Journal of the Pediatric Infectious Diseases Society

No abstract text is available yet for this article.

Oral antimicrobials remain the mainstay of long-term treatment for many infections. Meanwhile, the use of oral agents is becoming commonplace for treatment of several pediatric infections once managed exclusively with parenteral therapies. Unfortunately, antimicrobials are associated with several laboratory toxicities, particularly when high doses or combination therapies are used, but there is a paucity of data on optimal laboratory monitoring strategies. In this ID Consultant piece, we offer a summary of the three most common lab-based toxicities seen with long-term use of oral antimicrobials - drug-induced kidney injury, liver injury, and hematological toxicities - and we provide our recommended approach to monitoring...

The need for echocardiography in pediatric Staphylococcus aureus bacteremia (SAB) remains uncertain. We reviewed 331 pediatric SAB cases. Nine subjects, all with comorbidities, met echocardiogram criteria for infective endocarditis (IE). IE was associated with congenital heart disease and prolonged bacteremia, suggesting that echocardiography is unnecessary in most children with SAB.

A modified Vesikari severity score (MVSS) is a useful research tool for assessing severity of acute gastroenteritis. We present a MVSS for studies in which a follow-up assessment of symptoms cannot be obtained. The MVSS significantly correlated with other markers of severity, including illness duration and work and school absenteeism.

This study describes ceftazadime-avibactam use in seventeen young children from a resource-constrained-country, where intra-abdominal infection was common. All-cause mortality was 53%. Earlier initiation, dose optimization, recording infusion times and reviewing the need for additional antibiotics were identified as easy-to-implement-antimicrobial-stewardship-interventions.

Little is known about the potential benefits of maternal immunization in the setting of high-risk pregnancies resulting in small-for-gestational-age (SGA) infants. This study compares transplacental transfer of maternal SARS-CoV-2 anti-Spike antibody in pregnancies with SGA compared to appropriate-for-gestational-age infants.

BACKGROUND: Despite rising hepatitis C virus (HCV) prevalence among pregnant individuals in the United States, HCV testing among exposed infants remains low. Although recent guidelines recommend early RNA testing for HCV-exposed children to help improve testing rates, national studies describing factors associated with HCV testing and type of testing completed are lacking. METHODS: In this retrospective national study, we characterized HCV testing and care among HCV-exposed infants born 2010-2020 captured in the electronic health record-based TriNetX Research Network...

The management of hepatitis B virus (HBV) in pediatrics presents many challenges, given the potential sequelae of untreated infection including hepatic fibrosis, cirrhosis, and malignancy, and a lack of clear guidance on the timing of treatment initiation. The goal of this review is to feature common clinical scenarios that occur in the evaluation and treatment of HBV infection in children. Each vignette presents an opportunity to discuss guidelines and evidence-based practices as well as review landmark studies and evolving practices...

BACKGROUND: Data on the presentation, management and outcomes of Lassa fever (LF) in children are limited. METHODS: Description of the clinical and biological features, treatment and outcomes of RT-PCR-confirmed LF in children aged under 15, enrolled in the LASCOPE prospective cohort study in Nigeria between April 2018 and February 2023. RESULTS: 124 children (aged under 12 months: 19; over 12 months: 105) were hospitalized with RT-PCR-confirmed LF...

Post-artesunate delayed hemolysis (PADH) occurred in 6 of 24 children treated with artesunate for severe malaria in the United States; however severe hemolysis requiring hospitalization or transfusion was rare. In children in the U.S. treated with artesunate, counseling and symptom monitoring may be preferred to weekly laboratory surveillance for PADH.

In the US, the burden of hepatitis C virus (HCV) infection is disproportionately high among young adults including pregnant persons, resulting in increased infections among children as perinatal transmission remains the main route of HCV infection in children. Hence, in 2020, the Centers for Disease Control and Prevention (CDC) recommended universal HCV screening during each pregnancy. HCV infection in infancy is usually asymptomatic, so the diagnosis entirely relies on testing of perinatally-exposed infants which, historically, included anti-HCV antibody testing at ≥ 18 months of age...

Invasive aspergillosis (IA) is a potentially life-threatening complication of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). We conducted a systematic review and meta-analyses of studies on acute leukemia in children aged 0-17 years since 2000. Findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We included 24 studies with 3,661 ALL patients and 1,728 AML patients. IA cumulative incidence varied (0%-10% for ALL and 0%-18% for AML) across the studies...

BACKGROUND/OBJECTIVE: The Centers for Disease Control and Prevention (CDC) recommends oseltamivir phosphate for children <2 years old with confirmed or suspected influenza as they are at high risk for complications. We analyzed infant characteristics associated with non-prescription of oseltamivir over nine years. METHODS: We conducted a retrospective electronic health record (EHR) review of infants <12 months old born between January 1, 2012 and December 31, 2019 within the UPMC health system in Southwestern Pennsylvania who had >2 well-child visits during their first year...

There are conflicting recommendations on whether to use or not to use fluoroquinolone prophylaxis in pediatric oncology patients. An international pediatric clinical practice guideline (CPG) recommends administering levofloxacin prophylaxis in patients with acute myeloblastic leukemia and relapsed acute lymphoblastic leukemia receiving intensive chemotherapy as this practice has been found to reduce episodes of fever and bacteremia. A separate European CPG does not recommend levofloxacin prophylaxis because of concerns for adverse effects, including potentiation of fluoroquinolone resistance and possible increased resistance to other classes of antibiotics...

We characterised population pharmacokinetics in 42 African children receiving once-daily 25 mg (14-<20 kg) or 50 mg (>20 kg) dolutegravir. Co-administration with emtricitabine and tenofovir alafenamide reduced dolutegravir bioavailability by 19.6% (95%CI: 8.13-30.8%) compared to zidovudine or abacavir with lamivudine. Nevertheless, concentrations remained above efficacy targets, confirming current dosing recommendations.

BACKGROUND: Acute otitis media (AOM) accounts for roughly 25% of antibiotics prescribed to children annually. Despite national guidelines that recommend short (5-7 days) durations of antibiotics for children two years and older with AOM, most receive long (10-day) courses. This study aims to evaluate antibiotic durations prescribed for children aged 2-17 years with uncomplicated AOM across two pediatric academic health systems, and to assess the variability in prescribed durations between and within each system...

OBJECTIVE: The rising prevalence of hepatitis C infections among individuals of reproductive age further emphasizes the importance of evidence-based management of HCV during pregnancy to minimize perinatal transmission and to optimize maternal and fetal outcomes. In this review, we discuss the most recent recommendations on the management of HCV in pregnancy, including recommendations for screening and treatment during pregnancy and the postpartum period, as well as infant management to reduce perinatal transmission of HCV...

No abstract text is available yet for this article.

Hydroxyurea decreases painful events among children with sickle cell disease but could increase the risk of infections in treated patients through leucopenia. We performed a case-control study, comparing hydroxyurea treatment for sickle cell disease in cases with an invasive bacterial infection and in controls without infection. No difference was found.

No abstract text is available yet for this article.