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Severe Presentations and Outcomes in Hospitalized Pediatric Patients With Parvovirus B19 Infection During the 2024 Outbreak: A Multicenter Prospective Study in Italy. 2024年意大利爆发期间感染细小病毒B19的住院儿科患者的严重表现和结局:一项多中心前瞻性研究
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-10-15 DOI: 10.1097/INF.0000000000005014
Elisabetta Venturini, Agnese Maria Tamborino, Giusy Arrichiello, Federica Attaianese, Francesca Ippolita Calò Carducci, Claudio Cafagno, Désirée Caselli, Maia De Luca, Valeria Garbo, Vania Giacomet, Cecilia Liberati, Laura Lancella, Amelia Licari, Marco Maglione, Fabio Midulla, Cristina Moracas, Maria Moriondo, Marco Poeta, Claudia Rossini, Alfredo Guarino, Luisa Galli

Background: Since March 2024, the European Center for Disease Prevention and Control has reported increased Parvovirus B19 (B19V) infections across 14 European countries. While often self-limiting in healthy children, B19V may cause severe disease in vulnerable populations.

Methods: This multicenter prospective study aimed to characterize the clinical presentation of B19V infection in hospitalized children and identify risk factors for severe outcomes. Data were collected through the INF-ACT pediatric surveillance system, as part of the National Recovery and Resilience Plan. Children hospitalized with confirmed B19V infection were enrolled from January to December 2024 in 10 Italian INF-ACT centers.

Results: A total of 135 children were included (median age 7.6 years, interquartile range 4.4-9.9), with 78.5% of cases occurring between April and July 2024. Acute myocarditis (20.7%) and neurologic complications (17.8%) were the most frequent severe manifestations. Myocarditis was significantly associated with younger age ( P < 0.001), longer hospital stays (median 19.5 vs. 6.5 days; P = 0.0018) and higher intensive care unit (ICU) admission rates (71.4% vs. 20.8%; P < 0.001). Multivariate analysis showed myocardial involvement increased the risk of ICU admission over 20-fold ( P < 0.001).

Conclusions: Although often mild, B19V infection can cause severe complications in children, particularly myocarditis and neurologic involvement. Prompt recognition is essential, even in the absence of classic features like erythema infectiosum, to ensure timely monitoring and management of potentially life-threatening outcomes.

背景:自2024年3月以来,欧洲疾病预防控制中心报告了14个欧洲国家细小病毒B19 (B19V)感染的增加。虽然B19V病毒在健康儿童中往往具有自限性,但它可能在脆弱人群中引起严重疾病。方法:本多中心前瞻性研究旨在描述住院儿童B19V感染的临床表现,并确定严重后果的危险因素。作为国家恢复和复原力计划的一部分,通过INF-ACT儿科监测系统收集数据。2024年1月至12月,在意大利10个INF-ACT中心招募了确诊感染B19V的住院儿童。结果:共纳入135例患儿(中位年龄7.6岁,四分位数范围4.4 ~ 9.9),78.5%的病例发生在2024年4月~ 7月。急性心肌炎(20.7%)和神经系统并发症(17.8%)是最常见的严重表现。心肌炎与年龄较小(P < 0.001)、住院时间较长(中位19.5天对6.5天,P = 0.0018)和重症监护病房(ICU)住院率较高(71.4%对20.8%,P < 0.001)显著相关。多因素分析显示心肌受累使ICU住院风险增加20倍以上(P < 0.001)。结论:虽然B19V感染通常是轻微的,但在儿童中可引起严重的并发症,特别是心肌炎和神经系统受累。即使在没有传染性红斑等典型特征的情况下,及时识别也是至关重要的,以确保及时监测和管理可能危及生命的后果。
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引用次数: 0
Epidemiology and Clinical Impact of Mycoplasma pneumoniae in an Italian Pediatric Center: An Observational Study from 2017 to 2024. 意大利儿科中心肺炎支原体的流行病学和临床影响:2017年至2024年的观察性研究
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-17 DOI: 10.1097/INF.0000000000004993
Marco Bianchi, Mara Pisani, Lara Ricotta, Carmen D'Amore, Anna Chiara Vittucci, Sebastian Cristaldi, Anna Maria Musolino, Paola Bernaschi, Velia Chiara Di Maio, Venere Cortazzo, Claudio Cherchi, Renato Cutrera, Federica Pellizzoni, Alessia Arduini, Maria Antonietta Barbieri, Andrea Campana, Martina Di Giuseppe, Umberto Raucci, Laura Lancella, Marta Luisa Ciofi Degli Atti, Carlo Federico Perno, Alberto Villani

Background: Mycoplasma pneumoniae (MP) is a common cause of lower respiratory tract infections in children. During the COVID-19 pandemic, a marked decline in MP infections was observed, with a delayed resurgence reported in some European countries. This study aimed to assess the epidemiologic trends and clinical features of MP infections in a pediatric tertiary care academic hospital in Italy from 2017 to 2024.

Methods: We conducted a retrospective, single-center study including immunocompetent patients 30 days to 17 years of age, hospitalized with confirmed MP infection. Clinical, laboratory, and radiologic data were analyzed across 3 periods: prepandemic (2017-2019), pandemic (2020-2022) and postpandemic (2023-2024). Statistical analyses were performed to compare incidence and clinical characteristics over time.

Results: Of 303 included patients, 130 were hospitalized prepandemic and 148 postpandemics. The proportion of MP among acute respiratory infection hospitalizations nearly doubled, from 3.2% in 2019 to 6.1% in 2024. Despite the higher incidence, the need for respiratory support remained stable (25.7% overall; P = 0.3), the pediatric intensive care admissions were rare and unchanged (2.0% vs. 2.0%, P = 1.0) and median hospital stay was consistent across both periods (5 days, interquartile range 4-8; P = 0.803).

Conclusions: MP incidence increased significantly postpandemic, and clinical severity remained comparable to prepandemic levels. Ongoing epidemiologic surveillance is essential to better understand infection dynamics and to guide effective clinical management strategies.

背景:肺炎支原体(Mycoplasma pneumoniae, MP)是儿童下呼吸道感染的常见病因。在2019冠状病毒病大流行期间,观察到脊髓炎感染显著下降,但在一些欧洲国家报告出现了延迟复发。本研究旨在评估意大利某儿科三级专科医院2017 - 2024年MP感染的流行病学趋势和临床特征。方法:我们进行了一项回顾性的单中心研究,纳入了30天至17岁的免疫功能正常的住院确诊MP感染患者。临床、实验室和放射学数据分3个时期进行分析:大流行前(2017-2019)、大流行前(2020-2022)和大流行后(2023-2024)。进行统计分析,比较发病率和临床特征随时间的变化。结果:纳入的303例患者中,大流行前住院130例,大流行后住院148例。急性呼吸道感染住院患者中MP的比例几乎翻了一番,从2019年的3.2%增至2024年的6.1%。尽管发病率较高,但对呼吸支持的需求保持稳定(总体为25.7%,P = 0.3),儿科重症监护入院率很少且未发生变化(2.0%对2.0%,P = 1.0),两个时期的住院时间中位数一致(5天,四分位数间距为4-8,P = 0.803)。结论:MP发病率在大流行后显著增加,临床严重程度保持与大流行前水平相当。持续的流行病学监测对于更好地了解感染动态和指导有效的临床管理策略至关重要。
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引用次数: 0
Epidemiology and Risk Factors of Pediatric Clostridioides difficile Infection: A Nationwide Claims-based Comparison With Adults in Japan. 儿童艰难梭菌感染的流行病学和危险因素:日本全国范围内与成人的比较
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-12 DOI: 10.1097/INF.0000000000004992
Daisuke Yamasaki, Yoshiki Kusama, Shiho Ito, Masaki Tanabe

Background: Pediatric Clostridioides difficile infection (CDI) is a growing concern, yet nationwide data from Japan are scarce. Current guidelines often discourage CDI testing in infants due to a presumed low incidence of clinical disease. We aimed to characterize the epidemiology and risk factors of pediatric CDI in Japan, focusing on age-specific patterns and community-onset cases.

Methods: We performed a retrospective analysis using the Japan Medical Data Center claims database from 2013 to 2022. CDI cases were defined by the presence of both diagnostic testing and anti-CDI treatment within 7 days. Episodes that relapsed within 8 weeks were excluded. CDI onset setting was classified according to CDC/NHSN criteria. Risk factors were evaluated by age and onset setting.

Results: Of the 4090 CDI cases, 284 were pediatric. The incidence in children 0-2 years old was comparable to that in older children, challenging current assumptions. Risk factor profiles varied by age group and setting, with inflammatory bowel disease being a prominent risk factor in children (28.9% vs. 14.8% in adults/older adults), particularly in adolescents (43.5%). Critically, nearly half of community-onset pediatric CDI cases had no prior antibiotic exposure.

Conclusion: This first large-scale study of pediatric CDI in Japan revealed that CDI can occur in children without prior antibiotic exposure, particularly in community settings. These findings support consideration of revisions to management strategies for pediatric CDI.

背景:儿童艰难梭菌感染(CDI)日益受到关注,但来自日本的全国数据很少。目前的指导方针通常不鼓励在婴儿中进行CDI检测,因为假定临床疾病的发病率较低。我们的目的是描述日本儿童CDI的流行病学和危险因素,重点关注特定年龄模式和社区发病病例。方法:我们使用日本医疗数据中心2013年至2022年索赔数据库进行回顾性分析。CDI病例的定义是在7天内进行诊断检测和抗CDI治疗。排除8周内复发的发作。根据CDC/NHSN标准对CDI发病环境进行分类。危险因素按年龄和发病环境进行评估。结果:4090例CDI病例中,284例为儿童。0-2岁儿童的发病率与年龄较大的儿童相当,挑战了目前的假设。危险因素概况因年龄组和环境而异,炎症性肠病是儿童的主要危险因素(28.9% vs.成人/老年人14.8%),特别是青少年(43.5%)。至关重要的是,近一半的社区发病儿童CDI病例之前没有抗生素暴露。结论:日本首次对儿童CDI进行的大规模研究表明,CDI可以发生在没有抗生素暴露的儿童中,特别是在社区环境中。这些发现支持修订儿科CDI管理策略的考虑。
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引用次数: 0
Persistence of Antibodies at Three, Four and Five Years of Age to Ten-valent Pneumococcal Polysaccharide Protein D-conjugate Vaccine in South African Children According to HIV Status. 三、四、五岁南非儿童对十价肺炎球菌多糖蛋白d结合疫苗抗体的持久性
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-03 DOI: 10.1097/INF.0000000000005050
Alane Izu, Anthonet Koen, Lisa Jose, Clare Cutland, Linda de Gouveia, Anne von Gottberg, Michelle J Groome, Stephanie Jones, Shabir A Madhi

Background: Streptococcus pneumoniae remains a major cause of bacterial disease in young children, with increased risk and morbidity in children exposed to HIV but uninfected (CEHU) and children living with HIV (CLWH). This study assessed the persistence of vaccine-specific antibodies, opsonophagocytic activity (OPA) and nasopharyngeal carriage of S. pneumoniae and Haemophilus influenzae in HIV-unexposed children, CEHU and CLWH.

Methods: HIV-unexposed children, CEHU and CLWH who initially received a 10-valent pneumococcal polysaccharide protein D-conjugate vaccine 3-dose primary schedule at 6, 10 and 14 weeks with a booster at 9 months (3 + 1) were followed up at 3, 4 and 5 years to measure serum IgG concentrations, OPA and nasopharyngeal colonization. Geometric mean concentrations (GMCs) and titers, along with the prevalence of colonization, are reported for each group.

Results: Compared with HIV-unexposed children, CLWH had similar antibody concentrations for all serotypes at each timepoint except at 4 years where GMCs were lower for 6B and at 5 years where GMCs were lower for 6A. OPA titers were lower for 6B at 3 years and lower for 4B at 4 and 5 years in CLWH compared with HIV-unexposed children. Comparing CEHU to HIV-unexposed children, both study groups had similar GMCs and OPA titers for all serotypes during the study period. Prevalence of nasopharyngeal colonization of S. pneumoniae and H. influenzae was similar amongst the 3 study groups.

Conclusions: There was no association between HIV exposure or infection and antibody persistence or colonization at 3, 4 and 5 years of age.

背景:肺炎链球菌仍然是幼儿细菌性疾病的主要原因,暴露于艾滋病毒但未感染的儿童(CEHU)和感染艾滋病毒的儿童(CLWH)的风险和发病率增加。本研究评估了未暴露于hiv的儿童、CEHU和CLWH中疫苗特异性抗体的持久性、抗噬细胞活性(OPA)和肺炎链球菌和流感嗜血杆菌的鼻咽携带。方法:首次接种10价肺炎球菌多糖蛋白d结合疫苗的儿童、CEHU和CLWH在第6、10和14周接种3剂初级疫苗,在第9个月(3 + 1)接种加强疫苗,在第3、4和5年随访,测定血清IgG浓度、OPA和鼻咽定植。几何平均浓度(GMCs)和滴度,以及殖民化的流行,报告了每组。结果:与未接触hiv的儿童相比,CLWH在每个时间点的所有血清型抗体浓度相似,除了4岁时6B的GMCs较低和5岁时6A的GMCs较低。与未接触hiv的儿童相比,CLWH 3岁时6B的OPA滴度较低,4岁和5岁时4B的OPA滴度较低。将CEHU与未暴露于hiv的儿童进行比较,两个研究组在研究期间所有血清型的GMCs和OPA滴度相似。3个研究组中肺炎链球菌和流感嗜血杆菌的鼻咽部定植率相似。结论:在3、4、5岁时,HIV暴露或感染与抗体持续或定植没有关联。
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引用次数: 0
Healthcare Resource Utilization and Corresponding Costs of Respiratory Syncytial Virus Hospital Episodes Before the Age of Two in England, 2015-2019. 2015-2019年英国2岁前呼吸道合胞病毒住院发作的医疗资源利用及相应费用
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI: 10.1097/INF.0000000000005062
Maria João Fonseca, Saskia Hagenaars, Mersha Chetty, Mathieu Bangert, Lori Cirneanu, Jessica Lundbom, Richard Hudson

Background: A comprehensive analysis of the respiratory syncytial virus (RSV) burden in England is required. We estimated respiratory-related healthcare resource utilization (HCRU) and costs for infants experiencing RSV episodes.

Methods: A birth cohort of all infants born between March 01, 2015, and February 28, 2017 (n = 449,591) was established using Clinical Practice Research Datalink-Hospital Episode Statistics. Case cohorts included infants with an episode of (1) RSV, (2) bronchiolitis, (3) any respiratory tract infection at <24 months and (4) RSV-predicted at <12 months. Treatments, procedures, clinical outcomes, respiratory-related HCRU and associated costs, and the patient pathway during the month before and 24 months following the index episode were described in case and comparative cohorts.

Results: Among the 4813 infants in the RSV-coded case cohort (vs. comparative cohort), the mean number of respiratory-related healthcare visits was 5.1 (vs. 1.5), with the highest burden occurring in November and December, mostly in infants up to 12 months of age. Noninvasive and invasive ventilations were performed in 17% (vs. 0.47%) and 9% (vs.0.28%), respectively, 48% (vs. 38%) were prescribed antibiotics, and 0.44% (vs. 0.09%) died. Before and after the index episode, ~30% and ~75%, respectively, had another respiratory-related healthcare visit, with a mean cost of £4060 (vs. £242) per infant. Notably, minimal differences were observed across all outcomes between infants born before and during the RSV season.

Conclusions: This study quantifies the significant impact of RSV infections in infants on the healthcare system. It highlights the need for effective preventive strategies for infants entering their first season.

背景:需要对英国呼吸道合胞病毒(RSV)负担进行全面分析。我们估计了呼吸道相关医疗资源利用率(HCRU)和发生呼吸道合胞病毒发作的婴儿的费用。方法:使用临床实践研究数据链-医院事件统计建立2015年3月1日至2017年2月28日出生的所有婴儿的出生队列(n = 449,591)。病例队列包括发生(1)RSV,(2)细支气管炎,(3)呼吸道感染的婴儿。结果:在RSV编码病例队列(对比对照队列)的4813名婴儿中,呼吸相关医疗保健就诊的平均次数为5.1次(对比1.5次),最高负担发生在11月和12月,主要发生在12个月以下的婴儿。无创和有创通气分别占17% (vs. 0.47%)和9% (vs.0.28%),使用抗生素的占48% (vs. 38%),死亡的占0.44% (vs. 0.09%)。在指数发作之前和之后,分别有30%和75%的人再次进行了与呼吸相关的医疗保健访问,每个婴儿的平均费用为4060英镑(对242英镑)。值得注意的是,在RSV季节之前和期间出生的婴儿之间观察到的所有结果差异极小。结论:本研究量化了婴儿呼吸道合胞病毒感染对医疗保健系统的重大影响。它强调了对进入第一个季节的婴儿采取有效预防战略的必要性。
{"title":"Healthcare Resource Utilization and Corresponding Costs of Respiratory Syncytial Virus Hospital Episodes Before the Age of Two in England, 2015-2019.","authors":"Maria João Fonseca, Saskia Hagenaars, Mersha Chetty, Mathieu Bangert, Lori Cirneanu, Jessica Lundbom, Richard Hudson","doi":"10.1097/INF.0000000000005062","DOIUrl":"https://doi.org/10.1097/INF.0000000000005062","url":null,"abstract":"<p><strong>Background: </strong>A comprehensive analysis of the respiratory syncytial virus (RSV) burden in England is required. We estimated respiratory-related healthcare resource utilization (HCRU) and costs for infants experiencing RSV episodes.</p><p><strong>Methods: </strong>A birth cohort of all infants born between March 01, 2015, and February 28, 2017 (n = 449,591) was established using Clinical Practice Research Datalink-Hospital Episode Statistics. Case cohorts included infants with an episode of (1) RSV, (2) bronchiolitis, (3) any respiratory tract infection at <24 months and (4) RSV-predicted at <12 months. Treatments, procedures, clinical outcomes, respiratory-related HCRU and associated costs, and the patient pathway during the month before and 24 months following the index episode were described in case and comparative cohorts.</p><p><strong>Results: </strong>Among the 4813 infants in the RSV-coded case cohort (vs. comparative cohort), the mean number of respiratory-related healthcare visits was 5.1 (vs. 1.5), with the highest burden occurring in November and December, mostly in infants up to 12 months of age. Noninvasive and invasive ventilations were performed in 17% (vs. 0.47%) and 9% (vs.0.28%), respectively, 48% (vs. 38%) were prescribed antibiotics, and 0.44% (vs. 0.09%) died. Before and after the index episode, ~30% and ~75%, respectively, had another respiratory-related healthcare visit, with a mean cost of £4060 (vs. £242) per infant. Notably, minimal differences were observed across all outcomes between infants born before and during the RSV season.</p><p><strong>Conclusions: </strong>This study quantifies the significant impact of RSV infections in infants on the healthcare system. It highlights the need for effective preventive strategies for infants entering their first season.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":"45 2","pages":"194-201"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912511","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}
引用次数: 0
Disease Burden of the 2024-2025 Influenza Season in Children: Insights from a Tertiary Center in Turkey. 2024-2025年儿童流感季节的疾病负担:来自土耳其三级中心的见解
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-17 DOI: 10.1097/INF.0000000000005003
Elif Böncüoğlu, Kamile Ötiken Oktay, Özlem Özdemir Balci, Murat Anil
{"title":"Disease Burden of the 2024-2025 Influenza Season in Children: Insights from a Tertiary Center in Turkey.","authors":"Elif Böncüoğlu, Kamile Ötiken Oktay, Özlem Özdemir Balci, Murat Anil","doi":"10.1097/INF.0000000000005003","DOIUrl":"10.1097/INF.0000000000005003","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e63-e64"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086730","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}
引用次数: 0
Analysis of Pharmacokinetics and Comparison Between One-point Versus Two-point Sampling for Therapeutic Drug Monitoring of Vancomycin in Children. 万古霉素儿童治疗药物监测一点与两点取样药代动力学分析及比较。
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-17 DOI: 10.1097/INF.0000000000005006
Seonghae Yoon, Seunghwan Baek, Jae-Yong Chung, Kyunghoon Lee, Joon Hee Lee, Sunghee Lee, Jiin Seo, Young Min Cho, Ji Hyun Kim, Hyunju Lee

Background: Vancomycin therapeutic drug monitoring (TDM) is essential for optimizing efficacy and minimizing toxicity, particularly in acute kidney injury (AKI). However, recent guidelines favor area under the curve (AUC)-guided dosing over traditional trough monitoring to improve dosing. This study aimed to compare vancomycin TDM strategies in pediatric patients, examine the agreement between 1-point and 2-point sampling methods for AUC estimation, and explore the association between vancomycin exposure and clinical outcomes.

Methods: This retrospective cohort study included pediatric patients (2 months to 18 years of age) who underwent vancomycin TDM between 2017 and 2019 (trough-based dosing) and 2020 and 2022 (AUC-based dosing). The pharmacokinetic parameters were estimated using Bayesian software. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria. Receiver operating characteristic curve analysis was performed to identify the threshold values of AUC and trough concentrations for predicting AKI.

Results: A total of 288 patients were included in the study: 164 were from 2017 to 2019 and 124 were from 2020 to 2022, respectively. A comparison of the 1-point and 2-point sampling methods for estimating the AUC showed no significant differences. The incidence of AKI was slightly lower in the 2020-2022 cohort (2.4%) than in the 2017-2019 cohort (6.7%), though the difference was not statistically significant. The AUC threshold for predicting AKI was similar between 1-point and 2-point sampling methods (588-621 mg h/L).

Conclusions: AUC-based vancomycin dosing was associated with a reduced incidence of AKI in pediatric patients, without compromising efficacy. Further studies are warranted to refine the exposure targets for bacteremia resolution.

背景:万古霉素治疗药物监测(TDM)对于优化疗效和减少毒性至关重要,特别是在急性肾损伤(AKI)中。然而,最近的指南更倾向于曲线下面积(AUC)引导剂量,而不是传统的槽监测来改善剂量。本研究旨在比较万古霉素TDM策略在儿科患者中的应用,检验1点和2点抽样方法估算AUC的一致性,并探讨万古霉素暴露与临床结果之间的关系。方法:本回顾性队列研究纳入了2017年至2019年(波谷给药)和2020年至2022年(auc给药)期间接受万古霉素TDM治疗的儿科患者(2个月至18岁)。采用贝叶斯软件估计药代动力学参数。AKI是根据肾脏疾病:改善全球结局标准定义的。进行受试者工作特征曲线分析,以确定AUC和谷浓度的阈值,用于预测AKI。结果:共纳入288例患者,其中2017 - 2019年164例,2020 - 2022年124例。比较1点和2点抽样方法估计AUC没有显着差异。2020-2022年队列中AKI的发生率(2.4%)略低于2017-2019年队列(6.7%),但差异无统计学意义。预测AKI的AUC阈值在1点和2点采样方法之间相似(588-621 mg h/L)。结论:基于auc的万古霉素剂量与儿科患者AKI发生率降低相关,且不影响疗效。需要进一步的研究来完善菌血症解决方案的暴露靶点。
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引用次数: 0
Trends in Antibiotic Use for Pediatric Patients With Pneumonia: A Nationwide Analysis in South Korea (2016-2023). 儿童肺炎患者抗生素使用趋势:韩国全国分析(2016-2023)。
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-18 DOI: 10.1097/INF.0000000000004995
Ji Young Park, Jungmi Chae, Young June Choe, Yujeong Kim, Jihye Shin, Dong-Sook Kim, Hyunju Lee

Background: Pneumonia is a leading cause of antibiotic use for children. This study aimed to assess nationwide antibiotic prescribing patterns for pediatric pneumonia in South Korea between 2016 and 2023, a period encompassing both epidemic and nonepidemic periods of Mycoplasma pneumoniae pneumonia (MPP).

Methods: Using national claims data from the Health Insurance Review and Assessment Service, we analyzed antibiotic prescriptions for patients under 18 years diagnosed with bacterial pneumonia (International Classification of Diseases, 10th Revision codes; viral pneumonia was excluded). Antibiotic use was measured in days of therapy per 1000 patient-days (inpatients) or per 1000 patients (outpatients).

Results: Among 8.7 million inpatient days and 3.5 million outpatient visits, the 2-4 years group accounted for the highest burden (497.1 inpatient days and 161.6 outpatient visits per 1000 population). Macrolides were the most prescribed class in both inpatients [805.1 days of therapy (DOT)/1000 patient-days] and outpatients (4898.0 DOT/1000 patients), except in infants, where third-generation cephalosporins predominated. Use of third-generation cephalosporins increased sharply from 2022 and became the most prescribed class in 2023. Tertiary hospitals had higher use of tetracyclines (26.8 DOT/1000 patient-days) and quinolones but lower use of beta-lactams than other facility types. Antibiotic prescribing peaked in the fourth quarter of each year.

Conclusion: Among children in South Korea diagnosed with bacterial pneumonia, macrolides were most frequently prescribed, and prescriptions for third-generation cephalosporins showed an increasing trend. These findings underscore challenges in antimicrobial stewardship and need for strengthened nationwide antimicrobial stewardship policies for pediatric pneumonia tailored to age, setting, and seasonal trends.

背景:肺炎是儿童使用抗生素的主要原因。本研究旨在评估韩国2016年至2023年期间儿童肺炎的全国抗生素处方模式,这一时期包括肺炎支原体肺炎(MPP)的流行期和非流行期。方法:利用健康保险审查与评估服务中心的全国理赔数据,分析18岁以下诊断为细菌性肺炎(《国际疾病分类》第十次修订代码;病毒性肺炎除外)的患者的抗生素处方。抗生素使用以每1000患者日(住院患者)或每1000患者(门诊患者)的治疗天数来衡量。结果:在870万住院日和350万门诊人次中,2-4岁组负担最重(每千人497.1住院日和161.6门诊人次)。大环内酯类药物在住院患者[805.1天治疗(DOT)/1000患者-天]和门诊患者(4898.0 DOT/1000患者)中都是处方最多的类别,但在婴儿中以第三代头孢菌素为主。第三代头孢菌素的使用从2022年开始急剧增加,并在2023年成为处方最多的类别。三级医院的四环素类药物(26.8 DOT/1000患者日)和喹诺酮类药物的使用率较高,但β -内酰胺类药物的使用率低于其他医院。抗生素处方在每年第四季度达到顶峰。结论:在韩国诊断为细菌性肺炎的儿童中,大环内酯类药物的使用频率最高,第三代头孢菌素的使用呈增加趋势。这些发现强调了抗菌素管理面临的挑战,需要加强针对儿童肺炎的全国性抗菌素管理政策,以适应年龄、环境和季节性趋势。
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引用次数: 0
Postmalaria Labyrinthitis Ossificans: A Rare Complication of Plasmodium Infection. 疟疾后骨化性迷路炎:一种罕见的疟原虫感染并发症。
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-19 DOI: 10.1097/INF.0000000000005010
Francisca Sena Batista, Rosa Couto, Diogo Pinto, Ana Mafalda Matias, Lígia Neves, Filipa Castelão
{"title":"Postmalaria Labyrinthitis Ossificans: A Rare Complication of Plasmodium Infection.","authors":"Francisca Sena Batista, Rosa Couto, Diogo Pinto, Ana Mafalda Matias, Lígia Neves, Filipa Castelão","doi":"10.1097/INF.0000000000005010","DOIUrl":"10.1097/INF.0000000000005010","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e66-e67"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086810","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}
引用次数: 0
Human Metapneumovirus-associated Liver Enzyme Elevation in Children: Case Series of Nine Patients. 儿童人偏肺病毒相关肝酶升高:9例病例分析
IF 2.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2026-02-01 Epub Date: 2025-09-15 DOI: 10.1097/INF.0000000000005000
Abdulkerim Elmas, Tuğba Gürsoy Koca, Mustafa Akcam, Orkun Cemal Ozdemir
{"title":"Human Metapneumovirus-associated Liver Enzyme Elevation in Children: Case Series of Nine Patients.","authors":"Abdulkerim Elmas, Tuğba Gürsoy Koca, Mustafa Akcam, Orkun Cemal Ozdemir","doi":"10.1097/INF.0000000000005000","DOIUrl":"10.1097/INF.0000000000005000","url":null,"abstract":"","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":"e60-e61"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086821","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}
引用次数: 0
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Pediatric Infectious Disease Journal
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