BMC Pediatrics[JOURNAL]
Sun
200 papers
A complex case of piperacillin-tazobactam resistant Elizabethkingia anophelis neonatal meningitis: the challenge of treatment and literature review.
Wu Y, Ke S, Du L … +1 more , Li Z
BMC Pediatr · 2026 Jun · PMID 42337479 · Full text
BACKGROUND: Elizabethkingia anophelis is an emerging multidrug-resistant pathogen associated with severe neonatal infections and high mortality. Due to its intrinsic resistance to multiple antibiotics, including β-lactam...
BACKGROUND: Elizabethkingia anophelis is an emerging multidrug-resistant pathogen associated with severe neonatal infections and high mortality. Due to its intrinsic resistance to multiple antibiotics, including β-lactams, optimal antimicrobial therapy remains challenging. We report a rare case of neonatal meningitis complicated by brain abscess caused by piperacillin-tazobactam-resistant Elizabethkingia anophelis. CASE PRESENTATION: A full-term neonate presented with fever and poor responsiveness on day 15 after birth. Initial empirical antibiotic therapy was ineffective. Blood culture confirmed Elizabethkingia anophelis with resistance to piperacillin-tazobactam. Based on antimicrobial susceptibility testing, the treatment regimen was adjusted to levofloxacin combined with vancomycin. The patient showed marked clinical improvement, with normalization of temperature, negative blood cultures, and gradual resolution of the brain abscess. No significant adverse effects were observed during treatment. CONCLUSION: This case highlights the challenge of individualized antimicrobial selection in piperacillin-tazobactam-resistant neonatal Elizabethkingia meningitis. Early pathogen identification and timely optimization of antimicrobial therapy, including the judicious use of fluoroquinolones, may be critical for improving clinical outcomes.
Disseminated BCGosis in immunocompromised infants: a five-case series in the context of a national BCG vaccination policy change.
Alhusaini W, Sanyour G, Kutbi R … +5 more , Alhusaini Y, Alomari R, Algarni R, Mansouri W, Al-Juaid A
BMC Pediatr · 2026 Jun · PMID 42337472 · Full text
BACKGROUND: Disseminated Bacillus Calmette-Guérin (BCG) infection (BCGosis) is a rare but serious complication that primarily affects infants with underlying immunodeficiency disorders. In Saudi Arabia, where consanguini...
BACKGROUND: Disseminated Bacillus Calmette-Guérin (BCG) infection (BCGosis) is a rare but serious complication that primarily affects infants with underlying immunodeficiency disorders. In Saudi Arabia, where consanguinity rates are high and primary immunodeficiency disorders are more prevalent, concerns have been raised regarding the safety of routine neonatal BCG vaccination. In 2019, the national immunization schedule was revised to delay BCG vaccination from birth to six months of age. METHODS: This retrospective case series was conducted at a tertiary referral center in Jeddah, Saudi Arabia. Pediatric patients diagnosed with disseminated BCGosis between 2016 and 2023 were identified through electronic medical records. Disseminated BCGosis was defined as systemic infection with involvement of two or more noncontiguous organ systems with microbiological or molecular confirmation of Mycobacterium bovis. Clinical, microbiological, and immunological data were collected and analyzed descriptively. RESULTS: Five cases of disseminated BCGosis were identified during the study period, all occurring in immunocompromised infants who had received BCG vaccination at birth. Underlying primary immunodeficiency disorders included defects in the IL-12/interferon-gamma pathway and severe combined immunodeficiency. The median age at presentation was approximately 7 months. Clinical manifestations included persistent BCG-site inflammation, lymphadenopathy, and systemic symptoms. The interval from symptom onset to diagnosis ranged from 4 weeks to 7 months, with longer delays observed in cases presenting initially with localized disease. All cases were confirmed microbiologically. One patient died despite treatment, while the remaining patients responded to prolonged anti-tuberculous therapy and adjunctive immunotherapy. No cases of disseminated BCGosis were identified at our institution in the four years following the implementation of delayed BCG vaccination. CONCLUSIONS: This case series describes disseminated BCGosis occurring exclusively in immunocompromised infants vaccinated at birth and not being observed after the implementation of delayed BCG vaccination. Given the observational design and small sample size, these findings should be interpreted with caution. Delaying BCG vaccination may reduce exposure to live vaccination in vulnerable infants without apparent compromise of tuberculosis control. Multicenter studies are needed to validate these observations and inform immunization strategies in high-risk populations.
From clusters to clinical rules: unsupervised machine learning identifies four newborn hearing phenotypes with bedside risk stratification.
Liu C, Zhang J, Yang L
BMC Pediatr · 2026 Jun · PMID 42337460 · Full text
OBJECTIVE: To identify risk patterns among high-risk newborns associated with hearing screening failure using unsupervised machine learning. STUDY DESIGN: Retrospective cohort of 447 newborns. Partition around medoids cl...
OBJECTIVE: To identify risk patterns among high-risk newborns associated with hearing screening failure using unsupervised machine learning. STUDY DESIGN: Retrospective cohort of 447 newborns. Partition around medoids clustering (Gower distance) was applied to demographic, perinatal, and diagnostic data. CART decision tree and diagnostic co-occurrence network analyses were performed to translate phenotypes into clinical rules and reveal risk factor synergy. RESULTS: Four distinct phenotypes emerged: Cluster 1 (28.4%, term jaundice) had the lowest failure (20.5%); Cluster 2 (25.5%, preterm males with respiratory morbidity) the highest (48.2%); Cluster 3 (30.6%, preterm females) intermediate (38.0%); Cluster 4 (15.4%, term respiratory/infectious) moderate (24.6%) (all P < 0.001). The decision tree generated simple bedside rules (e.g., males with weight < 1.795 kg → 83.3% failure). Co-occurrence network revealed a tightly connected core of respiratory disorders, infection, and preterm/low birth weight (Jaccard 0.31-0.46), while jaundice was isolated. CONCLUSIONS: Unsupervised clustering identified ~ ~ four neonatal phenotypes ~ ~ four distinct risk co-occurrence patterns in a high-risk neonatal unit cohort. Complementary decision tree and network analyses provided clinically actionable rules and exposed synergistic risk factor patterns that logistic regression could not capture. These findings support pattern-based risk stratification as a valuable complement to variable-centered methods.
Respiratory function profiling using non-invasive methods in children aged 7-18 years: a hospital based study from North India.
Mendiratta K, Nair S, Bothra M … +1 more , Kalra A
BMC Pediatr · 2026 Jun · PMID 42337459 · Full text
BACKGROUND: Respiratory health during childhood is crucial for optimal growth and long-term well-being. Early lung function impairment may remain clinically silent, yet predispose to chronic respiratory morbidity. While...
BACKGROUND: Respiratory health during childhood is crucial for optimal growth and long-term well-being. Early lung function impairment may remain clinically silent, yet predispose to chronic respiratory morbidity. While spirometry is the standard for assessing airway function, its routine use in children is often limited. Simple bedside tests such as Single Breath Count (SBC), Breath Holding Time (BHT), and Peak Expiratory Flow Rate (PEFR) are non-invasive, inexpensive, and feasible in outpatient and community settings, and may serve as practical screening tools for early detection of ventilatory dysfunction. METHODOLOGY: This hospital-based observational study was conducted in the Department of Pediatrics at a tertiary care teaching hospital in North-Western Uttar Pradesh after ethical approval and informed consent. Children aged 7-18 years attending the outpatient department were enrolled; those with acute respiratory illness or severe systemic disease were excluded. Anthropometry was recorded, and respiratory function was assessed using SBC, BHT, and PEFR following standardized protocols. These respiratory parameters were analyzed in relation to age, height, and BMI using descriptive and inferential statistical methods. RESULTS: Among 190 children (mean age 11.5 ± 2.1 years), mean SBC, BHT, and PEFR were 32.4 ± 12.9, 30.4 ± 10.9, and 170.8 ± 60.4 L/min, respectively. All respiratory parameters increased with age, with PEFR peaking at 13 years. SBC and BHT showed significant positive associations with PEFR; There was a statistically significant positive correlation between SBC, BHT, PEFR and anthropometric parameters. On regression analysis, age and height were found to significantly influence the PEFR reading. CONCLUSION: Breath-holding time and height are significant predictors of PEFR in children. Simple bedside respiratory measures, SBC and BHT, may serve as practical adjuncts for assessing pulmonary function in resource-limited settings.
Recurrent and unusual infections unmasking a rare inborn error of immunity: a case report RAS-associated Autoimmune Lymphoproliferative Disease (RALD).
Ahmad Shawaludin MQ, Nik MAC, Zainudeen ZT … +2 more , Taib F, Abd Hamid IJ
BMC Pediatr · 2026 Jun · PMID 42337451 · Full text
BACKGROUND: RAS-associated Autoimmune Lymphoproliferative Disease (RALD) is a rare, non-malignant lymphoproliferative disorder caused by somatic mutations in RAS genes that impair lymphocyte apoptosis. Patients often pre...
BACKGROUND: RAS-associated Autoimmune Lymphoproliferative Disease (RALD) is a rare, non-malignant lymphoproliferative disorder caused by somatic mutations in RAS genes that impair lymphocyte apoptosis. Patients often present with features of lymphoproliferation, autoimmune manifestations, and an increased risk of malignant transformation. CASE PRESENTATION: We report the case of a 3-year-old boy with splenic microabscesses and Burkholderia pseudomallei IgM serology positivity, who was treated as melioidosis. He had recurrent respiratory infections and chronic rhinorrhoea since the age of one year. Clinical examination revealed persistent lymphadenopathy and hepatosplenomegaly. Laboratory investigations demonstrated persistent absolute monocytosis and thrombocytopenia, while immunological evaluation showed elevated IgM levels and B-cell lymphocytosis. Whole exome sequencing identified a heterozygous pathogenic variant in NRAS, NM_002524.5:c.35G > C, NP_002515.1:p.Gly12Ala, establishing the diagnosis of RALD. The patient was subsequently started on antibiotic prophylaxis and immunoglobulin replacement therapy, and his family was counseled regarding the potential role of immunosuppressive therapy and hematopoietic stem cell transplantation (HSCT) in future management. CONCLUSIONS: This case highlights the coexistence of an unusual infection with a rare inborn error of immunity, expanding the recognized infectious spectrum of RALD. It underscores the importance of considering RALD in patients presenting with recurrent or atypical infections and persistent lymphoproliferative features. Early recognition and molecular genetic testing are essential for confirming the diagnosis and guiding individualized management.
Neurological manifestations in Nigerian children with sickle cell disease: a single-center retrospective study.
Adetoye E, Adebanwo A, Banjo F … +22 more , Akanni C, Abdus-Salaam A, Otunaiya T, Abisola T, Bankole O, Folorunso T, Darah F, Okuribido J, Dele Y, Odumuyiwa F, Dickson C, Adebambo A, Ogunbayode G, Senjobi I, Odejide S, Odemona D, Adenuga B, Olofin C, Bello A, Ogunlade S, Olajide T, Ogunjimi L
BMC Pediatr · 2026 Jun · PMID 42337449 · Full text
BACKGROUND: Sickle cell disease (SCD) is a hereditary hemoglobinopathy that poses a significant public health problem in Nigeria, associated with significant morbidity and mortality among affected children. Neurological...
BACKGROUND: Sickle cell disease (SCD) is a hereditary hemoglobinopathy that poses a significant public health problem in Nigeria, associated with significant morbidity and mortality among affected children. Neurological manifestations contribute substantially to disability and adverse outcomes, however, comprehensive data on their burden and determinants in pediatric SCD patients remain limited. METHODS: This single-center retrospective study examined children under 15 years of age with confirmed SCD managed at Olabisi Onabanjo University Teaching Hospital (OOUTH) between March 2022 and February 2025. A structured proforma was used to extract demographic data, clinical history, neurological manifestations, associated factors, and outcomes. The neurological manifestations assessed included seizure, stroke, paralysis, headache, visual disturbance, and silent cerebral infarct. Laboratory and imaging data, where available, were used to support the diagnoses. Data were analyzed using descriptive and bivariate statistical methods. RESULTS: Among the 133 children with SCD, 28 (21.1%) had documented neurological manifestations. Seizures were the most frequent (12.8%), followed by headaches (9.8%), paralysis (9.0%), and stroke (6.8%). Most neurological events occurred between 5 and 10 years of age, with a mean onset of 7.2 ± 3.8 years. Neurological manifestations were significantly associated with age at presentation (p = 0.032), higher frequency of crises (p = 0.02), and prior history of neurological manifestations (p < 0.001). No statistically significant associations were observed between neurological manifestations and sex (p = 0.232), anemia (p = 0.6), or infections (p = 0.812). Neurological manifestations were associated with increased mortality, residual deficits, and longer hospital stay. Neurological manifestations were present in half (n = 4) of all recorded deaths, with an overall mortality of 6% in the patients studied. Among survivors, approximately one-third had residual neurological deficits. CONCLUSION: Neurological manifestations in children with SCD are relatively common and are associated with adverse outcomes, including disability and prolonged hospitalization. These findings underscore the urgent need for improved early detection and context-appropriate preventive and management strategies to reduce this burden in resource-limited settings.
Maternal knowledge and clinically relevant care gaps in preterm infant care in Gaza, Palestine: a cross-sectional study.
Abdeljawad M, Najim A, Abdeljawad H … +3 more , Rodgers J, Almukbel R, Mokbel K
BMC Pediatr · 2026 Jun · PMID 42332670 · Full text
BACKGROUND: Mothers of premature infants need practical knowledge to support feeding, thermal care, infection prevention, phototherapy safety and discharge preparation. Evidence on domain-specific maternal knowledge in r...
BACKGROUND: Mothers of premature infants need practical knowledge to support feeding, thermal care, infection prevention, phototherapy safety and discharge preparation. Evidence on domain-specific maternal knowledge in resource-constrained neonatal settings remains limited. This study assessed maternal knowledge of premature infant care in Gaza and explored clinically relevant item-level knowledge gaps to inform future education priorities. METHODS: A cross-sectional survey was conducted among 170 mothers of premature infants admitted to neonatal departments in four government hospitals in the Gaza Strip. A 30-item interviewer-administered questionnaire assessed knowledge across thermoregulation, feeding, phototherapy, and infection and skin care. Descriptive, bivariate and adjusted regression analyses were conducted, with exploratory item-level analyses used to identify clinically relevant knowledge gaps. RESULTS: Overall knowledge was moderate, with a mean score of 64.1% (SD = 22.3), but 53 mothers (31.2%) had poor knowledge. Knowledge differed across domains (p < 0.001), with feeding the weakest domain (53.6%) and infection and skin care the highest by observed percentage score (73.8%). In the parsimonious adjusted model, not receiving specialist premature-care antenatal follow-up was associated with lower odds of higher knowledge (adjusted OR = 0.44, 95% CI 0.20-0.97, p = 0.042). Item-level findings showed clinically relevant gaps in feeding tolerance, nil per os (NPO) management, nasogastric tube (NGT) feeding, phototherapy safety, handling practices and umbilical cord care. CONCLUSIONS: Although overall maternal knowledge was moderate, this masked clinically important gaps in practical caregiving domains, particularly feeding, phototherapy safety, handling practices and umbilical cord care. Given the cross-sectional design, findings should not be interpreted causally. These findings may inform the development and future evaluation of domain-specific education tools for antenatal counselling, bedside teaching and discharge preparation in similar constrained neonatal settings.
Effectiveness of a locally made eye protector for neonates treated with phototherapy at Queen Elizabeth Central Hospital (QECH), Malawi: a bench study.
Mwale G, Nyasulu T, Mudzengerere T … +1 more , Kawaza K
BMC Pediatr · 2026 Jun · PMID 42332639 · Full text
BACKGROUND: The highest incidence of severe neonatal jaundice occurs in Africa at 667.8 per 10,000 live births. At the Queen Elizabeth Central Hospital (QECH), approximately 75% of neonates have clinical jaundice, with u...
BACKGROUND: The highest incidence of severe neonatal jaundice occurs in Africa at 667.8 per 10,000 live births. At the Queen Elizabeth Central Hospital (QECH), approximately 75% of neonates have clinical jaundice, with up to 15% requiring treatment. While phototherapy is the standard treatment, the intense blue light poses the risk of retinal damage, which has led to the routine practice of eye protection for neonates receiving this therapy. Nonetheless, QECH, like other low-resource settings, lacks standard eye shields, forcing staff to improvise with different materials to shield the neonate's eyes. Whether these improvised methods are effective in that function is unknown, however. This study aims to develop a reusable eye shield and evaluate the effectiveness of the various eye protectors used for neonates receiving phototherapy at QECH. METHODS: In this bench study, improvised eye shields used between May and December 2023 were collected and compared to the newly developed eye shield using a gold-standard material. Twenty samples from each type of eye shield were measured using a light metre placed immediately beneath the material to measure the intensity of light irradiance at 10 cm, 15 cm, 25 cm, and 35 cm from the light source. Data were analysed using non-parametric statistical methods. RESULTS: Owing to the lack of standard eye care, nurses at QECH improvised eye protection for neonates using makeshift materials such as folded gauze, plaster, and surgical face masks. Among these, surgical masks were the least protective, with an average light irradiance of 12.78 µW/cm²/nm (95% CI 12.00-13.56) at the farthest distance. The shielding capacity of gauze and plaster materials was dependent on the thickness of the gauze used, which was determined by the available resources in the ward. The most protective gauze-based shields had an irradiance of 2.0 µW/cm²/nm, with an overall average of 5.96 µW/cm²/nm (95% CI 4.66-7.26). In comparison, the reusable cotton shield and the reference eye shield had no detectable light across all distances, registering a zero µW/cm²/nm light irradiance. CONCLUSION: For settings like QECH, where resources are limited and standard eye protection is unavailable for neonates undergoing phototherapy, the reusable cotton eye shield presents a viable alternative to improvised materials.
Urinary proteomic profiling identifies candidate biomarkers for pediatric MAFLD in comparison with obesity and healthy controls.
Zhang X, Zhu Z, Zhou Z … +6 more , Liu C, Du L, Guo Z, Pu G, He Q, Yang Y
BMC Pediatr · 2026 Jun · PMID 42332628 · Full text
PURPOSE: This exploratory pilot study, employing a single-center and cross-sectional design, aimed to characterize urinary protein alterations associated with pediatric metabolic-associated fatty liver disease (MAFLD) an...
PURPOSE: This exploratory pilot study, employing a single-center and cross-sectional design, aimed to characterize urinary protein alterations associated with pediatric metabolic-associated fatty liver disease (MAFLD) and to identify preliminary candidate proteins associated with MAFLD status within a cohort of children with obesity. METHODS: In this single-center, cross-sectional observational study, urine samples were collected from 39 children and assigned to three groups: healthy controls (n = 10), simple obesity (n = 14), and obesity with MAFLD (diagnosed by ultrasonography, n = 15). Data-independent acquisition (DIA)-based quantitative proteomics was performed. After quality control, shared proteins across groups were analyzed by one-way ANOVA and trend clustering. Functional enrichment was conducted using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Pearson correlation was used to examine associations between key proteins and clinical metabolic indicators. Exploratory discriminatory potential within this cohort was assessed using Receiver operating characteristic (ROC) curves. RESULTS: A total of 2,824 intersecting proteins were identified, and 49 showed significant differences among the three groups. Trend analysis and fold-change filtering (|logFC| > 0.585) identified 19 core proteins with consistent expression gradients across the healthy, obese, and MAFLD groups. Among these, 6-phosphogluconolactonase (PGLS), dipeptidyl peptidase 7 (DPP7), and complement factor I (CFI) demonstrated notable correlations with liver function markers and glucose-lipid metabolic indices. ROC analysis indicated that PGLS provided the strongest discrimination. CONCLUSION: We performed urinary proteomic profiling to characterize metabolic alterations in pediatric MAFLD. Our analysis identified distinct protein signatures across the HC-OB-MAFLD spectrum, highlighting metabolic dysregulation, oxidative stress, and complement activation as primary features of disease progression. While PGLS, DPP7, and CFI emerged as potential biomarkers, PGLS demonstrated the greatest potential for distinguishing MAFLD from simple obesity in this specific cohort. Due to the small sample size (n = 39) and cross-sectional design, these results provide preliminary molecular insights that require large-scale, longitudinal validation to confirm their clinical utility. TRIAL REGISTRATION: International Traditional Medicine Clinical Trial Registry ITMCTR2025001222, December 31, 2024. Retrospectively registered.
Impact of telemonitoring on glycemic control and quality of life in pediatric patients with type 1 diabetes, single center interventional control study.
Fawaz L, Badawi N, Hasan M … +1 more , Shamma R
BMC Pediatr · 2026 Jun · PMID 42332616 · Full text
BACKGROUND: Telehealth initiatives offer valuable alternatives for enhancing diabetes management and clinician-patient engagement. This study compared two diabetes education approaches for glycemic outcomes: standard met...
BACKGROUND: Telehealth initiatives offer valuable alternatives for enhancing diabetes management and clinician-patient engagement. This study compared two diabetes education approaches for glycemic outcomes: standard method includes regular physical visits at outpatient clinic versus telemonitoring. METHODS: We conducted an interventional trial involving 140 pediatric patients with Type 1 diabetes (T1D), who were equally randomized into a telecounseling group (Intervention group, n = 70) and a standard care group (Control group, n = 70). Participants in Intervention group received weekly telephone consultations from diabetes educators, during which glucose records, dietary patterns, and insulin dose adjustments were reviewed. Control group received diabetes education during routine outpatient clinic visits. Both groups were followed up initially at the start of the study and at 6 months. Socioeconomic status and quality of life (QoL) were assessed in all participants. RESULTS: Glycemic control differed significantly between groups. Mean HbA1c values were 8.21 ± 1.82 SDS (Intervention group) versus 9.25 ± 2.22 SDS (Control group). Diabetic ketoacidosis (DKA) episodes were higher in Control group (18%) vs. (1.7%) in Intervention group, p = 0.001. Complication rates (lipodystrophy, proteinuria, dyslipidemia) were elevated in Control group (37.7%) vs. (15.5%) in Intervention group, p = 0.01. Intervention group demonstrated significantly improved QoL scores (p = 0.002). CONCLUSION: The telemedicine strategy helped to achieve significantly greater HbA1c reductions and fewer diabetes-related complications versus conventional care.
Chronic kidney disease following pediatric cardiac surgery: a systematic review and meta-analysis.
Badeli H, Motiei M, Nejad AT … +1 more , Hassanzadeh-Rad A
BMC Pediatr · 2026 Jun · PMID 42332609 · Full text
BACKGROUND: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet...
BACKGROUND: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet the true burden of CKD remains unclear due to limited data. OBJECTIVES: To determine the pooled prevalence of chronic kidney disease among pediatric patients with a history of cardiac surgery. MATERIALS AND METHODS: A systematic literature search was conducted in PubMed, Scopus, and Web of Science from inception to March 1, 2025. Eligible studies included those reporting CKD prevalence in patients under 18 years of age who had undergone any type of cardiac surgery. We performed this systematic review and meta-analysis following PRISMA guidelines and Cochrane Collaboration recommendations using a random-effects model. Pooled prevalence estimates were calculated with 95% confidence intervals (95% CI). RESULTS: Data from five prospective studies involving 1002 pediatric patients were included. The studies were published between 2016 and 2022 and conducted in Canada, France, the United States, and Belgium. The pooled prevalence of CKD was 16% (95% CI: 9.0-26.0%), with moderate heterogeneity across studies (I² = 49.5%, p = 0.09). Sensitivity analysis confirmed the stability of the pooled estimate. CONCLUSIONS: The findings of this analysis highlight the need for long-term renal monitoring in this population, although further high-quality studies with standardized definitions and extended follow-up are warranted to confirm and refine these estimates.
Is longer indwelling duration an independent risk factor for UVC-related thrombosis? Insights from a matched case-control analysis.
Huang X, Wei B, Pan S … +6 more , Zhang S, Wei S, Mo X, Tang H, Mo Z, Chen J
BMC Pediatr · 2026 Jun · PMID 42332593 · Full text
BACKGROUND: Umbilical venous catheter (UVC)-associated thrombosis is a major complication in the neonatal intensive care unit (NICU). Whether longer catheter dwell time independently increases this risk remains highly de...
BACKGROUND: Umbilical venous catheter (UVC)-associated thrombosis is a major complication in the neonatal intensive care unit (NICU). Whether longer catheter dwell time independently increases this risk remains highly debated. This study aimed to isolate and evaluate specific risk factors for UVC-related thrombosis using a rigorous matched case-control design to control for baseline developmental confounders. METHODS: We conducted a retrospective, 1:2 matched case-control study. Neonates with ultrasound-confirmed UVC-related thrombosis were matched with controls based on gestational age and birth weight. Clinical characteristics, UVC indwelling duration, and laboratory biomarkers (including D-Dimer) were compared between the two cohorts. Receiver Operating Characteristic (ROC) curve analysis was utilized to evaluate the predictive utility of these variables. RESULTS: The study included 34 cases and 68 matched controls. Baseline demographics, including gestational age and birth weight, were successfully balanced between groups (all P > 0.05). The median UVC indwelling duration was identical in both the thrombosis and control cohorts (8.0 vs. 8.0 days, P = 0.206). Although D-Dimer levels exhibited greater variance in the thrombosis group, the median difference was not statistically significant (P = 0.808). Furthermore, ROC analysis demonstrated poor predictive value for both indwelling duration (AUC = 0.42) and D-Dimer levels (AUC = 0.55). CONCLUSIONS: When crucial baseline confounders are strictly controlled, longer UVC indwelling duration does not emerge as an independent risk factor for thrombosis. Clinical management should prioritize correct catheter tip positioning and standardized maintenance protocols rather than adhering to rigid, arbitrary removal timelines. Additionally, D-Dimer levels lack reliability as a standalone predictive biomarker in this specific neonatal population.
The role of STORCH infections in shaping neurodevelopment: a longitudinal case-control study in preterm children.
Marques L, Muller AB, Panceri C … +3 more , Procianoy RS, Silveira RC, Valentini NC
BMC Pediatr · 2026 Jun · PMID 42324525 · Full text
Congenital infections, often asymptomatic for both mother and fetus, can affect neurodevelopment. This study aimed to analyze neurodevelopmental outcomes and associated risk factors in preterm children with and without c...
Congenital infections, often asymptomatic for both mother and fetus, can affect neurodevelopment. This study aimed to analyze neurodevelopmental outcomes and associated risk factors in preterm children with and without congenital STORCH infections. A case-control study was conducted, with children assessed longitudinally. A retrospective case-control study was conducted including 248 preterm children. The control group showed higher cognitive and language scores than the STORCH case-group. The STORCH case-group had a significant decline in cognitive scores from 6 to 18 months (p<0.05), although their motor scores improved from 6 to 24 months (p<0.05). Risk factors for neurodevelopment in the STORCH case-group included APGAR, NICU seizures and stay, familyincome, sepsis, and twin birth (beta 0.27-0.49). For the control-group, risk factors included NICU seizures and stay, APGAR, family income, sepsis, mechanical ventilation, maternal education, and bronchopulmonary dysplasia (beta 0.12-0.31). Children with STORCH infections showed poorer cognitive and language development. Early prevention of STORCH infections is crucial to prevent negative developmental outcomes.
Bloodstream infections and antimicrobial resistance patterns among under-fives children with suspected bloodstream infections attending the pediatric clinic of Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar, northwest Ethiopia.
Abate A, Azage M
BMC Pediatr · 2026 Jun · PMID 42324521 · Full text
BACKGROUND: Antibiotic-resistant bloodstream infections are a major public health concern, particularly in children under five years of age. The objective of this study was to determine the prevalence of bloodstream infe...
BACKGROUND: Antibiotic-resistant bloodstream infections are a major public health concern, particularly in children under five years of age. The objective of this study was to determine the prevalence of bloodstream infections and assess the antimicrobial resistance profiles and their associated factors among febrile children under five years of age in Bahir Dar, northwest Ethiopia. METHODS: A cross-sectional study was conducted from November to December 2025 among 281 children under five years of age who attended the pediatric clinic of Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar. Sociodemographic and clinical data were collected using a structured questionnaire through face-to-face interviews with the parents or guardians. Approximately 3 mL of venous blood was aseptically collected and cultured using standard microbiological techniques. Bacterial identification was performed based on colony characteristics and biochemical tests. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Data were entered into EpiData version 3.1 and analyzed using SPSS version 26. Logistic regression analysis was used to identify factors associated with bloodstream infections, and statistical significance was set at p < 0.05. RESULTS: The prevalence of bloodstream infection was 19.2% (54/281; 95% CI: 14.0%-24.4%). The most common isolate was Klebsiella pneumoniae (31%), followed by Enterobacter cloacae (11%), Escherichia coli (9%), and Acinetobacter baumannii (9) %. Gram-negative bacteria accounted for 80% of the isolates. Antimicrobial susceptibility testing revealed high resistance rates to commonly used antibiotics, particularly ampicillin (87.0%, 40/46), trimethoprim-sulfamethoxazole (86.3%, 44/51), and cefepime 42/54 (77.8). Resistance was also high to ciprofloxacin (68.5%, 37/54), tobramycin (68.6%, 35/51), amoxicillin-clavulanic acid (66.0%, 31/47), gentamicin (63.3%, 31/49), tetracycline (61.1%, 33/54), and chloramphenicol (60.5%, 26/43). In contrast, lower resistance rates were observed for cefotaxime (37.0%, 20/54) and meropenem (20.4%, 11/54). Significant associated factors of blood stream infections included age < 1 year (AOR = 2.11; 95% CI: 1.46-2.86), fever duration > 7 days (AOR = 2.74; 95% CI: 1.22-6.15), partially immunized children (AOR = 3.21; 95% CI: 1.08-9.51; p = 0.036), and non-immunized children (AOR = 9.87; 95% CI: 3.61-26.9; p < 0.001). CONCLUSION: The prevalence of bloodstream infections among febrile children under five years of age was high. Younger age, fever duration > 7 days, and partially immunization and non-immunization were significant predictors of bloodstream infection. Strengthening antimicrobial stewardship, improving immunization coverage, and enhancing early diagnosis are essential to reduce the burden of bloodstream infections and combat antimicrobial resistance.
The mediating role of self-care in the relationship between eHealth literacy and quality of life among adolescents with type 1 diabetes.
Ranaei A, Lael-Monfared E, Peyman N
BMC Pediatr · 2026 Jun · PMID 42324514 · Full text
BACKGROUND: Type 1 diabetes is a common chronic disease in adolescents, requiring continuous self-care and attention to quality of life. With the rise of digital health technologies, eHealth literacy may play a key role...
BACKGROUND: Type 1 diabetes is a common chronic disease in adolescents, requiring continuous self-care and attention to quality of life. With the rise of digital health technologies, eHealth literacy may play a key role in promoting self-care behaviors and well-being. This study aimed to investigate the relationships between eHealth literacy, self-care behaviors, and quality of life in adolescents with type 1 diabetes. METHODS: In this descriptive-analytical cross-sectional study, 250 adolescents with type 1 diabetes completed validated questionnaires assessing Electronic Health Literacy (eHEALS), diabetes-specific self-care behaviors (SMOD-A), and health-related quality of life (Diabetes Quality of Life for Youth [DQOLY]). Data were analyzed using descriptive statistics, Spearman's correlation, and multiple linear regression. RESULTS: Participants (mean age = 14.36 years; 54.8% male) mostly had low eHealth literacy (81.2%). eHealth literacy correlated positively with self-care (r = 0.43) and quality of life (r = 0.36), while self-care was strongly related to quality of life (r = 0.51; p < 0.01). Regression models explained 35% of the variance in self-care and 29% in quality of life. Mediation analysis confirmed a significant indirect effect of eHealth literacy on quality of life through self-care behaviors (β = 0.219, p < 0.05). CONCLUSIONS: Enhancing eHealth literacy plays a key role in improving self-care behaviors among adolescents with type 1 diabetes, which is directly associated with better quality of life. The findings of this study clearly highlight the importance of promoting eHealth literacy as an essential component of targeted, technology-based educational interventions to improve diabetes management in this age group.
Neurological adverse events of blinatumomab in children with B-cell acute lymphoblastic leukemia: a retrospective study.
Zeng YY, Zhang Y, Chen F … +1 more , Fang YJ
BMC Pediatr · 2026 Jun · PMID 42324454 · Full text
OBJECTIVE: This study aims to conduct a real-world analysis of blinatumomab-associated neurological adverse events (NAEs) in pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL) to comprehensively elucidat...
OBJECTIVE: This study aims to conduct a real-world analysis of blinatumomab-associated neurological adverse events (NAEs) in pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL) to comprehensively elucidate its safety profile. METHODS: A retrospective analysis was conducted in children with B-ALL who were treated at hematology medical ward of our institution from January 2024 to December 2025. Document the occurrence of all NAEs during the dosing cycle of blinatumomab, including the time of occurrence, cycle of appearance, severity, management, and outcome. RESULTS: There were 13 individuals with an average age of 10.08 ± 4.23 years experienced a total of 18 NAEs among all the 60 B-ALL patients. These NAEs primarily manifest as headache, dizziness, tremor, delirium, status epilepticus, and cerebral herniation. Most NAEs occur during the first cycle of medication (77.78%). The median onset time of the NAEs was approximately 9.5 days, with a duration of approximately 2.78 ± 2.21 days. The majority of NAEs associated with blinatumomab are mild to moderate in severity (grade 1 or 2) (88.89%). Two patients experienced severe adverse events (AEs) (grade 4), manifesting as status epilepticus and cerebral herniation. There were statistically significant differences in age (10.08 ± 4.23 vs. 5.40 ± 3.57; P < 0.01), and the proportion of males (84.62% vs. 55.32%; P = 0.03) between the group with NAEs and without. Additionally, we found age was identified as an independent predictor of blinatumomab-associated NAEs. CONCLUSION: This study reveals real-world data on the neurological safety profile of blinatumomab, characterizes the features of it, and identifies age as an independent predictor of blinatumomab-associated NAEs in pediatric patients.
Medication adherence and treatment gap in Sudanese children with epilepsy during armed conflict: a one-unit retrospective clinical audit.
Saad HEHB, Eltahir SHM
BMC Pediatr · 2026 Jun · PMID 42323593 · Full text
BACKGROUND: Armed conflict disrupts health systems and disproportionately affects children with chronic neurological conditions such as epilepsy. Evidence on medication adherence during conflicts is limited. The audit ai...
BACKGROUND: Armed conflict disrupts health systems and disproportionately affects children with chronic neurological conditions such as epilepsy. Evidence on medication adherence during conflicts is limited. The audit aimed to assess antiseizure medication adherence, treatment continuity, and epilepsy-related outcomes among children attending a paediatric neurology clinic during a period of armed conflict. METHODS: A retrospective, single-centre, hospital-based clinical audit was conducted. Children with epilepsy who attended a paediatric neurology clinic during the conflict period were included. Medication adherence was assessed using the Proportion of Days Covered over the preceding 90 days, with adherence defined as Proportion of Days Covered over ≥ 80%. The treatment gap was defined as ≥ 30 consecutive days without antiseizure medication. Epilepsy-related clinical outcomes and caregiver-reported barriers to care were also recorded. Descriptive statistics with 95% confidence intervals (CI) were used. RESULTS: Of the 64 children included, 14/64 (21.9%) met the predefined criterion for medication adherence (PDC ≥ 80%), while 50/64 (78.1%) were non-adherent. A treatment gap of ≥ 30 consecutive days without antiseizure medication within the preceding 90 days was identified in the majority of participants 45/64(70.3%). Epilepsy-related complications during the conflict period included 38/64 (59.4%) with increased seizure frequency, 20/64 (31.3%) requiring hospital admission, and 12/64 (18.8%) experiencing status epilepticus. Caregivers frequently reported multiple barriers to adherence, most commonly medication stock-outs (40/64; 62.5%), displacement relocation (35/64; 54.7%), and loss of medical records (28/64; 43.8%). CONCLUSIONS: Medication non-adherence and treatment interruptions were highly prevalent among children with epilepsy during armed conflict. These findings highlight the vulnerability of epilepsy care to health system disruptions and underscore the need for conflict-adapted strategies to maintain access to essential antiseizure medications.
The relationship between erythrocyte transfusion in very preterm infants and inflammatory cytokines and morbidities: a prospective observational study.
Osmanova F, Bulbul A, Bas EK … +2 more , Avsar H, Divarcı A
BMC Pediatr · 2026 Jun · PMID 42323589 · Full text
BACKGROUND: It is essential to assess not only the hematologic outcomes but also the immunologic and inflammatory consequences of RBC transfusion in preterm infants. AIMS: This study aimed to evaluate changes in serum cy...
BACKGROUND: It is essential to assess not only the hematologic outcomes but also the immunologic and inflammatory consequences of RBC transfusion in preterm infants. AIMS: This study aimed to evaluate changes in serum cytokine levels following red blood cell (RBC) transfusion in preterm infants born at ≤ 32 weeks of gestation and to assess their potential proinflammatory effects and associations with neonatal morbidities. MATERIALS AND METHODS: This prospective, single-center observational study included preterm infants born at ≤ 32 weeks of gestation, aged > 7 days, who received RBC transfusion. Serum interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF), and melatonin were measured before and at 2 and 24 h after transfusion. Insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) were analyzed at 1, 2, and 3 weeks post-transfusion. RESULTS: Thirty-three infants met the inclusion criteria. The mean gestational age was 27.4 ± 2.7 weeks, and the mean birth weight was 1016 ± 356 g. Following transfusion, the hematocrit increased from 28.3 ± 3.1% to 35.0 ± 3.8%. No significant post-transfusion changes were observed in IL-1, IL-6, TNF-α, melatonin, or IGF-1 levels. However, VEGF increased (p = 0.045) and IGFBP-3 decreased (p = 0.022) significantly. During follow-up, clinical sepsis was observed in 7 (21.2%), 4 (12.1%), and 1 (3.0%) infants at weeks 1, 2, and 3, respectively (p = 0.007). Respiratory support requirements decreased over time, particularly for non-invasive synchronized intermittent mandatory ventilation (p = 0.029). CONCLUSIONS: In this single-arm observational cohort, RBC transfusion was followed by increased VEGF and decreased IGFBP-3 levels, without significant changes in major proinflammatory cytokines. During follow-up, respiratory support requirements decreased and clinical sepsis was observed in a subset of infants. However, because no non-transfused control group was included, these clinical findings should be interpreted as descriptive and exploratory temporal observations rather than evidence of causality.
Application of gamified interventions in children with type 1 diabetes: a scoping review.
Guan Y, Xie J, Wang F … +4 more , Ouyang Y, Tian J, Wang Q, Guo H
BMC Pediatr · 2026 Jun · PMID 42323588 · Full text
BACKGROUND: Type 1 diabetes poses substantial self-management challenges for children. Gamified interventions are a promising strategy to support this population, yet evidence on their design, implementation, and reporte...
BACKGROUND: Type 1 diabetes poses substantial self-management challenges for children. Gamified interventions are a promising strategy to support this population, yet evidence on their design, implementation, and reported outcomes remains scattered. This scoping review aims to systematically map the international evidence on gamified interventions for children with T1DM, focusing on their characteristics, delivery, and outcomes. METHODS: Following the Arksey and O'Malley framework, this scoping review systematically searched six databases (PubMed, CINAHL, Embase, Scopus, Cochrane Library, Web of Science) from January 1, 2010, to January 25, 2026. We also examined reference lists and performed citation tracking. RESULTS: Twenty-three of 762 retrieved articles were included. Interventions were primarily delivered via mobile applications (52%) and websites (17%). The most common gamification elements were goal setting, challenges, and fun (each 96%); social features were less frequent (35%). Most studies (70%) lacked an explicit theoretical framework, and intervention durations varied widely. The interventions demonstrated benefits for glycemic control, self-management, knowledge, and psychological distress, but inconsistent effects on quality of life. They were generally feasible, usable, and acceptable. CONCLUSION: Gamified interventions represent a promising approach to T1DM management in children, aligning well with their developmental needs. However, current studies often lack a theoretical foundation and evidence of sustained benefits. Future work should prioritize theory-driven design and rigorous long-term evaluation. PROTOCOL REGISTRATION: This review protocol is registered on the Open Science Framework (OSF) and accessible via the following link: https://doi.org/10.17605/OSF.IO/MN6AE.
Knowledge and awareness of epilepsy management, etiologies, and comorbidities among pediatricians in Palestine.
Zrineh A, Shalalfeh A, Demah R … +9 more , Aqel B, Abbas K, Amro J, Sowan H, Alsaid S, Altamimi W, Qadous S, Tarawah N, Alwawi A
BMC Pediatr · 2026 Jun · PMID 42323587 · Full text
BACKGROUND: Epilepsy is one of the most prevalent neurological conditions in pediatric populations, and its management extends beyond seizure control to encompass comorbidities, psychosocial well-being, and long-term car...
BACKGROUND: Epilepsy is one of the most prevalent neurological conditions in pediatric populations, and its management extends beyond seizure control to encompass comorbidities, psychosocial well-being, and long-term care. In the West Bank, Palestine, limited availability of pediatric neurologists means that general pediatricians often serve as the primary point of contact for children with epilepsy. Despite this critical role, no study has comprehensively assessed epilepsy knowledge among pediatricians in this setting. This study aimed to evaluate the knowledge and awareness of epilepsy management, etiologies, and comorbidities among pediatricians practicing in the West Bank. METHODS: A descriptive, cross-sectional study was conducted among 246 pediatric residents, general pediatricians, and pediatric subspecialists from November 2025 to March 2026. A validated questionnaire covering five knowledge domains (etiology, long-term management, comorbidities, quality of life, and first-aid management) was administered. Responses were classified as correct or incorrect, and composite scores were calculated for each domain. Group comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests, with post-hoc pairwise comparisons where applicable. RESULTS: The overall aggregate correct response rate was 71.3%, with a median total score of 18 out of 25. Respondents performed best in first-aid management (81.6%) and long-term management (76.5%), while the lowest scores were observed in quality of life (55.2%) and comorbidities (67.7%). Notable gaps included low recognition of social difficulties (33.7%), increased aggression (34.1%), and comorbid hyperactivity (46.3%) in children with epilepsy, as well as incomplete awareness of sudden unexpected death in epilepsy, recognized by only 62.6% of respondents. Kruskal-Wallis tests revealed significant differences by professional role for etiology (p < 0.001), long-term management (p = 0.019), and total score (p = 0.021). Age and medical school location showed no significant associations with knowledge scores, while gender was associated with a significant difference only in the quality of life domain (p = 0.020). CONCLUSIONS: Palestinian pediatricians demonstrate moderate overall epilepsy knowledge but exhibit clinically meaningful gaps in recognizing psychosocial consequences and comorbidities. These findings highlight the need for targeted continuing medical education programs and curricular reforms in pediatric residency training, with emphasis on the psychosocial dimensions and comorbidity burden of childhood epilepsy.
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