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. 2021 Jul 1;40(7):674-680.
doi: 10.1097/INF.0000000000003116.

New Approach to the Surveillance of Pediatric Infectious Diseases From Ambulatory Pediatricians in the Digital Era

Robert Cohen  1   2   3   4 , Stéphane Béchet  2 , Nathalie Gelbert  1 , Bruno Frandji  5 , François Vie Le Sage  1 , Georges Thiebault  1 , Fabienne Kochert  1 , Fabienne Cahn-Sellem  1 , Andreas Werner  1 , Naim Ouldali  2   6 , Corinne Levy  1   2   3   4
Affiliations

New Approach to the Surveillance of Pediatric Infectious Diseases From Ambulatory Pediatricians in the Digital Era

Robert Cohen et al. Pediatr Infect Dis J. .

Abstract

Background: Many ambulatory networks in several countries have established syndromic surveillance systems to detect outbreaks of different illnesses. Here, we describe a new Pediatric and Ambulatory Research in Infectious diseases network that combined automated data extraction from the computers of primary care pediatricians.

Methods: Pediatricians who used the same software, AxiSanté 5-Infansoft for electronic medical records were specially trained in infectious diseases, encouraged to comply with French treatments' recommendations, use of point-of-care tests and vaccination guidelines. Infectious disease diagnoses in children <16 years old in the records triggered automatic data extraction of complete records. A quality control process and external validation were developed.

Results: From September 2017 to February 2020, 107 pediatricians enrolled 57,806 children (mean age 2.9 ± 2.6 years at diagnosis) with at least one infectious disease diagnosis among those followed by the network. Among the 118,193 diagnoses, the most frequent were acute otitis media (n = 44,924, 38.0%), tonsillopharyngitis (n = 13,334, 11.3%), gastroenteritis (n = 12,367, 10.5%), influenza (n = 11,062, 9.4%), bronchiolitis (n = 10,531, 8.9%), enteroviral infections (n = 8474, 7.2%) and chickenpox (n = 6857, 5.8%). A rapid diagnostic test was performed in 84.7% of cases of tonsillopharyngitis and was positive in 44%. The antibiotic recommendations from French guidelines were strictly followed: amoxicillin was the most prescribed antibiotic and less than 10% of presumed viral infections were treated.

Conclusions: This "tailor-made" network set up with quality controls and external validation represents a new approach to the surveillance of pediatric infectious diseases in the digital era and could highly optimize pediatric practices.

Trial registration: ClinicalTrials.gov NCT04471493 NCT04471493.

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Conflict of interest statement

R.C. received personal fees and nonfinancial support from Pfizer; reported personal fees from Merck, GSK, Sanofi and AstraZeneca outside the submitted work. N.G. received nonfinancial support from Pfizer outside the submitted work. B.F. is employed by CompuGroup Medical France. F.V.L.S. reported personal fees from MSD Vaccins and GSK outside the submitted work. G.T. reported personal fees and nonfinancial support from MSD Vaccins, Sanofi Aventis, Pfizer outside the submitted work. F.C.-S. reported personnal fee and nonfinancial support from MSD Vaccins and Sanofi outside the submitted work. A.W. reported personal fees from MSD Vaccins, Sanofi Aventis, ALK-Abello, GSK, Pierre Fabre, Shire, Novartis and Pfizer outside the submitted work. N.O. received nonfinancial support from Pfizer, GSK and Sanofi outside the submitted work. C.L. received personal fees and nonfinancial support from Pfizer and Merck outside the submitted work. The other authors have no conflicts of interest to disclose.

References

    1. Holstiege J, Schink T, Molokhia M, et al. Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: a population-based cohort study. BMC Pediatr. 2014; 14:174.
    1. Lee GC, Reveles KR, Attridge RT, et al. Outpatient antibiotic prescribing in the United States: 2000 to 2010. BMC Med. 2014; 12:96.
    1. Palmu AA, Jokinen J, Nieminen H, et al. Effect of pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) on outpatient antimicrobial purchases: a double-blind, cluster randomised phase 3-4 trial. Lancet Infect Dis. 2014; 14:205–212.
    1. Levy C, Vie le Sage F, Varon E, et al. Pediatric Ambulatory and Hospital Networks for surveillance and clinical epidemiology of community-acquired infections. J Pediatr. 2018; 194:269–270.e2.
    1. European Centre for Disease Prevention and Control. Proposals for EU guidelines on the prudent use of antimicrobials in humans. 2018, ECDC. Available at: https://eceuropaeu/health/amr/sites/amr/files/amr_guidelines_prudent_use_enpdf . Accesssed February 23, 2021.

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