Pre-admission virus detection during the COVID-19 pandemic in children with and without symptoms of infection.

Aim: Pre-admission viral screening is used only in exceptional situations such as pandemics. We therefore evaluated pre-admission screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV) and influenza during the COVID-19 pandemic, comparing epidemiology and clinical features of admitted children.

Methods: Children were screened at a paediatric emergency department from 1 March 2020 to 30 June 2022 by nasopharyngeal sampling and polymerase chain reaction kit.

The pneumococcal conjugate vaccine had a sustained effect on Swedish children 8 years after its introduction.

Aim: The pneumococcal conjugate vaccine, which covered seven serotypes of Streptococcus pneumoniae (PCV7), was introduced in Stockholm, Sweden, in 2007. It was replaced by a 13-valent vaccine (PCV13) in 2011. We previously reported a decreased incidence of pneumonia and sinusitis among young children 4 years after the introduction of the PCV7.

Seizures in hospitalised paediatric patients with SARS-CoV-2 and comparison of severity with seizures in hospitalised paediatric patients with other respiratory viruses during the COVID-19 pandemic: a population-based cohort study.

Objective: To study seizures in patients hospitalised due to SARS-CoV-2 infection, and compare their severity with seizures in patients hospitalised due to other viral respiratory tract infections (RTIs).

Design: Observational population-based cohort study.

Setting: Northern Stockholm.

Human bocavirus 1 epidemiology in children in relation to virus load and codetection.

Aim: Human bocavirus 1 (HBoV1) has been associated with respiratory tract infections in children. We aimed at retrospectively describing patient characteristics, seasonality, pre-existing medical conditions, codetections, clinical manifestations and complications of HBoV1 infection in relation to viral load in the child population in Stockholm, with the overarching aim of elucidating the clinical significance of HBoV1.

Methods: We included all hospitalised children 0-17 years testing positive for HBoV1 by real-time polymerase chain reaction on nasopharyngeal aspirates 1 July 2008-30 June 2019.

Reduction of rotavirus as a cause of nosocomial diarrhoea in northern Stockholm after introducing the rotavirus vaccine.

Vaccination against rotavirus was offered in Stockholm to children born on 1 March 2014 and onwards with 85% coverage after two years. We investigated changes in nosocomial diarrhoea 2010-2018 in children admitted to Astrid Lindgren Children's Hospital, Stockholm, Sweden. We retrospectively identified cases from diagnostic and virology department registers.

All-cause gastroenteritis hospitalisations of children decreased after the introduction of rotavirus vaccine in Stockholm.

Background: In Stockholm, Sweden, rotavirus vaccination was offered to children born after 1 March 2014. Our aim was to describe rates of hospitalisation due to community-acquired gastroenteritis before and after the introduction of the vaccine, and aetiology, underlying medical conditions and complications in admitted children.

Methods: We retrospectively included patients from our catchment area hospitalised with a diagnosis of gastroenteritis during ten infection seasons 2008/2009-2017/2018, whereof six seasons prevaccination and four seasons postvaccination.

A Swedish population-based study of complications due to acute rhinosinusitis in children 5-18 years old.

Background: There are few population-based studies of complications due to acute rhinosinusitis in children. The aim was to clarify the admission and complication rate and analyze bacterial cultures in children five to 18 years old in Stockholm, Sweden.

Methods: This was a population-based observational cohort study with retrospectively collected data from individual medical records, from 1 July 2003 to 30 June 2016 in Stockholm, Sweden.

Children hospitalised with four common viral diseases showed epidemiological differences but few socio-economic variations.

Aim: This study explored the differences in demographic and socio-economic factors between children hospitalised due to four common viral infections.

Methods: Demographic data were obtained from Statistics Sweden on >3000 children admitted to Astrid Lindgren Children's Hospital in 2009-2014 with rotavirus, influenza, respiratory syncytial virus (RSV) or chickenpox. We compared demographic and socio-economic factors between case groups using logistic regression with rotavirus cases as reference.

Acute infection as cause of hospitalization of asylum-seeking children and adolescents in Stockholm, Sweden 2015-2016.

We aimed to identify hospitalizations due to infectious diseases among asylum seekers and compare them to those of the resident population 1.6.2015-31.

Rates and risk factors of severe respiratory syncytial virus infection in 2008-2016 compared with 1986-1998.

Aim: Since the introduction in 1979 of rapid testing using immunofluorescence, we have collected information about children hospitalised for confirmed respiratory syncytial virus (RSV) infection in the northern Stockholm area. We here report hospitalisation rates, risk factors and complications in 2008-2016 compared with 1986-1998.

Methods: Microbiological laboratory reports and retrospective chart review.

A 10-year retrospective survey of acute childhood osteomyelitis in Stockholm, Sweden.

Aim: Children with osteomyelitis present with a range of signs and symptoms and with varying degree of severity. The purpose of this study was to provide data on a population-based 10-year material of children with acute osteomyelitis.

Methods: All children, 0-14 years in Stockholm Region with acute osteomyelitis hospitalised in July 2005-June 2015, were retrospectively studied.

Trends of Pediatric Bloodstream Infections in Stockholm, Sweden: A 20-year Retrospective Study.

Background: The etiology of bloodstream infections (BSIs) changes over time due to updated immunization programs, new antibiotic-use strategies, changes in patient mix and travel. Continuous surveillance can guide empiric therapy and identify targets for prevention.

Method: We conducted a descriptive retrospective analysis among children <18 years of age who were detected with BSI between July 1998 and June 2018 for changes in the incidence, risk factors, and etiology of BSI in a Swedish tertiary hospital (Karolinska University Hospital).

Foreign background and older age of children were associated with infection in Swedish tuberculosis contacts.

Aim: We present our results using interferon-gamma release assays in any child <18 years or tuberculin skin tests in Bacille Calmette-Guérin unvaccinated children for tuberculosis contact investigation in Stockholm, Sweden.

Methods: During 2000-2019, we investigated 892 children with a median age of seven years. We explored associations between TB infection and characteristics such as closeness to contact, age, sex, BCG status and foreign origin.

Long-term Prognosis of Tuberculosis Infection and Disease in Swedish Children.

Background: Reports of the outcome of treatment of tuberculosis (TB) disease and infection (TBI) in children are scarce. Since 2010, we routinely use interferon-gamma release assays in addition to clinical history for the exclusion of TBI, although the safety of this approach has been questioned. We present the frequency of recurrent TB or progression to TB after treatment for TB disease or TB infection, respectively, and progression to disease in children considered TB uninfected at our pediatric TB clinic.

Antimicrobial Use in a Swedish Pediatric Hospital: Results From Eight Point-prevalence Surveys Over a 15-Year Period (2003-2017).

Background: Antimicrobial resistance is increasing, and data on antimicrobial use in Swedish children are limited. We evaluated trends in antimicrobial use and attempted to identify targets for improving the quality of antimicrobial prescribing in a tertiary care center.

Methods: One-day hospital-wide point prevalence surveys were conducted 8 times during 2003-2017 at Astrid Lindgren Children's Hospital.

Effective Tuberculosis Contact Investigation Using Interferon-Gamma Release Assays.

During 2000 to 2018, 1831 children were screened as part of tuberculosis contact investigation at the Stockholm Northern Clinic. The risk of a child having a positive tuberculin skin test was 33% and positive interferon-gamma release assay 12%. The risk of tuberculosis disease was 6.

Impact on affected families and society of severe rotavirus infections in Swedish children assessed in a prospective cohort study.

Background: Few prospective cohort studies have estimated the overall impact of severe rotavirus gastroenteritis (RVGE) leading to hospitalization on families and society. We assessed human and economic resources needed to care for an affected average child aged <5 years in Sweden.

Methods: The study was conducted in Astrid Lindgren Children's Hospital which serves approximately 14% of all Swedish children <5 years of age.

Changing diagnosis coding routines may confound the results of longitudinal childhood pneumonia studies.

Aim: This Swedish study compared the discharge diagnosis codes used for children up to the age of five hospitalised for acute lower respiratory tract infections before and after the introduction of the pneumococcal conjugate vaccine in 2007.

Methods: The International Classification of Diseases-10th revision codes were used. We compared the discharge diagnosis codes at the Astrid Lindgren Children's Hospital from 1 July 2005 to 30 June 2007 (n=1,127) and 1 July 2011 to 30 June 2013 (n=1,240) in relation to the diagnostic methods used.

Tuberculosis infection and disease in the 2015 cohort of unaccompanied minors seeking asylum in Northern Stockholm, Sweden.

Background: Minors with a stated age <18 years unaccompanied by a responsible adult form an increasing part of refugees to Europe. They are older than other asylum-seeking children and many come from countries with a high tuberculosis (TB) incidence. During the 2015 refugee crisis, 35,369 of 162,877 refugees (22%) seeking asylum in Sweden were unaccompanied minors, which gave us the opportunity to study their burden of TB infection and disease.

[The child immunisation programme--effective but insufficient. Experiences from the Astrid Lindgren pediatric hospital, 2008–2013].

The national Swedish immunisation programme includes vaccine against diphtheria, tetanus, polio, pertussis, Haemophilus influenzae type B, Pneumococcus as well as measles, mumps and rubella. Data were collected on hospital admissions for children 0- 17 years of age of vaccine-preventable diseases during 2008-2013 at Astrid Lindgren Children's Hospital, Stockholm. Patients were identified by discharge diagnosis codes as well as from the clinical microbiology laboratory.

The impact of pneumococcal conjugate vaccine on community-acquired pneumonia hospitalizations in children with comorbidity.

Unlabelled: The burden of community-acquired pneumonia (CAP) in high-income countries is still significant. The introduction of pneumococcal conjugate vaccines (PCV) has reduced the overall need for hospitalization for CAP. However, it is not clear whether children with underlying disease also have benefitted from the PCV immunization programme.

What can we learn from the past?-A pediatrician's view.

When the tuberculosis epidemic reached its peak in central Europe in the 1900s (not until the 2000s in sub-Saharan Africa), both contained and disseminated tuberculosis was mainly regarded as a childhood disease. From 1920, before the use of the Bacillus Calmette-Guérin (BCG) vaccine and the possibility of drug treatment, there was a drastic decline in the rate of tuberculosis incidence in the Western world. In 1970, the case rate had declined in Sweden from 500/100,000 individuals to 1/100,000 individuals.

Review of the aetiology, diagnostics and outcomes of childhood encephalitis from 1970 to 2009.

Aim: Encephalitis is a rare, serious condition, and antiviral therapies, increased knowledge of inflammatory pathways and improved diagnostics have increased the therapeutic possibilities. We describe 40 years of childhood encephalitis in Sweden, covering the diagnostics, aetiology and outcomes.

Methods: We reviewed the clinical data that were available for all children discharged from the Karolinska University Hospital in Stockholm following treatment for encephalitis from 1970 to 2009.

Paediatric tuberculosis cases increased in Stockholm from 1971 to 2015 following the rising number of children with immigrant backgrounds.

Aim: This study described the epidemiology and clinical features of childhood tuberculosis (TB) in Stockholm over a 45-year period, when there was a resurge of tuberculosis concomitant with increased immigration.

Methods: We describe 220 children up to the age of 16 years with active TB, seen at the Astrid Lindgren Children's Hospital from 1971 to 2015. The study period was divided into three 15-year periods.