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Sima CM, Buzilă ER, Trofin F, Păduraru D, Luncă C, Duhaniuc A, Dorneanu OS, Nastase EV. Emerging Strategies against Non-Typhoidal Salmonella: From Pathogenesis to Treatment. Curr Issues Mol Biol 2024; 46:7447-7472. [PMID: 39057083 PMCID: PMC11275306 DOI: 10.3390/cimb46070442] [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: 06/25/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Even with the intensive efforts by public health programs to control and prevent it, non-typhoidal Salmonella (NTS) infection remains an important public health challenge. It is responsible for approximately 150 million illnesses and 60,000 deaths worldwide annually. NTS infection poses significant risks with high rates of morbidity and mortality, leading to potential short- and long-term complications. There is growing concern among health authorities about the increasing incidence of antimicrobial resistance, with multidrug resistance totaling 22.6% in Europe, highlighting an urgent need for new therapeutic approaches. Our review aims to provide a comprehensive overview of NTS infection. We outline the molecular mechanisms involved in the pathogenesis of NTS infection, as well as the events leading to invasive NTS infection and the subsequent complications associated with it. Given the widespread implications of antimicrobial resistance, our review also presents the global landscape of resistance, including multidrug resistance, and delve into the underlying mechanisms driving this resistance. The rising rates of antibiotic resistance frequently lead to treatment failures, emphasizing the importance of investigating alternative therapeutic options. Therefore, in this review we also explore potential alternative therapies that could offer promising approaches to treating NTS infections.
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Affiliation(s)
- Cristina Mihaela Sima
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
| | - Elena Roxana Buzilă
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
- Iasi Regional Center for Public Health, National Institute of Public Health, 700465 Iasi, Romania
| | - Felicia Trofin
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
| | - Diana Păduraru
- “Dr. C.I. Parhon” Clinical Hospital, 700503 Iasi, Romania;
| | - Cătălina Luncă
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania
| | - Alexandru Duhaniuc
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
- Iasi Regional Center for Public Health, National Institute of Public Health, 700465 Iasi, Romania
| | - Olivia Simona Dorneanu
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.M.S.); (E.R.B.); (F.T.); (C.L.); (A.D.)
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
| | - Eduard Vasile Nastase
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
- Department of Internal Medicine II—Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Tao J, Cheng J, Shi Y, Li B, Tang P, Jiao J, Liu H. NLRX1 Mediates the Disruption of Intestinal Mucosal Function Caused by Porcine Astrovirus Infection via the Extracellular Regulated Protein Kinases/Myosin Light-Chain Kinase (ERK/MLCK) Pathway. Cells 2024; 13:913. [PMID: 38891045 PMCID: PMC11171766 DOI: 10.3390/cells13110913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
Porcine astrovirus (PAstV) has a potential zoonotic risk, with a high proportion of co-infection occurring with porcine epidemic diarrhea virus (PEDV) and other diarrheal pathogens. Despite its high prevalence, the cellular mechanism of PAstV pathogenesis is ill-defined. Previous proteomics analyses have revealed that the differentially expressed protein NOD-like receptor X1 (NLRX1) located in the mitochondria participates in several important antiviral signaling pathways in PAstV-4 infection, which are closely related to mitophagy. In this study, we confirmed that PAstV-4 infection significantly up-regulated NLRX1 and mitophagy in Caco-2 cells, while the silencing of NLRX1 or the treatment of mitophagy inhibitor 3-MA inhibited PAstV-4 replication. Additionally, PAstV-4 infection triggered the activation of the extracellular regulated protein kinases/ myosin light-chain kinase (ERK/MLCK) pathway, followed by the down-regulation of tight-junction proteins (occludin and ZO-1) as well as MUC-2 expression. The silencing of NLRX1 or the treatment of 3-MA inhibited myosin light-chain (MLC) phosphorylation and up-regulated occludin and ZO-1 proteins. Treatment of the ERK inhibitor PD98059 also inhibited MLC phosphorylation, while MLCK inhibitor ML-7 mitigated the down-regulation of mucosa-related protein expression induced by PAstV-4 infection. Yet, adding PD98059 or ML-7 did not affect NLRX1 expression. In summary, this study preliminarily explains that NLRX1 plays an important role in the disruption of intestinal mucosal function triggered by PAstV-4 infection via the ERK/MLC pathway. It will be helpful for further antiviral drug target screening and disease therapy.
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Affiliation(s)
- Jie Tao
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Jinghua Cheng
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Ying Shi
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Benqiang Li
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Pan Tang
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Jiajie Jiao
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
| | - Huili Liu
- Institute of Animal Husbandry and Veterinary Medicine, Shanghai Academy of Agricultural Sciences, Shanghai 201106, China; (J.T.); (J.C.); (Y.S.); (B.L.); (P.T.); (J.J.)
- Shanghai Key Laboratory of Agricultural Genetic Breeding, Shanghai 201106, China
- Shanghai Engineering Research Center of Pig Breeding, Shanghai 201302, China
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Martins E, Nascimento da Silva L, Carmo M. Probiotics, prebiotics, and synbiotics in childhood diarrhea. Braz J Med Biol Res 2024; 57:e13205. [PMID: 38656071 PMCID: PMC11027179 DOI: 10.1590/1414-431x2024e13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/08/2024] [Indexed: 04/26/2024] Open
Abstract
Acute diarrhea is the second leading cause of morbidity and mortality attributed to infections in children under five years of age worldwide, with 1.7 million annual estimated cases and more than 500,000 deaths. Although hydroelectrolytic replacement is the gold standard in treating diarrhea, it does not interfere with the restoration of the intestinal microbiota. Several studies have searched for an adequate alternative in restructuring intestinal homeostasis, finding that treatments based on probiotics, prebiotics, and synbiotics are effective, which made such treatments increasingly present in clinical practice by reducing illness duration with minimal side effects. However, there are still controversies regarding some unwanted reactions in patients. The diversity of strains and the peculiarities of the pathogens that cause diarrhea require further studies to develop effective protocols for prevention and treatment. Here, we provide a descriptive review of childhood diarrhea, emphasizing treatment with probiotics, prebiotics, and synbiotics.
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Affiliation(s)
- E.M.S. Martins
- Laboratório de Patogenicidade Microbiana, Universidade Ceuma, São Luís, MA, Brasil
| | | | - M.S. Carmo
- Laboratório de Patogenicidade Microbiana, Universidade Ceuma, São Luís, MA, Brasil
- Centro Universitário Dom Bosco, São Luís, MA, Brasil
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Chen MH, Deng SH, Wang MH, Yan XK. Clinical characteristics and influencing factors of infectious diarrhea in preschool children: An observational study. Medicine (Baltimore) 2023; 102:e33645. [PMID: 37115049 PMCID: PMC10145719 DOI: 10.1097/md.0000000000033645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Infectious diarrhea is a common disease in preschool children, but the pathogenic species, origins, and influencing factors remain debatable. Therefore, more studies are required to solve these debatable topics. A number of 260 eligible preschool children diagnosed with infectious diarrhea in our hospital were enrolled in the infection group. Meanwhile, a number of 260 matched healthy children from the health center were enrolled in the control group. The pathogenic species and origins, the time of onset of infectious diarrhea in the infection group, demographic data, exposure history, hygiene habits, dietary habits, and other variables in both groups were initially collected from medical documents. In addition, a questionnaire was used to complete and confirm study variables through face-to-face or telephone interviews. Then, the univariate and multivariate regression analyses were used to screen the influencing factors of infectious diarrhea. Among 260 infected children, salmonella (15.77%), rotavirus (13.85%), shigella (11.54%), vibrio (10.38%), and norovirus (8.85%) were the top 5 common pathogens; January (13.85%), December (12.69%), August (12.31%), February (11.92%), and July (8.46%) were the top 5 frequent times of infectious diarrhea. The distribution of onset time for infectious diarrhea was commonly found in winter and summer, and the pathogens always originated from foods. The results of multivariate regression analysis showed that recent exposure to diarrhea, flies, and/or cockroaches indoors were the 2 risk factors for infectious diarrhea; Meanwhile, rotavirus vaccination, regular hand-washing, tableware disinfection, separate preparation of cooked and raw foods, and regular intake of lactobacillus products were the 5 protective factors for infectious diarrhea in preschool children. Infectious diarrhea has a diversity of pathogenic species, origins, and influencing factors in preschool children. Activities focusing on these influencing factors such as rotavirus vaccination, consumption of lactobacillus products, and other conventional factors would be beneficial to preschool children's health.
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Affiliation(s)
- Mu-Heng Chen
- Department of Pediatrics, The Fenghua People’s Hospital, Ningbo City, Zhejiang Province, China
| | - Su-Han Deng
- Department of Pediatrics, The Fenghua People’s Hospital, Ningbo City, Zhejiang Province, China
| | - Ming-Huan Wang
- Department of Pediatrics, The Ningbo Women and Children’s Hospital, Ningbo City, Zhejiang Province, China
| | - Xu-Ke Yan
- Department of Pediatrics, The Fenghua People’s Hospital, Ningbo City, Zhejiang Province, China
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Choudhury J, Makkar A, Sharma V, Karamath SP, Parmar V, Kumar J P, Veligandla KC, Pinto CS, Mane A, Rathod R, Kotak BP. A Real-World Perspective of Co-amoxiclav Prescription Pattern With Probiotics for Pediatric Patients With Respiratory Tract Infections: Results of Quantitative and Qualitative Approach in Indian Outpatient Settings. Cureus 2023; 15:e36269. [PMID: 37073213 PMCID: PMC10105827 DOI: 10.7759/cureus.36269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Probiotics are co-prescribed with co-amoxiclav to prevent antibiotic-associated diarrhea (AAD). The study assesses the co-prescription pattern of probiotics with co-amoxiclav in pediatric patients with respiratory tract infections (RTIs). METHODS This was a mixed methods research study with a retrospective study and a prospective survey. The retrospective part included a multicenter, observational, real-world study utilizing patients' electronic medical records for three years (2018-2020) from seven outpatient pediatric clinics and hospitals. The qualitative evaluation was performed with a predefined questionnaire. RESULTS The patients having RTIs (N=984) were prescribed Clamp® (46.7%), CAA (23.8%), and CAM (29.5%). The mean age of the patients was 4.05 years, with 59.25% males and most patients having upper RTIs. Co-amoxiclav was prescribed twice daily for one to 15 days. A significantly lesser number of probiotic co-prescriptions were observed with Clamp® (19.57%) than with CAA (38.46%) and CAM (29.31%) at baseline (p<0.001). Similar findings were observed for follow-up visits one and two. Saccharomyces boulardii, Bacillus clausii,and lactic acid bacillus were the most commonly co-prescribed probiotics. The qualitative evaluation indicated that most clinicians were aware of the co-amoxiclav-related gastrointestinal side effects and the benefits of probiotics in preventing them. CONCLUSION The frequency of co-prescriptions of probiotics with Clamp® among pediatric patients with RTIs was significantly less, potentially indicating better gastrointestinal tolerability.
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Khaliq A, Holmes-Stahlman R, Ali D, Karatela S, Lassi ZS. Assessment of Determinants of Paediatric Diarrhoea Case Management Adherence in Pakistan. Life (Basel) 2023; 13:life13030677. [PMID: 36983833 PMCID: PMC10053143 DOI: 10.3390/life13030677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Worldwide, diarrhoea in children under five years of age is the second leading cause of death. Despite having high morbidity and mortality, diarrhoeal diseases can be averted by simple and cost-effective interventions. The Integrated Management of Childhood Illness (IMCI) has proposed the use of Oral Rehydration Salt (ORS) and zinc together with adequate food and fluid intake for the management of acute non-dysenteric watery diarrhoea in children. In the past, few studies examined the determinants of adherence to diarrhoea case management. Therefore, this study measured the determinants of therapeutic and dietary adherence to diarrhoea case management using the third and fourth wave of Pakistan Demographics and Health Surveys (PDHS) datasets. Data from 4068 children between 0 to 59.9 months with positive history of diarrhoea were included, while data on children with dysentery, severe dehydration, and co-morbid condition was excluded. This study reported therapeutic adherence in less than 10% of children in Pakistan, while dietary adherence was reported in 39.2% of children (37.7% in 2012–2013 and 40.7% in 2017–2018). A significant improvement in therapeutic (0.8% in 2012–2013 and 8.1% in 2017–2018) and dietary adherence (37.7% in 2012–2013 and 40.7% in 2017–2018) was reported in the 2017–2018 survey compared to the 2012–2013 survey. In general, children over the age of one year (compared to children <1 year) and of the richer/richest socioeconomic class (compared to poorest/poorer socioeconomic class) showed higher therapeutic and dietary adherence. Therapeutic and dietary adherence among diarrhoeal children can be improved by increasing the awareness and accessibility of ORS, zinc, and essential foods.
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Affiliation(s)
- Asif Khaliq
- School of Public Health & Social Work, Queensland University of Technology, Brisbane 4059, Australia
- Correspondence: ; Tel.: +61-0497404389
| | - River Holmes-Stahlman
- School of Biomedical Sciences, Queensland University of Technology, Brisbane 4059, Australia
| | - Danish Ali
- Department of Orthodontics, Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | - Shamshad Karatela
- School of Pharmacy, University of Queensland, Brisbane 4072, Australia
- Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville 4811, Australia
| | - Zohra S. Lassi
- Robinson Research Institute, The University of Adelaide, Adelaide 5005, Australia
- School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide 5005, Australia
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Bogari MH, Munshi A, Almuntashiri S, Bogari A, Abdullah AS, Albadri M, Hashim A, AlZahrani MS. Acute gastroenteritis-related acute kidney injury in a tertiary care center. Ann Saudi Med 2023; 43:82-89. [PMID: 37031372 PMCID: PMC10082947 DOI: 10.5144/0256-4947.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2023] Open
Abstract
BACKGROUND Acute gastroenteritis (AGE) can cause acute kidney injury (AKI) via hypoperfusion mechanisms. Early detection of AKI caused by AGE can significantly decrease mortality rates. In Saudi Arabia, studies investigating the association between AGE and AKI are limited; thus, we aimed to fill this knowledge gap. OBJECTIVES Analyze all cases of AGE reported in tertiary-care hospitals to assess the prevalence of AKI among AGE patients. DESIGN Retrospective cohort SETTINGS: Single tertiary-care center PATIENTS AND METHODS: The study included patients treated for AGE between October 2017 and October 2022. Stool culture was used to diagnose AGE. Inclusion criteria were infective diarrhea and/ or vomiting, and availability of data (demographics, comorbidities, malignancies, length of hospital stay, vital signs at the time of diagnosis, dehydration, causative agents of diarrhea, hemodialysis status, and laboratory data. MAIN OUTCOME MEASURES Prevalence of AKI among AGE patients and factors associated with development of AKI. SAMPLE SIZE 300 patients diagnosed with AGE. RESULTS Of the 300 patients with AGE, 41 (13.6%) had AKI, those older than 60 years were more likely to develop AKI. The most frequent cause of AGE was Salmonella spp. (n=163, 53.3%), whereas AKI was most common in Clostridium difficile AGE patients (n=21, 51.2%). Furthermore, the most common comorbidity in the present study was malignancy, especially leukemia and lymphoma the risk of AKI was independently associated with mild dehydration, higher serum urea concentrations and low GFR values. CONCLUSIONS Patients hospitalized for diarrheal disease are at an increased risk of developing AKI due to dehydration and comorbid conditions. It is crucial to keep kidney function in mind for AGE patients as this is associated with a high mortality rate and poor prognosis. LIMITATIONS The main limitation of this study was its retrospective design. Another limitation is that it is limited to a single center. CONFLICTS OF INTEREST None.
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Affiliation(s)
- Mohammed Hisham Bogari
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Adeeb Munshi
- From the Department of Infectious Diseases, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Saleh Almuntashiri
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Asim Bogari
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah Shaker Abdullah
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammed Albadri
- From the College of Medicine, King Saud Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ameer Hashim
- From the Department of Internal Medicine, Makkah Al-Mukarramah Region General Directorate of Health Affairs, Makkah, Saudi Arabia
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Sánchez X, Calderón N, Solis O, Jimbo-Sotomayor R. Antibiotic Prescription Patterns in Children Under 5 Years of Age With Acute Diarrhea in Quito-Ecuador. J Prim Care Community Health 2023; 14:21501319231196110. [PMID: 37646173 PMCID: PMC10467298 DOI: 10.1177/21501319231196110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Diarrheal disease remains a significant cause of child mortality, particularly in regions with limited access to healthcare and sanitation. Inappropriate practices, including unjustified medication prescriptions, pose challenges in the management of acute diarrhea (AD), especially in low- and middle-income countries. OBJECTIVE This study analyzed antibiotic prescription patterns and assessed compliance with Integrated Management of Childhood Illness (IMCI) guidelines in children under 5 with AD in the Ministry of Public Health (MOPH) Ambulatory Care Centers of Quito city, Ecuador. METHODS A cross-sectional design was used, collecting electronic health records (EHR) of patients diagnosed with AD from 21 health facilities in District 17D03. A probabilistic and stratified sampling approach was applied. Patient characteristics, prescriber characteristics, treatments, and compliance of IMCI guideline recommendations were evaluated. A stepwise logistic regression analysis examined the association between antibiotic prescription and patient and physician characteristics. RESULTS A total of 359 children under 5 years of age were included, with 58.77% being girls. 85.24% of the cases of AD were attributed to gastroenteritis and colitis of infectious and unspecified origin. Amebiasis and other protozoal intestinal diseases accounted for 13.37% and 1.11% of the cases, respectively. The completion rates of recording various IMCI parameters varied; parameters such as duration of diarrhea, presence of blood in stool, and evidence of sunken eyes had high completion rates (100%, 100%, and 87.47%, respectively), while parameters like state of consciousness, presence of thirst, and type of diarrhea had low completion rates (0.28%, 0.28%, and 0.84%, respectively). None of the cases had all parameters fully recorded. Antimicrobials were prescribed in 38.72% of the cases. Children aged 3 to 5 years had higher odds of receiving antimicrobial prescription for AD (aOR: 4.42, 95% CI 2.13-9.18, P < .0001) compared to those under 1 year, after adjusting for the number of loose stools per day, gender, and age of the health professional. CONCLUSION Variations in IMCI guideline compliance were observed, with no cases fully adhering to the guidelines. Antimicrobial prescription rates were notably high, especially among older children. Further research and specialized interventions are necessary to gain comprehensive insight into the factors underlying non-compliance with the IMCI guidelines.
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Affiliation(s)
- Xavier Sánchez
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
- Community and Primary Care Research Group - Ecuador (CPCRG-E), Quito, Ecuador
| | - Nathali Calderón
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | - Olga Solis
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | - Ruth Jimbo-Sotomayor
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
- Community and Primary Care Research Group - Ecuador (CPCRG-E), Quito, Ecuador
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Zhang B, Wei X, Ding M, Luo Z, Tan X, Zheng Z. Daidzein Protects Caco-2 Cells against Lipopolysaccharide-Induced Intestinal Epithelial Barrier Injury by Suppressing PI3K/AKT and P38 Pathways. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27248928. [PMID: 36558058 PMCID: PMC9781898 DOI: 10.3390/molecules27248928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
The intestinal epithelium provides an important barrier against bacterial endotoxin translocation, which can regulate the absorption of water and ions. The disruption of epithelial barrier function can result in water transport and tight junction damage, or further cause diarrhea. Therefore, reducing intestinal epithelial barrier injury plays an important role in diarrhea. Inflammatory response is an important cause of intestinal barrier defects. Daidzein improving the barrier integrity has been reported, but the effect on tight junction proteins and aquaporins is not well-described yet, and the underlying mechanism remains indistinct in the human intestinal epithelium. This study aimed to investigate the effects and mechanisms of daidzein on intestinal epithelial barrier injury induced by LPS, and a barrier injury model induced by LPS was established with human colorectal epithelial adenocarcinoma cell line Caco-2 cells. We found that daidzein protected the integrity of Caco-2 cell monolayers, reversed LPS-induced downregulation of ZO-1, occludin, claudin-1, and AQP3 expression, maintained intercellular junction of ZO-1, and suppressed NF-κB and the expression of inflammatory factors (TNF-α, IL-6). Furthermore, we found that daidzein suppressed the phosphorylation of the PI3K/AKT and P38 pathway-related proteins and the level of the related genes, and the PI3K/AKT and P38 pathway inhibitors increased ZO-1, occludin, claudin-1, and AQP3 expression. The study showed that daidzein could resist LPS-induced intestinal epithelial barrier injury, and the mechanism is related to suppressing the PI3K/AKT and P38 pathways. Therefore, daidzein could be a candidate as a dietary supplementation or drug to prevent or cure diarrhea.
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Affiliation(s)
- Baoping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
- Guangzhou Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, China
| | - Xiaohan Wei
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
- Guangzhou Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, China
| | - Mengze Ding
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
- Guangzhou Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, China
| | - Zhenye Luo
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
- Guangzhou Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, China
| | - Xiaomei Tan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
- Guangzhou Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, China
- Correspondence: (X.T.); (Z.Z.)
| | - Zezhong Zheng
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
- Correspondence: (X.T.); (Z.Z.)
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Luo Z, Liu C, Hu Y, Xia T, Zhang B, Chen F, Tan X, Zheng Z. Gegen Qinlian decoction restores the intestinal barrier in bacterial diarrhea piglets by promoting Lactobacillus growth and inhibiting the TLR2/MyD88/NF-κB pathway. Biomed Pharmacother 2022; 155:113719. [PMID: 36152417 DOI: 10.1016/j.biopha.2022.113719] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Acute bacterial diarrhea is a severe global problem with a particularly high incidence rate in children. The microecology inhabiting the intestinal mucosa is the key factor leading to diarrhea. Gegen Qinlian decoction (GQD) is used to treat bacterial diarrhea, however, its underlying mechanism remains unclear. Thus, this study aimed to clarify the restorative effect of GQD on the intestinal barrier from the perspective of gut microbiota. A Tibetan piglet model with bacterial diarrhea was established through orally administered Escherichia coli, and diarrheal piglets were treated with GQD for three days. After treatment, GQD significantly ameliorated the diarrheal symptoms. GQD decreased the levels of IL-6, LPS, and DAO, and increased SIgA, ZO-1, and occludin levels in intestinal mucosa, indicating the restoration of intestinal barrier. GQD modulated the microbial compositions inhabited on the intestinal mucosa, especially an increase of the Lactobacillus. Spearman analysis showed that Lactobacillus was the key genus of intestinal barrier-related bacteria. Bacterial culture in vitro validated that GQD directly promoted Lactobacillus growth and inhibited E. coli proliferation. Moreover, the expressions of TLR2, MyD88, and NF-κB in the colon decreased after GQD treatment. In conclusion, GQD may treat diarrhea and restore the intestinal mucosal barrier by facilitating Lactobacillus growth and inhibiting the TLR2/MyD88/NF-κB signaling pathway.
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Affiliation(s)
- Zhenye Luo
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Changshun Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Yannan Hu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Ting Xia
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Baoping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Feilong Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Xiaomei Tan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, PR China; Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou 510515, PR China.
| | - Zezhong Zheng
- South China Agricultural University College of Veterinary Medicine, Guangzhou 510642, PR China.
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11
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Jiang M, Wang HM, Zhou GL, Chen YS, Deng JK. Invasive Salmonella Infections Among Children in Shenzhen, China: A Five-year Retrospective Review. Pediatr Infect Dis J 2022; 41:684-689. [PMID: 35622427 DOI: 10.1097/inf.0000000000003588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Invasive Salmonella infections are highly prevalent worldwide. Clinical data of childhood invasive Salmonella infections from China are limited. METHODS Data of hospitalized children <18 years old with invasive Salmonella infections from 2016 to 2020 in Shenzhen Children's Hospital in Shenzhen were retrospectively collected. Serotypes and antimicrobial susceptibility tests of the invasive Salmonella isolates were performed. RESULTS Sixty-three cases were enrolled during the 5-year study period including 8 in 2016, 11 in 2017, 16 in 2018, 6 in 2019 and 22 in 2020. The median age was 15 months (interquartile range, 11-22 months), and 79.4% (50 cases) were <2 years of age. Underlying diseases were found in 28.6% (18 cases) of the patients with a great variety, but no cases of malaria or HIV infection were identified. Most of the invasive Salmonella cases were bloodstream infections (84.1%), followed by osteoarthritis (11.1%) and meningitis (4.8%). Gastroenteritis (49.2%) and pneumonia (28.6%) were found to be the major manifestations among the patients. Furthermore, invasive Salmonella infections resulted in the death of 3 children (4.8%). Salmonella enteritis (12 cases; 15.9%) and Salmonella typhimurium (9 cases; 19.0%) as the most common serovars were identified. The resistance rates of Salmonella strains to ceftriaxone, ceftazidime and cefepime were also measured to be 17.5%, 17.5% and 9.5%, respectively. CONCLUSIONS An increasing number of childhood invasive Salmonella infections with a broad range of serotypes was observed in Shenzhen, China. It is critical to pay attention to the antimicrobial resistance of the isolates taken from children with invasive Salmonella infections.
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Affiliation(s)
| | | | - Guang-Lun Zhou
- Department of Urology and Laboratory of Pelvic Floor Muscle Function
| | - Yun-Sheng Chen
- Department of Clinical Laboratory, Shenzhen Children's Hospital, Shenzhen, China
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12
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Feng X, Zhuang L, Chen L, Zhao H, Huang R, Guo Z. Comparison of different probiotics in the treatment of acute diarrhea in children: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2022; 101:e28899. [PMID: 35356899 PMCID: PMC10684214 DOI: 10.1097/md.0000000000028899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Acute diarrhea has a serious impact on the health and lives of children. Previous studies have shown that probiotics have positive and reliable efficacy in the treatment of acute diarrhea in children, but the efficacy of different types of probiotics varies. This study will evaluate the clinical efficacy of different kinds of probiotics in the treatment of acute diarrhea in children by means of network meta-analysis. METHODS According to the retrieval strategy, randomized controlled studies on probiotics in the treatment of acute diarrhea in children will be searched from PubMed, Embase, Web of Science, the Cochrane Library, CNQI, Wanfang, VIP, and Chinese biomedical databases. The retrieval time limit will be from the establishment of the database to January 2022. The quality level of the included studies will be assessed using the Cochrane Risk Bias Assessment Tool and the strength of evidence for outcome measures will be assessed using the Grading of Recommendation Assessment, Development, and Evaluation method. All data analysis will be performed by Revman5.3, Gemtc 0.14.3 and Stata 14.0. RESULTS This study will evaluate the efficacy of different kinds of probiotics in the treatment of acute diarrhea in children by evaluating diarrhea duration, stool frequency, length of hospital stay, adverse reactions, etc. CONCLUSIONS This study will provide a reliable evidence-based basis for the selection of probiotics for the treatment of acute diarrhea in children. ETHICS AND DISSEMINATION Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/MNJAE.
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Affiliation(s)
- Xiao Feng
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
| | - LiJuan Zhuang
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
| | - Ling Chen
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
| | - Hongying Zhao
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
| | - Rui Huang
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
| | - ZhiFeng Guo
Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
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13
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毛 俊, 杨 娅, 石 长, 陈 竹, 李 春, 王 永, 李 琳, 陈 军. Molecular epidemiological characteristics of the virus in 96 children with acute diarrhea in Changdu of Tibet, China. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:266-272. [PMID: 35351256 PMCID: PMC8974661 DOI: 10.7499/j.issn.1008-8830.2110012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/03/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To study the molecular epidemiological characteristics of the virus in children with acute viral diarrhea in Changdu of Tibet, China. METHODS Fecal specimens were collected from 96 children with acute diarrhea who visited the People's Hospital of Changdu, Tibet, from November 2018 to November 2020 and were tested for adenovirus, norovirus, astrovirus, sapovirus, and rotavirus. Gene sequencing was performed for the genotypes of these viruses. RESULTS The overall positive rate of the five viruses was 39% (37/96), among which astrovirus had the highest positive rate of 17%, followed by norovirus (9%), rotavirus (8%), adenovirus (7%), and sapovirus (5%). There was no significant difference in the positive rate of the five viruses among different age groups (P>0.05). Only the positive rate of astrovirus was significantly different among the four seasons (P<0.05). For adenovirus, 6 children had F41 type and 1 had C2 type; for norovirus, 6 had GⅠ.3 type, 1 had GⅠ.7 type, 1 had GⅡ.3 type, and 2 had GⅡ.4 Sydney_2012 type; HAstrV-1 type was observed in all children with astrovirus infection; for sapovirus, 1 child each had sporadic GⅠ.2, GⅠ.6, and GⅡ.1 sapovirus and 2 children had unknown type; 6 children had rotavirus G9[P8]. CONCLUSIONS Astrovirus and norovirus are important pathogens in children with acute diarrhea in Changdu, Tibet. The positive rate of adenovirus, norovirus, astrovirus, sapovirus, and rotavirus is not associated with age, and only the positive rate of astrovirus has obvious seasonality. F41 type is the dominant genotype of adenovirus; GⅠ.3 is the dominant genotype of norovirus; HAstrV-1 is the dominant genotype of astrovirus; sporadic GⅠ.2, GⅠ.6, and GⅡ.1 are the dominant genotypes of sapovirus; G9[P8] is the dominant genotype of rotavirus.
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Affiliation(s)
| | | | | | | | - 春 李
- 儿科学重庆市重点实验室重庆400016
- 重庆医科大学附属儿童医院新生儿科重庆400016
| | - 永明 王
- 儿科学重庆市重点实验室重庆400016
- 昌都市人民医院儿科,西藏昌都854000
- 重庆医科大学附属儿童医院新生儿科重庆400016
| | | | - 军华 陈
- 儿科学重庆市重点实验室重庆400016
- 昌都市人民医院儿科,西藏昌都854000
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14
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Dudnyk VM, Andrikevych II, Khromykh K, Mantak HI, Rudenko HM. ANTIBIOTIC ASSOCIATIVE DISORDERS OF THE MICROBIOCENOSIS OF THE COLON IN INFANTS WITH ACUTE RESPIRATORY DISEASES. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1323-1327. [PMID: 35758452 DOI: 10.36740/wlek202205217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: Study the effect of antibiotics of different groups on the condition of the colon microflora in infants with acute respiratory pathology. PATIENTS AND METHODS Materials and methods: 140 infants with acute respiratory pathology were examined. Clinical, laboratory and instrumental examination, assessment of the functional state of all organs and systems, chest x ray, clinical signs of the colon microbiocenosis violation, analysis of bacteriological examination and immunological studies of local colon immunity (immunoglobulin concentration (sIgA, IgA, IgG, IgM) in coprofiltrates) were done. RESULTS Results: The negative effect of antibiotics of different pharmacological groups on the colon microflora state in infants with acute respiratory diseases has been established. The indigenous microflora of the colon is most inhibited by drugs from the group of 3rd generation cephalosporins, aminoglycosides and their combination. While cephalosporins 1-2nd generations, penicillins and macrolides to a lesser extent affect the state of the microbiocenosis of the colon. The use of two courses of antibacterial therapy to a greater extent disrupts the microbiocenosis of the colon in the examined children, compared with one course of therapy. In commune acquired pneumonia and acute complicated bronchiolitis in infants on the background of antibiotic therapy there is a probable decrease in secretory immunoglobulin in coprofiltrate (sIgA), compared with healthy children (p <0.05). CONCLUSION Conclusions: The analysis of the obtained results showed that antibiotic therapy negatively affects not only the condition of the colon microflora in the examined children, but also suppresses humoral factors of local immunity of the colonic mucosa. Key words: digestive tract microbiocenosis, antibiotic therapy, children.
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Affiliation(s)
| | | | | | - Halyna I Mantak
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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15
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Yang JJ, Lee K. Epidemiologic Changes in Over 10 Years of Community-Acquired Bacterial Enteritis in Children. Pediatr Gastroenterol Hepatol Nutr 2022; 25:41-51. [PMID: 35087732 PMCID: PMC8762604 DOI: 10.5223/pghn.2022.25.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/06/2021] [Accepted: 10/03/2021] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Community-acquired bacterial enteritis (CABE) is a common problem in developed countries. It is important to understand the epidemiologic changes in bacterial pathogens for prevention and treatment. Therefore, we studied the epidemiologic changes in CABE in Korean children. METHODS A total of 197 hospitalized pediatric patients aged <19 years that presented with dysentery symptoms and showed positive polymerase chain reaction results for bacterial species in stool samples, were enrolled in this study for 10 years (June 2010 to June 2020). We classified patients in phase I (06, 2010-06, 2015) and phase II (07, 2015-06, 2020) and analyzed their epidemiologic and clinical characteristics. RESULTS The most common pathogens were Campylobacter species (42.6%) and Salmonella species were the second most common pathogens (23.9%). The abundance of pathogens decreased in the following order: Clostridium difficile (9.6%), Shigella (5.6%), and Clostridium perfringens (5.6%). Escherichia coli O157:H7 was found to be the rarest pathogen (2.0%). Campylobacter species showed an increase in the infection rate from 32.1% in phase I to 49.6% in phase II (p=0.0011). Shigella species showed a decline in the infection rate in phase I from 14.1% to 0.0% in phase II (p<0.001). C. difficile and C. perfringens showed an increase in infection rate in phase II compared to phase I, but the difference was not statistically significant. CONCLUSION The infection rate of Campylobacter species in CABE has been rising more recently, reaching almost 50%. This study may help establish policies for prevention and treatment of CABE in Korean children.
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Affiliation(s)
- Jae Jin Yang
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Kunsong Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
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16
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Dong X, Qi Y, Chai R, Xu H, Wang J, Wang Y, Chen Y, Zhang L, Lu Y, Chen H, Yao Y. Viral infection among children under the age of 5 with diarrhea in Shenyang from 2018 to 2020: A hospital-based study. J Med Virol 2021; 94:2662-2668. [PMID: 34877673 DOI: 10.1002/jmv.27511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/07/2022]
Abstract
Diarrhea is one of the leading causes of death among children, especially in the age under 5, but few studies are available on viral diarrhea in Shenyang. To understand the infection status and the relevant epidemiological characteristics of viral diarrhea and to fill gaps of the distribution of viruses across Shenyang in children under the age of 5 with diarrhea, from 2018 to 2020, stool specimens of children with diarrhea aged 0-59 months and surveillance data were collected in Sentinel Hospital of Shenyang. Specimens were then tested to determine the type of viruses, the seasonal and spatial patterns for major viruses were determined. Viruses were identified in 47.9% of the 897 samples from children with diarrhea. The main viruses of stool samples were rotavirus (16.9%, predominant type G9P[8]), calicivirus (14.7%), adenovirus (11.8%), and astrovirus (4.5%). Viral infections were mainly detected in the age of 0-12 months. In the area of Shenyang, Huanggu had the most cases (198, 22.1%), followed by Dadong (137, 15.3%) and Hunnan (135, 15.1%). The positive rate of viruses varied among patients of different ages, seasons, and regions. Public health entities and the government should develop corresponding measures for different age groups, seasons, and regions.
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Affiliation(s)
- Xinxin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ying Qi
- Infectious Disease Prevention and Control Institute, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Ruiyu Chai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Han Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Jin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yingshuang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ye Chen
- Infectious Disease Prevention and Control Institute, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Linlin Zhang
- Infectious Disease Prevention and Control Institute, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Ying Lu
- Infectious Disease Prevention and Control Institute, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Huijie Chen
- Infectious Disease Prevention and Control Institute, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Affiliation(s)
- Guadalupe Cara Viegelmann
- General Paediatric Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
| | - Jambay Dorji
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Xiaoxuan Guo
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore
| | - Hwee Ying Lim
- General Paediatric Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore
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Li W, Zhu Y, Lou J, Chen J, Xie X, Mao J. Rotavirus and adenovirus infections in children during COVID-19 outbreak in Hangzhou, China. Transl Pediatr 2021; 10:2281-2286. [PMID: 34733668 PMCID: PMC8506064 DOI: 10.21037/tp-21-150] [Citation(s) in RCA: 6] [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: 04/02/2021] [Accepted: 06/29/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aims to investigate the impact of protective measures and isolation on intestinal infection in children before and after COVID-19 outbreak in Hangzhou, China. METHODS Data on outpatient visits, intestinal infection visits, and tests of adenovirus or rotavirus from electronic healthcare records were extracted in Children's Hospital of Zhejiang University School of Medicine during the COVID-19 outbreak (January-December, 2020), and be compared with those in 2019 during the same period. RESULTS We found that pediatric outpatient visits, patients with intestinal infection and its proportion from January to December of 2020 were significantly less than that in the same period of 2019. Furthermore, the numbers of outpatient visits and patients with intestinal infection were the lowest in February and elevated slowly from March to December in 2020. We also found significantly decreased number of completed tests for intestinal viruses, positive cases of adenovirus and rotavirus, positive rate of rotavirus during January-December, 2020. The positive rates of adenovirus from March to September and December of 2020 were significantly lower than the levels of the same period in 2019. The positive rate of rotavirus and adenovirus in all age groups in 2020 is lower than the level of all age groups in 2019. CONCLUSIONS The outpatient visits and intestinal, rotavirus and adenovirus infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent intestinal virus infections in children.
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Affiliation(s)
- Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Yueling Zhu
- Department of Traditional Chinese Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jingan Lou
- Department of Gastroenterology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jie Chen
- Department of Gastroenterology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Xiaojun Xie
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jianhua Mao
- Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
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Huang WC, Tung YT, Wu MS, Liu MC, Lin TJ, Yang MT. Low-Osmolality Carbohydrate-Electrolyte Solution Ingestion Avoid Fluid Loss and Oxidative Stress After Exhaustive Endurance Exercise. Antioxidants (Basel) 2020; 9:antiox9040336. [PMID: 32326004 PMCID: PMC7222420 DOI: 10.3390/antiox9040336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023] Open
Abstract
Low-osmolality carbohydrate–electrolyte solution (LCS) ingestion can replace losses from exercise-induced dehydration, but the benefits of LCS ingestion strategy after exhaustive endurance exercise (EEE) remain unknown. The present study evaluated the effects of LCS ingestion on dehydration, oxidative stress, renal function, and aerobic capacity after EEE. In our study with its double-blind, crossover, counterbalanced design, 12 healthy male participants were asked to consume LCS (150 mL four times per hour) or placebo (water) 1 h before and 1 h after EEE. All participants completed a graded exercise test to exhaustion on a treadmill for the determination of maximal oxygen consumption (V˙O2max), applied to further intensity calibration, and then completed the EEE test. The average heart rate, maximal heart rate, running time to exhaustion, and peak oxygen uptake (VO2peak) were recorded during the exercise period. The participants’ body weight was recorded at different time points before and after the EEE to calculate the dehydration rate. Blood samples were drawn at baseline and before, immediately after, 1 h after, and 2 h after EEE to determine indicators of oxidative stress and renal function. The results indicated that the dehydration rates in participants with LCS ingestion at 15 min, 30 min, and 45 min after EEE were significantly lower than in participants with placebo ingestion (−1.86 ± 0.47% vs. −2.24 ± 0.72%; −1.78 ± 0.50% vs. −2.13 ± 0.74%; −1.54 ± 0.51% vs. −1.94 ± 0.72%, respectively; p < 0.05). In addition, the concentration of catalase in participants with LCS ingestion immediately after EEE was significantly higher than in participants with placebo ingestion (2046.21 ± 381.98 nmol/min/mL vs. 1820.37 ± 417.35 nmol/min/mL; p < 0.05). Moreover, the concentration of protein carbonyl in participants with LCS ingestion immediately after EEE was slightly lower than in participants with placebo ingestion (2.72 ± 0.31 nmol carbonyl/mg protein vs. 2.89 ± 0.43 nmol carbonyl/mg protein; p = 0.06). No differences were noted for other variables. Our findings conclude that LCS ingestion can effectively avoid fluid loss and oxidative stress after EEE. However, LCS ingestion had no benefits for renal function or aerobic capacity.
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Affiliation(s)
- Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
| | - Yu-Tang Tung
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 11301, Taiwan;
| | - Mai-Szu Wu
- TMU Research Center of Urology and Kidney, Taipei Medicine University, Taipei 110301, Taiwan;
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110301, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Ming-Che Liu
- Department of Urology, Taipei Medical University Hospital, Taipei 110301, Taiwan;
- Clinical Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- School of Dental Technology, College of oral Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Tsai-Jung Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan;
| | - Ming-Ta Yang
- Center for General Education, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence: ; Tel.: +886-2-27361661 (ext. 2275)
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Szajewska H, Hojsak I. Health benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12 in children. Postgrad Med 2020; 132:441-451. [DOI: 10.1080/00325481.2020.1731214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hania Szajewska
- Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Iva Hojsak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
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Feng J, Guo J, Wang JP, Chai BF. MiR-32-5p aggravates intestinal epithelial cell injury in pediatric enteritis induced by Helicobacter pylori. World J Gastroenterol 2019; 25:6222-6237. [PMID: 31749593 PMCID: PMC6848013 DOI: 10.3748/wjg.v25.i41.6222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/11/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pediatric enteritis is one of the infectious diseases in the digestive system that causes a variety of digestive problems, including diarrhea, vomiting, and bellyache in children. Clinically, Helicobacter pylori (H. pylori) infection is one of the common factors to cause pediatric enteritis. It has been demonstrated that aberrant expression of microRNAs (miRNAs) is found in gastrointestinal diseases caused by H. pylori, and we discovered a significant increase of miR-32-5p in H. pylori-related pediatric enteritis. However, the exact role of miR-32-5p in it is still unknown.
AIM To investigate the role of aberrant miR-32-5p in pediatric enteritis induced by H. pylori.
METHODS MiR-32-5p expression was detected by quantitative real time-polymerase chain reaction. The biological role of miR-32-5p in H. pylori-treated intestinal epithelial cells was evaluated by Cell Counting Kit-8 assay and flow cytometry. The potential target of miR-32-5p was predicted with TargetScanHuman and verified by luciferase assay. The downstream mechanism of miR-32-5p was explored by using molecular biology methods.
RESULTS We found that miR-32-5p was overexpressed in serum of H. pylori-induced pediatric enteritis. Further investigation revealed that H. pylori infection promoted the death of intestinal epithelial cells, and increased miR-32-5p expression. Moreover, miR-32-5p mimic further facilitated apoptosis and inflammatory cytokine secretion of intestinal epithelial cells. Further exploration revealed that SMAD family member 6 (SMAD6) was the direct target of miR-32-5p, and SMAD6 overexpression partially rescued cell damage induced by H. pylori. The following experiments showed that miR-32-5p/SMAD6 participated in the apoptosis of intestinal epithelial cells induced by transforming growth factor-β-activated kinase 1 (TAK1)-p38 activation under H. pylori infection.
CONCLUSION Our work uncovered the crucial role of aberrant expression of miR-32-5p in H. pylori–related pediatric enteritis, and suggested that the TAK1-p38 pathway is involved in it.
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Affiliation(s)
- Jing Feng
- Institute of Loess Plateau, Shanxi University, Taiyuan 030006, Shanxi Province, China
- Department of Gastroenterology, Shanxi Provincial People's Hospital, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
| | - Jian Guo
- Department of General Surgery, Shanxi Provincial People's Hospital, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
| | - Jun-Ping Wang
- Department of Gastroenterology, Shanxi Provincial People's Hospital, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
| | - Bao-Feng Chai
- Institute of Loess Plateau, Shanxi University, Taiyuan 030006, Shanxi Province, China
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Pediatric clinical practice guidelines in China: still a long way to go. World J Pediatr 2018; 14:417-418. [PMID: 30269304 DOI: 10.1007/s12519-018-0192-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/20/2018] [Indexed: 10/28/2022]
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