Improved use of antibiotics following implementation of antimicrobial stewardship in a neonatal intensive care unit.

Introduction: Inappropriate antibiotic use in infants can have multiple adverse effects and contribute to the development of bacteria resistant to antimicrobials. Antimicrobial stewardship programs can reduce unnecessary antibiotic use in children. The aim of this study was to evaluate the effect of an antimicrobial stewardship program implemented in 2017 in the Neonatal Intensive Care Unit (NICU) at The Children's Hospital Iceland.

Tonsillectomies are associated with an increased risk of meningococcal carriage.

Background: is a commensal organism with the potential to cause life-threatening disease. Colonisation is most common in adolescence and young adulthood. Various social factors have been associated with an increased risk of meningococcal carriage, but less is known about host factors that may influence the carriage status.

Influenza vaccination in pregnant women in Iceland 2010-2020 and the burden of influenza in pregnant women and their infants.

Introduction: Influenza vaccinations are recommended in pregnancy to protect both the pregnant woman and the unborn baby. The aim of this study was to assess the influenza vaccine uptake among pregnant women in Iceland in ten influenza seasons and to estimate the influenza disease burden on pregnant women and their infants.

Methods: This was a retrospective, descriptive study on influenza vaccine uptake among pregnant women and the burden of influenza and influenza-like illness (ILI) among pregnant women and their infants in ten influenza seasons.

Variant in the synaptonemal complex protein SYCE2 associates with pregnancy loss through effect on recombination.

Two-thirds of all human conceptions are lost, in most cases before clinical detection. The lack of detailed understanding of the causes of pregnancy losses constrains focused counseling for future pregnancies. We have previously shown that a missense variant in synaptonemal complex central element protein 2 (SYCE2), in a key residue for the assembly of the synaptonemal complex backbone, associates with recombination traits.

Early-onset group B streptococcal infections in five Nordic countries with different prevention policies, 1995 to 2019.

BackgroundNeonatal early-onset disease caused by group B (GBS) is a leading cause of infant morbidity. Intrapartum antibiotic prophylaxis (IAP) is effective in preventing early-onset GBS disease, but there is no agreement on the optimal strategy for identifying the pregnant women requiring this treatment, and both risk-based prophylaxis (RBP) and GBS screening-based prophylaxis (SBP) are used.AimThe aim of this study was to evaluate the effect of SBP as a public health intervention on the epidemiology of early-onset GBS infections.

Adequate immune responses to vaccines after chemotherapy for leukaemia diagnosed in childhood.

Aim: The survival rate after treatment for childhood leukaemia has greatly improved, but could result in protracted immune deficiency. This study examined the immune status of children after chemotherapy and evaluated their responses to immunisation.

Methods: Subjects who had completed their treatment for acute lymphoblastic leukaemia at The Children's Hospital Reykjavík, Iceland, during 2011-2020 had blood drawn and were then immunised for influenza in October 2021.

Long COVID in Icelandic Children: A Matched Cohort Study of Nonspecific Symptoms Following SARS-CoV-2 Infection.

Purpose: Pediatric severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections are usually mild and the mortality rates are low, but concerns have been raised about long-term symptoms that may resemble other postinfectious syndromes. Studies with robust control groups and high response rates have been few.

Methods: We obtained identifiers for all 837 Icelandic children diagnosed with SARS-CoV-2 by PCR between March 2020 and June 2021 and contacted them by telephone.

Meningococcal carriage in children and young adults: a cross-sectional and longitudinal study, Iceland, 2019 to 2021.

Background is a commensal bacterium which can cause invasive disease. Colonisation studies are important to guide vaccination strategies.AimThe study's aim was to determine the prevalence of meningococcal colonisation, duration of carriage and distribution of genogroups in Iceland.

Nasopharyngeal competition dynamics are likely to be altered following vaccine introduction: bacteriocin prevalence and diversity among Icelandic and Kenyan pneumococci.

Bacteriocins are antimicrobial peptides produced by bacteria to inhibit other bacteria in the surrounding environment. is a leading cause of disease worldwide and colonises the healthy human nasopharynx, where it competes for space and nutrients. Pneumococcal conjugate vaccines have reduced the incidence of disease, but they also restructure the bacterial population, and this restructuring likely alters the nasopharyngeal competition dynamics.

Deficit of homozygosity among 1.52 million individuals and genetic causes of recessive lethality.

Genotypes causing pregnancy loss and perinatal mortality are depleted among living individuals and are therefore difficult to find. To explore genetic causes of recessive lethality, we searched for sequence variants with deficit of homozygosity among 1.52 million individuals from six European populations.

Febrile Children with Pneumonia Have Higher Nasopharyngeal Bacterial Load Than Other Children with Fever.

Febrile episodes are common in children and the most frequent reason for attending emergency services. Although most infections have a benign and self-limiting course, severe and sometimes life-threatening infections occur. This prospective study describes a cohort of children presenting to a single-centre pediatric emergency department (ED) with suspected invasive bacterial infection, and explores the relationships between nasopharyngeal microbes and outcomes.

Obesity in adolescents does not influence early immune responses to influenza vaccination.

Background: Obesity has been linked to reduced vaccine responses against tetanus, hepatitis B and influenza. Data on the influence of paediatric obesity on influenza vaccine response is still lacking and this study aims to fill the gap.

Methods: A total of 30 children with obesity and 30 children with normal weight, aged 12-18 years, were recruited.

Clinical and Socioeconomic Burden of Respiratory Syncytial Virus in Iceland.

Introduction: Respiratory syncytial virus (RSV), a very common pathogen, causes variable disease severity. In addition to considerable clinical burden on children, their families and healthcare facilities, RSV infections in children also carry significant direct and indirect socioeconomic burden.

Methods: We analyzed data from 5 consecutive RSV seasons (2015-2020) and used virologically confirmed RSV infections and age <5 years as case definition.

The cerebrospinal fluid proteome of preterm infants predicts neurodevelopmental outcome.

Background: Survival rate increases for preterm infants, but long-term neurodevelopmental outcome predictors are lacking. Our primary aim was to determine whether a specific proteomic profile in cerebrospinal fluid (CSF) of preterm infants differs from that of term infants and to identify novel biomarkers of neurodevelopmental outcome in preterm infants.

Methods: Twenty-seven preterm infants with median gestational age 27 w + 4 d and ten full-term infants were enrolled prospectively.

Simplified antibiotic treatment for paediatric osteoarticular infections achieved good outcomes.

Aim: Early diagnosis of osteoarticular infections (OAI) in children and effective treatment prevents complications. The objective of this study was to evaluate effectiveness and safety of shortened intravenous antibiotic treatment of OAI. Incidence, diagnostics and pathogens of paediatric OAI were assessed.

SARS-CoV-2 Infections in Icelandic Children: Close Follow-up of All Confirmed Cases in a Nationwide Study.

Introduction: Children are less likely to acquire SARS-CoV-2 infections than adults and when infected, usually have milder disease. True infection and complication rates are, however, difficult to ascertain. In Iceland, a strict test, trace and isolate policy was maintained from the start of the pandemic and offers more accurate information of the number of truly infected children in a nationwide study.

Decreasing death rates and causes of death in Icelandic children-A longitudinal analysis.

Background: Global death rate in children has been declining during the last decades worldwide, especially in high income countries. This has been attributed to several factors, including improved prenatal and perinatal care, immunisations, infection management as well as progress in diagnosis and treatment of most diseases. However, there is certainly room for further progress.

Group B streptococcal infections in infants in Iceland: clinical and microbiological factors.

Group B streptococcus (GBS) is a leading cause of invasive neonatal infections. These have been divided into early-onset disease (EOD; <7 days) and late-onset disease (LOD; 7-89 days), with different GBS clonal complexes (CCs) associated with different disease presentations. Different GBS CCs are associated with timing of infection (EOD or LOD) and clinical presentation (sepsis, meningitis or pneumonia).

Longitudinal asthma and allergy study showed that childhood symptoms frequently persisted into adulthood.

Aims: The prevalence of allergic diseases is high and increasing in many countries. The aim of this study was to describe the prevalence of allergic diseases and changes in clinical expression in a birth cohort followed for three decades.

Methods: We followed Icelandic citizens born in 1987 for allergic diseases when they were 2, 4, 8, 15, 21 and 29 years of age.

Burden of rotavirus disease in young children in Iceland - Time to vaccinate?

Background: Acute gastroenteritis poses a significant burden on young children, families, health care facilities and societies. Rotavirus is the most common pathogen, but rotavirus infections are vaccine preventable. Information on the epidemiology of gastroenteritis in Icelandic children has until now not been available and rotavirus vaccination is currently not offered to Icelandic infants.

HSCT in two brothers with CGD arising from mutations in CYBC1 corrects the defect in neutrophil function.

Homozygous mutations in cytochrome b-245 chaperone 1 (CYBC1) have been recently described as causing recurrent infections and inflammatory disease in an Icelandic cohort and a patient from Saudi Arabia, by destabilising the dimerisation of gp91 with p22, manifesting as phenotypic chronic granulomatous disease (CGD). Haematopoietic stem cell transplantation is the treatment of choice in CGD, though experience of transplantation in this subtype of CGD is limited to a brief description in one patient. We provide clinical and transplant data for two Icelandic brothers with CGD due to homozygous p.