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BackgroundAcute coronavirus disease 2019 (COVID‐19) is associated with chronic symptoms. These have been termed the “post COVID‐19 condition.” The data on this condition in children are still limited. We therefore aimed to elucidate the characteristics of this post COVID‐19 condition.MethodsChildren referred to a long COVID‐19 clinic were included at Tokyo Metropolitan Children's Medical Center between October 2021 and July 2022. Children with another diagnosis and those who failed to meet criteria for post COVID‐19 condition were excluded. Demographic and clinical data were collected retrospectively.ResultsOf 33 referrals, nine were excluded, and 24 fulfilled the criteria for post COVID‐19 condition. The median age and percentage of girls were 12.5 (IQR: 11–13) years and 29.2%, respectively. All the patients had mild, acute COVID‐19. Dysgeusia and brain fog was observed more frequently during the Delta and Omicron variant periods, respectively. School absenteeism >4 weeks was observed in 41.6% of the patients. Common symptoms included malaise, headache, dysgeusia, and dysosmia. The median duration of post COVID‐19 condition was 4.5 (IQR: 2.8–5.2) months. Pain management and counseling using the pacing approach were the most commonly offered treatments. Symptom resolution and improvement was observed in 29.2% and 54.2% of the patients, respectively.ConclusionsOne third of the patients referred for long COVID did not fit the definition of the post COVID‐19 condition. After a median follow up of 4.5 months, the majority of the cases resolved or improved.

BackgroundAntibiotic resistance is a serious and growing concern worldwide. Although Enterobacteriaceae bloodstream infections (BSI) are severe, little is known regarding the impact of multidrug resistance (MDR) on children. This study aimed to describe the clinical and microbiological features of MDR Enterobacteriaceae BSI in a children’s hospital in Japan.MethodsChildren (<18 years of age) presenting with Enterobacteriaceae BSI at Tokyo Metropolitan Children’s Medical Center in Japan between March 2010 and March 2017 were enrolled. The clinical characteristics and outcomes of patients with MDR and non-MDR Enterobacteriaceae BSI were compared. The Centers for Disease Control and Prevention’s definition of MDR was used for this study.ResultsIn total 134 blood cultures from 127 patients were analyzed. The median age was 3.6 years (IQR: 0.3–9.8 years), and boys accounted for 52.8% of the subject pool. Underlying diseases were noted in 92.1% of patients. In 79.1%, BSI developed >48 hours after admission. The most common isolate was Escherichia coli (47.0%) followed by Klebsiella pneumoniae (23.1%). MDR was detected in 35.8% (48/134) of culture, with Escherichia coli occurring with the highest frequency (23.1%) followed by Klebsiella pneumoniae (7.5%). The MDR strains producing ESBL, AmpC, and carbapenemases comprised 17.9%, 7.5%, and 1.5% of the cases, respectively. Multivariate logistic regression analysis showed that the history of corticosteroid use within 30 days was independently associated with the development of MDR Enterobacteriaceae BSI (OR: 3.63; 95% CI: 1.35–9.73). Initial empiric therapy was less effective against MDR, than non-MDR, strains (51.1% vs. 83.8%, P < 0.001). MDR was not significantly associated with an increased rate of all-cause mortality (MDR 10.4% vs. non-MDR 3.5%, P = 0.134) or sepsis-related mortality (MDR 6.3% vs. non-MDR 2.3%, P = 0.349).ConclusionA history of corticosteroid use within 30 days was an independent risk factor for the development of MDR Enterobacteriaceae BSI in children. MDR did not increase the mortality rate significantly.Disclosures All authors: No reported disclosures.