Burden of Infections in Early Life and Risk of Infections and Systemic Antibiotics Use in Childhood.

Importance: A high infection burden in early childhood is common and a risk factor for later disease development. However, longitudinal birth cohort studies investigating early-life infection burden and later risk of infection and antibiotic episodes are lacking.

Objective: To investigate whether early-life infection burden is associated with a later risk of infection and systemic antibiotic treatment episodes in childhood.

Urinary Tract Infection in Children and the Potential Role of Pivmecillinam as a Treatment Option.

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.

Proteomic profiling of neonatal herpes simplex virus infection on dried blood spots.

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.

No associations between neuroborreliosis in children and psychiatric neurodevelopmental disorders: a nationwide, population-based, matched cohort study.

Background: It has been suggested that neuroborreliosis in children can manifest as psychiatric neurodevelopmental disorders or cause long-term neurodevelopmental sequelae. However, previous studies were limited by size and design.

Methods: We performed a nationwide, population-based, matched cohort study in Denmark between 1995 and 2021.

The pattern of childhood infections during and after the COVID-19 pandemic.

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.

incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic: a nationwide multicentre population-based cohort study.

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.

Risk of psychiatric neurodevelopmental disorders after meningitis in childhood: a nationwide, population-based cohort study.

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.

Central Venous Oxygen Saturation in Children With Cancer.

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.

Proteomic profiling reveals diagnostic signatures and pathogenic insights in multisystem inflammatory syndrome in children.

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.

Host RNA Expression Signatures in Young Infants with Urinary Tract Infection: A Prospective Study.

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.

Pertussis epidemic in Denmark, August 2023 to February 2024.

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.

Infection with SARS-CoV-2 following Second Dose Pfizer-BioNTech mRNA COVID-19 Vaccine BNT162b2 in Danish Adolescents Aged 12-18 Years: A Real-World Nationwide Danish Cohort Study.

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.

Normal saline for children with bronchiolitis: study protocol for a randomised controlled non-inferiority trial.

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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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).

Markers of intestinal mucositis to predict blood stream infections at the onset of fever during treatment for childhood acute leukemia.

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.

Symptom-Specific Hospital Contacts in 12-18-Year-Olds Vaccinated against COVID-19: A Danish Register-Based Cohort Study.

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.

A Protocol for Low-Input RNA-Sequencing of Patients with Febrile Neutropenia Captures Relevant Immunological Information.

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.