Background The overall global impact of COVID-19 in children and regional variability in pediatric outcomes are presently unknown. Methods To evaluate the magnitude of global COVID-19 death and intensive care unit (ICU) admission in children aged 0–19 years, a systematic review was conducted for articles and national reports as of December 7, 2020. This systematic review is registered with PROSPERO (registration number: CRD42020179696). Results We reviewed 16,027 articles as well as 225 national reports from 216 countries. Among the 3,788 global pediatric COVID-19 deaths, 3,394 (91.5%) deaths were reported from low- and middle-income countries (LMIC), while 83.5% of pediatric population from all included countries were from LMIC. The pediatric deaths/1,000,000 children and case fatality rate (CFR) were significantly higher in LMIC than in high-income countries (HIC) (2.77 in LMIC vs 1.32 in HIC; p < 0.001 and 0.24% in LMIC vs 0.01% in HIC; p < 0.001, respectively). The ICU admission/1,000,000 children was 18.80 and 1.48 in HIC and LMIC, respectively (p < 0.001). The highest deaths/1,000,000 children and CFR were in infants < 1 year old (10.03 and 0.58% in the world, 5.39 and 0.07% in HIC and 10.98 and 1.30% in LMIC, respectively). Conclusions The study highlights that there may be a larger impact of pediatric COVID-19 fatality in LMICs compared to HICs.

Although survival of individuals with cystic fibrosis (CF) has been continuously improving for the past 40 years, respiratory failure secondary to recurrent pulmonary infections remains the leading cause of mortality in this patient population. Certain pathogens such as Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and species of the Burkholderia cepacia complex continue to be associated with poorer clinical outcomes including accelerated lung function decline and increased mortality. In addition, other organisms such as anaerobes, viruses, and fungi are increasingly recognized as potential contributors to disease progression. Culture-independent molecular methods are also being used for diagnostic purposes and to examine the interaction of microorganisms in the CF airway. Given the importance of CF airway infections, ongoing initiatives to promote understanding of the epidemiology, clinical course, and treatment options for these infections are needed.

The first step of the AET protocol led to the greatest eradication success. Subsequent eradication attempts have a success rate below 50%. Prospective studies of eradication protocols for this population are needed to determine the most effective treatment strategy.

Cystic fibrosis (CF) is one of the most common life-shortening genetic diseases in Caucasians. Due to abnormal accumulation of mucus, respiratory failure caused by chronic infections is the leading cause of mortality in this patient population. The microbiology of these respiratory infections includes a distinct set of opportunistic pathogens, including Pseudomonas aeruginosa, Burkholderia spp., Achromobacter spp., Stenotrophomonas maltophilia, anaerobes, nontuberculous mycobacteria, and fungi. In recent years, culture-independent methods have shown the polymicrobial nature of lung infections, and the dynamics of microbial communities. The unique environment of the CF airway predisposes to infections caused by opportunistic pathogens. In this review, we will highlight how the epidemiology and role in disease of these pathogens in CF differ from that in individuals with other medical conditions. Infectious diseases (ID) physicians should be aware of these differences and the specific characteristics of infections associated with CF.

A case of scurvy in a 10-year-old boy with autism spectrum disorder is described. His clinical presentation was initially thought to be due to osteomyelitis, for which empirical antimicrobial therapy was initiated. Further invasive and ultimately unnecessary investigations were avoided when scurvy was considered in the context of a restricted diet and classic signs of vitamin C deficiency. Infectious diseases specialists should be aware of scurvy as an important mimicker of osteoarticular infections when involved in the care of patients at risk of nutritional deficiencies.

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The increase in CLABSI rates in Quebec NICUs seems to be associated with an increased proportion of cases with underlying intra-abdominal and pulmonary pathologies, which needs further investigation.

T imely diagnosis of infection enables outbreak control through rapid isolation of index cases and subsequent contact tracing. 1,2 Diagnosis of SARS-CoV-2 infection is predominantly based on polymerase chain reaction (PCR), which has a turnaround time of 24-48 hours. Rapid antigen detection tests (RADTs) are inexpensive and can be used at the point of care. They usually have high speci ficity and moderate sensitivity compared with PCR. [3][4][5][6] Given their rapid turnaround time, RADTs allow for efficient triage and management of exposed individuals. 7 The potential use of RADTs is especially relevant in schools, where outbreaks of SARS-CoV-2 infection can interrupt inperson teaching and negatively affect learning. [8][9][10][11] Rapid antigen detection tests perform best in the early stages of infection, when viral load is generally high. [12][13][14][15] Reported RADT sensitivity ranges from 28.9% to 98.3%, with improved sensitivity in samples with high viral loads and in symptomatic individuals. 16,17 The usual limits of detection for PCR is 600-1000 viral RNA copies/mL, whereas RADTs usually have limits of detection 2-3 logs higher (10 5 to 10 6 ). 18 Many studies have indicated the importance of high viral load dynamics with infectiousness. 19,20 For each unit increase in cycle threshold (Ct) value, the odds of recovering infectious virus decreased by 0.67, being under 10% when Ct values were greater than 35. Cycle threshold values of 17 to 32 corresponded to 10 5 and 10 1 SARS-CoV-2 RNA copies/µL, respectively.