Incidence Of Respiratory Infections Research Articles

The Relationship between Parents’ Knowledge and Behaviors with The Acute Respiratory Infection Incidence of Children Under Five in Tangerang

The purpose of the study was to obtain the relationship between the parents’ knowledge and behaviours towards the ARI incidence in children under five years. This research used a descriptive quantitative methods The population was parents who have children under five years in one sub-district in Tangerang. 180 samples were taken using total sampling technique. The data collection was collected online with a valid and reliable questionnaire. Univariate test results showed 94 respondents (52.2%) had a high level of knowledge, and 131 respondents (72.8%) had good behaviours. There was a significant relationship between parent’s knowledge with ARI incidence (p=0.007). There was also a significant relationship between parents’ behavior with ARI incidence (p=0.038). Nurses must be actively providing health education related to ARI to parents and follow up regularly. Further research can develop regarding the factors that influence the knowledge and behavior of parents of ARI in children under five years

Passive tobacco smoke in children and young people during the COVID-19 pandemic

Second-hand smoke (SHS) exposure is harmful to children and young people. They inhale double the amount of dust compared with adults, thus inhaling more smoke containing dust particles. They also have faster respiratory rates and narrower airways, meaning their SHS exposure is higher. SHS causes an increased incidence of respiratory infection, cough, increased sputum load, preschool wheeze, and asthma, and is also associated with significantly decreased lung function. It worsens pre-existing chronic respiratory conditions, including being a trigger for asthma attacks and contributing to the pathogenesis of asthma and pre-school wheeze.

Respiratory Infections Following Earthquake-Induced Tsunamis: Transmission Risk Factors and Lessons Learned for Disaster Risk Management.

Earthquake-induced tsunamis have the potential to cause extensive damage to natural and built environments and are often associated with fatalities, injuries, and infectious disease outbreaks. This review aims to examine the occurrence of respiratory infections (RIs) and to elucidate the risk factors of RI transmission following tsunamis which were induced by earthquakes in the last 20 years. Forty-seven articles were included in this review and referred to the RIs emergence following the 2004 Sumatra-Andaman, the 2009 Samoa, and the 2011 Japan earthquakes. Polymicrobial RIs were commonly detected among near-drowned tsunami survivors. Influenza outbreaks were commonly detected during the influenza transmission period. Overcrowded conditions in evacuation centers contributed to increased acute RI incidence rate, measles transmission, and tuberculosis detection. Destruction of health care infrastructures, overcrowded evacuation shelters, exposure to high pathogen densities, aggravating weather conditions, regional disease endemicity, and low vaccination coverage were the major triggering factors of RI occurrence in post-tsunami disaster settings. Knowledge of risk factors underlying RIs emergence following earthquake-induced tsunami can contribute to the implementation of appropriate disaster prevention and preparedness plans characterized by sufficient environmental planning, resistant infrastructures, resilient health care facilities, and well-established evacuation centers. Global and local disease surveillance is a key prerequisite for early warning and protection against RIs’ emergence and transmission in tsunami-prone areas.

Targeting the biology of ageing with mTOR inhibitors to improve immune function in older adults: phase 2b and phase 3 randomised trials

BackgroundThe COVID-19 pandemic highlights the need for therapies that improve immune function in older adults, including interferon (IFN)-induced antiviral immunity that declines with age. In a previous phase 2a trial, RTB101 (previously known as BEZ235), an oral mechanistic target of rapamycin (mTOR) inhibitor, was observed to increase IFN-induced antiviral gene expression and decrease the incidence of respiratory tract infections (RTIs) in older adults. Therefore, we aimed to investigate whether oral RTB101 upregulated IFN-induced antiviral responses and decreased the incidence of viral RTIs when given once daily for 16 weeks during winter cold and flu season.MethodsWe did a phase 2b and a phase 3 double-blind, randomised, placebo-controlled trial in adults aged at least 65 years enrolled in New Zealand, Australia, and the USA at 54 sites. In the phase 2b trial, patients were aged 65–85 years, with asthma, type 2 diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure, were current smokers, or had an emergency room or hospitalisation for an RTI within the past 12 months. In the phase 3 trial, patients were aged at least 65 years, did not have COPD, and were not current smokers. In the phase 2b trial, patients were randomly assigned to using a validated automated randomisation system to oral RTB101 5 mg, RTB101 10 mg once daily, or placebo in part 1 and RTB101 10 mg once daily, RTB101 10 mg twice daily, RTB101 10 mg plus everolimus once daily, or matching placebo in part 2. In the phase 3 trial, patients were randomly assigned to RTB101 10mg once daily or matching placebo. The phase 2b primary outcome was the incidence of laboratory-confirmed RTIs during 16 weeks of winter cold and influenza season and the phase 3 primary outcome was the incidence of clinically symptomatic respiratory illness defined as symptoms consistent with an RTI, irrespective of whether an infection was laboratory-confirmed. Patients, investigators, and sponsor were masked to treatment assignments. All patients who received at least part of one dose of study drug were included in the primary and safety analyses. The phase 2b trial was registered with ANZCTR, ACTRN12617000468325, ClinicalTrials.gov, NCT03373903, and the phase 3 trial was registered with ANZCTR, ACTRN12619000628145.FindingsIn the phase 2b trial, we recruited 652 participants in total between May 16, 2017, and Jan 10, 2018, 179 participants to part 1 of the study (randomly assigned 1:1:1 to RTB101 5 mg once daily [61 participants], RTB101 10 mg once daily [58 participants], or matching placebo [60 participants]) and 473 patients to part 2 (randomly assigned 1:1:1:1 to RTB101 10 mg once daily [118 participants], RTB101 10 mg twice daily [120 participants], RTB101 10 mg in combination with everolimus 0·1 mg daily [115 participants] or matching placebo [120 participants]). In our first prespecified statistical analysis of the primary efficacy endpoint for part 2 of the phase 2b trial efficacy of RTB101 10 mg in combination with everolimus 0·1 mg once daily compared with placebo did not meet statistical significance but, in our second prespecified analysis, which included data from part 1 and part 2, we found a statistically significant reduction in the proportion of patients who had one or more laboratory-confirmed RTIs in the RTB101 10 mg once daily treatment group (34 [19%] of 176) compared with the pooled placebo group (50 [28%] of 180; odds ratio [OR] 0·601 [90% CI 0·391–0·922]; p=0·02). In the phase 3 trial, we enrolled 1024 patients between May 7, 2018, and July 19, 2019. 513 (50·1%) participants were randomly assigned to RTB101 10 mg once daily and 510 (49·9%) to placebo. In the full analysis set of the phase 3 trial, RTB101 did not reduce the proportion of patients with clinically symptomatic respiratory illness (134 [26%] of 511 patients in the RTB101 treatment group vs 125 [25%] 510 patients in the placebo treatment group; OR 1·07 [90% CI 0·80–1·42]; p=0·65). In both trials, significantly more IFN-induced antiviral genes were upregulated in patients treated with RTB101 as compared with placebo. The study drug was found to be safe and well-tolerated across trials and treatment groups. Only one patient in the placebo group in the phase 3 trial had serious adverse events (nausea, fatigue, hyponatraemia, and arthralgia) which were considered related to study drug treatment. Three patients died in the phase 2b trial and one in the phase 3 trial but no deaths were considered related to study treatment.InterpretationThe combined results indicate that low doses of the mTOR inhibitor RTB101 are well tolerated and upregulate IFN-induced antiviral responses in older adults. Further refinement of clinical trial endpoints and patient populations might be required to identify whether upregulation of IFN responses by mTOR inhibitors consistently decreases the incidence or severity of viral infections in older adults.FundingresTORbio and the National Institute on Aging.

Should homes and workplaces purchase portable air filters to reduce the transmission of SARS-CoV-2 and other respiratory infections? A systematic review.

Respiratory infections, including SARS-CoV-2, are spread via inhalation or ingestion of airborne pathogens. Airborne transmission is difficult to control, particularly indoors. Manufacturers of high efficiency particulate air (HEPA) filters claim they remove almost all small particles including airborne bacteria and viruses. This study investigates whether modern portable, commercially available air filters reduce the incidence of respiratory infections and/or remove bacteria and viruses from indoor air. We systematically searched Medline, Embase and Cochrane for studies published between January 2000 and September 2020. Studies were eligible for inclusion if they included a portable, commercially available air filter in any indoor setting including care homes, schools or healthcare settings, investigating either associations with incidence of respiratory infections or removal and/or capture of aerosolised bacteria and viruses from the air within the filters. Dual data screening and extraction with narrative synthesis. No studies were found investigating the effects of air filters on the incidence of respiratory infections. Two studies investigated bacterial capture within filters and bacterial load in indoor air. One reported higher numbers of viable bacteria in the HEPA filter than in floor dust samples. The other reported HEPA filtration combined with ultraviolet light reduced bacterial load in the air by 41% (sampling time not reported). Neither paper investigated effects on viruses. There is an important absence of evidence regarding the effectiveness of a potentially cost-efficient intervention for indoor transmission of respiratory infections, including SARS-CoV-2. Two studies provide 'proof of principle' that air filters can capture airborne bacteria in an indoor setting. Randomised controlled trials are urgently needed to investigate effects of portable HEPA filters on incidence of respiratory infections.

Modulation of gut microbiota protects against viral respiratory tract infections: a systematic review of animal and clinical studies.

BackgroundEarlier studies suggest that probiotics have protective effects in the prevention of respiratory tract infections (RTIs). Whether such benefits apply to RTIs of viral origin and mechanisms supporting the effect remain unclear.AimTo determine the role of gut microbiota modulation on clinical and laboratory outcomes of viral RTIs.MethodsWe conducted a systematic review of articles published in Embase and MEDLINE through 20 April 2020 to identify studies reporting the effect of gut microbiota modulation on viral RTIs in clinical studies and animal models. The incidence of viral RTIs, clinical manifestations, viral load and immunological outcomes was evaluated.ResultsWe included 58 studies (9 randomized controlled trials; 49 animal studies). Six of eight clinical trials consisting of 726 patients showed that probiotics administration was associated with a reduced risk of viral RTIs. Most commonly used probiotics were Lactobacillus followed by Bifidobacterium and Lactococcus. In animal models, treatment with probiotics before viral challenge had beneficial effects against influenza virus infection by improving infection-induced survival (20/22 studies), mitigating symptoms (21/21 studies) and decreasing viral load (23/25 studies). Probiotics and commensal gut microbiota exerted their beneficial effects through strengthening host immunity.ConclusionModulation of gut microbiota represents a promising approach against viral RTIs via host innate and adaptive immunity regulation. Further research should focus on next generation probiotics specific to viral types in prevention and treatment of emerging viral RTIs.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00394-021-02519-x.

Effect of preoperative pneumococcal immunization on the incidence of respiratory infection in the postoperative period of cardiac surgery

Objective: To analyze whether the incidence of respiratory infections in the postoperative period of cardiac surgery is lower in patients immunized with the 13-valent pneumococcal conjugate vaccine. To study the main risk factors related to the development of infections in patients undergoing cardiac surgery. Methodology: 40 patients were included in the study, randomized 1: 1 to receive pneumococcal vaccine or placebo, 14 days before undergoing elective cardiac surgery. The incidence of infections in the 30 postoperative days was compared between groups. Results: There were 6 respiratory infections in the vaccine group and 2 in the placebo group (p=0.2024) and one death in the placebo group and none in the vaccine group (p=0.3173). Chronic obstructive pulmonary disease (p=0.003), diabetes mellitus (p=0.047) and peripheral arterial disease (p=0.0001) were listed as risk factors for the development of infections, which generated an increase in hospital stay (95% CI : 1.33- 7.13; p =0.0147) and ICU stay in the postoperative period (95% CI: 1.87- 33.45; p=0.0025). Conclusion: The application of pneumococcal vaccine 13v did not influence the development of postoperative pulmonary infections. Chronic obstructive pulmonary disease, diabetes mellitus and peripheral arterial disease were identified as risk factors for the development of infections, increasing the length of total hospital stay and time in the ICU.

Cumulative Effects of Particulate Matter Pollution and Meteorological Variables on the Risk of Influenza-Like Illness.

The cold season is usually accompanied by an increased incidence of respiratory infections and increased air pollution from combustion sources. As we are facing growing numbers of COVID-19 cases caused by the novel SARS-CoV-2 coronavirus, an understanding of the impact of air pollutants and meteorological variables on the incidence of respiratory infections is crucial. The incidence of influenza-like illness (ILI) can be used as a close proxy for the circulation of influenza viruses. Recently, SARS-CoV-2 has also been detected in patients with ILI. Using distributed lag nonlinear models, we analyzed the association between ILI, meteorological variables and particulate matter concentration in Bialystok, Poland, from 2013–2019. We found an exponential relationship between cumulative PM2.5 pollution and the incidence of ILI, which remained significant after adjusting for air temperatures and a long-term trend. Pollution had the greatest effect during the same week, but the risk of ILI was increased for the four following weeks. The risk of ILI was also increased by low air temperatures, low absolute humidity, and high wind speed. Altogether, our results show that all measures implemented to decrease PM2.5 concentrations would be beneficial to reduce the transmission of SARS-CoV-2 and other respiratory infections.

Seasonality of mortality and in-hospital complications in hip fracture surgery: Retrospective cohort research using a nationwide inpatient database.

Among older patients undergoing hip fracture surgery, previous studies have shown a seasonal variation of in-hospital surgical complications. However, little is known about seasonal effects on mortality and systemic complications after hip fracture surgery. In the present study, we evaluated whether mortality and in-hospital systemic complications are influenced by seasonal differences. We enrolled patients from a nationwide database who underwent hip fracture surgery between 2010 and 2018. The primary outcome was in-hospital mortality. The secondary outcomes were in-hospital systemic complications. The association between the seasonality and in-hospital outcomes was investigated using multivariable Cox, logistic regression and causal mediation analysis. With 425 856 patients (mean age 83.5 years; 79% women), overall in-hospital mortality was 5324 (1.2%). Fall and winter were associated with a higher mortality than spring (hazard ratio [HR] 1.16; P < 0.001; HR 1.14; P = 0.001, respectively). Across all the seasons, there were 36 834 overall systemic complications (8.6%), with respiratory infection being the most frequent (18 637 [4.4%]). Among these complications, only respiratory infection showed seasonal variation, with a higher prevalence in fall and winter. The mediated effect of respiratory infection on mortality was significantly higher in fall and winter compared with spring (fall, HR 1.06, proportion mediated 36.7%; winter, HR 1.14, proportion mediated 55.0%; all P < 0.001). We found a significantly higher mortality in fall and winter after hip fracture surgery. Specifically, in winter, the increased in-hospital death was largely attributed to the increased incidence of respiratory infection. Geriatr Gerontol Int 2021; 21: 398-403.

The role of multistraine probiotics in non-specific seasonal prevention of acute respiratory infections in children with recurrent URTI in organized teams

Introduction. A broad evidence base of numerous randomized clinical trials and meta-analyses asserts the role of intestinal microbiota dysbiosis in the development of various diseases, including those of infectious origin, in infancy and later stages of life.Purpose. Assessment of the efficacy of a multi-strain immuno-probiotic during rehabilitation of frequently ill children visiting organized groups during the period of epidemiological distress for acute respiratory diseases.Materials and methods.93 children older than 3 years of age were enrolled in an open comparative prospective clinical observation during the high-risk respiratory infection period – November, December. Children were observed for 1.5 months during administration of the multi-strain probiotic and 1 month after discontinuation of the probiotic. The subjects were randomized into two groups: the treatment group (60 children) received the multi-strain probiotic in the maximum age-specific dosage variances (children aged 3 to 12 years old – 1 capsule, older than 12 years of age – 2 capsules) once a day in the morning for 14 days and the comparison group (33 children) did not receive the multi-probiotic for the same period.Results and discussion. It was found that the incidence of disease in children receiving the multi-probiotic (the treatment group – 60 children) was statistically lower, and the disease severity was milder than in the group of children, who did not receive the probiotic (the comparison group – 33 children). Not a single child who received the multi-probiotic in the course of disease did not require antibiotic therapy during the entire observation period. Moreover, the incidence of respiratory infections in the treatment group within a month after discontinuation of the probiotic was 4.6 times lower than in the comparison group. No side effects were reported.Conclusions. The study results allowed the author to recommend the use of a multi-strain immuno-probiotic as a nonspecific immunomodulatory supplement for the seasonal prevention of acute respiratory infections, especially in frequently ill children at a high risk of infections.

Risk Factors of Acute Respiratory Infections Incidence in Toddlers of the Working Area of Puskesmas Inerie Ngada District

&#x0D; &#x0D; &#x0D; The main contributor to the decline in life expectancy in low-income countries is acute respiratory tract infections (ARIs/ISPA). Risk factors of ISPA events consist of intrinsic and extrinsic factors. This research purposed to analyze the risk factors of ISPA incidence in the working area of Puskesmas Inerie. This research was descriptive-analytical research with a cross-sectional design. Data collection employed interviews with 88 mothers who have toddlers, obtained by simple random sampling technique. Data analysis used a chi-square test. The data analysis results showed that the four research variables, namely nutritional status, occupancy, ventilation, and smoking behavior, related to ISPA incidence with p-value=0.000, 0.000, 0.001, and 0.01 consecutively. Poor home conditions lead to an increased risk of ISPA disease in toddlers. Therefore, the local community should improve the physical condition of the house and the nutritional status of toddlers in the working area of Puskesmas Inerie.&#x0D; &#x0D; &#x0D;

The Multifaceted Benefits of Exercise in Prevention of COVID-19

The Multifaceted Benefits of Exercise in Prevention of COVID-19

Take-home kits to detect respiratory viruses among healthcare personnel: Lessons learned from a cluster randomized clinical trial

BackgroundHealth care personnel (HCP) working in outpatient settings routinely interact with patients with acute respiratory illnesses. Absenteeism following symptom development and lack of staff trained to obtain samples limit efforts to identify pathogens among infected HCP. MethodsThe Respiratory Protection Effectiveness Clinical Trial assessed respiratory infection incidence among HCP between 2011 and 2015. Research assistants obtained anterior nasal and oropharyngeal swabs from HCP in the workplace following development of respiratory illness symptoms and randomly while asymptomatic. Participants received take-home kits to self-collect swabs when absent from work. Samples mailed to a central laboratory were tested for respiratory viruses by reverse transcription polymerase chain reaction. ResultsAmong 2,862 participants, 3,467 swabs were obtained from symptomatic participants. Among symptomatic HCP, respiratory virus was detected in 904 of 3,467 (26.1%) samples. Self-collected samples by symptomatic HCP at home had higher rates of viral detection (40.3%) compared to 24% obtained by trained research assistants in the workplace (P < .001). ConclusionsIn this randomized clinical trial, take-home kits were an easily implemented, effective method to self-collect samples by HCP. Other studies have previously shown relative equivalence of self-collected samples to those obtained by trained healthcare workers. Take-home kit self-collection could diminish workforce exposures and decrease the demand for personnel protective equipment worn to protect workers who collect respiratory samples.

The Influence of B Cell Depletion Therapy on Naturally Acquired Immunity to Streptococcus pneumoniae.

The anti-CD20 antibody Rituximab to deplete CD20+ B cells is an effective treatment for rheumatoid arthritis and B cell malignancies, but is associated with an increased incidence of respiratory infections. Using mouse models we have investigated the consequences of B cell depletion on natural and acquired humoral immunity to Streptococcus pneumoniae. B cell depletion of naïve C57Bl/6 mice reduced natural IgM recognition of S. pneumoniae, but did not increase susceptibility to S. pneumoniae pneumonia. ELISA and flow cytometry assays demonstrated significantly reduced IgG and IgM recognition of S. pneumoniae in sera from mice treated with B cell depletion prior to S. pneumoniae nasopharyngeal colonization compared to untreated mice. Colonization induced antibody responses to protein rather than capsular antigen, and when measured using a protein array B cell depletion prior to colonization reduced serum levels of IgG to several protein antigens. However, B cell depleted S. pneumoniae colonized mice were still partially protected against both lung infection and septicemia when challenged with S. pneumoniae after reconstitution of their B cells. These data indicate that although B cell depletion markedly impairs antibody recognition of S. pneumoniae in colonized mice, some protective immunity is maintained, perhaps mediated by cellular immunity.

Determinants of Acute Respiratory Infections Incidence in Children Under Five in the Working Area of the Siak Hulu II Community Health Center in Kampar Regency

BACKGROUND: The incidence of acute respiratory infections (ARIs) is high among under-five children, especially in developing countries. ARIs are a leading cause of morbidity and mortality in under-five children worldwide. ARIs in children take a heavy toll on life. ARI disease ranks first in the spread of illness in the Siak Hulu II Public Health.&#x0D; AIM: This study aims to determine the incidence of non-pneumonia ARI in children under five in the working area of the UPTD Siak Hulu II.&#x0D; METHODS: This research uses quantitative methods with a cross-sectional approach. The sample in this study was 74 children under five aged 12–59 months using the consecutive sampling technique. Data analysis used Chi-square, univariate and bivariate statistical tests.&#x0D; RESULTS: The results showed that there was a relationship between birth weight p = 0.017 and OR = 4.844, cigarette smoke exposure p = 0.012, indiscriminate snacking p = 0.013, maternal knowledge p = 0.016, and exclusive breastfeeding p = 0.038, with the incidence of non-pneumonia ARI in toddlers aged 12–59 months in the working area of the Siak Hulu II Health Center, Siak Hulu District, Kampar Regency. Respondents who have low birth weight have a 4.8 times greater risk of suffering from ARI.&#x0D; CONCLUSION: There is a relationship between birth weight, exposure to cigarette smoke, casual snacks, knowledge of mothers, and exclusive breastfeeding with the incidence of ARI in children under five in the work area of the UPTD Siak Hulu II Community Health Center, Siak Hulu District, Kampar Regency.

Little evidence for facemask use in children against COVID‐19

In a Perspective paper in Acta Paediatrica, Xu argues that the pressure on paediatric respiratory departments in Chinese hospitals decreased in early 2020 because children were wearing face masks during the COVID-19 pandemic.1 He concluded that doctors and parents should ask children to wear masks whenever there was a high incidence of respiratory infections, including COVID-19. I feel I should challenge those statements. Most countries seem to have noted reductions in the number children visiting hospitals during the start of the global phase of the pandemic in spring 2020. Decreases have been noted in paediatric emergency departments,2 paediatric asthma wards3 and, in particular, for cases of influenza A.4 But these decreases took place during the early stages of the pandemic, when few countries recommended that children used face masks. From personal experience, fewer children visited emergency departments in Sweden, despite the fact that nobody outside health care was advised to wear face masks.5 The decrease also outside China does not support the suggestion that using face masks explained the reduction in child hospital visits for reasons unrelated to COVID-19 during spring 2020. Although I acknowledge the abundance of studies that suggest that face mask have a protective effect, the evidence may not be as rock-solid as suggested by some face mask supporters. One of the most cited papers so far is the Chu et al systematic review and meta-analysis in The Lancet.6 But this study has some important limitations. Most of the face masks studies that were included looked at other respiratory pathogens, rather than COVID-19. The studies did not include children and very few of the studies were undertaken outside hospital settings. In addition, using face masks in the community and using them in hospitals are very different. It is also worth noting that the supplementary material provided by Chu et al6 also indicated the presence of publication bias, since studies that showed a protective effect of face masks were more likely to be published than negative studies. Asking children to wear face masks may have potential advantages and disadvantages. The potential advantages are clearly a decreased risk of COVID-19 in the child, as well as decreased transmission of the disease. However, it is important to take into account that children rarely become very sick from COVID-19,7 and while so-called multi-inflammatory syndrome8 and potentially also ‘long covid’ occur in children,9 these complications seem rare. Face masks also have potential disadvantages, such as hindering verbal and non-verbal communication. There is a risk that children will keep touching their masks and actually increase the viral load on their hands. Using face masks also risks replacing social distancing, as some parents may be tempted to send their children to school or daycare wearing a mask if they have minor symptoms rather than keeping them at home. Finally, the commercially made masks that are currently available, especially the N95 masks that are said to offer greater protection, rarely fit children. Hence the use of such masks might lead to a false sense of safety, despite leaking viruses due to their poor fit. However, the most important drawback of face masks in children may well be that their use could reduce the focus from other measures that may be more important, such as hand washing, social distancing and staying at home when they are sick. A PubMed search carried out on 10 November 2020, which focused on face masks, COVID-19 and the virus that causes it, identified no paper that offered any guidance on face mask use in children. That said, an absence of evidence is not the same as a lack of effect. If future research suggests that children using face masks decreases COVID-19 morbidity, face masks should be considered in children. But for now, I do not feel we can recommend that children wear face masks, especially since most of the children with COVID-19 get few symptoms7 and do not seem to drive the mortality of the pandemic.10 None.

Prognostic value of early leukocyte fluctuations for recovery from traumatic spinal cord injury.

BackgroundAcute traumatic spinal cord injury (SCI) induces a systemic immune response involving circulating white blood cells (WBCs). How this response is influenced by overall trauma severity, the neurological level of injury and/or correlates with patient outcomes is poorly understood. The objective of this study was to identify relationships between early changes in circulating WBCs, injury characteristics and long‐term patient outcomes in individuals with traumatic SCI.MethodsWe retrospectively analysed data from 161 SCI patients admitted to Brisbane's Princess Alexandra Hospital (exploration cohort). Logistic regression models in conjunction with receiver operating characteristic (ROC) analyses were used to assess the strength of specific links between the WBC response, respiratory infection incidence and neurological outcomes (American Spinal Injury Association Impairment Scale (AIS) grade conversion). An independent validation cohort from the Trauma Hospital Berlin, Germany (n = 49) was then probed to assess the robustness of effects and disentangle centre effects.ResultsWe find that the extent of acute neutrophilia in human SCI patients is positively correlated with New Injury Severity Scores but inversely with the neurological outcome (AIS grade). Multivariate analysis demonstrated that acute SCI‐induced neutrophilia is an independent predictor of AIS grade conversion failure, with an odds ratio (OR) of 4.16 and ROC area under curve (AUC) of 0.82 (P < 0.0001). SCI‐induced lymphopenia was separately identified as an independent predictor of better recovery (OR = 24.15; ROC AUC = 0.85, P < 0.0001). Acute neutrophilia and increased neutrophil‐lymphocyte ratios were otherwise significantly associated with respiratory infection presentation in both patient cohorts.ConclusionsOur findings demonstrate the prognostic value of modelling early circulating neutrophil and lymphocyte counts with patient characteristics for predicting the longer term recovery after SCI.

Genomic, Biochemical and Microbial Evaluation of Probiotic Potentials of Bacterial Isolates from Fermented Sorghum Products

The objective of this study was to investigate the probiotic potentials of Lactic-acid bacteria (LAB) isolates from indigenous fermented sorghum products (Ogi-baba and Pito). The LAB isolates were screened for potential probiotic properties by antagonistic activity against eight enteropathogenic clinical bacteria isolates (Escherichia coli, Klebsiella sp., Helicobacter pylori, Bacillus sp., Staphylococcus sp., Salmonella sp., Pseudomonas sp. and Listeria monocytogenes) as indicator organisms using the agar well diffusion technique. The organisms were also screened for acidity, bile tolerance, antibiotic susceptibility, production of lactic acid, diacetyl and hydrogen peroxide. β-galactosidase assay was also done. Genomic DNA was extracted from the two selected LAB isolates; the 16S rRNA were amplified and sequenced. The sequence data were subjected to Basic Local Alignment Search Tool (BLAST) and molecular phylogenetic analyses to identify the isolates which were strains of Lactobacillus plantarum and Pediococcus pentosaceus. The sequence data for these two isolates were submitted to the Genbank with accession numbers KP883298 and KP883297 respectively. P. pentosaceus inhibited growth of indicator bacteria (E. coli and L. monocytogenes) on bacteriocin screening medium whereas L. plantarum strain showed no activity. However, the P. pentosaceus strain (PB2) strain exhibited β-galactosidase activity as well as L. plantrum strain (OB6). The study revealed exceptional probiotic potentials of two LAB namely Lactobacillus plantarum strain (OB6) and Pediococcus pentosaceus strain (PB2) isolated from fermented sorghum products, Ogi-baba and Pito respectively. Hence, these strains may be potentially used as probiotic to prevent some enteropathogen-induced gastrointestinal disorders; reduce respiratory tract infections incidence and for lactose intolerance management.

An analysis of the clinical picture of respiratory tract infections in primary care patients

Aim: The aim of this study was to analyse the clinical picture of respiratory tract infections among adult patients visiting their general practitioners. Materials and methods: The analysis included 301 adult patients who reported to their general practitioners due to respiratory tract infection. W assessed clinical symptoms, age, final diagnosis, probable aetiology, additional tests, including Actim® Influenza A&amp;B rapid test to confirm influenza infection, radiographic and laboratory findings, as well as comorbidities, treatment used, vaccinations against influenza, and smoking habits. Results: Upper respiratory tract infections accounted for the vast majority of cases (74%), and these primarily included viral infections (62%), some of which required a change of therapy (23%) due to suspected secondary bacterial infection; lower respiratory tract infections accounted for 26% of cases. The main symptoms reported by the patients included cough, pharyngeal pain, fever, rhinitis, general malaise, nasal obstruction, headache, muscle pain and dysphonia. Acute pharyngitis was the dominant diagnosis (27%), followed by acute upper respiratory tract infection of multiple sites (13.6%), acute nasopharyngitis (known as common cold) (10%), purulent tonsillitis (11.6%), acute bronchitis (11%) and influenza (11%). Antibiotic therapy was used in 60% of patients with upper respiratory tract infection and 68% of patients with lower respiratory tract infection. Conclusions: The majority of patients were diagnosed with viral infections. The highest incidence of respiratory tract infections was observed in elderly individuals and patients with chronic cardiovascular diseases, lung diseases, diabetes mellitus and cancer. Smokers are more likely to develop lower respiratory tract infections (confirmed by additional tests) compared to other groups of patients. Individuals vaccinated against influenza account for a small proportion of patients.

АКТУАЛЬНЫЕ ВОПРОСЫ ИНФЕКЦИОННОЙ РЕСПИРАТОРНОЙ ПАТОЛОГИИ У ДЕТЕЙ

Acute respiratory infections (ARI) are still topical, holding the first place in the structure of infectious pediatric pathology. The most common causative agents of ARI are viruses. Currently, about 200 respiratory viruses are known, among which the most significant are influenza and parainfluenza viruses, rhinoviruses, respiratory syncytial virus, adenoviruses. Relatively recently, previously unknown serotypes of coronaviruses (SARS-CoV, MERS-CoV, NL63 and HKU), bocaviruses and metapneumovirus were described, and at the end of 2019 a new coronavirus SARS-CoV-2 was discovered, which causes COVID-19 infection. Pneumotropic bacteria Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, etc. contributed to the incidence of respiratory infections. Pertussis remains a serious infection for young children, which in recent years, despite the typical clinical picture, presents certain difficulties for diagnosis. The ability of ARI to provoke the development of secondary bacterial complications (bronchitis, bronchiolitis and pneumonia) often dictates the unjustified prescription of antibiotic therapy, which has led in recent years to an increase in antibiotic resistance. Thus, the relevance of ARI at the present stage is not in doubt, and the above problems dictate the need for an individual approach to each patient.