Pathogens

Editorial

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2 pages, 158 KiB

Open AccessEditorial

Respiratory Tract Infections in Children

by Tobias Tenenbaum

Pathogens 2021, 10(12), 1596; https://doi.org/10.3390/pathogens10121596 - 9 Dec 2021

Viewed by 1742

Abstract

Respiratory tract infections are a major threat, causing morbidity and mortality, especially among children [...] Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

Research

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7 pages, 981 KiB

Open AccessArticle

Fall of Community-Acquired Pneumonia in Children following COVID-19 Non-Pharmaceutical Interventions: A Time Series Analysis

by Alexis Rybak, David Dawei Yang, Cécile Schrimpf, Romain Guedj, Corinne Levy, Robert Cohen, Vincent Gajdos, Julie Tort, David Skurnik, Naïm Ouldali and François Angoulvant

Pathogens 2021, 10(11), 1375; https://doi.org/10.3390/pathogens10111375 - 24 Oct 2021

Cited by 13 | Viewed by 2176

Abstract

Non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of coronavirus disease 2019 (COVID-19). A first national lockdown was decided in France on the 17 March 2020. These measures had an impact on other viral and non-viral infectious diseases. We aimed to assess [...] Read more.

Non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of coronavirus disease 2019 (COVID-19). A first national lockdown was decided in France on the 17 March 2020. These measures had an impact on other viral and non-viral infectious diseases. We aimed to assess this impact on community-acquired pneumonia (CAP) in children. We performed a quasi-experimental interrupted time series analysis. We used data from a French prospective surveillance system of six pediatric emergency departments (PEDs). All visits from 1 January 2017 to 31 December 2020 were included. Pre-intervention period was before 17 March 2020 and post-intervention period was after 18 March 2020. We estimated the impact on the weekly number of visits for CAP and CAP admission using quasi-Poisson regression modeling. A total of 981,782 PEDs visits were analyzed; among them, 8318 visits were associated with CAP, and 1774 of these were followed by a hospital admission. A major decrease was observed for CAP visits (−79.7% 95% CI [−84.3; −73.8]; p < 0.0001), and CAP admission (−71.3% 95 CI [−78.8; −61.1]; p < 0.0001). We observed a dramatic decrease of CAP in children following NPIs implementation. Further studies are required to assess the long-term impact of these measures. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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12 pages, 1024 KiB

Open AccessArticle

General Characteristics of Children with Single- and Co-Infections and Febrile Seizures with a Main Focus on Respiratory Pathogens: Preliminary Results

by Henriette Rudolph, Katharina Gress, Christel Weiss, Horst Schroten, Ortwin Adams and Tobias Tenenbaum

Pathogens 2021, 10(8), 1061; https://doi.org/10.3390/pathogens10081061 - 20 Aug 2021

Cited by 7 | Viewed by 2726

Abstract

Febrile seizures (FS) affect up to 5% of children. The pathogen etiology in regard of viral loads has never been investigated. In a prospective cohort study we investigated the correlation between virus type and quantity in nasopharyngeal aspirates (NPAs) and the clinical characteristics [...] Read more.

Febrile seizures (FS) affect up to 5% of children. The pathogen etiology in regard of viral loads has never been investigated. In a prospective cohort study we investigated the correlation between virus type and quantity in nasopharyngeal aspirates (NPAs) and the clinical characteristics in pediatric patients with a FS. From January 2014 to April 2016, 184 children with a FS were prospectively enrolled. The mean age of all included children was 26.7 ± 18.3 months with a male to female ratio of 1.4:1. Males with an acute disease and a short duration or absence of prior symptoms had a higher risk for complex FS. The majority of patients with FS presented with a generalized convulsion (180; 98%) and was admitted to hospital (178; 97%). Overall, 79 (43%) single and in 59 (32%) co-infections were detected. Human herpes virus 6 (HHV6), influenza, adenovirus (AV) and rhinovirus (RV) were the dominant pathogens, all detected with clinically significant high viral loads. HHV6 positive cases were significantly younger and less likely to have a positive family/personal history for FS. Influenza positives showed a higher rate of complex seizures, lower leukocyte and higher monocyte counts. AV positive cases were more likely to have a positive family history for FS and showed higher C-reactive protein values. In conclusion, a high viral load may contribute to the development of a FS in respiratory tract infections. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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7 pages, 261 KiB

Open AccessArticle

Long-Term Persistence of Anti-SARS-CoV-2 Antibodies in a Pediatric Population

by Ana Méndez-Echevarría, Talía Sainz, Iker Falces-Romero, Beatriz de Felipe, Lucia Escolano, Sonia Alcolea, Lidia Pertiñez, Olaf Neth and Cristina Calvo

Pathogens 2021, 10(6), 700; https://doi.org/10.3390/pathogens10060700 - 4 Jun 2021

Cited by 15 | Viewed by 2257

Abstract

Background: Antibody dynamics over time after SARS-CoV-2 infection are still unclear, and data regarding children are scarce. Methods: A prospective cohort study was performed including children infected by SARS-CoV-2 between March and May 2020. Patients were categorized into 3 groups: children admitted with [...] Read more.

Background: Antibody dynamics over time after SARS-CoV-2 infection are still unclear, and data regarding children are scarce. Methods: A prospective cohort study was performed including children infected by SARS-CoV-2 between March and May 2020. Patients were categorized into 3 groups: children admitted with COVID-19; outpatient children with mild COVID-19; and seropositive children participating in a seroprevalence study among cohabitants of infected healthcare workers (HCWs). Six months after the infection, a new serological control was performed. Results: A total of 58 children were included, 50% male (median age 8.3 [IQR 2.8–13.5] years). The median time between the two serological studies was 186 (IQR 176–192) days, and 86% (48/56) of the children maintained positive IgG six months after the infection. This percentage was 100% in admitted patients and 78% among the rest of the included children (p = 0.022). The diagnoses of lower respiratory tract infection and multisystemic inflammatory syndrome were associated with persistence of IgG (p = 0.035). The children of HCWs in the seroprevalence study lost antibodies more often (p = 0.017). Initial IgG titers of the children who remained positive six months after the infection were significantly higher (p = 0.008). Conclusions: Most children infected by SARS-CoV-2 maintain a positive serological response six months after the infection. Those children who lost their IgG titer were more frequently asymptomatic or mildly symptomatic, presenting with low antibody titers after the infection. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

11 pages, 532 KiB

Open AccessArticle

The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis

by Rosalie S. Linssen, Bibiche den Hollander, Louis Bont, Job B. M. van Woensel, Reinout A. Bem and on behalf of the PICE Study Group

Pathogens 2021, 10(5), 567; https://doi.org/10.3390/pathogens10050567 - 7 May 2021

Cited by 5 | Viewed by 2080

Abstract

Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions [...] Read more.

Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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Review

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15 pages, 1253 KiB

Open AccessReview

Antigen-Presenting Cells in the Airways: Moderating Asymptomatic Bacterial Carriage

by Lisa J. M. Slimmen, Hettie M. Janssens, Annemarie M. C. van Rossum and Wendy W. J. Unger

Pathogens 2021, 10(8), 945; https://doi.org/10.3390/pathogens10080945 - 28 Jul 2021

Cited by 3 | Viewed by 2938

Abstract

Bacterial respiratory tract infections (RTIs) are a major global health burden, and the role of antigen-presenting cells (APCs) in mounting an immune response to contain and clear invading pathogens is well-described. However, most encounters between a host and a bacterial pathogen do not [...] Read more.

Bacterial respiratory tract infections (RTIs) are a major global health burden, and the role of antigen-presenting cells (APCs) in mounting an immune response to contain and clear invading pathogens is well-described. However, most encounters between a host and a bacterial pathogen do not result in symptomatic infection, but in asymptomatic carriage instead. The fact that a pathogen will cause infection in one individual, but not in another does not appear to be directly related to bacterial density, but rather depend on qualitative differences in the host response. Understanding the interactions between respiratory pathogens and airway APCs that result in asymptomatic carriage, will provide better insight into the factors that can skew this interaction towards infection. This review will discuss the currently available knowledge on airway APCs in the context of asymptomatic bacterial carriage along the entire respiratory tract. Furthermore, in order to interpret past and futures studies into this topic, we propose a standardized nomenclature of the different stages of carriage and infection, based on the pathogen’s position with regard to the epithelium and the amount of inflammation present. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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9 pages, 437 KiB

Open AccessReview

Atypical Bacterial Pathogens and Small-Vessel Leukocytoclastic Vasculitis of the Skin in Children: Systematic Literature Review

by Céline Betti, Pietro Camozzi, Viola Gennaro, Mario G. Bianchetti, Martin Scoglio, Giacomo D. Simonetti, Gregorio P. Milani, Sebastiano A. G. Lava and Alessandra Ferrarini

Pathogens 2021, 10(1), 31; https://doi.org/10.3390/pathogens10010031 - 2 Jan 2021

Cited by 9 | Viewed by 2689

Abstract

Leukocytoclastic small-vessel vasculitis of the skin (with or without systemic involvement) is often preceded by infections such as common cold, tonsillopharyngitis, or otitis media. Our purpose was to document pediatric (≤18 years) cases preceded by a symptomatic disease caused by an atypical bacterial [...] Read more.

Leukocytoclastic small-vessel vasculitis of the skin (with or without systemic involvement) is often preceded by infections such as common cold, tonsillopharyngitis, or otitis media. Our purpose was to document pediatric (≤18 years) cases preceded by a symptomatic disease caused by an atypical bacterial pathogen. We performed a literature search following the Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. We retained 19 reports including 22 cases (13 females and 9 males, 1.0 to 17, median 6.3 years of age) associated with a Mycoplasma pneumoniae infection. We did not find any case linked to Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella pneumophila. Patients with a systemic vasculitis (N = 14) and with a skin-limited (N = 8) vasculitis did not significantly differ with respect to gender and age. The time to recovery was ≤12 weeks in all patients with this information. In conclusion, a cutaneous small-vessel vasculitis with or without systemic involvement may occur in childhood after an infection caused by the atypical bacterial pathogen Mycoplasma pneumoniae. The clinical picture and the course of cases preceded by recognized triggers and by this atypical pathogen are indistinguishable. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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Other

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11 pages, 883 KiB

Open AccessSystematic Review

Severe Pneumonia in Neonates Associated with Legionella pneumophila: Case Report and Review of the Literature

by Alba Perez Ortiz, Camilla Hahn, Thomas Schaible, Neysan Rafat and Bettina Lange

Pathogens 2021, 10(8), 1031; https://doi.org/10.3390/pathogens10081031 - 15 Aug 2021

Cited by 10 | Viewed by 3283

Abstract

The causative agent of legionellosis is the Gram-negative intracellular bacteria Legionella spp. Its clinical presentation varies from a mild febrile illness called Pontiac fever to the severe and possible fatal pneumonia, Legionnaires’ disease. Immunocompromised patients, in particular, are affected. Only a small number [...] Read more.

The causative agent of legionellosis is the Gram-negative intracellular bacteria Legionella spp. Its clinical presentation varies from a mild febrile illness called Pontiac fever to the severe and possible fatal pneumonia, Legionnaires’ disease. Immunocompromised patients, in particular, are affected. Only a small number of infected neonates are described in the literature. Most of them have been associated with water birth or the use of air humidifiers. In the last five years, a growing number of cases have been reported in Germany by the national institute of disease surveillance and prevention (Robert-Koch Institute). Here, we describe a fatal case report of pulmonary legionellosis with acute respiratory distress syndrome (ARDS), sepsis, associated cutaneous manifestation, and extracorporeal membrane oxygenation in a full-term neonate. Moreover, we present a review of the literature discussing the epidemiology, risk factors, clinical features, diagnostics, treatment options, and prevention for this rare condition in neonates. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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8 pages, 1020 KiB

Open AccessCase Report

Severe Pneumonia and Sepsis Caused by Dialister pneumosintes in an Adolescent

by Maximilian Kaiser, Meike Weis, Katharina Kehr, Verena Varnholt, Horst Schroten and Tobias Tenenbaum

Pathogens 2021, 10(6), 733; https://doi.org/10.3390/pathogens10060733 - 10 Jun 2021

Cited by 7 | Viewed by 3998

Abstract

Background: Dialister pneumosintes (D. pneumosintes) is known to cause dental, periodontal or sinus infections. To date, the pathogen has only been described in a small number of cases with a severe infection. Case report: We describe the clinical case of a [...] Read more.

Background: Dialister pneumosintes (D. pneumosintes) is known to cause dental, periodontal or sinus infections. To date, the pathogen has only been described in a small number of cases with a severe infection. Case report: We describe the clinical case of a 13-year-old, obese female patient that presented with acute respiratory failure and sepsis. A CT-scan showed extensive bilateral patchy areas, subpleural and peribronchovascular consolidations with surrounding ground-glass opacity, extensive consolidations in the lower lobes of both lungs matching to a severe pneumonia and clinically emerging acute respiratory distress syndrome. Moreover, it showed extensive sinusitis of the right sinus frontalis, maxillaris and right cellulae ethmoidales. D. pneumosintes was isolated from an anaerobic blood culture obtained at admission. The antibiotic treatment included piperacillin/tazobactam and oral switch to ampicillin/sulbactam plus ciprofloxacin. Conclusions: We describe the first adolescent with severe systemic D. pneumosintes infection. Since the pathogen is difficult to culture the systemic virulence remains unclear. This work aims to sensitize health care specialists to consider D. pneumosintes infection in patients with periodontal or sinusal infection. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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7 pages, 219 KiB

Open AccessBrief Report

Emergence of Macrolide-Resistant Mycoplasma pneumoniae during an Outbreak in a Primary School: Clinical Characterization of Hospitalized Children

by Daniel Hubert, Roger Dumke, Stefan Weichert, Sybille Welker, Tobias Tenenbaum and Horst Schroten

Pathogens 2021, 10(3), 328; https://doi.org/10.3390/pathogens10030328 - 10 Mar 2021

Cited by 4 | Viewed by 2089

Abstract

Mycoplasma pneumoniae (M. pneumoniae) is a common causative pathogen of community-acquired pneumonia. Here, we report the development of macrolide resistance during a school outbreak of severe M. pneumoniae infections in southwest Germany. We conducted a case series to assess the clinical [...] Read more.

Mycoplasma pneumoniae (M. pneumoniae) is a common causative pathogen of community-acquired pneumonia. Here, we report the development of macrolide resistance during a school outbreak of severe M. pneumoniae infections in southwest Germany. We conducted a case series to assess the clinical and laboratory characteristics of hospitalized children with M. pneumonia infection and the prevalence of macrolide-resistant M. pneumoniae (MRMP) in this patient group. We retrospectively analyzed 23 children with serologically (19 patients) and/or PCR (eight patients) confirmed M. pneumoniae infection between October 2019 and December 2019. Most of the 15 hospitalized patients had lower respiratory tract infection (n = 10) and required oxygen therapy (83%). The median length of hospitalization was 7 days (range 3–10 days). In 8/15 patients (53.3%) azithromycin and in 4/15 (26.6%) clarithromycin treatment was applied. However, among the five patients for which extended molecular characterization was performed, sequencing of 23S rRNA revealed no mutation only in the first case, but development of macrolide resistance A2058G in four subsequent cases. Hence, we identified a cluster of hospitalized patients with emerging MRMP. Further studies are warranted to confirm a potential link between macrolide resistance and disease severity. Full article

(This article belongs to the Special Issue Respiratory Tract Infections in Children)

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