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1. Recommendations for pediatric tuberculosis vaccination in Italy

Author

Montagnani, C, Esposito, S, Galli, L, Chiappini, E, Principi, N, de Martino, M, Bosis, S, Tagliabue, C, Senatore, L, Ascolese, B, Villani, A, Lancella, L, Cursi, L, Grandin, A, Marabotto, C, Ciofi, D, Festini, F, Anziati, M, Becciani, S, Remaschi, G, Sollai, S, Tersigni, C, Venturini, E, Guarino, A, Lo Vecchio, A, Scotto, R, Gabiano, C, Garazzino, S, Le Serre, D, Raffaldi, I, Bernardi, F, Bertazzoni, E, Blasi, F, Bocchino, M, Assante, L, Castagnola, E, Losurdo, G, Codecasa, L, Di Mauro, G, Faccini, M, Marseglia, G, Mascolo, A, Di Comite, A, Stronati, M, Matteelli, A, Migliori, Gb, D’Ambrosio, L, Centis, R, Pasinato, Cirillo, Tortoli, Russo, Scaglione, F, Scala, E, and Tomà, P

Subjects
Pediatrics, medicine.medical_specialty, Tuberculosis, Immunology, Breastfeeding, Tuberculin, Reviews, Disease, Tuberculous meningitis, 03 medical and health sciences, 0302 clinical medicine, children, prevention, BCG, tuberculosis, vaccination, vaccine, 030225 pediatrics, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Immunization Schedule, Pharmacology, business.industry, medicine.disease, Settore MED/38, Pediatric tuberculosis, Vaccination, Italy, BCG Vaccine, business, BCG vaccine
Abstract

Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged

Published
2015

2. Medical care related laboratory-confirmed bloodstream infections in paediatrics

Author

Virano, S, Scolfaro, C, Garazzino, S, De Intinis, C, Ghisetti, V, Raffaldi, I, Calitri, C, Tovo, Pa, Regina Margherita Children’s Hospital Bloodstream Infections Study Group including Plazzotta, C, Zotti, Cm, Neve, V, Conio, A, Vitale, P, Giacchino, M, Bertin, D, Carraro, F, Le Serre, D, Iannandrea, S, Grassitelli, Sm, Luccoli, L, Esposito, I, Ragazzi, P, Carlino, C, Porcellini, Mg, Bonaudo, R, Calvo, Pl, Baldi, M, Laudati, R, Ferraris, S, Aidala, E, Valori, A, Banaudi, E, Riggi, C, Bertino, E, Coscia, A, Di Nicola, P, Cavecchia, I, Cerchio, R, Bosetti, Fm, Bianciotto, M, Farina, D, and Manzoni, P

Subjects
Male, Methicillin-Resistant Staphylococcus aureus, Staphylococcus aureus, Drug Resistance, Anti-Bacterial Agents, Bacteremia, Child, Child, Preschool, Cross Infection, Drug Resistance, Multiple, Bacterial, Female, Hospitals, Pediatric, Hospitals, Teaching, Humans, Incidence, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Italy, Prospective Studies, Risk Factors, Staphylococcal Infections, Pediatrics, Preschool, Pediatric, Teaching, Bacterial, Newborn, Hospitals, Intensive Care Units, Multiple
Abstract

The aim of this survey was to describe the incidence, epidemiology, microbiology, risk factors and outcome of medical care related laboratory-confirmed bloodstream infections (LCBIs) observed during a twelve-month prospective study in a Paediatric Teaching Hospital in Turin, Italy. Inclusion criteria were clinical signs of sepsis and positivity of one or more of the following tests: blood culture, polymerase chain reaction for bacterial and fungal DNA on blood, and culture on intravascular device tips. In all, 140 episodes of sepsis were documented in 131 children: 37 (26.4%) were healthcare outpatient-associated, 91 (65.0%) healthcare-associated and 12 (8.6%) community-acquired. The overall incidence of healthcare-associated LCBIs was 13.6/1,000 hospitalized patients and incidence density 1.4/1,000 inpatient days. The overall mortality was 3.9%. Forty-seven (36.7%) episodes involved newborns and 107 (83.6%) episodes were observed in children with an indwelling central venous catheter. Coagulase-negative staphylococci (26.8%), Staphylococcus aureus (15.2%), Escherichia coli (8.7%) and Candida spp. (7.2%) were responsible for the majority of cases. 9.5% of S. aureus isolates were methicillin-resistant and 6.5% of Gram negatives were extended-spectrum beta-lactamase-producing. Incidence and epidemiology of medical care related LCBIs were similar to the existing literature data. LCBIs caused by antibiotic-resistant microorganisms were fewer and mortality rate was lower. Most of the LCBIs recorded involved newborns and oncological children.

Published
2015

3. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy

Author

Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, Pier Angelo, Gabiano, C, Urbino, A, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Manuela, O, Carlo, C, Mores, N, Romagnoli, C, Chiaretti, A, Compagnone, A, Riccardi, R, Delogu, G, Sali, M, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Sodano, G, Maccariello, A, Rafaniello, C, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, Arrigo, T, Italian Multicentre Study Group for Drug, Vaccine Safety in Children, Menniti Ippolito, Francesca, Da Cas, Roberto, Traversa, Giuseppe, Santuccio, Carmela, Felicetti, Patrizia, Tartaglia, Loriana, Trotta, Francesco, Di Pietro, Pasquale, Barabino, Paola, Renna, Salvatore, Riceputi, Laura, Tovo, Pier Angelo, Gabiano, Clara, Urbino, Antonio, Baroero, Luca, Le Serre, Daniele, Virano, Silvia, Perilongo, Giorgio, Daverio, Marco, Gnoato, Elisa, Maretti, Michela, Galeazzo, Beatrice, Rubin, Giulia, Scanferla, Stefania, Da Dalt, Liviana, Stefani, Chiara, Zerbinati, Claudia, Chiappini, Elena, Sollai, Sara, De Martino, Maurizio, Mannelli, Francesco, Becciani, Sabrina, Giacalone, Martina, Montano, Simona, Remaschi, Giulia, Stival, Alessia, Furbetta, Mario, Abate, Piera, Leonardi, Ilaria, Pirozzi, Nicola, Raucci, Umberto, Reale, Antonino, Rossi, Rossella, Russo, Cristina, Mancinelli, Livia, Manuela, Onori, Carlo, Concato, Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Compagnone, Adele, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Prete, Valentina, Tipo, Vincenzo, Dinardo, Michele, Auricchio, Fabiana, Polimeno, Teodoro, Sodano, Giuseppe, Maccariello, Alessandra, Rafaniello, Concetta, Fucà, Fortunata, Di Rosa, Eleonora, Altavilla, Domenica, Mecchio, Anna, and Arrigo, Teresa

Subjects
Male, Pediatrics, Laboratory-confirmed case, Emergency Medical Services, Immunology and Microbiology (all), Laboratory-confirmed cases, Case-control study, Children, Influenza vaccine effectiveness, Seasonal influenza, Influenza vaccine effectivene, Emergency medical services, Medicine, Child, Vaccine effectiveness, Vaccination, Hospitalization, Systematic review, Infectious Diseases, Treatment Outcome, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, Influenza Vaccines, Child, Preschool, Molecular Medicine, Veterinary (all), Female, Case-Control Studie, Influenza Vaccine, Settore BIO/19 - MICROBIOLOGIA GENERALE, Human, medicine.medical_specialty, Settore BIO/14 - FARMACOLOGIA, Adolescent, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Immunology and Microbiology(all), Influenza, Human, Humans, Influenza-like illness, General Veterinary, General Immunology and Microbiology, business.industry, Emergency Medical Service, Public Health, Environmental and Occupational Health, Infant, Emergency department, veterinary(all), Confidence interval, Surgery, Case-Control Studies, Case-control study, Children, Influenza vaccine effectiveness, Laboratory-confirmed cases, influenza in children, business
Abstract

•Vaccine effectiveness in children visiting an Emergency Department for influenza.•Test negative case-control study in 11 paediatric centres in two influenza seasons.•Vaccine effectiveness in preventing ED visits: 38% (95% CI -52% to 75%).•Add information for recommendation for vaccination in children. Objective: To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children. Methods: We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children. Results: Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%). Discussion: This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children. © 2014 The Authors.

Published
2013

7. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy.

Author

Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Compagnone, Adele, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Trotta, F, Felicetti, P, Tartaglia, L, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, Pa, Gabiano, C, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Manuela, O, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Carlo, C, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T., Mores, Nadia (ORCID:0000-0002-4197-0914), Romagnoli, Costantino (ORCID:0000-0003-1176-2943), Chiaretti, Antonio (ORCID:0000-0002-9971-1640), Riccardi, Riccardo (ORCID:0000-0001-7515-6622), Delogu, Giovanni (ORCID:0000-0003-0182-8267), Sali, Michela (ORCID:0000-0003-3609-2990), Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Compagnone, Adele, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Trotta, F, Felicetti, P, Tartaglia, L, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, Pa, Gabiano, C, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Manuela, O, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Carlo, C, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T., Mores, Nadia (ORCID:0000-0002-4197-0914), Romagnoli, Costantino (ORCID:0000-0003-1176-2943), Chiaretti, Antonio (ORCID:0000-0002-9971-1640), Riccardi, Riccardo (ORCID:0000-0001-7515-6622), Delogu, Giovanni (ORCID:0000-0003-0182-8267), and Sali, Michela (ORCID:0000-0003-3609-2990)

Abstract

OBJECTIVE: To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children. METHODS: We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children. RESULTS: Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%). DISCUSSION: This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children.

Published
2014

8. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy

Author

Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, P, Gabiano, C, Urbino, A, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Manuela, O, Carlo, C, Mores, Nadia, Romagnoli, C, Chiaretti, Antonio, Compagnone, A, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Sodano, G, Maccariello, A, Rafaniello, C, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, Arrigo, T., Mores, Nadia (ORCID:0000-0002-4197-0914), Chiaretti, A (ORCID:0000-0002-9971-1640), Riccardi, Riccardo (ORCID:0000-0001-7515-6622), Delogu, Giovanni (ORCID:0000-0003-0182-8267), Sali, Michela (ORCID:0000-0003-3609-2990), Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, P, Gabiano, C, Urbino, A, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Manuela, O, Carlo, C, Mores, Nadia, Romagnoli, C, Chiaretti, Antonio, Compagnone, A, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Sodano, G, Maccariello, A, Rafaniello, C, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, Arrigo, T., Mores, Nadia (ORCID:0000-0002-4197-0914), Chiaretti, A (ORCID:0000-0002-9971-1640), Riccardi, Riccardo (ORCID:0000-0001-7515-6622), Delogu, Giovanni (ORCID:0000-0003-0182-8267), and Sali, Michela (ORCID:0000-0003-3609-2990)

Abstract

To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children.

Published
2014

9. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

Author

Alberto Villani, Patrizia Ballista, Luisa Galli, Laura Castiglioni, Elena Chiappini, Daniele Le Serre, Samantha Bosis, Gian Luigi Marseglia, Maurizio de Martino, Giuseppe Losurdo, Laura Lancella, Maria Di Gangi, Filippo Salvini, Cristina Venturelli, Andrea Lo Vecchio, Barbara Maria Bergamini, Eugenia Bruzzese, Elena Boccuzzi, Caterina Marabotto, Susanna Esposito, Michele Pinon, Piero Valentini, Laura Cursi, Elisa Fiumana, Elio Castagnola, Grazia Bossi, Marco Montesanti, Francesca Maschio, Chiara Fornabaio, Giulia Tosetti, Elisabetta Venturini, Alfredo Guarino, Margherita Codifava, Gabriella Bottone, Icilio Dodi, Rita Grandolfo, Carla Lupi, Nicola Palladino, Mariella Valenzise, Raffaele Domenici, V. Portelli, Danilo Buonsenso, Valentina Fiorito, Barbara Vecchi, Luisa Abbagnato, Pier-Angelo Tovo, Enrica Riva, Silvia Garazzino, Chiara Tersigni, Galli, L, Lancella, L, Tersigni, C, Venturini, E, Chiappini, E, Bergamini, Bm, Codifava, M, Venturelli, C, Tosetti, G, Marabotto, C, Cursi, L, Boccuzzi, E, Garazzino, S, Tovo, Pa, Pinon, M, Le Serre, D, Castiglioni, L, LO VECCHIO, Andrea, Guarino, Alfredo, Bruzzese, Eugenia, Losurdo, G, Castagnola, E, Bossi, G, Marseglia, Gl, Esposito, S, Bosis, S, Grandolfo, R, Fiorito, V, Valentini, P, Buonsenso, D, Domenici, R, Montesanti, M, Salvini, Fm, Riva, E, Dodi, I, Maschio, F, Abbagnato, L, Fiumana, E, Fornabaio, C, Ballista, P, Portelli, V, Bottone, G, Palladino, N, Valenzise, M, Vecchi, B, Di Gangi, M, Lupi, C, Villani, A, and de Martino, M.

Subjects
Male, Pediatrics, Children, Italian, Register, Tuberculosis, Antitubercular Agents, Drug resistance, Ambulatory Care Facilities, Catalysi, lcsh:Chemistry, 0302 clinical medicine, Health care, Epidemiology, Tuberculosis, Multidrug-Resistant, 030212 general & internal medicine, Registries, Child, lcsh:QH301-705.5, Spectroscopy, Pediatric, register, biology, Incidence (epidemiology), Computer Science Applications1707 Computer Vision and Pattern Recognition, Pulmonary, General Medicine, Multidrug-Resistant, Hospitals, Pediatric, Settore MED/38, Hospitals, Computer Science Applications, Pediatric tuberculosis, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, tuberculosis, Child, Preschool, Catalysis, Molecular Biology, Physical and Theoretical Chemistry, Organic Chemistry, Inorganic Chemistry, Female, medicine.medical_specialty, Adolescent, Tuberculosi, Humans, Infant, Tuberculosis, Pulmonary, Article, Mycobacterium tuberculosis, 03 medical and health sciences, children, 030225 pediatrics, medicine, Preschool, business.industry, Public health, medicine.disease, biology.organism_classification, Children, Italian, Register, Tuberculosis, lcsh:Biology (General), lcsh:QD1-999, business
Abstract

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

Published
2016

10. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis.

Author

Galli L, Lancella L, Tersigni C, Venturini E, Chiappini E, Bergamini BM, Codifava M, Venturelli C, Tosetti G, Marabotto C, Cursi L, Boccuzzi E, Garazzino S, Tovo PA, Pinon M, Le Serre D, Castiglioni L, Lo Vecchio A, Guarino A, Bruzzese E, Losurdo G, Castagnola E, Bossi G, Marseglia GL, Esposito S, Bosis S, Grandolfo R, Fiorito V, Valentini P, Buonsenso D, Domenici R, Montesanti M, Salvini FM, Riva E, Dodi I, Maschio F, Abbagnato L, Fiumana E, Fornabaio C, Ballista P, Portelli V, Bottone G, Palladino N, Valenzise M, Vecchi B, Di Gangi M, Lupi C, Villani A, and de Martino M

Subjects
Adolescent, Ambulatory Care Facilities statistics & numerical data, Antitubercular Agents therapeutic use, Child, Child, Preschool, Female, Hospitals, Pediatric statistics & numerical data, Humans, Infant, Italy, Male, Registries statistics & numerical data, Tuberculosis, Multidrug-Resistant diagnosis, Tuberculosis, Multidrug-Resistant drug therapy, Tuberculosis, Pulmonary diagnosis, Tuberculosis, Pulmonary drug therapy, Tuberculosis, Multidrug-Resistant epidemiology, Tuberculosis, Pulmonary epidemiology
Abstract

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

Published
2016
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11. Diagnosis and management of deep neck infections in children: the experience of an Italian paediatric centre.

Author

Raffaldi I, Le Serre D, Garazzino S, Scolfaro C, Bertaina C, Mignone F, Peradotto F, Tavormina P, and Tovo PA

Subjects
Abscess pathology, Adolescent, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Italy, Male, Neck microbiology, Neck surgery, Postoperative Complications etiology, Retrospective Studies, Abscess diagnosis, Abscess therapy, Neck pathology
Abstract

Deep neck infection (DNI) is a severe occurrence in children. We've examined the presenting signs and symptoms, the value of single diagnostic procedures, the rate of complications and the impact of the therapeutic options on the final outcome, in children with a DNI. We retrospectively evaluated patients, aged 0-18 years, who were admitted for a DNI, from January 2006 through December 2012, at Regina Margherita Children's Hospital, Turin, Italy. We subdivided them on the basis of type of treatment: pharmacological treatment alone or antimicrobial treatment plus surgery. An univariate analysis has been performed to examine the differences between the two groups. Sixty patients (32 males, 28 females) with diagnosis of DNI were enrolled; 33 children only received medical treatment (group 1), whereas 27 patients underwent also surgical interventions (group 2). The mean abscess size was significantly higher in group 2 than in group 1 (p = 0.01). The predominant organisms were Streptococcus sp. (11 cases, 52.4%, mostly Streptococcus pyogenes). The most frequent antibiotic regimen was a β lactam alone (either III generation cephalosporin or amoxicillin/clavulanate). The duration of intravenous antibiotic varied between the two groups, without statistical significance (p = 0.052); whereas the oral antibiotic administration was significantly shorter in group 1 than in group 2 (p = 0.0003). Three patients (5%) developed complications. This research confirms that the medical approach, with high doses of intravenous antibiotics for a minimum of 5 days, could be a tolerable and safe option for the treatment of patients with stable condition and/or small DNIs., (Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Published
2015
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12. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy.

Author

Menniti-Ippolito F, Da Cas R, Traversa G, Santuccio C, Felicetti P, Tartaglia L, Trotta F, Di Pietro P, Barabino P, Renna S, Riceputi L, Tovo PA, Gabiano C, Urbino A, Baroero L, Le Serre D, Virano S, Perilongo G, Daverio M, Gnoato E, Maretti M, Galeazzo B, Rubin G, Scanferla S, Da Dalt L, Stefani C, Zerbinati C, Chiappini E, Sollai S, De Martino M, Mannelli F, Becciani S, Giacalone M, Montano S, Remaschi G, Stival A, Furbetta M, Abate P, Leonardi I, Pirozzi N, Raucci U, Reale A, Rossi R, Russo C, Mancinelli L, Manuela O, Carlo C, Mores N, Romagnoli C, Chiaretti A, Compagnone A, Riccardi R, Delogu G, Sali M, Prete V, Tipo V, Dinardo M, Auricchio F, Polimeno T, Sodano G, Maccariello A, Rafaniello C, Fucà F, Di Rosa E, Altavilla D, Mecchio A, and Arrigo T

Subjects
Adolescent, Case-Control Studies, Child, Child, Preschool, Emergency Medical Services statistics & numerical data, Female, Hospitalization statistics & numerical data, Humans, Infant, Italy epidemiology, Male, Treatment Outcome, Influenza Vaccines administration & dosage, Influenza Vaccines immunology, Influenza, Human pathology, Influenza, Human prevention & control
Abstract

Objective: To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children., Methods: We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children., Results: Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%)., Discussion: This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2014
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