Objective To explore the clinical features, diagnosis, treatment, and prognosis of pertussis in neonates. Methods Clinical data from 17 neonates with pertussis conifrmed by real-time polymerase chain reaction (PCR) of Bordetella pertussis, were retrospectively analyzed. Results In 17 neonates ( 8 males and 9 females), 2 neonates were premature. The age at onset was from 15 to 27 days. Thirteen cases had a history of close contact with coughing patients, 4 cases had nasal congestion and runny nose in the early stage, 5 cases had typical spastic cough, one case had cough with inspiratory“whoop”, 6 cases had lfushing in face after severe cough, 7 cases had severe cough with cyanosis, 2 cases had systemic cyanosis before hospitalized, 7 cases had regurgitation after cough, and 3 cases had fever. Fifteen cases had increased peripheral blood white blood cell count, ( 12 . 57-79 . 63 )× 109/L, with lymphocyte at 45 . 1% -75 . 2%. The PCR copy number of pertussis was 7 . 12 × 102-1 . 04 × 108/mL. Seventeen neonates were all treated with intravenous infusion of erythromycin, and all of them had a signiifcantly improvement, and no death case. Conclusions Neonates with a history of contact with coughing patients, paroxysmal cough and increased of peripheral blood leucocyte presented as lymphocyte increase, need to be alert to pertussis, and relative examination should be taken as early as possible.

Acute Disease ; Enterocolitis, Necrotizing ; complications ; diagnosis ; Hand, Foot and Mouth Disease ; complications ; diagnosis ; Humans ; Severity of Illness Index

Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .

Objective To summarize the clinical characteristics and outcome of infants with group B streptococcus (GBS) blood stream infection.Methods The medical records of 55 cases with GBS blood stream infection who were hospitalized in Shenzhen Children′s Hospital from 1st January 2010 to 31st December 2015 were retrospectively analyzed.Results There were 30 boys and 25 girls in this study.The age ranged from 1 hour to 78 days.Six cases (10.9%) were early-onset and 49 cases (89.1%) were late-onset.Forty cases (72.7%) were neonates and 15 cases were infants.The meningitis was diagnosed in 20 patients (36.4%).Peripheral white blood cell (WBC) counts declined in 10 cases (18.2%), and elevated in 32 (58.2%) cases.Increased levels C-reactive protein were found in 41 cases (74.5%).All of isolates were susceptible to penicillin, ampicillin, linezolid and vancomycin, while the resistance rates to erythromycin, clindamycin, tetracycline and ciprofloxacin were 56.6% (30/53), 77.4% (41/53), 98.1% (52/53), and 1.9% (1/53), respectively.Meropenem was used in 18 cases, and penicillins or cephalosporins were used in 37 cases.Combined therapy with linezolid was used in 13 cases, combined therapy with vancomycin was used in 3 cases, and combined therapy with two kinds of antibiotics was used in 37 cases (67.3%).In clinical outcome analysis, 54 children (98.2%) were improved and 1 child (1.8%) died of complicated multiple organ dysfunction syndrome and intracranial hemorrhage.Conclusions GBS blood stream infection occurs commonly in the infants aged younger than 3 months, more than one third cases complicated with purulent meningitis.All of isolates are susceptible to penicillin, while the resistant rates are high to erythromycin and clindamycin.The percentage of combination therapy is high.The outcomes are not good.

Objective: To investigate the clinical characteristics of pertussis-associated pneumonia and analyze it's risk factors. Methods: Clinical data were taken from Shenzhen Children's Hospital with Bordetella pertussis infection and confirmed by culture or real-time polymerase chain reaction (PCR) of nasopharyngeal secretion from October 2013 to December 2015. Patients were divided into two groups, those with radiologically confirmed pneumonia in the course of their disease and those with not. Clinical data were retrospectively analyzed and compared. T test, Rank sum test or chi square test were used for comparison between groups. Risk factors were analyzed by unconditional Logistic regression analysis. Results: A total of 501 children hospitalized with Bordetella pertussis infection were included. Among them, 309 patients were diagnosed with pneumonia. The median age was 3 (2, 6) months. Symptoms were paroxysmal cough (n=252, 81.6%), tachypnea (n=69, 22.3%), and cyanosis (n=105, 34.0%). The time from onset of cough to radiologically confirmed pneumonia was between 1 and 66 days with a median of 9 (5.5, 15.0) days. The most common pathogen of coinfection was respiratory syncytial virus (RSV)(20 cases). Macrolides were used in 306 cases for (8.2±3.6) days. All cases showed significant improvement. There were more male children (62.1% (192/309) vs. 50.3% (95/189) , χ²=6.768, P=0.009), and more instances of comorbidities (13.3% (41/309) vs.5.8% (11/189) , χ²=6.957, P=0.008) in the pneumonia group than in the other. The age was younger (3 (2,6) vs.4 (2,6) months, Z=32.91, P=0.000) in pneumonia group than in the other. Male sex, younger age, and underlying disease were independent risk factors for pertussis-associated pneumonia (OR=1.648, 1.486, 2.695, P=0.008, 0.036, 0.005). Conclusions Pneumonia, as a complication of pertussis, is very easy to see in hospitalized children. The duration of hospitalization is extensive. It is more likely to happen in children who are male, young, and having underlying diseases. Pneumonia is easy to occur in the first 2 weeks of the course of disease.

Febrile seizures are the most common cause of convulsions in children.It is believed that the pathogenesis of febrile seizures involves a variety of factors, with most domestic and international studies focusing on genetic susceptibility; in contrast, the role of environmental factors, especially viral infections, is a relatively neglected field.Children are at high risk for various viral infections, many of which are prone to cause hyperthermia and induce febrile seizures when the individual convulsive temperature threshold is exceeded; in addition, inflammatory cytokines produced during viral infections may cross the blood-brain barrier affecting nerve cells.Focusing on the clinical characteristics and pathogenesis of febrile seizures caused by various viral infections in children, such as human herpesvirus-6, respiratory viruses(influenza virus, respiratory syncytial virus, adenovirus, severe acute respiratory syndrome coronavirus 2), gastroenteritis-associated viruses(rotavirus, norovirus), enteroviruses, this review may help clinicians understand the role of different viral infections in febrile seizures.

Objective:To investigate the efficacy of antiviral therapy and its selection in hospitalized children with infectious mononucleosis (IM).Methods:The IM children admitted to Shenzhen Children’s Hospital from January 2017 to December 2021 were divided into acyclovir (ACV) treatment group and non-antiviral treatment group, and the clinical data were collected for retrospective analysis.Results:A total of 370 children were included, the median age was 3.6 years, each age group proportion: <3 years (25.9%), 3-<6 years (53.0%). 6-<10 years (17.6%) and ≥10 years (3.5%). Male∶Female=1.5∶1. While 42.4% (157/370) of the 370 children received ACV, 57.6% (213/370) did not receive antiviral therapy; 52 cases were treated in infectious disease department, and none of them received antiviral treatment, and 318 cases were treated in non-infectious disease department, of which 157 cases were in ACV group. There was significant difference between the two groups ( P <0.001); Thirty-eight cases of children in non-infectious disease department complicated with abnormal liver function, of which 23 cases (60.5%) were in the ACV group and 15 cases (39.5%) were in the non-antiviral treatment group. There was no significant difference between the two groups ( P=0.060). Compared with the non-antiviral treatment group, the ACV group has longer hospitalization days and higher hospitalization expenses ( P<0.01). There was no significant difference in duration of fever ( P>0.05). The number of atypical lymphocytes recovered faster in ACV group ( P=0.001). Conclusions:The hospitalized children with IM were mostly boys, and most of them were from 3 to 6 years old. ACV treatment could not shorten the duration of fever and hospitalization days of IM children, nor could it reduce the hospitalization expenses. Abnormal liver function did not affect the decision of antiviral treatment, and infectious disease specialists prefer not to use antiviral drugs. The authors advocate reducing the use of antiviral drugs for IM.

Objective To investigate the clinical features, laboratory diagnostics, treatments, and prognosis of neonates infected with influenza. Methods The clinical data of 16 neonates diagnosed as influenza admitted to the neonatal ward from January 2015 to May 2017 were retrospectively analyzed. Results Of the 16 neonates, 11 were male and 5 were female. Mean age was 18.5 days. 75% (12/16) of them were reported to be exposed to family members with common cold- like symptoms before hospitalization. Clinical manifestations included nasal obstruction (11/16), fever (10/16), cough (10/16), and rhinorrhea (8/16). Influenza antigen rapid detection (colloidal gold method) was positive in all cases. Influenza immunofluorescence assays were performed in 15 cases, only 6.67% (1/15) was positive. Sputum culture was performed in 13 cases, 8 of which were positive. Of them, 75% (12/16) neonates were diagnosed with pneumonia. Only 12.5% (2/16) neonates were treated with neuraminidase inhibitor. All cases recovered well and were discharged after antibiotic treatment. Conclusions Neonates contacted with family members displaying common cold-like symptoms should be examined for influenza in time. The common clinical manifestations include catarrhal symptoms, fever and cough. The sensitivity of the influenza immunofluorescence assay is lower as compared with the colloidal gold method. Pneumonia may often be developed in neonatal influenza. The prognosis of neonatal influenza is satisfactory if treated.

Pertussis is a highly contagious,vaccine-preventable respiratory illness.The reemergence of pertussis occurs in recent years.Typical pertussis is characterized by severe paroxysmal coughing which can persist for weeks after initial onset,however,some infants may have no special symptom.Newborns and children who are not vaccinated or partially vaccinated present more severe symptoms.Pertussis related complications include pneumonia,encephalitis,pulmonary hypertension,hyper leukocytosis,and co-infections.Nucleic acid detection,bacterial culture and serum antibody test are helpful for laboratory diagnosis.The right specimen collection and culture medium choice are crucial to bacteriological diagnosis of pertussis.