Enhancement of Preventive Vaccination Approaches for Children with Health Problems: Prospective Cohort Study Results

Background. Modern preventive vaccination is intended to protect and enhance the health of every person considering age and health issues. Vaccination of children with chronic diseases in our country remains extremely topical and arguable problem that associated with many pending issues for doctors of various specialties, including those working as primary care specialists.Objective. The aim of the study is to develop major approaches and to prove scientifically the efficacy and safety of preventive vaccination for children with various chronic diseases.Methods. We have conducted comprehensive study of 100 children aged from 1 month to 17 years 11 months. Children were divided into 4 groups according to the specific disease. Vaccinal and infectious history was analyzed. The post-vaccination period was estimated due to the results of the questionnaire completed by parents. Vaccination immunogenicity was estimated based on the results of the level of specific antibodies to various controlled infections (measles, rubella, parotitis, hepatitis B, pertussis, haemophilus influenza type b).Results. Protective titers of antibodies against haemophilus influenza type b were revealed in 96.2% of all examined patients, tetanus and hepatitis B — in 95.2%, against pertussis — in 92.5%, rubella — in 91%, measles — in 87.5%, parotitis — in 71.9%, chickenpox — in 69% children a month after the completed vaccination. The postvaccinal period was characterized as favorable in most patients. Major changes in overall health status occurred after vaccination in 42% of children was the following: subfebrile fever, capriciousness, or fatigue. Local reactions have developed only in 15% of cases.Conclusion. The results of this study have demonstrated the preventive vaccination efficacy and safety in children with various chronic diseases

Gram Negative Bacteria (GNB) Isolated From Used Home-made and Surgical Nose/Face Mask by Local Residents of Akungba Akoko, Ondo State, a Threat to Life and False Sense of Protection against SARS-CoV-2 (COVID-19)

Nose/Face masks are physical barriers to respiratory droplets that may enter through the nose and mouth to cause infections in the respiratory tract. The study was determined and assess the presence of Gram-negative bacteria in used home-made and surgical nose mask by residents of Akungba-Akoko Ondo State and to determine the antimicrobial susceptibility and resistant profile of the isolated bacteria to eight (8) different antimicrobial agents. The antimicrobial analysis were performed using standard microbiological and biochemical methods. Antimicrobial Susceptibility test of all identified isolates to antimicrobial agents were determined using the standard Kirby-Bauer disk diffusion method. The Gram-negative bacteria that were detected from the used home-made and surgical nose mask in this study include: Haemophilus influenza, Proteus mirabilis, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia. During this study, all the Gram-negative bacteria isolates were resistant to Ciproflox in both used home-made and surgical nose mask. All isolates were also resistant to Ampicilin, Augmentin, Septrin and Streptomycin. In this study, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were isolated organism from used home-made nose mask, it was observed that Escherichia coli were resistant to Augmentin, Tarivid, Ciproflox, Gentamycin, and Reflaxine, and Pseudomonas aeruginosa were resistant to Tarivid, Ciproflox, and Nalidixic acid between 20 mm and 24 mm zones of inhibition respectively. Haemophilus influenza, Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis were isolated organism from used surgical nose mask. It was observed that all isolated organisms from the used surgical nose/face mask were resistant to Augmentin and Gentamycin between 20 and 24 mm zones of inhibition respectively. Klebsiella pneumoniae were isolated from both used home-made and surgical nose/face mask and were found to be resistant to Streptomycin, Septrin, Ampicilin, and Gentamicin between 20 to 22 mm zones of inhibition respectively. Proteus mirabilis were isolated from used surgical nose/face mask, they were found to be resistant to Ciproflox at 21mm zones of inhibition. Haemophilus influenza were resistant to Ampicilin, Septrin, Streptomycin, and Augmentin at 23 mm zones of inhibition. Isolates from used both home-made and surgical nose/face mask were subjected to modified and synergized antibiotics, it was observed that the isolates from both used home-made and surgical nose mask were resistant to all modified and synergized antibiotics between 20 and 25 mm zones of inhibition respectively. The result of this study validates the potency of Gram negative bacteria isolated from used both home-made and surgical nose/face mask and the degree of invasion and evasiveness, thereby causing various degrees of infections and a false sense of protection against SARS-CoV-2 (COVID-19). Finding from this research recommends a stringent measures were needed to be implemented, to halt and combat this revenging situation especially in the new era of mutating SARS-CoV-2 Virus not only in Nigeria, worldwide at large.

Xác định căn nguyên nhiễm trùng đường hô hấp dưới cộng đồng bằng kỹ thuật chuỗi phản ứng polymerase đa mồi tại Bệnh viện Đại học Y Hà Nội

Nhiễm trùng đường hô hấp dưới là một trong những nguyên nhân quan trọng gây ra bệnh tật và tử vong trên toàn thế giới. Chẩn đoán căn nguyên giúp định hướng cho điều trị và quản lí. Multiplex PCR là một kĩ thuật mới được áp dụng rộng rãi trên thế giới để chẩn đoán căn nguyên nhiễm trùng nhưng vẫn chưa được áp dụng phổ biến tại Việt Nam. Nghiên cứu của chúng tôi đánh giá căn nguyên nhiễm trùng đường hô hấp dưới cộng đồng bằng kỹ thuật Multiplex PCR. Nghiên cứu mô tả cắt ngang với 22 người bệnh nhiễm trùng hô hấp dưới cộng đồng được thực hiện đồng thời nuôi cấy vi khuẩn và PCR. Tỉ lệ nuôi cấy vi khuẩn dương tính trong 13,6% người bệnh, tỉ lệ PCR dương tính trong 27,2% người bệnh. Một số căn nguyên thường gặp đã được phát hiện như Streptococcus pneumoniae, Haemophilus influenza, HSV…

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis

Objectives: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). Methods: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). Results: A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice ( P < .013), respiratory distress ( P < .001), and pre-existence of epiglottic cyst ( P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza ( Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention ( P < .001). Conclusion: A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

Haemophilus influenzae infection among children with acute bacterial meningitis.

Objective: To determine the frequency of haemophilus influenzae infection in children less than 5 years with acute bacterial meningitis (ABM). Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 165 children aged 5 – 60 months of either gender having acute bacterial meningitis with duration of < 2 weeks were enrolled. Cerebrospinal fluid (CSF) of each child was sent for microbiological analysis. Results: There were 106 (64.2 %) boys and 59 (35.8 %) girls. Mean age was 2.72 ± 1.07 years. Most cases, 112 (67.9 %) belonged to urban areas. Maternal literacy was positive in 65 (39.4%) cases while 59 (35.8%) were fully vaccinated. Mean disease duration was 56.25 ± 15.36 hours and 112 (67.9%) had duration of illness more than 36 hours. Frequency of Haemophilus Influenzae was noted in 35 (21.2%) cases. Conclusion: Frequency of Haemophilus Influenzae was high among children with acute bacterial meningitis. Early diagnosis and appropriate management might help reducing prolonged hospitalization and disease morbidity related to Haemophilus Influenza.

The Antimicrobial Properties of Nanotitania Extract and Its Role in Inhibiting the Growth of Klebsiella pneumonia and Haemophilus influenza

Titanium dioxide (TiO2) is an antimicrobial agent which is considered of potential value in inhibiting the growth of multiple bacteria. Klebsiella pneumonia and Haemophilus influenza are two of the most common respiratory infection pathogens, and are the most. Klebsiella pneumonia causes fatal meningitis, while Haemophilus influenza causes mortality even in younger patients. Both are associated with bacteremia and mortality. The purpose of this study was to test a new antibacterial material, namely nanotitania extract combined with 0.03% silver that was developed at Universiti Malaysia Sabah (UMS) and tested against K. pneumonia and H. influenza. The nanoparticles were synthesized through a modified hydrothermal process, combined with molten salt and proven to have excellent crystallinity, with the band-gap energy falling in the visible light spectrum. The nanoparticle extract was tested using a macro-dilutional method, which involved combining it with 0.03% silver solution during the process of nanoparticle synthesis and then introducing it to the bacteria. A positive control containing the bacteria minus the nanoparticles extract was also prepared. 25 mg/mL, 12.5 mg/mL, and 6.25 mg/mL concentrations of the samples were produced using the macro dilution method. After adding the bacteria to multiple concentrations of nanoparticle extract, the suspensions were incubated for 24 h at a temperature of 37 °C. The suspensions were then spread on Mueller-Hinton agar (K. pneumonia) and chocolate blood agar (H. influenza), where the growth of bacteria was observed after 24 h. Nanoparticle extract in combination with silver at 0.03% was proven to have potential as an antimicrobial agent as it was able to inhibit H. influenza at all concentrations. Furthermore, it was also shown to be capable of inhibiting K. pneumonia at concentrations of 25 mg/mL and 50 mg/mL. In conclusion, the nanoparticle extract, when tested using a macro-dilutional method, displayed antimicrobial properties which were proven effective against the growth of both K. pneumonia and H. influenza.

Analysis of Microbiota and Mycobiota in Fungal Ball Rhinosinusitis: Specific Interaction between Aspergillus fumigatus and Haemophilus influenza?

Fungal ball (FB) rhinosinusitis (RS) is the main type of non-invasive fungal RS. Despite positive direct examination (DE) of biopsies, culture remains negative in more than 60% of cases. The aim of the study was to evaluate the performance/efficacy of targeted metagenomics (TM) to analyze microbiota and mycobiota in FB and find microbial associations. Forty-five sinus biopsies from patients who underwent surgery for chronic RS were included. After DE and culture, DNA was extracted, then fungal ITS1–ITS2 and bacterial V3–V4 16S rDNA loci were sequenced (MiSeqTM Illumina). Operational taxonomic units (OTUs) were defined via QIIME and assigned to SILVA (16S) and UNITE (ITS) databases. Statistical analyses were performed using SHAMAN. Thirty-eight patients had FB and seven had non-fungal rhinosinusitis (NFRS). DE and culture of FB were positive for fungi in 97.3 and 31.6% of patients, respectively. TM analysis of the 38 FB yielded more than one fungal genus in 100% of cases, with Aspergillus in 89.5% (34/38). Haemophilus was over-represented in FB with >1000 reads/sample in 47.3% (18/38) compared to NFRS (p < 0.001). TM allowed fungal identification in biopsies with negative culture. Haemophilus was associated with FB. Pathogenesis could result from fungi–bacteria interactions in a mixed biofilm-like structure.

Polyphenol-Rich Larix decidua Bark Extract with Antimicrobial Activity against Respiratory-Tract Pathogens: A Novel Bioactive Ingredient with Potential Pharmaceutical and Nutraceutical Applications

Larch (Larix decidua) bark is a sawmill waste, traditionally used for antiseptic, expectorant and dermatological (wound healing, eczema, psoriasis) purposes. In this work, we developed a food-grade dry larch bark extract (LBE) from sawmill by-products using hydro-alcoholic extraction. The antibacterial activity of LBE was evaluated against respiratory-tract pathogens, i.e. Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Klebsiella pneumoniae, Pseudomonas aeruginosa and Haemophilus influenza, and it was compared to that of grapefruit seed extract (GSE), a commercially available raw material commonly proposed as antibacterial ingredient for over-the-counter products. Procyanidins (PACs) and other polyphenols contents in LBE were determined by HPLC-FLD-MS and HPLC-DAD-MSn, respectively. The antimicrobial activity of LBE and GSE was assessed using the micro-plate dilution technique in concentration range of 2–200 µg/mL, and the safety of these dosages was assessed in cellular and animal models. LBE showed considerable contents of PACs (15% w/w; especially B-type) and other polyphenols (3.8% w/w), among which the characteristic spiropolyphenols larixinol and epilarixinol were identified, together with the flavonoids isoquercitrin and rutin, already reported as growth inhibitors of different respiratory-tract pathogens. LBE showed higher antimicrobial activity compared to GSE, demonstrated by a growth inhibition range of 10–40% towards five of six strains tested, compared to 10–15% of GSE. These results suggest that LBE may represent a natural and sustainable source of active compounds with antibacterial activity for pharmaceutical and nutraceutical applications.