients with coronavirus disease 2019 (COVID-19) and to identify factors associated with the occurrence and severity of pediatric COVID-19.

Methods This was a prospective cohort study conducted between April 2020 and July 2020. The study population consisted of 143 children (between 1 month and 18 years old), 103 of whom had COVID-19 and 40 of whom were negative for COVID-19 (randomly selected). The sACE levels and other laboratory data of all participants were measured at admission (day 0, baseline). Repeat measurements were performed in patients on the 5th day. Disease severity was documented at baseline and on the 5th day, and the change in severity between these time points was recorded.

Results Age and sex distribution were similar in the two groups. At baseline, 31 (30.1%) of the patients were asymptomatic, 58 (56.3%) had mild disease, and 14 (13.6%) had moderate disease. Baseline sACE levels were similar in the groups (p = 0.120). Higher weight was independently associated with low sACE levels in children (p = 0.037). The sACE level of patients on the 5th day was significantly lower compared with baseline (p = 0.007). Patients who experienced a decrease in disease severity were compared with those who did not demonstrate a decrease. Baseline sACE levels were significantly lower in those who experienced decreased severity (p = 0.039). Multiple linear regression revealed that COVID-19 severity at baseline was independently associated with the low sACE level at baseline (p = 0.023).

Conclusion Lower sACE at diagnosis was associated with COVID-19 severity in children. However, no strong evidence was found that could suggest the sACE level as an important predictor for the occurrence or severity of COVID-19 in children.

Objective Symptoms due to coronavirus disease 2019 (COVID-19) may persist or new symptoms may appear later. It was aimed to investigate the relationships between late respiratory system findings, allergen sensitivity, and laboratory findings in children with asymptomatic or symptomatic COVID-19 history.

Methods The study was conducted in tertiary hospital prospectively between April and July 2021. Children with respiratory system symptoms lasting longer than 1 month, with a history of asymptomatic or symptomatic COVID-19 infection and those who were anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)- antibody-positive were included. Late respiratory system findings, allergen sensitivity, and immunological and hematological findings were evaluated. Children with chronic diseases and those who were anti-SARS-CoV-2 antibody-negative were excluded.

Results Of 105 patients, 44.8% were female with a mean age of 10.7 (1–17) years. Median time from history or exposure to COVID-19 was 5 months in all patients. Post-COVID-19 respiratory symptoms were cough (61%), followed by shortness of breath (46.7%), and chest pain (21%), which were similar between symptomatic and asymptomatic patients (p > 0.05). Of the laboratory findings, only the hemoglobin value was significantly higher in symptomatic patients than in asymptomatic patients (p = 0.03), and there was no difference between them in terms of other parameters.

Conclusion It was shown that respiratory system symptoms may occur in the late period after COVID-19. The atopic status and laboratory findings of the patients did not affect this result.

Objective Ventriculitis is an example of the increasing global trend in difficult-to-treat infections in neonates caused by pathogens resistant to conventional therapies. This article describes the first use of intravenous and intraventricular tigecycline to treat ventriculitis caused by vancomycin-resistant enterococci in a preterm neonate and systematically review the literature on challenges posed by the definitions, diagnosis, and treatment of neonatal ventriculitis

Methods The authors searched PubMed and Internet search engines for “ventriculitis” in the period from 2003 to 2023 restricting the research to “Newborn,” “Human,” “English language,” and “full-text availability.”

Results Thirty-seven publications (20 case reports, 6 case series, and 11 research articles) were extracted upon research. Preterm birth, posthemorrhagic ventricular dilatation requiring placement of ventricular access devices, and sepsis preceded neonatal ventriculitis. Infections caused by rare microorganisms, in particular gram-negative bacteria resistant to conventional therapies, predominated in the publications describing the need for a combination of intravenous (IV) and intraventricular (IVT) therapies. Survivors of neonatal ventriculitis developed neurodevelopmental impairments such as hydrocephalus, seizures, motor function, hearing, and vision impairment.

Conclusion Clinical suspicion of ventriculitis indicated by subtle signs is key for prompt diagnosis. Effective IV and IVT antibiotics are essential to prevent serious sequelae and mortality. The drug delivery method should be changed if there is no clinical response. This study emphasizes the urgent need for pediatric trials of antibiotics against organisms resistant to other drugs.

Shewanella algae is a common microorganism in nature, but a rare pathogen in humans. It is a causative agent of skin and soft tissue infections, especially in patients with skin ulcers or trauma. S. algae can enter the body through the eyes, ears, gastrointestinal tract, or respiratory tract. Immunocompromised individuals are at increased risk of developing bacteremia and sepsis from the infection. This report presents a case of posttraumatic soft tissue infection caused by S. algae in an 18-year-old male after swimming in the sea. The bacteria were cultured from the wound site.