29 research outputs found
Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period
<p>Abstract</p> <p>Background</p> <p>Bacterial meningitis remains a source of substantial morbidity and mortality in childhood. During the last decades gradual changes have been observed in the epidemiology of bacterial meningitis, related to the introduction of new polysaccharide and conjugate vaccines. The study presents an overview of the epidemiological patterns of acute bacterial meningitis in a tertiary children 's hospital during a 32-year period, using information from a disease registry. Moreover, it discusses the contribution of communicable disease registries in the study of acute infectious diseases.</p> <p>Methods</p> <p>In the early 1970s a Meningitis Registry (MR) was created for patients admitted with meningitis in Aghia Sofia Children's Hospital in Athens. The MR includes demographic, clinical and laboratory data as well as treatment, complications and outcome of the patients. In 2000 a database was created and the collected data were entered, analyzed and presented in three chronological periods: A (1974–1984), B (1985–1994) and C (1995–2005).</p> <p>Results</p> <p>Of the 2,477 cases of bacterial meningitis registered in total, 1,146 cases (46.3%) were classified as "probable" and 1,331 (53.7%) as "confirmed" bacterial meningitis. The estimated mean annual Incidence Rate (IR) was 16.9/100,000 for bacterial meningitis, 8.9/100,000 for <it>Neisseria meningitidis</it>, 1.3/100,000 for <it>Streptococcus pneumoniae</it>, 2.5/100,000 for <it>Haemophilus influenzae </it>type b (Hib) before vaccination and 0.4/100,000 for Hib after vaccination. <it>Neisseria meningitis </it>constituted the leading cause of childhood bacterial meningitis for all periods and in all age groups. Hib was the second most common cause of bacterial meningitis before the introduction of Hib conjugate vaccine, in periods A and B. The incidence of bacterial meningitis due to <it>Streptococcus pneumoniae </it>was stable. The long-term epidemiological pattern of <it>Neisseria meningitidis </it>appears in cycles of approximately 10 years, confirmed by a significant rise of IR in period C. The Case Fatality Rate (CFR) from all causes was 3.8%, while higher CFR were estimated for <it>Streptococcus pneumoniae </it>(7.5%, RR=2.1, 95% CI 1.2–3.7) and <it>Neisseria meningitidis </it>(4.8%, RR=1.7, 95% CI 1.1–2.5) compared to other pathogens. Moreover, overall CFR varied significantly among the three time periods (p = 0.0015), and was estimated to be higher in period C.</p> <p>Conclusion</p> <p>By using the MR we were able to delineate long-term changes in the epidemiology of bacterial meningitis. Thus the MR proved to be a useful tool in the study and the prevention of communicable diseases in correlation with prevention strategies, such as vaccinations.</p
Aseptic Meningitis in Children: Analysis of 506 Cases
BACKGROUND: Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38%) and autumn (24%). The dominant clinical symptoms were fever (98%), headache (94%) and vomiting (67%). Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm(3) with polymorphonuclear predominance (>50%) in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9%) children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01). There were no serious complications or deaths. CONCLUSIONS: Enteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis
Oligonucleotide-Functionalized Gold Nanoparticles as Probes in a Dry-Reagent Strip Biosensor for DNA Analysis by Hybridization
Association of clinical and epidemiological characteristics with COVID-19 BNT162b2 mRNA vaccine short-term adverse reactions in healthcare workers
Introduction The aim of the study was to investigate the prevalence and severity of adverse reactions (ARs) after immunization of healthcare workers (HCWs) with BNT162b2 vaccine and to associate them with clinical and epidemiological characteristics. Methods A form containing demographic and clinical data as well as ARs after both doses of the vaccine was completed, and statistical association analysis was performed. Results A total of 502 HCWs (females 78.3%) with mean age (±SD) 48.17 years (±12.97) participated. After the first dose, 404 (80.5%) HCWs reported at least one local AR (LAR) and 366 (72.9%) after the second dose (p-value=0.004). After the first dose, 121 (24.1%) HCWs reported at least one systemic AR (SAR) and 275 (54.8%) after the second dose (p-value<0.0001). In the logistic regression analysis, there was no association of gender or medical history of underlying disease with LARs. There was a negative association of age with the cumulative score (CS) of LARs (OR: 0.82, 95% CI: 0.69–0.96) after the first dose. Females had a positive association with CS of SARs following both doses (OR, 95% CI: 2.57, 1.39–4.73 and 2.71, 1.76–4.19, respectively). Age was negatively associated with CS of SARs (OR: 0.66, 95% CI: 0.57–0.76) after the second dose. Severe ARs included Bell’s palsy (1) and tinnitus with temporary hearing loss (1). Conclusion The administration of the BNT162b2 vaccine in our HCWs cohort had a good safety profile with the most common ARs being self-limited. An increasing rate of SARs following the second vaccine dose was noticed. Rare but severe possible ARs should be further investigated
Detection of bacterial pathogens in synovial and pleural fluid with the FilmArray Blood Culture Identification System
We report the use of FilmArray Blood Culture Identification (BCID) multiplex PCR system for pathogen detection from a child with septic arthritis that Streptococcus pyogenes was identified directly from synovial fluid and a child with complicated pneumonia with pleural effusion that Streptococcus pneumoniae was identified from pleural fluid
Human Papillomavirus (HPV) Genotyping of Cutaneous Warts in Greek Children
The human papillomavirus (HPV) infects the squamous epithelium of the
skin and produces common warts, plantar warts, and flat warts, which
occur commonly on the hands, face, and feet. The objective of this study
was to determine the presence of HPV in warts in children in order to
associate the virus with the disease. Sixty-eight children with
clinically diagnosed cutaneous warts were recruited. Skin biopsy samples
were examined and DNA was extracted using a commercially available kit.
To distinguish between the HPV types, we used a specific pair of primers
to amplify the HPV DNA. Polymerase chain reaction amplification of the
L1 region was followed by restriction fragment length polymorphism
analysis and Luminex xMAP technology. HPV 57 was the predominant type in
our study, although the detection of the high-risk HPV type 16 in 33%
of our positive samples indicates the presence of mucosal high-risk HPV
types in the skin of children. It seems that the newly introduced
Luminex assay maximized the discrimination of genotypes even in the case
of multiple HPV infections. Or findings also suggest the presence of
high-risk HPV types in cutaneous warts
SARS-CoV-2 seroepidemiological study in healthcare workers and discordant results using seven different diagnostic methods
The aim of the study was to access the SARS-CoV-2 antibody
seroprevalence in healthcare workers (HCWs) of a tertiary pediatric
hospital after the first wave of the pandemic and to compare the results
among seven commercially available antibody detection assays, including
chemiluminescence (CMIA), electroluminescence (ECLIA), Epsilon
nzyme-Linked Immunosorbent Assay (ELISA), and rapid immunochromatography
(RIC). SARS-CoV-2 antibody detection was performed in serum samples of
1216 HCWs, using a reference CMIA assay and 8/1216 (0.66%) were
detected positive. Positive serum samples were further tested with other
assays; however, only one sample was positive by all tests. The rest 7
cases were negative with ECLIA and ELISA and gave discordant results
with RIC test. Six months later, new serum samples of seropositive HCWs
were analyzed with the same 7 tests, with inconsistent results again.
Identification of reliable SARS-CoV-2 antibody tests is important to
determine the actual number of past infections, the duration of
antibodies, and guide public health decisions
A Case-Control Study on the Risk Factors for Meningococcal Disease among Children in Greece.
The aim of this study was to identify environmental or genetic risk factors that are associated with invasive meningococcal disease (IMD) in children in Greece.A case-control study was performed in 133 children (44 cases and 89 controls) aged between 0-14 years, who were hospitalized in a children's hospital in Athens. Demographics and possible risk factors were collected by the use of a structured questionnaire. To investigate the association of mannose binding lectin (MBL) with IMD, a frequency analysis of the haplotypes of the MBL2 gene and quantitative measurement of MBL serum protein levels were performed using Nanogen NanoChipR 400 technology and immuno-enzyme techniques, respectively.The multivariate analysis revealed that changes in a child's life setting (relocation or vacation, OR = 7.16), paternal smoking (OR = 4.51), upper respiratory tract infection within the previous month (OR = 3.04) and the density of people in the house/100m2 (OR = 3.16), were independent risk factors associated with IMD. Overall 18.8% of patients had a MBL2 genotype with low functionality compared to 10.1% of healthy controls, but this was not statistically significant (p = 0.189).Prevention strategies aimed at reducing parental smoking and other risk factors identified in this study could decrease the risk of IMD among children in Greece
Varicella-related complications and hospitalisations in a tertiary pediatric medical center before vaccine introduction
PASTEURELLA MULTOCIDA INFECTION IN A NEONATE EVIDENCE FOR A HUMAN-TO-HUMAN HORIZONTAL TRANSMISSION
Pasteurella multocida is usually transmitted by animal contact; however,
in a significant proportion of cases, no animal exposure can be
identified. Although vertical transmission has been identified in
neonates, horizontal human-to-human spread has not been documented. A
case of neonatal sepsis and meningitis resulting from horizontal
transmission of P. multocida is described