Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 / 中华流行病学杂志

Objective To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou,China,2011-2017.Methods From March 2011 to February 2017,we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital.Through standard questionnaires and follow-up survey via telephone,we collected information regarding the demographic characteristics,medical history,clinical symptoms and both direct and indirect costs associated with influenza,of the patients.We then compared clinical characteristics and economic burden of influenza A/H1N1,A/H3N2,and B infections among children with ILI.Results We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs.791 (12.9％) of the swabs showed positive for influenza virus,including 88 (11.1％) subtype influenza A/H1N1,288 (36.4％) subtype influenza A/H3N2,and 415 (52.5％) type influenza B.The proportions of cough,rhinorrhea,wheezing,vomiting and convulsion in influenza-positive children were higher than those influenza-negative children.Except for the prevalence rates of cough (x2=9.227,P=0.010),wheezing (x2=7.273,P=0.026) and vomiting (x2=8.163,P=0.017),other clinical symptoms appeared similar between the three viral subtypes.Among all the ILI children,the average total cost per episode of influenza was 688.4 Yuan (95％ CI:630.1-746.7) for influenza-negative children;768.0 Yuan (95％CI:686.8-849.3) for influenza-positive children and 738.3 Yuan (95％CI:655.5-821.1) for influenza B.Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (x2=7.237,P=0.028).Conclusion Children infected influenza showed higher prevalence rates of cough,rhinorrhea,wheezing,vomiting and convulsion than those without influenza.Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 / 中华流行病学杂志

Objective To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou,China,2011-2017.Methods From March 2011 to February 2017,we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital.Through standard questionnaires and follow-up survey via telephone,we collected information regarding the demographic characteristics,medical history,clinical symptoms and both direct and indirect costs associated with influenza,of the patients.We then compared clinical characteristics and economic burden of influenza A/H1N1,A/H3N2,and B infections among children with ILI.Results We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs.791 (12.9％) of the swabs showed positive for influenza virus,including 88 (11.1％) subtype influenza A/H1N1,288 (36.4％) subtype influenza A/H3N2,and 415 (52.5％) type influenza B.The proportions of cough,rhinorrhea,wheezing,vomiting and convulsion in influenza-positive children were higher than those influenza-negative children.Except for the prevalence rates of cough (x2=9.227,P=0.010),wheezing (x2=7.273,P=0.026) and vomiting (x2=8.163,P=0.017),other clinical symptoms appeared similar between the three viral subtypes.Among all the ILI children,the average total cost per episode of influenza was 688.4 Yuan (95％ CI:630.1-746.7) for influenza-negative children;768.0 Yuan (95％CI:686.8-849.3) for influenza-positive children and 738.3 Yuan (95％CI:655.5-821.1) for influenza B.Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (x2=7.237,P=0.028).Conclusion Children infected influenza showed higher prevalence rates of cough,rhinorrhea,wheezing,vomiting and convulsion than those without influenza.Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Genetic elements of drug-resistance in a strain of multidrug-resistant Klebsiella pneumoniae isolated from bronchoalveolar lavage fluid / 中华临床感染病杂志

Objective To analyze the resistance genes in a muhidrug resistant Klebsiella pneumoniae (MDRKP) strain.Methods A MDRKP strain was isolated from bronchoalveolar lavage fluid in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University in February 2012.Acquired resistance genes to beta-lactams,aminoglycosides,quinolones,ompK35 and ompK36 gene for outer membrane porin protein,and carbapenems targeting PBP2 gene were analyzed by PCR and verified by DNA sequencing.Results Acquired resistance genes TEM-1,SHV-1 to beta-lactam antimicrobial agents and aac(6′)-I b to aminoglycoside antimicrobial agents were positive in the strain of MDRKP.While 16S rRNA methylase,ompK35 and ompK36 genes for outer membrane porin protein were negative.Compared with susceptible strains,there were 9 synonymous mutations in PBP2 gene sequence of this MDRKP strain,but the amino acid sequences were the same.No mutation in quinolone resistance determining region (QRDR) was observed.Conclusion The multidrug resistance of the isolated Klebsiella pneumoniae strain may be related to 2 kinds of beta-lactam acquired resistance genes,1 kind of aminoglycoside acquired resistance gene,ompK35 and ompK36 genes defects and synonymous mutation in PBP2 gene.

A retrospective study on the clinical features of the hospitalized children with influenza in Suzhou from 2005 to 2009 / 中华传染病杂志

Objective To analyze the clinical features of the hospitalized children with laboratory-confirmed influenza in Suzhou. Methods The demographic information, laboratory test results, clinical features, treatments and outcomes of the hospitalized children with laboratoryconfirmed influenza were collected retrospectively. The data were analyzed using chi square test,Cochran-Armitage trend test. Results Four hundred and eighty hospitalized children were diagnosed with laboratory-confirmed influenza during the period of 2005 to 2009. Among these cases, 414 were subtype A and 66 were subtype B. The positive rate was 2.66%. Four hundred and nineteen cases (87.29 %) were ≤ 5 years old. Most of the cases developed during winter (from December to April the next year) and summer (from July to August). The age and sex distribution didn't vary from year to year (x2=9. 7768,x2 = 8. 7573; both P＞0.05). The mean disease course was (16.22± 9.41)days, and the mean hospitalization duration was (7.89 ±2.97) days. The percentages of patients with symptoms of fever, dyspnea and diarrhea or requiring oxygen treatment decreased with age (Z =4. 9430, Z=2. 1021, Z=3. 2073 and Z=2. 3277, respectively; all P＜0.05). The percentages of cases with concomitant pneumonia and upper respiratory infection also decreased with age (Z =-3. 8762 and Z=-3. 5095, respectively; both P＜0.01). Fifteen point five percent (60/387 cases)of the cases were co-infected with pneumococcus and 15. 0% (72/480 cases) were co-infected with respiratory syncytial virus (RSV). The level of C-reactive protein was significantly higher in cases with bacterial co-infection than those with viral co-infection (Z= -3.1290, P ＜ 0. 01 ).Conclusions Hospitalized children with influenza are more common in winter and summer in Shuzhou.Many patients are co-infected with pneumococcus or RSV. The symptoms are more severe in younger children.

Detection of minimal residual disease in childhood acute lymphoblastic leukemia by multi-parameter flow cytometry / 中华检验医学杂志

Objective To establish a flow cytometric measurement of detecting minimal residual disease(MRD) according to the leukemia-associated immunophenotypes in children with acute lymphoblastic leukemia(ALL) and to explore the significance of MRD detection in ALL children for a individualized treatment. Methods A variety of four-color fluorescent antibody combinations were used to investigate the children's normal bone marrow. The normal bone marrow pattern at two-parameter plots was established to identify the residual tumor cells, seventy-five bone marrow samples from newly diagnosed ALL children were analyzed with four-color cytometry to determined the optimal combinations which can clearly distinguish the tumor cells from normal cells. The bone marrow samples were monitored with the combination panel in 60 patients at the end of induction therapy and follow-up treatment. Cytomorphology test, PCR amplification of 29 fusion genes as well as IgG and TCR gene rearrangements were performed simultaneously. Results Sixty-nine cases (92.0%) could be identified for effective antibody combinations to monitor MRD by four-color cytometry. Fusion genes or IgG and T cell receptor (TCR) gene rearrangements can be detected in 21 cases (28.0%) to monitor MRD by PCR. No MRD can be detected in 25 bone marrow samples at the end of induction therapy and follow-up treatment. Four-color cytometry could detect as low as 0.021%-4.130% residual leukemia cells. Conclusion MRD can be monitored by flow cytometry which is faster than PCR, and the sensitivity is superior to morphology method.

Carriage and Antibiotic Resistance of Streptococcus pneumoniae from Respiratory Infected Children / 中华医院感染学杂志

OBJECTIVE To study the carriage,the risk factors and the antibiotic resistant pattern of Streptococcus pneumoniae isolated from hospitalized children with respiratory infection below 3 years old.METHODS A total of 453 children with respiratory infection hospitalized at Children′s Hospital of Soochow University in Suzhou Jiangsu Province from Mar 2006 to Mar 2007 were enrolled and given deep orotracheal aspiration(OTA) technique to get the sputum.S.pneumoniae strains were tested and analyzed.RESULTS The carriage rate of S.pneumoniae was 9.3% which was related with age and season.The percentage of resistance to penicillin,erythromycin,tetracycline,clindamycin,chloramphenicol and trimethoprim/sulfamethoxazole was 16.7%,100%,95.2%,95.2%,14.3% and 73.8%,respectively.No resistant strains to ceftriaxone,ofloxacin and vancomycin were detected.All S.pneumoniae strains were resistant to multiple drugs.CONCLUSIONS The carriage of S.pneumoniae in respiratory infected children below 3 years old in Suzhou area is relatively low.Age and incidence season are the risk factors.The antibiotic resistance is serious.

Detection of Food-specific Serum IgG to Food Allergens in Children with Chronic Digestive Diseases / 医学研究杂志

Objective To assess the value of 14 common food allergens specific IgG in children with chronic digestive diseases.Methods The specific allergen food IgG was measured by utilizing enzyme-linked immunosorbent assay(ELISA) in 69 children with chronic digestive diseases,who had chronic abdominal pain and recurrent vomiting above three months with no organic disorders,incurable chronic diarrhea and anorexia with failing to thrive.Results The food allergen specific IgG increased was detected in 68 cases.The positive cases were 98.55%.There was one to nigh kind of food allergen specific IgG increased in 68 patients.Positive above two kind of specific IgG was 86.96%.The most specific IgG was to egg 92.8% and milk 73.9%;the other rates were: wheat 40.6%,soybean 27.5%.Chicken and pork were negative.All the patients changed their daily diet according to the assay results.More than 58.46% cases improved with their symptoms significantly in four weeks,about 26.15% cases improved to some extent.15.38% cases did not improved.After followed four months,there were 70.70% cases improved with their symptoms significantly,18.46% cases improved to some extent,only 10.76% cases no improved.Conclusion The detection of 14 common food allergens specific IgG might be significant valuable in assessment and treatment children with chronic digestive diseases.