Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis.
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.
Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, Florence 50139, Italy. luisa.galli@unifi.it.
Luisa
L
Galli
Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Ges&#249; Hospital, Rome 00165, Italy. laura.lancella@opbg.net.
Laura
L
Lancella
Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, Florence 50139, Italy. chia88.te@gmail.com.
Chiara
C
Tersigni
Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, Florence 50139, Italy. elisabetta-venturini@virgilio.it.
Elisabetta
E
Venturini
Department of Health Sciences, University of Florence, Pediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, Florence 50139, Italy. elena.chiappini@unifi.it.
Elena
E
Chiappini
Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy. bergamini.barbaramaria@unimo.it.
Barbara Maria
BM
Bergamini
Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy. mar.cody@libero.it.
Margherita
M
Codifava
Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy. criventurelli@alice.it.
Cristina
C
Venturelli
Department of Pediatrics, University of Modena and Reggio Emilia, Modena 41121, Italy. giuliatosetti@hotmail.com.
Giulia
G
Tosetti
Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Ges&#249; Hospital, Rome 00165, Italy. caterina.marabotto@gmail.com.
Caterina
C
Marabotto
Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Ges&#249; Hospital, Rome 00165, Italy. laura.cursi@opbg.net.
Laura
L
Cursi
Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Ges&#249; Hospital, Rome 00165, Italy. elena.boccuzzi@opbg.net.
Elena
E
Boccuzzi
Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy. silvia.garazzino@unito.it.
Silvia
S
Garazzino
Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy. pierangelo.tovo@unito.it.
Pier Angelo
PA
Tovo
Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy. michele.pinon@unito.it.
Michele
M
Pinon
Pediatric Infectious Diseases Unit, Regina Margherita Hospital, University of Turin, Turin 10126, Italy. daniele.leserre@gmail.com.
Daniele
D
Le Serre
Pediatric Unit, Ramazzini Hospital, Carpi (Modena) 41124, Italy. l.castiglioni@ausl.mo.it.
Laura
L
Castiglioni
Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy. andrea.lovecchio@unina.it.
Andrea
A
Lo Vecchio
Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy. alfguari@unina.it.
Alfredo
A
Guarino
Section of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples 80131, Italy. eugbruzz@unina.it.
Eugenia
E
Bruzzese
Infectious Diseases Unit, IRCCS Giannina Gaslini, Genoa 16148, Italy. giuseppelosurdo@ospedale-gaslini.ge.it.
Giuseppe
G
Losurdo
Infectious Diseases Unit, IRCCS Giannina Gaslini, Genoa 16148, Italy. eliocastagnola@ospedale-gaslini.ge.it.
Elio
E
Castagnola
Pediatric Clinic, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia 27100, Italy. g.bossi@smatteo.pv.it.
Grazia
G
Bossi
Pediatric Clinic, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia 27100, Italy. gl.marseglia@smatteo.pv.it.
Gian Luigi
GL
Marseglia
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit&#224; degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. susanna.esposito@unimi.it.
Susanna
S
Esposito
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit&#224; degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. samantha.bosis@unimi.it.
Samantha
S
Bosis
Infectious Diseases Unit, St. Giovanni XXIII Pediatric Hospital, Bari 70120, Italy. ritagrando@yahoo.it.
Rita
R
Grandolfo
Pediatric Unit, S. Maria del Carmine Hospital, Rovereto (Trento) 38068, Italy. valentina.fiorito@apss.tn.it.
Valentina
V
Fiorito
Institute of Pediatrics, Universit&#224; Cattolica del Sacro Cuore, Rome 00168, Italy. pvalentini@rm.unicatt.it.
Piero
P
Valentini
Institute of Pediatrics, Universit&#224; Cattolica del Sacro Cuore, Rome 00168, Italy. danilobuonsenso@gmail.com.
Danilo
D
Buonsenso
Pediatric Unit, "Campo di Marte" Hospital, Lucca 55100, Italy. r.domenici@usl2.toscana.it.
Raffaele
R
Domenici
Pediatric Unit, "Campo di Marte" Hospital, Lucca 55100, Italy. m.montesanti@usl2.toscana.it.
Marco
M
Montesanti
Pediatric Clinic, San Paolo Hospital, University of Milan, Milan 20142, Italy. filippo.salvini@ao-sanpaolo.it.
Filippo Maria
FM
Salvini
Pediatric Clinic, San Paolo Hospital, University of Milan, Milan 20142, Italy. enrica.riva@unimi.it.
Enrica
E
Riva
Department of Pediatrics, Parma University Hospital, Parma 43126, Italy. idodi@ao.pr.it.
Icilio
I
Dodi
Pediatric Unit, Ca' Foncello Civil Hospital, Treviso 31100, Italy. fmaschio@ulss.tv.it.
Francesca
F
Maschio
Pediatric Unit, St. Anna Hospital, Como 22100, Italy. luisa.abbagnato@libero.it.
Luisa
L
Abbagnato
Pediatric Unit, Arcispedale Sant'Anna, University of Ferrara, Ferrara 44100, Italy. efiumana@virgilio.it.
Elisa
E
Fiumana
Division of Infectious Diseases, Istituti Ospitalieri di Cremona, Cremona 26100, Italy. c.fornabaio@ospedale.cremona.it.
Chiara
C
Fornabaio
Pediatric Unit, Sesto San Giovanni Hospital, Milan 20099, Italy. patrizia.ballista@icp.mi.it.
Patrizia
P
Ballista
Infectious Diseases Unit, S. Antonio Abate Hospital, Trapani 91016, Italy. vincenzoportelli@asptrapani.it.
Vincenzo
V
Portelli
Department of Internal Medicine and Public Health, University of L'Aquila, L'Aquila 67100, Italy. gbottone@asl1abruzzo.it.
Gabriella
G
Bottone
Infectious Disease Section, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia 06100, Italy. nicola.palladino@asl1.umbria.it.
Nicola
N
Palladino
Department of Pediatrics, Gynecology, Microbiological and Biomedical Sciences, University of Messina, Messina 98126, Italy. marielvale@hotmail.com.
Mariella
M
Valenzise
Pediatric Infectious Disease Unit, Narni Hospital, Narni (Terni) 05035, Italy. barbara.vecchi@alice.it.
Barbara
B
Vecchi
Infectious Disease Section, Palermo-Civico Hospital, Azienda di Rilievo Nazionale ad Alta Specializzazione (ARNAS), Palermo 90127, Italy. digangim@libero.it.
Maria
M
Di Gangi
Pediatric clinic, Santa Maria della Misericordia Hospital, Perugia 06156, Italy. carlalupi@hotmail.it.
Carla
C
Lupi
Unit of General Pediatrics and Pediatric Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Bambino Ges&#249; Hospital, Rome 00165, Italy. alberto.villani@opbg.net.
Alberto
A
Villani
Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence 50139, Italy. maurizio.demartino@unifi.it.
Maurizio
M
de Martino
D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D012042:Registries / Q000706:statistics & numerical data; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents
Italian; children; register; tuberculosis