Tract Infections In Children Research Articles (Page 1)

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children under 5 years of age, resulting in significant morbidity and mortality worldwide. The aim of the current study is to investigate the prevalence and clinical features of RSV disease in hospitalized infants in Sierra Leone. A prospective study was conducted on children under 2 years of age who were hospitalized at Kenema Government Hospital between October 1, 2020, and January 31, 2023. A total of 912 children participated in the study, with 147 (22.8%) testing positive for RSV of 644 (70.6%) who tested positive for at least one virus. During the rainy seasons of 2021 and 2022 (May to November), a surge in RSV cases was observed, particularly those attributed to RSV-A. Conversely, during the dry season (December to April), RSV activity was relatively lower. Respiratory syncytial virus B was significantly associated with a higher disease severity score and increased likelihood of requiring oxygen therapy or referral to the intensive care unit (ICU). Younger children infected with RSV were significantly more likely to require oxygen therapy or referral to the ICU and exhibit higher severity scores. In conclusion, the current study provides valuable insights into the epidemiology and clinical characteristics of RSV in hospitalized children under 2 years of age in Sierra Leone. These findings highlight the need for continuous surveillance and monitoring of RSV infections, especially during peak and transitional seasons, to inform public health interventions and reduce the burden of RSV on children's health.

BMAL1 modulates respiratory syncytial virus-induced inflammation through p38 mitogen-activated protein kinase pathway: insights into circadian regulation.

Antibiotics are the most prescribed drugs in children in Europe. The aim was to evaluate the out-of-hospital prescription of antibiotics in children aged 0-4years with acute upper respiratory tract infections (URTI) in a Spanish Health Area during the period 2014-2023, as well as to analyze the differences according to age and health care setting. Retrospective study with data obtained from the Primary Care Information System of the Castilla-La Mancha Public Health Service (SESCAM). They correspond to a health area composed of 23 basic health zones and 69 municipalities. The variables selected included age, sex, diagnoses, setting (rural or urban), year of prescription, and antibiotics prescribed. A total of. 120,868 antibiotics were prescribed, with a rate of antibiotic prescription during this period (pPR) in children aged 0-4years with URTI of 688.1 prescriptions/1000 persons/year. Children aged 12-35months had the highest pPR (851.5). The pPR in rural areas was higher than in urban areas in all the pathologies studied: tonsillitis (486.3 versus 321.5), otitis (262.2 versus 203.7), and nasopharyngitis (96.2 versus 58.6). Amoxicillin was the most commonly used antibiotic (pPR 400.5). In urban areas, the prescription of beta-lactamase sensitive penicillins was significantly higher than in rural areas (p < 0.05) and significantly lower for amoxicillin (p < 0.05), amoxicillin/clavulanic acid (p < 0.01), and azithromycin (p < 0.01).Conclusions:Children aged 12-35months received most of the antibiotic prescriptions, especially in rural areas. In urban areas, fewer and narrower-spectrum antibiotics are prescribed, with a lower use of amoxicillin/clavulanic acid and azithromycin. What is Known? • Antibiotics are the most commonly prescribed drugs in the pediatric population throughout Europe, with children aged 0-4 years, along with the population over 75 years of age, being the age groups where antibiotics are mostly used. • Upper respiratory tract infections and acute otitis media are the most common diseases for which antibiotics are prescribed. What is New? • In recent years, antibiotic prescription rates in children have decreased and the quality of prescriptions has improved, with fewer prescriptions of amoxicillin/clavulanic acid and azithromycin and an increased use of penicillin and amoxicillin. • Antibiotic prescription rates in children are higher in rural areas than in urban areas, with a greater tendency to use broad-spectrum antibiotics in the former.

BackgroundThis study investigated the differences in clinical features of acute lower respiratory tract infection in children caused by suspected Omicron, respiratory syncytial virus (RSV), and influenza virus A (Flu A).MethodsA retrospective analysis was conducted on the clinical data of 241 hospitalized children with lower respiratory tract infections due to suspected Omicron, RSV, or Flu A at Chengdu Women and Children’s Central Hospital from December 9, 2022 to August 1, 2023. Differences in age, sex, clinical characteristics, laboratory results, imaging findings, and fractional exhaled nitric oxide (FENO) results between the three viral infections were analyzed.ResultsPatients infected with suspected Omicron were predominantly infants and toddlers; in contrast, those infected with Flu A were mostly preschool children. Fever was most common in Flu A-infected patients, followed by RSV-infected and Omicron-infected patients. Inspiratory crackles in the lungs were most frequently observed in suspected Omicron-infected patients, whereas wheezing was more common in RSV-infected patients. No wheezing was observed in the lungs of any suspected Omicron-infected patients. Patients with both suspected Omicron and RSV infections had longer hospital stays. Notably, Flu A infection significantly decreased white blood cell count and increased neutrophil percentage (Neu%) compared with the other two infections. Furthermore, patients with suspected Omicron infection exhibited a pronounced reduction in Neu%; however, the decrease in lymphocyte percentage (Lym%) was considerable in all groups, with the Flu A-infected group showing the greatest decline. C-reactive protein levels were markedly higher in the RSV- and Flu A-infected groups. Liver function was significantly affected in suspected Omicron-infected patients, who were also more likely to have Mycoplasma pneumoniae or bacterial infections. Pulmonary consolidation was more common in suspected Omicron-infected patients, and they had the highest positive rate of FENO.ConclusionsThe clinical manifestations of suspected Omicron infection in patients with acute lower respiratory tract infections are similar to those of Flu A and RSV infections. However, these infections exhibit more severe liver function damage, lung consolidation, and airway inflammation. Paying attention to respiratory tract infections caused by the suspected Omicron virus in children is imperative to ensure timely and appropriate diagnosis and treatment. Promoting child vaccination remains crucial for safeguarding susceptible populations and protecting children’s health.

Introduction: Lower Respiratory Tract Infections (LRTI), including pneumonia and bronchiolitis, represent a leading cause of morbidity and mortality in children under five years of age globally. Parental smoking, leading to environmental tobacco smoke (ETS) exposure, is a significant and modifiable risk factor. This systematic review synthesizes and critically appraises the contemporary evidence examining the association between parental smoking habits and the incidence and severity of LRTI in this vulnerable population. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for observational studies (cohort, case-control, cross-sectional) published up to July 2024. The PICO framework guided the selection of studies investigating the association between parental smoking (prenatal or postnatal) and LRTI (pneumonia, bronchiolitis, bronchitis) in children under five. The methodological quality and risk of bias of included studies were assessed using the Cochrane Risk of Bias tool for non-randomised studies (ROBINS-I). Results: Seventeen observational studies met the inclusion criteria. The evidence consistently demonstrates a significant association between parental smoking and an increased risk of LRTI. Pooled data from meta-analyses indicate that smoking by any household member increases the overall risk of LRTI by approximately 54% (OR=1.54, 95% CI 1.40–1.69). Postnatal maternal smoking was identified as the most potent risk factor (OR=1.58, 95% CI 1.45–1.73), exceeding the risk from paternal smoking alone (OR=1.22, 95% CI 1.10–1.35). The association was strongest for bronchiolitis, with household smoking increasing the risk by 151% (OR=2.51, 95% CI 1.96–3.21). Furthermore, exposure was linked to increased disease severity, including a higher likelihood of hospitalization, intensive care unit admission, and need for mechanical ventilation. A clear dose-response relationship was observed, with risk escalating with the number of smokers in the household and the proximity of smoking to the child. Discussion: The consistency of findings across diverse geographical settings and study designs, supported by strong biological plausibility, substantiates a causal relationship. Prenatal exposure appears to impair lung development, creating a congenital vulnerability, while postnatal exposure acts as a direct inflammatory trigger, impairing mucociliary clearance and immune function. The disproportionately high risk associated with maternal smoking is likely attributable to the greater time mothers typically spend in close proximity to their infants. Conclusion: There is robust and conclusive evidence that parental smoking is a major preventable cause of LRTI incidence and severity in children under five. The findings underscore the urgent need for targeted public health interventions that promote smoking cessation among parents and establish completely smoke-free home environments to protect vulnerable children.

Recurrent respiratory tract infections (RRTIs) are common in childhood and impose substantial socioeconomic burden. β-Glucans, particularly pleuran from Pleurotus ostreatus, demonstrate immunomodulatory properties through the pathogen-associated molecular pattern receptor interactions. This study evaluated a novel chewable pleuran-based supplement with vitaminD and zinc for preventing respiratory infections in children with RRTIs. This international, multicentre, randomised, double-blind, placebo-controlled trial enrolled 249 children with RRTIs from Slovakia, Czech Republic, and Serbia. Participants received either pleuran-based supplement (IMG® with vitaminD and zinc) or active placebo (vitaminD and zinc) for 3months during respiratory infection season (October-March). Primary endpoint was total respiratory tract infections (RTIs). Secondary endpoints included RTI subtypes, RTI duration, missed school days, and safety evaluations. In total, 217 children completed the study (104 active, 113 placebo). The active group experienced significantly fewer total RTIs versus placebo (2.35 ± 1.25 vs. 2.77 ± 1.78; P = 0.042), representing 15.2% reduction over 3months. Common cold episodes were reduced by 18.6% (1.53 ± 1.22 vs. 1.88 ± 1.25; P = 0.040). Effects were pronounced in children over 6years (P = 0.026 for total RTIs; P = 0.005 for common cold) and evident after the first month (P = 0.037). Tonsillopharyngitis showed significant reductions in frequency (P = 0.003) and duration (P = 0.009). Post hoc analysis of children enrolled at respiratory season onset confirmed significant reductions in common cold frequency (P = 0.004) and duration (P = 0.023). The supplement demonstrated excellent tolerability with 98.7% compliance and only mild adverse events. Chewable pleuran-based supplement with vitaminD and zinc significantly reduced respiratory tract infections in children with RRTIs, with rapid onset and favourable safety profile, demonstrating therapeutic potential in this vulnerable population. ClinicalTrials.gov ID NCT06974747.

A Risk Stratification Model to Predict Febrile Urinary Tract Infection After Cessation of Continuous Antibiotic Prophylaxis in Children with Known Vesicoureteral Reflux.

Background: Acute respiratory tract infections (ARTIs) remain among the leading causes of morbidity and mortality in children worldwide, particularly in low- and middle-income countries. These infections, including pneumonia, bronchitis, influenza, and bronchiolitis, are more prevalent in children due to their developing immune systems. They are commonly classified as upper or lower respiratory tract infections and occur more frequently in colder seasons and rural settings. Objective: The study aimed to determine the frequency and types of acute respiratory tract infections in children under five years of age and to identify the demographic and preventive factors associated with their occurrence. Methods: A cross-sectional study was conducted over ten months at Ayub Medical Complex, Abbottabad, involving 173 children aged ≤5 years. Participants were selected through stratified random sampling. Data were collected using a pretested structured questionnaire administered to parents, covering demographics, vaccination status, and infection history. Descriptive and inferential analyses were performed using IBM SPSS version 16. Quantitative variables were expressed as mean ± standard deviation, while categorical variables were reported as frequencies and percentages. Results: Out of 173 participants, 63 (36.4%) had acute respiratory tract infections, while 110 (63.6%) were infection-free. Males constituted 110 (63.6%) and females 63 (36.4%). Most participants resided in rural areas (133, 76.9%), with only 40 (23.1%) from urban regions. Pneumonia was the most prevalent infection (31, 17.9%), followed by bronchiolitis (8, 4.6%) and pharyngitis (4, 2.3%). Regarding immunization, 103 (59.5%) were fully vaccinated, 36 (20.8%) partially vaccinated, and 34 (19.7%) unvaccinated. Conclusion: The study concludes that ARTIs are more common among male children and those living in rural areas. Pneumonia is the predominant form, and complete immunization significantly reduces the risk of infection. Targeted interventions focusing on vaccination, nutrition, and environmental hygiene can effectively lower the disease burden.

Abstract: Acute cough and respiratory tract infections (RTIs), common in children, often lead to high antibiotic use. Echinacea, an herbal alternative, has been studied for its immune-modulating and antiviral effects to reduce the unnecessary use of antibiotics. This systematic review analyzed randomized controlled trials on Echinacea for pediatric acute cough and RTIs. PubMed, Cochrane Library, Semantic Scholar, and Google Scholar were searched on October 15, 2024. Five studies met all inclusion criteria and were retained for qualitative synthesis. The studies generally showed some concerns of bias in randomization and allocation concealment, as well as some issues about blinding and selective reporting. Grading of recommendations assessment, development, and evaluation assessment indicated high certainty of the reduction of symptom duration and antibiotic use, and moderate certainty for the prevention of infection. Evidence suggests that Echinacea purpurea, especially at higher doses (e.g., 2000 mg/day), may reduce RTI incidence, viral load, and symptom severity. Several trials have reported fewer antibiotic prescriptions and shorter fever duration, indicating public health benefits. Efficacy varied by formulation, extraction, and dosing, with tablet-based and hydroethanolic extracts showing more consistent results. Echinacea was well tolerated, only producing mild adverse effects of gastrointestinal discomfort and skin rashes. Some studies showed no significant difference from placebo, which underlines the need for standardized dosing and formulation. Overall, Echinacea may be a useful adjunct for pediatric RTI prevention and management, but further large, high-quality trials are needed to confirm optimal use, efficacy, and safety.

Background: Anemia is a significant risk factor for acute lower respiratory tract infections (ALRTIs) in children under 5 years old. Children with ALRTI have lower mean hemoglobin (Hb) levels, leading to bronchiolitis and bronchopneumonia. Early detection and treatment, along with preventive measures such as iron intake and deworming, can mitigate this risk. Aims and Objectives: The aim of this study is to determine whether anemia is an independent risk factor associated with ALRTIs among children aged 6 months–5 years. Materials and Methods: This is a case–control study that included 93 cases with confirmed respiratory tract infections and 93 controls without respiratory conditions, totaling 186 participants. Statistical analysis was performed by the Statistical Package for the Social Sciences version 24. Significance levels were denoted as P≤0.05. Results: The study investigated the link between low Hb levels and ALRTI in children aged 6 months–5 years. Results showed no gender difference but lower weight and Hb levels in the case group. Hematological and biochemical markers showed significant differences between the two groups. Chest X-ray findings revealed a range of abnormalities in the case group. Conclusion: This study concludes that anemia is a risk factor for infections, particularly acute ALRTIs, in children under the age of 5 years.

Abstract Objectives Acute respiratory infections(ARIs) represent a major global public health concern and affect all age groups. Children are infected approximately two to three times more frequently than adults. This study aimed to evaluate the prevalence and seasonality of viral pathogens associated with respiratory tract infections in children in our region. Materials and Methods Between January 2019 and December 2024, respiratory viral pathogens were analyzed using the Rotor-GeneQ MDxdevice (Qiagen, Germany) with the FastTrack Diagnostics "FTD Respiratory Pathogens 21 Assay" multiplex real-time PCR kit. Results The most frequently detected viral pathogen was RSV A/B (25.18%), while the least detected was PIV1 (0.54%). The most common pathogens were RSV A/B in 2019 and 2023, RSV A/B in 2020, PIV3 in 2021, RSVA/B in 2022, and Rhinovirus in 2024. RSV A/B was the most frequently detected virus in both girls and boys. HMPV A/B was significantly more common in males (p&amp;lt;0.05). Viral pathogens were detected in 73.60% of individuals aged ≤1 year, with RSV A/B being the most frequently identified. ARIs peaked during the winter months and were lowest in the summer. ARIs reached their highest level in December and dropped significantly in August. RSV A/B predominated in December, January, February, and March; Rhinovirus in April, May, and June; Adenovirus in July, August, September, and October; and Bocavirus in November. Conclusion Monitoring the annual and seasonal distribution of respiratory viruses is critical for predicting and identifying epidemics and pandemics. This approach can help ensure accurate pathogen identification and prevent inappropriate antimicrobial treatments.

Mycoplasma pneumoniae (Mp) represents one of the most prevalent pathogens responsible for community-acquired pneumonia (CAP) in pediatric populations. The detection of Mycoplasma pneumoniae resistance genes provides robust technical support and a theoretical foundation for the precise clinical diagnosis and treatment of MP infections. Accurate diagnosis and evaluation of drug resistance in Mp infection are essential for clinical treatment. Common detection methods for Mycoplasma pneumoniae include culture, antibody detection, and molecular biology-based assays. Mp culture is the gold standard for diagnosis but requires a specific medium, is time-consuming, and has low sensitivity. Antibody-based detection of Mp is widely used; however, false negatives may occur in the early stage of infection. Molecular biology-based detection provides rapid turnaround, low risk of contamination, high sensitivity, high specificity, and is not limited by the timing of sample collection or immune status. It has therefore been recognized as a new gold standard for diagnosing Mycoplasma pneumoniae infection. Macrolide agents are the first-choice treatment for Mp infection in children. However, with the extensive use of macrolides in respiratory tract infections in children, the incidence of drug-resistant Mycoplasma pneumoniae infection has been increasing. Patients infected with resistant strains experience significantly longer fever duration, extended hospitalization, and prolonged fever after administration compared with those infected with sensitive strains. Mutation sites identified to date include 2063, 2064, 2067, and 2617. In China, point mutations have been documented only at positions 2063 and 2064, with an A-to-G substitution at position 2063 being the most common. For these sites, polymerase chain reaction (PCR) combined with fluorescent probe technology has been employed to detect the nucleic acids and drug resistance mutations of Mycoplasma pneumoniae in human sputum samples. Detection of Mycoplasma pneumoniae resistance genes offers crucial technical support and a theoretical basis for accurate diagnosis and effective treatment of Mp infection.

Mycoplasma pneumoniae (MP) is a common cause of lower respiratory tract infections in children. During the COVID-19 pandemic, a marked decline in MP infections was observed, with a delayed resurgence reported in some European countries. This study aimed to assess the epidemiological trends and clinical features of MP infections in a pediatric tertiary care academic hospital in Italy from 2017 to 2024. We conducted a retrospective, single-center study including immunocompetent patients 30 days to 17 years of age, hospitalized with confirmed MP infection. Clinical, laboratory, and radiologic data were analyzed across 3 periods: prepandemic (2017-2019), pandemic (2020-2022) and postpandemic (2023-2024). Statistical analyses were performed to compare incidence and clinical characteristics over time. Of 303 included patients, 130 were hospitalized prepandemic and 148 postpandemics. The proportion of MP among acute respiratory infection hospitalizations nearly doubled, from 3.2% in 2019 to 6.1% in 2024. Despite the higher incidence, the need for respiratory support remained stable (25.7% overall; P = 0.3), the pediatric intensive care admissions were rare and unchanged (2.0% vs. 2.0%, P = 1.0) and median hospital stay was consistent across both periods (5 days, interquartile range 4-8; P = 0.803). MP incidence increased significantly postpandemic, and clinical severity remained comparable to prepandemic levels. Ongoing epidemiologic surveillance is essential to better understand infection dynamics and to guide effective clinical management strategies.

Background &amp; Objective: Bronchopneumonia is one of the most common forms of lower respiratory tract infections in children and often causes ineffective airway clearance due to secretions buildup. This study aims to evaluate the effectiveness of nursing interventions using aromatherapy inhalation therapy in improving airway clearance in children with bronchopneumonia. Method: Descriptive, applying the results of previous case studies, using a pediatric nursing care approach and the innovative intervention of aromatherapy inhalation therapy. Result: Significant effectiveness was demonstrated, marked by a decrease in respiratory rate from 44 breaths per minute to 32 breaths per minute, more effective coughing, and reduced rales on lung auscultation. Conclusion: Aromatherapy inhalation therapy intervention was proven to help thin secretions and facilitate mucus clearance. Therefore, this intervention can be considered an alternative supportive measure in pediatric nursing care for children with bronchopneumonia experiencing airway clearance disorders.

Background: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in children, particularly severe during infancy. Maternal RSV-specific neutralizing antibodies (nAbs), transferred via the placenta, may provide protection in early infancy, but the extent and duration of protection remain uncertain. Objective: We investigated the association between cord blood RSV-A nAb levels and the risk of hospitalization due to RSV-associated acute respiratory infection (RSV-ARI) by 24 months of age. Methods: We conducted a case–cohort study nested within a birth cohort in Nha Trang, Vietnam. From the full cohort (n = 1977), a random subcohort of 392 infants and all 66 infants hospitalized for RSV-ARI by age 24 months were included for RSV-A nAb testing. RSV-A nAb titers at birth were categorized into three groups in the subcohort (low: lowest quartile; middle; interquartile; high: highest quartile). Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) for RSV-ARI hospitalization. Results: The incidence of RSV-ARI hospitalization was 17.92 per 1000 person-years by 24 months, and 25.40 per 1000 person-years among infants aged <12 months. Among infants aged <6 months, those in the low nAb group had a significantly higher risk of hospitalization compared to the middle nAb group (adjusted HR: 4.05; 95% CI: 1.51–10.89). Maternal anemia was consistently associated with increased risk. Conclusions: Lower RSV-nAb titers at birth were associated with an increased risk of RSV-ARI hospitalization during early infancy. These findings support the importance of maternal immunization strategies to enhance infant protection against RSV.

Epidemiology of aminoglycosides resistance and phenotypic detection of aac(6')-Ib-cr gene in ESBL-producing Enterobacterales in febrile urinary tract infection in children.

Prevalence and risk factors of pediatric seizures in COVID-19 infection: A study from Thailand

Feilike mixture targeting the STAT1-NLRP3 axis represses the pyroptosis of epithelial cells to alleviate Mycoplasma pneumoniae pneumonia.

Respiratory syncytial virus (RSV) is the leading pathogenof acutelower respiratory tract infections in children under 5 years of ageworldwide. Respiratory syncytial virus pneumonia in infants and childrencauses more deaths than influenza each year due to the high rate ofsevere illness. There is a lack of safe and effective antiviral drugs,and the development of novel antirespiratory syncytial virus drugsis of great clinical importance. Selenomethionine (SeMet), as themain ingredient in commercially available selenium supplements, exertsexcellent antioxidant, antiviral, immunomodulatory, and other physiologicalfunctions mainly in the form of selenoprotein. The antiviral mechanismof SeMet anti-RSV was explored by detecting the apoptotic state, thedegree of DNA damage, cytokine and reactive oxygen species (ROS) secretionlevels, and the mitochondrial membrane potential. Meanwhile, thisstudy screened the affinity of SeMet for common RSV target proteinsand explored the dynamic interactions between SeMet and the screenedviral target proteins.Conclusions: SeMet inhibitedapoptosis and inflammatory responses by regulating the ROS-mediatedPARP/Bcl-2, NF-κB/JAK1-STAT3 signaling pathways. Meanwhile,SeMet formed a stable interaction with RSV polymerase and may bindto key amino acid residues of RSV polymerase mainly through hydrogenbonding.

BackgroundHuman 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 MethodsWe retrospectively analyzed the data of patients aged 18 or younger hospitalized due to hMPV infection at a tertiary hospital between 2014 and 2019.ResultsIn 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.ConclusionhMPV 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.