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Clinical Performance Evaluation of the NeuMoDx Flu A-B/RSV/SARS-CoV-2 Vantage Assay. Diagnostics (Basel) 2022; 12:diagnostics12123201. [PMID: 36553208 PMCID: PMC9777658 DOI: 10.3390/diagnostics12123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 infections may present with various symptoms that are similar to those of other respiratory diseases. For this reason, the need for simultaneous detection of at least RSV and influenza viruses together with SARS-CoV-2 was evident from the early stages of the pandemic. In the present study, we evaluated the clinical performance of the NeuMoDx™ Flu A-B/RSV/SARS-CoV-2 Vantage Assay against the conventional low-plex PCR utilized to detect influenza A-B, RSV, and SARS-CoV-2. There were 115 known positive clinical samples and 35 negative controls obtained from asymptomatic health-care workers included in the study; 25 samples were positive for influenza viruses, 46 for RSV, and 44 for SARS-CoV-2. The sensitivity, specificity, positive predictive value, and negative predictive value of the evaluated method for influenza and SARS-CoV-2 were 100%. The Spearman correlation coefficient was 0.586 (p < 0.05) for influenza and 0.893 (p < 0.05) for SARS-CoV-2. The sensitivity of the aforementioned assay for RSV was 93.47%; the specificity and the positive predictive value were 100%, and the negative predictive value was 92.10%, while the Spearman correlation coefficient was not applicable for the RSV. Overall, the assay under evaluation was shown to be a reliable alternative for the simultaneous detection of influenza viruses, RSV and SARS-CoV-2.
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Jiang XW, Huang TS, Xie L, Chen SZ, Wang SD, Huang ZW, Li XY, Ling WP. Development of a diagnostic assay by three-tube multiplex real-time PCR for simultaneous detection of nine microorganisms causing acute respiratory infections. Sci Rep 2022; 12:13306. [PMID: 35922526 PMCID: PMC9427838 DOI: 10.1038/s41598-022-15543-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Acute respiratory infections are widespread in vulnerable populations of all ages and are characterized by a variety of symptoms. The underlying infection can be caused by a multitude of microorganisms, including viruses and bacteria. Early detection of respiratory infections through rapid pathogen screening is vital in averting infectious respiratory disease epidemics. This study utilized a multiplex real-time PCR system to develop a three-tube reverse transcription-PCR (RT-PCR) assay, enabling simultaneously detect nine respiratory pathogens, including: influenza A and B, adenovirus, respiratory syncytial virus (RSV), Streptococcus pneumoniae, Legionella pneumophila, Haemophilus influenzae, Chlamydia pneumoniae, and Mycoplasma pneumoniae. This technique utilizes a one-step assay, with specifically designed TaqMan primer-probe sets combined in the same tube. This assay provided rapid and simplified detection of the nine prevalent pathogens, as well as increased sensitivity and reduced cross-contamination. This assay was evaluated using 25 related viral/bacterial strains as positive references, the other 25 irrelevant strains as negative controls, and clinical specimens from 179 patients. All positive strains were detected with no amplification of the non-target microorganism mixtures and the assay's detection limits ranged between 250-500 copies/ml (1.25-2.5 copies/reaction). A total of 167 (93.3%) samples tested positive for at least one of the pathogens identified; 109 of these samples were from patients confirmed to have RSV infections. The diagnostic accuracy of our assay was further confirmed by matching results from classical direct immunofluorescence assay and nucleotide sequencing. These data demonstrate the innovative multiplex real-time PCR assay as a promising alternative to the current approaches used for early screening of acute respiratory infections.
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Affiliation(s)
- Xi-Wen Jiang
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China.
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China.
| | - Tao-Sheng Huang
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Long Xie
- Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Si-Ze Chen
- Central Laboratory, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- The Precise Therapy Engineering Technology Research Center of Guangdong Province for Esophageal Cancer, Guangzhou, China
| | - Shi-Dong Wang
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Zhi-Wen Huang
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Xin-Yu Li
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
| | - Wei-Ping Ling
- Research Institute, DAAN Gene Co., Ltd., No. 19 Xiangshan Road, Guangzhou, China
- The Medicine and Biological Engineering Technology Research Center of the Ministry of Health, Guangzhou, China
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Jullien S, Richard-Greenblatt M, Casellas A, Tshering K, Ribó JL, Sharma R, Tshering T, Pradhan D, Dema K, Ngai M, Muñoz-Almagro C, Kain KC, Bassat Q. Association of Clinical Signs, Host Biomarkers and Etiology With Radiological Pneumonia in Bhutanese Children. Glob Pediatr Health 2022; 9:2333794X221078698. [PMID: 35252478 PMCID: PMC8891828 DOI: 10.1177/2333794x221078698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Abstract
Diagnosing pneumonia and identifying those requiring antibiotherapy remain challenging. Chest radiographs (CXR) are often used as the reference standard. We aimed to describe clinical characteristics, host-response biomarkers and etiology, and assess their relationship to CXR findings in children with pneumonia in Thimphu, Bhutan. Children between 2 and 59 months hospitalized with WHO-defined pneumonia were prospectively enrolled and classified into radiological endpoint and non-endpoint pneumonia. Blood and nasopharyngeal washing were collected for microbiological analyses and plasma levels of 11 host-response biomarkers were measured. Among 149 children with readable CXR, 39 (26.2%) presented with endpoint pneumonia. Identification of respiratory viruses was common, with no significant differences by radiological outcomes. No clinical sign was suggestive of radiological pneumonia, but children with radiological pneumonia presented higher erythrocyte sedimentation rate, C-reactive protein and procalcitonin. Markers of endothelial and immune activation had little accuracy for the reliable identification of radiological pneumonia.
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Affiliation(s)
- Sophie Jullien
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Melissa Richard-Greenblatt
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Aina Casellas
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | | | - Jose Luis Ribó
- Hospital Universitari General de Catalunya, Barcelona, Spain
| | - Ragunath Sharma
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Tshering
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Dinesh Pradhan
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Kumbu Dema
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Michelle Ngai
- University Health Network-Toronto General Hospital, Toronto, ON, Canada
| | - Carmen Muñoz-Almagro
- Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- Universitat Internacional of Catalunya, Barcelona, Spain
| | - Kevin C. Kain
- University Health Network-Toronto General Hospital, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Quique Bassat
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
- ICREA, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
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Pappa S, Haidopoulou K, Zarras C, Theodorakou E, Papadimitriou E, Iosifidis E, Gkeka I, Stoikou K, Vagdatli E, Skoura L, Papa A. Early initiation of the respiratory syncytial virus season in 2021-2022, Greece. J Med Virol 2022; 94:3453-3456. [PMID: 35199347 DOI: 10.1002/jmv.27671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/04/2022] [Accepted: 02/20/2022] [Indexed: 11/11/2022]
Abstract
Respiratory syncytial virus (RSV) is the most common viral pathogen causing respiratory disease in the pediatric population. An unexpected sudden upsurge of RSV infections among children was observed in September 2021 in Greece. Forty-one rhinopharyngeal samples from children under the age of 2 years with confirmed RSV bronchiolitis were tested to identify the genotype(s) of the RSV strain(s). The children were hospitalized during September-November 2021 in three tertiary hospitals in northern Greece. A one-step RT-PCR which amplifies a fragment of the second hypervariable region of the G protein gene was applied. PCR products were sequenced, and phylogenetic analysis was performed. Most (80.5%) RSV cases were typed as RSV-A, with RSV-B accounting for 19.5% of cases. RSV-A and RSV-B sequences clustered within the ON1 and BA genotypes, respectively. Since the same genotypes were detected in cases observed during 2016-2018 in northern Greece, it was suggested that the early upsurge of infections was not related to the emergence of novel strain(s), but it was the result of the absence of immunity among children and their mothers due to the restriction measures taken during the COVID-19 pandemic in the previous RSV season. Awareness is needed to diagnose even the out-of-season RSV infections, while molecular epidemiology plays a key role in monitoring the efficacy of currently available therapeutics and for those under development. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Styliani Pappa
- Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Haidopoulou
- 2nd Department of Pediatrics, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalampos Zarras
- Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
| | | | - Eleni Papadimitriou
- 1st Department of Pediatrics, Hippokration General Hospital, Thessaloniki, Greece
| | - Elias Iosifidis
- Infectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Hippokration General Hospital, Thessaloniki, Greece
| | - Ioanna Gkeka
- Microbiology Laboratory, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Konstantina Stoikou
- Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Vagdatli
- Microbiology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - Lemonia Skoura
- Microbiology Laboratory, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Anna Papa
- Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Lin X, Gu J. A biochemiluminescent assay for rapid diagnosis of influenza. Clin Exp Med 2022; 22:577-581. [PMID: 35001207 DOI: 10.1007/s10238-021-00778-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/23/2021] [Indexed: 11/03/2022]
Abstract
A biochemiluminescent assay of influenza diagnosis is presented. The assay diagnoses influenza based on detection of the influenza viral neuraminidase activity. An instrument designed for the assay is also reported. This assay solves the problem that current influenza virus diagnosis assays are susceptible to virus mutation. A luciferase-based complex is synthesized as biochemiluminescent substrate. The substrate is cleaved to free luciferin with presence of influenza neuraminidase in specimen. Luciferase is oxidized to oxyluciferin with luciferin as catalyzer resulting in luminescence, which is proportional to the neuraminidase activity and measured by instrument. The instrument uses a photomultiplier tube as sensor, with 24 test channels. Fine optical arrangements enable the instrument with high sensitivity and accuracy. A total of 389 clinical specimens were collected to evaluate the performance of the assay in clinical settings. This assay had a sensitivity and specificity of 95.92% (95% confidence interval 91.38-98.12%) and 97.93% (95% confidence interval 95.26-99.11%), respectively, compared to the colloidal gold assay. As a biochemiluminscence assay, this assay is advantageous in sensitivity and specificity. It does not require any washing or separation steps, which makes the instrument simple in design and easy to operate or maintenance. The assay is suitable for the rapid diagnosis of influenza virus in point-of-care settings.
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Affiliation(s)
- Xuexiang Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jia Gu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
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6
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Rais Y, Fu Z, Drabovich AP. Mass spectrometry-based proteomics in basic and translational research of SARS-CoV-2 coronavirus and its emerging mutants. Clin Proteomics 2021; 18:19. [PMID: 34384361 PMCID: PMC8358260 DOI: 10.1186/s12014-021-09325-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/07/2021] [Indexed: 01/08/2023] Open
Abstract
Molecular diagnostics of the coronavirus disease of 2019 (COVID-19) now mainly relies on the measurements of viral RNA by RT-PCR, or detection of anti-viral antibodies by immunoassays. In this review, we discussed the perspectives of mass spectrometry-based proteomics as an analytical technique to identify and quantify proteins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to enable basic research and clinical studies on COVID-19. While RT-PCR and RNA sequencing are indisputably powerful techniques for the detection of SARS-CoV-2 and identification of the emerging mutations, proteomics may provide confirmatory diagnostic information and complimentary biological knowledge on protein abundance, post-translational modifications, protein-protein interactions, and the functional impact of the emerging mutations. Pending advances in sensitivity and throughput of mass spectrometry and liquid chromatography, shotgun and targeted proteomic assays may find their niche for the differential quantification of viral proteins in clinical and environmental samples. Targeted proteomic assays in combination with immunoaffinity enrichments also provide orthogonal tools to evaluate cross-reactivity of serology tests and facilitate development of tests with the nearly perfect diagnostic specificity, this enabling reliable testing of broader populations for the acquired immunity. The coronavirus pandemic of 2019-2021 is another reminder that the future global pandemics may be inevitable, but their impact could be mitigated with the novel tools and assays, such as mass spectrometry-based proteomics, to enable continuous monitoring of emerging viruses, and to facilitate rapid response to novel infectious diseases.
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Affiliation(s)
- Yasmine Rais
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Zhiqiang Fu
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrei P Drabovich
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
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Broad Impact of Exchange Protein Directly Activated by cAMP 2 (EPAC2) on Respiratory Viral Infections. Viruses 2021; 13:v13061179. [PMID: 34205489 PMCID: PMC8233786 DOI: 10.3390/v13061179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
The recently discovered exchange protein directly activated by cAMP (EPAC), compared with protein kinase A (PKA), is a fairly new family of cAMP effectors. Soon after the discovery, EPAC has shown its significance in many diseases including its emerging role in infectious diseases. In a recent study, we demonstrated that EPAC, but not PKA, is a promising therapeutic target to regulate respiratory syncytial virus (RSV) replication and its associated inflammation. In mammals, there are two isoforms of EPAC-EPAC1 and EPAC2. Unlike other viruses, including Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola virus, which use EPAC1 to regulate viral replication, RSV uses EPAC2 to control its replication and associated cytokine/chemokine responses. To determine whether EPAC2 protein has a broad impact on other respiratory viral infections, we used an EPAC2-specific inhibitor, MAY0132, to examine the functions of EPAC2 in human metapneumovirus (HMPV) and adenovirus (AdV) infections. HMPV is a negative-sense single-stranded RNA virus belonging to the family Pneumoviridae, which also includes RSV, while AdV is a double-stranded DNA virus. Treatment with an EPAC1-specific inhibitor was also included to investigate the impact of EPAC1 on these two viruses. We found that the replication of HMPV, AdV, and RSV and the viral-induced immune mediators are significantly impaired by MAY0132, while an EPAC1-specific inhibitor, CE3F4, does not impact or slightly impacts, demonstrating that EPAC2 could serve as a novel common therapeutic target to control these viruses, all of which do not have effective treatment and prevention strategies.
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Su M, Wang Q, Li D, Wang LL, Wang CY, Wang JL, Zhang Q, Du LY, Liu JY, Xie GC. Prevalence and clinical characteristics of hospitalized children with community-acquired Mycoplasma pneumoniae pneumonia during 2017/2018, Chengde, China. Medicine (Baltimore) 2021; 100:e23786. [PMID: 33592835 PMCID: PMC7870167 DOI: 10.1097/md.0000000000023786] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 11/13/2020] [Indexed: 01/05/2023] Open
Abstract
Community acquired-pneumonia (CAP) has varying causative pathogens and clinical characteristics. This study investigated the prevalence of Mycoplasma pneumoniae (M pneumoniae) and evaluated the clinical characteristics in infected hospitalized children by disease severity.From throat swabs of hospitalized children (5 months to 14 years) with CAP collected between November 2017 and May 2018, M pneumoniae and other CAP pathogens were identified using polymerase chain reaction (PCR). Differences in clinical and laboratory test data were compared between severe and mild case groups.Of 333 hospitalized children enrolled, 221/333 (66.4%) tested positive for M pneumoniae and 24/221 (10.9%) patients were (n = 9, aged <5 years vs n = 15, ≥5 years) single infection by PCR, however, only 170/333 (51.1%) patients were presented with M pneumoniae IgM-positive. M pneumoniae detection rate by PCR was higher than by immunoglobulin (IgM) serology. In 123/221 (55.7%) M pneumoniae infected patients, coinfection with bacterial pathogens (n = 61, <5 years vs n = 62, ≥5 years) occurred. Children (aged 3-8 years) had most M pneumoniae infection. Severe M pneumoniae pneumonia (MPP) in children occurred mostly in older age (7 [interquartile ranges {IQR}, 6-8] years; P < .0001), with longer cough days (14 [IQR, 10-19.5] days; P = .002) and hospitalization duration (9.5 [IQR, 7-12.3] days; P < .0001), lower lymphocyte ratio (24.1, [IQR, 20.0-31.1] %; P = .001), higher neutrophils ratio (66.0, [IQR, 60.2-70.3]%; P < .0001), and serum C-reactive protein (CRP) level (3.8, [IQR, 1.3-10.9] mg/L; P = .027).M pneumoniae is the most commonly detected pathogen in CAP. High coinfection prevalence increases diagnosis difficulty by clinically nonspecific characteristics. M pneumoniae detection by PCR with IgM may improve precise and reliable diagnosis of community-acquired MPP.
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Affiliation(s)
- Meng Su
- Department of Pathogenic Biology
| | - Qian Wang
- Department of Respiratory, Children′s Hospital of Hebei Province, Shijiazhuang
| | - Dan Li
- Department of Pathogenic Biology
| | - Ling-Ling Wang
- Department of Preventive Medicine, Chengde Medical University
| | - Chun-Yang Wang
- Clinical Medical College, Xi’an Medical University, Xi’an
| | - Jiang-Li Wang
- Chengde Center for Disease Control and Prevention, Department of Microbiology Laboratory
| | - Qing Zhang
- Chinese Center for Viral Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing
| | | | - Jian-Ying Liu
- Department of Pediatrics, NO.2 Clinical Teaching Hospital Affiliated to Chengde Medical University, Chengde, China
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9
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任 康, 任 洛, 邓 昱, 谢 晓, 臧 娜, 谢 军, 罗 征, 罗 健, 符 州, 刘 恩, 李 渠. [Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:67-73. [PMID: 33476540 PMCID: PMC7818151 DOI: 10.7499/j.issn.1008-8830.2007139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI). METHODS Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed. RESULTS A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (P=0.030). A total of 298 samples were detected with single RSV, 148 were detected with RSV mixed with other viruses, 389 were detected with other viruses, and 241 were detected negative for viruses. Compared with the other viruses and negative virus groups, the single RSV group had a significantly younger age and significantly higher incidence rates of dyspnea, respiratory failure, and severe lower respiratory tract infection (P < 0.0083). The RSV-A positive group had a significantly higher proportion of boys than the RSV-B positive group (P=0.004), but there were no significant differences in clinical manifestations between the two groups. CONCLUSIONS In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.
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Affiliation(s)
- 康轶 任
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 洛 任
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 昱 邓
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 晓虹 谢
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 娜 臧
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 军 谢
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 征秀 罗
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 健 罗
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 州 符
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 恩梅 刘
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
| | - 渠北 李
- />重庆医科大学附属儿童医院呼吸科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染免疫重庆市重点实验室, 重庆 400014Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
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Ni M, Xu H, Luo J, Liu W, Zhou D. Simultaneous detection and differentiation of SARS-CoV-2, influenza A virus and influenza B virus by one-step quadruplex real-time RT-PCR in patients with clinical manifestations. Int J Infect Dis 2020; 103:517-524. [PMID: 33326873 PMCID: PMC7836965 DOI: 10.1016/j.ijid.2020.12.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To develop a novel quadruplex real-time reverse transcription polymerase chain reaction (rRT-PCR) assay for the diagnosis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, differential diagnosis and detection of co-infections. METHODS A one-step quadruplex rRT-PCR assay was developed for simultaneous detection and differentiation of SARS-CoV-2 ORF1ab and N genes, influenza A virus (hIAV) and influenza B virus (hIBV). RESULTS The quadruplex rRT-PCR assay had good sensitivity and specificity. Correlation coefficients and amplification efficiencies of all singleplex and quadruplex rRT-PCR reactions were within acceptable ranges. The 95% lower limits of detection for plasmid standards and positive nucleic acid extracts of the quadruplex rRT-PCR assay were 57.38-95.11 copies/μL and 114.65-154.25 copies/μL, respectively. Excellent results were attained for inter- and intra-assay reproducibility. Among these clinical samples, only four samples showed results inconsistent with the singleplex rRT-PCR assays. CONCLUSIONS To the authors' knowledge, this is the first study to report a quadruplex rRT-PCR assay for the detection of two SARS-CoV-2 genes, hIAV and hIBV with perfect clinical performance.
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Affiliation(s)
- Minjun Ni
- Ningbo International Travel Healthcare Centre, Ningbo, People's Republic of China
| | - Hengyi Xu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, People's Republic of China
| | - Jie Luo
- Ningbo International Travel Healthcare Centre, Ningbo, People's Republic of China
| | - Wei Liu
- Nanchang International Travel Healthcare Centre, Nanchang, People's Republic of China
| | - Donggen Zhou
- Ningbo International Travel Healthcare Centre, Ningbo, People's Republic of China; Nanchang International Travel Healthcare Centre, Nanchang, People's Republic of China.
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11
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Jullien S, Sharma R, Lhamu Mynak M, Henares D, Muñoz-Almagro C, Bassat Q. Pneumococcal nasopharyngeal carriage among Bhutanese children hospitalized with clinical pneumonia: serotypes and viral co-infection. BMC Infect Dis 2020; 20:940. [PMID: 33297987 PMCID: PMC7725031 DOI: 10.1186/s12879-020-05674-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/30/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Pneumococcal nasopharyngeal colonization (PNC) generally precedes pneumococcal disease. The purpose of this study was to determine the prevalence of PNC and to identify the pneumococcal serotypes circulating among Bhutanese children under five years of age admitted with clinical pneumonia, before the introduction of pneumococcal conjugate vaccine (PCV13) in the country. We also aimed to contribute to the understanding of the interplay between PNC and viral co-infection among this population. METHODS This was a prospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital in Bhutan over 12 consecutive months. Children aged 2 to 59 months admitted with WHO-defined clinical pneumonia were eligible for recruitment. We collected blood for bacterial culture and molecular identification of S. pneumoniae, and nasopharyngeal washing for screening of respiratory viruses, and for the detection and capsular typing of S. pneumoniae by real-time polymerase chain reaction (RT-PCR). RESULTS Overall, 189 children were recruited, and PNC was tested in 121 of them (64.0%). PNC was found in 76/121 children (62.8%) and S. pneumoniae was identified in blood (both by culture and RT-PCR) in a single child. Respiratory viruses were detected in a similar proportion among children with (62/70; 88.6%) and without PNC (36/40; 90.0%; p = 1.000), but rhinovirus detection was less common among children with PNC (20/70; 28.6% versus 19/40; 47.5%; p = 0.046). Capsular typing identified 30 different serotypes. Thirty-nine children (51.3%) were colonised with two to five different serotypes. A third of the children presented with serotypes considered highly invasive. Over half of the children (44/76; 57.9%) were carrying at least one serotype included in PCV13. CONCLUSIONS This study provides baseline information on the status of PNC among Bhutanese children admitted with clinical pneumonia prior to the introduction of PCV13, which is valuable to monitor its potential impact. PCV13 could theoretically have averted up to 58% of the pneumococcal infections among the children in this study, suggesting a future role for the vaccine to significantly reduce the burden associated with S. pneumoniae in Bhutan.
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Affiliation(s)
- Sophie Jullien
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain. .,Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
| | - Ragunath Sharma
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Mimi Lhamu Mynak
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Desiree Henares
- Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain.,Department of Medicine, Universitat Internacional of Catalunya, Barcelona, Spain
| | - Quique Bassat
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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12
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Pellegrinelli L, Galli C, Bubba L, Cereda D, Anselmi G, Binda S, Gramegna M, Pariani E. Respiratory syncytial virus in influenza-like illness cases: Epidemiology and molecular analyses of four consecutive winter seasons (2014-2015/2017-2018) in Lombardy (Northern Italy). J Med Virol 2020; 92:2999-3006. [PMID: 32314816 DOI: 10.1002/jmv.25917] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Besides seasonal influenza viruses (IV), several other pathogens-including respiratory syncytial virus (RSV)-are involved in clinically undistinguished influenza-like illnesses (ILIs). This study aimed at investigating the contribution of RSV in ILI cases in Lombardy (Northern Italy) during four consecutive winter seasons. MATERIALS AND METHODS In the framework of influenza surveillance, respiratory samples from ILI outpatients were collected from 2014-2015 to 2017-2018 season. IV-negative swabs were included in the study and analyzed to detect and molecularly characterize RSV-A and RSV-B. RESULTS A total of 12.9% (135/1047) of samples were positive to RSV that was mostly detected among children ≤5 years (51/183, 27.8%) and those aged 6 to 15 years (30/158, 18.9%), whereas elderly >65 years accounted for 12% of RSV cases (15/125). The median start of RSV epidemic was in the end of November, with a peak in mid-February and a width of nearly 4 months, almost overlapping seasonal influenza epidemic. RSV-A and RSV-B co-circulated in all considered seasons, with RSV-B predominating on RSV-A (63.6% vs 36.4%; P < .001). Most (85.2%) RSV-A belonged to genotype ON1 and the remaining to NA1. All RSV-B clustered within the BA genotype. CONCLUSIONS In this study, RSV significantly contributed to ILI cases, especially among pediatric population (<15 years), although it was detected in all age groups. RSV-B predominated on RSV-A, and the most recent evolved genotypes (BA and ON1, respectively) circulated. Investigating the epidemiological and molecular characteristics of RSV in ILI cases can increase baseline epidemiological information before the introduction of RSV vaccination.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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13
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Garcia-Garcia ML, Gonzalez-Carrasco E, Bracamonte T, Molinero M, Pozo F, Casas I, Calvo C. Impact of Prematurity and Severe Viral Bronchiolitis on Asthma Development at 6-9 Years. J Asthma Allergy 2020; 13:343-353. [PMID: 32982322 PMCID: PMC7509474 DOI: 10.2147/jaa.s258447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
Background Premature birth is associated with increased susceptibility for viral infections and chronic airway morbidity. Preterm children, even moderate and late, may be at risk for short- and long-term respiratory morbidities. Objective Our main goal was to compare the burden of two conditions, severe bronchiolitis and prematurity (early and moderate-late), on asthma development at 6–9 years. Patients and Methods A retrospective cohort of all preterm (<37weeks gestational age) and full-term children hospitalized for bronchiolitis, with current age between 6 and 9 years, was created. A second cohort was made up of preterm children, without admission for bronchiolitis, randomly chosen from the hospital premature births database. Prevalence and risk factors for asthma were analysed. Parents completed the International Study of Asthma and Allergies in Childhood (ISAAC) Questionnaire for asthma symptoms for children 6–7 years. Lung function and aeroallergen sensitization were evaluated. Results Of the 480 selected children, 399 could be contacted and agreed to participate: 133 preterm and 114 full-term cases with admission for bronchiolitis and 146 preterm control children without admission for bronchiolitis. The frequency of current asthma at 6–9 years was higher in preterm cases (27%) compared with full-term-cases (15%) and preterm controls (14%) (p=0.04). Among hospitalized-bronchiolitis children, prematurity (p=0.04), rhinovirus infection (p=0.03), viral coinfection (p=0.04) and paternal asthma (p=0.003) were risk factors for asthma at 6–9 years. Among premature children, with and without bronchiolitis admission, the risk factors for asthma at 6–9 years were admission for bronchiolitis (p=0.03) and aeroallergen sensitisation (p=0.01). Moderate and late preterm children without admission for bronchiolitis showed similar prevalence of current asthma than full-term ones, previously admitted for bronchiolitis. Conclusion Preterm birth is an important early life risk factor for asthma in childhood. The addition of other risk factors, such as severe bronchiolitis, especially by rhinovirus or viral coinfections, are associated with even higher risk for subsequent asthma.
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Affiliation(s)
- Maria Luz Garcia-Garcia
- Pediatrics Department, Severo Ochoa University Hospital, Fundación IDIPHISA, Alfonso X El Sabio University Madrid, Spain. Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Ersilia Gonzalez-Carrasco
- Department, Severo Ochoa University Hospital, Fundación IDIPHISA. Alfonso X El Sabio University, Madrid, Spain
| | - Teresa Bracamonte
- Pediatrics Department, Severo Ochoa University Hospital, Fundación IDIPHISA, Alfonso X El Sabio University Madrid, Spain. Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Mar Molinero
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious Diseases Department, Fundación IdiPaz, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain. TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Italy. La Paz University Hospital, Madrid, Spain
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Circulation profile of respiratory viruses in symptomatic and asymptomatic children from Midwest Brazil. Braz J Microbiol 2020; 51:1729-1735. [PMID: 32862400 PMCID: PMC7456363 DOI: 10.1007/s42770-020-00368-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 08/21/2020] [Indexed: 02/06/2023] Open
Abstract
Acute respiratory infection (ARI) is a major cause of morbidity and mortality worldwide. Most of these infections are caused by viruses. Infections pose as important triggers of acute episodes of chronic respiratory diseases (CRD). This study sought to evaluate the frequency and circulation profile of respiratory viruses among ARI symptomatic patients and completely asymptomatic children in Midwest Brazil. The study enrolled symptomatic children with and without ARI symptoms. During 1 year, 225 nasal respiratory samples were obtained from patients aged 4–14 years old. The samples were screened by multiplex nested-PCR for 16 common respiratory viruses. From 225 samples, 42 had at least one virus detected. Samples from four different patients had multiple viruses detected. The viral detection rate in symptomatic (20.1%) and asymptomatic patients (14.8%) showed no significant difference. The most frequent viruses detected were rhinovirus (28.6%), FLUA (11.9%), adenovirus (11.9%), human bocavirus (HBoV) (11.9%), and respiratory syncytial virus (RSV) antigenic group A (9.5%). Monthly detection rate was higher during the rainy season. RSVs were detected during the months with higher rainfall indexes and higher air humidity, while FLU and HBoV were detected during the winter months. The obtained results reinforce the importance of viral pathogens in pediatric population, emphasizing similar viral occurrence in symptomatic and asymptomatic children.
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Abstract
BACKGROUND Several evidence-based guidelines for the management of children with febrile neutropenia (FN) have been published, with special focus in bacterial and fungal infections. However, the role of acute respiratory infections caused by respiratory viruses (RV) has not been clearly established. The aim of this study was to evaluate the epidemiology, clinical presentation and outcome of acute respiratory infections in children with FN. METHODS Patients, <18 years of age admitted to the Pediatric Oncology-Hematology Unit after developing FN between November 2010 and December 2013, were prospectively included in the study. Children were evaluated by clinical examination and laboratory tests. Nasopharyngeal sample was obtained for detection of RV. RESULTS There was a total of 112 episodes of FN in 73 children admitted to the hospital during a 32-month period. According to disease severity, 33% of the episodes were considered moderate or severe. Rhinovirus was the most frequently detected RV (66.6%; 24/36), followed by parainfluenza. On regard to clinical outcome, RV-infected children developed fewer episodes of moderate or severe FN compared with non-RV infected children (16.7% vs. 33.3%; P = 0.08). CONCLUSIONS A great proportion of children with FN admitted to a tertiary hospital had a RV isolation. The rate of this RV isolation was significantly higher when a rapid molecular test was used compared with conventional microbiologic methods. Rhinovirus was the most frequently isolated, although its role as an active agent of acute infection was not clear. Children with FN and a RV isolate had a lower rate of severe disease.
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Tsergouli K, Pappa S, Haidopoulou K, Gogou M, Giannopoulos A, Papa A. Respiratory Syncytial Virus in Greece, 2016-2018. Intervirology 2020; 62:210-215. [PMID: 32348998 DOI: 10.1159/000506049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/18/2020] [Indexed: 01/03/2023] Open
Abstract
Human respiratory syncytial virus (RSV) is the leading cause of acute bronchiolitis in infants and young children. Children under the age of 2 years, hospitalized for bronchiolitis in the pediatric clinic of a tertiary hospital in northern Greece, were tested for RSV infection during two RSV seasons (2016-2017 and 2017-2018). RSV was detected in 37 of 71 (52.1%) patients, most of them younger than 6 months. Both RSV subtypes were detected - RSV-A (54.1%) and RSV-B (45.9%) - with predominance of RSV-A during the 2016-2017 and RSV-B during the 2017-2018 season. RSV-A and RSV-B sequences clustered within the ON1 and BA genotypes, respectively. Compared to the prototype strains, several amino acid substitutions were observed in the duplication region of the G gene. The study provides a first insight into the molecular epidemiology of RSV in Greece.
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Affiliation(s)
- Katerina Tsergouli
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Styliani Pappa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Haidopoulou
- Second Pediatric Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Gogou
- Second Pediatric Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Giannopoulos
- Second Pediatric Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece,
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Sederdahl BK, Williams JV. Epidemiology and Clinical Characteristics of Influenza C Virus. Viruses 2020; 12:E89. [PMID: 31941041 PMCID: PMC7019359 DOI: 10.3390/v12010089] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/14/2022] Open
Abstract
Influenza C virus (ICV) is a common yet under-recognized cause of acute respiratory illness. ICV seropositivity has been found to be as high as 90% by 7-10 years of age, suggesting that most people are exposed to ICV at least once during childhood. Due to difficulty detecting ICV by cell culture, epidemiologic studies of ICV likely have underestimated the burden of ICV infection and disease. Recent development of highly sensitive RT-PCR has facilitated epidemiologic studies that provide further insights into the prevalence, seasonality, and course of ICV infection. In this review, we summarize the epidemiology and clinical characteristics of ICV.
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Affiliation(s)
- Bethany K. Sederdahl
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
| | - John V. Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
- Institute for Infection, Inflammation, and Immunity in Children (i4Kids), University of Pittsburgh, Pittsburgh, PA 15224, USA
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Sánchez García L, Calvo C, Casas I, Pozo F, Pellicer A. Viral respiratory infections in very low birthweight infants at neonatal intensive care unit: prospective observational study. BMJ Paediatr Open 2020; 4:e000661. [PMID: 33024832 PMCID: PMC7513636 DOI: 10.1136/bmjpo-2020-000661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Very low birthweight (VLBW) infants are highly susceptible to respiratory infections. Information about prevalence of viral respiratory infections (VRIs) in neonatal intensive care unit (NICU) is scarce. Recent evidence suggests short-term and long-term impact of VRI in morbidity of VLBW infants. The goal of this study is to conduct a VRI surveillance in VLBW infants during NICU admission to address the prevalence, type of viruses and associated clinical features. METHODS Prospective observational cohort study on infants below 32 gestational weeks admitted to a tertiary NICU during a 2-year period. Respiratory virus detection (influenza, parainfluenza, rhinovirus (hRV), enterovirus, respiratory syncytial virus, metapneumovirus, coronavirus, bocavirus and adenovirus) was performed by real time multiplex PCR assays in nasopharyngeal aspirates (NPAs), within the first 72 hours after birth and weekly, until discharge. Additional samples were taken if clinically indicated. RESULTS 147 out of 224 eligible infants were enrolled. At least one positive NPA was found in 38% of the study cohort. Main viruses identified were hRV (58%) and adenovirus (31%). Among the 56 infants with positive NPA, 26 showed non-specific respiratory features in 58% (increased respiratory workload, tachypnoea, apnoea) or typical cold features in 38% (rhinorrhea, cough, fever), at least in one episode. Antibiotics were prescribed in 29% of cases. Positive infants showed higher rates of bronchopulmonary dysplasia (BPD), need for supplemental oxygen and mechanical ventilation, and had longer hospital stay. Cox regression analysis found BPD as an independent risk factor for viral infection (p<0.001) and symptomatic VRI (p<0.04). CONCLUSIONS Systematic surveillance in VLBW infants reports VRI is frequent, particularly by hRV. Asymptomatic infection is highly prevalent which is critical in the face of establishing appropriate preventive strategies. Infants with BPD are especially vulnerable to such infections.
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Affiliation(s)
- Laura Sánchez García
- Neonatology Department, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious Diseases Department, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Center of Microbiology, Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Center of Microbiology, Madrid, Spain
| | - Adelina Pellicer
- Neonatology Department, IdiPaz Foundation, La Paz University Hospital, Madrid, Spain
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Possible role of highly activated mucosal NK cells against viral respiratory infections in children undergoing haematopoietic stem cell transplantation. Sci Rep 2019; 9:18792. [PMID: 31827202 PMCID: PMC6906525 DOI: 10.1038/s41598-019-55398-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/13/2019] [Indexed: 12/29/2022] Open
Abstract
Infection is the leading cause of non-relapse-related mortality after allogeneic haematopoietic stem cell transplantation (HSCT). Altered functions of immune cells in nasal secretions may influence post HSCT susceptibility to viral respiratory infections. In this prospective study, we determined T and NK cell numbers together with NK activation status in nasopharyngeal aspirates (NPA) in HSCT recipients and healthy controls using multiparametric flow cytometry. We also determined by polymerase chain reaction (PCR) the presence of 16 respiratory viruses. Samples were collected pre-HSCT, at day 0, +10, +20 and +30 after HSCT. Peripheral blood (PB) was also analyzed to determine T and NK cell numbers. A total of 27 pediatric HSCT recipients were enrolled and 16 of them had at least one viral detection (60%). Rhinovirus was the most frequent pathogen (84% of positive NPAs). NPAs of patients contained fewer T and NK cells compared to healthy controls (p = 0.0132 and p = 0.120, respectively). Viral PCR + patients showed higher NK cell number in their NPAs. The activating receptors repertoire expressed by NK cells was also higher in NPA samples, especially NKp44 and NKp46. Our study supports NK cells relevance for the immune defense against respiratory viruses in HSCT recipients.
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Pérez-Sautu U, Wiley MR, Iglesias-Caballero M, Pozo F, Prieto K, Chitty JA, García-García ML, Calvo C, Casas I, Palacios G. Target-independent high-throughput sequencing methods provide evidence that already known human viral pathogens play a main role in respiratory infections with unexplained etiology. Emerg Microbes Infect 2019; 8:1054-1065. [PMID: 31335277 PMCID: PMC6691886 DOI: 10.1080/22221751.2019.1640587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Despite the advanced PCR-based assays available, a fraction of the pediatric respiratory infections remain unexplained every epidemic season, and there is a perception that novel viruses might be present in these specimens. We systematically collected samples from a prospective cohort of pediatric patients with respiratory infections, that returned negative results by validated molecular RT–PCR assays, and studied them with a target-independent, high-throughput sequencing-based approach. We also included a matched cohort of children with no symptoms of respiratory infection, as a contrast study population. More than fifty percent of the specimens from the group of patients with unexplained respiratory infections were resolved. However, the higher rate of detection was not due to the presence of novel viruses, but to the identification of well-known viral respiratory pathogens. Our results show that already known viral pathogens are responsible for the majority of cases that remain unexplained after the epidemic season. High-throughput sequencing approaches that use pathogen-specific probes are easier to standardize because they ensure reproducible library enrichment and sequencing. In consequence, these techniques might be desirable from a regulatory standpoint for diagnostic laboratories seeking to benefit from the many advantages of these sequencing technologies.
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Affiliation(s)
- Unai Pérez-Sautu
- a Influenza and Respiratory Viruses Unit, National Center for Microbiology, Instituto de Salud Carlos III (ISCIII) , Madrid , Spain.,b Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID) , Frederick , MD , USA
| | - Michael Ross Wiley
- b Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID) , Frederick , MD , USA.,c College of Public Health, University of Nebraska Medical Center , Omaha , NE , USA
| | - María Iglesias-Caballero
- a Influenza and Respiratory Viruses Unit, National Center for Microbiology, Instituto de Salud Carlos III (ISCIII) , Madrid , Spain
| | - Francisco Pozo
- a Influenza and Respiratory Viruses Unit, National Center for Microbiology, Instituto de Salud Carlos III (ISCIII) , Madrid , Spain
| | - Karla Prieto
- b Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID) , Frederick , MD , USA.,c College of Public Health, University of Nebraska Medical Center , Omaha , NE , USA
| | - Joseph Alex Chitty
- b Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID) , Frederick , MD , USA
| | | | | | - Inmaculada Casas
- a Influenza and Respiratory Viruses Unit, National Center for Microbiology, Instituto de Salud Carlos III (ISCIII) , Madrid , Spain
| | - Gustavo Palacios
- b Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID) , Frederick , MD , USA
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Mollers M, Barnadas C, Broberg EK, Penttinen P, Teirlinck AC, Fischer TK. Current practices for respiratory syncytial virus surveillance across the EU/EEA Member States, 2017. Euro Surveill 2019; 24:1900157. [PMID: 31595876 PMCID: PMC6784450 DOI: 10.2807/1560-7917.es.2019.24.40.1900157] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BackgroundRespiratory syncytial virus (RSV) is a major contributor to lower respiratory tract infections worldwide and several vaccine candidates are currently in development. Following vaccine introduction, reliable RSV surveillance should enable monitoring of vaccination impact. Data on the RSV disease burden in the European Union and European Economic Area (EU/EEA) are sparse.AimThe aim of this study was to gather knowledge on current practices of national RSV surveillance in the EU/EEA.MethodsNational Coordinators and National Focal Points for Influenza (epidemiologists and virologists) from the EU/EEA countries (n = 31) were invited to participate in an online survey in August and September 2017. The questionnaire covered questions on epidemiological and laboratory aspects of RSV surveillance.ResultsAll EU/EEA countries except Liechtenstein replied to the survey. Eighteen countries reported to have a sentinel surveillance system, 26 countries a non-sentinel surveillance system and three countries to have neither. RSV data collection was mostly done within the context of influenza surveillance. A wide range of diagnostic and characterisation assays was used for the detection of RSV.DiscussionThe majority of EU/EEA countries have some surveillance for RSV in place. The prevailing integration of RSV surveillance into the existing influenza sentinel surveillance system may lead to under-reporting of RSV. The documented variations in existing RSV surveillance systems and their outputs indicate that there is scope for developing guidelines on establishing comparable methods and outcomes for RSV surveillance across the EU/EEA, to ensure the availability of a consistent evidence base for assessing future vaccination programmes.
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Affiliation(s)
- Madelief Mollers
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious disease control, Bilthoven, the Netherlands,European Programme for Intervention Epidemiology Training (EPIET) and European Public Health Microbiology (EUPHEM) training programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden,These authors contributed equally to this manuscript
| | - Céline Barnadas
- European Programme for Intervention Epidemiology Training (EPIET) and European Public Health Microbiology (EUPHEM) training programme, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden,These authors contributed equally to this manuscript,Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Anne C Teirlinck
- National Institute for Public Health and the Environment (RIVM) - Centre for Infectious disease control, Bilthoven, the Netherlands,These authors contributed equally to this manuscript
| | - Thea K Fischer
- Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark,Department of Infectious Diseases and Centre for Global Health, University of Southern Denmark, Odense, Denmark,These authors contributed equally to this manuscript
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22
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Atilla E, Sahin D, Atilla PA, Dolapci I, Tekeli A, Bozdag SC, Yuksel MK, Toprak SK, Ilhan O, Arslan O, Ozcan M, Gurman G, Topcuoglu P. Upper respiratory viral infections in patients with haematological malignancies after allogeneic haematopoietic stem cell transplantation: a retrospective study. Antivir Ther 2019; 23:523-527. [PMID: 29424696 DOI: 10.3851/imp3224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Community respiratory viruses (CRVs) are associated with upper respiratory viral infections (URI), pneumonia or life-threatening respiratory disease in patients with allogeneic haematopoietic stem cell transplantation (allo-HSCT). Our aim is to demonstrate our URI experience related to CRVs after allo-HSCT. METHODS From January 2013 to November 2015, 39 post allo-HSCT patients with acute URI symptoms were included in the study. We evaluated CRVs by multiplex PCR from nasopharyngeal wash and throat swabs. RESULTS The median age of the patients was 39 (range 20-67 years). A total of 25 patients (64%) had viral panel positivity at a median 140 days post-transplant (range 3-617 days). The most common agents detected were respiratory syncytial virus (32%) and parainfluenza (32%). The patients with viral panel positivity had significantly lower lymphocyte count (1.05×109/l versus 3.09×109/l; P=0.013). During follow-up, 20 patients (80%) were diagnosed with pneumonia. Patients with concurrent bacterial or fungal infections were more likely to have pneumonia (100% versus 68%; P=0.023). 10 patients (40%) died due to pneumonia and related complications. Lower lymphocyte counts and higher C-reactive protein levels at the time of viral panel positivity were risk factors for mortality (1.5×109/l versus 0.39×109/l, P=0.007; 74.2 versus 199.7, P=0.006). CONCLUSIONS The viral panel was positive in 64% of patients with acute URI symptoms. Lower lymphocyte count was detected in CRV-positive patients. The onset of concomitant bacterial or fungal infections increased the risk of lower respiratory infection disease. Indeed, prospective studies should be designed for risks and outcomes of CRVs in allo-HSCT recipients.
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Affiliation(s)
- Erden Atilla
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Didem Sahin
- Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Pinar Ataca Atilla
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Istar Dolapci
- Department of Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Alper Tekeli
- Department of Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Sinem Civriz Bozdag
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Meltem Kurt Yuksel
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Selami Kocak Toprak
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Osman Ilhan
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Onder Arslan
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Muhit Ozcan
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Gunhan Gurman
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Pervin Topcuoglu
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
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Etemadi MR, Jalilian FA, Othman N, Lye MS, Ansari S, Yubbu P, Sekawi Z. Diversity of respiratory viruses detected among hospitalized children with acute lower respiratory tract infections at Hospital Serdang, Malaysia. J Virol Methods 2019; 269:1-6. [PMID: 30910688 PMCID: PMC7172173 DOI: 10.1016/j.jviromet.2019.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 11/24/2022]
Abstract
Discovery of new viruses have created a renewed interest in the epidemiology of respiratory viruses. Respiratory viruses are the major cause of acute lower respiratory tract infections (ALRTIs) in children. Assessment of the morbidity of specific etiological agents of ALRTIs is important to determine agent-specific interventions. Sensitive and rapid diagnosis of respiratory infections in hospitalized children is cost-effective.
Background The role of respiratory viruses as the major cause of acute lower respiratory tract infections (ALRTIs) in children is becoming increasingly evident due to the use of sensitive molecular detection methods. The aim of this study was to use conventional and molecular detection methods to assess the epidemiology of respiratory viral infections in children less than five years of age that were hospitalized with ALRTIs. Methods The cross-sectional study was designed to investigate the occurrence of respiratory viruses including respiratory syncytisl virus (RSV), human metapneumovirus (HMPV), influenza virus A and B (IFV-A and B), parainfluenzavirus 1, 2, 3 and 4 (PIV 1, 2, 3 and 4), human rhinoviruses (HRV), human enterovirus (HEV), human coronaviruses (HCoV) 229E and OC43, human bocavirus (HBoV) and human adenovirus (HAdV) in hospitalized children with ALRTIs, at Hospital Serdang, Malaysia, from June 16 to December 21, 2009. The study was also designed in part to assess the performance of the conventional methods against molecular methods. Results Viral pathogens were detected in 158 (95.8%) of the patients. Single virus infections were detected in 114 (67.9%) patients; 46 (27.9%) were co-infected with different viruses including double-virus infections in 37 (22.4%) and triple-virus infections in 9 (5.5%) cases. Approximately 70% of samples were found to be positive using conventional methods compared with 96% using molecular methods. A wide range of respiratory viruses were detected in the study. There was a high prevalence of RSV (50.3%) infections, particularly group B viruses. Other etiological agents including HAdV, HMPV, IFV-A, PIV 1–3, HBoV, HCoV-OC43 and HEV were detected in 14.5, 9.6, 9.1, 4.8, 3.6, 2.4 and 1.8 percent of the samples, respectively. Conclusion Our results demonstrated the increased sensitivity of molecular detection methods compared with conventional methods for the diagnosis of ARTIs in hospitalized children. This is the first report of HMPV infections in Malaysia.
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Affiliation(s)
- Mohammad Reza Etemadi
- Department of Biology, Faculty of Basic Sciences, Islamic Azad University of Arak, Arak, Iran; Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Farid Azizi Jalilian
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Norlijah Othman
- Department of Pediatrics, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Sara Ansari
- Department of Anatomy, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Putri Yubbu
- Department of Pediatrics, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Zamberi Sekawi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
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Benavides-Nieto M, Méndez-Echevarría A, Del Rosal T, García-García ML, Casas I, Pozo F, de la Serna O, Lopez-Granados E, Rodriguez-Pena R, Calvo C. The role of respiratory viruses in children with humoral immunodeficiency on immunoglobulin replacement therapy. Pediatr Pulmonol 2019; 54:194-199. [PMID: 30575324 PMCID: PMC7167964 DOI: 10.1002/ppul.24214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/14/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The role of viruses in children with respiratory tract infections and humoral immunodeficiencies has hardly been studied. We have evaluated these infections in children with humoral immunodeficiencies who required immunoglobulin replacement therapy, considering their relationship with symptoms, lung function, bacterial co-infection, and outcomes. METHODS We conducted a prospective case-control study during a 1-year period, including children with humoral immunodeficiencies receiving immunoglobulin replacement therapy. For each patient, at least one healthy family member was included. Respiratory samples for viral detection were taken every 1-3 months, and in case of respiratory tract infections. Symptoms questionnaires were filled biweekly. Spirometry and sputum culture were performed in every episode. RESULTS Sixty-six episodes were analyzed in 14 patients (median age 12 years; IQR 7-17), identifying 18 respiratory viruses (27.3%), being rhinovirus the most frequently isolated one (12/18; 66%). Positive viral episodes were associated with clinical symptoms (89% vs 43%), more frequent antibiotic treatment (44% vs 15%) or hospital admission (22% vs 0%) than negative ones. Patients with positive viral detection showed impaired lung function, with lower FEV1 and FVC values. CONCLUSIONS In our experience, viral respiratory tract infections can cause significant respiratory symptoms and impaired lung function, in children with HID, despite immunoglobulin replacement therapy. These patients could benefit from the monitoring of viral infections, as these may be a gateway for ongoing lung damage.
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Affiliation(s)
- Marta Benavides-Nieto
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Fundación IdiPaz, Madrid, Spain
| | - Ana Méndez-Echevarría
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Fundación IdiPaz, Madrid, Spain.,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Teresa Del Rosal
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Fundación IdiPaz, Madrid, Spain.,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - María Luz García-García
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.,Pediatrics and Pneumology Department, Severo Ochoa Hospital, Leganés, Madrid, Spain
| | - Inmaculada Casas
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.,Respiratory Virus and Influenza Unit, CNM, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Francisco Pozo
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.,Respiratory Virus and Influenza Unit, CNM, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Olga de la Serna
- Paediatric Pneumology Department, Hospital La Paz, Madrid, Spain
| | | | - Rebeca Rodriguez-Pena
- Immunology Department, Hospital Universitario La Paz, Fundación IdiPaz, Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Fundación IdiPaz, Madrid, Spain.,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain.,TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Pavia, Italy
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25
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Zhao L, Wang J, Li GX, Qiu FZ, Chen C, Zhao MC, Wang L, Duan SX, Feng ZS, Ma XJ. A highly sensitive 1-tube nested real-time RT-PCR assay using LNA-modified primers for detection of respiratory syncytial virus. Diagn Microbiol Infect Dis 2018; 93:101-106. [PMID: 30266400 PMCID: PMC7126397 DOI: 10.1016/j.diagmicrobio.2018.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/23/2018] [Accepted: 09/03/2018] [Indexed: 12/31/2022]
Abstract
Respiratory syncytial virus (RSV) causes serious respiratory tract infection worldwide. The relatively low RSV load makes it difficult to detect in frail, elderly, and severely immune-compromised patients. In the present study, we developed a locked nucleic acid–-based 1-tube nested real-time RT-PCR (OTNRT-PCR) assay with the advantages of extremely high sensitivity, facile operability, and less likelihood of cross-contamination. The sensitivity, specificity, and clinical performance of the OTNRT-PCR assay were compared in parallel with a conventional TaqMan probe-based real-time PCR (qRT-PCR) assay and a traditional 2-step nested RT-PCR assay. The limit of detection of the OTNRT-PCR assay was 1.02 × 10−1 TCID50/mL, equivalent to the traditional 2-step nested RT-PCR assay and 25-fold lower than the qRT-PCR assay. Of 616 nasopharyngeal aspirates tested, 143 RSV-negative samples by qRT-PCR were confirmed as positive by sequencing the OTNRT-PCR products. We therefore conclude that OTNRT-PCR is more sensitive than qRT-PCR for detection of RSV in clinical samples.
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Affiliation(s)
- Li Zhao
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Ji Wang
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Gui-Xia Li
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Fang-Zhou Qiu
- Hebei Medical University, Shijiazhuang, 050031, Hebei, China; Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Chen Chen
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Meng-Chuan Zhao
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Le Wang
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Su-Xia Duan
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China; Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Zhi-Shan Feng
- Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei, China.
| | - Xue-Jun Ma
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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26
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Chen J, Hu P, Zhou T, Zheng T, Zhou L, Jiang C, Pei X. Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009-2014. BMC Pediatr 2018; 18:216. [PMID: 29976175 PMCID: PMC6034247 DOI: 10.1186/s12887-018-1203-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/28/2018] [Indexed: 12/15/2022] Open
Abstract
Background Acute respiratory infection (ARI) is the leading cause of morbidity and mortality in pediatric patients worldwide and imposes an intense pressure on health care facilities. Data on the epidemiology profiles of ARIs are scarce in the western and rural areas of China. The purpose of the current study is to provide data on the presence of potential pathogens of ARIs in hospitalized children in Chengdu, west China. Methods Respiratory specimens were obtained from hospitalized patients (under 6 years old) with ARIs in a local hospital in Chengdu. Eight respiratory viruses were identified by PCR and 6 respiratory bacteria by biochemical reactions and Analytical Profile Index (API). Pathogens profiles, clinical characteristics and seasonality were analyzed. Results Fifty-one percent of patients were identified with at least one respiratory pathogen. Human rhinovirus (HRV) (23%), Respiratory syncytial virus (RSV) (22.7%) was the most commonly identified viruses, with Klebsiella pneumoniae (11.5%) the most commonly identified bacterium in the study. The presences of more than one pathogen were found, and multiple viral, bacterial, viral/bacterial combinations were identified in 14.9, 3.3 and 13.9% of patients respectively. Respiratory viruses were identified throughout the year with a seasonal peak in December–February. Pathogens profiles and clinical associations were different between infants (< 1 year of age) and older children (> 1 year of age). Infants with ARIs were more likely to have one or more viruses than older children. Infants identified with multiple pathogens had significantly higher proportions of tachypnea than infants that were not. Conclusions This study demonstrated that viral agents were frequently found in hospitalized children with ARI in Chengdu during the study period. This study gives us better information on the pathogen profiles, clinical associations, co-infection combinations and seasonal features of ARIs in hospitalized children, which is important for diagnoses and treatment of ARIs, as well as implementation of vaccines in this area. Moreover, future efforts in reducing the impact of ARIs will depend on programs in which available vaccines, especially vaccines on RSV, HRV and S. pneumoniae could be employed in this region and new vaccines could be developed against common pathogens.
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Affiliation(s)
- Jiayi Chen
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Research Center for Occupational Respiratory Diseases, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Pengwei Hu
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Shenzhen Nanshan Center for Disease Control and Prevention, 95#, Nanshang Road, Shenzhen, 518054, Guangdong, China
| | - Tao Zhou
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Tianli Zheng
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lingxu Zhou
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Chongqing Yuzhong District Center for Disease Control and Prevention, 254#, Heping Road, Yuzhong District, Chongqing, 400010, China
| | - Chunping Jiang
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiaofang Pei
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.
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27
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Gómez-Novo M, Boga JA, Álvarez-Argüelles ME, Rojo-Alba S, Fernández A, Menéndez MJ, de Oña M, Melón S. Human respiratory syncytial virus load normalized by cell quantification as predictor of acute respiratory tract infection. J Med Virol 2018; 90:861-866. [PMID: 29315642 DOI: 10.1002/jmv.25020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/19/2017] [Indexed: 11/06/2022]
Abstract
Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive, and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (P < 0.001). The viral mean load was 4.81 ± 1.98 log10 copies/1000 cells for patients under the age of 4-year-old (P < 0.001). The viral mean loads were 4.51 ± 2.04 cells in patients with low respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (P < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression.
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Affiliation(s)
- Miriam Gómez-Novo
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - José A Boga
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Susana Rojo-Alba
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Fernández
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María J Menéndez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - María de Oña
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Santiago Melón
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
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28
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Li X, Li J, Meng L, Zhu W, Liu X, Yang M, Yu D, Niu L, Shen X. Viral etiologies and epidemiology of patients with acute respiratory infections based on sentinel hospitals in Gansu Province, Northwest China, 2011-2015. J Med Virol 2018; 90:828-835. [PMID: 29388679 PMCID: PMC7166685 DOI: 10.1002/jmv.25040] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/17/2018] [Indexed: 01/01/2023]
Abstract
Understanding etiological role and epidemiological profile is needed to improve clinical management and prevention of acute respiratory infections (ARIs). A 5-year prospective study about active surveillance for outpatients and inpatients with ARIs was conducted in Gansu province, China, from January 2011 to November 2015. Respiratory specimens were collected from patients and tested for eight respiratory viruses using polymerase chain reaction (PCR) or reverse transcription polymerase chain reaction (RT-PCR). In this study, 2768 eligible patients with median age of 43 years were enrolled including pneumonia (1368, 49.2%), bronchitis (435, 15.7%), upper respiratory tract infection or URTI (250, 9.0%), and unclassified ARI (715, 25.8%). Overall, 29.2% (808/2768) were positive for any one of eight viruses, of whom 130 cases were identified with two or more viruses. Human rhinovirus (HRV) showed the highest detection rate (8.6%), followed by influenza virus (Flu, 7.3%), respiratory syncytial virus (RSV, 6.1%), human coronavirus (hCoV, 4.3%), human parainfluenza (PIV, 4.0%), adenovirus (ADV, 2.1%), human metapneumovirus (hMPV, 1.6%), and human bocavirus (hBoV, 0.7%). Compared with URTI, RSV was more likely identified in pneumonia (χ2 = 12.720, P < 0.001) and hCoV was more commonly associated with bronchitis than pneumonia (χ2 = 15.019, P < 0.001). In patients aged less than 5 years, RSV showed the highest detection rate and hCoV was the most frequent virus detected in adults and elderly. The clear epidemical seasons were observed in HRV, Flu, and hCoV infections. These findings could serve as a reference for local health authorities in drawing up further plans to prevent and control ARIs associated with viral etiologies.
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Affiliation(s)
- Xuechao Li
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
| | - Juansheng Li
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
| | - Lei Meng
- Centers' for Disease Control and Prevention, Gansu Province, P.R. China
| | - Wanqi Zhu
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
| | - Xinfeng Liu
- Centers' for Disease Control and Prevention, Gansu Province, P.R. China
| | - Mei Yang
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
| | - Deshan Yu
- Centers' for Disease Control and Prevention, Gansu Province, P.R. China
| | - Lixia Niu
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
| | - Xiping Shen
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China
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Vergara A, Cilloniz C, Luque N, Garcia-Vidal C, Tejero J, Perelló R, Lucena CM, Torres A, Marcos MA. Detection of human cytomegalovirus in bronchoalveolar lavage of intensive care unit patients. Eur Respir J 2018; 51:51/2/1701332. [DOI: 10.1183/13993003.01332-2017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/30/2017] [Indexed: 11/05/2022]
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Kuan CS, Yew SM, Hooi PS, Lee LM, Ng KP. Detection of Respiratory Viruses from ARTI Patients by xTAG RVP Fast v2 Assay and Conventional Methods. Malays J Med Sci 2018; 24:33-43. [PMID: 29386970 DOI: 10.21315/mjms2017.24.5.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 08/11/2017] [Indexed: 10/18/2022] Open
Abstract
Introduction Acute respiratory tract infections (ARTIs) are a major cause of morbidity and mortality in paediatric patients. Therefore, early detection of the viral aetiologies of ARTIs is essential for patient management and infection control. In this study, we evaluated the performance of a new multiplex polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel [RVP] Fast v2) in the detection of respiratory viruses by comparing it with that of viral culture and direct immunofluorescence (IF) staining. Methods Nasopharyngeal swab and aspirate samples were collected prospectively from 199 patients who presented with ARTIs at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia during a 10-month period. The PCR assay was conducted in parallel with conventional culture and direct IF staining methods. Results The positive rate of the xTAG RVP Fast v2 assay (78.4%) in detecting respiratory viruses was higher than that of the viral isolation (7.5%) and direct IF (23.1%) methods. Using the xTAG RVP Fast v2 assay, human enterovirus/human rhinovirus (HEV/HRV) was the most frequently detected (46.2%). The xTAG RVP Fast v2 assay revealed mixed infection caused by two or three respiratory viruses in 40 specimens, and these were undetected by the viral isolation and direct IF methods. Conclusion The xTAG RVP Fast v2 assay was superior to conventional methods in the identification of common respiratory viruses, with higher sensitivity and shorter turnaround times for laboratory results.
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Affiliation(s)
- Chee Sian Kuan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Su Mei Yew
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Poh Sim Hooi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Lu Mei Lee
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Kee Peng Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Del Valle-Mendoza J, Silva-Caso W, Cornejo-Tapia A, Orellana-Peralta F, Verne E, Ugarte C, Aguilar-Luis MA, De Lama-Odría MDC, Nazario-Fuertes R, Esquivel-Vizcarra M, Casabona-Ore V, Weilg P, Del Valle LJ. Molecular etiological profile of atypical bacterial pathogens, viruses and coinfections among infants and children with community acquired pneumonia admitted to a national hospital in Lima, Peru. BMC Res Notes 2017; 10:688. [PMID: 29208015 PMCID: PMC5718007 DOI: 10.1186/s13104-017-3000-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 11/25/2017] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The main objective of this study was to detect the presence of 14 respiratory viruses and atypical bacteria (Mycoplasma pneumoniae, Chlamydia pneumoniae), via polymerase chain reaction in patients under 18 years old hospitalized due to community-acquired pneumonia (CAP) from Lima, Peru. RESULTS Atypical pathogens were detected in 40% (58/146); viral etiologies in 36% (52/146) and coinfections in 19% (27/146). The most common etiological agent was M. pneumoniae (n = 47), followed by C. pneumoniae (n = 11). The most frequent respiratory viruses detected were: respiratory syncytial virus A (n = 35), influenza virus C (n = 21) and parainfluenza virus (n = 10). Viral-bacterial and bacterium-bacterium coinfections were found in 27 cases. In our study population, atypical bacteria (40%) were detected as frequently as respiratory viruses (36%). The presence of M. pneumoniae and C. pneumoniae should not be underestimated as they can be commonly isolated in Peruvian children with CAP.
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Affiliation(s)
- Juana Del Valle-Mendoza
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru. .,Instituto de Investigación Nutricional, Av. La Molina 1885, Lima 12, Peru.
| | - Wilmer Silva-Caso
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru.,Instituto de Investigación Nutricional, Av. La Molina 1885, Lima 12, Peru
| | - Angela Cornejo-Tapia
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru
| | - Fiorella Orellana-Peralta
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru
| | | | | | - Miguel Angel Aguilar-Luis
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru.,Instituto de Investigación Nutricional, Av. La Molina 1885, Lima 12, Peru
| | - María Del Carmen De Lama-Odría
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru
| | | | | | - Verónica Casabona-Ore
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru
| | - Pablo Weilg
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Av. San Marcos cdra. 2. Cedros de Villa, Chorrillos, Lima, Peru
| | - Luis J Del Valle
- Barcelona Research Center for Multiscale Science and Engineering, Departament d'Enginyeria Quıímica, EEBE, Universitat Politècnica de Catalunya (UPC), Barcelona Tech, C/Eduard Maristany, 10-14, Ed. I2, 08019, Barcelona, Spain.
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Garcia-Garcia ML, Calvo C, Ruiz S, Pozo F, del Pozo V, Remedios L, Exposito N, Tellez A, Casas I. Role of viral coinfections in asthma development. PLoS One 2017; 12:e0189083. [PMID: 29206851 PMCID: PMC5716580 DOI: 10.1371/journal.pone.0189083] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/17/2017] [Indexed: 11/27/2022] Open
Abstract
Background Viral respiratory infections, especially acute bronchiolitis, play a key role in the development of asthma in childhood. However, most studies have focused on respiratory syncytial virus or rhinovirus infections and none of them have compared the long-term evolution of single versus double or multiple viral infections. Objective Our aim was to compare the frequency of asthma development at 6–8 years in children with previous admission for bronchiolitis associated with single versus double or multiple viral infection. Patients & methods A cross-sectional study was performed in 244 children currently aged 6–8 years, previously admitted due to bronchiolitis between September 2008 and December 2011. A structured clinical interview and the ISAAC questionnaire for asthma symptoms for 6-7-year-old children, were answered by parents by telephone. Specimens of nasopharyngeal aspirate for virological study (polymerase chain reaction) and clinical data were prospectively taken during admission for bronchiolitis. Results Median current age at follow-up was 7.3 years (IQR: 6.7–8.1). The rate of recurrent wheezing was 82.7% in the coinfection group and 69.7% in the single-infection group, p = 0.06. The number of wheezing-related admissions was twice as high in coinfections than in single infections, p = 0.004. Regarding the ISAAC questionnaire, 30.8% of coinfections versus 15% of single infections, p = 0.01, presented “wheezing in the last 12 months”, data that strongly correlate with current prevalence of asthma. “Dry cough at night” was also reported more frequently in coinfections than in single infections, p = 0.02. The strongest independent risk factors for asthma at 6–8 years of age were: age > 9 months at admission for bronchiolitis (OR: 3.484; CI95%: 1.459–8.317, p:0.005), allergic rhinitis (OR: 5.910; 95%CI: 2.622–13.318, p<0.001), and viral coinfection-bronchiolitis (OR: 3.374; CI95%: 1.542–7.386, p:0.01). Conclusions Asthma at 6–8 years is more frequent and severe in those children previously hospitalized with viral coinfection-bronchiolitis compared with those with single infection. Allergic rhinitis and older age at admission seem also to be strong independent risk factors for asthma development in children previously hospitalised because of bronchiolitis.
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Affiliation(s)
- Maria Luz Garcia-Garcia
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University, Madrid, Spain
- Traslational Research Network in Pediatric Infectious Diseases (RITIP)
- * E-mail:
| | - Cristina Calvo
- Traslational Research Network in Pediatric Infectious Diseases (RITIP)
- TEDDY Network (European Network of Excellence for Pediatric Clinical Research)
- Pediatrics Department, La Paz Hospital, Alfonso X El Sabio University, Madrid, Spain
| | - Sara Ruiz
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University, Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
| | - Victoria del Pozo
- Department of Immunology, CIBER de Enfermedades Respiratorias (CIBERES), IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Laura Remedios
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University, Madrid, Spain
| | - Nadia Exposito
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University, Madrid, Spain
| | - Ana Tellez
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University, Madrid, Spain
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
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Zheng SY, Wang LL, Ren L, Luo J, Liao W, Liu EM. Epidemiological analysis and follow-up of human rhinovirus infection in children with asthma exacerbation. J Med Virol 2017; 90:219-228. [PMID: 28500687 PMCID: PMC7167043 DOI: 10.1002/jmv.24850] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 04/19/2017] [Indexed: 12/20/2022]
Abstract
To determine the prevalence of human rhinovirus (HRV) infection in children with acute asthma exacerbations, investigation of HRV viral load and severity of asthma exacerbations is also required. Nasopharyngeal aspirates and swabs were collected and assessed for respiratory viruses. HRV-positive samples were sequenced to identify types and determine viral load. Outpatients with asthma exacerbations underwent follow-up evaluations, their swabs were collected and clinical outcomes were recorded at their next clinic visit 4 weeks later. One hundred forty-three inpatients and 131 outpatients, including 88 patients with asthma exacerbations and 43 controls with stable asthma were recruited. HRV-A was mainly detected in September and February (45.5% and 33.3%, respectively), while HRV-C was mainly detected in November and April (70.0% and 55.6%, respectively). HRV-C was the primary type and was primarily found in inpatients with severe asthma exacerbations. HRV-A viral load in the group of inpatients with severe exacerbations was higher than in the mild and moderate groups (P < 0.001 and P = 0.022). The HRV-A viral load of both inpatients and outpatients was higher than that of HRV-C (P < 0.001 and P = 0.036). The main genotypes were HRV-C53 and HRV-A20 among inpatients, and this genotype caused more severe clinical manifestations. HRV persisted for no more than 4 weeks, and their symptoms or signs of disease were well-controlled well. HRV-C was most frequently detected in asthma exacerbations. HRV-A with high viral load led to severe asthma exacerbations.
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Affiliation(s)
- Shou-Yan Zheng
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Li-Li Wang
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Luo Ren
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jian Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Liao
- Department of Pediatrics, Southwest Hospital of The Third Military Medical University, Chongqing, China
| | - En-Mei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
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Brotons P, Bassat Q, Lanaspa M, Henares D, Perez-Arguello A, Madrid L, Balcells R, Acacio S, Andres-Franch M, Marcos MA, Valero-Rello A, Muñoz-Almagro C. Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique. PLoS One 2017; 12:e0184762. [PMID: 28910402 PMCID: PMC5599037 DOI: 10.1371/journal.pone.0184762] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-chain reaction in nasopharyngeal samples to diagnose invasive pneumococcal disease in children. METHODS Matched case-control study of patients <5 years of age with invasive pneumococcal disease admitted to the Manhiça District Hospital (Mozambique) and asymptomatic controls recruited in different periods between 2006 and 2014. Cases were confirmed by a positive bacterial culture for S. pneumoniae in blood or cerebrospinal fluid. Nasopharyngeal aspirates were collected from cases and controls and pneumococcal density was quantified by lytA real-time polymerase-chain reaction. RESULTS Thirty cases (median age 12.8 months) and sixty controls (median age 11.7 months) were enrolled and 70% of them were male. Nasopharyngeal pneumococcal carriage was high in both groups: 28/30 (93.3%) for cases vs. 53/60 (88.3%) for controls (p = 0.71). Mean nasopharyngeal pneumococcal load was identified as a marker for invasive pneumococcal disease (7.0 log10 copies/mL in cases vs. 5.8 log10 copies/mL in controls, p<0.001) and showed good discriminatory power (AUC-ROC: 82.1%, 95% CI 72.5%-91.8%). A colonization density of 6.5 log10 copies/mL was determined as the optimal cut-off value to distinguish cases from controls (sensitivity 75.0%, specificity 73.6%). CONCLUSION Use of non-invasive nasopharyngeal aspirates coupled with rapid and accurate quantification of pneumococcal load by real-time polymerase chain reaction has the potential to become a useful surrogate marker for early diagnosis of invasive pneumococcal disease in children.
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Affiliation(s)
- Pedro Brotons
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Quique Bassat
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
- Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Miguel Lanaspa
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
| | - Desiree Henares
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
| | - Amaresh Perez-Arguello
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
| | - Lola Madrid
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
| | | | | | - Maria Andres-Franch
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Angeles Marcos
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Ana Valero-Rello
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
- * E-mail:
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Calvo C, Aguado I, García-García ML, Ruiz-Chercoles E, Díaz-Martinez E, Albañil RM, Campelo O, Olivas A, Muñóz-Gonzalez L, Pozo F, Fernandez-Arroyo R, Fernandez-Rincón A, Calderon A, Casas I. Respiratory viral infections in a cohort of children during the first year of life and their role in the development of wheezing. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017; 87:104-110. [PMID: 32289042 PMCID: PMC7146761 DOI: 10.1016/j.anpede.2016.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Cristina Calvo
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, Spain
- Corresponding author.
| | - Isabel Aguado
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, Spain
| | | | | | | | | | - Olga Campelo
- Centro de Salud Leganés Norte, Leganés, Madrid, Spain
| | | | | | - Francisco Pozo
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Ana Calderon
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Casas
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
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García-García ML, Calvo C, Moreira A, Cañas JA, Pozo F, Sastre B, Quevedo S, Casas I, Del Pozo V. Thymic stromal lymphopoietin, IL-33, and periostin in hospitalized infants with viral bronchiolitis. Medicine (Baltimore) 2017; 96:e6787. [PMID: 28471975 PMCID: PMC5419921 DOI: 10.1097/md.0000000000006787] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Much attention has recently been focused on thymic stromal lymphopoietin (TSLP), IL-33, and periostin in allergic disease, but less is known about their role in viral bronchiolitis.The aim of the study was to investigate whether infants exhibit enhanced nasal airway secretion of TSLP, IL-33, and periostin during natural respiratory viral bronchiolitis compared to healthy controls.In total, 213 infants < 2 years of age, hospitalized with bronchiolitis from October/2013 to April/2016 were enrolled alongside 45 healthy infants. Nasopharyngeal aspirates (NPA) were screened for respiratory viruses by the polymerase chain reaction. TSLP, IL-33, and periostin were measured in NPAs. Clinical data were recorded.At least 1 virus was detected in 186 (87.3%) hospitalized infants: 149 (70%) respiratory syncytial virus (RSV); 42 (19.7%) rhinovirus (HRV); 16 (7.5%) parainfluenza virus (PIV); 9 (4.2%) adenovirus; 10 (4.7%) bocavirus; and 7 (3.3%) metapneumovirus (hMPV). Infants with bronchiolitis had higher levels of TSLP (P = .02), IL-33 (P<.001), and periostin (P = .003) than healthy controls.Detectable levels of TSLP and periostin were more frequent in virus-positive than in virus-negative patients (P = .05). TSLP and IL-33 were also more common in coinfections, mainly RSV and HRV, than in single-infections (P < .05). No patient with bronchiolitis but with negative viral detection had detectable levels of nasal TSLP or IL-33. Infants with hospital stay ≥5 days were more likely to have detectable levels of nasal TSLP and periostin after adjusting by age (P = .01).Bronchiolitis by common respiratory viruses is associated with elevated nasal levels of TSLP, IL-33, and periostin, factors known to be important in the development of Th2-response. Respiratory viruses in early life might shift immune responses toward Th2, involving asthma, and allergic diseases.
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Affiliation(s)
- María Luz García-García
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Cristina Calvo
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
- TEDDY Network (European Network of Excellence for Pediatric Clinical Research)
| | - Ana Moreira
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
| | - José Antonio Cañas
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Beatriz Sastre
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
| | - Sergio Quevedo
- Pediatrics Department, Severo Ochoa Hospital, Leganés, Alfonso X El Sabio University
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Victoria Del Pozo
- Department of Immunology, IIS-Fundación Jiménez Díaz
- CIBER de Enfermedades Respiratorias (CIBERES)
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Human metapnuemovirus infections in hospitalized children and comparison with other respiratory viruses. 2005-2014 prospective study. PLoS One 2017; 12:e0173504. [PMID: 28301570 PMCID: PMC5354294 DOI: 10.1371/journal.pone.0173504] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 02/21/2017] [Indexed: 11/20/2022] Open
Abstract
Background Human metapneumovirus (HMPV) has an important etiological role in acute lower respiratory infections in children under five years. Our objectives were to estimate the relative contribution of HMPV to hospitalization in children with acute respiratory infection, to define the clinical and epidemiological features of HMPV single and multiple infections, and to compare HMPV infections with respiratory syncytial virus (HRSV), rhinovirus (HRV), adenovirus and human bocavirus infections in the same population. Methods and findings A prospective study performed on all children less than 14 years of age with a respiratory tract disease admitted to a secondary hospital between September 2005- June 2014. Clinical characteristics of patients were analyzed. Nasopharyngeal aspirate was taken at admission for viral study with polymerase chain reaction for 16 respiratory viruses. A total of 3,906 children were included. At least one respiratory virus was detected in 75.2% of them. The most common identified virus was HRSV, followed by HRV. HMPV was detected in 214 cases (5.5%); 133 (62%) were single infections and the remaining were detected in coinfection with other viruses. 90.7% cases were detected between February and May. Children’s mean age was 13.83 ± 18 months. Fever was frequent (69%), and bronchiolitis (27%), and recurrent wheezing (63%) were the main clinical diagnosis. Hypoxia was present in 65% of the patients and 47% of them had an infiltrate in X-ray. Only 6 (2.8%) children were admitted to the intensive care unit. Only the duration of the hospitalization was different, being longer in the coinfections group (p <0.05). There were many differences in seasonality and clinical characteristics between HMPV and other respiratory viruses being more similar to HRSV. Conclusions HMPV infections accounted for 5.5% of total viral infections in hospitalized children. The clinical characteristics were similar to HRSV infections, but seasonality and clinical data were different from other viral infections.
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Viral Agents Causing Acute Respiratory Infections in Children under Five: A Study from Eastern India. Int J Pediatr 2016; 2016:7235482. [PMID: 28018433 PMCID: PMC5149672 DOI: 10.1155/2016/7235482] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/29/2016] [Accepted: 10/30/2016] [Indexed: 02/06/2023] Open
Abstract
Background. Acute respiratory infections (ARIs) are important cause of mortality and morbidity in children under five in developing country. Methods. This observational study was conducted over two-year period in a tertiary care teaching hospital of Eastern India. Nasal and throat swabs were collected, transported to the laboratory at 2-8°C in viral transport media, and then processed for detection of viruses using mono/multiplex real-time polymerase chain reaction. Results. A total of 300 children aged 2-60 months with ARIs were included. The most common age group affected with LRI was 2-12 mo and with URI was >12-60 mo. Viruses were detected in 248 cases. In URI, 77 were positive for single virus and 19 were positive for more than one virus; in LRI, 113 were positive for single virus and 12 were positive for more than one virus. The most common viruses isolated from URI cases were rhinovirus and adenovirus. The most common viruses isolated from LRI cases were respiratory syncytial virus and influenza virus. Most cases occurred in the months of January, December, and August. Conclusion. Viruses constitute a significant cause of ARI in children under five. RSV, ADV, RV, and IFV were the most prevalent viruses isolated.
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Calvo C, Aguado I, García-García ML, Ruiz-Chercoles E, Díaz-Martinez E, Albañil RM, Campelo O, Olivas A, Muñóz-Gonzalez L, Pozo F, Fernandez-Arroyo R, Fernandez-Rincón A, Calderon A, Casas I. [Respiratory viral infections in a cohort of children during the first year of life and their role in the development of wheezing]. An Pediatr (Barc) 2016; 87:104-110. [PMID: 27743968 PMCID: PMC7185499 DOI: 10.1016/j.anpedi.2016.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/21/2016] [Accepted: 08/02/2016] [Indexed: 11/05/2022] Open
Abstract
Introducción Las infecciones respiratorias virales que requieren hospitalización parecen conferir riesgo de desarrollar sibilancias recurrentes, pero existen pocos datos publicados en poblaciones no seleccionadas por tener factores de riesgo. Nuestro objetivo principal fue analizar si las infecciones respiratorias virales sintomáticas y asintomáticas, de diferente gravedad, durante el primer año de vida en una cohorte de recién nacidos, suponen un mayor riesgo de sibilancias recurrentes. Pacientes y métodos Se incluyeron 302 recién nacidos. Se recogió aspirado nasofaríngeo a los niños cuando presentaron una infección respiratoria y de forma periódica en los controles de salud (2, 4, 6 y 12 meses). Se estudiaron 16 virus respiratorios mediante reacción en cadena de polimerasa (PCR). Resultados Se analizaron 1.293 muestras (1.005 controles de salud y 288 infecciones respiratorias). El 30,8% de las muestras tomadas en los controles de salud fueron positivas, frente a un 77,8% en las infecciones respiratorias, p < 0,001 (OR: 3, IC 95%: 2,4-3,8). Un total de 239 (79%) lactantes tuvieron al menos una detección viral positiva durante el primer año de vida. El virus más frecuentemente identificado (71%) fue el rinovirus (RV). En 27 lactantes (11%) se detectaron sibilancias recurrentes durante su primer año de vida (2,9 DE: 1,2 episodios). El 58,3% de los lactantes cuya primera infección respiratoria requirió hospitalización desarrollaron sibilancias de repetición, frente al 8,6% de los niños cuya primera infección fue leve o asintomática, p < 0,001 (OR: 2,18; lC 95%: 1,05-4,5). Conclusiones En nuestra serie, las infecciones respiratorias virales graves en los primeros meses de vida supusieron un factor de riesgo para desarrollar sibilancias recurrentes. No ocurrió lo mismo con las infecciones respiratorias leves.
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Affiliation(s)
- Cristina Calvo
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, España.
| | - Isabel Aguado
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, España
| | | | | | | | | | - Olga Campelo
- Centro de Salud Leganés Norte, Leganés, Madrid, España
| | | | | | - Francisco Pozo
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España
| | | | | | - Ana Calderon
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España
| | - Inmaculada Casas
- Laboratorio de Gripe y Virus Respiratorios, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, España
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Calderón A, Pozo F, Calvo C, García-García M, González-Esguevillas M, Molinero M, Casas I. Genetic variability of respiratory syncytial virus A in hospitalized children in the last five consecutive winter seasons in Central Spain. J Med Virol 2016; 89:767-774. [PMID: 27696460 DOI: 10.1002/jmv.24703] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 12/18/2022]
Abstract
Human respiratory syncytial virus group A (RSV-A) was detected in symptomatic hospital attended children in Central Spain for a continuous time period, September 2010 to April 2015. In order to accurately describe the epidemiology of this virus, the genetic diversity of the complete G gene and the clinical manifestations observed were jointly analyzed. Out of 3,011 respiratory specimens taken from 2,308 children, 640 were positive to RSV (21.3%) and 405 were RSV-A (63.2%). Complete G gene sequences of 166 randomly selected RSV-A virus identified NA1 and ON1 genotypes. In 2011-2012, ON1 emerged sporadically and become dominant in 2012-2013 with 38 cases (70%). In 2014-2015, all the 44 sequences contained the 72-nt duplication (100%). Clinical diagnosis of children with ON1 genotype were bronchiolitis in 55 (62.5%), recurrent wheezing or asthma exacerbations in 22 (25%), laryngotracheobronchitis in 3 (3.4%), and upper respiratory tract infections in eight. Results showed replacement and substitution of circulating NA1 genotype with the new ON1 genotype. Nevertheless, at this stage, none of the RSV-A genotypes identified have resulted in significant clinical differences. The amino acid composition of the complete G gene ON1 sequences demonstrated an accumulation of single changes not related with different clinical presentation. J. Med. Virol. 89:767-774, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ana Calderón
- Respiratory Virus and Influenza Unit, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Mónica González-Esguevillas
- Respiratory Virus and Influenza Unit, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Molinero
- Respiratory Virus and Influenza Unit, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
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del Rosal T, García-García M, Calvo C, Gozalo F, Pozo F, Casas I. Recurrent wheezing and asthma after bocavirus bronchiolitis. Allergol Immunopathol (Madr) 2016; 44:410-4. [PMID: 26657170 DOI: 10.1016/j.aller.2015.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/20/2015] [Accepted: 07/07/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human bocavirus (HBoV) was recently discovered and identified as an important cause of respiratory infection in young children. However, the relationship between HBoV-bronchiolitis and the development of recurrent wheezing has not yet been established. OBJECTIVE We designed this study in order to describe the mid-term outcome, regarding the development of recurrent wheezing and asthma of HBoV-bronchiolitis patients and to compare it with RSV-bronchiolitis infants. METHODS We studied 80 children (10 with HBoV and 70 with RSV infection), currently aged ≥4 years and previously hospitalised during the seasons 2004-2009 due to acute bronchiolitis. Epidemiological and clinical data were collected through structured clinical interviews at the follow-up visit. Spirometry and skin prick tests to common food and inhaled allergens were performed. RESULTS All HBoV-patients developed recurrent wheezing and half of them had asthma at age 5-7 years. Almost 30% required hospital admission for recurrent wheezing. Asthma (odds ratio (OR)=1.28) and current asthma (OR=2.18) were significantly more frequent in children with HBoV-bronchiolitis than in RSV-bronchiolitis. FEV1 values were 99.2±4.8 in HBoV-group vs. 103±11 in RSV-group, p: 0.09. No differences were found with respect to allergic rhinitis, atopic dermatitis, food allergy, proportion of positive prick tests, and family history of atopy or asthma. CONCLUSIONS Severe HBoV-bronchiolitis in infancy was strongly associated with asthma at 5-7 years.
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Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.36953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Calvo C, García-García ML, Pozo F, Carballo D, Martínez-Monteserín E, Casas I. Infections and coinfections by respiratory human bocavirus during eight seasons in hospitalized children. J Med Virol 2016; 88:2052-2058. [PMID: 27124519 PMCID: PMC7166349 DOI: 10.1002/jmv.24562] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 12/26/2022]
Abstract
The human bocavirus (hBoV) has been identified in respiratory infections in children in a large number of studies. Despite this, the pathogenic role of the HBoV is under discussion. The main objectives of the study were: to determine the incidence of HBoV in hospitalized children; to describe the main clinical features of the positive children; and to compare the data with those from other viral infections in the same population. A prospective study was performed between 2005 and 2013 including children up to 14‐year old with respiratory infection admitted to the Severo Ochoa Hospital (Spain). Nasopharyngeal aspirates were taken from 3,275 patients and were tested for HBoV and other 15 respiratory viruses by RT‐nested PCR. HBoV was detected in 319 patients (9.9%); 80 cases as a single pathogen, and 239 cases (75%) as coinfections with other viruses. The HBoV was the fourth most common virus detected, behind respiratory syncytial virus (39.8%), rhinovirus (30.6%), and adenovirus (15%). The most common clinical diagnosis, in cases that HBoV was detected as a single pathogen was asthma exacerbation followed by pneumonia. A seasonal distribution was shown, with higher positivity rates in December and January. Children affected by HBoV were older than children infected by other viruses. Differences in terms of clinical diagnosis were found, bronchiolitis diagnosis was lower compared with the other viruses, and HBoV was associated with diagnosis of pneumonia, with increased use of antibiotics (41.8%), and radiographic infiltrates (47%). These findings could suggest a pathogenic role of HBoV in respiratory infections in children under 14 years of age. J. Med. Virol. 88:2052–2058, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Cristina Calvo
- Department of Pediatrics, Severo Ochoa Hospital, Leganés, Madrid, Spain. .,University Alfonso X el Sabio, Madrid, Spain.
| | - María Luz García-García
- Department of Pediatrics, Severo Ochoa Hospital, Leganés, Madrid, Spain.,University Alfonso X el Sabio, Madrid, Spain
| | - Francisco Pozo
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
| | | | | | - Inmaculada Casas
- Respiratory Virus and Influenza Unit, National Microbiology Center (ISCIII), Madrid, Spain
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Association between secondary thrombocytosis and viral respiratory tract infections in children. Sci Rep 2016; 6:22964. [PMID: 26965460 PMCID: PMC4786797 DOI: 10.1038/srep22964] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/19/2016] [Indexed: 01/07/2023] Open
Abstract
Secondary thrombocytosis (ST) is frequently observed in children with a variety of clinical conditions. The leading cause of ST is respiratory tract infection (RTI) in children. Nasopharyngeal aspirate samples were collected and assessed for common respiratory viruses. The relationships between virus infections and secondary thrombocytosis were analyzed retrospectively. The blood platelet count and the presence of respiratory viruses were determined for 3156 RTI patients, and 817 (25.9%) cases with platelet ≥500 × 10(9)/L were considered as the thrombocytosis group. Compared with the normal group, the detection rates of respiratory syncytial virus (RSV) and human rhinovirus (HRV) were significantly higher in the thrombocytosis group (P = 0.017 and 0.042, respectively). HRV single infection was a risk factor associated with thrombocytosis [odds ratio (OR) = 1.560, 95% confidence interval (CI) = 1.108-2.197]. Furthermore, ST was more likely to occur in younger patients who had clinical manifestations of wheezing and dyspnea and who had been diagnosed with bronchiolitis. Furthermore, the course of disease lasted longer in these patients. ST is associated with viral respiratory tract infections, especially RSV and HRV infections. HRV single infection is a risk factor associated with thrombocytosis.
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Antón A, Marcos MA, Torner N, Isanta R, Camps M, Martínez A, Domínguez A, Jané M, Jiménez de Anta MT, Pumarola T. Virological surveillance of influenza and other respiratory viruses during six consecutive seasons from 2006 to 2012 in Catalonia, Spain. Clin Microbiol Infect 2016; 22:564.e1-9. [PMID: 26939538 PMCID: PMC7172104 DOI: 10.1016/j.cmi.2016.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/10/2016] [Accepted: 02/11/2016] [Indexed: 01/20/2023]
Abstract
Most attention is given to seasonal influenza and respiratory syncytial virus outbreaks, but the cumulative burden caused by other respiratory viruses (RV) is not widely considered. The aim of the present study is to describe the circulation of RV in the general population during six consecutive seasons from 2006 to 2012 in Catalonia, Spain. Cell culture, immunofluorescence and PCR-based assays were used for the RV laboratory-confirmation and influenza subtyping. Phylogenetic and molecular characterizations of viral haemagglutinin, partial neuraminidase and matrix 2 proteins were performed from a representative sampling of influenza viruses. A total of 6315 nasopharyngeal samples were collected, of which 64% were laboratory-confirmed, mainly as influenza A viruses and rhinoviruses. Results show the significant burden of viral aetiological agents in acute respiratory infection, particularly in the youngest cases. The study of influenza strains reveals their continuous evolution through either progressive mutations or by segment reassortments. Moreover, the predominant influenza B lineage was different from that included in the recommended vaccine in half of the studied seasons, supporting the formulation and use of a quadrivalent influenza vaccine. Regarding neuraminidase inhibitors resistance, with the exception of the 2007/08 H275Y seasonal A(H1N1) strains, no other circulating influenza strains carrying known resistance genetic markers were found. Moreover, all circulating A(H1N1)pdm09 and A(H3N2) strains finally became genetically resistant to adamantanes. A wide knowledge of the seasonality patterns of the RV in the general population is well-appreciated, but it is a challenge due to the unpredictable circulation of RV, highlighting the value of local and global RV surveillance.
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Affiliation(s)
- A Antón
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain.
| | - M A Marcos
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain
| | - N Torner
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain; Public Health Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - R Isanta
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain
| | - M Camps
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain
| | - A Martínez
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain; Public Health Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - A Domínguez
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain; Public Health Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - M Jané
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
| | - M T Jiménez de Anta
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain
| | - T Pumarola
- WHO National Influenza Centre, Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic Barcelona - ISGlobal - University of Barcelona, Barcelona, Spain
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Huang L, Zhou L, Chen J, Chen K, Liu Y, Chen X, Tang F. Acute effects of air pollution on influenza-like illness in Nanjing, China: A population-based study. CHEMOSPHERE 2016; 147:180-7. [PMID: 26766354 DOI: 10.1016/j.chemosphere.2015.12.082] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/21/2015] [Accepted: 12/22/2015] [Indexed: 05/19/2023]
Abstract
Influenza-like illness causes substantial morbidity and mortality. Air pollution has already been linked to many health issues, and increasing evidence in recent years supports an association between air pollution and respiratory infections. It is a pioneer study in China to quantify the effects of air pollution on influenza-like illness. This study used wavelet coherence analysis and generalized additive models to explore the potential association between air pollution (including particulate matter with aerodynamic diameter ≦2.5 μm (PM2.5), particulate matter with aerodynamic diameter ≦10 μm (PM10) and nitrogen dioxide (NO2)) and influenza-like illness (a total of 59860 cases) in Nanjing, China from January 1, 2013 to December 31, 2013. The average concentrations of PM2.5, PM10 and NO2 were 77.37 μg/m(3), 135.20 μg/m(3) and 55.80 μg/m(3). An interquartile range increase in PM2.5 concentration was associated with a 2.99% (95% confidence interval (CI): 1.64%, 4.36%) increase in daily influenza-like cases on the same day, while the corresponding increase in NO2 was associated with a 3.77% (95% CI: 2.01%, 5.56%) increase in daily cases. People aged 0-4 were proved to be significantly susceptible to PM10 and NO2; 5-14 ages were significantly susceptible to PM2.5 and PM10; and 15-24 ages were significantly susceptible to all the analyzed air pollutants. Air pollution effects tended to be null or negative for patients aged over 25, which might be due to the small number of influenza-like cases in this age group. This study can be useful for understanding the adverse health effects of air pollution and the cause of influenza-like illness.
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Affiliation(s)
- Lei Huang
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China
| | - Lian Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jin Chen
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China
| | - Kai Chen
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xiaodong Chen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
| | - Fenyang Tang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
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Cho HJ, Hong SW, Kim HJ, Kwak YS. Development of a Multiplex PCR Method to Detect Fungal Pathogens for Quarantine on Exported Cacti. THE PLANT PATHOLOGY JOURNAL 2016; 32:53-7. [PMID: 26889115 PMCID: PMC4755675 DOI: 10.5423/ppj.nt.09.2015.0184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 05/22/2023]
Abstract
Major diseases in grafted cacti have been reported and Fusarium oxysporum, Bipolaris cactivora, Phytophthora spp. and Collectotrichum spp. are known as causal pathogens. These pathogens can lead to plant death after infection. Therefore, some European countries have quarantined imported cacti that are infected with specific fungal pathogens. Consequently, we developed PCR detection methods to identify four quarantined fungal pathogens and reduce export rejection rates of Korean grafted cacti. The pathogen specific primer sets F.oF-F.oR, B.CF-B.CR, P.nF-P.nR, and P.cF-P.CR were tested for F. oxysporum, B. cactivora, P. nicotinae, and P. cactorum, respectively. The F.oF-F.oR primer set was designed from the Fusarium ITS region; the B.CF-B.CR and P.nF-P.nR primers respectively from Bipolaris and Phytophthora ITS1; and the P.cF-P.CR primer set from the Ypt1protein gene region. The quarantine fungal pathogen primer pairs were amplified to the specific number of base pairs in each of the following fungal pathogens: 210-bp (F. oxysporum), 510-bp (B. cactivora), 313-bp (P. nicotinae), and 447-bp (P. cactorum). The detection limit for the mono- and multiplex PCR primer sets was 0.1 ng of template DNA under in vitro conditions. Therefore, each primer set successfully diagnosed contamination of quarantine pathogens in export grafted cacti. Consequently, our methodology is a viable tool to screen contamination of the fungal pathogen in exported grafted cacti.
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Affiliation(s)
- Hyun ji Cho
- Division of Applied Life Science, Gyeongsang National University, Jinju 660-701,
Korea
| | - Seong Won Hong
- Department of Plant Medicine and Research Institute of Life Science, Gyeongsang National University, Jinju 660-701,
Korea
| | - Hyun-ju Kim
- Plant Quarantine Technology Center, Animal and Plant Quarantine Agency, Suwon 443-400,
Korea
| | - Youn-Sig Kwak
- Department of Plant Medicine and Research Institute of Life Science, Gyeongsang National University, Jinju 660-701,
Korea
- Corresponding author. Phone) +82-55-772-1922, FAX) +82-55-772-1929, E-mail)
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Abstract
BACKGROUND The incidence of enterovirus D68 (EV-D68) and the spectrum of clinical disease in children are not well known in European countries. We have designed a study with the objective of describing the clinical impact of EV-D68 detected in children with respiratory tract infections. METHODS As a part of a prospective study to identify the etiology and clinical characteristics of viral respiratory infections in children in Spain, we performed the analysis of the cases of EV infections in all children hospitalized in a secondary hospital in Madrid, during the epidemic respiratory season 2012-2013. A second group of samples was corresponded to infants of the same area, with ambulatory respiratory infection or asymptomatic. Phylogenetic EV-D68 analysis was made using the viral protein 1 gene (VP1). Clinical data of EV-D68 patients were compared with those infected by rhinovirus in the same period and population. RESULTS The study population consisted of 720 patients corresponding to 399 episodes of hospitalization for respiratory causes, 44 episodes of ambulatory respiratory infections and 277 children determined as a healthy control group. A total of 22 patients were positive for EVs (3.05%), and 12 of them were specifically typed as EV-D68 (11/443 respiratory infections, 2.5%). The most frequent diagnosis in the 10 hospitalized children with EV-D68 detection was recurrent wheezing. Hypoxia was present in 70% of cases, but admission in the intensive care unit was not required. No neurological signs or symptoms were observed. One patient had an ambulatory mild bronchiolitis and another was asymptomatic. No differences were found with rhinovirus infections except less duration of hypoxia and fever in EV-D68 group. CONCLUSIONS EV-D68 infections were detected in 3.05% of respiratory studied samples (2.5% of admissions). The infection was associated with wheezing episodes with hypoxia. No admissions to intensive care unit or neurological symptoms were found.
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Pavic-Espinoza I, Bendezú-Medina S, Herrera-Alzamora A, Weilg P, Pons MJ, Aguilar-Luis MA, Petrozzi-Helasvuo V, del Valle Mendoza J. High prevalence of Bordetella pertussis in children under 5 years old hospitalized with acute respiratory infections in Lima, Peru. BMC Infect Dis 2015; 15:554. [PMID: 26626910 PMCID: PMC4667485 DOI: 10.1186/s12879-015-1287-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/24/2015] [Indexed: 11/10/2022] Open
Abstract
Background Pertussis diagnosis may go unrecognized when other pathogens, such as respiratory syncytial virus (RSV) circulate. Methods A prospective cross-sectional study was conducted in Lima, Peru from January 2009 to September 2010. A total of 596 children under 5 years old admitted with clinical diagnoses of acute respiratory infections were test for B. pertussis and RSV detection by polymerase chain reaction (PCR). Results The pertussis toxin and IS481 genes were detected in 19.12 % (114/596) of the cases and the respiratory syncytial viruses (RSV-A and RSV-B) were identified in 17.28 % (103/596) of patients. Infants under 3 months old were the most frequently affected by this pathogens in 43 % (49/114) and 35.9 % (37/103) respectively. An increase of B. pertussis was observed from February to March and from October to November with a Seasonal index between 1.32 and 1.51 and 1.24–3.5 respectively. Conclusions Epidemiologic surveillance for B. pertussis is essential in Peru, especially in children that could most benefit from the vaccine. B. pertussis should be suspected in infants hospitalized for acute respiratory symptoms for early treatment and prevent complications.
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Affiliation(s)
- Ivana Pavic-Espinoza
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Sandy Bendezú-Medina
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Angella Herrera-Alzamora
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Pablo Weilg
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - María J Pons
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Miguel Angel Aguilar-Luis
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Verónica Petrozzi-Helasvuo
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
| | - Juana del Valle Mendoza
- Centro de Investigación de la Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC, Av. San Marcos cdra. 2. Cedros de Villa, Lima, Peru.
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Impact of Human Rhinovirus Types and Viral Load on the Severity of Illness in Hospitalized Children With Lower Respiratory Tract Infections. Pediatr Infect Dis J 2015; 34:1187-92. [PMID: 26267309 DOI: 10.1097/inf.0000000000000879] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human rhinovirus (HRV) is not only responsible for at least one-half of all common colds but also associated with bronchitis, bronchiolitis, pneumonia and acute asthma exacerbation. However, the impact of different HRV types and viral load on disease severity has not been thoroughly elucidated. METHODS From January 2012 to September 2014, 1742 nasopharyngeal aspirate specimens from hospitalized children with lower respiratory tract infections were analyzed by quantitative HRV-specific real-time polymerase chain reaction. RESULTS Among these 1742 children, HRV (407/1742, 23%) was the second most common viral agent after respiratory syncytial virus. HRV-A, HRV-B, HRV-C and HRV untyped were detected in 229 (56%), 27 (7%), 100 (25%) and 51 (13%) specimens, respectively. Children except who experienced wheezing were more common in the HRV-C detection group than in the HRV-A detection group; there were no other significant differences between the 2 groups, including the percent of children diagnosed with severe diseases. Logistic regression models demonstrated that there was no difference in disease severity among HRV types. In HRV-A detection group, in children younger than 2 years, the viral load was higher in the severe group than in the nonsevere group; but in the HRV-C detection group, there was no difference. CONCLUSIONS HRV was frequently present in hospitalized children with lower respiratory tract infections in Chongqing, China. The disease severity for HRV-C and HRV-A was similar. A high load of HRV-A in the lower respiratory tract might be connected with disease severity in children younger than 2 years.
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