Publications by authors named "Pokorn M"
Mycoplasma pneumoniae causes atypical pneumonia in children and young adults. Its lack of a cell wall makes it resistant to beta-lactams, which are the first-line treatment for typical pneumonia. Current diagnostic tests are time-consuming and have low specificity, leading clinicians to administer empirical antibiotics.
View Article and Find Full Text PDFBackground: The objective of this prospective study was to assess the proportion and clinical consequences of human bocavirus 1 (HBoV1) replication in children hospitalized for acute bronchiolitis (AB) with HBoV1 DNA in the nasopharynx (NP).
Methods: For this purpose, we detected HBoV1 DNA and mRNA (evidence of viral replication and viable virus) in NP in cases and healthy control children. This research allowed us to distinguish active HBoV1 infections from inactive ones.
Pro- and anti-inflammatory cytokines help regulate the inflammatory response. A cytokine storm is a dysregulated cytokine response associated with sepsis and other conditions that result in a hyper-inflammatory state. Extracorporeal cytokine adsorption has the potential to restore a balanced inflammatory response.
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- The study assesses the effectiveness of white blood cell count (WBC) in predicting serious bacterial infections (SBI) in children compared to C reactive protein (CRP) and absolute neutrophil count (ANC).
- After analyzing data from over 17,000 febrile children across multiple European emergency departments, WBC showed poor predictive value with a sensitivity of 56% and specificity of 74% for WBC >15.
- The findings suggest that CRP is a better marker for identifying SBI in children, and WBC should only be used for specific cases rather than as a routine diagnostic tool.
We have read the recent narrative review article by Jakše et al [...
View Article and Find Full Text PDFBackground: Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious hyperinflammatory complication following infection with severe acute respiratory syndrome coronavirus 2. The mechanisms underpinning the pathophysiology of MIS-C are poorly understood. Moreover, clinically distinguishing MIS-C from other childhood infectious and inflammatory conditions, such as Kawasaki disease or severe bacterial and viral infections, is challenging due to overlapping clinical and laboratory features.
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- * Using data from 12 European EDs, researchers analyzed presenting symptoms and management of febrile children under 18, identifying those suitable for a fast track system based on simplicity and minimal resource use.
- * Findings revealed that respiratory symptoms were the most common, while neurological patients utilized more imaging and had higher admission rates, and gastrointestinal patients underwent more lab tests, indicating varying needs among the different symptom groups.
Invasive meningococcal disease (IMD) is an acute life-threatening infection caused by the gram-negative bacterium, . Globally, there are approximately half a million cases of IMD each year, with incidence varying across geographical regions. Vaccination has proven to be successful against IMD, as part of controlling outbreaks, and when incorporated into national immunization programs.
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- Differentiating between self-resolving viral infections and bacterial infections in children with fever is challenging and can lead to improper use of antibiotics; this study aims to identify host protein biomarkers that could help distinguish between these infections.
- The research used a multi-cohort approach and high-dimensional proteomic datasets from various European studies to shortlist potential protein biomarkers by performing several analyses and tests on collected samples.
- A sparse protein signature was successfully identified, which distinguishes between bacterial and viral infections, and its effectiveness was validated through Luminex assays and disease risk score calculations.
Article Synopsis
- Antibiotic overprescription in pediatric emergency departments (EDs) contributes to antimicrobial resistance, prompting a study on empiric antibiotic use in European EDs for febrile children.
- Out of 2130 febrile cases studied, 72.7% were classified as bacterial and 27.3% as viral, with 85.1% of bacterial and 46.3% of viral cases receiving empiric systemic antibiotics within the first two days.
- A large portion of patients with viral infections were still given antibiotics, typically from the WHO's "Watch" category, highlighting the need for better diagnostic methods in EDs to accurately distinguish between bacterial and viral infections.
External validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children.
Arch Dis Child
December 2023
Article Synopsis
- The study aimed to validate and update the Feverkids tool, a clinical prediction model designed to help differentiate between bacterial pneumonia, serious bacterial infections (SBIs), and non-SBI causes of fever in immunocompromised children.
- Conducted in 15 hospitals across nine European countries, the study involved observational data from febrile immunocompromised children aged 0-18 years.
- Results showed improved accuracy in predicting bacterial pneumonia and SBIs after model updates, indicating effective thresholds that can help minimize unnecessary medical interventions and antibiotic use.
Background: The PERFORM study aimed to understand causes of febrile childhood illness by comparing molecular pathogen detection with current clinical practice.
Methods: Febrile children and controls were recruited on presentation to hospital in 9 European countries 2016-2020. Each child was assigned a standardized diagnostic category based on retrospective review of local clinical and microbiological data.
Children constitute 6-10% of all patients attending the emergency department (ED) by emergency medical services (EMS). However, discordant EMS use in children occurs in 37-61% with fever as an important risk factor. We aimed to describe EMS utilisation among febrile children attending European EDs.
View Article and Find Full Text PDFBackground: To identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections.
Methods: Children presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138).
Objectives: To describe the characteristics and clinical outcomes of children with fever ≥5 days presenting to emergency departments (EDs).
Design: Prospective observational study.
Setting: 12 European EDs.
This study determines and compares the frequency of human mastadenovirus (HAdV) presence in children with acute bronchiolitis (AB), acute gastroenteritis (AGE), and febrile seizures (FS), ascertains types of HAdVs associated with each individual syndrome and contrasts the findings with a control group of children. The presence of HAdVs was ascertained in simultaneously collected nasopharyngeal (NP) swabs and stool samples amplifying the hexon gene by RT-PCR; these were sequenced to determine the types of HAdVs. HAdVs were grouped into eight different genotypes.
View Article and Find Full Text PDFAim: This study investigated febrile children with petechial rashes who presented to European emergency departments (EDs) and investigated the role that mechanical causes played in diagnoses.
Methods: Consecutive patients with fever presenting to EDs in 11 European emergency departments in 2017-2018 were enrolled. The cause and focus of infection were identified and a detailed analysis was performed on children with petechial rashes.
This clinical guideline is intended for use by orthopedic surgeons and physicians who care for patients with possible or documented septic arthritis of a native joint (SANJO). It includes evidence and opinion-based recommendations for the diagnosis and management of patients with SANJO.
View Article and Find Full Text PDFBackground: The impact and outcomes of postnatal cytomegalovirus (CMV) infection are not entirely clear. We aimed to determine the associations between treatment outcomes of postnatal CMV infection and its antiviral treatment.
Methods: Retrospective study in a tertiary center.
Background: Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability.
Methods And Findings: A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks.
Objectives: To estimate the incidence and describe the spectrum of inflammatory and autoimmune diseases linked to SARS-CoV-2 infection and COVID-19 vaccination in children from two neighbouring south central European countries.
Methods: We performed a multi-centre prospective cohort study of children under 18 years diagnosed with inflammatory/autoimmune diseases linked to SARS-CoV-2 infection or COVID-19 vaccination, who were admitted to the paediatric tertiary care hospitals in Slovenia and Friuli Venezia Giulia, Italy, from January 1, 2020, to December 31, 2021. Disease incidence was calculated based on laboratory-confirmed cases only.
To assess and describe the aetiology and management of febrile illness in children with primary or acquired immunodeficiency at high risk of serious bacterial infection, as seen in emergency departments in tertiary hospitals. Prospective data on demographics, presenting features, investigations, microbiology, management, and outcome of patients within the 'Biomarker Validation in HR patients' database in PERFORM, were analysed. Immunocompromised children (< 18 years old) presented to fifteen European hospitals in nine countries, and one Gambian hospital, with fever or suspected infection and clinical indication for blood investigations.
View Article and Find Full Text PDFObjective: Focal renal infections in children have to be diagnosed early in order to enable an appropriate antibiotic treatment. The purpose of this paper was to investigate the efficacy and clinical utility of intravenous renal contrast-enhanced ultrasound (CEUS) as an alternative imaging method for the diagnosis and follow-up of focal renal infections in children.
Methods: Fourteen children aged from 6 months to 17 years (mean 6.