Infectious Morbidity Research Articles

Morbidity and Mortality of HIV-Exposed Uninfected Infants in a Tertiary Referral Facility in Yaoundé, Cameroon.

Following the recorded progress in the prevention of mother-to-child transmission of HIV in Yaoundé, Cameroon, the proportion of HIV-exposed infants who are uninfected (UIH) is increasing. These children are subject to infectious and non-infectious fragility. The purpose of this study was to assess infectious morbidity and mortality rates among UIH in Yaoundé, Cameroon. We conducted a retrospective cohort study. Infants were included in the study and defined as the study subjects if they were between the ages of 24 months or younger, if they were born to HIV-positive mothers, and if they were confirmed to be HIV-negative. The main study outcomes were morbidity rate (defined as infectious, clinical events that required consultation or hospitalization) and death. Data were entered and saved in the Census and Survey Processing System (Cspro) 7.3. Statistical analyses were performed in R Software 3.6.2. The significance level was set at 0.05. In total, 240 subjects were recruited of whom 53.3% were males. Most of the HIV-positive mothers (95.7%) had used combination antiretroviral (ARV) therapy for at least four weeks during pregnancy. Among the subjects, 93.2% received ARV prophylaxis, 68.7% were exclusively breastfed for six months, 94.7% were fully vaccinated, and 60.6% had received cotrimoxazole up to the detection of the non-infection. Overall, the morbidity rate stood at 34.2%. The incidence of morbidity was 3 per 1,000 child months of the follow-up. The main pathologies were acute respiratory infections (60.79%) and malaria (17.65%). Three deaths were recorded, representing an overall mortality rate of 1.25% for an incidence of 1.1 per 1,000 child months of the follow-up (FU). Clinical events were more frequent in mothers diagnosed with HIV during pregnancy under the azidothymidine (AZT) + lamivudine (3TC) + névirapine (NVP) -based protocol (odds ratio of 3.83 [1.09-14.45; p = 0.039]). Morbidity was also higher for the follow-up periods of less than six months. The overall mortality rate among UIH was low. However, the morbidity rate was considerably higher. Emphasis should be focused on in-care retention for up to 24 months for all UIH, which should include monitoring of HIV-infected mothers prior to pregnancy.

Medical Device-Associated Healthcare Infections: Sterilization and the Potential of Novel Biological Approaches to Ensure Patient Safety.

Healthcare-associated infections caused by multi-drug-resistant pathogens are increasing globally, and current antimicrobial options have limited efficacy against these robust species. The WHO details the critically important bacterial and fungal species that are often associated with medical device HAIs. The effective sterilization of medical devices plays a key role in preventing infectious disease morbidity and mortality. A lack of adherence to protocol and limitations associated with each sterilization modality, however, allows for the incidence of disease. Furthermore, issues relating to carcinogenic emissions from ethylene oxide gas (EtO) have motivated the EPA to propose limiting EtO use or seeking alternative sterilization methods for medical devices. The Food and Drug Administration supports the sterilization of healthcare products using low-temperature VH2O2 as an alternative to EtO. With advances in biomaterial and medical devices and the increasing use of combination products, current sterilization modalities are becoming limited. Novel approaches to disinfection and sterilization of medical devices, biomaterials, and therapeutics are warranted to safeguard public health. Bacteriophages, endolysins, and antimicrobial peptides are considered promising options for the prophylactic and meta-phylactic control of infectious diseases. This timely review discusses the application of these biologics as antimicrobial agents against critically important WHO pathogens, including ESKAPE bacterial species.

Respiratory syncytial virus disease morbidity in Australian infants aged 0 to 6 months: a systematic review with narrative synthesis

BackgroundA significant proportion of the global respiratory syncytial virus (RSV) associated morbidity is accounted for by infants aged 0 to 6 months, who are particularly vulnerable to severe disease. In 2015, 44% of global hospitalisations in infants in this age group were secondary to RSV. The objective of this systematic review is to appraise and synthesise the local evidence of RSV infection morbidity among Australian infants aged 0 to 6 months and to assess the implications for future immunisation strategies.MethodsElectronic databases (Medline, Embase, Pubmed and Global Health) were searched for full-text articles published between 2000 and 2023 in English language. Studies that examined markers of RSV disease morbidity in infants aged 0 to 6 months in Australia who had laboratory confirmed RSV infection were eligible for inclusion. The outcomes of interest were incidence, prevalence, testing rate, positivity rate, mortality, emergency department visits, community health visits, hospitalisation, intensive care unit admission, supplementary oxygen use, mechanical ventilation, risk factors for disease severity and monoclonal antibody use.ResultsThe database search identified 469 studies. After removal of duplicates and full-text review, 17 articles were eligible for inclusion. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis without meta-analysis guidelines.ConclusionsQualitative analysis of the included studies showed that Australian infants aged 0 to 6 months have higher rates of RSV testing, positivity and incidence; and more likely to develop severe disease that requires hospitalisation, intensive care unit admission or respiratory support, compared to children and adults of all ages. Aboriginal and Torres Strait Islander infants aged 0 to 6 months demonstrated higher rates of RSV infection and hospitalisation, compared to non-Indigenous infants. Age-related trends persisted in geographic areas with varying seasonal transmission of RSV, and during the SARS-CoV-2 pandemic. Passive immunisation strategies targeting infants in their first 6 months of life, either via vaccination of pregnant women or administration of long-acting monoclonal antibody during infancy, could effectively reduce RSV disease burden in Australia.

Perinatal outcomes and long-term infectious morbidity of offspring born to mothers with familial Mediterranean fever.

To investigate perinatal outcomes and long-term infectious morbidity in children of mothers with familial Mediterranean fever (FMF). A population-based cohort study comparing perinatal outcomes and long-term infectious morbidity of offspring of mothers with and without FMF was conducted. All singleton deliveries between the years 1991-2021 in a tertiary medical center were included. The study groups were followed until 18years of age for long-term infectious morbidity. A Kaplan-Meier survival curve was used to compare the cumulative incidence of long-term infectious morbidity, and generalized estimation equation (GEE) models as well as Cox proportional hazards models were constructed to control for confounders. During the study period, 356,356 deliveries met the inclusion criteria. 411 of them were women with FMF. The mean follow-up period interval was 9.7years (SD = 6.2) in both study groups. Using GEE models, preterm delivery, cesarean delivery, and low birth weight were independently associated with maternal FMF. The total infectious-related hospitalization rate was significantly higher in offspring born to mothers with FMF compared to the comparison group (Kaplan-Meier survival curve, log-rank p < 0.001). Using a Cox proportional hazards model, controlling for gestational age, maternal age, diabetes mellitus, cesarean delivery, and hypertensive disorders, being born to a mother with FMF was found to be an independent risk factor for long-term infection-related hospitalization of the offspring. Maternal FMF was found to be independently associated with long-term infection-related hospitalization of the offspring. This positive correlation may reflect an intra-uterine pro-inflammatory environment which may result in the offspring's long-term susceptibility to infection.

Peningkatan Pengetahuan Masyarakat Melalui Edukasi Dalam Pencegahan ISPA Di Desa Cinta Rakyat Kecamatan Percut Sei Tuan

&lt;table width="598" border="1" cellspacing="0" cellpadding="0"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td valign="top" width="371"&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Abstract &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p align="center"&gt; &lt;/p&gt;&lt;p&gt;&lt;em&gt;Acute respiratory infections are a major cause of infectious disease morbidity and mortality worldwide. According to the World Health Organization, about 4 million people died from acute respiratory infections, 98% of which were caused by lower respiratory tract infections. Infant, child and elderly mortality rates are very high, especially in low- and middle-income countries. efforts to control ARI through health promotion education activities or counseling. Education is carried out with the aim of increasing knowledge and even the community is expected to be able to improve health status. The method in this service activity uses educational methods or counseling based on lecture discussions about ARI. The targets in this activity are mothers who have babies and children. Health problem factors, namely the habit of burning garbage can cause air pollution that comes from burning smoke in the environment and smoking habits.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;

Medical and sociological analysis of health indicators of medical workers

The health of the population is an important indicator of the high level of state development. Morbidity with temporary disability affects the working potential of the pop ulation and the economy as a whole. The purpose of the research is to study and analyze occupational morbidity among medical workers in order to further optimize the conditions and nature of work. The morbidity of the working-age population is characterized by a high number of cases and duration in days of diseases of the respiratory system, the circulatory system, and the musculoskeletal system. Thus, according to the age and gender criterion, the incidence of the diseases of the circulatory system, blood and hematopoietic organs, respiratory organs, skin, and subcutaneous adipose tissue tends to increase among the young population under 40 years of age, while infectious and parasitic morbidity, diseases of blood and hematopoi etic organs, and the incidence of the circulatory system diseases rise among the population over 40 years of age. The results of sociological monitoring showed that in about 70 % of cases, doctors noted a deterioration in their health status, but issued temporary disability leaves only in 30 % of cases. Nursing personnel also issued sick leaves only in 50 % of cas es, while they felt a deterioration in their health status in 50 % of cases. It is also worth noting that, while on sick leave, medical personnel go to work in almost 40 % of cases; the reason for this was the production necessity or the lack of labor force. The re spondents indicated respiratory diseases, infectious and parasitic diseases, and diseases of the musculoskeletal system as the leading cause of temporary disability.

Effects of Zinc Supplementation on Metabolomic Profiles in Tanzanian Infants: A Randomized Trial

BackgroundProvision of zinc supplementation to young children has been associated with reduced infectious morbidity and better growth outcomes. However, the metabolic pathways underlying these outcomes are unclear, and metabolomic data from humans undergoing zinc supplementation, particularly infants, are generally lacking. ObjectivesThis study aimed to examine the effect of zinc supplementation on metabolic profiles in Tanzanian infants aged 6 wk and 6 mo. MethodsBlood samples were collected at age 6 wk and 6 mo from 50 Tanzanian infants who were enrolled in a randomized placebo-controlled trial of zinc supplementation (5 mg oral daily). Metabolomic analysis using an ultrahigh-performance liquid chromatography/tandem mass spectroscopy platform was performed to identify potential metabolomic profiles and biomarkers associated with zinc supplementation. Principal component analysis (PCA) was used to summarize metabolomic data from all samples. Two-way repeated measures analysis of variance with compound symmetry covariance structures were used to compare metabolome levels over time between infants in the 2 treatment arms. ResultsIn PCA, the samples tended to be more separated by child age (6 wk compared with 6 mo) than by zinc supplementation status. We found that zinc supplementation affected a variety of metabolites associated with amino acid, lipid, nucleotide, and xenobiotic metabolism, including indoleacetate in the tryptophan metabolism pathway; 3-methoxytrosine and 4-hydrxoyphenylphruvate in the tyrosine pathway; eicosanedioate, 2-aminooctanoate, and N-acetyl-2-aminooctanoate in the fatty acid pathway; and N6-succinyladenosine in the purine metabolism pathway. Compared to the relatively small number of metabolites associated with zinc supplements, many infant metabolites changed significantly from age 6 wk to 6 mo. ConclusionsZinc supplementation, despite having overall clinical benefits, appears to induce limited metabolomic changes in blood metabolites in young infants. Future larger studies may be warranted to further examine metabolic pathways associated with zinc supplementation.The parent trial was registered at clinicaltrials.gov as NCT00421668.

Possibilities of a biobank for serological monitoring of infectious morbidity

Currently, monitoring infectious morbidity, control and forecasting the epidemic process is a topical health problem.Aim. To analyze the capabilities of the biobank for serological monitoring of infectious diseases using the Epstein- Barr virus (EBV), which is associated with infectious mononucleosis, as well as somatic pathology, including cancer.Material and methods. Using the quantitative enzyme- linked immunosorbent assay for specific antibodies to various EBV proteins, we studied blood serum samples from healthy individuals (2010, 2016, 2019, 2020, 2021 and 2022) from the collection of the N. F. Gamaleya National Center of Epidemiology and Microbiology.Results. For the first time, the intensity of EBV epidemic process among apparently healthy adult residents of the capital was assessed using samples of biological material and a biobank information database. At the time of examination, 0,8% of individuals were not infected with EBV, and 9,4% suffered reactivation of a chronic infection. There were no significant changes in detection rate of markers over the years.Conclusion. Certified collections of blood sera can be effectively used to study population immunity, the prevalence of individual infections, population protection nationwide, etc.

Predicting peripartum infection in laboring patients at high risk in Cameroon, Africa

ObjectiveTo develop a predictive model for peripartum infection among high risk laboring patients in Cameroon, Africa. Study designWe conducted a secondary analysis of the Cameroon Antibiotic Prophylaxis Trial (NCT 3248297), a multicenter 3-arm double-blind randomized controlled trial of oral azithromycin ± amoxicillin among term pregnancies with prolonged labor or rupture of membranes in Cameroon 1/2018–5/2020. Patients with chorioamnionitis prior to randomization, study drug contraindications, or planned cesarean were excluded. The outcome of interest was a composite of maternal peripartum infection (chorioamnionitis, endometritis, sepsis by World Health Organization criteria, wound infection/abscess) diagnosed up to 6 weeks postpartum. Potential predictors were compared between patients with and without the composite outcome, and evaluated at a 0.05 alpha level. Statistically significant exposures were analyzed using multivariable regression (to generate adjusted odds ratios and 95 % confidence intervals) with backwards selection to generate a parsimonious model. Receiver operating characteristic curves with associated area under the curve assessed the model’s predictive ability. A nomogram based on the final best fit multivariable model was constructed. ResultsOf 756 patients in the parent trial, 652 were analyzed: 45 (7 %) had peripartum infection. Those with infection were more likely to be nulliparous, lower education level, higher gestational age, receive antibiotics per hospital protocols, and undergo cesarean. In our best-fit multivariable model, none/primary education (vs university), cesarean birth, and antibiotic receipt per physician discretion (vs for cesarean prophylaxis) were significantly associated with increased infection risk. This model was moderately predictive (AUC = 0.75, 95 % CI 0.67–0.82). When using this 3 factor model, for a patient with a cesarean birth, receipt of antibiotics per physician discretion, and university education, the probability of peripartum infection was 35 % (95 % CI 0.11–0.73). ConclusionsWhile several variables such as parity are associated with infectious morbidity within 6 weeks among high risk laboring patients in Cameroon, only education level, antibiotic indication, and cesarean birth were independently associated, and a model including these 3 factors was moderately predictive. Validation of our findings in a larger population is warranted.

Attenuated inflammatory response in infant mice with Staphylococcus epidermidis CNS catheter infection

Children under one year of age are consistently found to be at the highest risk for shunt infection as a complication of hydrocephalus treatment, and repeated infections in the same patient are common. The mechanisms responsible for the increase in infant infection are not known. Our laboratory adapted our existing mouse model of Staphylococcus epidermidis central nervous system (CNS) catheter infection to characterize infection in infant mice as a foundation of on-going studies to determine the mechanisms of increased morbidity in infant shunt infections. The well-established model of S. epidermidis biofilm infection in the CNS was adapted to generate infection in 14-day old C57BL/6 mice. The catheter preparation was identical to the adult model, in which silicone catheters are pre-coated with a clinically derived biofilm-forming strain of S. epidermidis strain 1457) to introduce S. epidermidis into the brain. The catheters are stereotactically implanted into the lateral left ventricle. Bacterial titers as well as cytokine and chemokine levels were measured at days 1, 3, and 5 in mice implanted with sterile and S. epidermidis-coated catheters. Cultures demonstrated both catheter-associated and parenchymal infection through day 5 post-implantation. In contrast to prior adult models of CNS catheter infection, however, the catheter-associated bacterial burdens were less than or equal to parenchymal bacterial burdens. There was no significant difference between the chemokine and cytokine levels in the brain tissues of pups with sterile versus S. epidermidis infected catheters for any of the analytes tested. The infant model of S. epidermidis CNS catheter infection is characterized by both a greater degree of parenchymal spread of bacteria and the absence of the elevated pro-inflammatory cytokines previously observed in adult mice with this infection. The attenuated inflammatory response may contribute to the increased infection risk observed in this population.

Vaccination for Respiratory Syncytial Virus: A Narrative Review and Primer for Clinicians.

Respiratory syncytial virus (RSV) poses a significant burden on public health, causing lower respiratory tract infections in infants, young children, older adults, and immunocompromised individuals. Recent development and licensure of effective RSV vaccines provide a promising approach to lessening the associated morbidity and mortality of severe infections. This narrative review aims to empower clinicians with the necessary knowledge to make informed decisions regarding RSV vaccination, focusing on the prevention and control of RSV infections, especially among vulnerable populations. The paper explores the available RSV vaccines and existing evidence regarding their efficacy and safety in diverse populations. Synthesizing this information for clinicians can help the latter understand the benefits and considerations associated with RSV vaccination, contributing to improved patient care and public health outcomes.

Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status

ObjectivesAntimicrobial resistance (AMR), a growing global menace, poses a significant threat to maternal and fetal health. Gestational diabetes mellitus (GDM) causes double trouble in pregnancy, increasing the risk of a variety of infectious morbidities while also raising the possible association with AMR. Asymptomatic bacteriuria (ASB) is a common problem in pregnancy, but little research has been done to date explicitly examining the relationship between GDM and ASB and yielded conflicting results. Even fewer studies have specifically examined the relationship between GDM and AMR in women with ASB. Retrieving the most recent information on the disease burden, the range of causative pathogens, their patterns of AMR, and associated risk factors in pregnant women is crucial to stop the exponential rise in AMR in pregnancy and improve maternal and neonatal outcomes of infectious morbidities. Hence, this study was planned to investigate the association between glycemic status and the contemporary bacterial profile, antimicrobial resistance(AMR), and associated variables among pregnant women with ASB Study designThis prospective, hospital-based, cross-sectional study was conducted among 320 pregnant women; divided into two groups, GDM and non-GDM. Data regarding sociodemographic and clinical characteristics were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of significant bacterial uropathogens and their AMR pattern was determined using recommended culture methods. ResultsWe found ASB in 46.25% of study participants with significantly higher occurrence in the GDM group. Dominant isolates were Escherichia coli followed by Klebsiella pneumoniae. AMR was noted in 51.35% and multidrug resistance(MDR) in 23.65% of isolates. Overall AMR, MDR and higher degrees of AMR were higher among uropathogens isolated from the GDM group as compared to the non GDM group, although the difference was not statistically significant. ConclusionThe high occurrence of ASB in pregnancy along with substantially high AMR in this study suggests the need for effective infection control and stewardship programmes. By defining the association of ASB and AMR with hyperglycemia, our study calls for the exploitation of this potential association in halting the pandemic of AMR and in improving the management of infectious morbidities, thus in-turn alleviating their undesired maternal and infant outcomes.

STAT3 Deficiency Alters the Macrophage Activation Pattern and Enhances Matrix Metalloproteinase 9 Expression during Staphylococcal Pneumonia.

Staphylococcus aureus is a significant cause of morbidity and mortality in pulmonary infections. Patients with autosomal-dominant hyper-IgE syndrome due to STAT3 deficiency are particularly susceptible to acquiring staphylococcal pneumonia associated with lung tissue destruction. Because macrophages are involved in both pathogen defense and inflammation, we investigated the impact of murine myeloid STAT3 deficiency on the macrophage phenotype invitro and on pathogen clearance and inflammation during murine staphylococcal pneumonia. Murine bone marrow-derived macrophages (BMDM) from STAT3 LysMCre+ knockout or Cre- wild-type littermate controls were challenged with S. aureus, LPS, IL-4, or vehicle control invitro. Pro- and anti-inflammatory responses as well as polarization and activation markers were analyzed. Mice were infected intratracheally with S. aureus, bronchoalveolar lavage and lungs were harvested, and immunohistofluorescence was performed on lung sections. S. aureus infection of STAT3-deficient BMDM led to an increased proinflammatory cytokine release and to enhanced upregulation of costimulatory MHC class II and CD86. Murine myeloid STAT3 deficiency did not affect pathogen clearance invitro or invivo. Matrix metalloproteinase 9 was upregulated in Staphylococcus-treated STAT3-deficient BMDM and in lung tissues of STAT3 knockout mice infected with S. aureus. Moreover, the expression of miR-155 was increased. The enhanced inflammatory responses and upregulation of matrix metalloproteinase 9 and miR-155 expression in murine STAT3-deficient as compared with wild-type macrophages during S. aureus infections may contribute to tissue damage as observed in STAT3-deficient patients during staphylococcal pneumonia.

Preoperative vaginal wash with povidone iodine solution to reduce post caesarean infectious morbidity

Post-operative infection is frequently seen in Caesarean section. Vaginal wash with 10% povidone iodine &amp; Antibiotic prophylaxis may have significant impact in reduction of infections and thus the need to study their roles in sepsis prevention systematically.

Prevalence of Tuberculosis in HIV- or Tuberculosis-exposed neonates at the University Teaching Hospital in Lusaka over a period of six months

Background: Tuberculosis (TB) is the leading cause of mortality globally and represents a major health problem. The burden of TB in Zambia is among the highest in the African region with a national prevalence estimated at 455/100 000 for all age groups. A large proportion of people with TB are in the reproductive age group as such may either be pregnant or have young children. As at 2014 the prevalence of TB among women attending antenatal care in Zambia was estimated to be 1.5% in HIV infected women and 1.4% in uninfected women. There is a close association between maternal TB and HIV infection and postpartum infant morbidity and mortality. TB in neonates is very rare but a tenfold increase in the risk of acquiring TB in infants born to HIV infected mothers has been documented. Methods: A cross sectional study was conducted to establish the prevalence of tuberculosis in neonates exposed to either HIV or TB, or to both TB and HIV. The study included neonates aged 28 days and below that were admitted to the intensive care unit (NICU) and nurseries on general pediatric wards at the University teaching hospital. Mothers to neonates that had a positive rapid HIV test were approached, made aware of the study and invited to participate by giving consent to have their baby included in the study. When consent was granted, basic demographic details and medical information were collected. One gastric lavage sample was collected before the first feed of the day and analysed using Xpert MTB- RIF test. Results: One hundred forty-nine consecutive neonates that met the inclusion criteria were enrolled in the study. The average age of the neonates was nine days, 49 % had mean birth weight of 2.50kg (0.85 SD), 86 full term delivery and 73 (49%) were male. One hundred, ten (110) were born to multiparous (74%) vs 38 primiparous (26%) mothers. All the neonates enrolled in the study were HIV exposed and only one neonate was exposed to both TB and HIV. Mycobacterium tuberculosis was detected in 2 out 149 samples analysed using the Xpert MTB-RIF test. None were positive for rifampicin resistance Conclusion: The prevalence of TB using Xpert MTB-RIF test performed on gastric aspirates of HIV exposed neonates admitted to the University teaching hospital is 1.3 %.

Prevalence and morbidity of urogenital schistosomiasis among pre-school age children in Cubal, Angola.

Schistosomiasis is one of the most important neglected tropical diseases, with a great impact on public health and more than 200,000 deaths annually. Schistosoma haematobium causes urinary tract (UT) morbidity. Since schistosomiasis morbidity control programs focus on children older than 5 years, pre-school age children (PSAC) morbidity is not well known. We conducted a cross-sectional study in Cubal (Angola) among 245 PSAC with the objective of evaluating the prevalence of S. haematobium infection, the intensity of infection, and associated morbidity. For this purpose, urine filtration test followed by microscopic visualization and ultrasound examinations were performed. The estimated overall prevalence of urogenital schistosomiasis was 30.2% (CI 95%; 24.5-35.9), with 20.3% (CI 95%; 15.3-25.3) of the samples analysed showing a high intensity of infection. A total of 54.5% (CI 95%; 47.6-61.8) of infected children presented UT lesions, showing a significant association between schistosomiasis infection and UT morbidity (p-value < 0.001). Bladder wall thickening was the most common lesion, being present in 100% of abnormal ultrasounds. We found that anaemia and severe malnutrition were not significantly associated with the development of UT lesions. S. haematobium infection in PSAC causes great UT detectable morbidities. Therefore, there is an evident need of including them in mass drug administration (MDA) campaigns and consequently the development of an adapted praziquantel treatment dosage for children under 2 years of age.

Development and validation of a multiplex real-time PCR assay for detection and quantification of Streptococcus pneumoniae in pediatric respiratory samples

ABSTRACT Streptococcus pneumoniae ( Spn ) is a bacterial pathogen that causes a range of disease manifestations in children, from acute otitis media to pneumonia, septicemia, and meningitis. Primary Spn laboratory diagnostic identification methods include culture, antigen testing, single-plex real-time PCR, and syndromic PCR panels. However, each method lacks sensitivity, specificity, and/or cost efficiency. We developed and validated a quantitative, multiplex PCR assay using three Spn genomic targets ( lytA, piaB , and SP2020) for improved sensitivity and specificity to detect Spn in pleural fluid (PF), bronchoalveolar lavage (BAL), tracheal aspirate (TA), and upper respiratory (UR, research only) samples. Validation testing included analytical sensitivity (limit of detection), specimen storage, analytical specificity (cross-reactivity), and accuracy studies. Limit of detection is 500 genome copies/mL in lower respiratory samples and 100 copies/mL in upper respiratory specimens, with a quantification range of 1,000 to 10,000,000 copies/mL. Specimens can be stored frozen at least 60 days and Spn DNA is stable through three freeze-thaw cycles. No cross-reactivity was observed against 20 closely related microorganisms and/or microorganisms that can be detected in similar sample types, including Streptococcus pseudopneumoniae . In testing of residual clinical specimens, Spn was detected in 5 of 23 (21.7%) PF, 2 of 19 (10.5%) BAL, 1 of 20 (5.0%) TA, and 44 of 178 (24.7%) UR residual specimens. For accuracy studies, 98 specimens were tested and overall percent agreement with a qualitative, lytA -based comparator assay was 96.9% across all sample types. This multiplex, quantitative PCR assay is a sensitive and specific method for Spn detection in pediatric respiratory samples. IMPORTANCE Streptococcus pneumoniae ( Spn ) is the world’s leading cause of lower respiratory tract infection morbidity and mortality in children. However, current clinical microbiological methods have disadvantages. Spn can be difficult to grow in laboratory conditions if a patient is pre-treated, and Spn antigen testing has unclear clinical utility in children. Syndromic panel testing is less cost-effective than targeted PCR if clinical suspicion is high for a single pathogen. Also, such testing entails a full, expensive validation for each panel target if used for multiple respiratory sources. Therefore, better diagnostic modalities are needed. Our study validates a multiplex PCR assay with three genomic targets for semi-quantitative and quantitative Spn molecular detection from lower respiratory sources for clinical testing and from upper respiratory sources for research investigation.

Prevention of the Seasonal Spread of Arvi Among Early Children

Acute respiratory viral infections (ARVI) are widespread infectious diseases, cause significant economic damage and therefore are not only a serious medical, but also the most important socio-economic problem for humanity. This group of diseases accounts for up to 90% of all infectious morbidity. Mostly children and people over 60 years of age fall ill - the so-called risk groups for the incidence of ARVI. Every adult suffers from influenza or other acute respiratory viral infections on average 2-4 times a year, a schoolchild - 4-5 times, a preschool child - 6 times, a child of the first year of life has from 2 to 12 episodes of acute respiratory viral infections. The polyetiology of ARVI pathogens and the variability of viruses involved in the epidemic process, complications after an illness, necessitate the search for new diagnostic methods and optimization of treatment and preventive measures. Modern approaches to the treatment of influenza and acute respiratory viral infections of other etiologies are reduced to the use of complex drugs that combine antiviral, immunomodulatory, symptomatic and pathogenetic effects.

Severe acute malnutrition promotes bacterial binding over proinflammatory cytokine secretion by circulating innate immune cells.

Children with severe acute malnutrition (SAM) have high infectious mortality and morbidity, implicating defects in their immune defenses. We hypothesized that circulating innate immune cells from children (0 to 59 months) hospitalized with SAM in Zambia and Zimbabwe (n = 141) have distinct capacity to respond to bacteria relative to adequately nourished healthy controls (n = 92). SAM inpatients had higher neutrophil and monocyte Escherichia coli binding capacity but lower monocyte activation and proinflammatory mediator secretion in response to lipopolysaccharide or heat-killed Salmonella typhimurium than controls. Among SAM cases, wasting severity was negatively associated with cytokine secretion, children with HIV had lower monocyte activation, and the youngest children released the least myeloperoxidase upon stimulation. Inpatient bacterial binding capacity and monocyte activation were associated with higher odds of persistent SAM at discharge, a risk factor for subsequent mortality. Thus, SAM shifts innate immune cell function, favoring bacterial containment over proinflammatory activation, which may contribute to health deficits after discharge.

Epidemical process and aetiological structure of salmonelloses in the Zaporizhzhia region

The aim of the work is to conduct a comparative analysis of the salmonellosis epidemic process caused by non-typhoidal salmonellae in the Zaporizhzhia region for improving the system of epidemiological surveillance. Materials and methods. The retrospective epidemiological analysis of salmonellosis incidence in the Zaporizhzhia region was conducted using the annual reports from 2018 to 2022. The data sources included the “Report on Individual Infections and Parasitic Diseases” and “Infectious Morbidity of the Population in Ukraine”. The analysis employed standard statistical methods commonly used in medical research to evaluate the gathered results. Results. The findings suggest that the Zaporizhzhia region recorded a total of 1392 cases of salmonellosis between 2018 and 2022. Notably, the incidence rates for 2020 and 2021 significantly exceeded the national averages in Ukraine, while in 2022, there was a notable decrease of almost 2 times in the region’s salmonellosis incidence rates. Although adults accounted for the majority of cases (53.4 %), the prevalence of salmonellosis among children was alarmingly high. Among the pathogens causing salmonellosis, Enteritidis, Blegdam, and Typhimurium serovars were the most dominant. Notably, the region harbors salmonella strains that exhibit resistance to cephalosporins, ampicillin, and fluoroquinolones, reflecting concerns over antibiotic resistance patterns. Conclusions. The elevated prevalence of salmonellosis infection rates within the population of the Zaporizhzhia region underscores the pressing nature of the epidemic disease control challenge, particularly considering the heightened vulnerability of children. An additional threat to the epidemic’s well-being is the circulation of antibiotic-resistant salmonella.