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Mittal J, Rajvanshi N, Suvarna K, Kumar P, Goyal JP. Association of vitamin D with disease severity in infants with bronchiolitis. Eur J Pediatr 2024:10.1007/s00431-024-05513-7. [PMID: 38530447 DOI: 10.1007/s00431-024-05513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/14/2024] [Accepted: 03/02/2024] [Indexed: 03/28/2024]
Abstract
Vitamin D's role in immune system regulation and its contribution to host defenses against respiratory infections may have implications for bronchiolitis pathophysiology. This cross-sectional study aimed to determine the association between the clinical severity of bronchiolitis and serum vitamin D levels in infants. Infants aged 1 month to 12 months, diagnosed with bronchiolitis, and healthy controls attending routine immunization were enrolled. Baseline characteristics were recorded, including clinical details, bronchiolitis severity, and course during hospital stay. Bronchiolitis severity score (BSS) was used to score the severity. A 1-2 ml serum sample was obtained for vitamin D levels estimation. The median age of cases (n = 64; 65.6% male) was 5 [3, 8] months, and that of the control group (n = 30) was 3 [2, 9] months. No statistically significant differences were observed between the two groups in age, gender, weight, mode of delivery, family history of atopy/asthma, feeding pattern, smoke exposure, and daily vitamin D supplementation. The median vitamin D levels were not significantly different between the groups (p = 0.68). Among infants with bronchiolitis, 62.5% had vitamin D insufficiency (≤ 20 ng/ml). A significantly higher median BSS indicates that infants with vitamin D insufficiency exhibited more severe disease (p = 0.019). Although a negative correlation between BSS and vitamin D levels was noted, it did not reach statistical significance [rs = (-)0.17; p = 0.16]. CONCLUSION Infants with Vitamin D insufficiency experienced more severe bronchiolitis with elevated BSS scores. It highlights the potential role of vitamin D deficiency in severe bronchiolitis. WHAT IS KNOWN • Vitamin D level is low in infants with bronchiolitis. WHAT IS NEW • Infant with low vitamin D level experienced more severe bronchiolitis.
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Affiliation(s)
- Jashan Mittal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nikhil Rajvanshi
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kkomal Suvarna
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prawin Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jagdish Prasad Goyal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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2
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Romero-Gómez MP, Bloise-Sánchez I, Gómez-Arroyo B, González-Donapetry P, Cendejas-Bueno E, García-Rodríguez J. Rapid antigen test for adenovirus in children: Age and onset of symptoms are important. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:617-620. [PMID: 37076330 DOI: 10.1016/j.eimce.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/23/2022] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Respiratory infection is the most common human adenovirus (HAdV) disease accounting for 7-8% of viral respiratory diseases in children less than 5 years. Differentiation of bacterial infections and viral infections is a common clinical problem. MATERIAL AND METHODS One hundred oropharyngeal swabs obtained from October 2019 to November 2020 from patients attending the paediatric emergency room with suspicion of upper respiratory tract infection and negative results in influenza and RSV tests were included. Oropharyngeal swabs specimens were rapidly processed with STANDARD™ F Adeno Respi Ag FIA and the results were confirmed by RealStar® Adenovirus PCR Kit 1.0 (Altona diagnostics). RESULTS STANDARD™ F Adeno Respi Ag FIA had sensitivity and specificity values of 71.93% and 100% respectively. The performance of the test was higher in samples from children younger than 24 months and taken less than 72h since the beginning of symptoms. In this subgroup the test had 88.8% sensitivity and 100% specificity. CONCLUSION STANDARD™ F Adeno Respi Ag FIA may improve the management of respiratory diseases in children younger than 24 months and less than 72h since the beginning of symptoms in paediatric emergency rooms.
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Affiliation(s)
| | - Iván Bloise-Sánchez
- Servicio de Microbiología, Hospital Universitario La Paz, IdiPAZ, Madrid 28046, Spain
| | | | | | - Emilio Cendejas-Bueno
- Servicio de Microbiología, Hospital Universitario La Paz, IdiPAZ, Madrid 28046, Spain
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Pierantoni L, Lasala V, Dondi A, Cifaldi M, Corsini I, Lanari M, Zama D. Antibiotic Prescribing for Lower Respiratory Tract Infections and Community-Acquired Pneumonia: An Italian Pediatric Emergency Department's Real-Life Experience. Life (Basel) 2023; 13:1922. [PMID: 37763325 PMCID: PMC10532937 DOI: 10.3390/life13091922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/01/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Lower respiratory tract infections (LRTIs) and community-acquired pneumonia (CAP) are among the most frequent reasons for referrals to the pediatric emergency department (PED). The aim of this study is to describe the management of antibiotic prescription in febrile children with LRTI or CAP admitted to a third-level PED and to investigate the different variables that can guide physicians in this decision-making. METHODS This is an observational, retrospective, monocentric study including patients < 14 years old who were presented to the PED for a febrile LRTI or CAP during the first six months of the year 2017. Demographic and clinical data, PED examinations, recommended therapy, and discharge modality were considered. Two multivariate logistic regression analyses were performed on patients with complete profiles to investigate the impact of demographic, laboratory, and clinical variables on antibiotic prescription and hospital admission. RESULTS This study included 584 patients with LRTI (n = 368) or CAP (n = 216). One hundred and sixty-eight individuals (28.7%) were admitted to the hospital. Lower age, higher heart rate, and lower SpO2 were associated with an increased risk of hospitalization. Antibiotics were prescribed to 495 (84.8%) patients. According to the multivariate logistic regression, the diagnosis and duration of fever were substantially linked with antibiotic prescription. CONCLUSIONS The present study reports real-life data about our PED experience. A high rate of antibiotic prescription was noted. In the future, it is necessary to improve antibiotic stewardship programs to increase clinical adherence to guidelines.
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Affiliation(s)
- Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (I.C.); (M.L.); (D.Z.)
| | - Valentina Lasala
- Specialty School of Paediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (I.C.); (M.L.); (D.Z.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Marina Cifaldi
- Pediatric Clinic, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria of Parma, 43126 Parma, Italy;
| | - Ilaria Corsini
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (I.C.); (M.L.); (D.Z.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (I.C.); (M.L.); (D.Z.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (I.C.); (M.L.); (D.Z.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
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Alsayed AR, Abed A, Abu-Samak M, Alshammari F, Alshammari B. Etiologies of Acute Bronchiolitis in Children at Risk for Asthma, with Emphasis on the Human Rhinovirus Genotyping Protocol. J Clin Med 2023; 12:3909. [PMID: 37373604 DOI: 10.3390/jcm12123909] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
This research aims to determine acute bronchiolitis' causative virus(es) and establish a viable protocol to classify the Human Rhinovirus (HRV) species. During 2021-2022, we included children 1-24 months of age with acute bronchiolitis at risk for asthma. The nasopharyngeal samples were taken and subjected to a quantitative polymerase chain reaction (qPCR) in a viral panel. For HRV-positive samples, a high-throughput assay was applied, directing the VP4/VP2 and VP3/VP1 regions to confirm species. BLAST searching, phylogenetic analysis, and sequence divergence took place to identify the degree to which these regions were appropriate for identifying and differentiating HRV. HRV ranked second, following RSV, as the etiology of acute bronchiolitis in children. The conclusion of the investigation of all available data in this study distributed sequences into 7 HRV-A, 1 HRV-B, and 7 HRV-C types based on the VP4/VP2 and VP3/VP1 sequences. The nucleotide divergence between the clinical samples and the corresponding reference strains was lower in the VP4/VP2 region than in the VP3/VP1 region. The results demonstrated the potential utility of the VP4/VP2 region and the VP3/VP1 region for differentiating HRV genotypes. Confirmatory outcomes were yielded, indicating how nested and semi-nested PCR can establish practical ways to facilitate HRV sequencing and genotyping.
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Affiliation(s)
- Ahmad R Alsayed
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman 11931, Jordan
| | - Anas Abed
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 11931, Jordan
| | - Mahmoud Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman 11931, Jordan
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia
| | - Bushra Alshammari
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
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Gsenger J, Bruckner T, Ihling CM, Rehbein RM, Schnee SV, Hoos J, Manuel B, Pfeil J, Schnitzler P, Tabatabai J. RSV-CLASS -Clinical Assessment Severity Score: An easy-to-use clinical disease severity score for respiratory syncytial virus infection in hospitalized children. J Med Virol 2023; 95:e28541. [PMID: 36727642 DOI: 10.1002/jmv.28541] [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: 11/23/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/03/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of acute respiratory tract infection in infants and young children often leading to severe disease requiring hospitalization. However, validated tools for systematic assessment of disease severity are lacking. This study aimed at creating and validating a standardized, simple-to-use disease severity score for RSV infection in children-the RSV-CLASS (Clinical Assessment Severity Score). Therefore, data from over 700 RSV-infected children over six winter seasons (2014-2020) was analyzed using univariate and multiple regression analyses for the prediction of lower respiratory tract infection (LRTI) as a proxy for a severe course of the disease. Testing a broad range of respiratory symptoms, they eventually yielded seven items. Performing stepwise selection, these were reduced to the final four items: cough, tachypnea, rales, and wheezing, each receiving one point in the proposed score named RSV-CLASS. The score was calculated for children in two cohorts A and B, one for development and one for validation, with an area under the curve of 0.90 and 0.87, respectively. With a score value of 3 or 4, 97.8% and 100% of the children, respectively, were admitted with LRTI and classified correctly. The RSV-CLASS is a disease severity score based on a neutral, analytical approach using prospective data from a large study cohort. It will contribute to systematically assessing the disease severity of RSV infection and can be used for evidence-based clinical decision-making as well as for research settings.
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Affiliation(s)
- Julia Gsenger
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
| | - Thomas Bruckner
- Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Clara Marlene Ihling
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Dr. von Haunersches Kinderspital, University Hospital of the LMU Munich, Munich, Germany
| | - Rebecca Marie Rehbein
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Valerie Schnee
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
| | - Johannes Hoos
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Paul Schnitzler
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Tabatabai
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Rapid antigen test for adenovirus in children: Age and onset of symptoms are important. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Fu J, Xu Y, Arts EJ, Bai Z, Chen Z, Zheng Y. Viral disinfection using nonthermal plasma: A critical review and perspectives on the plasma-catalysis system. CHEMOSPHERE 2022; 309:136655. [PMID: 36191766 DOI: 10.1016/j.chemosphere.2022.136655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The transmission of viral infections via aerosol has become a serious threat to public health. This has produced an ever-increasing demand for effective forms of viral inactivation technology/processes. Plasma technology is rising in popularity and gaining interest for viral disinfection use. Due to its highly effectively disinfection and flexible operation, non-thermal plasma (NTP) is a promising technology in decontaminating bacteria or virus from air or surfaces. This review discusses the fundamentals of non-thermal plasma and the disinfection mechanisms of the biocidal agents produced in plasma, including ultraviolet (UV) photons, reactive oxygen species, and reactive nitrogen species. Perspectives on the role of catalysts and its potential applications in cold plasma disinfection are discussed.
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Affiliation(s)
- Jile Fu
- School of Chemistry and Chemical Engineering, Key Laboratory of Green Chemical Media and Reactions, Ministry of Education, Collaborative Innovation Center of Henan Province for Fine Chemicals Green Manufacturing, Henan Normal University, Xinxiang, 453007, China; Department of Chemical and Biochemical Engineering, Western University, London, Ontario, Canada
| | - Yiyi Xu
- Department of Chemical and Biochemical Engineering, Western University, London, Ontario, Canada
| | - Eric J Arts
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Zhengyu Bai
- School of Chemistry and Chemical Engineering, Key Laboratory of Green Chemical Media and Reactions, Ministry of Education, Collaborative Innovation Center of Henan Province for Fine Chemicals Green Manufacturing, Henan Normal University, Xinxiang, 453007, China.
| | - Zhongwei Chen
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada.
| | - Ying Zheng
- Department of Chemical and Biochemical Engineering, Western University, London, Ontario, Canada.
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8
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Tosif S, Ibrahim LF, Hughes R, R Cheng D, Wurzel D, Overmars I, Steer AC, Bryant PA, Duke T, Lewena S, Babl FE, McNab S, Crawford N. Characteristics and outcomes of SARS-CoV-2 infection in Victorian children at a tertiary paediatric hospital. J Paediatr Child Health 2022; 58:618-623. [PMID: 34693586 PMCID: PMC8662161 DOI: 10.1111/jpc.15786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/10/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022]
Abstract
AIM Victoria experienced two 'waves' of COVID-19 between March and September 2020 and more cases than any other jurisdiction in Australia. Although world-wide reports of COVID-19 reflect that children are less likely to experience severe disease compared with adults, hospitalisations and deaths have been reported. We report testing and outcomes of children with SARS-CoV-2 infection presenting to a tertiary paediatric hospital in Melbourne. METHODS We conducted a prospective cohort study at The Royal Children's Hospital (RCH), including all children and adolescents (aged 0-18 years) who presented and were tested for SARS-CoV-2 over a 6-month period, between 21 March 2020, up to the 21 September 2020. Detailed epidemiological and clinical data were recorded. RESULTS A total of 19 708 tests for SARS-CoV-2 were performed in 14 419 patients. One hundred and eighty patients tested positive for SARS-CoV-2 (1.2%). 110 (61%) were symptomatic, 60 (33%) were asymptomatic and 10 (6%) were pre-symptomatic. Close contacts of a positive case were associated with a higher risk of a testing positive for SARS-CoV-2 (120/2027 (6%) vs. 60/14589 (0.4%), RD 5.5 (95% CI 4.5 to 6.5), P < 0.001). Eighteen (10%) SARS-CoV-2-positive patients were admitted to hospital with one patient requiring intensive care. All patients recovered fully with no deaths. CONCLUSION In Victorian children presenting to a tertiary hospital, SARS-CoV-2 infection caused predominantly mild or asymptomatic infection, with most children not requiring hospitalisation.
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Affiliation(s)
- Shidan Tosif
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Laila F Ibrahim
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia,Hospital‐in‐the‐Home DepartmentThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Rebecca Hughes
- Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Daryl R Cheng
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Danielle Wurzel
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia,Department of Respiratory MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Isabella Overmars
- Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia
| | - Andrew C Steer
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Infectious Diseases Unit, Department of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Penelope A Bryant
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Hospital‐in‐the‐Home DepartmentThe Royal Children's HospitalMelbourneVictoriaAustralia,Infectious Diseases Unit, Department of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Trevor Duke
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Intensive Care UnitThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Stuart Lewena
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Emergency DepartmentThe Royal Children's HospitalMelbourneVictoriaAustralia,Emergency Research, Clinical SciencesMurdoch Children 's Research InstituteMelbourneVictoriaAustralia
| | - Franz E Babl
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Emergency DepartmentThe Royal Children's HospitalMelbourneVictoriaAustralia,Emergency Research, Clinical SciencesMurdoch Children 's Research InstituteMelbourneVictoriaAustralia
| | - Sarah McNab
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Nigel Crawford
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Infection and ImmunityMurdoch Children 's Research InstituteMelbourneVictoriaAustralia,Departments of General MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
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Menasria T, Aguilera M. Genomic Diversity of SARS-CoV-2 in Algeria and North African Countries: What We Know So Far and What We Expect? Microorganisms 2022; 10:microorganisms10020467. [PMID: 35208920 PMCID: PMC8877871 DOI: 10.3390/microorganisms10020467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022] Open
Abstract
Here, we report a first comprehensive genomic analysis of SARS-CoV-2 variants circulating in North African countries, including Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, with respect to genomic clades and mutational patterns. As of December 2021, a total of 1669 high-coverage whole-genome sequences submitted to EpiCoV GISAID database were analyzed to infer clades and mutation annotation compared with the wild-type variant Wuhan-Hu-1. Phylogenetic analysis of SARS-CoV-2 genomes revealed the existence of eleven GISAID clades with GR (variant of the spike protein S-D614G and nucleocapsid protein N-G204R), GH (variant of the ORF3a coding protein ORF3a-Q57H) and GK (variant S-T478K) being the most common with 25.9%, 19.9%, and 19.6%, respectively, followed by their parent clade G (variant S-D614G) (10.3%). Lower prevalence was noted for GRY (variant S-N501Y) (5.1%), S (variant ORF8-L84S) (3.1%) and GV (variant of the ORF3a coding protein NS3-G251V) (2.0%). Interestingly, 1.5% of total genomes were assigned as GRA (Omicron), the newly emerged clade. Across the North African countries, 108 SARS-CoV-2 lineages using the Pangolin assignment were identified, whereby most genomes fell within six major lineages and variants of concern (VOC) including B.1, the Delta variants (AY.X, B.1.617.2), C.36, B.1.1.7 and B.1.1. The effect of mutations in SAR-CoV-2 genomes highlighted similar profiles with D614G spike (S) and ORF1b-P314L variants as the most changes found in 95.3% and 87.9% of total sequences, respectively. In addition, mutations affecting other viral proteins appeared frequently including; N:RG203KR, N:G212V, NSP3:T428I, ORF3a:Q57H, S:N501Y, M:I82T and E:V5F. These findings highlight the importance of genomic surveillance for understanding the SARS-CoV-2 genetic diversity and its spread patterns, leading to a better guiding of public health intervention measures. The know-how analysis of the present work could be implemented worldwide in order to overcome this health crisis through harmonized approaches.
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Affiliation(s)
- Taha Menasria
- Department of Applied Biology, Faculty of Exact Sciences and Natural and Life Sciences, University of Larbi Tebessi, Tebessa 12002, Algeria
- Department of Microbiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Correspondence: or (T.M.); (M.A.)
| | - Margarita Aguilera
- Department of Microbiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Correspondence: or (T.M.); (M.A.)
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10
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Rai E, Alaraimi R, Al Aamri I. Pediatric lower respiratory tract infection: Considerations for the anesthesiologist. Paediatr Anaesth 2022; 32:181-190. [PMID: 34927318 DOI: 10.1111/pan.14382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
Neonatal and childhood infectious diseases continue to be a global health problem. Acute respiratory tract infections are typically classified as upper respiratory tract infection and lower respiratory tract infections. The most common lower respiratory infections in childhood are pneumonia and bronchiolitis. Vaccination against measles, diphtheria, pertussis, Haemophilus influenzae, pneumococcus, and influenza resulted in a significant reduction in the incidence of acute respiratory tract infection globally. Though the global burden of the disease has decreased, the mortality rates still are higher in developing countries. Patients with severe lower respiratory tract infections and their complications are often evaluated for elective or emergency procedures. In this review article, the authors aim to discuss the etiology, pathogenesis, preoperative evaluation of lower respiratory tract infections, and the anesthesia implications pertinent to the practice of anesthesia.
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Affiliation(s)
- Ekta Rai
- Christian Medical College, Vellore, India
| | - Rashid Alaraimi
- Emergency Physician & Neurocritical Care Fellow, Montreal Neurological Institute and Hospital, Montreal, QC, Canada
| | - Is'haq Al Aamri
- Adult and Pediatric Cardiac Anesthesia Consultant, National Heart Center, Muscat, Oman
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11
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Sakleshpur S, Steed AL. Influenza: Toward understanding the immune response in the young. Front Pediatr 2022; 10:953150. [PMID: 36061377 PMCID: PMC9437304 DOI: 10.3389/fped.2022.953150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/28/2022] [Indexed: 12/12/2022] Open
Abstract
Annually influenza causes a global epidemic resulting in 290,000 to 650,000 deaths and extracts a massive toll on healthcare and the economy. Infants and children are more susceptible to infection and have more severe symptoms than adults likely mitigated by differences in their innate and adaptive immune responses. While it is unclear the exact mechanisms with which the young combat influenza, it is increasingly understood that their immune responses differ from adults. Specifically, underproduction of IFN-γ and IL-12 by the innate immune system likely hampers viral clearance while upregulation of IL-6 may create excessive damaging inflammation. The infant's adaptive immune system preferentially utilizes the Th-2 response that has been tied to γδ T cells and their production of IL-17, which may be less advantageous than the adult Th-1 response for antiviral immunity. This differential immune response of the young is considered to serve as a unique evolutionary adaptation such that they preferentially respond to infection broadly rather than a pathogen-specific one generated by adults. This unique function of the young immune system is temporally, and possibly mechanistically, tied to the microbiota, as they both develop in coordination early in life. Additional research into the relationship between the developing microbiota and the immune system is needed to develop therapies effective at combating influenza in the youngest and most vulnerable of our population.
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Affiliation(s)
- Sonia Sakleshpur
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Ashley L Steed
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
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12
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Kumar V, Kancharla S, Jena MK. In silico virtual screening-based study of nutraceuticals predicts the therapeutic potentials of folic acid and its derivatives against COVID-19. Virusdisease 2021; 32:29-37. [PMID: 33532517 PMCID: PMC7843005 DOI: 10.1007/s13337-020-00643-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
The recent outbreak of the novel coronavirus (SARS-CoV-2) in the Wuhan province of China has taken millions of lives worldwide. In this pandemic situation and absence of known drugs and vaccines against novel coronavirus disease (COVID-19), there is an urgent need for the repurposing of the existing drugs against it. So, here we have examined a safe and cheap alternative against this virus by screening hundreds of nutraceuticals compounds against known therapeutic targets of SARS-COV-2 by molecular docking. The virtual screening results were then analyzed for binding energy and interactive residues and compared with some already known hits in the best binding pose. All these analyses of this study strongly predicted the potential of Folic acid and its derivates like Tetrahydrofolic acid and 5-methyl tetrahydrofolic acid against SARS-COV-2. The strong and stable binding affinity of this water-soluble vitamin and its derivatives against the SARS-COV-2, indicating that they could be valuable drugs against the management of this COVID-19 pandemic. This study could serve as the starting point for further investigation of these molecules through in vitro and in vivo assays.
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Affiliation(s)
- Vipul Kumar
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411 India
| | | | - Manoj Kumar Jena
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411 India
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13
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Moschovis PP, Sampayo EM, Cook A, Doros G, Parry BA, Lombay J, Kinane TB, Taylor K, Keating T, Abeyratne U, Porter P, Carl J. The diagnosis of respiratory disease in children using a phone-based cough and symptom analysis algorithm: The smartphone recordings of cough sounds 2 (SMARTCOUGH-C 2) trial design. Contemp Clin Trials 2021; 101:106278. [PMID: 33444779 DOI: 10.1016/j.cct.2021.106278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
The diagnosis of acute respiratory diseases in children can be challenging, and no single objective diagnostic test exists for common pediatric respiratory diseases. Previous research has demonstrated that ResAppDx, a cough sound and symptom-based analysis algorithm, can identify common respiratory diseases at the point of care. We present the study protocol for SMARTCOUGH-C 2, a prospective diagnostic accuracy trial of a cough and symptom-based algorithm in a cohort of children presenting with acute respiratory diseases. The objective of the study is to assess the performance characteristics of the ResAppDx algorithm in the diagnosis of common pediatric acute respiratory diseases.
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Affiliation(s)
- Peter P Moschovis
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Esther M Sampayo
- Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Anna Cook
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Gheorghe Doros
- Boston University School of Public Health and Baim Institute for Clinical Research, Boston, MA, USA
| | - Blair A Parry
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jesiel Lombay
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - T Bernard Kinane
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | | | - Paul Porter
- Perth Children's Hospital, Joondalup Health Campus, Perth, Australia
| | - John Carl
- Cleveland Clinic Foundation, Cleveland, OH, USA
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14
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Mirzaei R, Attar A, Papizadeh S, Jeda AS, Hosseini-Fard SR, Jamasbi E, Kazemi S, Amerkani S, Talei GR, Moradi P, Jalalifar S, Yousefimashouf R, Hossain MA, Keyvani H, Karampoor S. The emerging role of probiotics as a mitigation strategy against coronavirus disease 2019 (COVID-19). Arch Virol 2021; 166:1819-1840. [PMID: 33745067 PMCID: PMC7980799 DOI: 10.1007/s00705-021-05036-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023]
Abstract
COVID-19 is an acute respiratory infection accompanied by pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has affected millions of people globally. To date, there are no highly efficient therapies for this infection. Probiotic bacteria can interact with the gut microbiome to strengthen the immune system, enhance immune responses, and induce appropriate immune signaling pathways. Several probiotics have been confirmed to reduce the duration of bacterial or viral infections. Immune fitness may be one of the approaches by which protection against viral infections can be reinforced. In general, prevention is more efficient than therapy in fighting viral infections. Thus, probiotics have emerged as suitable candidates for controlling these infections. During the COVID-19 pandemic, any approach with the capacity to induce mucosal and systemic reactions could potentially be useful. Here, we summarize findings regarding the effectiveness of various probiotics for preventing virus-induced respiratory infectious diseases, especially those that could be employed for COVID-19 patients. However, the benefits of probiotics are strain-specific, and it is necessary to identify the bacterial strains that are scientifically established to be beneficial.
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Affiliation(s)
- Rasoul Mirzaei
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Adeleh Attar
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saher Papizadeh
- Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Salimi Jeda
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Hosseini-Fard
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Jamasbi
- Department of Anatomical Sciences, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Sima Kazemi
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saman Amerkani
- Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholam Reza Talei
- Department of Virology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Lorestan, Iran
| | - Pouya Moradi
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saba Jalalifar
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Rasoul Yousefimashouf
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Akhter Hossain
- The Florey University of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Hossein Keyvani
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Sajad Karampoor
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
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15
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Wacharachaisurapol N, Jitrungruengnij N, Janewongwirot P, Suchartlikitwong P, Chautrakarn S, Jantarabenjakul W, Anugulruengkitt S, Theerawit T, Sophonphan J, Deerojanawong J, Pancharoen C, Puthanakit T. High prescribing rates of third-generation cephalosporins in children hospitalized with acute lower respiratory infections at a university hospital. Int J Infect Dis 2020; 102:369-374. [PMID: 33186703 DOI: 10.1016/j.ijid.2020.10.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Antibiotics are frequently prescribed for the treatment of acute lower respiratory infections (ALRI) in children ≤5 years of age, even though viral aetiologies are the most common. The aim of this study was to describe antibiotic prescribing rates and patterns in children ≤5 years of age hospitalized with ALRI. METHODS A retrospective study was conducted involving patients aged 1 month to 5 years hospitalized with ALRI at a university hospital. Patient demographics, ALRI diagnosis, microbiological data, antibiotics prescribed, and treatment outcomes were recorded and analysed. RESULTS A total of 1283 patients were enrolled. Their median age was 1.6 years (interquartile range 0.8-2.8 years). Thirty-six percent had a co-morbidity. The diagnosis at discharge was viral ALRI in 81% and bacterial pneumonia in 19%. The mortality rate was 0.4%. The overall antibiotic prescribing rate was 46% (95% confidence interval 43-49%). Antibiotic prescribing rates were higher among children with co-morbidities (65% vs 35%, p < 0.001) and older children (57% for >2-5 years vs 39% for ≤2 years, p < 0.001). Parenteral third-generation cephalosporins were prescribed in up to 68% of all prescriptions. CONCLUSIONS Nearly-half of hospitalized children with ALRI were prescribed antibiotics. The majority of prescribed antibiotics were third-generation cephalosporins. An antimicrobial stewardship programme and antibiotic guidelines should be implemented to promote the judicious use of antibiotics.
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Affiliation(s)
- Noppadol Wacharachaisurapol
- Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Nattapong Jitrungruengnij
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pakpoom Janewongwirot
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pintip Suchartlikitwong
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sineenart Chautrakarn
- Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Watsamon Jantarabenjakul
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Suvaporn Anugulruengkitt
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tuangtip Theerawit
- Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jiratchaya Sophonphan
- HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Jitladda Deerojanawong
- Division of Paediatric Pulmonary, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chitsanu Pancharoen
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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16
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Broggi A, Granucci F, Zanoni I. Type III interferons: Balancing tissue tolerance and resistance to pathogen invasion. J Exp Med 2020; 217:132623. [PMID: 31821443 PMCID: PMC7037241 DOI: 10.1084/jem.20190295] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/23/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022] Open
Abstract
Type III IFNs, or IFN-λ, are the latest addition to the IFN family. Thanks to a restricted pattern of expression of their receptor and to unique immunomodulatory properties, IFN-λ stimulates pathogen clearance while, at the same time, curbing inflammation to maintain barrier integrity. Type III IFNs, or IFN-λ, are the newest members of the IFN family and were long believed to play roles that were redundant with those of type I IFNs. However, IFN-λ displays unique traits that delineate them as primary protectors of barrier integrity at mucosal sites. This unique role stems both from the restricted expression of IFN-λ receptor, confined to epithelial cells and to a limited pool of immune cells, and from unique immunomodulatory properties of IFN-λ. Here, we discuss recent findings that establish the unique capacity of IFN-λ to act at the barriers of the host to balance tissue tolerance and immune resistance against viral and bacterial challenges.
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Affiliation(s)
- Achille Broggi
- Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, MA.,Division of Gastroenterology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Francesca Granucci
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy.,National Institute of Molecular Genetics "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Ivan Zanoni
- Division of Immunology, Boston Children's Hospital and Harvard Medical School, Boston, MA.,Division of Gastroenterology, Boston Children's Hospital and Harvard Medical School, Boston, MA.,Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
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17
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Alemayehu S, Kidanu K, Kahsay T, Kassa M. Risk factors of acute respiratory infections among under five children attending public hospitals in southern Tigray, Ethiopia, 2016/2017. BMC Pediatr 2019; 19:380. [PMID: 31651291 PMCID: PMC6814116 DOI: 10.1186/s12887-019-1767-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 10/09/2019] [Indexed: 11/21/2022] Open
Abstract
Background Acute Respiratory infection accounts for 94,037000 disability adjusted life years and 1.9 million deaths worldwide. Acute respiratory infections is the most common causes of under-five illness and mortality. The under five children gets three to six episodes of acute respiratory infections annually regardless of where they live. Disease burden due to acute respiratory infection is 10–50 times higher in developing countries when compared to developed countries. The aim of this study was to assess risk factors of acute respiratory infection among under-five children attending Public hospitals in Southern Tigray, Ethiopia 2016/2017. Methods Institution based case control study was conducted from Nov 2016 to June 2017. Interviewer administered structured questionnaire was used to collect data from a sample of 288 (96 cases and 192 controls) children under 5 years of age. Systematic random sampling was used to recruit study subjects and SPSS version 20 was used to analyze the data. Bivariate and multivariate analysis were employed to examine statistical association between the outcome variable and selected independent variables at 95% confidence level. Level of statistical Significance was declared at p < 0.05. Tables, figures and texts were used to present data. Result One hundred sixty (55.6%) and 128 (44.4%) of the participants were males and females respectively. Malnutrition (AOR = 2.89; 95%CI: 1.584–8.951; p = 0.039), cow dung use (AOR =2.21; 95%CI: 1.121–9.373; p = 0.014), presence of smoker in the family (AOR = 0.638; 95% CI: 0.046–0.980; p = 0.042) and maternal literacy (AOR = 3.098; 95%CI: 1.387–18.729; p = 0.021) were found to be significant predictors of acute respiratory infection among under five children. Conclusion According to this study maternal literacy, smoking, cow dung use and nutritional status were strongly associated with increased risk of childhood acute respiratory infection. Health care providers should work jointly with the general public, so that scientific knowledge and guidelines for adopting particular preventive measures for acute respiratory infection are disseminated.
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Affiliation(s)
- Sielu Alemayehu
- Mekelle University, College of Health Sciences, School of Nursing, P.O.B: 1817, Mekelle, Tigray, Ethiopia.
| | - Kalayou Kidanu
- Mekelle University, College of Health Sciences, School of Nursing, P.O.B: 1817, Mekelle, Tigray, Ethiopia
| | - Tensay Kahsay
- Mekelle University, College of Health Sciences, School of Nursing, P.O.B: 1817, Mekelle, Tigray, Ethiopia
| | - Mekuria Kassa
- Mekelle University, College of Health Sciences, School of Nursing, P.O.B: 1817, Mekelle, Tigray, Ethiopia
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18
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Derrar F, Izri K, Kaddache C, Boukari R, Hannoun D. Virologic study of acute lower respiratory tract infections in children admitted to the paediatric department of Blida University Hospital, Algeria. New Microbes New Infect 2019; 30:100536. [PMID: 31193119 PMCID: PMC6517316 DOI: 10.1016/j.nmni.2019.100536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 02/03/2023] Open
Abstract
Acute lower respiratory tract infections (ALRTI) such as pneumonia and bronchiolitis are major causes of mortality and morbidity in children under 5 years of age. The main microbial agents responsible for ALRTI are either bacterial agents (Streptococcus pneumoniae, Haemophilus influenzae type b, Mycoplasma pneumoniae) or viruses (respiratory syncytial virus (RSV, also known as human orthopneumovirus), Myxovirus influenzae, Myxovirus parainfluenzae, adenovirus) [1]. More recently, other viruses (rhinovirus, metapneumovirus, coronavirus, bocavirus) have been implicated in ALRTI; their identification has been facilitated by new molecular biology techniques such as real-time PCR. To our knowledge, these emerging viruses have never been the subject of epidemiologic studies in our country.
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Affiliation(s)
- F. Derrar
- Viral Respiratory Unit, Virology Department, Institut Pasteur of Algeria, Algiers, Algeria
| | - K. Izri
- Viral Respiratory Unit, Virology Department, Institut Pasteur of Algeria, Algiers, Algeria
| | - C. Kaddache
- Paediatric Department, University Hospital of Blida, Blida, Algeria
| | - R. Boukari
- Paediatric Department, University Hospital of Blida, Blida, Algeria
| | - D. Hannoun
- National Institut of Public Health, Algeria
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19
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Kerry RG, Malik S, Redda YT, Sahoo S, Patra JK, Majhi S. Nano-based approach to combat emerging viral (NIPAH virus) infection. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2019; 18:196-220. [PMID: 30904587 PMCID: PMC7106268 DOI: 10.1016/j.nano.2019.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/19/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022]
Abstract
Emergence of new virus and their heterogeneity are growing at an alarming rate. Sudden outburst of Nipah virus (NiV) has raised serious question about their instant management using conventional medication and diagnostic measures. A coherent strategy with versatility and comprehensive perspective to confront the rising distress could perhaps be effectuated by implementation of nanotechnology. But in concurrent to resourceful and precise execution of nano-based medication, there is an ultimate need of concrete understanding of the NIV pathogenesis. Moreover, to amplify the effectiveness of nano-based approach in a conquest against NiV, a list of developed nanosystem with antiviral activity is also a prerequisite. Therefore the present review provides a meticulous cognizance of cellular and molecular pathogenesis of NiV. Conventional as well several nano-based diagnosis experimentations against viruses have been discussed. Lastly, potential efficacy of different forms of nano-based systems as convenient means to shield mankind against NiV has also been introduced.
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Affiliation(s)
- Rout George Kerry
- Post Graduate Department of Biotechnology, Utkal University, Vani Vihar, Bhubaneswar, Odisha, India
| | - Santosh Malik
- Departmentof Life Science, National Institute of Technology, Rourkela, Odisha, India
| | | | - Sabuj Sahoo
- Post Graduate Department of Biotechnology, Utkal University, Vani Vihar, Bhubaneswar, Odisha, India
| | - Jayanta Kumar Patra
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, Republic of Korea.
| | - Sanatan Majhi
- Post Graduate Department of Biotechnology, Utkal University, Vani Vihar, Bhubaneswar, Odisha, India.
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20
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Sarna M, Ware RS, Lambert SB, Sloots TP, Nissen MD, Grimwood K. Timing of First Respiratory Virus Detections in Infants: A Community-Based Birth Cohort Study. J Infect Dis 2019; 217:418-427. [PMID: 29165576 PMCID: PMC7107408 DOI: 10.1093/infdis/jix599] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/16/2017] [Indexed: 11/13/2022] Open
Abstract
Background Determining timing of first virus detection episodes (fVDEs) for different respiratory viruses in infants identifies risk periods and informs preventive interventions, including vaccination. We describe the ages and nature of fVDEs in an infant birth cohort and explore factors associated with increased odds of symptomatic fVDEs. Methods The Observational Research in Childhood Infectious Diseases (ORChID) study is a community-based birth cohort describing acute respiratory infections in infants until their second birthday. Parents recorded daily symptoms and collected nose swabs weekly, which were batch-tested using polymerase chain reaction assays for 17 respiratory viruses. Results One hundred fifty-eight infants participated in ORChID. The median age for fVDEs was 2.9 months for human rhinovirus (HRV) but was ≥13.9 months for other respiratory viruses. Overall, 52% of HRV fVDEs were symptomatic, compared with 57%–83% of other fVDEs. Respiratory syncytial virus and human metapneumovirus fVDEs were more severe than HRV fVDEs. Older age and the winter season were associated with symptomatic episodes. Conclusions Infants do not always experience respiratory symptoms with their fVDE. Predominance of early HRV detections highlights the need for timing any intervention early in life. fVDEs from other respiratory viruses most commonly occur when maternal vaccines may no longer provide protection.
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Affiliation(s)
- Mohinder Sarna
- School of Public Health, University of Queensland, Brisbane.,UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Robert S Ware
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane.,Menzies Health Institute Queensland, Griffith University, Gold Coast
| | - Stephen B Lambert
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Theo P Sloots
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Michael D Nissen
- UQ Child Health Research Centre, School of Medicine, University of Queensland, Brisbane
| | - Keith Grimwood
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast.,Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Queensland, Australia
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21
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Famoroti T, Sibanda W, Ndung'u T. Prevalence and seasonality of common viral respiratory pathogens, including Cytomegalovirus in children, between 0-5 years of age in KwaZulu-Natal, an HIV endemic province in South Africa. BMC Pediatr 2018; 18:240. [PMID: 30031377 PMCID: PMC6054853 DOI: 10.1186/s12887-018-1222-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/11/2018] [Indexed: 11/29/2022] Open
Abstract
Background Acute respiratory tract infections contribute significantly to morbidity and mortality among young children in resource-poor countries. However, studies on the viral aetiology of acute respiratory infections, seasonality and the relative contributions of comorbidities such as immune deficiency states to viral respiratory tract infections in children in these countries are limited. Methods A retrospective analysis of laboratory test results of upper or lower respiratory specimens of children between 0 and 5 years of age collected between 1st January 2011 and 31st July 2015 from hospitals in KwaZulu-Natal, South Africa. Respiratory specimens were tested for viral respiratory pathogens using multiplex polymerase chain reaction (PCR), HIV testing was performed either by serological or PCR methods. Cytomegalovirus (CMV) respiratory infection was determined using the CMV R-gene PCR kit. Results In total 2172 specimens were analysed, of which 1175 (54.1%) were from males. The median age was 3.0 months (interquartile range [IQR] 1–7). Samples from the lower respiratory tract accounted for 1949 (89.7%) of all specimens. Respiratory multiplex PCR results were positive in 834 (45.7%) specimens. Respiratory syncytial virus (RSV) was the most commonly detected virus in 316 (32.1%) patients, followed by adenovirus (ADV) in 215 (21.8%), human rhinovirus (Hrhino) in 152 (15.4%) and influenza A (FluA) in 50 (5.1%). A seasonal time series pattern was observed for ADV (winter peak), enterovirus (EV) (autumn), human bocavirus (HBoV) (summer), and parainfluenza viruses 1 and 3 (PIV1 and 3) (spring). Stationary or untrended seasonal variation was observed for FluA (winter peak) and RSV (summer). HIV results were available for 1475 (67.9%) specimens; of these 348 (23.6%) were positive. CMV results were available for 714 (32.9%) specimens, of which 416 (58.3%) were positive. There was a statistically significant association between the coinfection of HIV and CMV with ADV. Conclusions In this study, we identified the most common respiratory viral pathogens detected among hospitalized children in KwaZulu-Natal. The coinfection between HIV and CMV was found to be associated with an increased risk of only adenovirus infection. Most viral pathogens showed a seasonal trend of occurrence. Our data has implications for the rational design of public health programmes.
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Affiliation(s)
- Temitayo Famoroti
- Department of Virology, National Health Laboratory Service, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
| | - Wilbert Sibanda
- Biostatistics Unit, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Thumbi Ndung'u
- HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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22
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Mummidi PS, Tripathy R, Dwibedi B, Mahapatra A, Baraha S. Viral aetiology of wheezing in children under five. Indian J Med Res 2018. [PMID: 28639594 PMCID: PMC5501050 DOI: 10.4103/ijmr.ijmr_840_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & objectives: Wheezing is a common problem in children under five with acute respiratory infections (ARIs). Viruses are known to be responsible for a considerable proportion of ARIs in children. This study was undertaken to know the viral aetiology of wheezing among the children less than five years of age, admitted to a tertiary care hospital in eastern India. Methods: Seventy five children, under the age of five years admitted with wheezing, were included in the study. Throat and nasal swabs were collected, and real-time multiplex polymerase chain reaction (PCR) assay was used to screen for influenza 1 and 2, respiratory syncytial virus (RSV), parainfluenza virus (PIV) 1, 2, 3 and 4, rhinovirus, human meta-pneumovirus, bocavirus (HBoV), Coronavirus, adenovirus, Enterovirus and Parechovirus. Results: The total viral detection rate was 28.57 per cent. Viral RNA markers were detected from children diagnosed to be having pneumonia (3 cases), bronchiolitis (9 cases), episodic wheeze (2 cases) and multitrigger wheeze (6 cases). RSV was the most common virus (35%) followed by PIV1, 2 and 3 (20%), HBoV (10%) and rhinovirus (5%). However, mixed infection was observed in 30 per cent of cases. Interpretation & conclusions: The study reported the presence of respiratory viral agents in 28.57 per cent of children with wheezing; RSV and PIV were most common, accounting to 55 per cent of the total cases. Mixed infection was reported in 30 per cent of cases. Seasonal variation in the occurrence of these viruses was also noted. Further studies need to be done with a large sample and longer follow up period to verify these findings.
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Affiliation(s)
| | - Radha Tripathy
- Department of Paediatrics, Hitech Medical College & Hospital, Bhubaneswar, India
| | - Bhagirathi Dwibedi
- Regional Medical Research Centre, Indian Council of Medical Research (ICMR), Bhubaneswar, India
| | - Amarendra Mahapatra
- Regional Medical Research Centre, Indian Council of Medical Research (ICMR), Bhubaneswar, India
| | - Suryakanta Baraha
- Department of Paediatrics, Hitech Medical College & Hospital, Bhubaneswar, India
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Gao J, Li Y, Wang Q, Ma X, Zhang Y. Oxysophocarpine inhibits lung injury induced by respiratory syncytial virus. Am J Transl Res 2017; 9:4083-4093. [PMID: 28979683 PMCID: PMC5622252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/02/2016] [Indexed: 06/07/2023]
Abstract
Oxysophocarpine (OSC) has various pharmacological effects. This study was designed to investigate whether OSC confers protection against respiratory syncytial virus (RSV) infection-induced lung injury. Here, we found that OSC inhibited RSV replication and increased the viability of RSV-infected lung epithelial A549 cells. OSC suppressed the RSV-increased production and release of pro-inflammatory cytokines and chemokines [tumor necrosis factor-α, interleukin-6 (IL-6), IL-8, regulated on activation in normal T-cell expressed and secreted, macrophage inflammatory protein-1α; and monocyte chemoattractant protein-1] in A549 cells. OSC also reduced the formation of reactive oxygen species and enhanced the activities of antioxidant enzymes in RSV-infected cells. The anti-oxidative effect of OSC on RSV-infected cells was dependent on NF-E2-related factor 2 activation. In vivo, OSC significantly alleviated RSV-triggered mouse lung injury. Overall, these results indicated that OSC attenuates RSV-enhanced pulmonary damage by inhibiting oxidative stress and inflammation.
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Affiliation(s)
- Jie Gao
- Department of Pediatrics, Henan University Huaihe HospitalKaifeng 475000, Henan, P. R. China
| | - Ying Li
- Department of Pediatrics, Henan University Huaihe HospitalKaifeng 475000, Henan, P. R. China
| | - Qiwei Wang
- Department of Pediatrics, Henan University Huaihe HospitalKaifeng 475000, Henan, P. R. China
| | - Xiaojian Ma
- Department of Pediatrics, Henan University Huaihe HospitalKaifeng 475000, Henan, P. R. China
| | - Yan Zhang
- Department of Pediatrics, Henan University Huaihe HospitalKaifeng 475000, Henan, P. R. China
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Sarna M, Ware RS, Sloots TP, Nissen MD, Grimwood K, Lambert SB. The burden of community-managed acute respiratory infections in the first 2-years of life. Pediatr Pulmonol 2016; 51:1336-1346. [PMID: 27228308 DOI: 10.1002/ppul.23480] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Contemporary information on acute respiratory infections (ARIs) in children is based on hospital cohorts, primary healthcare presentations, and high-risk birth cohort studies. We describe the burden and determinants of symptomatic episodes of ARIs in unselected healthy infants in the first 2-years of life. METHODS One hundred and fifty-four infants from subtropical Brisbane, Australia participated in a longitudinal, community-based birth cohort study. A daily tick-box diary captured pre-defined respiratory symptoms. Parents also completed a burden diary, recording family physician and hospital visits, and antibiotic use. RESULTS Participants contributed 88,032 child-days (78.2% of expected), of which 17,316 (19.7%) days were symptomatic during 1,651 ARI episodes: incidence rate 0.56 ARIs per child-month (95%CI: 0.54, 0.59). Runny nose (14,220 days; 6.0-days median duration) and dry cough (6,880 days; 4.0-days median duration) were reported most frequently. Overall, 955 burden diaries recorded 455 family physician visits (1-8 visits per ARI) and 48 hospital presentations, including six hospital admissions. Antibiotics were prescribed on 209 occasions (21.9% of ARI episodes where burden diary submitted). Increasing age, non-summer seasons, and attendance at childcare were associated with an increased risk of ARI. CONCLUSIONS ARIs are a common cause of morbidity in the first 2-years of life, with children experiencing 13 discrete ARI episodes and almost 5-months of respiratory symptoms. Most ARIs are managed in the community by parents and family physicians. Antibiotic prescribing remains common for ARIs in young children. Secular societal changes, including greater use of childcare in early childhood, may have maintained the high ARI incidence in this age-group. Pediatr Pulmonol. 2016;51:1336-1346. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Mohinder Sarna
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert S Ware
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Theo P Sloots
- Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Queensland Pediatric Infectious Diseases Laboratory, Centre for Children's Health Research, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Michael D Nissen
- Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Keith Grimwood
- Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Gold Coast, Queensland, Australia
| | - Stephen B Lambert
- Queensland Pediatric Infectious Diseases Laboratory, Centre for Children's Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.,Communicable Diseases Branch, Queensland Health, Brisbane, Queensland, Australia
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Tong ASW, Hon KL, Tsang YCK, Chan RWY, Chan CC, Leung TF, Chan PKS. Paramyxovirus Infection: Mortality and Morbidity in a Pediatric Intensive Care Unit. J Trop Pediatr 2016; 62:352-60. [PMID: 27037248 DOI: 10.1093/tropej/fmw016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES We investigated mortality and morbidity of patients admitted to a pediatric intensive care unit (PICU) with paramyxovirus infection. METHODS A retrospective study between October 2002 and March 2015 of children with a laboratory-confirmed paramyxovirus infection was included. RESULTS In all, 98 (5%) PICU admissions were tested positive to have paramyxovirus infection (respiratory syncytial virus = 66, parainfluenza = 27 and metapneumovirus = 5). The majority of admissions were young patients (median age 1.05 years). Bacteremia and bacterial isolation in any site were present in 10% and 28%, respectively; 41% were mechanically ventilated, and 20% received inotropes. The three respiratory viruses caused similar mortality and morbidity in the PICU. Fatality (seven patients) was associated with malignancy, positive bacterial culture in blood, the use of mechanical ventilation, inotrope use, lower blood white cell count and higher C reactive protein (p = 0.02-0.0005). Backward binary logistic regression for these variables showed bacteremia (odds ratio [OR]: 31.7; 95% CI: 2.3-427.8; p = 0.009), malignancy (OR: 45.5; 95% CI: 1.4-1467.7; p = 0.031) and use of inotropes (OR: 15.0; 95% CI: 1.1-196.1; p = 0.039) were independently associated with non-survival. March and July appeared to be the two peak months for PICU hospitalizations with paramyxovirus infection. CONCLUSIONS Infections with paramyxoviruses account for 5% of PICU admissions and significant morbidity. Patient with premorbid history of malignancy and co-morbidity of bacteremia are associated with non-survival. March and July appeared to be the two peak months for PICU admissions with paramyxoviruses.
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Affiliation(s)
- Alice S W Tong
- Department of Paediatrics, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong
| | - Kam Lun Hon
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Yin Ching K Tsang
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Renee Wan Yi Chan
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Ching Ching Chan
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Ting Fan Leung
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Paul K S Chan
- Department of Microbiology, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Ramezannia M, Hosseini SM, Fotouhi F, Khansarinejad B, Mazaheri V. Development of a multiplex real-time RT-PCR assay for detection of human parainfluenza viruses in patients with respiratory symptoms. Future Virol 2016. [DOI: 10.2217/fvl-2016-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The human parainfluenza viruses (HPIVs) are common viral causes of both upper and lower respiratory tract infections in infants and children. The purpose of this study was to develop a real-time reverse transcription PCR assay to detect HPIVs in clinical specimens in a single test. Specimens: Specific primers and probes matched to conserved region of hemagglutinin–neuraminidase genes were designed. Clinical specimens were collected from hospitalized children of ≤5 years old. Results & conclusion: Of 230 specimens, 48 samples contained one of HPIV types 1–4. The most percentage of positive HPIVs belonged to HPIV2. HPIVs were found in fall, winter and spring but not in summer months. In conclusion, our in-house multiplex real-time reverse transcription PCR is a suitable technique for simultaneous detection of HPIVs in clinical samples.
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Affiliation(s)
- Mahboobeh Ramezannia
- Department of Influenza & Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, Iran
| | - Seyed Masoud Hosseini
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Fotouhi
- Department of Influenza & Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Behzad Khansarinejad
- Department of Microbiology & Immunology, Arak University of Medical Sciences, Arak, Iran
| | - Vahideh Mazaheri
- Department of Influenza & Other Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
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Prediction of the respiratory syncitial virus epidemic using climate variables in Bogotá, D.C. BIOMEDICA 2016; 36:378-389. [PMID: 27869386 DOI: 10.7705/biomedica.v36i3.2763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 03/28/2016] [Indexed: 11/21/2022]
Abstract
lntroduction: The respiratory syncitial virus is one of the most common causes of mortality in children and older adults in the world. Objective: To predict the initial week of outbreaks and to establish the most relevant climate variables using naive Bayes classifiers and receiver operating characteristic curves (ROC). Materials and methods: The initial dates of the outbreaks in children less than five years old for the period 2005-2010 were obtained for Bogotá, Colombia. We selected the climatological variables using a correlation matrix and we constructed 1,020 models using different climatological variables and data from different weeks previous to the initial outbreak. In addition, we selected models using a six-year period (2005-2010), a four-year period (2005-2008), and a two-year period (2009-2010). We obtained the best predictive models and the most relevant climatological variables to predict the outbreak using naive Bayes classifiers and ROC curves. Results: The best models were those using a two-year period (2009-2010) and week 0, with 52% and 60% of effectiveness, respectively. Humidity was the most frequent variable in the best models (62%). Conclusions: We used naive Bayes classifiers to establish the best models to predict correctly the initial week of the outbreak. Our results suggest that the best models used humidity, wind speed and minimum temperature in outbreaks prediction.
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Association of RSV-A ON1 genotype with Increased Pediatric Acute Lower Respiratory Tract Infection in Vietnam. Sci Rep 2016; 6:27856. [PMID: 27306333 PMCID: PMC4910061 DOI: 10.1038/srep27856] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 05/26/2016] [Indexed: 12/26/2022] Open
Abstract
Since the initial discovery of RSV-A ON1 in Canada in 2010, ON1 has been reported worldwide, yet information regarding its clinical impact and severity has been controversial. To investigate the clinical relevance of RSV-A ON1,acute respiratory infection (ARI) cases enrolled to our population-based prospective pediatric ARI surveillance at Khanh Hoa General Hospital, Central Vietnam from January 2010 through December 2012 were studied. Clinical-epidemiological information and nasopharyngeal samples were collected. Multiplex PCR assays were performed for screening 13 respiratory viruses. RSV-positive samples were further tested for subgroups (A/B) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region. Statistical analysis was performed to evaluate the clinical-epidemiological characteristics of RSV-A ON1. A total of 1854 ARI cases were enrolled and 426 (23.0%) of them were RSV-positive. During the study period, RSV-A and B had been co-circulating. NA1 was the predominant RSV-A genotype until the appearance of ON1 in 2012. RSV-related ARI hospitalization incidence significantly increased after the emergence of ON1. Moreover, multivariate analysis revealed that risk of lower respiratory tract infection was 2.26 (95% CI: 1.37-3.72) times, and radiologically-confirmed pneumonia was 1.98 (95% CI: 1.01-3.87) times greater in ON1 compared to NA1 cases. Our result suggested that ON1 ARI cases were clinically more severe than NA1.
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Sinha IP, McBride AKS, Smith R, Fernandes RM. CPAP and High-Flow Nasal Cannula Oxygen in Bronchiolitis. Chest 2015; 148:810-823. [PMID: 25836649 DOI: 10.1378/chest.14-1589] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Severe respiratory failure develops in some infants with bronchiolitis because of a complex pathophysiologic process involving increased airways resistance, alveolar atelectasis, muscle fatigue, and hypoxemia due to mismatch between ventilation and perfusion. Nasal CPAP and high-flow nasal cannula (HFNC) oxygen may improve the work of breathing and oxygenation. Although the mechanisms behind these noninvasive modalities of respiratory support are not well understood, they may help infants by way of distending pressure and delivery of high concentrations of warmed and humidified oxygen. Observational studies of varying quality have suggested that CPAP and HFNC may confer direct physiologic benefits to infants with bronchiolitis and that their use has reduced the need for intubation. No trials to our knowledge, however, have compared CPAP with HFNC in bronchiolitis. Two randomized trials compared CPAP with oxygen delivered by low-flow nasal cannula or face mask and found some improvements in blood gas results and some physiologic parameters, but these trials were unable to demonstrate a reduction in the need for intubation. Two trials evaluated HFNC in bronchiolitis (one comparing it with headbox oxygen, the other with nebulized hypertonic saline), with the results not seeming to suggest important clinical or physiologic benefits. In this article, we review the pathophysiology of respiratory failure in bronchiolitis, discuss these trials in detail, and consider how future research studies may be designed to best evaluate CPAP and HFNC in bronchiolitis.
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Affiliation(s)
- Ian P Sinha
- From the Respiratory Unit, Alder Hey Children's Hospital, Liverpool, England.
| | - Antonia K S McBride
- From the Respiratory Unit, Alder Hey Children's Hospital, Liverpool, England
| | - Rachel Smith
- From the Respiratory Unit, Alder Hey Children's Hospital, Liverpool, England
| | - Ricardo M Fernandes
- Department of Pediatrics, Santa Maria Hospital, Lisbon Academic Medical Centre, Lisbon, Portugal; Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
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Onakpoya IJ, Hayward G, Heneghan CJ. Antibiotics for preventing lower respiratory tract infections in high-risk children aged 12 years and under. Cochrane Database Syst Rev 2015; 2015:CD011530. [PMID: 26408070 PMCID: PMC10624245 DOI: 10.1002/14651858.cd011530.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Lower respiratory tract infections (LRTIs) in young children account for 1.4 million deaths annually worldwide. Antibiotics could be beneficial in preventing LRTIs in high-risk children, and may also help prevent school absenteeism and work days missed by children and/or carers. While it is well documented that the efficacy of antibiotic prophylaxis for RTIs decreases over time, there are no reviews that describe the use of antibiotic prophylaxis to prevent LRTIs in high-risk children aged 12 years and under. OBJECTIVES To assess the effectiveness and safety of antibiotic prophylaxis in the prevention of bacterial LRTIs in high-risk children aged 12 years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 1) and the Database of Abstracts of Reviews of Effects (DARE), MEDLINE and MEDLINE In-Process (OvidSP) (1946 to 13 February 2015), EMBASE (OvidSP) (1974 to 12 February 2015), Science Citation Index Expanded (1945 to 13 February 2015) and Conference Proceedings Citation Index-Science (Web of Science Core Collection) (1990 to 13 February 2015). We searched for ongoing studies on ClinicalTrials.gov and the World Health Organization ICTRP. We handsearched the bibliographies of retrieved full texts of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing oral or intravenous antibiotics versus placebo or no treatment to prevent infections in high-risk children aged 12 years and under. We used a combination of the Centers for Disease Control and Prevention (CDC), National Health Service (NHS), American Academy of Paediatrics (AAP) and National Institute for Health and Care Excellence (NICE) guidelines to define conditions at higher risk of complications. Our primary outcome was the incidence of bacterial lower respiratory infections. Secondary outcomes included clinical function, hospital admission, mortality, growth, use of secondary antibiotics, time off school or parental work, quality of life and adverse events. DATA COLLECTION AND ANALYSIS We extracted data using a customised data extraction sheet, assessed the risk of bias of included studies using the Cochrane 'Risk of bias' criteria, and used the GRADE criteria to rate the quality of the evidence. We used a random-effects model for meta-analysis. We presented the results narratively where we could not statistically combine data. MAIN RESULTS We included 10 RCTs of high-risk children using antibiotics (azithromycin, ciprofloxacin, co-trimoxazole, isoniazid, oral penicillin V or vancomycin) to prevent LRTIs. Three studies included HIV-infected children (n = 1345), four cystic fibrosis (n = 429) and one each sickle cell disease (n = 219), cancer (n = 160) and low birth weight neonates with underlying respiratory disorders (n = 40). The study duration ranged from seven days to three years. The quality of the evidence from studies including children with HIV infection, cystic fibrosis or cancer was moderate. Due to inadequate data, we were unable to rate the quality of the evidence for two studies: one in children with sickle cell disease (low risk of bias), and another in low birth weight neonates with underlying respiratory disorders (high risk of bias).In HIV-infected children receiving continuous isoniazid prophylaxis, there was no significant difference in the incidence of pulmonary tuberculosis (risk ratio (RR) 0.64, 95% confidence interval (CI) 0.32 to 1.29, I(2) statistic = 47%, P value = 0.21). There was no significant effect on mortality with co-trimoxazole or isoniazid prophylaxis (RR 0.82, 0.46 to 1.46, I(2) statistic = 76%, P value = 0.58); however, analysis of one study that used co-trimoxazole showed a significant reduction in mortality (RR 0.67, 95% CI 0.53 to 0.85, P value = 0.001). There was a significant decrease in the rates of hospital admission per child-year of follow-up with co-trimoxazole prophylaxis in one study (P value = 0.01). There was no evidence of increased adverse events due to antibiotic prophylaxis (RR 1.10, 95% CI 0.75 to 1.64, I(2) statistic = 22%, P value = 0.28); however, there was scant reporting of antibiotic resistance - the one study that did assess this found no increase.In two studies of children with cystic fibrosis receiving ciprofloxacin prophylaxis, there was no significant difference in Pseudomonas infections (RR 0.76, 0.44 to 1.31, I(2) statistic = 0%, P value = 0.33). In two studies assessing the benefit of azithromycin prophylaxis, there was a significant reduction in the frequency of pulmonary exacerbations (RR 0.60, 95% CI 0.48 to 0.76, I(2) statistic = 0%, P value < 0.0001). The effect of antibiotic prophylaxis on growth in children with cystic fibrosis was inconsistent across the studies. There was an increased risk of emergence of pathogenic strains with either azithromycin or ciprofloxacin prophylaxis in two studies reporting this outcome. There was no significant difference in the quality of life (one study). In three studies, there was no significant increase in the frequency of adverse events with prophylaxis with azithromycin (two studies) or ciprofloxacin (one study). There was no evidence of increased antibiotic resistance in two studies.In the one study of children with sickle cell disease, a significantly lesser proportion of children with pneumococcal septicaemia was reported with penicillin V prophylaxis (P value = 0.0025).In the one study of children with cancer there was a significant decrease in Pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole prophylaxis (RR 0.03, 95% CI 0.00 to 0.47, P value < 0.01). There was no significant increase in the frequency of adverse events with antibiotic prophylaxis.In low birth weight children with underlying respiratory disorders, there was no significant difference in the proportion of children with pulmonary infection with vancomycin prophylaxis (P value = 0.18).No included studies reported time off school or carer time off work. AUTHORS' CONCLUSIONS There is inconclusive evidence that antibiotic prophylaxis in certain groups of high-risk children can reduce pneumonia, exacerbations, hospital admission and mortality in certain conditions. However, limitations in the evidence base mean more clinical trials assessing the effectiveness of antibiotics for preventing LRTIs in children at high risk should be conducted. Specifically, clinical trials assessing the effectiveness of antibiotics for preventing LRTIs in congenital heart disease, metabolic disease, endocrine and renal disorders, neurological disease or prematurity should be a priority.
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Affiliation(s)
- Igho J Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK, Oxon
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del Valle Mendoza J, Cornejo-Tapia A, Weilg P, Verne E, Nazario-Fuertes R, Ugarte C, del Valle LJ, Pumarola T. Incidence of respiratory viruses in Peruvian children with acute respiratory infections. J Med Virol 2015; 87:917-24. [PMID: 25784285 PMCID: PMC7167149 DOI: 10.1002/jmv.24159] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 11/08/2022]
Abstract
Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses.
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Affiliation(s)
- Juana del Valle Mendoza
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Perú; Nutrition Research Institute, Lima, Perú
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Onakpoya IJ, Hayward G, Heneghan CJ. The use of antibiotics for preventing lower respiratory tract infections in at risk children less than 12 years old. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Comparison of three different techniques for the isolation of viral RNA in sputum. J Clin Virol 2014; 61:265-9. [DOI: 10.1016/j.jcv.2014.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/28/2014] [Accepted: 07/18/2014] [Indexed: 11/23/2022]
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Greenbaum AH, Chen J, Reed C, Beavers S, Callahan D, Christensen D, Finelli L, Fry AM. Hospitalizations for severe lower respiratory tract infections. Pediatrics 2014; 134:546-54. [PMID: 25113302 DOI: 10.1542/peds.2014-0244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hospitalization for lower respiratory tract infections (LRTIs) among children have been well characterized. We characterized hospitalizations for severe LRTI among children. METHODS We analyzed claims data from commercial and Medicaid insurance enrollees (MarketScan) ages 0 to 18 years from 2007 to 2011. LRTI hospitalizations were identified by the first 2 listed International Classification of Diseases, Ninth Revision discharge codes; those with ICU admission and/or receiving mechanical ventilation were defined as severe LRTI. Underlying conditions were determined from out- and inpatient discharge codes in the preceding year. We report insurance specific and combined rates that used both commercial and Medicaid rates and adjusted for age and insurance status. RESULTS During 2007-2011, we identified 16797 and 12053 severe LRTI hospitalizations among commercial and Medicaid enrollees, respectively. The rates of severe LRTI hospitalizations per 100000 person-years were highest in children aged <1 year (commercial: 244; Medicaid: 372, respectively), and decreased with age. Among commercial enrollees, ≥ 1 condition increased the risk for severe LRTI (1 condition: adjusted relative risk, 2.68; 95% confidence interval, 2.58-2.78; 3 conditions: adjusted relative risk, 4.85; 95% confidence interval, 4.65-5.07) compared with children with no medical conditions. Using commercial/Medicaid combined rates, an estimated 31289 hospitalizations for severe LRTI occurred each year in children in the United States. CONCLUSIONS Among children, the burden of hospitalization for severe LRTI is greatest among children aged <1 year. Children with underlying medical conditions are at greatest risk for severe LRTI hospitalization.
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Affiliation(s)
- Adena H Greenbaum
- Influenza Division, National Center for Immunizations and Respiratory Diseases, Epidemic Intelligence Service assigned to the Influenza Division
| | - Jufu Chen
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Carrie Reed
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Suzanne Beavers
- Division of Environmental Hazards and Health Effects, National Center for Environmental Health
| | - David Callahan
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, and
| | - Deborah Christensen
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyn Finelli
- Influenza Division, National Center for Immunizations and Respiratory Diseases
| | - Alicia M Fry
- Influenza Division, National Center for Immunizations and Respiratory Diseases,
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van den Berg E, Bem RA, Bos AP, Lutter R, van Woensel JBM. The effect of TIP on pneumovirus-induced pulmonary edema in mice. PLoS One 2014; 9:e102749. [PMID: 25047452 PMCID: PMC4105480 DOI: 10.1371/journal.pone.0102749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/20/2014] [Indexed: 01/14/2023] Open
Abstract
Background Pulmonary edema plays a pivotal role in the pathophysiology of respiratory syncytial virus (RSV)-induced respiratory failure. In this study we determined whether treatment with TIP (AP301), a synthetic cyclic peptide that mimics the lectin-like domain of human TNF, decreases pulmonary edema in a mouse model of severe human RSV infection. TIP is currently undergoing clinical trials as a therapy for pulmonary permeability edema and has been shown to decrease pulmonary edema in different lung injury models. Methods C57BL/6 mice were infected with pneumonia virus of mice (PVM) and received TIP or saline (control group) by intratracheal instillation on day five (early administration) or day seven (late administration) after infection. In a separate set of experiments the effect of multiple dose administration of TIP versus saline was tested. Pulmonary edema was determined by the lung wet-to-dry (W/D) weight ratio and was assessed at different time-points after the administration of TIP. Secondary outcomes included clinical scores and lung cellular response. Results TIP did not have an effect on pulmonary edema in different dose regimens at different time points during PVM infection. In addition, TIP administration did not affect clinical severity scores or lung cellular response. Conclusion In this murine model of severe RSV infection TIP did not affect pulmonary edema nor course of disease.
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Affiliation(s)
- Elske van den Berg
- Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | - Reinout A. Bem
- Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Albert P. Bos
- Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Rene Lutter
- Department of Respiratory Medicine and Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Job B. M. van Woensel
- Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
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The effect of birth month on the risk of respiratory syncytial virus hospitalization in the first year of life in the United States. Pediatr Infect Dis J 2014; 33:e135-40. [PMID: 24445838 DOI: 10.1097/inf.0000000000000250] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the most common cause of severe respiratory illness in infants. To help direct targeted interventions and future RSV vaccine programs, we examined risk of RSV-related hospitalization by infant age and birth month. METHODS We conducted Poisson regression analyses to evaluate birth month as a risk factor for RSV-related pediatric hospitalizations (identified by any mention of ICD-9-CM diagnosis codes: 466.11, 480.1 or 079.6) from State Inpatient Data in Arizona, Iowa, New York, Oregon and Wisconsin between July 1996 and June 2006. We used an age cohort approach to compute total relative risk of RSV during the first year of life. RESULTS We identified 82,296 RSV-related infant hospital admissions, corresponding to 13.9 per 1000 person-years among infants <12 months of age. Of these, 42% of the patients were female and 73% were <6 months old. One-month-old infants born in January were ~10 times more at risk for RSV-related hospitalization than 1-month-old infants born in October [relative risk: 9.8 (7.8-12.4)]. Across the first year of life, infants born in December and January had a 2- and 3-fold higher risk, respectively, of an RSV-related hospitalization event than infants born in July. CONCLUSIONS Birth month and age at admission impacted the risk of RSV-related hospitalization within the first year of life in 5 states we investigated. As RSV vaccine candidates are currently under investigation in clinical trials, our findings help identify ideal RSV vaccine schedules to prevent early and severe events while improving the use of expensive prophylactic drugs.
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ten Bruggencate SJM, Bovee-Oudenhoven IMJ, Feitsma AL, van Hoffen E, Schoterman MHC. Functional role and mechanisms of sialyllactose and other sialylated milk oligosaccharides. Nutr Rev 2014; 72:377-89. [PMID: 24828428 DOI: 10.1111/nure.12106] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Human milk is a rich source of oligosaccharides. Acidic oligosaccharides, such as sialyllactose (SL), contain sialic acid (SA) residues. In human milk, approximately 73% of SA is bound to oligosaccharides, whereas only 3% is present in free form. Oligosaccharides are highly resistant to hydrolysis in the gastrointestinal tract. Only a small portion of the available oligosaccharides in breast milk is absorbed in the neonatal small intestine. SL and sialylated oligosaccharides are thought to have significant health benefits for the neonate, because of their roles in supporting resistance to pathogens, gut maturation, immune function, and cognitive development. The need for SA to allow proper development during the neonatal period is thought to exceed the endogenous synthesis. Therefore, these structures are important nutrients for the neonate. Based on the potential benefits, SL and sialylated oligosaccharides may be interesting components for application in infant nutrition. Once the hurdle of limited availability of these oligosaccharides has been overcome, their functionality can be explored in more detail, and supplementation of infant formula may become feasible.
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Immunochromatographic test for detection of adenovirus from respiratory samples: is it a real solution for pediatric emergency department? J Virol Methods 2013; 195:236-9. [PMID: 24096271 PMCID: PMC7119683 DOI: 10.1016/j.jviromet.2013.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 09/01/2013] [Accepted: 09/03/2013] [Indexed: 11/23/2022]
Abstract
Rapid diagnosis of adenoviral respiratory infections is required in order to decide optimal treatment strategies. We evaluated the adenovirus antigen IC test Adeno Respiratory Letitest, versus the shell-vial culture and multiplex PCR. Using multiplex-PCR as the reference standard, the overall sensitivity was 77.89% and the specificity was 73.64%. It is a simple and rapid method for detection of adenovirus in pediatric respiratory samples. It would be necessary to improve the specificity and sensitivity of the test.
Rapid diagnosis of adenoviral respiratory infections is required in order to decide optimal treatment strategies. The adenovirus antigen immunochromatography Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain), was evaluated versus the shell-vial culture and multiplex PCR (Clart Pneumovir Version 3.0, Genomica, Madrid, Spain), in nasopharyngeal washes and oropharyngeal swabs specimens from subjects with respiratory tract infections. Between April 2011 and November 2012, 224 patients were included. The IC Adeno Respiratory Card Letitest was positive for 77.9% (74 of 95) of patients diagnosed at bedside. Using multiplex-PCR as the reference standard, the overall sensitivity was 77.9% and the specificity was 73.6%. Taking shell-viral culture as the reference method, the Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain) sensitivity and specificity values were 80.0% and 60.9%, respectively. Using RT-PCR (Clart Pneumovir Version 3.0, Genomica, Madrid, Spain) as the reference standard, the viral culture sensitivity was 53.2% and the specificity was 100%. The Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain) assay could be a simple and rapid method for antigenic detection of adenovirus in pediatric respiratory samples although it would be necessary to improve the specificity and sensitivity of the test.
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Baer G, Baumann P, Buettcher M, Heininger U, Berthet G, Schäfer J, Bucher HC, Trachsel D, Schneider J, Gambon M, Reppucci D, Bonhoeffer JM, Stähelin-Massik J, Schuetz P, Mueller B, Szinnai G, Schaad UB, Bonhoeffer J. Procalcitonin guidance to reduce antibiotic treatment of lower respiratory tract infection in children and adolescents (ProPAED): a randomized controlled trial. PLoS One 2013; 8:e68419. [PMID: 23936304 PMCID: PMC3735552 DOI: 10.1371/journal.pone.0068419] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 05/25/2013] [Indexed: 01/31/2023] Open
Abstract
Background Antibiotics are overused in children and adolescents with lower respiratory tract infection (LRTI). Serum-procalcitonin (PCT) can be used to guide treatment when bacterial infection is suspected. Its role in pediatric LRTI is unclear. Methods Between 01/2009 and 02/2010 we randomized previously healthy patients 1 month to 18 years old presenting with LRTI to the emergency departments of two pediatric hospitals in Switzerland to receive antibiotics either according to a PCT guidance algorithm established for adult LRTI or standard care clinical guidelines. In intention-to-treat analyses, antibiotic prescribing rate, duration of antibiotic treatment, and number of days with impairment of daily activities within 14 days of randomization were compared between the two groups. Results In total 337 children, mean age 3.8 years (range 0.1–18), were included. Antibiotic prescribing rates were not significantly different in PCT guided patients compared to controls (OR 1.26; 95% CI 0.81, 1.95). Mean duration of antibiotic exposure was reduced from 6.3 to 4.5 days under PCT guidance (−1.8 days; 95% CI −3.1, −0.5; P = 0.039) for all LRTI and from 9.1 to 5.7 days for pneumonia (−3.4 days 95% CI −4.9, −1.7; P<0.001). There was no apparent difference in impairment of daily activities between PCT guided and control patients. Conclusion PCT guidance reduced antibiotic exposure by reducing the duration of antibiotic treatment, while not affecting the antibiotic prescribing rate. The latter may be explained by the low baseline prescribing rate in Switzerland for pediatric LRTI and the choice of an inappropriately low PCT cut-off level for this population. Trial Registration Controlled-Trials.com ISRCTN17057980 ISRCTN17057980
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Affiliation(s)
- Gurli Baer
- Department of Pediatrics, University Basel, Basel, Switzerland
| | | | | | - Ulrich Heininger
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
| | - Gerald Berthet
- Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Juliane Schäfer
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Heiner C. Bucher
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Daniel Trachsel
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
| | - Jacques Schneider
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
| | - Muriel Gambon
- University Children's Hospital Basel, Basel, Switzerland
| | - Diana Reppucci
- University Children's Hospital Basel, Basel, Switzerland
| | | | | | - Philipp Schuetz
- Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Beat Mueller
- Department of Internal Medicine, Kantonsspital Aarau, Basel, Switzerland
| | - Gabor Szinnai
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
| | - Urs B. Schaad
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
| | - Jan Bonhoeffer
- Department of Pediatrics, University Basel, Basel, Switzerland
- University Children's Hospital Basel, Basel, Switzerland
- * E-mail:
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Temesgen WA. Patients' attitude towards medical students involvement in their health care at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2010. Ethiop J Health Sci 2013; 23:158-64. [PMID: 23950632 PMCID: PMC3742893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients' willingness to the involvement of medical students in their health care is the mandatory input to medical education. Admitted patients' willingness level should be known and factors affecting willingness should be identified and it is necessary to act upon them for better medical care. METHODOLOGY A cross-sectional hospital based survey was conducted to assess the admitted patients' attitude towards medical students' involvement in their health care at Tikur Anbesa Specialized Hospital in 2010. Data were collected from 422 adult patients admitted in Tikur Anbesa Specialized Hospital from April to May 2010 using structured questionnaire and by interview method. The data gathered in this way were then processed using SPSS version 15. RESULT Three hundred and ninety-two participants had responded to all questions they were asked (response rate = 92.8%). One hundred and five (26.8%) patients had negative attitude to medical students' involvement in their health care. The proportion of patients' having positive attitude towards students was slightly reduced from medical to surgical and to gynecology wards 77.4%, 72.0%, 69.2% respectively. Patients who had previous interactions with students were more likely to have negative attitude (AOR (95% CI) = 1.72(1.03, 2.87). The odds patients admitted in gynecology and obstetrics ward to prefer female students to care for them was higher (AOR (95% CI) =1.93(1.13, 3.30). CONCLUSION Almost half of the patients admitted to Tikur Anbessa Specialized Hospital objected to clinical procedures on them even physical examination, hence developing clinical skills in TASH might be challenging for the majority of students. The challenge might be worsened for male students in gynecology wards.
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Respiratory virus multiplex RT-PCR assay sensitivities and influence factors in hospitalized children with lower respiratory tract infections. Virol Sin 2013; 28:97-102. [PMID: 23575731 PMCID: PMC7090616 DOI: 10.1007/s12250-013-3312-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 03/18/2013] [Indexed: 01/18/2023] Open
Abstract
Multiplex RT-PCR assays have been widely used tools for detection and differentiation of a panel of respiratory viral pathogens. In this study, we evaluated the Qiagen ResPlex II V2.0 kit and explored factors influencing its sensitivity. Nasopharyngeal swab (NPS) specimens were prospectively collected from pediatric inpatients with lower respiratory tract infections at the time of admission in the Shenzhen Children’s Hospital from May 2009 to April 2010. Total nucleic acids were extracted using the EZ1 system (Qiagen, Germany) and 17 respiratory viruses and genotypes including influenza A virus (FluA), FluB, parainfluenza virus 1 (PIV1), PIV2, PIV3, PIV4, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), rhinoviruses (RhV), enteroviruses (EnV), human bocaviruses (hBoV), adenoviruses (AdV), four coronaviruses (229E, OC43, NL63 and HKU1), and FluA 2009 pandemic H1N1(H1N1-p) were detected and identified by the ResPlex II kit. In parallel, 16 real-time TaqMan quantitative RT-PCR assays were used to quantitatively detect each virus except for RhV. Influenza and parainfluenza viral cultures were also performed. Among the total 438 NPS specimens collected during the study period, one or more viral pathogens were detected in 274 (62.6%) and 201(45.9%) specimens by monoplex TaqMan RT-PCR and multiplex ResPlex, respectively. When results from monoplex PCR or cell culture were used as the reference standard, the multiplex PCR possessed specificities of 92.9–100.0%. The sensitivity of multiplex PCR for PIV3, hMPV, PIV1 and BoV were 73.1%, 70%, 66.7% and 55.6%, respectively, while low sensitivities (11.1%–40.0%) were observed for FluA, EnV, OC43, RSV and H1N1. Among the seven viruses/genotypes detected with higher frequencies, multiplex PCR sensitivities were correlated significantly with viral loads determined by the TaqMan RT-PCR in FluA, H1N1-p and RSV (p=0.011−0.000). The Qiagen ResPlex II multiplex RT-PCR kit possesses excellent specificity for simultaneous detection of 17 viral pathogens in NPS specimens in pediatric inpatients at the time of admission. The sensitivity of multiplex RT-PCR was influenced by viral loads, specimen process methods, primer and probe design and amplification condition.
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Acute viral lower respiratory tract infections in Cambodian children: clinical and epidemiologic characteristics. Pediatr Infect Dis J 2013; 32:e8-13. [PMID: 22926214 DOI: 10.1097/inf.0b013e31826fd40d] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Viruses are detected in most hospitalized children admitted for acute respiratory infections. Etiologic understanding is needed to improve clinical management and prevention, particularly in resource-limited tropical countries. METHODS A 3-year prospective descriptive study was conducted among Cambodian children admitted to 2 provincial hospitals for acute lower respiratory tract infection. Molecular detection for 18 viral pathogens using multiplex polymerase chain reaction/reverse transcription polymerase chain reactions was performed. RESULTS We enrolled 1006 children less than 5 years of age of whom 423 (42%), 428 (42%) and 155 (16%) had pneumonia, bronchiolitis and unclassified lower respiratory tract infections, respectively. Of the 551 (55%) with documented viral infection, a single virus was detected in 491 (89%), including rhinovirus (n = 169; 34%), respiratory syncytial virus (n = 167; 34%), parainfluenza virus (n = 40; 8%), human metapneumovirus (n = 39; 8%), influenza virus (n = 31; 6%), bocavirus (n = 16; 3%), adenovirus (n = 15; 3%), coronavirus (n = 9; 2%) and enterovirus (n = 5; 1%). Coinfections with multiple viruses were detected in 6% (2 viruses detected in 59 cases; 3 viruses detected in 1 case). CONCLUSION Similar to other tropical countries, rhinovirus and respiratory syncytial virus were the principal viral pathogens detected among children hospitalized for lower tract respiratory infection in Cambodia.
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Hustedt JW, Christie C, Hustedt MM, Esposito D, Vazquez M. Seroepidemiology of human bocavirus infection in Jamaica. PLoS One 2012; 7:e38206. [PMID: 22666484 PMCID: PMC3362556 DOI: 10.1371/journal.pone.0038206] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/02/2012] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Human bocavirus (HBoV) is a newly identified human parvovirus. HBoV is associated with upper and lower respiratory tract infections and gastroenteritis in children. Little is known about the seroepidemiology of HBoV in populations in the Caribbean. METHODS In a cross-sectional study conducted at the University Hospital of the West Indies in Kingston, Jamaica, 287 blood samples were collected from pediatric patients and tested for the presence of HBoV-specific antibody using a virus-like-particle based enzyme-linked immunosorbent assay (ELISA). RESULTS HBoV-specific antibodies were found to be present in 220/287 (76.7%) of samples collected from the pediatric population. Seroprevalence of HBoV was highest in those ≥2 years old. The seroepidemiological profile suggests that most children are exposed to HBoV during the first two years of life in Jamaica. CONCLUSION HBoV infection is common in children in Jamaica. HBoV seroprevalence rates in the Caribbean are similar to those previously reported in other areas of the world.
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Affiliation(s)
- Joshua W Hustedt
- Division of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America.
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Lambert SB, Ware RS, Cook AL, Maguire FA, Whiley DM, Bialasiewicz S, Mackay IM, Wang D, Sloots TP, Nissen MD, Grimwood K. Observational Research in Childhood Infectious Diseases (ORChID): a dynamic birth cohort study. BMJ Open 2012; 2:bmjopen-2012-002134. [PMID: 23117571 PMCID: PMC3547315 DOI: 10.1136/bmjopen-2012-002134] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Even in developed economies infectious diseases remain the most common cause of illness in early childhood. Our current understanding of the epidemiology of these infections is limited by reliance on data from decades ago performed using low-sensitivity laboratory methods, and recent studies reporting severe, hospital-managed disease. METHODS AND ANALYSIS The Observational Research in Childhood Infectious Diseases (ORChID) study is an ongoing study enrolling a dynamic birth cohort to document the community-based epidemiology of viral respiratory and gastrointestinal infections in early childhood. Women are recruited antenatally, and their healthy newborn is followed for the first 2 years of life. Parents keep a daily symptom diary for the study child, collect a weekly anterior nose swab and dirty nappy swab and complete a burden diary when a child meets pre-defined illness criteria. Specimens will be tested for a wide range of viruses by real-time PCR assays. Primary analyses involves calculating incidence rates for acute respiratory illness (ARI) and acute gastroenteritis (AGE) for the cohort by age and seasonality. Control material from children when they are without symptoms will allow us to determine what proportion of ARIs and AGE can be attributed to specific pathogens. Secondary analyses will assess the incidence and shedding duration of specific respiratory and gastrointestinal pathogens. ETHICS AND DISSEMINATION This study is approved by The Human Research Ethics Committees of the Children's Health Queensland Hospital and Health Service, the Royal Brisbane and Women's Hospital and The University of Queensland. TRIAL REGISTRATION clinicaltrials.gov NCT01304914.
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Affiliation(s)
- Stephen Bernard Lambert
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
- Queensland Health Immunisation Program, Communicable Diseases Branch, Queensland Health, Brisbane, Queensland, Australia
| | - Robert S Ware
- School of Population Health and the Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Anne L Cook
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
| | - Frances A Maguire
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
| | - David M Whiley
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
| | - Seweryn Bialasiewicz
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
| | - Ian M Mackay
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
| | - David Wang
- Departments of Molecular Microbiology and Pathology & Immunology, Washington University, School of Medicine, St. Louis, Missouri, USA
| | - Theo P Sloots
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
- Microbiology Division, Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Michael D Nissen
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
- Microbiology Division, Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Keith Grimwood
- Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, The University of Queensland and the Royal Children's Hospital, Brisbane, Queensland, Australia
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Grogan JA, Logan C, O'Leary J, Rush R, O'Sullivan N. Real-time PCR-based detection of Bordetella pertussis and Bordetella parapertussis in an Irish paediatric population. J Med Microbiol 2011; 60:722-729. [PMID: 21393459 DOI: 10.1099/jmm.0.030049-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Novel real-time PCR assays targeting the Bordetella pertussis insertion sequence IS481, the toxin promoter region and Bordetella parapertussis insertion sequence IS1001 were designed. PCR assays were capable of detecting ≤10 copies of target DNA per reaction, with an amplification efficiency of ≥90 %. From September 2003 to December 2009, per-nasal swabs and nasopharyngeal aspirates submitted for B. pertussis culture from patients ≤1 month to >15 years of age were examined by real-time PCR. Among 1324 patients, 76 (5.7 %) were B. pertussis culture positive and 145 (10.95 %) were B. pertussis PCR positive. Of the B. pertussis PCR-positive patients, 117 (81 %) were aged 6 months or less. A total of 1548 samples were examined, of which 87 (5.6 %) were culture positive for B. pertussis and 169 (10.92 %) were B. pertussis PCR positive. All culture-positive samples were PCR positive. Seven specimens (0.5 %) were B. parapertussis culture positive and 10 (0.8 %) were B. parapertussis PCR positive, with all culture-positive samples yielding PCR-positive results. A review of patient laboratory records showed that of the 1324 patients tested for pertussis 555 (42 %) had samples referred for respiratory syncytial virus (RSV) testing and 165 (30 %) were positive, as compared to 19.4 % of the total 5719 patients tested for RSV in this period. Analysis of the age distribution of RSV-positive patients identified that 129 (78 %) were aged 6 months or less, similar to the incidence observed for pertussis in that patient age group. In conclusion, the introduction of the real-time PCR assays for the routine detection of B. pertussis resulted in a 91 % increase in the detection of the organism as compared to microbiological culture. The incidence of infection with B. parapertussis is low while the incidence of RSV infection in infants suspected of having pertussis is high, with a similar age distribution to B. pertussis infection.
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Affiliation(s)
- Juanita A Grogan
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin Ireland.,Department of Microbiology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Catriona Logan
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin Ireland.,Department of Microbiology, Our Lady's Children's Hospital, Dublin, Ireland
| | - John O'Leary
- Trinity College, Dublin, Ireland.,Department of Pathology, The Coombe Women and Infants University Hospital, Dublin Ireland
| | - Rebecca Rush
- Department of Microbiology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Niamh O'Sullivan
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin Ireland.,Department of Microbiology, Our Lady's Children's Hospital, Dublin, Ireland
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Hustedt JW, Vazquez M. The changing face of pediatric respiratory tract infections: how human metapneumovirus and human bocavirus fit into the overall etiology of respiratory tract infections in young children. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2010; 83:193-200. [PMID: 21165338 PMCID: PMC3002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lower respiratory tract infections are one of the leading causes of morbidity and mortality in children worldwide. Recent technological advances in the field of molecular biology have allowed virologists to detect many previously undetected viral pathogens. Two of these, human metapneumovirus (hMPV) and human bocavirus (HBoV), are of particular clinical interest to pediatric health care providers. This review discusses the most common viral respiratory infections in children, explores the role of newly discovered respiratory pathogens, and describes techniques for the diagnosis of viral respiratory infections.
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Affiliation(s)
- Joshua W Hustedt
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.
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Balada-Llasat JM, LaRue H, Kelly C, Rigali L, Pancholi P. Evaluation of commercial ResPlex II v2.0, MultiCode-PLx, and xTAG respiratory viral panels for the diagnosis of respiratory viral infections in adults. J Clin Virol 2010; 50:42-5. [PMID: 21050809 PMCID: PMC7185502 DOI: 10.1016/j.jcv.2010.09.022] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 09/28/2010] [Accepted: 09/29/2010] [Indexed: 01/10/2023]
Abstract
Background Commercial multiplex PCR panels for respiratory viruses (PRV) have been recently developed. ResPlex II Panel v2.0 (Qiagen), MultiCode®-PLx (EraGen Biosciences), and xTAG® (Luminex) PRV's were studied. All assays detect influenza A and B, adenovirus, parainfluenza 1–3, respiratory syncytial virus A and B, human metapneumovirus and human rhinovirus. The ResPlex II additionally detects coronavirus (229E, OC43, NL63, HKU1), coxsackie/echo virus, bocavirus and differentiates adenoviruses (B, E). The MultiCode-PLX assay detects 229E, OC43, and NL63, differentiates parainfluenza 4a, 4b and adenoviruses (B, C, E). The xTAG additionally subtypes influenza A as seasonal H1 and H3. Study design 202 specimens collected from adult patients with signs of respiratory infection from November, 2008 to May, 2009 were used for evaluating the performance of the three commercial PRV assays. Viral culture and xTAG were used as the standards to assess sensitivity and specificity. Results The PRV assays detected more viruses than culture. When compared to culture, the xTAG PRV showed a sensitivity and specificity of 100% and 91%, compared to MultiCode-PLx with 89% and 87%, and ResPlex II with 89% and 94%, respectively. Co-infection was detected in a small subset of patient specimens. Each panel showed differences in sensitivities for individual viruses. Conclusions While the ResPlex II and MultiCode-PLx offer a broader virus detection range and greater ease of use, the xTAG PRV showed increased sensitivity to common viral targets represented in the assays, and also had the ability to differentiate human from non-human influenza A H1.
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Affiliation(s)
- Joan-Miquel Balada-Llasat
- Clinical Microbiology, Department of Pathology, The Ohio State University Medical Center, 1492 E Broad Street, Columbus, OH 43205, United States
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Thomson JA, Widjaja C, Darmaputra AAP, Lowe A, Matheson MC, Bennett CM, Allen K, Abramson MJ, Hosking C, Hill D, Dharmage SC. Early childhood infections and immunisation and the development of allergic disease in particular asthma in a high-risk cohort: A prospective study of allergy-prone children from birth to six years. Pediatr Allergy Immunol 2010; 21:1076-85. [PMID: 20337970 DOI: 10.1111/j.1399-3038.2010.01018.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The role of early childhood infections and immunisation in the development of allergic diseases remains controversial. To examine these associations, six hundred and twenty infants with first-degree relatives with allergic diseases were recruited into the Melbourne Atopy Cohort Study. Information on risk factors and outcomes was collected by interviewer administered questionnaire and was based on parental report and/or a physician's diagnosis. Risk factors examined included early childhood infections (including gastroenteritis, otitis media and lower respiratory tract infections) and immunisations in the first 2 yr of life. Outcomes were current asthma, allergic rhinitis and eczema at 6 yr of age. Univariate and multivariate regression analysis were used to estimate relative risk (RR) and assess confounding. By 6 yr, 79% of the original cohort remained in the study. Those with at least three episodes of gastroenteritis showed an increased risk (crude RR 2.36, 95%CI 1.41 3.95; adjusted RR 2.03 95%CI 1.50 2.75) for the later development of asthma at age 6. Of the scheduled immunisations, Sabin immunisation in the second year had a reduced risk of asthma at 6 yr (crude RR 0.60, 95%CI 0.37 0.98; adjusted RR 0.63 95%CI 0.39 1.02). Combined diphtheria and tetanus (CDT) immunisation in the first year had an increased risk of asthma at 6 yr (RR 1.76, 95%CI 1.11 2.78; adjusted RR 1.88 95%CI 1.28 2.77). Recurrent gastroenteritis in early childhood is associated with a later risk of asthma. This may reflect a cause and effect relationship, or exposure to common risk factors. In contrast, Sabin immunisation in the second year is associated with a decreased risk of asthma in later childhood. CDT immunisation in the first year may be a risk factor for asthma, but the need for CDT immunisation may also be a marker of increased risk of asthma in later childhood.
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Affiliation(s)
- Jennifer A Thomson
- The Centre for MEGA Epidemiology, Melbourne School of Population Health, The University of Melbourne, Melbourne, Australia.
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Abstract
OBJECTIVES To investigate if morbidity in young children admitted to a pediatric intensive care unit (PICU with a laboratory proven diagnosis of influenza and parainfluenza infection) had increased. METHODS Retrospective study from January 2003 through December 2009 was carried out. Every child in the PICU with a laboratory-confirmed influenza or parainfluenza infection was included. RESULTS 18 influenza (influenza A =13 and influenza B = 5) and 17 parainfluenza admissions were identified over the 7-year period. Parainfluenza type 3 (n = 9) was the commonest subtype of parainfluenza infection. The median age of children admitted with influenza was higher than parainfluenza (4.5 vs 1.7 years, p = 0.044). Admissions associated with proven influenza and parainfluenza infections accounted for 2% of PICU annual admissions. There was only one death in 2003. 51% of these patients required ventilatory support, 45% received systemic corticosteroids, and 91% received initial broad spectrum antibiotic coverage. Bacterial co-infections were identified in 25% of these patients. The incidence of influenza admissions had not increased significantly in 2009 (H1N1 pandemic) when compared with 2003 (SARS epidemic) (p = 0.3). There were only two PICU cases of pandemic H1N1 in 2009 and both survived. The annual incidence of severe PICU cases of influenza and parainfluenza were 0.94 and 0.88 per 100,000 children per annum, respectively. CONCLUSIONS Pandemic H1N1, influenza and parainfluenza viruses may be associated with significant childhood morbidity and PICU admissions.
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Quantitative proteome profiling of respiratory virus-infected lung epithelial cells. J Proteomics 2010; 73:1680-93. [PMID: 20470912 DOI: 10.1016/j.jprot.2010.04.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 04/22/2010] [Accepted: 04/26/2010] [Indexed: 11/20/2022]
Abstract
Respiratory virus infections are among the primary causes of morbidity and mortality in humans. Influenza virus, respiratory syncytial virus (RSV), parainfluenza (PIV) and human metapneumovirus (hMPV) are major causes of respiratory illness in humans. Especially young children and the elderly are susceptible to infections with these viruses. In this study we aim to gain detailed insight into the molecular pathogenesis of respiratory virus infections by studying the protein expression profiles of infected lung epithelial cells. A549 cells were exposed to a set of respiratory viruses [RSV, hMPV, PIV and Measles virus (MV)] using both live and UV-inactivated virus preparations. Cells were harvested at different time points after infection and processed for proteomics analysis by 2-dimensional difference gel electrophoresis. Samples derived from infected cells were compared to mock-infected cells to identify proteins that are differentially expressed due to infection. We show that RSV, hMPV, PIV3, and MV induced similar core host responses and that mainly proteins involved in defense against ER stress and apoptosis were affected which points towards an induction of apoptosis upon infection. By 2-D DIGE analyses we have gathered information on the induction of apoptosis by respiratory viruses in A549 cells.
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