Research Roundup: COVID In Children; Diabetes; Gonorrhea; Broad-Spectrum Antibiotics

JAMA Pediatrics: Prevalence Of SARS-CoV-2 Infection In Children Without Symptoms Of Coronavirus Disease 2019
During the coronavirus disease 2019 (COVID-19) pandemic, determination of prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children without symptoms of COVID-19 is critical to guide infection control policy. While estimates have been reported in children undergoing emergency surgery1 and oncologic care,2 these small studies have limited generalizability to large populations of children without symptoms. When children's hospitals resumed elective medical and surgical care in April and May 2020, many implemented routine SARS-CoV-2 testing for children presenting for care not associated with suspicion of COVID-19. Here, we report the prevalence of positive SARS-CoV-2 test results in children without symptoms at 28 children's hospitals across the US. (Marija Sola et al, 8/25)

The Journal Of Pediatrics: Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, And Immune Responses  
This study reveals that children may be a potential source of contagion in the SARS-CoV-2 pandemic in spite of milder disease or lack of symptoms, and immune dysregulation is implicated in severe post-infectious MIS-C. (Yonker et al, 8/19)

American Diabetes Association: Metabolic Syndrome And COVID-19 Mortality Among Adult Black Patients In New Orleans
Coronavirus disease 2019 (COVID-19) mortality is high in patients with hypertension, obesity, and diabetes. We examined the association between hypertension, obesity, and diabetes, individually and clustered as metabolic syndrome (MetS), and COVID-19 outcomes in patients hospitalized in New Orleans during the peak of the outbreak. (Xie et al, 8/1)

Also —

CIDRAP: Antibiotic Resistance Likely Not A Major Driver Of Gonorrhea Spread In NYC
An analysis of gonococcal isolates collected in New York City in 2012 and 2013 showed that all large transmission clusters were susceptible to current gonorrhea therapies. In their analysis of genome sequences, antibiotic susceptibility, and patient data from 897 gonococcal isolates cultured by the New York City Public Health Laboratory from January 2012 through June 2014—a convenience sample that represents 1.5% of total gonorrhea infections in New York City during the period—the researchers found that the New York City gonococcal phylogeny reflected global diversity, with isolates from 22 of the 23 global Neisseria gonorrhea lineages.They also observed that the isolates clustered on the phylogeny by sexual behavior (P < 0.001), with one lineage significantly associated with isolates from men who have sex with men (MSM) and another associated with isolates from heterosexuals. They also clustered based on race and ethnicity (P < 0.001). (8/24)

CIDRAP: CMS Sepsis Bundle Linked To Increased Use Of Broad-Spectrum Antibiotics
Implementation of a core measure sepsis bundle by the Centers for Medicare and Medicaid Services (CMS) was associated with an immediate and long-term increase in the use of broad-spectrum antibiotics for hospital-onset multidrug-resistant (MDR) organisms, researchers reported late last week in Clinical Infectious Diseases. In the study, a team led by researchers from Virginia Commonwealth University evaluated monthly antibiotic data for four categories of antibiotics at 111 US hospitals before and after the 2015 implementation of the Sepsis Bundle Core Performance Measure for hospitals participating in Inpatient Quality Reporting (SEP-1). One element of the bundle is initiation of broad-spectrum antibiotics within 3 hours of sepsis diagnosis. The four antibiotic categories evaluated included antibiotics for surgical prophylaxis, broad-spectrum agents for community-acquired infections, broad-spectrum antibiotics for hospital-onset/MDR organisms, and anti–methicillin resistant Staphylococcus aureus agents. (8/24)