Streptococcus pneumoniae kolonizacija ikimokyklinio amžiaus vaikų nosiaryklėje ir jos įtaka ūminių kvėpavimo takų infekcijų eigai

Streptococcus pneumoniae nfection is a serious public health concern in the world, especially among infants and young children. Data on S.pneumoniae carriage rate, incidence of pneumococcal disease, serotype distribution and resistance to antimicrobials in Lithuania are limited. The aim of the research was to evaluate S.pneumoniae nasopharyngeal colonisation in preschool children and its influence on the course of acute respiratory tract infections. The prospective study was carried out in five cities from all main regions of the country from February 2012 to March 2013. A total of 900 children were included. S.pneumoniae nasopharyngeal colonisation rate was high (40.8%) in preschool children with acute respiratory tract infections. The most prevalent S.pneumoniae serotypes (6A, 6B, 14, 15, 19F and 23F) in Lithuania were the same ones that had been predominant in other European countries before introduction of pneumococcal vaccines into national immunisation programme. S.pneumoniae nasopharyngeal colonisation had a negative impact on the course of acute respiratory tract infections (longer recovery duration, longer absent from day-care centres, higher rates of acute otitis media, bronchitis and pneumonia, more frequent use of antimicrobials). Most S.pneumoniae strains were sensitive to commonly used antimicrobials (e.g., penicillin, macrolides). Currently commercially available pneumococcal conjugate vaccines could be effective for children in Lithuania

Streptococcus pneumoniae nasopharyngeal colonisation in preschool children and its influence on the course of acute respiratory tract infections

Streptococcus pneumoniae nfection is a serious public health concern in the world, especially among infants and young children. Data on S.pneumoniae carriage rate, incidence of pneumococcal disease, serotype distribution and resistance to antimicrobials in Lithuania are limited. The aim of the research was to evaluate S.pneumoniae nasopharyngeal colonisation in preschool children and its influence on the course of acute respiratory tract infections. The prospective study was carried out in five cities from all main regions of the country from February 2012 to March 2013. A total of 900 children were included. S.pneumoniae nasopharyngeal colonisation rate was high (40.8%) in preschool children with acute respiratory tract infections. The most prevalent S.pneumoniae serotypes (6A, 6B, 14, 15, 19F and 23F) in Lithuania were the same ones that had been predominant in other European countries before introduction of pneumococcal vaccines into national immunisation programme. S.pneumoniae nasopharyngeal colonisation had a negative impact on the course of acute respiratory tract infections (longer recovery duration, longer absent from day-care centres, higher rates of acute otitis media, bronchitis and pneumonia, more frequent use of antimicrobials). Most S.pneumoniae strains were sensitive to commonly used antimicrobials (e.g., penicillin, macrolides). Currently commercially available pneumococcal conjugate vaccines could be effective for children in Lithuania

Antibiotic resistance of Streptococcus pneumoniae, isolated from nasopharynx of preschool children with acute respiratory tract infection in Lithuania

Background: Increasing pneumococcal resistance to commonly used antibiotics and multidrug resistance is a serious public health concern. Data on distribution of resistant Streptococcus pneumoniae (SPn) strains among children in Lithuania are limited. We evaluated the circulation of SPn serotypes and antimicrobial susceptibility among preschool children in Lithuania before the introduction of universal infant pneumococcal vaccination. Methods: A prospective study was carried out from February 2012 to March 2013 in five cities of Lithuania. A total of 900 children under six years of age who presented to primary care centre or a hospital emergency department with acute respiratory tract infection were enrolled in the study. Nasopharyngeal swabs were obtained and cultured for SPn. Positive samples (n = 367) were serotyped and tested for antimicrobial susceptibility. Associations of pneumococcal non-susceptibility with study site, season, age, sex, attendance of day care centre and treatment with antimicrobials (between one and six months prior the study) were evaluated. Results: About a half (56.7 %) of SPn strains were susceptible to all the antibiotics tested. Pneumococcal non-susceptibility to penicillin, erythromycin, clindamycin and trimethoprim–sulphamethoxazole was 15.8, 21.3, 16.9 and 27.3 %, respectively. None of the tested isolates was resistant to norfloxacin or vancomycin. We found a geographical variation of pneumococcal resistance within the cities of the country. Age, sex, the attendance of day care centre and treatment with antimicrobials prior the study was not significantly associated with a carriage of non-susceptible SPn strains. Among non-susceptible SPn serotypes 67.9 %–82.4 % were present in currently available pneumococcal conjugate vaccines. Conclusions: The rates of nasopharyngeal SPn susceptibility to penicillin and macrolides are still high among preschool children in Lithuania, however they are lower compared with previous studies. A strict policy with respect to antibiotic prescription together with widespread use of vaccination could potentially reduce the carriage rate of antibiotic-resistant pneumococci in our country

Influenza and Respiratory Syncytial Virus Infections in Pediatric Patients during the COVID-19 Pandemic: A Single-Center Experience

The overlap of coronavirus disease 2019 (COVID-19) with other common respiratory pathogens may complicate the course of the disease and prognosis. The aim of the study was to evaluate the rates, characteristics, and outcomes of pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), influenza A/B infections, and their coinfections. A single-center prospective cross-sectional study was performed at the pediatric emergency department in Vilnius from 1 October 2021 to 30 April 2022. In total, 5127 children were screened for SARS-CoV-2, RSV, and influenza A/B. SARS-CoV-2 PCR tests were positive for 21.0% of children (1074/5127). The coinfection rate of respiratory viruses (RSV, influenza A) in patients with COVID-19 was 7.2% (77/1074). Among the 4053 SARS-CoV-2 negative patients, RSV was diagnosed in 405 (10.0%) patients and influenza A/B in 827 (20.4%) patients. Patients with COVID-19 and coinfection did not have a more severe clinical course than those with RSV or influenza infection alone. RSV and SARS-CoV-2 primarily affected younger patients (up to 2 years), while the influenza was more common in older children (4–10 years). Patients infected with RSV were more severely ill, reflected by higher hospitalization proportion and need for respiratory support

Screening for coronavirus disease 2019 (COVID-19) at the Pediatric Emergency Department during different pandemic phases

The wide spectrum of COVID-19 symptoms complicates the selection of target groups for screening. We aimed to compare data of children screened for COVID-19 at the pediatric emergency department in Vilnius between different phases throughout 1 year (Phase I: March–May, 2020; Phase II: June–September, 2020; and Phase III: October, 2020–February, 2021) and to evaluate the possible predictors of the disease. SARS-CoV-2 PCR tests were positive for 2.7% of tested children (248/9,238), significantly higher during the Phase III (5.5%) compared with the Phase I (0.6%, p = 0.000) and Phase II (0.3%, p = 0.000). Infants and teenagers (12–17 years) accounted for a larger proportion of COVID-19 patients (24.6 and 26.2%, respectively) compared to other age groups: 1–2 years (18.9%), 3–6 years (14.9%), and 7–11 years (15.3%). There were more COVID-19 cases among children with a known SARS-CoV-2 exposure compared to those who did not declare any contact (18.2 vs. 1.1%, p = 0000). When symptoms were adjusted for age, gender and known exposure to SARS-CoV-2, we found that fever (OR 2.66; 95% CI 1.89–3.81), pharyngitis (OR 1.35; 95% CI 1.01–1.80), headache (OR 1.81; 95% CI 1.09–2.90), and anosmia/ageusia (OR 6.47; 95% CI 1.61–22.47) were the most significant predictors. Conclusion: Although high numbers of testing were maintained throughout the year, the positive test results were significantly higher during the Phase III. Age (<1 year, 12–17 years), a history of exposure to SARS-CoV-2 and some symptoms, such as fever, pharyngitis, headache and anosmia/ageusia could aid in targeting groups for screening for COVID-19 in children

The influence of Streptococcus pneumoniae nasopharyngeal colonization on the clinical outcome of the respiratory tract infections in preschool children

Background: Streptococcus pneumoniae (SPn) is an important pathogen causing a variety of clinical manifestations. The effects of SPn nasopharyngeal colonization on respiratory tract infections are poorly studied. We evaluated the association of SPn colonization with features of respiratory tract infections. Methods: Children under the age of 6 years who visited a primary care physician because of respiratory tract infections were enrolled in the study. History was taken, children were clinically assessed by the physician, and nasopharyngeal swabs were obtained and cultured for SPn. Positive samples were serotyped. Associations of SPn colonization with clinical signs and symptoms, recovery duration, absence from day care centre, frequencies of specific diagnoses, and treatment with antimicrobials were evaluated. Results: In total 900 children were enrolled. The prevalence of SPn colonization was 40.8 % (n = 367). There were minor differences between male and female subjects (199 of 492, 40.4 % vs 168 of 408, 41.2 %, p = 0.825). Children with and without siblings had similar colonization rates (145 of 334, 43.4 % vs 219 of 562, 39.0 %, p = 0.187). Clinical signs and symptoms were not associated with SPn colonization. Children colonized with SPn had longer recovery duration compared to non-colonized children (114 of 367, 31.1 % vs 98 of 533, 18.4 %, p < 0.001) and were longer absent from day care (270 of 608, 44.4 % vs 94 of 284, 33.1 %, p = 0.001). Pneumonia, sinusitis, and acute otitis media were more frequently diagnosed in children colonized with SPn. Children attending day care centres had significantly higher prevalence of SPn colonization (270 of 367, 44.4 % vs 338 of 533, 33.1 %, p = 0.001). Children with pneumonia, sinusitis and acute otitis media were more frequently treated with antimicrobials than children with other diagnoses. Conclusions: SPn nasopharyngeal colonization has a negative impact on the course of respiratory tract infection, likely because of SPn being the cause of the disease or a complicating factor. It is also associated with and may be responsible for higher frequencies of bronchitis, pneumonia, acute otitis media, sinusitis and the need of antimicrobial treatment