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Katkowska M, Garbacz K, Kopala W, Schubert J, Bania J. Genetic diversity and antimicrobial resistance of Staphylococcus aureus from recurrent tonsillitis in children. APMIS 2019; 128:211-219. [PMID: 31692060 DOI: 10.1111/apm.13007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
The aim of this study was to analyze the prevalence of Staphylococcus aureus in the tonsils of children subjected tonsillectomy due to recurrent tonsilitis and to determine the spa types of the pathogens, carriage of virulence genes and antimicrobial resistance profiles. The study included 73 tonsillectomized children. Bacteria, including S. aureus were isolated from tonsillar surface prior to tonsillectomy, recovered from tonsillar core at the time of the surgery, and from posterior pharynx 2-4 weeks after the procedure. Staphylococcus aureus isolates were compared by spa typing, tested for antimicrobial susceptibility and for the presence of superantigenic toxin genes (sea-seu, eta, etb, tst, lukS/lukF-PV) by multiplex polymerase chain reaction. Seventy-three patients (mean 7.1 ± 4.1 years, 61.6% male) were assessed. The most commonly isolated bacteria were S. aureus. The largest proportion of staphylococcal isolates originated from tonsillar core (63%), followed by tonsillar surface (45.1%) and posterior pharynx in tonsillectomized children (18.2%, p = 0.007). Five (6.3%) isolates were identified as MRSA (mecA-positive). Up to 67.5% of the isolates synthesized penicillinases (blaZ-positive isolates), and 8.8% displayed MLSB resistance. The superantigenic toxin genes were detected in more than half of examined isolates (56.3%). spa types t091, t084, and t002, and clonal complexes (CCs) CC7, CC45, and CC30 turned out to be most common. Staphylococcus aureus associated with RT in children showed pathogenicity potential and considerable genetic diversity, and no clones were found to be specific for this condition although further studies are needed.
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Affiliation(s)
- Marta Katkowska
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wacław Kopala
- Voivodeship Specialist Children's Hospital, Olsztyn, Poland
| | - Justyna Schubert
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Bania
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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Coughtrie AL, Jefferies JM, Cleary DW, Doncaster CP, Faust SN, Kraaijeveld AR, Moore MV, Mullee MA, Roderick PJ, Webb JS, Yuen HM, Clarke SC. Microbial epidemiology and carriage studies for the evaluation of vaccines. J Med Microbiol 2019; 68:1408-1418. [DOI: 10.1099/jmm.0.001046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Abigail L. Coughtrie
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Johanna M. Jefferies
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - David W. Cleary
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | | | - Saul N. Faust
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Clinical Research Facility, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | | | - Michael V. Moore
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Mark A. Mullee
- NIHR Research Design Service South Central, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Paul J. Roderick
- Global Health Research Institute, University of Southampton, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Jeremy S. Webb
- Centre for Biological Sciences, University of Southampton, Southampton, UK
| | - Ho Ming Yuen
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Stuart C. Clarke
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
- Global Health Research Institute, University of Southampton, Southampton, UK
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Reinato LAF, Pereira FMV, Lopes LP, Pio DPM, Gir E. Nasal colonization in nursing professionals from units specialized in HIV/AIDS. Rev Bras Enferm 2017. [PMID: 26222177 DOI: 10.1590/0034-7167.2015680119i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to investigate the presence of microorganisms in the nostrils of the nursing professionals of a Brazilian teaching hospital. METHOD cross-sectional study in two inpatient units specialized in HIV/AIDS. Nasal secretion samples of nursing professionals were collected in one month. The samples were processed at the microbiology laboratory of the institution and analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 19.0. Ethical aspects were abided. RESULTS from the 73 members of the nursing staff, samples of nasal secretions were collected from 61 (80.2%). Six types of microorganisms were isolated in 22 (41.0%) positive cultures. It is noteworthy that Staphylococcus aureus accounted for 22.9%, four of them oxacillin-resistant (MRSA). CONCLUSION Staphylococcus aureus microorganism accounted for the largest prevalence in individuals of this study.
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Affiliation(s)
- Lílian Andreia Fleck Reinato
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Fernanda Maria Vieira Pereira
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Letícia Pimenta Lopes
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Daiana Patrícia Marchetti Pio
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Elucir Gir
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Foster-Nyarko E, Kwambana B, Aderonke O, Ceesay F, Jarju S, Bojang A, McLellan J, Jafali J, Kampmann B, Ota MO, Adetifa I, Antonio M. Associations between nasopharyngeal carriage of Group B Streptococcus and other respiratory pathogens during early infancy. BMC Microbiol 2016; 16:97. [PMID: 27230066 PMCID: PMC4882866 DOI: 10.1186/s12866-016-0714-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 05/19/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In West Africa, the carriage of Group B Streptococcus (GBS), among infants is poorly characterised. We investigated co-carriage of GBS with other respiratory pathogens in the infants' nasopharynx in The Gambia. METHODS We assessed the carriage, serotypes and antibiotic susceptibility of Beta-haemolytic Streptococci (BHS) groups A-G; along with the carriage of Streptococcus pneumoniae; Haemophilus influenzae; Staphylococcus aureus and Moraxella catarrhalis in 1200 two-month old infants. RESULTS The BHS prevalence was 20.0 % and GBS dominated (13.8 %), particularly serotypes V and II; serotype V being negatively associated with H. Influenzae carriage (OR 0.41 [95 % CI: 0.18-0.93], p = 0.033). Although co-colonization of GBS and other BHS was not seen, colonization with GBS was positively associated with S. aureus (OR 1.89 [95 % CI: 1.33-2.69], P < 0.001) and negatively associated with S. pneumoniae (OR 0.47 [95 % CI: 0.33-0.67], p < 0.001) and M. catarrhalis (OR 0.61 [95 % CI: 0.40-0.92], p = 0.017). ≥ 89 % of GBS isolates were susceptible to most antibiotics tested, except for tetracycline resistance, which was 89 %. CONCLUSION This study provides baseline data on the carriage of GBS in two month old infants from West Africa. The dominant serotypes of GBS in this setting are serotypes V and II. This may be important for future GBS vaccine development for the West African sub-region.
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Affiliation(s)
| | - Brenda Kwambana
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Odutola Aderonke
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Fatima Ceesay
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Sheikh Jarju
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Abdoulie Bojang
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Jessica McLellan
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - James Jafali
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
| | - Martin O Ota
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia
- Current Address: WHO Regional Office for Africa, Brazzaville, Congo
| | - Ifedayo Adetifa
- Disease Control and Elimination Theme, Medical Research Council Unit, Banjul, The Gambia
- Current Address: Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin Antonio
- Vaccines and Immunity Theme, Medical Research Council Unit, Banjul, The Gambia.
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
- Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK.
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Othman DSMP, Schirra H, McEwan AG, Kappler U. Metabolic versatility in Haemophilus influenzae: a metabolomic and genomic analysis. Front Microbiol 2014; 5:69. [PMID: 24624122 PMCID: PMC3941224 DOI: 10.3389/fmicb.2014.00069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 02/09/2014] [Indexed: 12/11/2022] Open
Abstract
Haemophilus influenzae is a host adapted human pathogen known to contribute to a variety of acute and chronic diseases of the upper and lower respiratory tract as well as the middle ear. At the sites of infection as well as during growth as a commensal the environmental conditions encountered by H. influenzae will vary significantly, especially in terms of oxygen availability, however, the mechanisms by which the bacteria can adapt their metabolism to cope with such changes have not been studied in detail. Using targeted metabolomics the spectrum of metabolites produced during growth of H. influenzae on glucose in RPMI-based medium was found to change from acetate as the main product during aerobic growth to formate as the major product during anaerobic growth. This change in end-product is likely caused by a switch in the major route of pyruvate degradation. Neither lactate nor succinate or fumarate were major products of H. influenzae growth under any condition studied. Gene expression studies and enzyme activity data revealed that despite an identical genetic makeup and very similar metabolite production profiles, H. influenzae strain Rd appeared to favor glucose degradation via the pentose phosphate pathway, while strain 2019, a clinical isolate, showed higher expression of enzymes involved in glycolysis. Components of the respiratory chain were most highly expressed during microaerophilic and anaerobic growth in both strains, but again clear differences existed in the expression of genes associated e.g., with NADH oxidation, nitrate and nitrite reduction in the two strains studied. Together our results indicate that H. influenzae uses a specialized type of metabolism that could be termed “respiration assisted fermentation” where the respiratory chain likely serves to alleviate redox imbalances caused by incomplete glucose oxidation, and at the same time provides a means of converting a variety of compounds including nitrite and nitrate that arise as part of the host defence mechanisms.
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Affiliation(s)
| | - Horst Schirra
- Centre for Advanced Imaging, The University of Queensland St. Lucia, QLD, Australia
| | - Alastair G McEwan
- School of Chemistry and Molecular Biosciences, The University of Queensland St. Lucia, QLD, Australia
| | - Ulrike Kappler
- School of Chemistry and Molecular Biosciences, The University of Queensland St. Lucia, QLD, Australia
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Nayak DM, Kumar N, Bhaskaranand N, Nayak C. Bacterial profile of the oropharynx in infants: an assessment of the confounding factors for colonization. Indian J Pediatr 2011; 78:807-11. [PMID: 21340728 DOI: 10.1007/s12098-011-0367-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 01/07/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the composition of non pathogenic microflora (NPM) and pathogenic microflora (PM) and the assessment of factors affecting their colonization in the oropharynx. METHODS Oropharyngeal swabs were obtained from 464 infants, aged 15 days to I year, with or without clinical signs and symptoms of upper respiratory tract infection (URTI), for the current study.Culture was done on blood and chocolate agar, and the colonies were identified using standard microbiological procedures. RESULTS The influence of age, presence of siblings and feeding patterns on colonization of oropharynx and the profile of NPM and PM in symptomatic and asymptomatic infants was studied. Colonization of oropharynx by NPM decreased with age whereas by PM increased with age significantly. Isolation of PM significantly increased in cases having siblings less than 18 years of age at home. Season showed a significant influence on the colonization of microflora in the oropharynx. Colonization by NPM was significantly higher in exclusively breast fed (EBF) infants, whereas by PM was higher in mixed fed (MF) infants. Symptomatic infants were higher in the MF group than in EBF group. Certain species of NPM exhibited significant inhibitory effects on colonization of PM. CONCLUSIONS Assessment of the factors influencing the oropharyngeal colonization of microflora in infants identifies the risk factors for various infections in later life.
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Affiliation(s)
- Dinesh M Nayak
- Department of Pediatrics, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal 576 104 Karnataka, India.
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Pereira LMP, Juman S, Bekele I, Seepersadsingh N, Adesiyun AA. Selected bacterial recovery in Trinidadian children with chronic tonsillar disease. Braz J Otorhinolaryngol 2009; 74:903-911. [PMID: 19582348 PMCID: PMC9448947 DOI: 10.1016/s1808-8694(15)30152-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2007] [Accepted: 06/11/2007] [Indexed: 12/04/2022] Open
Abstract
Pharyngotonsillitis in children is widely treated with antibiotics. Aim: To examine tonsil surface and core microflora following elective adenotonsillectomy in children. Methods: Tonsils of 102 Trinidadian children were prospectively examined for surface and core bacteriological culture and identification between 2005-2006. Results: Tonsils (360) yielded 800 isolates of Streptococcus spp. (51.3%), Staphylococcus spp. (42.3%) and Gram-negative genera (6.4%). Surface and core recovery of staphylococci and streptococci were similar (p>0.05). More (p<0.001) surfaces (82.2%) than cores (63.3%) grew Streptococcus spp.; α-haemolytic Streptococcus prevalence was higher (p<0.001) than ß-haemolytic Streptococcus on surfaces (74.4% vs. 18.6%) than cores (58.9% vs. 13.7%). Surfaces and cores were not concordant for streptococci (p<0.0004) and α-haemolytic Streptococcus (p<0.007). Surface and core ß-haemolytic Streptococcus yield was higher (p<0.05) in 6-16 than 1-5 year olds (31% and 23.8% vs 12.5% and 8%). S. pyogenes surface and core prevalence was (84.6% vs 70%) and (50.0% vs 25.0%) in older and younger children respectively. Klebsiella spp. (6.6 %, 2.2%), Proteus (4.4%, 4.4%) and Pseudomonas (4.4 %, 1.1%) grew on surfaces and cores respectively.
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Affiliation(s)
| | | | - Isaac Bekele
- Dr (Senior Lecturer, Biometrics and Head, Department of Food Production)
| | | | - Abiodun A Adesiyun
- Dr (Professor of Veterinary Public Health and Director, School of Veterinary Medicine)
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8
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Ozdemir B, Beyazova U, Camurdan AD, Sultan N, Ozkan S, Sahin F. Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Turkish infants. J Infect 2008; 56:332-9. [PMID: 18377994 DOI: 10.1016/j.jinf.2008.02.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 11/20/2007] [Accepted: 02/16/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aims of this study were to determine nasopharyngeal carriage rates, serotype distribution and antimicrobial resistance patterns of Streptococcus pneumoniae in healthy 0 to 2 year-old infants who live within a rural or urban locale and not attending daycare centers. In order to evaluate the possible impact of pneumococcal conjugate vaccine in this population, coverage of the isolated serotypes by the vaccine was also calculated. METHODS The study was conducted on 564 healthy infants attending 2 different well child clinics, one of which is located in an urban region and the other in a rural region. Specimens were collected with nasopharyngeal swabs. Serotyping was performed with standard antisera. Penicillin susceptibility was determined with E-test. Chi-square tests and logistic regression were used for data analysis. RESULTS The pneumococcal carriage rate was 22.5%. Age (>2 months age) [2.98 (1.41-6.29) p=0.004] and presence of another child within the house who attends school [1.72 (1.13-2.62) p=0.01] increased the carriage rate. The most frequently isolated serotypes were 11 (11.8%), 23 (7.9%), 19F (7.1%), 22 (6.3%), 9 (5.5%), 19 (5.5%) and 23B (5.5%). The total coverage of vaccine and vaccine-related serotypes by 7, 11 and 13 valent pneumococcal conjugate vaccines were 51.2, 59.0 and 59.0%, respectively. Of the isolated pneumococci, 10 (8.5%) were intermediately resistant and 8 (6.8%) were highly resistant to penicillin. CONCLUSION This study provides data about the local carriage rate and serotype distribution of S. pneumoniae strains in Turkish children, which is important in predicting the possible effects of different valent pneumococcal conjugate vaccines in this population.
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Affiliation(s)
- Bengu Ozdemir
- Department of Pediatrics, Bilgi Medical Center, Batikent, Ankara, Turkey
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Murphy TF. Vaccine development for non-typeable Haemophilus influenzae and Moraxella catarrhalis: progress and challenges. Expert Rev Vaccines 2007; 4:843-53. [PMID: 16372880 DOI: 10.1586/14760584.4.6.843] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An urgent need exists for vaccines to prevent infections caused by nontypeable Haemophilus influenzae and Moraxella catarrhalis. These bacteria cause otitis media in children, a clinical problem associated with enormous morbidity and cost. H. influenzae and M. catarrhalis also cause lower respiratory tract infections in adults with chronic lung disease. Infections in this clinical setting are associated with disability and death. Recent progress in identifying potential vaccine antigens in both bacteria raises great promise in developing effective vaccines. This paper reviews the key issues in vaccine development for H. influenzae and M. catarrhalis, including areas where progress has been stalled, and proposes areas that deserve investigation in the next 5 years.
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Affiliation(s)
- Timothy F Murphy
- University at Buffalo, State University of New York, Medical Research 151, Buffalo VAMC, 3495 Bailey Avenue, Buffalo, NY 14215, USA.
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Nilsson P, Ripa T. Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares. J Clin Microbiol 2006; 44:3334-9. [PMID: 16954269 PMCID: PMC1594670 DOI: 10.1128/jcm.00880-06] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to determine the frequency and persistence of Staphylococcus aureus carriage in the throat in relation to anterior naris carriage. By use of a sensitive enrichment broth, S. aureus was cultured from the two sites from 259 patients upon admission to an orthopedic ward and from 87 staff members of the same ward. The throat was the most common carriage site in both groups. Forty percent of the patients and 54% of the staff were positive for S. aureus in the throat, compared to 31% and 36%, respectively, in the anterior nares. To determine the persistence of carriage, 67 individuals were repeatedly sampled from the anterior nares and the throat over 2 years (5 to 10 sampling occasions; mean, 7.8). The majority, 58% (39/67), were defined as persistent carriers of S. aureus, considering culture results from both sites. Of the 39 persistent carriers, 15 individuals were culture positive from only the throat on more than half of the sampling occasions (these are called preferential throat carriers) while only 5% (two individuals) were preferential anterior naris carriers by use of the same definition. Typing of the collected S. aureus isolates by pulsed-field gel electrophoresis revealed that the same strain of S. aureus was present, over time, in the throat of an individual at least to the same extent as in the anterior nares. Throat carriage was at least as persistent as carriage in the anterior nares.
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Affiliation(s)
- Peter Nilsson
- Department of Clinical Microbiology and Infection Control, The County Hospital of Halmstad, S-30185 Halmstad, Sweden.
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Dubos F, Lorrot M, Soulier M, Rozenberg F, Lebon P, Gendrel D. Production d’interféron alpha dans le sérum des très jeunes nourrissons lors d’infections virales. Med Mal Infect 2004; 34:561-5. [PMID: 15603931 DOI: 10.1016/j.medmal.2004.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Accepted: 09/07/2004] [Indexed: 11/24/2022]
Abstract
UNLABELLED IFN-alpha detection is useful in some clinical circumstances, but its use has never been validated in young infants with viral infections. OBJECTIVE The authors wanted to determine it there was any difference in the assessment of IFN-alpha production between infants under or over six months of age. PATIENTS AND METHOD A series of 233 children with identified common viral infections who had been assessed for IFN-alpha production was retrospectively analyzed. The viral infections were enteroviral meningitis (n =103), respiratory syncytial virus infections (n =60), and rotavirus gastroenteritis (n =70). Data collected from the group of infants under six months of age (n =105) was compared to that of the older children (n =128). Qualitative and quantitative values of interferon-alpha were determined for each group. RESULTS Interferon-alpha was detected in very young infants (81.9% of cases) as often as in the older age group (80.3% of cases), for any of the three viral infections (P =0.3-0.63). The mean level of interferon-alpha production detected was not lower in the youngest group, and even higher in the group under six months of age with enteroviral meningitis. CONCLUSION Interferon-alpha detection in very young infants is efficient and may be useful to differentiate between viral and bacterial infection particularly when the etiological diagnosis appears uncertain.
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Affiliation(s)
- F Dubos
- Service de pédiatrie, hôpital Saint-Vincent-de-Paul, 82, avenue Denfert-Rochereau, 75014 Paris, France.
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Bogaert D, De Groot R, Hermans PWM. Streptococcus pneumoniae colonisation: the key to pneumococcal disease. THE LANCET. INFECTIOUS DISEASES 2004; 4:144-54. [PMID: 14998500 DOI: 10.1016/s1473-3099(04)00938-7] [Citation(s) in RCA: 1354] [Impact Index Per Article: 67.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Streptococcus pneumoniae is an important pathogen causing invasive diseases such as sepsis, meningitis, and pneumonia. The burden of disease is highest in the youngest and oldest sections of the population in both more and less developed countries. The treatment of pneumococcal infections is complicated by the worldwide emergence in pneumococci of resistance to penicillin and other antibiotics. Pneumococcal disease is preceded by asymptomatic colonisation, which is especially high in children. The current seven-valent conjugate vaccine is highly effective against invasive disease caused by the vaccine-type strains. However, vaccine coverage is limited, and replacement by non-vaccine serotypes resulting in disease is a serious threat for the near future. Therefore, the search for new vaccine candidates that elicit protection against a broader range of pneumococcal strains is important. Several surface-associated protein vaccines are currently under investigation. Another important issue is whether the aim should be to prevent pneumococcal disease by eradication of nasopharyngeal colonisation, or to prevent bacterial invasion leaving colonisation relatively unaffected and hence preventing the occurrence of replacement colonisation and disease. To illustrate the importance of pneumococcal colonisation in relation to pneumococcal disease and prevention of disease, we discuss the mechanism and epidemiology of colonisation, the complexity of relations within and between species, and the consequences of the different preventive strategies for pneumococcal colonisation.
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Affiliation(s)
- D Bogaert
- Laboratory of Paediatrics, Erasmus MC-Sophia, Rotterdam, Netherlands
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13
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Podbielski A, Beckert S, Schattke R, Leithäuser F, Lestin F, Gossler B, Kreikemeyer B. Epidemiology and virulence gene expression of intracellular group A streptococci in tonsils of recurrently infected adults. Int J Med Microbiol 2003; 293:179-90. [PMID: 12868654 DOI: 10.1078/1438-4221-00253] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Intracellularly persistent group A streptococci (GAS, Streptococcus pyogenes) have been associated with recurrent tonsillopharyngitis and antibiotic treatment failure. As a supplementation of the published in vitro data, conventional bacteriology and molecular epidemiology was performed on material from 29 adult patients of a German army hospital with anamnestic signs of recurrent tonsillopharyngitis. Pre-surgery tonsil swabs and the surgically removed tonsils were examined with respect to growth of aerobic bacteria in absence and presence of antibiotics with exclusively extracellular activity. Under such antibiotic selection, Staphylococcus aureus and GAS were cultured from specimens of 13 and 3 patients, respectively. In every material GAS-positive by culture methods, the intracellular location of the penicillin-susceptible GAS isolates was confirmed by immunohistologic examination of tonsillar sections using a GAS-specific IgG antibody. The three intracellular GAS isolates were typed by emm gene sequencing and could be associated to types M6 and M49 (two isolates). The bacteria were serially passaged on sheep blood agar, and semiquantitative mRNA analysis from virulence genes was performed using bacteria of the 4th and 25th passage after isolation. An M-type-specific pattern of virulence gene expression and different gene expression levels in relation to the passage number were observed.
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Affiliation(s)
- Andreas Podbielski
- Department of Medical Microbiology and Hospital Hygiene, University Hospital, Rostock, Germany.
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Abstract
PURPOSE OF REVIEW This review will consider recent developments in the clinical aspects of infections due to non-typeable Haemophilus influenzae. In addition, newer developments in the areas of mechanisms of pathogenesis, host pathogen interaction, immune responses and efforts toward vaccine development will be reviewed briefly. RECENT FINDINGS Non-typeable H. influenzae continues to be a common cause of otitis media in infants and children, sinusitis in children and adults, pneumonia in adults, and lower respiratory tract infection in adults with chronic obstructive pulmonary disease. While the rate of beta-lactamase production by isolates of H. influenzae varies geographically, most regions show a rate of 20-35% of isolates producing beta-lactamase. Recent studies have highlighted the possible role of bacterial biofilms formed by H. influenzae as a cause of otitis media. Several lines of evidence indicate that H. influenzae causes intracellular infection in the lower respiratory tract in chronic obstructive pulmonary disease and this observation has important implications in understanding the human immune response to the bacterium. Lipooligosaccharide is an important virulence factor for H. influenzae and research is generating new information on the complex role of this molecule in colonization and infection of the respiratory tract. Several surface molecules are under active evaluation as vaccine antigens. SUMMARY Non-typeable H. influenzae is an important cause of respiratory tract infections in children and adults. Most strains are susceptible to amoxicillin/clavulanate, fluoroquinolones and the newer macrolides. Research in the next decade promises substantial progress in the challenge of developing vaccines for nontypeable H. influenzae.
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Affiliation(s)
- Timothy F Murphy
- Department of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA.
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