Circulating B7-H3(CD276) elevations in cerebrospinal fluid and plasma of children with bacterial meningitis.

The objective of this study was to analyze the clinical significance of cerebrospinal fluid (CSF) and plasma concentrations of B7-H3, tumor necrosis factor-alpha (TNF-alpha), gamma interferon (IFN-gamma), and interleukin-17 (IL-17) in bacterial and aseptic meningitis in children. The participants were six children with bacterial meningitis, 16 with aseptic meningitis, and 12 control subjects. All participants were between 2 months and 12 years of age on admission. Cytokines determination was performed by enzyme-linked immunosorbent assay technique. CSF and plasma-circulating B7-H3 were significantly higher in the bacterial meningitis group as compared with the aseptic group (p = 0.001) and the control group (p = 0.000 and p = 0.001 respectively). However, CSF and plasma-circulating B7-H3 in aseptic meningitis were not significantly higher than control group (p = 0.071 and p = 0.72 respectively).CSF and plasma-circulating TNF-alpha were significantly higher in the bacterial meningitis group as compared with the aseptic group (p = 0.004 and p < 0.0001 respectively) and control group (p = 0.004 and p < 0.0001 respectively). Similarly, we did not observe significant elevated TNF-alpha levels in CSF and plasma in aseptic group compared with control group (p = 0.03 and p = 0.12 respectively). IFN-gamma levels in CSF and plasma were undetectable in control group, and we did not find statistical significances in both of CSF and plasma between the elevated IFN-gamma level in bacterial meningitis group and aseptic meningitis group(p = 0.055 and p = 0.095 respectively) CSF and plasma levels of IL-17 were undetectable in all subjects. There were correlations between B7-H3 and TNF-alpha, IFN-gamma (r = 0.875, p = 0.000; r = -0.693, p = 0.000, respectively) in CSF in meningitis subjects. In plasma, levels of B7-H3 in bacterial meningitis on admission correlated positively with TNF-alpha (r = 0.968, p = 0.002), and white blood cell counts (r = 0.973, p = 0.001). Detectable CSF levels of B7-H3, TNF-alpha, and IFN-gamma on admission were not associated significantly with any of CSF characteristics. Additionally, CSF and plasma levels of B7-H3 decreased remarkably after treatment. Altogether, our data indicated that circulating B7-H3 and TNF-alpha levels in the CSF and plasma were useful markers for distinguishing bacterial from aseptic meningitis, and Circulating B7-H3 was demonstrated to be useful in evaluating the intensity of the infectious inflammatory process in the central nervous system in children.

[Viral pathogens of acute respiratory infection in hospitalized children from Suzhou].

OBJECTIVE: To investigate the viral pathogens of acute respiratory infection (ARI) in hospitalized children from Suzhou of China. METHODS: The nasopharyngeal aspirate samples were obtained from 1,668 hospitalized children with ARI. Common respiratory viruses, including respiratory syncytial virus (RSV), influenza virus A and B, parainfluenza viruses 1, 2 and 3 and adenovirus, were detected using direct immunofluorescence. Human metapneumovirus (hMPV) gene fragments were detected by RT-PCR. RESULTS: Viral agents were identified in 597 cases (35.8%). RSV was the most frequent (17.6%). RSV infection is more common in children less than 1 year old. A highest detection rate of RSV was found during winter and spring. hMPV was detected in 10.6% of the cases, with a peak detection rate between March and May. Single viral infection was found in 561 cases (33.6%) and mixed viral infection in 36 cases (including 27 cases at age of less than 1 year). RSV and hMPV co-infection was common (n=22). CONCLUSIONS: RSV is common pathogen of ARI in children from Suzhou. RSV viral activity peaks during winter and spring. The children at age of less than 1 year are susceptible to RSV. hMPV is also an important pathogen of ARI, with a peak detection rate between March and May. Mixed viral infection is common in children less than 1 year old.

[Serodiagnosis of human bocavirus lower respiratory tract infection in children].

OBJECTIVE: To study the application of serodiagnosis of human bocavirus (HBoV) lower respiratory tract infection in children. METHOD: From January to April, 2013, samples including serum, sputum and bronchoalveolar lavage fluids (BALFs) were obtained from 714 children hospitalized with ALRI. Serums were tested for HBoV-specific IgG and IgM antibodies by ELISA and all kinds of samples were tested for HBoV DNA by quantitative real-time fluorescent PCR. The results of HBoV serologic tests, viral DNA in sputum and their combination were compared with those of HBoV DNA in serums and/or BALFs, which was considered as the "standard". Their consistence and differences were evaluated, and the diagnostic parameters including sensitivity, specificity, positive predictive value, negative predictive value, consistency rate, Kappa value and J value were calculated. Age distributions of the HBoV positive patients tested by the latter two methods were also compared. RESULT: The positive rate of HBoV serology was 13.2% (94/714) . The results of HBoV serology, its DNA in sputum and their combination were all consistent with those of HBoV DNA in serums and/or BALFs (χ(2) = 91.834, 124.662, 138.643, P < 0.001 for all comparisons) . Differences were significant by McNemar test (χ(2) = 23.547, 33.440, 12.410, P all <0.001) . All the diagnostic parameters for single HBoV serologic test or single viral DNA test in sputa were approximate. However, they were improved to 70.4%, 94.8%, 38.0%, 98.6%, 93.7%, 0.463(P < 0.001), 0.65 for sensitivity, specificity, positive predictive value, negative predictive value, consistency rate, Kappa value and J value, respectively, when the methods were combined. HBoV was found positive mainly in children under 3 years of age, especially in the 1 year group. The positive rates were the highest in both group -1 year, and group -3 years was the next. However, the rate was the lowest in group >3 years and in the group -6 months. CONCLUSION: Diagnostic power can be improved and age distribution can be demonstrated when serologic tests were combined with traditional sputum DNA detection in children with HBoV lower respiratory tract infection.