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Children
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Viral Respiratory Infections and Bacterial Superinfections in Children—2nd Edition
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Viral Respiratory Infections and Bacterial Superinfections in Children—2nd Edition

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Infectious Diseases".

Deadline for manuscript submissions: closed (15 March 2026) | Viewed by 2408

Special Issue Editors

Dr. Victor Daniel Miron

E-Mail
Guest Editor
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: infectious diseases; pediatric infectious diseases; viral diagnostics; viral epidemiology; viral infection; influenza; respiratory syncytial viruses; SARS-CoV-2; respiratory tract infections; pneumococcal infections; bacterial superinfection; medicine based; vaccination; childhood/pediatric obesity
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Irina Magdalena Dumitru

E-Mail Website
Guest Editor
1. Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
2. Clinical Infectious Disease Hospital of Constanta, 900178 Constanta, Romania
Interests: infectious diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Viral respiratory infections are exceedingly prevalent among children and represent a significant health concern within the pediatric population. These infections are one of the primary causes for pediatric assessments or for visits to hospital emergency departments. A common concern that often arises in the treatment of these viral infections is the fear of bacterial superinfection. This fear frequently leads to the premature or unnecessary addition of antibiotics to the treatment regimen, a practice that has been shown to contribute markedly to the escalating rates of antimicrobial resistance. Considering this, the purpose of this Special Issue is to cast a spotlight on the clinical and epidemiological characteristics of bacterial superinfections that may occur in the backdrop of various respiratory viral infections such as influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, among others. It is also aimed at gathering and showcasing practical evidence drawn from real clinical cases to better understand these phenomena. Additionally, this Special Issue seeks to provide insight into the bacterial complications that can accompany viral respiratory infections, including conditions like sinusitis, otitis, pneumonia, meningitis, or sepsis. By presenting well-documented evidence and making easy-to-use data available, this Special Issue aspires to be a valuable resource for clinicians. It aims to aid in the effective management of viral respiratory infections complicated by bacterial superinfections, thereby improving patient outcomes and contributing to the fight against antimicrobial resistance.

Dr. Victor Daniel Miron
Prof. Dr. Irina Magdalena Dumitru
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • viral infections
  • bacterial superinfections
  • respiratory viruses
  • influenza
  • RSV
  • SARS-CoV-2
  • pneumococcal disease
  • otitis, pneumonia, meningitis, sepsis
  • antimicrobial resistance

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Related Special Issue

Published Papers (3 papers)

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Research

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11 pages, 430 KB  
Article
Association Between Point-of-Care Viral Testing for Influenza and Adenovirus and Antibiotic Management in a Pediatric Emergency Department in Italy
by Tommaso Bellini, Andrea Lacovara, Daniele Franzone, Marcello Mariani, Giorgia Iovinella, Martina Virgilio, Julia Lasagna, Simona Matarese, Carlotta Pepino, Francesca Canzoneri, Milena Guazzi, Emanuela Piccotti and Andrea Moscatelli
Children 2026, 13(1), 151; https://doi.org/10.3390/children13010151 - 21 Jan 2026
Cited by 1 | Viewed by 617
Abstract
Background: Respiratory tract infections (RTIs) represent one of the most prevalent reasons for visits to Pediatric Emergency Departments (PEDs). Because viral and bacterial presentations frequently overlap, a substantial proportion of antibiotic prescriptions in pediatric acute care are potentially unnecessary, contributing to antimicrobial resistance. [...] Read more.
Background: Respiratory tract infections (RTIs) represent one of the most prevalent reasons for visits to Pediatric Emergency Departments (PEDs). Because viral and bacterial presentations frequently overlap, a substantial proportion of antibiotic prescriptions in pediatric acute care are potentially unnecessary, contributing to antimicrobial resistance. Rapid Diagnostic Tests (RDTs) for respiratory viruses have been suggested as tools to enhance diagnostic precision and support antimicrobial stewardship. However, evidence regarding their real-world impact in pediatric emergency settings is limited. Objectives: This study aimed to assess the association between point-of-care RDT results and antibiotic management in a tertiary PED, focusing on both the discontinuation of antibiotics in children already receiving treatment and the avoidance of new antibiotic prescriptions in untreated children. The secondary objective was to evaluate the short-term safety through 72-h return visits. Methods: A retrospective cohort study was conducted at a tertiary PED during two epidemic seasons (December–February 2023–2024 and 2024–2025). Children aged <18 years who underwent RDTs for febrile respiratory illnesses were included. Patients were stratified based on whether they were already receiving antibiotic therapy at presentation. The primary outcomes were antibiotic discontinuation among treated patients and initiation among untreated patients. Unplanned return visits to the PED within 72-h post-discharge were used as a pragmatic short-term safety outcome to capture early clinical deterioration. RDTs (SD Biosensor Standard F Antigen) were performed at the bedside with a turnaround time of 10–15 min. Results: A total of 1238 children were included, of whom 330 (26.6%) tested positive for influenza and/or adenovirus. Among the 234 children already receiving antibiotics, discontinuation was significantly more frequent in the RDT-positive group (p < 0.001; OR 0.044). Among the 1004 untreated children, antibiotic prescription was significantly lower in the positive group than in the negative group (p < 0.001; OR 0.097). Return visits within 72-h did not differ between the groups in either cohort. No invalid tests occurred. Conclusions: Influenza/adenovirus RDT positivity was associated with lower antibiotic initiation among untreated children and higher discontinuation among those already receiving antibiotics, with no differences in 72-h return visits. These findings suggest a potential role for bedside viral testing as a decision-support tool for antibiotic management in the PED. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children—2nd Edition)
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Review

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17 pages, 258 KB  
Review
Taming the Inflammation: The Role of Corticosteroids in Pediatric Mycoplasma Pneumonia
by Maria Sole Valentino, Costanza Pagliani, Chiara Lovati, Roberta Caiazzo, Crescenzo Coppola, Raffaella Di Tonno, Marta Stracuzzi and Vania Giacomet
Children 2026, 13(3), 333; https://doi.org/10.3390/children13030333 - 26 Feb 2026
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Abstract
Background/Objectives: To summarize the available evidence on the use of corticosteroids in the treatment of pediatric Mycoplasma pneumoniae pneumonia, including severe and refractory forms. Methods: We conducted a narrative literature review of studies published between 2000 and 2024 that investigated corticosteroid [...] Read more.
Background/Objectives: To summarize the available evidence on the use of corticosteroids in the treatment of pediatric Mycoplasma pneumoniae pneumonia, including severe and refractory forms. Methods: We conducted a narrative literature review of studies published between 2000 and 2024 that investigated corticosteroid therapy in children with Mycoplasma pneumoniae pneumonia, including various clinical presentations such as severe Mycoplasma pneumoniae pneumonia and refractory Mycoplasma pneumoniae pneumonia. Both randomized controlled trials and observational studies were included. Results: Early administration of corticosteroids, particularly within 24–36 h of hospital admission, was associated with improved clinical outcomes, including faster fever resolution, shorter hospital stay, and enhanced radiological recovery. High-dose regimens (≥5 mg/kg/day) or pulse therapy appeared effective in severe or refractory cases, while inhaled corticosteroids showed benefit in milder forms. Predictive factors for corticosteroid response included elevated C-reactive protein, lactate dehydrogenase, and ferritin levels. The overall safety profile was acceptable, with minimal adverse effects reported in most studies. Conclusions: Corticosteroids may play a beneficial role as adjunctive therapy in pediatric Mycoplasma pneumoniae pneumonia, especially in selected cases. However, further high-quality studies are required to define optimal timing, dosage, and patient selection. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children—2nd Edition)

Other

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16 pages, 983 KB  
Case Report
Persistent SARS-CoV-2 Positive Tests in Neonates: Clinical Outcomes, Transmission Pathways, and Immune Vulnerability—Case Series
by Orly Grobeisen-Duque, Oscar Villavicencio-Carrisoza, Mariana Diaz-Garcia, Monica Selena Fonseca-Perez, Miguel Angel Diaz-Zurita, Moises Leon-Juarez, Martha Lucia Granados-Cepeda, Victor Hugo Ramirez-Santes, Maria Isabel Villegas-Mota, Mario Rodriguez-Bosch, Rene Humberto Barrera-Reyes, Irma Alejandra Coronado-Zarco, Sandra Acevedo-Gallegos, Carolina Valencia-Contreras, Manuel Cortes-Bonilla, Jorge Arturo Cardona-Pérez and Addy Cecilia Helguera-Repetto
Children 2026, 13(2), 264; https://doi.org/10.3390/children13020264 - 13 Feb 2026
Viewed by 586
Abstract
Background: In 2020, the World Health Organization declared a Public Health Emergency of International Concern due to the global outbreak of SARS-CoV-2. Recognized as a severe and highly contagious disease, it affected both the adult and pediatric population. However, due to the [...] Read more.
Background: In 2020, the World Health Organization declared a Public Health Emergency of International Concern due to the global outbreak of SARS-CoV-2. Recognized as a severe and highly contagious disease, it affected both the adult and pediatric population. However, due to the early timing of the pandemic, limited research was conducted in the perinatal field, leaving many questions regarding the true impact of maternal transmission to fetuses and its consequences during the neonatal period. Methods: In this case series, we reviewed data from ten newborns delivered in the Instituto Nacional de Perinatología (INPer) in Mexico City (tertiary referral institute), all from high-risk pregnancies, between November 2020 and January 2021, all of whom tested positive for SARS-CoV-2 at various points during their hospital stay. Results: Despite showing correct extrauterine adaptation after birth, several of them developed complications such as sepsis, superinfections, inadequate weight gain, and, in some cases, death. Conclusions: These results highlight the urgent need for targeted neonatal care protocols and further research to better understand the impact of persistent viral positivity and immune vulnerability in this population. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children—2nd Edition)
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