Multicenter Study on Children With Bordetella parapertussis Infections.

Clinical characteristics and macrolide resistance analysis of pertussis in children: a retrospective study

Purpose Pertussis is mainly caused by Bordetella pertussis. Currently, no reports exist on the incidence of B. pertussis infection or on its patterns of macrolide resistance among pediatric cases in Xiamen, Fujian Province, China. The aim of this study was to determine the clinical characteristics and macrolide resistance patterns in pediatric pertussis. Methods We retrospectively collected data from 968 children with pertussis between February 2021 and January 2025. Demographic characteristics, disease trends, clinical features, and macrolide resistance among outpatients and inpatients were analyzed. Results Most inpatients with pertussis were infants aged < 3 months, whereas most outpatients were school-aged children. Inpatients demonstrated significantly higher rates of leukocytosis, fever, co-infection, recent exposure to individuals with a cough, comorbid pneumonia, and macrolide use and experienced longer time from cough onset to confirmed diagnosis than did outpatients. The proportion of children who presented with spasmodic cough, violent coughing with facial flushing, inspiratory whoop, tachypnea, cyanosis, hypoxemia, and respiratory failure, as well as the average hospital stay, was significantly higher among children with severe pertussis than among those with common pertussis. Age younger than 3 months, being unvaccinated, co-infection, leukocytosis, lymphocytosis, spasmodic cough, facial flushing, inspiratory whoop, tachypnea, and cyanosis were risk factors for severe pertussis. Macrolides were the main antibiotics prescribed for children with pertussis. The detection rate of drug-resistant mutation sites was 77.52% in outpatients and 92.50% in inpatients. Conclusion It is necessary to enhance the vaccination of pertussis for special populations, including women in the later pregnancy stages and school-aged children. Children with pertussis who have risk factors should be monitored to identify severe cases. The empirical use of macrolides for pertussis treatment is effective in most cases; alternative agents should be considered if the response is suboptimal, especially when drug-resistant mutation sites are identified.

Influence of COVID-19 on Clinical Outcomes of Clostridioides difficile Infection

Backgroud/Objectives: Clostridioides difficile infection (CDI) remains a major problem for healthcare facilities. The COVID-19 pandemic was associated with increased hospitalizations, frequent antibiotic use, and changes in infection prevention and control regulations, which may have influenced the epidemiological and clinical characteristics of CDI. The aim of this study was to evaluate whether a history of COVID-19 was associated with clinical characteristics, treatment exposure, recurrence, ribotype distribution, and mortality in patients with CDI. Methods: This retrospective study included patients diagnosed with CDI during the period 2020–2022 at the Louis Pasteur University Hospital in Košice, Slovakia. We analyzed 324 patients, of whom 172 (53.1%) had no history of COVID-19 and 144 (44.4%) had previous or concurrent COVID-19, defined as documented infection within three months before or at the time of CDI diagnosis. Eight patients (2.5%) developed COVID-19 after CDI diagnosis and were excluded from the comparative analyses. Results: Patients with previous or concurrent COVID-19 had higher exposure to PPIs (88.2% vs. 73.3%; p = 0.0009), corticosteroids (70.1% vs. 26.2%; p < 0.0001), cephalosporins (72.9% vs. 61.6%; p = 0.034) and macrolides (37.5% vs. 20.3%; p = 0.0007). Overall antibiotic exposure was high (93.8%) and did not differ significantly between patients with previous or concurrent COVID-19 and those without COVID-19 (93.8% vs. 94.2%; p = 0.871). Previous or concurrent COVID-19 was not associated with increased 90-day mortality after CDI (42.4% vs. 43.6%; p = 0.824). Conclusions: Our findings suggest that a history of COVID-19 was associated with the risk factor profile, recurrence rate and the molecular epidemiology of CDI, rather than with a more severe clinical course or worse prognosis.

Clinical characteristics and co-infection patterns of human metapneumovirus infection in children under 5 years of age.

OBJECTIVE Human metapneumovirus (HMPV) is a significant cause of acute respiratory tract infections (ARTIs) in young children. This study aimed to describe the clinical characteristics, co-infection patterns, and seasonal trends of HMPV in children under 5 years of age. METHODS This retrospective study included pediatric patients under 5 years old admitted to Jordan University Hospital (JUH) between October 2014 and May 2024 with PCR-confirmed HMPV infection. Demographic, clinical, laboratory, and outcome data were extracted from medical records. RESULTS A total of 109 pediatric patients were diagnosed with HMPV. The most frequent symptoms were fever (75%), difficulty breathing (72%), and feeding difficulties (68%), while common clinical signs included dyspnea (63%), abnormal chest sounds (60%), and retractions (45%). Co-infection was significantly associated with prematurity (p = 0.039). Patients with isolated HMPV infections were more likely to receive nebulized therapy (p = 0.020), whereas those with co-infections more frequently required high-flow nasal cannula support (p = 0.007). Rhinovirus, RSV, and bocavirus were the most commonly detected co-pathogens. Most HMPV cases occurred between January and April. CONCLUSIONS HMPV represents a significant cause of pediatric respiratory illness. Co-infections were frequent and associated with increased respiratory support requirements. These findings enhance understanding of HMPV's clinical presentation and outcomes.

Clinical characteristics and predictors of severe pertussis in hospitalized children after the COVID-19 period in Türkiye: a multicenter study

Emerging Q Fever Infection in Türkiye

This study presents the first and largest human case series of Q fever from the Black Sea region of Türkiye, highlighting the wide clinical spectrum of the disease and the need for enhanced awareness and diagnostic capacity.

Tracheobronchial invasion by nontuberculous mycobacteria: a rare but overlooked clinical manifestation—a multicenter retrospective analysis

Background Nontuberculous mycobacteria (NTM) can disseminate and infect various organs throughout the body. However, whether NTM can infect tracheobronchial tissue is rarely reported. This study aimed to address the knowledge gap regarding the epidemiological, demographic, and clinical characteristics of patients with tracheobronchial NTM infection. Methods In this multicenter retrospective cohort study, clinical, demographic, microbiological, and radiological data from hospitalized patients with tracheobronchial NTM infections from January 2015 to May 2025 were collected and analyzed descriptively. Results Twenty-nine patients (2.3%) were included, and all the patients presented with disseminated NTM infection. Seventeen patients had comorbidities, including 5 with acquired immunodeficiency syndrome and 1 with anti-interferon-γ autoantibody syndrome. Median diagnostic delay was 130 days, and 89.7% of the patients were initially misdiagnosed with tuberculosis or malignancy. The most common symptoms were cough, expectoration, anemia, fever, weight loss, skin lesions, and bone pain. Chest CT revealed nodules, patchy opacities, mass-like shadows, and bronchial stenosis, with or without hilar/mediastinal lymphadenopathy, whereas osteolytic bone destruction was evident in 11 patients. The most common features of bronchoscopy were intraluminal masses/neoplasms/nodules. Metagenomic next-generation sequencing (mNGS) of BALF (n=12) demonstrated 100% positivity, outperforming BALF culture (46.2%, 12/26) and sputum culture (39.3%, 11/28). Mycobacterium colombiense accounted for 24.1% of cases. With respect to therapeutic management, 27 patients received systemic antimicrobial therapy, while 2 did not receive specific anti-N™ treatment. One patient underwent combined endoscopic resection. Overall, 23 patients (79.3%) achieved improvement or cure, 5 showed disease progression, 1 experienced relapse, and 1 died. Conclusions Tracheobronchial NTM infection is rare but clinically significant, often occurring in the context of disseminated disease with pulmonary involvement. Immunocompromised hosts, particularly those with AIDS or anti–IFN-γ autoantibody syndrome, are highly susceptible. Bronchoscopy typically reveals mass lesions causing luminal stenosis or occlusion. In this cohort, M. colombiense was the most frequently isolated NTM species. Early bronchoscopy, mNGS-based pathogen detection, and timely systemic or endoscopic intervention should be considered to prevent irreversible airway stenosis. Further studies are needed to validate optimal treatment strategies. Clinical Trial Registration https://www.ClinicalTrials.gov, identifier NCT07377864.