Rotavirus genotypes in the post-vaccine era: A systematic review and meta-analysis of global, regional, and temporal trends in settings with and without rotavirus vaccine introduction.

BACKGROUND: Even moderate differences in rotavirus vaccine effectiveness against non-vaccine genotypes may exert selective pressures on circulating rotaviruses. Whether this vaccine effect or natural temporal fluctuations underlie observed changes in genotype distributions is unclear. METHODS: We systematically reviewed studies reporting rotavirus genotypes from children <5 years of age globally between 2005 and 2023. We compared rotavirus genotypes between vaccine-introducing and non-introducing settings globally and by World Health Organization (WHO) region, calendar time, and time since vaccine introduction. RESULTS: Crude pooling of genotype data from 361 studies indicated higher G2P[4], a non-vaccine genotype, prevalence in vaccine-introducing settings, both globally and by WHO region. This difference did not emerge when examining genotypes over time in the Americas, the only region with robust longitudinal data. Relative to non-introducing settings, G2P[4] detections were more likely in settings with recent introduction (e.g. 1-2 years post-introduction aOR: 4.39 (95% CI: 2.87-6.72)) but were similarly likely in settings with more time elapsed since introduction, (e.g. 7 or more years aOR (1.62 95% CI: 0.49-5.37)). CONCLUSIONS: When accounting for both regional and temporal trends, there was no substantial evidence of long-term vaccine-related selective pressures on circulating genotypes. Increased prevalence of G2P[4] may be transient after rotavirus vaccine introduction.

Racial and Ethnic Disparities in Mpox Cases and Vaccination Among Adult Males - United States, May-December 2022.

As of December 31, 2022, a total of 29,939 monkeypox (mpox) cases* had been reported in the United States, 93.3% of which occurred in adult males. During May 10-December 31, 2022, 723,112 persons in the United States received the first dose in a 2-dose mpox (JYNNEOS)† vaccination series; 89.7% of these doses were administered to males (1). The current mpox outbreak has disproportionately affected gay, bisexual, and other men who have sex with men (MSM) and racial and ethnic minority groups (1,2). To examine racial and ethnic disparities in mpox incidence and vaccination rates, rate ratios (RRs) for incidence and vaccination rates and vaccination-to-case ratios were calculated, and trends in these measures were assessed among males aged ≥18 years (males) (3). Incidence in males in all racial and ethnic minority groups except non-Hispanic Asian (Asian) males was higher than that among non-Hispanic White (White) males. At the peak of the outbreak in August 2022, incidences among non-Hispanic Black or African American (Black) and Hispanic or Latino (Hispanic) males were higher than incidence among White males (RR = 6.9 and 4.1, respectively). Overall, vaccination rates were higher among males in racial and ethnic minority groups than among White males. However, the vaccination-to-case ratio was lower among Black (8.8) and Hispanic (16.2) males than among White males (42.5) during the full analytic period, indicating that vaccination rates among Black and Hispanic males were not proportionate to the elevated incidence rates (i.e., these groups had a higher unmet vaccination need). Efforts to increase vaccination among Black and Hispanic males might have resulted in the observed relative increased rates of vaccination; however, these increases were only partially successful in reducing overall incidence disparities. Continued implementation of equity-based vaccination strategies is needed to further increase vaccination rates and reduce the incidence of mpox among all racial and ethnic groups. Recent modeling data (4) showing that, based on current vaccination coverage levels, many U.S. jurisdictions are vulnerable to resurgent mpox outbreaks, underscore the need for continued vaccination efforts, particularly among racial and ethnic minority groups.

Elovl2-Ablation Leads to Mitochondrial Membrane Fatty Acid Remodeling and Reduced Efficiency in Mouse Liver Mitochondria.

The fatty acid elongase elongation of very long-chain fatty acids protein 2 (ELOVL2) controls the elongation of polyunsaturated fatty acids (PUFA) producing precursors for omega-3, docosahexaenoic acid (DHA), and omega-6, docosapentaenoic acid (DPAn-6) in vivo. Expectedly, Elovl2-ablation drastically reduced the DHA and DPAn-6 in liver mitochondrial membranes. Unexpectedly, however, total PUFAs levels decreased further than could be explained by Elovl2 ablation. The lipid peroxidation process was not involved in PUFAs reduction since malondialdehyde-lysine (MDAL) and other oxidative stress biomarkers were not enhanced. The content of mitochondrial respiratory chain proteins remained unchanged. Still, membrane remodeling was associated with the high voltage-dependent anion channel (VDAC) and adenine nucleotide translocase 2 (ANT2), a possible reflection of the increased demand on phospholipid transport to the mitochondria. Mitochondrial function was impaired despite preserved content of the respiratory chain proteins and the absence of oxidative damage. Oligomycin-insensitive oxygen consumption increased, and coefficients of respiratory control were reduced by 50%. The mitochondria became very sensitive to fatty acid-induced uncoupling and permeabilization, where ANT2 is involved. Mitochondrial volume and number of peroxisomes increased as revealed by transmission electron microscopy. In conclusion, the results imply that endogenous DHA production is vital for the normal function of mouse liver mitochondria and could be relevant not only for mice but also for human metabolism.

[Adequate antimicrobial drug use in a third level pediatric hospital]. / Uso adecuado de antimicrobianos en pediatría en un hospital de tercer nivel.

BACKGROUND: The inadequate use of antimicrobials contributes to the development of bacterial resistance, reduces the effectiveness of established treatments and increases costs and mortality due to infectious diseases. The aim of this article was to evaluate if the use of antimicrobials was carried out properly in hospitalized pediatric patients. METHODS: An epidemiological observational, cross-sectional study was carried out in UMAE-48 in León, Guanajuato. Sample was non-probabilistic by convenience with 60 % of expected adequate treatments, 4 standard deviation. Analysis of statistical distribution frequency technique was used by type of final grade of each treatment that was administered: adequate, justified, therapeutic, restricted and prophylactic. The test chi-square test for comparing of percentages. RESULTS: Antimicrobial therapy were evaluated 283 prescriptions in 217 patients, 53 % were men and 47 % women. The general treatment was adequate in 51.2 %, justified 66 %, therapeutic 53.4 %, 40.8 % restricted and 48% prophylactic. Comparison of percentages with statistical test of chi-square test, we found association with adequate treatment in neonates service (chi-square test 8.287; p 0.004) and inadequate treatment in preterm infants service (chi-square test 4.853; p 0.028) p < 0, 05. The most commonly used antimicrobials, 43.7 % penicillins and 37.1 % aminoglycoside. CONCLUSION: Only half of the treatments was antimicrobials are prescribed properly.

Introducción: el uso inadecuado de antimicrobianos contribuye al desarrollo de la resistencia bacteriana, reduce la efectividad de los tratamientos establecidos e incrementa los gastos y la mortalidad por enfermedades infecciosas. El objetivo de este artículo es evaluar si el uso de antimicrobianos en pacientes pediátricos hospitalizados se realiza de forma adecuada. Métodos: estudio epidemiológico observacional, transversal en la UMAE No. 48 de León, Guanajuato. Muestra no probabilística, con un 60 % de tratamientos adecuados esperados, desviación estándar 4. Se utilizó la técnica estadística de análisis de distribución de frecuencias por calificación final de tratamiento administrado: profiláctico, terapéutico, restringido, justificado y adecuado. Se realiza chi cuadrada para comparación de porcentajes. Resultados: se evalúan 283 prescripciones antimicrobianas en 217 pacientes, hombres (53 %) y mujeres (47 %). De los cuales fueron tratamientos adecuados: general 51.2 %, justificado 66 %, terapéutico 53.4 %, restringido 40.8 % y profiláctico 48 %. Comparación de porcentajes con chi cuadrada, asociación estadística significativa de tratamiento adecuado en neonatos (chi cuadrada 8.287; p 0.004) y tratamiento inadecuado en prematuros (chi cuadrada 4.853; p 0.028) con p < 0.05. Los antibióticos más usados fueron: penicilinas 43.7 % y aminoglucósidos 37.1 %. Conclusión: solo la mitad de los tratamientos antimicrobianos se prescriben de forma adecuada.