Symptoms Of Respiratory Infection Research Articles

Kidney Outcomes and Trajectories of Tubular Injury and Function in Critically Ill Patients With and Without COVID-19.

COVID-19 may injure the kidney tubules via activation of inflammatory host responses and/or direct viral infiltration. Most studies of kidney injury in COVID-19 lacked contemporaneous controls or measured kidney biomarkers at a single time point. To better understand mechanisms of acute kidney injury in COVID-19, we compared kidney outcomes and trajectories of tubular injury, viability, and function in prospectively enrolled critically ill adults with and without COVID-19. The COVID-19 Host Response and Outcomes study prospectively enrolled patients admitted to ICUs in Washington State with symptoms of lower respiratory tract infection, determining COVID-19 status by nucleic acid amplification on arrival. We evaluated major adverse kidney events (MAKE) defined as a doubling of serum creatinine, kidney replacement therapy, or death, in 330 patients after inverse probability weighting. In the 181 patients with available biosamples, we determined trajectories of urine kidney injury molecule-1 (KIM-1) and epithelial growth factor (EGF), and urine:plasma ratios of endogenous markers of tubular secretory clearance. At ICU admission, the mean age was 55 ± 16 years; 45% required mechanical ventilation; and the mean serum creatinine concentration was 1.1 mg/dL. COVID-19 was associated with a 70% greater occurrence of MAKE (relative risk 1.70; 95% CI, 1.05-2.74) and a 741% greater occurrence of KRT (relative risk 7.41; 95% CI, 1.69-32.41). The biomarker cohort had a median of three follow-up measurements. Urine EGF, secretory clearance ratios, and estimated glomerular filtration rate (eGFR) increased over time in the COVID-19 negative group but remained unchanged in the COVID-19 positive group. In contrast, urine KIM-1 concentrations did not significantly change over the course of the study in either group. Among critically ill adults, COVID-19 is associated with a more protracted course of proximal tubular dysfunction and reduced eGFR despite similar degrees of kidney injury.

Identification, Genetic Characterization, and Pathogenicity of Three Feline Herpesvirus Type 1 Isolates from Domestic Cats in China.

(1) Background: Feline herpesvirus (FHV-1) is a significant pathogen in cats, causing respiratory and ocular diseases with consequential economic and welfare implications. (2) Methods: This study aimed to isolate and characterize FHV-1 from clinical samples and assess its pathogenicity. We collected 35 nasal and ocular swabs from cats showing symptoms of upper respiratory tract infection and FHV positivity detected by polymerase chain reaction (PCR). Viral isolation was carried out using feline kidney (F81) cell lines. Confirmation of FHV-1 presence was achieved through PCR detection, sequencing, electron microscopy, and indirect immunofluorescence assay. The isolated strains were further characterized by evaluating their titers, growth kinetics, and genetic characteristics. Additionally, we assessed the pathogenicity of the isolated strains in a feline model, monitoring clinical signs, viral shedding, and histopathological changes. (3) Results: Three strains of FHV-1 were isolated, purified, and identified. The isolated FHV-1 strains exhibited high homology among themselves and with domestic isolates and FHV-1 viruses from around the world. However, they showed varying degrees of virulence, with one strain (FHV-A1) causing severe clinical signs and histopathological lesions. (4) Conclusion: This study advances our understanding of the genetic and pathogenic characteristics of FHV-1 in China. These findings underscore FHV-A1 isolate as a potentially ideal candidate for establishing a challenge model and as a potential vaccine strain for vaccine development.

Effects of daily consumption of Chinese chicken soup on energy and macronutrients intake

Through various media, people have become increasingly aware of the importance of maintaining a healthy diet, with Cantonese soup, especially chicken soup, emerging as a popular choice due to its comforting and potentially medicinal properties. Chicken soup is valued not only for its rich protein and essential vitamins but also for its hydration benefits and the possibility of easing symptoms of respiratory infections through its anti-inflammatory effects. Despite its recognized health benefits, the specific impact of daily consumption of Cantonese chicken soup on energy levels and nutrient intake remains understudied, prompting further research into its effects on high school students' dietary health. In this three-week randomized controlled trial, sixteen participants including 6 girls and 10 boys from the same high school (mean age 16 years) were included in the analysis. Dietary information, energy levels, and nutrient intakes were gathered using two ASA 24 questionnaires, with the calculations performed by ASA24. Independent samples t-tests and chi square tests were used to compare continuous and categorical variables between the intervention group and the control group, respectively. Paired t-tests were performed to compare pre- and post-ASA24 responses in total energy and macronutrient intakes. Daily consumption of Chinese chicken soup does not seem to improve total energy intake, but it significantly increased % total energy intake from carbohydrates (p<0.05). Further studies with a larger sample size are warranted to confirm the finding.

Heyndrickxia coagulans strain SANK70258 suppresses symptoms of upper respiratory tract infection via immune modulation: a randomized, double-blind, placebo-controlled, parallel-group, comparative study.

Probiotic consumption strongly influences local intestinal immunity and systemic immune status. Heyndrickxia coagulans strain SANK70258 (HC) is a spore-forming lactic acid bacterium that has immunostimulatory properties on peripheral tissues. However, few reports have examined the detailed effectiveness of HC on human immune function and its mechanism of action. Therefore, we conducted a randomized, double-blind, placebo-controlled, parallel-group study to comprehensively evaluate the effects of HC on immunostimulatory capacity, upper respiratory tract infection (URTI) symptoms, and changes in intestinal organic-acid composition. Results of a questionnaire survey of URTI symptoms showed that runny nose, nasal congestion, sneezing, and sore throat scores as well as the cumulative number of days of these symptoms were significantly lower in the HC group than in the placebo group during the study period. Furthermore, the salivary secretory immunoglobulin A (sIgA) concentration was significantly higher, and the natural killer (NK) cell activity tended to be higher in the HC group than in the placebo group. In addition, we performed an exposure culture assay of inactivated influenza virus on peripheral blood mononuclear cells (PBMCs) isolated from the blood of participants in the HC and placebo groups. Gene-expression analysis in PBMCs after culture completion showed that IFNα and TLR7 expression levels were significantly higher in the HC group than in the placebo group. In addition, the expression levels of CD304 tended to be higher in the HC group than in the placebo group. On the other hand, the HC group showed a significantly higher increase in the intestinal butyrate concentration than the placebo group. HC intake also significantly suppressed levels of IL-6 and TNFα produced by PBMCs after exposure to inactivated influenza virus. Collectively, these results suggest that HC activated plasmacytoid dendritic cells expressing TLR7 and CD304 and strongly induced IFNα production, subsequently activating NK cells and increasing sIgA levels, and induced anti-inflammatory effects via increased intestinal butyrate levels. These changes may contribute to the acquisition of host resistance to viral infection and URTI prevention.

The Epidemiology of Circulating Respiratory Pathogens during the COVID-19 Pandemic.

Objective To survey the epidemiology of respiratory pathogens during the coronavirus disease 2019 (COVID-19) pandemic using multiplex polymerase chain reaction (PCR). Methods Specimens were assayed using multiplex nested PCR. Materials Specimens were obtained from outpatients who presented with symptoms of upper respiratory tract infection and asymptomatic outpatients who had contact with patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at Tohoku Medical and Pharmaceutical University Hospital in Sendai, Japan, from November 1, 2020, to May 31, 2023. The analysis included multiple specimens collected from the same patients at different time-points. Data were collected from the electronic records after testing. Results This study included 8,335 patients (4,311 men) with a median age of 59 years old, and 11,741 total specimens were collected. At least 1 positive SARS-CoV-2 result was obtained for 1,710 (14.6%) specimens. Furthermore, 15 pathogens were identified in the positive specimens, and rhinovirus/enterovirus was detected more frequently than other viruses. We identified a larger number of SARS-CoV-2-positive specimens in patients ≥10 years old. In contrast, in patients 0-9 years old, we identified a larger number of specimens positive for rhinovirus/enterovirus than for other viruses. Conclusion In this study, we examined the epidemiology of circulating respiratory pathogens during the COVID-19 pandemic era.

Parental Concerns for Children With Cold-like Symptoms With Reduced Access to Evaluation in Primary Care Settings During the COVID-19 Pandemic: A Qualitative Study

IntroductionWe aimed to explore concerns of parents when their children had symptoms of infection during the COVID-19 pandemic. MethodTwo Norwegian internet forums were searched for parents’ experiences when their children had Upper Respiratory Infection (URI) symptoms 2020-2021. 197 posts were included and analysed using thematic analysis. ResultsParents described COVID-19 related and general worries regarding their children with URI symptoms. The first theme, “It is not “just a cold” during the pandemic”, captures how e.g. infection control measures influenced parents’ concerns. The second theme, “Concerns and consequences of fever and cold symptoms”, describes general parental worries. Varying levels of worries regarding health care services, limitations of family life and concerns for relatives were highlighted. DiscussionKnowledge of parents’ concerns about cold symptoms may help primary health care providers target individual patient counselling and provide background information when policy makers develop information material for infection prevention and treatment.

The anti-infective effect of β-glucans in children.

Background: β-glucans are bioactive β-D-glucose polysaccharides of natural origin, presenting antimicrobial and immunomodulation properties, with a low risk of toxicity. Objectives: This scoping review aims to present the current knowledge on the anti-infective properties of β-glucans in the pediatric population. Methods: We used the PRISMA Extension for Scoping Reviews Checklist to prepare this review. Studies were identified by electronic searches of Pubmed, Embase, and Cochrane databases up to May 2021. Results: The primary search allowed us to find 6232 studies, twelve of which were finally included in the analysis. Eight studies were designed as randomized, placebo-controlled trials, while in four studies the intervention outcome was compared with the pre-intervention period in the same group. The type of preparation and doses varied between studies: in five trials pleuran was administered (in dose 10 mg/5 kg of body weight/day), and in one study baker's yeast β-glucan was used (in two doses: 35mg/day and 75 mg/day). In six other studies, the analyzed preparation comprised β-glucan and other substances. The shortest study lasted seven days, while the most prolonged intervention lasted six months, followed by six months of follow-up. Ten out of twelve trials demonstrated the effectiveness of β-glucans in reducing respiratory tract infection incidence or alleviation of upper respiratory tract infection symptoms. Ten out of twelve studies have reported a good tolerance and safety profile. Conclusions: Good tolerance of β-glucans shows a favorable benefit-risk ratio of this type of intervention. Nevertheless, further monitoring of their efficacy and safety in high-quality research is necessary.

The Impact of Pretransplant Respiratory Virus Detection on Posttransplant Outcomes in Children Undergoing Hematopoietic Cell Transplantation.

Pretransplant respiratory virus (RV) infections have been associated with negative transplant outcomes in adult hematopoietic cell transplantation (HCT) recipients. In the era of HCT delay because of high-risk RVs, we examined the impact of pretransplant RV detection on transplant outcomes in pediatric HCT recipients. This retrospective cohort study included pediatric myeloablative allogeneic HCT recipients from 2010 to 2019. All patients were screened for RV at least once within 90 days before HCT using reverse transcriptase polymerase chain reaction (PCR), regardless of symptoms. Posttransplant outcomes included days alive and out of hospital and progression to lower respiratory tract infection (LRTI). Among 310 patients, 134 had an RV detected in the 90 days before HCT. In univariable analysis, transplant factors including younger age, total body irradiation, umbilical cord blood transplantation, lymphocyte count <100/mm3, HCT comorbidity index score ≥3, and viral factors including symptomatic infection, human rhinovirus as a virus type, and symptomatic pretransplant upper respiratory tract infection were associated with fewer days alive and out of hospital. In multivariable analysis, transplant factors remained significant, but not viral factors. There was a higher incidence of progression to posttransplant LRTI with the same pretransplant RV if the last positive PCR before HCT was ≤30 days compared with >30 days (P = .007). In the setting of recommending HCT delay for high-risk RVs, symptomatic upper respiratory tract infection, including human rhinovirus infections, may lead to increased duration of hospitalization and early progression to LRTI when transplantation is performed within 30 days of the last positive PCR test.

Clinical and Etiological Findings of Viral Pneumonia: A Single Centre Prospective Study

Introduction: Viral pneumonia is a prominent cause of illness that can occur in all age group throughout the year. Worldwide about 200 million cases of viral community acquired pneumonia occur every year of which 50% cases in children and 50% in adults [1]. Bacterial coinfection found only in 3% of cases [2]. The aim of our study is to find out most common viral pathogen causing pneumonia, most common bacterial co-infection, their typical clinical presentation, common abnormal lab parameters, CT findings, duration of ICU and hospital stay. Materials and Methods: All cases with sign and symptoms of respiratory infections with confirmed diagnosis of viral pneumonia (confirmed by BioFire FilmArray Pneumonia Panel from lower respiratory tract sample, confirmed by microscopy) were included in the study after proper consent. Demographic data, clinical history, laboratory investigations, all routine and radiological investigations are noted and evaluated. Results: Of the total 69 cases Influenza A virus (36%) is the predominant etiological agents followed by human rhinovirus (26%) in these cases. Human Rhinovirus predominate in the early part 2023 but towards end of this year Influenza A virus became the predominant cause for pneumonia. Patients of all age groups are affected but there is definitively a seasonal variation with more in the winter months. Most of the patients have typical respiratory findings like cough (83%) and fever (76%). CT scan showed bilateral ground glass opacity (56%) in most cases, and few had consolidation (29%) features. Blood CRP level (91%) was raised in most of these patients. Haemophilus Influenzae (34%) is the most common associated bacterial co-infection followed by Streptococcus Pneumoniae (26%). All patients responded well to conservative management. Conclusions: Viral pneumonia is not uncommon in the community. Though we found Influenza A followed by Human Rhinovirus are the two most common pathogens in these cases but only 59% of them have bacterial co-infection, so not all patients require antibiotics from the beginning. As most are infected with Haemophilus influenzae so aminopenicillin group is the antibiotics of choice for these patients. Hence as a pulmonologist we must be aware of these cases, their typical presentation and not to over treat these cases with high end antibiotics as most require only symptomatic treatment. Even though it is a single centre study, but it definitely throws a light on the pattern of viral pneumonia in our community

Hubungan Lama Kerja dan Penggunaan APD terhadap Kejadian ISPA pada Pekerja PT. Cakra Indo Pratama (CIP) Site Bukit Asam Tanjung Enim

Background: Work duration of more than 5 years has a risk of experiencing symptoms of acute respiratory infections, acute respiratory infections are upper or lower tract diseases, usually infectious and cause various diseases that range from asymptomatic diseases or mild infections to severe and deadly diseases, the need for efforts for occupational safety in PT. CIP workers, Personal Protective Equipment is one of the last efforts for the company to protect its workforce from factors and potential hazards. The purpose of the study: To determine the relationship between length of work and the use of personal protective equipment to acute respiratory infections in PT. CIP field workers. Research Methods: Quantitative type research using analytical observations with a cross-sectional study approach. Results: research using Chi-Square found that the relationship between length of work with the incidence of acute respiratory infections obtained a p value = 0.391, between the use of personal protective equipment with the incidence of , acute respiratory infections obtained a p value = 0.001. Conclusion: There is no significant relationship between length of work and the incidence of acute respiratory infections, while there is a significant relationship between the use of personal protective equipment and the incidence of acute respiratory infections.

Risk Factors for COVID-19 and Respiratory Tract Infections during the Coronavirus Pandemic.

(1) Background: Some individuals are more susceptible to developing respiratory tract infections (RTIs) or coronavirus disease (COVID-19) than others. The aim of this work was to identify risk factors for symptomatic RTIs including COVID-19 and symptomatic COVID-19 during the coronavirus pandemic by using infection incidence, participant baseline, and regional COVID-19 burden data. (2) Methods: Data from a prospective study of 1000 frontline healthcare workers randomized to Bacillus Calmette-Guérin vaccination or placebo, and followed for one year, was analyzed. Parametric time-to-event analysis was performed to identify the risk factors associated with (a) non-specific symptomatic respiratory tract infections including COVID-19 (RTIs+COVID-19) and (b) symptomatic RTIs confirmed as COVID-19 using a polymerase chain reaction or antigen test (COVID-19). (3) Results: Job description of doctor or nurse (median hazard ratio [HR] 1.541 and 95% confidence interval [CI] 1.299-1.822), the reported COVID-19 burden (median HR 1.361 and 95% CI 1.260-1.469 for 1.4 COVID-19 cases per 10,000 capita), or a BMI > 30 kg/m2 (median HR 1.238 and 95% CI 1.132-1.336 for BMI of 35.4 kg/m2) increased the probability of RTIs+COVID-19, while positive SARS-CoV-2 serology at enrollment (median HR 0.583 and 95% CI 0.449-0.764) had the opposite effect. The reported COVID-19 burden (median HR 2.372 and 95% CI 2.116-2.662 for 1.4 COVID-19 cases per 10,000 capita) and a job description of doctor or nurse (median HR 1.679 and 95% CI 1.253-2.256) increased the probability of developing COVID-19, while smoking (median HR 0.428 and 95% CI 0.284-0.648) and positive SARS-CoV-2 serology at enrollment (median HR 0.076 and 95% CI 0.026-0.212) decreased it. (4) Conclusions: Nurses and doctors with obesity had the highest probability of developing RTIs including COVID-19. Non-smoking nurses and doctors had the highest probability of developing COVID-19 specifically. The reported COVID-19 burden increased the event probability, while positive SARS-CoV-2 IgG serology at enrollment decreased the probability of RTIs including COVID-19, and COVID-19 specifically.

Multisite development and validation of machine learning models to predict severe outcomes and guide decision-making for emergency department patients with influenza.

Millions of Americans are infected by influenza annually. A minority seek care in the emergency department (ED) and, of those, only a limited number experience severe disease or death. ED clinicians must distinguish those at risk for deterioration from those who can be safely discharged. We developed random forest machine learning (ML) models to estimate needs for critical care within 24h and inpatient care within 72h in ED patients with influenza. Predictor data were limited to those recorded prior to ED disposition decision: demographics, ED complaint, medical problems, vital signs, supplemental oxygen use, and laboratory results. Our study population was comprised of adults diagnosed with influenza at one of five EDs in our university health system between January 1, 2017 and May 18, 2022; visits were divided into two cohorts to facilitate model development and validation. Prediction performance was assessed by the area under the receiver operating characteristic curve (AUC) and the Brier score. Among8032 patientswith laboratory-confirmed influenza,incidence of critical care needs was 6.3% and incidence of inpatient care needswas 19.6%.Themost common reasons for ED visitwere symptoms of respiratory tract infection,fever,and shortness of breath. Model AUCswere0.89 (95% CI 0.86-0.93)for prediction of criticalcare and0.90(95% CI0.88-0.93)for inpatient care needs;Brier scores were0.026 and0.042, respectively.Importantpredictorsincludedshortness of breath,increasingrespiratory rate,and ahigh number of comorbid diseases. ML methods can be used to accurately predict clinical deterioration in ED patients with influenza and have potential to support ED disposition decision-making.

A Quasi-Experimental Controlled Educational Intervention for Mothers To Reduce Unnecessary Emergency Department Admissions in Children with Respiratory Tract Infection Symptoms

Objective:Although children presenting with respiratory tract infection (RTI) symptoms can be managed by in primary care, these symptoms are the most common reasons for children to present to the emergency department(ED). The aim of this study is to investigate the effect of the education given to mothers by their family physician in reducing the unnecessary admissions of children with RTI symptoms to the ED.&#x0D; Method:A quasi-experimental, single-blinded, controlled educational intervention study was conducted with the mothers of 6 months–6 years old children. Family Medicine Units were randomized as control and intervention group. Sociodemographic features, admissions to ED, fever-related practices were questioned and a questionnaire including propositions on Knowledge, Attitude and Behaviour (KAB) about RTI symptoms (KABaRTIS) were applied in both groups before-after the intervention. Intervention group received one-to-one, face-to-face education focusing on home management of acute RTI symptoms and alarm findings, also a booklet was given. No intervention was made to the control group. &#x0D; Result:Study was completed with 178 mothers(Control:118, Intervention:60). The KABaRTIS scores of the mothers increased significantly in both groups(Control:76.9-82.2;p

Multiplex PCR for respiratory bacteria in acute care.

The purpose of the study was to evaluate the clinical utility of multiplex PCR for detecting bacterial respiratory pathogens in nasopharyngeal samples. Acutely ill adults in the emergency department with respiratory infection symptoms, fever, chest pain or poor general condition were enrolled for this cohort study. Samples were stored at -70 °C until being analysed with multiplex PCR for seven respiratory bacteria. Of the 912 patients enrolled, those with positive bacterial samples (n = 130, 14%) were significantly younger than those with a negative finding (55.5 years vs 62.2 years, p < 0.001), and their mean C-reactive protein (CRP) concentration was higher (110 mg/L vs 59 mg/L, p < 0.0001). Patients with a positive respiratory bacterial finding had a higher probability of pneumonia (35% vs 13%, p < 0.001) and a higher likelihood of receiving a prescription for antibiotics than those with a negative finding (79% vs 59%, p < 0.0001). Positive detection of Streptococcus pneumoniae was associated with a 4.5-fold risk of pneumonia in a multivariate model and detection of an atypical respiratory pathogen with a 9-fold risk. Bacterial PCR performed on nasopharyngeal samples appeared to offer a valuable addition to the diagnostics of infections in adults in acute care.

Analysis of the course and treatment of COVID-19: the experience of the Morozov Children’s City Clinical Hospital

Morozov Children’s City Clinical Hospital, almost in the first months of the development of the COVID-19 epidemic, began to admit not only patients with acute infection, but mainly with combined comorbid pathology. Based on a retrospective analysis of 290 medical records of children hospitalized with COVID-19 at the Children’s City Clinical Hospital, an analysis of children admitted to the hospital with predominantly comorbid pathology was carried out between April 2020 and September 2020. Six of these children had a fatal outcome. Most children were in the first 3 years of life (38,4 %) and puberty (37,3 %). The diagnoses of hospitalized patients were varied: pneumonia — 41 (14,4 %), surgical pathology and trauma — 69 (24,3 %), somatic pathology — 120 (42,3 %), including: diseases of the gastrointestinal tract, kidneys and urinary tract pathways, hematological diseases, neurological, type I diabetes mellitus, joint diseases, diseases of the newborn period, oncological diseases, diseases of the cardiovascular system. To diagnose covid pneumonia, along with rapid methods of SARS-COV2, computed tomography of the lungs was used. Analyzing the course of diseases in surgical children, it can be noted that coronavirus infection did not affect the course of the underlying disease. At the same time, COVID-19 infection in hematological patients provoked a worsening of the condition with symptoms of an acute respiratory viral infection (hyperthermia, weakness, cough, rhinitis). In patients with symptomatic focal epilepsy and in patients with increased intracranial pressure, SARS-COV-2 caused activation of seizures. It should be noted that the onset of type 1 diabetes was observed in 5 out of 6 admitted children. In these cases, COVID-19 infection was a provoking factor; it also caused an exacerbation in 1 child who had “long-term” diabetes. The article presents case histories and diagnoses of 6 children aged 3 years 9 months to 17 years with deaths, severe comorbid pathology (leukemia, brain stem tumor, immunodeficiency state), in whom COVID-19 infection aggravated the course of the underlying disease with the development of generalized combined bacterial infection, sepsis, bleeding.

Lactoferrin in the Prevention of Recurrent Respiratory Infections in Preschool Children: A Prospective Randomized Study.

Few studies have evaluated the effect of bovine lactoferrin (bLf) on reducing respiratory infections in preschool children. This randomized controlled trial evaluated the effect of bLf in preschool children with recurrent respiratory infections. Participants were randomly assigned bLf (n = 25) or control (n = 25). Outcomes included respiratory infection episodes (RIEs), symptom duration, school absence and medication. Fifty children aged 4.2 ± 0.1 years were included. During the active 4-month phase, median number of RIEs was reduced by 50% in the bLf group [1-episode, interquartile range (IQR): 0-2] vs. control (2, IQR: 1-3; p = 0.02). The proportion of participants with >3 RIEs was significantly lower in bLf (n = 1, 4%) vs. control (n = 7, 28%) with 80% lower odds of upper RIEs in the bLf arm (odds ratio: 0.20, 95% CI:0.06-0.74, p = 0.015). The duration of symptoms (3 vs. 6, p = 0.009) and days absent from school (3 vs. 6, p = 0.15) were lower in the active arm. Over the 2-month follow-up, no significant differences were observed between groups for infection episodes, symptom duration or school absence. However, bLf-treated children received significantly less corticosteroids over the entire 6-month study period (32% vs. 60%; p = 0.047). bLf supplementation significantly reduced the frequency and duration of RIEs in children with decreased corticosteroid use.

Virus removal by high-efficiency air (HEPA) filters and filtration capacity enhancement by nanotextiles: a pilot study.

Portable household air purifiers are widely used devices designed to maintain a high-quality level of indoor air. Portable air purifiers equipped with the high-efficiency air (HEPA) filter served 100h in a household space occupied by two adults without any symptoms of respiratory tract infection. The main objective of the study was to determine microbial contamination on the HEPA filter and to investigate if the selected nanotextile monolayer made of polyamide 6 (PA6) nanofibers can capture potential microorganisms when installed downstream of the HEPA filter as the final filtration medium. Samples were taken from the inlet and outlet surfaces. Samples from the nanotextile were collected in the same manner as from the HEPA filter. QIAStat DX® 1.0 Analyzer using the Respiratory SARS CoV-2 Panel multiplex PCR detection system was selected for microorganism detection. Adenovirus was detected on the inlet surface of the HEPA filter. The outlet surface of the filter contained no viruses included in the Respiratory SARS CoV-2 Panel portfolio. The nanotextile monolayer was replaced twice during the 100h of operation, so three pieces were used and all contained coronavirus 229 E. Coronavirus 229 E was then detected in the nasopharynx of one of the members of the household as well. It may be assumed that the selected nanotextile is capable of capturing a virus of a small size.

Fulminant invasive group A streptococcal infection in children

Group A streptococcal infections dominate among invasive streptococcal infections, with the major causative agent, Streptococcus pyogenes, being quite stable in the environment and bearing a large number of chromosome encoded pathogenicity factors or transmitted by horizontal transfer through bacteriophages. Different genetic variants of S. pyogenes can have a different set of pathogenicity factors able to change during pathogen evolution and determine virulence level for specific isolate. With a short incubation period, the disease can proceed with developing invasive infection and toxic shock syndrome with unfavorable outcome within 7 days from disease onset. The purpose of this article is to increase the doctors’ alertness to early recognition and diagnosis, which directly affects adequate treatment in a timely manner and disease outcome. The data on streptococcal morbidity in Russia and worldwide, review of laboratory diagnostic methods and pathogen genetic typing are presented. The maximum number of cases of streptococcal septicemia in Russia was registered in 2022, which accounted for 69% of all cases during the 2014–2022 observation period. The article also describes two clinical cases of fulminant invasive group A streptococcal infection in children with symptoms of acute respiratory viral infections at the onset of the disease. The results of various laboratory diagnostics methods verifying the diagnosis are presented. The genetic characterization of microbial isolates was performed by deep DNA sequencing. In the biological material from patients (including autopsy in one case), S. pyogenes sequence type ST-28, serotypes emm-1.25 and emm-1.0 were identified. The increasing importance of invasive streptococcal infection for health care in Russia and other countries may be associated with a possible change in dominating S. pyogenes genetic variants. In this regard, the study on circulating S. pyogenes genotypes on an ongoing basis as part of surveillance of streptococcal infection and development of vaccine for specific prevention are required.

Host transcriptomics and machine learning for secondary bacterial infections in patients with COVID-19: a prospective, observational cohort study

Viral respiratory tract infections are frequently complicated by secondary bacterial infections. This studyaimed to use machine learning to predict the risk of bacterial superinfection in SARS-CoV-2-positive individuals. In this prospective, multicentre, observational cohort study done in nine centres in six countries (Australia, Indonesia, Singapore, Italy, Czechia, and France) blood samples and RNA sequencing were used to develop a robust model of predicting secondary bacterial infections in the respiratory tract of patients with COVID-19. Eligible participants were older than 18 years, had known or suspected COVID-19, and symptoms of a recent respiratory infection. A control cohort of participants without COVID-19 who were older than 18 years and with no infection symptoms was also recruited from one Australian centre. In the pre-analysis phase, data were filtered to include only individuals with complete blood transcriptomics and patient data (ie, age, sex, location, and WHO severity score at the time of sample collection). The dataset was then divided randomly (4:1) into a training set (80%) and a test set (20%). Gene expression data in the training set and control cohort were used for differential expression analysis. Differentially expressed genes, along with WHO severity score, location, age, and sex, were used for feature selection with least absolute shrinkage and selection operator (LASSO) in the training set. For LASSO analysis, samples were excluded if gene expression data were not obtained at study admission, no longitudinal clinical information was available, a bacterial infection at the time of study admission was present, or a fungal infection in the absence of a bacterial infection was detected. LASSO regression was performed using three subsets of predictor variables: patient data alone, gene expression data alone, or a combination of patient data and gene expression data. The accuracy of the resultant models was tested on data from the test set. Between March, 2020, and October, 2021, we recruited 536 SARS-CoV-2-positive individuals and between June, 2013, and January, 2020, we recruited 74 participants into the control cohort. After prefiltering analysis and other exclusions, samples from 158 individuals were analysed in the training set and 47 in the test set. The expression of seven host genes (DAPP1, CST3, FGL2, GCH1, CIITA, UPP1, and RN7SL1) in the blood at the time of study admission was identified by LASSO as predictive of the risk of developing a secondary bacterial infection of the respiratory tract more than 24 h after study admission. Specifically, the expression of these genes in combination with a patient's WHO severity score at the time of study enrolment resulted in an area under the curve of 0·98 (95% CI 0·89-1·00), a true positive rate (sensitivity) of 1·00 (95% CI 1·00-1·00), and a true negative rate (specificity) of 0·94 (95% CI 0·89-1·00) in the test cohort. The combination of patient data and host transcriptomics at hospital admission identified all seven individuals in the training and test sets who developed a bacterial infection of the respiratory tract 5-9 days after hospital admission. These data raise the possibility that host transcriptomics at the time of clinical presentation, together with machine learning, can forward predict the risk of secondary bacterial infections and allow for the more targeted use of antibiotics in viral infection. Snow Medical Research Foundation, the National Health and Medical Research Council, the Jack Ma Foundation, the Helmholtz-Association, the A2 Milk Company, National Institute of Allergy and Infectious Disease, and the Fondazione AIRC Associazione Italiana per la Ricerca contro il Cancro.

Clinical features and outcomes of influenza and RSV coinfections: a report from Canadian immunization research network serious outcomes surveillance network

BackgroundInfluenza and RSV coinfections are not commonly seen but are concerning as they can lead to serious illness and adverse clinical outcomes among vulnerable populations. Here we describe the clinical features and outcomes of influenza and RSV coinfections in hospitalized adults.MethodsA cohort study was performed with pooled active surveillance in hospitalized adults ≥ 50 years from the Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN SOS) during the 2012/13, 2013/14, and 2014/15 influenza seasons. Descriptive statistics summarized the characteristics of influenza/RSV coinfections. Kaplan-Meier estimated the probability of survival over the first 30 days of hospitalization.ResultsOver three influenza seasons, we identified 33 cases of RSV and influenza coinfection, accounting for 2.39 cases per 1,000 hospitalizations of patients with acute respiratory illnesses. Adults aged 50 + years commonly reported cough (81.8%), shortness of breath (66.7%), sputum production (45.5%), weakness (33.3%), fever (27.3%), and nasal congestion (24.2%) as constitutional and lower respiratory tract infection symptoms. The mortality rate was substantial (12.1%), and age, comorbidity burden, and frailty were associated with a higher risk for adverse clinical outcomes.ConclusionsOlder adults are at higher risk for complications from influenza and RSV coinfections, especially those over 65 with a high comorbidity burden and frailty.