Life-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study

Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe. Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures. Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis. Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

The behavioural intentions of specialty coffee consumers in South Africa

More than 1.6 billion cups of coffee are consumed worldwide on a daily basis. South Africa is rapidly adapting to worldwide trends with speciality coffee consumption on the rise, with South Africa recently having been recognised as a key player in the speciality coffee industry. Emerging market trends in speciality coffee consumption have resulted in a number of changes in consumption patterns, preferences and consumer behaviour. The purpose of this study was to determine the behavioural intention of speciality coffee consumers in South Africa, using the Theory of Planned Behaviour. The data were gathered from a non-probability sample of 327 respondents, who were selected through a self-completion online questionnaire. The results indicate that males consume more speciality coffee than females. The majority of respondents consume speciality coffee more than once a day, and foam cappuccinos are consumed most regularly. The results of the stepwise multiple regression analysis demonstrate the utility of the Theory of Planned Behaviour as a conceptual framework for predicting the behavioural intention of speciality coffee consumers. The findings indicate that attitude, subjective norms and perceived behavioural control are important predictors of behavioural intention. Furthermore, perceived behavioural control is the most important factor influencing speciality coffee consumption, and the most influential of the direct measures of the Theory of Planned Behaviour. With the current rise in speciality coffee consumption among South Africans, the Theory of Planned Behaviour framework contributes to understanding those factors which influence regular speciality coffee consumption. It is recommended that marketers and practitioners adapt their offerings to appeal to the specific needs of the growing speciality coffee market in South Africa.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1470-64312017-07-31hb2016Marketing Managemen