Adolescents are known to be at higher risk for sexually transmitted infections (STIs) due to behavioral and biological factors. Compared to adults, STI diagnosis and treatment are often delayed in this population. STIs can cause a range of health problems in adolescents, yet data on STIs among Korean adolescents are limited. We retrospectively reviewed female adolescents aged ≤18 years who underwent STI testing at Pusan National University Hospital via a Sunflower Center, an integrated service center for victims of violence in South Korea, from July 2017 to February 2024. STI was defined as a positive result for HIV antibody or VDRL in blood tests or detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Mycoplasma genitalium, Trichomonas vaginalis, HSV-1, or HSV-2 via multiplex PCR on cervical swabs. A total of 123 cases were reviewed. The median age was 15.5 years (range: 11.5–18.9), with 12.2% aged ≤12 years, and 43.9% aged 13–15 or 16–18 years, respectively. Of these, 58.5% reported prior sexual experience, and 9.8% had unclear histories. The overall positive rate for STI testing was 35.0% (43/123), with rates of 20.0% in those ≤12 years, 40.7% in ages 13–15, and 33.3% in ages 16–18. Among those with prior or unclear sexual experience, the positive rate for STI testing was 41.7%, compared to 20.5% among those without sexual experience. The most frequently detected pathogen was C. trachomatis (29.3%), followed by M. genitalium (12.2%), N. gonorrhoeae and HSV-2 (each 4.1%). Multiple pathogens were detected in 37.2% of STI-positive cases. Additionally, 92.7% of all cases tested positive for at least one of Mycoplasma hominis, Ureaplasma species, Gardnerella vaginalis, or Candida albicans, with 97.7% co-detection in STI-positive cases. Understanding the risk of STI exposure among adolescents is critical for effective prevention and timely treatment of STIs in adolescents. All Authors: No reported disclosures

Purpose Influenza-associated encephalitis/encephalopathy (IAE) in children ranges from a mild, self-limited illness to rapidly fatal neurological deterioration. This study investigated the clinical features, treatment timing, and risk factors associated with mortality and unfavorable neurological outcomes in pediatric IAE. Methods This retrospective study included 17 children diagnosed with IAE at a tertiary center between October 2025 and February 2026. IAE was defined by laboratory-confirmed influenza infection and clinical criteria for encephalitis after alternative etiologies had been excluded. Patients were categorized into three outcome groups: full recovery, mild-to-moderate sequelae, and mortality. Clinical characteristics were compared among the three groups and analyzed to identify potential risk factors associated with adverse neurological outcomes. Results Among the 17 patients (median age, 8.1 years), 10 recovered fully, four developed sequelae, and three died. Vaccination history differed significantly among the outcome groups (P=0.011); none of the patients who died had received influenza vaccination for at least 2 years before admission. Two fatal cases deteriorated abruptly within 12 hours after presentation and died before treatment could be initiated. The treatment interval differed significantly among the groups (P=0.003). In multivariable Firth models, treatment within 24 hours and prior vaccination showed protective trends, whereas brainstem involvement on magnetic resonance imaging and ventilator support were associated with increased odds of mortality; however, statistical significance was not reached. Conclusion Although many children with IAE recover completely, the disease can progress rapidly to fatal outcomes in a subset of patients. Prompt recognition, early treatment initiation, and prior influenza vaccination may reduce the risk of severe neurological complications.

Background:Invasive group A streptococcal (iGAS) infection has resurged globally following the coronavirus disease 2019 pandemic; however, long-term nationwide data from Asia is limited. This study aimed to investigate the epidemiology, clinical burden and molecular characteristics of iGAS infection in the Republic of Korea (ROK) over a 10-year period. Methods:A nationwide multicentre study for iGAS was conducted across 23 university-affiliated hospitals from 2015 to 2024. iGAS was defined as culture-confirmed isolation of Streptococcus pyogenes from sterile sites. Clinical data were collected using standardised forms. Available isolates were emm-typed and whole genome sequencing was performed for emm1 isolates. Findings:A total of 454 iGAS cases were identified. The mean annual incidence was 4.72/100,000 admissions (95% CI 4.26-5.13), declining from 7.03 (95% CI 6.26-7.77) in 2015-2019 to 1.72 (95% CI 1.27-2.26) in 2020-2022. In 2023-2024, the incidence returned to pre-pandemic levels among children (10.45 per 100,000 admissions, 95% CI 5.95-14.39), whereas the adult incidence partially recovered (2.47 per 100,000 admissions, 95% CI 1.76-3.33). Skin and soft tissue infection (22.7%), streptococcal toxic shock syndrome (STSS, 19.6%), and bacteremia without focus (17.0%) were the most common iGAS infections. Intensive care unit admission was required in 28.9% of iGAS cases, and overall mortality was 15.5%. Mortality was independently associated with STSS (aOR 20.07, 95% CI 9.30-43.30; p < 0.0001), older age (aOR 20.07, 95% CI 9.30-43.30; p < 0.0001), chronic medical condition (aOR 2.96, 95% CI 1.41-6.22; p = 0.004), and immunocompromised condition (aOR 2.33, 95% CI 1.07-5.09; p = 0.034) among adults. Among 98 isolates, the predominant strains were emm1 (32/98, 32.7%), emm12 (13/98, 13.3%), emm28 (11/98, 11.2%), and emm89 (8/98, 8.2%). Of 32 emm1 isolates, two (6.3%) isolates belonged to the epidemic M1UK lineage were identified (2020, 2024). Interpretation:Following marked pandemic-associated suppression, iGAS incidence rapidly rebounded among children in the ROK. This study reports the first detection of the M1UK lineage in the ROK, highlighting the need for statutory notification of iGAS as a nationally notifiable disease to enable continuous national surveillance with molecular characterization for monitoring emerging epidemic-prone strains. Funding:This work was supported by the Korea Disease Control and Prevention Agency.

In South Korea, the 10-valent and 13-valent pneumococcal conjugate vaccines (PCVs) have been part of the national immunization program since 2014, and 15-valent was recently introduced in 2024. To understand the current dynamics of pneumococcal serotype distribution in South Korea, we investigated the genotypes of Streptococcus pneumoniae isolates from pediatric invasive pneumococcal disease (IPD).eBURST diagram of multilocus sequence typing from invasive pneumococcal isolates, from 2016 to 2023 IPD cases from children under 19 years of age were collected through a prospective hospital-based surveillance at 20 hospitals between 2016 and 2023 in South Korea. Serotypes were determined using the Quellung reaction. Genotypes were determined by MLST. Alleles and sequence types were submitted to the web database for assignment. The eBURST diagram was created using the Phyloviz program. Distribution of serotype and genotype was compared between the pre-COVID-19 period (2016-2019) and the during/post-COVID-19 period (2020-2023). Among the 187 cases with determined serotypes, the most common were 10A (21.9%), 15C (11.8%), 15A (9.1%), 15B (8.0%), 19A (7.5%), and 23B (5.9%). Compared to the pre-COVID-19 period, serotype 23B increased from 0.9% to 14.3% (P < 0.001) and serotype 6C from 0.9% to 7.1% (P = 0.029), while serotype 10A declined from 27.4% to 12.9% (P = 0.018). The most common clonal complex (CC) was CC166 (24.1%), followed by CC1263 (20.9%), CC320 (12.8%), and CC81 (9.6%). The most prevalent sequence type (ST) was ST11189 (19.3%), followed by ST166 (16.6%). The decrease in serotype 10A was associated with a reduction in the dominant ST11189, while the increases in serotypes 23B and 6C were linked to ST166 and ST13556, respectively, in the during/post-COVID-19 period. A notable shift in serotype and genotype distribution of pediatric IPD has occurred in South Korea, with the emergence of serotype 23B-CC166 and serotype 6C-CC81. These findings underscore the need to consider emerging non-vaccine serotypes in future immunization strategies to prevent IPD in children. All Authors: No reported disclosures

Background: Influenza causes substantial morbidity in young children, particularly those aged 6-35 months. In this age group, optimisation of vaccine dose regimens remains important to ensure adequate immunogenicity while maintaining acceptable safety. This study evaluated the immunogenicity and safety of a full 0.5 mL dose of quadrivalent inactivated influenza vaccine (NBP607-QIV) in young children. Methods: This Phase 3, randomised, double-blind, active-controlled, multicentre study was conducted in Korea, Thailand, and Malaysia. Healthy children aged 6-35 months were randomised 2:1 to receive NBP607-QIV (0.5 mL) or control vaccine (0.25 mL). Immunogenicity was assessed using the haemagglutination inhibition assay. Primary endpoints were non-inferiority of NBP607-QIV versus Agrippal for seroconversion rate (SCR) and adjusted post-vaccination geometric mean titre (GMT) ratio against three shared strains. Immunogenicity against the additional B/Yamagata strain was evaluated according to Committee for Medicinal Products for Human Use (CHMP) criteria. Safety was assessed based on adverse events. Results: A total of 676 participants were randomised, and 675 were included in the safety set. Non-inferiority of NBP607-QIV versus control vaccine was demonstrated for SCR for all shared strains and for the adjusted GMT ratio for A/H1N1 and B/Victoria, but not for A/H3N2. Immunogenicity against the B/Yamagata strain met CHMP criteria for SCR and geometric mean ratio (GMR). Immunogenicity was consistent across prespecified subgroups, and the incidence of adverse events was comparable between groups, with no clinically meaningful safety concerns. Conclusions: NBP607-QIV administered at a 0.5 mL dose demonstrated acceptable immunogenicity and a safety profile comparable to that of a licensed trivalent influenza vaccine in children aged 6-35 months, supporting its use in this paediatric population.

BACKGROUND:In Korea, the 10-valent and 13-valent pneumococcal conjugate vaccines (PCVs) were introduced into the national immunization program (NIP) in 2014 for the protection in children. A decade later, in 2024, PCV15 replaced PCV10 and was included in the NIP in April, while PCV20 was licensed for use in October. To inform optimal vaccination policy, this study aimed to analyze the current distribution of serotypes responsible for invasive pneumococcal diseases (IPDs) in children. METHODS:IPD cases from children under 19 years of age were collected from a prospective hospital-based surveillance study conducted at 20 hospitals between 2016 and 2023. Data on the changes in IPD case number and serotype distribution were compared between the pre- coronavirus disease 2019 (COVID-19) period (2016-2019) and the during/post-COVID-19 period (2020-2023). RESULTS:Of the 187 cases with a determined serotype, the most frequent serotypes identified were 10A (21.9%), 15C (11.8%), 15A (9.1%), 15B (8.0%), and 19A (7.5%), and 23B (5.9%). Compared to the pre-COVID-19 period, the proportion of serotype 10A decreased (27.4% vs. 12.9%), while serotypes 23B (0.9% vs. 14.3%) and 6C (0.9% vs. 7.1%) increased. In regard to the vaccine serotype, PCV13 serotypes accounted for 12.3%, PCV15/PCV20 common serotypes for 3.2%, and PCV20 unique serotypes for 35.3% of IPD cases. Serotype 15C, cross protected by the 15B conjugate vaccines, accounted for 11.8%, and non-PCV20 serotypes for 36.4%. CONCLUSION:Given the approval of two new PCVs, the study results identified the substantial contribution of non-PCV13 serotypes to pediatric IPD and provide critical insights for optimal vaccination strategies to protect children against pneumococcal diseases.

BACKGROUND:Pediatric urinary tract infections (UTIs) are increasingly complicated to treat due to antimicrobial resistance (AMR). The coronavirus disease 2019 (COVID-19) pandemic has led to substantially reduced pediatric antibiotic prescribing, but its impact on resistance trends remains unclear. This study aimed to investigate the AMR trends in urinary pathogens from children under 24 months of age hospitalized with febrile UTI during the pre-, during-, and post-COVID-19 pandemic periods. METHODS:We conducted a retrospective study of children aged <24 months who were hospitalized at a tertiary center in Korea between 2008 and 2023 for first febrile UTI. The patients were stratified by age (<100 days vs. 100 days to 24 months) and pandemic period (pre-, during-, and post-COVID-19). Interrupted time-series (ITS) analysis and multivariable logistic regression were used to assess the temporal trends and predictors of ciprofloxacin nonsusceptibility. RESULTS:Ciprofloxacin susceptibility decreased significantly during the pandemic, especially among infants < 100 days. ITS analysis demonstrated an immediate 12.1% increase in ciprofloxacin nonsusceptibility at pandemic onset, which persisted thereafter. Extended-spectrum β-lactamase production was the strongest predictor of ciprofloxacin resistance. CONCLUSIONS:These findings suggest that adult antibiotic use and clonal dissemination may contribute to the persistence and spread of AMR, highlighting the need for integrated stewardship and genomic surveillance.

BACKGROUND:Neonatal herpes simplex virus (HSV) infection is rare but can cause severe disease, even death. However, data on neonatal HSV infection is limited in Asia. Thus, this study estimated the incidence of neonatal HSV infections and evaluated the characteristics in hospitalized patients in Korea, where seroprevalence of HSV infection in child-bearing age women is not well known. METHODS:This is the first multicenter retrospective study in 12 university hospitals in Korea. Neonates aged ≤ 28 days with confirmed HSV infection were identified from January 2008 to December 2017, and a chart review was performed. RESULTS:Among 12 medical centers, 16 patients were identified in 6 centers. The estimated incidence rate was 1/7,888 in hospitalized neonates. Eight (50%) patients were males, and the median age at diagnosis was 11 days (range, 4-28 days). Ten (62.5%) patients were HSV-1-positive, and 6 (37.5%) patients were HSV-2-positive. Four (25%) patients had disseminated infection, 11 (68.8%) patients had central nervous system disease, and 1 (6.2%) patient had skin, eye, and/or mouth disease. All the patients received intravenous acyclovir, with a median treatment duration of 19 days (range, 3-68 days). Four (25%) patients received additional oral acyclovir suppressive therapy, with the median treatment duration of 5 months (3-6 months). Four patients (25%) developed seizures (one case with disseminated disease and 3 cases with central nervous system disease), and 2 of them recovered without neurologic complications. Two (12.5%) patients with disseminated disease died within 30 days from the diagnosis, and one of them had a maternal history of previous genital herpetic lesions. Medical records of maternal genital herpes were not available in 10 (62.5%) patients with neonatal HSV infections. CONCLUSION:Although uncommon, neonatal HSV infection occurs in Korean babies with a high 30-day mortality of 12.5%. Increased awareness is warranted among Korean pediatricians for the early diagnosis and treatment of neonatal HSV infection.

Background:Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations. We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP. Methods:From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0-4, 5-9, and 10-21 days). Results:Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend<0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10-21 days. Conclusions:The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.

Pertussis is endemic worldwide, with epidemics occurring every 2 to 5 years despite a high vaccination coverage. After limited circulation during the coronavirus disease 2019 (COVID-19) pandemic, pertussis cases have increased rapidly worldwide since mid-late 2023, returning to pre-pandemic patterns. In Korea, 90 cases of pertussis were reported from April 2020 to May 2023, with elderly individuals aged ≥65 years accounting for 48.9%. Pertussis cases have increased sharply since June 2024, showing a nationwide epidemic, with a large increase among adolescents aged 13-15 years. As of August 2024, the national incidence rate of pertussis was estimated to be 37.75 per 100,000 population, with the highest incidence of 526.2 per 100,000 population in 13-year-olds. In Europe, during 2023-2024, an increase in pertussis incidence among infants was observed, along with large increases in 10-19-year-olds. In China, the number of reported cases of pertussis has increased rapidly since late 2023, with an age shift to older children, increase of vaccine escape, and a marked increase in the prevalence of macrolide-resistant Bordetella pertussis. The recent global resurgence of pertussis is due to decreased opportunities for boosting immunity by natural infection during the COVID-19 pandemic in combination with waning of immunity-induced pertussis vaccines.

Pulmonary paragonimiasis is a parasitic infection caused by lung flukes of the Paragonimus genus, primarily acquired by consuming raw or undercooked freshwater crustaceans. Despite improvements in sanitation, paragonimiasis, once widespread in Asia, remains a concern due to its potential for re-emergence in endemic regions such as Korea. The infection typically begins when metacercariae are ingested, excyst in the intestine, and migrate to the lungs, causing pleuritis and pneumonia. However, large empyema cases associated with paragonimiasis, especially in pediatric patients, are exceedingly rare. A 14-year-old Korean adolescent presented to the emergency clinic with dyspnea, cough, and blood-tinged sputum. Her symptoms had worsened over 5 months, and she had recently developed a fever. Physical examination revealed decreased breath sounds in the left lung, and chest computed tomography revealed a small cavitary nodule and a collapsed left lung with massive pleural effusion displacing the mediastinum. The pleural fluid was turbid and yellowish, indicative of empyema. Laboratory tests indicated eosinophilia with an absolute eosinophil count of 970 cells/μL, and further investigation confirmed pulmonary paragonimiasis through the detection of Paragonimus eggs in bronchoalveolar lavage fluid. Oral praziquantel was administered, but residual atelectasis necessitated video-assisted thoracic surgery for decortication. Histopathology confirmed Paragonimus eggs in pleural tissue, and lung function improved postsurgery. Due to recent improvements in sanitation, cases of pulmonary paragonimiasis in the pediatric population progressing to surgical decortication are extremely rare. This case highlights the importance of considering parasitic infections in children with cavitary lung lesions, particularly in endemic regions. Despite significant reductions in the prevalence of paragonimiasis, clinicians must remain vigilant, especially in patients with a history of consuming freshwater crustaceans. Effective treatment with praziquantel and, in severe cases, surgical decortication can lead to successful outcomes.

Mycoplasma pneumoniae is the leading cause of community-acquired pneumonia in children. With increasing macrolide resistance, the use of second-line antibiotics such as tetracyclines and quinolones is also increasing. Clinical data were collected from 13 institutions between September 2023 and February 2024. MPP was defined as the detection of M. pneumoniae via polymerase chain reaction or serological tests and radiologic evidence of pneumonic infiltration. Among the 389 children with MPP included in the analysis, 89.1% were macrolide resistant (MR). The treatment groups were as follows: spontaneous resolution (SR, 21.9%), macrolide alone (ML, 18.0%), macrolide with other treatments (ML-O, 38.0%), and second-line antibiotics and/or steroids (2nd-A/S, 22.1%). The median fever duration was 5 days for the SR group, 7 days for both the ML and 2nd-A/S groups, and 8 days for the ML-O group. The ML-O group had significantly greater hospitalization rates (93.9% vs. 81.4-84.7%, P = 0.023) and longer hospital stays (5.0 days vs. 3.0-4.0 days, P < 0.001). The median times to defervescence from the initiation of macrolide and second-line treatments were 2-3 days and 0-2 days, respectively. In conclusion, despite high MR rates, macrolide monotherapy remains effective in many patients, even those with macrolide-resistant M. pneumoniae.

A resurgence of Mycoplasma pneumoniae (MP)—the leading cause of community-acquired bacterial pneumonia, particularly in children—occurred following the COVID-19 pandemic. We aimed to investigate the clinical manifestations, macrolide resistance patterns, and therapeutic approaches related to the MP pneumonia epidemic. Children and adolescents diagnosed with MP pneumonia in September–December 2023 were screened. Clinical data were retrospectively collected from 13 major hospitals using concordant microbiological criteria, including either a positive PCR result or four-fold increase in serological markers. Demographic characteristics, treatment modalities, and clinical outcomes were analyzed. Of the 474 screened patients, 374 (median age: 7.7 [IQR, 5.4–9.6] years; hospitalization rate: 88.6%) met the microbiological confirmation criteria. Most patients experienced fever (98.9%), and lobular/lobar consolidation (59.1%) was the dominant radiological finding. The macrolide resistance rate remained high at 87.0%; corticosteroids were widely used (55.6%) alongside macrolides, despite resistance. Patients with consolidation had prolonged fever (median 8 vs. 7 days, p = 0.020) and higher hospitalization rates (92.3% vs. 83.0%, p = 0.008). Macrolide resistance did not significantly influence radiological outcomes. This study highlights the ongoing challenge of macrolide resistance in MP pneumonia and need for tailored therapeutic approaches. Despite high resistance, macrolides remain commonly prescribed, often concurrently with corticosteroids.

There is an ongoing burden of pneumococcal disease in children despite the use of pneumococcal conjugate vaccines (PCVs). This phase 3, open-label, single-arm, multisite, descriptive study was designed to evaluate the safety and immunogenicity of a 3 + 1 regimen of V114 (VAXNEUVANCE (TM)), a 15-valent PCV, in South Korean infants and toddlers. Adverse events (AEs) were reported for 14 d following any vaccination, and throughout the study period for serious AEs. Serotype-specific immunoglobulin G (IgG) response rates (proportion of participants meeting an IgG threshold value of >= 0.35 mu g/mL) and geometric mean concentrations (GMCs) for the 15 serotypes at 30 d postdose 3 (PD3) and at 30 d postdose 4 (PD4) were evaluated as endpoints. Healthy infants enrolled at 42-90 d after birth were vaccinated with V114 (N = 57). The most commonly reported AEs were those solicited in the trial. The majority of reported AEs were transient and of mild or moderate intensity. Few serious AEs were reported; none were vaccine related. No participants died nor discontinued the study vaccine because of an AE. V114 was immunogenic for all 15 serotypes contained in the vaccine, as assessed by IgG response rates at 30 d PD3 and IgG GMCs at 30 d PD3 and at 30 d PD4. V114 was well tolerated and immunogenic when administered as a 3 + 1 regimen in healthy South Korean infants and toddlers.

BACKGROUND:We aimed to describe the clinical and microbiological characteristics of enterococcal bacteremia, as well as the effect of Enterococcus resistance against vancomycin on clinical outcomes in Korean children. METHODS:We retrospectively reviewed the medical records of children diagnosed with enterococci isolated from blood cultures at Pusan National University Children's Hospital between December 2009 and November 2021. RESULTS:In total, 64 patients were enrolled in the study. The median age was 0 years (range 0-15), and 43 (67.2%) patients were male. Enterococcus faecalis (50%) was the most commonly identified bacterial strain. Significant underlying diseases were present in 60 patients (93.8%), and the source of bacteremia was identified in 36 patients (56.3%). Among these, intravascular device was the most common identifiable source. Fifty-six (87.5%) patients had previously received broad-spectrum antibiotics and 54 (84.4%) patients were nosocomial in origin. Twenty-nine (45.3%) strains were resistant to ampicillin, and 16 (25%) strains were resistant to vancomycin. All patients with vancomycin-resistant enterococci (VRE) had underlying disease (P = 0.199), and focus of bacteremia was significantly more frequent in VRE patients (P = 0.014). Of all the patients, after appropriate antibiotic treatment, five (7.8%) patients had recurrent enterococcal bacteremia, and seven (10.9%) patients were diagnosed with bacteremia, defined as other pathogens from blood culture. The 30-day mortality rate was 7.8%. CONCLUSION:Enterococcal bacteremia in children is usually nosocomial and occurs in children with serious underlying diseases. Because the number of enrolled patients and mortality were small in our study, it is difficult to identify whether the factor that determines prognosis in patients with enterococcal bacteremia is VRE or an underlying disease. Further studies with a large number of patients in a specific group are needed.

This study is the first multicenter study to estimate the birth prevalence of symptomatic congenital cytomegalovirus disease in Korea. The prevalence was 0.06 % and the administrative prevalence was 0.01% for overall congenital cytomegalovirus infection. The birth prevalence of symptomatic congenital cytomegalovirus (cCMV) disease among live birth in Korea from a multicenter study was 0.06% during 2001-2015 with increasing frequency. The administrative prevalence of cCMV infection by big-data analysis from the national health insurance system was 0.01% and the average healthcare cost was US$2010 per person.

Background Tuberculosis (TB) exposure in congregate settings related to neonates is a serious medical and social issue. TB exposure happens during the neonatal period, but contact investigations for exposed infants are usually conducted after the neonatal period. Generally, recommendations for screening and managing close contact are different for neonates and children. Thus, there are challenges in contact investigations. We aimed to report contact investigations with a single tuberculin skin test (TST) on infants exposed to infectious TB in a postpartum care center. Methods The index case was a healthcare worker with active pulmonary TB: sputum acid-fast bacilli smear negative, culture positive, and no cavitary lesion. All exposed infants underwent medical examinations and chest X-ray. After TB disease was ruled out, contacts received window period prophylaxis with isoniazid (INH) until three months after the last exposure. TST was performed only once after completing the prophylaxis. Results A total of 288 infants were selected as high-priority contacts. At the initial contact investigation, the age of infants ranged from 8 to 114 days. None of these exposed infants had TB disease. The prevalence of latent TB infection (LTBI) was 25.3% (73/288; 95% confidence interval [CI], 20.7–30.7). There were no serious adverse events related to the window period prophylaxis or LTBI treatment with INH. During the 1-year follow-up period, no infants progressed to overt TB disease. The size of TST induration in infants vaccinated with percutaneous Bacillus Calmette-Guérin (BCG) vaccine was significantly larger than that of infants vaccinated with intradermal BCG vaccine (median, 8 mm vs. 5 mm; P = 0.002). In multiple logistic regression analysis, independent factors associated with TST positivity (≥ 10 mm induration) were male (adjusted odds ratio [aOR], 2.98; 95% CI, 1.6–5.64), percutaneous BCG vaccination (aOR, 3.30; 95% CI, 1.75–6.48), TST reading between 60 and 72 hours after injecting purified protein derivative (aOR, 2.87; 95% CI, 1.53–5.49), and INH prophylaxis more than four weeks (aOR, 0.49; 95% CI, 0.25–0.94). Conclusion A single TST at three months after the last TB exposure with INH prophylaxis could be used as a main protocol in contact investigations for infants exposed to infectious TB during the neonatal period in congregate settings in Korea.

Direct hemoperfusion therapy with a polymyxin B-immobilized fiber column (PMX-HP) has been introduced as a therapeutic option for gram negative bacterial septic shock in adults. However, its use in neonates and children has not yet been established. We successfully performed hemoperfusion therapy using an adult polymyxin B-immobilized fiber column in a neonate with carbapenem resistant Acinetobacter baumannii septic shock. The application was technically feasible because the neonate was on extracorporeal membrane oxygenation (ECMO). Although it did not rescue the patient, there was significant short-lasting improvement in pulmonary oxygenation and hemodynamics, leading to wean the patient from ECMO. PMX-HP could be used as an adjunctive treatment for selected neonatal and pediatric patients with gram negative bacterial septic shock.

의 유전자 결함이 포함되어 있다.여러 국가의 원발성면역결핍증 등록에 따르면 십만 명당 1-11.8명의유병률을 보이며[2] 국내에서 는 어린이 십만 명당 1.125명에 발생하는 희귀질환이다[3].유전자 결함으로 인한 면역계 세포들의 수적 또는 기능적 이상으로 감염 에 대한 감수성이 증가하여 발생하는 빈번한 감염이 주요한 임상 적 특징이고, 결핍된 면역계의 구성에 따라 여러 감염 양상이 함께 나타날 수 있다