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3. Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Author

Channon-Wells, Samuel, Vito, Ortensia, McArdle, Andrew J, Seaby, Eleanor G, Patel, Harsita, Shah, Priyen, Pazukhina, Ekaterina, Wilson, Clare, Broderick, Claire, D'Souza, Giselle, Keren, Ilana, Nijman, Ruud G, Tremoulet, Adriana, Munblit, Daniel, Ulloa-Gutierrez, Rolando, Carter, Michael J, Ramnarayan, Padmanabhan, De, Tisham, Hoggart, Clive, Whittaker, Elizabeth, Herberg, Jethro A, Kaforou, Myrsini, Cunnington, Aubrey J, Blyuss, Oleg, Levin, Michael, consortium, Best Available Treatment Study, Chouli, Mohamed, Hamadouche, Nacera, Ladj, Mohamed Samir, Vázquez, Jorge Agrimbau, Carmona, Rodrigo, Collia, Adrian Gustavo, Ellis, Alejandro, Natta, Diego, Pérez, Laura, Rubiños, Mayra, Veliz, Natalia, Yori, Silvana, Britton, Philip N, Burgner, David P, Carey, Emma, Crawford, Nigel W, Giuliano, Hayley, McMinn, Alissa, Wong, Shirley, Wood, Nicholas, Holter, Wolfgang, Krainz, Matthias, Ulreich, Raphael, Zurl, Christoph, Dehoorne, Joke, Haerynck, Filomeen, Hoste, Levi, Schelstraete, Petra, Vandekerckhove, Kristof, Willems, Jef, Farias, Camila Giuliana Almeida, Almeida, Flávia Jacqueline, Leal, Izabel Alves, da Silva, André Ricardo Araujo, Araujo e Silva, Anna Esther, Barreiro, Sabrina TA, da Silva, Daniella Gregória Bomfim Prado, Cervi, Maria Celia, dos Santos Naja Cardoso, Mirian Viviane, Teixeira, Cristiane Henriques, Jarovsky, Daniel, Araujo, Julienne Martins, Berezin, Eitan Naaman, Sáfadi, Marco Aurélio Palazzi, la Ossa, Rolando Andres Paternina-de, Vieira, Cristina Souza, Dimitrova, Anna, Ganeva, Margarita, Stefanov, Stefan, Telcharova-Mihaylovska, Albena, Biggs, Catherine M, Lopez, Alison, Scuccimarri, Rosie, Tan, Ryan, Wasserman, Sam, Withington, Davinia, Ampuero, Camila, Aravena, Javiera, B, Raul Bustos, Casanova, Daniel, Cruces, Pablo, Diaz, Franco, García-Salum, Tamara, Godoy, Loreto, Medina, Rafael A, Galaz, Gonzalo Valenzuela, Camacho-Moreno, Germán, Avila-Aguero, María L, Brenes-Chacón, Helena, Camacho-Badilla, Kattia, Ivankovich-Escoto, Gabriela, Naranjo-Zuniga, Gabriela, and Soriano-Fallas, Alejandra

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Comparative Effectiveness Research, Clinical Research, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Best Available Treatment Study (BATS) consortium, Clinical sciences
Abstract

BackgroundMultisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments.MethodsThe Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370.FindingsWe enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2-11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75-1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58-1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91-1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70-1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11-0·20]; p

Published
2023

5. Favorable course of leptospirosis and hantavirus-induced acute tubulointerstitial nephritis under corticosteroid treatment

Author

Matthys, Annelies, Dehoorne, Jo, Dendooven, Amélie, Schelstraete, Petra, and Prytula, Agnieszka

Subjects
Hantavirus infections -- Complications and side effects, Corticosteroids -- Dosage and administration -- Testing, Nephritis -- Causes of -- Demographic aspects -- Drug therapy, Leptospirosis -- Complications and side effects, Health
Abstract

Background We present two children with acute tubulointerstitial nephritis (ATIN) caused by leptospirosis in a 12-year-old boy and hantavirus in a 10-year-old girl. The role of glucocorticoids in the management of ATIN triggered by infectious agents is unclear. Case-diagnosis/treatment Both children were hospitalized with jaundice, elevated serum creatinine, and thrombocytopenia. There was no oliguria or hypertension. Urine analysis revealed tubular proteinuria. Kidney biopsy was performed on one patient and showed tubulointerstitial inflammation with mild mesangial proliferation. Both patients were treated with glucocorticoids in view of deteriorating kidney function with respective serum creatinine values of 5.2 and 4.1 mg/dl. Both children exhibited an excellent clinical and biochemical response to treatment. Neither of the patients required dialysis. Positive serology test results indicated a recent leptospirosis and hantavirus infection. Conclusions Leptospirosis and hantavirus associated ATIN share common clinical and biochemical features. Due to the low incidence in Europe these infectious causes of kidney dysfunction may be overlooked. Glucocorticoids may be considered in the management of ATIN., Author(s): Annelies Matthys [sup.1] [sup.2] , Jo Dehoorne [sup.1] [sup.2] , Amélie Dendooven [sup.3] , Petra Schelstraete [sup.2] [sup.4] , Agnieszka Prytula [sup.1] [sup.2] Author Affiliations: (1) https://ror.org/00xmkp704, grid.410566.0, 0000 [...]

Published
2023
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6. SARS-CoV-2 Infection in Children Less Than Forty Days Hospitalized in Belgium Between 2020 and 2022

Author

Demey, Milena, Bruyneel, Arnaud, Chatzis, Olga, Christiaens, Christelle, Cossey, Veerle, De Crombrugghe, Gabrielle, De Lille, Lieve, Goetghebuer, Tessa, Gueulette, Emmanuelle, Hainaut, Marc, Heijmans, Catherine, Hubinont, Hortense, Lé, Phu-Quoc, Lecomte, Laurie, Mattijs, Inge, Mignon, Céline, Mondovits, Bénédicte, Rodesch, Marine, Rooze, Shancy, Schelstraete, Petra, Stroobant, Diane, Thielemans, Laurence, Thomas, Ingrid, Valbona, Selimaj K., Van Damme, Emmi, Van der Linden, Dimitri, Van Praet, Jens, Vermeulen, Françoise, Weynants, David, and Tilmanne, Anne

Published
2024
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7. The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C

Author

Caorsi, Roberta, Consolaro, Alessandro, Speziani, Camilla, Sozeri, Betul, Ulu, Kadir, Faugier-Fuentes, Enrique, Menchaca-Aguayo, Hector, Ozen, Seza, Sener, Seher, Akhter Rahman, Shahana, Imnul Islam, Mohammad, Haerynck, Filomeen, Simonini, Gabriele, Mastri, Mariel Viviana, Avcin, Tadej, Sršen, Saša, de Albuquerque Pedrosa Fernandes, Taciana, Stanevicha, Valda, Vojinovic, Jelena, Sobh, Ali, Fingerhutova, Sarka, Minxova, Lenka, Gagro, Alenka, Rodrigues Fonseca, Adriana, Pandya, Devang, Varbanova, Boriana, Sánchez-Manubens, Judith, Ganeva, Margarita, Montin, Davide, Boyarchuk, Oksana, Minghini, Andrea, Bracaglia, Claudia, Brogan, Paul, Candotti, Fabio, Cattalini, Marco, Meyts, Isabelle, Minoia, Francesca, Taddio, Andrea, Wouters, Carine, De Benedetti, Fabrizio, Bovis, Francesca, Ravelli, Angelo, Ruperto, Nicolino, Gattorno, Marco, Bilginer, Yelda, Laila, Kamrul, Islam, Mohammed Mahbubul, Meertens, Bram, Hoste, Levi, Dehoorne, Joke, Schelstraete, Petra, Vandekerckhove, Kristof, Willems, Jef, Matthijs, Inge, Filocamo e Gisella Beatrice Beretta, Giovanni, Magalhaes, Claudia Saad, Chubata, Oksana, Ricci, Francesca, Vukovic, Antonija, Temelkova, Katya, Avramovic, Mojca Zajc, Emersic, Nina, Bizjak, Masa, Vesel, Tina, Rodrigues, Marta Felix, Gasparello de Almeida, Rozana, Lukjanovica, Kristine, Elnagdy, Marwa H., Soliman, Ahmed, Terifajova, Eva, Brejchova, Ivana, Magner, Martin, Myrup, Charlotte, Vougiouka, Olga, Jelusic, Marija, La Torre, Francesco, Rigante, Donato, Maggio, Maria Cristina, Verdoni, Lucio, Rubio-Perez, Nadina, Cornejo, Gabriel Vega, Villarreal Trevino, Ana Victoria, Brito, Iva, Oliveira-Ramos, Filipa, Alexeeva, Ekaterina, Chasnyk, Vyacheslav, Arkachaisri, Thaschawee, Boyko, Yaryna, Vyzhga, Yulia, and Samsonenko, Svitlana

Published
2024
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8. Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Author

Chouli, Mohamed, Hamadouche, Nacera, Ladj, Mohamed Samir, Agrimbau Vázquez, Jorge, Carmona, Rodrigo, Collia, Adrian Gustavo, Ellis, Alejandro, Natta, Diego, Pérez, Laura, Rubiños, Mayra, Veliz, Natalia, Yori, Silvana, Britton, Philip N., Burgner, David P., Carey, Emma, Crawford, Nigel W., Giuliano, Hayley, McMinn, Alissa, Wong, Shirley, Wood, Nicholas, Holter, Wolfgang, Krainz, Matthias, Ulreich, Raphael, Zurl, Christoph, Dehoorne, Joke, Haerynck, Filomeen, Hoste, Levi, Schelstraete, Petra, Vandekerckhove, Kristof, Willems, Jef, Almeida Farias, Camila Giuliana, Almeida, Flávia Jacqueline, Alves Leal, Izabel, Araujo da Silva, André Ricardo, Araujo e Silva, Anna Esther, Barreiro, Sabrina T.A., Bomfim Prado da Silva, Daniella Gregória, Cervi, Maria Celia, dos Santos Naja Cardoso, Mirian Viviane, Henriques Teixeira, Cristiane, Jarovsky, Daniel, Martins Araujo, Julienne, Naaman Berezin, Eitan, Palazzi Sáfadi, Marco Aurélio, Paternina-de la Ossa, Rolando Andres, Souza Vieira, Cristina, Dimitrova, Anna, Ganeva, Margarita, Stefanov, Stefan, Telcharova-Mihaylovska, Albena, Biggs, Catherine M., Lopez, Alison, Scuccimarri, Rosie, Tan, Ryan, Wasserman, Sam, Withington, Davinia, Ampuero, Camila, Aravena, Javiera, Bustos B, Raul, Casanova, Daniel, Cruces, Pablo, Diaz, Franco, García-Salum, Tamara, Godoy, Loreto, Medina, Rafael A., Valenzuela Galaz, Gonzalo, Camacho-Moreno, Germán, Avila-Aguero, María L., Brenes-Chacón, Helena, Camacho-Badilla, Kattia, Ivankovich-Escoto, Gabriela, Naranjo-Zuniga, Gabriela, Soriano-Fallas, Alejandra, Ulloa-Gutierrez, Rolando, Yock-Corrales, Adriana, Amer, Maysa Abbas, Abdelmeguid, Yasmine, Ahmed, Yomna H.H.Z., Badib, Adham, Badreldin, Karim, Elkhashab, Yara, Heshmat, Hassan, Hussein, Amna, Mohamed Hussein, Amna Hussein, Ibrahim, Sandra, Shoman, Walaa, Yakout, Radwa M, Heinonen, Santtu, Angoulvant, François, Belot, Alexandre, Ouldali, Naïm, Beske, Florian, Heep, Axel, Masjosthusmann, Katja, Reiter, Karl, van den Heuvel, Ingeborg, von Both, Ulrich, Agrafiotou, Aikaterini, Antachopoulos, Charalampos, Charisi, Konstantina, Eleftheriou, Irini, Farmaki, Evangelia, Fotis, Lampros, Kafetzis, Dimitrios, Koletsi, Patra, Kourtesi, Katerina, Lampidi, Stavroula, Liakopoulou, Theodota, Maritsi, Despoina, Michailidou, Elisa, Milioudi, Maria, Mparmpounaki, Ioanna, Papadimitriou, Eleni, Papaevangelou, Vassiliki, Roilides, Emmanuel, Tsiatsiou, Olga, Tsolas, Georgios, Tsolia, Maria, Vantsi, Petrina, Banegas Pineda, Linda Yajeira, Borjas Aguilar, Karla Leversia, Cantillano Quintero, Edwin Mauricio, Ip, Patrick, Kwan, Mike Yat Wah, Kwok, Janette, Lau, Yu Lung, To, Kelvin, Wong, Joshua Sung Chih, David, Mate, Farkas, David, Kalcakosz, Szofia, Szekeres, Klaudia, Zsigmond, Borbala, Aslam, Nadeem, Luder, Anthony, Andreozzi, Laura, Bianco, Francesco, Bucciarelli, Valentina, Buonsenso, Danilo, Cimaz, Rolando, De Luca, Maia, Dellepiane, Rosa Maria, Fabi, Marianna, Filice, Emanuele, Lanari, Marcello, Lo Vecchio, Andrea, Mastrolia, Maria Vincenza, Mauro, Angela, Mazza, Angelo, Papa, Mario Virgilio, Romani, Lorenza, Scarano, Sara Maria, Simonini, Gabriele, Tipo, Vincenzo, Verdoni, Lucio, Macharia, Anne-Marie, Musiime, Grace, Reel, Bhupi, Wangai, Frederick, Pace, David, Torpiano, Paul, Anaya-Enriquez, Nancy, Carreon-Guerrero, Juan Manuel, Chacon-Cruz, Enrique, Cheung López, Mariana, Faugier Fuentes, Enrique, Fonseca Flores, Marisol, García-Domínguez, Miguel, Giron Vargas, Ana Luisa, Lopez-Delgado, Ivan, Lopez Hernández, Liliana, Menchaca Aguayo, Hector F., Montaño-Duron, Jesus Gilberto, Pérez-Gaxiola, Giordano, Ramos Tiñini, Pamela, Tostado-Morales, Edgardo, Valadez, Julio, Inchley, Christopher, Klevberg, Sjur, Knudsen, Per Kristian, Måseide, Per Helge, Carrera, Jose Manuel, Castaño, Elizabeth, Daza Timana, Carlos Alberto, De Leon, Tirza, Estripeaut, Dora, Levy, Jacqueline, Norero, Ximena, Record, Javier, Rojas-Bonilla, Magda, Wong, Mayra, Iramain, Ricardo, Hernandez, Roger, Huamán, Gian, Munaico, Manuel, Peralta, Carlos, Seminario, Diego, Zapata Yarlequé, Elmer Hans, Gadzinska, Justyna, Ludwikowska, Kamila, Mandziuk, Joanna, Okarska-Napierała, Magdalena, Alacheva, Zalina A., Alexeeva, Ekaterina, Ananin, Petr V., Antsupova, Margarita, Bakradze, Maya D., Berbenyuk, Anna, Bobkova, Polina, Borzakova, Svetlana, Chashchina, Irina L., El-Taravi, Yasmin, Fisenko, Andrey P., Gautier, Marina S., Glazyrina, Anastasia, Gorlenko, Cyrill, Grosheva, Mariia, Kiselev, Herman, Kondrikova, Elena, Korobyants, Evgeniya, Korsunskiy, Anatoliy A., Kovygina, Karina, Krasnaya, Ekaterina, Kurbanova, Seda, Kurdup, Maria K., Mamutova, Anna V., Mazankova, Lyudmila, Mitushin, Ilya L., Munblit, Daniel, Nargizyan, Anzhelika, Orlova, Yanina O., Osmanov, Ismail M., Polyakova, Anastasia S., Pushkareva, Anna, Romanova, Olga, Samitova, Elmira, Shvedova, Anastasia, Sologub, Anna, Iakovleva, Ekaterina, Tepaev, Rustem F., Tkacheva, Anna A., Yegiyan, Margarita, Yusupova, Valeriya, Zholobova, Elena, Grasa, Carlos Daniel, Epalza, Cristina, Lopez Segura, Nuria, Martinon-Torres, Federico, Melendo, Susana, Mendez-Echevarria, Ana, Mesa Guzmán, Juan Miguel, Palacios Argueta, Jorge Roberto, Rivero-Calle, Irene, Rivière, Jacques, Rodríguez-González, Moisés, Rojo, Pablo, Sanchez Manubens, Judith, Soler-Palacin, Pere, Soriano-Arandes, Antoni, Tagarro, Alfredo, Villaverde, Serena, Altman, Maria, Brodin, Petter, Horne, AnnaCarin, Palmblad, Karin, Brotschi, Barbara, Meyer Sauteur, Patrick, Pachlopnik Schmid, Jana, Prader, Seraina, Relly, Christa, Schlapbach, Luregn J., Seiler, Michelle, Strasser, Sophie, Trück, Johannes, Weber, Kathrin, Wütz, Daniela, Hamdan, Alaa, Melhem, Ibrahim, Moussa, Ahmed, Dunk, Joke, Ketharanathan, Naomi, Vermont, Clementien, Akyüz Özkan, Esra, Cetin, Benhur Sirvan, Erdeniz, Emine Hafize, Şahin, Irfan Oğuz, Borisova, Galina, Boyarchuk, Oksana, Boychenko, Lidiya, Boyko, Yaryna, Diudenko, Nadiia, Dyvonyak, Olha, Kasiyan, Olexandr, Katerynych, Kostiantyn, Kostyuchenko, Larysa, Mamenko, Marina, Melnyk, Kateryna, Miagka, Nelia, Nazarenko, Liliya, Nezgoda, Iryna, Rykova, Stanislava, Svyst, Olga, Teslenko, Maria, Trykosh, Mykola, Vasilenko, Nataliya, Volokha, Alla, Adams, Charlotte, Akomolafe, Toju, Al-Abadi, Eslam, Alders, Nele, Alifieraki, Styliani, Ansumanu, Hareef, Aston, Emily, Avram, Paula, Bamford, Alasdair, Banks, Millie, Basu Roy, Robin, Beattie, Thomas, Boleti, Olga, Bracken, Abbey, Broad, Jonathan, Cai, James, Carrol, Enitan D., Carter, Michael, Chandran, Anchit, Charlesworth, James, Chawla, Jaya, Cooper, Hannah, Cooray, Samantha, Davies, Patrick, Davis, Francesca, Drysdale, Simon B., Dzora, Ella, Emonts, Marieke, Evans, Ceri, Fidler, Katy, Foster, Caroline, Gong, Chen, Gongrun, Berin, Gonzalez, Carmen, Gorgun, Berin, Grandjean, Louis, Grant, Karlie, Guo, Jonathan, Hacohen, Yael, Hall, Jack, Hamid, Hytham K.S., Hassell, Jane, Hesketh, Christine, Hewlett, Jessica, Hnieno, Ahmad, Holt-Davis, Hannah, Hossain, Aleena, Hu, Shiying, Hudson, Lee D., Jheeta, Sharon, Johnson, Mae, Johnson, Sarah, Jyothish, Deepthi, Kampmann, Beate, Kavirayani, Akhila, Kelly, Deborah, Kirubakaran, Arangan, Kucera, Filip, Langer, Daniel, Lawson, George, Lees, Emily A, Lenihan, Rebecca, Lillie, Jon, Longbottom, Katherine, Lyall, Hermione, Mackdermott, Niamh, Maltby, Sarah, Mclelland, Thomas, McMahon, Anne-Marie, Miller, Danielle, Miranda, Mariana, Mirza, Luwaiza, Morrison, Zoe, Moshal, Karyn, Muller, Jennifer, Musuka, Phoebe, Myttaraki, Evangelia, Nadel, Simon, Nair, Sreedevi, Nuttall, Luke, Oremakinde, Oyinkansola, Osaghae, Daniella, Osman, Fatima, Ostrzewska, Anna, Paccagnella, Davide, Panthula, Mrinalini, Papachatzi, Eleni, Papadopoulou, Charalampia, Patel, Fahim, Patel, Harsita, Payne, Helen, Penner, Justin, Polandi, Shervin, Prendergast, Andrew J., Ramnarayan, Padmanabhan, Ranasinghe, Lasith, Ravichandran, Muthukumaran, Rhys-Evans, Sophie, Riordan, Andrew, Rodrigues, Charlene M.C., Roe, Lauren, Romaine, Sam, Schobi, Nina, Seddon, James, Shingadia, Delane, Sikdar, Oishi, Srivastava, Anand, Struik, Siske, Sun, Thomas, Tan, Rachel Wei, Taylor, Alice, Taylor, Amanda, Taylor, Andrew, Tran, Steven, Tsagkaris, Stavros, Tudor-Williams, Gareth, van den Berg, Sarah, van der Velden, Fabian, Ventilacion, Lyn, Wellman, Paul A., Withers Green, Joseph, Yanney, Michael P., Yeung, Shunmay, Badheka, Aditya, Badran, Sarah, Bailey, Dwight M., Burch, Anna Kathryn, Burns, Jane C., Cichon, Catherine, Cirks, Blake, Dallman, Michael D., Delany, Dennis R., Fairchok, Mary, Friedman, Samantha, Geracht, Jennifer, Langs-Barlow, Allison, Mann, Kelly, Padhye, Amruta, Quade, Alexis, Ramirez, Kacy Alyne, Rockett, John, Sayed, Imran Ali, Santos, Roberto P., Shahin, Amr A., Tremoulet, Adriana, Umaru, Samuel, Widener, Rebecca, Mujuru, Hilda Angela, Kandawasvika, Gwendoline, Channon-Wells, Samuel, Vito, Ortensia, McArdle, Andrew J, Seaby, Eleanor G, Shah, Priyen, Pazukhina, Ekaterina, Wilson, Clare, Broderick, Claire, D'Souza, Giselle, Keren, Ilana, Nijman, Ruud G, Carter, Michael J, De, Tisham, Hoggart, Clive, Whittaker, Elizabeth, Herberg, Jethro A, Kaforou, Myrsini, Cunnington, Aubrey J, Blyuss, Oleg, and Levin, Michael

Published
2023
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10. A multicentric, randomized, controlled clinical trial to study the impact of bedside model-informed precision dosing of vancomycin in critically ill children—BENEFICIAL trial.

Author

De Cock, Pieter A., Colman, Roos, Amza, Anca, De Paepe, Peter, De Pla, Hans, Vanlanduyt, Lieselot, Van der Linden, Dimitri, Schelstraete, Petra, Cools, Filip, Clarysse, Alexander, Debouver, Phebe, Biarent, Dominique, Vens, Daphne Vania, Smits, Anne, Godart, Valerie, Vanhaesebrouck, Sophie, Dhont, Evelyn, Bordon, Victoria, Mauel, Reiner, and Van Der Werff Ten Bosch, Jutte

Subjects
CRITICALLY ill children, DRUG monitoring, PEDIATRIC intensive care, NEONATAL intensive care, ACUTE kidney failure
Abstract

Background : Vancomycin is a commonly prescribed antibiotic to treat serious Gram-positive infections in children. The efficacy of vancomycin is known to be directly related to the pharmacokinetic/pharmacodynamic (PK/PD) index of the area under the concentration–time curve (AUC) divided by the minimal inhibitory concentration (MIC) of the pathogen. In most countries, steady-state plasma concentrations are used as a surrogate parameter for this target AUC/MIC, but this practice has some drawbacks. Hence, AUC-based dosing using model-informed precision dosing (MIPD) tools has been proposed for increasing the target attainment rate and reducing vancomycin-related nephrotoxicity. Solid scientific evidence for these claimed benefits is lacking in children. This randomized controlled trial aims to investigate the large-scale utility of MIPD dosing of vancomycin in critically ill children. Methods: Participants from 14 neonatal intensive care, pediatric intensive care, and pediatric hemo-oncology ward units from 7 hospitals are randomly allocated to the intervention or standard-of-care comparator group. In the intervention group, a MIPD dosing calculator is used for AUC-based dosing, in combination with extra sampling for therapeutic drug monitoring in the first hours of treatment, as compared to standard-of-care. An AUC24h between 400 and 600 is targeted, assuming an MIC of 1 mg/L. Patients in the comparator group receive standard-of-care dosing and monitoring according to institutional guidelines. The primary endpoint is the proportion of patients reaching the target AUC24h/MIC of 400–600 between 24 and 48 h after the start of vancomycin treatment. Secondary endpoints are the proportion of patients with (worsening) acute kidney injury during vancomycin treatment, the proportion of patients reaching target AUC24h/MIC of 400–600 between 48 and 72 h after the start of vancomycin treatment, time to clinical cure, ward unit length-of-stay, hospital length-of-stay, and 30-day all-cause mortality. Discussion: This trial will clarify the propagated benefits and provide new insights into how to optimally monitor vancomycin treatment in critically ill children. Trial registration: Eudract number: 2019–004538-40. Registered on 2020–09-08 ClinicalTrials.gov NCT046666948. Registered on 2020–11-28 [ABSTRACT FROM AUTHOR]

Published
2024
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14. Spleen function is reduced in individuals with NR5A1 variants with or without DSD: a cross-sectional study

Author

Cools, Martine, primary, Grijp, Celien, additional, Neirinck, Jana, additional, Tavernier, Simon J, additional, Schelstraete, Petra, additional, Van De Velde, Julie, additional, Morbée, Lieve, additional, De Baere, Elfride, additional, Bonroy, Carolien, additional, van Bever, Yolande, additional, Bruggenwirth, Hennie, additional, Vermont, Clementien, additional, Hannema, Sabine E, additional, De Rijke, Yolanda, additional, Abdulhadi-Atwan, Maha, additional, Zangen, David, additional, Verdin, Hannah, additional, and Haerynck, Filomeen, additional

Published
2023
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16. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, PEtra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, and Sharland, Mike

Published
2019
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17. Expansion of MALDI-TOF MS database as a strategy for identification of Haemophilusspecies other than H. influenzae

Author

Willems, Eva, Hamerlinck, Hannelore, Messiaen, Anne-Sophie, Schelstraete, Petra, Van Braeckel, Eva, Vande Weygaerde, Yannick, Verhasselt, Bruno, Boelens, Jerina, and Vandendriessche, Stien

Abstract

ABSTRACTObjectivesThis study aimed to evaluate an expanded matrix-assisted laser desorption-ionization-time of flight mass spectrometry (MALDI-TOF MS) database for the identification of Haemophilusspecies other than H. influenzae(Hi).MethodsA total of 144 Haemophilusspecies, cultured from respiratory samples from people (living) with cystic fibrosis, were identified with MALDI-TOF MS and 16S rRNA sequencing. Of these, 99 Haemophilusstrains showed >99% similarity with the best matching strain in the National Center for Biotechnology Information (NCBI) database and were assigned to a single Haemophilussubspecies using both MALDI-TOF MS and 16S rRNA sequencing. The MS profiles of a subset of strains (n = 58/99) were added to the Bruker MALDI-TOF MS database. Subsequently, 270 different strains that were analyzed previously in a routine setting were re-analyzed.Results16S rRNA sequencing reliably identified 99/144 Haemophilusstrains (>99% similarity). H. haemolyticus16S rRNA identification was suboptimal since only 3/21 H. haemolyticusstrains attained a similarity of >99% with H. haemolyticus16S rRNA sequence in the NCBI database. Expansion of the MALDI-TOF MS database improved the number of reliable identifications only moderately for H. haemolyticus, H. influenzaeand H. paraphrohaemolyticus(<10%). By contrast, improved identification was more outspoken for H.parahaemolyticus, H. parainfluenzae, H. sputorumand H. pittmaniae(>85%).Conclusion16S rRNA sequencing is a valuable method for the identification of Haemophilussp. other than Hi. Expansion of the MALDI-TOF MS database, based on 16S rRNA sequencing results, increased the proportion of reliable identifications and in this study resulted in an increase of 10% of Haemophilussp. other than Hi strain identifications.

Published
2024
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19. Comparison of SARS-CoV-2 seroconversion in children with chronic diseases with healthy children and adults during the first waves of the COVID-19 pandemic

Author

Hoste, Levi, primary, Prytula, Agnieszka, additional, Dehoorne, Jo, additional, De Bruyne, Ruth, additional, Van Biervliet, Stephanie, additional, De Waele, Kathleen, additional, Maes, Evelyn, additional, Bordon, Victoria, additional, Vanlander, Arnaud, additional, Claes, Karlien, additional, Vande Walle, Johan, additional, Schelstraete, Petra, additional, Van daele, Sabine, additional, and Haerynck, Filomeen, additional

Published
2023
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20. Spleen function is reduced in individuals with NR5A1 variants with or without a difference of sex development: a cross-sectional study.

Author

Cools, Martine, Grijp, Celien, Neirinck, Jana, Tavernier, Simon J, Schelstraete, Petra, Velde, Julie Van De, Morbée, Lieve, Baere, Elfride De, Bonroy, Carolien, Bever, Yolande van, Bruggenwirth, Hennie, Vermont, Clementien, Hannema, Sabine E, Rijke, Yolanda De, Abdulhadi-Atwan, Maha, Zangen, David, Verdin, Hannah, and Haerynck, Filomeen

Subjects
ENDOCRINOLOGY, SEX differentiation disorders, SPLEEN, GONADAL diseases, ASPLENIA, HYPERSPLENISM
Abstract

Objective NR5A1 is a key regulator of sex differentiation and has been implicated in spleen development through transcription activation of TLX1. Concerns exist about hypo- or asplenism in individuals who have a difference of sex development (DSD) due to an NR5A1 disease-causing variant. We aimed to assess spleen anatomy and function in a clinical cohort of such individuals and in their asymptomatic family member carriers. Design Cross-sectional assessment in 22 patients with a DSD or primary ovarian insufficiency and 5 asymptomatic carriers from 18 families, harboring 14 different NR5A1 variants. Methods Spleen anatomy was assessed by ultrasound, spleen function by peripheral blood cell count, white blood cell differentiation, percentage of nonswitched memory B cells, specific pneumococcal antibody response, % pitted red blood cells, and Howell–Jolly bodies. Results Patients and asymptomatic heterozygous individuals had significantly decreased nonswitched memory B cells compared to healthy controls, but higher than asplenic patients. Thrombocytosis and spleen hypoplasia were present in 50% of heterozygous individuals. Four out of 5 individuals homozygous for the previously described p.(Arg103Gln) variant had asplenia. Conclusions Individuals harboring a heterozygous NR5A1 variant that may cause DSD have a considerable risk for functional hyposplenism, irrespective of their gonadal phenotype. Splenic function should be assessed in these individuals, and if affected or unknown, prophylaxis is recommended to prevent invasive encapsulated bacterial infections. The splenic phenotype associated with NR5A1 variants is more severe in homozygous individuals and is, at least for the p.(Arg103Gln) variant, associated with asplenism. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Whole blood tcr vβ21.3 staining as a diagnostic test for multisystem inflammatory syndrome in children : a proof-of-concept study

Author

Hoste, Levi, Willems, Jef, Dhont, Evelyn, Schelstraete, Petra, Dehoorne, Jo, Vandekerckhove, Kristof, Belot, Alexandre, Bader-Meunier, Brigitte, Malcus, Christophe, Tavernier, Simon, and Haerynck, Filomeen

Subjects
Medicine and Health Sciences
Abstract

Background and Aims Multisystem inflammatory syndrome in children (MIS-C) is a rare inflammatory condition, occurring 1-2 months after SARS-CoV-2 infection in children. The clinical features of MIS-C are nonspecific. Since early treatment is of prognostic value, clinicians are faced with the challenge to recognize patients timely. However, lacking a specific test, diagnosing MIS-C remains largely based on clinical expertise. Enrichment of Vβ21.3+ T-cell receptors is a frequent finding in MIS-C. We aimed to assess the value of whole blood (WB) Vβ21.3 staining as a diagnostic test for MIS-C. Methods EDTA blood was obtained in healthy controls (HCs) and patients fulfilling the WHO MIS-C case definition (before immunomodulatory treatment). WB was stained, lysed and fixed within 2h of sampling. By flow cytometry, the relative frequency of Vβ21.3+ T-cells (CD3/CD4/CD8) was assessed as well as activation markers (HLA-DR). Results Four patients and five HCs were included. The Vβ21.3+ T-cell proportions were increased in one case (3.6-5.6% of T-cells), a 12yo girl presenting typical MIS-C and responding rapidly with first-line treatment. Although all other patients fulfilled the MIS-C case definition at inclusion, their further disease course led to alternative diagnoses, including Streptococcus pyogenes sepsis, haemophagocytic lymphohistiocytosis and metabolic cardiomyopathy. These non-MIS-C patients and HCs showed only 1.0-2.6% Vβ21.3+ T-cells. Additionally, in MIS-C 37.7% of Vβ21.3+ lymphocytes were HLA-DR+, while only 0.1-11% in HCs and non-MIS-C patients. Conclusions We provide proof-of-concept that Vβ21.3 staining can be used as a rapid diagnostic test to distinguish MIS-C from other inflammatory diseases. Its sensitivity and specificity should be assessed in larger prospective studies.

Published
2022

27. TIM3+ TRBV11-2 T cells and IFNγ signature in patrolling monocytes and CD16+ NK cells delineate MIS-C

Author

MIS-C Clinicians, Hoste, Levi, Roels, Lisa, Naesens, Leslie, Bosteels, Victor, Vanhee, Stijn, Dupont, Sam, Bosteels, Cedric, Browaeys, Robin, Vandamme, Niels, Verstaen, Kevin, Roels, Jana, Van Damme, Karel F A, Maes, Bastiaan, De Leeuw, Elisabeth, Declercq, Jozefien, Aegerter, Helena, Seys, Leen, Smole, Ursula, De Prijck, Sofie, Vanheerswynghels, Manon, Claes, Karlien, Debacker, Veronique, Van Isterdael, Gert, Backers, Lynn, Claes, Kathleen B M, Bastard, Paul, Jouanguy, Emmanuelle, Zhang, Shen-Ying, Mets, Gilles, Dehoorne, Joke, Vandekerckhove, Kristof, Schelstraete, Petra, Willems, Jef, Stordeur, Patrick, Janssens, Sophie, Beyaert, Rudi, Saeys, Yvan, Casanova, Jean-Laurent, Lambrecht, Bart N, Haerynck, Filomeen, Tavernier, Simon J, Daelemans, Siel, Pulmonary Medicine, Clinical sciences, Growth and Development, and Pediatrics

Subjects
Male, T-Lymphocytes, CHILDREN, LIPOPOLYSACCHARIDE, infectious diseases, Lymphocyte Activation, HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS, DISEASE, pediatric SARS-CoV-2 infection, Monocytes, Cohort Studies, IFNγ signature, TIM3+ TRBV11-2 T cells, Medicine and Health Sciences, Immunology and Allergy, immunodysregulation syndrome, Child, Complement Activation, Hepatitis A Virus Cellular Receptor 2, Interleukin-15, B-Lymphocytes, Superantigens, Patrolling, hemic and immune systems, Systemic Inflammatory Response Syndrome, Cell biology, Killer Cells, Natural, Interferon Type I, SHOCK, Cytokines, Female, Adolescent, MULTISYSTEM INFLAMMATORY SYNDROME, Immunology, Receptors, Antigen, T-Cell, CD16+ NK cells, MIS-C, SARS-COV-2, CD16, Biology, Article, Infectious Disease and Host Defense, Interferon-gamma, Humans, Pediatrics, Perinatology, and Child Health, Cell Proliferation, Inflammation, INTERFERON-GAMMA, SARS-CoV-2, Receptors, IgG, Biology and Life Sciences, COVID-19, Immunity, Humoral, Enterocytes, patrolling monocytes, BARRIER FUNCTION, Alveolar Epithelial Cells, Blood Vessels, Signature (topology)
Abstract

MIS-C is a novel immunodysregulation syndrome in children with a history of SARS-CoV-2 infection. This study employs a multi-omics approach to explore its immunopathogenesis. The authors show that IFNγ-mediated interactions between T cells, monocytes, and NK cells reside at the heart of the disease., In rare instances, pediatric SARS-CoV-2 infection results in a novel immunodysregulation syndrome termed multisystem inflammatory syndrome in children (MIS-C). We compared MIS-C immunopathology with severe COVID-19 in adults. MIS-C does not result in pneumocyte damage but is associated with vascular endotheliitis and gastrointestinal epithelial injury. In MIS-C, the cytokine release syndrome is characterized by IFNγ and not type I interferon. Persistence of patrolling monocytes differentiates MIS-C from severe COVID-19, which is dominated by HLA-DRlo classical monocytes. IFNγ levels correlate with granzyme B production in CD16+ NK cells and TIM3 expression on CD38+/HLA-DR+ T cells. Single-cell TCR profiling reveals a skewed TCRβ repertoire enriched for TRBV11-2 and a superantigenic signature in TIM3+/CD38+/HLA-DR+ T cells. Using NicheNet, we confirm IFNγ as a central cytokine in the communication between TIM3+/CD38+/HLA-DR+ T cells, CD16+ NK cells, and patrolling monocytes. Normalization of IFNγ, loss of TIM3, quiescence of CD16+ NK cells, and contraction of patrolling monocytes upon clinical resolution highlight their potential role in MIS-C immunopathogenesis., Graphical Abstract

Published
2021

28. Mental Health Outcomes Among Parents of Children With a Chronic Disease During the COVID-19 Pandemic: The Role of Parental Burn-Out

Author

Wauters, Aline, primary, Vervoort, Tine, additional, Dhondt, Karlien, additional, Soenens, Bart, additional, Vansteenkiste, Maarten, additional, Morbée, Sofie, additional, Waterschoot, Joachim, additional, Haerynck, Filomeen, additional, Vandekerckhove, Kristof, additional, Verhelst, Helene, additional, Van Aken, Sara, additional, Raes, Ann, additional, Schelstraete, Petra, additional, Walle, Johan Vande, additional, and Van Hoecke, Eline, additional

Published
2021
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35. Administration of ciprofloxacin through a nasogastric tube in pediatric oncology and stem cell transplantation patients.

Author

Bauters, Tiene, Buyle, Franky, Schelstraete, Petra, and Dhooge, Catharina

Subjects
OCCUPATIONAL roles, CIPROFLOXACIN, NASOENTERAL tubes, TIME, PEDIATRICS, PATIENTS, DIET therapy, MEDICAL protocols, NURSES, HEMATOPOIETIC stem cell transplantation, ENTERAL feeding, CANCER patient medical care, TRANSPLANTATION of organs, tissues, etc.
Abstract

Pediatric oncology and hematopoietic stem cell transplantation patients are facing many gastrointestinal side effects of chemotherapy, including nausea, vomiting, mucositis, and diarrhea. International guidelines advise early enteral tube feeding as the first option of nutritional support in children undergoing myeloablative hematopoietic stem cell transplantation. When using enteral feeding tubes for nutritional purposes as well as drug administration, some pharmaceutical, nursing, and technical issues have to be taken into account. Ciprofloxacin is a fluoroquinolone, widely used because of its broad spectrum antimicrobial activity and favorable pharmacokinetic properties. However, its co-administration with polyvalent cations (as present in enteral feeding) makes the absorption of ciprofloxacin more difficult and may alter the pharmacokinetic parameters. Literature data are conflicting on how long the enteral feeding should be discontinued for patients receiving ciprofloxacin via an enteral feeding tube, ranging from 2 h before to 6 h after the administration of ciprofloxacin. Our research question was guided by challenges and concerns of nurses about the delay time between ciprofloxacin administration and restart of the enteral feeding without compromising the nutritional intake of the children. Our guideline was adapted, nurses were instructed accordingly, and patient leaflets with correct information were created. [ABSTRACT FROM AUTHOR]

Published
2023
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36. Plasma C3d levels as a diagnostic marker for complete complement factor I deficiency

Author

Naesens, Leslie, Smet, Julie, Tavernier, Simon S.J., Schelstraete, Petra, Hoste, Levi, Lambrecht, Stijn, Verhelst, Hélène, van der Werff Ten Bosch, Jutte, Ferster, Alina, Blumental, Sophie, Hilbert, Pascale, Kerre, Tessa, Schurmans, Thierry, Licht, Christoph, Roumenina, Lubka L.T., Stordeur, Patrick, Haerynck, Filomeen, Naesens, Leslie, Smet, Julie, Tavernier, Simon S.J., Schelstraete, Petra, Hoste, Levi, Lambrecht, Stijn, Verhelst, Hélène, van der Werff Ten Bosch, Jutte, Ferster, Alina, Blumental, Sophie, Hilbert, Pascale, Kerre, Tessa, Schurmans, Thierry, Licht, Christoph, Roumenina, Lubka L.T., Stordeur, Patrick, and Haerynck, Filomeen

Abstract

SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2020

38. Plasma C3d levels as a diagnostic marker for complete complement factor I deficiency

Author

Naesens, Leslie, primary, Smet, Julie, additional, Tavernier, Simon J., additional, Schelstraete, Petra, additional, Hoste, Levi, additional, Lambrecht, Stijn, additional, Verhelst, Helene, additional, van der Werff ten Bosch, Jutte, additional, Ferster, Alina, additional, Blumental, Sophie, additional, Hilbert, Pascale, additional, Kerre, Tessa, additional, Vande Walle, Johan, additional, Licht, Christoph, additional, Roumenina, Lubka T., additional, Stordeur, Patrick, additional, and Haerynck, Filomeen, additional

Published
2021
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39. Sensitivity and specificity of 14 SARS-CoV-2 serological assays and their diagnostic potential in RT-PCR negative COVID-19 infections

Author

Van Honacker, Eveline, primary, Coorevits, Liselotte, additional, Boelens, Jerina, additional, Verhasselt, Bruno, additional, Van Braeckel, Eva, additional, Bauters, Fré, additional, De Bus, Liesbet, additional, Schelstraete, Petra, additional, Willems, Jef, additional, Vandendriessche, Stien, additional, and Padalko, Elizaveta, additional

Published
2020
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40. Mental Health Outcomes Among Parents of Children With a Chronic Disease During the COVID-19 Pandemic: The Role of Parental Burn-Out.

Author

Wauters, Aline, Vervoort, Tine, Dhondt, Karlien, Soenens, Bart, Vansteenkiste, Maarten, Morbée, Sofie, Waterschoot, Joachim, Haerynck, Filomeen, Vandekerckhove, Kristof, Verhelst, Helene, Aken, Sara Van, Raes, Ann, Schelstraete, Petra, Walle, Johan Vande, Hoecke, Eline Van, Van Aken, Sara, and Van Hoecke, Eline

Subjects
JUVENILE diseases, COVID-19 pandemic, COVID-19, MENTAL health, CHRONIC diseases, CO-sleeping
Abstract

Objective: The COVID-19 pandemic and associated quarantine measures highly impacted parental psychological well-being. Parents of children with chronic diseases might be specifically vulnerable as they already face multiple challenges to provide adequate care for their child. The research questions of the current study were twofold: (a) to examine whether parents of children with a chronic disease experienced more anxiety and depression compared to parents of healthy children and (b) to examine a series of risk factors for worsened well-being (i.e., depression, anxiety, and sleep problems), such as sociodemographic variables, COVID-19-specific variables (i.e., financial worries, living space, and perceived quality of health care), and parental psychological experiences (i.e., parental burn-out and less positive parenting experiences).Methods: Parents of children with a chronic disease (i.e., the clinical sample; N = 599 and 507 for Research Questions 1 and 2, respectively) and parents of healthy children (i.e., the reference sample: N = 417) filled out an online survey.Results: Findings demonstrated that the parents in the clinical sample reported higher levels of anxiety than parents in the reference sample. Analyses within the clinical sample indicated that COVID-19-specific stressors and parental psychological experiences were associated with higher levels of anxiety, depression, and sleep problems. Mediation analyses furthermore indicated that the association of COVID-19-specific stressors with all outcome measures was mediated by parental burn-out.Conclusions: Parents of children with a chronic disease constitute a vulnerable group for worse well-being during the current pandemic. Findings suggest interventions directly targeting parental burn-out are warranted. [ABSTRACT FROM AUTHOR]

Published
2022
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43. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

Author

Götzinger, Florian, primary, Santiago-García, Begoña, additional, Noguera-Julián, Antoni, additional, Lanaspa, Miguel, additional, Lancella, Laura, additional, Calò Carducci, Francesca I, additional, Gabrovska, Natalia, additional, Velizarova, Svetlana, additional, Prunk, Petra, additional, Osterman, Veronika, additional, Krivec, Uros, additional, Lo Vecchio, Andrea, additional, Shingadia, Delane, additional, Soriano-Arandes, Antoni, additional, Melendo, Susana, additional, Lanari, Marcello, additional, Pierantoni, Luca, additional, Wagner, Noémie, additional, L'Huillier, Arnaud G, additional, Heininger, Ulrich, additional, Ritz, Nicole, additional, Bandi, Srini, additional, Krajcar, Nina, additional, Roglić, Srđan, additional, Santos, Mar, additional, Christiaens, Christelle, additional, Creuven, Marine, additional, Buonsenso, Danilo, additional, Welch, Steven B, additional, Bogyi, Matthias, additional, Brinkmann, Folke, additional, Tebruegge, Marc, additional, Pfefferle, Jasmin, additional, Zacharasiewicz, Angela, additional, Berger, Angelika, additional, Berger, Roland, additional, Strenger, Volker, additional, Kohlfürst, Daniela S., additional, Zschocke, Anna, additional, Bernar, Benoît, additional, Simma, Burkhard, additional, Haberlandt, Edda, additional, Thir, Christina, additional, Biebl, Ariane, additional, Vanden Driessche, Koen, additional, Boiy, Tine, additional, Van Brusselen, Daan, additional, Bael, An, additional, Debulpaep, Sara, additional, Schelstraete, Petra, additional, Pavic, Ivan, additional, Nygaard, Ulrikka, additional, Glenthoej, Jonathan P., additional, Heilmann Jensen, Lise, additional, Lind, Ilona, additional, Tistsenko, Mihhail, additional, Uustalu, Ülle, additional, Buchtala, Laura, additional, Thee, Stephanie, additional, Kobbe, Robin, additional, Rau, Cornelius, additional, Schwerk, Nicolaus, additional, Barker, Michael, additional, Tsolia, Maria, additional, Eleftheriou, Irini, additional, Gavin, Patrick, additional, Kozdoba, Oksana, additional, Zsigmond, Borbàla, additional, Valentini, Piero, additional, Ivaškeviciene, Inga, additional, Ivaškevicius, Rimvydas, additional, Vilc, Valentina, additional, Schölvinck, Elisabeth, additional, Rojahn, Astrid, additional, Smyrnaios, Anastasios, additional, Klingenberg, Claus, additional, Carvalho, Isabel, additional, Ribeiro, Andreia, additional, Starshinova, Anna, additional, Solovic, Ivan, additional, Falcón, Lola, additional, Neth, Olaf, additional, Minguell, Laura, additional, Bustillo, Matilde, additional, Gutiérrez-Sánchez, Aida M., additional, Guarch Ibáñez, Borja, additional, Ripoll, Francesc, additional, Soto, Beatriz, additional, Kötz, Karsten, additional, Zimmermann, Petra, additional, Schmid, Hanna, additional, Zucol, Franziska, additional, Niederer, Anita, additional, Buettcher, Michael, additional, Cetin, Benhur S., additional, Bilogortseva, Olga, additional, Chechenyeva, Vera, additional, Demirjian, Alicia, additional, Shackley, Fiona, additional, McFetridge, Lynne, additional, Speirs, Lynne, additional, Doherty, Conor, additional, Jones, Laura, additional, McMaster, Paddy, additional, Murray, Clare, additional, Child, Frances, additional, Beuvink, Yvonne, additional, Makwana, Nick, additional, Whittaker, Elisabeth, additional, Williams, Amanda, additional, Fidler, Katy, additional, Bernatoniene, Jolanta, additional, Song, Rinn, additional, Oliver, Zoe, additional, and Riordan, Andrew, additional

Published
2020
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46. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, Sharland, Mike, Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, Petra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, GARPEC and Global-PPS networks, on behalf of the, GARPEC Network, Global-PPS Network, Children's Hospital, HUS Children and Adolescents, and Clinicum

Subjects
medicine.medical_specialty, Adolescent, medicine.drug_class, 030231 tropical medicine, Antibiotics, MEDLINE, Psychological intervention, CHILDREN, World Health Organization, Pediatrics, Essential medicines, 03 medical and health sciences, Antimicrobial Stewardship, 0302 clinical medicine, Antibiotic resistance, POINT PREVALENCE SURVEY, SURVEILLANCE, Medicine and Health Sciences, Medicine, Antimicrobial stewardship, Humans, 030212 general & internal medicine, Medical prescription, Child, Neonatal sepsis, business.industry, lcsh:Public aspects of medicine, STEWARDSHIP, Infant, Newborn, Infant, lcsh:RA1-1270, General Medicine, medicine.disease, 3142 Public health care science, environmental and occupational health, Drug Utilization, 3. Good health, Anti-Bacterial Agents, QUALITY INDICATORS, Family medicine, Child, Preschool, Health Care Surveys, Human medicine, business, Pharmacy Service, Hospital
Abstract

Summary: Background: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Funding: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS.

Published
2019

47. A human immune dysregulation syndrome characterized by severe hyperinflammation with a homozygous nonsense Roquin-1 mutation

Author

Tavernier, Simon J, Athanasopoulos, Vicki, Verloo, Patrick, Behrens, Gesine, Staal, Jens, Bogaert, Delfien, Naesens, L, de Bruyne, Marieke, van Gassen, Sofie, Parthoens, Eef, Ellyard, Julia, Cappello, Jean, Morris, Lucy, van Gorp, Hanne, van Isterdael, Gert, Saeys, Y, Lamkanfi, Mohamed, Schelstraete, Petra, Dehoorne, Jo, Bordon, Victoria, Van Coster, Rudy, Lambrecht, Bart, Menten, Bjorn, Beyaert, Rudi, Vinuesa, Carola, Heissmeyer, Vigo, Dullaers, Melissa, Haerynck, Filomeen, Tavernier, Simon J, Athanasopoulos, Vicki, Verloo, Patrick, Behrens, Gesine, Staal, Jens, Bogaert, Delfien, Naesens, L, de Bruyne, Marieke, van Gassen, Sofie, Parthoens, Eef, Ellyard, Julia, Cappello, Jean, Morris, Lucy, van Gorp, Hanne, van Isterdael, Gert, Saeys, Y, Lamkanfi, Mohamed, Schelstraete, Petra, Dehoorne, Jo, Bordon, Victoria, Van Coster, Rudy, Lambrecht, Bart, Menten, Bjorn, Beyaert, Rudi, Vinuesa, Carola, Heissmeyer, Vigo, Dullaers, Melissa, and Haerynck, Filomeen

Abstract

Hyperinflammatory syndromes are life-threatening disorders caused by overzealous immune cell activation and cytokine release, often resulting from defects in negative feedback mechanisms. In the quintessential hyperinflammatory syndrome familial hemophagocytic lymphohistiocytosis (HLH), inborn errors of cytotoxicity result in effector cell accumulation, immune dysregulation and, if untreated, tissue damage and death. Here, we describe a human case with a homozygous nonsense R688* RC3H1 mutation suffering from hyperinflammation, presenting as relapsing HLH. RC3H1 encodes Roquin-1, a posttranscriptional repressor of immune-regulatory proteins such as ICOS, OX40 and TNF. Comparing the R688* variant with the murine M199R variant reveals a phenotypic resemblance, both in immune cell activation, hypercytokinemia and disease development. Mechanistically, R688* Roquin-1 fails to localize to P-bodies and interact with the CCR4-NOT deadenylation complex, impeding mRNA decay and dysregulating cytokine production. The results from this unique case suggest that impaired Roquin-1 function provokes hyperinflammation by a failure to quench immune activation.

Published
2019

48. Emergence of livestock-associated MRSA isolated from cystic fibrosis patients: Result of a Belgian national survey

Author

Dodemont, Magali, Argudín, María Ángeles M.A., Willekens, Julie, Vanderhelst, Eef, Pierard, Denis, Miendje Deyi, Yvette Véro, Hanssens, Laurence, Franckx, Hilde, Schelstraete, Petra, Leroux-Roels, Isabel, Nonhoff, Claire, Deplano, Ariane, Knoop, Christiane, Malfroot, Anne, Denis, Olivier, Dodemont, Magali, Argudín, María Ángeles M.A., Willekens, Julie, Vanderhelst, Eef, Pierard, Denis, Miendje Deyi, Yvette Véro, Hanssens, Laurence, Franckx, Hilde, Schelstraete, Petra, Leroux-Roels, Isabel, Nonhoff, Claire, Deplano, Ariane, Knoop, Christiane, Malfroot, Anne, and Denis, Olivier

Abstract

Background: This study aims to determine the prevalence and characteristics of Staphylococcus aureus in Belgian cystic fibrosis (CF) patients. Methods: Non-duplicate respiratory samples from 510 CF-patients (2012−2013) were examined. One isolate per patient was analysed unless different phenotypes were recovered. Isolates were investigated for mecA/mecC, toxins presence, spa-typing, MLST and SCCmec-typing. Potential livestock-associated (LA) isolates were examined for their immune-evasion-cluster (IEC) genes. Results: S. aureus (n = 380), including 41 small-colony variants (SCVs), were isolated from 66.7% patients. The prevalence of methicillin-resistant S. aureus (MRSA) colonization was 4.9%. Two MRSA isolates carried toxic shock syndrome toxin 1 (TSST-1). Most MRSA (65%) belonged to two nosocomial epidemic clones (CC5, CC8) widespread in Belgium. Methicillin susceptible S. aureus (MSSA) showed great genetic diversity. Five of 33 isolates belonging to potential LA-lineages were IEC negative, including three methicillin-resistant isolates, suggesting an animal origin. Conclusions: The MRSA-prevalence in Belgian CF-patients remained constant (2001−2013), but SCV-prevalence increased. Most MRSA belonged to health-care-associated clones. Three patients carrying LA-MRSA were found, requiring further investigation to determine the risk factors for LA-MRSA acquisition., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2019

49. Contribution of quantiferon-tb gold-in-tube to the diagnosis of mycobacterium tuberculosis infection in young children in a low tb prevalence country

Author

37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID19: May 6 - 11, 2019: Ljubljana, Slovenia), Debulpaep, Sara, Levy, Jack, Schelstraete, Petra, Mascart, Françoise, Van Den Driessche, Koenraad, 37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID19: May 6 - 11, 2019: Ljubljana, Slovenia), Debulpaep, Sara, Levy, Jack, Schelstraete, Petra, Mascart, Françoise, and Van Den Driessche, Koenraad

Abstract

info:eu-repo/semantics/published

Published
2019

50. Contribution of QuantiFERON-TB gold-in-tube to the diagnosis of Mycobacterium tuberculosis infection in young children in a low TB prevalence country

Author

Debulpaep, Sara, Corbiere, Véronique, Levy, Jack, Schelstraete, Petra, Vanden Driesche, Koen, Mascart, Françoise, Mouchet, Françoise, Debulpaep, Sara, Corbiere, Véronique, Levy, Jack, Schelstraete, Petra, Vanden Driesche, Koen, Mascart, Françoise, and Mouchet, Françoise

Abstract

Interferon Gamma Release Assay (IGRA) has proven to be a useful test to evaluate the immune response to Mycobacterium tuberculosis antigens in children over the age of five years as an alternative to tuberculin skin testing (TST). Much less is known about its performance in younger children, who are at higher risk for developing tuberculosis (TB) disease after exposure. We aimed to evaluate the accuracy of using IGRA in TB screening in this population. Methods Children below the age of five years at high risk for TB infection were prospectively enrolled, to compare the performance of TST and the QuantiFERON-TB Gold-In-Tube test (QFT). Children were treated in accordance with the diagnosis made at baseline and followed-up for 12 months. Results We included a total of 60 children of which 97 blood samples were available for analysis. There was 90.72% agreement between TST and QFT (Kappa test 0.59, moderate agreement). With TST as a reference, the QFT positive predictive value was 0.72 and the negative predictive value 0.93. Discordant results were observed with 6% TST+/QFT-paired tests. When we restricted the comparison of TST and QFT to non-BCG-vaccinated children, the degree of agreement was more substantial (95%, Kappa test 0.75) and the negative predictive value was 0.99. We observed 3% discordant TST-/QFT+ results. All children with active TB disease had concordant positive QFT results, with QFT values above 4.00 IU/ml. Conclusion In a low TB prevalence country, serial testing of QFT was found to produce a moderate agreement with TST results. False positive QFT results would have been eliminated by using a higher cutoff without misdiagnosing the children with TB disease. Some of the false negative QFT results could be explained by false positive TST results on consecutive testing. For now, the most prudent approach would be to consider discordant QFT-/TST+ results as false negative QFT results, taking into account the young age of our population and the potential, SCOPUS: no.j, info:eu-repo/semantics/published

Published
2019

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