International Journal of Molecular Sciences (Jun 2016)
Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis
- Luisa Galli,
- Laura Lancella,
- Chiara Tersigni,
- Elisabetta Venturini,
- Elena Chiappini,
- Barbara Maria Bergamini,
- Margherita Codifava,
- Cristina Venturelli,
- Giulia Tosetti,
- Caterina Marabotto,
- Laura Cursi,
- Elena Boccuzzi,
- Silvia Garazzino,
- Pier Angelo Tovo,
- Michele Pinon,
- Daniele Le Serre,
- Laura Castiglioni,
- Andrea Lo Vecchio,
- Alfredo Guarino,
- Eugenia Bruzzese,
- Giuseppe Losurdo,
- Elio Castagnola,
- Grazia Bossi,
- Gian Luigi Marseglia,
- Susanna Esposito,
- Samantha Bosis,
- Rita Grandolfo,
- Valentina Fiorito,
- Piero Valentini,
- Danilo Buonsenso,
- Raffaele Domenici,
- Marco Montesanti,
- Filippo Maria Salvini,
- Enrica Riva,
- Icilio Dodi,
- Francesca Maschio,
- Luisa Abbagnato,
- Elisa Fiumana,
- Chiara Fornabaio,
- Patrizia Ballista,
- Vincenzo Portelli,
- Gabriella Bottone,
- Nicola Palladino,
- Mariella Valenzise,
- Barbara Vecchi,
- Maria Di Gangi,
- Carla Lupi,
- Alberto Villani,
- Maurizio de Martino
Affiliations
- Luisa Galli
- Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, Florence 50139, Italy
- Laura Lancella
- Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Hospital, Rome 00165, Italy
- Chiara Tersigni
- Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, Florence 50139, Italy
- Elisabetta Venturini
- Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, Florence 50139, Italy
- Elena Chiappini
- Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children’s University Hospital, Florence 50139, Italy
- Barbara Maria Bergamini
- Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy
- Margherita Codifava
- Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy
- Cristina Venturelli
- Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy
- Giulia Tosetti
- Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy
- Caterina Marabotto
- Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Hospital, Rome 00165, Italy
- Laura Cursi
- Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Hospital, Rome 00165, Italy
- Elena Boccuzzi
- Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Hospital, Rome 00165, Italy
- Silvia Garazzino
- Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy
- Pier Angelo Tovo
- Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy
- Michele Pinon
- Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy
- Daniele Le Serre
- Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy
- Laura Castiglioni
- Pediatric Unit, Ramazzini Hospital, Carpi (Modena) 41124, Italy
- Andrea Lo Vecchio
- Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy
- Alfredo Guarino
- Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy
- Eugenia Bruzzese
- Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy
- Giuseppe Losurdo
- Infectious Diseases Unit, IRCCS Giannina Gaslini, Genoa 16148, Italy
- Elio Castagnola
- Infectious Diseases Unit, IRCCS Giannina Gaslini, Genoa 16148, Italy
- Grazia Bossi
- Pediatric Clinic, University of Pavia, IRCCS Policlinico “S. Matteo” Foundation, Pavia 27100, Italy
- Gian Luigi Marseglia
- Pediatric Clinic, University of Pavia, IRCCS Policlinico “S. Matteo” Foundation, Pavia 27100, Italy
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Samantha Bosis
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Rita Grandolfo
- Infectious Diseases Unit, St. Giovanni XXIII Pediatric Hospital, Bari 70120, Italy
- Valentina Fiorito
- Pediatric Unit, S. Maria del Carmine Hospital, Rovereto (Trento) 38068, Italy
- Piero Valentini
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- Danilo Buonsenso
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- Raffaele Domenici
- Pediatric Unit, “Campo di Marte” Hospital, Lucca 55100, Italy
- Marco Montesanti
- Pediatric Unit, “Campo di Marte” Hospital, Lucca 55100, Italy
- Filippo Maria Salvini
- Pediatric Clinic, San Paolo Hospital, University of Milan, Milan 20142, Italy
- Enrica Riva
- Pediatric Clinic, San Paolo Hospital, University of Milan, Milan 20142, Italy
- Icilio Dodi
- Department of Pediatrics, Parma University Hospital, Parma 43126, Italy
- Francesca Maschio
- Pediatric Unit, Ca’ Foncello Civil Hospital, Treviso 31100, Italy
- Luisa Abbagnato
- Pediatric Unit, St. Anna Hospital, Como 22100, Italy
- Elisa Fiumana
- Pediatric Unit, Arcispedale Sant’Anna, University of Ferrara, Ferrara 44100, Italy
- Chiara Fornabaio
- Division of Infectious Diseases, Istituti Ospitalieri di Cremona, Cremona 26100, Italy
- Patrizia Ballista
- Pediatric Unit, Sesto San Giovanni Hospital, Milan 20099, Italy
- Vincenzo Portelli
- Infectious Diseases Unit, S. Antonio Abate Hospital, Trapani 91016, Italy
- Gabriella Bottone
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila 67100, Italy
- Nicola Palladino
- Infectious Disease Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia 06100, Italy
- Mariella Valenzise
- Department of Pediatrics, Gynecology, Microbiological and Biomedical Sciences, University of Messina, Messina 98126, Italy
- Barbara Vecchi
- Pediatric Infectious Disease Unit, Narni Hospital, Narni (Terni) 05035, Italy
- Maria Di Gangi
- Infectious Disease Section, Palermo-Civico Hospital, Azienda di Rilievo Nazionale ad Alta Specializzazione (ARNAS), Palermo 90127, Italy
- Carla Lupi
- Pediatric clinic, Santa Maria della Misericordia Hospital, Perugia 06156, Italy
- Alberto Villani
- Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Gesù Hospital, Rome 00165, Italy
- Maurizio de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence 50139, Italy
- DOI
- https://doi.org/10.3390/ijms17060960
- Journal volume & issue
-
Vol. 17,
no. 6
p. 960
Abstract
Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.
Keywords