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Badjo AOR, Niendorf S, Jacobsen S, Zongo A, Mas Marques A, Vietor AC, Kabore NF, Poda A, Some SA, Ouattara A, Ouangraoua S, Schubert G, Eckmanns T, Leendertz FH, Belarbi E, Ouedraogo AS. Genetic diversity of enteric viruses responsible of gastroenteritis in urban and rural Burkina Faso. PLoS Negl Trop Dis 2024; 18:e0012228. [PMID: 38976836 DOI: 10.1371/journal.pntd.0012228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/20/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Viral gastrointestinal infections remain a major public health concern in developing countries. In Burkina Faso, there are very limited updated data on the circulating viruses and their genetic diversity. OBJECTIVES This study investigates the detection rates and characteristics of rotavirus A (RVA), norovirus (NoV), sapovirus (SaV) and human astrovirus (HAstV) in patients of all ages with acute gastrointestinal infection in urban and rural areas. STUDY DESIGN & METHODS From 2018 to 2021, stool samples from 1,295 patients with acute gastroenteritis were collected and screened for RVA, NoV, SaV and HAstV. Genotyping and phylogenetic analyses were performed on a subset of samples. RESULTS At least one virus was detected in 34.1% of samples. NoV and SaV were predominant with detection rates of respectively 10.5 and 8.8%. We identified rare genotypes of NoV GII, RVA and HAstV, recombinant HAstV strains and a potential zoonotic RVA transmission event. CONCLUSIONS We give an up-to-date epidemiological picture of enteric viruses in Burkina Faso, showing a decrease in prevalence but a high diversity of circulating strains. However, viral gastroenteritis remains a public health burden, particularly in pediatric settings. Our data advocate for the implementation of routine viral surveillance and updated management algorithms for diarrheal disease.
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Affiliation(s)
- Ange Oho Roseline Badjo
- Laboratory of Emerging and Re-emerging Pathogens, Nazi Boni University, Bobo Dioulasso, Burkina Faso
| | | | | | | | | | | | | | - Armel Poda
- Laboratory of Emerging and Re-emerging Pathogens, Nazi Boni University, Bobo Dioulasso, Burkina Faso
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Department of Infectious Diseases, University Hospital Souro Sanou, Bobo-Dioulasso, Burkina Faso
| | | | - Aminata Ouattara
- Laboratory of Emerging and Re-emerging Pathogens, Nazi Boni University, Bobo Dioulasso, Burkina Faso
- Bacteriology and Virology Department Souro Sanou University Hospital, Bobo-Dioulasso, Burkina Faso
| | | | | | | | | | | | - Abdoul-Salam Ouedraogo
- Laboratory of Emerging and Re-emerging Pathogens, Nazi Boni University, Bobo Dioulasso, Burkina Faso
- Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Bacteriology and Virology Department Souro Sanou University Hospital, Bobo-Dioulasso, Burkina Faso
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Wang T, Zeng H, Kang J, Lei L, Liu J, Zheng Y, Qian W, Fan C. Establishment of a Nucleic Acid Detection Method for Norovirus GII.2 Genotype Based on RT-RPA and CRISPR/Cas12a-LFS. Pol J Microbiol 2024; 73:253-262. [PMID: 38905280 PMCID: PMC11192556 DOI: 10.33073/pjm-2024-023] [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: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 06/23/2024] Open
Abstract
To establish a rapid detection method for norovirus GII.2 genotype, this study employed reverse transcription recombinase polymerase amplification (RT-RPA) combined with CRISPR/Cas12a and lateral flow strip (RT-RPA-Cas12a-LFS). Here, the genome of norovirus GII.2 genotype was compared to identify highly conserved sequences, facilitating the design of RT-RPA primers and crRNA specific to the conserved regions of norovirus GII.2. Subsequently, the reaction parameters of RT-RPA were optimized and evaluated using agar-gel electrophoresis and LFS. The results indicate that the conserved sequences of norovirus GII.2 were successfully amplified through RT-RPA at 37°C for 25 minutes. Additionally, CRISPR/Cas12a-mediated cleavage detection was achieved through LFS at 37°C within 10 minutes using the amplification products as templates. Including the isothermal amplification reaction time, the total time is 35 minutes. The established RT-RPA-Cas12a-LFS method demonstrated specific detection of norovirus GII.2, yielding negative results for other viral genomes, and exhibited an excellent detection limit of 10 copies/μl. The RT-RPA-Cas12a-LFS method was further compared with qRT-PCR by analyzing 60 food-contaminated samples. The positive conformity rate was 100%, the negative conformity rate was 95.45%, and the overall conformity rate reached 98.33%. This detection method for norovirus GII.2 genotype is cost-effective, highly sensitive, specific, and easy to operate, offering a promising technical solution for field-based detection of the norovirus GII.2 genotype.
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Affiliation(s)
- Ting Wang
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Hao Zeng
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Jie Kang
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Lanlan Lei
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Jing Liu
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Yuhong Zheng
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
| | - Weidong Qian
- School of Biomedical and Pharmaceutical Sciences, Shaanxi University of Science and Technology, Xian, China
| | - Cheng Fan
- Shaanxi Institute of Supervision and Testing on Product Quality, Xian, China
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Cao Y, Yang J, Li N, Zhang R, Jiang L, Zhou X, Xiang Y, Cun J, Qiao E. Detection and complete genome sequence analysis of human adenovirus in children with acute diarrhea in Yunnan, China, 2015-2021. Arch Virol 2024; 169:34. [PMID: 38263334 PMCID: PMC10805858 DOI: 10.1007/s00705-023-05950-z] [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: 08/10/2023] [Accepted: 11/08/2023] [Indexed: 01/25/2024]
Abstract
The aims of this study were to determine the distribution and prevalence of gastroenteritis caused by human adenovirus (HAdV) in children in Yunnan province, China, in 2015-2021 and to identify preventive measures that can be taken to reduce morbidity and mortality in children.HAdV is a significant agent of diarrhea in children, but limited data are available regarding the epidemiology and genetic diversity of HAdV in children with diarrhea in Yunnan province, China. A total of 1754 fecal samples were subjected to real-time RT-PCR to detect and quantify HAdV. Positive samples were further analyzed using next-generation sequencing (NGS), and epidemiological data were analyzed as well.1754 patients with diarrhea were enrolled, of which 1041 were male and 713 were female (M:F ratio: 1.46). Seventy-two stool samples out of 1754 (4.10%) were positive for HAdV. The detection rates of all age groups varied from 2.50-4.78%. The highest incidence of HAdV was observed in children under 2 years of age, especially in children 12-24 months-old. From 2015-2021, the annual detection rate ranged from 1.62-12.26%. HAdV was detected throughout the year, but with marked seasonality. Children were most likely to be positive for HAdV in June and November. We detected HAdV in 15.53% (16/103) of samples collected in June and in 8.19% (14/171) of those collected in November. The entire viral genome was successfully sequenced for 13 of the 72 HAdV-positive samples, and 76.92% (10/13) of these were classified as genotype F41 and 23.08% (3/13) were classified as genotype C2.ConclusionsIn Yunnan province, children of all ages are susceptible to HAdV infection, but there has been marked variation in the yearly prevalence. The highest rate of HAdV detection was in June, followed by November. Priority should be given to disease prevention over the development of targeted antiviral therapies, and effective vaccines for preventing HAdV diarrhea are needed. It is also important to establish a surveillance system to collect relevant clinical and epidemiological data quickly in order to assess the potential risk of HAdV infection in children and to identify epidemic strains for the development of effective vaccines.
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Affiliation(s)
- Yihui Cao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Jinghui Yang
- The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Nan Li
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Ruixian Zhang
- The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Lili Jiang
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Xiaofang Zhou
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Yibin Xiang
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Jianping Cun
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China.
| | - Enfa Qiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China.
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Miyagi Y. Identification of Pediatric Bacterial Gastroenteritis From Blood Counts and Interviews Based on Machine Learning. Cureus 2023; 15:e43644. [PMID: 37600437 PMCID: PMC10434729 DOI: 10.7759/cureus.43644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Differentiating between bacterial and viral gastroenteritis is crucial in pediatric enteritis practice. Our objective was to use machine learning (ML) to identify acute gastroenteritis (AG) caused by bacteria based on blood cell counts and interview findings. METHODS ML was performed using a decision tree classifier based on data from previously published papers. We included 164 children between one and 108 months diagnosed with gastroenteritis, with 112 having bacterial AG and 52 having viral AG as subjects and controls. Feature selection was performed using least absolute shrinkage and selection operator (LASSO), and the classifier's performance was evaluated by five-fold cross-validation. Additionally, we presented a tree diagram of the decision tree classifier as a flowchart for practical applications. RESULTS The area under curve (AUC) was 0.80, indicating a moderate model. Three important features in this model were platelet-lymphocyte ratio, eosinophil count, and leukocyte count. CONCLUSIONS In conclusion, this study demonstrates that bacterial AG can be estimated from blood cell counts with moderate accuracy. These findings may be valuable in narrowing down bacterial AG in children with gastrointestinal symptoms.
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Affiliation(s)
- Yoshifumi Miyagi
- Department of Pediatrics, Haibara General Hospital, Shizuoka, JPN
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Chen L, Wang J, Chen J, Zhang R, Zhang H, Qi X, He Y. Epidemiological characteristics of Vibrio parahaemolyticus outbreaks, Zhejiang, China, 2010-2022. Front Microbiol 2023; 14:1171350. [PMID: 37448578 PMCID: PMC10336542 DOI: 10.3389/fmicb.2023.1171350] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Background Vibrio parahaemolyticus is one of the most common foodborne pathogens and poses a significant disease burden. The purpose of the study was to elucidate the epidemiological characteristics of Vibrio parahaemolyticus outbreaks in Zhejiang Province, and provide insights for the targeted prevention and control of foodborne diseases. Methods Descriptive statistical methods were utilized to analyze the data on Vibrio parahaemolyticus outbreaks reported by all Centers for Disease Control and Prevention (CDCs) through Foodborne Disease Outbreaks Surveillance System (FDOSS) in Zhejiang Province from 2010 to 2022. Results From 2010 to 2022, a total of 383 outbreaks caused by Vibrio parahaemolyticus were reported by 90 CDCs in 11 prefectures of Zhejiang Province, resulting in 4,382 illnesses, 326 hospitalizations and 1 death. The main symptoms of the outbreak-related cases were diarrhea (95.18%), abdominal pain (89.23%), nausea (55.64%), vomiting (50.57%), fever (24.21%), etc. The outbreaks occurring between July and September accounted for 77.54% of all outbreaks (297 out of 383). Outbreaks associated with restaurants accounted for the majority (57.96%, 222/383) of all outbreaks, followed by those linked to staff canteens (15.40%, 59/383) and rural banquets (11.23%, 43/383). 31.85% of all outbreaks were associated with the consumption of aquatic products, while ready-to-eat foods such as Chinese cold dishes and cooked meat products accounted for 12.53% of all outbreaks. Serotype O3:K6 (81.94%, 118/144) was the predominant serotype responsible for outbreaks from 2010 to 2020, while serotype O10:K4 (57.89%, 33/57) was the predominant serotype from 2021 to 2022. Conclusion In-depth and comprehensive analysis of long-term surveillance data on Vibrio parahaemolyticus outbreaks is essential to gain insight into the epidemiological characteristics, identify long-term patterns and recent trends, and enable governments to prioritize interventions and develop targeted policies to mitigate such outbreaks.
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Kuang H, Dou G, Cheng L, Wang X, Xu H, Liu X, Ding F, Yang X, Liu S, Bao L, Liu H, Liu Y, Li B, Jin Y, Liu S. Humoral regulation of iron metabolism by extracellular vesicles drives antibacterial response. Nat Metab 2023; 5:111-128. [PMID: 36658400 DOI: 10.1038/s42255-022-00723-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 12/07/2022] [Indexed: 01/21/2023]
Abstract
Immediate restriction of iron initiated by the host is a critical process to protect against bacterial infections and has been described in the liver and spleen, but it remains unclear whether this response also entails a humoral mechanism that would enable systemic sequestering of iron upon infection. Here we show that upon bacterial invasion, host macrophages immediately release extracellular vesicles (EVs) that capture circulating iron-containing proteins. Mechanistically, in a sepsis model in female mice, Salmonella enterica subsp. enterica serovar Typhimurium induces endoplasmic reticulum stress in macrophages and activates inositol-requiring enzyme 1α signaling, triggering lysosomal dysfunction and thereby promoting the release of EVs, which bear multiple receptors required for iron uptake. By binding to circulating iron-containing proteins, these EVs prevent bacteria from iron acquisition, which inhibits their growth and ultimately protects against infection and related tissue damage. Our findings reveal a humoral mechanism that can promptly regulate systemic iron metabolism during bacterial infection.
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Affiliation(s)
- Huijuan Kuang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Geng Dou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Linfeng Cheng
- Department of Medical Microbiology and Parasitology, The Fourth Military Medical University, Xi'an, PR China
| | - Xiangdong Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Haokun Xu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Xuemei Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, PR China
| | - Feng Ding
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Xiaoshan Yang
- Stomatology Hospital, Southern Medical University, Guangzhou, PR China
| | - Siying Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Lili Bao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Huan Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, PR China
| | - Yao Liu
- Department of Paediatric Dentistry, School of Stomatology, China Medical University, Shenyang, PR China
| | - Bei Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Yan Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China.
| | - Shiyu Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China.
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7
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Fan K, Eslick GD, Nair PM, Burns GL, Walker MM, Hoedt EC, Keely S, Talley NJ. Human intestinal spirochetosis, irritable bowel syndrome, and colonic polyps: A systematic review and meta-analysis. J Gastroenterol Hepatol 2022; 37:1222-1234. [PMID: 35385602 PMCID: PMC9545717 DOI: 10.1111/jgh.15851] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 12/09/2022]
Abstract
Human colonic spirochetosis (CS) is usually due toBrachyspira pilosicolior Brachyspira aalborgiinfection. While traditionally considered to be commensal bacteria, there are scattered case reports and case series of gastrointestinal (GI) symptoms in CS and reports of colonic polyps with adherent spirochetes. We performed a systematic review and meta-analysis investigating the association between CS and GI symptoms and conditions including the irritable bowel syndrome (IBS) and colonic polyps. Following PRISMA 2020 guidelines, a systematic search of Medline, CINAHL, EMBASE, and Web of Science was performed using specific keywords for CS and GI disease. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Of 75 studies identified in the search, 8 case-control studies met the inclusion criteria for meta-analysis and 67 case series studies met the inclusion criteria for pooled prevalence analysis. CS was significantly associated with diarrhea (n = 141/127, cases/controls, OR: 4.19, 95% CI: 1.72-10.21, P = 0.002) and abdominal pain (n = 64/65, OR: 3.66, 95% CI: 1.43-9.35, P = 0.007). CS cases were significantly more likely to have Rome III-diagnosed IBS (n = 79/48, OR: 3.84, 95% CI: 1.44-10.20, P = 0.007), but not colonic polyps (n = 127/843, OR: 8.78, 95% CI: 0.75-103.36, P = 0.084). In conclusion, we found evidence of associations between CS and both diarrhea and IBS, but not colonic polyps. CS is likely underestimated due to suboptimal diagnostic methods and may be an overlooked risk factor for a subset of IBS patients with diarrhea.
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Affiliation(s)
- Kening Fan
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Guy D Eslick
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Prema M Nair
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Grace L Burns
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Marjorie M Walker
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Emily C Hoedt
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
| | - Nicholas J Talley
- Hunter Medical Research InstituteNew Lambton HeightsNew South WalesAustralia
- NHMRC Centre for Research Excellence in Digestive Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
- Australian Gastrointestinal Research Alliance (AGIRA)NewcastleNew South WalesAustralia
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleNewcastleNew South WalesAustralia
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Stanyevic B, Sepich M, Biondi S, Baroncelli GI, Peroni D, Di Cicco M. The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy. Eur J Pediatr 2022; 181:349-358. [PMID: 34327610 PMCID: PMC8760218 DOI: 10.1007/s00431-021-04210-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/14/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022]
Abstract
Few data are available on the prevalence and features of acute gastroenteritis (AGE) in hospitalized children in Italy, where specific rotavirus vaccines were introduced into the national vaccination plan in 2017. To evaluate vaccination effects on AGE epidemiology, we analysed data from children aged ≤ 18 years admitted for AGE at the University Hospital of Pisa in 2019, comparing them with those recorded in 2012. Demographical, clinical, diagnostic, and treatment data were collected reviewing medical records and were therefore compared. In 2019 and 2012, 86 (median age 2.5 years [IQR 1.4-5.9]) and 85 children (median age 2.3 years [IQR 1.3-5.1]) were respectively admitted with AGE. The most common symptoms were diarrhoea and vomiting; decreased skin turgor was more frequent in 2019 (54% and 34% respectively, p = 0.01). Viral infections were more common than bacterial ones; in 2019, a decrease in rotavirus infections (67% and 22%, p = 0.003) and an increase in adenovirus infections (50% and 10%, p = 0.002) and in the number of patients with negative stool testing (58% and 39%, p = 0.04) were found.Conclusions: Viral infections are the leading cause of AGE in hospitalized children in Italy. The introduction of rotavirus vaccines did not reduce the number of hospitalizations per year. Adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for AGE. What is Known: • Rotavirus is the leading cause of acute severe gastroenteritis in children worldwide, especially < 5 years of age. • The introduction of specific vaccines may be changing its epidemiology. • Few data are available on acute gastroenteritis in hospitalized children in Italy. What is New: • Viral infections are the leading cause of acute gastroenteritis in hospitalized children in Italy. • Specific vaccines are reducing rotavirus infections, but adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for gastroenteritis.
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Affiliation(s)
- Brigida Stanyevic
- School of Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy
| | - Margherita Sepich
- Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy ,Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy
| | - Samanta Biondi
- Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
| | | | - Diego Peroni
- Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy ,Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy
| | - Maria Di Cicco
- Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy. .,Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy.
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Peer V, Schwartz N, Green MS. Sex Differences in Salmonellosis Incidence Rates-An Eight-Country National Data-Pooled Analysis. J Clin Med 2021; 10:jcm10245767. [PMID: 34945061 PMCID: PMC8708425 DOI: 10.3390/jcm10245767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: There are few studies on sex differences in the incidence rates (IR) for salmonellosis over several countries by age and time period. The purpose of this study was to explore the extent and consistency of the sex and age-specific differences. Methods: We analyzed national data from eight countries between 1994 and 2016. We computed country-specific male to female incidence rate ratios (IRRs) for each age group and pooled the data using meta-analytic methods. Variations of the IRRs by age, country and time period were evaluated using meta-regression. Results: The pooled male to female incidence RRs for ages 0–1, 1–4, 5–9 and 10–14, were 1.04 (1.02–1.06), 1.02 (1.01–1.03), 1.07 (1.05–1.08) and 1.28 (1.23–1.33), respectively. For the ages 15–44 and 45–64, the incidence rates were significantly higher in females. Meta-regression analyses indicate that age groups contributed most of the variation in the male to female IRRs. Conclusions: We suggest that genetic and hormonal factors and interactions between hormones and gut microbiota could contribute to the sex differences observed in young children. These findings should provide clues about the mechanisms of the infection, and should be useful in targeting treatments and development of vaccines. Highlights: (1) This manuscript provides consistent estimates of the excess salmonellosis incidence rates in male children up to age 15, which suggests an impact of sex hormones or genetic differences. (2) Our findings should promote the further investigations on sex-related determinants of infectious diseases.
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Affiliation(s)
- Victoria Peer
- Correspondence: ; Tel.: +972-05-3734-5973; Fax: +972-089-779-775
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Incidence of enterovirus in patients with acute gastroenteritis. Eur J Clin Microbiol Infect Dis 2021; 40:2185-2190. [PMID: 33987803 DOI: 10.1007/s10096-021-04275-6] [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: 02/12/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
Enteroviruses (EV) have been linked to lymphocytic meningitis and exanthems, but they may also be involved in acute gastroenteritis (AGE), a condition whose aetiological agent often remains unidentified. In this work 1214 samples from individuals with AGE were studied with the aim of establishing the incidence of EV. The samples were collected between September and December in three different years and subjected to real-time genomic amplification in order to determine the viral load (VL). Of the 1214 samples studied, infection by a single virus was found in 328 cases (27%) and coinfection in 69 (5.7%). While adenoviruses (AdV) were the most frequent (14.8% of total), EV were present in 126 (10.4%) of the individuals tested. Of the 126 EV-positive samples, this virus was found as a single infection and coinfection in 76 (6.3%) and 50 (4.1%) cases, respectively. VL for EV was 5.58±1.51 log copies/ml (range 3.73-9.69) in the former and 6.27±1.75 (range 3.73-10.5) (p=0.02) in the latter. EV were identified in 97 children under 5 (16.9%) and in 29 (4.5%) patients over 5. Patients less than 5 years showed a higher VL that those more than 5 years age [6.08±1.57 (range 3.82-9.69) vs. 5.07±1.53 (range 3.73-10.58); (p=0.002)]. There was a high incidence of EV in AGE patients, and they were more frequent in those under 5, where they were found to replicate more efficiently. These results therefore indicate that testing for EV should be included in the diagnosis of AGE.
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Parrón I, Barrabeig I, Alseda M, Cornejo-Sánchez T, Guix S, Jané M, Izquierdo C, Rius C, Domínguez À. Involvement of Workers in Closed and Semiclosed Institutions in Outbreaks of Acute Gastroenteritis Due to Norovirus. Viruses 2020; 12:E1392. [PMID: 33291823 PMCID: PMC7762007 DOI: 10.3390/v12121392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Norovirus outbreaks frequently occur in closed or semiclosed institutions. Recent studies in Catalonia and various countries indicate that, during outbreaks in these institutions, norovirus is detected in between 23% and 60% of workers, and the prevalence of infection in asymptomatic workers involved in outbreaks ranges from 17% to 40%. In this work, we carried out a prospective study to investigate the involvement of workers in closed and semiclosed institutions during outbreaks. The attack rates (ARs) and the rate ratios (RRs) were calculated according to the type of transmission and occupational category. The RRs and 95% confidence intervals (CIs) between workers and users were calculated. The mean cycle of quantification (Cq) values were compared according to the genogroup and the presence of symptoms. ARs were higher in person-to-person transmission than in common vehicle outbreaks, and 38.8% of workers were symptomatic. The RR between workers and users was 0.46 (95% CI 0.41-0.52). The ARs in workers were high, particularly in workers with closer contact with users. The mean Cq was lower in patients than in asymptomatic infected persons, although the difference was only significant for genogroup I (GI). The frequency of asymptomatic infected persons suggests that personal hygiene measures should be followed by all workers in the centers affected.
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Affiliation(s)
- Ignacio Parrón
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
| | - Irene Barrabeig
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
| | - Miquel Alseda
- Sub-Direcció Regional a Lleida del Departament de Salut, 25006 Lleida, Spain;
| | | | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, Institute of Nutrition and Food Safety, University of Barcelona, 08028 Barcelona, Spain;
| | - Mireia Jané
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Conchita Izquierdo
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
| | - Cristina Rius
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
| | - Àngela Domínguez
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
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