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137 results on '"Eleftheriou, Irini"'

1. Diagnosis of Multisystem Inflammatory Syndrome in Children by a Whole-Blood Transcriptional Signature

Author

Jackson, Heather R, Miglietta, Luca, Habgood-Coote, Dominic, D'Souza, Giselle, Shah, Priyen, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp KA, Beudeker, Coco R, Brengel-Pesce, Karen, Carrol, Enitan D, Carter, Michael J, De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette, Papatheodorou, Irene, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J, Rivero-Calle, Irene, Rojo, Pablo, Secka, Fatou, Schlapbach, Luregn J, Tremoulet, Adriana H, Tsolia, Maria, Usuf, Effua, Van Der Flier, Michiel, Von Both, Ulrich, Vermont, Clementien, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan JM, Cunnington, Aubrey, Burns, Jane C, Wright, Victoria, Martinon-Torres, Federico, Herberg, Jethro A, Rodriguez-Manzano, Jesus, Kaforou, Myrsini, and Levin, Michael

Subjects
Paediatrics, Medical Microbiology, Biomedical and Clinical Sciences, Pediatric, Genetics, Infectious Diseases, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Child, Humans, COVID-19, Systemic Inflammatory Response Syndrome, Hospitals, Mucocutaneous Lymph Node Syndrome, COVID-19 Testing, MIS-C, diagnostic signature, host diagnostics, host response, pediatric infectious diseases, rapid diagnostics, transcriptomics, Medical microbiology
Abstract

BackgroundTo identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections.MethodsChildren presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138). Genes significantly differentially expressed (SDE) between MIS-C and comparator groups were identified. Feature selection was used to identify genes that optimally distinguish MIS-C from other diseases, which were subsequently translated into RT-qPCR assays and evaluated in an independent validation set comprising MIS-C (n = 37), KD (n = 19), DB (n = 56), DV (n = 43), and COVID-19 (n = 39).ResultsIn the discovery set, 5696 genes were SDE between MIS-C and combined comparator disease groups. Five genes were identified as potential MIS-C diagnostic biomarkers (HSPBAP1, VPS37C, TGFB1, MX2, and TRBV11-2), achieving an AUC of 96.8% (95% CI: 94.6%-98.9%) in the discovery set, and were translated into RT-qPCR assays. The RT-qPCR 5-gene signature achieved an AUC of 93.2% (95% CI: 88.3%-97.7%) in the independent validation set when distinguishing MIS-C from KD, DB, and DV.ConclusionsMIS-C can be distinguished from KD, DB, and DV groups using a 5-gene blood RNA expression signature. The small number of genes in the signature and good performance in both discovery and validation sets should enable the development of a diagnostic test for MIS-C.

Published
2023

2. Multisystem inflammatory syndrome in children (MIS-C): A nationwide collaborative study in the Greek population

Author

Lampidi, Stavroula, Maritsi, Despoina, Charakida, Marietta, Eleftheriou, Irini, Farmaki, Evangelia, Spyridis, Nikos, Charisi, Konstantina, Vantsi, Petrina, Filippatos, Filippos, Skourti, Kleopatra, Papadopoulou-Alataki, Efimia, Papadopoulou-Legbelou, Kyriaki, Kampouridou, Parthena, Grivea, Ioanna N., Vergadi, Eleni, Gkentzi, Despoina, Dimou, Despina, Koletsi, Patra, Fotis, Lampros, Liakopoulou, Theodota, Agrafiotou, Aikaterini, Kourtesi, Katerina, Tsolas, Georgios, Kafetzis, Dimitrios, Papaevangelou, Vassiliki, Dimitriou, Gabriel, Galanakis, Emmanouil, Syrogiannopoulos, George A., Spoulou, Vassiliki, Michos, Athanasios, Roilides, Emmanuel, and Tsolia, Maria N.

Published
2024
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3. 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 M., von Both, Ulrich, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A., and Carrol, Enitan D.

Published
2023
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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. Seroprevalence of anti-SARS-CoV-2 antibodies among children and their parents in Greece

Author

Dimopoulou, Dimitra, Kyritsi, Maria, Dadouli, Katerina, Vergadi, Eleni, Tsiligianni, Ekaterini, Papadimitriou, Eleni, Mavridi, Artemis, Giannakopoulos, Spyridon, Tsiourvopoulou, Georgia, Palyvou, Maria, Angeli, Evangelia, Brikos, Nikitas, Eleftheriou, Irini, Spoulou, Vassiliki, Michos, Athanasios, Gkentzi, Despoina, Siomou, Ekaterini, Papaevangelou, Vassiliki, Grivea, Ioanna, Syrogiannopoulos, George, Galanakis, Emmanouil, Hadjichristodoulou, Christos, and Tsolia, Maria

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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8. Correction to: Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study

Author

Tan, Chantal D., van der Walle, Eline E. P. L., Vermont, Clementien L., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, and Moll, Henriëtte A.

Published
2022
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9. Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study

Author

Tan, Chantal D., van der Walle, Eline E. P. L., Vermont, Clementien L., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, and Moll, Henriëtte A.

Published
2022
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10. 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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13. Which low urgent triaged febrile children are suitable for a fast track? An observational European study

Author

Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany M., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Rudzāte, Aleksandra, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriette A., Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany M., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, Rudzāte, Aleksandra, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, and Moll, Henriette A.

Abstract

Background:The number of paediatric patients visiting the ED with non-urgent problems is increasing, leading to poor patient flow and ED crowding. Fast track aims to improve the efficiency of evaluation and discharge of low acuity patients. We aimed to identify which febrile children are suitable for a fast track based on presenting symptoms and management. Methods:This study is part of the Management and Outcome of Fever in children in Europe study, which is an observational study including routine data of febrile children <18 years attending 12 European EDs. We included febrile, low urgent children (those assigned a triage acuity of either’standard’ or’non-urgent’ using the Manchester Triage System) and defined children as suitable for fast track when they have minimal resource use and are discharged home. Presenting symptoms consisted of neurological (n=237), respiratory (n=8476), gastrointestinal (n=1953) and others (n=3473, reference group). Multivariable logistic regression analyses regarding presenting symptoms and management (laboratory blood testing, imaging and admission) were performed with adjustment for covariates: patient characteristics, referral status, previous medical care, previous antibiotic use, visiting hours and ED setting. Results:We included 14 139 children with a median age of 2.7 years (IQR 1.3–5.2). The majority had respiratory symptoms (60%), viral infections (50%) and consisted of self-referrals (69%). The neurological group received imaging more often (adjusted OR (aOR) 1.8, 95% CI 1.1 to 2.9) and were admitted more frequently (aOR 1.9, 95% CI 1.4 to 2.7). The respiratory group had fewer laboratory blood tests performed (aOR 0.6, 95% CI 0.5 to 0.7), were less frequently admitted (aOR 0.6, 95% CI 0.5 to 0.7), but received imaging more often (aOR 1.8, 95% CI 1.6 to 2.0). Lastly, the gastrointestinal group had more laboratory blood tests performed (aOR 1.2. 95% CI 1.1 to 1.4) a

Published
2024

14. Which low urgent triaged febrile children are suitable for a fast track? An observational European study

Author

Infectieziekten patientenzorg, Child Health, Infection & Immunity, Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany M., Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, Van Der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, RudzÄa Te, Aleksandra, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriette A., Infectieziekten patientenzorg, Child Health, Infection & Immunity, Tan, Chantal D., Vermont, Clementien L., Zachariasse, Joany M., Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, Emonts, Marieke, Van Der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K., Martinon-Torres, Federico, Nijman, Ruud G., Pokorn, Marko, Rivero-Calle, Irene, RudzÄa Te, Aleksandra, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, and Moll, Henriette A.

Published
2024

15. Which low urgent triaged febrile children are suitable for a fast track? An observational European study

Author

Tan, Chantal D, primary, Vermont, Clementien L, additional, Zachariasse, Joany M, additional, von Both, Ulrich, additional, Carrol, Enitan D, additional, Eleftheriou, Irini, additional, Emonts, Marieke, additional, van der Flier, Michiel, additional, Herberg, Jethro, additional, Kohlmaier, Benno, additional, Levin, Michael, additional, Lim, Emma, additional, Maconochie, Ian K, additional, Martinon-Torres, Federico, additional, Nijman, Ruud G, additional, Pokorn, Marko, additional, Rivero-Calle, Irene, additional, Rudzāte, Aleksandra, additional, Tsolia, Maria, additional, Zenz, Werner, additional, Zavadska, Dace, additional, and Moll, Henriette A, additional

Published
2024
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16. 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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17. 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 R., Zandstra, Judith, Menikou, Stephanie, Hamilton, Melissa Shea, McArdle, Andrew J., Fischer, Roman, Thorne, Adam M., Huang, Honglei, Tanck, Michael W., Jansen, Machiel H., De, Tisham, Agyeman, Philipp K.A., Von Both, Ulrich, Carrol, Enitan D., Emonts, Marieke, Eleftheriou, Irini, Van der Flier, Michiel, Fink, Colin, Gloerich, Jolein, De Groot, Ronald, Moll, Henriette A., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria N., Usuf, Effua, Wright, Victoria J., Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Casals-Pascual, Climent, Cunnington, Aubrey J., Martinon-Torres, Federico, Herberg, Jethro A., de Jonge, Marien I., Levin, Michael, Kuijpers, Taco W., Kaforou, Myrsini, Jackson, Heather R., Zandstra, Judith, Menikou, Stephanie, Hamilton, Melissa Shea, McArdle, Andrew J., Fischer, Roman, Thorne, Adam M., Huang, Honglei, Tanck, Michael W., Jansen, Machiel H., De, Tisham, Agyeman, Philipp K.A., Von Both, Ulrich, Carrol, Enitan D., Emonts, Marieke, Eleftheriou, Irini, Van der Flier, Michiel, Fink, Colin, Gloerich, Jolein, De Groot, Ronald, Moll, Henriette A., Pokorn, Marko, Pollard, Andrew J., Schlapbach, Luregn J., Tsolia, Maria N., Usuf, Effua, Wright, Victoria J., Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Casals-Pascual, Climent, Cunnington, Aubrey J., Martinon-Torres, Federico, Herberg, Jethro A., de Jonge, Marien I., Levin, Michael, Kuijpers, Taco W., and Kaforou, Myrsini

Abstract

BACKGROUND: Differentiating between self-resolving viral infections and bacterial infections in children who are febrile is a common challenge, causing difficulties in identifying which individuals require antibiotics. Studying the host response to infection can provide useful insights and can lead to the identification of biomarkers of infection with diagnostic potential. This study aimed to identify host protein biomarkers for future development into an accurate, rapid point-of-care test that can distinguish between bacterial and viral infections, by recruiting children presenting to health-care settings with fever or a history of fever in the previous 72 h. METHODS: In this multi-cohort machine learning study, patient data were taken from EUCLIDS, the Swiss Pediatric Sepsis study, the GENDRES study, and the PERFORM study, which were all based in Europe. We generated three high-dimensional proteomic datasets (SomaScan and two via liquid chromatography tandem mass spectrometry, referred to as MS-A and MS-B) using targeted and untargeted platforms (SomaScan and liquid chromatography mass spectrometry). Protein biomarkers were then shortlisted using differential abundance analysis, feature selection using forward selection-partial least squares (FS-PLS; 100 iterations), along with a literature search. Identified proteins were tested with Luminex and ELISA and iterative FS-PLS was done again (25 iterations) on the Luminex results alone, and the Luminex and ELISA results together. A sparse protein signature for distinguishing between bacterial and viral infections was identified from the selected proteins. The performance of this signature was finally tested using Luminex assays and by calculating disease risk scores. FINDINGS:376 children provided serum or plasma samples for use in the discovery of protein biomarkers. 79 serum samples were collected for the generation of the SomaScan dataset, 147 plasma sample

Published
2023

18. Diagnosis of Multisystem Inflammatory Syndrome in Children by a Whole-Blood Transcriptional Signature

Author

Jackson, Heather R., Miglietta, Luca, Habgood-Coote, Dominic, D'souza, Giselle, Shah, Priyen, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K.A., Beudeker, Coco R., Brengel-Pesce, Karen, Carrol, Enitan D., Carter, Michael J., De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, Van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette, Papatheodorou, Irene, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J., Rivero-Calle, Irene, Rojo, Pablo, Secka, Fatou, Schlapbach, Luregn J., Tremoulet, Adriana H., Tsolia, Maria, Usuf, Effua, Van Der Flier, Michiel, Von Both, Ulrich, Vermont, Clementien, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Cunnington, Aubrey, Burns, Jane C., Wright, Victoria, Martinon-Torres, Federico, Herberg, Jethro A., Rodriguez-Manzano, Jesus, Kaforou, Myrsini, Levin, Michael, Jackson, Heather R., Miglietta, Luca, Habgood-Coote, Dominic, D'souza, Giselle, Shah, Priyen, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K.A., Beudeker, Coco R., Brengel-Pesce, Karen, Carrol, Enitan D., Carter, Michael J., De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, Van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette, Papatheodorou, Irene, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J., Rivero-Calle, Irene, Rojo, Pablo, Secka, Fatou, Schlapbach, Luregn J., Tremoulet, Adriana H., Tsolia, Maria, Usuf, Effua, Van Der Flier, Michiel, Von Both, Ulrich, Vermont, Clementien, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Cunnington, Aubrey, Burns, Jane C., Wright, Victoria, Martinon-Torres, Federico, Herberg, Jethro A., Rodriguez-Manzano, Jesus, Kaforou, Myrsini, and Levin, Michael

Abstract

Background: To identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections. Methods: Children presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138). Genes significantly differentially expressed (SDE) between MIS-C and comparator groups were identified. Feature selection was used to identify genes that optimally distinguish MIS-C from other diseases, which were subsequently translated into RT-qPCR assays and evaluated in an independent validation set comprising MIS-C (n = 37), KD (n = 19), DB (n = 56), DV (n = 43), and COVID-19 (n = 39). Results: In the discovery set, 5696 genes were SDE between MIS-C and combined comparator disease groups. Five genes were identified as potential MIS-C diagnostic biomarkers (HSPBAP1, VPS37C, TGFB1, MX2, and TRBV11-2), achieving an AUC of 96.8% (95% CI: 94.6%-98.9%) in the discovery set, and were translated into RT-qPCR assays. The RT-qPCR 5-gene signature achieved an AUC of 93.2% (95% CI: 88.3%-97.7%) in the independent validation set when distinguishing MIS-C from KD, DB, and DV. Conclusions: MIS-C can be distinguished from KD, DB, and DV groups using a 5-gene blood RNA expression signature. The small number of genes in the signature and good performance in both discovery and validation sets should enable the development of a diagnostic test for MIS-C.

Published
2023

19. 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

20. 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

21. Diagnosis of Multisystem Inflammatory Syndrome in Children by a Whole-Blood Transcriptional Signature

Author

Infectieziekten onderzoek1 (Bont), Infection & Immunity, NVIC bedrijfsvoering, Other research (not in main researchprogram), CDL Onderzoek Pasterkamp, Infectieziekten patientenzorg, Child Health, Jackson, Heather R., Miglietta, Luca, Habgood-Coote, Dominic, D'souza, Giselle, Shah, Priyen, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K.A., Beudeker, Coco R., Brengel-Pesce, Karen, Carrol, Enitan D., Carter, Michael J., De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, Van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette, Papatheodorou, Irene, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J., Rivero-Calle, Irene, Rojo, Pablo, Secka, Fatou, Schlapbach, Luregn J., Tremoulet, Adriana H., Tsolia, Maria, Usuf, Effua, Van Der Flier, Michiel, Von Both, Ulrich, Vermont, Clementien, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Cunnington, Aubrey, Burns, Jane C., Wright, Victoria, Martinon-Torres, Federico, Herberg, Jethro A., Rodriguez-Manzano, Jesus, Infectieziekten onderzoek1 (Bont), Infection & Immunity, NVIC bedrijfsvoering, Other research (not in main researchprogram), CDL Onderzoek Pasterkamp, Infectieziekten patientenzorg, Child Health, Jackson, Heather R., Miglietta, Luca, Habgood-Coote, Dominic, D'souza, Giselle, Shah, Priyen, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K.A., Beudeker, Coco R., Brengel-Pesce, Karen, Carrol, Enitan D., Carter, Michael J., De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, Van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette, Papatheodorou, Irene, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J., Rivero-Calle, Irene, Rojo, Pablo, Secka, Fatou, Schlapbach, Luregn J., Tremoulet, Adriana H., Tsolia, Maria, Usuf, Effua, Van Der Flier, Michiel, Von Both, Ulrich, Vermont, Clementien, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Coin, Lachlan J.M., Cunnington, Aubrey, Burns, Jane C., Wright, Victoria, Martinon-Torres, Federico, Herberg, Jethro A., and Rodriguez-Manzano, Jesus

Published
2023

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

Author

Shah, Priyen; https://orcid.org/0000-0001-9164-8862, 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; https://orcid.org/0000-0003-4194-7295, Rudzate, Aleksandra, Sagmeister, Manfred G; https://orcid.org/0000-0001-5677-2518, Schweintzger, Nina A, Secka, Fatou; https://orcid.org/0000-0002-6515-7186, Thakker, Clare, van der Velden, Fabian, Vermont, Clementien, Vincek, Katarina; https://orcid.org/0000-0003-2146-1829, Agyeman, Philipp K A, Cunnington, Aubrey J, De Groot, Ronald, Emonts, Marieke, Fidler, Katy, Kuijpers, Taco W, Mommert-Tripon, Marine, Brengel-Pesce, Karen, Mallet, Francois, et al, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Shah, Priyen; https://orcid.org/0000-0001-9164-8862, 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; https://orcid.org/0000-0003-4194-7295, Rudzate, Aleksandra, Sagmeister, Manfred G; https://orcid.org/0000-0001-5677-2518, Schweintzger, Nina A, Secka, Fatou; https://orcid.org/0000-0002-6515-7186, Thakker, Clare, van der Velden, Fabian, Vermont, Clementien, Vincek, Katarina; https://orcid.org/0000-0003-2146-1829, Agyeman, Philipp K A, Cunnington, Aubrey J, De Groot, Ronald, Emonts, Marieke, Fidler, Katy, Kuijpers, Taco W, Mommert-Tripon, Marine, Brengel-Pesce, Karen, Mallet, Francois, et al, and Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598

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 feb

Published
2023

23. 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 R, Zandstra, Judith, Menikou, Stephanie, Hamilton, Melissa Shea, McArdle, Andrew J, Fischer, Roman, Thorne, Adam M, Huang, Honglei, Tanck, Michael W, Jansen, Machiel H, De, Tisham, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Carrol, Enitan D, Emonts, Marieke, Eleftheriou, Irini, Van der Flier, Michiel, Fink, Colin, Gloerich, Jolein, De Groot, Ronald, Moll, Henriette A, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria N, Usuf, Effua, Wright, Victoria J; https://orcid.org/0000-0001-7826-1516, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, et al, Jackson, Heather R, Zandstra, Judith, Menikou, Stephanie, Hamilton, Melissa Shea, McArdle, Andrew J, Fischer, Roman, Thorne, Adam M, Huang, Honglei, Tanck, Michael W, Jansen, Machiel H, De, Tisham, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Carrol, Enitan D, Emonts, Marieke, Eleftheriou, Irini, Van der Flier, Michiel, Fink, Colin, Gloerich, Jolein, De Groot, Ronald, Moll, Henriette A, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tsolia, Maria N, Usuf, Effua, Wright, Victoria J; https://orcid.org/0000-0001-7826-1516, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, and et al

Abstract

Background: Differentiating between self-resolving viral infections and bacterial infections in children who are febrile is a common challenge, causing difficulties in identifying which individuals require antibiotics. Studying the host response to infection can provide useful insights and can lead to the identification of biomarkers of infection with diagnostic potential. This study aimed to identify host protein biomarkers for future development into an accurate, rapid point-of-care test that can distinguish between bacterial and viral infections, by recruiting children presenting to health-care settings with fever or a history of fever in the previous 72 h. Methods: In this multi-cohort machine learning study, patient data were taken from EUCLIDS, the Swiss Pediatric Sepsis study, the GENDRES study, and the PERFORM study, which were all based in Europe. We generated three high-dimensional proteomic datasets (SomaScan and two via liquid chromatography tandem mass spectrometry, referred to as MS-A and MS-B) using targeted and untargeted platforms (SomaScan and liquid chromatography mass spectrometry). Protein biomarkers were then shortlisted using differential abundance analysis, feature selection using forward selection-partial least squares (FS-PLS; 100 iterations), along with a literature search. Identified proteins were tested with Luminex and ELISA and iterative FS-PLS was done again (25 iterations) on the Luminex results alone, and the Luminex and ELISA results together. A sparse protein signature for distinguishing between bacterial and viral infections was identified from the selected proteins. The performance of this signature was finally tested using Luminex assays and by calculating disease risk scores. Findings: 376 children provided serum or plasma samples for use in the discovery of protein biomarkers. 79 serum samples were collected for the generation of the SomaScan dataset, 147 plasma samples for the MS-A dataset, and 150 plasma samples for the MS

Published
2023

24. Diagnosis of Multisystem Inflammatory Syndrome in Children by a Whole-Blood Transcriptional Signature

Author

Jackson, Heather R; https://orcid.org/0000-0002-1054-9983, Miglietta, Luca, Habgood-Coote, Dominic, D’Souza, Giselle, Shah, Priyen; https://orcid.org/0000-0001-9164-8862, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Beudeker, Coco R, Brengel-Pesce, Karen, Carrol, Enitan D, Carter, Michael J, De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina; https://orcid.org/0000-0002-6929-4903, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette; https://orcid.org/0000-0001-9304-3322, Papatheodorou, Irene; https://orcid.org/0000-0001-7270-5470, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, et al, Jackson, Heather R; https://orcid.org/0000-0002-1054-9983, Miglietta, Luca, Habgood-Coote, Dominic, D’Souza, Giselle, Shah, Priyen; https://orcid.org/0000-0001-9164-8862, Nichols, Samuel, Vito, Ortensia, Powell, Oliver, Davidson, Maisey Salina, Shimizu, Chisato, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Beudeker, Coco R, Brengel-Pesce, Karen, Carrol, Enitan D, Carter, Michael J, De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Epalza, Cristina; https://orcid.org/0000-0002-6929-4903, Georgiou, Pantelis, De Groot, Ronald, Fidler, Katy, Fink, Colin, van Keulen, Daniëlle, Kuijpers, Taco, Moll, Henriette; https://orcid.org/0000-0001-9304-3322, Papatheodorou, Irene; https://orcid.org/0000-0001-7270-5470, Paulus, Stephane, Pokorn, Marko, Pollard, Andrew J; https://orcid.org/0000-0001-7361-719X, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, and et al

Abstract

Background: To identify a diagnostic blood transcriptomic signature that distinguishes multisystem inflammatory syndrome in children (MIS-C) from Kawasaki disease (KD), bacterial infections, and viral infections. Methods: Children presenting with MIS-C to participating hospitals in the United Kingdom and the European Union between April 2020 and April 2021 were prospectively recruited. Whole-blood RNA Sequencing was performed, contrasting the transcriptomes of children with MIS-C (n = 38) to those from children with KD (n = 136), definite bacterial (DB; n = 188) and viral infections (DV; n = 138). Genes significantly differentially expressed (SDE) between MIS-C and comparator groups were identified. Feature selection was used to identify genes that optimally distinguish MIS-C from other diseases, which were subsequently translated into RT-qPCR assays and evaluated in an independent validation set comprising MIS-C (n = 37), KD (n = 19), DB (n = 56), DV (n = 43), and COVID-19 (n = 39). Results: In the discovery set, 5696 genes were SDE between MIS-C and combined comparator disease groups. Five genes were identified as potential MIS-C diagnostic biomarkers (HSPBAP1, VPS37C, TGFB1, MX2, and TRBV11-2), achieving an AUC of 96.8% (95% CI: 94.6%–98.9%) in the discovery set, and were translated into RT-qPCR assays. The RT-qPCR 5-gene signature achieved an AUC of 93.2% (95% CI: 88.3%–97.7%) in the independent validation set when distinguishing MIS-C from KD, DB, and DV. Conclusions: MIS-C can be distinguished from KD, DB, and DV groups using a 5-gene blood RNA expression signature. The small number of genes in the signature and good performance in both discovery and validation sets should enable the development of a diagnostic test for MIS-C.

Published
2023

25. 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 M, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Nijman, Ruud G, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A, Carrol, Enitan D, PERFORM consortium (Personalised Risk assessment in febrile chil, Tan, Chantal D, Vermont, Clementien L, Zachariasse, Joany M, von Both, Ulrich; https://orcid.org/0000-0001-8411-1071, Eleftheriou, Irini, Emonts, Marieke, van der Flier, Michiel, Herberg, Jethro, Kohlmaier, Benno, Levin, Michael, Lim, Emma, Maconochie, Ian K, Martinón-Torres, Federico; https://orcid.org/0000-0002-9023-581X, Nijman, Ruud G, Pokorn, Marko, Rivero-Calle, Irene, Tsolia, Maria, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A, Carrol, Enitan D, and PERFORM consortium (Personalised Risk assessment in febrile chil

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 around

Published
2023

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

Author

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

Published
2023
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28. LONG TERM EFFECTS OF SARS-COV-2 INFECTION ON CHILDREN'S VASCULATURE

Author

Karaviti, Dareilena, primary, Charakida, Marietta, additional, Dimopoulou, Dimitra, additional, Eleftheriou, Irini, additional, Liaska, Marianthi, additional, Papadaki, Maria, additional, Maritsi, Despoina, additional, Sakou, Irine-Ikbale, additional, Marmarinos, Antonios, additional, Avgeris, Margaritis, additional, Gourgiotis, Dimitrios, additional, Spyridis, Nikos, additional, and Tsolia, Maria, additional

Published
2023
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29. Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe: A cross-sectional survey of paediatricians

Author

Dewez, Juan Emmanuel, primary, Pembrey, Lucy, additional, Nijman, Ruud G., additional, del Torso, Stefano, additional, Grossman, Zachi, additional, Hadjipanayis, Adamos, additional, Van Esso, Diego, additional, Lim, Emma, additional, Emonts, Marieke, additional, Burns, James, additional, Gras-LeGuen, Christèle, additional, Kohlfuerst, Daniela, additional, Dornbusch, Hans Jürgen, additional, Brengel-Pesce, Karen, additional, Mallet, Francois, additional, von Both, Ulrich, additional, Tsolia, Maria, additional, Eleftheriou, Irini, additional, Zavadska, Dace, additional, de Groot, Ronald, additional, van der Flier, Michiel, additional, Moll, Henriëtte, additional, Hagedoorn, Nienke, additional, Borensztajn, Dorine, additional, Oostenbrink, Rianne, additional, Kuijpers, Taco, additional, Pokorn, Marko, additional, Vincek, Katarina, additional, Martinón-Torres, Federico, additional, Rivero, Irene, additional, Agyeman, Philipp, additional, Carrol, Enitan D., additional, Paulus, Stéphane, additional, Cunnington, Aubrey, additional, Herberg, Jethro, additional, Levin, Michael, additional, Mujkić, Aida, additional, Geitmann, Karin, additional, Da Dalt, Liviana, additional, Valiulis, Arūnas, additional, Lapatto, Risto, additional, Syridou, Garyfallia, additional, Altorjai, Péter, additional, Torpiano, Paul, additional, Størdal, Ketil, additional, Illy, Károly, additional, Mazur, Artur, additional, Spreitzer, Mateja Vintar, additional, Rios, Joana, additional, Wyder, Corinne, additional, Romankevych, Ivanna, additional, Basmaci, Romain, additional, Ibanez-Mico, Salvador, additional, and Yeung, Shunmay, additional

Published
2022
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30. Seroprevalence of anti-SARS-CoV-2 antibodies among children and their parents in Greece

Author

Dimopoulou, Dimitra, primary, Kyritsi, Maria, additional, Dadouli, Katerina, additional, Vergadi, Eleni, additional, Tsiligianni, Ekaterini, additional, Papadimitriou, Eleni, additional, Mavridi, Artemis, additional, Giannakopoulos, Spyridon, additional, Tsiourvopoulou, Georgia, additional, Palyvou, Maria, additional, Angeli, Evangelia, additional, Brikos, Nikitas, additional, Eleftheriou, Irini, additional, Spoulou, Vassiliki, additional, Michos, Athanasios, additional, Gkentzi, Despoina, additional, Siomou, Ekaterini, additional, Papaevangelou, Vassiliki, additional, Grivea, Ioanna, additional, Syrogiannopoulos, George, additional, Galanakis, Emmanouil, additional, Hadjichristodoulou, Christos, additional, and Tsolia, Maria, additional

Published
2022
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31. Decreasing Incidence of the Multisystem Inflammatory Syndrome in Children Over 3 Pandemic Waves

Author

Eleftheriou, Irini, primary, Maritsi, Despina, additional, Lampidi, Stavroula, additional, Charisi, Konstantina, additional, Vantsi, Petrina, additional, Skourti, Kleopatra, additional, Filippatos, Filippos, additional, Amplianitis, Ioannis, additional, Dimou, Despina, additional, Papadopoulou-Legbelou, Kyriaki, additional, Papadopoulou-Alataki, Efimia, additional, Kampouridou, Parthena, additional, Koletsi, Patra, additional, Fotis, Lampros, additional, Vergadi, Elena, additional, Gkentzi, Despoina, additional, Farmaki, Evangelia, additional, Papaevangelou, Vassiliki, additional, Galanakis, Emmanouil, additional, Grivea, Ioanna N., additional, Syrogiannopoulos, George A., additional, Spoulou, Vana, additional, Spyridis, Nikos, additional, Michos, Athanasios, additional, Roilides, Emmanuel, additional, and Tsolia, Maria N., additional

Published
2022
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32. 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
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33. 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 and 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

34. 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

35. Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe:A cross-sectional survey of paediatricians

Author

Dewez, Juan Emmanuel, Pembrey, Lucy, Nijman, Ruud G., del Torso, Stefano, Grossman, Zachi, Hadjipanayis, Adamos, Van Esso, Diego, Lim, Emma, Emonts, Marieke, Burns, James, Gras-LeGuen, Christèle, Kohlfuerst, Daniela, Dornbusch, Hans Jürgen, Brengel-Pesce, Karen, Mallet, Francois, von Both, Ulrich, Tsolia, Maria, Eleftheriou, Irini, Zavadska, Dace, de Groot, Ronald, van der Flier, Michiel, Moll, Henriëtte, Hagedoorn, Nienke, Borensztajn, Dorine, Oostenbrink, Rianne, Kuijpers, Taco, Pokorn, Marko, Vincek, Katarina, Martinó n-Torres, Federico, Rivero, Irene, Agyeman, Philipp, Carrol, Enitan D., Paulus, Stéphane, Cunnington, Aubrey, Herberg, Jethro, Levin, Michael, Mujkić, Aida, Geitmann, Karin, Da Dalt, Liviana, Valiulis, Arunas, Lapatto, Risto, Syridou, Garyfallia, Altorjai, Péter, Torpiano, Paul, Størdal, Ketil, Illy, Károly, Mazur, Artur, Spreitzer, Mateja Vintar, Rios, Joana, Wyder, Corinne, Romankevych, Ivanna, Basmaci, Romain, Ibanez-Mico, Salvador, Yeung, Shunmay, Dewez, Juan Emmanuel, Pembrey, Lucy, Nijman, Ruud G., del Torso, Stefano, Grossman, Zachi, Hadjipanayis, Adamos, Van Esso, Diego, Lim, Emma, Emonts, Marieke, Burns, James, Gras-LeGuen, Christèle, Kohlfuerst, Daniela, Dornbusch, Hans Jürgen, Brengel-Pesce, Karen, Mallet, Francois, von Both, Ulrich, Tsolia, Maria, Eleftheriou, Irini, Zavadska, Dace, de Groot, Ronald, van der Flier, Michiel, Moll, Henriëtte, Hagedoorn, Nienke, Borensztajn, Dorine, Oostenbrink, Rianne, Kuijpers, Taco, Pokorn, Marko, Vincek, Katarina, Martinó n-Torres, Federico, Rivero, Irene, Agyeman, Philipp, Carrol, Enitan D., Paulus, Stéphane, Cunnington, Aubrey, Herberg, Jethro, Levin, Michael, Mujkić, Aida, Geitmann, Karin, Da Dalt, Liviana, Valiulis, Arunas, Lapatto, Risto, Syridou, Garyfallia, Altorjai, Péter, Torpiano, Paul, Størdal, Ketil, Illy, Károly, Mazur, Artur, Spreitzer, Mateja Vintar, Rios, Joana, Wyder, Corinne, Romankevych, Ivanna, Basmaci, Romain, Ibanez-Mico, Salvador, and Yeung, Shunmay

Abstract

Background Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability. Methods and findings A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks. Questions focused on the availability and use of currently available POCTs. Data were analysed descriptively and using Median Odds Ratio (MOR) to measure variation between countries. Multilevel regression modelling using changes in the area under the receiver operating characteristic curve of models were used to assess the contribution of individual or workplace versus country level factors, to the observed variation. The commonest POCT was urine dipsticks (UD) which were available to >80% of primary care and hospital paediatricians in 68% (13/19) and 79% (23/29) countries, respectively. Availability of all POCTs varied between countries. In primary care, the country (MOR) varied from 1.61 (95%CI: 1.04-2.58) for lactate to 7.28 (95%CI: 3.04-24.35) for UD. In hospitals, the country MOR varied from 1.37 (95%CI:1.04-1.80) for lactate to 11.93 (95% CI:3.35-72.23) for UD. Most paediatricians in primary care (69%, 795/1154) and hospital (81%, 962/1188) would use a diagnostic test in the case scenario of an infant with undifferentiated fever. Multilevel regression modelling showed that the country of work was more important in predicting both the availability and use of POCTs than individual or workplace characteristics. Conclusion There is substantial variability in the adoption of POCTs for the management of acute infections in children across Europe. To inform future implementation of both existing and innovative tests, further research is needed to understand what drives the variation between countries, the needs of frontline clinici

Published
2022

36. Guideline adherence in febrile children below 3 months visiting European Emergency Departments:an observational multicenter study

Author

Tan, Chantal D., van der Walle, Eline E. P. L., Vermont, Clementien L., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, Moll, Henriette A., Tan, Chantal D., van der Walle, Eline E. P. L., Vermont, Clementien L., von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, and Moll, Henriette A.

Abstract

Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0–18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0–2.3). Management per ED varied as follows: use of diagnostic tests 14–83%, antibiotic treatment 23–54%, admission 34–86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0–38%), partial adherence occurred in 56% (484/868, range 35–77%). Conclusion: There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children.What is Known:• Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment.• There is practice variation in management of young febrile children due to differences in guidelines and their usage and adherence.What is

Published
2022

37. Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe: A cross-sectional survey of paediatricians

Author

Infectieziekten patientenzorg, Child Health, Infection & Immunity, Dewez, Juan Emmanuel, Pembrey, Lucy, Nijman, Ruud G., del Torso, Stefano, Grossman, Zachi, Hadjipanayis, Adamos, Van Esso, Diego, Lim, Emma, Emonts, Marieke, Burns, James, Gras-LeGuen, Christèle, Kohlfuerst, Daniela, Dornbusch, Hans Jürgen, Brengel-Pesce, Karen, Mallet, Francois, von Both, Ulrich, Tsolia, Maria, Eleftheriou, Irini, Zavadska, Dace, de Groot, Ronald, van der Flier, Michiel, Moll, Henriëtte, Hagedoorn, Nienke, Borensztajn, Dorine, Oostenbrink, Rianne, Kuijpers, Taco, Pokorn, Marko, Vincek, Katarina, Martinó n-Torres, Federico, Rivero, Irene, Agyeman, Philipp, Carrol, Enitan D., Paulus, Stéphane, Cunnington, Aubrey, Herberg, Jethro, Levin, Michael, Mujkić, Aida, Geitmann, Karin, Da Dalt, Liviana, Valiulis, Arunas, Lapatto, Risto, Syridou, Garyfallia, Altorjai, Péter, Torpiano, Paul, Størdal, Ketil, Illy, Károly, Mazur, Artur, Spreitzer, Mateja Vintar, Rios, Joana, Wyder, Corinne, Infectieziekten patientenzorg, Child Health, Infection & Immunity, Dewez, Juan Emmanuel, Pembrey, Lucy, Nijman, Ruud G., del Torso, Stefano, Grossman, Zachi, Hadjipanayis, Adamos, Van Esso, Diego, Lim, Emma, Emonts, Marieke, Burns, James, Gras-LeGuen, Christèle, Kohlfuerst, Daniela, Dornbusch, Hans Jürgen, Brengel-Pesce, Karen, Mallet, Francois, von Both, Ulrich, Tsolia, Maria, Eleftheriou, Irini, Zavadska, Dace, de Groot, Ronald, van der Flier, Michiel, Moll, Henriëtte, Hagedoorn, Nienke, Borensztajn, Dorine, Oostenbrink, Rianne, Kuijpers, Taco, Pokorn, Marko, Vincek, Katarina, Martinó n-Torres, Federico, Rivero, Irene, Agyeman, Philipp, Carrol, Enitan D., Paulus, Stéphane, Cunnington, Aubrey, Herberg, Jethro, Levin, Michael, Mujkić, Aida, Geitmann, Karin, Da Dalt, Liviana, Valiulis, Arunas, Lapatto, Risto, Syridou, Garyfallia, Altorjai, Péter, Torpiano, Paul, Størdal, Ketil, Illy, Károly, Mazur, Artur, Spreitzer, Mateja Vintar, Rios, Joana, and Wyder, Corinne

Published
2022

38. Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study

Author

Tan, Chantal D, van der Walle, Eline E P L, Vermont, Clementien L, von Both, Ulrich, Carrol, Enitan D, Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A, Tan, Chantal D, van der Walle, Eline E P L, Vermont, Clementien L, von Both, Ulrich, Carrol, Enitan D, Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, and Moll, Henriëtte A

Abstract

UNLABELLED Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. There is practice variation in management due to differences in guidelines and their usage and adherence. We aimed to assess whether management in febrile children below 3 months attending European Emergency Departments (EDs) was according to the guidelines for fever. This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0-18 years) attending twelve EDs in eight European countries. In febrile children below 3 months (excluding bronchiolitis), we analyzed actual management compared to the guidelines for fever. Ten EDs applied the (adapted) NICE guideline, and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment, and admission. We included 913 children with a median age of 1.7 months (IQR 1.0-2.3). Management per ED varied as follows: use of diagnostic tests 14-83%, antibiotic treatment 23-54%, admission 34-86%. Adherence to the guideline was 43% (374/868) for blood cultures, 29% (144/491) for lumbar punctures, 55% (270/492) for antibiotic prescriptions, and 67% (573/859) for admission. Full adherence to these four management components occurred in 15% (132/868, range 0-38%), partial adherence occurred in 56% (484/868, range 35-77%). CONCLUSION There is large practice variation in management. The guideline adherence was limited, but highest for admission which implies a cautious approach. Future studies should focus on guideline revision including new biomarkers in order to optimize management in young febrile children. WHAT IS KNOWN • Febrile children below 3 months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. • There is practice variation in management of young febrile children due to differences in guidelines and their usage and adherence

Published
2022

39. Correction to: Guideline adherence in febrile children below 3 months visiting European Emergency Departments: an observational multicenter study

Author

Tan, Chantal D, van der Walle, Eline E P L, Vermont, Clementien L, von Both, Ulrich, Carrol, Enitan D, Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, Moll, Henriëtte A, Tan, Chantal D, van der Walle, Eline E P L, Vermont, Clementien L, von Both, Ulrich, Carrol, Enitan D, Eleftheriou, Irini, 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, Yeung, Shunmay, Zenz, Werner, Zavadska, Dace, and Moll, Henriëtte A

Published
2022

40. 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

41. Relationship Between Molecular Pathogen Detection and Clinical Disease in Febrile Children Across Europe

Author

Shah, Priyen, primary, Voice, Marie, additional, Calvo-Bado, Leonides, additional, Calle, Irene Rivero, additional, Morris, Sophie, additional, Nijman, Ruud, additional, Broderick, Claire, additional, De, Tisham, additional, Eleftheriou, Irini, additional, Galassini, Rachel, additional, Khanijau, Aakash, additional, Kolberg, Laura, additional, Kolnik, Mojca, additional, Rudzate, Aleksandra, additional, Sagmeister, Manfred, additional, Schweintzger, Nina, additional, Secka, Fatou, additional, Thakker, Clare, additional, van der Velden, Fabian, additional, Vermont, Clementien, additional, Vincek, Katarina, additional, Agyeman, Philipp KA, additional, Cunnington, Aubrey, additional, De Groot, Ronald, additional, Emonts, Marieke, additional, Fidler, Katy, additional, Kuijpers, Taco, additional, Mallet, Francois, additional, Moll, Henriette, additional, Paulus, Stéphane, additional, Pokorn, Marko, additional, Pollard, Andrew J., additional, Schlapbach, Luregn J., additional, Shen, Ching-Fen, additional, Tsolia, Maria, additional, Usuf, Effua, additional, van der Flier, Michiel, additional, von Both, Ulrich, additional, Yeung, Shunmay, additional, Zavadsaka, Dace, additional, Zenz, Werner, additional, Wright, Victoria J., additional, Carrol, Enitan, additional, Kaforou, Myrsini, additional, Martinon-Torres, Federico, additional, Fink, Colin, additional, Levin, Michael, additional, Herberg, Jethro A., additional, and Consortium, PERFORM, additional

Published
2022
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42. A novel framework for phenotyping children with suspected or confirmed infection for future biomarker studies

Author

Nijman, Ruud G., Oostenbrink, Rianne, Moll, Henriette A., Casals-Pascual, Climent, von Both, Ulrich, Cunnington, Aubrey, De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Fink, Colin, van der Flier, Michiel, de Groot, Ronald, Kaforou, Myrsini, Kohlmaier, Benno, Kuijpers, Taco W., Lim, Emma, Maconochie, Ian K., Paulus, Stephane, Martinon-Torres, Federico, Pokorn, Marko, Romaine, Sam T., Calle, Irene Rivero, Schlapbach, Luregn J., Smit, Frank J., Tsolia, Maria, Usuf, Effua, Wright, Victoria J., Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Levin, Michael, Herberg, Jethro A., Carrol, Enitan D., National Institute of Health and Medical Research, and European Commission

Subjects
serious bacterial infection, sepsis, children, biomarkers, 1114 Paediatrics and Reproductive Medicine, Pediatrics, clinical phenotypes, Original Research, 1199 Other Medical and Health Sciences
Abstract

Background: The limited diagnostic accuracy of biomarkers in children at risk of a serious bacterial infection (SBI) might be due to the imperfect reference standard of SBI. We aimed to evaluate the diagnostic performance of a new classification algorithm for biomarker discovery in children at risk of SBI. Methods: We used data from five previously published, prospective observational biomarker discovery studies, which included patients aged 0–

Published
2021

43. A Novel Framework for Phenotyping Children With Suspected or Confirmed Infection for Future Biomarker Studies

Author

Nijman, Ruud G, Oostenbrink, Rianne, Moll, Henriette A, Casals-Pascual, Climent, von Both, Ulrich, Cunnington, Aubrey, De, Tisham, Eleftheriou, Irini, Emonts, Marieke, Fink, Colin, van der Flier, Michiel, de Groot, Ronald, Kaforou, Myrsini, Kohlmaier, Benno, Kuijpers, Taco W, Lim, Emma, Maconochie, Ian K, Paulus, Stephane, Martinon-Torres, Federico, Pokorn, Marko, Romaine, Sam T, Calle, Irene Rivero, Schlapbach, Luregn J, Smit, Frank J, Tsolia, Maria, Usuf, Effua, Wright, Victoria J, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Levin, Michael, Herberg, Jethro A, Carrol, Enitan D, and PERFORM consortium (Personalized Risk assessment in febrile chil

Abstract

Background: The limited diagnostic accuracy of biomarkers in children at risk of a serious bacterial infection (SBI) might be due to the imperfect reference standard of SBI. We aimed to evaluate the diagnostic performance of a new classification algorithm for biomarker discovery in children at risk of SBI. Methods: We used data from five previously published, prospective observational biomarker discovery studies, which included patients aged 0

Published
2021

44. A Novel Framework for Phenotyping Children With Suspected or Confirmed Infection for Future Biomarker Studies

Author

Nijman, Ruud G. Oostenbrink, Rianne Moll, Henriette A. and Casals-Pascual, Climent von Both, Ulrich Cunnington, Aubrey and De, Tisham Eleftheriou, Irini Emonts, Marieke Fink, Colin and van der Flier, Michiel de Groot, Ronald Kaforou, Myrsini and Kohlmaier, Benno Kuijpers, Taco W. Lim, Emma Maconochie, Ian K. Paulus, Stephane Martinon-Torres, Federico Pokorn, Marko and Romaine, Sam T. Calle, Irene Rivero Schlapbach, Luregn J. and Smit, Frank J. Tsolia, Maria Usuf, Effua Wright, Victoria J. Yeung, Shunmay Zavadska, Dace Zenz, Werner and Levin, Michael Herberg, Jethro A. Carrol, Enitan D. PERFORM Consortium Personalized Ri

Abstract

Background: The limited diagnostic accuracy of biomarkers in children at risk of a serious bacterial infection (SBI) might be due to the imperfect reference standard of SBI. We aimed to evaluate the diagnostic performance of a new classification algorithm for biomarker discovery in children at risk of SBI. Methods: We used data from five previously published, prospective observational biomarker discovery studies, which included patients aged 0

Published
2021

45. Development and validation of a prediction model for invasive bacterial infections in febrile children at European Emergency Departments: MOFICHE, a prospective observational study

Author

Hagedoorn, Nienke N. Borensztajn, Dorine Nijman, Ruud Gerard and Nieboer, Daan Herberg, Jethro Adam Balode, Anda von Both, Ulrich Carrol, Enitan Eleftheriou, Irini Emonts, Marieke and van der Flier, Michiel de Groot, Ronald Kohlmaier, Benno and Lim, Emma Maconochie, Ian Martinon-Torres, Federico Pokorn, Marko Strle, Franc Tsolia, Maria Zavadska, Dace Zenz, Werner Levin, Michael Vermont, Clementien Moll, Henriette A.

Abstract

Objectives To develop and cross-validate a multivariable clinical prediction model to identify invasive bacterial infections (IBI) and to identify patient groups who might benefit from new biomarkers. Design Prospective observational study. Setting 12 emergency departments (EDs) in 8 European countries. Patients Febrile children aged 0-18 years. Main outcome measures IBI, defined as bacteraemia, meningitis and bone/joint infection. We derived and cross-validated a model for IBI using variables from the Feverkidstool (clinical symptoms, C reactive protein), neurological signs, non-blanching rash and comorbidity. We assessed discrimination (area under the receiver operating curve) and diagnostic performance at different risk thresholds for IBI: sensitivity, specificity, negative and positive likelihood ratios (LRs). Results Of 16 268 patients, 135 (0.8%) had an IBI. The discriminative ability of the model was 0.84 (95% CI 0.81 to 0.88) and 0.78 (95% CI 0.74 to 0.82) in pooled cross-validations. The model performed well for the rule-out threshold of 0.1% (sensitivity 0.97 (95% CI 0.93 to 0.99), negative LR 0.1 (95% CI 0.0 to 0.2) and for the rule-in threshold of 2.0% (specificity 0.94 (95% CI 0.94 to 0.95), positive LR 8.4 (95% CI 6.9 to 10.0)). The intermediate thresholds of 0.1%-2.0% performed poorly (ranges: sensitivity 0.59-0.93, negative LR 0.14-0.57, specificity 0.52-0.88, positive LR 1.9-4.8) and comprised 9784 patients (60%). Conclusions The rule-out threshold of this model has potential to reduce antibiotic treatment while the rule-in threshold could be used to target treatment in febrile children at the ED. In more than half of patients at intermediate risk, sensitive biomarkers could improve identification of IBI and potentially reduce unnecessary antibiotic prescriptions.

Published
2021

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

Author

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

Published
2021
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49. Sinus Bradycardia in Children Treated With Remdesivir for COVID-19

Author

Eleftheriou, Irini Liaska, Marianthi Krepis, Panagiotis and Dasoula, Foteini Dimopoulou, Dimitra Spyridis, Nikos Tsolia, Maria and Eleftheriou, Irini Liaska, Marianthi Krepis, Panagiotis and Dasoula, Foteini Dimopoulou, Dimitra Spyridis, Nikos Tsolia, Maria

Published
2021

50. Impact of a clinical decision rule on antibiotic prescription for children with suspected lower respiratory tract infections presenting to European emergency departments:A simulation study based on routine data

Author

Hagedoorn, Nienke N., Wagenaar, Josephine H.L., Nieboer, Daan, Bath, David, Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Vermont, Clementien L., Oostenbrink, Rianne, Moll, Henriette A., Hagedoorn, Nienke N., Wagenaar, Josephine H.L., Nieboer, Daan, Bath, David, Von Both, Ulrich, Carrol, Enitan D., Eleftheriou, Irini, 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, Yeung, Shunmay, Zavadska, Dace, Zenz, Werner, Vermont, Clementien L., Oostenbrink, Rianne, and Moll, Henriette A.

Abstract

Background: Discriminating viral from bacterial lower respiratory tract infections (LRTIs) in children is challenging thus commonly resulting in antibiotic overuse. The Feverkidstool, a validated clinical decision rule including clinical symptoms and C-reactive protein, safely reduced antibiotic use in children at low/intermediate risk for bacterial LRTIs in a multicentre trial at emergency departments (EDs) in the Netherlands. Objectives: Using routine data from an observational study, we simulated the impact of the Feverkidstool on antibiotic prescriptions compared with observed antibiotic prescriptions in children with suspected LRTIs at 12 EDs in eight European countries. Methods: We selected febrile children aged 1month to 5 years with respiratory symptoms and excluded upper respiratory tract infections. Using the Feverkidstool, we calculated individual risks for bacterial LRTI retrospectively. We simulated antibiotic prescription rates under different scenarios: (1) applying effect estimates on antibiotic prescription from the trial; and (2) varying both usage (50%-100%) and compliance (70%-100%) with the Feverkidstool s advice to withhold antibiotics in children at low/intermediate risk for bacterial LRTI (10%). Results: Of 4938 children, 4209 (85.2%) were at low/intermediate risk for bacterial LRTI. Applying effect estimates from the trial, the Feverkidstool reduced antibiotic prescription from 33.5% to 24.1% [pooled risk difference: 9.4% (95% CI: 5.7%-13.1%)]. Simulating 50%-100% usage with 90% compliance resulted in risk differences ranging from 8.3% to 15.8%. Our simulations suggest that antibiotic prescriptions would be reduced in EDs with high baseline antibiotic prescription rates or predominantly (85%) low/intermediate-risk children. Conclusions: Implementation of the Feverkidstool could reduce antibiotic prescriptions in children with suspected LRTIs in European EDs.

Published
2021

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