S. Hoque, K. S. Anwar, Md. Azraf Hossain Khan, Ummay Nasrin Sultana, Md. Ahasan Ali, T. Hossain, L. Sharmin, A. Kabir, Md. Abid Hossain Mollah, S. Hoque, Masuma Khan, N. Pham, P. Khamrin, S. Okitsu, S. Hayakawa, H. Ushijima
Abstract Objective Hand, foot, and mouth disease (HFMD), caused by various human enteroviruses (EVs), has emerged in the children of Bangladesh in recent years. However, the etiological agents of HFMD in Bangladeshi children are not yet elucidated. This study aimed to investigate the causative agents with molecular characterization. Methods Viral RNAs were detected from the blister fluid samples by reverse transcription polymerase chain reaction; genotyping was done by sequence-based analysis of the partial viral capsid protein 1 (VP1) region, and the evolutionary relationships among the genotypes were investigated by phylogenetic analysis. Results EV-RNAs were identified in 14 (61%) blister fluid samples out of 23 children who were suspected of HFMD during an outbreak in Rajshahi in 2020. Genome sequence analysis of the VP1 gene was performed on four strains: all the four were coxsackievirus A16 (CVA16) that clustered in B1c subgenotype. These strains showed 95 to 98% nucleotide identity with those reported in India in 2013/2018. Conclusion After our first report on clinical evidence of childhood HFMD in Bangladesh, this time, we provided laboratory confirmation of the emergence of CVA16 as a causative agent of HFMD in Bangladeshi children. There is an urgent need for nationwide, in-depth, clinicoepidemiological surveillance on HFMD including its virology and genetics before it becomes endemic in Bangladesh.
{"title":"Emergence of Coxsackievirus A16 Causing Childhood Hand, Foot, and Mouth Disease: First Molecular Evidence from Bangladesh","authors":"S. Hoque, K. S. Anwar, Md. Azraf Hossain Khan, Ummay Nasrin Sultana, Md. Ahasan Ali, T. Hossain, L. Sharmin, A. Kabir, Md. Abid Hossain Mollah, S. Hoque, Masuma Khan, N. Pham, P. Khamrin, S. Okitsu, S. Hayakawa, H. Ushijima","doi":"10.1055/s-0043-57235","DOIUrl":"https://doi.org/10.1055/s-0043-57235","url":null,"abstract":"Abstract Objective Hand, foot, and mouth disease (HFMD), caused by various human enteroviruses (EVs), has emerged in the children of Bangladesh in recent years. However, the etiological agents of HFMD in Bangladeshi children are not yet elucidated. This study aimed to investigate the causative agents with molecular characterization. Methods Viral RNAs were detected from the blister fluid samples by reverse transcription polymerase chain reaction; genotyping was done by sequence-based analysis of the partial viral capsid protein 1 (VP1) region, and the evolutionary relationships among the genotypes were investigated by phylogenetic analysis. Results EV-RNAs were identified in 14 (61%) blister fluid samples out of 23 children who were suspected of HFMD during an outbreak in Rajshahi in 2020. Genome sequence analysis of the VP1 gene was performed on four strains: all the four were coxsackievirus A16 (CVA16) that clustered in B1c subgenotype. These strains showed 95 to 98% nucleotide identity with those reported in India in 2013/2018. Conclusion After our first report on clinical evidence of childhood HFMD in Bangladesh, this time, we provided laboratory confirmation of the emergence of CVA16 as a causative agent of HFMD in Bangladeshi children. There is an urgent need for nationwide, in-depth, clinicoepidemiological surveillance on HFMD including its virology and genetics before it becomes endemic in Bangladesh.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"220 - 225"},"PeriodicalIF":0.3,"publicationDate":"2022-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45954406","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}
Zeynep Savaş Şen, G. Tanır, M. Polat, Y. Coşgun, R. Yalçınkaya, Suna Özdem, Rüveyda Gümüşer Cinni, A. Kaman, Türkan Aydın Teke, F. Öz
Abstract Objective Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic disease that is mainly transmitted by tick bites. During the COVID-19 pandemic, a change of notifications has been reported for most infectious diseases. We aimed to compare CCHF in pediatric patients during the COVID-19 pandemic and before the pandemic period with demographic, clinical, and laboratory features. Methods Overall, 18 CCHF patients were evaluated and divided into two groups: those admitted from May 2014 to February 2020 were placed in the “prepandemic” group and those admitted from March 2020 to August 2021 were placed in the “pandemic” group. Patients were diagnosed as CCHF with polymerase chain reaction (PCR) and immunoglobulin M (IgM) antibody positivity in the blood samples. Results Pediatric CCHF cases were more frequent during the 2 years of the COVID-19 pandemic period compared with the 6 years before the pandemic (10 cases and 8 cases, respectively). There were no demographic and clinically significant differences between the two groups. Prepandemic patients had lower platelet (PLT) levels than pandemic patients ( p = 0.021). Two CCHF patients in the pandemic group were hospitalized with a preliminary diagnosis of multisystem inflammatory syndrome in children (MIS-C). Seventeen patients (94.4%) were treated with ribavirin. All the patients recovered. Conclusion The frequency of CCHF appeared to have been increased during the COVID-19 pandemic. But there was no difference between the prepandemic and pandemic groups from a demographic and clinical finding point of view of patients diagnosed with CCHF.
{"title":"Pediatric Crimean–Congo Hemorrhagic Fever Experience during the COVID-19 Pandemic","authors":"Zeynep Savaş Şen, G. Tanır, M. Polat, Y. Coşgun, R. Yalçınkaya, Suna Özdem, Rüveyda Gümüşer Cinni, A. Kaman, Türkan Aydın Teke, F. Öz","doi":"10.1055/s-0043-1772208","DOIUrl":"https://doi.org/10.1055/s-0043-1772208","url":null,"abstract":"Abstract Objective Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic disease that is mainly transmitted by tick bites. During the COVID-19 pandemic, a change of notifications has been reported for most infectious diseases. We aimed to compare CCHF in pediatric patients during the COVID-19 pandemic and before the pandemic period with demographic, clinical, and laboratory features. Methods Overall, 18 CCHF patients were evaluated and divided into two groups: those admitted from May 2014 to February 2020 were placed in the “prepandemic” group and those admitted from March 2020 to August 2021 were placed in the “pandemic” group. Patients were diagnosed as CCHF with polymerase chain reaction (PCR) and immunoglobulin M (IgM) antibody positivity in the blood samples. Results Pediatric CCHF cases were more frequent during the 2 years of the COVID-19 pandemic period compared with the 6 years before the pandemic (10 cases and 8 cases, respectively). There were no demographic and clinically significant differences between the two groups. Prepandemic patients had lower platelet (PLT) levels than pandemic patients ( p = 0.021). Two CCHF patients in the pandemic group were hospitalized with a preliminary diagnosis of multisystem inflammatory syndrome in children (MIS-C). Seventeen patients (94.4%) were treated with ribavirin. All the patients recovered. Conclusion The frequency of CCHF appeared to have been increased during the COVID-19 pandemic. But there was no difference between the prepandemic and pandemic groups from a demographic and clinical finding point of view of patients diagnosed with CCHF.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42447701","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}
Busra Zeynep Yilmaz, Ö. Akcan, S. Pekcan, H. Parlatan, G. D. Emlik, M. Doğan
Abstract Sphingomonas paucimobilis is a rarely pathogenic organism that usually infects immunocompromised patients and causes nosocomial infections, but a few community-acquired infections have been identified in relatively healthy adult patients. Herein we report a 5-year-old child who presented with acute ischemic stroke caused by S. paucimobilis that was treated successfully with antibiotics and antithrombotic agents. According to our knowledge, this is the first case of acute ischemic infarction with S. paucimobilis in a previously healthy child.
{"title":"A Rare Presentation of Sphingomonas paucimobilis in a Healthy Child: Acute Ischemic Stroke","authors":"Busra Zeynep Yilmaz, Ö. Akcan, S. Pekcan, H. Parlatan, G. D. Emlik, M. Doğan","doi":"10.1055/s-0043-1767770","DOIUrl":"https://doi.org/10.1055/s-0043-1767770","url":null,"abstract":"Abstract Sphingomonas paucimobilis is a rarely pathogenic organism that usually infects immunocompromised patients and causes nosocomial infections, but a few community-acquired infections have been identified in relatively healthy adult patients. Herein we report a 5-year-old child who presented with acute ischemic stroke caused by S. paucimobilis that was treated successfully with antibiotics and antithrombotic agents. According to our knowledge, this is the first case of acute ischemic infarction with S. paucimobilis in a previously healthy child.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"168 - 170"},"PeriodicalIF":0.3,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42711234","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}
U. Qureshi, A. Bhat, M. S. Lone, Muzafar Jan, N. Wani, M. Shah
Abstract Objective Neonatal bronchiolitis is not well characterized. We studied the profile of acute bronchiolitis in term newborns during a respiratory syncytial virus (RSV) surge following relaxation in coronavirus disease 2019 (COVID-19) appropriate behavior. Methods This was a retrospective descriptive study performed in the neonatology division of a tertiary care pediatric hospital at Srinagar, Jammu and Kashmir, India. Term neonates (born at ≥37 completed gestational weeks) from 7 up to 28 days of life admitted with bronchiolitis over a 1-month period (November 2021) were included. Results Out of total 480 neonatal admissions over a month, 35 (7%) had acute bronchiolitis. Eight neonates were excluded. Out of 27 included neonates, 13 were males. Mean age at presentation was 20 days. All neonates were born at term (≥37 completed gestational weeks). Cough (26), rapid breathing (20), and lower chest indrawing (20) were the predominant presenting features. Median SPO 2 was 87% (interquartile range 85–92%). Fourteen (52%) neonates needed admission to neonatal intensive care unit. Respiratory support was needed in the form of oxygen through nasal prongs in 24 (89%) newborns. Heated humidified high-flow nasal cannula (HHHFNC) and bubble continuous positive airway pressure were used in five neonates each. Two neonates were mechanically ventilated. The mean duration of the hospital stay was 6.2 days. All neonates survived. Conclusion A series of 27 term neonates with bronchiolitis during an RSV surge is reported in the aftermath of lifting of COVID-19 restrictions. Many of these neonates were sick enough to require significant respiratory support. The outcome was good in all neonates.
{"title":"Acute Bronchiolitis in Term Newborns Following Relaxation in COVID-19 Appropriate Behavior","authors":"U. Qureshi, A. Bhat, M. S. Lone, Muzafar Jan, N. Wani, M. Shah","doi":"10.1055/s-0043-1768441","DOIUrl":"https://doi.org/10.1055/s-0043-1768441","url":null,"abstract":"Abstract Objective Neonatal bronchiolitis is not well characterized. We studied the profile of acute bronchiolitis in term newborns during a respiratory syncytial virus (RSV) surge following relaxation in coronavirus disease 2019 (COVID-19) appropriate behavior. Methods This was a retrospective descriptive study performed in the neonatology division of a tertiary care pediatric hospital at Srinagar, Jammu and Kashmir, India. Term neonates (born at ≥37 completed gestational weeks) from 7 up to 28 days of life admitted with bronchiolitis over a 1-month period (November 2021) were included. Results Out of total 480 neonatal admissions over a month, 35 (7%) had acute bronchiolitis. Eight neonates were excluded. Out of 27 included neonates, 13 were males. Mean age at presentation was 20 days. All neonates were born at term (≥37 completed gestational weeks). Cough (26), rapid breathing (20), and lower chest indrawing (20) were the predominant presenting features. Median SPO 2 was 87% (interquartile range 85–92%). Fourteen (52%) neonates needed admission to neonatal intensive care unit. Respiratory support was needed in the form of oxygen through nasal prongs in 24 (89%) newborns. Heated humidified high-flow nasal cannula (HHHFNC) and bubble continuous positive airway pressure were used in five neonates each. Two neonates were mechanically ventilated. The mean duration of the hospital stay was 6.2 days. All neonates survived. Conclusion A series of 27 term neonates with bronchiolitis during an RSV surge is reported in the aftermath of lifting of COVID-19 restrictions. Many of these neonates were sick enough to require significant respiratory support. The outcome was good in all neonates.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"245 - 249"},"PeriodicalIF":0.3,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49130826","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}
Abstract Objective This study aimed to evaluate the cluster of differentiation (CD)64, CD16, CD11b, CD63 human leukocyte antigen-DR (HLA-DR), and CD62L leukocyte surface marker abnormalities using flow cytometry in the early diagnosis of late-onset neonatal sepsis. Methods Forty-four neonates were included in this study. Of them, 22 neonates with clinical late-onset neonatal sepsis were included in the study group, and the remaining 22 neonates without sepsis were considered the control group. Complete sepsis screening was performed. Additionally, monocyte and neutrophil surfaces marker were examined using flow cytometry. Results The expression of the leukocyte surface markers CD16 and CD64 on monocytes and neutrophils was significantly higher in the study group than in the control group ( p < 0.05), while the CD63, CD62L, CD11b, and HLA-DR levels were similar to those in the control group ( p > 0.05). Furthermore, receiver operating characteristic curve analysis indicated that neutrophil CD64 (nCD64) is a diagnostic marker for neonatal sepsis, with an area under the curve of 0.901. The CD64 and CD16, which are the respective leukocyte surface markers on neutrophils and monocytes, are useful tests in the early diagnosis of late-onset neonatal sepsis. Conclusion In addition to acute phase proteins, cell surface antigens such as CD16 and more specifically CD64 should be used in routine investigations for the early diagnosis of late-onset neonatal sepsis. Such use in combination with acute phase reactants can improve diagnostic accuracy.
{"title":"Evaluation of Changes in Leukocyte Surface Markers in the Early Diagnosis of Late-Onset Neonatal Sepsis","authors":"Efsun Korkmaz Seven, C. Aydemir, I. Tekin","doi":"10.1055/s-0043-1767814","DOIUrl":"https://doi.org/10.1055/s-0043-1767814","url":null,"abstract":"Abstract Objective This study aimed to evaluate the cluster of differentiation (CD)64, CD16, CD11b, CD63 human leukocyte antigen-DR (HLA-DR), and CD62L leukocyte surface marker abnormalities using flow cytometry in the early diagnosis of late-onset neonatal sepsis. Methods Forty-four neonates were included in this study. Of them, 22 neonates with clinical late-onset neonatal sepsis were included in the study group, and the remaining 22 neonates without sepsis were considered the control group. Complete sepsis screening was performed. Additionally, monocyte and neutrophil surfaces marker were examined using flow cytometry. Results The expression of the leukocyte surface markers CD16 and CD64 on monocytes and neutrophils was significantly higher in the study group than in the control group ( p < 0.05), while the CD63, CD62L, CD11b, and HLA-DR levels were similar to those in the control group ( p > 0.05). Furthermore, receiver operating characteristic curve analysis indicated that neutrophil CD64 (nCD64) is a diagnostic marker for neonatal sepsis, with an area under the curve of 0.901. The CD64 and CD16, which are the respective leukocyte surface markers on neutrophils and monocytes, are useful tests in the early diagnosis of late-onset neonatal sepsis. Conclusion In addition to acute phase proteins, cell surface antigens such as CD16 and more specifically CD64 should be used in routine investigations for the early diagnosis of late-onset neonatal sepsis. Such use in combination with acute phase reactants can improve diagnostic accuracy.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"193 - 198"},"PeriodicalIF":0.3,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42596785","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}
Abstract Objective Sepsis and septic shock are leading causes of mortality and morbidity in intensive care units. Our study aimed to compare the pediatric risk of mortality (PRISM-3) score, which is used for predicting mortality risk among critically ill patients in pediatric intensive care units, with laboratory parameters, particularly lactate parameters. Methods This study included 38 patients aged 1 month to 18 years who were managed for sepsis and septic shock in a pediatric intensive care unit. Lactate, D-dimer, troponin T, and N-terminal prohormone of brain natriuretic peptide levels were measured at the 0th and 24th hours. The patients were divided into survivors and nonsurvivors and those with septic shock and those without. Results There were a total of 38 patients with a median age of 12 months, of whom 17 (44.7%) were males and 21 (55.3%) were females. Six (15.8%) patients died within 7 days after the diagnosis. Nonsurvivors had significantly higher median values of PRISM-3 ( p = 0.002), C-reactive protein ( p = 0.046), and partial arterial carbon dioxide pressure ( p = 0.041). PRISM-3 showed a good discriminatory power (area under the curve [AUROC] = 0.878; p < 0.0001) and baseline lactate level showed a moderate level of discriminatory power (AUROC = 0.734 p = 0.0254) for early mortality within 7 days. Conclusion PRISM-3 and baseline lactate predict early mortality in children with sepsis and septic shock. We suggest that adding lactate, which is not included in the PRISM-3 score, to the score may increase the score's predictive ability for mortality. We believe, however, that randomized, controlled, multicenter studies with larger sample sizes should be conducted to test this hypothesis.
{"title":"Relationship between Initial Lactate Level with Mortality in Children with Sepsis and Septic Shock: A Comparison with the PRISM-3 Score","authors":"Göksu Başargan, M. Argun, Hasan Samsa","doi":"10.1055/s-0043-1764477","DOIUrl":"https://doi.org/10.1055/s-0043-1764477","url":null,"abstract":"Abstract Objective Sepsis and septic shock are leading causes of mortality and morbidity in intensive care units. Our study aimed to compare the pediatric risk of mortality (PRISM-3) score, which is used for predicting mortality risk among critically ill patients in pediatric intensive care units, with laboratory parameters, particularly lactate parameters. Methods This study included 38 patients aged 1 month to 18 years who were managed for sepsis and septic shock in a pediatric intensive care unit. Lactate, D-dimer, troponin T, and N-terminal prohormone of brain natriuretic peptide levels were measured at the 0th and 24th hours. The patients were divided into survivors and nonsurvivors and those with septic shock and those without. Results There were a total of 38 patients with a median age of 12 months, of whom 17 (44.7%) were males and 21 (55.3%) were females. Six (15.8%) patients died within 7 days after the diagnosis. Nonsurvivors had significantly higher median values of PRISM-3 ( p = 0.002), C-reactive protein ( p = 0.046), and partial arterial carbon dioxide pressure ( p = 0.041). PRISM-3 showed a good discriminatory power (area under the curve [AUROC] = 0.878; p < 0.0001) and baseline lactate level showed a moderate level of discriminatory power (AUROC = 0.734 p = 0.0254) for early mortality within 7 days. Conclusion PRISM-3 and baseline lactate predict early mortality in children with sepsis and septic shock. We suggest that adding lactate, which is not included in the PRISM-3 score, to the score may increase the score's predictive ability for mortality. We believe, however, that randomized, controlled, multicenter studies with larger sample sizes should be conducted to test this hypothesis.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"145 - 152"},"PeriodicalIF":0.3,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46915756","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}
M. Emiroğlu, B. Bozkurt, Sule Acar Duyan, G. Alkan, Sadiye Kubra Tuter Oz, A. Sert, M. Korez
Abstract Objective The aims of this study were to determine the prevalence and clinical features of ophthalmic involvement in multisystem inflammatory syndrome in children (MIS-C) and to evaluate its association with other organ system involvement and the severity of the disease. Methods The demographic data and information on the ophthalmologic and other systemic organ manifestations, laboratory findings, treatment modalities, and clinical outcomes of 97 patients with MIS-C were retrospectively obtained from their hospital records. Sixty-two patients with MIS-C who were examined by ophthalmologists were included in the study. Statistical analysis was performed using R version 3.6.0, and a p- value < 0.05 was accepted as statistically significant. Results The patients' median age was 82 months (range, 11–204 months). Of the patients, 62.9% were male. The most common systemic involvements were mucocutaneous (83.9%) and cardiovascular (82.3%). Kawasaki disease was clinically observed in 71% of the patients (incomplete form, 53.2%). Ophthalmic involvement was observed in 39 patients (62.9%). Thirty-two patients (51.6%) had conjunctival hyperemia; 29 (48.4%) lid edema; 7 follicular conjunctivitis; 3 uveitis; 2 subconjunctival hemorrhage; and 1 episcleritis. The patients with ophthalmic involvement were 6.4 times (95% confidence interval [CI], 1.49–27.48; p = 0.013) more likely to exhibit cardiac involvement and 3.53 times (95% CI, 1.35–9.63; p = 0.012) more likely to have severe disease. Conclusion Conjunctival hyperemia, lid edema, and follicular conjunctivitis were observed in at least half of the patients with MIS-C, and those with ophthalmic involvement had a higher risk of cardiac involvement or severe disease.
{"title":"Ophthalmic Manifestations of Multisystem Inflammatory Syndrome in Children","authors":"M. Emiroğlu, B. Bozkurt, Sule Acar Duyan, G. Alkan, Sadiye Kubra Tuter Oz, A. Sert, M. Korez","doi":"10.1055/s-0043-1768659","DOIUrl":"https://doi.org/10.1055/s-0043-1768659","url":null,"abstract":"Abstract Objective The aims of this study were to determine the prevalence and clinical features of ophthalmic involvement in multisystem inflammatory syndrome in children (MIS-C) and to evaluate its association with other organ system involvement and the severity of the disease. Methods The demographic data and information on the ophthalmologic and other systemic organ manifestations, laboratory findings, treatment modalities, and clinical outcomes of 97 patients with MIS-C were retrospectively obtained from their hospital records. Sixty-two patients with MIS-C who were examined by ophthalmologists were included in the study. Statistical analysis was performed using R version 3.6.0, and a p- value < 0.05 was accepted as statistically significant. Results The patients' median age was 82 months (range, 11–204 months). Of the patients, 62.9% were male. The most common systemic involvements were mucocutaneous (83.9%) and cardiovascular (82.3%). Kawasaki disease was clinically observed in 71% of the patients (incomplete form, 53.2%). Ophthalmic involvement was observed in 39 patients (62.9%). Thirty-two patients (51.6%) had conjunctival hyperemia; 29 (48.4%) lid edema; 7 follicular conjunctivitis; 3 uveitis; 2 subconjunctival hemorrhage; and 1 episcleritis. The patients with ophthalmic involvement were 6.4 times (95% confidence interval [CI], 1.49–27.48; p = 0.013) more likely to exhibit cardiac involvement and 3.53 times (95% CI, 1.35–9.63; p = 0.012) more likely to have severe disease. Conclusion Conjunctival hyperemia, lid edema, and follicular conjunctivitis were observed in at least half of the patients with MIS-C, and those with ophthalmic involvement had a higher risk of cardiac involvement or severe disease.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"211 - 219"},"PeriodicalIF":0.3,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47361199","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}
Z. Haytoğlu, E. Haytoğlu, F. Ozlu, H. Yıldızdaş, F. Kibar, S. Çetiner, Selvi Gulası, G. Uysal, O. Gundeslioglu, D. Alabaz, M. Sucu, U. Celik
Abstract Objective The factors affecting the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies from mother to newborn and the duration of seropositivity rates in these infants have not yet been clearly demonstrated. The objectives of this study were to assess the levels of SARS-CoV-2 spike–specific immunoglobulin G (IgG) in women infected in the pregnancy period and newborns born to these women and to search the transplacental transfer ratio of spike-specific IgG. Methods Seventy pregnant women with symptomatic SARS-CoV-2 infection and their newborns were prospectively followed. Anti–SARS-CoV-2 immunoassay was used for the detection of the in vitro quantitative determination of total antibodies to the SARS-CoV-2 spike protein. Results Spike-specific IgG was demonstrated in 89.1% (44 of 46) of pregnant women infected more than 14 days before delivery and in 92.6% (43 of 44) of their newborns. Median transfer ratio of spike-specific Ig was 0.87 (interquartile range [IQR], 0.34–0.90), 1.0 (IQR, 0.9–0.29), and 0.81 (IQR, 0.02–1.0) in first trimester ( n = 4), second trimester ( n = 14), and third trimester ( n = 28) pregnant women, respectively. Antibody transfer ratio was correlated with time elapsed from infection ( p < 0.001). Peak antibody transfer ratio above 1 was observed at a median 60 to 120 days after the infection from delivery. Antibody transfer ratio was high in pregnant women infected more than 60 days before delivery ( p < 0.001). Transfer ratio was significantly higher in the severe-critically symptomatic women ( n = 15) than the mild-moderately symptomatic women ( n = 55) ( p = 0.001). At 3 months, 18 of 25 infants (72%) had spike-specific IgG. Conclusion Timing from infection to delivery and severity of maternal infection are critical in assessing the antibody generation and transport. Higher antibody transfer ratio can be detected in neonates when SARS-CoV-2 infection is present for more than 60 days before birth. Maternally derived antibody can persist for 3 months after birth.
{"title":"Detection of SARS-CoV-2 Antibodies in Matched Pregnant Women and Newborn Blood","authors":"Z. Haytoğlu, E. Haytoğlu, F. Ozlu, H. Yıldızdaş, F. Kibar, S. Çetiner, Selvi Gulası, G. Uysal, O. Gundeslioglu, D. Alabaz, M. Sucu, U. Celik","doi":"10.1055/s-0043-1768200","DOIUrl":"https://doi.org/10.1055/s-0043-1768200","url":null,"abstract":"Abstract Objective The factors affecting the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies from mother to newborn and the duration of seropositivity rates in these infants have not yet been clearly demonstrated. The objectives of this study were to assess the levels of SARS-CoV-2 spike–specific immunoglobulin G (IgG) in women infected in the pregnancy period and newborns born to these women and to search the transplacental transfer ratio of spike-specific IgG. Methods Seventy pregnant women with symptomatic SARS-CoV-2 infection and their newborns were prospectively followed. Anti–SARS-CoV-2 immunoassay was used for the detection of the in vitro quantitative determination of total antibodies to the SARS-CoV-2 spike protein. Results Spike-specific IgG was demonstrated in 89.1% (44 of 46) of pregnant women infected more than 14 days before delivery and in 92.6% (43 of 44) of their newborns. Median transfer ratio of spike-specific Ig was 0.87 (interquartile range [IQR], 0.34–0.90), 1.0 (IQR, 0.9–0.29), and 0.81 (IQR, 0.02–1.0) in first trimester ( n = 4), second trimester ( n = 14), and third trimester ( n = 28) pregnant women, respectively. Antibody transfer ratio was correlated with time elapsed from infection ( p < 0.001). Peak antibody transfer ratio above 1 was observed at a median 60 to 120 days after the infection from delivery. Antibody transfer ratio was high in pregnant women infected more than 60 days before delivery ( p < 0.001). Transfer ratio was significantly higher in the severe-critically symptomatic women ( n = 15) than the mild-moderately symptomatic women ( n = 55) ( p = 0.001). At 3 months, 18 of 25 infants (72%) had spike-specific IgG. Conclusion Timing from infection to delivery and severity of maternal infection are critical in assessing the antibody generation and transport. Higher antibody transfer ratio can be detected in neonates when SARS-CoV-2 infection is present for more than 60 days before birth. Maternally derived antibody can persist for 3 months after birth.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"178 - 185"},"PeriodicalIF":0.3,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42753103","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}
A. Bolat, Deniz Yaprak, Melike Arslan, Ayşe Büyükçam, N. Balamtekin
Objective There are many adverse effects of drugs used to eradicate Helicobacter pylori, and reconstructing the microbiota by external ingestion of probiotics seems to have good effects on H. pylori eradication and prevents side effects. Methods The study included 161 outpatients aged between 8 and 18 years diagnosed with H. pylori gastritis in the Gülhane Training and Research Hospital Pediatric Gastroenterology unit from June 1, 2018, through March 31, 2020, and patients were randomized into two groups. Eighty patients in the probiotic group (first group) received H. pylori eradication therapy for 14 days; additionally, Bifidobacterium lactis B94 was administered for 14 days for eradication of H. pylori. Eighty-one patients in the standard therapy group (second group) received the same eradication therapy but no probiotics. All patients were asked to complete a detailed questionnaire regularly, including changes in symptoms and side effects of drugs on days 0, 7, and 14 of treatment. The eradication success was checked with the H. pylori stool antigen test kit 8 weeks after completion of the treatment regimen. Results The mean age of the patients was 14.2 ± 2.9 years, and 88 (64.7%) were female. The eradication rates were similar between the standard therapy and the probiotic groups by intention-to-treat analysis (p = 0.930). In order of frequency, the most common eradication treatment–related side effects were abdominal pain, taste abnormalities, and anorexia. In addition, therapy-related epigastric pain and flatulence were similar initially (p > 0.05) but seemed to be significantly lower in the probiotic group than in the standard therapy group on days 7 and 14 (p < 0.05). Conclusions Our results suggest that additional probiotic supplementation has not changed the eradication rates but seems to reduce some specific gastrointestinal adverse events in children with H. pylori infections treated with a bismuth-based quadruple eradication regimen. More extensive randomized controlled trials are needed to explain probiotics' effects on H. pylori eradication and drug side effects.
{"title":"Assessment of Efficacy and Adverse Effects of Bismuth-Based Treatment Combined with Bifidobacterium Lactis for Eradication of Helicobacter Pylori in Turkish Children","authors":"A. Bolat, Deniz Yaprak, Melike Arslan, Ayşe Büyükçam, N. Balamtekin","doi":"10.1055/s-0042-1758142","DOIUrl":"https://doi.org/10.1055/s-0042-1758142","url":null,"abstract":"\u0000 Objective There are many adverse effects of drugs used to eradicate Helicobacter pylori, and reconstructing the microbiota by external ingestion of probiotics seems to have good effects on H. pylori eradication and prevents side effects.\u0000 Methods The study included 161 outpatients aged between 8 and 18 years diagnosed with H. pylori gastritis in the Gülhane Training and Research Hospital Pediatric Gastroenterology unit from June 1, 2018, through March 31, 2020, and patients were randomized into two groups. Eighty patients in the probiotic group (first group) received H. pylori eradication therapy for 14 days; additionally, Bifidobacterium lactis B94 was administered for 14 days for eradication of H. pylori. Eighty-one patients in the standard therapy group (second group) received the same eradication therapy but no probiotics. All patients were asked to complete a detailed questionnaire regularly, including changes in symptoms and side effects of drugs on days 0, 7, and 14 of treatment. The eradication success was checked with the H. pylori stool antigen test kit 8 weeks after completion of the treatment regimen.\u0000 Results The mean age of the patients was 14.2 ± 2.9 years, and 88 (64.7%) were female. The eradication rates were similar between the standard therapy and the probiotic groups by intention-to-treat analysis (p = 0.930). In order of frequency, the most common eradication treatment–related side effects were abdominal pain, taste abnormalities, and anorexia. In addition, therapy-related epigastric pain and flatulence were similar initially (p > 0.05) but seemed to be significantly lower in the probiotic group than in the standard therapy group on days 7 and 14 (p < 0.05).\u0000 Conclusions Our results suggest that additional probiotic supplementation has not changed the eradication rates but seems to reduce some specific gastrointestinal adverse events in children with H. pylori infections treated with a bismuth-based quadruple eradication regimen. More extensive randomized controlled trials are needed to explain probiotics' effects on H. pylori eradication and drug side effects.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41599525","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}
Objective Preventive measures in the setting of a suspected measles case in a hospital setting are important to stop the secondary spread. In this report, we evaluated the prevention attempts after two suspected cases of measles were reported in a pediatric clinic. Methods We evaluated prevention interventions including isolation, intravenous immunoglobulin, or measles–mumps–rubella (MMR) vaccine after two patients were diagnosed with maculopapular rash compatible with measles in the pediatric clinic. Results There were 50 patients (29 were outpatients, 21 were inpatients), 19 health care personnel (HCP), and 50 caregivers who were in contact with index cases. All of the HCP and 40 of the caregivers were immune to measles. Additional dose of MMR vaccine was recommended to five of the outpatients by phone. A total of 12 patients who were being followed up as inpatients (8 patients aged 6–12 months, 4 patients aged ≥ 12 months) were vaccinated with one dose of MMR vaccine. Only a 12-year-old male patient was admitted due to complaints suggesting measles after 14 days from discharge. It was learned that he had received a single dose of vaccine before so he was recommended an additional dose of MMR vaccine by the phone, but he did not go to the health institution on the day of the call. Conclusion Postexposure prophylaxis is effective to prevent measles transmission. Although young infants have the highest risk for transmission of measles in a health care–associated outbreak, adolescents and older children who are single vaccinated also have high risk for clinical measles.
{"title":"Prevention of Health Care–Associated Measles Transmission in a Pediatric Clinic","authors":"A. Kaman, M. M. Oğuz","doi":"10.1055/s-0042-1758054","DOIUrl":"https://doi.org/10.1055/s-0042-1758054","url":null,"abstract":"\u0000 Objective Preventive measures in the setting of a suspected measles case in a hospital setting are important to stop the secondary spread. In this report, we evaluated the prevention attempts after two suspected cases of measles were reported in a pediatric clinic.\u0000 Methods We evaluated prevention interventions including isolation, intravenous immunoglobulin, or measles–mumps–rubella (MMR) vaccine after two patients were diagnosed with maculopapular rash compatible with measles in the pediatric clinic.\u0000 Results There were 50 patients (29 were outpatients, 21 were inpatients), 19 health care personnel (HCP), and 50 caregivers who were in contact with index cases. All of the HCP and 40 of the caregivers were immune to measles. Additional dose of MMR vaccine was recommended to five of the outpatients by phone. A total of 12 patients who were being followed up as inpatients (8 patients aged 6–12 months, 4 patients aged ≥ 12 months) were vaccinated with one dose of MMR vaccine. Only a 12-year-old male patient was admitted due to complaints suggesting measles after 14 days from discharge. It was learned that he had received a single dose of vaccine before so he was recommended an additional dose of MMR vaccine by the phone, but he did not go to the health institution on the day of the call.\u0000 Conclusion Postexposure prophylaxis is effective to prevent measles transmission. Although young infants have the highest risk for transmission of measles in a health care–associated outbreak, adolescents and older children who are single vaccinated also have high risk for clinical measles.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57975571","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}
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