Infection and Chemotherapy最新文献

Background: Human metapneumovirus (hMPV) frequently causes respiratory tract infections in children. Although hMPV infections are usually mild and self-limited, they may cause significant morbidity and mortality. However, data on pediatric hospitalizations due to hMPV infection are limited.

Materials and methods: We retrospectively analyzed the data of patients aged 18 or younger hospitalized due to hMPV infection at a tertiary hospital between 2014 and 2019.

Results: In total, 266 pediatric patients were admitted for hMPV infection. The incidence of hospitalizations due to hMPV infections was 6.4 per 1,000 hospitalized children, and the incidence of pediatric intensive care unit (PICU) admissions due to hMPV was 4.1 per 1,000 PICU-admitted children. The median age was 2.2 years (42 days-18.5 years), with 125 patients (47.0%) younger than two years old. Twenty-eight patients (10.5%) were treated in the PICU, and five of them (17.9%) died. The proportion of patients with underlying diseases was higher in the PICU group than in the general ward group (85.7% vs. 63.4%, P=0.02). The proportions of cardiologic diseases (21.4% vs. 8.8%, P=0.048) and genetic diseases (35.7% vs. 5.5%, P<0.001) were higher in the PICU group.

Conclusion: hMPV can cause severe infections that lead to PICU admission, particularly in patients with underlying conditions and fatal outcomes. Further data on hMPV infection in children admitted to the PICU and the overall disease burden in society are required.

The 20-valent pneumococcal conjugate vaccine (PCV20) was approved by the Korean Ministry of Food and Drug Safety in October 2024. Despite the ongoing national immunization programs that include pneumococcal conjugate vaccines for children and 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults, the burden of invasive pneumococcal disease and pneumococcal community-acquired pneumonia remains high among the elderly and high-risk adults. Serotypes 3 and 19A, both included in 13-valent pneumococcal conjugate vaccine (PCV13), continue to be the most prevalent serotypes, and infections caused by non-PCV13 serotypes have increased. Given the need to broaden serotype coverage and simplify vaccination strategies, the Korean Society of Infectious Diseases recommends either a single dose of PCV20 or sequential vaccination with 15-valent pneumococcal conjugate vaccine followed by PPSV23 for adults aged 65 years and older, and for high-risk adults aged 19-64 years. These recommendations are based on immunogenicity, safety, and cost-effectiveness data from recent clinical trials. Vaccine selection, dosing intervals, and schedules should be determined according to individual underlying medical conditions and previous vaccination history to optimize protection against pneumococcal disease in the adult population.

Background: Influenza is a leading cause of pediatric respiratory illness globally, yet comparative data on influenza A and B in tropical regions remain scarce. This study aimed to compare clinical features, healthcare utilization, and outcomes in children hospitalized with laboratory-confirmed influenza A and B.

Materials and methods: We conducted a retrospective cross-sectional study of children aged ≤12 years hospitalized with laboratory-confirmed influenza at a tertiary referral centre from May 2022 to December 2023. Influenza diagnosis was established using antigen-based detection via direct fluorescent antibody testing. Demographics, clinical features, laboratory results, interventions received, and patient outcomes were analyzed.

Results: Among 177 hospitalized children, 116 (65.5%) had influenza A and 61 (34.5%) had influenza B. Seizures were significantly more common in influenza A (27.6% vs. 3.3%, P<0.001). Influenza B was associated with higher rates of diarrhea (31.1% vs. 14.7%, P=0.010) and signs of respiratory distress (tachypnea: 42.6% vs. 26.7%, P=0.031; chest recessions: 41.0% vs. 25.0%, P=0.028; adventitious breath sounds: 45.9% vs. 29.3%, P=0.028). Children with influenza B more frequently required non-invasive ventilation (13.1% vs. 3.4%, P=0.015), and intravenous fluids (70.5% vs. 55.2%, P=0.048). Median hospital stay was longer in influenza B (3 vs. 2 days, P=0.008).

Conclusion: Influenza A was more frequently associated with neurologic manifestations, whereas influenza B showed a higher prevalence of lower respiratory and gastrointestinal symptoms and required greater supportive care. These findings highlight the distinct clinical profiles of influenza A and B and their implications for healthcare resource utilization.

Background: Herpes zoster (HZ; shingles) results from the reactivation of the varicella-zoster virus following a primary infection with varicella (chickenpox) in earlier life. Vaccination against HZ has been effective in preventing the disease. SKYZoster, a live attenuated zoster vaccine developed in Korea, was first licensed in Korea on September 29, 2017, and subsequently approved in Thailand (May 20, 2020) and Malaysia (December 13, 2022). This post-marketing surveillance (PMS) study aimed to assess and evaluate the safety profile of SKYZoster in adults who received the vaccine during a 4-year period in Korea.

Materials and methods: This PMS study was an open, non-comparative, multi-center study conducted from September 29, 2017, to September 28, 2021. Adults aged ≥50 years who were vaccinated with SKYZoster in Korea were enrolled in this study. Adverse events (AEs) that occurred during the first 42 days after vaccination were recorded and classified using the System Organ Class and Preferred Term using MedDRA 24.1.

Results: A total of 651 participants were included in the safety evaluation. Participants had a mean age of 62.15±8.59 years, with 55.30% of the participants being female and 1.69% (11 participants) had an allergy history. Overall, 121 AEs were reported in 76 participants (11.67%), including 51 adverse drug reactions (ADRs) in 37 participants (5.68%). Most AEs (120/121; 99.17%) were mild in severity and no serious AEs were reported. The most frequently reported ADRs were injection site reactions including vaccination site pain (2.92%), erythema (1.08%), and pruritus (0.46%). Multiple logistic regression analysis identified that allergy history (P=0.0001), concomitant medication use (P=0.0179) and current medical history (P=0.0351) were significantly associated with an increased AE incidence.

Conclusion: Over a 4-year post-marketing safety evaluation period, SKYZoster exhibited an acceptable safety profile in routine clinical practice in Korea. The vaccine was well-tolerated, with no serious adverse event reported, reaffirming its role in preventing HZ in adults.