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Altawalah H, Alfouzan W, Al-Fadalah T, Zalzala MA, Ezzikouri S. Viral etiology of severe lower respiratory tract infections in SARS-CoV-2 negative hospitalized patients during the COVID-19 pandemic in Kuwait. Heliyon 2024; 10:e29855. [PMID: 38681623 PMCID: PMC11046192 DOI: 10.1016/j.heliyon.2024.e29855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Background The prevalence of respiratory infections is largely underexplored in Kuwait. The aim of our study is to determine the etiology of infections from patients who are SARS-CoV-2 negative hospitalized with severe lower respiratory tract infections (LRTIs) in Kuwait during the coronavirus disease 2019 (COVID-19) pandemic. Methods We conducted an observational cross-sectional study among severe LRTI patients between September 2021 and March 2022. Respiratory samples from 545 non-COVID-19 severe LRTIs patients were prospectively evaluated with FTD Respiratory 21 Plus® real-time PCR, targeting 20 different viruses and 1 atypical bacterial pathogen. Results Among all 545 hospitalized cases, 411 (75.4 %) tested positive for at least one respiratory pathogen. The most common were rhinovirus (HRV) (32.7 %), respiratory syncytial virus (RSV) (20.9 %), metapneumovirus (HMPV) (14.1 %), bocavirus (13.2 %), and influenza A (12.7 %). The proportion of pathogens detected was highest in the under-5 age group, while HKU1 (44.4 %) predominated in the elderly (>50 years). Conclusion Our study reveals a high prevalence of respiratory viruses in severe acute lower respiratory tract infections among non-COVID-19 hospitalized patients in Kuwait. HRV remains the main etiology affecting the country, particularly in infants. These results underscore the necessity of employing multiplex PCR for accurate diagnosis and describing the epidemiology of infections among severe lower respiratory tract infections. This will facilitate the use of specific antiviral therapy and help avoid excessive or inappropriate antibiotic therapy.
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Affiliation(s)
- Haya Altawalah
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
- Virology Unit, Yacoub Behbehani Center, Sabah Hospital, Ministry of Health, Kuwait, Kuwait
| | - Wadha Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
- Laboratory Medicine, Farwania Hospital, Ministry of Health, Farwania, Kuwait
| | - Talal Al-Fadalah
- Qualities and Accreditation Directorate, Ministry of Health, Kuwait, Kuwait
| | - Mariam Ali Zalzala
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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2
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Yan Y, Sun J, Ji K, Guo J, Han L, Li F, Sun Y. High incidence of the virus among respiratory pathogens in children with lower respiratory tract infection in northwestern China. J Med Virol 2023; 95:e28367. [PMID: 36458544 PMCID: PMC9877598 DOI: 10.1002/jmv.28367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/20/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
Lower respiratory tract infection (LRTI) is one of the major reasons for childhood mortality that threaten the health of the public. We aimed to investigate the epidemiological pathogens and their infection analysis among children with LRTI. Sputum specimens were collected for polymerase chain reaction detection and microbiological tests to identify the viral infection and bacterial infection. The serological specimens were separated from venous blood using for Mycoplasma pneumoniae and Chlamydia pneumoniae detection. The virus was confirmed in 86.2% of the children. Human rhinovirus (38.3%), respiratory syncytial virus (32.1%), and parainfluenza virus type 3 (27.2%) were the most frequently identified pathogens. Patients with viral and bacterial coinfection showed younger age (p = 0.032), a higher proportion of wheezing rales (p = 0.032), three depressions sign (p = 0.028), and tachypnea (p = 0.038), and more likely associated with severe pneumonia (p = 0.035). Additionally, older children were more susceptible to viral-atypical bacterial coinfection (p = 0.032). Vomiting (p = 0.011) and fever (p = 0.003) were more likely to occur in children with viral-atypical bacterial coinfection. Attention should be paid to the virus infection of LRTI, as viral-bacterial coinfection and viral-atypical bacterial co-infection may have a detrimental impact on the gravity of LTRI.
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Affiliation(s)
- Yan Yan
- Department of Biochemistry and Molecular Biology, School of Basic Medical ScienceNingxia Medical UniversityYinchuanChina
| | - Jinhan Sun
- Department of Clinical MedicineNingxia Medical UniversityYinchuanChina
| | - Kai Ji
- Department of Biochemistry and Molecular Biology, School of Basic Medical ScienceNingxia Medical UniversityYinchuanChina
| | - Jianhui Guo
- Department of Biochemistry and Molecular Biology, School of Basic Medical ScienceNingxia Medical UniversityYinchuanChina
| | - Lei Han
- Clinical Laboratory of Yinchuan Women and Children Healthcare HospitalYinchuanChina
| | - Fang Li
- Department of Respiratory and Critical Care, General Hospital of Ningxia Medical UniversityNingxia Medical UniversityYinchuanChina
| | - Yuning Sun
- Department of Biochemistry and Molecular Biology, School of Basic Medical ScienceNingxia Medical UniversityYinchuanChina
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Ogunbayo AE, Mogotsi MT, Sondlane H, Nkwadipo KR, Sabiu S, Nyaga MM. Pathogen Profile of Children Hospitalised with Severe Acute Respiratory Infections during COVID-19 Pandemic in the Free State Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610418. [PMID: 36012053 PMCID: PMC9408356 DOI: 10.3390/ijerph191610418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 05/30/2023]
Abstract
Severe acute respiratory infections (SARI) contribute to mortality in children ≤5 years. Their microbiological aetiologies are often unknown and may be exacerbated in light of coronavirus disease 19 (COVID-19). This study reports on respiratory pathogens in children ≤5 years (n = 84) admitted with SARI during and between the second and third waves of COVID-19 infection in South Africa. Nasopharyngeal/oropharyngeal swabs collected were subjected to viral detection using QIAstat-Dx® Respiratory SARS-CoV-2 Panel. The results revealed viral positivity and negativity detection rates of 88% (74/84) and 12% (10/84), respectively. Of the 21 targeted pathogens, human rhinovirus/enterovirus (30%), respiratory syncytial virus (RSV; 26%), and severe acute respiratory syndrome coronavirus 2 (24%) were mostly detected, with other viruses being 20% and a co-infection rate of 64.2% (54/84). Generally, RSV-positive samples had lower Ct values, and fewer viruses were detected during the third wave. Changes in the circulation patterns of respiratory viruses with total absence of influenza virus could be attributed to measures against COVID-19 transmission, which may result in waned immunity, thereby increasing susceptibility to severe infections in the following season. High viral co-infection rate, as detected, may complicate diagnosis. Nonetheless, accurate identification of the pathogens may guide treatment decisions and infection control.
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Affiliation(s)
- Ayodeji E. Ogunbayo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Milton T. Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Hlengiwe Sondlane
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Kelebogile R. Nkwadipo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Saheed Sabiu
- Department of Biotechnology and Food Science, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Martin M. Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
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4
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Wang W, Guan R, Liu Z, Zhang F, Sun R, Liu S, Shi X, Su Z, Liang R, Hao K, Wang Z, Liu X. Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China. Front Microbiol 2022; 13:935688. [PMID: 36033842 PMCID: PMC9399728 DOI: 10.3389/fmicb.2022.935688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Persistent infection and prolonged shedding of human bocavirus 1 (HBoV1) in children have been reported, and the role of HBoV1 as a sole causative pathogen in acute respiratory infection (ARI) is yet to be established. While the reported prevalence of HBoV infection varies due to different detection methods and sampling criteria, determining the viral and bacterial etiology of HBoV infection using multiplex real-time PCR is yet to be reported. Herein, we aimed to further explore the pathogenicity of HBoV in patients with ARI by screening the viral and bacterial infections in children with ARI in Qingdao and comparing the epidemiological, clinical characteristics, and etiological results. Human bocavirus was identified in 28.1% of the samples, and further sequencing analysis of the detected HBoV confirmed 96.4% as HBoV1. The rate of HBoV as a single viral infection was 75%, and the rate of coinfection with bacteria was 66.1%, suggesting the need for continued monitoring of HBoV in children with ARIs. Clinical characterization suggested that HBoV infection may affect the function of organs, such as the liver, kidney, and heart, and the blood acid–base balance. Additionally, it is essential to promote awareness about the importance of disinfection and sterilization of the hospital environment and standardizing operations. The interactions between HBoV and other pathogens remain to be investigated in further detail in the future.
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Affiliation(s)
- Wenjing Wang
- Department of Epidemiology and Health Statistics, The College of Public Health of Qingdao University, Qingdao, China
| | - Renzheng Guan
- Department of Pediatrics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ziran Liu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Feng Zhang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Rui Sun
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Sitong Liu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xiaoyan Shi
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Zhilei Su
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Rongxiang Liang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Kangyu Hao
- Department of Epidemiology and Health Statistics, The College of Public Health of Qingdao University, Qingdao, China
| | - Zhaoguo Wang
- Department of Epidemiology and Health Statistics, The College of Public Health of Qingdao University, Qingdao, China
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- *Correspondence: Zhaoguo Wang
| | - Xianming Liu
- Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao, China
- Xianming Liu
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Multipathogen Detection in Patients with Respiratory Tract Infection: Identification of Non-respiratory Viruses Using Multiplex Real-time Polymerase Reaction. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm.120553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Due to the overlapping clinical characteristics of respiratory tract infections (RTIs) and the unavailability of appropriate diagnostic techniques, the diagnosis of RTIs is controversial. Objectives: The study aimed to prompt the diagnosis of RTIs using commercial multiplex real-time PCR. Methods: The survey undertook for two years (2019 - 2020) on 144 flu-negative immunocompetent outpatients. Respiratory samples were examined by multiplex PCR assays. Results: Study population consisted of females (n = 77, 53.5%) and males (n = 67, 46.5%). The mean age was 42.8 ± 23.7 years. Thirty-one (21.5%) patients were infected with only one viral or bacterial infection. Eighty-two (57%) were infected with more than one pathogen. Ninety-five (37%) and 161 (62%) tests were positive for bacterial and viral pathogens, respectively. Community-acquired Pneumonia (CAP) and atypical CAP pathogens included 17% and 10% of respiratory specimens, respectively. The predominant pathogens consisted of Human Herpes Virus 7 (HHV-7) (n = 38, 15.5%), Epstein-Barr Virus (EBV) (n = 34, 13.8%), Mycoplasma pneumoniae (n = 24, 9.8%), and Human Herpes Virus 6 (HHV-6) (n = 21, 8.5%). There were associations between pathogen findings and special age categories. Fever, cough, dyspnea, and hemoptysis were associated with certain pathogens. There was no substantial difference between viral and bacterial Ct concerning gender, age group, and comorbidities. Conclusions: Multiplex diagnostic assays significantly increased the rate of appropriate diagnosis of respiratory pathogens. However, further investigation is needed to find non-respiratory viruses' significance in respiratory specimens of immunocompetent symptomatic patients.
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Wang ZB, Ren L, Lu QB, Zhang XA, Miao D, Hu YY, Dai K, Li H, Luo ZX, Fang LQ, Liu EM, Liu W. The Impact of Weather and Air Pollution on Viral Infection and Disease Outcome Among Pediatric Pneumonia Patients in Chongqing, China, from 2009 to 2018: A Prospective Observational Study. Clin Infect Dis 2021; 73:e513-e522. [PMID: 32668459 DOI: 10.1093/cid/ciaa997] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND For pediatric pneumonia, the meteorological and air pollution indicators have been frequently investigated for their association with viral circulation but not for their impact on disease severity. METHODS We performed a 10-year prospective, observational study in 1 hospital in Chongqing, China, to recruit children with pneumonia. Eight commonly seen respiratory viruses were tested. Autoregressive distributed lag (ADL) and random forest (RF) models were used to fit monthly detection rates of each virus at the population level and to predict the possibility of severe pneumonia at the individual level, respectively. RESULTS Between 2009 and 2018, 6611 pediatric pneumonia patients were included, and 4846 (73.3%) tested positive for at least 1 respiratory virus. The patient median age was 9 months (interquartile range, 4‒20). ADL models demonstrated a decent fitting of detection rates of R2 > 0.7 for respiratory syncytial virus, human rhinovirus, parainfluenza virus, and human metapneumovirus. Based on the RF models, the area under the curve for host-related factors alone was 0.88 (95% confidence interval [CI], .87‒.89) and 0.86 (95% CI, .85‒.88) for meteorological and air pollution indicators alone and 0.62 (95% CI, .60‒.63) for viral infections alone. The final model indicated that 9 weather and air pollution indicators were important determinants of severe pneumonia, with a relative contribution of 62.53%, which is significantly higher than respiratory viral infections (7.36%). CONCLUSIONS Meteorological and air pollution predictors contributed more to severe pneumonia in children than did respiratory viruses. These meteorological data could help predict times when children would be at increased risk for severe pneumonia and when interventions, such as reducing outdoor activities, may be warranted.
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Affiliation(s)
- Zhi-Bo Wang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Luo Ren
- Department of Respiratory Medicine, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xiao-Ai Zhang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Dong Miao
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Yuan-Yuan Hu
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Ke Dai
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Hao Li
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - Zheng-Xiu Luo
- Department of Respiratory Medicine, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Li-Qun Fang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
| | - En-Mei Liu
- Department of Respiratory Medicine, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Wei Liu
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, People's Republic of China
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Sakurai Y, Higashiguchi T. Transient hyperphosphatasemia: Possible association with pediatric acute respiratory infection. Pediatr Investig 2021; 5:94-98. [PMID: 34179704 PMCID: PMC8212759 DOI: 10.1002/ped4.12265] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/02/2021] [Indexed: 11/15/2022] Open
Abstract
IMPORTANCE Acute respiratory infections are quite prevalent in children. Transient hyperphosphatasemia (TH) is defined as the transient elevation of serum alkaline phosphatase (ALP) level, which occurs mainly in infants and children without liver or bone disorders. Although no apparent cause has been identified, a possible association of respiratory infections with TH has been reported in the literature. OBJECTIVE In this study, we aimed to investigate the association between TH and respiratory infectious diseases. METHODS We collected the results of biochemical investigations, including ALP level, for a period of 5 years in our hospital. We then examined the patients with transiently elevated ALP levels of > 2000 U/L. RESULTS During the observation period, 1501 blood samples were collected from 1097 patients. Marked elevation of serum ALP level was observed in 12 patients. All patients with hyperphosphatasemia, except for one with Fanconi syndrome attributable to the underlying Wilson's disease, were aged < 5 years and were diagnosed with TH. Ten of these 11 patients with TH had acute respiratory infections. Marked ALP elevation was not found in any patients with non-inflammatory diseases. ALP isoenzyme profiles showed a characteristic pattern in all six patients in whom the ALP isoenzyme test was conducted. INTERPRETATION Our results suggest an association between respiratory infections and TH. The consideration of TH in patients with acute respiratory infections may lead to earlier and accurate diagnosis of this condition, thereby avoiding unnecessary medical interventions.
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Juliana AE, Tang MJ, Kemps L, Noort AC, Hermelijn S, Plötz FB, Zonneveld R, Wilschut JC. Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname. PLoS One 2021; 16:e0247000. [PMID: 33606795 PMCID: PMC7894877 DOI: 10.1371/journal.pone.0247000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/29/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Viruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries. METHODS Between 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS). RESULTS Of a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS. CONCLUSIONS Viruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.
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Affiliation(s)
- Amadu E. Juliana
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
- * E-mail:
| | - Ming-Jan Tang
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Lex Kemps
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Albert C. Noort
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Sandra Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Frans B. Plötz
- Department of Pediatrics, Tergooi Hospitals, Blaricum, The Netherlands
- Department of Pediatrics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rens Zonneveld
- Department of Pediatrics, Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Jan C. Wilschut
- Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Liu K, Jing H, Chen Y, Zheng X, Jiang H, Kong D, Zheng Y, Chen S, Liu P, Jiang Y. Evaluation of TaqMan Array card (TAC) for the detection of 28 respiratory pathogens. BMC Infect Dis 2020; 20:820. [PMID: 33172401 PMCID: PMC7653217 DOI: 10.1186/s12879-020-05562-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/30/2020] [Indexed: 12/22/2022] Open
Abstract
Background Respiratory infections are a serious threat to human health. So, rapid detection of all respiratory pathogens can facilitate prompt treatment and prevent the deterioration of respiratory disease. Previously published primers and probes of the TaqMan array card (TAC) for respiratory pathogens are not sensitive to Chinese clinical specimens. This study aimed to develop and improve the TAC assay to detect 28 respiratory viral and bacterial pathogens in a Chinese population. Methods To improve the sensitivity, we redesigned the primers and probes, and labeled the probes with minor groove binders. The amplification efficiency, sensitivity, and specificity of the primers and probes were determined using target-gene containing standard plasmids. The detection performance of the TAC was evaluated on 754 clinical specimens and the results were compared with those from conventional methods. Results The performance of the TAC assay was evaluated using 754 clinical throat swab samples and the results were compared with those from gold-standard methods. The sensitivity and specificity were 95.4 and 96.6%, respectively. The lowest detection limit of the TAC was 10 to 100 copies/μL. Conclusions TAC is an efficient, accurate, and high-throughput approach to detecting multiple respiratory pathogens simultaneously and is a promising tool for the identification of pathogen outbreaks.
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Affiliation(s)
- Keke Liu
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China.,Shandong Academy of Clinical Medicine, Shandong Provincial Hospital, Jinan, 250021, China
| | - Hongbo Jing
- Department of Laboratory Medicine, Shunyi District Center for Disease Control and Prevention, Beijing, China
| | - Ying Chen
- School of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, 100048, China
| | - Xin Zheng
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Hua Jiang
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Decong Kong
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Yvling Zheng
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Shuiping Chen
- Department of Laboratory Medicine, the Fifth Medical Centre, Chinese PLA General Hospital, Beijing, China.
| | - Peng Liu
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China.
| | - Yongqiang Jiang
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China.
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10
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Li L, Xu L, Zhu R, Song J, Wang X. Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational cohort study on 27,792 patients. BMC Infect Dis 2020; 20:8. [PMID: 31906848 PMCID: PMC6945440 DOI: 10.1186/s12879-019-4724-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 12/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background There have been no systematic studies of microbiological differences before and after antibiotics treatment. The aim of this study was to evaluate the effect of prior receipt of antibiotics on the microorganism distribution. Methods A retrospective, observational cohort study was conducted in a 3200-bed tertiary, referral, teaching hospital in eastern China. During a 2-year period, all hospitalized patients treated with antimicrobial agents were enrolled in this study. Among 48,692 patients evaluated, the 27,792 (57.1%) who were sampled within 2 days before or after administration of the first dose of antimicrobial agents were included. Distribution of clinical specimens and the microorganism were compared between before and after antibiotic drug treatment groups. Results Compared to specimens taken after antibiotics exposure, specimens taken before antibiotics exposure had a higher proportion of blood and urine specimens and a higher culture positive rate (all P < 0.001). Higher percentages of Staphylococcus aureus (9.9% vs. 8.5%, P = 0.041), non-fermenting bacteria (27.7% vs. 19.9%, P < 0.001), and fungi (8.4% vs. 4.0%, P < 0.001) were isolated from the group after antibiotics exposure, while the percentages of Streptococcus spp. (4.8% vs. 2.7%, P < 0.001), Haemophilus influenzae (2.3% vs. 0.8%, P < 0.001), and Moraxella catarrhalis (0.7% vs. 0.1%, P < 0.001) were higher in the group before antibiotics exposure. Further analysis found significant differences of microbes derived from respiratory secretions, blood or urine samples. We found, after antibiotics exposure, the separation rate of non-fermenting bacteria was significantly increased (all P < 0.05), and the separation rate of Candida spp. was higher, with statistical significance in airway secretion and urine samples (both P < 0.05), but the separation rate of Staphylococcus aureus among the three groups was not affected by antibiotics. In addition, the isolation rate of Streptococcus spp. in blood and urine samples decreased significantly (both P < 0.05) after antibiotics exposure. Interestingly, no statistical difference was found for microbes isolated from body fluid specimens between the two groups. Conclusions The outcome revealed that antibiotic-insensitive organisms such as non-fermentative bacteria and fungi were more frequently isolated after antibiotics exposure. However, this trend might be specimen dependent and was not obvious in body fluid specimens.
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Affiliation(s)
- Leiqing Li
- Department of Critical Care Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Lingcheng Xu
- Department of Infection Prevention and Control, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Rongsheng Zhu
- Department of Infection Prevention and Control, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Jiaojiao Song
- Department of Infection Prevention and Control, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Xuanding Wang
- Department of Infection Prevention and Control, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Pham HT, Nguyen TNT, Tran QA, Ngo TT. Prevalence and Associated Factors with Mixed Coinfections among under 5-Year-Old Children with Severe Viral Pneumonia in Vietnam. JOURNAL OF CHILD SCIENCE 2020. [DOI: 10.1055/s-0040-1713623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractCommunity-acquired pneumonia (CAP) is well-recognized as a leading cause of disease burden in children. This study aimed to identify the prevalence of coinfection and associated factors in Vietnamese children ages 1 month to 5 years with viral pneumonia. We performed a cross-sectional study of children who were diagnosed with severe viral pneumonia. Demographic, clinical, and subclinical characteristics were compared between children with viral alone and bacterial coinfection. Multivariate logistic regression was used to determine which factors were associated with risk of coinfection. Of 202 children with severe viral pneumonia, the most common causative agent was respiratory syncytial virus (respiratory syncytial virus [RSV]: 36.1%), followed by influenza virus A (24.3%) and adenovirus (19.8%). Fifty-three children (26.2%) had bacterial superinfection and/or coinfection with other viruses. Haemophilus influenza was the most common bacterium (9.4%), followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (with 4.0%). In infants (toddlers), ages 12 to 24 months with severe viral pneumonia, (odds ratio [OR] = 3.37, 95% confidence interval [CI]: 1.22–9.33), the higher concentrations of procalcitonin (PCT; OR = 1.16; 95% CI: 1.00–1.34), and neutrophils (OR = 1.13; 95% CI: 1.04–1.22) were associated with a higher risk of coinfection. This study underlined the pervasiveness of coinfections among young children with severe viral pneumonia. Provision of effective antiviral treatment, especially for RSV, as well as the advancement of sensitive and rapid diagnostic tools for screening pathogens of pneumonia, is critical to reducing the burden of this disease.
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Affiliation(s)
- Hien T. Pham
- International Outpatient Department, National Children’s Hospital, Hanoi, Vietnam
| | - Tran N. T. Nguyen
- Respiratory Department, National Children’s Hospital, Hanoi, Vietnam
| | - Quynh A. Tran
- Surgical Department, National Children’s Hospital, Hanoi, Vietnam
| | - Tam T. Ngo
- Faculty of Health Sciences, Thang Long University, Hanoi, Vietnam
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12
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Nolan VG, Arnold SR, Bramley AM, Ampofo K, Williams DJ, Grijalva CG, Self WH, Anderson EJ, Wunderink RG, Edwards KM, Pavia AT, Jain S, McCullers JA. Etiology and Impact of Coinfections in Children Hospitalized With Community-Acquired Pneumonia. J Infect Dis 2019; 218:179-188. [PMID: 29228381 PMCID: PMC7108488 DOI: 10.1093/infdis/jix641] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/05/2017] [Indexed: 12/22/2022] Open
Abstract
Background Recognition that coinfections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance. Methods We analyzed data from 2219 children hospitalized with CAP and compared demographic and clinical characteristics and outcomes between groups with viruses alone, bacteria alone, or coinfections. We also assessed the frequency of selected pairings of codetected pathogens and their clinical characteristics. Results A total of 576 children (26%) had a coinfection. Children with only virus detected were younger, more likely to be black, and more likely to have comorbidities such as asthma, compared with children infected with typical bacteria alone. Children with virus-bacterium coinfections had a higher frequency of leukocytosis, consolidation on chest radiography, parapneumonic effusions, intensive care unit admission, and need for mechanical ventilation and an increased length of stay, compared with children infected with viruses alone. Virus-virus coinfections were generally comparable to single-virus infections, with the exception of the need for oxygen supplementation, which was higher during the first 24 hours of hospitalization in some virus-virus pairings. Conclusions Coinfections occurred in 26% of children hospitalized for CAP. Children with typical bacterial infections, alone or complicated by a viral infection, have worse outcomes than children infected with a virus alone.
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Affiliation(s)
- Vikki G Nolan
- Division of Epidemiology, School of Public Health, University of Memphis
| | - Sandra R Arnold
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis
| | - Anna M Bramley
- Centers for Disease Control and Prevention, Emory University School of Medicine, Atlanta, Georgia
| | - Krow Ampofo
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City
| | - Derek J Williams
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Evan J Anderson
- Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Richard G Wunderink
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kathryn M Edwards
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Andrew T Pavia
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City
| | - Seema Jain
- Centers for Disease Control and Prevention, Emory University School of Medicine, Atlanta, Georgia
| | - Jonathan A McCullers
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis
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13
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Bhuiyan MU, Blyth CC, West R, Lang J, Rahman T, Granland C, de Gier C, Borland ML, Thornton RB, Kirkham LAS, Martin A, Richmond PC, Smith DW, Jaffe A, Snelling TL. Combination of clinical symptoms and blood biomarkers can improve discrimination between bacterial or viral community-acquired pneumonia in children. BMC Pulm Med 2019; 19:71. [PMID: 30940126 PMCID: PMC6444754 DOI: 10.1186/s12890-019-0835-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/20/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Differentiating bacterial from viral pneumonia is important for guiding targeted management and judicious use of antibiotics. We assessed if clinical characteristics and blood inflammatory biomarkers could be used to distinguish bacterial from viral pneumonia. METHODS Western Australian children (≤17 years) hospitalized with radiologically-confirmed community-acquired pneumonia were recruited and clinical symptoms and management data were collected. C-reactive protein (CRP), white cell counts (WCC) and absolute neutrophil counts (ANC) were measured as part of routine care. Clinical characteristics and biomarker levels were compared between cases with definite bacterial pneumonia (clinical empyema and/or bacteria detected in blood or pleural fluid), presumed viral pneumonia (presence of ≥1 virus in nasopharyngeal swab without criteria for definite bacterial pneumonia), and other pneumonia cases (pneumonia in the absence of criteria for either definite bacterial or presumed viral pneumonia). The area-under-curve (AUC) of the receiver operating characteristic (ROC) curve for varying biomarker levels were used to characterise their utility for discriminating definite bacterial from presumed viral pneumonia. For biomarkers with AUC > 0.8 (fair discriminator), Youden index was measured to determine the optimal cut-off threshold, and sensitivity, specificity, predictive values (positive and negative) were calculated. We investigated whether better discrimination could be achieved by combining biomarker values with the presence/absence of symptoms. RESULTS From May 2015 to October 2017, 230 pneumonia cases were enrolled: 30 with definite bacterial pneumonia, 118 with presumed viral pneumonia and 82 other pneumonia cases. Differences in clinical signs and symptoms across the groups were noted; more definite bacterial pneumonia cases required intravenous fluid and oxygen supplementation than presumed viral or other pneumonia cases. CRP, WCC and ANC were substantially higher in definite bacterial cases. For a CRP threshold of 72 mg/L, the AUC of ROC was 0.82 for discriminating definite bacterial pneumonia from presumed viral pneumonia. Combining the CRP with either the presence of fever (≥38οC) or the absence of rhinorrhea improved the discrimination. CONCLUSIONS Combining elevated CRP with the presence or absence of clinical signs/ symptoms differentiates definite bacterial from presumed viral pneumonia better than CRP alone. Further studies are required to explore combination of biomarkers and symptoms for use as definitive diagnostic tool.
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Affiliation(s)
- Mejbah U. Bhuiyan
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Christopher C. Blyth
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- Perth Children’s Hospital, Perth, Australia
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Australia
| | - Rachel West
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Jurissa Lang
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Australia
| | - Tasmina Rahman
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Caitlyn Granland
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Camilla de Gier
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Meredith L. Borland
- Perth Children’s Hospital, Perth, Australia
- Division of Emergency Medicine, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Ruth B. Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Lea-Ann S. Kirkham
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | | | - Peter C. Richmond
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- Perth Children’s Hospital, Perth, Australia
| | - David W. Smith
- Department of Microbiology, PathWest Laboratory Medicine WA, Perth, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Adam Jaffe
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Thomas L. Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
- Perth Children’s Hospital, Perth, Australia
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14
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Virus genes and host correlates of pathology are markedly reduced during respiratory syncytial and influenza virus co-infection in BALB/c mice. Heliyon 2019; 5:e01094. [PMID: 30623128 PMCID: PMC6319304 DOI: 10.1016/j.heliyon.2018.e01094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/14/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022] Open
Abstract
Globally, influenza A virus (IAV) and respiratory syncytial virus (RSV) infection remain very high. There is also a high burden of IAV and RSV co-infection in developing countries. To develop universally protective vaccines against these infections, it is imperative that viral genes and immune correlates of pathology are elucidated. As such, we profiled virus genes expressions, histopathology and immunological responses of BALB/c mice infected with RSV and/or IAV in this study. RSV A2 and/or influenza A/H3N2/Perth/16/09 (Pr/H3N2) were induced over a seven-day period in BALB/c mice. Anaesthetized BALB/c mice (12–14 g) were divided into six groups (15–20 mice per group), inoculated with 32 μl each of 3LD50 Pr/H3N2 and/or 100 TCID50 RSV. Two groups (R or I) received RSV or Pr/H3N2 intranasally. Prior infection with either RSV or Pr/H3N2 was followed with a second challenge of the other virus 24 hours post inoculation in RI and IR groups. Another set was exposed to the two viruses simultaneously (I + R group) while the last group served as healthy controls. Five to seven mice per group were euthanized at days 2, 4 and 7. Lung and spleen organs were harvested for virus genes quantitation and immune cells phenotyping respectively. I + R group showed progressive downregulation of RSV F, G, NS1 and NS2 genes. IAV PB2 and M genes had high fold increase on day 2 and 4 post infections. However, by day 7 post infection, M and PB2 fold increase was lower. Also, increased proportions of NKT and T cell subsets were observed throughout the period in I + R group. Conversely, I group was characterized by reduced NKT cell counts and enhanced CD8 T cells levels while R group only showed an increased proportion of CD8 T cells towards the peak of infection. This study shows that RSV and IAV co-infection lead to reduced virulence and pathology compared to single infections. This information is very useful in combinatorial RSV/IAV vaccine design and development.
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15
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Cai K, Wang Y, Guo Z, Xu X, Li H, Zhang Q. Clinical characteristics and antimicrobial resistance of pneumococcal isolates of pediatric invasive pneumococcal disease in China. Infect Drug Resist 2018; 11:2461-2469. [PMID: 30538512 PMCID: PMC6263219 DOI: 10.2147/idr.s183916] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Streptococcus pneumoniae causes serious infections globally, including invasive pneumococcal disease (IPD). We analyze clinical features of pediatric IPD cases identified in China and antibiotic susceptibility of isolated pneumococcal strains. Methods Confirmed pediatric IPD patients were prospectively recruited to the study. Symptoms at the time of hospitalization, laboratory tests, antimicrobial susceptibility of pneumococcal isolates, treatments, hospital stay, and residual findings at discharge were analyzed systematically. Results From January 2008 to December 2017, a total of 123 hospitalized children diagnosed with IPD were enrolled: 68 from pediatric departments of Xinhua Hospital, and 55 from Lanzhou University Second Hospital. Of these pediatric IPD patients, 81 (65.86%) were male, and 98 (79.67%) <5 years old. Most cases (96, 78.05%) were diagnosed during the cold season between September and February. Sepsis was observed in 82 (66.67%) patients, 48 (39.02%) children were diagnosed with meningitis, 41 (33.33%) with pneumonia, 30 (24.39%) with pleurisy, and 4 (3.25%) with osteomyelitis. Underlying diseases were noted in 35 (28.45%) patients and concurrent infections in 45 (36.58%). The overall mortality rate was 2.44%. IPD children who developed sepsis and necrotizing pneumonia showed higher proportions of intensive care-unit admission, intravenous γ-globulin, glucocorticoid use, hemofiltration and ventilator, and longer duration of fever, hospital stay, and antibiotic use than nonsepsis and pneumonia subjects. Antimicrobial resistance of S. pneumoniae showed a highly unsusceptible rate for erythromycin (96.75%), trimethoprim-sulfamethoxazole (79.67%), and tetracycline (77.23%). All isolates were sensitive to vancomycin, linezolid, and levofloxacin. Conclusion Clinical symptoms were severe in the majority of pediatric IPD patients. More intensive treatments were demanded for IPD children with sepsis and necrotizing pneumonia. High resistance rates for erythromycin, trimethoprim–sulfamethoxazole, and tetracycline were found.
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Affiliation(s)
- Kang Cai
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Yizhong Wang
- Department of Infectious Diseases, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China,
| | - Zhongqin Guo
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiaonan Xu
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Huajun Li
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Qingli Zhang
- Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, .,Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai, China,
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16
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Bacterial and Viral Etiology of Acute Respiratory Illness among Children from two Different Geographical Localities of Odisha, 2015-2016. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.2.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Choi E, Ha KS, Song DJ, Lee JH, Lee KC. Clinical and laboratory profiles of hospitalized children with acute respiratory virus infection. KOREAN JOURNAL OF PEDIATRICS 2018; 61:180-186. [PMID: 29963101 PMCID: PMC6021362 DOI: 10.3345/kjp.2018.61.6.180] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/17/2017] [Accepted: 10/30/2017] [Indexed: 11/27/2022]
Abstract
Purpose Despite the availability of molecular methods, identification of the causative virus in children with acute respiratory infections (ARIs) has proven difficult as the same viruses are often detected in asymptomatic children. Methods Multiplex reverse transcription polymerase chain reaction assays were performed to detect 15 common respiratory viruses in children under 15 years of age who were hospitalized with ARI between January 2013 and December 2015. Viral epidemiology and clinical profiles of single virus infections were evaluated. Results Of 3,505 patients, viruses were identified in 2,424 (69.1%), with the assay revealing a single virus in 1,747 cases (49.8%). While major pathogens in single virus-positive cases differed according to age, human rhinovirus (hRV) was common in patients of all ages. Respiratory syncytial virus (RSV), influenza virus (IF), and human metapneumovirus (hMPV) were found to be seasonal pathogens, appearing from fall through winter and spring, whereas hRV and adenovirus (AdV) were detected in every season. Patients with ARIs caused by RSV and hRV were frequently afebrile and more commonly had wheezing compared with patients with other viral ARIs. Neutrophil-dominant inflammation was observed in ARIs caused by IF, AdV, and hRV, whereas lymphocyte-dominant inflammation was observed with RSV A, parainfluenza virus, and hMPV. Monocytosis was common with RSV and AdV, whereas eosinophilia was observed with hRV. Conclusion In combination with viral identification, recognition of virus-specific clinical and laboratory patterns will expand our understanding of the epidemiology of viral ARIs and help us to establish more efficient therapeutic and preventive strategies.
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Affiliation(s)
- Eunjin Choi
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kee-Soo Ha
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jung Hwa Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kwang Chul Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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18
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Recurrent wheezing in neonatal pneumonia is associated with combined infection with Respiratory Syncytial Virus and Staphylococcus aureus or Klebsiella pneumoniae. Sci Rep 2018; 8:995. [PMID: 29343795 PMCID: PMC5772642 DOI: 10.1038/s41598-018-19386-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/14/2017] [Indexed: 11/14/2022] Open
Abstract
Both viral and bacterial infections can be associated with wheezing episodes in children; however, information regarding combined infections with both viral and bacterial pathogens in full term neonates is limited. We sought to investigate the effects of viral–bacterial codetection on pneumonia severity and recurrent wheezing. A retrospective cohort study was conducted on neonates admitted to our hospital with pneumonia from 2009 to 2015. Of 606 total cases, 341 were diagnosed with RSV only, and 265 were diagnosed with both RSV and a potential bacterial pathogen. The leading four species of bacteria codetected with RSV were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Enterobacter cloacae. Neonates with RSV and a potential bacterial pathogen were significantly more likely to have worse symptoms, higher C-reactive protein values and more abnormal chest x-ray manifestations with Bonferroni correction for multiple comparisons (P < 0.01). On Cox regression analysis, an increased risk of recurrent wheezing was found for neonates positive for RSV–Staphylococcus aureus and RSV–Klebsiella pneumoniae. Our findings indicate that the combination of bacteria and RSV in the neonatal airway is associated with more serious clinical characteristics. The presence of RSV and Staphylococcus aureus or Klebsiella pneumoniae may provide predictive markers for wheeze.
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19
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Brealey JC, Chappell KJ, Galbraith S, Fantino E, Gaydon J, Tozer S, Young PR, Holt PG, Sly PD. Streptococcus pneumoniae colonization of the nasopharynx is associated with increased severity during respiratory syncytial virus infection in young children. Respirology 2017; 23:220-227. [PMID: 28913912 PMCID: PMC7169064 DOI: 10.1111/resp.13179] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/27/2017] [Accepted: 07/19/2017] [Indexed: 11/26/2022]
Abstract
Background and Objective Respiratory syncytial virus (RSV) is the most significant cause of acute respiratory infection (ARI) in early life. RSV and other respiratory viruses are known to stimulate substantial outgrowth of potentially pathogenic bacteria in the upper airways of young children. However, the clinical significance of interactions between viruses and bacteria is currently unclear. The present study aimed to clarify the effect of viral and bacterial co‐detections on disease severity during paediatric ARI. Methods Nasopharyngeal aspirates from children under 2 years of age presenting with ARI to the emergency department were screened by quantitative PCR for 17 respiratory viruses and the bacterial pathogens Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Associations between pathogen detection and clinical measures of disease severity were investigated. Results RSV was the most common virus detected, present in 29 of 58 samples from children with ARI (50%). Detection of S. pneumoniae was significantly more frequent during RSV infections compared to other respiratory viruses (adjusted effect size: 1.8, P: 0.03), and co‐detection of both pathogens was associated with higher clinical disease severity scores (adjusted effect size: 1.2, P: 0.03). Conclusion Co‐detection of RSV and S. pneumoniae in the nasopharynx was associated with more severe ARI, suggesting that S. pneumoniae colonization plays a pathogenic role in young children. http://onlinelibrary.wiley.com/doi/10.1111/resp.13209/abstract High loads of bacteria colonizing the upper respiratory tract are often observed during paediatric respiratory syncytial virus (RSV) infections. The present study identified an association between co‐detection of RSV and Streptococcus pneumoniae and more severe disease, suggesting the bacteria has a pathogenic role in these young children.
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Affiliation(s)
- Jaelle C Brealey
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Keith J Chappell
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD, Australia
| | - Sally Galbraith
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Emmanuelle Fantino
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Jane Gaydon
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Centre for Children's Health Research, South Brisbane, QLD, Australia
| | - Sarah Tozer
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.,Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, Centre for Children's Health Research, South Brisbane, QLD, Australia
| | - Paul R Young
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD, Australia
| | - Patrick G Holt
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia.,Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
| | - Peter D Sly
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
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20
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Leung TF, Chan RWY, Kwok A, Ho WCS, Tao MKP, Hon KL, Cheng FWT, Li AM, Chan PKS. School-based surveillance for influenza vaccine effectiveness during 2014-2015 seasons in Hong Kong. Influenza Other Respir Viruses 2017; 11:319-327. [PMID: 28444974 PMCID: PMC5485870 DOI: 10.1111/irv.12455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 12/20/2022] Open
Abstract
Background Influenza imposes substantial healthcare burden in children, which can be prevented by vaccination. Influenza vaccination coverage varies widely among childhood populations worldwide, which has significant impact on herd immunity and usefulness of influenza vaccine. However, there are limited real‐life data on influenza vaccine effectiveness (VE) in children. Objective This prospective study aimed to investigate clinical spectrum of childhood influenza and VE in preventing influenza in Hong Kong children. Methods A total of 623 children were recruited from 15 kindergartens and primary schools. Parents completed a questionnaire on subjects’ health and influenza vaccination history. Flocked nasopharyngeal swabs (FNPSs) were collected in biweekly school visits during 2014‐2015 influenza seasons. Influenza A and B viruses were detected and typed by molecular assays. Results A total of 2633 FNPS samples were collected, with two or more samples being obtained from 607 (97.4%) of subjects. Thirty‐six (11.2%) subjects had influenza A or B in 2014, whereas all 19 (6.3%) subjects identified in 2015 had influenza A. Ninety‐nine subjects reported influenza‐like illness (ILI), and nine illness visits were arranged. Influenza vaccination was protective against ILI but not mild laboratory‐confirmed influenza by surveillance. Moderate overall influenza VE of 42%‐52% was observed for ILI, and subgroup analyses showed much higher VE for both ILI (70.9% vs 34.6%) and mild laboratory‐confirmed influenza (44.0% vs −6.2%) in school‐age children than preschoolers who were vaccinated within 12 months. Conclusions Mild laboratory‐confirmed influenza infection is common in children during influenza seasons. Influenza vaccination is effective against ILI but not mild infection identified by surveillance.
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Affiliation(s)
- Ting F Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Renee W Y Chan
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Angela Kwok
- Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wendy C S Ho
- Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Mars K P Tao
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kam L Hon
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Frankie W T Cheng
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Albert M Li
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Paul K S Chan
- Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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21
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Chiu NC, Chi H, Peng CC, Chang HY, Huang DTN, Chang L, Lei WT, Lin CY. Retrospective study of prognostic factors in pediatric invasive pneumococcal disease. PeerJ 2017; 5:e2941. [PMID: 28149700 PMCID: PMC5270593 DOI: 10.7717/peerj.2941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/26/2016] [Indexed: 12/27/2022] Open
Abstract
Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion, S. pneumoniae remains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission. Further large-scale studies are warranted.
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Affiliation(s)
- Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,MacKay Medical College, New Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,MacKay Medical College, New Taipei, Taiwan
| | - Chun-Chih Peng
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.,MacKay Medical College, New Taipei, Taiwan
| | - Hung-Yang Chang
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Daniel Tsung-Ning Huang
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Lung Chang
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.,MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Wei-Te Lei
- Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Chien-Yu Lin
- Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
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22
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Song JH, Huh K, Chung DR. Community-Acquired Pneumonia in the Asia-Pacific Region. Semin Respir Crit Care Med 2016; 37:839-854. [PMID: 27960208 PMCID: PMC7171710 DOI: 10.1055/s-0036-1592075] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Aging population, dense urbanization, and poor access to health care make the Asia-Pacific region vulnerable to CAP. The high incidence of CAP poses a significant health and economic burden in this region. Common etiologic agents in other global regions including Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, Staphylococcus aureus, and respiratory viruses are also the most prevalent pathogens in the Asia-Pacific region. But the higher incidence of Klebsiella pneumoniae and the presence of Burkholderia pseudomallei are unique to the region. The high prevalence of antimicrobial resistance in S. pneumoniae and M. pneumoniae has been raising the need for more prudent use of antibiotics. Emergence and spread of community-acquired methicillin-resistant S. aureus deserve attention, while the risk has not reached significant level yet in cases of CAP. Given a clinical and socioeconomic importance of CAP, further effort to better understand the epidemiology and impact of CAP is warranted in the Asia-Pacific region.
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Affiliation(s)
- Jae-Hoon Song
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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23
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Abstract
Human rhinovirus (HRV) and coronavirus (HCoV) infections are associated with both upper respiratory tract illness (“the common cold”) and lower respiratory tract illness (pneumonia). New species of HRVs and HCoVs have been diagnosed in the past decade. More sensitive diagnostic tests such as reverse transcription-polymerase chain reaction have expanded our understanding of the role these viruses play in both immunocompetent and immunosuppressed hosts. Recent identification of severe acute respiratory syndrome and Middle East respiratory syndrome viruses causing serious respiratory illnesses has led to renewed efforts for vaccine development. The role these viruses play in patients with chronic lung disease such as asthma makes the search for antiviral agents of increased importance.
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Affiliation(s)
- Stephen B Greenberg
- Department of Medicine, Ben Taub Hospital, Baylor College of Medicine, Houston, Texas
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24
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O'Grady KF, Grimwood K, Sloots TP, Whiley DM, Acworth JP, Phillips N, Goyal V, Chang AB. Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom. Clin Microbiol Infect 2016; 22:527-34. [PMID: 26916343 PMCID: PMC7128568 DOI: 10.1016/j.cmi.2016.02.004] [Citation(s) in RCA: 14] [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: 12/15/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 12/13/2022]
Abstract
Most studies exploring the role of upper airway viruses and bacteria in paediatric acute respiratory infections (ARI) focus on specific clinical diagnoses and/or do not account for virus-bacteria interactions. We aimed to describe the frequency and predictors of virus and bacteria codetection in children with ARI and cough, irrespective of clinical diagnosis. Bilateral nasal swabs, demographic, clinical and risk factor data were collected at enrollment in children aged <15 years presenting to an emergency department with an ARI and where cough was a symptom. Swabs were tested by polymerase chain reaction for 17 respiratory viruses and seven respiratory bacteria. Logistic regression was used to investigate associations between child characteristics and codetection of the organisms of interest. Between December 2011 and August 2014, swabs were collected from 817 (93.3%) of 876 enrolled children, median age 27.7 months (interquartile range 13.9-60.3 months). Overall, 740 (90.6%) of 817 specimens were positive for any organism. Both viruses and bacteria were detected in 423 specimens (51.8%). Factors associated with codetection were age (adjusted odds ratio (aOR) for age <12 months = 4.9, 95% confidence interval (CI) 3.0, 7.9; age 12 to <24 months = 6.0, 95% CI 3.7, 9.8; age 24 to <60 months = 2.4, 95% CI 1.5, 3.9), male gender (aOR 1.46; 95% CI 1.1, 2.0), child care attendance (aOR 2.0; 95% CI 1.4, 2.8) and winter enrollment (aOR 2.0; 95% CI 1.3, 3.0). Haemophilus influenzae dominated the virus-bacteria pairs. Virus-H. influenzae interactions in ARI should be investigated further, especially as the contribution of nontypeable H. influenzae to acute and chronic respiratory diseases is being increasingly recognized.
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Affiliation(s)
- K F O'Grady
- Institute of Health and Biomedical Innovation, Queensland University of Technology, South Brisbane, Australia.
| | - K Grimwood
- Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Southport, Australia
| | - T P Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, South Brisbane, Australia
| | - D M Whiley
- UQ Centre for Clinical Research, The University of Queensland, Herston, Australia
| | - J P Acworth
- Department of Emergency Medicine, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - N Phillips
- Department of Emergency Medicine, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - V Goyal
- Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia; Children's Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - A B Chang
- Institute of Health and Biomedical Innovation, Queensland University of Technology, South Brisbane, Australia; Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia; Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
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25
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Jin HI, Lee YM, Choi YJ, Jeong SJ. Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year. KOREAN JOURNAL OF PEDIATRICS 2016; 59:120-5. [PMID: 27186218 PMCID: PMC4865622 DOI: 10.3345/kjp.2016.59.3.120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/12/2015] [Accepted: 10/28/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region. METHODS We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively. RESULTS The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October. CONCLUSION Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis.
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Affiliation(s)
- Hye Il Jin
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Yoo Mi Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - You Jin Choi
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Su Jin Jeong
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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26
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Wang Y, Zhu N, Li Y, Lu R, Wang H, Liu G, Zou X, Xie Z, Tan W. Metagenomic analysis of viral genetic diversity in respiratory samples from children with severe acute respiratory infection in China. Clin Microbiol Infect 2016; 22:458.e1-9. [PMID: 26802214 PMCID: PMC7172101 DOI: 10.1016/j.cmi.2016.01.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/21/2015] [Accepted: 01/11/2016] [Indexed: 12/11/2022]
Abstract
Severe acute respiratory infection (SARI) in children is thought to be mainly caused by infection with various viruses, some of which have been well characterized; however, analyses of respiratory tract viromes among children with SARI versus those without are limited. In this study, nasopharyngeal swabs from children with and without SARI (135 versus 15) were collected in China between 2008 and 2010 and subjected to multiplex metagenomic analyses using a next-generation sequencing platform. The results show that members of the Paramyxoviridae, Coronaviridae, Parvoviridae, Orthomyxoviridae, Picornaviridae, Anelloviridae and Adenoviridae families represented the most abundant species identified (>50% genome coverage) in the respiratory tracts of children with SARI. The viral population found in the respiratory tracts of children without SARI was less diverse and mainly dominated by the Anelloviridae family with only a small proportion of common epidemic respiratory viruses. Several almost complete viral genomes were assembled, and the genetic diversity was determined among several samples based on next-generation sequencing. This research provides comprehensive mapping of the viromes of children with SARI and indicates high heterogeneity of known viruses present in the childhood respiratory tract, which may benefit the detection and prevention of respiratory disease.
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Affiliation(s)
- Y Wang
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - N Zhu
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - Y Li
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - R Lu
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - H Wang
- State Key Laboratory for Infectious Disease Prevention and Control and National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - G Liu
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - X Zou
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China
| | - Z Xie
- Key Laboratory of Major Diseases in Children and National Key Discipline of Paediatrics Capital Medical University, Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - W Tan
- Key Laboratory of Medical Virology, Ministry of Health; National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, China.
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