Persistence of non-typeable Haemophilus Influenzae in the pharynx of children with adenotonsillar hypertrophy after treatment with azithromycin.

This study was performed in children with adenotonsillar hypertrophy to evaluate the effect of azithromycin (AZT) on the presence of NTHi in monocyte/macrophages (CD14(+) cells) of adenoids/tonsils and the persistence of NTHi after adenotonsillectomy. A total of 36 pediatric patients participated in the study: 20 children were treated with AZT before adenotonsillectomy, and 16 children did not receive the antibiotic prior to surgery. NTHi were identified by culture and PCR in swabs and tissue samples. NTHi was detected in the lysates of CD14(+) cells by fluorescence in situ hybridization (FISH) and by culture. The molecular typing was used to cluster NTHi isolates from each child. The intracellular NTHi was found in 10 (62.5%) untreated patients and was identified in three (15%) azithromycin-treated patients (P = 0.003). The proportion of the persistent NTHi strains was similar in both groups. AZT treatment followed by adenotonsillectomy did not completely eliminate NTHi from pharynges; however, it significantly reduced the risk of carriage of Haemophilus influenzae inside the CD14(+) cells.

Vaccination status and perception of influenza vaccination in the Polish population.

Influenza is still considered to be the most dangerous infectious disease of the twenty-first century. Outbreaks of influenza occur worldwide and affect all ages. The disease is severe, often with threatening complications and can lead to death, albeit many people have it in disregard. One of the main ways of preventing the disease is vaccination. The most effective method of prevention against influenza illness and its complications are annual vaccinations. Vaccinations, although recommended by the Ministry of Health in Poland, are not subject to refund. This paper presents the results of research conducted with the use of an anonymous questionnaire containing 18 questions to be completed by parents of school children, students of technical and medical universities, patients, medical staff, and people over 65 years of age. The study was conducted in the season of 2012/2013 in Poland. The survey involved 1,203 people in various age groups with different educational background. The analysis of the study shows that respondents very rarely use this form of prevention. Even if the vaccination were refunded, the percentage of people vaccinated against influenza would not increase significantly. Among the respondents, those who are in favor of influenza vaccination are in the minority.

Detection of respiratory tract pathogens with molecular biology methods.

This paper describes the use in routine diagnosis of virological kit, which was designed to identify the 15 most common respiratory viruses in clinical specimens of nasopharyngeal aspirates, swabs, and bronchoalveolar lavage. It is a one-step multiplex RT-PCR system for the detection of influenza virus type A and type B, human respiratory syncytial virus type A, B; human adenovirus, human metapneumovirus, human coronaviruses 229E/NL63 and OC43, human parainfluenza type 1, 2, 3, human rhinovirus type A, B, human enterovirus, and bocavirus 1, 2, 3, 4. The article presents research conducted on the basis of swabs collected from patients who came to the Ear, Nose, and Throat Emergency Care Unit at the Department of Otolaryngology, Military Medical Institute in Warsaw, in February 2013. Due to the nature of work in an laryngological emergency ward, the material was collected only from those patients who reported problems associated with rhinitis or any dysfunction of the upper respiratory tract. The study shows that patients who came to seek laryngological assistance were usually infected with viruses having affinity for the airway epithelium.

Identification of intracellular bacteria in adenoid and tonsil tissue specimens: the efficiency of culture versus fluorescent in situ hybridization (FISH).

Monocyte/macrophage cells from human nasopharyngeal lymphoid tissue can be a source of bacteria responsible for human chronic and recurrent upper respiratory tract infection. Detection and characterization of pathogens surviving intracellularly could be a key element in bacteriological diagnosis of the infections as well as in the study on interactions between bacteria and their host. The present study was undertaken to assess the possibility of isolation of viable bacteria from the cells expressing monocyte/macrophage marker CD14 in nasopharyngeal lymphoid tissue. Overall, 74 adenotonsillectomy specimens (adenoids and tonsils) from 37 children with adenoid hypertrophy and recurrent infections as well as 15 specimens from nine children with adenoid hypertrophy, which do not suffer from upper respiratory tract infections (the control group), were studied. The suitability of immunomagnetic separation for extraction of CD14(+) cells from lymphoid tissue and for further isolation of the intracellular pathogens has been shown. The coexistence of living pathogens including Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pyogenes with the bacteria representing normal nasopharyngeal microbiota inside CD14(+) cells was demonstrated. Twenty-four strains of these pathogens from 32.4 % of the lysates of CD14(+) cells were isolated. Concurrently, the fluorescent in situ hybridization (FISH) with a universal EUB388, and the species-specific probes demonstrated twice more often the persistence of these bacterial species in the lysates of CD14(+) cells than conventional culture. Although the FISH technique appears to be more sensitive than traditional culture in the intracellular bacteria identification, the doubts on whether the bacteria are alive, and therefore, pathogenic would still exist without the strain cultivation.

[Effect of surgical treatment of otitis media with effusion on children. Personal experience]. / Wyniki leczenia operacyjnego wysiekowego zapalenia ucha srodkowego u dzieci w materiale wlasnym.

The authors present their observations upon surgically treated children with otitis media with effusion. The results are indicative of usefulness of ventilation tubes, myringotomy and adenoidectomy in the treatment of the otitis media with effusion in children. The efficiency of the treatment is based on the hearing examination and tympanometry, and the lack of recurrence of inflammation of the middle ear. 67.6% of cases revealed normal hearing.

[Evaluation of selected immunologic indices in children with subglottic laryngitis]. / Ocena wybranych wskazników immunologicznych u dzieci z podglosniowym zapaleniem krtani.

Subglottic laryngitis (croup) is a common disease in children. Its etiology is not quite clear. Thirty children (28 boys and 2 girls), aged between 4 months and up to 5 years (mean 3.6 years), have been hospitalized for the inflammatory swelling of the subglottic space. Laboratory and allergy tests, including: immunoglobulins A, G, M, total IgE, specific IgE blood levels, blood T cell level, and NBT test have been carried out in all children. An increased IgE blood level have been noted in 15 (50%) children, and significantly increased blood level of specific IgE in 10 (33%) children of this subgroup. Blood IgA, IgG, and IgM level have been normal in all children. An increase in NBT test have been seen in 10 (33) children, and a decrease in the number of T cells in 21 (70%) children.