Frequency Of Infections Research Articles

Genomic epidemiology and genetic characteristics of clinical Campylobacter species cocirculating in West Bengal, India, 2019, using whole genome analysis.

Campylobacter species are the most common pathogens responsible for foodborne gastroenteritis worldwide. India is a region with frequent diarrheal infections and a high level of Campylobacter infection incidence, but the detailed genomic information is limited. This study aimed to characterize 112 isolates of Campylobacter from diarrhea patients at two hospitals in Kolkata, West Bengal, by whole genome analysis. The Campylobacter isolates consisted of 90 C. jejuni, 20 C. coli, and 2 C. lari isolates. Multilocus sequence typing analysis revealed that the largest sequence type (ST) populations were ST-2131 in C. jejuni and ST-830 in C. coli and seven novel STs were found in C. jejuni and one in C. coli. Notably, ST-2131, which is rarely seen elsewhere, was positive for a sialylated LOS-related gene (wlaN +neuA + cstIII) associated with Guillain-Barré syndrome. Antibiotic resistance factors predicted from the genome sequence included blaOXA variants (58.9%), tet(O) (54.5%), tet(W) (0.9%), ant(6)-Ia (0.9%), mutation in GyrA (T86I, T86I+D90N, T86I+P104S, T86I+D90N+P104S) (79.5%), and mutation in 23S rRNA (A2075G) (12.5%). In addition to the high drug resistance of Campylobacter in Kolkata, Campylobacter pathogens were circulating that may be associated with Guillain-Barré syndrome. This study indicates the importance of genomic analysis in the surveillance of pathogens, which provides genomic information on genetic diversity, virulence mechanisms, and determinants of antimicrobial resistance.

Safety and efficacy of a novel mini-pool intravenous immunoglobulin therapy in children with primary immunodeficiency.

Intravenous polyvalent immunoglobulins (IVIG) for prophylaxis in patients with primary immunodeficiency disorders (PIDs) exposes them to life-threatening infections and debilitating diseases. To improve access to IVIG in lower middle-income countries, the WHO recommends a stepwise approach for the local production of purified and virus-inactivated plasma immunoglobulins by national blood transfusion services using new technologies and medical devices. One new technology relies on single-use sterile medical devices for the purification of plasma immunoglobulin G (IgG), as well as lipid-enveloped virus inactivation from mini-pools of recovered plasma separated from whole blood (mini-pool IVIG [MP-IVIG]). This study aimed to compare the safety and efficacy of MP-IVIG to standard IVIG (STD-IVIG). In this prospective crossover clinical study, we investigated the safety and efficacy of MP-IVIG for STD-IVIG preparations as a replacement therapy in a cohort of 21 paediatric patients with PID. Both MP-IVIG and STD-IVIG were effective in reducing the frequency of severe bacterial infections and hospital admissions in patients with PID. Mild side effects have been observed in seven patients (6.2%) with PID who received MP-IVIG and five patients (5.3%) who received STD-IVIG. No moderate or severe side effects or haemolytic transfusion reactions were reported. The mortality rates were also comparable and were not related to the study products. MP-IVIG presented no safety issues and was as effective as STD-IVIG in IgG replacement in patients with PID. Due to the small numbers, the results have to be addressed with caution.

Chinese expert consensus on the diagnosis and treatment of adult T-cell leukemia/lymphoma (2024)

Adult T-cell leukemia/lymphoma (ATL), a rare and unique proliferative tumor of T lymphocytes, is associated with human T-cell leukemia virus type 1 (HTLV-1) infection. Due to its diverse clinical features, multidrug resistance of malignant cells, frequent opportunistic infection, and poor prognosis, ATL remains a clinical challenge. A unified understanding of ATL is currently lacking, and its diagnosis and treatment are not standardized in China due to the small number of cases. Therefore, to strengthen our understanding of ATL, hematology experts have formulated the "Chinese expert consensus on the diagnosis and treatment of adult T-cell leukemia/lymphoma (2024)" based on the latest research progress at home and abroad. This consensus proposes the latest diagnostic and subtype criteria for ATL in China. Furthermore, it briefly describes the infection situation of HTLV-1 in coastal areas of China, the epidemic trends in China, and the latest evidence and recommendations regarding the pathogenesis, clinical manifestations, and treatment strategies, with the aim to standardize the clinical diagnosis and treatment of ATL and ultimately improve the overall survival of patients with ATL.

Expanding the known haemosporidian parasite diversity in Eurasian Bluethroat (Luscinia svecica) subspecies through amplicon sequencing

Monitoring haemosporidian parasites in birds is essential to comprehend the dynamics of avian malaria, a disease that significantly affects bird populations worldwide. This study concentrated on the prevalence and diversity of haemosporidian parasites in 198 specimens from two subspecies of the Eurasian bluethroat (Luscinia svecica), aiming to explore the genetic diversity and species richness of haemosporidian fauna across the host populations. By utilizing next-generation amplicon high-throughput sequencing (NGS), we observed a marked increase in the detection of haemosporidian diversity, revealing cryptic variants and species previously unidentified by Sanger sequencing. A high prevalence of Plasmodium was seen in all studied sites, accompanied by a less frequent Leucocytozoon infection in the red-spotted subspecies and minimal occurrence of Haemoproteus. Both previously known and new, low prevalence cryptic variants were detected, underscoring the complexity of haemosporidian infections in avian hosts. The use of species delimitation tools provided a detailed understanding of haemosporidian species diversity, their coexistence within hosts, and their phylogenetic relationships. Despite the varying ecological characteristics of the study sites, no significant difference in haemosporidian alpha diversity among populations was found. However, significant differences in beta diversity were identified, suggesting that habitat characteristics and geographic distance influence parasite distribution. These findings highlight the importance of advanced molecular techniques in revealing the hidden diversity of parasites, offering valuable insights into the ecology and evolution of haemosporidian infections. Given the threatened status of one of the host’s populations, knowledge on local diversity of haemosporidian parasites also has implications for possible conservation strategies.

Antibiotic and Surgical Treatment of Diabetic Foot Osteomyelitis: The Histopathological Evidence

Background: Osteomyelitis is one of the most frequent infections of the diabetic foot, accounting for 20–70% of foot infections. The treatment of osteomyelitis continues to be debated, and the possibility of performing conservative surgery associated with targeted antibiotic treatment allows for reductions in the amount of bone removed, the resolution of osteomyelitis, and a reduction in the changes in the biomechanics of the foot. The objective of this study was to evaluate the outcomes of osteomyelitis treatment with a combination of antibiotic and surgical procedures based on a histopathological analysis of the infected bone and margins. Materials and Methods: We analyzed 25 diabetic patients with osteomyelitis. We treated each patient with empiric antibiotic treatment, surgical removal of the infected bone, and targeted antibiotic treatment. During the surgical procedure, we collected infected bone samples and margins for microbiological and histopathological analyses. Results: All the patients had type 2 diabetes, with a mean age of 71 ± 10 years. Antibiotic therapy was administered orally for an average duration of 21 ± 9 days, aimed at improving the microbiological outcome. Histological examinations of the resected infected bone revealed the presence of osteomyelitis in 23 (92%) patients. The healthy margin sample, surgically assessed as non-infected, was confirmed negative in 80% of cases. At a follow-up of 18 ± 7 months, we achieved complete healing in twenty patients (80%), with an average healing time of 70 ± 41 days. No recurrence of osteomyelitis was observed. Conclusions: The data from this study demonstrate that the combination of targeted antibiotic therapy and conservative surgical treatment is effective in resolving osteomyelitis without recurrence with a very long follow-up. Histological analyses allowed us to confirm the actual presence of osteomyelitis and demonstrate that clinical differentiation during surgery is effective in identifying a healthy margin.

The Prevalence and Genetic Characteristics of Porcine Circovirus Type 2 in Shandong Province, China, 2018–2020

Porcine circovirus type 2 (PCV2) is an important swine pathogen that has caused considerable economic losses in the global swine industry. During our surveillance of pigs in Shandong, China, from 2018 to 2020, we found that the PCV2 infection rate was 7.89% (86/1090). In addition, we found frequent mixed infections of PCV2 with porcine reproductive and respiratory syndrome virus (PRRSV), classical swine fever virus (CSFV), and porcine herpesvirus (PRV). Thirteen positive clinical samples were selected to amplify the complete genome of PCV2, and were sequenced. Among the 13, we detected two genotypes: PCV2b (1/13) and PCV2d (12/13). This suggests that PCV2d is the dominant genotype circulating in Shandong Province. Additionally, we found three positively selected sites in the ORF2 region, located on the previously reported antigenic epitopes. This investigation will contribute to understanding of the molecular epidemiology and genetic diversity of PCV2 strains in China.

Seoul orthohantavirus evades innate immune activation by reservoir endothelial cells

Seoul orthohantavirus evades innate immune activation by reservoir endothelial cells

Modern approaches to the prevention of frequent respiratory infections in childhood

Modern approaches to the prevention of frequent respiratory infections in childhood

Risk factors for septic shock in older patients with urinary tract infection.

Few studies have addressed the risk factors for the development of septic shock in older patients with urinary tract infections. We decided to investigate whether a similar risk exists in in older patients. A total of 1478 older patients (492 men, 986 women) aged 65years or older (mean age 85.1years) who were hospitalized and treated for urinary tract infections were included in this study, and factors contributing to the development of septic shock in these patients, including in terms of the causative pathogens and treatments employed, were investigated through a retrospective review of the patients' medical charts. Underlying urinary tract infection with urolithiasis was found as the most significant risk factor for the development of septic shock (p < 0.01). Patients with urolithiasis were more frail, had higher urinary pH and calcium levels, and showed a higher frequency of infections caused by antimicrobial-resistant and rare bacteria. Cluster analysis revealed a higher incidence of death, septic shock, urolithiasis, and frailty in the patient group treated with carbapenem and/or MRSA agents. Septic shock was associated with a high risk of death in older patients with urinary tract infections, and urolithiasis was identified as an independent risk factor for the development of septic shock. Urolithiasis was also associated with frailty, suggesting that prevention of frailty may indirectly improve the prognosis of patients with septic shock secondary to urinary tract infections.

Frequency of upper respiratory tract infections in patients with myasthenia gravis compared to the general population

IntroductionPatients with myasthenia gravis (MG) undergoing immunomodulating therapies are at an increased risk of serious infections. However, the risk of developing self-limited infections, particularly upper respiratory tract infections (URTI), remains unclear. This study aimed to determine the frequency of URTI among patients with MG compared to the general population and to identify potential predisposing factors. MethodsA monthly questionnaire was administered to patients with MG and a control group over a period of 6 months. The questionnaire assessed the presence of URTI symptoms within the previous month. Statistical analysis was conducted using a chi-square or Fischer exact test, as appropriate. ResultsThe study included 161 participants (50 MG patients and 111 control subjects). The frequency of URTI was comparable between the MG group (70 %) and controls (82 %) (p = 0.09). Among patients with MG, a higher proportion of patients who received rituximab developed URTI (93 %) than those who did not (61 %), P = 0.04. ConclusionThe frequency of URTI was similar in patients with MG compared to the general population. Due to the small sample size and several other limitations, further research is warranted to validate these findings and explore associations between rituximab and URTI.

Nurses' attitudes towards safety and their association with nurses' perceptions of adverse events and quality of care: a cross-sectional study.

To explore nurses' attitudes towards safety and their association with nurses' perceptions of adverse events and quality of care in Saudi Arabian hospitals. A cross-sectional study using a web-based survey. A web-based survey was administered to nurses working in five hospitals in Saudi Arabia. Nurses' attitudes regarding safety, nurses' perceptions of the frequency of seven adverse events, and nurses' views on quality of care were collected. Descriptive and predictive analyses were performed. Nurses' attitudes regarding safety (n = 653) were classified as less than positive, with an overall score of 68.96%. The highest subscale mean score was for safety behaviour (73.1%), which was followed by job satisfaction (72.6%); the lowest subscale mean score was for working conditions (61.7%). Positive attitudes towards safety were associated with a lower frequency of pressure injuries, patient falls, healthcare-associated infections and unexpected deaths due to deterioration; positive attitudes towards safety were also associated with higher quality of care. Nurses' attitudes towards safety contribute to preventing avoidable adverse events and to improving quality of care. This study builds on the growing body of evidence that demonstrates fostering a strong safety culture is essential for improving patient outcomes.

Clinicopathological significance and prognostic values of claudin18.2 expression in solid tumors: a systematic review and meta-analysis.

Claudin18.2 has been established as a putative therapeutic target in human solid malignancies. The aim of this study is to determine claudin18.2 expression as a clinicopathological and prognostic factor in human solid tumors through a systematic review and meta-analysis. Articles were systematically reviewed for studies that included the correlation between claudin18.2 expression and clinicopathological features and prognosis in solid tumors. Meta-analysis was conducted to estimate either odds ratio and 95% confidence intervals (CIs) of clinicopathological factors or hazard ratio and 95% CIs of survival outcomes for claudin18.2 expression in all available solid tumors. 21 studies including 5,331 patients were identified. Overall proportion of claudin18.2 positivity was 29.7%. Analyses of clinicopathological features demonstrated that claudin18.2 positivity correlated with male predominance, lower T stage, more frequent MUC5AC positivity when all primary tumors included. In subgroup analysis, gastric cancer showed significant correlation between high claudin18.2 expression and frequent EBV infection, male predominance and lower T stage. In lung cancer, claudin18.2 expression was associated with favorable overall survival. However, analyses of survival outcomes in all solid tumors showed that claudin18.2 expression was not associated with overall survival and pooled disease-free survival, tumor-specific survival, progression-free survival and relapse-free survival. Our study emphasizes evaluation of claudin18.2 expression as a potential prognostic factor in lung adenocarcinoma and further exploration in other solid tumors as well. https://www.crd.york.ac.uk/prospero/, identifier CRD42023468651.

Assessing the Impact of Vitamin D Supplementation on Respiratory Infections in Children and Adolescents: A Cross-Sectional Study.

Recent studies suggest that vitamin D supplementation and higher serum 25-hydroxyvitamin D (25-OHD) concentrations may reduce the incidence of respiratory infections in children and adolescents. This cross-sectional study aimed to evaluate the association between different concentrations of vitamin D supplementation, serum 25-OHD concentrations, and the frequency of respiratory infections among individuals aged 1 to 18 years, for a duration of 2 years. Concerning sun exposure in relation to vitamin D, the study took place in Romania, at approximately 45-degree northern latitude. A total of 194 patients were divided into groups based on weekly vitamin D supplementation (<400 IU, 400-800 IU, >800 IU), serum 25-OHD concentrations (<20 ng/mL, 20-30 ng/mL, >30 ng/mL), and age (<6 years, 6-12 years, 12-18 years). The overall incidence of respiratory infections was 41.2%. Participants receiving >800 IU/week had a significantly lower incidence of infections (16.7%) compared to those receiving <400 IU/week (60.0%, p < 0.001). Similarly, participants with serum 25-OHD concentrations >30 ng/mL had an infection rate of 16.7%, compared to 61.4% in those with concentrations <20 ng/mL (p < 0.001). Age-specific analyses revealed that the protective effect of vitamin D was most pronounced in children under 6 years old. Logistic regression showed that higher vitamin D supplementation and serum 25-OHD concentrations were independently associated with reduced odds of respiratory infections (OR = 0.25 and OR = 0.22, respectively, p < 0.001). These findings support the potential role of vitamin D supplementation in preventing respiratory infections in the pediatric population.

Orange Peel Lactiplantibacillus plantarum: Development of A Mucoadhesive Nasal Spray with Antimicrobial and Anti-inflammatory Activity

Background/Objectives: Due to the high frequency and severity of upper respiratory bacterial infections, probiotics could offer a new medical approach. We explored the antibacterial and anti-inflammatory properties of the new strain Lactiplantibacillus plantarum BIA and formulated a nasal spray. Methods: L. plantarum BIA was isolated from orange peel and taxonomically identified through 16S rRNA gene sequencing. Its antibacterial activity was tested against Pseudomonas aeruginosa, Streptococcus pyogenes, Bacillus subtilis, Escherichia coli, and Staphylococcus aureus, while anti-inflammatory potential was evaluated by Griess assay. BIA genome was fully sequenced and analyzed to assess its safety. BIA was formulated in a freeze-dried matrix, containing prebiotics and cryoprotectants, to be reconstituted with a polymer solution. Solutions containing two types of hydroxypropyl methylcellulose (HPMC) and hyaluronic acid were evaluated as resuspending media and compared in terms of pH, viscosity, and mucoadhesion ability. The biological activity of BIA formulated as nasal spray was verified together with the stability of the selected formulations. Results: L. plantarum BIA inhibited human pathogens’ growth and showed anti-inflammatory activity and a safe profile. In the best-performing formulation, the probiotic is lyophilized in 10% fructooligosaccharides, 0.1% ascorbic acid, and 0.5% lactose and reconstituted with HPMC high viscosity 1% w/v. This composition ensured the probiotic’s viability for up to six months in its dried form and one week after reconstitution. It also allowed interaction with the nasal mucosa, preserving its antimicrobial and anti-inflammatory activities. Conclusion: The developed nasal spray could become a promising formulation in the field of nasal infectious and inflammatory diseases.

Surveillance of SARS-CoV-2 in Healthcare Workers Before and After COVID-19 Vaccination: A Cohort Study in a Primary Care Unit of Brazil.

Healthcare workers (HCWs) are at higher risk of SARS-CoV-2 infection. Viral surveillance for early detection of COVID-19 is a critical strategy to understand this population's infection dynamics and prevent transmission. The study examines SARS-CoV-2 infection and reinfection among HCWs vaccinated against COVID-19 working at a primary healthcare unit serving a disenfranchised community in Brazil. The study was conducted in Cidade Estrutural, Federal District, Brazil, between February and October 2021. Participants were interviewed and provided samples. A prospective open cohort study was used to analyze the frequency of SARS-CoV-2 infection and reinfection, and the vaccine-induced seroconversion. Nasopharyngeal swab specimen was collected from workers presenting with flu-like symptoms and subjected to RT-qPCR. Peripheral blood samples were also collected every 30 ± 2 days for eight months, starting from the day participants received their first dose of COVID-19 vaccine, and submitted to serological testing (IgM and IgG chemiluminescence). The frequencies of infection and reinfection (RT-qPCR positive results 90 days after the infection) were calculated along with their respective confidence intervals (95% CI). Of the 128 workers, 61 (47.65%; CI: 39.19-56.25) reported probable SARS-CoV-2 infection before vaccination and 50 (39.06%; CI: 31.04-47.71) had SARS-CoV-2 infection after vaccination, confirmed by molecular test. Reinfection was identified in seven workers (7/50, 14%; CI: 6.95-26.18) based on the 90-day interval between results. The serological data from the 128 workers during the cohort indicated that 68 (53.12%; CI: 44.5-61.5) had IgG antibodies and 46 had IgM antibodies (35.93%; CI: 28.14-44.54) against SARS-CoV-2. SARS-CoV-2 infection was common in 56% of the community health workers (CHWs), 50% of registered nurses, and licensed vocational nurses (33%). Following the COVID-19 vaccination, the percentage of infections among HCWs decreased from 47.83% to 4.35%. These results demonstrate that (i) approximately 40% of the workers were infected with SARS-CoV-2 in 2021 and (ii) reinfections confirmed by RT-qPCR occurred in 14% of the HCWs after vaccination. The results provide valuable insights into the circulation of SARS-CoV-2 among HCWs in a primary care unit serving a minoritized community.

Role of albumin and prealbumin in assessing nutritional status and predicting increased risk of infectious complications during childhood cancer treatment.

Proper nutrition in patients with cancer is important for preventing treatment complications and achieving remission. Malnutrition in these patients leads to reduced production of essential structural proteins. The aim of the study was to assess the role of albumin and prealbumin in assessing the nutritional status of cancer patients and in predicting an increased risk of infectious complications during treatment. The study included 40 pediatric patients with newly diagnosed cancer and 30 healthy children serving as controls. Prealbumin, albumin, and C-reactive protein (CRP) levels and the upper arm muscle area (UAMA) were measured before and after treatment in children with cancer and compared with the control group to evaluate nutritional status. Additionally, we assessed associations between these parameters and the incidence of infectious complications during cancer treatment in patients with anthropometric malnutrition, as well as associations with an increased risk of malnutrition related to inflammation before treatment. At baseline, patients with cancer had lower prealbumin and albumin levels (p< 0.001), higher CRP levels (p < 0.001), and lower UAMA percentiles (p = 0.0245) compared with controls. Cancer treatment resulted in an increase in prealbumin and albumin levels (p < 0.001) and a reduction in CRP levels (p < 0.001), with no change in UAMA (p = 1.000). Prealbumin deficiency was more common than albumin deficiency before and after cancer treatment. Median prealbumin and albumin levels tended to increase with an increasing UAMA percentile range, but these differences were not significant (p> 0.05). The incidence of infectious complications during treatment in patients with risk factors for inflammation-related malnutrition was similar to that in patients with pre-existing anthropometric malnutrition without inflammation (p = 1.000). In a univariable logistic regression model including prealbumin and albumin deficiency, as well as low UAMA percentile, albumin deficiency before treatment was shown to be a significant predictor of 3 or more infectious episodes during treatment (p = 0.02). Albumin and prealbumin deficiency may predict the risk of malnutrition associated with inflammation in patients with cancer. Hypoalbuminemia may predict an unfavorable course of treatment complicated by frequent infections in these patients.

Viral hepatitis A in children: a false prosperity?

The article presents current data on the state of the issue of Hepatitis A (HA) in children in the Russian Federation and describes clinical and epidemiologic features of rare cases of severe course of the disease, as well as pathogenetic mechanisms of liver damage mediated by cell immune response. Objective. To identify clinical and epidemiologic features of the modern course of HA and its outcomes in children of Saint Petersburg within the period of 2018— 2023. Materials and methods. The study included 89 children diagnosed with HA, undergoing treatment at the Children's Research and Clinical Center for Infectious Diseases from 2018 to 2023. The analysis of disease progression in this group of patients was presented using clinical-anamnestic, epidemiologic, biochemical, virologic and instrumental data. Results. The analysis of infection sources showed a high frequency of HA infection within the family (44.9 ± 0.8%) and significantly less in childcare facilities and schools (7.9 ± 1.0%). The frequency of children with unidentified sources of infection remained high (47.2 ± 0.7%). One-third of all disease cases were imported from southern regions. Most hospitalized children had icteric HA (64.0 ± 0.6%) of moderate severity (79.8 ± 0.5%). Severe HA was observed in 6 patients (6.7 ± 1.0%). During the study, 17 patients (19.1 ± 0.9%) had a prolonged, complicated course of the disease, including ascites and aplastic anemia (12.6 ± 2.2%). Ascites was found in 4 patients with severe severity and in 5 patients with moderate severity of HA. Conclusions. Currently, there is an upward trend in the incidence of HA in the Russian Federation and Saint Petersburg, especially among schoolchildren (56.2%). A rather high frequency of severe (6.7%) and complicated forms (19.1%) of the disease is observed, and the growth of ascites and aplastic anemia cases in HA draws particular attention.

Frequency and risk factors of nosocomial infections in atrauma center: acase study from the Beni Suef University Hospital, Egypt.

Hospital-acquired infections (HAI) cause asignificant risk to patient maintenance and wellbeing, particularly within the specialized environment of atrauma center. This study focuses on investigating the frequency of HAI in atrauma center through acomprehensive surveillance and monitoring system. This observational study, conducted between January 2023 and June 2023, focused on the 16-bed trauma center. HAI diagnoses were based on the centers for disease control and prevention (CDC) definitions that typically include specific criteria for different types of infections, for example, urinary tract infections, surgical site infections, bloodstream infections, and others. Among the 160 trauma center-admitted patients, 89were included in the study. 44patients contracted HAI, resulting in afrequency of 49.4%. The incidence rates (IR) were 21/1000 central venous catheter (CVC) days for catheter-related bloodstream infections (CRBSI), 10/100 urinary catheter days for catheter-associated urinary tract infections (CAUTI), and 34/1000 ventilator days for ventilator-associated pneumonia (VAP). The HAI percentages noticed in the trauma center are comparatively lower than those reported in other developing country hospitals. The incidence of VAP aligns with findings from other studies.

Assessment of the Communicable Disease Status of Children in Türkiye: A Community-Based Cross-Sectional Study.

Assessment of children's communicable disease status is effective in preventing child morbidity. This study aims to evaluate the infectious disease status of children aged 0-14 in Türkiye. The research is a cross-sectional study conducted using the microdataset of the "Türkiye Health Survey 2022" obtained from the Turkish Statistical Institute. Seven thousand nineteen individuals aged 0-14 were included in the analysis. Data on communicable diseases of children aged 0-14 years in the 6-month period before the survey date was obtained by asking the household head. In our research, the data of 7019 individuals aged 0-14 was evaluated. It was determined that 2.2% of children had a vaccine-preventable infectious disease in the last 6 months. It was observed that the frequency of upper respiratory tract infection, lower respiratory tract infection, urinary tract infection, and diarrhea in children was higher in the 0-6 age group than in the 7-14 age group. Urinary tract infections were more common in girls, whereas respiratory tract infections, communicable diseases, and diarrhea were more common in boys. It was determined that diarrhea and upper respiratory tract infections occur in approximately one out of every three children in the 0-6 age group.

Low Infection Rates With Long-Term Dupilumab Treatment in Patients Aged 6 Months to 5 Years: An Open-Label Extension Study.

To evaluate long-term infection rates in children aged 6 months to 5 years with moderate-to-severe atopic dermatitis (AD) treated with dupilumab. This was a post hoc analysis of an ongoing open-label extension (OLE) study of dupilumab. Pediatric patients aged 6 months to 5 years with moderate-to-severe AD who had previously taken part in the LIBERTY AD PRESCHOOL phase 2 and 3 clinical trials received weight-based subcutaneous dupilumab every 2 or 4 weeks. Exposure-adjusted infection rates after a median dupilumab exposure of 52 weeks are compared with data from the earlier randomized, placebo-controlled, 16-week LIBERTY AD PRESCHOOL phase 3 trial. Infection rates were overall lower in the OLE study compared with the dupilumab and placebo groups in the earlier 16-week trial, including total infections (101.0 patients/100 patient-years [PY]), nonherpetic skin infections (22.7 patients/100PY), herpetic infections (7.3 patients/100PY), and nonskin infections (92.9 patients/100PY). The frequency of severe and serious infections was low (3.1 patients/100PY), compared with 17.1 placebo-treated patients/100PY and 0 dupilumab-treated patients in the earlier 16-week trial, and no infections leading to treatment discontinuation were observed. Systemic anti-infective medication use (58.9 patients/100PY) was lower in the OLE study compared with both the dupilumab and placebo groups in the 16-week trial. Overall, reduced infection rates are observed in infants and young children with moderate-to-severe AD treated with dupilumab long-term, supporting the known safety profile of dupilumab.