The potential risks and impact of the start of the 2015–2016 influenza season in the WHO European Region: a rapid risk assessment

Background: Countries in the World Health Organization (WHO) European Region are reporting more severe influenza activity in the 2015–2016 season compared to previous seasons. Objectives: To conduct a rapid risk assessment to provide interim information on the severity of the current influenza season. Methods: Using the WHO manual for rapid risk assessment of acute public health events and surveillance data available from Flu News Europe, an assessment of the current influenza season from 28 September 2015 (week 40/2015) up to 31 January 2016 (week 04/2016) was made compared with the four previous seasons. Results: The current influenza season started around week 51/2015 with higher influenza activity reported in Eastern Europe compared to Western Europe. There is a strong predominance of influenza A(H1N1)pdm09 compared to previous seasons, but the virus is antigenically similar to the strain included in the seasonal influenza vaccine. Compared to the 2014/2015 season, there was a rapid increase in the number of severe cases in Eastern European countries with the majority of such cases occurring among adults aged < 65 years. Conclusions: The current influenza season is characterized by an early start in Eastern European countries, with indications of a more severe season. Currently circulating influenza A(H1N1)pdm09 viruses are antigenically similar to those included in the seasonal influenza vaccine, and the vaccine is expected to be effective. Authorities should provide information to the public and health providers about the current influenza season, recommendations for the treatment of severe disease and effective public health measures to prevent influenza transmission

Composition of children pharyngeal microbiome by 16S rRNA deep sequencing

&lt;p&gt;The upper respiratory tract (URT) is colonised by a large variety of bacteria that constitute the respiratory microbiota. Most do not have a role and may even be protective. The aim of the present study was to analyse the microbiome and characterize the relative abundance of microbial communities of the pharynx by next generation sequencing of the 16S rRNA gene of bacteria in healthy children and children with a respiratory infection. Ten phyla were identified in the 8 study subjects. The most abundant phyla detected, were Firmicutes, Proteobacteria and Bacteroidetes, while the relative abundance of each was highly variable across the subjects. At the family, genus and species level, 24 families, 19 genera and 71 species respectively were common both in patients and healthy subjects, while some (28 families and 24 genera) were identified only in healthy subjects and few (7 families, 8 genera and 9 species) were identified only in patients. No statistically significant differences were observed in relation to the age or gender of the subjects. Interestingly, the most abundant bacteria detected in healthy children were Streptococcus, Prevotella, Moraxella, Veillonella and leptotrichia, while in young patients Moraxellawas not detected among the most prevalent bacteria, supporting the notion that it may play a protective role in infection. Protective and pathogenic bacteria have been identified in healthy children and in patients. Such studies can form the basis for new approaches to fight diseases responding poorly to traditional interventions.&lt;/p&gt

Kuzey Yunenistanda Pandemik H1N1 2009 Enfeksiyonun Epidemiyolojik Surveyans�

In response to the health emergency declared by the World Health Organization (WHO) in April 2009, Greece set up an enhanced surveillance system for pandemic H1N1 2009 by the 30th of April 2009. During the period of study (weeks 19-53), 3.903 suspected pharyngeal were examined at the National Influenza Centre for northern Greece. 1439 specimens were confirmed as pandemic H1N1 2009 (37.23%) infections. The hospitalization rate increased dramatically during November and December, while the death rate was 1.3%.Dünya sağlık örgütünün 2009 yılının Nisan ayında bildirmiş olduğu acil durumda Yunanistan pandemik H1N1 2009 enfeksiyonu için surveyans sistemini geliştirdi. Çalışma dönemi içinde (19-53 hafta) 3903 şüpheli faringeali Ulusal Kuzey Yunanistan İnfluenza Merkezinde tarandı. 1439 örnek pandemik H1N1 2009 olarak tespit edildi (%37.23). Hastaneye yatma oranı Kasım ve Aralık ayında dramatik olarak artmıştır. Ölüm oranı %1.3 idi

The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: From colonization to bloodstream infection

Purpose. To highlight the clinical significance of carbapenem-resistant Klebsiella pneumoniae (CRKP) rectal colonization by examining the risk factors for CRKP rectal colonization and subsequent bloodstream infection (BSI) in critically ill patients. Methodology. Prospective study of CRKP rectal colonization in an intensive care unit (ICU) during a 39-month period. CRKP strains isolated from both the blood cultures and corresponding rectal specimens (n=96) of patients were screened by PCR for the presence of antibiotic resistance-associated genes. Molecular analyses were conducted to investigate the clonal relatedness of CRKP strains from the rectal and blood specimens. Results. Among the 498 patients, 226 were rectally colonized by CRKP, 48 of whom developed a CRKP BSI. The median time from hospital admission to the detection of CRKP rectal colonization was 8 days, while the median time from colonization to BSI was 4 days. The duration of ICU stay, patient/nurse ratio and prior use of antianaerobic antimicrobials were associated with CRKP rectal colonization. No specific factor was associated with BSIs in the colonized patients. The blaKPC-2 gene was detected in all 96 strains, which were all classified as sequence type ST-258. Representative pairs (n=48) of CRKP strains colonizing and infecting the same patient shared the same pulsotype. Conclusion. Our results indicate that hospitalized patients become infected with their colonizing strains, supporting the strong association between colonization and BSI. Limiting antianaerobic antimicrobial administration, reducing the duration of ICU stay and maintaining a low patient/nurse ratio are possible strategies to restrict rectal CRKP colonization in ICUs. © 2019 The Authors

Comparative evaluation of minocycline susceptibility testing methods in carbapenem-resistant Acinetobacter baumannii

In this study, the performance of two commonly used routine antimicrobial susceptibility testing methods, the automated VITEK®2 system and Etest (bioMérieux, Marcy-l&apos;Étoile, France), was compared with the standard broth microdilution (BMD) method on 87 multidrug- and carbapenem-resistant Acinetobacter baumannii clinical isolates. Clinical and Laboratory Standards Institute (CLSI) 2015 breakpoints (susceptible, ≤4 mg/L; intermediate, 8 mg/L; and resistant, ≥16 mg/L) were used. Minocycline showed excellent activity, with 94.3% of isolates susceptible by BMD (VITEK®2, 73.6%; Etest, 63.2%). The MIC50/90 values (minimum inhibitory concentrations required to inhibit 50% and 90% of the isolates, respectively) were as follows: BMD, 1/4 mg/L; VITEK®2, ≤1/8 mg/L; and Etest, 4/16 mg/L. Etest produced 14.9% major/20.7% minor errors and VITEK®2 produced 3.4% major/17.2% minor errors. These data indicate that VITEK®2 may be more reliable than Etest for routine susceptibility testing of minocycline for A. baumannii isolates. As both VITEK®2 and Etest produced higher minocycline MICs compared with the reference method, BMD may be needed to validate the categorisation of carbapenem-resistant A. baumannii by these assays as minocycline non-susceptible. © 2016 Elsevier B.V. and International Society of Chemotherap

NK and NKT cell depletion alters the outcome of experimental pneumococcal pneumonia: Relationship with regulation of interferon- γ production

Background. Natural killer (NK) and natural killer T (NKT) cells contribute to the innate host defense but their role in bacterial sepsis remains controversial. Methods. C57BL/6 mice were infected intratracheally with 5 × 105 cfu of Streptococcus pneumoniae. Animals were divided into sham group (Sham); pretreated with isotype control antibody (CON) group; pretreated with anti-asialo GM1 antibody (NKd) group; and pretreated with anti-CD1d monoclonal antibody (NKTd) group before bacterial challenge. Serum and tissue samples were analyzed for bacterial load, cytokine levels, splenocyte apoptosis rates, and cell characteristics by flow cytometry. Splenocyte miRNA expression was also analyzed and survival was assessed. Results. NK cell depletion prolonged survival. Upon inhibition of NKT cell activation, spleen NK (CD3-/NK1.1+) cells increased compared to all other groups. Inhibition of NKT cell activation led to higher bacterial loads and increased levels of serum and splenocyte IFN-γ. Splenocyte miRNA analysis showed that miR-200c and miR-29a were downregulated, while miR-125a-5p was upregulated, in anti-CD1d treated animals. These changes were moderate after NK cell depletion. Conclusions. NK cells appear to contribute to mortality in pneumococcal pneumonia. Inhibition of NKT cell activation resulted in an increase in spleen NK (CD3-/NK1.1+) cells and a higher IFN-γ production, while altering splenocyte miRNA expression. © 2015 Eirini Christaki et al