Paediatrics (RCH) - Research Publications

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Author: Harrison, Joanne × Author: Ranganathan, Sarath × Author: Shanthikumar, Shivanthan × End date: 2023 × Type: Journal Article ×

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    Patient and family perspectives regarding the use of telehealth for cystic fibrosis care
    Shanthikumar, S ; Moore, E ; Corda, J ; Reardon, N ; Louey, S ; Frayman, K ; Harrison, J ; Ranganathan, S (WILEY, 2021-05)
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    Optimism with Caution: Elexacaftor-Tezacaftor-Ivacaftor in Patients with Advanced Pulmonary Disease
    Kuek, SL ; Ranganathan, SC ; Harrison, J ; Robinson, PJ ; Shanthikumar, S (AMER THORACIC SOC, 2021-08-01)
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    Pulmonary Mycobacterium abscessus complex in children with cystic fibrosis: A practical management guideline
    Andrew, EC ; Connell, T ; Robinson, P ; Curtis, N ; Massie, J ; Robertson, C ; Harrison, J ; Shanthikumar, S ; Bryant, PA ; Starr, M ; Steer, A ; Ranganathan, S ; Gwee, A (WILEY, 2019-05)
    The treatment of Mycobacterium abscessus complex (MABSC) pulmonary infections is an emerging challenge in patients with cystic fibrosis (CF). Multidrug therapy for prolonged durations is required and carries the significant burden of drug-related toxicity, cost and selective pressure for multiresistant bacteria. International guidelines acknowledge that clinical and in vitro data to support treatment regimens are limited, particularly in children. As part of a collaboration between the infectious diseases and respiratory units at our institution, we have developed a modified treatment guideline that aims to balance the aims of MABSC eradication and slowing disease progression with minimising drug toxicity and resistance. The outcomes of this treatment approach will be monitored and reported. In this manuscript, we discuss the available evidence for treatment choices and present our treatment guideline for paediatric patients with CF and MABSC infection.
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    Is cardiorespiratory disease associated with increased susceptibility of SARS-CoV-2 in children?
    Du Berry, C ; Saunders, T ; McMinn, A ; Tosif, S ; Shanthikumar, S ; Vandeleur, M ; Harrison, J ; Burgner, D ; Ranganathan, S ; Crawford, N ; Wurzel, D (WILEY, 2021-12)
    BACKGROUND: There are limited data in pediatric populations evaluating whether chronic cardiorespiratory conditions are associated with increased risk of coronavirus disease 2019 (COVID-19). We aimed to compare the rates of chronic cardiac and respiratory disease in children testing positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2[+]) compared with those testing negative (SARS-CoV-2[-]) at our institution. METHOD: Prospective cohort with nested case-control study of all children tested by polymerase chain reaction (PCR) for SARS-CoV-2 by nasopharyngeal/oropharyngeal sampling between March and October 2020. Children were identified prospectively via laboratory notification with age and sex-matching of SARS-CoV-2[+] to SARS-CoV-2[-] (1:2). Clinical data were extracted from the electronic medical record. RESULTS: In total, 179 SARS-CoV-2[+] children (44% females, median age 3.5 years, range: 0.1-19.0 years) were matched to 391 SARS-CoV-2[-] children (42% female, median age 3.7 years, range: 0.1-18.3 years). The commonest comorbidities showed similar frequencies in the SARS-CoV-2[+] and [-] groups: asthma (n = 9, 5% vs. n = 17, 4.4%, p = 0.71), congenital heart disease (n = 6, 3.4% vs. n = 7, 1.8%, p = 0.25) and obstructive sleep apnoea (n = 4, 2.2% vs. n = 10, 2.3%, p = 0.82). In the SARS-CoV-2[+] group, the prevalence of symptomatic disease was similar among children with and without cardiorespiratory comorbidities (n = 12, 75% vs. n = 103, 57%, p = 0.35). A high proportion of children hospitalized with SARS-CoV-2 infection had cardiac comorbidities (23.8%). CONCLUSIONS: In this single site data set, rates of pre-existing cardiorespiratory disease were similar in SARS-CoV-2[+] and SARS-CoV-2[-] children. Rates of symptomatic infection were similar between children with and without cardiorespiratory comorbidity. High rates of comorbid cardiac disease were observed among hospitalized children with COVID-19 warranting further research to inform vaccine prioritization.