ABSTRACT
Many microbial species have been recognized as enteropathogens for humans. Here, we predicted the causative agents of acute diarrhea using data from multiplex quantitative PCR (qPCR) assays targeting 19 enteropathogens. For this, a case-control study was conducted at eight hospitals in Thailand. Stool samples and clinical data were collected from 370 hospitalized patients with acute diarrhea and 370 non-diarrheal controls. Multiple enteropathogens were detected in 75.7% and 13.0% of diarrheal stool samples using multiplex qPCR and bacterial culture methods, respectively. Asymptomatic carriers of enteropathogens were found among 87.8% and 45.7% of individuals by qPCR and culture methods, respectively. These results suggested the complexity of identifying causative agents of diarrhea. An analysis using the quantification cut-off values for clinical relevance drastically reduced pathogen-positive stool samples in control subjects from 87.8% to 0.5%, whereas 48.9% of the diarrheal stool samples were positive for any of the 11 pathogens. Among others, rotavirus, norovirus GII, Shigella/EIEC, and Campylobacter were strongly associated with acute diarrhea (P-value < 0.001). Characteristic clinical symptoms, epidemic periods, and age-related susceptibility to infection were observed for some enteropathogens. Investigations based on qPCR approaches covering a broad array of enteropathogens might thus improve our understanding of diarrheal disease etiology and epidemiological trends.
Subject(s)
Bacteria , Diarrhea/microbiology , Feces/microbiology , Multiplex Polymerase Chain Reaction , Real-Time Polymerase Chain Reaction , Acute Disease , Bacteria/classification , Bacteria/genetics , Bacteria/isolation & purification , Diarrhea/epidemiology , Female , Humans , Male , Thailand/epidemiologyABSTRACT
BACKGROUND: Acute asthmatic exacerbation and readmission may be associated with severe influenza infection and asthmatic children are a priority group for influenza vaccination. To date, our study is the first to evaluate the outcome of the influenza vaccine in asthmatic Asian children. OBJECTIVE: To analyze the outcomes of inactivated influenza vaccine in children with mild persistent asthma METHODS: A cross sectional non-randomized study was performed on 93 mild persistent asthmatic children who attended the Pediatric Allergy clinic between June 2012 in Chiang Rai Hospital and August 2013. Forty eight patients were immunized with 2 doses of inactivated influenza vaccine at one month interval. Respiratory illnesses and asthma-related events were compared between the immunized and the un-immunized groups. RESULTS: The two study groups had similar demographic and clinical characteristic except with regards to eczema, including asthma controllers and skin prick testing results. One year after the vaccine was administered, the immunized group had significantly reduced acute respiratory tract illnesses, asthma exacerbations, ER visits, bronchodilator usage and systemic steroid administrations. Hospitalizations (p < 0.001) and their duration (p < 0.034) were also reduced in the immunized group. CONCLUSIONS: Immunization of inactivated influenza vaccine in children with mild persistent asthma decreased respiratory illnesses and asthma-related events.
