ABSTRACT
Background: Dengue virus infection is a major public health problem. A hypothesis put forward for severe dengue is the cytokine storm, a sudden increase in cytokines that induces vascular permeability. Previous studies and our recent meta-analysis showed that IL-6, IL-8, IFNγ, TNFα, VEGF-A and VCAM-1 are associated with dengue shock syndrome. Therefore, in this study we aim to validate the association of these cytokines with severe dengue. Methods & Findings: In a hospital based case control study in Vietnam, children with dengue fever, other febrile illness and healthy controls were recruited. Dengue virus infection was confirmed by several diagnostic tests. Multiplex Immunoassay using Luminex technology was used to measure cytokines simultaneously. A positive association with dengue shock syndrome was found for VCAM-1, whereas a negative association was found for IFNγ. Furthermore, the multivariate logistic analysis also showed that VCAM-1 and IFNγ were independently correlated with dengue shock syndrome. Conclusion: IFNγ and VCAM-1 were associated with dengue shock syndrome, although their role in the severe dengue pathogenesis remains unclear. Additional studies are required to further investigate the function of these cytokines in severe dengue.
ABSTRACT
Background: Dengue virus infection is a major public health problem. A hypothesis put forward for severe dengue is the cytokine storm, a sudden increase in cytokines that induces vascular permeability. Previous studies and our recent meta-analysis showed that IL-6, IL-8, IFNγ, TNFα, VEGF-A and VCAM-1 are associated with dengue shock syndrome. Therefore, in this study we aim to validate the association of these cytokines with severe dengue. Methods & Findings: In a hospital based-case control study in Vietnam, children with dengue fever, other febrile illness and healthy controls were recruited. Dengue virus infection was confirmed by several diagnostic tests. Multiplex immunoassay using Luminex technology was used to measure cytokines simultaneously. A positive association with dengue shock syndrome was found for VCAM-1, whereas a negative association was found for IFNγ. Furthermore, multivariate logistic analysis also showed that VCAM-1 and IFNγ were independently correlated with dengue shock syndrome. Conclusion: IFNγ and VCAM-1 were associated with dengue shock syndrome, although their role in the severe dengue pathogenesis remains unclear. Additional studies are required to shed further light on the function of these cytokines in severe dengue.
ABSTRACT
A prospective cohort study about the incidence of nosocomial infection (NI) was carried out on 671 patients treated at Pediatric Intensive Care Unit in 14 months. The incidence of NI was 22.9% and 29.3/1000 patient-days, in which nosocomial pneumonia accounts for 49.4%, 43.1/1000 ventilator-days; septicema: 27.3%, 49.3/1000 central catheter-days; surgical site infection: 12.3%, catheter-induced infection: 11.7%; urinary tract infection: 58%, 41.9/1000 urinary catheter-day. Day of onset NI was 6.4±5 days. NI rate is higher in moderate malnutrition, co-morbidities, immunocompromise patients. Main causes were gram negative (79.8%). The mortality rate of the patients with NI was 36.4% significantly higher than that of the patients without NI (8.6%)
Subject(s)
Child , Cross InfectionABSTRACT
A prospective cohort study was conducted on 671 patients, who were admitted to the pediatric intensive care unit of the Children Hospital N0 1 in the period of 14 months, to identify risk factors for nosocomial infections (NI). Results: NI rate was 22.9% and 29.3/1000 patient-days, in which nosocomial pneumonia accounted for 49.4%, surgical site infection 12.3%, catheter site infection 11.7%, urinary tract infection 5.8%. There is no significant difference of NI rate in age and sex (p>0.05). By multiple logistic regression analysis, the risk factors for NI were: 2nd degree malnutrition, PRISM score, multiple invasive interventions, antibiotic therapy, H2 receptor blocker, parenteral nutrition. Risk factors for nosocomial pneumonia were intubation, duration of intubation >5 days, reintubation, H2 receptor blockers, aspiration. Risk factors for blood stream infection included venous cutdown, central venous catheter, duration of central venous catheter >3 days, parenteral nutrition. The risk factors for surgical site infection consisted of gastrointestinal surgery, post operative drain, duration of drain >5 days. The risk factors for urinary tract infection were urinary catheter, duration of urinary catheter >3 days