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Rampedi PN, Ogunrombi MO, Adeleke OA. Leading Paediatric Infectious Diseases-Current Trends, Gaps, and Future Prospects in Oral Pharmacotherapeutic Interventions. Pharmaceutics 2024; 16:712. [PMID: 38931836 PMCID: PMC11206886 DOI: 10.3390/pharmaceutics16060712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Paediatric infectious diseases contribute significantly to global health challenges. Conventional therapeutic interventions are not always suitable for children, as they are regularly accompanied with long-standing disadvantages that negatively impact efficacy, thus necessitating the need for effective and child-friendly pharmacotherapeutic interventions. Recent advancements in drug delivery technologies, particularly oral formulations, have shown tremendous progress in enhancing the effectiveness of paediatric medicines. Generally, these delivery methods target, and address challenges associated with palatability, dosing accuracy, stability, bioavailability, patient compliance, and caregiver convenience, which are important factors that can influence successful treatment outcomes in children. Some of the emerging trends include moving away from creating liquid delivery systems to developing oral solid formulations, with the most explored being orodispersible tablets, multiparticulate dosage forms using film-coating technologies, and chewable drug products. Other ongoing innovations include gastro-retentive, 3D-printed, nipple-shield, milk-based, and nanoparticulate (e.g., lipid-, polymeric-based templates) drug delivery systems, possessing the potential to improve therapeutic effectiveness, age appropriateness, pharmacokinetics, and safety profiles as they relate to the paediatric population. This manuscript therefore highlights the evolving landscape of oral pharmacotherapeutic interventions for leading paediatric infectious diseases, crediting the role of innovative drug delivery technologies. By focusing on the current trends, pointing out gaps, and identifying future possibilities, this review aims to contribute towards ongoing efforts directed at improving paediatric health outcomes associated with the management of these infectious ailments through accessible and efficacious drug treatments.
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Affiliation(s)
- Penelope N. Rampedi
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho Health Science University, Pretoria 0208, South Africa; (P.N.R.); (M.O.O.)
| | - Modupe O. Ogunrombi
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho Health Science University, Pretoria 0208, South Africa; (P.N.R.); (M.O.O.)
| | - Oluwatoyin A. Adeleke
- Preclinical Laboratory for Drug Delivery Innovations, College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- School of Biomedical Engineering, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 3J5, Canada
- School of Pharmacy, Sefako Makgatho Health Science University, Pretoria 0208, South Africa
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Automatic Identification of MALDI-TOF MS Database Using Classical Bordetella Species Isolates. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1679951. [PMID: 35756428 PMCID: PMC9217575 DOI: 10.1155/2022/1679951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Objective To evaluate and expand the automatic identification and clustering of clinical Bordetella species by MALDI-TOF MS. Methods Twenty-eight field isolated strains, identified by whole-gene sequencing analysis, were analyzed by MALDI-TOF MS, and the spectra obtained were used to replenish the internal database of the manufacturer. To evaluate and expand the robustness of the database, MALDI-TOF MS identified 91 clinical isolates (except those used for implementation). A distance tree based on mass spectrometry data is constructed to confirm similarity and clusters of each clinical Bordetella species by using the MALDI Biotyper 3.1 software. Results In this research, when we used the implemented Bruker Daltonics database in our laboratory, 91 clinical isolates were identified at the genus level (100%) and 93.4% were identified at the species level (85/91). We performed proteomics analysis and divided these 91 isolates into cluster I (2.2%) and cluster II (97.8%). The largest group is cluster II (n = 89 isolates), which has been divided into two subclusters. Trees created by analyzing the protein mass spectra of the three species of the clinical isolates reflected their classification. Conclusion MALDI-TOF MS may present an attractive alternative to automatically confirm and cluster the fastidious bacteria difficult to culture. Extension of identification of the MALDI-TOF MS database is viably fast, more efficient, and alternative to conventional methods in confirming the classical Bordetella species. This strategy could promote the epidemiological and taxonomic research of this important pathogen.
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Nascimento RMD, Baptista PN, Lopes KADM, Pimentel AM, Cruz FDSP, Ximenes RADA. Protective effect of exclusive breastfeeding and effectiveness of maternal vaccination in reducing pertussis-like illness. J Pediatr (Rio J) 2021; 97:500-507. [PMID: 33465336 PMCID: PMC9432170 DOI: 10.1016/j.jped.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/24/2020] [Accepted: 10/10/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness. METHOD This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date. RESULTS Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; -34% a 60%). CONCLUSIONS Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.
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Affiliation(s)
| | - Paulo Neves Baptista
- Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil
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Walkowski W, Bassett J, Bhalla M, Pfeifer BA, Ghanem ENB. Intranasal Vaccine Delivery Technology for Respiratory Tract Disease Application with a Special Emphasis on Pneumococcal Disease. Vaccines (Basel) 2021; 9:vaccines9060589. [PMID: 34199398 PMCID: PMC8230341 DOI: 10.3390/vaccines9060589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/17/2021] [Accepted: 05/22/2021] [Indexed: 12/17/2022] Open
Abstract
This mini-review will cover recent trends in intranasal (IN) vaccine delivery as it relates to applications for respiratory tract diseases. The logic and rationale for IN vaccine delivery will be compared to methods and applications accompanying this particular administration route. In addition, we will focus extended discussion on the potential role of IN vaccination in the context of respiratory tract diseases, with a special emphasis on pneumococcal disease. Here, elements of this disease, including its prevalence and impact upon the elderly population, will be viewed from the standpoint of improving health outcomes through vaccine design and delivery technology and how IN administration can play a role in such efforts.
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Affiliation(s)
- William Walkowski
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Justin Bassett
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Manmeet Bhalla
- Department of Microbiology and Immunology, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA;
| | - Blaine A. Pfeifer
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA; (W.W.); (J.B.); (B.A.P.)
| | - Elsa N. Bou Ghanem
- Department of Microbiology and Immunology, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA;
- Correspondence:
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Cytokine expression patterns in hospitalized children with Bordetella pertussis, Rhinovirus or co-infection. Sci Rep 2021; 11:10948. [PMID: 34040002 PMCID: PMC8154898 DOI: 10.1038/s41598-021-89538-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/12/2021] [Indexed: 02/02/2023] Open
Abstract
Mechanisms of interaction between Bordetella pertussis and other viral agents are yet to be fully explored. We studied the inflammatory cytokine expression patterns among children with both viral-bacterial infections. Nasopharyngeal aspirate (NPA) samples were taken from children, aged < 1 year, positive for Rhinovirus, Bordetella pertussis and for Rhinovirus and Bordetella pertussis. Forty cytokines were evaluated in NPA by using human cytokine protein arrays and a quantitative analysis was performed on significantly altered cytokines. Forty cytokines were evaluated in NPA by using human cytokine protein arrays and a quantitative analysis was performed on significantly altered cytokines. Our results show that co-infections display a different inflammatory pattern compared to single infections, suggesting that a chronic inflammation caused by one of the two pathogens could be the trigger for exacerbation in co-infections.
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Wang C, Zhang H, Zhang Y, Xu L, Miao M, Yang H, Liu Y, He S, Pang L. Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study. BMC Pediatr 2021; 21:65. [PMID: 33546645 PMCID: PMC7863367 DOI: 10.1186/s12887-021-02507-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 01/14/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants METHODS: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed RESULTS: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) CONCLUSIONS: 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.
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Affiliation(s)
- Caiying Wang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Huimin Zhang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yanlan Zhang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Xu
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Min Miao
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongling Yang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yuhuan Liu
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shuxin He
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Pang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
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Cimolai N. Pharmacotherapy for Bordetella pertussis infection. II. A synthesis of clinical sciences. Int J Antimicrob Agents 2020; 57:106257. [PMID: 33310117 DOI: 10.1016/j.ijantimicag.2020.106257] [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: 11/09/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023]
Abstract
Despite the plethora of studies that have examined laboratory susceptibility testing for Bordetella pertussis, assessments of treatment have lagged far behind both in quality and quantity. Macrolides and trimethoprim/sulfamethoxazole historically served the needs of both treatment and prevention, albeit there is still controversy about the degree of protection measured both bacteriologically and clinically. As high-level macrolide resistance has emerged in some geographic regions and since macrolides have been the mainstay of therapy, alternative antibiotics need to be defined for pertussis. In vitro susceptibility testing suggests the potential for several alternatives to macrolides, including trimethoprim/sulfamethoxazole, specific β-lactam agents, chloramphenicol, some quinolones and possibly some tetracyclines. For the latter antibiotics, more clinical studies for treatment and prophylaxis are required in to order to establish bacteriological-clinical correlates for outcome. In the interim, if the clinical circumstances mandate the use of proposed interim alternatives to macrolides, outcomes should be assessed with test of cure by culture, since genetic amplification technologies do not discriminate bacterial viability. Whereas there may be debate in regard to using placebo or macrolides as the controls for alternative antibiotic therapy in geographies where most B. pertussis isolates are antibiotic-susceptible, both placebo and macrolide controls should be assessed along with alternative antibiotics in well-designed controlled studies in regions pressured by macrolide resistance. Outcomes of clinical response and epidemiological patterns of disease should continue to be monitored given the degree of macrolide resistance that is emerging.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, British Columbia, V6H3V4, Canada.
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