Cytomegalovirus seroprevalence among solid organ donors in Hungary: correlations with age, gender, and blood group.

BACKGROUND: Cytomegalovirus (CMV) is endemic throughout the world, affecting most of the population, but the seroprevalence of CMV is known to vary among countries. CMV causes a mild infection in persons with intact immunity; however, CMV infection in organ transplantation is associated with significant morbidity and mortality. The present retrospective study was designed to evaluate the age-, gender-, and blood group-adjusted CMV seroprevalence among solid organ donors, representing fairly the overall Hungarian population (according to Hungarian Central Statistic Institute). This information is important for calculating risk-factors for CMV-seronegative recipients. No nationwide estimates of CMV seroprevalence in Hungary (as a representative of Eastern Middle Europe) have been published yet. METHODS: We investigated 2070 organ donors for CMV seroprevalence by measuring the CMV-specific immunoglobulin G. The donors were divided into 3 age groups (2-20, 21-50, and 51-70 years old). A study was also conducted on a fourth group consisting of 200 residents from an old age home. CMV seroprevalence differences were searched according to age-, gender- and blood-group distribution. RESULTS: The CMV seroprevalence of organ donors is 85% and of all investigated persons is 86%. The age-specific prevalence increases, starting from 72% in the first group to 99% in the fourth group. Seroprevalence of females was found to be significantly higher than of males (P=.0001). CONCLUSION: We have shown that the overall CMV seroprevalence in the Hungarian population is moderately high at 86%. The opportunity for CMV-seronegative recipients to get a graft from a seronegative donor is statistically only 2%. The seroprevalence of the youngest age group is 72% and so it can be concluded that the Hungarian population acquires the infection mainly in childhood or in the early adulthood. Female gender is a risk factor for CMV infection. This fact must be taken into consideration during the planning of patients' follow-up, prophylaxis, and therapy.

H1N1 vaccination in pediatric renal transplant patients.

BACKGROUND: Solid organ transplant recipients undergoing immunosuppressive therapy are considered to be at high risk of serious infectious complications. In 2009, a new influenza pandemic caused serious infections and deaths, especially among children and immunocompromised patients. Herein we have reported the safety and efficacy of a single-shot monovalent whole-virus vaccine against H1N1 infection in the pediatric renal transplant population. METHODS: In November and December 2009, we vaccinated 37 renal transplant children and adolescents and measured their antibody responses. Seroprotection, seroconversion, and seroconversion factors were analyzed at 21 days after vaccination. RESULTS: None of the vaccinated patients experienced vaccine-related side effects. None of the patients had an H1N1 influenza infection after vaccination. All of the patients showed elevations in antibody titer at 21 days after vaccination. In contrast, only 29.72% of the patients achieved a safe seroprotection level and only 18.75% a safe seroconversion rate. More intense immunosuppressive treatment displayed negative effect on seroprotection and seroconversion, and antibody production significantly increased with age. No other factor was observed to influence seroprotection. CONCLUSIONS: We recommend vaccination of children and adolescent renal transplant recipients against H1N1 virus. However, a single shot of vaccine may not be sufficient; to achieve seroprotection, a booster vaccination and measurement of the antibody response are needed to assure protection of our patients.

Detection and toxin production of Staphylococcus aureus in sudden infant death cases in Hungary.

The potential role of microbial agents was investigated in 13 cases of Sudden Infant Death Syndrome and in 9 non-SIDS cases in Budapest between September 1996 and May 1998. Autopsy, histological examination and microbiological tests were performed on samples of blood, cerebrospinal fluid, pharyngeal samples and lung tissue from infants under one year died suddenly, without previous diseases. The multifactorial pathomechanism of SIDS was suggested by the isolation of toxin producing Staphylococcus aureus-, Enterobacteriaceae and Candida albicans strains in large number and by the detection of Parainfluenza Type 2 virus antigen. S. aureus proved the predominant bacteria in the SIDS cases. Nasopharyngeal microbial flora and S. aureus carrier of 100 age matched healthy infants were tested during the same period. S. aureus was isolated from 54% of SIDS cases and 37% from healthy infants /OR = 1.986 (95% Confidence interval = 0.55-7.33), p = 0243/. The enterotoxin and TSST-1 toxin producing activity of S. aureus showed the characteristic difference. The toxigenic S. aureus was detected in 46% of SIDS cases and 16% of healthy infants /OR = 4.5 (95% CI = 1.15-17.72), p = 0.010/. The distribution of toxigenic and nontoxigenic isolates was 86% in SIDS cases and 43% in healthy infants /OR = 7.875 (CI = 0.78-191.89), p = 0.041/.

Potential role of microbiological agents in sudden infant death syndrome.

The potential role of microbiological agents was investigated in 10 cases of Sudden Infant Death Syndrome in Budapest between September 1996 and December 1997. Autopsy, histological examination and microbiological tests were performed on samples of blood, cerebrospinal fluid, pharyngeal and bronchial samples from infants under six months died suddenly, without previous diseases. The multifactorial pathomechanism of SIDS was suggested by detection of Parainfluenza Type virus antigen, isolation of toxin producing Staphylococcus aureus, Enterobacteriaceae and Candida albicans strains in large number of more samples of the same infant.

[The influenza viruses: past, present and future]. / Influenzavírusok: múlt, jelen és jövo.

Influeza disease is an underestimated public health problem. Epidemics spread rapidly from country to country and may affect as many as 500 million people all over the world in a year. The disease, particularly influenza A may kill the patients and the new influenza viruses which appeared in 1957 (Asian influenza) and 1968 (Hong Kong) are estimated to have caused at least 3 000 000 deaths in the world. There are several aspects in virus replication and maturation that have attracted considerable interest in recent years: the ubiquitous enzyme responsible for the activation of hemagglutinin at multibasic cleavage sites has been found to be furin, a member for a family of subtilisin-like eukaryotic proteases; the M2 protein forms adamantanamin-sensitive ion channels and regulates the pH in transport vesicles; the interferon induced Mx1 protein interferes also with replication of Thogoto virus, a hitherto unclassified tickborne virus now thought to belong to the orthomyxovirus family. Inactivated influenza vaccines were first licensed in 1941. Extensive efficacy trials showed that vaccines were immunogenic and gave 70% protection. During the 1960s and 1970s, several improvements in vaccine production methods helped making current vaccines much less reactogenic: zonal centrifugation, high growth reassortants, "split"-vaccines, subunit vaccines. Killed complete virons of influenza virus absorbed to aluminium phosphate have been used for vaccination in Hungary since 1969. The protectiv effect of vaccine recorded in different studies varied, but was usually between 25% and 76% ...

[First isolation of Borrelia burgdorferi (Lyme spirochaeta) from ticks in Hungary]. / A Borrelia burgdorferi (Lyme spirochaeta) elsö hazai izolálása kullancsokból.

31 field collected Ixodes ricinus adult ticks were investigated for the Lyme-disease spirochete. 5/31 Ixodes ricinus contained Borrelia burgdorferi. The spirochete was successfully cultivated in four cases, and they were found in two ticks by immunofluorescence technique and dark field microscopy, as well. Two of the isolated strains were tested by Western blot. The antigen pattern in both strains showed marked bands in 41 and 60 kD antigen, but only a week band appeared at 32 kD, with the lack of the OspB. The mechanism of infection and the way of prevention is discussed.