Profiles and predictive value of cytokines in children with human metapneumovirus pneumonia.

BACKGROUND: Human metapneumovirus (HMPV) is an important cause of respiratory tract infections in young children. Early innate immune response to HMPV is focused on induction of antiviral interferons (IFNs) and other pro-inflammatory cytokines that are critical for the formation of adaptive immune responses. To evaluate the predictive value of Th1/Th2 cytokines which include IL-2, IL-4, IL-6, IL-10, INF-γ and TNF-α in pneumonia caused by HMPV. METHODS: A retrospective study was performed among 59 pneumonia pediatric patients with HMPV infection and 33 healthy children as the control cohort, which was detected by the immunofluorescence assay, and the Th1/Th2 cytokines were measured by flow cytometry. 131 children infected with Influenza virus A (IVA) and 41 children infected with influenza virus B (IVB) were detected by RT-PCR assay in throat swabs. RESULTS: When compared with the healthy children, children who were infected with HMPV pneumonia had a significantly lower level of IL-2 (p < 0.001) and higher levels of IL-4 (p < 0.001), IL-6 (p = 0.001), IL-10 (p < 0.001), and IFN-γ (p < 0.001). Compared with patients diagnosed with IVA or IVB infection, HMPV-positive patients had significantly higher levels of IL-4 (p < 0.001 and < 0.001), IFN-γ (p < 0.001 and < 0.001), and TNF-α (p < 0.001 and 0.016). Moreover, compared with IVA patients, HMPV-positive patients had a significantly lower level of IL-6 (p = 0.033). Finally, when comparing cytokine levels among the patients with HMPV pneumonia, IL-6 and TNF-α levels were found to be significantly higher in the severe group than the mild group (p = 0.027 and 0.049). The IL-6 and TNF-α were used to differentiate between mild symptoms and severe symptoms in children diagnosed with HMPV pneumonia with an AUC of 0.678 (95% CI 0.526-0.829) and 0.658 (95% CI 0.506-0.809), respectively. CONCLUSION: Our study indicated that difference in cytokine trends depending on the virus species. The levels of IL-4, TNF-α and IFN-γ were significantly distinguished in children infected with HMPV versus IVA and IVB. IL-6 and TNF-α may be helpful in assessing the severity and prognosis of HMPV infection.

Validated predictive modelling of sulfonamide and beta-lactam resistance genes in landfill leachates.

The spread of antimicrobial resistance via landfill leachates jeopardizes millions of people's health, which can be exacerbated due to the unclear quantitative relationships between leachate characteristics and occurrences of antibiotic resistance genes (ARGs). Here, in parallel with sampling raw leachates from a real landfill, we constructed a lab-scale landfill and collected its leachates for 260 days. All leachate samples were analyzed for the abundance of integrons, sulfonamide resistance (sulR; sul1 and sul2) and beta-lactams resistance (blaR; blaOXA, blaCTX-M, and blaTEM) genes. The enrichment of sulR subtypes was closely associated with the integrons' prevalence during the landfilling process (0.65-0.75 log10(copies/mL)), which can be explained by the multiple linear regression that contained intl1, pH, and nitrogen compounds as variables. The predicted abundance of sulR genes (6.06 ±â€¯0.6 log10(copies/mL)) was statistically the same as the observed value in raw leachates (P = 0.73). The abundance of blaR genes decreased from 5.0 to 2.5 log10(copies/mL) during the experiment (P < 0.001); and a locally weighted regression of blaR genes with integrons, COD and total nitrogen accurately predicted blaR genes abundance in raw leachate (Bootstrap = 10,000, P = 0.67). The partial least squares path modelling (PLS-PM) showed that variations of blaR genes in the lab and raw leachates shared an identical pattern (PLS-PM, Bootstrap = 10,000, P > 0.05), which was influenced by integrons and environmental factors with the coefficients of -0.11 and 0.39, respectively. We believe the validated models are highly useful tools to streamline the strategies for monitoring and prediction of ARGs.

The development and psychometric testing of Inpatients' Involvement in Medication Safety Scale (IIMSS).

AIM: To develop and test the psychometric characteristics of the Inpatients' Involvement in Medication Safety Scale. BACKGROUND: Medication safety is the third biggest challenge threatening patient safety. Patient involvement in medication safety management is essential, and however, few tools have been developed to assess the related process. METHODS: The scale was formulated through literature review, semi-structured interviews and Delphi expert consultation. A group of 461 inpatients from a tertiary hospital were selected to examine the reliability and validity of the scale. RESULTS: The scale consisted of three dimensions and 23 items. Cronbach's α coefficient was 0.916 for the total scale and was 0.777-0.858 for three subscales; the test-retest reliability was 0.742 for the total scale. The content validity was 0.957, and the item content validity ranged from 0.833 to 1.000. The cumulative variance contribution of three selected factors was 51.19%. CONCLUSIONS: The Inpatients' Involvement in Medication Safety Scale has good reliability and validity and can be used to evaluate inpatients' involvement in medication safety. IMPLICATIONS FOR NURSING MANAGEMENT: The scale provides theoretical reference for clinical nursing safety management, as well as helps nurses to provide targeted medication care for patients and their families.

Epidemiological and genetic characteristics of respiratory syncytial virus infection in children from Hangzhou after the peak of COVID-19.

BACKGROUND: Respiratory syncytial virus (RSV) is one of the main pathogens that causes acute lower respiratory tract infection (ARTI) in infants. During the Coronavirus Disease 2019 (COVID-19) pandemic, although strict interventions have been implemented, RSV infection has not decreased. OBJECTIVES: To study the epidemiological and genetic characteristics of RSV circulating in Hangzhou after the peak of COVID-19. METHODS: A total of 1225 nasopharyngeal swabs were collected from outpatients with ARTIs from July 2021 to January 2022 in The Children's Hospital, Zhejiang University School of Medicine. RESULTS: A total of 267 (21.79%) of the 1225 samples were RSV positive. There was no gender bias. However, an obvious age preference for infection was observed, and children aged 3-6 years were more susceptible, which was very different from previous RSV pandemic seasons. Phylogenetic analysis of 115 sequenced RSV isolates showed that all the RSV-A viruses belong to the ON1 subtype, which could be clustered into three clusters. While all the RSV-B viruses belong to BA9. Further analysis of the mutations highlights the fixation of ten mutations, which should be given extra attention regarding their biological properties. CONCLUSION: The incidence of RSV infection in preschool children reported in this study is high. Phylogenetic analysis showed that the subtype A ON1 genotype was the dominant strain in Hangzhou from July 2021 to January 2022.

[Effects of Activated Carbon on the Fate of Antibiotic Resistance Genes During Anaerobic Digestion of the Organic Fraction of Municipal Solid Waste].

The organic fraction of municipal solid waste (OFMSW) has become one of the sources and reservoirs of antibiotic resistance genes (ARGs). It is essential to explore the fate of ARGs during biological treatment of OFMSW. Therefore, the changes in several types of ARGs and integron genes during anaerobic digestion of the OFMSW were analyzed by quantitative PCR. Furthermore, the effects of different particle sizes of activated carbon on the behaviors of the target genes and the potential microbial mechanisms of ARGs dynamics were investigated. The results showed that the total ARGs in the initial system were reduced after anaerobic digestion with or without the presence of activated carbon. The removal rate of the absolute abundance of total ARGs was 29.95%-63.40%. In the final system of anaerobic digestion of the OFMSW, the abundance of total ARGs in powdered activated carbon (PAC) groups was significantly higher than that in the control group (P<0.05). The supplementation of PAC inhibited the reduction of ARGs, and the supplementation of granular activated carbon had no significant effect on the change in ARGs. The potential host bacteria of ARGs were mainly Clostridia, Bacteroidia, and Synergistia during anaerobic digestion. The enrichment of host bacteria caused by PAC addition was the main reason for the increase in the target genes. Moreover, Clostridia might have been the main driving factor for the growth and decline of ARGs. These results will help us to understand the dissemination of ARGs and the impacts of activated carbon addition on ARGs during anaerobic digestion of the OFMSW.