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Editorial
Infection
Impact and role of vitamins as immunonutrition in children during COVID-19 pandemic
Yoo Min Lee
Clin Exp Pediatr. 2023;66(5):212-214.   Published online April 18, 2023
· Vitamins have effector mechanisms in the innate and adaptive immune systems and potential roles in preventing and reducing the severity of coronavirus disease 2019 (COVID-19).
· Vitamins may be immunonutrients in the treatment of COVID-19 infections and prevention of patient deterioration due to critical illness, thus demonstrating the significance of a nutritious, well-balanced diet.
Review Article
Infection
COVID-19 in immunocompromised children and adolescents
Byung Ok Kwak, Byung Wook Eun
Clin Exp Pediatr. 2023;66(5):182-189.   Published online April 18, 2023
Most immunocompromised children and adolescents are not at increased risk of developing severe coronavirus disease 2019 (COVID-19). COVID-19 outcomes for low- or medium-risk immunocompromised children are favorable, while more serious illness reportedly occurs in high-risk immunocompromised children by underlying disease, its treatments, and other factors. Therefore, the early detection and timely management of severe COVID-19 and treatment of underlying disease are important. Hospitalization and COVID-19 vaccination should be carefully considered.
Original Article
Infection
Predicting COVID-19 transmission in a student population in Seoul, South Korea, 2020–2021
Young Hwa Lee, Han Ho Kim, Young June Choe
Clin Exp Pediatr. 2023;66(4):173-178.   Published online December 22, 2022
Question: What is the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) infection among students in Korea?
Finding: The community population was closely associated with the risk of COVID-19, and the number of students per school class were inversely associated with COVID-19 rates in students.
Meaning: Our finding suggests that controlling the community-level burden of COVID-19 can help prevent sudden acute respiratory syndrome coronavirus 2 infection in school-aged children.
Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study
In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease
Clin Exp Pediatr. 2023;66(3):134-141.   Published online December 22, 2022
Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.
Review Article
Infection
Pathogenetic and etiologic considerations of febrile seizures
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Global varicella vaccination programs
Young Hwa Lee, Young June Choe, Jia Lee, Eunseong Kim, Jae Young Lee, Kwan Hong, Yoonsun Yoon, Yun-Kyung Kim
Clin Exp Pediatr. 2022;65(12):555-562.   Published online November 2, 2022
It is important to evaluate its effectiveness at the national level and to determine the varicella vaccine schedule based on the evidence generated through the studies.
Perspective
Infection
Statement on healthcare system preparedness in response to COVID-19 Omicron subvariants BA.4 and BA.5 surge in Korea from the Korean Pediatric Society and Korean Society of Pediatric Infectious Diseases
Eun Young Cho, Dong Hyun Kim, Soo-Han Choi, Ki Wook Yun, Jong Gyun Ahn, Hye-Kyung Cho, Hyunju Lee, Jina Lee, Taek-Jin Lee, Byung-Wook Eun, Jin Lee, Dae Sun Jo, Yun-Kyung Kim, Yae-Jean Kim; Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2022;65(11):510-511.   Published online September 23, 2022
In order to respond to the recent surge in coronavirus disease 2019 (COVID-19) cases and the continuously changing epidemiology of COVID-19, a sustainable and flexible pediatric healthcare system must be prepared considering the specificity of pediatric care. We demand a more proactive response from the health authorities to check the current state of pediatric COVID-19 patient care and to ensure that pediatric patients receive appropriate and timely management.
Review Article
Infection
Therapeutics for the treatment of coronavirus disease 2019 in children and adolescents
Soo-Han Choi, Jae Hong Choi, Ki Wook Yun
Clin Exp Pediatr. 2022;65(8):377-386.   Published online June 27, 2022
· Children and adolescents with high risks for severe coronavirus disease 2019 (COVID-19) should be identified and proper treatment should be provided promptly according to the patient’s condition.
· Remdesivir can be considered for pediatric patients of all ages with COVID-19 who have an emergent or increase in supplemental oxygen.
· The use of corticosteroids is not recommended for patients with nonsevere COVID-19. Corticosteroids are recommended in children and adolescents with severe and critical COVID-19.
Original Article
Infection
Role of lung ultrasound patterns in monitoring coronavirus disease 2019 pneumonia and acute respiratory distress syndrome in children
Satyabrata Roychowdhoury, Subhajit Bhakta, Manas Kumar Mahapatra, Saptarshi Ghosh, Sayantika Saha, Mithun Chandra Konar, Mihir Sarkar, Mousumi Nandi
Clin Exp Pediatr. 2022;65(7):358-366.   Published online May 13, 2022
Question: Potential role of patterns of lung ultrasonography (US) in monitoring changes in mechanically ventilated patients with coronavirus disease 2019 (COVID-19) pneumonia.
Finding: Interstitial syndrome, an irregular pleural line, and peripheral microconsolidation were the most prevalent findings. Changes in lung aeration after mechanical ventilation corelated with improved oxygenation. A fall in lung ultrasound reaeration score ≤ 5 may predict successful weaning.
Meaning: Lung US is gaining wider utility for monitoring COVID-19 pneumonia.
Letter to the Editor
Infection
Changes in epidemiology of parainfluenza virus and respiratory syncytial virus infection during coronavirus disease 2019 pandemic in Korea
Kyung-Ran Kim, Hwanhee Park, Doo Ri Kim, Yae-Jean Kim
Clin Exp Pediatr. 2022;65(6):320-321.   Published online March 10, 2022
Question: How the epidemiology of other childhood respiratory viruses has changed during coronavirus disease 2019 (COVID-19) in Korea?
Finding: Parainfluenza virus (PIV) typically circulated in the spring, and respiratory syncytial virus (RSV) epidemic started in autumn in Korea before COVID-19 pandemic. PIV and RSV seasons disappeared in 2020 and came back in 2021 with atypical seasonality. PIV season was changed from spring to autumn, and the beginning of RSV season was slightly delayed from autumn to early winter in 2021.
Meaning: Circulation of PIV and RSV was changed to unusual seasons and patterns during COVID-19 pandemic period.
Editorial
Infection
Effects of nonpharmaceutical interventions for coronavirus disease 2019
Jae Hong Choi
Clin Exp Pediatr. 2022;65(5):250-251.   Published online March 22, 2022
∙ Nonpharmaceutical interventions (NPIs) have decreased the incidence of various infectious diseases, including coronavirus disease 2019 (COVID-19).
∙ During the 2-year COVID-19 pandemic, NPIs changed patients’ daily lives, and the impact on mental health was notable.
∙ The effects of NPIs were evaluated in detail, considering both infections and mental health.
Review Article
Infection
Four months of rifampicin monotherapy for latent tuberculosis infection in children
Chi Eun Oh, Dick Menzies
Clin Exp Pediatr. 2022;65(5):214-221.   Published online October 29, 2021
· Recently, the importance of a short-term treatment regimen including rifamycin has been highlighted in the treatment of latent tuberculosis infection (LTBI).
· Four prospective or retrospective studies in children consistently reported that a 4-month daily rifampicin regimen (4R) had a higher completion rate than and comparable safety to a nine-month daily isoniazid regimen.
· We suggest rifampicin 20–30 mg/kg/day for children aged 0–2 years and 15–20 mg/kg/day for children aged 2–10 years in 4R to treat LTBI.
Epidemiological changes in infectious diseases during the coronavirus disease 2019 pandemic in Korea: a systematic review
Jong Gyun Ahn
Clin Exp Pediatr. 2022;65(4):167-171.   Published online November 30, 2021
· Nonpharmaceutical interventions (NPIs) have had a major impact on the epidemiology of various infectious diseases in Korea.
· Respiratory diseases and gastrointestinal viral diseases were significantly reduced during the NPI period.
· The decrease in Kawasaki disease after the introduction of NPI is an unintended result.
· Infectious diseases that decreased during NPI use may re-emerge.
· We must continuously monitor the epidemiology of various infectious diseases during the coronavirus era
Etiological and pathophysiological enigmas of severe coronavirus disease 2019, multisystem inflammatory syndrome in children, and Kawasaki disease
Jung-Woo Rhim, Jin-Han Kang, Kyung-Yil Lee
Clin Exp Pediatr. 2022;65(4):153-166.   Published online November 23, 2021
· Severe cases of coronavirus disease, Kawasaki disease (KD), and multisystem inflammatory syndrome in children (MIS-C) share similar findings: a protracted clinical course, multiorgan involvement, and similar activated biomarkers.
· Here we propose etiological agents in KD and MIS-C as species in the microbiota and introduce a common pathogenesis through the protein-homeostasis-system hypothesis.
· Early proper dose of corticosteroids and/or intravenous immunoglobulin may help to reduce morbidity and mortality in these diseases.
Editorial
Infection
Importance of maintaining a high childhood vaccination rate and surveillance program against Japanese encephalitis in Korea
Su Eun Park
Clin Exp Pediatr. 2022;65(3):127-128.   Published online February 16, 2022
∙ Recent epidemiologic changes of Japanese encephalitis (JE) in Korea are area (rural to urban or suburban) and age shift (children to adult).
∙ Although the main factors contributing to recent epidemiologic changes of JE are not well identified, maintaining high vaccination rates of JE appear to be important in preventing of JE in all age groups.
∙ Continuous surveillance for epidemiology and seroprevalence should be carried out.
Review Article
Infection
Changes in age-specific seroprevalence of Japanese encephalitis virus and impact of Japanese encephalitis vaccine in Korea
Byung Ok Kwak, Young Jin Hong, Dong Hyun Kim
Clin Exp Pediatr. 2022;65(3):108-114.   Published online September 24, 2021
Since the introduction of a universal Japanese encephalitis (JE) vaccination program and urbanization, the incidence of JE has dramatically decreased in Korea. However, recent JE cases have occurred, predominantly among unvaccinated adults and with a shift in age distribution. Continuous surveillance of the seroprevalence of JE is required to establish a proper immunization policy in Korea.
Original Article
Infection
Viral load and rebound in children with coronavirus disease 2019 during the first outbreak in Daegu city
Mi Ae Chu, Yoon Young Jang, Dong Won Lee, Sung Hoon Kim, Namhee Ryoo, Sunggyun Park, Jae Hee Lee, Hai Lee Chung
Clin Exp Pediatr. 2021;64(12):652-660.   Published online October 12, 2021
Question: What is the natural course of viral load in children with coronavirus disease 2019 (COVID-19)?
Finding: A significant number of patients still had a relatively high viral load once clinically asymptomatic. Nearly half of the patients experienced viral rebound, which contributed to prolonged viral detection in their respiratory specimens.
Meaning: Further studies are needed to determine the clinical significance of viral rebound in asymptomatic or mild pediatric cases of COVID-19.
Review Article
Infection
Recommendation for use of diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b conjugate, and hepatitis B vaccine in infants
Hye-Kyung Cho, Su Eun Park, Yae-Jean Kim, Dae Sun Jo, Yun-Kyung Kim, Byung-Wook Eun, Taek-Jin Lee, Jina Lee, Hyunju Lee, Ki Hwan Kim, Eun Young Cho, Jong Gyun Ahn, Eun Hwa Choi; The Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2021;64(12):602-607.   Published online June 8, 2021
∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020.
∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth.
∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months.
Letter to the Editor
Infection
Multisystem inflammatory syndrome in children and Kawasaki disease in infants: 2 sides of the same coin?
Hing Cheong Kok, Dinesh Nair, Ke Juin Wong, Siew Moy Fong
Clin Exp Pediatr. 2021;64(11):599-601.   Published online October 7, 2021
Question: Are multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in infants, 2 sides of the same coin?
Finding: Here we report on a 4-month-old girl with MIS-C and signs of KD with shock. Most (83%) infants with MIS-C had features of KD, especially KD shock syndrome.
Meaning: MIS-C is similar to KD, and likely is a consequence of dysregulated immune responses secondary to sudden acute respiratory syndrome coronavirus 2 infection.
Clinical Note
Infection
A neonate infected with coronavirus disease 2019 with severe symptoms suggestive of multisystem inflammatory syndrome in childhood
Fatemeh Eghbalian, Ghazal Sami, Saeid Bashirian, Ensiyeh Jenabi
Clin Exp Pediatr. 2021;64(11):596-598.   Published online September 10, 2021
Question: Can multisystem inflammatory syndrome in childhood (MIS-C) occur in the neonate associated with coronavirus disease 2019 (COVID-19)?
Finding: A 9-day-old neonate infected with COVID-19 had fever, respiratory distress, and gastrointestinal symptoms suggestive of MIS-C. This neonate recovered after treatment with intravenous immunoglobulin (IVIG).
Meaning: IVIG successfully treated a rare case of a 9-day-old neonate with COVID-19 and severe symptoms suggestive of MIS-C.
Original article
Infection
The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis
Behnam Abedi, Mehran Akbari, Sahar KhodaShenas, Alireza Tabibzadeh, Ali Abedi, Reza Ghasemikhah, Marzieh Soheili, Shnoo Bayazidi, Yousef Moradi
Clin Exp Pediatr. 2021;64(11):575-581.   Published online February 5, 2021
Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis.
Review Article
Infection
Effects of nasopharyngeal microbiota in respiratory infections and allergies
Hyun Mi Kang, Jin Han Kang
Clin Exp Pediatr. 2021;64(11):543-551.   Published online April 15, 2021
· The nasal microbiota varies with age and is shaped by various factors in healthy individuals.
· The pathological condition of the respiratory tract appears to be associated with reduced nasal microbiota biodiversity, while dysbiosis is involved in the pathophysiology of many respiratory diseases, including otitis, sinusitis, allergic diseases, and lower respiratory infections.
Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia
Hye-Kyung Cho
Clin Exp Pediatr. 2021;64(9):459-467.   Published online February 10, 2021
• To avoid unnecessary exposure to secondary antibiotics, it is needed to diagnose Mycoplasma pneumoniae (MP) pneumonia carefully, especially when unresponsiveness to macrolide is suspected.
• Serologic and molecular tests for MP infection and excluding respiratory infection caused by other pathogens might be considered.
• It is necessary to continuously monitor antibiotic susceptibility of MP, and efforts to lower antibiotic pressure are required.
Original Article
Infection
Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis
Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei
Clin Exp Pediatr. 2021;64(8):415-421.   Published online November 20, 2020
The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.
Review Article
Infection
Updates on the coronavirus disease 2019 vaccine and consideration in children
Hyun Mi Kang, Eun Hwa Choi, Yae-Jean Kim
Clin Exp Pediatr. 2021;64(7):328-338.   Published online June 21, 2021
· The number of coronavirus disease 2019 cases has exponentially increased worldwide, and children ≤19 years old account for 11.0% of all confirmed cases.
· mRNA vaccines, BNT162b2 and mRNA-1273, and adenoviral vector vaccines, AZD1222 and Ad26.COV2.S, authorized for emergency use in the Emergency Use Listing of the World Health Organization are reviewed.
· Clinical trials of these vaccines have shown that they are safe and serious adverse reactions are rarely observed.
School closures during the coronavirus disease 2019 outbreak
Eun Young Cho, Young June Choe
Clin Exp Pediatr. 2021;64(7):322-327.   Published online May 31, 2021
· Earlier modeling studies of the effects of school closures on severe acute respiratory syndrome coronavirus 2 were largely derived from the pandemic influenza model, resulting in conflicting implications.
· Observational findings suggest no clear effect of school closures on community transmission or overall mortality.
· School closures must be weighed against potential high social costs, which can also negatively affect children’s health.
Original Article
Infection
Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade
Woosuck Suh, Bi Na Kim, Hyun Mi Kang, Eun Ae Yang, Jung-Woo Rhim, Kyung-Yil Lee
Clin Exp Pediatr. 2021;64(6):293-300.   Published online October 14, 2020
Question: How has the antibiotic susceptibility of urinary pathogens changed and what does it imply?
Finding: A yearly increase in multidrug-resistant and extended-spectrum β-lactamase (ESBL)–producing pathogens was observed. A higher recurrence rate was observed in cases of febrile urinary tract infection caused by ESBL producers in patients with underlying vesicoureteral reflux (VUR).
Meaning: The initial empirical antibiotic should reflect the changing susceptibility patterns and underlying VUR status.
Editorial
Infection
Should we prescribe carbapenem for treating febrile urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in children with vesicoureteral reflux?
Ji Young Park
Clin Exp Pediatr. 2021;64(6):284-285.   Published online January 5, 2021
Recent studies are focused on the noninferiority of noncarbapenem therapy for the treatment of extended-spectrum β-lactamases producing Enterobacteriaceae infections to reduce the utilization of carbapenem.
Babies born to mothers positive for SARS-CoV-2 – Are they in danger?
Joon Kee Lee
Clin Exp Pediatr. 2021;64(6):280-281.   Published online May 4, 2021
Concerns have arisen in the coronavirus disease 2019 (COVID-19) pandemic upon pregnancy and postnatal care starting from reproductive decision-making. To the utmost knowledge, reproductive decisions should not be based primarily on health-related COVID-19 concerns, as the possibility of vertical transmission is negligible and the perinatal outcome is generally not poor compared to pregnancies without COVID-19, as long as infection control measures are well kept.
Clinical note
Infection
Coronavirus disease 2019 in a 13-year-old patient with acute lymphoblastic leukemia
Seyed Kamal Eshagh Hossaini, Zahra Movahedi, Ahmad Hormati, Hosein Heydari, Seyed Jalal Eshagh Hosseini, Fatemeh Khodadust, Mahboubeh Afifian, Sajjad Ahmadpour
Clin Exp Pediatr. 2021;64(5):247-250.   Published online March 8, 2021
Question: What should be considered in an immunocompromised child with coronavirus disease 2019 (COVID-19)?
Finding: Due to the importance of appropriately managing COVID-19 in children with cancer, the possibility of a fatal outcome should be considered in immunocompromised patients who receive chemotherapy agents.
Meaning: In all kinds of infections including COVID-19, disuse management and the development of international guidelines for children with cancer is challenging but important.
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