Publications by authors named "Ulrikka Nygaard"

We investigated the potential role of pivmecillinam in the treatment of urinary tract infections in children. Among 351 children (0-6 years) with urinary tract infections, 83% could be treated with pivmecillinam following urine culture. Resistance was highest in infants (0-3 months) caused by the high prevalence of Enterococcus faecalis.

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Background: Neonatal herpes simplex virus (HSV) infection is life-threatening, with a mortality of up to 70-80% when disseminated, often due to vague symptoms and delayed treatment. Neonatal screening using dried blood spot (DBS) samples is among the most impactful preventative health measures ever implemented, but screening for HSV has not been investigated.

Methods: We investigated high throughput multiplexed proteomics on DBS samples collected on days 2-3 of life from a nationwide cohort of neonates with HSV infection (n = 53) and matched controls.

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The rates of most paediatric infectious diseases declined during the initial phase of the COVID-19 pandemic due to the implementation of non-pharmaceutical interventions. However, after the gradual release of these interventions, resurgences of infections occurred with notable variations in incidence, clinical manifestations, pathogen strains, and age distribution. This Review seeks to explore these changes and the rare clinical manifestations that were made evident during the resurgence of known childhood infections.

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Background: infections resurged globally in 2023-2024 after a three-year decline during the COVID-19 pandemic. We explored the incidence and severity of infections in children and adolescents before, during, and after the pandemic.

Methods: This nationwide, population-based cohort study included all Danish children and adolescents aged 0-17 years with a positive PCR test from May 1, 2016, to April 30, 2024.

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Background: Few studies have investigated the risk of psychiatric neurodevelopmental disorders (PNDD) after childhood meningitis.

Methods: Nationwide population-based cohort study (Denmark, 1995-2021) of children with positive cerebrospinal fluid for bacteria or enterovirus, stratified on age as young infants (0 to <90 days,  = 637) or older children (≥90 days to <17 years,  = 1,218). We constructed a comparison cohort from the general population ( = 18,550), and cohorts of siblings of participants.

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  • The study examines the effectiveness of smartphone applications for education and clinical decision support in neonatal emergency care, targeting the reduction of neonatal mortality in low- and middle-income countries.
  • A systematic search revealed 20 studies about various apps, finding that most participants deemed them acceptable, and many reported improvements in knowledge and skills.
  • The review underscores the potential of these applications to lower neonatal mortality rates but calls for more research to validate their effectiveness and address gaps in the literature.
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  • The study investigated the causes of acute peripheral facial palsy (PFP) in Danish children and examined if neuroborreliosis-related PFP could be diagnosed without lumbar punctures by using clinical symptoms and serum Borrelia burgdorferi (Bb) antibodies.
  • Researchers analyzed data from 326 children who underwent lumbar puncture for PFP between 2019 and 2023, focusing on the diagnostic accuracy of serum Bb IgG compared to a clinical risk scoring system that included additional clinical parameters.
  • Findings revealed that 42% of the patients had neuroborreliosis, with high positive predictive values for both serum Bb IgG (88%) and the risk score (90%), suggesting that in high-endemic
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Objective: Central venous saturation (ScvO 2 ) can guide resuscitation of children with septic shock. The normal range of ScvO 2 is typically considered as 0.70-0.

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  • - This study explored whether starting treatment for bone and joint infections (BJIs) in children with oral antibiotics is as effective and safe as beginning with intravenous (IV) antibiotics, which are often more expensive and burdensome.
  • - Conducted in Denmark from September 2020 to June 2023, the trial involved children aged 3 months to 17 years and compared high-dose oral antibiotics (amoxicillin/clavulanic acid or dicloxacillin) to IV ceftriaxone, with strict inclusion and exclusion criteria to ensure appropriate patient selection.
  • - The main goal was to assess any lasting complications in mobility or function after six months, determining that if the risk difference in negative outcomes between the two treatment methods
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Multisystem inflammatory syndrome in children (MIS-C) is a severe disease that emerged during the COVID-19 pandemic. Although recognized as an immune-mediated condition, the pathogenesis remains unresolved. Furthermore, the absence of a diagnostic test can lead to delayed immunotherapy.

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Early diagnosis of infections in young infants remains a clinical challenge. Young infants are particularly vulnerable to infection, and it is often difficult to clinically distinguish between bacterial and viral infections. Urinary tract infection (UTI) is the most common bacterial infection in young infants, and the incidence of associated bacteremia has decreased in the recent decades.

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We report a record high pertussis epidemic in Denmark since August 2023. Highest incidence was in adolescents, while peak incidence in infants was lower vs previous epidemics in 2019 and 2016. Among infants aged 0-2 months, over half (29/48) were hospitalised and one infant died, underlining the disease severity in the youngest.

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In this real-world cohort study based on Danish nationwide registers, the cumulated proportion, relative risk (RR) of SARS-CoV-2 breakthrough infections, and vaccine effectiveness (VE) were investigated in adolescents aged 12-18 years following vaccination with the BNT162b2 vaccine compared to unvaccinated controls. Adolescents with and without vaccination with the first dose of BNT162b2 between 1 May and 30 September 2021 were included. Effect estimates include proportions with a positive SARS-CoV-2 RT-PCR test among vaccinated and unvaccinated, RR, and VE at three different time points.

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Introduction: Bronchiolitis is one of the most common reasons for hospital admissions in early childhood. As supportive treatment, some treatment guidelines suggest using nasal irrigation with normal saline (NS) to facilitate clearance of mucus from the airways. In addition, most paediatric departments in Denmark use nebulised NS for the same purpose, which can mainly be administered as inpatient care.

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Aim: Non-tuberculous mycobacteria (NTM) lymphadenitis typically resolves spontaneously, yet factors influencing the duration remain explored. We aimed to identify clinical parameters associated with shorter spontaneous resolution.

Methods: This cohort study included children with NTM lymphadenitis from 1 January 2015 to 1 March 2021 at Copenhagen University Hospital.

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Article Synopsis
  • This study examines how vaccination against SARS-CoV-2 affects health outcomes and hospital visits for Danish children and adolescents (ages 5-18) infected with the Omicron variant.
  • It compares vaccinated and unvaccinated individuals, finding that vaccinated younger children had fewer emergency room visits and hospitalizations, but both groups had similar risks for severe outcomes like croup and pneumonia.
  • Overall, the vaccine appears to provide a modest reduction in hospital contacts but does not affect severe health outcomes after infection.
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  • A significant rise in invasive group A streptococcal (iGAS) infections in children was observed globally in 2022, prompting a study in Denmark to compare the incidence and severity of these infections across different clinical types and GAS emm variants over multiple seasons from 2016 to 2023.
  • The study was a nationwide, multicentre cohort analysis that included data from all Danish children and adolescents aged 0-17 with confirmed iGAS infections, using data from active hospital records and the Danish Microbiology Database.
  • Of the 1.15 million Danish children, 174 cases of iGAS were studied, with 76 cases specifically identified in the 2022-23 period; this reflects differences
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Tick-borne encephalitis (TBE) is a viral tick-borne infection occurring in many parts of Europe and Asia as described in this review. Increasing TBE case numbers have been reported over recent decades. In Denmark the infection is rare (1-14 annual cases).

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Despite chemotherapy-induced intestinal mucositis being a main risk factor for blood stream infections (BSIs), no studies have investigated mucositis severity to predict BSI at fever onset during acute leukemia treatment. This study prospectively evaluated intestinal mucositis severity in 85 children with acute leukemia, representing 242 febrile episodes (122 with concurrent neutropenia) by measuring plasma levels of citrulline (reflecting enterocyte loss), regenerating islet-derived-protein 3α (REG3α, an intestinal antimicrobial peptide) and CCL20 (a mucosal immune regulatory chemokine) along with the general neutrophil chemo-attractants CXCL1 and CXCL8 at fever onset. BSI was documented in 14% of all febrile episodes and in 20% of the neutropenic febrile episodes.

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We investigated the association between SARS-CoV-2 infection and new-onset type 1 diabetes (T1D) in children and adolescents in a nationwide, matched cohort study. The hazard ratio of new-onset T1D within 6 months after SARS-CoV-2 infection was 1.22 (0.

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In this register-based real-life cohort study, changes in symptom-specific hospital contacts among 12-18-year-olds following two doses of the BNT162b2 COVID-19 vaccine compared to unvaccinated peers were investigated. Using national register data, vaccinated and unvaccinated adolescents were sex and age-matched each week during the inclusion period from May to September 2021. Symptom-specific hospital contacts covering ICD-10 R diagnoses were assessed before first the vaccine dose and after the second vaccine dose.

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Improved methods are needed for diagnosing infectious diseases in children with cancer. Most children have fever for other reasons than bacterial infection and are exposed to unnecessary antibiotics and hospital admission. Recent research has shown that host whole blood RNA transcriptomic signatures can distinguish bacterial infection from other causes of fever.

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Article Synopsis
  • - The study evaluated the effectiveness of switching from intravenous to oral antibiotics (amoxicillin) for treating neonates with early-onset infection (EOI) and included data from 835 term-born neonates over two years.
  • - Results showed that 90% of neonates with probable infection successfully switched to oral therapy, with no readmissions due to infection and a shorter average hospital stay compared to those on intravenous therapy.
  • - Although oral therapy proved safe and beneficial for easing the treatment process, the overall use of antibiotics did not increase after implementing switch therapy.
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