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Pathogens
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Recent Advances in Pediatric Infectious Diseases
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Recent Advances in Pediatric Infectious Diseases

A special issue of Pathogens (ISSN 2076-0817).

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 19469

Special Issue Editors

Dr. Susan A. Maloney

E-Mail Website
Guest Editor
Centers for Disease Control and Prevention, Atlanta, GA, USA
Interests: pediatric infectious diseases; tuberculosis; HIV; public health; migrant health
Dr. Maria Gutierrez

E-Mail Website
Guest Editor
Joe Di Maggio Children’s Hospital, Hollywood, FL, USA
Interests: pediatric infectious diseases; HIV; pediatric infection control

Special Issue Information

Dear Colleagues,

Despite being largely preventable and treatable, infectious diseases remain leading causes of morbidity and mortality in children and adolescents, especially in low and middle-income countries. Globally, in 2020, 5.0 million children under 5 years of age died; infectious diseases, including pneumonia, diarrhea, malaria, tuberculosis (TB) and human immunodeficiency virus (HIV) were responsible for over 30% of global deaths among these children. Further, according to the 2019 Global Burden of Disease Study, 6 infectious diseases were among the top 10 causes of the disability adjusted life years (DALYs) in children younger than 10 years—and 11 infectious diseases were among the top 20 causes of DALYs--including lower respiratory infections, diarrheal diseases, malaria, meningitis, pertussis, congenital syphilis, measles, TB, HIV, invasive non-typhoidal salmonella, and typhoid and paratyphoid.

Although progress has been made, there still exist considerable knowledge gaps and a continuing need for specific approaches, diagnostic tools and antimicrobial drugs and vaccines tailored to pediatric patients. Recent events such as the COVID pandemic, as well as the threat of other emerging diseases, such as monkey pox and enterovirus D68, underline the need to intensify and augment attention, resources and investment focused on combatting infectious diseases in children and adolescents.

This Special Issue of Pathogens highlights recent advances in fundamental and applied research and program implementation science related to key infectious diseases in children, with a focus on epidemiology and current approaches and innovations for effective diagnosis, treatment and prevention. These efforts provide the basis for enhancing our capabilities to end childhood illness and death from infectious diseases.

Dr. Susan A. Maloney
Dr. Maria Gutierrez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnosis
  • prevention
  • vaccines
  • pediatric infections
  • pediatric infectious diseases
  • antibiotic treatment/resistance
  • antiviral treatment

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Published Papers (7 papers)

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Research

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15 pages, 1296 KiB  
Article
Comprehensive Summary of Safety Data on Nirsevimab in Infants and Children from All Pivotal Randomized Clinical Trials
by Vaishali S. Mankad, Amanda Leach, Yue Chang, Ulrika Wählby Hamrén, Alexandre Kiazand, Robert J. Kubiak, Therese Takas, Tonya Villafana and Manish Shroff
Pathogens 2024, 13(6), 503; https://doi.org/10.3390/pathogens13060503 - 13 Jun 2024
Cited by 2 | Viewed by 3413
Abstract
Background: Nirsevimab is approved in the US for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants during their first RSV season and in children aged ≤24 months who remain vulnerable to severe RSV disease through their [...] Read more.
Background: Nirsevimab is approved in the US for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants during their first RSV season and in children aged ≤24 months who remain vulnerable to severe RSV disease through their second RSV season. We summarize a pre-specified analysis of nirsevimab safety data from three randomized controlled trials: Phase 2b (NCT02878330; healthy infants born ≥29 to <35 weeks’ gestational age [wGA]); Phase 3 MELODY (NCT03979313; healthy infants born ≥35 wGA); and Phase 2/3 MEDLEY (NCT03959488; infants with congenital heart disease [CHD] and/or chronic lung disease of prematurity [CLD] or born ≤35 wGA). Methods: Participants (randomized 2:1) received a single intramuscular dose of nirsevimab or comparator (placebo, Phase 2b/MELODY; 5× once-monthly palivizumab, MEDLEY) before their first RSV season (recipients < 5 kg, nirsevimab 50 mg; ≥5 kg, nirsevimab 100 mg). In MEDLEY, children with CHD/CLD continued to a second RSV season: first-season nirsevimab recipients received nirsevimab 200 mg; first-season palivizumab recipients were re-randomized 1:1 to receive nirsevimab 200 mg or 5× once-monthly palivizumab. Results: The incidence, severity, and nature of AEs were similar across treatments (nirsevimab, n = 3184; placebo, n = 1284; palivizumab, n = 304). Most AEs were mild to moderate in severity, with ≥98% unrelated to treatment. AEs of special interest occurred infrequently (<1%): no anaphylaxis or thrombocytopenia were treatment-related, and no immune complex disease was reported. Deaths (incidence < 1.0%) were all unrelated to treatment. Conclusions: A single dose per season of nirsevimab for the prevention of RSV disease had a favorable safety profile, irrespective of wGA or comorbidities. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
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16 pages, 4006 KiB  
Article
Descriptive Epidemiology of Pathogens Associated with Acute Respiratory Infection in a Community-Based Study of K–12 School Children (2015–2023)
by Cristalyne Bell, Maureen Goss, Derek Norton, Shari Barlow, Emily Temte, Cecilia He, Caroline Hamer, Sarah Walters, Alea Sabry, Kelly Johnson, Guanhua Chen, Amra Uzicanin and Jonathan Temte
Pathogens 2024, 13(4), 340; https://doi.org/10.3390/pathogens13040340 - 19 Apr 2024
Viewed by 1385
Abstract
School-based outbreaks often precede increased incidence of acute respiratory infections in the greater community. We conducted acute respiratory infection surveillance among children to elucidate commonly detected pathogens in school settings and their unique characteristics and epidemiological patterns. The ORegon CHild Absenteeism due to [...] Read more.
School-based outbreaks often precede increased incidence of acute respiratory infections in the greater community. We conducted acute respiratory infection surveillance among children to elucidate commonly detected pathogens in school settings and their unique characteristics and epidemiological patterns. The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) is a longitudinal, laboratory-supported, school-based, acute respiratory illness (ARI) surveillance study designed to evaluate the utility of cause-specific student absenteeism monitoring for early detection of increased activity of influenza and other respiratory viruses in schools from kindergarten through 12th grade. Eligible participants with ARIs provided demographic, epidemiologic, and symptom data, along with a nasal swab or oropharyngeal specimen. Multipathogen testing using reverse-transcription polymerase chain reaction (RT-PCR) was performed on all specimens for 18 respiratory viruses and 2 atypical bacterial pathogens (Chlamydia pneumoniae and Mycoplasma pneumoniae). Between 5 January 2015 and 9 June 2023, 3498 children participated. Pathogens were detected in 2455 of 3498 (70%) specimens. Rhinovirus/enteroviruses (36%) and influenza viruses A/B (35%) were most commonly identified in positive specimens. Rhinovirus/enteroviruses and parainfluenza viruses occurred early in the academic year, followed by seasonal coronaviruses, RSV, influenza viruses A/B, and human metapneumovirus. Since its emergence in 2020, SARS-CoV-2 was detected year-round and had a higher median age than the other pathogens. A better understanding of the etiologies, presentations, and patterns of pediatric acute respiratory infections can help inform medical and public health system responses. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
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13 pages, 1291 KiB  
Article
Neurodevelopmental Outcomes of Normocephalic Colombian Children with Antenatal Zika Virus Exposure at School Entry
by Sarah B. Mulkey, Elizabeth Corn, Meagan E. Williams, Colleen Peyton, Regan Andringa-Seed, Margarita Arroyave-Wessel, Gilbert Vezina, Dorothy I. Bulas, Robert H. Podolsky, Michael E. Msall and Carlos Cure
Pathogens 2024, 13(2), 170; https://doi.org/10.3390/pathogens13020170 - 13 Feb 2024
Cited by 2 | Viewed by 2470
Abstract
The long-term neurodevelopmental effects of antenatal Zika virus (ZIKV) exposure in children without congenital Zika syndrome (CZS) remain unclear, as few children have been examined to the age of school entry level. A total of 51 Colombian children with antenatal ZIKV exposure without [...] Read more.
The long-term neurodevelopmental effects of antenatal Zika virus (ZIKV) exposure in children without congenital Zika syndrome (CZS) remain unclear, as few children have been examined to the age of school entry level. A total of 51 Colombian children with antenatal ZIKV exposure without CZS and 70 unexposed controls were evaluated at 4–5 years of age using the Behavior Rating Inventory of Executive Function (BRIEF), the Pediatric Evaluation of Disability Inventory (PEDI-CAT), the Bracken School Readiness Assessment (BSRA), and the Movement Assessment Battery for Children (MABC). The mean ages at evaluation were 5.3 and 5.2 years for cases and controls, respectively. Elevated BRIEF scores in Shift and Emotional Control may suggest lower emotional regulation in cases. A greater number of cases were reported by parents to have behavior and mood problems. BSRA and PEDI-CAT activity scores were unexpectedly higher in cases, most likely related to the COVID-19 pandemic and a delayed school entry among the controls. Although PEDI-CAT mobility scores were lower in cases, there were no differences in motor scores on the MABC. Of 40 cases with neonatal neuroimaging, neurodevelopment in 17 with mild non-specific findings was no different from 23 cases with normal neuroimaging. Normocephalic children with ZIKV exposure have positive developmental trajectories at 4–5 years of age but differ from controls in measures of emotional regulation and adaptive mobility, necessitating continued follow-up. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
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Review

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39 pages, 2097 KiB  
Review
Pediatric Tuberculosis: A Review of Evidence-Based Best Practices for Clinicians and Health Care Providers
by Brittany K. Moore, Stephen M. Graham, Subhadra Nandakumar, Joshua Doyle and Susan A. Maloney
Pathogens 2024, 13(6), 467; https://doi.org/10.3390/pathogens13060467 - 1 Jun 2024
Cited by 2 | Viewed by 3482
Abstract
Advances in pediatric TB care are promising, the result of decades of advocacy, operational and clinical trials research, and political will by national and local TB programs in high-burden countries. However, implementation challenges remain in linking policy to practice and scaling up innovations [...] Read more.
Advances in pediatric TB care are promising, the result of decades of advocacy, operational and clinical trials research, and political will by national and local TB programs in high-burden countries. However, implementation challenges remain in linking policy to practice and scaling up innovations for prevention, diagnosis, and treatment of TB in children, especially in resource-limited settings. There is both need and opportunity to strengthen clinician confidence in making a TB diagnosis and managing the various manifestations of TB in children, which can facilitate the translation of evidence to action and expand access to new tools and strategies to address TB in this population. This review aims to summarize existing guidance and best practices for clinicians and health care providers in low-resource, TB-endemic settings and identify resources with more detailed and actionable information for decision-making along the clinical cascade to prevent, find, and cure TB in children. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
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20 pages, 371 KiB  
Review
Prenatal Maternal Immunization for Infant Protection: A Review of the Vaccines Recommended, Infant Immunity and Future Research Directions
by Elizabeth M. Quincer, Lisa M. Cranmer and Satoshi Kamidani
Pathogens 2024, 13(3), 200; https://doi.org/10.3390/pathogens13030200 - 23 Feb 2024
Cited by 1 | Viewed by 3169
Abstract
Prenatal maternal immunization is an effective tool to protect mothers and infants from poor health outcomes due to infectious diseases. We provide an overview of the rationale for the use of prenatal vaccines, discuss the immunologic environment of the maternal–fetal interface including the [...] Read more.
Prenatal maternal immunization is an effective tool to protect mothers and infants from poor health outcomes due to infectious diseases. We provide an overview of the rationale for the use of prenatal vaccines, discuss the immunologic environment of the maternal–fetal interface including the impact of maternal vaccines prenatally and subsequently on the infant’s immune response, and review vaccines currently recommended in pregnancy and landscape for the future of maternal vaccination. This review aims to provide an understanding of the recent history and progress made in the field and highlight the importance of continued research and development into new vaccines for pregnant populations. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
12 pages, 261 KiB  
Review
Pediatric Drug-Resistant Tuberculosis: The Current and Future Prospects for Management and Prevention
by Dhanya Dharmapalan and Sushant Satish Mane
Pathogens 2023, 12(11), 1372; https://doi.org/10.3390/pathogens12111372 - 20 Nov 2023
Cited by 1 | Viewed by 2196
Abstract
In the continued battle against one of the oldest enemies known to mankind, Mycobacterium tuberculosis (MTB), the emergence of drug resistance to antituberculosis drugs among children poses multiple challenges for early detection and treatment. Molecular diagnostics and newer drugs like bedaquiline and [...] Read more.
In the continued battle against one of the oldest enemies known to mankind, Mycobacterium tuberculosis (MTB), the emergence of drug resistance to antituberculosis drugs among children poses multiple challenges for early detection and treatment. Molecular diagnostics and newer drugs like bedaquiline and delamanid have strengthened the armamentarium and helped design convenient, safe, and child-friendly therapeutic regimens against drug-resistant tuberculosis (TB). Preventive strategies like treatment of TB infection among children living in close contact with patients with drug-resistant TB and effective vaccines against TB are currently in the investigative stages of development and implementation. In addition to the implementation of recent novel diagnostics and treatment modalities, effective psychosocial and nutritional support, as well as dedicated monitoring for compliance and adverse effects, are crucial determinants for successful treatment outcomes in these children. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
9 pages, 255 KiB  
Review
Granulicatella spp., a Causative Agent of Infective Endocarditis in Children
by Chiara Albano, Sara Bagarello, Salvatore Giordano, Maria Fiorella Sanfilippo, Calogero Comparato, Giuseppe Scardino, Valeria Garbo, Giovanni Boncori, Anna Condemi, Antonio Cascio and Claudia Colomba
Pathogens 2022, 11(12), 1431; https://doi.org/10.3390/pathogens11121431 - 28 Nov 2022
Cited by 2 | Viewed by 2144
Abstract
Granulicatella spp. are non-motile, non-sporulating, facultatively anaerobic Gram-positive cocci. Throughout the literature, these organisms have been referred to by several names, such as “nutritionally deficient streptococci”, “vitamin-B dependent streptococci” and “pyridoxal-dependent streptococci”, because of their fastidious nutritional requirements, which can often make culture [...] Read more.
Granulicatella spp. are non-motile, non-sporulating, facultatively anaerobic Gram-positive cocci. Throughout the literature, these organisms have been referred to by several names, such as “nutritionally deficient streptococci”, “vitamin-B dependent streptococci” and “pyridoxal-dependent streptococci”, because of their fastidious nutritional requirements, which can often make culture isolation challenging. Known to be a member of the normal microbiota of the human oral cavity and urogenital and intestinal tracts, similar to other streptococci, Granulicatella spp. can cause bacteremia, sepsis and infective endocarditis. Considering the difficulty in growing this organism on culture medium, the fact that it is now included among the bacteria known to be responsible for culture-negative infective endocarditis suggests that its pathogenic role could be highly underestimated. Moreover, being considered such a rare causative agent, it is not a target of standard antibiotic empiric treatment. We present a rare case of G. elegans endocarditis in a young child and review the medical literature on Granulicatella endocarditis in the pediatric population, with the aim of sharing knowledge about this microorganism, which can be challenging for a clinician who is not familiar with it. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Infectious Diseases)
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