Underdeveloped Immune Systems Research Articles

P-236. Impact of a New Dressing Protocol for the Prevention of Central Line-Associated Bloodstream Infections in one Neonatal Intensive Care Unit (NICU)

Abstract Background Newborns in the neonatal intensive care unit (NICU) are vulnerable to infections due to their extremely fragile skin, underdeveloped immune systems, and usual long-term hospitalizations. These infants often require prolonged use of central venous catheters (CVCs). Bloodstream infections can arise from these CVCs and are a major cause of death in the NICU. Every CVC dressing change can damage their fragile skin, increasing infection risk, and potentially resulting in central line-associated bloodstream infections (CLABSIs). Centers for Disease Control and Prevention recommends dressing changes every seven days, more often if visibly damaged or dirty. Our objective was to evaluate the effectiveness of a new protocol and dressing optimized for long-term skin adhesion implemented in the Centre Hospitalier Universitaire Sainte-Justine (CHUSJ) NICU. Methods The CHUSJ NICU is a level III-IV NICU with 900 admissions a year from both inborn and outborn infants. CLABSI surveillance is done prospectively by the Infection Prevention and Control team. All CVCs installed in NICU patients are recorded daily. Inclusion criteria were all recorded NICU CVCs from January 1, 2017, to December 31, 2023. Segmented interrupted time-series analysis was conducted according to the three-stage intervention rollout (first for gestational age of 28 weeks or more, then large premature infants, then the entire unit), with a pre-intervention period of January 1, 2017, to May 1, 2021, modeling CLABSIs/1000 CVC days/month and adjusting for mean birth weight. Results 2653 CVCs and 71 CLABSIs were reported during the surveillance period. Pre-intervention rates were 1.85 CLABSIs/1000 CVC days. CLABSI rate ratios were: during initial intervention rollout 0.448 (95% confidence interval 0.407, 0.492), during the second stage 0.952 (0.932, 0.973), and since complete implementation 0.610 (0.581, 0.639) that of pre-intervention period rates, for the entire NICU population. Conclusion With reports of CLABSI rate rebounds during the COVID-19 pandemic and increasing NICU outbreaks from multidrug-resistant organisms with associated high mortality, new infection prevention protocols are crucial to combat these trends in CLABSI rates and severity of case outcomes, especially for the vulnerable NICU population. Disclosures All Authors: No reported disclosures

THE NUTRITIONAL STATUS OF TODDLERS IS A RISK FACTOR FOR MALARIA INCIDENCE AT KIMI HEALTH CENTER

Malaria remains a global health issue, particularly in tropical and subtropical regions. In Indonesia, Papua Province specifically Nabire Regency reports a high incidence of malaria, although a decline has been observed since 2010. Infants and pregnant women are the most vulnerable groups. Nutritional status, influenced by dietary patterns, environment, and access to healthcare, plays a crucial role in susceptibility to malaria. Malnourished children are more prone to severe malaria infections due to their underdeveloped immune systems. This research focuses on Kimi Health Center in Nabire Regency and aims to explore the relationship between the nutritional status of children under five and malaria incidence in 2024. The goal of this study is to determine the relationship between the nutritional status of children under five and malaria incidence at Kimi Health Center, Teluk Umar District, Nabire Regency, in 2024. The research design employs an analytical descriptive approach with a cross-sectional method to analyze the relationship between nutritional status and malaria incidence. Data was collected at one point in time and analyzed using univariate and bivariate analysis with the Kendall tau-b test through SPSS software. The results show that nutritional status significantly influences susceptibility to malaria. Children with poor nutrition are at a higher risk of experiencing severe malaria due to immune system dysfunction. Malnutrition, such as Protein-Energy Malnutrition (PEM), worsens parasitemia and anemia. Nutrient deficiencies, including iron, vitamin A, and zinc, also weaken the immune system. Therefore, improving nutritional status is a crucial effort in malaria control within endemic areas.

Infection in nicu setting pose serious health risks to neonates - A meta-analysis

Infections in Neonatal Intensive Care Units (NICUs) pose significant health risks to neonates, particularly due to their underdeveloped immune systems and the invasive procedures often necessary for treatment. These infections can lead to severe complications, prolonged hospital stays, and increased mortality rates. This meta-analysis aims to assess the prevalence, risk factors, outcomes, and preventive strategies associated with infections in NICU settings to better understand the scope of the problem and provide insights for improved healthcare practices. A systematic search was conducted across multiple databases, including PubMed, CINAHL, and Medline, for peer-reviewed studies published in the last two decades. Studies were selected based on criteria that included focus on NICU-acquired infections, study design, and outcomes reported on neonatal health. Data on infection prevalence, types, risk factors, treatment efficacy, and preventive interventions were extracted and analyzed using meta-analytic techniques to calculate pooled estimates and examine statistical associations. Findings indicate a high prevalence of infections in NICUs, with bloodstream infections, pneumonia, and urinary tract infections as the most common types. Risk factors such as prematurity, low birth weight, invasive procedures, and prolonged NICU stay significantly increase infection rates. Neonates with infections demonstrated higher morbidity, longer hospital stays, and a higher risk of long-term health complications. Preventive measures, particularly hand hygiene protocols, sterilization practices, and early identification strategies, were associated with reduced infection rates. Infections in NICUs remain a critical issue, impacting neonatal outcomes and healthcare costs. Strengthening preventive measures and developing standardized protocols for infection control are essential to reduce infection rates and improve neonatal health outcomes. Further research is needed to identify the most effective interventions and foster a culture of infection prevention within NICU settings.

The effective multiplicity of infection for HCMV depends on the activity of the cellular 20S proteasome.

Human cytomegalovirus (HCMV) is a betaherpesvirus capable of infecting numerous cell types and persisting throughout an infected individual's life. Disease usually occurs in individuals with compromised or underdeveloped immune systems. Several antivirals exist but have limitations relating to toxicity and resistance. HCMV replication involves upregulation of host proteasomal activities, which play important roles in the temporal stages of replication. Here, we defined the impact on replication kinetics of the proteasome inhibitor, bortezomib. We demonstrate that bortezomib significantly reduces levels of viral genomes and infectious virions produced from a population of cells. Inhibition reduced expression of viral proteins that are influenced by genome synthesis. When added prior to 24 hpi, we observe decreases in PCNA and Cdk1 while increases in p21 whose regulations contribute to efficient replication. This response synergized with an antiviral, maribavir. Since some replication occurred, we tested the hypothesis that a subset of infected cells might break through inhibition. Initially, we simulated bortezomib activities using a mechanistic computational model of late-lytic replication. Upon reducing multiplicity of infection (MOI) in silico, we observed near-identical simulated results compared to experimental data. Next, we analyzed replication using live-cell imaging. This revealed treated cultures do contain a population of cells with fully developed late-stage cytoplasmic assembly compartments but at significantly lower numbers. We refer to this as the effective MOI. Overall, our studies support a hypothesis in which 20S proteasome inhibition disrupts HCMV replication by reducing the MOI to an effective MOI, defined by a fraction of infected cells capable of progressing to fulminant infection.IMPORTANCEHuman cytomegalovirus (HCMV) infection and reactivation continues to contribute to morbidity and mortality around the world. Antiviral compounds are available but have limitations. Here, we have defined the impact of the proteasome inhibitor bortezomib on HCMV replication. Proteasomal activities play a critical role in temporal changes required for replication. We demonstrate that disrupting these activities inhibits viral replication while likely supporting increased antiviral activity of the anti-HCMV agent, maribavir. Using a combination of live-cell imaging and computational tools, we discover that a subset of infected cells progresses to fulminant infection, which we define as the effective multiplicity of infection, and this subset would otherwise be missed when analyzing the average of the population.

Type 3 immune response protects against Salmonella Typhimurium infection in the small intestine of neonatal rats

ABSTRACT Bacterial infections, particularly Salmonella, pose a significant health risk to neonates due to their underdeveloped immune systems. Understanding the immune responses in the neonatal intestine during S. Typhimurium infection is crucial for developing effective therapeutic and prevention strategies. This study found neonatal rats exhibited severe symptoms, including significant mortality, body weight loss, diarrhea, and bacterial load increases in the gastrointestinal tract and various organs, particularly in the ileum. Moreover, neonatal rats exhibited a high percentage of type 3 immune cells including Th17, γδT17, and ILC3 after S. Typhimurium infection. Furthermore, cintirorgon treatment during early life, the agonist of RORγt, significantly enhanced IL-17A-secreting type 3 immune response and alleviated the symptoms. Our data reveal targeting RORγt and IL-17A pathways may offer a promising therapeutic strategy for bacterial infections in neonatal populations.

Indole-3-propionic acid enhances growth performance and reduces diarrhea via modulating redox status and intestinal inflammation in weaned piglets

Indole-3-propionic acid (IPA) has anti-inflammatory properties, which can be beneficial for weaned piglets with underdeveloped immune systems. The study explores the impact of IPA supplementation on growth performance, oxidative stress, and inflammation response in weaned piglets. In Exp. 1, 90 weaned piglets were divided into six groups (5 replicates per group, 3 pigs per replicate), with each group receiving a basal diet with varying amounts of IPA (0, 50, 100, 200, 400, or 600 mg/kg) for 42 d. Piglets fed the diets with 50, 100, and 200 mg/kg of IPA exhibited reduced feed conversion ratios (F:G) compared to the control piglets (P = 0.035). Notably, 50 and 100 mg/kg IPA treatments significantly reduced diarrhea incidence and serum interleukin (IL)-6 content (P < 0.05). Conversely, a high dosage of 600 mg/kg IPA led to increased serum contents of tumor necrosis factor (TNF)-α, and IL-6 (P < 0.05). Optimal antioxidant benefits were observed at 100 mg/kg IPA supplementation, which significantly reduced malondialdehyde levels while enhancing serum total antioxidant capacity and total superoxide dismutase activity on d 14 (P < 0.05). Exp. 2 investigated the effects of IPA on lipopolysaccharide (LPS) challenge in weaned piglets. The study consisted of 32 weaned piglets allocated into 4 groups, with 8 replicates per group and 1 piglet per replicate: a control group, a LPS challenge group, a LPS challenge group supplemented with 100 mg/kg IPA, and a group supplemented with 100 mg/kg IPA alone. Upon administration of LPS or saline injection, the results indicated that dietary IPA supplementation in challenged piglets enhanced villus height: crypt depth, modulated IL-8 and IL-22 mRNA relative expression, and increased the tight junction protein claudin-1 mRNA relative expression in the intestinal mucosa (P < 0.05). These findings suggest that dietary supplementation of IPA at specific concentrations significantly improves growth performance, reduces diarrhea incidence, and mitigates inflammation and oxidative stress in weaned piglets. It may be concluded that incorporating IPA into the diet of weaned piglets can effectively improve their health and development.

Geographically weighted logistic regression model for identifying risk factors for malaria infection among under-5 children in Ghana

Malaria remains a significant public health challenge globally, particularly affecting children under-5 years of age due to their underdeveloped immune systems. Identifying the risk factors associated with malaria infection in this vulnerable group is crucial for improving policy formulation and creating effective training programs. However, there is limited information on how the relationship between malaria risk and associated factors varies across different regions, especially among children in Ghana. This is important because understanding these spatial variations can enhance targeted interventions including area remediation and resource allocation. To address this gap, a geographically weighted logistic regression (GWLR) model was developed to identify spatially varying risk factors for malaria infection among children under five in Ghana. The model was built on the premise that the relationship between malaria and potential risk factors is not uniform across geographic areas. Data from the Ghana Malaria Indicator Survey collected through the demographic and health survey program were used for analysis. The study found that the GWLR model fit the data better than the conventional binary logistic regression (BLR) model, based on the information criterion used and mode evaluation metrics. The results indicated that risk factors for malaria such as a child's age, anaemia status, dwellings sprayed, place of residence, electricity access, NHIS (National Health Insurance Scheme) coverage, age of the household head, and household wealth index, were non-stationary across the study area. These findings underscore the importance of spatially tailored interventions to reduce malaria risk in children under-5. The results contribute to the body of literature on malaria risk factors and provide valuable insights for Ghana's national malaria control policies, potentially enhancing the effectiveness of future public health strategies.

Early-life immunomodulation by carvacrol delivered in ovo in broiler chickens

In the first 2 wk after hatching, broiler chickens are vulnerable to enteric pathogens due to underdeveloped gastrointestinal and immune systems. Carvacrol has been reported to improve digestive and immune functions. This study aimed to optimize immune development of broiler chickens by delivering carvacrol in ovo. Effects of 2 in ovo treatments delivered at embryonic day (E)17.5 (saline or carvacrol) were evaluated at 3 stages (E19.5, hatch, and d 14 posthatch). Hatchability, performance parameters, lymphoid organ and yolk sac weights were determined. Histomorphology assessment was performed for jejunal samples at hatch and bursa of Fabricius samples at hatch and d 14. Gene expression of immune-relevant genes was determined for jejunal, bursal, and yolk sac samples over time. At hatch, BW was 0.85% lower (P = 0.02) after in ovo carvacrol delivery compared to the controls. Interactions between in ovo treatment and age were found for gene expression. At hatch, carvacrol treatment resulted in lower expression of proinflammatory cytokines IL-8 and IFN-γ in the yolk sac compared to the controls (P = 0.05 and < .001, respectively) suggesting a potential role for carvacrol-mediated immune modulation. At d 14, carvacrol treatment led to lower expression of proinflammatory cytokine IL-6 in the bursa compared to the controls (P = 0.002). In ovo carvacrol delivery led to bursal histomorphometric changes, including a larger cortex in the bursal follicles (P = 0.03), and a higher cortex/medulla ratio (P = 0.04) compared to the controls, indicating increased B-cell stimulation and maturation. Main effects were found for carvacrol treatment in the jejunum, with overall higher expression of proinflammatory mediators IL-1β and NF-κB, and anti-inflammatory IL-10 compared to the controls (P = 0.04, 0.02, and 0.02 respectively) from E19.5 to d 14. Age-related main effects showed various alterations in expression dynamics of immune-related genes across all tissues over time. Our findings suggest changes in immune parameters occur as the chicken develops, but these mostly do not interact with in ovo carvacrol treatment. In ovo carvacrol treatment alters immune activity of broiler chickens independent of age.

The Effect of Oral Colostrum Application on the Condition of the Mouth and Incidence of Late-Onset Sepsis Among Premature Infants: A Randomized Controlled Trial.

Premature infants have higher risks of infection due to their underdeveloped immune systems and changes to the oral cavity's normal flora colonization. To assess the effect of oral colostrum application on the condition of the mouth and the incidence of late-onset sepsis (LOS) among premature infants. In this randomized controlled trial, 70 newborn premature infants were randomly allocated to colostrum or sterile water groups. The Mouth Care Assessment Tool was used to evaluate the condition of the mouth for 5 days after oral colostrum application. The incidence of LOS was measured using clinical and laboratory indicators from 72hours after birth until discharge. The condition of the mouth was significantly different on days 4 and 5, demonstrating that the colostrum group had less need for oral care ( P <.001) compared to the control group. There was no significant difference between the 2 groups in clinical symptoms and laboratory values related to LOS ( P >.05). Oral colostrum application can benefit oral mucosal health and reduce the need for oral care among premature infants. It is also safe alternative oral care for premature infants who cannot breastfeed during the first few days of life. Future research should include infants of different gestational ages and mechanically ventilated infants to assess the effect of oral colostrum application on serum immune factors.

The Effects of Climate Change on Maternal, Fetal and Neonatal Health: An in-Depth Review

The substantial elevation in atmospheric greenhouse gas levels is a consequence of human activities, resulting in a 1.1°C elevation in surface temperature as the worldwide average. The detrimental outcomes of this temperature rise encompass severe weather events, deterioration in food, water, and air quality, alongside an escalation in vector-borne infectious diseases and/or transmission risks. The mitigation and adaptation to climate change are pivotal factors for the survival of humanity in the midst of this existential crisis. Climate change exerts notable effects on maternal, fetal, and neonatal health, with women experiencing more adverse impacts compared to men. Pregnant women may face conditions such as hypertensive disorders like preeclampsia and eclampsia, gestational diabetes mellitus (GDM), variations in pregnancy duration, and mental health disorders. Fetal and newborn health can be affected, leading to results like preterm birth (&amp;lt;37 weeks of gestation), low birth weight (&amp;lt;2500 grams), congenital anomalies (including atrial septum issues), early membrane rupture (EMR), underdeveloped immune systems, intrauterine growth restriction (IUGR), and neonatal death. Effective interventions aimed at reducing heat-related risks should include health education on heat and heat increase risks for caregivers - other than parents - and clinicians responsible for childcare. Additionally, there is a need for improvements in cooling systems in healthcare facilities, fair enhancements in housing quality, and food systems. Focus should also be placed on nutrition and lifestyle counseling. Despite the growing attention to the influence of climate on human health, the risks associated with heat and other factors associated with climate for women, pregnant individuals, newborns, infants, and children are not sufficiently addressed. This review seeks to investigate the effects of climate change on maternal, fetal, and neonatal outcomes related to health based on existing literature.

Enhancing handwashing skills in preschoolers through movement and puzzle games

Preschoolers are highly susceptible to illnesses due to their underdeveloped immune systems. The lack of understanding among preschoolers regarding the importance of proper hygiene practices makes them vulnerable to diseases such as respiratory infections, diarrhea, typhoid, and others. This community outreach initiative aimed to enhance preschoolers' knowledge and handwashing skills to prevent the spread of various diseases. The project employed educational sessions and hands-on training in handwashing techniques at TKIT Lukmanul Hakim. The outcomes demonstrated significant improvements: before the intervention, 18 children (54%) had adequate knowledge and 5 children (15.2%) had insufficient knowledge; after the intervention, 100% of the children exhibited good knowledge. Regarding handwashing skills, 20 children (60.6%) had poor skills before the training, while this improved to 69.7% with good skills after the training.

Effective methods for engaging with YOPI (Young, Old, Pregnant, Immunocompromised) on food safety matters

Young, older, pregnant, and immunocompromised (YOPI) people are most vulnerable to foodborne illnesses due to impaired or underdeveloped immune systems(1). There is a lack of information regarding how YOPI groups access, receive or use information about food safety, what influences their food safety behaviour, and their preferences for receiving food safety advice. The objective of this research was to develop a better understanding of how YOPI consumers in New Zealand access and use food safety information, the types and sources of food safety information used, how information and advice are obtained, and how these influence their decision-making about food safety practices and related behaviours. Research questions were guided by a rapid review of literature. Twenty qualitative focus groups (comprising of either young, old, pregnant, or immunocompromised individuals) based in one of three locations in New Zealand were conducted. This was complemented with data from health care providers from relevant sectors (nutritionists, dietitians, aged care providers, cancer nurses, Well Child Tamariki Ora providers, and midwives). Recruitment included a focus on ethnic groups (Māori and Pasifika) to ensure diversity of experiences and perspectives were represented in the research and to reflect NZFS’s interest in developing fit-for-purpose messages and resources for these YOPI populations. Thematic and segmentation analysis was conducted to understand current food safety behaviours and how to best communicate food safety matters. Typologies of participants were developed by grouping participants based on common features: attitudes, beliefs, and experiences. The research revealed most participants are comfortable with their food safety practices and reported habitual behaviours. Many YOPI did not perceive themselves to be at a greater risk of foodborne illness, particularly older people. A key finding was that access to information does not necessarily lead to behaviour change. Groups undergoing periods of change (immunocompromised, pregnant and young) were more likely to seek additional information. Families and health professionals are trusted sources of information, with all groups reporting some use of the internet as an information source. An individual’s risk perception was the main motivating factor for obtaining and following advice. Habit, cost of food, and lack of information were key barriers to obtaining or acting on information, along with pregnant people reporting social pressures as a reason to not obtain or act on relevant advice. In general, there are three key types of food-safety messaging all groups would like to receive: situation-specific advice; information received alongside other key information (e.g., starting solids); and general information for the whole population. Gaining insights into YOPI preferences on food safety matters can aid the development of appropriate communication and engagement methods of the risks and impacts of food safety matters to vulnerable people.

Childhood Health Risks and Vulnerabilities Associated with Climate Change in the Philippines: Basis for Child Health Vulnerability Framework

Rising temperatures and intensifying storms have characterized the past decade in Iligan City, Philippines, demonstrably increasing the frequency and intensity of extreme weather events. This poses a growing threat to children's health and well-being. To gain an in-depth understanding of local experiences, a qualitative study was employed using purposive sampling of 15 parents and barangay health workers. Extreme heat, heavy rain, flooding and landslides were identified as the most frequent climate-related disasters, leading to injuries, displacement, and outbreaks of waterborne diseases among children. Vulnerabilities stem from living in flood-prone areas, children's underdeveloped immune systems, and existing health issues, amplifying their risks. The proposed framework emphasizes early warning systems and climate-resilient infrastructure (e.g., flood protection measures) to address geographic vulnerabilities. It also incorporates nutrition programs, child-friendly health services, and Mental Health and Psychosocial Support (MHPSS) to tackle children's physical and mental health needs. By implementing these interventions based on local needs and vulnerabilities identified in this study, the Local Government Unit (LGU) can effectively mitigate the impact of climate change on children's health in Iligan City.

Paediatric Malaria: Associated Symptoms and Risk Factors among Children in Isheri, Alimosho Local Government Area, Lagos State, Nigeria

Malaria is a significant health issue, especially in tropical and subtropical regions. Children are particularly vulnerable to malaria due to their underdeveloped immune systems. Although many countries have implemented interventions to control and eliminate malaria, the disease remains a major public health challenge in endemic areas. This study is a cross-sectional survey conducted to determine the prevalence of paediatric malaria and identify associated risk factors in children under 5 years old at the Isheri Primary Health Centre in the Alimosho Local Government Area of Lagos State. The survey was carried out from June to September 2023. Blood samples were collected from 219 children, 44.7% male and 55.3% female. Parasitological analysis was conducted according to WHO standards, and data on associated risk factors and malaria prevention practices were collected through a pretested structured questionnaire. Statistical analyses such as T-test and One-way ANOVA were employed, with significance set at p&gt;0.05. The findings revealed an overall prevalence of paediatric malaria in the study location at 49.3% (n=108), with P. falciparum being the main parasite. Males had a 55.1% malaria infection rate, while females had a rate of 40.5%. All malaria-infected children tested positive for the asexual malaria parasite, with parasite density ranging from 2087 to 328000μL-1 and a mean value of 47267 — 80 (95% CI 35244-59292). Children &lt; 5years of age (55324 μL-1, 95% CI 29378-81271) had slightly higher asexual parasite density than those &gt; 5 years (44045μL-1, 95% CI 30440-576550). Haematological analysis showed that the infected children had a significantly higher count of neutrophils than the uninfected (p = 0.002). Furthermore, children who did not report experiencing fever and chills had a significantly higher parasite density than those who did (p&lt;0.05). The use of insecticide-treated bed nets (ITN) also had an impact, with children under 5 years of age not using ITNs having a higher parasite density (65390 μL-1, 95% CI 18219-112562) than those who did. The study also assessed environmental risk factors and found that stagnant water and poultry farms did not significantly impact the prevalence of paediatric malaria. The study concluded that improved access to malaria interventions is essential to interrupt transmission, particularly in the at-risk groups, to achieve the United Nations Sustainable Development Goals agenda for health.

Seropositive rate of Toxocara spp. Larvae and some associated factors among children in Phuc Hung Private General Hospital, Quang Ngai province in 2022

Background: Toxocariasis in dogs and cats belongs to the group of “animal diseases”, which means diseases from vertebrates that are transmitted to humans. Children are very susceptible to this diseases due to their underdeveloped immune systems and high exposure to pathogens. Toxocara spp. larvae migrate to various human body organs including brain, eyes, liver, lung,... and cause some dangerous clinical symptoms. Objectives: Determine the seropositive rate of Toxocara spp. larvae and some associated factors among children at the study site. Methods: A cross-sectional study was conducted in Phuc Hung private general hospital, Quang Ngai province from April to September, 2022 on 405 children aged 3 - ≤ 15 years old, who were assigned ELISA test and direct interviews with family members using a set of closed-ended questions. Results: The seropositive rate of Toxocara spp. larvae in children is about 20.5%. Eosinophil in children who has seropositive of Toxocara spp. larvae is 4.84 times higher than normal. Households with dogs has the seropositive rate of Toxocara spp. larvae 2.38 times higher than households without dogs. Children who regularly holding dogs and expose to soil have the seropositive rate of Toxocara spp. larvae 3.35 and 3.21 times higher than those who do not have these habit, respectively. Children who do not often wash their hands before eating have the seropositive rate of Toxocara spp. larvae 1.14 times higher compared the group of children who regularly wash their hands before eating. Conclusion: Strengthen communication, health education and provide knowledge on prevention of Toxocariasis for children and parents. Key words: Toxocara, seropositive rate, children.

Microplastics in the Bronchoalveolar Lavage Fluid of Chinese Children: Associations with Age, City Development, and Disease Features.

This study characterized the occurrence patterns of microplastics (MPs) in the bronchoalveolar lavage fluid (BALF) of children with pulmonary diseases. MPs were detected in 89.6% of BALF samples with an average of 4.31 ± 2.77 items/10 mL, supporting the hypothesis that inhalation is a significant pathway of airborne MP exposure to pediatric lungs. Inhaled MPs were predominantly composed of 10 polymer types [e.g., polypropylene (41.9%), polyethylene (19.4%), and polyester (13.6%)], with the majority being smaller than 20 μm. MP levels in BALF exhibited a negative correlation with children's age, probably owing to the preferential crawling and tumbling actions in indoor environments and underdeveloped immune systems of young children. Participants living in urban areas suffered from higher pulmonary MP exposure, likely due to higher environmental levels, compared with suburban/rural residents (P < 0.05). Although no significant differences were found between MP levels in pediatric lungs with community-acquired pneumonia (CAP) and asthma (P > 0.05), the severe CAP group displayed significantly higher MP contamination than the nonsevere group (P < 0.05), indicating that some yet undiscovered relationship(s) between inhaled MPs and pediatric pulmonary diseases may exist.

Correlation of Immature Granulocytes and C-Reactive Protein with Blood Culture in Neonatal-SIRS at Gambiran Hospital

Sepsis can occur in patients with Systemic Inflammatory Response Syndrome (SIRS) symptoms, especially in neonates due to their underdeveloped immune systems. Blood culture as the gold standard test to diagnose sepsis in SIRS patients takes a long time to perform. The other rapid test parameters are needed to support the early diagnosis of infection (sepsis) in SIRS patients, including Immature Granulocytes (IG%) and C-Reactive Protein (CRP). This study aimed to determine the correlation between IG% with blood culture and CRP with blood culture in neonatal SIRS patients at Gambiran Hospital, Kediri. The research design used retrospectively using secondary data. A total of 63 samples were obtained using simple random sampling on the medical record of neonatal SIRS patients who met the inclusion criteria, without any exclusion criteria. There were significant results with a value of p=0.000 (p &lt; 0.05) between IG% and blood culture using the Mann-Whitney test, as well as on CRP and blood culture using the independent samples T-test. The bivariate statistical test between IG% and CRP was carried out using the Spearman test and showed significant results with p=0.000 (p &lt; 0.05) with a correlation coefficient (rs) of 0.740, which indicated a strong positive relationship. It was concluded that there was a correlation between IG% and CRP with blood culture in neonatal SIRS patients.

A 16S rRNA Sequencing Study Describing the Environmental Microbiota of Two Powdered Infant Formula Built Facilities.

Microbial safety is critically important for powdered infant formula (PIF) fed to neonates, with under-developed immune systems. The quality and safety of food products are dictated by those microorganisms found in both raw materials and the built production environment. In this study, a 2-year monitoring program of a production environment was carried out in two PIF factories located in the Republic of Ireland, and the environmental microbiome in different care areas of these sites was studied by using a 16S ribosomal RNA (rRNA)-based sequencing technique. Results highlighted a core microbiome associated with the PIF factory environment containing 24 bacterial genera representing five phyla, with Acinetobacter and Pseudomonas as the predominant genera. In different care areas of the PIF factory, as hygiene standards increased, deciphered changes in microbial community compositions became smaller over time and approached stability, and bacteria dominating the care area became less influenced by the external environment and more by human interactions and raw materials. These observations indicated that the microbial composition can be altered in response to environmental interventions. Genera Cronobacter and Salmonella were observed in trace amounts in the PIF factory environment, and bacterial genera known to be persistent in a stressed environment, such as Acinetobacter, Bacillus, Streptococcus, and Clostridium, were likely to have higher abundances in dry environment-based care areas. To our knowledge, this is the first study to characterize the PIF production environment microbiome using 16S rRNA-based sequencing. This study described the composition and changing trends of the environmental microbial communities in different care areas of the PIF manufacturing facility, and it provided valuable information to support the safer production of PIF in the future.

Hand Hygiene: Knowledge and Practice among Pre-School Students

Human health has been jeopardized due to a lack of understanding about proper hand washing techniques. Because of their underdeveloped immune systems, preschool children are more vulnerable to infectious infections. Hand hygiene inhibits the spread of infectious illnesses. The purpose of this study was to develop a better understanding of pre-school children’s hand hygiene knowledge and behavior on the current situation of COVID-19. A total of 232 children aged 5 and 6 years old from 10 pre-schools in the Sepang region of Selangor, Malaysia, were chosen for this study. A questionnaire containing socio-demographic information, knowledge, and hand hygiene behavior was distributed. A completed hand hygiene education programme, including a video on correct hand washing technique, was presented to the test group. The results were statistically examined using descriptive analysis and an independent t-test. More than 90% of the participants displayed effective hand washing technique. Hand hygiene routine practice was much superior (p < 0.05) in the test group. Indeed, further progress should be made through targeted health education initiatives emphasizing the importance of hand hygiene in health.

Hazard Analysis and Risk-Based Preventive Controls (HARPC): Current Food Safety and Quality Standards for Complementary Foods.

Food safety is imperative, especially for infants and young children because of their underdeveloped immune systems. This requires adequate nutritious food with appropriate amounts of macro- and micronutrients. Currently, a well-established system for infant food is enforced by the regulatory bodies, but no clear system exists for complementary food, which is consumed by children from the age of 6 month to 24 months. As the child grows beyond 6 months, the need for nutrients increases, and if the nutritional needs are not fulfilled, it can lead to health problems, such as stunted growth, weak immune system, and cardiovascular diseases. Hence, it is important to have regulatory bodies monitoring complementary food in a similar capacity as is required for infant formula. The objective of this review is to provide an overview of the existing regulatory bodies, such as the Codex Alimentarius, International Standard Organization (ISO), Food and Drug Administration (FDA), etc., and their regulations specifically for infant formula that can be adopted for complementary foods. This study focuses on the development of a hazard analysis and risk-based preventive controls (HARPC)-based food safety plan to ensure safe food processing and prevent any possible outbreaks.