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164 results on '"Hagedoorn, Nienke N."'

4. A multi-platform approach to identify a blood-based host protein signature for distinguishing between bacterial and viral infections in febrile children (PERFORM): a multi-cohort machine learning study

Author

Jackson, Heather Ruth, Zandstra, Judith, Menikou, Stephanie, Hamilton, Shea, McArdle, Andrew J, De, Tisham, Agyeman, Philipp K A, Von Both, Ulrich, Carrol, Enitan D, Emonts, Marieke, Eleftheriou, Irini, Van der Flier, Michiel, Fink, Colin, De Groot, Ronald, Moll, Henriette A, Pokorn, Marko, Pollard, Andrew, Schlapbach, Luregn J, Tsolia, Maria, Usuf, Effua, Wright, Victoria, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan JM, Cunnington, Aubrey J, Martinon-Torres, Federico, Herberg, Jethro, De Jonge, Marien I, Levin, Michael, Kuijpers, Taco, Kaforou, Myrsini, Abdulla, Amina, Aebi, Christoph, Agbeko, Rachel, Ali, Ladan, Alkema, Wynand, Allen, Karen, Anderson, Suzanne, Ansari, Imran, Arif, Tasnim, Avramoska, Tanja, Baas, Bryan, Bahovec, Natalija, Balode, Anda, Bãrdzdina, Arta, Barendregt, A M, Barral-Arca, Ruth, Bath, David, Bauchinger, Sebastian, Baumard, Lucas, Baumgart, Hinrich, Baxter, Frances, Bell, Kathryn, Bell, Ashley, Bello, Xabier, Bellos, Evangelos, Benesch, Martin, Bennet, Joshua, Berger, Christoph, Bernhard-Stirnemann, Sara, Bibi, Sagida, Bidlingmaier, Christoph, Binder, Alexander, Binder, Vera, Blackmore, Jennifer, Bojang, Kalifa, Borensztajn, Dorine M, Brengel-Pesce, Karen, Broderick, Claire, Buschbeck, Judith, Calvo-Bado, Leonides, Carnota, Sandra, Carter, Michael J, Castro, María Barreiro, Cebey-López, Miriam, Ceesay, Samba, Ceolotto, Astrid, Chan, Adora, Cocklin, Elizabeth, Collings, Kalvin, Crulley, Stephen, Curras-Tuala, María José, D'alessandro, Umberto, D'Souza, Giselle, Danhauser, Katharina, Darboe, Saffiatou, Darnell, Sarah, De Haan, L, De Vries, Gabriella, Deksne, Dãrta, Devine, Kirsty, Dewez, Juan Emmanuel, Dik, W, Dudley, Julia, Eber, Ernst, Fabian, Daniel, Farto, Cristina Balo, Fernández, Sonia Serén, Fidler, Katy, Fitchett, Elizabeth, Galassini, Rachel, Gallisti, Siegfried, García, Mirian Ben, Gardovska, Dace, Geissler, J, Gerrits, G P J M, Giannoni, Eric, Gloerich, Jolein, Gómez-Carballa, Alberto, González, Fernando Álves, Gores, Gunther, Grãvele, Dagne, Griese, Matthias, Grope, Ilze, Gurung, Meeru, Haas, Nikolaus, Habgood-Coote, Dominic, Hagedoorn, Nienke N, Haidl, Harald, Harrison, Rebekah, Hauer, Almuthe, Heidema, J, Heininger, Ulrich, Henriet, Stefanie, Hibberd, Martin, Hoggart, Cllive, Hösele, Susanne, Hourmat, Sara, Hude, Christa, Huijnen, Martijn, Iglesias, Pilar Leboráns, Iglesias, Marisol Vilas, Jennings, Rebecca, Johnson, Joanne, Jongerius, Ilse, Jorgensen, Rikke, Kahlert, Christian, Kandasamy, Rama, Kappler, Matthias, Keldorfer, Markus, Kelly, Dominic F, Khanijau, Aakash, Kim, Nayoung, Kim, Eunjung, King, Sharon, Kolberg, Laura, Kolnik, Mojca, Kloosterhuis, Lieke, Kohlfürst, Daniela S, Kohlmaier, Benno, Krenn, Larissa, Leigh, Simon, Leitner, Manuel, Leurent, Baptiste, Lim, Emma, Lin, Naomi, Liu, Ching-Chuan, Löffler, Sabine, Lurz, Eberhard, Mackerness, Christine, Maconochie, Ian, Mallet, Francois, Marmarinos, Antonis, Martin, Alex, Martin, Mike, Martinón Sánchez, José María, Martinón-Torres, Nazareth, McAlinden, Paul, McDonald, Sam, McDonell, Anne, Meiere, Anija, Meierford, Anne, Miedema, C J, Miners, Alec, Mistry, Ravi, Mommert, Marine, Morris, Sophie, Muench, Georg, Murdoch, David R, Mustafa, Sobia, Natalucci, Giancarlo, Neeleman, C, Newall, Karen, Nichols, Samuel, Niederer-Loher, Anita, Niedrist, Tobias, Nijman, Ruud, Nokalna, Ieve, Nordberg, Gudrun, O'Connor, Daniel, Obihara, C C, Oliver, Zoe, Oosthoek, Wilma, Ora, Miguel Sadiki, Osterman, Veronika, Pachot, Alexandre, Pajkrt, D, Pardo-Seco, Jacobo, Pavãre, Jana, Paz, Ivonne Pena, Paulus, Stéphane, Pérez, Belén Mosquera, Persand, Salina, Pfleger, Andreas, Pfurtscheller, Klaus, Philipsen, Ria, Pickering, Alisa, Pierce, Benjamin, Pilch, Heidemarie, Pischedda, Sara, Pölz, Lena, Posfay-Barbe, Klara M, Powell, Oliver, Prunk, Petra, Pučuka, Zanda, Rajic, Glorija, Rashid, Aqeela, Redondo-Collazo, Lorenzo, Reiter, Karl, Relly, Christa, Rhodes, Mathew, Rial, Jose Gómez, Richmond, Vivien, Riedel, Thomas, Rivero Calle, Irene, Roca, Anna, Rödl, Siegfried, Rodríguez, Lidia Piñeiro, Rodríguez-Tenreiro, Carmen, Romaine, Sam, Rowlands, Emily, Rudzate, Aleksandra, Sagmeister, Manfred, Saidykhan, Momodou, Sallas, Antonio, Sarr, Isatou, Schoen, Carola, Schonenberg, D, Schweintzger, Nina, Secka, Fatou, Selecka, Katrīna, Shah, Priyen, Shen, Ching-Fen, Shrestha, Shrijana, Skrabl-Baumgartner, Andrea, Soon, Joshua, Sperl, Matthias, Sprenkeler, Evelien, Spyridis, Nikos, Srovin, Tina Plankar, Stampfer, Laura, Stevens, Molly, Stocker, Martin, Strenger, Volker, Suárez, Carlos Durán, Svile, Dace, Syggelou, Kelly, Tal, Chantal, Tambouratzi, Maria, Tavliavini, Emma, Thakker, Clare, Thomson, Evelyn, Throson, Stephen, Till, Holger, Tramper-Stranders, G A, Trasorras, Cristina Serén, Trobisch, Andreas, Urbãne, Urzula Nora, Usman, Mariama, Valentine, Lucille, Van Aerde, Koen, Van den Berg, J M, Van den Broek, Bryan, Van der Giessen, Ilona, Van der Kuip, M, Van der Velden, Fabian, Van Furth, A M, Van Gool, Alain J, Van Leur, M, van Mierlo, G, Vázquez, Sara Ray, Vermont, Clementien, Vicente, Luisa García, Vincek, Katarina, Vito, Ortensia, Voice, Marie, Wallia, Diane, Walsh, Ben, Wang, Shih-Min, Wedderburn, Catherine, Willems, Esther, Wilson, Clare, Wood, Amanda, Woodsford, Phil, Wyss, Verena, Xagorari, Marietta, Zachariasse, Joany, Zaman, Syed M A, Zurl, Christoph, Zwerenz, Manuela, Jackson, Heather R, Hamilton, Melissa Shea, Fischer, Roman, Thorne, Adam M, Huang, Honglei, Tanck, Michael W, Jansen, Machiel H, Pollard, Andrew J, Tsolia, Maria N, Wright, Victoria J, Coin, Lachlan J M, Casals-Pascual, Climent, Herberg, Jethro A, de Jonge, Marien I, and Kuijpers, Taco W

Published
2023
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5. Relationship between molecular pathogen detection and clinical disease in febrile children across Europe: a multicentre, prospective observational study

Author

Shah, Priyen, Voice, Marie, Calvo-Bado, Leonides, Calle, Irene Rivero, Morris, Sophie, Nijman, Ruud, Broderick, Claire, De, Tisham, Eleftheriou, Irini, Galassini, Rachel, Khanijau, Aakash, Kolberg, Laura, Kolnik, Mojca, Rudzate, Aleksandra, Sagmeister, Manfred, Schweintzger, Nina, Secka, Fatou, Thakker, Clare, Van der Velden, Fabian, Vermont, Clementien, Vincek, Katarina, Agyeman, Philipp K.A., Cunnington, Aubrey J., De Groot, Ronald, Emonts, Marieke, Fidler, Katy, Kuijpers, Taco, Mommert-Tripon, Marine, Brengel-Pesce, Karen, Mallet, Francois, Moll, Henriette, Paulus, Stéphane, Pokorn, Marko, Pollard, Andrew, Schlapbach, Luregn J., Shen, Ching-Fen, Tsolia, Maria, Usuf, Effua, Van der Flier, Michiel, Von Both, Ulrich, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Wright, Victoria, Carrol, Enitan D., Kaforou, Myrsini, Martinon-Torres, Federico, Fink, Colin, Levin, Michael, Herberg, Jethro, Baumard, Lucas, Bellos, Evangelos, Coin, Lachlan, D'Souza, Giselle, Habgood-Coote, Dominic, Hamilton, Shea, Hoggart, Cllive, Hourmat, Sara, Jackson, Heather, Lin, Naomi, Menikou, Stephanie, Nichols, Samuel, Paz, Ivonne Pena, Powell, Oliver, Vito, Ortensia, Wilson, Clare, Abdulla, Amina, Ali, Ladan, Darnell, Sarah, Jorgensen, Rikke, Maconochie, Ian, Mustafa, Sobia, Persand, Salina, Walsh, Ben, Stevens, Molly, Kim, Nayoung, Kim, Eunjung, Pierce, Benjamin, Dudley, Julia, Richmond, Vivien, Tavliavini, Emma, Liu, Ching-Chuan, Wang, Shih-Min, González, Fernando Álves, Farto, Cristina Balo, Barral-Arca, Ruth, Castro, María Barreiro, Bello, Xabier, Ben García, Mirian, Carnota, Sandra, Cebey-López, Miriam, Curras-Tuala, María José, Suárez, Carlos Durán, Vicente, Luisa García, Gómez-Carballa, Alberto, Rial, Jose Gómez, Iglesias, Pilar Leboráns, Martinón-Torres, Nazareth, Martinón Sánchez, José María, Pérez, Belén Mosquera, Pardo-Seco, Jacobo, Rodríguez, Lidia Piñeiro, Pischedda, Sara, Vázquez, Sara Ray, Rodríguez-Tenreiro, Carmen, Redondo-Collazo, Lorenzo, Ora, Miguel Sadiki, Sallas, Antonio, Fernández, Sonia Serén, Trasorras, Cristina Serén, Iglesias, Marisol Vilas, Balode, Anda, Bãrdzdina, Arta, Deksne, Dãrta, Gardovska, Dace, Grãvele, Dagne, Grope, Ilze, Meiere, Anija, Nokalna, Ieve, Pavãre, Jana, Pučuka, Zanda, Selecka, Katrīna, Svile, Dace, Urbãne, Urzula Nora, Bojang, Kalifa, Zaman, Syed M.A., Anderson, Suzanne, Roca, Anna, Sarr, Isatou, Saidykhan, Momodou, Darboe, Saffiatou, Ceesay, Samba, D'alessandro, Umberto, Borensztajn, Dorine M., Hagedoorn, Nienke N., Tal, Chantal, Zachariasse, Joany, Dik, W., Aebi, Christoph, Berger, Christoph, Wyss, Verena, Usman, Mariama, Giannoni, Eric, Stocker, Martin, Posfay-Barbe, Klara M., Heininger, Ulrich, Bernhard-Stirnemann, Sara, Niederer-Loher, Anita, Kahlert, Christian, Natalucci, Giancarlo, Relly, Christa, Riedel, Thomas, Cocklin, Elizabeth, Jennings, Rebecca, Johnson, Joanne, Leigh, Simon, Newall, Karen, Romaine, Sam, Tambouratzi, Maria, Marmarinos, Antonis, Xagorari, Marietta, Syggelou, Kelly, Spyridis, Nikos, Blackmore, Jennifer, Harrison, Rebekah, Kohlmaier, Benno, Kohlfürst, Daniela S., Zurl, Christoph, Binder, Alexander, Hösele, Susanne, Leitner, Manuel, Pölz, Lena, Rajic, Glorija, Bauchinger, Sebastian, Baumgart, Hinrich, Benesch, Martin, Ceolotto, Astrid, Eber, Ernst, Gallisti, Siegfried, Gores, Gunther, Haidl, Harald, Hauer, Almuthe, Hude, Christa, Keldorfer, Markus, Krenn, Larissa, Pilch, Heidemarie, Pfleger, Andreas, Pfurtscheller, Klaus, Nordberg, Gudrun, Niedrist, Tobias, Rödl, Siegfried, Skrabl-Baumgartner, Andrea, Sperl, Matthias, Stampfer, Laura, Strenger, Volker, Till, Holger, Trobisch, Andreas, Löffler, Sabine, Dewez, Juan Emmanuel, Hibberd, Martin, Bath, David, Miners, Alec, Fitchett, Elizabeth, Wedderburn, Catherine, Meierford, Anne, Leurent, Baptiste, De Jonge, Marien I., van Aerde, Koen, Alkema, Wynand, van den Broek, Bryan, Gloerich, Jolein, Van Gool, Alain J., Henriet, Stefanie, Huijnen, Martijn, Philipsen, Ria, Willems, Esther, Gerrits, G.P.J.M., Van Leur, M., Heidema, J., De Haan, L., Miedema, C.J., Neeleman, C., Obihara, C.C., Tramper-Stranders, G.A., Kandasamy, Rama, Carter, Michael J., O'Connor, Daniel, Bibi, Sagida, Kelly, Dominic F., Gurung, Meeru, Throson, Stephen, Ansari, Imran, Murdoch, David R., Shrestha, Shrijana, Oliver, Zoe, Lim, Emma, Valentine, Lucille, Allen, Karen, Bell, Kathryn, Chan, Adora, Crulley, Stephen, Devine, Kirsty, Fabian, Daniel, King, Sharon, McAlinden, Paul, McDonald, Sam, McDonell, Anne, Pickering, Alisa, Thomson, Evelyn, Wood, Amanda, Wallia, Diane, Woodsford, Phil, Baxter, Frances, Bell, Ashley, Rhodes, Mathew, Agbeko, Rachel, Mackerness, Christine, Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, Arif, Tasnim, Bennet, Joshua, Collings, Kalvin, Van der Giessen, Ilona, Martin, Alex, Rashid, Aqeela, Rowlands, Emily, Soon, Joshua, De Vries, Gabriella, van der Velden, Fabian, Martin, Mike, Mistry, Ravi, Zwerenz, Manuela, Buschbeck, Judith, Bidlingmaier, Christoph, Binder, Vera, Danhauser, Katharina, Haas, Nikolaus, Griese, Matthias, Kappler, Matthias, Lurz, Eberhard, Muench, Georg, Reiter, Karl, Schoen, Carola, Pachot, Alexandre, Mommert, Marine, Srovin, Tina Plankar, Bahovec, Natalija, Prunk, Petra, Osterman, Veronika, Avramoska, Tanja, Jongerius, Ilse, van den Berg, J.M., Schonenberg, D., Barendregt, A.M., Pajkrt, D., van der Kuip, M., van Furth, A.M., Sprenkeler, Evelien, Zandstra, Judith, van Mierlo, G., Geissler, J., Rivero-Calle, Irene, Sagmeister, Manfred G., Schweintzger, Nina A., Kuijpers, Taco W., van der Flier, Michiel, and von Both, Ulrich

Published
2023
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6. Febrile illness in high-risk children: a prospective, international observational study

Author

van der Velden, Fabian J. S., de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich, Kolberg, Laura, Carrol, Enitan D., Khanijau, Aakash, Herberg, Jethro A., De, Tisham, Galassini, Rachel, Kuijpers, Taco W., Martinón-Torres, Federico, Rivero-Calle, Irene, Vermont, Clementien L., Hagedoorn, Nienke N., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K. A., Usuf, Effua, Secka, Fatou, de Groot, Ronald, Levin, Michael, van der Flier, Michiel, and Emonts, Marieke

Published
2023
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7. Impact of infection on proteome-wide glycosylation revealed by distinct signatures for bacterial and viral pathogens

Author

Abdulla, Amina, Aebi, Christoph, van Aerde, Koen, Agbeko, Rachel, Agyeman, Philipp, D’alessandro, Umberto, Ali, Ladan, Alkema, Wynand, Allen, Karen, González, Fernando Álvez, Anderson, Suzanne, Ansari, Imran, Araf, Tasnim, Avramoska, Tanja, Baas, Bryan, Bahovec, Natalija, Farto, Cristina Balo, Balode, Anda, Barendregt, A.M., Barral-Arca, Ruth, Castro, María Barreiro, Bārzdiņa, Arta, Bath, David, Bauchinger, Sebastian, Baumard, Lucas, Baumgart, Hinrich, Baxter, Frances, Bell, Ashley, Bell, Kathryn, Bello, Xabier, Bellos, Evangelos, Benesch, Martin, Ben García, Mirian, Bennet, Joshua, Berger, Christoph, van den Berg, J.M., Bernhard-Stirnemann, Sara, Bibi, Sagida, Bidlingmaier, Christoph, Binder, Alexander, Binder, Vera, Bojang, Kalifa, Borensztajn, Dorine M., von Both, Ulrich, Brengel-Pesce, Karen, van den Broek, Bryan, Buschbeck, Judith, Calvo-Bado, Leo, Carnota, Sandra, Carrol, Enitan D., Carter, Michael J., Cebey-López, Miriam, Ceesay, Samba, Ceolotto, Astrid, Chan, Adora, Cocklin, Elizabeth, Collings, Kalvin, Crulley, Stephen, Cunnington, Aubrey, Curras-Tuala, María José, Danhauser, Katharina, Darboe, Saffiatou, Darnell, Sarah, De, Tisham, Deksne, Dārta, Devine, Kirsty, Dewez, Juan Emmanuel, Dudley, Julia, Suárez, Carlos Durán, Eber, Ernst, Eleftheriou, Irini, Emonts, Marieke, Fabian, Daniel, Feuchtinger, Tobias, Fidler, Katy, Fink, Colin, van der Flier, Michiel, van Furth, A.M., Galassini, Rachel, Gallistl, Siegfried, Vicente, Luisa García, Gardovska, Dace, Geissler, J., Gerrits, G.P.J.M., Giannoni, Eric, van der Giessen, Ilona, Gloerich, Jolein, Gómez-Carballa, Alberto, Rial, Jose Gómez, van Gool, Alain J., Gores, Gunther, Grāvele, Dagne, Griese, Matthias, Grope, Ilze, de Groot, Ronald, Gurung, Meeru, de Haan, L., Haas, Nikolaus, Habgood-Coote, Dominic, Hagedoorn, Nienke N., Haidl, Harald, Hamilton, Shea, Hauer, Almuthe, Heidema, J., Heininger, Ulrich, Henriet, Stefanie, Herberg, Jethro, Hoggart, Clive, Hösele, Susanne, Hourmat, Sara, Hude, Christa, Huijnen, Martijn, Jackson, Heather, Jennings, Rebecca, Johnston, Joanne, de Jonge, Marien I., Jongerius, Ilse, Jorgensen, Rikke, Kaforou, Myrsini, Kahlert, Christian, Kandasamy, Rama, Kappler, Matthias, Keil, Julia, Keldorfer, Markus, Kell, Dominic F., Kim, Eunjung, King, Sharon, Kloosterhuis, Lieke, Kohlfürst, Daniela S., Kohlmaier, Benno, Kolberg, Laura, Kolnik, Mojca, Krenn, Larissa, Kuijpers, Taco, van der Kuip, M., Iglesias, Pilar Leboráns, Leigh, Simon, Leitner, Manuel, van Leur, M., Lim, Emma, Lin, Naomi, Liu, Ching-Chuan, Löffler, Sabine, Lurz, Eberhard, Maconochie, Ian, Mackerness, Christine, Mallet, François, Martinón-Torres, Federico, Marmarinos, Antonis, Martin, Alex, Martin, Mike, Martinón Sánchez, José María, Martinón-Torres, Nazareth, McAlinden, Paul, McDonnell, Anne, McDonald, Sam, Miedema, C.J., Meiere, Anija, Menikou, Stephanie, van Mierlo, G., Miners, Alec, Mistry, Ravi, Moll, Henriëtte A., Mommert, Marine, Pérez, Belén Mosquera, Murdoch, David R., Mustafa, Sobia, Natalucci, Giancarlo, Neeleman, C., Newall, Karen, Nichols, Samuel, Niedrist, Tobias, Niederer-Loher, Anita, Nijman, Ruud, Nokalna, Ieva, Urbāne, Urzula Nora, Nordberg, Gudrun, Obihara, C.C., O'Connor, Daniel, Oosthoek, Wilma, Osterman, Veronika, Pachot, Alexandre, Pajkrt, D., Pardo-Seco, Jacobo, Paulus, Stéphane, Pavāre, Jana, Paz, Ivonne Pena, Persand, Salina, Pfleger, Andreas, Pfurtscheller, Klaus, Philipsen, Ria, Pickering, Ailsa, Pierce, Benjamin, Pilch, Heidemarie, Rodríguez, Lidia Piñeiro, Pischedda, Sara, Srovin, Tina Plankar, Pokorn, Marko, Pollard, Andrew J., Pölz, Lena, Posfay-Barbe, Klara M., Prunk, Petra, Pučuka, Zanda, Rajic, Glorija, Rashid, Aqeela, Redondo-Collazo, Lorenzo, Relly, Christa, Calle, Irene Rivero, Vázquez, Sara Rey, Rhodes, Mathew, Richmond, Vivien, Riedel, Thomas, RocaIsatou Sarr, Anna, Rödl, Siegfried, Rodríguez-Tenreiro, Carmen, Romaine, Sam, Rowlands, Emily, Ora, Miguel Sadiki, Sagmeister, Manfred G., Saidykhan, Momodou, Salas, Antonio, Schlapbach, Luregn J., Schonenberg, D., Secka, Fatou, Selecka, Katrīna, Fernández, Sonia Serén, Trasorras, Cristina Serén, Shah, Priyen, Shen, Ching-Fen, Shrestha, Shrijana, Sidorova, Aleksandra, Skrabl-Baumgartner, Andrea, D’Souza, Giselle, Sperl, Matthias, Sprenkeler, Evelien, Schweintzger, Nina A., Stampfer, Laura, Stevens, Molly, Stocker, Martin, Strenger, Volker, Svile, Dace, Syggelou, Kelly, Tambouratzi, Maria, Tan, Chantal, Tavliavini, Emma, Thomson, Evelyn, Thorson, Stephen, Till, Holger, Tramper-Stranders, G.A., Trobisch, Andreas, Tsolia, Maria, Usuf, Effua, Valentine, Lucille, Vermont, Clementien L., Iglesias, Marisol Vilas, Vincek, Katarina, Voice, Marie, de Vries, Gabriella, Wallia, Diane, Wang, Shih-Min, Willems, Esther, Wilson, Clare, Wood, Amanda, Woodsford, Phil, Wright, Victoria, Xagorari, Marietta, Yeung, Shunmay, Zachariasse, Joany, Zavadska, Dace, Zaman, Syed M.A., Zandstra, Judith, Zenz, Werner, Zurl, Christoph, Zwerenz, Manuela, Suppers, Anouk, van den Heuvel, Lambert P., van de Kar, Nicole, Philipsen, Ria H.L.A., van Dael, Maurice, Wright, Victoria J., Herberg, Jethro A., Torres, Federico Martinon, Levin, Michael, Lefeber, Dirk J., and Wessels, Hans J.C.T.

Published
2023
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9. Febrile children with comorbidities at the emergency department — a multicentre observational study

Author

Borensztajn, Dorine M., Hagedoorn, Nienke N., Carrol, Enitan D., von Both, Ulrich, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, van der Velden, Fabian J. S., Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany M., and Moll, Henriette A.

Published
2022
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12. Correction to: Febrile illness in high-risk children: a prospective, international observational study

Author

van der Velden, Fabian J. S., de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich, Kolberg, Laura, Carrol, Enitan D., Khanijau, Aakash, Herberg, Jethro A., De, Tisham, Galassini, Rachel, Kuijpers, Taco W., Martinón-Torres, Federico, Rivero-Calle, Irene, Vermont, Clementien L., Hagedoorn, Nienke N., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K. A., Usuf, Effua, Secka, Fatou, de Groot, Ronald, Levin, Michael, van der Flier, Michiel, and Emonts, Marieke

Published
2023
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14. Hemostasis Proteins in Invasive Meningococcal and Nonmeningococcal Infections: A Prospective Multicenter Study

Author

Hagedoorn, Nienke N., Boeddha, Navin P., Kohlfuerst, Daniela S., Anderson, Suzanne, Carrol, Enitan D., Agapow, Paul, van der Flier, Michiel, Hazelzet, Jan, Herberg, Jethro, Kuijpers, Taco, Levin, Michael, Martinon-Torres, Federico, van Rijswijk, Angelique, Schlapbach, Luregn J., Vermont, Clementien, Zenz, Werner, Dik, Willem A., Driessen, Gertjan, and Emonts, Marieke

Published
2022
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15. Global distribution of Leptospira serovar isolations and detections from animal host species: A systematic review and online database

Author

Hagedoorn, Nienke N., primary, Maze, Michael J., additional, Carugati, Manuela, additional, Cash‐Goldwasser, Shama, additional, Allan, Kathryn J., additional, Chen, Kevin, additional, Cossic, Brieuc, additional, Demeter, Elena, additional, Gallagher, Sarah, additional, German, Richard, additional, Galloway, Renee L., additional, Habuš, Josipa, additional, Rubach, Matthew P., additional, Shiokawa, Kanae, additional, Sulikhan, Nadezhda, additional, and Crump, John A., additional

Published
2024
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17. Rapid Viral Testing and Antibiotic Prescription in Febrile Children With Respiratory Symptoms Visiting Emergency Departments in Europe

Author

Tan, Chantal D., Hagedoorn, Nienke N., Dewez, Juan E., Borensztajn, Dorine M., von Both, Ulrich, Carrol, Enitan D., Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Strle, Franc, Tsolia, Maria, Vermont, Clementien L., Yeung, Shunmay, Zachariasse, Joany M., Zenz, Werner, Zavadska, Dace, and Moll, Henriette A.

Published
2022
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18. Detectable A Disintegrin and Metalloproteinase With Thrombospondin Motifs-1 in Serum Is Associated With Adverse Outcome in Pediatric Sepsis

Author

Boeddha, Navin P., Driessen, Gertjan J., Hagedoorn, Nienke N., Kohlfuerst, Daniela S., Hoggart, Clive J., van Rijswijk, Angelique L., Ekinci, Ebru, Priem, Debby, Schlapbach, Luregn J., Herberg, Jethro A., de Groot, Ronald, Anderson, Suzanne T., Fink, Colin G., Carrol, Enitan D., van der Flier, Michiel, Martinón-Torres, Federico, Levin, Michael, Leebeek, Frank W., Zenz, Werner, de Maat, Moniek P. M., Hazelzet, Jan A., Emonts, Marieke, and Dik, Willem A.

Published
2021
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19. Global distribution ofLeptospiraserovar isolations and detections from animal host species: a systematic review and online database

Author

Hagedoorn, Nienke N., primary, Maze, Michael J., additional, Carugati, Manuela, additional, Cash-Goldwasser, Shama, additional, Allan, Kathryn J., additional, Chen, Kevin, additional, Cossic, Brieuc, additional, Demeter, Elena, additional, Gallagher, Sarah, additional, German, Richard, additional, Galloway, Renee L., additional, Habuš, Josipa, additional, Rubach, Matthew P., additional, Shiokawa, Kanae, additional, Sulikhan, Nadezhda, additional, and Crump, John A., additional

Published
2023
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20. External validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children

Author

Martin, Alexander James, primary, van der Velden, Fabian Johannes Stanislaus, additional, von Both, Ulrich, additional, Tsolia, Maria N, additional, Zenz, Werner, additional, Sagmeister, Manfred, additional, Vermont, Clementien, additional, de Vries, Gabriella, additional, Kolberg, Laura, additional, Lim, Emma, additional, Pokorn, Marko, additional, Zavadska, Dace, additional, Martinón-Torres, Federico, additional, Rivero-Calle, Irene, additional, Hagedoorn, Nienke N, additional, Usuf, Effua, additional, Schlapbach, Luregn, additional, Kuijpers, Taco W, additional, Pollard, Andrew J, additional, Yeung, Shunmay, additional, Fink, Colin, additional, Voice, Marie, additional, Carrol, Enitan, additional, Agyeman, Philipp K A, additional, Khanijau, Aakash, additional, Paulus, Stephane, additional, De, Tisham, additional, Herberg, Jethro Adam, additional, Levin, Michael, additional, van der Flier, Michiel, additional, de Groot, Ronald, additional, Nijman, Ruud, additional, and Emonts, Marieke, additional

Published
2023
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21. Impact of infection on proteome-wide glycosylation revealed by distinct signatures for bacterial and viral pathogens

Author

Willems, Esther, primary, Gloerich, Jolein, additional, Suppers, Anouk, additional, van der Flier, Michiel, additional, van den Heuvel, Lambert P., additional, van de Kar, Nicole, additional, Philipsen, Ria H.L.A., additional, van Dael, Maurice, additional, Kaforou, Myrsini, additional, Wright, Victoria J., additional, Herberg, Jethro A., additional, Torres, Federico Martinon, additional, Levin, Michael, additional, de Groot, Ronald, additional, van Gool, Alain J., additional, Lefeber, Dirk J., additional, Wessels, Hans J.C.T., additional, de Jonge, Marien I., additional, Abdulla, Amina, additional, Aebi, Christoph, additional, van Aerde, Koen, additional, Agbeko, Rachel, additional, Agyeman, Philipp, additional, D’alessandro, Umberto, additional, Ali, Ladan, additional, Alkema, Wynand, additional, Allen, Karen, additional, González, Fernando Álvez, additional, Anderson, Suzanne, additional, Ansari, Imran, additional, Araf, Tasnim, additional, Avramoska, Tanja, additional, Baas, Bryan, additional, Bahovec, Natalija, additional, Farto, Cristina Balo, additional, Balode, Anda, additional, Barendregt, A.M., additional, Barral-Arca, Ruth, additional, Castro, María Barreiro, additional, Bārzdiņa, Arta, additional, Bath, David, additional, Bauchinger, Sebastian, additional, Baumard, Lucas, additional, Baumgart, Hinrich, additional, Baxter, Frances, additional, Bell, Ashley, additional, Bell, Kathryn, additional, Bello, Xabier, additional, Bellos, Evangelos, additional, Benesch, Martin, additional, Ben García, Mirian, additional, Bennet, Joshua, additional, Berger, Christoph, additional, van den Berg, J.M., additional, Bernhard-Stirnemann, Sara, additional, Bibi, Sagida, additional, Bidlingmaier, Christoph, additional, Binder, Alexander, additional, Binder, Vera, additional, Bojang, Kalifa, additional, Borensztajn, Dorine M., additional, von Both, Ulrich, additional, Brengel-Pesce, Karen, additional, van den Broek, Bryan, additional, Buschbeck, Judith, additional, Calvo-Bado, Leo, additional, Carnota, Sandra, additional, Carrol, Enitan D., additional, Carter, Michael J., additional, Cebey-López, Miriam, additional, Ceesay, Samba, additional, Ceolotto, Astrid, additional, Chan, Adora, additional, Cocklin, Elizabeth, additional, Collings, Kalvin, additional, Crulley, Stephen, additional, Cunnington, Aubrey, additional, Curras-Tuala, María José, additional, Danhauser, Katharina, additional, Darboe, Saffiatou, additional, Darnell, Sarah, additional, De, Tisham, additional, Deksne, Dārta, additional, Devine, Kirsty, additional, Dewez, Juan Emmanuel, additional, Dudley, Julia, additional, Suárez, Carlos Durán, additional, Eber, Ernst, additional, Eleftheriou, Irini, additional, Emonts, Marieke, additional, Fabian, Daniel, additional, Feuchtinger, Tobias, additional, Fidler, Katy, additional, Fink, Colin, additional, van Furth, A.M., additional, Galassini, Rachel, additional, Gallistl, Siegfried, additional, Vicente, Luisa García, additional, Gardovska, Dace, additional, Geissler, J., additional, Gerrits, G.P.J.M., additional, Giannoni, Eric, additional, van der Giessen, Ilona, additional, Gómez-Carballa, Alberto, additional, Rial, Jose Gómez, additional, Gores, Gunther, additional, Grāvele, Dagne, additional, Griese, Matthias, additional, Grope, Ilze, additional, Gurung, Meeru, additional, de Haan, L., additional, Haas, Nikolaus, additional, Habgood-Coote, Dominic, additional, Hagedoorn, Nienke N., additional, Haidl, Harald, additional, Hamilton, Shea, additional, Hauer, Almuthe, additional, Heidema, J., additional, Heininger, Ulrich, additional, Henriet, Stefanie, additional, Herberg, Jethro, additional, Hoggart, Clive, additional, Hösele, Susanne, additional, Hourmat, Sara, additional, Hude, Christa, additional, Huijnen, Martijn, additional, Jackson, Heather, additional, Jennings, Rebecca, additional, Johnston, Joanne, additional, Jongerius, Ilse, additional, Jorgensen, Rikke, additional, Kahlert, Christian, additional, Kandasamy, Rama, additional, Kappler, Matthias, additional, Keil, Julia, additional, Keldorfer, Markus, additional, Kell, Dominic F., additional, Kim, Eunjung, additional, King, Sharon, additional, Kloosterhuis, Lieke, additional, Kohlfürst, Daniela S., additional, Kohlmaier, Benno, additional, Kolberg, Laura, additional, Kolnik, Mojca, additional, Krenn, Larissa, additional, Kuijpers, Taco, additional, van der Kuip, M., additional, Iglesias, Pilar Leboráns, additional, Leigh, Simon, additional, Leitner, Manuel, additional, van Leur, M., additional, Lim, Emma, additional, Lin, Naomi, additional, Liu, Ching-Chuan, additional, Löffler, Sabine, additional, Lurz, Eberhard, additional, Maconochie, Ian, additional, Mackerness, Christine, additional, Mallet, François, additional, Martinón-Torres, Federico, additional, Marmarinos, Antonis, additional, Martin, Alex, additional, Martin, Mike, additional, Martinón Sánchez, José María, additional, Martinón-Torres, Nazareth, additional, McAlinden, Paul, additional, McDonnell, Anne, additional, McDonald, Sam, additional, Miedema, C.J., additional, Meiere, Anija, additional, Menikou, Stephanie, additional, van Mierlo, G., additional, Miners, Alec, additional, Mistry, Ravi, additional, Moll, Henriëtte A., additional, Mommert, Marine, additional, Pérez, Belén Mosquera, additional, Murdoch, David R., additional, Mustafa, Sobia, additional, Natalucci, Giancarlo, additional, Neeleman, C., additional, Newall, Karen, additional, Nichols, Samuel, additional, Niedrist, Tobias, additional, Niederer-Loher, Anita, additional, Nijman, Ruud, additional, Nokalna, Ieva, additional, Urbāne, Urzula Nora, additional, Nordberg, Gudrun, additional, Obihara, C.C., additional, O'Connor, Daniel, additional, Oosthoek, Wilma, additional, Osterman, Veronika, additional, Pachot, Alexandre, additional, Pajkrt, D., additional, Pardo-Seco, Jacobo, additional, Paulus, Stéphane, additional, Pavāre, Jana, additional, Paz, Ivonne Pena, additional, Persand, Salina, additional, Pfleger, Andreas, additional, Pfurtscheller, Klaus, additional, Philipsen, Ria, additional, Pickering, Ailsa, additional, Pierce, Benjamin, additional, Pilch, Heidemarie, additional, Rodríguez, Lidia Piñeiro, additional, Pischedda, Sara, additional, Srovin, Tina Plankar, additional, Pokorn, Marko, additional, Pollard, Andrew J., additional, Pölz, Lena, additional, Posfay-Barbe, Klara M., additional, Prunk, Petra, additional, Pučuka, Zanda, additional, Rajic, Glorija, additional, Rashid, Aqeela, additional, Redondo-Collazo, Lorenzo, additional, Relly, Christa, additional, Calle, Irene Rivero, additional, Vázquez, Sara Rey, additional, Rhodes, Mathew, additional, Richmond, Vivien, additional, Riedel, Thomas, additional, RocaIsatou Sarr, Anna, additional, Rödl, Siegfried, additional, Rodríguez-Tenreiro, Carmen, additional, Romaine, Sam, additional, Rowlands, Emily, additional, Ora, Miguel Sadiki, additional, Sagmeister, Manfred G., additional, Saidykhan, Momodou, additional, Salas, Antonio, additional, Schlapbach, Luregn J., additional, Schonenberg, D., additional, Secka, Fatou, additional, Selecka, Katrīna, additional, Fernández, Sonia Serén, additional, Trasorras, Cristina Serén, additional, Shah, Priyen, additional, Shen, Ching-Fen, additional, Shrestha, Shrijana, additional, Sidorova, Aleksandra, additional, Skrabl-Baumgartner, Andrea, additional, D’Souza, Giselle, additional, Sperl, Matthias, additional, Sprenkeler, Evelien, additional, Schweintzger, Nina A., additional, Stampfer, Laura, additional, Stevens, Molly, additional, Stocker, Martin, additional, Strenger, Volker, additional, Svile, Dace, additional, Syggelou, Kelly, additional, Tambouratzi, Maria, additional, Tan, Chantal, additional, Tavliavini, Emma, additional, Thomson, Evelyn, additional, Thorson, Stephen, additional, Till, Holger, additional, Tramper-Stranders, G.A., additional, Trobisch, Andreas, additional, Tsolia, Maria, additional, Usuf, Effua, additional, Valentine, Lucille, additional, Vermont, Clementien L., additional, Iglesias, Marisol Vilas, additional, Vincek, Katarina, additional, Voice, Marie, additional, de Vries, Gabriella, additional, Wallia, Diane, additional, Wang, Shih-Min, additional, Willems, Esther, additional, Wilson, Clare, additional, Wood, Amanda, additional, Woodsford, Phil, additional, Wright, Victoria, additional, Xagorari, Marietta, additional, Yeung, Shunmay, additional, Zachariasse, Joany, additional, Zavadska, Dace, additional, Zaman, Syed M.A., additional, Zandstra, Judith, additional, Zenz, Werner, additional, Zurl, Christoph, additional, and Zwerenz, Manuela, additional

Published
2023
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22. Prevalence and distribution of non-typhoidal Salmonella enterica serogroups and serovars isolated from normally sterile sites: A global systematic review.

Author

Hagedoorn, Nienke N., Murthy, Shruti, Birkhold, Megan, Marchello, Christian S., and Crump, John A.

Abstract

To inform coverage by potential vaccines, we aimed to systematically review evidence on the prevalence and distribution of non-typhoidal Salmonella enterica serogroups and serovars. We searched four databases from inception through 4 June 2021. Articles were included that reported at least one non-typhoidal S. enterica strain by serogroup or serovar isolated from a normally sterile site. Of serogrouped isolates, we pooled the prevalence of serogroup O:4, serogroup O:9, and other serogroups using random-effects meta-analyses. Of serotyped isolates, we pooled the prevalence of Salmonella Typhimurium (member of serogroup O:4), Salmonella Enteritidis (member of serogroup O:9), and other serovars. Of 82 studies yielding 24,253 serogrouped isolates, the pooled prevalence (95% CI) was 44.6% (36.2%–48.2%) for serogroup O:4, 45.5% (37.0%–49.1%) for serogroup O:9, and 9.9% (6.1%–13.3%) for other serogroups. Of serotyped isolates, the pooled prevalence (95%CI) was 36.8% (29.9%–44.0%) for Salmonella Typhimurium, 37.8% (33.2%–42.4%) for Salmonella Enteritidis, and 18.4% (11.4%–22.9%) for other serovars. Of global serogrouped non-typhoidal Salmonella isolates from normally sterile sites, serogroup O:4 and O:9 together accounted for 90%, and among serotyped isolates, serovars Typhimurium and Enteritidis together accounted for 75%. Vaccine development strategies covering serogroups O:4 and O:9, or serovars Typhimurium and Enteritidis, have the potential to prevent the majority of non-typhoidal Salmonella invasive disease. [ABSTRACT FROM AUTHOR]

Published
2024
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23. External validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children.

Author

Martin, Alexander James, Stanislaus van der Velden, Fabian Johannes, von Both, Ulrich, Tsolia, Maria N., Zenz, Werner, Sagmeister, Manfred, Vermont, Clementien, de Vries, Gabriella, Kolberg, Laura, Lim, Emma, Pokorn, Marko, Zavadska, Dace, Torres, Federico Martinón, Rivero Calle, Irene, Hagedoorn, Nienke N., Usuf, Effua, Schlapbach, Luregn, Kuijpers, Taco W., Pollard, Andrew J., and Shunmay Yeung

Subjects
FEBRILE neutropenia, BACTERIAL diseases, URINARY tract infections, IMMUNOCOMPROMISED patients, PREDICTION models, PNEUMONIA, RESPIRATORY infections
Published
2024
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25. Are children with prolonged fever at a higher risk for serious illness? A prospective observational study

Author

Nijman, Ruud G, primary, Tan, Chantal D, additional, Hagedoorn, Nienke N, additional, Nieboer, Daan, additional, Herberg, Jethro Adam, additional, Balode, Anda, additional, von Both, Ulrich, additional, Carrol, Enitan D, additional, Eleftheriou, Irini, additional, Emonts, Marieke, additional, van der Flier, Michiel, additional, de Groot, Ronald, additional, Kohlmaier, Benno, additional, Lim, Emma, additional, Martinón-Torres, Federico, additional, Pokorn, Marko, additional, Strle, Franc, additional, Tsolia, Maria, additional, Yeung, Shunmay, additional, Zachariasse, Joany M, additional, Zavadska, Dace, additional, Zenz, Werner, additional, Levin, Michael, additional, Vermont, Clementien L, additional, Moll, Henriette A, additional, and Maconochie, Ian K, additional

Published
2023
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26. Relationship between molecular pathogen detection and clinical disease in febrile children across Europe:a multicentre, prospective observational study

Author

Shah, Priyen, Voice, Marie, Calvo-Bado, Leonides, Rivero-Calle, Irene, Morris, Sophie, Nijman, Ruud, Broderick, Claire, De, Tisham, Eleftheriou, Irini, Galassini, Rachel, Khanijau, Aakash, Kolberg, Laura, Kolnik, Mojca, Rudzate, Aleksandra, Sagmeister, Manfred, Schweintzger, Nina, Secka, Fatou, Thakker, Clare, van der Velden, Fabian, Vermont, Clementien, Vincek, Katarina, Agyeman, Philipp K.A., Cunnington, Aubrey J., De Groot, Ronald, Emonts, Marieke, Fidler, Katy, Kuijpers, Taco, Mommert-Tripon, Marine, Brengel-Pesce, Karen, Mallet, Francois, Moll, Henriette, Paulus, Stéphane, Pokorn, Marko, Pollard, Andrew, van der Flier, Michiel, Borensztajn, Dorine M., Hagedoorn, Nienke N., Zachariasse, Joany, Dik, W., Stocker, Martin, Willems, Esther, De Haan, L., Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, De Vries, Gabriella, van den Berg, J. M., Barendregt, A. M., Shah, Priyen, Voice, Marie, Calvo-Bado, Leonides, Rivero-Calle, Irene, Morris, Sophie, Nijman, Ruud, Broderick, Claire, De, Tisham, Eleftheriou, Irini, Galassini, Rachel, Khanijau, Aakash, Kolberg, Laura, Kolnik, Mojca, Rudzate, Aleksandra, Sagmeister, Manfred, Schweintzger, Nina, Secka, Fatou, Thakker, Clare, van der Velden, Fabian, Vermont, Clementien, Vincek, Katarina, Agyeman, Philipp K.A., Cunnington, Aubrey J., De Groot, Ronald, Emonts, Marieke, Fidler, Katy, Kuijpers, Taco, Mommert-Tripon, Marine, Brengel-Pesce, Karen, Mallet, Francois, Moll, Henriette, Paulus, Stéphane, Pokorn, Marko, Pollard, Andrew, van der Flier, Michiel, Borensztajn, Dorine M., Hagedoorn, Nienke N., Zachariasse, Joany, Dik, W., Stocker, Martin, Willems, Esther, De Haan, L., Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, De Vries, Gabriella, van den Berg, J. M., and Barendregt, A. M.

Abstract

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. Subsequently, centralised molecular tests (CMTs) for 19 respiratory and 27 blood pathogens were performed. Findings: Of 4611 febrile children, 643 (14%) were classified as definite bacterial infection (DB), 491 (11%) as definite viral infection (DV), and 3477 (75%) had uncertain aetiology. 1061 controls without infection were recruited. CMTs detected blood bacteria more frequently in DB than DV cases for N. meningitidis (OR: 3.37, 95% CI: 1.92–5.99), S. pneumoniae (OR: 3.89, 95% CI: 2.07–7.59), Group A streptococcus (OR 2.73, 95% CI 1.13–6.09) and E. coli (OR 2.7, 95% CI 1.02–6.71). Respiratory viruses were more common in febrile children than controls, but only influenza A (OR 0.24, 95% CI 0.11–0.46), influenza B (OR 0.12, 95% CI 0.02–0.37) and RSV (OR 0.16, 95% CI: 0.06–0.36) were less common in DB than DV cases. Of 16 blood viruses, enterovirus (OR 0.43, 95% CI 0.23–0.72) and EBV (OR 0.71, 95% CI 0.56–0.90) were detected less often in DB than DV cases. Combined local diagnostics and CMTs respectively detected blood viruses and respiratory viruses in 360 (56%) and 161 (25%) of DB cases, and virus detection ruled-out bacterial infection poorly, with predictive values of 0.64 and 0.68 respectively. Interpretation: Most febrile children cannot be conclusively defined as having bacterial or viral infection when molecular tests supplement conventional approaches. Viruses are detected in most patients with bacterial infections, and the clinical value of individual pathogen detection in determining treatment is low. New approaches are needed to help determine which

Published
2023

27. Emergency medical services utilisation among febrile children attending emergency departments across Europe:an observational multicentre study

Author

Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany, von Both, Ulrich, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A., Carrol, Enitan D., Cunnington, Aubrey, De, Tisham, Kaforou, Myrsini, Hagedoorn, Nienke N., Dik, W., Stocker, Martin, Groot, Ronald de, Willems, Esther, Haan, L. de, Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, Vries, Gabriella de, Velden, Fabian van der, Haas, N., Berg, J. M.van den, Barendregt, A. M., Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany, von Both, Ulrich, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A., Carrol, Enitan D., Cunnington, Aubrey, De, Tisham, Kaforou, Myrsini, Hagedoorn, Nienke N., Dik, W., Stocker, Martin, Groot, Ronald de, Willems, Esther, Haan, L. de, Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, Vries, Gabriella de, Velden, Fabian van der, Haas, N., Berg, J. M.van den, and Barendregt, A. M.

Abstract

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. This study is part of an observational multicentre study assessing management and outcome in febrile children up to 18 years (MOFICHE) attending twelve EDs in eight European countries. Discordant EMS use was defined as the absence of markers of urgency including intermediate/high triage urgency, advanced diagnostics, treatment, and admission in children transferred by EMS. Multivariable logistic regression analyses were performed for the association between (1) EMS use and markers of urgency, and (2) patient characteristics and discordant EMS use after adjusting all analyses for the covariates age, gender, visiting hours, presenting symptoms, and ED setting. A total of 5464 (15%, range 0.1–42%) children attended the ED by EMS. Markers of urgency were more frequently present in the EMS group compared with the non-EMS group. Discordant EMS use occurred in 1601 children (29%, range 1–59%). Age and gender were not associated with discordant EMS use, whereas neurological symptoms were associated with less discordant EMS use (aOR 0.2, 95%CI 0.1–0.2), and attendance out of office hours was associated with more discordant EMS use (aOR 1.6, 95%CI 1.4–1.9). Settings with higher percentage of self-referrals to the ED had more discordant EMS use (p < 0.05). Conclusion: There is large practice variation in EMS use in febrile children attending European EDs. Markers of urgency were more frequently present in children in the EMS group. However, discordant EMS use occurred in 29%. Further research is needed on non-medical factors influencing discordant EMS use in febrile children across Europe, so that pre-emptive strategies can be implemented. What is Known: •Children constitute a

Published
2023

28. Genomic investigations of unexplained acute hepatitis in children

Author

Morfopoulou, Sofia, Buddle, Sarah, Torres Montaguth, Oscar Enrique, Atkinson, Laura, Guerra-Assunção, José Afonso, Moradi Marjaneh, Mahdi, Zennezini Chiozzi, Riccardo, Storey, Nathaniel, Campos, Luis, Hutchinson, J. Ciaran, Counsell, John R., Pollara, Gabriele, Roy, Sunando, Venturini, Cristina, Antinao Diaz, Juan F., Siam, Ala’a, Tappouni, Luke J., Asgarian, Zeinab, Ng, Joanne, Hanlon, Killian S., Lennon, Alexander, McArdle, Andrew, Nijman, Ruud, Peters, Mark, Emonts, Marieke, van der Zee, Carlijn, Vermont, Clementien L., Moll, Henriëtte A., Borensztajn, Dorine M., Hagedoorn, Nienke N., Tan, Chantal, Zachariasse, Joany, Dik, W., van der Flier, Michiel, Stocker, Martin, Tempel, Dennie, Hoffmann, Florian, de Groot, Ronald, Willems, Esther, de Haan, L., Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, de Vries, Gabriella, van den Berg, J. M., Barendregt, A. M., Breuer, Judith, Morfopoulou, Sofia, Buddle, Sarah, Torres Montaguth, Oscar Enrique, Atkinson, Laura, Guerra-Assunção, José Afonso, Moradi Marjaneh, Mahdi, Zennezini Chiozzi, Riccardo, Storey, Nathaniel, Campos, Luis, Hutchinson, J. Ciaran, Counsell, John R., Pollara, Gabriele, Roy, Sunando, Venturini, Cristina, Antinao Diaz, Juan F., Siam, Ala’a, Tappouni, Luke J., Asgarian, Zeinab, Ng, Joanne, Hanlon, Killian S., Lennon, Alexander, McArdle, Andrew, Nijman, Ruud, Peters, Mark, Emonts, Marieke, van der Zee, Carlijn, Vermont, Clementien L., Moll, Henriëtte A., Borensztajn, Dorine M., Hagedoorn, Nienke N., Tan, Chantal, Zachariasse, Joany, Dik, W., van der Flier, Michiel, Stocker, Martin, Tempel, Dennie, Hoffmann, Florian, de Groot, Ronald, Willems, Esther, de Haan, L., Neeleman, C., Tramper-Stranders, G. A., Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, de Vries, Gabriella, van den Berg, J. M., Barendregt, A. M., and Breuer, Judith

Abstract

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children.

Published
2023

29. Comparison of the epidemiology of invasive pneumococcal disease between Australia and New Zealand in 2017–2021:an observational study based on surveillance data

Author

Hagedoorn, Nienke N., Anglemyer, Andrew, Gilkison, Charlotte, Hartley, Mica, Walls, Tony, Hagedoorn, Nienke N., Anglemyer, Andrew, Gilkison, Charlotte, Hartley, Mica, and Walls, Tony

Abstract

Background: The Australian immunisation schedule uses 13-valent pneumococcal conjugate vaccine (PCV13), while New Zealand (NZ) changed from PCV13 to 10-valent PCV (PCV10) in 2017. In NZ, cases of serotype 19A (not in PCV10) have been increasing since 2017. We compared invasive pneumococcal disease (IPD) epidemiology between Australia and NZ in 2017–2021. Methods: We collated IPD notification data from national surveillance systems. Between Australia and NZ, we compared IPD incidence rates and assessed the proportion of serotype 19A, and stratified for ethnicity and age. Findings: Between 2017 and 2021, the crude IPD incidence per 100,000 in Australia ranged from 4.3 to 8.4, and ranged from 6.9 to 11.4 in NZ. The highest age-adjusted IPD rates were observed in Australian Indigenous people (range: 27.3–35.5) followed by NZ Māori/Pacific peoples (range 19.7–30.4). For children <2 years, ethnicity-adjusted IPD rates were similar between Australia and NZ in 2017–2020. In 2021, however, the ethnicity-adjusted incidence in children <2 years was higher in NZ (30.2; 95% CI 21.1–39.4) than in Australia (23.3 95% CI: 19.5–27.1) (p < 0.01). In Australia, the proportion of serotype 19A remained 5%, whereas in NZ serotype 19A increased from 11.5% to 29.5% with the largest increase in children <2 years and 2–4 years. Interpretation: Despite higher risks in Indigenous populations in Australia compared to all other groups, the overall IPD rate in NZ is increasing, particularly among children. The numbers and proportions of IPD due to serotype 19A are increasing in NZ especially in children. These data support the NZ decision from December 2022 to change to PCV13. Funding: This research received no specific funding.

Published
2023

30. European study confirms the combination of fever and petechial rash as an important warning sign for childhood sepsis and meningitis

Author

Kohlmaier, Benno, Leitner, Manuel, Hagedoorn, Nienke N., Borensztajn, Dorine M., von Both, Ulrich, Carrol, Enitan D., Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tan, Chantal D., Tsolia, Maria, Vermont, Clementien L., Zachariasse, Joany M., Zavadska, Dace, Moll, Henriette A., Zenz, Werner, Kohlmaier, Benno, Leitner, Manuel, Hagedoorn, Nienke N., Borensztajn, Dorine M., von Both, Ulrich, Carrol, Enitan D., Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tan, Chantal D., Tsolia, Maria, Vermont, Clementien L., Zachariasse, Joany M., Zavadska, Dace, Moll, Henriette A., and Zenz, Werner

Abstract

Aim: 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. The results are presented as odds ratios (OR) with 95% confidence intervals (CI). Results: We found that 453/34010 (1.3%) febrile children had petechial rashes. The focus of the infection included sepsis (10/453, 2.2%) and meningitis (14/453, 3.1%). Children with a petechial rash were more likely than other febrile children to have sepsis or meningitis (OR 8.5, 95% CI 5.3–13.1) and bacterial infections (OR 1.4, 95% CI 1.0–1.8) as well as need for immediate life-saving interventions (OR 6.6, 95% CI 4.4–9.5) and intensive care unit admissions (OR 6.5, 95% CI 3.0–12.5). Conclusion: The combination of fever and petechial rash is still an important warning sign for childhood sepsis and meningitis. Ruling out coughing and/or vomiting was insufficient to safely identify low-risk patients.

Published
2023

31. Febrile illness in high-risk children:a prospective, international observational study

Author

van der Velden, Fabian J.S., de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich, Kolberg, Laura, Carrol, Enitan D., Khanijau, Aakash, Herberg, Jethro A., De, Tisham, Galassini, Rachel, Kuijpers, Taco W., Martinón-Torres, Federico, Rivero-Calle, Irene, Vermont, Clementien L., Hagedoorn, Nienke N., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K.A., Usuf, Effua, Secka, Fatou, de Groot, Ronald, Levin, Michael, van der Flier, Michiel, Emonts, Marieke, van der Velden, Fabian J.S., de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich, Kolberg, Laura, Carrol, Enitan D., Khanijau, Aakash, Herberg, Jethro A., De, Tisham, Galassini, Rachel, Kuijpers, Taco W., Martinón-Torres, Federico, Rivero-Calle, Irene, Vermont, Clementien L., Hagedoorn, Nienke N., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K.A., Usuf, Effua, Secka, Fatou, de Groot, Ronald, Levin, Michael, van der Flier, Michiel, and Emonts, Marieke

Abstract

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. Febrile episodes were assigned clinical phenotypes using the validated PERFORM algorithm. Logistic regression was used to assess the effect size of predictive features of proven/presumed bacterial or viral infection. A total of 599 episodes in 482 children were analysed. Seventy-eight episodes (13.0%) were definite bacterial, 67 episodes probable bacterial (11.2%), and 29 bacterial syndrome (4.8%). Fifty-five were definite viral (9.2%), 49 probable viral (8.2%), and 23 viral syndrome (3.8%). One hundred ninety were unknown bacterial or viral infections (31.7%), and 108 had inflammatory or other non-infectious causes of fever (18.1%). Predictive features of proven/presumed bacterial infection were ill appearance (OR 3.1 (95% CI 2.1–4.6)) and HIV (OR 10.4 (95% CI 2.0–54.4)). Ill appearance reduced the odds of having a proven/presumed viral infection (OR 0.5 (95% CI 0.3–0.9)). A total of 82.1% had new empirical antibiotics started on admission (N = 492); 94.3% proven/presumed bacterial (N = 164), 66.1% proven/presumed viral (N = 84), and 93.2% unknown bacterial or viral infections (N = 177). Mortality was 1.9% (N = 11) and 87.1% made full recovery (N = 522). Conclusion: The aetiology of febrile illness in immunocompromised children is diverse. In one-third of cases, no cause for the fever will be identified. Justification for stan

Published
2023

32. A Novel Combination of Host Protein Biomarkers to Distinguish Bacterial from Viral Infections in Febrile Children in Emergency Care

Author

Infectieziekten patientenzorg, Child Health, Infection & Immunity, Tan, Chantal D., Van Den Broek, Bryan, Womersley, Rebecca S., Kaforou, Myrsini, Hagedoorn, Nienke N., Van Der Flier, Michiel, Jackson, Heather, Moll, Henriette A., Snijder, Rozemarijn, De Jonge, Marien I., Vermont, Clementien L., Infectieziekten patientenzorg, Child Health, Infection & Immunity, Tan, Chantal D., Van Den Broek, Bryan, Womersley, Rebecca S., Kaforou, Myrsini, Hagedoorn, Nienke N., Van Der Flier, Michiel, Jackson, Heather, Moll, Henriette A., Snijder, Rozemarijn, De Jonge, Marien I., and Vermont, Clementien L.

Published
2023

33. Correction to: Febrile illness in high-risk children: a prospective, international observational study

Author

van der Velden, Fabian J S, de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Kolberg, Laura; https://orcid.org/0000-0002-3311-8254, Carrol, Enitan D, Khanijau, Aakash, Herberg, Jethro A; https://orcid.org/0000-0001-6941-6491, De, Tisham, Galassini, Rachel, Kuijpers, Taco W, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Rivero-Calle, Irene, Vermont, Clementien L, Hagedoorn, Nienke N, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Usuf, Effua, Secka, Fatou, et al, van der Velden, Fabian J S, de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Kolberg, Laura; https://orcid.org/0000-0002-3311-8254, Carrol, Enitan D, Khanijau, Aakash, Herberg, Jethro A; https://orcid.org/0000-0001-6941-6491, De, Tisham, Galassini, Rachel, Kuijpers, Taco W, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Rivero-Calle, Irene, Vermont, Clementien L, Hagedoorn, Nienke N, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Usuf, Effua, Secka, Fatou, and et al

Published
2023

34. Adeno-associated virus 2 infection in children with non-A–E hepatitis

Author

Ho, Antonia, Orton, Richard, Tayler, Rachel, Asamaphan, Patawee, Herder, Vanessa, Davis, Chris, Tong, Lily, Smollett, Katherine, Manali, Maria, Allan, Jay, Rawlik, Konrad, McDonald, Sarah E., Vink, Elen, Pollock, Louisa, Gannon, Louise, Evans, Clair, McMenamin, Jim, Roy, Kirsty, Marsh, Kimberly, Divala, Titus, Holden, Matthew T.G., Lockhart, Michael, Yirrell, David, Currie, Sandra, O’Leary, Maureen, Henderson, David, Shepherd, Samantha J., Jackson, Celia, Gunson, Rory, MacLean, Alasdair, McInnes, Neil, Bradley-Stewart, Amanda, Battle, Richard, Hollenbach, Jill A., Henderson, Paul, Nijman, Ruud, Peters, Mark, Emonts, Marieke, van der Zee, Carlijn C.W., Vermont, Clementien L., Moll, Henriëtte A., Borensztajn, Dorine M., Hagedoorn, Nienke N., Tan, Chantal, Zachariasse, Joany, Dik, W., van der Flier, Michiel, Stocker, Martin, Tempel, Dennie, Hoffmann, Florian, Pediatrics, Erasmus MC other, Rehabilitation Medicine, Immunology, Cardiology, and Business Economics

Subjects
SDG 3 - Good Health and Well-being
Abstract

An outbreak of acute hepatitis of unknown aetiology in children was reported in Scotland 1 in April 2022 and has now been identified in 35 countries 2. Several recent studies have suggested an association with human adenovirus with this outbreak, a virus not commonly associated with hepatitis. Here we report a detailed case–control investigation and find an association between adeno-associated virus 2 (AAV2) infection and host genetics in disease susceptibility. Using next-generation sequencing, PCR with reverse transcription, serology and in situ hybridization, we detected recent infection with AAV2 in plasma and liver samples in 26 out of 32 (81%) cases of hepatitis compared with 5 out of 74 (7%) of samples from unaffected individuals. Furthermore, AAV2 was detected within ballooned hepatocytes alongside a prominent T cell infiltrate in liver biopsy samples. In keeping with a CD4+ T-cell-mediated immune pathology, the human leukocyte antigen (HLA) class II HLA-DRB1*04:01 allele was identified in 25 out of 27 cases (93%) compared with a background frequency of 10 out of 64 (16%; P = 5.49 × 10−12). In summary, we report an outbreak of acute paediatric hepatitis associated with AAV2 infection (most likely acquired as a co-infection with human adenovirus that is usually required as a ‘helper virus’ to support AAV2 replication) and disease susceptibility related to HLA class II status.

Published
2023

36. Febrile illness in high-risk children: a prospective, international observational study

Author

van der Velden, Fabian J. S., de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich, Kolberg, Laura, Carrol, Enitan D., Khanijau, Aakash, Herberg, Jethro A., De, Tisham, Galassini, Rachel, Kuijpers, Taco W., Martinón-Torres, Federico, Rivero-Calle, Irene, Vermont, Clementien L., Hagedoorn, Nienke N., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K. A., Usuf, Effua, Secka, Fatou, de Groot, Ronald, Levin, Michael, van der Flier, Michiel, Emonts, Marieke, Cunnington, Aubrey, Herberg, Jethro, Kaforou, Myrsini, Wright, Victoria, Baumard, Lucas, Bellos, Evangelos, D’Souza, Giselle, Habgood-Coote, Dominic, Hamilton, Shea, Hoggart, Clive, Hourmat, Sara, Jackson, Heather, Maconochie, Ian, Menikou, Stephanie, Lin, Naomi, Nichols, Samuel, Nijman, Ruud, Powell, Oliver, Pena Paz, Ivonne, Shah, Priyen, Shen, Ching-Fen, Vito, Ortensia, Wilson, Clare, Abdulla, Amina, Ali, Ladan, Darnell, Sarah, Jorgensen, Rikke, Mustafa, Sobia, Persand, Salina, Stevens, Molly M., Kim, Nayoung, Kim, Eunjung, Fidler, Katy, Dudley, Julia, Richmond, Vivien, Tavliavini, Emma, Liu, Ching-Chuan, Wang, Shih-Min, Salas, Antonio, Álvez González, Fernando, Balo Farto, Cristina, Barral-Arca, Ruth, Barreiro Castro, María, Bello, Xabier, García, Mirian Ben, Carnota, Sandra, Cebey-López, Miriam, Curras-Tuala, María José, Durán Suárez, Carlos, García Vicente, Luisa, Gómez-Carballa, Alberto, Gómez Rial, Jose, Leboráns Iglesias, Pilar, Martinón-Torres, Nazareth, Martinón Sánchez, José María, Mosquera Pérez, Belén, Pardo-Seco, Jacobo, Rodríguez, Lidia Piñeiro, Pischedda, Sara, Vázquez, Sara Rey, Rivero Calle, Irene, Rodríguez-Tenreiro, Carmen, Redondo-Collazo, Lorenzo, Sadiki Ora, Miguel, Serén Fernández, Sonia, Serén Trasorras, Cristina, Vilas Iglesias, Marisol, Balode, Anda, Bārzdiņa, Arta, Deksne, Dārta, Gardovska, Dace, Grāvele, Dagne, Grope, Ilze, Meiere, Anija, Nokalna, Ieva, Pavāre, Jana, Pučuka, Zanda, Selecka, Katrīna, Rudzāte, Aleksandra, Svile, Dace, Urbāne, Urzula Nora, Bojang, Kalifa, Zaman, Syed M. A., Anderson, Suzanne, RocaIsatou Sarr, Anna, Saidykhan, Momodou, Darboe, Saffiatou, Ceesay, Samba, D’alessandro, Umberto, Moll, Henriëtte A., Vermont, Clementien L, Borensztajn, Dorine M., Tan, Chantal, Zachariasse, Joany, Dik, W, Agyeman, Philipp KA, Berger, Christoph, Giannoni, Eric, Stocker, Martin, Posfay-Barbe, Klara M, Heininger, Ulrich, Bernhard-Stirnemann, Sara, Niederer-Loher, Anita, Kahlert, Christian R., Natalucci, Giancarlo, Relly, Christa, Riedel, Thomas, Aebi, Christoph, Schlapbach, Luregn J, Carrol, Enitan D, Cocklin, Elizabeth, Jennings, Rebecca, Johnston, Joanne, Leigh, Simon, Lewis-Burke, Nadia, Newall, Karen, Romaine, Sam, Eleftheriou, Irini, Tambouratzi, Maria, Marmarinos, Antonis, Xagorari, Marietta, Syggelou, Kelly, Calvo-Bado, Leo, Schweintzger, Nina A., Sagmeister, Manfred G., Kohlfürst, Daniela S., Zurl, Christoph, Binder, Alexander, Hösele, Susanne, Leitner, Manuel, Pölz, Lena, Rajic, Glorija, Bauchinger, Sebastian, Baumgart, Hinrich, Benesch, Martin, Ceolotto, Astrid, Eber, Ernst, Gallistl, Siegfried, Gores, Gunther, Haidl, Harald, Hauer, Almuthe, Hude, Christa, Keldorfer, Markus, Krenn, Larissa, Pilch, Heidemarie, Pfleger, Andreas, Pfurtscheller, Klaus, Nordberg, Gudrun, Niedrist, Tobias, Rödl, Siegfried, Skrabl-Baumgartner, Andrea, Sperl, Matthias, Stampfer, Laura, Strenger, Volker, Till, Holger, Trobisch, Andreas, Löffler, Sabine, Dewez, Juan Emmanuel, Hibberd, Martin, Bath, David, Miners, Alec, Fitchett, Elizabeth, de Jonge, Marien I., van Aerde, Koen, Alkema, Wynand, van den Broek, Bryan, Gloerich, Jolein, van Gool, Alain J., Henriet, Stefanie, Huijnen, Martijn, Philipsen, Ria, Willems, Esther, Gerrits, G.P.J.M., van Leur, M., Heidema, J., de Haan, L., Miedema, C.J., Neeleman, C., Obihara, C.C., Tramper-Stranders, G.A., Kandasamy, Rama, Paulus, Stéphane, Carter, Michael J., O’Connor, Daniel, Bibi, Sagida, Kelly, Dominic F., Gurung, Meeru, Thorson, Stephen, Ansari, Imran, Murdoch, David R., Shrestha, Shrijana, Oliver, Zoe, Valentine, Lucille, Allen, Karen, Bell, Kathryn, Chan, Adora, Crulley, Stephen, Devine, Kirsty, Fabian, Daniel, King, Sharon, McAlinden, Paul, McDonald, Sam, McDonnell, Anne, Pickering, Ailsa, Thomson, Evelyn, Wood, Amanda, Wallia, Diane, Woodsford, Phil, Baxter, Frances, Bell, Ashley, Rhodes, Mathew, Agbeko, Rachel, Mackerness, Christine, Baas, Bryan, Kloosterhuis, Lieke, Oosthoek, Wilma, Arif, Tasnim, Bennet, Joshua, Collings, Kalvin, van der Giessen, Ilona, Martin, Alex, Rashid, Aqeela, Rowlands, Emily, van der Velden, Fabian, Soon, Joshua, Martin, Mike, Mistry, Ravi, Zwerenz, Manuela, Buschbeck, Judith, Bidlingmaier, Christoph, Binder, Vera, Danhauser, Katharina, Haas, Nikolaus, Griese, Matthias, Feuchtinger, Tobias, Keil, Julia, Kappler, Matthias, Lurz, Eberhard, Muench, Georg, Reiter, Karl, Schoen, Carola, Mallet, François, Brengel-Pesce, Karen, Pachot, Alexandre, Mommert, Marine, Kolnik, Mojca, Vincek, Katarina, Srovin, Tina Plankar, Bahovec, Natalija, Prunk, Petra, Osterman, Veronika, Avramoska, Tanja, Kuijpers, Taco, Jongerius, Ilse, van den Berg, J. M., Schonenberg, D., Barendregt, A. M., Pajkrt, D., van der Kuip, M., van Furth, A. M., Sprenkeler, Evelien, Zandstra, Judith, van Mierlo, G., Geissler, J., consortium, PERFORM, Paediatric Infectious Diseases / Rheumatology / Immunology, AII - Infectious diseases, ARD - Amsterdam Reproduction and Development, and Pediatrics

Subjects
All institutes and research themes of the Radboud University Medical Center, Fever, SDG 3 - Good Health and Well-being, Antibiotics, Paediatric, Pediatrics, Perinatology and Child Health, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], 610 Medicine & health, Infection, 610 Medizin und Gesundheit, Immunocompromised
Abstract

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 (N = 492); 94.3% proven/presumed bacterial (N = 164), 66.1% proven/presumed viral (N = 84), and 93.2% unknown bacterial or viral infections (N = 177). Mortality was 1.9% (N = 11) and 87.1% made full recovery (N = 522). Conclusion: The aetiology of febrile illness in immunocompromised children is diverse. In one-third of cases, no cause for the fever will be identified. Justification for standard intravenous antibiotic treatment for every febrile immunocompromised child is debatable, yet effective. Better clinical decision-making tools and new biomarkers are needed for this population. What is Known:• Immunosuppressed children are at high risk for morbidity and mortality of serious bacterial and viral infection, but often present with fever as only clinical symptom.• Current diagnostic measures in this group are not specific to rule out bacterial infection, and positivity rates of microbiological cultures are low. What is New:• Febrile illness and infectious complications remain a significant cause of mortality and morbidity in HR children, yet management is effective.• The aetiology of febrile illness in immunocompromised children is diverse, and development of pathways for early discharge or cessation of intravenous antibiotics is debatable, and requires better clinical decision-making tools and biomarkers.

Published
2022

37. Febrile illness in high-risk children: a prospective, international observational study

Author

Velden, Fabian J.S. van der, primary, de Vries, Gabriella, additional, Martin, Alexander, additional, Lim, Emma, additional, von Both, Ulrich, additional, Kolberg, Laura, additional, Carrol, Enitan D., additional, Khanijau, Aakash, additional, Herberg, Jethro A., additional, De, Tisham, additional, Galassini, Rachel, additional, Kuijpers, Taco W., additional, Martinón-Torres, Federico, additional, Rivero-Calle, Irene, additional, Vermont, Clementien L., additional, Hagedoorn, Nienke N., additional, Pokorn, Marko, additional, Pollard, Andrew J., additional, Schlapbach, Luregn J., additional, Tsolia, Maria, additional, Elefhteriou, Irini, additional, Yeung, Shunmay, additional, Zavadska, Dace, additional, Fink, Colin, additional, Voice, Marie, additional, Zenz, Werner, additional, Kohlmaier, Benno, additional, Agyeman, Philipp K.A., additional, Usuf, Effua, additional, Secka, Fatou, additional, de Groot, Ronald, additional, Levin, Michael, additional, Flier, Michiel van der, additional, Emonts, Marieke, additional, and Consortium, PERFORM, additional

Published
2022
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38. Characteristics and management of adolescents attending the ED with fever:A prospective multicentre study

Author

Borensztajn, Dorine, Hagedoorn, Nienke N., Carrol, Enitan, Von Both, Ulrich, Dewez, Juan Emmanuel, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon Torres, Federico, Nijman, Ruud, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany, Moll, Henriette A., Borensztajn, Dorine, Hagedoorn, Nienke N., Carrol, Enitan, Von Both, Ulrich, Dewez, Juan Emmanuel, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon Torres, Federico, Nijman, Ruud, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany, and Moll, Henriette A.

Abstract

Objective Most studies on febrile children have focused on infants and young children with serious bacterial infection (SBI). Although population studies have described an increased risk of sepsis in adolescents, little is known about febrile adolescents attending the emergency department (ED). We aimed to describe patient characteristics and management of febrile adolescents attending the ED. Design and setting The MOFICHE/PERFORM study (Management and Outcome of Febrile Children in Europe/Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union), a prospective multicentre study, took place at 12 European EDs. Descriptive and multivariable regression analyses were performed, comparing febrile adolescents (12-18 years) with younger children in terms of patient characteristics, markers of disease severity (vital signs, clinical alarming signs), management (diagnostic tests, therapy, admission) and diagnosis (focus, viral/bacterial infection). Results 37 420 encounters were included, of which 2577 (6.9%) were adolescents. Adolescents were more often triaged as highly urgent (38.9% vs 34.5%) and described as ill appearing (23.1% vs 15.6%) than younger children. Increased work of breathing and a non-blanching rash were present less often in adolescents, while neurological signs were present more often (1% vs 0%). C reactive protein tests were performed more frequently in adolescents and were more often abnormal (adjusted OR (aOR) 1.7, 95% CI 1.5 to 1.9). Adolescents were more often diagnosed with SBI (OR 1.8, 95% CI 1.6 to 2.0) and sepsis/meningitis (OR 2.3, 95% CI 1.1 to 5.0) and were more frequently admitted (aOR 1.3, 95% CI 1.2 to 1.4) and treated with intravenous antibiotics (aOR 1.7, 95% CI 1.5 to 2.0). Conclusions Although younger children presented to the ED more frequently, adolescents were more often diagnosed with SBI and sepsis/meningitis. Our data emphasise the importance of awareness of severe infections

Published
2022

39. Shock Index in the early assessment of febrile children at the emergency department:A prospective multicentre study

Author

Hagedoorn, Nienke N., Zachariasse, Joany M., Borensztajn, Dorine, Adriaansens, Elise, Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro Adam, Kohlmaier, Benno, Lim, Emma, MacOnochie, Ian, Martinón-Torres, Federico, Nijman, Ruud Gerard, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zavadska, Dace, Zenz, Werner, Levin, Michael, Vermont, Clementien, Moll, Henriette A., Hagedoorn, Nienke N., Zachariasse, Joany M., Borensztajn, Dorine, Adriaansens, Elise, Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro Adam, Kohlmaier, Benno, Lim, Emma, MacOnochie, Ian, Martinón-Torres, Federico, Nijman, Ruud Gerard, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zavadska, Dace, Zenz, Werner, Levin, Michael, Vermont, Clementien, and Moll, Henriette A.

Abstract

Objective (1) To derive reference values for the Shock Index (heart rate/systolic blood pressure) based on a large emergency department (ED) population of febrile children and (2) to determine the diagnostic value of the Shock Index for serious illness in febrile children. Design/setting Observational study in 11 European EDs (2017-2018). Patients Febrile children with measured blood pressure. Main outcome measures Serious bacterial infection (SBI), invasive bacterial infection (IBI), immediate life-saving interventions (ILSIs) and intensive care unit (ICU) admission. The association between high Shock Index (>95th centile) and each outcome was determined by logistic regression adjusted for age, sex, referral, comorbidity and temperature. Additionally, we calculated sensitivity, specificity and negative/positive likelihood ratios (LRs). Results Of 5622 children, 461 (8.2%) had SBI, 46 (0.8%) had IBI, 203 (3.6%) were treated with ILSI and 69 (1.2%) were ICU admitted. High Shock Index was associated with SBI (adjusted OR (aOR) 1.6 (95% CI 1.3 to 1.9)), ILSI (aOR 2.5 (95% CI 2.0 to 2.9)), ICU admission (aOR 2.2 (95% CI 1.4 to 2.9)) but not with IBI (aOR: 1.5 (95% CI 0.6 to 2.4)). For the different outcomes, sensitivity for high Shock Index ranged from 0.10 to 0.15, specificity ranged from 0.95 to 0.95, negative LRs ranged from 0.90 to 0.95 and positive LRs ranged from 1.8 to 2.8. Conclusions High Shock Index is associated with serious illness in febrile children. However, its rule-out value is insufficient which suggests that the Shock Index is not valuable as a screening tool for all febrile children at the ED.

Published
2022

40. Hemostasis Proteins in Invasive Meningococcal and Nonmeningococcal Infections:A Prospective Multicenter Study

Author

Hagedoorn, Nienke N., Boeddha, Navin P., Kohlfuerst, Daniela S., Anderson, Suzanne, Carrol, Enitan D., Agapow, Paul, van der Flier, Michiel, Hazelzet, Jan, Herberg, Jethro, Kuijpers, Taco, Levin, Michael, Martinon-Torres, Federico, van Rijswijk, Angelique, Schlapbach, Luregn J., Vermont, Clementien, Zenz, Werner, Dik, Willem A., Driessen, Gertjan, Emonts, Marieke, Hagedoorn, Nienke N., Boeddha, Navin P., Kohlfuerst, Daniela S., Anderson, Suzanne, Carrol, Enitan D., Agapow, Paul, van der Flier, Michiel, Hazelzet, Jan, Herberg, Jethro, Kuijpers, Taco, Levin, Michael, Martinon-Torres, Federico, van Rijswijk, Angelique, Schlapbach, Luregn J., Vermont, Clementien, Zenz, Werner, Dik, Willem A., Driessen, Gertjan, and Emonts, Marieke

Abstract

OBJECTIVES: We aimed to describe the variation of hemostasis proteins in children with bacterial infections due to different pathogens (Neisseria meningitidis, Streptococcus pneumoniae, Staphylococcus aureus, and group A streptococcus [GAS]) and to study hemostasis proteins in relation to mortality. DESIGN: Preplanned analysis in prospective cohort study. SETTING: Hospitals in five European countries (Austria, The Netherlands, Spain, Switzerland, and the United Kingdom). PATIENTS: Admitted children (2012-2016) with community-acquired infections due to meningococci (n = 83), pneumococci (n = 64), S. aureus (n = 50), and GAS (n = 44) with available serum samples collected less than 48 hours after admission. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fibronectin, plasminogen activator inhibitor type 1 (PAI-1), thrombomodulin, and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13) were measured in serum in 2019-2020. Additionally, von Willebrand factor, protein C, protein S, and factor IX were measured in citrate plasma available from a subset of patients. Outcome measures included in-hospital mortality and disease severity (need for ventilation/inotropes, Pediatric Index of Mortality score). Of 241 children, 21 (8.7%) died and 177 (73.5%) were admitted to PICU. Mortality rate was similar for the pathogen groups. Levels of fibronectin and thrombomodulin differed for the different pathogens (p < 0.05). Fibronectin levels were lower in GAS infections than in S. pneumoniae and S. aureus infections but did not differ from meningococcal infections. Thrombomodulin levels in meningococcal infections were higher than in S. aureus and pneumococcal infections. Overall, the area under the curve for mortality was 0.81 (95% CI, 0.70-0.92) for thrombomodulin and 0.78 (95% CI, 0.69-0.88) for ADAMTS-13. The association of each hemostasis protein did not vary across pathogens for any of the outcome measures. CONCLUSIONS: Hemostat

Published
2022

41. Characteristics and management of adolescents attending the ED with fever: A prospective multicentre study

Author

Infectieziekten patientenzorg, Child Health, NVIC bedrijfsvoering, Other research (not in main researchprogram), Borensztajn, Dorine, Hagedoorn, Nienke N., Carrol, Enitan, Von Both, Ulrich, Dewez, Juan Emmanuel, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon Torres, Federico, Nijman, Ruud, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany, Moll, Henriette A., Infectieziekten patientenzorg, Child Health, NVIC bedrijfsvoering, Other research (not in main researchprogram), Borensztajn, Dorine, Hagedoorn, Nienke N., Carrol, Enitan, Von Both, Ulrich, Dewez, Juan Emmanuel, Emonts, Marieke, Van Der Flier, Michiel, De Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon Torres, Federico, Nijman, Ruud, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany, and Moll, Henriette A.

Published
2022

42. Febrile children with comorbidities at the emergency department — a multicentre observational study

Author

Infectieziekten patientenzorg, Child Health, Infection & Immunity, Borensztajn, Dorine M., Hagedoorn, Nienke N., Carrol, Enitan D., von Both, Ulrich, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, van der Velden, Fabian J.S., Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany M., Moll, Henriette A., Infectieziekten patientenzorg, Child Health, Infection & Immunity, Borensztajn, Dorine M., Hagedoorn, Nienke N., Carrol, Enitan D., von Both, Ulrich, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, van der Velden, Fabian J.S., Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany M., and Moll, Henriette A.

Published
2022

43. Hemostasis Proteins in Invasive Meningococcal and Nonmeningococcal Infections: A Prospective Multicenter Study

Author

Infectieziekten patientenzorg, Child Health, Infection & Immunity, Hagedoorn, Nienke N., Boeddha, Navin P., Kohlfuerst, Daniela S., Anderson, Suzanne, Carrol, Enitan D., Agapow, Paul, Van Der Flier, Michiel, Hazelzet, Jan, Herberg, Jethro, Kuijpers, Taco, Levin, Michael, Martinon-Torres, Federico, Van Rijswijk, Angelique, Schlapbach, Luregn J., Vermont, Clementien, Zenz, Werner, Dik, Willem A., Driessen, Gertjan, Emonts, Marieke, Infectieziekten patientenzorg, Child Health, Infection & Immunity, Hagedoorn, Nienke N., Boeddha, Navin P., Kohlfuerst, Daniela S., Anderson, Suzanne, Carrol, Enitan D., Agapow, Paul, Van Der Flier, Michiel, Hazelzet, Jan, Herberg, Jethro, Kuijpers, Taco, Levin, Michael, Martinon-Torres, Federico, Van Rijswijk, Angelique, Schlapbach, Luregn J., Vermont, Clementien, Zenz, Werner, Dik, Willem A., Driessen, Gertjan, and Emonts, Marieke

Published
2022

44. Hemostasis Proteins in Invasive Meningococcal and Nonmeningococcal Infections: A Prospective Multicenter Study

Author

Hagedoorn, Nienke N, Boeddha, Navin P, Kohlfuerst, Daniela S, et al, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Hagedoorn, Nienke N, Boeddha, Navin P, Kohlfuerst, Daniela S, et al, and Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598

Abstract

Objectives: We aimed to describe the variation of hemostasis proteins in children with bacterial infections due to different pathogens ( Neisseria meningitidis, Streptococcus pneumoniae, Staphylococcus aureus , and group A streptococcus [GAS]) and to study hemostasis proteins in relation to mortality. Design: Preplanned analysis in prospective cohort study. Setting: Hospitals in five European countries (Austria, The Netherlands, Spain, Switzerland, and the United Kingdom). Patients: Admitted children (2012-2016) with community-acquired infections due to meningococci ( n = 83), pneumococci ( n = 64), S. aureus (n = 50), and GAS ( n = 44) with available serum samples collected less than 48 hours after admission. Interventions: None. Measurements and main results: Fibronectin, plasminogen activator inhibitor type 1 (PAI-1), thrombomodulin, and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13) were measured in serum in 2019-2020. Additionally, von Willebrand factor, protein C, protein S, and factor IX were measured in citrate plasma available from a subset of patients. Outcome measures included in-hospital mortality and disease severity (need for ventilation/inotropes, Pediatric Index of Mortality score).Of 241 children, 21 (8.7%) died and 177 (73.5%) were admitted to PICU. Mortality rate was similar for the pathogen groups. Levels of fibronectin and thrombomodulin differed for the different pathogens ( p < 0.05). Fibronectin levels were lower in GAS infections than in S. pneumoniae and S. aureus infections but did not differ from meningococcal infections. Thrombomodulin levels in meningococcal infections were higher than in S. aureus and pneumococcal infections. Overall, the area under the curve for mortality was 0.81 (95% CI, 0.70-0.92) for thrombomodulin and 0.78 (95% CI, 0.69-0.88) for ADAMTS-13. The association of each hemostasis protein did not vary across pathogens for any of the outcome measures. Conclusions: Hemostati

Published
2022

45. Febrile illness in high-risk children: a prospective, international observational study

Author

van der Velden, Fabian J S, de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Kolberg, Laura; https://orcid.org/0000-0002-3311-8254, Carrol, Enitan D, Khanijau, Aakash, Herberg, Jethro A; https://orcid.org/0000-0001-6941-6491, De, Tisham, Galassini, Rachel, Kuijpers, Taco W, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Rivero-Calle, Irene, Vermont, Clementien L, Hagedoorn, Nienke N, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Usuf, Effua, Secka, Fatou, et al, van der Velden, Fabian J S, de Vries, Gabriella, Martin, Alexander, Lim, Emma, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Kolberg, Laura; https://orcid.org/0000-0002-3311-8254, Carrol, Enitan D, Khanijau, Aakash, Herberg, Jethro A; https://orcid.org/0000-0001-6941-6491, De, Tisham, Galassini, Rachel, Kuijpers, Taco W, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Rivero-Calle, Irene, Vermont, Clementien L, Hagedoorn, Nienke N, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria, Elefhteriou, Irini, Yeung, Shunmay, Zavadska, Dace, Fink, Colin, Voice, Marie, Zenz, Werner, Kohlmaier, Benno, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Usuf, Effua, Secka, Fatou, and et al

Abstract

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. Febrile episodes were assigned clinical phenotypes using the validated PERFORM algorithm. Logistic regression was used to assess the effect size of predictive features of proven/presumed bacterial or viral infection. A total of 599 episodes in 482 children were analysed. Seventy-eight episodes (13.0%) were definite bacterial, 67 episodes probable bacterial (11.2%), and 29 bacterial syndrome (4.8%). Fifty-five were definite viral (9.2%), 49 probable viral (8.2%), and 23 viral syndrome (3.8%). One hundred ninety were unknown bacterial or viral infections (31.7%), and 108 had inflammatory or other non-infectious causes of fever (18.1%). Predictive features of proven/presumed bacterial infection were ill appearance (OR 3.1 (95% CI 2.1-4.6)) and HIV (OR 10.4 (95% CI 2.0-54.4)). Ill appearance reduced the odds of having a proven/presumed viral infection (OR 0.5 (95% CI 0.3-0.9)). A total of 82.1% had new empirical antibiotics started on admission (N = 492); 94.3% proven/presumed bacterial (N = 164), 66.1% proven/presumed viral (N = 84), and 93.2% unknown bacterial or viral infections (N = 177). Mortality was 1.9% (N = 11) and 87.1% made full recovery (N = 522). Conclusion: The aetiology of febrile illness in immunocompromised children is diverse. In one-third of cases, no cause for the fever will be identified. Justification for standard

Published
2022

46. Shock Index in the early assessment of febrile children at the emergency

Author

Hagedoorn, Nienke N, Zachariasse, Joany M, Borensztajn, Dorine, Adriaansens, Elise, von Both, Ulrich, Carrol, Enitan D, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro Adam, Kohlmaier, Benno, Lim, Emma, Maconochie, Ian, Martinon-Torres, Federico, Nijman, Ruud Gerard, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zavadska, Dace, Zenz, Werner, Levin, Michael, Vermont, Clementien, Moll, Henriette A, and Consortium, PERFORM

Published
2022

47. Characteristics and management of adolescents attending the ED with fever: a prospective multicentre study

Author

Borensztajn, Dorine, Hagedoorn, Nienke N, Carrol, Enitan, von Both, Ulrich, Dewez, Juan Emmanuel, Emonts, Marieke, van der Flier, Michiel, de Groot, Ronald, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian, Martinon Torres, Federico, Nijman, Ruud, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Vermont, Clementien, Zavadska, Dace, Zenz, Werner, Zachariasse, Joany, Moll, Henriette A, PERFORM Consortium: Personalised Risk assessment in febrile chil, Pediatrics, and National Institute of Health and Medical Research

Subjects
Adolescent, Fever, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], CHILDREN, paediatric infectious disease & immunisation, 1117 Public Health and Health Services, Medicine, General & Internal, ADHERENCE, All institutes and research themes of the Radboud University Medical Center, General & Internal Medicine, EPIDEMIOLOGY, Humans, Prospective Studies, MENINGOCOCCAL DISEASE, PROCALCITONIN, Child, Science & Technology, SEPSIS, Vital Signs, RECOGNITION, Infant, 1103 Clinical Sciences, Paediatrics, General Medicine, Bacterial Infections, EMERGENCY-DEPARTMENT, INVASIVE BACTERIAL-INFECTIONS, PERFORM Consortium: Personalised Risk assessment in febrile children to optimise Real-life Management across the European Union, Child, Preschool, Medicine, Emergency Service, Hospital, paediatric A&E and ambulatory care, Life Sciences & Biomedicine, 1199 Other Medical and Health Sciences
Abstract

ObjectiveMost studies on febrile children have focused on infants and young children with serious bacterial infection (SBI). Although population studies have described an increased risk of sepsis in adolescents, little is known about febrile adolescents attending the emergency department (ED). We aimed to describe patient characteristics and management of febrile adolescents attending the ED.Design and settingThe MOFICHE/PERFORM study (Management and Outcome of Febrile Children in Europe/Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union), a prospective multicentre study, took place at 12 European EDs. Descriptive and multivariable regression analyses were performed, comparing febrile adolescents (12–18 years) with younger children in terms of patient characteristics, markers of disease severity (vital signs, clinical alarming signs), management (diagnostic tests, therapy, admission) and diagnosis (focus, viral/bacterial infection).Results37 420 encounters were included, of which 2577 (6.9%) were adolescents. Adolescents were more often triaged as highly urgent (38.9% vs 34.5%) and described as ill appearing (23.1% vs 15.6%) than younger children. Increased work of breathing and a non-blanching rash were present less often in adolescents, while neurological signs were present more often (1% vs 0%). C reactive protein tests were performed more frequently in adolescents and were more often abnormal (adjusted OR (aOR) 1.7, 95% CI 1.5 to 1.9). Adolescents were more often diagnosed with SBI (OR 1.8, 95% CI 1.6 to 2.0) and sepsis/meningitis (OR 2.3, 95% CI 1.1 to 5.0) and were more frequently admitted (aOR 1.3, 95% CI 1.2 to 1.4) and treated with intravenous antibiotics (aOR 1.7, 95% CI 1.5 to 2.0).ConclusionsAlthough younger children presented to the ED more frequently, adolescents were more often diagnosed with SBI and sepsis/meningitis. Our data emphasise the importance of awareness of severe infections in adolescents.

Published
2022

48. Shock Index in the early assessment of febrile children at the emergency

Author

Hagedoorn, Nienke N. Zachariasse, Joany M. Borensztajn, Dorine and Adriaansens, Elise von Both, Ulrich Carrol, Enitan D. and Eleftheriou, Irini Emonts, Marieke van der Flier, Michiel de Groot, Ronald Herberg, Jethro Adam Kohlmaier, Benno Lim, Emma Maconochie, Ian Martinon-Torres, Federico Nijman, Ruud Gerard Pokorn, Marko Rivero-Calle, Irene Tsolia, Maria and Zavadska, Dace Zenz, Werner Levin, Michael Vermont, Clementien Moll, Henriette A. PERFORM Consortium

Abstract

EU multicentre ED study of presenting vital signs in >5000 febrile children with an association between “shock index” and serious illness, but low sensitivity limits utility in screening. Objective (1) To derive reference values for the Shock Index (heart rate/systolic blood pressure) based on a large emergency department (ED) population of febrile children and (2) to determine the diagnostic value of the Shock Index for serious illness in febrile children. Design/setting Observational study in 11 European EDs (2017-2018). Patients Febrile children with measured blood pressure. Main outcome measures Serious bacterial infection (SBI), invasive bacterial infection (IBI), immediate life-saving interventions (ILSIs) and intensive care unit (ICU) admission. The association between high Shock Index (>95th centile) and each outcome was determined by logistic regression adjusted for age, sex, referral, comorbidity and temperature. Additionally, we calculated sensitivity, specificity and negative/positive likelihood ratios (LRs). Results Of 5622 children, 461 (8.2%) had SBI, 46 (0.8%) had IBI, 203 (3.6%) were treated with ILSI and 69 (1.2%) were ICU admitted. High Shock Index was associated with SBI (adjusted OR (aOR) 1.6 (95% CI 1.3 to 1.9)), ILSI (aOR 2.5 (95% CI 2.0 to 2.9)), ICU admission (aOR 2.2 (95% CI 1.4 to 2.9)) but not with IBI (aOR: 1.5 (95% CI 0.6 to 2.4)). For the different outcomes, sensitivity for high Shock Index ranged from 0.10 to 0.15, specificity ranged from 0.95 to 0.95, negative LRs ranged from 0.90 to 0.95 and positive LRs ranged from 1.8 to 2.8. Conclusions High Shock Index is associated with serious illness in febrile children. However, its rule-out value is insufficient which suggests that the Shock Index is not valuable as a screening tool for all febrile children at the ED.

Published
2022

49. Children with Fever and Petechial Rash Presenting to the Paediatric Emergency Department (ED): A European Multicentre Observational Study

Author

Kohlmaier, Benno, primary, Leitner, Manuel, additional, Hagedoorn, Nienke N., additional, Borensztajn, Dorine, additional, von Both, Ulrich, additional, Carrol, Enitan, additional, Emonts, Marieke, additional, van der Flier, Michiel, additional, De Groot, Ronald, additional, Herberg, Jethro A., additional, Levin, Michael, additional, Lim, Emma, additional, Maconochie, Ian K., additional, Martinon-Torres, Federico, additional, Nijman, Ruud, additional, Pokorn, Marko, additional, Calle, Irene Rivero, additional, Tan, Chantal D., additional, Tsolia, Maria, additional, Vermont, Clementien, additional, Zachariasse, Joany M., additional, Zavadska, Dace, additional, Moll, Henriette, additional, and Zenz, Werner, additional

Published
2022
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