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Objective:To analyze the features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infected with other common respiratory pathogens among coronavirus disease 2019 (COVID-19) patients in Shanghai City, and to provide a reference for scientific prevention and control of COVID-19 and other respiratory infectious diseases.Methods:Descriptive epidemiological approaches were used to analyze the data of COVID-19 reported cases in Shanghai City from January 2020 to February 2021 in the information system of Chinese Disease Prevention and Control. Clinical data of the participants were collected, and their SARS-CoV-2 nucleic acid-positive respiratory specimens were collected at the time of illness onset or admission. Multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the 22 respiratory pathogens. Independent-samples t test was used for statistical analysis. Results:Of the 272 patients with COVID-19, 15(5.5%) had co-infection of SARS-CoV-2 with other respiratory pathogens, all of which were double infection. There were three cases infected with enterovirus/rhinovirus, two of each with adenovirus, human metapneumovirus and coronavirus NL63/HKU1, and one of each with coronavirus 229E, influenza A virus H1N1, parainfluenza virus 1 and respiratory syncytial virus B. Two cases infected with Mycoplasma pneumoniae. Among the 272 COVID-19 patients, 212(77.9%) had fever, 117(43.0%) had cough, 46(16.9%) had fatigue, and 35(12.9%) had sore throat. The white blood cell count of co-infection cases was higher than that of non-co-infection cases ((6.8±1.7)×10 9/L vs (5.3±1.6)×10 9/L), and the difference was statistically significant ( t=3.09, P=0.008). Conclusions:There is a certain proportion of co-infection of SARS-CoV-2 with other respiratory pathogens among the COVID-19 cases in Shanghai City, mainly viral pathogens, especially enterovirus/rhinovirus. A rational combination of drugs was recommended to improve the cure rate. Surveillance of acute respiratory infection should be further strengthened as well.
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Objective:To investigate the distribution characteristics and clinical significance of non-bacterial respiratory pathogens in children with respiratory tract infection.Methods:A total of 5 718 children with respiratory tract infection treated in outpatient, emergency and inpatient of Children′s Hospital Affiliated to Capital Institute of Pediatrics from January to December 2019 were retrospectively analyzed.Pharyngeal swabs were collected and nucleic acids of 7 common non-bacterial respiratory pathogens were detected and analyzed by double amplification technique. Chi square test was used to compare the rates. Results:A total of 5 718 children were included in the study.At least one respiratory pathogen nucleic acid positive was detected in 1 835 cases (32.09%). A total of 98 children had mixed infection of more than 2 pathogens (1.71%), which were mainly Mycoplasma pneumoniae (MP) and parainfluenza virus (PIV). The positive rates of 7 respiratory pathogens from high to low were MP (12.31%), PIV (6.23%), RSV (6.14%), influenza A virus (4.62%), adenovirus (2.80%), influenza B virus (1.40%) and chlamydia pneumoniae (0.33%). The positive rate of pathogens in male patients was 32.07% (1 073/3 346 cases), which was 32.12% (762/2 372 cases) in female patients.There was no significant difference in the positive rate of pathogens between males and females ( χ2=0.002, P=0.964). The positive rate of MP infection in male patients was significantly lower than that in females (11.48% vs. 13.49%) ( χ2=5.217, P=0.022). The total positive rate of infection in the 6 to <12 years old group was the highest (42.41%). The total positive rate (44.93%) and mixed infection rate (3.33%) were significantly higher in the fourth quarter than those of the others (30.43% vs.27.31% vs.34.59% vs.44.93%, 1.23% vs.1.10% vs.1.40% vs.3.33%; χ2=110.971, 26.968, all P<0.001). The total positive rate of pathogen infection in the outpatient and emergency department was 41.74% (606/1 452 cases), which was significantly higher than that of hospitalized children (31.13%) (1 328/4 266 cases) ( χ2=54.438, P<0.001). Conclusions:Non-bacterial respiratory pathogens are important pathogens leading to respiratory tract infections in children, among which MP infection is the most prevalent.Timely and accurate detection of pathogens is helpful for the diagnosis and treatment of respiratory tract infection and avoiding the abuse of antibiotics.
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Objective@#To investigate the effect of capillary electrophoresis-based multiplex PCR (CEMP) in detecting pathogens for children respiratory tract infection, and to provide scientific basis for clinical diagnosis and treatment rapidly and accurately.@*Methods@#The cases were defined according to the national monitoring program of febrile respiratory syndrome during the 12th Five-Year Plan, and the samples were collected from nasopharyngeal swabs, bronchoalveolar lavage fluid and sputum of children with respiratory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018.Multiplex PCR amplification was performed by one-step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by "Genemapper software" software.Detecting pathogens included Influenza A virus (InfA), Human Adenovirus (HADV), Boca virus (Boca), Human Rhinovirus (HRV), Novel InfA-09H1 (InfA-09H1) and Seasonal Influenza virus H3N2 (InfA-H3N2), Parainfluenza virus (HPIV), Human metapneumonia virus (HMPV), Influenza B virus (InfB), Mycoplasma pneumoniae (Mp), Chlamydia pneumoniae (CP), Human Coronavirus (HCOV), Human Respiratory Syncytial virus (HRSV).@*Results@#The effective detection rate of the CEMP assay was 95.71%.The positive detection rate of respiratory tract pathogens was 62.84% and the mixed infection rate was 9.61%.The mixed infection was mainly InfA and HRSV.The highest three positive rates were named InfA, HRSV and Mp.The positive rate of HRSV was significantly higher in the 0-3 age group than that in older group.Different pathogens were detected in different age groups, and the high-occurrence season of respiratory tract infection with virus was from December to March of the next year.InfA-09H1 was the main prevalent influenza virus in January, February and March 2017, InfA-H3N2 was the main prevalent influenza virus in November and December 2017, and the outbreak of InfB was happened in Changchun in late 2017 and early 2018.HRSV was detected only in the coldest season in Changchun from November to March of the next year.Different pathogens were detected in different respiratory infection.HRSV was the main pathogen detected in pneumonia; InfA-03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection.@*Conclusion@#CEMP is an efficient, rapid and accurate method for the detection of pathogens in patients with respiratory tract infections, and it will have a broad application prospect to develop reagents suitable for clinical diagnosis.
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Objective To investigate the effect of capillary electrophoresis﹣based multiplex PCR ( CEMP) in detecting pathogens for children respiratory tract infection,and to provide scientific basis for clin﹣ical diagnosis and treatment rapidly and accurately. Methods The cases were defined according to the na﹣tional monitoring program of febrile respiratory syndrome during the 12th Five﹣Year Plan,and the samples were collected from nasopharyngeal swabs,bronchoalveolar lavage fluid and sputum of children with respira﹣tory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018. Multi﹣plex PCR amplification was performed by one﹣step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by"Genemapper software" software. Detecting pathogens included Influenza A virus (InfA),Human Adenovirus (HADV),Boca virus ( Boca), Human Rhinovirus ( HRV), Novel InfA﹣09H1 ( InfA﹣09H1 ) and Seasonal Influenza virus H3N2 ( InfA﹣H3N2),Parainfluenza virus ( HPIV),Human metapneumonia virus ( HMPV), Influenza B virus ( InfB), Mycoplasma pneumoniae (Mp),Chlamydia pneumoniae ( CP),Human Coronavirus ( HCOV),Human Re﹣spiratory Syncytial virus (HRSV). Results The effective detection rate of the CEMP assay was 95. 71%. The positive detection rate of respiratory tract pathogens was 62. 84% and the mixed infection rate was 9. 61%. The mixed infection was mainly InfA and HRSV. The highest three positive rates were named InfA, HRSV and Mp. The positive rate of HRSV was significantly higher in the 0﹣3 age group than that in older group. Different pathogens were detected in different age groups,and the high﹣occurrence season of respiratory tract infection with virus was from December to March of the next year. InfA﹣09H1 was the main prevalent influenza virus in January,February and March 2017,InfA﹣H3N2 was the main prevalent influenza virus in November and December 2017,and the outbreak of InfB was happened in Changchun in late 2017 and early 2018. HRSV was detected only in the coldest season in Changchun from November to March of the next year. Different pathogens were detected in different respiratory infection. HRSV was the main pathogen detec﹣ted in pneumonia; InfA﹣03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection. Conclusion CEMP is an effi﹣cient,rapid and accurate method for the detection of pathogens in patients with respiratory tract infections,and it will have a broad application prospect to develop reagents suitable for clinical diagnosis.
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Objective To investigate the epidemiology of pathogens causing acute respiratory in-fections in children in Beijing from December 2016 to February 2018. Methods Clinical data of 34665 ca-ses of acute respiratory infections in Beijing Children's Hospital from December 2016 to February 2018 were reviewed. Indirect immunofluorescence antibody test ( IFAT) was performed to detect IgM antibodies against eight common respiratory pathogens including respiratory syncytial virus ( RSV) , influenza virus A ( IFA) , influenza virus B (IFB), parainfluenza virus (PIV), adenovirus (ADV),Mycoplasma pneumonia (MP), Chlamydia pneumonia (CP) and Legionella pneumophila (LP). SPSS19. 0 software was used for statistical analysis. Results In the 34665 cases, 50. 45％ children were infected with at least one kind of respiratory pathogen. There were 56. 11％ (10309/18372) in mild outpatient group and 44. 06％ (7179/16293) in severe inpatient group. IFB was the most prevalent pathogen with a positive rate of 36. 56％ and co-infection rate of 9. 78％. IFB and MP co-infection was more common. Most of RSV strains were detected in children under 1 year of age. The positive rates of IFA, IFB and PIV peaked in patients at ages of 4-5 years. The rates of ADV, MP, CP and LP infections increased with age. IFB, MP, IFA and RSV were more prevalent in winter and spring. Other pathogens caused sporadic cases throughout the year. There were significant differences in the detection rates of IgM antibodies against the eight respiratory pathogens between the mild and severe groups (P=0. 00). Conclusions This study analyzed the epidemiology of respiratory pathogens in Beijing from December 2016 to February 2018 through reviewing test results of IgM antibodies against eight common respiratory pathogens in children with acute respiratory infections. It might be conductive to the prevention of antimicrobial abuse and reduction of economic burden to families.
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Respiratory infections, which are caused by airborne pathogens, are the most common disease of all ages worldwide. This study was conducted to characterize the airborne respiratory pathogens in the public facilities in Busan, South Korea. A total of 260 public facilities were investigated in 2017, 52 seasonal indoor air from 2 hospitals and 208 indoor air samples from 208 randomly selected daycare centers. Among respiratory pathogen, 8 viral pathogens including human adenovirus (HAdV), human bocavirus (HBoV), human rhinovirus (HRV), human parainfluenza virus (HPIV), human respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), human coronavirus (HCoV) and influenza virus (IFV), and 3 bacterial pathogens including Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydophila pneumoniae, were investigated by multiplex real-time reverse transcription polymerase chain reaction. Pathogens were detected in 9 cases (3.4%). Among 9 positive samples, 6 (2.3%) cases were positive for HBoV and 3 (1.2%) cases were positive for IFV. All the positive cases were detected in daycare centers. Additionally, the concentration of HBoV was determined. In HBoV-positive samples, the cycle threshold (Ct) values of HBoV were 29.73~36.84, which are corresponding to the viral concentration of 4.91 × 10⁰ ~ 9.57 × 10² copies/ml. Serotype distribution of isolated HBoV was analyzed by sequencing of VP1/VP2 gene. All of the HBoV isolates were identified as HBoV type 1 with a high similarity among the isolates (>97%). No bacterial pathogen was identified in indoor air samples. Although virus concentration was not high in public facilities (daycare center), the presence of respiratory viral pathogens has been identified. Effective ventilation and air purification strategies are needed to reduce the indoor concentration of respiratory pathogens. A long-term and ongoing surveillance plan for respiratory pathogen management should be established.
Subject(s)
Humans , Adenoviruses, Human , Bordetella pertussis , Chlamydial Pneumonia , Chlamydophila pneumoniae , Coronavirus , Human bocavirus , Korea , Metapneumovirus , Mycoplasma pneumoniae , Orthomyxoviridae , Paramyxoviridae Infections , Pneumonia, Mycoplasma , Polymerase Chain Reaction , Public Facilities , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Reverse Transcription , Rhinovirus , Seasons , Serogroup , VentilationABSTRACT
OBJECTIVE: To discuss essential points in performance evaluation and clinical trial of respiratory multi-pathogen nucleic acid assay, providing constructive suggestions for product research and development as well as regulatory registration. METHODS: Based on the features and intended use of the assay, requirements of national food and drug regulatory division and personal experiences in examining IVD products to demonstrate essential points and approaches in performance evaluation and clinical trial by illustrating examples. RESULTS: The verification of the limit of detection, analytical specificity, precision and the enterprise references were included in the performance evaluation. The total number of samples and the number of positive sample, genotype, reference products and statistical analysis etc. were included in the clinical trial study. CONCLUSION: The performance evaluation and the clinical trial study are an important part of the estimation of product performance. They are an important way to assess the safety and effectiveness of the product before the product goes into the market and also an important part of the technical review in the product registration. Applicants should take full account of scientific and comprehensive evaluation methods in product development and registration process, and based on the product characteristics and intended use to verify the product adequately.
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Streptococcus pseudopneumoniae is a member of Viridans streptococci, associated with chronic obstructive lung disease and lower respiratory infection. It is non-capsulated, bile insoluble and optochin susceptible in ambient air but intermediate or resistant in 5%CO2. But, its role as a pathogen is yet to be established. The objective of the study was to detect the prevalence and to determine the clinical significance of S.pseudopneumoniae in sputum samples. The study period was 5 months. Good quality sputum samples (>25 neutrophils and <10 epithelial cells/LPF) of patients suspected of LRTIs, were inoculated onto chocolate agar. Alpha haemolytic colonies were identified by testing for capsule by India ink preparation, bile solubility and optochin susceptibility in ambient air and 5%CO2. Antibiotic sensitivity testing was done by Kirby-Bauer's disc diffusion method. Out of 66 alpha haemolytic colonies, 4 were S.pseudopneumoniae, 17 were S.pneumoniae and 45 were other Viridans streptococci. Antibiotic sensitivity patterns of S.pseudopneumoniae and S.pneumoniae were analyzed. S.pseudopneumoniae is misinterpreted as S.pneumoniae unless specifically looked for. As there is scant information available, studies have to be encouraged for better determination of clinical importance of S.pseudopneumoniae. This will help in right diagnosis and successful treatment.
Subject(s)
Drug Resistance, Microbial , Humans , Microbial Sensitivity Tests , Respiratory Tract Infections/microbiology , Sputum/microbiology , Streptococcus/classification , Streptococcus/drug effects , Streptococcus/isolation & purification , Streptococcus/microbiologyABSTRACT
Objective To investigate the diagnosis value of serum procalcitonin(PCT)detection combined with antibody de-tection of respiratory pathogens in children with pneumonia.Methods 1 256 cases of pneumonia in children were collected in the hospital from 2013 July to 2014 January were analyzed,detection PCT by chemiluminescence,using enzyme linked immu-nosorbent assay for detection of Mycoplasma pneumoniae ,Chlamydia pneumoniae and common respiratory virus.Results The positive rates of PCT was 30.7%,and MP IgM,CP IgM,RSV IgM,ADV IgM and FLUA IgM were 21.4%,16.8%, 11.8%,8.4%,and 10.9%.PCT in children with different gender in the largest number of positive cases,respectively,male 227 cases and female 158 cases,but the PCT and respiratory pathogen antibody positive in different gender did not exist sta-tistical difference (P >0.05).In different age groups,procalcitonin positive cases in 1 years in the group most,Mycoplasma pneumoniae and Chlamydia pneumoniae IgM positive cases in 1~3 years old were the largest number,the number of respir-atory virus positive patients with different maximum performance in different age groups.PCT and respiratory pathogen an-tibody positive in different age there was no statistical difference (P >0.05).Conclusion The PCT combined with respira-tory pathogen detection of antibodies help the clinic to determine the type of pneumonia in children,to provide help for the diagnosis and treatment of pneumonia in children.
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Objective To investigate the correlation between atypical respiratory pathogens infection and serum total IgE levels . Methods Serum IgM level was detected in 1 913 blood samples of children with atypical respiratory infection by using indirect im‐munofluorescence assay ,including mycoplasma pneumonia(MP) ,legionella pneumophila (LP) ,rickettsia Q(QFR) ,chlamydia pneu‐monia(CPn) ,adenovirus (Adv) ,respiratory syncytial virus (RSV) ,influenza A virus (IAv) ,influenza B virus (IBv) and parainflu‐enza virus (PIV)1/2/3 .The serum total IgE level was detected by immune scatter turbidimetry .Software SPSS 17 .0 was used in data statistical analysis .Results A total of 991 out of 1 913 samples of respiratory inflected children exhibited positive(positive group) ,while 922 exhibited negative(negative group) in indirect immunofluorescence assay .650 out of the 991 positive samples (65 .59% ) contained MP infection and the combination of MP infection and other virus infections .The serum total IgE level in posi‐tive group was significantly higher than that of the negative group ,and the serum total IgE level in samples with MP infection was higher than that in samples with IBv infection ,Adv infection ,and RSV infection .In the samples in which serum total IgE level was higher than the clinical reference range (100 kU/mL) ,the infection rate of MP infection alone was 31 .29% ,which was evidently higher than that in samples of low IgE level(< 100 kU/mL ,21 .30% ) .On the other hand ,the infection rate of RSV alone was 1 .88% and the infection rate of Adv alone was 3 .13% ,which were both evidently lower than those in samples with normal serum total IgE level(both 6 .53% ) .Conclusion MP is the most common pathogen in children with atypical respiratory pathogen infec‐tion ,and can lead to higher serum total IgE levels .
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La fibrosis quística (FQ) se caracteriza por disfunciones en las glándulas de secreción exocrina del organismo. Las primeras manifestaciones suelen observarse en el sistema respiratorio, constituyendo una de las causas más importantes de morbimortalidad en los pacientes afectados. Los microorganismos patógenos que colonizan frecuentemente el tracto respiratorio de estos pacientes son Staphylococcus aureus, Haemophilus spp., y Pseudomonas aeruginosa. Entre noviembre de 2001 y agosto de 2004 se estudiaron 222 muestras respiratorias de pacientes con FQ de entre 4 meses y 11 años de edad. Se aislaron S. aureus (38,7%), P. aeruginosa (37,4%) y Haemophilus spp., (15,3%). En S. aureus la meticilina-resistencia fue del 25,9% y se asoció con altas resistencias a eritromicina (35,0%) y clindamicina (29,4%). El mayor porcentaje de resistencia observado en las cepas de P. aeruginosa fue frente a gentamicina (31,0%). Los aislamientos de Haemophilus spp. fueron resistentes a ampicilina (23,0%) debido a la presencia de beta-lactamasas, y a trimetoprima/sulfametoxazol (59,0%).
Cystic Fibrosis (CF) is characterized by a dysfunction of the exocrine secretion glands. The first symptoms often appear in the respiratory system which constitutes one of the most important morbimortality causes in these patients. Chronic respiratory tract colonization is caused mainly by bacteria such as Staphylococcus aureus, Haemophilus spp. and Pseudomonas aeruginosa. Respiratory samples from patients with CF (age group: 4 months to 11 years) were analyzed from November 2001 to August 2004. The most frequently isolated microorganisms were S. aureus (38.7%), P. aeruginosa (37.4%) and Haemophilus spp (15.3%). A high resistance to erithromycine (35.0%) and clindamicine (29.4%) was observed in S. aureus strains and 25.9% of them were methicillin-resistant. P. aeruginosa strains were mainly gentamicin-resistant (31.0%). The rate of ampicillin-resistant Haemophilus spp. was 23.0% and it was due to the presence of beta-lactamases, but a high trimethoprim-sulfamethoxazole resistance was observed in this microorganism (59.0%).