Recently, there have been outbreaks of Group A Streptococcus (GAS) infection in foreign countries.The reasons are varied.With the relaxation of control for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection, it is very likely that concurrent or secondary GAS infection peaks will occur at the same time as the number of Corona Virus Disease 2019(COVID-19) cases increases dramatically.Children are generally susceptible to GAS and are more vulnerable.In response to possible outbreaks, early identification of GAS infections and rational use of antibiotics are particularly important.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Hyper-IgE syndrome (HIES) comprises a group of rare primary immunodeficiencies, which are characterized by extremely high serum IgE levels, eczema, recurrent skin and pulmonary infections.Signal transduction and activator of transcription 3( STAT3)-HIES is the most common type, which is caused by dominant-negative mutations in STAT3.STAT3-HIES confers broad innate and acquired immune defects, defects in skeletal, connective tissue, and vascular functions, causing a clinical phenotype including eczema, staphylococcal and fungal skin and pulmonary infections, scoliosis and minimal trauma fractures, vascular tortuosity and aneurysm.In this article, the advance in diverse clinical manifestations and management strategies of STAT3-HIES was summarized.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To investigate the epidemiological and clinical characteristics of human parainfluenza viruses (HPIVs) infection among hospitalized children with community-acquired pneumonia (CAP) in China, and provide basic data for diagnosis, treatment and prevention of HPIVs infection.Methods:From November 2014 to February 2020, 5 448 hospitalized children with CAP were enrolled in 14 hospitals in 11 provinces and municipalities directly under the Central Government in southern China and northern China. Nasopharyngeal aspirates or throat swabs were collected, and the nucleic acids of 18 types respiratory viruses including HPIV1-4 were screened by suspension array technology. Demographic data and clinical information were collected for statistical analysis.Results:The total detection rate of HPIVs in 5 448 children with CAP was 8.83% (481/5 448), and the detection rate in males was higher than that in females (62.79% vs. 37.21%; χ2=0.000, P=0.992). The detection rate of HPIVs in 1~< 3 years age group was higher than that in other age groups, and the difference was statistically significant ( χ2=61.893, P<0.001). The detection rate of HPIVs in the northern region was higher than that in the southern region (9.02% vs 8.65%), but the difference was not statistically significant ( χ2=0.239, P=0.625). The prevalence of HPIV1-4 in northern and southern China was not completely same. HPIV1 was mainly prevalent in autumn in both northern and southern regions. HPIV2 was prevalent in summer in northern China, and the detection rate was low in southern China. HPIV3 reached its peak in both spring and summer in both northern and southern China, but its duration was longer in southern China than in northern China. HPIV4 is mainly popular in autumn in both southern China and northern China. Among 481 children infected with HPIVs, 58.42% (281/481) were infected with HPIV alone, and the main clinical manifestations were cough (90.75%) and fever (68.68%). Out of the HPIV-positive cases, 42.62% (205/481) were co-infected with another type of HPIV or a different virus, while 11.43% (55/481) had co-infections with two or more different viruses. HPIV3 was the most common type of co-infection with other viruses. HPIV3 infection accounted for the largest proportion (76.80%) in 47 HPIVs-positive children with severe pneumonia. Conclusions:HPIVs is one of the most important pathogens causing CAP in children in China, and children under 3 years of age are the main populations of HPIVs infection. The prevalence characteristics of all types of HPIVs in children in the north and south are not completely same. HPIV3 is the dominant type of HPIV infections and causes more severe diseases.

Acute respiratory tract infection is the most common infectious disease in children, which seriously threatens children′s health.Rapid and accurate etiological diagnosis is of great significance for the clinical treatment and control of these diseases.Pathogen nucleic acid test was applied and became the main method of respiratory tract infection diagnosis for its high sensitivity and specificity.To regulate the application of pathogen nucleic acid amplification test in respiratory tract infection in children, improve the diagnosis level, expert consensus on nucleic acid amplification test of respiratory pathogens in children was prepared to guide the application and promote pathogens diagnosis ability.

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalizations in infants under 1 year of age, seriously jeopardizing infants′ health.Most hospitalizations (up to 80%) due to RSV-LRTI occur in otherwise healthy infants born at term.At present, no effective treatment and preventative measure against RSV is available domestically.Passive immunization with fully human long-acting monoclonal antibody Nirsevimab offers immediate protection for all infants experiencing their first RSV season with one shot, thus ushering in a new era of prevention of RSV infection among infants.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective:To explore the clinical characteristics of Mycoplasma pneumoniae (MP) bronchiolitis to provide references for clinical prevention and treatment.Methods:From January 2019 to January 2020, the clinical data of children diagnosed with MP bronchiolitis in the Department of Respiratory 2 of Hebei Children′s Hospital were retrospectively collected and analyzed, and the patients were followed up to observe the prognosis.Results:Among the 67 children, there were 39 boys and 28 girls, with age of 5 (1-14) years.All the children had cough, 63 cases (94.0%) had fever, 49 cases (77.8%) had high fever (≥39.0 ℃), and the median total fever course was 8(1-27) d; 10 cases (14.9%) had wheezing; 5 cases (7.5%) had dyspnea; 3 cases (4.5%) had hypoxemia; wet rales were heard in 58 cases (86.6%) and wheezing in 10 cases (14.9%). Forty-eight patients (71.6%) had family allergy history or personal allergy history.The average value of peripheral blood white blood cells was (8.6±2.6)×10 9/L; the me-dian of C reactive protein was 9.1(0.5-55.6) mg/L, of which 7 cases (10.4%) were ≥30 mg/L; the median of lactate dehydrogenase was 278(181-590) U/L.Tree bud sign and central lobular nodules were the main findings of high-resolution CT of the chest.Among them, 45 cases (67.2%) had bilateral lesions, 38 cases (56.7%) involved ≥3 lung lobes, and 22 cases (32.8%) had a little lung consolidation, 19 cases (28.4%) had a small amount of pleural effusion.The bronchoscopic features of 35 children (52.2%): 71.4%(25/35 cases) showed white flocculent and cord-like secretions, 17.1%(6/35 cases) displayed mucus plugs blocking the lumen, and 10.9%(4/35 cases) showed no-dular protrusions and granulation tissue hyperplasia.All children were treated with Azithromycin sequentially; 42 children (62.7%) were treated with low-dose hormones, and the average initiation time was on day (10.62±2.71) and the median course was 14(2-42) d. Sixty-seven cases were followed up for half a year, of which 61 cases (91.0%) had almost complete lung recovery, and 6 cases (9.0%) developed bronchiolitis obliterans (BO). Conclusions:MP bronchiolitis mostly occurs in infants and preschool children with a family history of allergies or personal allergies.Fever and cough are the main clinical manifestations.In severe cases, dyspnea and hypoxemia may occur.The physical signs of the lungs are mainly include wet rales, some of which are wheezing.White flocculent and cord-like secretions are the main manifestations of bronchoscopy.After active treatment, most children have a good prognosis, and some children may develop BO.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.