A relationship between causative agents of infectious diarrhea and fatal outcomes in pre-school children

Infectious diarrhea is one of the leading causes of fatal outcomes in young children. Differential diagnostics of such infections within the first hours of illness poses significant objective obstacles. Data from laboratory studies of autopsy material and pathological studies provide valuable information for understanding the spectrum of differential diagnostics and etiological structure of infectious diarrhea with fatal outcomes in young children. Materials and methods. There were analyzed 100 cases of fatal outcomes in children under the age of six years registered in Russia from November 2011 to December 2019, who was diagnosed with infectious diarrhea at different levels of the healthcare system. The data were assessed based on available medical case reports and the laboratory testing of autopsy samples performed by using nucleic acid amplification methods. Results. The diagnosis of infectious diarrhea was revised in 24 patients, based on the data of a set of intravital and post-mortem studies. In patients with unconfirmed diagnosis of acute intestinal infections, pneumonia was the most often detected — in 45.8% (11/24), sepsis — in 29.2% (7/24), meningitis/meningoencephalitis, acute surgical pathology and asphyxiation associated with vomit aspiration — in 16.7 % (4/24) cases. The causative agents of infectious diarrhea were identified in 71 of 76 patients with confirmed diagnosis of acute intestinal infections. Most prevalent were group A rotaviruses — 52.6% (40/76), group F adenoviruses — 17.1% (13/76), and noroviruses — 13.2% (10/76). Combination of pathogens was detected in 29 cases (38.2%). Prehospital lethal outcomes in patients with infectious diarrhea were observed in 17 cases (22.4%). In total, rate of neonatal deaths due to acute intestinal infections accounted for 62.2% and 2-year-old toddlers — 20.3%. 64 of 76 (84%) children had no unfavorable premorbid background. The most common pathologies associated with infectious diarrhea with developing fatal outcomes were pneumonia (including aspiration pneumonia) in 22.4% (17/76) and aspiration asphyxia in 6.6% (5/76). Hemolytic-uremic syndrome associated with diarrhea was diagnosed in 7.9% (6/76) of children. Conclusions. Within the first years of life children comprise a risk group for developing fatal outcomes during infectious diarrhea. Lack of unfavorable premorbid background should not be considered as a reliable positive prognostic criterion. Diagnostics of pneumonia should be included in the mandatory examination plan for children with severe infectious diar rhea. Based on study of clinical and autopsy material, group A rotaviruses were the lead causative agents among those resulting in infectious diarrhea with fatal outcomes in young children. Special attention should be paid to preventing vomit aspiration within the first days after disease onset

ОЦЕНКА ЭПИДЕМИОЛОГИЧЕСКИХ ЭФФЕКТОВ ПРИМЕНЕНИЯ ПЯТИВАЛЕНТНОЙ РОТАВИРУСНОЙ ВАКЦИНЫ ПРИ НИЗКОМ УРОВНЕ ОХВАТА ВАКЦИНАЦИЕЙ ЦЕЛЕВОЙ КОГОРТЫ

Background: Assessment of the informativeness of using various parameters characterizing the epidemic process during rotavirus infection to analyze the effects of the RotaTeq (MSD, USA) pentavalent rotavirus vaccine’s using at low (<20%) level of vaccination coverage of the target cohort. Materials and methods: Were analyzed the correlation links between the vaccination coverage rates and the number of reported cases of rotavirus infection, incidence rates, the number of rotavirus-positive laboratory tests and their shares among the examined children for the territories of Moscow and the Moscow Region in 2014-2018, using the database of the laboratory information system and data of the Federal statistical monitoring, Results: The presence of a strong reliable inverse correlation between the coverage of vaccination and the only of the analyzed indicators – the share of positive results of laboratory studies in the age group of children 6-24 months was revealed. There was a one and a half to two-fold decrease in the share of positive laboratory tests for rotavirus infection in the years of reaching 18–20% vaccination coverage. Conclusion: The obtained data indicate the high informative value of laboratory information system data and the perspective of their use for a comprehensive assessment of the activity of the epidemic process.Цель: оценка информативности использования различных параметров, характеризующих эпидемический процесс при ротавирусной инфекции, для оценки эффектов применения пятивалентной ротавирусной вакцины РотаTек (MSD, США) при низком (<20%) уровне охвата вакцинацией целевой когорты. Материалы и методы: с использованием базы данных лабораторной информационной системы и данных  едерального статистического наблюдения были проанализированы корреляционные связи уровней охвата вакцинацией с количеством регистрируемых случаев ротавирусной инфекции, показателями заболеваемости, количеством положительных результатов лабораторных исследований на ротавирусы и их долей среди обследованных детей для территорий Москвы и Московской области в 2014–2018 гг. Результаты: выявлено наличие сильной достоверной обратной корреляционной связи между охватом вакцинацией и единственным из проанализированных показателей – долей положительных результатов лабораторных исследований в возрастной группе детей 6–24 мес. В годы достижения 18–20% охвата вакцинацией наблюдалось 1,5–2-кратное снижение доли положительных лабораторных исследований на ротавирусную инфекцию. Заключение: полученные данные свидетельствуют о высокой информативной ценности данных лабораторной информационной системы и перспективности их использования для комплексной оценки активности эпидемического процесса

Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review

<p>Abstract</p> <p>Background</p> <p>Rotavirus affects 95% of children worldwide by age 5 years and is the leading cause of severe dehydrating diarrhea. The objective of this review was to estimate the burden of rotavirus gastroenteritis (RVGE) in the Western European pediatric population.</p> <p>Methods</p> <p>A comprehensive literature search (1999-2010) was conducted in PubMed and other sources (CDC; WHO, others). Data on the epidemiology and burden of RVGE among children < 5 years-old in Western Europe --including hospital-acquired disease--were extracted.</p> <p>Results</p> <p>76 studies from 16 countries were identified. The mean percentage of acute gastroenteritis (AGE) cases caused by rotavirus ranged from 25.3%-63.5% in children < 5 years of age, peaking during winter. Incidence rates of RVGE ranged from 1.33-4.96 cases/100 person- years. Hospitalization rates for RVGE ranged from 7% to 81% among infected children, depending on the country. Nosocomial RVGE accounted for 47%-69% of all hospital-acquired AGE and prolonged hospital stays by 4-12 days. Each year, RVGE incurred $0.54-$53.6 million in direct medical costs and $1.7-$22.4 million in indirect costs in the 16 countries studied. Full serotyping data was available for 8 countries. G1P[8], G2P[4], G9P[8], and G3P[8] were the most prevalent serotypes (cumulative frequency: 57.2%- 98.7%). Serotype distribution in nosocomial RVGE was similar.</p> <p>Conclusions</p> <p>This review confirms that RVGE is a common disease associated with significant morbidity and costs across Western Europe. A vaccine protecting against multiple serotypes may decrease the epidemiological and cost burden of RVGE in Western Europe.</p

Ротавирусная инфекция у детей — нерешенная проблема. Обзор рекомендаций по вакцинопрофилактике

These clinical guidelines were developed by the professional association of pediatric specialists «Union of Pediatricians of Russia» and approved by the Association’s Executive Committee at the Congress of Pediatricians of Russia «Actual Problems of Pediatrics». Clinical guidelines are devoted to the problem of rotavirus infection, the relevance of which is determined by the high prevalence level and significant contribution of infectious diarrhea to the mortality pattern of children in the first 5 years of life. We present epidemiological data and detailed information on the infectious agent and pathogenesis of rotavirus infection progression. A detailed picture of clinical manifestations as well as extraintestinal complications is presented. The approach to specific prophylaxis has been reasoned. Practical recommendations for immunization as well as various regimens for administering the vaccine, depending on the age and condition of the patient, are given.Данные клинические рекомендации разработаны профессиональной ассоциацией детских специалистов «Союз педиатров России» и утверждены Исполкомом ассоциации на Съезде педиатров России «Актуальные проблемы педиатрии». Клинические рекомендации посвящены проблеме ротавирусной инфекции, актуальность которой определяется высоким уровнем распространенности и значительным вкладом инфекционной диареи в структуру смертности детей первых 5 лет жизни. Приводятся эпидемиологические данные, подробно описаны особенности возбудителя, патогенез развития ротавирусной инфекции. Представлена развернутая картина клинических проявлений, а также внекишечных осложнений. Обоснована тактика специфической профилактики. Даны практические рекомендации по проведению иммунизации, а также различные схемы введения вакцины в зависимости от возраста и состояния пациента

ASSESSMENT OF POSSIBLE USE OF CARBON ISOTOPE RATIOS IN AMINO ACIDS FOR MEAT PRODUCT GEOGRAPHICAL ORIGIN IDENTIFICATION

Possible use of compound-specific isotope analysis (GC-C-IRMS) was assessed using 255 meat samples from 24 countries. Upon results of isotope ratio (δ13C) determination in amino acids after gas chromatographic separation samples were classified using Support Vector Machines and linear discriminate analysis. Prognosis accuracy was 65-75%. Despite the fact that the use of compound analysis only provides low identification accuracy there's a possibility to considerably increase reliability of classification in combination with other data by means of extending dimension by the number of variables

Assessing applicability of isotope-ratio mass spectrometry (IRMS) for geographical identification of whole milk

Applicability of isotope-ratio mass spectrometry of light elements (C, N, О, H) has been assessed for identification of geographical origin of Russian milk collected in different parts of the Russian Federation (235 sample of whole milk). Quantitative assessment was carried out in a series of statistical tests based on nonparametric dispersion analysis

Compacts formation process

Introduction. Biomass is used as foodstuff, for feed making, and for energy production. This is a dispersed material characterized by high porosity and low density, which is poorly adapted for use. Therefore, to improve its processability, biomass is subjected to compaction to shape compacts (feed wafers, granules, etc.). Materials and Methods. The process of packing biomass in compacts is considered. It is shown that the resistance of dispersed materials to compaction, which includes biomass, is determined by the structural and mechanical properties of the material compacted – structural strength, internal friction, connectivity pressure, strength of the material particles, and bond strength between particles. Theoretical studies have determined the relationships between all the characteristics of dry biomass which form the basis for calculating machines for shaping biomass in compacts. Research Results. A technique is developed that allows determining the critical parameters of the press with ring dies due to the requirements for the compacts and structural and mechanical properties of the material compacted. The technique is recommended for designing machines providing the formation of biomass in compacts with specified properties. Discussion andConclusions. The obtained patterns can be used under designing presses for the production of tailored compacts