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In the United States, the burden of hepatitis C virus (HCV) infection is disproportionately high among young adults including pregnant persons, resulting in increased infections among children as perinatal transmission remains the main route of HCV infection in children. Hence, in 2020, the Centers for Disease Control and Prevention (CDC) recommended universal HCV screening during each pregnancy. HCV infection in infancy is usually asymptomatic, so the diagnosis entirely relies on testing of perinatally exposed infants which, historically, included anti-HCV antibody testing at ≥18 months of age. However, nation-wide perinatal HCV testing rates have been suboptimal with significant loss to follow-up. To address this problem, in 2023, the CDC introduced early single HCV RNA testing at 2–6 months of age with an alternative for HCV RNA testing up to 17 months of age if not previously tested. The high sensitivity and specificity of the HCV real-time PCR laid the grounds for this policy shift. In this review, we highlight how these new CDC recommendations will enhance testing of infants and children and ultimately contribute to overall HCV elimination efforts. We also emphasize the role of all pediatric providers and obstetricians in implementing these new guidelines. Additionally, we offer our perspective and practical advice for testing of perinatally exposed infants and children. Currently, curative oral antivirals for HCV-infection treatment are approved for children ≥3 years of age. As pediatricians, advocating for children's wellness, it is our utmost duty to ensure that every child exposed to perinatal hepatitis C has been tested, diagnosed, linked to care, treated, and achieved cure. [ABSTRACT FROM AUTHOR]

Listeria monocytogenes is a relatively uncommon cause of foodborne infection in the general population. Most cases of Listeriosis occur among newborns, pregnant women, the elderly and those with impairment of cellular immunity. Neonatal Listeria meningitis is rare. We present a case of Listeria meningitis at the age of 15 days in a previously healthy neonate who presented with acute onset of fever, poor feeding and lethargy. Sepsis workup revealed L. monocytogenes identified in cerebrospinal fluid PCR and culture. The infant’s course was complicated by transient syndrome of inappropriate antidiuretic hormone and subsequent hydrocephalus that required a ventriculoperitoneal shunt placement. Though rare, neonatal infections due to Listeria can present with meningitis leading to serious and devastating complications. Our case emphasises the importance of considering Listeria in cases of neonatal meningitis and the value of close follow-up of such cases through early detection and management of acute and long-term complications. [ABSTRACT FROM AUTHOR]

The article discusses the "Recommendations for HCV testing among perinatally exposed infants and children," published by the U.S. Centers for Disease Control and Prevention (CDC) in the November 2023 issue of "Morbidity and Mortality Weekly Report." Topics include previous recommendation for all infants with HCV exposure, how to successfully identify all exposed infants and prevent loss to follow up and inadequate testing, and steps needed to successfully implement the testing strategy.

Antipyretic analgesics are commonly used to prevent and treat adverse events following immunizations. Current practice discourages routine use due to possible blunting of vaccine immune responses. We surveyed 150 parents/caregivers of recently vaccinated 6- and 15-month-old children to determine the prevalence of and beliefs regarding antipyretic analgesics use around vaccinations. 11% used them prophylactically, before vaccination. Use in the first 48 hours after vaccination was 64%, primarily to prevent and/or treat fever and pain. Acetaminophen was administered 2.6 times more frequently than ibuprofen. Ibuprofen was used more in the 15-month compared with the 6-month-old children (28% vs 7.4%, respectively, P = .001). The majority of caregivers disagreed with their use for fever (53%) or pain (59%). Antipyretic analgesic use, including prophylaxis, around vaccinations was common in our study population. Effective interventions are needed to target parents/caregivers to eliminate unnecessary antipyretic analgesic use around vaccination time and foster nonmedication alternatives. [ABSTRACT FROM AUTHOR]

Acute respiratory infections (ARI) are the leading cause of pediatric morbidity and mortality worldwide. Information on etiological agents of ARI in developing countries is still limited. This study conducted in Alexandria, Egypt, was designed to determine the prevalence of several microorganisms in 113 children hospitalized with ARI. Overall, 65 agents were identified; 58 (51.3%) individuals were found to be positive for at least one pathogen, and seven of them were also positive for two agents. Chlamydophila pneumoniae was the most commonly detected agent (n=32; 28.3%), followed by Mycoplasma pneumoniae, respiratory syncytial and influenza. Positivity for C. pneumoniae, which was the most commonly detected agent, was associated with male sex and with mild disease of the upper respiratory tract. [ABSTRACT FROM AUTHOR]

Background: Streptococcus canis (S. canis), belonging to β-hemolytic group G streptococci, is increasingly reported to cause sepsis and severe infections in adults with comorbidities but is rarely reported in children., Methods: We describe a case of S. canis neonatal sepsis in a term infant with a rapidly fatal outcome. We reviewed the literature on neonatal infections due to all group G streptococci including S. canis., Results: We identified 10 articles describing 19 cases of neonatal sepsis due to group G streptococcus, of which only 3 cases were identified at the species level. Most patients presented in the first week of life with neonatal sepsis with bacteremia present in 90% of cases. Among the patients, gestational age ranged from 31 to 42 weeks. Prematurity was reported in 35% of the patients. All patients were treated with β-lactams with or without aminoglycosides. Mortality was 26%., Conclusions: S. canis infection is rare in the setting of neonatal sepsis; however, it can lead to high morbidity and mortality. It is imperative to promptly administer empiric antibiotics for critically ill neonates until neonatal sepsis is ruled out. β-lactams provide adequate coverage against S. canis. Further epidemiological and clinical studies focusing on S. canis are needed to fully understand the transmission and disease burden of this pathogen in neonates., Competing Interests: E.S. received funding from the Centers for Disease Control and Prevention contracts 75D30122C15052 and 75D30123P18282. The other authors have no conflicts of interest to disclose., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Listeria monocytogenes is a relatively uncommon cause of foodborne infection in the general population. Most cases of Listeriosis occur among newborns, pregnant women, the elderly and those with impairment of cellular immunity. Neonatal Listeria meningitis is rare. We present a case of Listeria meningitis at the age of 15 days in a previously healthy neonate who presented with acute onset of fever, poor feeding and lethargy. Sepsis workup revealed L. monocytogenes identified in cerebrospinal fluid PCR and culture. The infant's course was complicated by transient syndrome of inappropriate antidiuretic hormone and subsequent hydrocephalus that required a ventriculoperitoneal shunt placement. Though rare, neonatal infections due to Listeria can present with meningitis leading to serious and devastating complications. Our case emphasises the importance of considering Listeria in cases of neonatal meningitis and the value of close follow-up of such cases through early detection and management of acute and long-term complications., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Antibiotics are commonly prescribed in pediatric outpatient settings; however, efforts to decrease inappropriate use have largely focused on inpatients. We obtained baseline metrics to identify conditions that may benefit from establishment of outpatient antimicrobial stewardship interventions (ASP). We evaluated rates and appropriateness of antibiotic prescribing for children with acute otitis media (AOM), community acquired pneumonia (CAP), and skin and soft tissue infections (SSTI) in ambulatory settings within a large healthcare system in the US Midwest. We retrospectively reviewed 77,821 visits and associated diagnostic codes for children less than 17 years seen in ambulatory settings within our health system from August 1, 2009 to July 31, 2010. We measured rates of antibiotic prescribing by location, provider type, patient age, and diagnosis, and assessed concordance with treatment guidelines for AOM, CAP, and SSTI. AOM, CAP, and SSTI comprised about 1/3 of all infections in the study population. Antibiotics were prescribed in 14,543 (18.7%) visits. Antibiotic prescribing rates were 1.1 to 1.2 times higher among Emergency Room (ER) providers compared to Pediatricians and Family Physicians. Antibiotics prescribed for AOM and SSTI were concordant with guidelines in approximately 97% of cases. In contrast, 47% of antibiotics prescribed for treatment of CAP in children < 5 years old were macrolides, which are not recommended first line therapy for CAP in this age group. Antibiotic prescribing for pediatric outpatients within our health system is not guideline-concordant for treatment of CAP.