[Pathogenic characteristics of viral gastroenteritis among pediatric inpatients under five years old during 2014-2017]

Clinical effects of Saccharomyces boulardii combined with aluminum phosphate in treatment of acute antibiotic-associated diarrhea in children

BACKGROUND

Acute antibiotic-associated diarrhea is mainly related to intestinal bacterial infection. The more kinds of antibiotics used in the treatment process, the wider antibacterial spectrum, and the longer the use time, the more serious the diarrhea. According to statistics, due to immature body development and low immunity in children, the incidence of acute antibiotic-associated diarrhea is about 11%-40% in children, bringing adverse effects to them.

AIM

To investigate the application value of boulardii yeast combined with aluminum phosphate in children with acute antibiotic-associated diarrhea.

METHODS

A total of 122 children with acute antibiotic-associated diarrhea treated at Mingzhou Hospital of North Zhejiang from June 2019 to June 2021 were selected as research subjects, and they were randomly divided into either a control group or a study group. Both groups were given aluminum phosphate for 3 d, and the study group was additionally treated with boulardii yeast for 3 d. The efficacy, clinical symptoms, immune indicators, and inflammatory factors were compared between the two groups and among different age groups.

RESULTS

The total effective rate of the study group was 93.44%, which was significantly higher than that of the control group (80.33%; χ² = 4.604, P = 0.032). There was no significant difference in therapeutic efficacy among different age groups (3-6 years, 6-9 years, and 9-13 years) (χ² = 0.667, P = 0.716). Before treatment, there were no significant differences in CD3+, CD4+, and CD8+ T cells, or CD4+/CD8+ T cell ratio between the two groups (t = 0.630, 0.146, 0.265, and 0.417, respectively, P > 0.05). After treatment, CD3+ and CD4+ T cells and CD4+/CD8+ T cell ratio in the study group were significantly higher than those in the control group (t = 9.137, 6.483, and 12.068, respectively, P < 0.05), while CD8+ T cells were lower than those in the control group (t = 16.047, P < 0.05). Before treatment, there was no significant difference in IgA or IgG between the two groups (t = 0.367 and 0.243, respectively, P > 0.05). After treatment, IgA and IgG were increased in both groups, and they were significantly higher in the study group than in the control group (t = 19.358 and 8.754, respectively, P < 0.05). There was no significant difference in IL-6 or TNF-α between the two groups before treatment, but they decreased after treatment (t = 8.867 and 9.210, respectively, P < 0.05). The time to disappearance of abdominal pain and abdominal distension in the study group was shorter than that in the control group (t = 10.765 and 14.471, respectively, P < 0.05).

CONCLUSION

Boulardii yeast combined with aluminum phosphate is effective in the treatment of acute antibiotic-associated diarrhea, which can accelerate the disappearance of clinical symptoms and signs, improve immune function, and reduce the levels of inflammatory factors.

Genetic diversity of group A rotavirus in acute gastroenteritis outpatients in Shanghai from 2017 to 2018

Background

Group A Rotavirus (RVA), despite being an important pathogen in hospitalized children, is less studied in pediatric outpatients, and even rarely investigated in adults. This study aims to understand the genetic diversity of RVA in outpatients across all age groups in Shanghai, and thus providing a molecular basis for vaccine implementation and evaluation.

Methods

Stool samples were first screened by Real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR). RVA genotyping was performed through the amplification of partial VP7 and VP4 gene. Strains of interest were further sequenced and analyzed using MEGA 6.0.

Results

Four thousand nine hundred one samples were collected, from which 7.61% (373 cases) were screened positive for RVA. RVA prevalence was higher in children (9.30%) than in adults (7.21%) (χ² = 4.72, P < 0.05). 9.38% RVA positive cases had taken antibiotics before hospital visit while 49.60% had been prescribed antibiotics afterwards. RVA displayed a strong seasonality in both adults and children with a shared commonality in genotype repertoire, where G9P[8] was the most prevalent strain (67.96%) followed by G3P[8] (15.49%) and G1P[8] (12.32%). Meanwhile the first local case of fecal shedding of the G10P[15] vaccine strain was also discovered.

Conclusions

While the prevalence of rotavirus is highest during cold seasons, it is revealed for the first time that G9P[8] is the predominant genotype in both adults and pediatric outpatients. Clinically, higher occurrence of nausea or vomiting was observed in RVA positive cases. Antibiotic overuse was implicated in both non-clinical and clinical settings. The finding emphasizes the importance of RVA genotyping in surveillance as it provides the basis for new vaccine application as well as a baseline for future vaccine efficacy evaluation.