Antibiotic treatment in infants: effect on the gastro-intestinal microbiome and long term consequences

The gastrointestinal microbiome is crucial for the development of a balanced immune system. Antibiotics are frequently administered to infants and cause intestinal dysbiosis. This narrative review highlights the long term health consequences of antibiotic administration to infants and young children. The necessity of administration of antibiotics should be well considered, since an association with short term consequences such as antibiotic associated diarrhoea and long term adverse effects such as overweight, inflammatory bowel syndrome, allergic disease  have been reported.  Conclusion:  The pros and cons of antibiotic administration to infants and young children should be considered

Varying presentations of multisystem inflammatory syndrome temporarily associated with COVID-19

Background. A novel coronavirus identified in 2019 leads to a pandemic of severe acute respiratory distress syndrome with important morbidity and mortality. Initially, children seemed minimally affected, but there were reports of cases similar to (atypical) Kawasaki disease or toxic shock syndrome, and evidence emerges about a complication named paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C). Case Presentations. Two cases were compared and discussed demonstrating varying presentations, management, and evolution of MIS-C. These cases are presented to increase awareness and familiarity among paediatricians and emergency physicians with the different clinical manifestations of this syndrome. Discussion. MIS-C may occur with possible diverse clinical presentations. Early recognition and treatment are paramount for a beneficial outcome

Monitoring of human coronaviruses in Belgian primary care and hospitals, 2015-20: a surveillance study.

BACKGROUND: Seasonal human coronaviruses (hCoVs) broadly circulate in humans. Their epidemiology and effect on the spread of emerging coronaviruses has been neglected thus far. We aimed to elucidate the epidemiology and burden of disease of seasonal hCoVs OC43, NL63, and 229E in patients in primary care and hospitals in Belgium between 2015 and 2020. METHODS: We retrospectively analysed data from the national influenza surveillance networks in Belgium during the winter seasons of 2015-20. Respiratory specimens were collected through the severe acute respiratory infection (SARI) and the influenza-like illness networks from patients with acute respiratory illness with onset within the previous 10 days, with measured or reported fever of 38°C or greater, cough, or dyspnoea; and for patients admitted to hospital for at least one night. Potential risk factors were recorded and patients who were admitted to hospital were followed up for the occurrence of complications or death for the length of their hospital stay. All samples were analysed by multiplex quantitative RT-PCRs for respiratory viruses, including seasonal hCoVs OC43, NL63, and 229E. We estimated the prevalence and incidence of seasonal hCoV infection, with or without co-infection with other respiratory viruses. We evaluated the association between co-infections and potential risk factors with complications or death in patients admitted to hospital with seasonal hCoV infections by age group. Samples received from week 8, 2020, were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). FINDINGS: 2573 primary care and 6494 hospital samples were included in the study. 161 (6·3%) of 2573 patients in primary care and 371 (5·7%) of 6494 patients admitted to hospital were infected with a seasonal hCoV. OC43 was the seasonal hCoV with the highest prevalence across age groups and highest incidence in children admitted to hospital who were younger than 5 years (incidence 9·0 [95% CI 7·2-11·2] per 100 000 person-months) and adults older than 65 years (2·6 [2·1-3·2] per 100 000 person-months). Among 262 patients admitted to hospital with seasonal hCoV infection and with complete information on potential risk factors, 66 (73·3%) of 90 patients who had complications or died also had at least one potential risk factor (p=0·0064). Complications in children younger than 5 years were associated with co-infection (24 [36·4%] of 66; p=0·017), and in teenagers and adults (≥15 years), more complications arose in patients with a single hCoV infection (49 [45·0%] of 109; p=0·0097). In early 2020, the Belgian SARI surveillance detected the first SARS-CoV-2-positive sample concomitantly with the first confirmed COVID-19 case with no travel history to China. INTERPRETATION: The main burden of severe seasonal hCoV infection lies with children younger than 5 years with co-infections and adults aged 65 years and older with pre-existing comorbidities. These age and patient groups should be targeted for enhanced observation when in medical care and in possible future vaccination strategies, and co-infections in children younger than 5 years should be considered during diagnosis and treatment. Our findings support the use of national influenza surveillance systems for seasonal hCoV monitoring and early detection, and monitoring of emerging coronaviruses such as SARS-CoV-2. FUNDING: Belgian Federal Public Service Health, Food Chain Safety, and Environment; Belgian National Insurance Health Care (Institut national d'assurance maladie-invalidité/Rijksinstituut voor ziekte-en invaliditeitsverzekering); and Regional Health Authorities (Flanders Agentschap zorg en gezondheid, Brussels Commission communautaire commune, Wallonia Agence pour une vie de qualité)

Some trainees are more equal than others - the pediatric residency pay gap

Background and aims In Belgium, medical doctors in specialty training (residency years) are employed under a distinct and unique statute (sui generis). Although legal provisions exist, recent polls showed relevant heterogeneity in adherence to employment contracts, wages, and social benefits. Methods Junior representatives of the Flemish association for pediatrics (Jong VVK) conducted a descriptive cross-sectional study among trainees in pediatrics in Flanders in 2019, who are employed in both university and non-university training centers. By means of an anonymized online survey their wages, working conditions and fringe benefits were collected and studied. Results Fifty-four surveys were completed by 48 unique trainees. Data concerned employment regimens from 21 hospitals. The average gross and net monthly salary were, respectively, € 3182,63 (standard deviation € 221,86) and € 2424,28 (SD € 223,35) . Noteworthy, the difference between the most wealthy incomes (P95) versus the least (P5) was € 713,79 net per month. Only minimal effect of seniority could be found. The average extra salary for all earnings besides the standard income (e.g. on on-call duties, overtime, transportation expenses,...) was € 305,87 per month, an additional income of barely 15%. The average net income per hour (€ 9,32) only just exceeds the nationally fixed minimum wage, undervaluing the trainee’s past education, medical degree, experience and responsibility. Fringe benefits were infrequently provided. Besides 63% in the possibility of receiving a bike fee, 51% a hospitalization insurance and 45% an insurance concerning civil liability, other benefits were provided in less than a quarter of respondents with no-one receiving meal vouchers, 2% a vacation salary and 8% an end-year bonus. Conclusion The trainee in pediatrics in Flanders is being paid disproportionately and unfairly for his extensive and stressful professional activities. The roots for this inequity can be traced back to the outdated sui generis statute, an inadequate legal framework and a weak and non-vacant position of the resident on the labour market. There is a relevant heterogeneity in gross and net income and fringe benefits are unevenly provided. Moreover, it is striking that the individual trainee is not well informed about his or her employment conditions and transparency is lacking

Impact of COVID-19 Pandemic on Paediatric Trainees in Belgium

Background and objectives: The COVID-19 pandemic has put strain on the activities and well-being of health care workers. We aimed to measure the direct and indirect impact on a personal and professional level for paediatric trainees in Flanders, Belgium.Study design: Junior representatives of the Flemish Society for Paediatrics (Jong VVK) conducted a longitudinal study among their fellow paediatric trainees. The impact of COVID-19 on daily tasks, education and emotional well-being for the first (March-April 2020) and second wave (October-November 2020) of the pandemic were studied.Results: One hundred and nineteen surveys were completed in the first wave, representing data of 51% (119/233) of the total number of paediatric trainees in Flanders. Eighty surveys were completed in the second wave. Educational program changes occurred in 25% (30/119) of trainees and more than half (61%; 72/119) described the pandemic as an impediment for their educational progress. The perception of impaired education persisted for 30% of the responders (24/80) during the second wave. One out of three (30%; 35/119) felt their job was more exhausting than usual and 38% (45/119) perceived more stress at work. These numbers were comparable at both time points. Increases in stress paralleled with increased irritability in daily life and poorer sleep quality. Conclusions: COVID-19 had an important impact on the daily tasks, education and emotional well-being of the paediatric trainees. Medical training centres should be aware that there is a perception of impediment on the educational program of the paediatric trainee.</jats:p

Some trainees are more equal than others : the paediatric residency payment gap, as illustrated in a cross-sectional study in Flanders

Objective: In Belgium, medical doctors in specialty training are employed under a distinct statute (sui generis). Recent polls showed relevant heterogeneity in adherence to employment contracts, wages, and social benefits. We aimed to study the wages, working conditions and fringe benefits and identify this heterogeneity among Flemish paediatric trainees. Methods: We conducted a cross-sectional study among approximately 200 trainees in paediatrics in Flanders. By an anonymized survey, wages, working conditions and fringe benefits were collected. Results: Fifty-four surveys were completed, containing data from a quarter of all trainees. Data concerned employment regimens from 21 hospitals. The median gross and net monthly salary were, respectively, €3175.55 (IQR 3031.5-3365) and €2400.52 (IQR 2265.5-2645). Only minimal effect of seniority could be found. The median extra salary for all earnings besides the standard income was €311.16 per month, an additional income of 15%. The median net income per hour (€9.23) just exceeds the nationally fixed minimum wage. Fringe benefits were infrequently provided. Interpretation: The trainee in paediatrics in Flanders is being paid disproportionately and unfairly. The roots for this inequity can be traced back to an outdated statute, an inadequate legal framework and a weak position on the labour market. With this detailed survey, we found relevant heterogeneity in trainees’ incomes, with unevenly provided fringe benefits, lack of transparency and misinformation being frequently presen

The burden and surveillance of RSV disease in young children in Belgium-expert opinion

Infections with respiratory syncytial virus (RSV) can cause severe disease. In young children, RSV is the most common cause of lower respiratory tract illness and life-threatening infections most commonly occur in the first years of life. In adults, elderly and immunocompromised people are most vulnerable. Recently there has been an acceleration in the development of candidate RSV vaccines, monoclonal antibodies and therapeutics which are expected to become available in Europe within the next 2–10 years. Understanding the true burden of childhood RSV disease will become very important to support public health authorities and policy makers in the assessment of new therapeutic opportunities against RSV disease. A systematic literature search was performed to map local data on the burden of RSV disease and to evaluate available RSV surveillance systems. A group of 9 paediatric infectious diseases specialists participated in an expert panel. The purpose of this meeting was to evaluate and map the burden associated with RSV infection in children, including patient pathways and the epidemiological patterns of virus circulation in Belgium. Sources of information on the burden of RSV disease in Belgium are very limited. For the outpatient setting, it is estimated that 5–10% of young patients seen in primary care are referred to the hospital. Around 3500 children between 0 and 12 months of age are hospitalized for RSV-bronchiolitis every year and represent the majority of all hospitalizations. The current Belgian RSV surveillance system was evaluated and found to be insufficient. Knowledge gaps are highlighted and future perspectives and priorities offered. Conclusion: The Belgian population-based RSV surveillance should be improved, and a hospital-led reporting system should be put in place to enable the evaluation of the true burden of RSV disease in Belgium and to improve disease management in the future

Extending influenza surveillance to detect non-influenza respiratory viruses of public health relevance: analysis of surveillance data, 2015-2019, Belgium

info:eu-repo/semantics/publishe

Influenza Versus Other Respiratory Viruses – Assessing Severity Among Hospitalized Children in Belgium (2010-2022)

Preprintinfo:eu-repo/semantics/publishe

Monitoring of human coronaviruses in Belgian primary care and hospitals, 2015–20: a surveillance study

info:eu-repo/semantics/publishe