Influenza-Associated Outcomes Among Pregnant, Postpartum, and Nonpregnant Women of Reproductive Age

By Namrata Prasad, Q Sue Huang, Tim Wood, Nayyereh Aminisani, Colin McArthur, Michael G Baker, Ruth Seeds, Mark G Thompson, Marc-Alain Widdowson, E Claire Newbern

 The Journal of Infectious Diseases, June 15, 2019.

 

 

Pregnant women are prioritized for seasonal influenza vaccination, but the evidence on the risk of influenza during pregnancy that is used to inform these policies is limited.

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Evidence for Cross-Protection Against Subsequent Febrile Respiratory Illness Episodes From Prior Infections by Different Viruses Among Singapore Military Recruits 2009–2014

By I-Cheng Mark Chen, Jin Phang Loh, Cheryl X P Chuah, Qiu Han Christine Gao, Yinxiaohe Sun, Sock Hoon Ng, Wee-Hong Victor Koh, Ee Hui Goh, Xiahong Zhao, Paul Anantharajah Tambyah Alex R Cook, Jeremiah Chng, Junxiong Pang, Boon-Huan Tan, Vernon J Lee

The Journal of Infectious Diseases, June 15, 2019.

 

 

Few studies have evaluated the relative cross-protection conferred by infection with different groups of viruses through studies of sequential infections in humans. We investigated the presence of short-lived relative cross-protection conferred by specific prior viral infections against subsequent febrile respiratory illness (FRI).

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Pneumococcal Colonization in Healthy Adult Research Participants in the Conjugate Vaccine Era, United Kingdom, 2010–2017

By Hugh Adler, Elissavet Nikolaou, Katherine Gould, Jason Hinds, Andrea M Collins, Victoria Connor, Caz Hales, Helen Hill, Angela D Hyder-Wright, Seher R Zaidi, Esther L German, Jenna F Gritzfeld, Elena Mitsi, Sherin Pojar, Stephen B Gordon, Adam P Roberts, Jamie Rylance, Daniela M Ferreira

The Journal of Infectious Diseases, June 15, 2019.

 

 

Pneumococcal colonization is rarely studied in adults, except as part of family surveys. We report the outcomes of colonization screening in healthy adults (all were nonsmokers without major comorbidities or contact with children aged <5 years) who had volunteered to take part in clinical research. Using nasal wash culture, we detected colonization in 6.5% of volunteers (52 of 795). Serotype 3 was the commonest serotype (10 of 52 isolates). The majority of the remaining serotypes (35 of 52 isolates) were nonvaccine serotypes, but we also identified persistent circulation of serotypes 19A and 19F. Resistance to at least 1 of 6 antibiotics tested was found in 8 of 52 isolates.

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Serum Metabolome Is Associated With the Nasopharyngeal Microbiota and Disease Severity Among Infants With Bronchiolitis

By Christopher J Stewart, Jonathan M Mansbach, Nadim J Ajami, Joseph F Petrosino, Zhaozhong Zhu, Liming Liang, Carlos A Camargo, Jr, Kohei Hasegawa

The Journal of Infectious Diseases, June 15, 2019.

 

 

Emerging evidence suggests relationships between the nasopharyngeal metabolome and both the microbiota and severity of bronchiolitis. However, the influence of host systemic metabolism on disease pathobiology remains unclear. We aimed to examine metabolome profiles and their association with more-severe disease, defined by use of positive pressure ventilation (PPV), in infants hospitalized for bronchiolitis.

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Effectiveness of the 10-valent pneumococcal conjugate vaccine among girls, boys, preterm and low-birth-weight infants - Results from a randomized, double-blind vaccine trial.

By H.Nieminen, H.Rinta-Kokko, J.Jokinen, T.Puumalainen, M.Moreira, D.Borys, L.Schuerman, A.A.Palmu

Vaccine, To be published June 19, 2019

 

Several studies have shown differences in susceptibility to infections and immune response to vaccines by sex. Prematurely born infants are at higher risk for pneumococcal diseases, with lower effectiveness for some vaccines compared to term infants. We have reported the effectiveness of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) on several endpoints in the Finnish Invasive Pneumococcal disease (FinIP) vaccine trial. Now, we present the results of a post-hoc analysis evaluating PHiD-CV10 effectiveness in subgroups by sex, gestational age, and birth weight.

The FinIP trial was a phase III/IV cluster-randomized, double-blind trial. Infants enrolled < 7 months of age received PHiD-CV10 in two thirds of clusters (3 + 1 or 2 + 1 schedule) and hepatitis B vaccine as control in remaining third. Outcome data included invasive pneumococcal disease, pneumonia, tympanostomy tube placements, and antimicrobial purchases collected through national, routinely used health registers. Negative binomial model was used in the incidence and vaccine effectiveness estimation, and differences in incidences between subgroups were tested among control children.

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Evolution of serotypes in bacteremic pneumococcal adult pneumonia in the period 2001–2014, after introduction of the pneumococcal conjugate vaccine in bizkaia (spain)

By Pedro P. España, Ane Uranga, Luis Alberto, Ruiz Jose María Quintana, Amaia Bilbao, Amaia Aramburu, Leyre Serrano, Rafael Ayarza, Ana Patricia Martinez, Rafael Zalacain

Vaccine, To be Published June 27, 2019

 

The introduction of pneumococcal conjugate vaccines (PCV7 and PCV13) in children has led to a change in the pattern of pneumococcal serotypes causing pneumococcal disease in adults. The aim of this study is to analyze the distribution of pneumococcal serotypes in adults with bacteremic pneumococcal community-acquired pneumonia (BPP) after the introduction of PCVs in childhood, and the impact of age and comorbidity on this distribution. We conducted an observational study of all adults hospitalized with BPP between 2001 and 2014, in two tertiary hospitals. Overall, we identified 451 cases of BPP (2001–2005: 194, 2006–2010: 134, 2011–2014: 123). The rate of appearance of new cases decreased over the study period. In 70% of the cases, the serotypes found were among those included in PCV13. The most prevalent serotypes were 3 (23.1%), 7F (14.6%), 19A (8.4%) and 1 (7.5%). There was a significant trend to decrease in the percentage of BPP cases due to PCV7 from period 2001–2005 to 2011–2014 (p = 0.0166) and a significant trend to increase in the six serotypes added to form PCV 13 (p = 0.0003). Serotype 3 was the most frequent in patients who developed complications during hospitalization. We did not detect a significant increase in cases caused by non-PCV13 serotypes. The most frequent non-PCV13 serotype was 22F. In conclusion, a significant proportion of adults continue to develop BPP with vaccine serotypes despite infant pneumococcal vaccination. There is a need for further strategies to reduce the current burden of this disease on adults.

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Effects of Sequential Influenza A(H1N1)pdm09 Vaccination on Antibody Waning

By Jon Zelner, Joshua G Petrie, Rob Trangucci, Emily T Martin, Arnold S Monto

The Journal of Infectious Diseases, To be published July 2019

 

Antibody waning following influenza vaccination has been repeatedly evaluated, but waning has rarely been studied in the context of longitudinal vaccination history.

We developed a Bayesian hierarchical model to assess the effects of sequential influenza A(H1N1)pdm09 vaccination on hemagglutination inhibition antibody boosting and waning in a longitudinal cohort of older children and adults from 2011 to 2016, a period during which the A(H1N1)pdm09 vaccine strain did not change.

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Enterovirus D68 Causing Acute Respiratory Infection Clinical Characteristics and Differences With Acute Respiratory Infections Associated With Enterovirus Non-D68

By Milagrosa Montes, Eider Oñate, Ainhoa Muguruza, Esther Tamayo, Itxaso Marti Carrera, Ana Iturzaeta, Gustavo Cilla

The Pediatric Infectious Disease Journal, To be published July 2019

 

Enterovirus (EV) D68 is mainly associated with acute respiratory infection (ARI). Since 2014, when outbreaks in different countries were observed, this emerging virus was considered a potential threat to public health.

During 2015–2017, the presence of enterovirus RNA was investigated in all respiratory samples of children younger than 15 years of age with ARI, obtained for virologic studies in the Pediatric Emergency Care Units and wards of 2 hospitals in Gipuzkoa (Spain), using a commercial multiplex real-time polymerase chain reaction. When enterovirus was detected, a polymerase chain reaction to amplify a specific viral polyprotein (VP1) gene region of EV-D68 was performed.

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The Clinical Presentation of Pediatric Mycoplasma pneumoniae Infections—A Single Center Cohort

By Oren Gordon, Yonatan Oster, Ayelet Michael-Gayego, Rachel Marans, Dina Averbuch, Dan Engelhard, Allon Moses, Ran Nir-Paz

The Pediatric Infectious Disease Journal, To be Published July 2019

 

Mycoplasma pneumoniae (MP) is a major cause of community-acquired upper and lower respiratory infections in school-age children; however, there is increasing recognition that younger children are also affected. Clinical manifestations vary from asymptomatic, to severe complicated pneumonia sometimes with extrapulmonary manifestations.

We reviewed the medical records of all MP positive pediatric patients admitted to the Hadassah-Hebrew University Medical Center. MP positive case was defined if MP polymerase chain reaction was positive from an oropharyngeal swab sent from 2007 to 2017.

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An Online Tool to Calculate the Likelihood of Respiratory Syncytial Virus Infection in Children Hospitalized With Acute Respiratory Disease

By Britta Manuel, Matthes Hackbusch, Julia Tabatabai, Johannes Hoos, Rebecca Peters, Sarah Valerie Schnee, Clara Marlene Ihling, Paul Schnitzler, Johannes Pfeil, Johannes

The Pediatric Infectious Disease Journal, To be Published July 2019

 

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection in young children. Early detection of RSV infection can avoid unnecessary diagnostic and therapeutic intervention and is required to prevent the nosocomial spread of RSV infection in pediatric hospitals. We developed a web tool to calculate the probability of RSV infection in children hospitalized with acute respiratory tract infection (ARTI) (RSVpredict).

During winter seasons 2014/2015 to 2017/2018, 1545 children hospitalized with clinical symptoms of ARTI at the University Hospital Heidelberg/Germany were prospectively included. Medical information was reported on a standardized data sheet, and nasopharyngeal swabs were obtained for multiplex real-time polymerase chain reaction analyses. We applied logistic regression to develop a prediction model and developed a web-based application to predict the individual probability of RSV infection.

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Challenges & Opportunities in Diagnosing and Managing Pneumonia in High Resource Settings

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Join the Pneumonia Innovations Network for our “Challenges & Opportunities in Diagnosing and Managing Pneumonia in High Resource Settings” Webinar Event on Tuesday, July 2, 2019 at 10:00 AM EST / 14:00 GMT. The webinar will last approximately 1 hour.

Listen to talks by:

Samir Shah, Cincinnati Children's Hospital Medical Center and the James M. Anderson Center for Health Systems ExcellenceLilliam Ambroggio, University of Colorado and the Children’s Hospital ColoradoTodd Florin, Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine
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Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

By Stephanie W Lo, Rebecca A Gladstone, Andries J van Tonder, John A Lees, Mignon du Plessis, Rachel Benisty, Noga Givon-Lavi, Paulina A Hawkins, Jennifer E Cornick, Brenda Kwambana-Adams, Pierra Y Law, Pak Leung Ho, Martin Antonio, Dean B Everett, Prof Ron Dagan, Anne von Gottberg, Prof Keith P Klugman, Lesley McGee, Robert F Breiman, Stephen D Bentley, and The Global Pneumococcal Sequencing Consortium

The Lancet Infectious Diseases, June 10, 2019

 

Invasive pneumococcal disease remains an important health priority owing to increasing disease incidence caused by pneumococci expressing non-vaccine serotypes. We previously defined 621 Global Pneumococcal Sequence Clusters (GPSCs) by analysing 20 027 pneumococcal isolates collected worldwide and from previously published genomic data. In this study, we aimed to investigate the pneumococcal lineages behind the predominant serotypes, the mechanism of serotype replacement in disease, as well as the major pneumococcal lineages contributing to invasive pneumococcal disease in the post-vaccine era and their antibiotic resistant traits.

We whole-genome sequenced 3233 invasive pneumococcal disease isolates from laboratory-based surveillance programmes in Hong Kong (n=78), Israel (n=701), Malawi (n=226), South Africa (n=1351), The Gambia (n=203), and the USA (n=674). The genomes represented pneumococci from before and after pneumococcal conjugate vaccine (PCV) introductions and were from children younger than 3 years. We identified predominant serotypes by prevalence and their major contributing lineages in each country, and assessed any serotype replacement by comparing the incidence rate between the pre-PCV and PCV periods for Israel, South Africa, and the USA. We defined the status of a lineage as vaccine-type GPSC (≥50% 13-valent PCV [PCV13] serotypes) or non-vaccine-type GPSC (>50% non-PCV13 serotypes) on the basis of its initial serotype composition detected in the earliest vaccine period to measure their individual contribution toward serotype replacement in each country. Major pneumococcal lineages in the PCV period were identified by pooled incidence rate using a random effects model.

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Haemophilus influenzae type b vaccination and anthropometric, cognitive, and schooling outcomes among Indian children

By Arindam Nandi, Anil B. Deolalikar, David E. Bloom, Ramanan Laxminarayan

Annals of the New York Academy of Sciences, June 10, 2019

 

Haemophilus influenzae type b (Hib) affects 337,000 Indian children every year. A vaccine against Hib was introduced in 2011 as part of the pentavalent vaccine and scaled up nationwide. This study investigated the associations between Hib vaccination and child anthropometry, cognition, and schooling outcomes in India. We used longitudinal survey data and employed propensity score matching to control for observed systematic differences between children who reported receipt or nonreceipt of Hib vaccine before age 6 years (n = 1824). Z‐scores of height‐for‐age (HAZ) and BMI‐for‐age (BMIZ), percentage scores of English, mathematics, reading, and Peabody Picture Vocabulary tests, and attained schooling grade of children were examined. Hib‐vaccinated children had 0.25 higher HAZ, scored 4.09 percentage points (pp) higher on the English test and 4.78 pp higher on the mathematics test, and attained 0.16 more schooling grades than Hib‐unvaccinated children at age 11–12 years. At age 14–15 years, they had 0.18 higher HAZ, scored 3.63 pp higher on the reading test and 3.22 pp higher on the mathematics test, and attained 0.15 more schooling grades than Hib‐unvaccinated children. The findings indicate potential long‐term health, cognitive, and schooling benefits of the Hib vaccine, subject to the effect of unobserved confounding factors.

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Underlying Diseases and Causative Microorganisms of Recurrent Pneumonia in Children: A 13-Year Study in a University Hospital

By Tuğçe Tural-Kara, Halil Özdemir, Nihan Yıldız, Bilge Aldemir Kocabaş, Tuğba Erat, Aysun Yahşi, Figen Doğu, Ercan Tutar, Erdal İnce, Ergin Çiftçi

Journal of Tropical Pediatrics, June 2019

 

Pneumonia is a significant cause of death for children, particularly those in developing countries. The records of children who were hospitalized because of pneumonia between January 2003 and December 2015 were retrospectively reviewed, and patients who met the recurrent pneumonia criteria were included in this study. During this 13-year period, 1395 patients were hospitalized with pneumonia; of these, 129 (9.2%) met the criteria for recurrent pneumonia. Underlying diseases were detected in 95 (73.6%) patients, with aspiration syndrome (21.7%) being the most common. Rhinovirus (30.5%), adenovirus (17.2%) and respiratory syncytial virus (13.9%) were the most frequent infectious agents. These results demonstrate that underlying diseases can cause recurrent pneumonia in children. Viruses are also commonly seen in recurrent pneumonia. Appropriate treatments should be chosen based on an analysis of the underlying disease, the patient’s clinical condition and the laboratory and radiological data.

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Predictors of uptake of newly introduced vaccines in Malawi – monovalent human rotavirus and pneumococcal conjugate vaccines: Evidence from the 2015–16 Malawi demographic and health survey

By Peter Austin Morton Ntenda, Edward Tisungane Mwenyenkulu, Nuntiput Putthanachote, Owen Nkoka, Thomas Gabriel Mhone, Mfundi President Sebenele Motsa, Tinashe Tizifa

Journal of Tropical Pediatrics, June 2019

 

The purpose of this study was to examine the uptake and predictors of monovalent human rotavirus and pneumococcal conjugate vaccines among children of age 12–35 months in Malawi.

This study used cross-sectional data obtained from the 2015–16 Malawi Demographic and Health Survey. Multivariate logistic regression was used to identify the factors related to uptake of pneumococcal and rotavirus vaccination.

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A prospective multicentre study testing the diagnostic accuracy of an automated cough sound centred analytic system for the identification of common respiratory disorders in children

By Paul Porter, Udantha Abeyratne, Vinayak Swarnkar, Jamie Tan, Ti-wan Ng, Joanna M. Brisbane, Deirdre Speldewinde, Jennifer Choveaux, Roneel Sharan, Keegan Kosasih, and Phillip Della

Respiratory Research, June 6, 2019

 

The differential diagnosis of paediatric respiratory conditions is difficult and suboptimal. Existing diagnostic algorithms are associated with significant error rates, resulting in misdiagnoses, inappropriate use of antibiotics and unacceptable morbidity and mortality. Recent advances in acoustic engineering and artificial intelligence have shown promise in the identification of respiratory conditions based on sound analysis, reducing dependence on diagnostic support services and clinical expertise. We present the results of a diagnostic accuracy study for paediatric respiratory disease using an automated cough-sound analyser.

We recorded cough sounds in typical clinical environments and the first five coughs were used in analyses. Analyses were performed using cough data and up to five-symptom input derived from patient/parent-reported history. Comparison was made between the automated cough analyser diagnoses and consensus clinical diagnoses reached by a panel of paediatricians after review of hospital charts and all available investigations.

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Longer-Term Assessment of Azithromycin for Reducing Childhood Mortality in Africa

By Jeremy D. Keenan, M.D., Ahmed M. Arzika, M.S., Ramatou Maliki, M.S., Nameywa Boubacar, M.D., Sanoussi Elh Adamou, M.D., Maria Moussa Ali, M.P.H., Catherine Cook, M.P.H., Elodie Lebas, R.N., Ying Lin, M.P.H., Kathryn J. Ray, Ph.D., Kieran S. O’Brien, M.P.H., Thuy Doan, M.D., Ph.D., Catherine E. Oldenburg, Sc.D., M.P.H., E. Kelly Callahan, M.P.H., Paul M. Emerson, Ph.D., Travis C. Porco, Ph.D., M.P.H., and Thomas M. Lietman, M.D.

The New England Journal of Medicine, June 6, 2019

 

The MORDOR I trial (Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance) showed that in Niger, mass administration of azithromycin twice a year for 2 years resulted in 18% lower postneonatal childhood mortality than administration of placebo. Whether this benefit could increase with each administration or wane owing to antibiotic resistance was unknown.

In the Niger component of the MORDOR I trial, we randomly assigned 594 communities to four twice-yearly distributions of either azithromycin or placebo to children 1 to 59 months of age. In MORDOR II, all these communities received two additional open-label azithromycin distributions. All-cause mortality was assessed twice yearly by census workers who were unaware of participants’ original assignments.

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ASM Microbe 2019 Meeting: June 20 - 24, San Francisco, CA

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The American Society for Microbiology is hosting a meeting, ASM Microbe, from June 20 - 24 in San Francisco, CA (USA). 

 

At ASM Microbe you will:

Delve into your scientific interests and specialties with sessions in eight specialty tracks curated just for you.Explore cutting-edge research in the poster and oral presentations.Connect with experts in the microbial sciences. 

 

 

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Mycoplasma pneumoniae detection in children with respiratory tract infections and influence on management–a retrospective cohort study in Switzerland

By Alexa Dierig  Hans Hellmuth Hirsch  Marie‐Luise Decker  Julia Anna Bielicki  Ulrich Heininger  Nicole Ritz

Acta Paediatrica, June 5, 2019

 

To evaluate the frequency of Mycoplasma pneumoniae in nasopharyngeal specimens from children with respiratory tract infections (RTI) and to detail clinical characteristics and management.

The study was designed as a retrospective cohort study. All children with RTI and nucleic acid amplification testing from nasopharyngeal specimens were analysed. Clinical data was extracted from electronic health records for all M.pneumoniae positive cases. Stored samples of cases and a random selection of matched controls were re‐tested using a M.pneumoniae‐specific nucleic acid amplification test.

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The diagnostic value of metagenomic next-generation sequencing for identifying Streptococcus pneumoniae in paediatric bacterial meningitis

By Xi-xi Zhang, Ling-yun Guo, Lin-lin Liu, Ao Shen, Wen-ya Feng, Wen-hua Huang, Hui-li Hu, Bing Hu, Xin Guo, Tian-ming Chen, He-ying Chen, Yong-qiang Jiang, and Gang Liu

BMC Infectious Diseases, June 4, 2019

 

There is currently no research on the diagnostic value of metagenomic next-generation sequencing (mNGS) for a single pathogens in CSF. The aim of this study was to analyse the value of mNGS for identifying Streptococcus pneumoniae (S. pneumoniae) in paediatric bacterial meningitis.

Bacterial meningitis (BM) cases from October 23, 2014, to December 31, 2016, and December 1, 2017, to July 31, 2018 at Beijing Children’s Hospital were reviewed. Clinical features and pathogens were analysed.

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