The global evolution of pathogens causing early-onset sepsis (EOS), a critical condition in preterm infants, necessitates a re-evaluation of risk factors to develop updated prevention and treatment strategies. This nationwide case–control study in Taiwan analyzed data from the National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database from 2010 to 2019. The study included 176,681 mother–child pairs with preterm births. We identified 2942 clinical EOS cases from 5535 diagnosed sepsis cases, excluding unlikely cases. A control group of 14,710 preterm neonates without EOS was selected at a 1:5 ratio. Clinical EOS increased since 2017. Adjusted logistic regression identified significant EOS risk factors in preterm infants, including maternal fever, chorioamnionitis, maternal diabetes mellitus, maternal antibiotic usage, very preterm birth, birth weight (all with p < 0.001), maternal pneumonia (p = 0.002), and maternal CS (p = 0.004). Effective treatment of maternal conditions like diabetes, fever, and infections is essential to prevent EOS in preterm infants. Key measures include reducing unnecessary antibiotics or steroids, minimizing unnecessary cesarean sections, avoiding premature or prolonged rupture of membranes (PPROM), and increasing gestational age and neonatal birth weight. High-risk preterm neonates should be closely monitored for EOS and considered for antibiotics when warranted.

The COVID-19 pandemic and Taiwan’s strict prevention policies from May 2020 to April 2023 significantly altered the epidemiology of viral infections. This study analyzed pediatric COVID-19 and influenza cases at Wei Gong Memorial Hospital from January 2015 to March 2024. Clinical features were compared among children hospitalized during the Omicron BA.2.3.7 (April–July 2022), Omicron BA.5 (August–December 2022), and Omicron JN.1 (2024) waves and those with influenza in 2024 and 2015–2016. Between 2015 and 2024, there were 2729 influenza A (36.6%), 974 influenza B (13.1%), and 3752 COVID-19 (50.3%) cases, with 84.7% of COVID-19 cases occurring in May–December 2022. In 2024, high fever (>40 °C) was more common in influenza A cases (32.9%) than in COVID-19 or influenza B (p < 0.004). Leukocytosis (>12,000/µL) was more frequent in COVID-19 cases (33.3%) than in influenza A (12.2%) or B (0%) (p < 0.001). Pneumonia was more prevalent in COVID-19 cases in 2024 (27.3%) than in 2022 (p ≤ 0.030), and pneumonia rates for influenza A (14.8%) and B (16.7%) in 2024 exceeded those in 2015–2016 (p ≤ 0.030). Increased pneumonia rates in 2024 emphasize the importance of vigilance and timely intervention for pediatric COVID-19 and influenza cases.

Neonatal sepsis remains a significant cause of morbidity and mortality among newborns worldwide. Although the implementation of intrapartum antibiotic prophylaxis (IAP) has led to changes in the microbiological landscape of early-onset sepsis (EOS), the incidence among full-term neonates has not declined as expected. This underscores the ongoing need to identify and understand maternal and neonatal risk factors to inform more effective prevention strategies. We conducted a nationwide, population-based matched case–control study using data from January 1, 2010, to December 31, 2019, encompassing all pregnant individuals and their term infants in Taiwan. The primary objective was to identify clinical risk factors associated with EOS by comparing neonates diagnosed with EOS to matched controls without EOS. Conditional logistic regression was used for statistical analysis, adjusting for relevant maternal and neonatal covariates. A total of 1,694,043 mother–term infant pairs were included in the analysis, representing one of the largest national cohorts to date. Despite the implementation of a universal antenatal screening program and IAP in 2012, the incidence of clinical EOS did not decline over the study period and showed a slight increase around 2018. Adjusted analyses identified several significant risk factors for EOS, including chorioamnionitis (OR 8.99; 95% CI, 3.07–26.33), maternal pneumonia (OR 17.35; 95% CI, 6.85–43.90), Cesarean section (OR 1.45; 95% CI, 1.28–1.64), maternal diabetes mellitus (OR 1.95; 95% CI, 1.52–2.51), maternal antibiotic use during pregnancy (OR 1.33; 95% CI, 1.17–1.52), premature rupture of membranes (PROM) (OR 1.69; 95% CI, 1.32–2.15), birth weight (OR 0.99; 95% CI, 0.99–0.99) (all p < 0.001), and maternal genitourinary tract infections (OR 1.85; 95% CI, 1.22–2.80; p = 0.004). Mortality was notably higher among neonates with EOS (0.667%) compared to those without EOS (0.0926%) (p < 0.001). This study provides the most comprehensive analysis to date of EOS risk in term neonates using a nationwide dataset. Our findings indicate that cesarean delivery, maternal antibiotic use, specific maternal infections, maternal diabetes mellitus, premature rupture of membranes, and lower birth weight are associated with an increased risk of EOS. Further research is warranted to explore the potential causal relationships underlying these associations.

Background: To date, no study has compared the clinical characteristics of Mycoplasma pneumoniae-associated segmental/lobar pneumonia, Mycoplasma bronchopneumonia, and COVID-19 pneumonia primarily caused by the NB.1.8.1 variant in children. Methods: We examined the epidemiologic trends of pneumonia, segmental/lobar pneumonia, and COVID-19 pneumonia at a teaching hospital from 2015 to 2025. In addition, we compared the clinical characteristics of children hospitalized with Mycoplasma segmental/lobar pneumonia, Mycoplasma bronchopneumonia, and COVID-19 pneumonia during the NB.1.8.1 variant wave in 2024–2025. Results: Between 2015 and 2024, 10,601 pneumonia cases were identified, including 525 cases of segmental/lobar pneumonia and 162 cases of COVID-19 pneumonia. An outbreak of segmental/lobar M. pneumoniae pneumonia and COVID-19 pneumonia occurred in Taiwan during 2024–2025. Starting in early 2025, monthly Mycoplasma positivity rates among children with segmental/lobar pneumonia and bronchopneumonia exceeded 60%. Mycoplasma pneumonia predominantly affected children aged 6–11 years, whereas COVID-19 pneumonia mainly occurred in those younger than 3 years of age. Fever, cough, and rhinorrhea were the most common symptoms in all groups, limiting clinical differentiation. Children with segmental/lobar Mycoplasma pneumonia were more likely to present with prolonged fever (>5 days), lymphocytopenia, a neutrophil-to-lymphocyte ratio (NLR) ≥ 3, and elevated C-reactive protein (CRP) levels, each of which was strongly associated with macrolide non-response (all p < 0.001). Conclusions: Children with segmental/lobar Mycoplasma pneumonia demonstrated more severe clinical manifestations. Segmental/lobar involvement and inflammatory markers, such as lymphocytopenia, elevated NLR, and increased CRP levels, were associated with macrolide non-response. These indicators may help guide therapeutic decision-making in pediatric M. pneumoniae pneumonia.

Background/Objectives: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) substantially affect quality of life. Previous studies have not evaluated whether the associations between early-life antibiotic exposure and the risks of ASD and ADHD differ according to the antibiotic agents administered during infancy. Methods: This nationwide case–control study used Taiwan’s National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database. The cohort included 1,693,718 term neonates born between 2004 and 2015 and followed through to 2022. For ASD (n = 7265) and ADHD (n = 39,056) cases, antibiotic-exposed children were matched 1:1 with unexposed children based on sex, gestational age, birth weight, and birth year. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. Results: Oral antibiotic exposure was associated with lower ASD but higher ADHD risk, while parenteral exposure was associated with increased risks of both outcomes. Amoxicillin and erythromycin exposure during the first year of life were associated with lower ASD risk, whereas ampicillin exposure at 4–12 months was associated with higher ASD risk (all p ≤ 0.033). For ADHD, exposure to amoxicillin/clavulanic acid, cefixime, ampicillin, and ampicillin/sulbactam was associated with increased risk, whereas erythromycin, cephalexin, and sulfamethoxazole-trimethoprim were associated with reduced risk (all p < 0.047). Conclusions: Associations between early-life antibiotic exposure and the risks of ASD and ADHD varied according to antibiotic agents, route of administration, and timing of exposure. These findings may help explain inconsistencies among previous studies and inform antibiotic prescribing during infancy.

Background/Objectives: Few previous studies have evaluated both radiological changes and the clinical effectiveness of platelet-rich plasma (PRP) injections, a biomedical therapy, in patients with chronic discogenic and/or radicular low back pain. Methods: This retrospective comparative cohort study reviewed patients with chronic LBP (>3 months) refractory to first-line conservative therapy between July 2022 and August 2024. Patients who underwent lumbar transforaminal epidural or intradiscal PRP injections, according to clinical presentation and imaging findings, were assigned to the PRP group. (n = 312), while those continuing conservative treatment served as controls (n = 391). Patients receiving both treatments were excluded. Pain and functional outcomes were evaluated using the Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI). Follow-up continued through February 2025. Results: Baseline demographic and clinical characteristics were comparable between groups (p > 0.05). At three months, the PRP group demonstrated significantly greater reductions in pain (NRS: 4.51 ± 0.79 from a baseline of 7.20 ± 0.89) and disability (ODI: 23.73 ± 3.96 from 37.21 ± 3.14), when compared with the conservative group (both p < 0.001). These improvements were sustained at six months (NRS: 2.86 ± 0.80 vs. 6.54 ± 1.99; ODI: 15.37 ± 3.99 vs. 33.70 ± 9.95; both p < 0.001). MRI changes were more frequent in the PRP group (73.09% vs. 9.28%, p < 0.001); however, these findings should be considered exploratory due to potential selection bias in imaging follow-up. Conclusions: PRP injection was associated with greater improvements in pain and function than conservative treatment. MRI improvements were more frequent in the PRP group, but these findings remain exploratory.