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1.
Artigo em Inglês | MEDLINE | ID: mdl-32048070

RESUMO

Blood myxovirus resistance protein A (MxA) has broad antiviral activity, and it is a potential biomarker for symptomatic virus infections. Limited data is available of MxA in coinciding viral and bacterial infections. We investigated blood MxA levels in children hospitalized with a febrile urinary tract infection (UTI) with or without simultaneous respiratory virus infection. We conducted a prospective observational study of 43 children hospitalized with febrile UTI. Nasopharyngeal swab samples were collected at admission and tested for 16 respiratory viruses by nucleic acid detection methods. Respiratory symptoms were recorded, and blood MxA levels were determined. The median age of study children was 4 months (interquartile range, 2-14 months). A respiratory virus was detected in 17 (40%) children with febrile UTI. Of the virus-positive children with febrile UTI, 7 (41%) had simultaneous respiratory symptoms. Blood MxA levels were higher in virus-positive children with respiratory symptoms (median, 778 [interquartile range, 535-2538] µg/L) compared to either virus-negative (155 [94-301] µg/L, P < 0.001) or virus-positive (171 [112-331] µg/L, P = 0.006) children without respiratory symptoms at presentation with febrile UTI. MxA differentiated virus-positive children with respiratory symptoms from virus-negative without symptoms by an area under the receiver operating characteristic curve of 0.96. Respiratory viruses were frequently detected in children with febrile UTI. In UTI with simultaneous respiratory symptoms, host antiviral immune response was demonstrated by elevated blood MxA protein levels. MxA protein could be a robust biomarker of symptomatic viral infection in children with febrile UTI.

2.
J Infect Chemother ; 25(12): 1070-1073, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31253474

RESUMO

Dermacoccus spp. have rarely been reported as human pathogens. We describe a case of a 4-year-old boy with congenital heart disease who was diagnosed with a brain abscess. The abscess was drained and the sample grew Streptococcus intermedius, Aggregatibacter aphrophilus and Dermacoccus sp.. Dermacoccus grew after 5 days of incubation and the patient was treated with meropenem.

3.
J Infect ; 74(4): 385-392, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28077283

RESUMO

OBJECTIVES: Besides group A streptococcus (GAS), microbial causes of pharyngitis in children are not well known. We aimed to document the viral and bacterial aetiology of pharyngitis and to assess the pathogenic role of viruses by determining the myxovirus resistance protein A (MxA) in the blood as a marker of interferon response. METHODS: In this prospective observational study, throat swabs and blood samples were collected from children (age 1-16 years) presenting to the emergency department with febrile pharyngitis. Microbial cause was sought by bacterial culture, polymerase chain reaction, and serology. Blood MxA level was determined. RESULTS: A potential pathogen was detected in 88% of 83 patients: GAS alone in 10%, GAS and viruses in 13%, group C or G streptococci alone in 2% and together with viruses in 3%, and viruses alone in 59% of cases. Enteroviruses, rhinoviruses, and adenoviruses were the most frequently detected viruses. Blood MxA levels were higher in children with viral (880 [245-1250] µg/L; median [IQR]) or concomitant GAS-viral (340 [150-710] µg/L) than in those with sole GAS (105 [80-160] µg/L) infections. CONCLUSIONS: Detection of respiratory viruses simultaneously with elevated blood MxA levels supports the causative role of viruses in the majority of children with pharyngitis.


Assuntos
Biomarcadores/sangue , Proteínas de Resistência a Myxovirus/sangue , Faringite/diagnóstico , Faringite/virologia , Viroses/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Febre , Humanos , Lactente , Interferons/imunologia , Masculino , Proteínas de Resistência a Myxovirus/isolamento & purificação , Faringite/etiologia , Faringite/microbiologia , Faringe/microbiologia , Faringe/virologia , Reação em Cadeia da Polimerase , Estudos Prospectivos , Testes Sorológicos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/isolamento & purificação , Viroses/virologia , Vírus/isolamento & purificação
4.
J Immunol Methods ; 433: 31-7, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26928648

RESUMO

The etiological diagnosis of infection by Streptococcus pneumoniae in children is difficult, and the use of indirect techniques is frequently warranted. We aimed to study the use of pneumococcal proteins for the serological diagnosis of pneumococcal infection in children with pneumonia. We analyzed paired serum samples from 13 Brazilian children with invasive pneumococcal pneumonia (positive control group) and 23 Finnish children with viral pharyngitis (negative control group), all aged <5years-old. Children with pharyngitis were evaluated for oropharyngeal colonization, and none of them carried S. pneumoniae. We used a multiplex bead-based assay with eight proteins: Ply, CbpA, PspA1 and 2, PcpA, PhtD, StkP and PcsB. The optimal cut-off for increase in antibody level for the diagnosis of pneumococcal infection was determined for each antigen by ROC curve analysis. The positive control group had a significantly higher rate of ≥2-fold rise in antibody levels against all pneumococcal proteins, except Ply, compared to the negative controls. The cut-off of ≥2-fold increase in antibody levels was accurate for pneumococcal infection diagnosis for all investigated antigens. However, there was a substantial increase in the accuracy of the test with a cut-off of ≥1.52-fold rise in antibody levels for PcpA. When using the investigated protein antigens for the diagnosis of pneumococcal infection, the detection of response against at least one antigen was highly sensitive (92.31%) and specific (91.30%). The use of serology with pneumococcal proteins is a promising method for the diagnosis of pneumococcal infection in children with pneumonia. The use of a ≥2-fold increase cut-off is adequate for most pneumococcal proteins.


Assuntos
Anticorpos Antibacterianos/sangue , Imunoensaio/métodos , Pneumonia Pneumocócica/diagnóstico , Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Brasil , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Microesferas , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Testes Sorológicos , Streptococcus pneumoniae/isolamento & purificação
5.
Acta Paediatr ; 105(5): 508-13, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26644355

RESUMO

AIM: Procalcitonin (PCT) and C-reactive protein (CRP) are biomarkers of bacterial infection with distinct clinical qualities. This study aimed to determine the occurrence and significance of discrepancies in plasma PCT and CRP levels in hospitalised children. METHODS: This was a single centre, retrospective analysis of simultaneous PCT and CRP measurements. Clinical characteristics, microbiological findings and diagnoses were compared between cases in which only PCT or CRP levels were elevated. RESULTS: We studied 635 pairs of PCT and CRP measurements and found discrepancies in 29% of these. In the group with increased PCT and low CRP, there were more children with hypoxia or haemodynamic stress (14 versus 0, p < 0.001) and more bacteraemic patients (eight versus zero, p = 0.001) than in the group with low PCT and increased CRP. The latter group was associated with focal bacterial infections (three versus 18, p = 0.009), inflammatory conditions (one versus 12, p = 0.016) and postoperative setting (one versus 19, p = 0.001). Diabetic ketoacidosis was associated with a marked elevation of PCT. CONCLUSION: Discrepancies in plasma PCT and CRP levels occurred in 29% of acutely ill children. Both biomarkers can increase in the absence of bacterial infection, but PCT may offer an advantage over CRP in the diagnosis of bacteraemia.


Assuntos
Infecções Bacterianas/diagnóstico , Proteína C-Reativa/metabolismo , Calcitonina/sangue , Cetoacidose Diabética/diagnóstico , Viroses/diagnóstico , Doença Aguda , Bacteriemia/sangue , Bacteriemia/diagnóstico , Infecções Bacterianas/sangue , Biomarcadores/sangue , Criança , Pré-Escolar , Cetoacidose Diabética/sangue , Hospitalização , Humanos , Lactente , Modelos Logísticos , Estudos Retrospectivos , Viroses/sangue
6.
PLoS One ; 10(6): e0129920, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26034987

RESUMO

BACKGROUND: Several point-of-care (POC) tests are available for evaluation of febrile patients, but the data about their performance in acute care setting is sparse. We investigated the analytical accuracy and feasibility of POC tests for white blood cell (WBC) count and C-reactive protein (CRP) at the pediatric emergency department (ED). METHODS: In the first part of the study, HemoCue WBC and Afinion AS100 CRP POC analyzers were compared with laboratory's routine WBC (Sysmex XE-2100) and CRP (Modular P) analyzers in the hospital central laboratory in 77 and 48 clinical blood samples, respectively. The POC tests were then adopted in use at the pediatric ED. In the second part of the study, we compared WBC and CRP levels measured by POC and routine methods during 171 ED patient visits by 168 febrile children and adolescents. Attending physicians performed POC tests in capillary fingerprick samples. RESULTS: In parallel measurements in the laboratory both WBC and CRP POC analyzers showed good agreement with the reference methods. In febrile children at the emergency department (median age 2.4 years), physician performed POC determinations in capillary blood gave comparable results with those in venous blood analyzed in the laboratory. The mean difference between POC and reference test result was 1.1 E9/L (95% limits of agreement from -6.5 to 8.8 E9/L) for WBC and -1.2 mg/L (95% limits of agreement from -29.6 to 27.2 mg/L) for CRP. CONCLUSIONS: POC tests are feasible and relatively accurate methods to assess CRP level and WBC count among febrile children at the ED.


Assuntos
Bacteriemia/sangue , Biomarcadores/sangue , Proteína C-Reativa/análise , Serviço Hospitalar de Emergência , Febre/sangue , Sistemas Automatizados de Assistência Junto ao Leito , Adolescente , Bacteriemia/diagnóstico , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Febre/diagnóstico , Humanos , Testes Imunológicos , Lactente , Laboratórios Hospitalares , Contagem de Leucócitos , Masculino , Testes Imediatos , Prognóstico , Estudos Retrospectivos
7.
J Clin Virol ; 57(2): 136-40, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23490399

RESUMO

BACKGROUND: Rapid etiological diagnosis of a respiratory virus infection may have impact on antiviral and antibiotic therapy, patient cohorting, and prediction of the clinical course. Most point-of-care tests for detection of respiratory viruses have limitations in diagnostic performance and clinical usability. A novel, multianalyte point-of-care antigen detection test system (mariPOC(®); ArcDia International Oy Ltd., Turku, Finland) detects eight respiratory viruses (influenza A and B viruses, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus, and parainfluenza type 1, 2, and 3 viruses) from a single nasopharyngeal swab specimen by a fully automated, random-access immunoassay method. OBJECTIVES: To evaluate mariPOC(®) point-of-care test system in comparison with reverse transcription polymerase chain reaction (RT-PCR) in a pediatric emergency department setting. STUDY DESIGN: Prospectively collected samples from 158 children (mean age, 1.8 years) with respiratory symptoms and/or fever were analyzed both by mariPOC(®) and by multiplex RT-PCR. RESULTS: The sensitivities and specificities (95% confidence intervals) of the mariPOC(®) test were for influenza A (n = 7), 71% (38-100) and 100%; influenza B (n = 22), 86% (72-100) and 98% (95-100); RSV (n = 35), 89% (78-99) and 100%; adenovirus (n = 12), 25% (1-50) and 97% (95-99); and for human metapneumovirus (n = 8), 50% (15-85) and 100%, respectively. Parainfluenzaviruses were detected only in five patients. CONCLUSIONS: This novel point-of-care test system is a rapid, practical, and specific method for simultaneous detection of eight respiratory viruses. Compared with RT-PCR, its sensitivity is moderately high for detection of RSV and influenza viruses, and low for adenovirus.


Assuntos
Antígenos Virais/análise , Imunoensaio/métodos , Sistemas Automatizados de Assistência Junto ao Leito , Infecções Respiratórias/virologia , Viroses/diagnóstico , Vírus/isolamento & purificação , Doença Aguda , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Nasofaringe/virologia , Orthomyxoviridae , Valor Preditivo dos Testes , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias/diagnóstico , Sensibilidade e Especificidade , Viroses/virologia , Vírus/classificação , Vírus/imunologia
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