JOURNAL WATCH


https://doi.org/10.5005/jp-journals-10081-1331
Pediatric Infectious Disease
Volume 3 | Issue 4 | Year 2021

What’s New in Pediatric Infections?


Vikram S Kumar

Professor Department of Pediatrics, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka, India e-mail: vikramskumar@yahoo.co.in

Corresponding Author:

Source: Little P, Francis NA, Stuart B, O’Reilly G, Thompson N, Becque T, Hay AD, Wang K, Sharland M, Harnden A, Yao G. Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial. Lancet 2021. DOI: 10.1016/S0140-6736(21)01431-8

In ARTIC PC, a double-blind, randomized, placebo-controlled trial done at 56 general practices in England, researchers examined the effect of amoxicillin on the duration of moderately bad symptoms in children presenting with uncomplicated (non-pneumonic) lower respiratory tract infections (LRTIs) in primary care, overall and in key clinical subgroups (patients with chest signs, fever, physician rating of unwell, sputum or chest rattle, and short of breath).

Source: Choi GJ, Park JY, Choi JS, Choi SR, Kim D, Lee JH, Woo YJ, Lee J, Kim YJ. Influenza-associated neurologic complications in hospitalized pediatric patients: a multicenter retrospective study in Republic of Korea. Pediat Infect Dis J 2021. DOI: 10.1097/INF.0000000000003332

Findings from this retrospective review of hospitalized cases of influenza infection suggest that it is not uncommon that these cases suffer from influenza-associated neurologic complications. Full recovery occurs in most of the cases experiencing the complications. Korean children exhibited the occurrence of influenza-associated neurologic complications at frequency not significantly different from children in Western countries.

Source: Baguiya A, Bonet M, Cecatti JG, Brizuela V, Curteanu A, Minkauskiene M, Jayaratne K, Ribeiro-do-Valle CC, Budianu MA, Souza JP, Kouanda S. Perinatal outcomes among births to women with infection during pregnancy. Archi Dis Childhood 2021;106(10):946–953. DOI: 10.1136/archdischild-2021-321865

One-third of all births had a negative perinatal outcome. The primary risk factors for adverse perinatal outcomes were preexisting maternal medical conditions and severe infection-related maternal outcomes.

Source: Kindgren E, Ludvigsson J. Infections and antibiotics during fetal life and childhood and their relationship to juvenile idiopathic arthritis: a prospective cohort study. Pedia Rheumat 2021;19:145. DOI: 10.1186/s12969-021-00611-4

In a large birth cohort from the general population, an association of exposure to antibiotics early in life was observed with an increased risk for juvenile idiopathic arthritis (JIA). A dose dependent relationship was noted between the two. Results thereby support implementation of further, more restrictive, antibiotic policies during the first years of life.

Source: Anderson J, Oeum M, Verkolf E, Licciardi PV, Mulholland K, Nguyen C, Chow K, Waller G, Costa AM, Daley A, Crawford NW. Factors associated with severe respiratory syncytial virus disease in hospitalised children: a retrospective analysis. Archi Dis Childhood 2021. DOI: 10.1136/archdischild-2021-322435

According to this retrospective cohort study, younger age, prematurity and parainfluenza virus type III (PIV3) co-detection were associated with severe respiratory syncytial virus (RSV) disease in children <2 years of age hospitalized with RSV infection. The link between PIV3 and severe RSV disease is a unique discovery that merits further exploration.

Source: Glynn JR, Fielding K, Mzembe T, Sichali L, Banda L, McLean E, Kanjala C, Crampin AC, Ponnighaus JM, Warndorff DK, Fine PE. BCG re-vaccination in Malawi: 30-year follow-up of a large, randomised, double-blind, placebo-controlled trial. The Lancet Global Health 2021;9(10):e1451–e1459. DOI: 10.1016/S2214-109X(21)00309-0

In this rural African population with a high prevalence of HIV, there was no indication that repeated BCG vaccination gives significant protection against overall tuberculosis. Given the many studies performed, subgroup effects should not be over interpreted. The evidence for limited protection against HIV-negative tuberculosis and a delayed benefit in individuals who were vaccinated as children, on the other hand, is consistent with other findings in the literature.

Source: Davies P, du Pré P, Lillie J, Kanthimathinathan HK. One-year outcomes of critical care patients post–COVID-19 multisystem inflammatory syndrome in children. JAMA Pediat 2021. DOI: 10.1001/jamapediatrics.2021.2993

Researchers sought to report medium- to long-term outcomes of the novel pediatric inflammatory multisystem syndrome temporally linked with SARS-CoV-2 (PIMS-TS)1 or multisystem inflammatory syndrome in children (MIS-C).

Source: Jao J, Balmert LC, Sun S, Qiu Y, Kraus TA, Kirmse B, Sperling RS, Abrams EJ, Myer L, Arpadi S, Geffner ME. Distinct cord blood C-peptide, adipokine, and lipidomic signatures by in utero HIV exposure. Pediat Res 2021;1-9. DOI: 10.1038/s41390-021-01705-1

The results of this study demonstrate that higher cord insulin and C-peptide in HIV-exposed uninfected (HEU) vs HIV-unexposed uninfected (HUU) newborns, as well as differences in cord metabolites, metabolic-related cytokines, and eicosanoids, may reflect a propensity for fuel storage and an inflammatory milieu suggestive of fetal metabolic changes correlated with in utero HIV/ART exposure.

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