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Trifonova I, Korsun N, Madzharova I, Velikov P, Alexsiev I, Grigorova L, Voleva S, Yordanova R, Ivanov I, Tcherveniakova T, Christova I. Prevalence and clinical impact of mono- and co-infections with endemic coronaviruses 229E, OC43, NL63, and HKU-1 during the COVID-19 pandemic. Heliyon 2024; 10:e29258. [PMID: 38623185 PMCID: PMC11016702 DOI: 10.1016/j.heliyon.2024.e29258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
Introduction Endemic human coronaviruses (eHCoVs) are found worldwide and usually result in mild to moderate upper respiratory tract infections. They can lead to more severe illnesses such as croup, bronchiolitis, and pneumonia in vulnerable populations. During the coronavirus disease 2019 (COVID-19) pandemic, information on HCoV prevalence and incidence and clinical impact of co-infections of HCoV with SARS-CoV-2 was lacking. Objectives Thus, this study aimed to determine the prevalence and clinical significance of infections caused by eHCoVs during the COVID-19 pandemic in Bulgaria. Methods From January 2021 to December 2022, nasopharyngeal swabs of patients with acute upper or lower respiratory tract infections were tested for 17 respiratory viruses using multiplex real-time polymerase chain reaction assays. The clinical data and laboratory parameters of patients infected with respiratory viruses were analysed. Results Of the 1375 patients screened, 24 (1.7 %) were positive for HCoVs, and 197 (14.3 %) were positive for eight other seasonal respiratory viruses. Five (0.7 %) of 740 patients positive for SARS-CoV-2 were co-infected with eHCoVs. Co-infected patients had a mean C-reactive protein level of 198.5 ± 2.12 mg/mL and a mean oxygen saturation of 82 ± 2.8 mmHg, while those in patients co-infected with SARS-CoV-2 and other respiratory viruses were 61.8 mg/mL and 92.8 ± 4.6 mmHg, respectively (p < 0.05). Pneumonia was diagnosed in 63.3 % of patients with HCoV infection and 6 % of patients positive for other seasonal respiratory viruses (p < 0.05). Patients with SARS-CoV-2 mono-infection stayed in hospital for an average of 5.8 ± 3.7 days, whereas the average hospital stay of patients with eHCoV and SARS-CoV-2 co-infection was 9 ± 1.4 days (p < 0.05). Conclusion These findings indicate the low prevalence of eHCoVs and low co-infection rate between eHCoVs and SARS-CoV-2 during the COVID-19 pandemic in Bulgaria. Despite their low incidence, such mixed infections can cause severe signs that require oxygen therapy and longer hospital stays, underlining the need for targeted testing of severe COVID-19 cases to identify potential co-infections.
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Affiliation(s)
- I. Trifonova
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - N. Korsun
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - I. Madzharova
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - P. Velikov
- Infectious Disease Hospital “Prof. Ivan Kirov”, Department for Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Bulgaria
| | - I. Alexsiev
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - L. Grigorova
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
| | - S. Voleva
- Infectious Disease Hospital “Prof. Ivan Kirov”, Department for Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Bulgaria
| | - R. Yordanova
- Infectious Disease Hospital “Prof. Ivan Kirov”, Department for Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Bulgaria
| | - I. Ivanov
- Infectious Disease Hospital “Prof. Ivan Kirov”, Department for Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Bulgaria
| | - T. Tcherveniakova
- Infectious Disease Hospital “Prof. Ivan Kirov”, Department for Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Bulgaria
| | - I. Christova
- National Laboratory “Influenza and ARD”, Department of Virology, National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, Bulgaria
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Korsun N, Trifonova I, Madzharova I, Alexiev I, Uzunova I, Ivanov I, Velikov P, Tcherveniakova T, Christova I. Resurgence of respiratory syncytial virus with dominance of RSV-B during the 2022-2023 season. Front Microbiol 2024; 15:1376389. [PMID: 38628867 PMCID: PMC11019023 DOI: 10.3389/fmicb.2024.1376389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Respiratory syncytial virus (RSV) is a common cause of upper and lower respiratory tract infections. This study aimed to explore the prevalence of respiratory syncytial virus (RSV) and other respiratory viruses in Bulgaria, characterize the genetic diversity of RSV strains, and perform amino acid sequence analyses of RSV surface and internal proteins. Methods Clinical and epidemiological data and nasopharyngeal swabs were prospectively collected from patients with acute respiratory infections between October 2020 and May 2023. Real-time PCR for 13 respiratory viruses, whole-genome sequencing, phylogenetic, and amino acid analyses were performed. Results This study included three epidemic seasons (2020-2021, 2021-2022, and 2022-2023) from week 40 of the previous year to week 20 of the following year. Of the 3,047 patients examined, 1,813 (59.5%) tested positive for at least one viral respiratory pathogen. RSV was the second most detected virus (10.9%) after SARS-CoV-2 (22%). Coinfections between RSV and other respiratory viruses were detected in 68 cases, including 14 with SARS-CoV-2. After two seasons of low circulation, RSV activity increased significantly during the 2022-2023 season. The detection rates of RSV were 3.2, 6.6, and 13.7% in the first, second, and third seasons, respectively. RSV was the most common virus found in children under 5 years old with bronchiolitis (40%) and pneumonia (24.5%). RSV-B drove the 2022-2023 epidemic. Phylogenetic analysis indicated that the sequenced RSV-B strains belonged to the GB5.0.5a and GB5.0.6a genotypes. Amino acid substitutions in the surface and internal proteins, including the F protein antigenic sites were identified compared to the BA prototype strain. Conclusion This study revealed a strong resurgence of RSV in the autumn of 2022 after the lifting of anti-COVID-19 measures, the leading role of RSV as a causative agent of serious respiratory illnesses in early childhood, and relatively low genetic diversity in circulating RSV strains.
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Affiliation(s)
- Neli Korsun
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivaylo Alexiev
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Ivan Ivanov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | - Petar Velikov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | | | - Iva Christova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Velev V, Pavlova M, Alexandrova E, Popov М, Lutakov I, Tcherveniakova T, Angelova A, Hristozova E, Kalchev Y, Ivanov I. Study on patients with Clostridioides difficile infection during the COVID-19 pandemic in Bulgaria. BIOTECHNOL BIOTEC EQ 2023. [DOI: 10.1080/13102818.2023.2169194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Valeri Velev
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Pavlova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ekaterina Alexandrova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Мetodi Popov
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Lutakov
- University Hospital "Queen Joanna - ISUL", Medical University of Sofia, Sofia, Bulgaria
| | | | - Andreana Angelova
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Eli Hristozova
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Yordan Kalchev
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ivan Ivanov
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
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Trifonova I, Christova I, Madzharova I, Angelova S, Voleva S, Yordanova R, Tcherveniakova T, Krumova S, Korsun N. Clinical significance and role of coinfections with respiratory pathogens among individuals with confirmed severe acute respiratory syndrome coronavirus-2 infection. Front Public Health 2022; 10:959319. [PMID: 36117597 PMCID: PMC9479447 DOI: 10.3389/fpubh.2022.959319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/04/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction This study aimed to determine the prevalence, viral profile, and clinical features of coinfections with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and other respiratory viruses. Methods Nasopharyngeal samples and clinical data of 221 hospitalized patients and 21 outpatients were collected and analyzed. Real-time reverse transcription-polymerase chain reaction was used to detect SARS-CoV-2, influenza virus, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV) 1,2,3, rhinovirus (RV), adenovirus (AdV), bocaviruses (BoV), and seasonal coronaviruses (OC43, 229E, NL63, and HKU1). Viral load was determined by capillary electrophoresis. Results From November 2020 to mid-March 2022, 242 SARS-CoV-2 positive patients were tested for seasonal respiratory viruses, and 24 (9.9%) cases of coinfections were detected. The distribution of viruses involved in cases of coinfections were as follows: HMPV (n = 6; 25%), RSV (n = 4;16.7%), AdV (n = 4; 16.7%), BoV (n = 4; 16.7%), PIV3 (n = 2; 8.3%), influenza A (H3N2; n = 2; 8.3%), RV (n = 1; 4.62%), and RV+BoV (n = 1; 4.62%). The proportion of detected coinfections with SARS-CoV-2 was highest in children aged 0-5 years (59%), followed by those >65 years (33%). In specimens with detected coinfection, the viral load of influenza was higher than that of SARS-CoV-2, and the mean viral load of SARS-CoV-2 was higher than that of the other respiratory viruses. C-reactive protein (CRP) and lymphocytes count in co-infected patients >65 years of age were on average higher than in children <16 years of age (mean CRP of 161.8 ± 133.1 mg/L; 19.7 ± 3.09% vs. mean 6.9 ± 8.9 mg/L, 0.9 ± 3.1%; p < 0.01). Patients >65 years of age co-infected with SARS-CoV-2 and other respiratory viruses had longer hospital stays than those <16 years of age (mean 9 ± 3.96 days vs. 5.44 ± 1.89 days; p = 0.025). The combination of AdV and SARS-CoV-2 is fatal for patients aged >65 years. Conclusion In patients aged >65 years, coinfection with SARS CoV-2 and other respiratory viruses, together with concomitant diseases, causes worsening of the clinical picture and complications, and can be fatal. Screening of patients with SARS CoV-2 for other respiratory viruses is needed to select appropriate treatments and prevent a fatal outcome of the disease.
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Affiliation(s)
- Ivelina Trifonova
- National Laboratory “Influenza and ARD”, Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iva Christova
- National Laboratory “Influenza and ARD”, Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory “Influenza and ARD”, Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Svetla Angelova
- Clinical Virology Laboratory, University Hospital “Prof. Dr. Stoyan Kirkovich”, Stara Zagora, Bulgaria
| | - Silvya Voleva
- Clinic for Neuro Infections, Airborne, Roof, and Transmissible Infections, Infectious Hospital “Prof. Ivan Kirov”, Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Ralitsa Yordanova
- Clinic for Neuro Infections, Airborne, Roof, and Transmissible Infections, Infectious Hospital “Prof. Ivan Kirov”, Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Tatiana Tcherveniakova
- Clinic for Neuro Infections, Airborne, Roof, and Transmissible Infections, Infectious Hospital “Prof. Ivan Kirov”, Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Stefka Krumova
- National Laboratory “Influenza and ARD”, Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Neli Korsun
- National Laboratory “Influenza and ARD”, Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Velev V, Popov M, Velikov P, Dinkova M, Ilieva V, Gospodinova G, Tcherveniakova T, Pavlova M. COVID-19 and gastrointestinal injury: a brief systematic review and data from Bulgaria. Infez Med 2020; 28:37-41. [PMID: 32532936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
UNLABELLED In December 2019, a new Coronavirus (SARS-CoV-2) emerged in China, causing the pandemic disease COVID-19. The clinical presentation is variable, but the predominant symptoms are those of the upper respiratory tract. AIM The aim of the current study is to describe the incidence and type of the gastrointestinal injury (GI) in COVID-19, as well as their prognostic value. MATERIALS AND METHODS We conducted a coincidental search on this topic in PubMed, Web of Science and EMBASE. We also followed a group of 31 Bulgarian COVID-19 patients throughout the course of their disease and analyzed their symptoms (catarrhal and other) and outcome. RESULTS The publications concerning our survey followed a total of 1509 COVID-19 patients. In the Bulgarian cohort, only 14 from the 31 patients were laboratory-confirmed COVID-19 cases. Approximately 1/3 of the infected individuals presented with GI. In some patients this was the first, or only, symptom of the disease. It was also indicative of a more severe disease course. CONCLUSION GI may be an important symptom and prognostic factor in COVID-19. Therefore, patients with acute gastrointestinal symptoms must be actively tested for SARS-CoV-2.
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Affiliation(s)
- Valeri Velev
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Metodi Popov
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Petar Velikov
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Maria Dinkova
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Viktoria Ilieva
- University Hospital of Pulmonary Diseases "St. Sofia", Medical University of Sofia, Bulgaria
| | - Gabriela Gospodinova
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Tatiana Tcherveniakova
- University Hospital for Infectious and Parasitic Diseases "Prof. Iv. Kirov", Sofia, Bulgaria, Medical University of Sofia, Bulgaria
| | - Maria Pavlova
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Alexiev I, Golkocheva-Markova E, Kostadinova A, Dimitrova R, Nikolova L, Gancheva A, Tenev T, Elenkov I, Tcherveniakova T, Yancheva N, Stoycheva M, Doychinova T, Pekova L, Alexandrova M, Timchev A, Strashimirov D, Nikolova M. The prevalence of hepatitis B and C co-infections among people with HIV-1 in Bulgaria: 2010–2015. Future Virol 2019. [DOI: 10.2217/fvl-2019-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To evaluate hepatitis B virus (HBV) and hepatitis C virus (HCV) among individuals with HIV/AIDS in Bulgaria diagnosed between 2010 and 2015. Materials & methods: A total of 1158 individuals were diagnosed with HIV/AIDS during the study period. Different transmission groups were tested with ELISA and real-time PCR for HBV and HCV markers. Results: Hepatitis B surface antigen and hepatitis C virus antiboby were found in 9.3 and 23.2% of the tested. HBV DNA and HCV RNA has been found in 47.4 and 69.6%. Hepatitis B and C co-infections were predominant in multiple risk behavior groups, including people who inject drugs, men who have sex with men, prisoners and Roma individuals. Conclusion: HIV prevalence in Bulgaria is low but the rates of hepatitis B and C co-infections among these patients fall within the upper range reported in Europe.
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Affiliation(s)
- Ivailo Alexiev
- National Reference Confirmatory Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Elitsa Golkocheva-Markova
- National Reference Laboratory of Hepatitis, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Asya Kostadinova
- National Reference Confirmatory Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Reneta Dimitrova
- National Reference Confirmatory Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Lora Nikolova
- National Reference Confirmatory Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Anna Gancheva
- National Reference Confirmatory Laboratory of HIV, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Tencho Tenev
- National Reference Laboratory of Hepatitis, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivaylo Elenkov
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Tatiana Tcherveniakova
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Nina Yancheva
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Mariyana Stoycheva
- Department of Infectious Diseases, Medical University, Plovdiv, Bulgaria
| | - Tsetsa Doychinova
- Department of Infectious Diseases, Medical University, Pleven, Bulgaria
| | - Lilia Pekova
- Clinic of Infectious Diseases, University Hospital, Stara Zagora, Bulgaria
| | - Marina Alexandrova
- National Reference Laboratory of Immunology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Andon Timchev
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Dimitar Strashimirov
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Maria Nikolova
- National Reference Laboratory of Immunology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Korsun N, Angelova S, Trifonova I, Georgieva I, Voleva S, Tzotcheva I, Mileva S, Ivanov I, Tcherveniakova T, Perenovska P. Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria. Braz J Microbiol 2018; 50:117-125. [PMID: 30637646 PMCID: PMC6863252 DOI: 10.1007/s42770-018-0033-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
Acute lower respiratory infections (ALRIs) are a leading cause of morbidity and hospital admissions in children. This study aimed to determine the viral etiology of these infections in children aged < 5 years during three successive epidemic seasons in Bulgaria. Nasopharyngeal and throat specimens were collected from children with bronchiolitis and pneumonia during the 2015/2016, 2016/2017, and 2017/2018 seasons. The viral etiology was determined by individual real-time PCR assays against 11 respiratory viruses. Of the 515 children examined, 402 (78.1%) were positive for at least one virus. Co-infections with two and three viruses were found in 64 (15.9%) of the infected children. Respiratory syncytial virus (RSV) was the predominant pathogen (37.5%), followed by rhinoviruses (13.8%), metapneumovirus (9.1%), adenoviruses (7%), bocaviruses (7%), influenza A(H1N1)pdm09 (4.9%), A(H3N2) (4.3%), type B (4.1%), and parainfluenza viruses 1/2/3 (2.9%). RSV-B were more prevalent than RSV-A during the three seasons. At least one respiratory virus was identified in 82.6% and 70.1% of the children with bronchiolitis and pneumonia, respectively. Respiratory viruses, especially RSV, are principal pathogens of ALRIs in children aged < 5 years. Diagnostic testing for respiratory viruses using molecular methods may lead to the reduced use of antibiotics and may assist in measures to control infection.
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Affiliation(s)
- Neli Korsun
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria.
| | - Svetla Angelova
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria
| | - Irina Georgieva
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria
| | - Silvia Voleva
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria
| | - Iren Tzotcheva
- Medical University, University Hospital Alexandrovska, Pediatric Clinic, 1 St. Georgi Sofiiski, 1431, Sofia, Bulgaria
| | - Sirma Mileva
- National Center of Infectious and Parasitic Diseases, National Laboratory "Influenza and ARD", 44A Stoletov Blvd, 1233, Sofia, Bulgaria
- Medical University, University Hospital Alexandrovska, Pediatric Clinic, 1 St. Georgi Sofiiski, 1431, Sofia, Bulgaria
| | - Ivan Ivanov
- Infectious Hospital Prof. Ivan Kirov, 17 Akademik Ivan E. Geshov, 1431, Sofia, Bulgaria
| | | | - Penka Perenovska
- Medical University, University Hospital Alexandrovska, Pediatric Clinic, 1 St. Georgi Sofiiski, 1431, Sofia, Bulgaria
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Valkov T, Hristova J, Tcherveniakova T, Svinarov D. Blood-Brain Barrier and Intrathecal Immune Response in patients with neuroinfections. Infez Med 2017; 25:320-325. [PMID: 29286010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cerebrospinal fluid/serum albumin ratio is one of the most informative parameters for blood-brain barrier (BBB) integrity in cases of central nervous system (CNS) infectious diseases. Normally, CNS albumin concentration is a function of diffusion processes along with CSF drainage and resorption. In pathological processes CSF albumin levels are dependent only on the rate of CSF drainage resulting in non-linear reciprocal changes of albumin quotient (Qalb). IgG, IgA and IgM concentrations both in CSF and serum can be compared to Qalb, thus determining the intrathecal immune response. The aim of the study was to detect BBB permeability impairment and the intrathecal immune response in patients with CNS infections with various etiologies. CSF/serum ratios were calculated and related to IgG IgA and IgM concentrations in CSF and blood serum. The results were integrated and presented by Reibergrams. The results demonstrated typical patterns which prove albumin to be the main modulator of protein dynamics and at the same time explicates the complex pathophysiological mechanisms involved in BBB disruption and intrathecal immune response in CNS infections. The diagnostic model presented in our study seeks to explain the observations of meningitis and meningoencephalitis pathophysiology and points out the mandatory cooperation between clinicians and laboratory for accurate diagnosis and proper treatment.
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Affiliation(s)
- Trifon Valkov
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases "Prof. Ivan Kirov", Sofia, Bulgaria; Dept. of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University, Sofia, Bulgaria
| | - Julieta Hristova
- Dept. of Clinical Laboratory and Clinical Immunology, Faculty of Medicine, Medical University, Sofia, Bulgaria; Clinical Laboratory and Clinical Pharmacology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Tatiana Tcherveniakova
- Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases "Prof. Ivan Kirov", Sofia, Bulgaria; Dept. of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University, Sofia, Bulgaria
| | - Dobrin Svinarov
- Dept. of Clinical Laboratory and Clinical Immunology, Faculty of Medicine, Medical University, Sofia, Bulgaria; Clinical Laboratory and Clinical Pharmacology, Alexandrovska University Hospital, Sofia, Bulgaria
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Yancheva N, Dimitrova V, Simov V, Elenkov I, Aleksiev I, Nikolova M, Tcherveniakova T. Clinical and laboratory features in newborn infants born to HIV-infected women. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)31157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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