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Menezes RC, Ferreira IBB, Sobral L, Garcia SL, Pustilnik HN, Araújo-Pereira M, Andrade BB. Severe viral lower respiratory tract infections in Brazilian children: Clinical features of a national cohort. J Infect Public Health 2024; 17:1-9. [PMID: 37988811 DOI: 10.1016/j.jiph.2023.09.015] [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: 05/13/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The accurate etiological diagnosis of lower respiratory tract infections (LRTI) is essential for their effective clinical management. The extensive use of molecular methods during the COVID-19 pandemic has enabled massive data acquisition on viral lower respiratory tract infections. The current study aims to identify clinical features associated with eight viral agents among children presenting severe LRTI. METHODS retrospective cohort study of data from the Brazilian Influenza Epidemiological Surveillance Information System. Patients under 20 years-old who had severe LRTI with etiological confirmation through RT-PCR between 2020 and 2022 were included. Binary logistic regressions were used to examine associations between pathogens and symptoms. RESULTS 60,657 cases were assessed. The main viral agents detected were Sars-CoV-2 (COV2) (41.2%), Respiratory Syncytial Virus (29.1%), Human Rhinovirus (HRV) (12.1%), and Influenza (FLU) (5.5%). A general mortality rate of 4.3% was observed. The multivariate analysis evidenced that COV2 less likely presented with cough (OR: 0.34; 95%CI: 0.32-0.36), respiratory discomfort (Adjusted Odds Ratio (aOR): 0.61; 95%Confidence Interval (CI): 0.59-0.64), and desaturation (aOR: 0.71; 95%CI: 0.69-0.75). RSV strongly associated with cough (aOR: 2.59; 95%CI: 2.45-2.75) and respiratory discomfort (aOR: 1.54; 95%CI: 1.46-1.62), whereas FLU was linked to fever (aOR: 2.27; 95%CI: 2.06-2.50) and sore throat (aOR: 1.48; 95%CI: 1.34-1.64). CONCLUSIONS The viral agents responsible for severe LRTI have distinct associations with clinical features in children.
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Affiliation(s)
- Rodrigo C Menezes
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Instituto de Pesquisa Clínica e Translacional (IPCT), UniFTC, Bahia, Brazil; Universidade Federal da Bahia (UFBA), Bahia, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Bahia, Brazil
| | - Isabella B B Ferreira
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Instituto de Pesquisa Clínica e Translacional (IPCT), UniFTC, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | - Luciana Sobral
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Instituto de Pesquisa Clínica e Translacional (IPCT), UniFTC, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | - Stefania L Garcia
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Universidade Salvador, Bahia, Brazil
| | - Hugo N Pustilnik
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Universidade Salvador, Bahia, Brazil
| | - Mariana Araújo-Pereira
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Instituto de Pesquisa Clínica e Translacional (IPCT), UniFTC, Bahia, Brazil; Universidade Federal da Bahia (UFBA), Bahia, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Bahia, Brazil
| | - Bruno B Andrade
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER Initiative), Brazil; Instituto de Pesquisa Clínica e Translacional (IPCT), UniFTC, Bahia, Brazil; Universidade Federal da Bahia (UFBA), Bahia, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Bahia, Brazil; Universidade Salvador, Bahia, Brazil.
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Dina J, Moisan A, Thibon P, Creveuil C, Adnet J, Vabret A, Brouard J, Plantier JC. Characteristics of respiratory viruses' circulation through a six-year period (2016-2022) in a pediatric population in Normandy, France, and the impact of COVID-19 pandemic. Microbiol Spectr 2023; 11:e0186723. [PMID: 37882556 PMCID: PMC10714951 DOI: 10.1128/spectrum.01867-23] [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: 05/04/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023] Open
Abstract
IMPORTANCE The report highlights an epidemiological change in the circulation of respiratory viruses in pediatric populations due to strategies adopted against COVID-19 pandemic. COVID-19 has resulted in a significant increase in requests for multiplex respiratory research to identify the virus responsible for the symptoms. The diagnostic needs have increased, and the number of samples analyzed in 2021-2022 is equal to the samples analyzed over the four epidemic periods preceding the pandemic. The report suggests the importance of active surveillance of respiratory viruses' circulation and new recommendations for respiratory virus detection in pediatric patients.
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Affiliation(s)
- J. Dina
- INSERM U1311, Dynamicure, UNICAEN, UNIROUEN, Virology Department, CHU Caen, Paris, France
| | - A. Moisan
- INSERM U1311, Dynamicure, UNIROUEN, UNICAEN, Virology Department, CHU de Rouen, France
| | - P. Thibon
- Centre d’appui pour la Prévention des Infections Associées aux Soins, CPias Normandie, CHU de Caen, France
| | | | - J. Adnet
- INSERM U1311, Dynamicure, UNICAEN, UNIROUEN, Virology Department, CHU Caen, Paris, France
| | - A. Vabret
- INSERM U1311, Dynamicure, UNICAEN, UNIROUEN, Virology Department, CHU Caen, Paris, France
| | - J. Brouard
- INSERM U1311, Dynamicure, UNICAEN, UNIROUEN, Pediatrics Department, CHU Caen, France
| | - J. C. Plantier
- INSERM U1311, Dynamicure, UNIROUEN, UNICAEN, Virology Department, CHU de Rouen, France
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Johnson EK, Sylte D, Chaves SS, Li Y, Mahe C, Nair H, Paget J, van Pomeren T, Shi T, Viboud C, James SL. Hospital utilization rates for influenza and RSV: a novel approach and critical assessment. Popul Health Metr 2021; 19:31. [PMID: 34126993 PMCID: PMC8204427 DOI: 10.1186/s12963-021-00252-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/31/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Influenza and respiratory syncytial virus (RSV) contribute significantly to the burden of acute lower respiratory infection (ALRI) inpatient care, but heterogeneous coding practices and availability of inpatient data make it difficult to estimate global hospital utilization for either disease based on coded diagnoses alone. METHODS This study estimates rates of influenza and RSV hospitalization by calculating the proportion of ALRI due to influenza and RSV and applying this proportion to inpatient admissions with ALRI coded as primary diagnosis. Proportions of ALRI attributed to influenza and RSV were extracted from a meta-analysis of 360 total sources describing inpatient hospital admissions which were input to a Bayesian mixed effects model over age with random effects over location. Results of this model were applied to inpatient admission datasets for 44 countries to produce rates of hospital utilization for influenza and RSV respectively, and rates were compared to raw coded admissions for each disease. RESULTS For most age groups, these methods estimated a higher national admission rate than the rate of directly coded influenza or RSV admissions in the same inpatient sources. In many inpatient sources, International Classification of Disease (ICD) coding detail was insufficient to estimate RSV burden directly. The influenza inpatient burden estimates in older adults appear to be substantially underestimated using this method on primary diagnoses alone. Application of the mixed effects model reduced heterogeneity between countries in influenza and RSV which was biased by coding practices and between-country variation. CONCLUSIONS This new method presents the opportunity of estimating hospital utilization rates for influenza and RSV using a wide range of clinical databases. Estimates generally seem promising for influenza and RSV associated hospitalization, but influenza estimates from primary diagnosis seem highly underestimated among older adults. Considerable heterogeneity remains between countries in ALRI coding (i.e., primary vs non-primary cause), and in the age profile of proportion positive for influenza and RSV across studies. While this analysis is interesting because of its wide data utilization and applicability in locations without laboratory-confirmed admission data, understanding the sources of variability and data quality will be essential in future applications of these methods.
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Affiliation(s)
- Emily K Johnson
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA.
| | - Dillon Sylte
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - You Li
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cedric Mahe
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
- Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Tayma van Pomeren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
| | - Ting Shi
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Spencer L James
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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Singer TG, Evankovich KD, Fisher K, Demmler-Harrison GJ, Risen SR. Coronavirus Infections in the Nervous System of Children: A Scoping Review Making the Case for Long-Term Neurodevelopmental Surveillance. Pediatr Neurol 2021; 117:47-63. [PMID: 33676141 PMCID: PMC7988307 DOI: 10.1016/j.pediatrneurol.2021.01.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The objective of this study was to describe the case literature of human coronavirus infections in the nervous system of children, including from SARS-CoV-2, and to provide guidance to pediatric providers for managing the potential long-term effects on neurodevelopment of human coronavirus infections in the nervous system. METHODS Using a structured strategy, the PubMed and Ovid:Embase databases were queried for articles about the clinical presentation and pathophysiology of coronavirus infections in the nervous system of children and young adults, aged 0 to 24 years. RESULTS Of 2302 articles reviewed, 31 described SARS-CoV-2 infections in the nervous system of children and 21 described other human coronaviruses: HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1, MERS-CoV, SARS-CoV-1. Excepting MERS-CoV, we found cases of neurological disease in children from each human coronavirus. Children with non-SARS-CoV-2 infections have suffered acute flaccid paralysis, acute disseminated encephalomyelitis, encephalitis, and seizures. In addition, cases of ischemic, hemorrhagic, and microvascular strokes have occurred in children with SARS-CoV-2. Patients with multisystem inflammatory syndrome in children have suffered encephalitis, stroke, pseudotumor cerebri syndrome, and cytotoxic lesions of deep brain structures. Despite these reports, few articles evaluated the impact of human coronavirus infections on long-term neurodevelopmental domains including cognitive, language, academic, motor, and psychosocial outcomes. CONCLUSIONS Neurological manifestations of human coronavirus infections can cause severe disease in children. The case literature suggests a critical gap in knowledge of the long-term effects on child neurodevelopment of these infections. As the current SARS-CoV-2 pandemic continues, this gap must be filled to facilitate optimal outcomes in recovering children.
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Affiliation(s)
- Timothy G. Singer
- Baylor College of Medicine, Global Child Health Residency, Texas Children’s Hospital, Houston, Texas,Communications should be addressed to: Dr. Singer; Pediatric House Staff Office; 6621 Fannin St, West Tower 19th Floor; Houston, TX USA 77030
| | - Karen D. Evankovich
- Baylor College of Medicine, Department of Pediatrics, Sections of Psychology and Neurology, Texas Children’s Hospital, Houston, Texas
| | - Kristen Fisher
- Baylor College of Medicine, Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Texas Children’s Hospital, Houston, Texas
| | - Gail J. Demmler-Harrison
- Baylor College of Medicine, Pediatric Infectious Disease, Texas Children’s Hospital, Houston, Texas
| | - Sarah R. Risen
- Baylor College of Medicine, Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Texas Children’s Hospital, Houston, Texas
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Fillatre A, François C, Segard C, Duverlie G, Hecquet D, Pannier C, Roussel C, Zawadzki P, Brochot E, Castelain S. Epidemiology and seasonality of acute respiratory infections in hospitalized children over four consecutive years (2012-2016). J Clin Virol 2018; 102:27-31. [PMID: 29477833 PMCID: PMC7106524 DOI: 10.1016/j.jcv.2018.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/04/2018] [Accepted: 02/19/2018] [Indexed: 01/11/2023]
Abstract
The respiratory viral profile varied with age. The distribution of viruses is variable over the year depending on the species. Persistence of non-enveloped viruses throughout the year. Atmospheric temperature was rarely a limiting factor in the circulation of viruses.
Background Acute respiratory infections are a principal cause of illness and mortality especially in young children worldwide. Objectives To study the epidemiology and seasonality of viral respiratory infections in hospitalized children (under the age of 16) between September 2012 and August 2016. Study design Nasopharyngeal swabs or aspirates were collected from 3199 symptomatic patients and then screened with a routine multiplex PCR assay. Results Respiratory viruses were detected for 1624 (50.8%) of the 3199 children in the study population. Of these, 210 (13.3%) were positive for two viruses, 28 (1.7%) were positive for three, and 3 (0.2%) were positive for four. The viral profile varied with age. Some viruses were significantly more frequent in children under the age of 1 month (such as human respiratory syncytial virus (p < 0.0001)), whereas others were significantly more frequent in children over that age (such as influenza viruses (p < 0.0001) and adenoviruses (p = .0006)). The distribution of viruses is variable over the year depending on the species. However, the atmospheric temperature was rarely found to be a limiting factor in the circulation of respiratory viruses. Conclusions our results constitute a detailed description of the distribution of respiratory viruses among hospitalized children over four consecutive years. Our data notably highlight the persistence of non-enveloped viruses and some enveloped viruses throughout the year–regardless of temperature variations.
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Affiliation(s)
- Adrien Fillatre
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Catherine François
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France; EA4294, Université de Picardie Jules Verne, Amiens, France
| | - Christine Segard
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Gilles Duverlie
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France; EA4294, Université de Picardie Jules Verne, Amiens, France
| | - Denise Hecquet
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Christine Pannier
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Catherine Roussel
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Patricia Zawadzki
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France
| | - Etienne Brochot
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France; EA4294, Université de Picardie Jules Verne, Amiens, France
| | - Sandrine Castelain
- Virology Department Centre de Biologie Humaine, Centre Hospitalo-Universitaire Amiens Picardie, Amiens, France; EA4294, Université de Picardie Jules Verne, Amiens, France.
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Tran LC, Tournus C, Dina J, Morello R, Brouard J, Vabret A. SOFIA ®RSV: prospective laboratory evaluation and implementation of a rapid diagnostic test in a pediatric emergency ward. BMC Infect Dis 2017. [PMID: 28651525 PMCID: PMC5485495 DOI: 10.1186/s12879-017-2557-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is responsible for severe respiratory infections and higher costs in medical care. The two aims of this work were to assess the performances of SOFIA®RSV tests in “real-life-laboratory” conditions (study 1) and implemented at point-of-care testing in a pediatric emergency department (ED, study 2), during two consecutive winter seasons. Methods In study 1, fresh nasopharyngeal swabs from patients of all ages were sampled in 1.5 ml of Universal virological Transport Medium (UTM) and prospectively tested using SOFIA®RSV tests. In study 2, conducted in a pediatric ED, nasopharyngeal swabs were placed in 3 ml of UTM. All SOFIA®RSV tests were confirmed by molecular testing, considered as reference method. The epidemiological and clinical features of tested patients, as well as the care of these patients after obtaining quick results were evaluated. Results The sensitivities of SOFIA®RSV in infants (aged under 24 months) performed in the laboratory and in the pediatric ED were respectively 95% (95% CI: 86.8–98.1) and 74.8% (95% CI: 68.0–80.9) compared to PCR. In study 1, the sensitivity among children (from 2 to 15 years old) and adults (above 15 years old) dropped to 45% (95% CI: 23.1–68.5) and 59% (95% CI: 32.9–81.6), respectively. In study 2, there were some differences in bed-management of SOFIA®RSV positive compared to SOFIA®RSV negative infants. Conclusions SOFIA®RSV tests performed in the laboratory and in the pediatric ED show high and satisfactory sensitivities among young children under 24 months, which supports its robustness and reliability. However, the impact of these tests on patient care at point-of-care cannot be clearly assessed when considering the limits of the study 2 design. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2557-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Léa C Tran
- Department of Pediatrics, CHU de Caen, Normandy, Caen, France.
| | - Céline Tournus
- Normandy University, UNICAEN, EA 4655-U2RM, EA 2656-GRAM, Caen, France.,Department of Virology, National Reference Laboratory for Measles and Paramyxoviridae, CHU de Caen, Normandy, Caen, France
| | - Julia Dina
- Normandy University, UNICAEN, EA 4655-U2RM, EA 2656-GRAM, Caen, France.,Department of Virology, National Reference Laboratory for Measles and Paramyxoviridae, CHU de Caen, Normandy, Caen, France
| | - Rémy Morello
- Department of Statistics and Clinical Research, CHU de Caen, Normandy, Caen, France
| | - Jacques Brouard
- Department of Pediatrics, CHU de Caen, Normandy, Caen, France
| | - Astrid Vabret
- Normandy University, UNICAEN, EA 4655-U2RM, EA 2656-GRAM, Caen, France.,Department of Virology, National Reference Laboratory for Measles and Paramyxoviridae, CHU de Caen, Normandy, Caen, France
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Achten NB, Wu P, Bont L, Blanken MO, Gebretsadik T, Chappell JD, Wang L, Yu C, Larkin EK, Carroll KN, Anderson LJ, Moore ML, Sloan CD, Hartert TV. Interference Between Respiratory Syncytial Virus and Human Rhinovirus Infection in Infancy. J Infect Dis 2017; 215:1102-1106. [PMID: 28368456 PMCID: PMC5426371 DOI: 10.1093/infdis/jix031] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/15/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) and human rhinovirus (HRV) are the most common viruses associated with acute respiratory tract infections in infancy. Viral interference is important in understanding respiratory viral circulation and the impact of vaccines. METHODS To study viral interference, we evaluated cases of RSV and HRV codetection by polymerase chain reaction in 2 prospective birth cohort studies (the Infant Susceptibility to Pulmonary Infections and Asthma Following RSV Exposure [INSPIRE] study and the Tennessee Children's Respiratory Initiative [TCRI]) and a double-blinded, randomized, controlled trial (MAKI), using adjusted multivariable regression analyses. RESULTS Among 3263 respiratory tract samples, 24.5% (798) and 37.3% (1216) were RSV and HRV positive, respectively. The odds of HRV infection were significantly lower in RSV-infected infants in all cohorts, with adjusted odds ratios of 0.30 (95% confidence interval [CI], .22-.40 in the INSPIRE study, 0.18 (95% CI, .11-.28) in the TCRI (adjusted for disease severity), and 0.34 (95% CI, .16-.72) in the MAKI trial. HRV infection was significantly more common among infants administered RSV immunoprophylaxis, compared with infants who did not receive immunoprophylaxis (OR, 1.65; 95% CI, 1.65-2.39). CONCLUSIONS A negative association of RSV on HRV codetection was consistently observed across populations, seasons, disease severity, and geographical regions. Suppressing RSV infection by RSV immunoprophylaxis might increase the risk of having HRV infection.
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Affiliation(s)
- Niek B Achten
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands
| | - Pingsheng Wu
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine
| | - Louis Bont
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands
| | - Maarten O Blanken
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands
| | | | | | | | | | - Emma K Larkin
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine
| | - Kecia N Carroll
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Larry J Anderson
- Department of Pediatrics, Emory University, Atlanta, Georgia; and
| | - Martin L Moore
- Department of Pediatrics, Emory University, Atlanta, Georgia; and
| | - Chantel D Sloan
- Department of Health Science, College of Life Sciences, Brigham Young University, Provo, Utah
| | - Tina V Hartert
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine
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de Blic J, Brouard J, Vabret A, Deschildre A. [The interactions between microorganisms and the small airways. A paediatric focus]. Rev Mal Respir 2017; 34:134-146. [PMID: 28262277 PMCID: PMC7125672 DOI: 10.1016/j.rmr.2016.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 02/26/2016] [Indexed: 11/19/2022]
Abstract
The spectrum of respiratory viruses is expanding and emerging diseases have been described regularly over the last fifteen years. The origin of these emerging respiratory viruses may be zoonotic (by crossing species barrier, after changes to RNA viruses such as avian influenza virus type A or coronaviruses), or related to the use of new identification techniques (metapneumovirus, bocavirus). The relationship between bronchiolitis and asthma is now better understood thanks to prospective follow up of birth cohorts. The role of rhinovirus has become predominant with respect to respiratory syncytial virus. The identification of predisposing factors immunological, functional, atopic and genetic, for the onset of asthma after rhinovirus infection suggests that viral infection reveals a predisposition rather than itself being a cause of asthma. The role of bacteria in the natural history of asthma is also beginning to be better understood. The results of the COPSAC Danish cohort have shown the frequency of bacterial identification during wheezy episodes before 3 years, and the impact of bacterial colonization at the age of one month on the onset of asthma by age 5 years. The role of bacterial infections in severe asthma in young children is also discussed.
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Affiliation(s)
- J de Blic
- Service de pneumologie et allergologie pédiatriques, hôpital universitaire Necker-Enfants-Malades, université Paris Descartes, Assistance publique des Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France.
| | - J Brouard
- EA 4655 U2RM, UCBN, service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14032 Caen, France
| | - A Vabret
- EA 4655 U2RM, UCBN, laboratoire de virologie, CHU de Caen, avenue Clémenceau, 14032 Caen, France
| | - A Deschildre
- Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille cedex, France
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9
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Brouard J, Tran L, Flammang A, Dupont C, Vabret A. Vaccination antigrippale de l’enfant : vaccins inactivés ou vivants atténués ? Arch Pediatr 2017; 24:211-214. [DOI: 10.1016/j.arcped.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
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10
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Visseaux B, Collin G, Ichou H, Charpentier C, Bendhafer S, Dumitrescu M, Allal L, Cojocaru B, Desfrère L, Descamps D, Mandelbrot L, Houhou-Fidouh N. Usefulness of multiplex PCR methods and respiratory viruses' distribution in children below 15 years old according to age, seasons and clinical units in France: A 3 years retrospective study. PLoS One 2017; 12:e0172809. [PMID: 28235002 PMCID: PMC5325537 DOI: 10.1371/journal.pone.0172809] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/09/2017] [Indexed: 02/01/2023] Open
Abstract
Background To date, only influenza and RSV testing are recommended for respiratory viruses’ detection in paediatric units. In this study, we described, according to seasons, ages and clinical units, the results obtained in children (<15 years old) by multiplex-PCR (mPCR) tests allowing a quick and wide range detection of all respiratory viruses. These results were also compared with RSV specific detection. Methods All nasopharyngeal mPCR and RSV tests requested by clinicians in our French teaching hospitals group between 2011 and 2014 were retrospectively included. All repeated samples for the same children in the same month were discarded. Results Of the 381 mPCR tests (344 children) performed, 51.4% were positive. Positivity and viral co-infection rates were higher in the 6–36 months old strata (81% and 25%, p<0.0001 and p = 0.04, respectively). Viral distribution showed strong variations across ages. During specific influenza epidemic periods, only 1/39 (2.5%) mPCR tests were positive for influenza and 19/39 (48.7%) for other viruses. During specific RSV epidemic periods, only 8/46 (17.4%) mPCR tests were positive for RSV and 14/46 (30.4%) for other viruses. 477/1529 (31.2%) of RSV immunochromatography-tests were positive. Among the negatives immunochromatography-test also explored by mPCR, 28/62 (31%) were positive for other respiratory viruses. Conclusion This study provides a wide description of respiratory viruses’ distribution among children in hospital settings using mPCR over 3 years. It emphasizes the number of undiagnosed respiratory viruses according to the current diagnosis practice in France and gives a better picture of respiratory viruses identified in hospital settings by mPCR all over the year in France.
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Affiliation(s)
- Benoit Visseaux
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
- * E-mail:
| | - Gilles Collin
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Houria Ichou
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Charlotte Charpentier
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | - Samia Bendhafer
- Service de Néonatologie, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - Madalina Dumitrescu
- Service des Urgences pédiatrique, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - Lahcene Allal
- Service de Maternité, Hôpital Bichat, AP-HP, Paris, France
| | - Bogdan Cojocaru
- Service des Urgences pédiatrique, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - Luc Desfrère
- Service de Néonatologie, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - Diane Descamps
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
| | | | - Nadhira Houhou-Fidouh
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France
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deBruyne J, Nathan A, Qiao Y, Jafar F, Chan YF, Eg K, Thavagnanam S, Bakar S, Sam IC. Viruses and hospitalization for childhood lower respiratory tract infection in Malaysia: A prospective study. ACTA ACUST UNITED AC 2017. [DOI: 10.4103/prcm.prcm_2_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Goktas S, Sirin MC. Prevalence and Seasonal Distribution of Respiratory Viruses During the 2014 - 2015 Season in Istanbul. Jundishapur J Microbiol 2016; 9:e39132. [PMID: 27800148 PMCID: PMC5086027 DOI: 10.5812/jjm.39132] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/16/2016] [Accepted: 08/07/2016] [Indexed: 02/07/2023] Open
Abstract
Background Acute respiratory tract infection (ARTI) is one of the most common infections worldwide, causing significant morbidity and mortality. Objectives This study was conducted to determine the prevalence and seasonal distribution of respiratory viruses in our region, in children and adults with a pre-diagnosis of ARTI. Methods A total of 845 nasopharyngeal swab specimens were analyzed with the RespiFinder Smart 22 kit (PathoFinder BV, Netherlands) and the Rotor-Gene 6000 real-time PCR system. Results At least one pathogen was detected in 612 (72.4%) of the specimens. Overall, 902 pathogens were detected; 821 (91%) were viruses and 81 (9%) were bacteria. The most commonly detected pathogens were influenza A virus (IFV-A) (n = 219), influenza B virus (IFV-B) (n=157), rhinovirus/enterovirus (n = 107), human bocavirus (HBoV) (n = 91), respiratory syncytial virus (RSV) A/B (n = 64), adenovirus (n = 56), human coronaviruses (n = 51), Mycoplasma pneumoniae (n = 49), parainfluenza viruses (n = 40), human metapneumovirus (n = 36), Bordetella pertussis (n = 15), Legionella pneumophila (n = 11), and Chlamydophila pneumoniae (n = 6), respectively. Among the 215 (25.4%) co-infected cases, IFV-A/HBoV and IFV-A/IFV-B were the most common co-infections. IFV-A was the most prevalent agent in all age groups except for children under 5 years of age, in whom RSV A/B was the most common pathogen. Approximately two thirds of the respiratory viruses were detected in early spring and winter, with peaks in January, March, and April. Conclusions With regard to the prevalence and seasonal distribution of respiratory viruses, our epidemiological data for the 2014 - 2015 season in Istanbul showed a predominance of IFV-A infections with a peak activity in early spring. Enhanced surveillance and early detection of respiratory viral pathogens can be useful in the diagnosis, treatment, and prevention of ARTIs, and for guiding the development of appropriate public health strategies.
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Affiliation(s)
- Safak Goktas
- Gelisim Medical Laboratories, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Mumtaz Cem Sirin
- Izmir Tepecik Training and Research Hospital, Department of Medical Microbiology, Izmir, Turkey
- Corresponding author: Mumtaz Cem Sirin, Izmir Tepecik Training and Research Hospital, Department of Medical Microbiology, Izmir, Turkey. Tel: +90-5327905288, Fax: +90-2324330756, E-mail:
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Bonnin P, Miszczak F, Kin N, Resa C, Dina J, Gouarin S, Viron F, Morello R, Vabret A. Study and interest of cellular load in respiratory samples for the optimization of molecular virological diagnosis in clinical practice. BMC Infect Dis 2016; 16:384. [PMID: 27503120 PMCID: PMC4977610 DOI: 10.1186/s12879-016-1730-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Respiratory viral diagnosis of upper respiratory tract infections has largely developed through multiplex molecular techniques. Although the sensitivity of different types of upper respiratory tract samples seems to be correlated to the number of sampled cells, this link remains largely unexplored. METHODS Our study included 800 upper respiratory tract specimens of which 400 negative and 400 positive for viral detection in multiplex PCR. All samples were selected and matched for age in these 2 groups. For the positive group, samples were selected for the detected viral species. RESULTS Among the factors influencing the cellularity were the type of sample (p < 0.0001); patient age (p < 0.001); viral positive or negative nature of the sample (p = 0.002); and, for the positive samples, the number of viral targets detected (0.004 < p < 0.049) and viral species. CONCLUSION The cellular load of upper respiratory samples is multifactorial and occurs for many in the sensitivity of molecular detection. However it was not possible to determine a minimum cellularity threshold allowing molecular viral detection. The differences according to the type of virus remain to be studied on a larger scale.
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Affiliation(s)
- Paul Bonnin
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Fabien Miszczak
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Nathalie Kin
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Cecile Resa
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
| | - Julia Dina
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Stephanie Gouarin
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Florent Viron
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
| | - Remy Morello
- Normandie University, Caen, France
- Statistics and Clinical Research Department, CHU de Caen, F-14033 Caen, France
| | - Astrid Vabret
- Normandie University, Caen, France
- EA 4655-U2RM, UNICAEN, F-14032 Caen, France
- Department of Virology, CHU de Caen, F-14033 Caen, France
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Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, Zhang Y, Ho W, Yu G, Zhang T. Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016; 95:e4509. [PMID: 27495104 PMCID: PMC4979858 DOI: 10.1097/md.0000000000004509] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) represent one of the main health problems in children. Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance. Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs. The authors systematically reviewed data from randomized controlled trials (RCTs) to investigate the effect of probiotic consumption on RTIs in children. METHODS MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for RCTs regarding the effect of probiotics on RTIs in children. The outcomes included number of children experienced with at least 1 RTI episode, duration of illness episodes, days of illness per subject, and school/day care absenteeism due to infection. A random-effects model was used to calculate pooled relative risks, or mean difference (MD) with the corresponding 95% confidence interval (CI). RESULTS A total of 23 trials involving 6269 children were eligible for inclusion in the systematic review. None of the trials showed a high risk of bias. The quality of the evidence of outcomes was moderate. The age range of subjects was from newborn to 18 years. The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82-0.96, P = 0.004). Children supplemented with probiotics had fewer numbers of days of RTIs per person compared with children who had taken a placebo (6 RCTs, 2067 children, MD -0.16, 95% CI -0.29 to 0.02, P = 0.03), and had fewer numbers of days absent from day care/school (8 RCTs, 1499 children, MD -0.94, 95% CI -1.72 to -0.15, P = 0.02). However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD -0.60, 95% CI -1.49 to 0.30, P = 0.19). CONCLUSION Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children.
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Affiliation(s)
- Yizhong Wang
- Department of Gastroenterology, Hepatology, and Nutrition
- Correspondence: Yizhong Wang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Guangjun Yu, Department of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Ting Zhang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: )
| | - Xiaolu Li
- Department of Gastroenterology, Hepatology, and Nutrition
| | - Ting Ge
- Department of Gastroenterology, Hepatology, and Nutrition
| | - Yongmei Xiao
- Department of Gastroenterology, Hepatology, and Nutrition
| | - Yang Liao
- Department of Gastroenterology, Hepatology, and Nutrition
| | - Yun Cui
- Pediatric Intensive Care Unit, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China
| | - Yucai Zhang
- Pediatric Intensive Care Unit, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China
| | - Wenzhe Ho
- Department of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, PA
| | - Guangjun Yu
- Department of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China
- Correspondence: Yizhong Wang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Guangjun Yu, Department of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Ting Zhang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: )
| | - Ting Zhang
- Department of Gastroenterology, Hepatology, and Nutrition
- Correspondence: Yizhong Wang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Guangjun Yu, Department of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: ); Ting Zhang, Department of Gastroenterology, Hepatology, and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China (e-mail: )
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15
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Brouard J, Dupont C, Tran L, Ribault M, Vabret A. [Rhinovirus during childhood: Asthma at adolescence? The chicken or the egg causality dilemma]. Arch Pediatr 2016; 23:557-60. [PMID: 27021809 PMCID: PMC7133363 DOI: 10.1016/j.arcped.2016.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 11/27/2022]
Affiliation(s)
- J Brouard
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France; EA 4655 U2RM, équipe E3 : « virologie respiratoire comparée », 14032 Caen, France.
| | - C Dupont
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - L Tran
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - M Ribault
- Service de pédiatrie médicale, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - A Vabret
- Laboratoire de virologie, CHU de Caen, avenue Clemenceau, 14033 Caen, France; EA 4655 U2RM, équipe E3 : « virologie respiratoire comparée », 14032 Caen, France
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16
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Probiotics for the treatment of upper and lower respiratory‐tract infections in children: systematic review based on randomized clinical trials. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2015. [DOI: 10.1016/j.jpedp.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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17
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Araujo GVD, Oliveira Junior MHD, Peixoto DM, Sarinho ESC. Probiotics for the treatment of upper and lower respiratory-tract infections in children: systematic review based on randomized clinical trials. J Pediatr (Rio J) 2015; 91:413-27. [PMID: 26054771 DOI: 10.1016/j.jped.2015.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/06/2015] [Accepted: 03/19/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Evaluate the effect of probiotics on the symptoms, duration of disease, and the occurrence of new episodes of upper and lower respiratory infections in healthy children. SOURCES In order to identify eligible randomized controlled trials, two reviewers accessed four electronic databases [MEDLINE/PubMed, Scopus (Elsevier), Web of Science, and Cochrane (Cochrane VHL)], as well as ClinicalTrials.gov until January 2015. Descriptors were determined by using the Medical Subject Headings tool, following the same search protocol. SUMMARY OF THE FINDINGS Studies showed to be heterogeneous regarding strains of probiotics, the mode of administration, the time of use, and outcomes. The present review identified 11 peer-reviewed, randomized clinical trials, which analyzed a total of 2417 children up to 10 incomplete years of age. In the analysis of the studies, reduction in new episodes of disease was a favorable outcome for the use of probiotics in the treatment of respiratory infections in children. It is noteworthy that most of these studies were conducted in developed countries, with basic sanitation, health care, and strict, well-established and well-organized guidelines on the use of probiotics. Adverse effects were rarely reported, demonstrating probiotics to be safe. CONCLUSIONS Despite the encouraging results - reducing new episodes of respiratory infections - the authors emphasize the need for further research, especially in developing countries, where rates of respiratory infections in children are higher when compared to the high per capita-income countries identified in this review.
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Affiliation(s)
- Georgia Véras de Araujo
- Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Centro de Pesquisas em Alergia e Imunologia, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
| | - Mário Henriques de Oliveira Junior
- Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Department of Internal Medicine, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Décio Medeiros Peixoto
- Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Centro de Pesquisas em Alergia e Imunologia, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Department of Pediatrics, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Emanuel Sávio Cavalcanti Sarinho
- Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Centro de Pesquisas em Alergia e Imunologia, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Department of Pediatrics, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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18
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Epidemiology and virology of acute respiratory infections during the first year of life: a birth cohort study in Vietnam. Pediatr Infect Dis J 2015; 34:361-70. [PMID: 25674708 PMCID: PMC4418783 DOI: 10.1097/inf.0000000000000643] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Understanding viral etiology and age-specific incidence of acute respiratory infections in infants can help identify risk groups and inform vaccine delivery, but community-based data is lacking from tropical settings. METHODS One thousand four hundred and seventy-eight infants in urban Ho Chi Minh City and 981 infants in a semi-rural district in southern Vietnam were enrolled at birth and followed to 1 year of age. Acute respiratory infection (ARI) episodes were identified through clinic-based illness surveillance, hospital admissions and self-reports. Nasopharyngeal swabs were collected from infants with respiratory symptoms and tested for 14 respiratory pathogens using multiplex reverse transcription-polymerase chain reaction. RESULTS Estimated incidence of ARI was 542 and 2691 per 1000 infant-years, and hospitalization rates for ARI were 81 and 138 per 1000 infant-years, in urban and semi-rural cohorts, respectively, from clinic- and hospital-based surveillance. However self-reported ARI episodes were just 1.5-fold higher in the semi-rural versus urban cohort, indicating that part of the urban-rural difference was explained by under-ascertainment in the urban cohort. Incidence was higher in infants ≥6 months of age than <6 months, but this was pathogen-specific. One or more viruses were detected in 53% (urban) and 64% (semi-rural) of samples from outpatients with ARI and in 78% and 66% of samples from hospitalized ARI patients, respectively. The most frequently detected viruses were rhinovirus, respiratory syncytial virus, influenza virus A and bocavirus. ARI-associated hospitalizations were associated with longer stays and more frequent ICU admission than other infections. CONCLUSIONS ARI is a significant cause of morbidity in Vietnamese infants and influenza virus A is an under-appreciated cause of vaccine-preventable disease and hospitalizations in this tropical setting. Public health strategies to reduce infant ARI incidence and hospitalization rates are needed.
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[Winter viral ecology in a pediatric intensive care unit: a prospective study]. Arch Pediatr 2014; 22:368-72. [PMID: 25534558 PMCID: PMC7133265 DOI: 10.1016/j.arcped.2014.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/19/2014] [Accepted: 10/31/2014] [Indexed: 01/08/2023]
Abstract
Le but de cette étude prospective était d’évaluer l’épidémiologie des virus respiratoires chez les enfants hospitalisés dans une unité de réanimation et de soins continus pédiatriques pendant 3 mois d’hiver, en 2012–2013. Ont été inclus tous les enfants admis en réanimation pédiatrique du centre hospitalier universitaire (CHU) de Caen et ayant bénéficié d’une recherche d’infection par un virus respiratoire à partir d’un prélèvement nasal analysé par amplification génique (PCR) multiplex. Sur 105 enfants admis, 84 répondaient aux critères d’inclusion. Trente-sept enfants présentaient un ou plusieurs symptômes respiratoires à l’admission. Cinquante-quatre échantillons étaient positifs (64,3 %) avec 70 virus détectés. Le virus dont la prévalence était la plus élevée était le virus respiratoire syncytial (VRS) (n = 28 ; 40,0 %), suivi par le rhinovirus (n = 24 ; 34,3 %). Parmi les enfants sans symptômes respiratoires, 42,6 % étaient infectés par un ou plusieurs virus. Aucune différence de durée d’hospitalisation, de durée de ventilation mécanique n’a été mise en évidence en fonction du virus détecté. La principale limite de cette étude est l’analyse par PCR, beaucoup plus sensible que d’autres méthodes de détection, notamment chez des sujets asymptomatiques sur le plan respiratoire. Cette étude révèle cependant un taux élevé d’infections respiratoires causées par des virus chez les enfants qui ne présentent pas de symptômes respiratoires à leur admission en unité de réanimation et soins continus. Elle suggère un intérêt du dépistage de ces infections virales à l’admission des enfants et un bénéfice à l’extension des mesures d’isolement pour tous les enfants en réanimation pédiatrique.
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Gooskens J, van der Ploeg V, Sukhai RN, Vossen ACTM, Claas ECJ, Kroes ACM. Clinical evaluation of viral acute respiratory tract infections in children presenting to the emergency department of a tertiary referral hospital in the Netherlands. BMC Pediatr 2014; 14:297. [PMID: 25491885 PMCID: PMC4276012 DOI: 10.1186/s12887-014-0297-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 11/18/2014] [Indexed: 01/02/2023] Open
Abstract
Background The relative incidence and clinical impact of individual respiratory viruses remains unclear among children presenting to the hospital emergency department with acute respiratory tract infection (ARTI). Methods During two winter periods, respiratory virus real-time multiplex PCR results were evaluated from children (< 18 years) presenting to the emergency department of a tertiary referral hospital with ARTI that had been sampled within 48 hours of hospital presentation. In an attempt to identify virus-specific distinguishing clinical features, single virus infections were correlated with presenting signs and symptoms, clinical findings and outcomes using multivariate logistic regression. Results In total, 274 children with ARTI were evaluated and most were aged < 3 years (236/274, 86%). PCR detected respiratory viruses in 224/274 (81.8%) children and included 162 (59%) single and 62 (23%) mixed virus infections. Respiratory syncytial virus (RSV) and human rhinovirus (HRV) single virus infections were common among children aged < 3 years, but proportional differences compared to older children were only significant for RSV (95% CI 1.3–15). Clinical differentiation between viral ARTIs was not possible due to common shared presenting signs and symptoms and the high frequency of mixed viral infections. We observed virus-associated outcome differences among children aged < 3 years. Oxygen treatment was associated with RSV (OR 3.6) and inversely correlated with FLU (OR 0.05). Treatment with steroids (OR 3.4) or bronchodilators (OR 3.4) was associated with HRV. Severe respiratory complications were associated with HRV (OR 3.5) and inversely correlated with RSV (OR 0.24). Conclusions Respiratory viruses are frequently detected in young children presenting to the hospital emergency department with ARTI and require PCR diagnosis since presenting signs and symptoms are not discriminant for a type of virus. RSV and HRV bear a high burden of morbidity in the pediatric clinical setting.
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Affiliation(s)
- Jairo Gooskens
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Vishnu van der Ploeg
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Ram N Sukhai
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Ann C T M Vossen
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Eric C J Claas
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Aloys C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
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Ozen M, Kocabas Sandal G, Dinleyici EC. Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review. Expert Opin Biol Ther 2014; 15:9-20. [PMID: 25430686 DOI: 10.1517/14712598.2015.980233] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Acute upper respiratory tract infections (URTIs) contribute substantially to pediatric morbidity and mortality worldwide. Prevention of these infections in childhood is a very important public health challenge. Previous systematic reviews, including both adult and childhood populations, have reported that probiotics seem promising, but with modest evidence. This study aimed to focus on prophylactic probiotic use in the prevention of URTIs in childhood. METHODS Relevant trials on two databases were identified in a systematic review, from inception to June 2014. Study selection, data extraction and quality assessment were carried out by two reviewers. In this review, the effects of probiotics, particularly the Lactobacillus and Bifidobacterium strains, on the incidence and symptom scores of URTI in otherwise healthy children were evaluated for the first time. This review comprises 14 randomized controlled trials (RCTs) applied to a pediatric population with high-quality methodology. RESULTS This systematic review suggests that probiotics in immunocompetent children have a modest effect both in diminishing the incidence of URTIs and the severity of the infection symptoms. CONCLUSIONS At least one beneficial effect of prophylactic probiotic was observed in the majority of RCTs. Even a minimal reduction of 5 - 10% in the incidence of URTIs would have an important clinical and economic mpact on societies. Furthermore, the long-term administration of probiotics appeared to have a good safety profile in childhood and none of the studies reported any serious adverse events related to the probiotic strain.
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Affiliation(s)
- Metehan Ozen
- Department of Pediatrics, Acibadem University Faculty of Medicine , Istanbul , Turkey
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Ouédraogo S, Traoré B, Nene Bi ZAB, Yonli FT, Kima D, Bonané P, Congo L, Traoré RO, Yé D, Marguet C, Plantier JC, Vabret A, Gueudin M. Viral etiology of respiratory tract infections in children at the pediatric hospital in Ouagadougou (Burkina Faso). PLoS One 2014; 9:e110435. [PMID: 25360527 PMCID: PMC4215928 DOI: 10.1371/journal.pone.0110435] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/22/2014] [Indexed: 11/29/2022] Open
Abstract
Background Acute respiratory infections (ARIs) are a major cause of morbidity and mortality in children in Africa. The circulation of viruses classically implicated in ARIs is poorly known in Burkina Faso. The aim of this study was to identify the respiratory viruses present in children admitted to or consulting at the pediatric hospital in Ouagadougou. Methods From July 2010 to July 2011, we tested nasal aspirates of 209 children with upper or lower respiratory infection for main respiratory viruses (respiratory syncytial virus (RSV), metapneumovirus, adenovirus, parainfluenza viruses 1, 2 and 3, influenza A, B and C, rhinovirus/enterovirus), by immunofluorescence locally in Ouagadougou, and by PCR in France. Bacteria have also been investigated in 97 samples. Results 153 children (73.2%) carried at least one virus and 175 viruses were detected. Rhinoviruses/enteroviruses were most frequently detected (rhinovirus n = 88; enterovirus n = 38) and were found to circulate throughout the year. An epidemic of RSV infections (n = 25) was identified in September/October, followed by an epidemic of influenza virus (n = 13), mostly H1N1pdm09. This epidemic occurred during the period of the year in which nighttime temperatures and humidity were at their lowest. Other viruses tested were detected only sporadically. Twenty-two viral co-infections were observed. Bacteria were detected in 29/97 samples with 22 viral/bacterial co-infections. Conclusions This study, the first of its type in Burkina Faso, warrants further investigation to confirm the seasonality of RSV infection and to improve local diagnosis of influenza. The long-term objective is to optimize therapeutic management of infected children.
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Affiliation(s)
- Solange Ouédraogo
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | - Blaise Traoré
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | | | | | - Donatien Kima
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | - Pierre Bonané
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | - Lassané Congo
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | | | - Diarra Yé
- Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso
| | - Christophe Marguet
- Respiratory Diseases, Allergy and CF Unit, Paediatric Department, Rouen University Hospital Charles Nicolle, EA3830, Inserm CIC204, Rouen, France
| | | | - Astrid Vabret
- Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France
| | - Marie Gueudin
- Laboratory of Virology, GRAM EA 2656 Rouen University Hospital Charles Nicolle, Rouen, France
- * E-mail:
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23
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Ochoa TJ, Bautista R, Dávila C, Salazar JA, Bazán C, Guerra O, Llanos JP, López L, Zea-Vera A, Ecker L. Respiratory syncytial virus-associated hospitalizations in pre-mature infants in Lima, Peru. Am J Trop Med Hyg 2014; 91:1029-34. [PMID: 25294617 DOI: 10.4269/ajtmh.13-0648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We conducted a prospective cohort study in four hospitals in Lima, Peru in infants with a birth weight ≤ 1,500 g followed from birth hospital discharge up to 1 year of age to determine the incidence of respiratory syncytial virus (RSV) hospitalizations. We enrolled 222 infants from March of 2009 to March of 2010: 48 infants with a birth weight < 1,000 g and 174 infants with a birth weight of 1,000-1,500 g (birth weight = 1,197 ± 224 g; gestational age = 30.1 ± 2.6 weeks). There were 936 episodes of respiratory infections; the incidence of respiratory infections during the first 1 year of life was 5.7 episodes/child-years. The incidence of RSV respiratory infections that required emergency room management was 103.9 per 1,000 child-years, and the incidence of RSV hospitalizations was 116.2 per 1,000 child-years (244.9 in infants with a birth weight < 1,000 g and 88.9 in infants 1,000-1,500 g; P < 0.05). The incidence of RSV respiratory infections that required emergency management or hospitalization is high among pre-mature infants in Lima.
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Affiliation(s)
- Theresa J Ochoa
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Rossana Bautista
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Carmen Dávila
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - José Antonio Salazar
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Carlos Bazán
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Oscar Guerra
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Jean Pierre Llanos
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Luis López
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Alonso Zea-Vera
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
| | - Lucie Ecker
- Department of Pediatrics, Universidad Peruana Cayetano Heredia, Lima, Peru; Univeristy of Texas School of Public Health, Houston, Texas; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Instituto Nacional Materno Perinatal, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; Hospital Nacional Madre Niño San Bartolome, Lima, Peru; Abbott Laboratories, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigacion Nutricional, Lima, Peru
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24
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Feret V, Naud J, Harambat J, Malato L, Fleury H, Fayon M. [Viral epidemiology and clinical severity during the peak of the influenza A(H1N1) variant epidemic in febrile respiratory diseases of children]. Arch Pediatr 2014; 21:709-15. [PMID: 24947110 PMCID: PMC7127584 DOI: 10.1016/j.arcped.2014.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 04/01/2014] [Accepted: 04/17/2014] [Indexed: 12/05/2022]
Abstract
En mars 2009, un nouveau virus a fait émergence, le virus Influenzae A(H1N1) variant. Nous avons voulu en étudier la répercussion médicale. Objectifs Définir la prévalence virale dans les atteintes respiratoires fébriles hospitalisées de l’enfant en période d’épidémie grippale A(H1N1) variant et déterminer les caractéristiques cliniques, paracliniques et évolutives liées aux virus identifiés. Méthodes Il s’est agi d’une étude épidémiologique, prospective, monocentrique menée à l’hôpital des Enfants du centre hospitalier universitaire de Bordeaux (Aquitaine, France) pendant l’épidémie grippale du 23 novembre au 20 décembre 2009 inclus. Tous les enfants hospitalisés pour atteinte respiratoire fébrile ont été inclus. Résultats Soixante-treize enfants ont été inclus. Une identification virale a été possible dans 52 % des cas, incluant 23 % de A(H1N1) variant [A(H1N1)v] et 29 % d’autres identifications dont 22 % de virus respiratoires syncitiaux. Une seule co-infection a été observée entre le virus [A(H1N1)v] et un pool viral (adénovirus ou virus para-influenzae ou bocavirus). Il n’existait pas de différence significative concernant l’âge, le sexe ou les facteurs de risque de gravité en fonction des virus identifiés. Concernant le virus [A(H1N1)v], les symptômes les plus fréquents étaient l’altération de l’état général, la toux, les atteintes oto-rhino-laryngologiques et les anomalies de la fréquence respiratoire, avec significativement moins de signes de lutte et d’anomalie auscultatoire mais plus de convulsions. Sur le plan paraclinique, il n’y avait pas de différence significative entre les groupes. Évolution et prise en charge ont été comparables. Conclusion Une faible prédominance du virus [A(H1N1)v] a été notée pendant l’épidémie grippale en Aquitaine dans les atteintes respiratoires fébriles justifiant une hospitalisation. Les caractéristiques cliniques, paracliniques et évolutives étaient peu spécifiques. L’ensemble de ces éléments n’a pas révélé de gravité particulière liée au virus [A(H1N1)v].
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Affiliation(s)
- V Feret
- Département de pédiatrie médicale, hôpital des Enfants, CHU Pellegrin, place Amélie-Rabat-Léon, 33076 Bordeaux cedex, France.
| | - J Naud
- Département de pédiatrie médicale, hôpital des Enfants, CHU Pellegrin, place Amélie-Rabat-Léon, 33076 Bordeaux cedex, France
| | - J Harambat
- Département de pédiatrie médicale, hôpital des Enfants, CHU Pellegrin, place Amélie-Rabat-Léon, 33076 Bordeaux cedex, France
| | - L Malato
- Service de virologie, CHU Pellegrin, 33076 Bordeaux cedex, France
| | - H Fleury
- Service de virologie, CHU Pellegrin, 33076 Bordeaux cedex, France
| | - M Fayon
- Service de virologie, CHU Pellegrin, 33076 Bordeaux cedex, France; Centre d'investigation clinique Inserm (CIC 0005), CHU de Bordeaux, 33076 Bordeaux, France
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25
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Liu S, Hu P, Du X, Zhou T, Pei X. Lactobacillus rhamnosus GG supplementation for preventing respiratory infections in children: a meta-analysis of randomized, placebo-controlled trials. Indian Pediatr 2013; 50:377-81. [PMID: 23665598 DOI: 10.1007/s13312-013-0123-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the effectiveness of administering Lactobacillus rhamnosus GG (LGG) for preventing respiratory infections in children. DESIGN Systematic Review and Meta-analysis. DATA SOURCES Electronic databases and trial registries. RESULTS Four RCTs involving 1805 participants met the inclusion criteria. Compared with placebo, LGG administration was associated with a reduced incidence of acute otitis media (four RCTs, n=1805, RR 0.76, 95% CI 0.64-0.91, fixed effects model, NNT 17, 95% CI 11-46), a reduced risk of upper respiratory infections (one RCT, n=281, RR 0.62, 95% CI 0.50-0.78, NNT 4, 95% CI 3-8) and antibiotic treatments (four RCTs, n=1805, RR 0.80, 95% CI 0.71-0.91, fixed effects model). There was no significant difference between the LGG and the control groups in the risk of overall respiratory infections and the incidence of lower respiratory infections. However, subgroup analysis of two studies on children older than 1 year showed significant reduction in the risk of overall respiratory infections (two RCTs, n=794, RR 0.73, 95% CI 0.57-0.92, random effects model, NNT 8, 95% CI 5-14). Adverse effects were similar in both groups. No serious adverse events were reported. CONCLUSION The administration of Lactobacillus rhamnosus GG compared with placebo has the potential to reduce the incidence of acute otitis media, the upper respiratory infections and antibiotic use in children.
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Affiliation(s)
- Shan Liu
- Department of Public Health Microbiology, West China School of Public Health, Sichuan University, China
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26
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Abstract
Respiratory syncytial virus (RSV) is amongst the most important pathogenic infections of childhood and is associated with significant morbidity and mortality. Although there have been extensive studies of epidemiology, clinical manifestations, diagnostic techniques, animal models and the immunobiology of infection, there is not yet a convincing and safe vaccine available. The major histopathologic characteristics of RSV infection are acute bronchiolitis, mucosal and submucosal edema, and luminal occlusion by cellular debris of sloughed epithelial cells mixed with macrophages, strands of fibrin, and some mucin. There is a single RSV serotype with two major antigenic subgroups, A and B. Strains of both subtypes often co-circulate, but usually one subtype predominates. In temperate climates, RSV infections reflect a distinct seasonality with onset in late fall or early winter. It is believed that most children will experience at least one RSV infection by the age of 2 years. There are several key animal models of RSV. These include a model in mice and, more importantly, a bovine model; the latter reflects distinct similarity to the human disease. Importantly, the prevalence of asthma is significantly higher amongst children who are hospitalized with RSV in infancy or early childhood. However, there have been only limited investigations of candidate genes that have the potential to explain this increase in susceptibility. An atopic predisposition appears to predispose to subsequent development of asthma and it is likely that subsequent development of asthma is secondary to the pathogenic inflammatory response involving cytokines, chemokines and their cognate receptors. Numerous approaches to the development of RSV vaccines are being evaluated, as are the use of newer antiviral agents to mitigate disease. There is also significant attention being placed on the potential impact of co-infection and defining the natural history of RSV. Clearly, more research is required to define the relationships between RSV bronchiolitis, other viral induced inflammatory responses, and asthma.
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Affiliation(s)
- Andrea T. Borchers
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - M. Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6501, Davis, CA 95616 USA
| | - Laurel J. Gershwin
- Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA USA
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27
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Harada Y, Kinoshita F, Yoshida LM, Minh LN, Suzuki M, Morimoto K, Toku Y, Tomimasu K, Moriuchi H, Ariyoshi K. Does respiratory virus coinfection increases the clinical severity of acute respiratory infection among children infected with respiratory syncytial virus? Pediatr Infect Dis J 2013; 32:441-5. [PMID: 23838658 DOI: 10.1097/inf.0b013e31828ba08c] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection in children less than 5 years of age. The impact of non-RSV respiratory virus coinfection on the severity of RSV disease is unknown. METHODS This hospital-based prospective study was conducted in Nagasaki, Japan, on all children less than 5 years of age with acute respiratory infection (ARI) who had undergone a rapid RSV diagnostic test between April 2009 and March 2010. Thirteen respiratory viruses were identified from nasopharyngeal swab samples using a multiplex polymerase chain reaction; polymerase chain reaction-positive samples were considered as confirmed respiratory virus infections. The cases were classified into 3 categories (pneumonia, moderate-to-severe nonpneumonic ARI and mild ARI) according to the findings of the chest radiograph and the hospitalization records. RESULTS Among 384 cases enrolled, 371 were eligible for analysis, of whom 85 (23%) were classified as pneumonia cases; 137 (37%) as moderate-to-severe nonpneumonic ARI cases and 162 (40%) as mild ARI cases. RSV was detected in 172 cases (61.6%), and 31 cases (18.0%) had double or triple infections with other respiratory viruses. RSV infection was more frequently observed in pneumonia cases (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.31-3.9) and moderate-to-severe nonpneumonic ARI cases (OR: 2.95; 95% CI: 1.82-4.78) than in mild ARI cases. The association with moderate-to-severe nonpneumonic ARI cases was stronger with RSV/non-RSV respiratory virus coinfection (adjusted OR: 4.91; 95% CI: 1.9-12.7) than with RSV single infection (adjusted OR: 2.77; 95% CI: 1.64-4.7). CONCLUSIONS Non-RSV respiratory virus coinfection is not uncommon in RSV-infected children and may increase the severity of RSV disease.
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Affiliation(s)
- Yoshitaka Harada
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Japan
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Shin YS, Kang DS, Lee KS, Kim JK, Chung EH. Clinical characteristics of respiratory virus infection in children admitted to an intensive care unit. ALLERGY ASTHMA & RESPIRATORY DISEASE 2013. [DOI: 10.4168/aard.2013.1.4.370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Youn Shim Shin
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Dong Soo Kang
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Kun Song Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Jae Kyoung Kim
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Eun Hee Chung
- Department of Pediatrics, National Medical Center, Seoul, Korea
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29
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Greenberger PA. Terminology, close-calls, and bracketology for allergy, asthma, and immunology. Ann Allergy Asthma Immunol 2012; 110:141-5. [PMID: 23548520 DOI: 10.1016/j.anai.2012.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 10/24/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Paul A Greenberger
- Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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