Identification of Pathogens Potentially Associated with Non-Malarial Fever in Children: A Pilot Study in Peri-Urban Dakar, Senegal

ABSTRACTFever is one of the most common reasons for pediatric consultation in Africa. Malaria incidence has now dropped considerably, yet etiologies of non-malarial febrile diseases are poorly documented. This pilot study aimed to 1) identify pathogens potentially associated with non-malarial fever in children younger than 10 years in the suburbs of Dakar and 2) describe the epidemiological characteristics of these patients. During the study period, all eligible children (< 10 years of age, body temperature ≥ 38°C, negative result for the malaria rapid diagnostic test, living in Guediawaye/Pikine for the previous four calendar months, not receiving any anti-infectious treatment since the onset of fever, and with parent’s consent to participate) presenting to the health post in Medina Gounass located in Guediawaye on Mondays and Fridays were included. In total, 106 children participated in the study, and PCR from nasopharyngeal swabs, hemoculture, C-reactive protein, blood cell counts, and quantitative buffy coat from blood samples and coproculture from stool samples were performed. In 70 (66%) children, at least one pathogen was isolated. Viruses were identified in 55 children, most commonly enteroviruses, rhinoviruses, and adenoviruses, and dengue virus was identified in three children. Only five children had bacterial infections, and 10 had bacterial and viral coinfections. Ninety-seven children (92%) received prescription for antibiotics. Many strains of bacteria were found to be resistant to several antibiotics. Despite limitations, this pilot study showed that pathogens potentially associated with non-malarial fever in children younger than 10 years near Dakar were predominantly viruses, most commonly upper respiratory infections, although bacteria accounted for a small proportion.

Download Full-text

Vitamin D3 supplementation in adults with bronchiectasis: A pilot study

Chronic Respiratory Disease ◽

10.1177/1479972318761646 ◽

2018 ◽

Vol 15 (4) ◽

pp. 384-392 ◽

Cited By ~ 6

Author(s):

Jim Bartley ◽

Jeff Garrett ◽

Carlos A Camargo ◽

Robert Scragg ◽

Alain Vandal ◽

...

Keyword(s):

Vitamin D ◽

New Zealand ◽

Pilot Study ◽

Respiratory Infections ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Cell Counts ◽

Before And After ◽

Related Quality ◽

Vitamin D3 Supplementation

Vitamin D supplementation prevents acute respiratory infections and, through modulating innate and adaptive immunity, could have a potential role in bronchiectasis management. The primary aims of this pilot study were to assess serum 25-hydroxyvitamin D (25(OH)D) levels in New Zealand adults with bronchiectasis, and their 25(OH)D levels after vitamin D3 supplementation. Adults with bronchiectasis received an initial 2.5 mg vitamin D3 oral loading dose and 0.625 mg vitamin D3 weekly for 24 weeks. The primary outcome was serum 25(OH)D levels before and after vitamin D3 supplementation. Secondary outcomes (time to first infective exacerbation, exacerbation frequency, spirometry, health-related quality of life measures, sputum bacteriology and cell counts and chronic rhinosinusitis) were also assessed. This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12612001222831). The initial, average 25(OH)D level was 71 nmol/L (95% confidence interval (CI): [58, 84]), rising to 218 nmol/L (95% CI: [199, 237]) at 12 weeks and 205 nmol/L (95% CI: [186, 224]) at 24 weeks. The initial serum cathelicidin level was 25 nmol/L (95% CI: [17, 33]), rising to 102 nmol/L (95% CI: [48, 156]) at 12 weeks and 151 nmol/L (95% CI: [97, 205]) at 24 weeks. Over the 24-week study period, we observed statistically significant changes of 1.11 (95% CI: [0.08, 2.14]) in the Leicester Cough Questionnaire and −1.97 (95% CI: [−3.71, −0.23]) in the Dartmouth COOP charts score. No significant adverse effects were recorded. Many New Zealand adults with bronchiectasis have adequate 25(OH)D levels. Weekly vitamin D3 supplementation significantly improved 25(OH)D levels.

Download Full-text

ROLE OF PARENTAL OBSERVATIONS IN EARLY DIAGNOSIS OF SERIOUS BACTERIAL INFECTIONS IN CHILDREN WITH FEVER ADMITTED TO THE HOSPITAL: A SEMI-QUALITATIVE PILOT STUDY

10.26226/morressier.58fa176ad462b80290b51da4 ◽

2017 ◽

Author(s):

Urzula Urbane

Keyword(s):

Pilot Study ◽

Early Diagnosis ◽

Bacterial Infections ◽

Serious Bacterial Infections

Download Full-text

Faculty Opinions recommendation of Safety and efficacy of C-reactive protein-guided antibiotic use to treat acute respiratory infections in Tanzanian children: a planned subgroup analysis of a randomized, controlled non-inferiority trial evaluating a novel electronic clinical decision algorithm (ePOCT).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735024057.793560941 ◽

2019 ◽

Author(s):

Thomas Althaus

Keyword(s):

Subgroup Analysis ◽

Respiratory Infections ◽

Clinical Decision ◽

Antibiotic Use ◽

Acute Respiratory Infections ◽

C Reactive Protein ◽

Decision Algorithm ◽

Safety And Efficacy ◽

Reactive Protein ◽

Randomized Controlled

Download Full-text

Current Issues of Empirical Therapy of Severe Bacterial Community-Acquired Pneumonia During the Season of Respiratory Viral Infections

Antibiotics and Chemotherapy ◽

10.37489/0235-2990-2020-65-9-10-64-70 ◽

2020 ◽

Vol 65 (9-10) ◽

pp. 64-70

Author(s):

V. B. Beloborodov ◽

I. A. Kovalev ◽

G. V. Sapronov

Keyword(s):

Antimicrobial Therapy ◽

Influenza A ◽

Bacterial Infections ◽

Randomized Clinical Trials ◽

Respiratory Infections ◽

Molecular Genetic ◽

Seasonal Fluctuation ◽

Empirical Therapy ◽

Community Acquired Pneumonia ◽

Adverse Event Rate

Progredient growth of morbidity and mortality of patients with community-acquired pneumonia (CAP) requires optimization of treatment including antibacterial therapy. Implementation of molecular-genetic methods of diagnostics of viral and viral-bacterial infections in clinical practice has significantly augmented the conception of etiology of community-acquired pneumonia. Seasonal fluctuation of CAP prevalence corresponds with growth of morbidity of acute respiratory infections and influenza which contribute to the etiological structure of CAP by increasing the risk of infection caused by staphylococci. The synergy between influenza A virus and S.aureus has been shown; it is associated with an increase of virus replication in the presence of specific staphylococcal proteases and the ability of viruses to increase adhesion of S.aureusin the respiratory tract, to decrease phagocytosis of S.aureus by macrophages/neutrophils and production of antimicrobial peptides, as well as to increase the probability of secondary bacterial co-infection. Therefore, the most important requirement for the empiric therapy agents of CAP is high streptococcal and staphylococcal activity. According to the current guidelines on antimicrobial therapy of severe CAP, antipneumococcic cephalosporins, macrolides, and fluoroquinolones are the basic treatment agents, but none of them have the combined high antistaphylococcal and antipneumococcal activity inherent in ceftaroline. The advantages of ceftaroline over ceftriaxone and levofloxacin in terms of the probability of reaching target concentrations for clinically relevant pharmacokinetic/pharmacodynamic parameters are shown. Meta-analysis of randomized clinical trials showed the higher clinical efficacy of ceftaroline in comparison to ceftriaxone with similar adverse event rate. Summarized analysis of antibiotic susceptibility data, pharmacokinetic/pharmacodynamic and clinical data, as well as negative epidemiological trends confirms the necessity of optimization of antimicrobial therapy of CAP for implementation of ceftaroline advantages against pneumococci and staphylococci in comparison to other β-lactams. Therefore, empiric treatment with ceftaroline is the most rational option for the therapy of CAP in critically ill patients during the season of respiratory viral infection.

Download Full-text

Persistent Allergic Minimum Phlogosis as Mechanistic Link Between Recurrent Respiratory Infections and Atopy: A Single Center Pilot Study

Current Respiratory Medicine Reviews ◽

10.2174/1573398x13666170517142831 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Caterina Cuppari ◽

Sara Manti ◽

Annamaria Salpietro ◽

Simona Valenti ◽

Dominique De Vivo ◽

...

Keyword(s):

Pilot Study ◽

Respiratory Infections ◽

Single Center ◽

Recurrent Respiratory Infections

Download Full-text

Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

International Journal of STD & AIDS ◽

10.1177/0956462420918682 ◽

2020 ◽

Vol 31 (7) ◽

pp. 705-707

Author(s):

Venkateshwaran Sivaraj ◽

Rudiger Pittrof ◽

Olubanke Davies ◽

Ranjababu Kulasegaram

Keyword(s):

Bacterial Infections ◽

Substance Misuse ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hiv Positive ◽

Care Hospital ◽

Hiv Viral Load ◽

Cd4 Cell Count ◽

Cell Counts ◽

Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

Download Full-text

The lung–gut axis during viral respiratory infections: the impact of gut dysbiosis on secondary disease outcomes

Mucosal Immunology ◽

10.1038/s41385-020-00361-8 ◽

2021 ◽

Author(s):

Valentin Sencio ◽

Marina Gomes Machado ◽

François Trottein

Keyword(s):

Gut Microbiota ◽

Bacterial Infections ◽

Respiratory Infections ◽

Critical Role ◽

Good Health ◽

Disease Outcomes ◽

And Function ◽

Viral Respiratory Infections ◽

The Impact ◽

Viral Respiratory

AbstractBacteria that colonize the human gastrointestinal tract are essential for good health. The gut microbiota has a critical role in pulmonary immunity and host’s defense against viral respiratory infections. The gut microbiota’s composition and function can be profoundly affected in many disease settings, including acute infections, and these changes can aggravate the severity of the disease. Here, we discuss mechanisms by which the gut microbiota arms the lung to control viral respiratory infections. We summarize the impact of viral respiratory infections on the gut microbiota and discuss the potential mechanisms leading to alterations of gut microbiota’s composition and functions. We also discuss the effects of gut microbial imbalance on disease outcomes, including gastrointestinal disorders and secondary bacterial infections. Lastly, we discuss the potential role of the lung–gut axis in coronavirus disease 2019.

Download Full-text

The Efficacy of Convalescent Plasma Use in Critically Ill COVID-19 Patients

Medicina ◽

10.3390/medicina57030257 ◽

2021 ◽

Vol 57 (3) ◽

pp. 257

Author(s):

Livius Tirnea ◽

Felix Bratosin ◽

Iulia Vidican ◽

Bianca Cerbu ◽

Mirela Turaiche ◽

...

Keyword(s):

Pilot Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Therapeutic Option ◽

White Blood Cells ◽

The United States ◽

Plasma Therapy ◽

Reactive Protein ◽

United States Food ◽

States Food

Background and Objectives: On 24 March 2020, the United States Food and Drug Administration (FDA) announced the approval of convalescent plasma therapy for critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergency investigational new drug. This pilot study from Romania aimed to determine if convalescent plasma transfusion can be beneficial in the treatment of selected critically ill patients diagnosed with a SARS-CoV-2 infection. Materials and Methods: Donor and receiver eligibility for critically ill coronavirus disease 2019 (COVID-19) patients was based on Romanian guidelines issued at the time of the study. Here, we describe the evolution of a total of five eligible patients diagnosed with COVID-19 who received convalescent plasma (CP) in Romania. Results: In spite of our efforts and convalescent plasma administration, three of the five patients did not survive, while the other two recovered completely. Over the course of our five-day laboratory record, the surviving patients had significantly lower values for C-reactive protein, interleukin-6, and white blood cells. Conclusions: This pilot study provides insufficient evidence to determine the efficacy of convalescent plasma use as a therapeutic option for critically ill COVID-19 patients.

Download Full-text

Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study

European Journal of Medical Research ◽

10.1186/s40001-021-00553-3 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Ghodsiyeh Azarkar ◽

Freshteh Osmani

Keyword(s):

Risk Factors ◽

Platelet Count ◽

Protein Level ◽

Clinical Characteristics ◽

Single Center ◽

C Reactive Protein ◽

Reactive Protein ◽

Risk Of Death ◽

Survivor Group ◽

Epidemiological Characteristics

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.

Download Full-text