Pub Date : 2024-08-07DOI: 10.1097/INF.0000000000004515
Rachael M Stone, Cyrine E Haidar, Nancy M Kornegay, Patricia J Barker, Seth E Karol, Joshua Wolf, Jane S Hankins, Mary V Relling, Kristine R Crews
We sought to determine whether Pneumocystis jirovecii pneumonia prophylaxis with sulfamethoxazole-trimethoprim (SMX-TMP) is associated with an increased frequency of acute hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency versus non-G6PD-deficient controls in a pediatric oncology population. There was no statistically significant difference in change in hemoglobin or transfusion requirements after starting SMX-TMP between groups. These findings suggest no increased risk of acute hemolytic anemia with SMX-TMP administered at prophylaxis doses in patients with G6PD deficiency.
{"title":"Sulfamethoxazole-Trimethoprim Prophylaxis in Pediatric Oncology Patients With Glucose-6-Phosphate Dehydrogenase Deficiency.","authors":"Rachael M Stone, Cyrine E Haidar, Nancy M Kornegay, Patricia J Barker, Seth E Karol, Joshua Wolf, Jane S Hankins, Mary V Relling, Kristine R Crews","doi":"10.1097/INF.0000000000004515","DOIUrl":"https://doi.org/10.1097/INF.0000000000004515","url":null,"abstract":"<p><p>We sought to determine whether Pneumocystis jirovecii pneumonia prophylaxis with sulfamethoxazole-trimethoprim (SMX-TMP) is associated with an increased frequency of acute hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency versus non-G6PD-deficient controls in a pediatric oncology population. There was no statistically significant difference in change in hemoglobin or transfusion requirements after starting SMX-TMP between groups. These findings suggest no increased risk of acute hemolytic anemia with SMX-TMP administered at prophylaxis doses in patients with G6PD deficiency.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009201","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}
Pub Date : 2024-08-07DOI: 10.1097/INF.0000000000004516
Elisabeth Ralser, Christina Edwards, Michaela Höck, Susanne Sprung, Ursula Kiechl-Kohlendorfer, Elke Griesmaier
A term baby underwent unexpected, fatal resuscitation in the delivery room. The mother suffered from a common cold during her last trimester of pregnancy. All other examinations throughout gestation were normal. Despite immediate, extended and effective resuscitation, heart rate did not exceed 15-20 beats/minute. In the autopsy, fetal myocarditis due to influenza A infection was detected.
{"title":"Fatal Neonatal Influenza A Myocarditis.","authors":"Elisabeth Ralser, Christina Edwards, Michaela Höck, Susanne Sprung, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1097/INF.0000000000004516","DOIUrl":"https://doi.org/10.1097/INF.0000000000004516","url":null,"abstract":"<p><p>A term baby underwent unexpected, fatal resuscitation in the delivery room. The mother suffered from a common cold during her last trimester of pregnancy. All other examinations throughout gestation were normal. Despite immediate, extended and effective resuscitation, heart rate did not exceed 15-20 beats/minute. In the autopsy, fetal myocarditis due to influenza A infection was detected.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009243","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}
Pub Date : 2024-08-05DOI: 10.1097/INF.0000000000004509
Yudan Li, Changpeng Liu, Ting Shi, Mao Sheng, Qinghui Chen, Jun Zhu, Na He, Genming Zhao, Jianmei Tian, Tao Zhang
Background: To help understand the disease burden of vaccine-preventable bacterial disease, we delineated the epidemiologic and clinical characteristics of radiographic-confirmed community-acquired pneumonia (CXR-CAP) among Chinese children.
Methods: We retrospectively screened the electronic database of the hospital information system to identify all pediatric CAP cases admitted to the Children's Hospital of Soochow University between 2010 and 2014. Radiographic findings and clinical data were extracted from the medical charts through individual chart reviews. CXR-CAP cases were defined as the presence of consolidation or pleural effusion noted on chest radiograph reports. We employed a multivariate logistic regression model to identify the potential risk factors associated with CXR-CAP.
Results: Among the 27,485 hospitalized CAP cases with radiologic data, 6322 (23.00%) were identified as CXR-CAP cases, while 21,163 (77.00%) were categorized as non-CXR-CAP cases. Children with CXR-CAP were notably older than those without CXR-CAP (non-CXR-CAP; χ2 = 1313.22; P < 0.01). CXR-CAP cases exhibited a higher rate of intensive care unit admission (3.55% vs. 1.94%; P < 0.01), extended hospital stays (73.87% vs. 63.79%; P < 0.01) and increased mortality rates (0.19% vs. 0.04%; P < 0.01). The factors associated with CXR-CAP included age (>12 months), season (summer and autumn), fever, abnormal breath sounds, C-reactive protein (>8 mg/L) and alanine transaminase (>40 U/L).
Conclusions: CXR-CAP cases consisted of a substantial proportion of hospitalized patients with CAP and had more severe clinical manifestations than in-patients without CXR-CAP among Chinese children.
{"title":"The Epidemiologic and Clinical Features of Radiographic-Confirmed Community-Acquired Pneumonia Among Chinese Children: A Retrospective Hospital-Based Study.","authors":"Yudan Li, Changpeng Liu, Ting Shi, Mao Sheng, Qinghui Chen, Jun Zhu, Na He, Genming Zhao, Jianmei Tian, Tao Zhang","doi":"10.1097/INF.0000000000004509","DOIUrl":"https://doi.org/10.1097/INF.0000000000004509","url":null,"abstract":"<p><strong>Background: </strong>To help understand the disease burden of vaccine-preventable bacterial disease, we delineated the epidemiologic and clinical characteristics of radiographic-confirmed community-acquired pneumonia (CXR-CAP) among Chinese children.</p><p><strong>Methods: </strong>We retrospectively screened the electronic database of the hospital information system to identify all pediatric CAP cases admitted to the Children's Hospital of Soochow University between 2010 and 2014. Radiographic findings and clinical data were extracted from the medical charts through individual chart reviews. CXR-CAP cases were defined as the presence of consolidation or pleural effusion noted on chest radiograph reports. We employed a multivariate logistic regression model to identify the potential risk factors associated with CXR-CAP.</p><p><strong>Results: </strong>Among the 27,485 hospitalized CAP cases with radiologic data, 6322 (23.00%) were identified as CXR-CAP cases, while 21,163 (77.00%) were categorized as non-CXR-CAP cases. Children with CXR-CAP were notably older than those without CXR-CAP (non-CXR-CAP; χ2 = 1313.22; P < 0.01). CXR-CAP cases exhibited a higher rate of intensive care unit admission (3.55% vs. 1.94%; P < 0.01), extended hospital stays (73.87% vs. 63.79%; P < 0.01) and increased mortality rates (0.19% vs. 0.04%; P < 0.01). The factors associated with CXR-CAP included age (>12 months), season (summer and autumn), fever, abnormal breath sounds, C-reactive protein (>8 mg/L) and alanine transaminase (>40 U/L).</p><p><strong>Conclusions: </strong>CXR-CAP cases consisted of a substantial proportion of hospitalized patients with CAP and had more severe clinical manifestations than in-patients without CXR-CAP among Chinese children.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894042","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}
Pub Date : 2024-08-05DOI: 10.1097/INF.0000000000004491
Kelly S Chapman, Misheck Luhanga, George Mtonga, Nickolas Agathis, Dumbani Kayira, Susan Hrapcak, Monita Patel, Howard Kress, Melissa Arons
From Malawi's HIV case surveillance, we report clinical characteristics and outcomes of 4461 children living with HIV on antiretroviral treatment aged <5 years from January to December, 2022. Among the 4% of children living with HIV who died, 43% were asymptomatic, 35% had advanced or severe symptoms at the time of HIV diagnosis and 50% died within 6 months of receiving an HIV diagnosis.
{"title":"Mortality Among Children Under Five Years of Age Living With HIV on Antiretroviral Treatment From HIV Case Surveillance Data, Malawi, 2022.","authors":"Kelly S Chapman, Misheck Luhanga, George Mtonga, Nickolas Agathis, Dumbani Kayira, Susan Hrapcak, Monita Patel, Howard Kress, Melissa Arons","doi":"10.1097/INF.0000000000004491","DOIUrl":"https://doi.org/10.1097/INF.0000000000004491","url":null,"abstract":"<p><p>From Malawi's HIV case surveillance, we report clinical characteristics and outcomes of 4461 children living with HIV on antiretroviral treatment aged <5 years from January to December, 2022. Among the 4% of children living with HIV who died, 43% were asymptomatic, 35% had advanced or severe symptoms at the time of HIV diagnosis and 50% died within 6 months of receiving an HIV diagnosis.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894040","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}
Pub Date : 2024-08-02DOI: 10.1097/INF.0000000000004495
Mahtab Ashrafi Khozani, Mahdi Abastabar, Maryam Moazeni, Mohammad Sadegh Rezai, Roya Farhadi, Jamshid Yazdani Charati, Sabah Mayahi, Iman Haghani, Mona Ghazanfari, Mahin Tavakoli, Javad Javidnia, Emmanuel Roilides, Mohammad Taghi Hedayati
Background: Although the Candida species continue to be the most frequent colonizer of neonatal skin, a clear increase of colonization due to rare yeast-like fungi has been reported. In this study, we report an unusual high prevalence of Cryptococcus diffluens colonization in neonates admitted to the neonatal intensive care unit (NICU) over a 1-month period.
Methods: From January 2020 to June 2021, the study included all neonates who were admitted to the NICU of Bu Ali Sina Hospital at least 28 days old. Skin swabs from different anatomical areas were collected. Sampling was done 3 times/week. Each sample was inoculated into Sabouraud Dextrose Agar containing chloramphenicol and CHROMagar Candida, separately. The plates were incubated at 30 °C and 35 °C, respectively. Identification of the isolates was molecularly confirmed. In vitro antifungal susceptibility testing of the isolates was performed against different antifungal agents using the Clinical Laboratory Standards Institute protocol.
Results: Among 1026 samples collected from 78 neonates, 213 yeast isolates were recovered, of which the Candida species were the most common (77.5%), followed by C. diffluens (16.9%). During the study, 55 isolated yeasts were collected from December 26, 2020, to January 26, 2021, of which 65.5% were C. diffluens , while Candida spp. constituted 100% and 98.3% of the isolates before and after this period, respectively. The most frequent sources of C. diffluens were genital regions (27.8%). Of 36 C. diffluens isolates, 13.9%, 22.2%, 52.8%, and 83.3% were non-wild type to fluconazole, amphotericin B, itraconazole and 5-flucytosine, respectively.
Conclusions: We reported for the first time an unusual high prevalence of C. diffluens colonization in neonates hospitalized in NICU. Our findings also showed the high minimum inhibitory concentration of amphotericin B and 5-flucytosine against C. diffluens .
{"title":"An Unusual High Prevalence of Cryptococcus (Naganishia) diffluens Colonization in Neonates Hospitalized in a Referral Neonatal Intensive Care Unit.","authors":"Mahtab Ashrafi Khozani, Mahdi Abastabar, Maryam Moazeni, Mohammad Sadegh Rezai, Roya Farhadi, Jamshid Yazdani Charati, Sabah Mayahi, Iman Haghani, Mona Ghazanfari, Mahin Tavakoli, Javad Javidnia, Emmanuel Roilides, Mohammad Taghi Hedayati","doi":"10.1097/INF.0000000000004495","DOIUrl":"10.1097/INF.0000000000004495","url":null,"abstract":"<p><strong>Background: </strong>Although the Candida species continue to be the most frequent colonizer of neonatal skin, a clear increase of colonization due to rare yeast-like fungi has been reported. In this study, we report an unusual high prevalence of Cryptococcus diffluens colonization in neonates admitted to the neonatal intensive care unit (NICU) over a 1-month period.</p><p><strong>Methods: </strong>From January 2020 to June 2021, the study included all neonates who were admitted to the NICU of Bu Ali Sina Hospital at least 28 days old. Skin swabs from different anatomical areas were collected. Sampling was done 3 times/week. Each sample was inoculated into Sabouraud Dextrose Agar containing chloramphenicol and CHROMagar Candida, separately. The plates were incubated at 30 °C and 35 °C, respectively. Identification of the isolates was molecularly confirmed. In vitro antifungal susceptibility testing of the isolates was performed against different antifungal agents using the Clinical Laboratory Standards Institute protocol.</p><p><strong>Results: </strong>Among 1026 samples collected from 78 neonates, 213 yeast isolates were recovered, of which the Candida species were the most common (77.5%), followed by C. diffluens (16.9%). During the study, 55 isolated yeasts were collected from December 26, 2020, to January 26, 2021, of which 65.5% were C. diffluens , while Candida spp. constituted 100% and 98.3% of the isolates before and after this period, respectively. The most frequent sources of C. diffluens were genital regions (27.8%). Of 36 C. diffluens isolates, 13.9%, 22.2%, 52.8%, and 83.3% were non-wild type to fluconazole, amphotericin B, itraconazole and 5-flucytosine, respectively.</p><p><strong>Conclusions: </strong>We reported for the first time an unusual high prevalence of C. diffluens colonization in neonates hospitalized in NICU. Our findings also showed the high minimum inhibitory concentration of amphotericin B and 5-flucytosine against C. diffluens .</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894035","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}
Pub Date : 2024-08-02DOI: 10.1097/INF.0000000000004492
Ashley Stark, Rachel G Greenberg, Rick Pittman, Kristin E D Weimer
Congenital cytomegalovirus is a leading cause of neurodevelopmental impairment and sensorineural hearing loss. We evaluated infants ≤21 days postnatal age who had both urine and saliva cytomegalovirus testing and determined concordance between the 2 tests and influence of very low birth weight on concordance. Discordance was low overall between urine and saliva testing; however, discordance was high in very low birth weight infants.
{"title":"Concordance of Cytomegalovirus Saliva and Urine Testing in Infants for the Detection of Congenital Infection.","authors":"Ashley Stark, Rachel G Greenberg, Rick Pittman, Kristin E D Weimer","doi":"10.1097/INF.0000000000004492","DOIUrl":"https://doi.org/10.1097/INF.0000000000004492","url":null,"abstract":"<p><p>Congenital cytomegalovirus is a leading cause of neurodevelopmental impairment and sensorineural hearing loss. We evaluated infants ≤21 days postnatal age who had both urine and saliva cytomegalovirus testing and determined concordance between the 2 tests and influence of very low birth weight on concordance. Discordance was low overall between urine and saliva testing; however, discordance was high in very low birth weight infants.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894038","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}
Background: Measles is highly infectious, requiring ≥95% vaccine coverage rate (VCR) to prevent outbreaks. This study aimed to understand the impact of the COVID-19 pandemic on routine measles-containing vaccine (MCV) VCRs in Serbia and estimate national and regional catch-up vaccination required to prevent outbreaks.
Methods: A multiplier model was used to calculate annual MCV dose 1 (MCV1) and MCV dose 2 (MCV2) VCRs for children 1-6 and 6-12 years of age, respectively, for 2011-2022. Postpandemic (2023-2024) VCRs were modeled. The numbers of administered doses were compared to prepandemic and postpandemic, and monthly catch-up rates were calculated for 12-, 18- and 24-month campaigns.
Results: Between prepandemic and pandemic periods, national MCV1 VCR decreased from 88% to 81%, while MCV2 VCR decreased from 92% to 89%, corresponding to 20,856 missed MCV1 and 8760 missed MCV2 doses. Assuming national VCRs returned to prepandemic levels post-2022, 18% of children 1-6 years of age and 11% of children 6-12 years of age would have missed their MCV1 and MCV2 doses, respectively, by 2024. To catch up missed doses under this scenario, most regions would require monthly catch-up rates of 25%, 16% or 12% for MCV1 and 14%, 9% or 7% for MCV2, considering 12-, 18- or 24-month campaigns, respectively.
Conclusions: The pandemic negatively impacted MCV VCRs in Serbia, leaving a sizeable proportion of children with missed doses. Significant catch-up efforts are required to recover VCRs to prepandemic levels and avoid future measles outbreaks, with increased monthly administration rates versus those in prepandemic periods.
{"title":"Impact of the COVID-19 Pandemic on Measles Vaccination Coverage and Estimated Catch-Up Efforts for Serbia.","authors":"Colleen Burgess, Bogdan Lisul, Manjiri Pawaskar, Tanaz Petigara, Janice Murtagh, Milena Kanazir, Goranka Loncarevic, Cristina Carias","doi":"10.1097/INF.0000000000004487","DOIUrl":"https://doi.org/10.1097/INF.0000000000004487","url":null,"abstract":"<p><strong>Background: </strong>Measles is highly infectious, requiring ≥95% vaccine coverage rate (VCR) to prevent outbreaks. This study aimed to understand the impact of the COVID-19 pandemic on routine measles-containing vaccine (MCV) VCRs in Serbia and estimate national and regional catch-up vaccination required to prevent outbreaks.</p><p><strong>Methods: </strong>A multiplier model was used to calculate annual MCV dose 1 (MCV1) and MCV dose 2 (MCV2) VCRs for children 1-6 and 6-12 years of age, respectively, for 2011-2022. Postpandemic (2023-2024) VCRs were modeled. The numbers of administered doses were compared to prepandemic and postpandemic, and monthly catch-up rates were calculated for 12-, 18- and 24-month campaigns.</p><p><strong>Results: </strong>Between prepandemic and pandemic periods, national MCV1 VCR decreased from 88% to 81%, while MCV2 VCR decreased from 92% to 89%, corresponding to 20,856 missed MCV1 and 8760 missed MCV2 doses. Assuming national VCRs returned to prepandemic levels post-2022, 18% of children 1-6 years of age and 11% of children 6-12 years of age would have missed their MCV1 and MCV2 doses, respectively, by 2024. To catch up missed doses under this scenario, most regions would require monthly catch-up rates of 25%, 16% or 12% for MCV1 and 14%, 9% or 7% for MCV2, considering 12-, 18- or 24-month campaigns, respectively.</p><p><strong>Conclusions: </strong>The pandemic negatively impacted MCV VCRs in Serbia, leaving a sizeable proportion of children with missed doses. Significant catch-up efforts are required to recover VCRs to prepandemic levels and avoid future measles outbreaks, with increased monthly administration rates versus those in prepandemic periods.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894039","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}
Pub Date : 2024-08-01Epub Date: 2024-05-29DOI: 10.1097/INF.0000000000004404
Maja K Pietrzak, Maria Pokorska-Śpiewak
{"title":"Shingles in Children.","authors":"Maja K Pietrzak, Maria Pokorska-Śpiewak","doi":"10.1097/INF.0000000000004404","DOIUrl":"10.1097/INF.0000000000004404","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162052","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}