Bacterial Complications Research Articles

Efficacy of methylprednisolone pulse therapy in patients with COVID-19

Objective. To assess efficacy and safety of methylprednisolone pulse therapy in patients with COVID-19. Materials and Methods. A retrospective analysis of 57 patients with moderate and severe novel coronavirus infection (COVID-19) receiving methylprednisolone pulse therapy (500 mg/day IV for 2–3 consecutive days) was performed. Pre- and post-therapy examination of the patients included clinical (severity and duration of fever, gas exchange parameters), imaging (computed tomography) and laboratory tests (including C-reactive protein, procalcitonin, D-dimer). Results. Methylprednisolone pulse therapy resulted in improved gas exchange (the mean duration of SpO2 recovery was 3.9 ± 0.25 days), body temperature normalization (the mean time to defervescence was 2.1 ± 0.2 days), significant decrease in inflammatory marker levels (CRP, D-dimer). No patients required an enhancement of respiratory support (transfer to ICU). Methylprednisolone pulse therapy was well-tolerated and did not cause bacterial complications. Conclusions. Methylprednisolone pulse therapy in patients with COVID-19 was shown to decrease activity of systemic inflammatory response, severity of coagulation disorders and contribute to recovery of gas exchange lung function. Given the high efficacy and low cost of methylprednisolone pulse therapy, it could be one of the promising approaches to the management of patients with moderate and severe COVID-19. Further studies are needed to determine prognostic criteria of progression and optimal time for initiation of corticosteroid therapy.

Применение природных средств в комплексной профилактике и лечении респираторных инфекций у детей

In pediatric practice, much attention is paid to natural components used for the prevention and treatment of respiratory infections. Nasal drops Tamba Tuya (Adonis LLC, Russia) contain extracts of peloid from lake Tambukan, thuja, essential oils of fir, lavender, vitamin E, dexpanthenol, dihydroquercetin, glycerol, olive oil, and peach oil. These components are effective for the prevention and treatment of rhinitis, adenoiditis, bacterial complications, as well as for prevention of adverse reactions from decongestants. We have developed a method of its application that has not only local, but also systemic effects in children. Step 1: nasal rinsing with saline solutions; step 2: instilling Tamba Tuya drops (1–2 drops in each nostril) three times a day; step 3: infriction of the drops into the skin on the temples for 2–3 minutes as aromatherapy, which ensures penetration of the drug components through the skin into the blood with a systemic effect. Minimum course duration: 2 weeks. The use of the drops from the first days of respiratory infections in 30 children aged 4 to 7 years in the experimental group (30 children were in the control group) ensured milder (76.3% compared to 60% in the control group) and shorter disease (by 2 days). The majority of participants (83.3%) from the experimental group demonstrated rapid resolution of rhinitis symptoms and lower need for decongestants. A total of 86.6% of children in the experimental group and 53.3% of controls showed an improvement in emotional and behavioral responses, including activity, adaptability, intensity, mood, and distraction. Key words: children, prevention, treatment, respiratory infections

Острые респираторные инфекции в амбулаторной практике в эпоху COVID-19: роль и место антибактериальной терапии

Acute respiratory infections of the upper and lower respiratory tract are currently the leading cause of human morbidity, mainly due to the seasonal rise of the incidence rates of viral infections. This results in the heavy burden of annual health care costs. The COVID-19 pandemic exacerbated the problem. The associations between respiratory viruses and bacteria are not always clear thus accounting for the diversity of the risks of the complicated course and fatal outcomes of various bacterial viral coinfections. Influenza virus is associated with the high rate of bacterial complications (in particular, during seasonal peaks). Meanwhile, this is less typical of the novel coronavirus infection. In addition, several studies demonstrate the competitive edge of SARS-CoV-2 when interacting with other respiratory viruses. The specificities of viral bacterial associations greatly affect the treatment whose inadequacy (in particular, the prescription of antibiotics) is the leading cause of the increasing antimicrobial resistance of contemporary germs. The novel coronavirus infection SARS-CoV-2 is no exception in terms of inappropriate antibiotic prescribing as occurred often in the seasonal rise of acute respiratory viral infections. The understanding of this issue, the optimization of treatment strategies, and a reduction in health care costs will allow for preserving antibiotics as a class of highly effective medications. KEYWORDS: acute respiratory infections, COVID-19, bacterial coinfection, outpatient care, lung damage, antimicrobial therapy. FOR CITATION: Khamitov R.F. Acute respiratory infections in outpatient care in the era of the COVID-19 pandemic: the role and position of antibacterial therapy. Russian Medical Inquiry. 2020;4(4):214–218. DOI: 10.32364/2587-6821-2020-4-4-214-218.

Инфекции дыхательных путей в педиатрической практике: сложные ответы на простые вопросы

Despite modern highly-effective treatment and preventive tools available to physicians, respiratory tract infections (RTIs) are still the most common reason for referral to pediatricians. A myriad of papers are published every year, however, there is a growing concern over this issue. This paper responds to seemingly simple questions that, however, are often challenging and controversial for physicians and pediatricians. These questions are the use of antibiotics for acute RTIs to prevent bacterial complications, the impact of antibiotic resistance of respiratory pathogens (Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae) on antibacterial treatment choice, current position of macro-lides in the treatment for RTIs and ENT infections, the prescription of aminopenicillins and inhibitor-protected aminopenicillins in specific clinical situations, dosage regimens of amoxicillin and amoxicillin/clavulanic acid in pediatrics, the position of peroral third-generation cephalosporins in the treatment for RTIs, and optimal antibacterial treatment duration in children. Pediatricians often face these issues in routine clinical practice.Keywords: pediatrics, respiratory tract infections, acute respiratory disorders, antibiotics, antibiotic resistance.For citation: Andreeva I.V., Stetsyuk O.U., Egorova O.A. Respiratory tract infections in pediatrics: difficult answers to simple questions. Russian Journal of Woman and Child Health. 2020;3(2):105–111. DOI: 10.32364/2618-8430-2020-3-2-105-111.

Комплексная терапия пациентов с респираторными инфекциями и заболеваниями дыхательных путей

The article provides an overview of the symposium on the complex therapy of patients with respiratory infections and diseases of the respiratory tract, held on October 29, 2020 with the support of Materia Medica Holding as part of the XXX National Congress on Respiratory Diseases, which was held from October 27 to 30 online with the support of the Russian Respiratory Society and the Ministry of Health of the Russian Federation. The aim of the symposium was to familiarize physicians, general practitioners, pulmonologists and infectious disease specialists with possible ways of managing patients with respiratory diseases caused by respiratory infections, as well as with the results of randomized clinical trials (RCTs) on the management of patients with chronic obstructive pulmonary disease (COPD). The co-chairs of the symposium and keynote speakers were three leading experts in this field – professors A. A. Zaitsev (Moscow), R. F. Khamitov (Kazan) and A. A. Wiesel (Kazan). At the symposium, the results of RCTs were presented, proving the effectiveness of antiviral and immune stimulating drug in influenza and other acute respiratory viral infections, regardless of the timing of the therapy started, its favorable safety profile, as well as the ability to reduce the need for antipyretic drugs and help prevent bacterial complications. Data from another RCT demonstrate the ability of antitussive drug to reduce cough and reduce its severity in COPD, reducing the impact of COPD on patients' lives.

Role and place of macrolides in complex therapy of patients with suppurative lesions of skin and its appendages

Objective — to improvе the effectiveness of therapy of patients with suppurative lesions of the skin and its appendages by including the antibacterial drug Doramycin (spiramycin) in the complex treatment of pyoderma.Materials and methods. 24 patients with pyoderma aged from 24 to 61 years were under observation. Among them there were 11 (45.8 %) women and 13 (54.2 %) men whose disease duration ranged from 2 months to 25 years. Treatment of patients with pyoderma involved the prescription of the antibacterial drug Doramycin, 2 pills 2 times a day together with the basic therapy.Results and discussion. Patients were diagnosed with various nosological forms of pyoderma: staphylococcal impetigo (common form), multiple folliculitis, vulgaris sycosis, furunculosis, hydradenitis, chronic ulcerative pyoderma. Patients with secondary bacterial complications of foot mycosis and infectious eczema were also included in the study.The dynamics of the regression of the objective and subjective manifestations of the disease were evaluated on the basis of elimination or reduction of the severity of erythema, pustulation, infiltration and area of the affected zone of the skin. The rate of disappearance or reduction of itching, pain, burning in the lesions were taken into account.The result of treatment in the form of clinical recovery was observed in 100 % of patients with superficial pyoderma. In patients with deep forms of pyoderma, the disease regressed slower, with most of them experiencing clinical recovery and significant improvement. Clinical improvement was diagnosed in 2 patients with severe recurrent pyoderma.No adverse reactions and complications during treatment were observed. No disease recurrences were fixed during the next 6 months.Conclusions. Complex therapy with the inclusion of the antibacterial drug Doramycin is effective and safe and may be recommended for the treatment of patients with deep and superficial (widespread) forms of pyoderma.

Gram-negative hospital pathogens at risk of severe bacterial infection

Background. Nosocomial infections remain an urgent problem of modern medicine. Along with bacterial infection of the bloodstream a special danger is posed by ventilation-dependent lung infection (VDLI), the main source which are still at the intensive care unit (ICU).Objectives. Assessment of the spread of bacterial infections in ICU over a five-year period. Analysis of the severity of postoperative complications depending on the infection location.Methods. A retrospective analysis of the frequency and form of blood flow and ventilation-dependent lung infection in patients, operated under cardiopulmonary bypass in the years 2013–2017.Results. The rate of blood contamination in the departments ranged from 8.0 to 9.8 %; against the ICU — from 17 to 24 % (p < 0,01). Gram-negative associated mortality was significantly higher than gram-positive (p < 0.001). Acinetobacter spp. and Klebsiella spp. are the most common agents. Analysis of the primary detection of the pathogen showed that in 73.6 % of cases, the trachea is the area of the initial localization of combined-form infection.Conclusions. The risk of bacterial complications in the early postoperative period is associated with gram-negative pathogen s (Acinetobacter spp. and Klebsiella spp.). Constant bacteriological monitoring in ICU is an effective prognostic tool of blood flow and ventilation-dependent lung infection.

Treatment of influenza and other acute respiratory viral infections in patients with diabetes mellitus

The study of the influenza and ARVI clinical performance, the development of patients with diabetes mellitus, evaluation of the effectiveness and safety application of antiviral therapy, carried out in the framework of routine clinical practice. 126 patients aged from 22 to 83 years (27.8% of men) with ARVI or influenza that occurred with medical care during the first 5 days of the disease (60.3% in the first 48 hours) are included. All patients suffer from diabetes, for the treatment of which oral hypoglycemic agents or insulins were constantly taken. The patients were divided into two groups: the first group received standard symptomatic treatment of ARVI; antiviral drug Kagocel. Diabetes and other acute respiratory viral infections. There is an increase in the incidence of bacterial complications - 2.2 times, an increase in the frequency of systemic antibiotics - 2.3 times. The purpose of the drug prescription led to a more rapid regression of all the symptoms of influenza and ARVI, but the most striking positive dynamics was observed in the symptoms of general weakness and headache. The prescription of Kagocel was accompanied by a 58% reduction in the number of bacterial complications and a 53% reduction in the use of antibiotics, which led to a reduction in the number of cases of the disease and an improvement in initial diseases, with an frequency increase in 1.8 times. The most significant effect achieved with early treatment and early initiation of antiviral therapy (in the first 48 hours of the disease).

Results of a multicentre double-blind placebo-controlled randomized trial of the liquid form of Anaferon for children in the treatment of acute upper respiratory tract infections

Acute respiratory infections (ARI) are major causes of morbidity in children. Symptomatic treatment is insufficiently effective and requires additional drugs with etiotropic action. This multi-center double blind placebo-controlled randomized clinical study with superiority model design considers a liquid formulation of Anaferon for children.Methods. The study included 142 children from 1 month to 3 years 11 month 29 days old with ARI of the upper respiratory tract. They were randomized into Anaferon for children and Placebo groups (71 in each group) via interactive voice randomization system. The treatment period was 5 days, observation period – 14 days. The average duration of the symptoms and the severity of the respiratory disease were used as primary efficacy endpoints.Results. All 142 patients were randomized and included into ITT (Intention to treat) analysis. 140 patients (70 patients in each group) were included into PP-analysis. The patients in the Anaferon for children group had better results with average duration of ARI as compared to the Placebo group (87.7±31.5h vs. 103.3±19.4h; p =0.007). The authors marked efficacy of Anaferon for children in such parameters as disease severity (ITT-analysis: p=0.0004), total severity of disease symptoms (ITT-analysis: ANOVA: “Group” factor p=0.0004; “Day” factor p<0.0001), and percentage of recovered patients (Log-rank test, p=0.035). There were no discrepancies between the groups in concomitant therapy (ITT-analysis: ANOVA “Group-Day” factor p=0.88), bacterial complications frequency (p=1.0), adverse effects (Fisher criteria: p=0.5321). The authors registered 14 cases of adverse events (10 cases in Anaferon group and 4 cases in Placebo group) in 11 patients. None of the adverse events had a certain or probable relation to the studied drug.Conclusion. Anaferon for children proved their efficiency and safety in young children with ARI.

New approaches to the prevention of recurrent respiratory diseases in preschool age

Objective. To evaluate the effectiveness of the natural terpenoids complex in preschool children with recurrent acute respiratory infections (ARI).Material and methods. There were examined 7129 children of 3-7 years old, they were divided into 3 groups. In main group (n = 2400) there was endonasally (on the mucous membrane of the nasal cavity with cotton buds) used a complex of natural terpenoids 2 times a day (morning and evening) 5 days a week for 1 - 3 months. Prevention and treatment of children from the comparison group (n = 2,379) was carried out with dioxotetrahydroxy tetrahydronaphthalene. The control group consisted of children (n = 2,350), who received no therapy. Upon completion of the course of therapy, children were examined in dynamics.Results. The authors noted positive clinical effect of the natural terpenoid complex, as evidenced by a 1.6 times decrease in acute respiratory infections during the year and the duration of the acute episode of the disease by 2.5 days, as well as a positive effect on the elimination of Epstein Barr virusin frequently ill children when using drug for 65.51 ± 2.98 days. The authors observed a favorable clinical effect against the decrease in neutrophils and eosinophils in the rhinocytogram, as well as mixed flora and cocci, indicating a decrease in mucosal neutrophilic inflammation and prevention of bacterial complications.

Treatment of ARVI and influenza in patients with arterial hypertension

to study the flow phenomena of influenza and ARVI in patients with arterial hypertension, as well as the effectiveness of antiviral therapy. Analyzed data was collected during the international multicenter prospective observational FLU-EE study "Treatment of ARVI and influenza in routine clinical practice". The study included 18946 patients with established diagnosis of influenza or ARVI of varying severity. 577 patients 51-70 years old who have a history of arterial hypertension (70% of women) were selected from this cohort. These patients regularly received angiotensin - converting enzyme inhibitors for treatment in monotherapy or in combination with other drugs, used to heal diseases of the cardiovascular system. Patients were divided into two groups depending on the therapy. The first group received symptomatic treatment of influenza and ARVI (comparison group, n=86); the second group received the antiviral drug Kagocel in the complex treatment (n=491). Persons with arterial hypertension and other diseases of the cardiovascular system are at risk for severe flu. The administration of the antiviral drug Kagocel as part of the complex therapy of influenza and ARVI makes it possible to speed up the regression of the intoxication syndrome, reduce the incidence of bacterial complications by 36% and the need for antibiotic therapy by 38%. Moreover, a positive effect was registered both with the early treatment of patients for medical help (by 45%) and with delayed treatment, on the 3rd day and later (by 35%). The use of the antiviral drug Kagocel as part of complex therapy for influenza and other acute respiratory viral infections has shown its effectiveness for different groups of patients, including hypertension, despite the fact that cardiovascular pathology, often combined with comorbid diseases, significantly worsens the course and outcome of ARVI.

Combined immunization with attenuated live influenza vaccine and chimeric pneumococcal recombinant protein improves the outcome of virus-bacterial infection in mice.

Influenza and its bacterial complications are a leading cause of morbidity and mortality worldwide. The effect of combined immunization with live influenza vaccine and recombinant chimeric pneumococcal protein in dual infection caused by influenza H1N1 and S. pneumoniae (serotype 3) has been studied. The combined vaccine consisted of the strain A/California/2009/38 (H1N1) pdm and chimeric recombinant protein PSPF composed of immunodominant fragments of the surface virulence factors of S. pneumoniae—PsaA, PspA, and Shr1875—associated with modified salmonella flagellin. Vaccinated mice were infected with the influenza virus 24 hours before or 24 hours after the onset of pneumococcal infection. The protective effect of combined vaccination was shown on both models of viral-bacterial infection.

SEVERE PERTUSSIS IN CHILDHOOD: UPDATE AND CONTROVERSY - SYSTEMATIC REVIEW.

ABSTRACTObjective: Through a systematic review, this essay aimed at revising the concepts of severe pertussis, updating the epidemiology, pathophysiology, clinical presentation, antibiotic therapy and auxiliary therapeutic options for symptomatology and complications.Data sources:This review considered publications from the last 30years in the databases US National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Cochrane, Google Scholar, as well as protocols of the Ministry of Health and recommendations of the Centers for Disease Control and Prevention, related to childhood pertussis (whooping cough), with emphasis on its severe form. This research was based on keywords derived from the terms “pertussis”, “azithromycin”, “antitussives”, “leukocyte reduction” in Portuguese and English. Duplicate studies and those with unavailable full-text were excluded.Data synthesis:Among 556 records found, 54 were selected for analysis. Pertussis, as a reemerging disease, has affected all age groups, evidencing the transient immunity conferred by infection and vaccination. Severe cases occur in neonates and infants, with secondary viral and bacterial complications and malignant pertussis, a longside hyperleukocytosis, respiratory failure and shock. Macrolides continue to be the chosen antibiotics, while antitussives for coughing remain without efficacy. The prompt treatment in Intensive Care Units improved the prognostic in severe cases, and transfusion was promising among procedures for leukoreduction. Conclusions: Approaching severe pertussis in childhood remains a challenge for diagnostic and therapy, as the available therapeutic options are still unsatisfactory. Strategies of prevention are expected to reduce the occurrence of severe cases, while new studies should confirm the role of auxiliary therapies.

Microbial Composition of the Human Nasopharynx Varies According to Influenza Virus Type and Vaccination Status

Factors that contribute to enhanced susceptibility to severe bacterial disease after influenza virus infection are not well defined but likely include the microbiome of the respiratory tract. Vaccination against influenza, while having variable effectiveness, could also play a role in microbial community stability. We collected nasopharyngeal samples from 215 individuals infected with influenza A/H3N2 or influenza B virus and profiled the microbiota by target sequencing of the 16S rRNA gene. We identified signature taxonomic groups by performing linear discriminant analysis and effective size comparisons (LEfSe) and defined bacterial community types using Dirichlet multinomial mixture (DMM) models. Influenza infection was shown to be significantly associated with microbial composition of the nasopharynx according to the virus type and the vaccination status of the patient. We identified four microbial community types across the combined cohort of influenza patients and healthy individuals with one community type most representative of the influenza virus-infected group. We also identified microbial taxa for which relative abundance was significantly higher in the unvaccinated elderly group; these taxa include species known to be associated with pneumonia.IMPORTANCE Our results suggest that there is a significant association between the composition of the microbiota in the nasopharynx and the influenza virus type causing the infection. We observe that vaccination status, especially in more senior individuals, also has an association with the microbial community profile. This indicates that vaccination against influenza, even when ineffective to prevent disease, could play a role in controlling secondary bacterial complications.

Substance Abuse–Related Soft Tissue Infections: A Uniquely Complicated Subset of a Common Problem

We hypothesize that soft tissue infections (SSIs) related to intravenous drug usage (IVDU) are associated with a more complicated and costly course than those not associated with IVDU. For the period 2005-2018, ICD 9/ICD 10 billing codes were used to identify patients admitted with SSIs and their causes/complications and associated costs. IVDU-related infections were then compared with non-IVDU-related infections. t test was used to compare treatment costs and length of stay. Logistic regression analysis was used to assess the likelihood/risk of specific events in the IVDU versus non-IVDU populations. Of 47,281 patients admitted with SSIs, 1323 were associated with IVDU. IVDU-related patients tended to be younger (36.2 vs 49.3 years, P = 0.001). Both cost and length of stay were significantly greater in the IVDU group ($30,471 vs $16,020, P = 0.001; 5.7days vs 3.7days, P = 0.001). In addition, IVDU admissions were more likely to be associated with chronic blood-borne infections (hepatitis B/C, HIV, P = 0.001) and a significantly greater incidence of secondary infectious complications, including endocarditis (P = 0.001), bacteremia (P = 0.001), and osteomyelitis (P = 0.003). SSI admissions related to IVDU are a unique subgroup of patients. These patients not only have longer and more costly lengths of stay but are also at higher risk for secondary complications such as chronic blood-borne viral illness and secondary bacterial infectious complications, such as bacteremia, endocarditis, and osteomyelitis. Further prospective study of these findings is warranted as we continue to battle the growing problem of IVDU in the United States.

Long-Term Maintenance of the Functional Changes Induced by Influenza A Virus and/or LPS in Human Endothelial ECV-304 Cell Sublines.

Influenza A virus and secondary bacterial infection may have remote effects in the form of cardiovascular complications or fibrosis in different organs. However, the mechanisms governing the development of complications remain poorly studied. The present work reports the comparative assessment of the functional changes which take place in human ECV-304 endothelial cell sublines obtained previously by the long-term culturing of cells after exposure to varying infectious doses (IDs) of influenza A virus, and/or bacterial lipopolysaccharide (LPS). It has been demonstrated that, in the course of long-term culturing (six passages) after exposure to pathogenic agents (influenza virus and/or LPS), endothelial cells maintain changes in their migratory activity, permeability, and expression of mRNA for cytokines TNFα and TGFβ (along with the changes in their proliferation activity, which has been demonstrated earlier). The pattern of changes depended on the type of the agent (agents) to which the cells were exposed. The differences in migratory activity (which was at its maximum 4 h after wounding) between the cell sublines at the sixth passage correlated with the differences in their proliferation activity at the first passage (proliferation data were obtained previously). In particular, an increase in migration and proliferation was observed in the sublines exposed to low virus doses (ECV-1ID), as well as exposed to LPS (ECV-LPS), while the suppression of migration and proliferation was observed in the subline exposed to high virus doses (ECV-1000ID). In the ECV-1ID, ECV-LPS, and most notably in ECV-1ID + LPS sublines, we detected an increase in the expression of mRNA for cytokines TNFα and TGFβ, which, however, didn’t lead to the induction of apoptosis. We have also demonstrated an increase in cell permeability in the analyzed sublines, which was indicated by a decrease in the expression of the mRNAs for the genes encoding occludin and ZO-1, the tight junctions proteins . This paper also reports an evaluation of the effects of the antiviral preparations rimantadine and alpisarin on the functional state of cell sublines. As a result, it has been demonstrated that these drugs may be able to prevent the development of the pathological changes caused by influenza A virus and/or LPS in endothelial cells. The results obtained in the present work may be of use when studying the mechanisms of development of the influenza A virus and secondary bacterial infection complications.

Protective effect of intranasal peste des petits ruminants virus and bacterin vaccinations: Clinical, hematological, serological, and serum oxidative stress changes in challenged goats.

Background and Aim:The current vaccination for peste des petits ruminants virus (PPRV) is stalled by myriad challenges and continuous endemicity of pneumonia due to fulminant bacterial complication in goats. The present study evaluated the protective effect of intranasal PPRV linage 1 and bacterine vaccinations.Materials and Methods:Twelve West African Dwarf (WAD) goats aged 6 months were randomly grouped and vaccinated within 2 weeks using a combination of PPRV lineage 1 vaccine (Nig/75), and bacterin from Mannheimia haemolytica (Mh) or Pasteurella multocida intranasally. The goats were observed for 3 weeks post-vaccination before comingled with a known infected WAD goat with apparent clinical signs of peste des petits ruminants and further observed clinically for 5 weeks post-infection (PI). Blood samples were taken for hematology while sera were assayed for antioxidants (glutathione peroxidase, glutathione transferase, and superoxide dismutase) activities and pro-oxidants (malondialdehyde content, reduced glutathione, hydrogen peroxide generation, and myeloperoxidase) using spectrophotometric methods. Data were subjected to parametric statistics at α=0.05 using GraphPad Prism version 21.Results:Clinically, there were pyrexia, oculonasal discharge, diarrhea, anemia, leukopenia, and increased pro-oxidants in the unvaccinated goats, while moderate neutrophilia and leukocytosis were observed in PPRV and bacterin vaccinated goats. Two unvaccinated goats were weak and euthanized at 13 and 28 days PI. The goats vaccinated with PPRV and Mh showed better response clinically and biochemically.Conclusion:The mucosal vaccination of goats with PPRV vaccine and bacterine will protect against exposure and culminate in the development of protective mucosal, humoral, and cell-mediated immune responses. This vaccination strategy will provide framework needed in the prevention and control of endemic caprine pneumonia in Nigeria.

Identification and treatment of bacterial meningitis complications in children

A variety of neurological complications might occur during the course of childhood bacterial meningitis (BM). The incidence rate of neurological sequelae in patients with neurological complications is as high as 30%-50%.Therefore, in order to reduce the mortality and morbidity of childhood BM, it is of great importance to identify the complications as early as possible, standardize the treatment and enhance the understating of prevention and follow-ups. Key words: Bacterial meningitis; Complication; Identification; Treatment

A formulation of neem and hypericum oily extract for the treatment of the wound myiasis by Wohlfahrtia magnifica in domestic animals.

Untreated, traumatic, or wound myiases can cause severe consequences to animal health and welfare as well as economic losses to livestock productions. For healing myiasis-caused wounds, disinfectant such as creolin is wrongly but currently used in association with insecticides. Though effective, creolin is highly toxic to the patients, is inadequate with respect to the repellent effect, and may delay the healing of treated wounds. In this uncontrolled study, the efficacy of the patented plant-derived formulation 1 Primary Wound Dressing© (1-PWD), composed of neem oil (Azadirachta indica A. Juss.) and the oily extract of Hypericum perforatum (L.) flowers, has been investigated. Forty-four domestic animals of different species suffering from wound myiasis lasting for up to 25days, at different parts of the body, were enrolled in the study. No systemic or local antibiotic or disinfectants' treatment was administered. Larvae recovered on open wounds and adults reared from mature larvae were identified as Wohlfahrtia magnifica. All the treated wounds healed in a range of 10 to 32days without further infestation. None of the recruited animals presented bacterial complications. Data herein presented indicate that the tested natural plant-derived formulation is able to manage the infestation caused by W. magnifica larvae and the healing process of traumatic infested wounds in several domestic animal species, without any side effect on the living tissue and without the need to use local or systemic chemical or other products.

A Trilogy of Influenza, Immunization, and Antimicrobial Resistance: A Review Article

: Influenza virus could lead in a mild acute respiratory illness or severe systemic and respiratory disease, therefore, during the activity of influenza considerable number of respiratory syndromes and complications can be related to this virus. On the other hand, risk for concomitant and post-influenza bacterial complications threat is not huge enough to consider to prescribe empiric antibiotics. Influenza vaccine prevents millions of illnesses and flu-related visits every year. Influenza immunization has clear effects on disease burden as well as the number of patients with resistant disease acquired and transmitted in communities. Vaccination program indirectly diminishes antibiotic use and reduces the exposure of bacteria to antibiotics and consequently selective pressure for resistance. It seems there is definite evidence to consider annual influenza immunization in antimicrobial stewardship program and promote the global and national health quality. Hereby, we review scientific evidence of direct and indirect effects of influenza as well as the influence of vaccination and prevention program health systems.