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Epelboin L, Mahamat A, Bonifay T, Demar M, Abboud P, Walter G, Drogoul AS, Berlioz-Arthaud A, Nacher M, Raoult D, Djossou F, Eldin C. Q Fever as a Cause of Community-Acquired Pneumonia in French Guiana. Am J Trop Med Hyg 2022; 107:407-415. [PMID: 35977720 PMCID: PMC9393466 DOI: 10.4269/ajtmh.21-0711] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
In French Guiana, community-acquired pneumonia (CAP) represents over 90% of Coxiella burnetii acute infections. Between 2004 and 2007, we reported that C. burnetii was responsible for 24.4% of the 131 CAP hospitalized in Cayenne. The main objective of the present study was to determine whether the prevalence of Q fever pneumonia remained at such high levels. The secondary objectives were to identify new clinical characteristics and risk factors for C. burnetii pneumonia. A retrospective case-control study was conducted on patients admitted in Cayenne Hospital, between 2009 and 2012. All patients with CAP were included. The diagnosis of acute Q fever relied on titers of phase II IgG ≥ 200 and/or IgM ≥ 50 or seroconversion between two serum samples. Patients with Q fever were compared with patients with non-C. burnetii CAP in bivariate and multivariate analyses. During the 5-year study, 275 patients with CAP were included. The etiology of CAP was identified in 54% of the patients. C. burnetii represented 38.5% (106/275; 95% CI: 31.2-45.9%). In multivariate analysis, living in Cayenne area, being aged 30-60 years, C-reactive protein (CRP) > 185 mg/L, and leukocyte count < 10 G/L were independently associated with Q fever. The prevalence of Q fever among CAP increased to 38.5%. This is the highest prevalence ever reported in the world. This high prevalence justifies the systematic use of doxycycline in addition to antipneumococcal antibiotic regimens.
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Affiliation(s)
- Loïc Epelboin
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, Guyane française
| | - Aba Mahamat
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- Corsica Centre for Healthcare-Associated Infections Control and Prevention, Hôpital Eugénie, Ajaccio, France
| | - Timothée Bonifay
- Département Universitaire de Médecine Générale, Université des Antilles, Pointe-à-Pitre, Guadeloupe
| | - Magalie Demar
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, Guyane française
- Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, Guyane française
| | - Philippe Abboud
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, Guyane française
| | - Gaëlle Walter
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | | | | | - Mathieu Nacher
- Centre d’Investigation Clinique, CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Félix Djossou
- Infectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, Cayenne, Guyane française
| | - Carole Eldin
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
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Dimopoulou D, Vourli S, Douros K, Pournaras S, Papaevangelou V. Use of point-of-care molecular tests reduces hospitalization and oseltamivir administration in children presenting with influenza-like illness. J Med Virol 2021; 93:3944-3948. [PMID: 32965697 DOI: 10.1002/jmv.26538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 01/15/2023]
Abstract
Influenza is associated with increased morbidity, healthcare costs, hospitalization rates, and mortality in children. Rapid immunochromatography assay (ICA), a test with low sensitivity, is often used as point-of-care (POC) test. Recently, the rapid syndromic molecular test FilmArray has become available. This observational study aims to evaluate whether the use of FilmArray would decrease the use of antivirals and hospitalization rates among children presenting to the emergency room (ER) with influenza-like illness (ILI) symptoms. Nasopharyngeal swabs were prospectively collected from children, aged 0-16 years, presenting with ILI at the ER of a tertiary hospital during the peak endemic period. Patients were allocated to be tested by either FilmArray or ICA. The use of antivirals and hospitalization rates were noted. Logistic regression models were used to investigate the impact of testing methods on decision-making. Overall, 80 children were included (mean age: 5 years). Admissions were more likely to occur if an ICA test was performed (OR, 3.16; 95% CI, 1.01-9.82; p = .046). Oseltamivir administration was more likely among children who had undergone the ICA test (OR, 4.67; 95% CI, 1.06-20.43; p = .041). The implementation of rapid molecular test had no impact on complementary diagnostic testing or antibacterial prescription. The use of FilmArray significantly reduced both hospitalization and oseltamivir administration in children. Further knowledge on the use of POC tests is required to improve current management of children presenting with ILI and decrease associated healthcare costs.
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Affiliation(s)
- Dimitra Dimopoulou
- Third Department of Pediatrics, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Vourli
- Laboratory of Microbiology, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Douros
- Third Department of Pediatrics, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Pournaras
- Laboratory of Microbiology, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Pediatrics, ATTIKON University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Mathibe LJ, Zwane NP. Unnecessary antimicrobial prescribing for upper respiratory tract infections in children in Pietermaritzburg, South Africa. Afr Health Sci 2020; 20:1133-1142. [PMID: 33402958 PMCID: PMC7751518 DOI: 10.4314/ahs.v20i3.15] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Acute upper respiratory tract infections (URTIs) are contagious diseases of the upper airways, but they are self-limiting in nature. Therefore, antimicrobial-use for the majority of the URTIs is considered inappropriate. Unfortunately, globally, antimicrobials are still being prescribed for the treatment of URTIs, especially in children. However, there is insufficient evidence on the causes of this phenomenon in South Africa. Objective To investigate whether the parents/guardians accompanying children with URTIs expected/influenced physicians and/or nurses to prescribe antibiotics. Methods This was a prospective descriptive and explorative questionnaire-based study. Participants were guardians who accompanied children aged five years and below, diagnosed with acute URTIs. Findings Three hundred and six parents/guardians participated in this study. Seventy six percent (n=233) of participants received antibiotics for URTIs for their children, and 67% (n=156) of these did not make requests for antimicrobial therapy. On overall, there was a statistically significant (p < 0.0001) chance (with OR of 5.9; 95% CI, 2.4 – 14.2) for receiving antibiotics for URTIs without a request. Conclusion Physicians and other healthcare providers need education on rational prescribing of antimicrobials, and to implement evidence-based standard treatment guidelines, to reduce inappropriate use of antibiotics in children with self-limiting URTIs.
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Affiliation(s)
- Lehlohonolo John Mathibe
- Division of Pharmacology (Therapeutics), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa
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Qin S, Zhang W, Chen F, Luo F, Zhou Q, Ke P, Chen C. Antibodies against atypical pathogens and respiratory viruses detected by Pneumoslide IgM test in adults with community-acquired pneumonia in Guangzhou City. J Clin Lab Anal 2020; 34:e23419. [PMID: 32537759 PMCID: PMC7521227 DOI: 10.1002/jcla.23419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/21/2020] [Accepted: 05/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background To detect the serum antibodies against respiratory viruses and atypical pathogens in adults with community‐acquired pneumonia (CAP) in Guangzhou City (Guangdong province, China). Methods A retrospective study was carried out with samples from 685 adults who were admitted with CAP and 108 non‐CAP control patients. Atypical pathogens and respiratory viruses in serum were detected using the Pneumoslide IgM test from Vircell, Spain. All patients were divided into 6 groups according to age: 18‐24, 25‐44, 45‐59, 60‐74, 75‐89, and >90. Results The total positive rate of CAP was 35.4%, which was highest in the 18‐24 age group (P < .05). The highest positive rate, 17.11%, was observed for Mycoplasma pneumoniae (MP). The mean age of MP‐infected patients was higher than that of the controls (P < .05). The positive rates for influenza B (INFB), Legionella pneumophila (LP1), Coxiella burnetii (COX), influenza A (INFA), parainfluenza virus (PIV), respiratory syncytial virus (RSV), Chlamydophila pneumoniae (CP), and adenovirus (ADV) were 5.56%, 3.07%, 2.63%, 2.34%, 1.90%, 1.61, 0.88%, and 0.29%, respectively. There were 4.37% of patients with CAP having multiple infections. The main symptoms observed in the 685 CAP patients were cough and sputum production, in 78.4% and 67.4%. Fever was followed by 54% of CAP patients. Dyspnea (39.1%), anorexia (36.8%), increased thirst (26.7%), chills (18.7), headache (14.6%), and nausea (13.1%) were also frequently observed in the CAP patients. Conclusions MP infection was the most common in adult CAP patients in Guangzhou City with the highest positive rate in the 18‐24 age groups.
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Affiliation(s)
- Sheng Qin
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weizheng Zhang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fu Chen
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fudong Luo
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiang Zhou
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peifeng Ke
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cha Chen
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Alves MS, da Silva Cariolano M, Dos Santos Ferreira HL, Sousa de Abreu Silva E, Felipe KKP, Monteiro SG, de Sousa EM, Abreu AG, Campbell LA, Rosenfeld ME, Hirata MH, Hirata RDC, Bastos GM, de Paula Abreu Silva IC, Lima-Neto LG. High frequency of Chlamydia pneumoniae and risk factors in children with acute respiratory infection. Braz J Microbiol 2020; 51:629-636. [PMID: 31997263 DOI: 10.1007/s42770-020-00229-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022] Open
Abstract
This study was performed as a contribution for a better understanding of Chlamydia pneumoniae frequency in children with respiratory infections. A total of 416 children were recruited from two clinical centers in Sao Luis, Brazil. Of these patients, 165 children had upper respiratory tract infections (URTI), 150 had community-acquired pneumonia (CAP), and 101 were asymptomatic volunteer children. Clinical and epidemiological data from the participants were recorded. Nasopharyngeal swab samples were collected to extract DNA. C. pneumoniae DNA positivity and copy numbers were obtained by an absolute quantitative real-time PCR method. RESULTS: Positivity for C. pneumoniae DNA was higher in samples from URTI children (38.2%) and from CAP children (18.0%) than in those from the control group (7.9%; p < 0.001). Moreover, C. pneumoniae DNA was denser in children with URTI than in asymptomatic children. Considering the cutoff, the highest value of C. pneumoniae DNA found in asymptomatic children of the 3.98 log10 copies/mL, 8.5% (14/165) of the children with URTI, and 3.3% (5/150) with CAP presented high copy numbers of C. pneumoniae DNA. CONCLUSION: Taken together, these results revealed a high frequency of C. pneumoniae in both children with URTI and CAP.
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Affiliation(s)
- Matheus Silva Alves
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil
| | - Marilha da Silva Cariolano
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil
| | | | - Elen Sousa de Abreu Silva
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil
| | | | - Silvio Gomes Monteiro
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil
| | - Eduardo Martins de Sousa
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil.,Programa de Pós-Graduação da Rede BIONORTE, Sao Luis, Brazil
| | - Afonso Gomes Abreu
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Maranhão, Sao Luis, MA, Brazil
| | - Lee Ann Campbell
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Michael E Rosenfeld
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Mario Hiroyuki Hirata
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil.,Institute Dante Pazzanese of Cardiology, Sao Paulo, SP, Brazil
| | - Rosario Dominguez Crespo Hirata
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Lidio Gonçalves Lima-Neto
- Programa de Pós-Graduação, Universidade CEUMA, Rua dos Castanheiros, no. 1, Renascença II, Sao Luis, MA, 65075-120, Brazil. .,Programa de Pós-Graduação da Rede BIONORTE, Sao Luis, Brazil.
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Zhao MC, Wang L, Qiu FZ, Zhao L, Guo WW, Yang S, Feng ZS, Li GX. Impact and clinical profiles of Mycoplasma pneumoniae co-detection in childhood community-acquired pneumonia. BMC Infect Dis 2019; 19:835. [PMID: 31601192 PMCID: PMC6788033 DOI: 10.1186/s12879-019-4426-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/29/2019] [Indexed: 12/02/2022] Open
Abstract
Background Increasing number of hospitalized children with community acquired pneumonia (CAP) is co-detected with Mycoplasma pneumoniae (Mp). The clinical characteristics and impact of Mp co-detected with other bacterial and/or viral pathogens remain poorly understood. The purpose of this study was to evaluate the demographic and clinical features of CAP children with Mp mono-detection and Mp co-detection. Methods A total of 4148 hospitalized children with CAP were recruited from January to December 2017 at the Children’s Hospital of Hebei Province, affiliated to Hebei Medical University. A variety of respiratory viruses, bacteria and Mp were detected using multiple modalities. The demographic and clinical features of CAP children with Mp mono-detection and Mp co-detection were recorded and analyzed. Results Among the 110 CAP children with Mp positive, 42 (38.18%) of them were co-detected with at least one other pathogen. Co-detection was more common among children aged ≤3 years. No significant differences were found in most clinical symptoms, complications, underlying conditions and disease severity parameters among various etiological groups, with the following exceptions. First, prolonged duration of fever, lack of appetite and runny nose were more prevalent among CAP children with Mp-virus co-detection. Second, Mp-virus (excluding HRV) co-detected patients were more likely to present with prolonged duration of fever. Third, patients co-detected with Mp-bacteria were more likely to have abnormal blood gases. Additionally, CAP children with Mp-HRV co-detection were significantly more likely to report severe runny nose compared to those with Mp mono-detection. Conclusion Mp co-detection with viral and/or bacterial pathogens is common in clinical practice. However, there are no apparent differences between Mp mono-detection and Mp co-detections in terms of clinical features and disease severity.
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Affiliation(s)
- Meng-Chuan Zhao
- Institute of Pediatric Research, Children's Hospital of Hebei Province, affiliated to Hebei Medical University, 133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China
| | - Le Wang
- Institute of Pediatric Research, Children's Hospital of Hebei Province, affiliated to Hebei Medical University, 133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China
| | - Fang-Zhou Qiu
- Graduate School of Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, 050017, Hebei Province, China
| | - Li Zhao
- Graduate School of Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, 050017, Hebei Province, China
| | - Wei-Wei Guo
- Institute of Pediatric Research, Children's Hospital of Hebei Province, affiliated to Hebei Medical University, 133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China
| | - Shuo Yang
- Institute of Pediatric Research, Children's Hospital of Hebei Province, affiliated to Hebei Medical University, 133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China
| | - Zhi-Shan Feng
- Department of Laboratory Medicine, People's Hospital of Hebei Province, 384 Heping West Road, Shijiazhuang, 050051, Hebei Province, China.
| | - Gui-Xia Li
- Institute of Pediatric Research, Children's Hospital of Hebei Province, affiliated to Hebei Medical University, 133 Jianhua South Street, Shijiazhuang, 050031, Hebei Province, China.
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Chen J, Li X, Wang W, Jia Y, Lin F, Xu J. The prevalence of respiratory pathogens in adults with community-acquired pneumonia in an outpatient cohort. Infect Drug Resist 2019; 12:2335-2341. [PMID: 31440068 PMCID: PMC6679678 DOI: 10.2147/idr.s213296] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose Community-acquired pneumonia is a common illness worldwide. In adults, community-acquired bacterial pneumonia has been well studied, but viral pneumonia is less well understood. We designed this study to identify respiratory pathogens, including common pneumonia-causing bacteria, viruses and atypical pneumonia pathogens, using reverse transcription-polymerase chain reaction. Patients and methods We conducted a retrospective study of outpatients with community-acquired pneumonia at the Fever Clinic of Peking University Third Hospital. We collected sputum or throat swabs from patients diagnosed with community-acquired pneumonia. Multiplex real-time reverse transcription-polymerase chain reaction was performed for 20 pathogens, including 9 viruses, 3 atypical pathogens and 8 bacteria. Results There were 232 outpatients enrolled in our study, and 153 patients (65.9%) had positive test results, of which 26.7% were viruses, 19.4% were atypical pathogens and 19.8% were bacteria. Mycoplasma pneumoniae infection was detected at the highest frequency (19.0%), exceeding Streptococcus pneumoniae infection. The most commonly identified viral pathogens were IFVs (15.1%), PIVs (3.4%) and RhV (2.6%). The most commonly identified bacteria were Streptococcus pneumoniae (9.1%), Haemophilus influenza (6.5%) and Klebsiella pneumoniae (2.6%). Conclusion Our study suggests that viruses were commonly detected in outpatients with CAP, and IFVs were the most common viruses, especially during flu season. Patients with viral infection were prone to viral-bacterial coinfection. Mycoplasma pneumoniae was the leading pathogen in the outpatients with CAP. Viral infection occurs in a large number of outpatients with CAP, and it should receive greater attention in clinical work.
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Affiliation(s)
- Jing Chen
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
| | - Xiaoguang Li
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
| | - Wei Wang
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
| | - Ying Jia
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
| | - Fei Lin
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
| | - Jie Xu
- Department of Infectious Disease, Peking University Third Hospital, Beijing, People's Republic of China
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Tang J, Chen J, He T, Jiang Z, Zhou J, Hu B, Yang S. Diversity of upper respiratory tract infections and prevalence of Streptococcus pneumoniae colonization among patients with fever and flu-like symptoms. BMC Infect Dis 2019; 19:24. [PMID: 30616564 PMCID: PMC6323860 DOI: 10.1186/s12879-018-3662-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 12/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Many upper respiratory pathogens cause similar symptoms. In China, routine molecular tests for upper respiratory pathogens are not widely performed and antibiotics abuse in treating upper respiratory tract infections (URTIs) is a major public health concern. METHODS We performed qualitative real-time PCR tests to detect common upper respiratory tract pathogens including 9 viruses and 3 bacteria in 1221 nasopharyngeal swabs from patients with fever and influenza-like symptoms in a Chinese city. A quantitative real-time PCR was also performed to measure the bacterial density of the colonizing Streptococcus pneumoniae in these samples. RESULTS We found very diverse pathogens including 81.7% viruses, 11.6% bacteria and 6.7% mixed viruses and bacteria. S. pneumoniae colonization was found in 8.0% of the cases but most of them had low bacterial density (Mean = 3.9 log cfu/ml). We also discovered an increase of S. pneumoniae colonization frequency (but not the density) in patients with detectable upper respiratory tract pathogens, in a pathogen variety-dependent manner. CONCLUSIONS Our study provided strong evidence against empiric antibiotic use for treating URTIs, and highlighted a strong need for improving the diagnostic capacity for URTIs by using more molecular testing in China.
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Affiliation(s)
- Jialiang Tang
- Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang, China
| | - Jinkun Chen
- Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang, China
| | - Tingting He
- Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang, China
| | - Zhuojing Jiang
- Shaoxing Center for Disease Control and Prevention, Shaoxing, Zhejiang, China
| | - Jiale Zhou
- IngeniGen XunMinKang Biotechnology Inc. Shaoxing, Zhejiang, China
| | - Bin Hu
- IngeniGen XunMinKang Biotechnology Inc. Shaoxing, Zhejiang, China
| | - Shangxin Yang
- Zhejiang-Californina International Nanosystems Institute, Zhejiang University, Zhejiang, Hangzhou, China. .,Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, University of California Los Angeles, 11633 San Vicente Blvd, Los Angeles, CA, 90049, USA.
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Cui J, Yan W, Xie H, Xu S, Wang Q, Zhang W, Ni A. A retrospective seroepidemiologic survey of Chlamydia pneumoniae infection in patients in Beijing between 2008 and 2017. PLoS One 2018; 13:e0206995. [PMID: 30403740 PMCID: PMC6221324 DOI: 10.1371/journal.pone.0206995] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/23/2018] [Indexed: 11/18/2022] Open
Abstract
Background Chlamydia pneumoniae (C. pneumoniae) is an obligate intracellular bacterium and a human pathogen that causes respiratory infectious diseases. More than 50% of the adult population worldwide was once infected with C. pneumoniae, but investigations into this topic are insufficient in mainland China. Methods Anti-C. pneumoniae IgG and IgM antibodies were detected using micro-immunofluorescence test in serum samples of patients visiting Peking Union Medical College Hospital between 2008 and 2017 for routine medical purposes, and the aim of this retrospective study was to analyze the test results. Results Among 12,050 serum specimens tested for anti-C. pneumoniae IgG and IgM antibodies, the overall prevalence of anti-C. pneumoniae IgG antibodies was 86.6%, 87.2% for men and 86.0% for women. Adult men (>20 years) were found to have a significantly higher prevalence of anti-C. pneumoniae IgG than women (χ2 = 30.32, P = 0.000). 3 to 5 years old patients were observed to have the lowest prevalence of anti-C. pneumoniae IgG, 42.8%, then increased with age, reaching the highest level of 98.6% in patients over 70 years of age. In the 10,434 specimens with C. pneumoniae IgG antibodies, the total geometric mean titer (GMT) for C. pneumoniae IgG was 45.71. Although GMTs were found to be significantly higher among all men than among all women (t = 5.916, P = 0.000), sex difference actually began in patients over 40 years of age and increased in the elderly. In the total 12,050 specimens, 1.2% had anti-C. pneumoniae IgM, 3.3% had anti-C. pneumoniae IgG with titers equal to or greater than 1:512; 0.39% had ≥4-fold increasing titers of antibodies in acute and convalescent phase paired samples, and 4.4% were finally confirmed to have acute antibodies against C. pneumoniae. 6 to 10 years old patients were found to have the highest rate of both IgM antibodies (3.9%) and acute antibodies (6.2%) against C. pneumoniae. Acute antibodies against C. pneumoniae were found to be more frequent in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 14.0%, χ2 = 20.43, P = 0.000), patients with pneumonia (7.8%, χ2 = 51.87, P = 0.000) and patients with acute respiratory tract infection (12.3%, χ2 = 60.91, P = 0.000) than among all patients (4.4%). Both anti-C. pneumoniae IgG and IgM antibodies should be tested for acute antibodies against C. pneumoniae as testing for either alone will underestimate by a maximum of two-thirds the incidence of acute antibodies against C. pneumoniae. Conclusions More than 86% of Chinese patients on an average were once infected with C. pneumoniae. Adult men had both a higher prevalence and higher levels of antibodies than women. 6 to10 year old patients were found to have the most frequent acute infection of C. pneumoniae. C. pneumoniae is associated with AECOPD, pneumonia and acute respiratory tract infection. Anti-C. pneumoniae IgG and IgM should be tested simultaneously to avoid underestimation of acute antibodies against C. pneumoniae.
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Affiliation(s)
- Jingtao Cui
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjuan Yan
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongjie Xie
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoxia Xu
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiaofeng Wang
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihong Zhang
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anping Ni
- Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail:
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10
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Chen J, Hu P, Zhou T, Zheng T, Zhou L, Jiang C, Pei X. Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009-2014. BMC Pediatr 2018; 18:216. [PMID: 29976175 PMCID: PMC6034247 DOI: 10.1186/s12887-018-1203-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/28/2018] [Indexed: 12/15/2022] Open
Abstract
Background Acute respiratory infection (ARI) is the leading cause of morbidity and mortality in pediatric patients worldwide and imposes an intense pressure on health care facilities. Data on the epidemiology profiles of ARIs are scarce in the western and rural areas of China. The purpose of the current study is to provide data on the presence of potential pathogens of ARIs in hospitalized children in Chengdu, west China. Methods Respiratory specimens were obtained from hospitalized patients (under 6 years old) with ARIs in a local hospital in Chengdu. Eight respiratory viruses were identified by PCR and 6 respiratory bacteria by biochemical reactions and Analytical Profile Index (API). Pathogens profiles, clinical characteristics and seasonality were analyzed. Results Fifty-one percent of patients were identified with at least one respiratory pathogen. Human rhinovirus (HRV) (23%), Respiratory syncytial virus (RSV) (22.7%) was the most commonly identified viruses, with Klebsiella pneumoniae (11.5%) the most commonly identified bacterium in the study. The presences of more than one pathogen were found, and multiple viral, bacterial, viral/bacterial combinations were identified in 14.9, 3.3 and 13.9% of patients respectively. Respiratory viruses were identified throughout the year with a seasonal peak in December–February. Pathogens profiles and clinical associations were different between infants (< 1 year of age) and older children (> 1 year of age). Infants with ARIs were more likely to have one or more viruses than older children. Infants identified with multiple pathogens had significantly higher proportions of tachypnea than infants that were not. Conclusions This study demonstrated that viral agents were frequently found in hospitalized children with ARI in Chengdu during the study period. This study gives us better information on the pathogen profiles, clinical associations, co-infection combinations and seasonal features of ARIs in hospitalized children, which is important for diagnoses and treatment of ARIs, as well as implementation of vaccines in this area. Moreover, future efforts in reducing the impact of ARIs will depend on programs in which available vaccines, especially vaccines on RSV, HRV and S. pneumoniae could be employed in this region and new vaccines could be developed against common pathogens.
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Affiliation(s)
- Jiayi Chen
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Research Center for Occupational Respiratory Diseases, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, China
| | - Pengwei Hu
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Shenzhen Nanshan Center for Disease Control and Prevention, 95#, Nanshang Road, Shenzhen, 518054, Guangdong, China
| | - Tao Zhou
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Tianli Zheng
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lingxu Zhou
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.,Chongqing Yuzhong District Center for Disease Control and Prevention, 254#, Heping Road, Yuzhong District, Chongqing, 400010, China
| | - Chunping Jiang
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiaofang Pei
- Department of Public Health Laboratory Sciences, West China School of Public Health (No.4 West China Teaching Hospital), Sichuan University, 16#, Section 3, Renmin Road South, Chengdu, 610041, Sichuan, People's Republic of China.
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11
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Tramper-Stranders GA. Childhood community-acquired pneumonia: A review of etiology- and antimicrobial treatment studies. Paediatr Respir Rev 2018; 26:41-48. [PMID: 28844414 PMCID: PMC7106165 DOI: 10.1016/j.prrv.2017.06.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 06/16/2017] [Accepted: 06/21/2017] [Indexed: 11/15/2022]
Abstract
Community acquired pneumonia (CAP) is a leading cause of childhood morbidity worldwide. Because of the rising antimicrobial resistance rates and adverse effects of childhood antibiotic use on the developing microbiome, rational prescribing of antibiotics for CAP is important. This review summarizes and critically reflects on the available evidence for the epidemiology, etiology and antimicrobial management of childhood CAP. Larger prospective studies on antimicrobial management derive mostly from low- or middle-income countries as they have the highest burden of CAP. Optimal antimicrobial management depends on the etiology, age, local vaccination policies and resistance patterns. As long as non-rapid surrogate markers are used to distinguish viral- from bacterial pneumonia, the management is probably suboptimal. For a young child with signs of non-severe pneumonia (with or without wheezing), watchful waiting is recommended because of probable viral etiology. For children with more severe CAP with fever, a five-day oral amoxicillin course would be the first choice therapy and dosage will depend on local resistance rates. There is no clear evidence yet for superiority of a macrolide-based regimen for all ages. For cases with CAP requiring hospitalization, several studies have shown that narrow-spectrum IV beta-lactam therapy is as effective as a broad-spectrum cephalosporin therapy. For most severe disease, broad-spectrum therapy with or without a macrolide is suggested. In case of empyema, rapid IV-to-oral switch seems to be equivalent to prolonged IV treatment.
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12
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Xu W, Guo L, Dong X, Li X, Zhou P, Ni Q, Zhou X, Wagner AL, Li L. Detection of Viruses and Mycoplasma pneumoniae in Hospitalized Patients with Severe Acute Respiratory Infection in Northern China, 2015-2016. Jpn J Infect Dis 2018; 71:134-139. [PMID: 29491245 DOI: 10.7883/yoken.jjid.2017.412] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Severe acute respiratory infection (SARI) presents a huge disease and economic burden worldwide. The present study described the frequency and types of different infectious etiologies among hospitalized patients with SARI in Tianjin, China, during 2015 and 2016. Basic information, in addition to a throat or serum sample, was collected from SARI patients. Nine viruses were detected using reverse transcription polymerase chain reaction, and Mycoplasma pneumoniae was detected using the Serodia Myco II gelatin particle agglutination test. A total of 585 specimens from 2,290 SARI cases were collected. The most common infection (19.66%, 115/585) was M. pneumoniae, followed by influenza virus A/B (6.15%, 36/585), and respiratory syncytial virus (4.96%, 29/585). Identification of viral or M. pneumoniae infections was the highest in the pediatric medicine ward (74.84%, 119/159), followed by the intensive care unit (37.04%, 80/216) and respiratory medicine ward (34.29%, 72/210). M. pneumoniae was highest (38.71%, 24/62) in the 5-14-year age group. Influenza was the main infection in January 2015 and March 2016. The correlation coefficient for the proportion of hospitalized cases of SARI and the positive detection rate within the same week was 0.25. M. pneumoniae and influenza were the leading pathogens among hospitalized SARI patients. A continued surveillance of hospitalized cases of SARI can detect emerging diseases, such as avian influenza A (H7N9) virus and other respiratory disease outbreaks.
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Affiliation(s)
- Wenti Xu
- Department of Infectious Disease Control, Tianjin Centers for Disease Control and Prevention
| | - Liru Guo
- Department of Pathogen Test, Tianjin Centers for Disease Control and Prevention
| | - Xiaochun Dong
- Department of Infectious Disease Control, Tianjin Centers for Disease Control and Prevention
| | - Xiaoxia Li
- Department of Disease Prevention, Tianjin Third Center Hospital
| | - Penghui Zhou
- Department of Infectious Disease Control, Tianjin Centers for Disease Control and Prevention
| | - Qiang Ni
- Department of Disease Prevention, Tianjin Third Center Hospital
| | - Xinying Zhou
- Department of Pediatrics, Tianjin Third Center Hospital
| | | | - Lin Li
- Department of Infectious Disease Control, Tianjin Centers for Disease Control and Prevention
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13
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Huang HS, Tsai CL, Chang J, Hsu TC, Lin S, Lee CC. Multiplex PCR system for the rapid diagnosis of respiratory virus infection: systematic review and meta-analysis. Clin Microbiol Infect 2017; 24:1055-1063. [PMID: 29208560 PMCID: PMC7128951 DOI: 10.1016/j.cmi.2017.11.018] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To provide a summary of evidence for the diagnostic accuracies of three multiplex PCR systems (mPCRs)-BioFire FilmArray RP (FilmArray), Nanosphere Verigene RV+ test (Verigene RV+) and Hologic Gen-Probe Prodesse assays-on the detection of viral respiratory infections. METHODS A comprehensive search up to 1 July 2017 was conducted on Medline and Embase for studies that utilized FilmArray, Verigene RV+ and Prodesse for diagnosis of viral respiratory infections. A summary of diagnostic accuracies for the following five viruses were calculated: influenza A virus (FluA), influenza B virus, respiratory syncytial virus, human metapneumovirus and adenovirus. Hierarchical summary receiver operating curves were used for estimating the viral detection performance per assay. RESULTS Twenty studies of 5510 patient samples were eligible for analysis. Multiplex PCRs demonstrated high diagnostic accuracy, with area under the receiver operating characteristic curve (AUROC) equal to or more than 0.98 for all the above viruses except for adenovirus (AUROC 0.89). FilmArray, Verigene RV+ and ProFlu+ (the only Prodesse assay with enough data) demonstrated a summary sensitivity for FluA of 0.911 (95% confidence interval, 0.848-0.949), 0.949 (95% confidence interval, 0.882-0.979) and 0.954 (95% confidence interval, 0.871-0.985), respectively. The three mPCRs were comparable in terms of detection of FluA. CONCLUSIONS Point estimates calculated from eligible studies showed that the three mPCRs (FilmArray, Verigene RV+ and ProFlu+) are highly accurate and may provide important diagnostic information for early identification of respiratory virus infections. In patients with low pretest probability for FluA, these three mPCRs can predict a low possibility of infection and may justify withholding empirical antiviral treatments.
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Affiliation(s)
- H-S Huang
- Department of Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan; Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan
| | - C-L Tsai
- Department of Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - J Chang
- Department of Gastroenterology, Nutrition, and Hepatology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - T-C Hsu
- Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - S Lin
- Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan; Industrial Engineering and Operations Research Department at the University of California, Berkeley, California, USA
| | - C-C Lee
- Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Abstract
Legionella pneumophila and influenza types A and B viruses can cause either community-acquired pneumonia with respiratory failure, or Legionella infection could attribute to influenza infection with potentially fatal prognosis. Copathogenesis between pandemic influenza and bacteria is characterized by complex interactions between coinfecting pathogens and the host. Understanding the underlying reason of the emersion of the secondary bacterial infection during an influenza infection is challenging. The dual infection has an impact on viral control and may delay viral clearance. Effective vaccines and antiviral therapy are crucial to increase resistance toward influenza, decrease the prevalence of influenza, and possibly interrupt the potential secondary bacterial infections.
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Affiliation(s)
- Eleni E Magira
- 1st Department of Critical Care Medicine, Evangelismos General Hospital, National and Kapodistrian University of Athens, 45-47 Ispilandou Street, Athens 10675, Greece.
| | - Sryros Zakynthinos
- 1st Department of Critical Care and Pulmonary Services, Center of Sleep Disorders, Evangelismos General Hospital, National and Kapodistrian University of Athens, 45-47 Ipsilantou Street, Athens 10676, Greece
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15
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Zhao MC, Li GX, Zhang D, Zhou HY, Wang H, Yang S, Wang L, Feng ZS, Ma XJ. Clinical evaluation of a new single-tube multiplex reverse transcription PCR assay for simultaneous detection of 11 respiratory viruses, Mycoplasma pneumoniae and Chlamydia in hospitalized children with acute respiratory infections. Diagn Microbiol Infect Dis 2017; 88:115-119. [PMID: 28365060 PMCID: PMC7132751 DOI: 10.1016/j.diagmicrobio.2017.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 12/09/2022]
Abstract
Respiratory Pathogen 13 Detection Kit (13× kit) is able to simultaneously detect 11 respiratory viruses, Mycoplasma pneumoniae (MP) and Chlamydia in a single reaction. Using 572 Nasopharyngeal aspirates collected from hospitalized children, the clinical performance of 13× kit for detecting 11 respiratory viruses was evaluated in comparison with a routinely used 2-tube multiplex reverse transcription PCR assay (2-tube assay) at provincial Centers for Disease Control and Prevention in China. The clinical performance of 13× kit for detecting MP and Chlamydia was evaluated by commercial real-time quantitative PCR (qPCR) kits or sequencing. For tested viruses, the assay concordance was 95.98% and the kappa coefficient was 0.89. All the MP and Chlamydia positive samples detected by 13× kit were confirmed as true positives. The utilization of the 13× kit in clinical settings will be helpful for doctors to assess clinical outcome according to virus type or multiple infections, and to limit the use of antibiotics. A 13× kit allowed for simultaneous detection of 11 respiratory viruses, MP and Ch. The detection rate of 13× kit was comparable to that of 2-tube assay (kappa >0.75). A 13× kit has high sensitivity (97.41%) and specificity (91.89%). MP and Chlamydia detected by 13× kit were verified by qPCR/sequencing as true positives.
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Affiliation(s)
- Meng-Chuan Zhao
- Pediatric Research Institute, Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei Province, China; Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206,China.
| | - Gui-Xia Li
- Pediatric Research Institute, Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei Province, China.
| | - Dan Zhang
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206,China.
| | - Hang-Yu Zhou
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206,China.
| | - Hao Wang
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206,China; Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 41345, Sweden.
| | - Shuo Yang
- Pediatric Research Institute, Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei Province, China.
| | - Le Wang
- Pediatric Research Institute, Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei Province, China.
| | - Zhi-Shan Feng
- Pediatric Research Institute, Children's Hospital of Hebei Province, Shijiazhuang, 050031, Hebei Province, China.
| | - Xue-Jun Ma
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206,China.
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16
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Xie M, Ma Q, Chen X, Lu X, Zhong B. Epidemiological characteristics of seven respiratory viruses among pediatric patients with acute respiratory tract infections from 2011 to 2015 in Dongguan, Southern China. Braz J Infect Dis 2017; 21:486-488. [PMID: 28238626 PMCID: PMC9427964 DOI: 10.1016/j.bjid.2016.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 12/16/2016] [Indexed: 12/31/2022] Open
Affiliation(s)
- Mingyu Xie
- Guangdong Medical University, Children's Hospital of Dongguan, Department of Pediatric Infectious Diseases, Dongguan, China; Dongguan Institute of Pediatrics, Department of Medical and Molecular Genetics, Dongguan, China
| | - Qiang Ma
- Guangdong Medical University, Children's Hospital of Dongguan, Department of Pediatric Infectious Diseases, Dongguan, China; Dongguan Institute of Pediatrics, Department of Medical and Molecular Genetics, Dongguan, China
| | - Xiuying Chen
- Guangdong Medical University, Children's Hospital of Dongguan, Department of Pediatric Infectious Diseases, Dongguan, China; Dongguan Institute of Pediatrics, Department of Medical and Molecular Genetics, Dongguan, China
| | - Xiaomei Lu
- Guangdong Medical University, Children's Hospital of Dongguan, Department of Pediatric Infectious Diseases, Dongguan, China; Dongguan Institute of Pediatrics, Department of Medical and Molecular Genetics, Dongguan, China.
| | - Baimao Zhong
- Guangdong Medical University, Children's Hospital of Dongguan, Department of Pediatric Infectious Diseases, Dongguan, China; Dongguan Institute of Pediatrics, Department of Medical and Molecular Genetics, Dongguan, China.
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17
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del Valle-Mendoza J, Orellana-Peralta F, Marcelo-Rodríguez A, Verne E, Esquivel-Vizcarra M, Silva-Caso W, Aguilar-Luis MA, Weilg P, Casabona-Oré V, Ugarte C, del Valle LJ. High Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Children with Acute Respiratory Infections from Lima, Peru. PLoS One 2017; 12:e0170787. [PMID: 28129377 PMCID: PMC5271412 DOI: 10.1371/journal.pone.0170787] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/11/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mycoplasma pneumoniae and Chlamydia pneumoniae are atypical pathogens responsible for pneumonia and a leading cause of morbidity and mortality in low income countries. The study objective is to determine the prevalence of this pathogens in Peruvian children with acute respiratory infections. METHODS A consecutive cross-sectional study was conducted in Lima, Peru from May 2009 to September 2010. A total of 675 children admitted with clinical diagnoses of acute respiratory infections were tested for Mycoplasma pneumoniae and Chlamydia pneumoniae detection by polymerase chain reaction (PCR), and clinical symptoms were registered by the attending physician. RESULTS Mycoplasma pneumonia was detected in 25.19% (170/675) of nasopharyngeal samples and Chlamydia pneumonia in 10.52% (71/675). The most common symptoms in patients with these atypical pathogens were rhinorrhea, cough and fever. A higher prevalence of Mycoplasma pneumoniae cases were registered in summer, between December 2009 and March 2010. CONCLUSIONS Mycoplasma pneumoniae and Chlamydia pneumonia are a significant cause of morbidity in Peruvian children with acute respiratory infections (ARI). Further studies should evaluate the use of reliable techniques such as PCR in Peru in order to avoid underdiagnoses of these atypical pathogens.
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Affiliation(s)
- Juana del Valle-Mendoza
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | - Fiorella Orellana-Peralta
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | | | | | | | - Wilmer Silva-Caso
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | - Pablo Weilg
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
| | - Verónica Casabona-Oré
- School of Medicine, Research and Innovation Centre of the Faculty of Health Sciences. Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | | | - Luis J. del Valle
- Centre de Biotecnologia Molecular (CEBIM), Departament d’Enginyeria Química, ETSEIB, Universitat Politècnica de Catalunya (UPC) Barcelona Tech, Barcelona, Spain
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18
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Song JH, Huh K, Chung DR. Community-Acquired Pneumonia in the Asia-Pacific Region. Semin Respir Crit Care Med 2016; 37:839-854. [PMID: 27960208 PMCID: PMC7171710 DOI: 10.1055/s-0036-1592075] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Aging population, dense urbanization, and poor access to health care make the Asia-Pacific region vulnerable to CAP. The high incidence of CAP poses a significant health and economic burden in this region. Common etiologic agents in other global regions including Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, Staphylococcus aureus, and respiratory viruses are also the most prevalent pathogens in the Asia-Pacific region. But the higher incidence of Klebsiella pneumoniae and the presence of Burkholderia pseudomallei are unique to the region. The high prevalence of antimicrobial resistance in S. pneumoniae and M. pneumoniae has been raising the need for more prudent use of antibiotics. Emergence and spread of community-acquired methicillin-resistant S. aureus deserve attention, while the risk has not reached significant level yet in cases of CAP. Given a clinical and socioeconomic importance of CAP, further effort to better understand the epidemiology and impact of CAP is warranted in the Asia-Pacific region.
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Affiliation(s)
- Jae-Hoon Song
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Epidemiological and clinical characteristics of respiratory viral infections in children in Shanghai, China. Arch Virol 2016; 161:1907-13. [PMID: 27138548 PMCID: PMC7086729 DOI: 10.1007/s00705-016-2866-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 04/14/2016] [Indexed: 12/21/2022]
Abstract
Acute respiratory tract infections (ARTIs) due to various viruses are not only the most common causes of upper and lower respiratory infection but are also major causes of morbidity and mortality in children. In this study, we investigated the prevalence and clinical characteristics of children with virus-related ARTIs and determined the spectrum of respiratory viruses and their correlation with meteorological variables in Jiading District, Shanghai, China. Nasopharyngeal swabs from 2819 children with ARTIs were collected from August 2011 to December 2014, and used for detection of respiratory viruses by multiplex RT-PCR. Seventeen respiratory viruses were detected among 691 (24.5 %) of 2819 patients. The highest prevalence of respiratory viruses was detected in the age group of less than 1 year (29.0 %), and the prevalence decreased with age. This suggests that children less than one year old are the most susceptible to infection. Influenza virus (IFV) was the most frequently detected virus (5.8 %), followed by parainfluenza virus (PIV) (5.7 %), enterovirus (EV) (4.3 %), and respiratory syncytial virus (RSV) (3.6 %). Statistical analysis showed that epidemics of IFV, PIV and EV had distinct seasonal variations. Mean monthly temperature appeared to be the only meteorological factor associated with IFV and PIV infection. These findings will provide valuable information for decision-making, prevention and treatment of ARTIs in children.
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20
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Parrott GL, Kinjo T, Fujita J. A Compendium for Mycoplasma pneumoniae. Front Microbiol 2016; 7:513. [PMID: 27148202 PMCID: PMC4828434 DOI: 10.3389/fmicb.2016.00513] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Historically, atypical pneumonia was a term used to describe an unusual presentation of pneumonia. Currently, it is used to describe the multitude of symptoms juxtaposing the classic symptoms found in cases of pneumococcal pneumonia. Specifically, atypical pneumonia is a syndrome resulting from a relatively common group of pathogens including Chlamydophila sp., and Mycoplasma pneumoniae. The incidence of M. pneumoniae pneumonia in adults is less than the burden experienced by children. Transmission rates among families indicate children may act as a reservoir and maintain contagiousness over a long period of time ranging from months to years. In adults, M. pneumoniae typically produces a mild, “walking” pneumonia and is considered to be one of the causes of persistent cough in patients. M. pneumoniae has also been shown to trigger the exacerbation of other lung diseases. It has been repeatedly detected in patients with bronchitis, asthma, chronic obstructive pulmonary disorder, and cystic fibrosis. Recent advances in technology allow for the rapid diagnosis of M. pneumoniae through the use of polymerase chain reaction or rapid antigen tests. With this, more effort has been afforded to identify the causative etiologic agent in all cases of pneumonia. However, previous practices, including the overprescribing of macrolide treatment in China and Japan, have created increased incidence of macrolide-resistant M. pneumoniae. Reports from these countries indicate that >85% of M. pneumoniae pneumonia pediatric cases are macrolide-resistant. Despite its extensively studied past, the smallest bacterial species still inspires some of the largest questions. The developments in microbiology, diagnostic features and techniques, epidemiology, treatment and vaccines, and upper respiratory conditions associated with M. pneumoniae in adult populations are included within this review.
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Affiliation(s)
- Gretchen L Parrott
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Takeshi Kinjo
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
| | - Jiro Fujita
- Department of Infectious Diseases, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus Nishihara, Japan
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21
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Yang HJ. Safety of influenza vaccination in children with allergic diseases. Clin Exp Vaccine Res 2015; 4:137-44. [PMID: 26273572 PMCID: PMC4524898 DOI: 10.7774/cevr.2015.4.2.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/20/2015] [Accepted: 05/30/2015] [Indexed: 11/15/2022] Open
Abstract
Global guidelines strongly recommend annual influenza vaccination in people age 6 months and older, particularly in asthmatic children. There is no doubt about the benefit of influenza vaccination in asthmatic children. However, some of the vaccine's components may elicit an IgE mediated hypersensitivity or disease exacerbation, including life-threatening events, in children with allergic diseases. As a result, concerns regarding the safety of the vaccine still continue today. The influenza vaccine is grown on hens' eggs and contains a trace of egg protein. Consequently, it can provoke an allergic reaction or anaphylaxis in children with an egg allergy or exacerbation in those with asthma. Therefore, we need to know the risks and benefits of the influenza vaccine and the best strategy for safe vaccination. Although most guidelines have consistently reported the safety of influenza vaccination in children with allergic disease, and have recommended annual administration, safety concerns impede guideline-based performance in practice. The safety and efficacy of influenza vaccination for allergic children are summarized in the present review.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
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22
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Development of a Multilocus Sequence Typing Scheme for Molecular Typing of Mycoplasma pneumoniae. J Clin Microbiol 2015. [PMID: 26202118 DOI: 10.1128/jcm.01301-15] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Mycoplasma pneumoniae is a major human respiratory pathogen causing both upper and lower respiratory disease in humans of all ages, and it can also result in other serious extrapulmonary sequelae. A multilocus sequence typing (MLST) scheme for M. pneumoniae was developed based on the sequences of eight housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, and adk) and applied to 55 M. pneumoniae clinical isolates and the two type strains M129 and FH. A total of 12 sequence types (STs) resulted for 57 M. pneumoniae isolates tested, with a discriminatory index of 0.21 STs per isolate. The MLST loci used in this scheme were shown to be stable in 10 strains following 10 sequential subculture passages. Phylogenetic analysis of concatenated sequences of the eight loci indicated two distinct genetic clusters that were directly linked to multilocus variable-number tandem repeat analysis (MLVA) type. Genetic MLST clustering was confirmed by genomic sequence analysis, indicating that the MLST scheme developed in this study is representative of the genome. Furthermore, this MLST scheme was shown to be more discriminatory than both MLVA and P1 typing for the M. pneumoniae isolates examined, providing a method for further and more detailed analysis of observed epidemic peaks of M. pneumoniae infection. This scheme is supported by a public Web-based database (http://pubmlst.org/mpneumoniae).
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