Analysis of intestinal and nasopharyngeal microbiota of children with meningococcemia in pediatric intensive care unit: INMACS-PICU study

This article belongs to the Special Issue Pediatric Diagnostic Microbiology.Microbiota composition might play a role in the pathophysiology and course of sepsis, and understanding its dynamics is of clinical interest. Invasive meningococcal disease (IMD) is an important cause of community-acquired serious infection, and there is no information regarding microbiota composition in children with meningococcemia. In this study, we aimed to evaluate the intestinal and nasopharyngeal microbiota composition of children with IMD.[Materials and Methods]: In this prospective, multi-center study, 10 children with meningococcemia and 10 age-matched healthy controls were included. Nasopharyngeal and fecal samples were obtained at admission to the intensive care unit and on the tenth day of their hospital stay. The V3 and V4 regions of the 16S rRNA gene were amplified following the 16S Metagenomic Sequencing Library Preparation.[Results]: Regarding the alpha diversity on the day of admission and on the tenth day at the PICU, the Shannon index was significantly lower in the IMD group compared to the control group (p = 0.002 at admission and p = 0.001, on the tenth day of PICU). A statistical difference in the stool samples was found between the IMD group at Day 0 vs. the controls in the results of the Bray–Curtis and Jaccard analyses (p = 0.005 and p = 0.001, respectively). There were differences in the intestinal microbiota composition between the children with IMD at admission and Day 10 and the healthy controls. Regarding the nasopharyngeal microbiota analysis, in the children with IMD at admission, at the genus level, Neisseria was significantly more abundant compared to the healthy children (p < 0.001). In the children with IMD at Day 10, genera Moraxella and Neisseria were decreased compared to the healthy children. In the children with IMD on Day 0, for paired samples, Moraxella, Neisseria, and Haemophilus were significantly more abundant compared to the children with IMD at Day 10. In the children with IMD at Day 10, the Moraxella and Neisseria genera were decreased, and 20 different genera were more abundant compared to Day 0.[Conclusions]: We first found alterations in the intestinal and nasopharyngeal microbiota composition in the children with IMD. The infection itself or the other care interventions also caused changes to the microbiota composition during the follow-up period. Understanding the interaction of microbiota with pathogens, e.g., N. meningitidis, could give us the opportunity to understand the disease’s dynamics.This study was supported by the Eskisehir Osmangazi University Scientific Research Grant (2018/11046).Peer reviewe

Ergenlerde İnternet kullanımı ile uyku problemleri arasındaki ilişki

Giriş: Uyku sorunları ergenlerde sık olarak görülmektedir. Elektronik medyanın ergenlerin uyku kalitelerini ve günlük işlevselliklerini olumsuz etkilediği gösterilmiştir. Bu çalışma ergenlerde internet kullanımı ile uyku problemleri arasındaki ilişkiyi incelemeyi amaçlamaktadır. Yön­tem­: Toplam 1212 ergen çalışmaya dahil edildi. Kendi bildirim çalışma anketi iki ana bölüm içeriyordu: Young’ın İnternet Bağımlılık Ölçeği (İBÖ) ve uyku alışkanlıkları/uyku problemleri üzerine yarı yapılandırılmış bir ölçek. Bul­gu­lar: Çalışma örnekleminin %16’sı uyku kalitelerini kötü ya da çok kötü değerlendirdi. Örneklemin dörtte biri interneti hergün kullandığını bildirirken, %27’si online olduğunda bir saatten fazla zaman geçirdiğini bildirdi. Ortalama İBÖ total skoru 35,56±13,87 idi. Yüksek İBÖ skoru olan ergenlerin düşük İBÖ skoru olanlara göre gece yatağa daha geç gittiği, uykuya dalmak için daha uzun süreye ihtiyaç duyduğu ve gece daha sık uyandığı bildirildi (p=0,001). Yüksek İBÖ skoru olan ergenlerde içlerinde uykuya dalma ve sürdürme güçlükleri, uyanma güçlüğü ve gün içinde uykulu hissetmeyi içeren çok sayıda uyku probleminin daha sık olduğu bulundu. Ayrıca, uyku kaliteleri düşük İBÖ skoru olan ergenlere göre daha kötü idi (p=0,001). So­nuç: Problemli uyku alışkanlıkları ve uyku sorunlarının yüksek İBÖ skoru olan ergenlerde daha sık olduğu bulundu. Sağlık çalışanları, aşırı ve kontrolsüz internet kullanımının ergenlerin uyku alışkanlıkları üzerine yaptığı muhtemel olumsuz etkiler konusunda farkında olmalıdırlar.Introduction: Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. Met&shy;hod: A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young’s Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Re&shy;sults: Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56&plusmn;13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=0.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=0.001). Conc&shy;lu&shy;si&shy;on: Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents’ sleep habits

The evaluation of asthma and COPD awareness in Turkey (GARD Turkey Project-National Control Program of Chronic Airway Diseases)

Giriş: Önemli mortalite ve morbidite nedeni olan kronik hava yolu hastalıkları gerek sağlık çalışanları gerekse hasta ve yakınları tarafından yeterince bilinmemektedir. Bu nedenle de yeterince teşhis ve tedavi edilememekte ve koruyucu önlemler uygulanamamaktadır. Çalışmamızın amacı "Kronik Hava Yolu Hastalıklarını Önleme Kontrol Programı" çerçevesinde toplumumuzda astım ve kronik obstrüktif akciğer hastalığı (KOAH) farkındalığıyla ilgili bilgilerin değerlendirilmesidir. Materyal ve Metod: Türkiye'de, nüfusu 200'den büyük kentsel ve kırsal yerleşim yerlerinde ikamet eden, 15 yaş üstü erkek ve kadınlar çalışmaya alındı. Katılımcılara astım ve KOAH ile ilgili sorular içeren anket uygulandı. Bulgular: Ülke genelinde, 6000 kent ve 6000 kırsal yerleşim merkezinde olmak üzere, toplam 12.000 kişiye gidilmiş olup, 8527 kişiye ulaşıldı. Çalışmaya anketi başarıyla tamamlayan 4182 (%50.1)'si kadın, 4160 (%49.9)'ı erkek toplam 8342 kişi dahil edildi. KOAH'ın akciğerlerle ilgili bir hastalık olduğu (%49.6), gelişiminde en önemli etkenin sigara olduğu (%51.1) ve korunma ve tedavide ilk seçeneğin sigaranın bırakılması olduğu (%48) yaklaşık her iki kişiden biri tarafından bilinmekteydi. Ancak KOAH'ın tedavi edilebilir bir hastalık olduğu toplumun %25.2'sinde bilinmekteydi. Astımın tüm yaş gruplarında görülebildiği (%80) iyi bilinmekle birlikte astımın kalıtsal bir hastalık olabileceği (%51.1) ve bulaşıcı olmadığı (%58) ortalama her iki kişiden birinde bilinmekteydi. Bununla birlikte astım ilaçlarının bağımlılık yapıp yapmadığı konusunda popülasyonun %55.2'si fikri olmadığını belirtirken, katılımcıların %27'si ilaçların bağımlılık yapmadığını belirtti. Sonuç: Astım ve KOAH ülkemizde yeterli ölçüde bilinmemektedir. Önemli mortalite ve morbidite nedeni olan, iş gücü ve ekonomik kayıplara yol açan bu hastalıklarla ilgili toplum bilincinin oluşması ve bilgi düzeyinin artırılması tedavi başarı oranlarının artırılması açısından önemlidir.Introduction: Although chronic respiratory disorders are important causes of morbidity and mortality, health care workers, patients and caretakers are not well informed about these disorders. Therefore these problems are underdiagnosed and undertreated; also preventive measures are not widely taken. Our aim was to evaluate the knowledge of asthma and chronic obstructive pulmonary disease (COPD) in Turkey. This study was designed and performed as a Global Alliance Against Respiratory Disorders (GARD) project. Materials and Methods: People greater than 15 years of age who lived in cities with a population of 200 or greater were eligible for the study. A questionnaire including demographic data and questions regarding asthma and COPD was used for the evalution of the participants. Results: 12.000 people were selected (6000 in rural and 6000 in urban areas); 8527 people were reached. 8342 people who completed the questionnaire were included to the study. There were 4182 (50.1%) female and 4160 (%49.9) male subjects. 49.6% of the subjcets knew that COPD is a lung disease, 51.1% indicated that smoking is the most important risk factor for COPD and 48% identified quitting smoking as the most important preventive measure. Every other person had baseline knowledge on COPD. However only 25.2% knew that there are treatment options for COPD. 80% of subjects said astma can be seen in all age groups. 51.1% knew asthma is a genetic disease and 58% said it is not an infectious disease. However when whether asthma medications caused drug dependency only 27% answered as -No- while 55.2% said -They do not know-. Conclusion: Awareness of COPD and asthma seem to be infsufficient among Turkish people. Since these disorders are important causes of morbidity and mortality and have high impact on work and economic loss, it is important to increase knowledge among public

Health-related quality of life and perceived health status of Turkish population

Purpose; This study was conducted to assess the health-related quality of life (HRQOL) and perceived health status of the Turkish population

COVID-19 Salgının Çocukların Yeme Düzeni ve Ebeveynlerin Kaygı Düzeyi Üzerindeki Etkileri: Çok Merkezli Bir Çalışma

Amaç: Çalışmamız Koronavirüs hastalığı-2019 (COVID-19) salgınının birinci ayında çocukların yeme düzenlerini, ebeveynlerinin koronavirüsü bulaşma riski ile ilgili kaygılarını ve bu kaygı ile ilişkili etkenlerin değerlendirilmesini ve salgın öncesi ile karşılaştırılmasını amaçlamıştır. Gereç ve Yöntem: Çalışma çok merkezli (n=8) ve kesitsel olarak planlanmıştır. Çalışma merkezlerine başvuran 6-18 yaş arası çocukların ailelerinden çalışmaya katılmayı kabul edenlere bilgilendirilmiş gönüllü olur formu ve anketleri içeren bilgiler, e-posta veya mesajlaşma yoluyla iletilmiştir. Bulgular: Çalışmaya ortalama 11,1 yaşında (standart sapma=3,4) 893 çocuk dahil edilmiştir. Çalışmaya dahil edilen çocukların %50,7’si (n=453) kızdır. Ailelerin çoğu, salgının birinci ayında çocuklarının yeme düzeninde değişiklik bildirmezken (%63,6, n=568), %21,4’ü çocuklarının yeme düzeninin daha iyi, %15,0’ı ise daha kötü olduğunu bildirmiştir. Ebeveynlerin %40.0’ı kendileri veya çocuklarına virüs bulaşmasından “çok kaygılı” olduğunu belirtmiştir. Kaygı düzeyi yüksek olan ebeveynler, düşük olanlara göre anlamlı derecede daha genç ve düşük eğitimlidir (sırasıyla; p<0,001, p=0,001). Sonuç: COVID-19 salgını ebeveynlerin kaygı düzeyini ve çocuklarının yeme düzenlerini etkilemiştir. Genç ve düşük eğitimli ebeveynlerin bulaşma riski açısından daha kaygılı oldukları saptanmıştır. Ebeveynlik yaşı ve eğitimi koruyucu ruh sağlığı girişimleri açısından önemli olabilir.Objectives: Our study aimed to evaluate the eating patterns of children as well as parental anxiety on virus transmission along with associated factors in the first month of the Coronavirus disease-2019 (COVID-19) pandemic and to compare the results to pre-epidemic patterns. Materials and Methods: This study was planned as a multi-center (n=8), cross-sectional study. Informed consent forms and questionnaires were sent to the parents of the children between the ages of 6 and 18 years who applied to the study centers and accepted study participation via e-mail or instant messaging applications. Results: During the study period, 893 children with a mean age of 11.1 years (standard deviation=3.4) were enrolled. More than half (50.7%, n=453) were girls. The majority of families reported no change in eating patterns of their children in the first month of the pandemic (63.6%, n=568). More than one-fifth (21.4%, n=191) reported an improvement in eating patterns while 15.0% reported worsening. A significant minority of parents (40.0%) reported feeling “very anxious” for potential risk of transmission to themselves or their children. Parents with higher levels of anxiety were significantly younger and had lower levels of education (p<0.001, p=0.001, respectively). Conclusion: The COVID-19 epidemic has affected both parents’ anxiety and children’s eating patterns. The association of younger parental age and lower levels of education with elevated levels of anxiety related to transmission risk may be important for protective interventions in mental health

Analysis of Intestinal and Nasopharyngeal Microbiota of Children with Meningococcemia in Pediatric Intensive Care Unit: INMACS-PICU Study

Microbiota composition might play a role in the pathophysiology and course of sepsis, and understanding its dynamics is of clinical interest. Invasive meningococcal disease (IMD) is an important cause of community-acquired serious infection, and there is no information regarding microbiota composition in children with meningococcemia. In this study, we aimed to evaluate the intestinal and nasopharyngeal microbiota composition of children with IMD. Materials and Methods: In this prospective, multi-center study, 10 children with meningococcemia and 10 age-matched healthy controls were included. Nasopharyngeal and fecal samples were obtained at admission to the intensive care unit and on the tenth day of their hospital stay. The V3 and V4 regions of the 16S rRNA gene were amplified following the 16S Metagenomic Sequencing Library Preparation. Results: Regarding the alpha diversity on the day of admission and on the tenth day at the PICU, the Shannon index was significantly lower in the IMD group compared to the control group (p = 0.002 at admission and p = 0.001, on the tenth day of PICU). A statistical difference in the stool samples was found between the IMD group at Day 0 vs. the controls in the results of the Bray–Curtis and Jaccard analyses (p = 0.005 and p = 0.001, respectively). There were differences in the intestinal microbiota composition between the children with IMD at admission and Day 10 and the healthy controls. Regarding the nasopharyngeal microbiota analysis, in the children with IMD at admission, at the genus level, Neisseria was significantly more abundant compared to the healthy children (p Moraxella and Neisseria were decreased compared to the healthy children. In the children with IMD on Day 0, for paired samples, Moraxella, Neisseria, and Haemophilus were significantly more abundant compared to the children with IMD at Day 10. In the children with IMD at Day 10, the Moraxella and Neisseria genera were decreased, and 20 different genera were more abundant compared to Day 0. Conclusions: We first found alterations in the intestinal and nasopharyngeal microbiota composition in the children with IMD. The infection itself or the other care interventions also caused changes to the microbiota composition during the follow-up period. Understanding the interaction of microbiota with pathogens, e.g., N. meningitidis, could give us the opportunity to understand the disease’s dynamics