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2.
Clin Infect Dis ; 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32170305

RESUMO

BACKGROUND: Early-life exposures to antibiotics may increase the risk of developing childhood asthma. However, little is known about the mechanisms linking antibiotic exposures to asthma. We hypothesized that changes in the nasal airway microbiota serve as causal mediator in the antibiotics-asthma link. METHODS: In a population-based birth-cohort study in Finland, we identified longitudinal nasal microbiota profiles during age 2-24 months using 16S rRNA gene sequencing and unsupervised machine learning approach. We performed a causal mediation analysis to estimate the natural direct effect of systemic antibiotic treatments during age 0-11 months on risks of developing physician-diagnosed asthma by age 7 years and the natural indirect (causal mediation) effect through longitudinal changes in the nasal microbiota. RESULTS: In our birth cohort of 697 children, 8.0% later developed asthma. Exposure to ≥2 antibiotic treatments during age 0-11 months was associated with a 4.0% increase in the absolute risk of developing asthma (absolute increase, 95%CI, 0.9%-7.2%, P=0.006). Unsupervised clustering approach identified six longitudinal nasal microbiota profiles. Infants with a larger number of antibiotic treatments had a higher risk of having a profile with early Moraxella sparsity (per each antibiotic treatment, adjusted relative rate ratio, 1.38; 95%CI, 1.15-1.66; P<0.001). This effect of antibiotics on asthma was mediated, in part, by longitudinal changes in the nasal microbiota (natural indirect effect, P=0.008), accounting for 16% of the total effect. CONCLUSIONS: Early exposures to antibiotics were associated with an increased risk of asthma, and the effect was mediated, in part, by longitudinal changes in the nasal airway microbiota.

3.
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.

4.
Pediatr Res ; 2020 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-31954376

RESUMO

BACKGROUND: The effects of antibiotics on infant gut microbiota are unclear. We hypothesized that the use of common antibiotics results in long-term aberration in gut microbiota. METHODS: Antibiotic-naive infants were prospectively recruited when hospitalized because of a respiratory syncytial virus infection. Composition of fecal microbiota was compared between those receiving antibiotics during follow-up (prescribed at clinicians' discretion because of complications such as otitis media) and those with no antibiotic exposure. Fecal sampling started on day 1, then continued at 2-day intervals during the hospital stay, and at 1, 3 and 6 months at home. RESULTS: One hundred and sixty-three fecal samples from 40 patients (median age 2.3 months at baseline; 22 exposed to antibiotics) were available for microbiota analyses. A single course of amoxicillin or macrolide resulted in aberration of infant microbiota characterized by variation in the abundance of bifidobacteria, enterobacteria and clostridia, lasting for several months. Recovery from the antibiotics was associated with an increase in clostridia. Occasionally, antibiotic use resulted in microbiota profiles associated with inflammatory conditions. CONCLUSIONS: Antibiotic use in infants modifies especially bifidobacterial levels. Further studies are warranted whether administration of bifidobacteria will provide health benefits by normalizing the microbiota in infants receiving antibiotics.

6.
J Infect ; 80(1): 69-75, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31521741

RESUMO

OBJECTIVES: Respiratory syncytial virus (RSV) is a major cause of hospitalization in young children, but there are little data on RSV infections in early childhood in the community. We conducted a prospective population-based birth-cohort study to determine the rates and characteristics of RSV infections in young children. METHODS: We followed 923 children for acute respiratory infections (ARIs) from birth to age 24 months with daily diaries and study clinic visits. Nasal swab samples were obtained at the onset of ARIs and analyzed for RSV by RT-PCR and antigen tests. The rates of RSV infections and associated outcomes were estimated. RESULTS: RSV was detected in 289 (6%) of 4728 ARIs with a nasal sample. The mean estimated annual rate of RSV infections was 37 (95% confidence interval [CI], 35-38) per 100 children at age 0-24 months. For RSV-associated outcomes, the estimated annual rates per 100 children were 34 (95% CI, 32-37) physician visits, 16 (95% CI, 15-17) antibiotic treatments, 12 (95% CI, 11-13) acute otitis media, and 6 (95% CI, 4-7) wheezing illnesses. The prevalence of RSV was 0.6% in asymptomatic children. CONCLUSIONS: RSV infections impose a high burden of disease in healthy young children in the community.

7.
Front Med (Lausanne) ; 6: 235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31750306

RESUMO

Background: Rhinovirus (RV) is the most common cause of respiratory tract infections in children but, still, the clinical characteristics of RV-associated pneumonia have not been sufficiently investigated. Methods: We identified children and adolescents younger than 18 years of age treated for community-acquired pneumonia as inpatients at the Turku University Hospital from 2003 to 2014 and analyzed for RV by PCR of a respiratory tract specimen. We collected the data from medical records and compared RV-positive children with RV-negative children. Results: Of the study population of 313 children with pneumonia who were studied for RV, it was detected in 82 (26%). RV-positive children were younger (median age 2.6 years, interquartile range [IQR] 1.1-4.6 vs. 3.5 years, IQR 1.7-8.3, p = 0.002) and they had more often a history of preterm birth (16% vs. 5%, adjusted odds ratio 2.89, 95% confidence interval 1.21-6.92, p = 0.017) than RV-negative children. RV-positive children had a higher median white blood cell count than RV-negative children at presentation with pneumonia. The signs, symptoms, and severity of pneumonia were mostly similar in RV-positive and RV-negative children. Conclusions: RV was frequently detected in young children hospitalized with community-acquired pneumonia. We identified premature birth as a factor associated with RV-positive pneumonia. The clinical features of pneumonia did not clearly differ between RV-positive and RV-negative children. Further studies are needed to clarify the clinical significance of detection of RV in children with pneumonia.

8.
Pediatr Infect Dis J ; 38(12): 1195-1198, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31634297

RESUMO

BACKGROUND: Lyme borreliosis (LB) is a common cause of acute facial palsy in children living in endemic areas for Borrelia burgdorferi. The need for lumbar puncture in diagnostics of LB in children with facial palsy has been questioned. Our aim was to evaluate the prevalence of LB and the diagnostic value of a cerebrospinal fluid (CSF) sample among children with an acute facial palsy. METHODS: We collected medical records and laboratory data of children and adolescents 0-16 years of age (n = 94) diagnosed with facial palsy between 2002 and 2016 in the Turku University Hospital. A positive B. burgdorferi serology in serum or CSF or a positive B. burgdorferi polymerase chain reaction in CSF were considered as signs of definite LB. C-X-C motif chemokine ligand 13 (CXCL13) values were measured in CSF samples from 28 children during 2014-2016. RESULTS: Lumbar puncture was performed on 84 of 94 children with facial palsy. LB was confirmed in 29 of 42 children with, and in 4 of 42 without, pleocytosis. The sensitivity and specificity of pleocytosis to predict LB were 88% (95% confidence interval, 78%-98%) and 75% (62%-88%), respectively, and the positive and negative predictive values were 69% (55%-83%) and 90% (81%-99%), respectively. An increased CSF CXCL13 value had 67% (51%-83%) sensitivity and 100% specificity for LB. CONCLUSIONS: Because serum serology can be negative at presentation, lumbar puncture is a valuable tool when diagnosing LB among children with facial palsy. Pleocytosis and increased protein and CXCL13 values in the CSF suggest LB as the cause of facial palsy.

9.
mSphere ; 4(5)2019 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511367

RESUMO

Serological assays are used to diagnose and characterize host immune responses against microbial pathogens. Microarray technologies facilitate high-throughput immunoassays of antibody detection against multiple pathogens simultaneously. To improve survey of influenza A virus (IAV), influenza B virus (IBV), respiratory syncytial virus (RSV), and adenovirus (AdV) antibody levels, we developed a microarray consisting of IAV H1N1, IAV H1N1pdm09 (vaccine), IAV H3N2, IBV Victoria, IBV Yamagata, RSV, AdV type 5 hexon protein, and control antigens printed on the bottom of a microtiter plate well. Bound IgG antibodies were detected with anti-human IgG-coated photon-upconverting nanoparticles and measured with a photoluminescence imager. The performance of the microarray immunoassay (MAIA) was evaluated with serum samples (n = 576) collected from children (n = 288) at 1 and 2 years of age and tested by standard enzyme immunoassays (EIAs) for antibodies to IAV vaccine and RSV. EIAs and MAIA showed substantial to almost perfect agreement (Cohen's κ, 0.62 to 0.83). Applying MAIA, we found seroprevalences of 55% for IAV H1N1, 54% for IAV vaccine, 30% for IAV H3N2, 24% for IBV Victoria, 25% for IBV Yamagata, 38% for RSV, and 26% for AdV in 1-year-old children (n = 768). By the age of 2 years, IgG seropositivity rates (n = 714) increased to 74% for IAV H1N1, 71% for IAV vaccine, 49% for IAV H3N2, 47% for IBV Yamagata, 49% for IBV Victoria, 68% for RSV, and 58% for AdV. By analyzing increases in antibody levels not biased by vaccinations, we found a reinfection rate of 40% for RSV and 31% for AdV in children between 1 and 2 years of age.IMPORTANCE The multiplex immunoassay was successfully used to simultaneously detect antibodies against seven different viruses. The developed serological microarray is a new promising tool for diagnostic, epidemiological, and seroprevalence analyses of virus infections.


Assuntos
Anticorpos Antivirais/sangue , Ensaios de Triagem em Larga Escala/métodos , Infecções Respiratórias/virologia , Testes Sorológicos/métodos , Vírus/imunologia , Adenoviridae/imunologia , Pré-Escolar , Estudos de Coortes , Humanos , Imunoensaio/métodos , Lactente , Vírus da Influenza A/imunologia , Vírus da Influenza B/imunologia , Análise em Microsséries , Estudos Observacionais como Assunto , Vírus Sinciciais Respiratórios/imunologia , Infecções Respiratórias/imunologia
10.
J Clin Virol ; 120: 17-19, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521013

RESUMO

BACKGROUND: Diagnosis of human bocavirus 1 (HBoV1) has been based on qualitative PCRs detecting HBoV1 DNA or detection of HBoV1 mRNA. OBJECTIVE: This study aims to assess whether a rapid and automated HBoV1 antigen test is suitable for diagnosis of acute HBoV1 infection. STUDY DESIGN: HBoV1 antigen detection has been compared with quantitative HBoV1 DNA PCR and HBoV1 mRNA RT-PCR. RESULTS AND CONCLUSION: We conclude that HBoV1 antigen detection has higher clinical specificity and positive predictive value than HBoV1 DNA qualitative PCRs, yet a lower sensitivity than HBoV1 mRNA detection. Additionally, HBoV1 antigen detection is beneficial in its rapidity and availability as a point-of-care test.

11.
Thorax ; 74(6): 592-599, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31076501

RESUMO

BACKGROUND: Emerging evidence shows that airway microbiota may modulate local immune responses, thereby contributing to the susceptibility and severity of acute respiratory infections (ARIs). However, there are little data on the longitudinal relationships between airway microbiota and susceptibility to ARIs in children. OBJECTIVE: We aimed to investigate the association of early nasal microbiota and the subsequent risk of ARIs during the first years of life. METHODS: In this prospective population-based birth-cohort study in Finland, we followed 839 healthy infants for ARIs from birth to age 24 months. Nasal microbiota was tested using 16S rRNA gene sequencing at age 2 months. We applied an unsupervised clustering approach to identify early nasal microbiota profiles, and examined the association of profiles with the rate of ARIs during age 2-24 months. RESULTS: We identified five nasal microbiota profiles dominated by Moraxella, Streptococcus, Dolosigranulum, Staphylococcus and Corynebacteriaceae, respectively. Incidence rate of ARIs was highest in children with an early Moraxella-dominant profile and lowest in those with a Corynebacteriaceae-dominant profile (738 vs 552/100 children years; unadjusted incidence rate ratio (IRR), 1.34; 95% CI 1.16 to 1.54; p < 0.001). After adjusting for nine potential confounders, the Moraxella-dominant profile-ARI association persisted (adjusted IRR (aIRR), 1.19; 95% CI 1.04 to 1.37; p = 0.01). Similarly, the incidence rate of lower respiratory tract infections (a subset of all ARIs) was significantly higher in children with an early Moraxella-dominant profile (aIRR, 2.79; 95% CI 1.04 to 8.09; p = 0.04). CONCLUSION: Moraxella-dominant nasal microbiota profile in early infancy was associated with an increased rate of ARIs during the first 2 years of life.


Assuntos
Microbiota , Cavidade Nasal/microbiologia , Infecções Respiratórias/microbiologia , Doença Aguda , Corynebacterium/isolamento & purificação , Suscetibilidade a Doenças , Feminino , Finlândia/epidemiologia , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Moraxella/isolamento & purificação , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Staphylococcus/isolamento & purificação , Streptococcus/isolamento & purificação
12.
Psychoneuroendocrinology ; 107: 187-190, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31146139

RESUMO

INTRODUCTION: Prenatal exposure to maternal psychological distress (PD) may have programming effects on the fetus/infant hypothalamic-pituitary-adrenal (HPA) axis and subsequently on the development of the fetus' immune function. Therefore, our aim was to study whether prenatal exposure to PD is related to early infant HPA axis reactivity in the context of a subclinical rhinovirus infection that challenges infants HPA axis postnatally. METHODS: This study included 336 10-week-old infants from the nested case control Focus Cohort of the FinnBrain Birth Cohort Study. The outcome was infant HPA axis reactivity in a stress test. The acute stressor comprised of pediatric examination with venipuncture and nasal swabs for virus assessment. Saliva cortisol samples were collected at 5 time points: baseline, 0, 15, 25 and 35 min after the stressor. HPA axis reactivity was defined by the cumulative post-stressor cortisol concentration. RESULTS: HPA axis reactivity was blunted in the PD/rhinovirus + group compared to the average of control/rhinovirus+, PD/rhinovirus-, and control/rhinovirus- groups (difference: 14.7 ln [nmol/L] × min, 95% confidence interval 3.8-25.6, p = .008). HPA axis reactivity was significantly blunted only in boys with rhinovirus detected when separately tested for boys and girls (p = .04). CONCLUSION: Our finding of PD-exposed rhinovirus-positive infants having blunted cortisol secretion gives rise to a hypothesis that maternal PD during pregnancy influences infant HPA axis functioning and the functioning of the immune system. Future studies are needed to test whether this suppression of the HPA axis that co-occurs with rhinovirus infection associates with later disease development (e.g., asthma).

13.
Vaccine ; 37(22): 2935-2941, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31027929

RESUMO

BACKGROUND: Pneumococcal conjugate vaccines reduce the incidence of invasive pneumococcal diseases, pneumonia, acute otitis media (AOM), and antimicrobial prescriptions in children. We investigated the effectiveness of at least one dose of the ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10; GSK) against respiratory tract infections (RTIs) in children under two years of age. METHODS: 424 children enrolled in a cluster-randomized, double-blind Finnish Invasive Pneumococcal disease (FinIP) vaccine trial during the years 2009-2010 were actively followed in a prospective cohort study (STEPS study) for RTIs from birth to two years of age. Children received the PHiD-CV10 vaccine, or a control vaccine (hepatitis A or B vaccine) according to an age-specific schedule. Data on RTIs were collected by symptom diaries, clinic visits, an electronic registry on hospitalizations, and by nasal swab samples analyzed for respiratory viruses. We estimated the vaccine effectiveness against all RTI episodes and RTI episodes with or without AOM by comparing the corresponding incidence rates between PHiD-CV10 vaccinated and control children, adjusted for presence of siblings and cluster as a random effect. RESULTS: A total of 3193 RTI episodes were documented after the first vaccination in 368 children with all data available. The majority of the illnesses were upper RTIs caused by rhinovirus. The PHiD-CV10-vaccinated children had lower mean annual rates of all RTI episodes (6.4; 95% confidence interval [CI], 6.0-6.8) and RTI episodes with AOM (1.0; 95% CI, 0.9-1.2) as compared to the control children (7.4; 95% CI, 6.8-8.0 and 1.3; 95% CI, 1.1-1.6, respectively). The vaccine effectiveness was 12% (95% CI, 2-22%) against all RTIs, 23% (95% CI, 0-40%) against RTIs with AOM, and 10% (95% CI, 0-19%) against RTIs without AOM. CONCLUSIONS: Vaccination with PHiD-CV10 resulted in lower rates of RTIs in children under two years of age compared to children vaccinated with control vaccine.

14.
JMIR Res Protoc ; 8(4): e12705, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31025954

RESUMO

BACKGROUND: There is a need to better distinguish viral infections from antibiotic-requiring bacterial infections in children presenting with clinical community-acquired pneumonia (CAP) to assist health care workers in decision making and to improve the rational use of antibiotics. OBJECTIVE: The overall aim of the Trial of Respiratory infections in children for ENhanced Diagnostics (TREND) study is to improve the differential diagnosis of bacterial and viral etiologies in children aged below 5 years with clinical CAP, by evaluating myxovirus resistance protein A (MxA) as a biomarker for viral CAP and by evaluating an existing (multianalyte point-of-care antigen detection test system [mariPOC respi] ArcDia International Oy Ltd.) and a potential future point-of-care test for respiratory pathogens. METHODS: Children aged 1 to 59 months with clinical CAP as well as healthy, hospital-based, asymptomatic controls will be included at a pediatric emergency hospital in Stockholm, Sweden. Blood (analyzed for MxA and C-reactive protein) and nasopharyngeal samples (analyzed with real-time polymerase chain reaction as the gold standard and antigen-based mariPOC respi test as well as saved for future analyses of a novel recombinase polymerase amplification-based point-of-care test for respiratory pathogens) will be collected. A newly developed algorithm for the classification of CAP etiology will be used as the reference standard. RESULTS: A pilot study was performed from June to August 2017. The enrollment of study subjects started in November 2017. Results are expected by the end of 2019. CONCLUSIONS: The findings from the TREND study can be an important step to improve the management of children with clinical CAP. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12705.

15.
J Pediatr ; 208: 229-235.e1, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30723014

RESUMO

OBJECTIVE: To assess the relation between maternal prenatal psychological distress, comprising depression and anxiety symptoms and relationship quality, and the risk of recurrent respiratory infections (RRIs) in children up to 2 years of age. Children with RRIs frequently use health care services and antibiotics. Prenatal maternal psychological distress can be one, previously unidentified risk factor for RRIs. STUDY DESIGN: The study population was drawn from a population-based pregnancy cohort in Finland (www.finnbrain.fi). Children with RRIs (n = 204) and a comparison group (n = 1014) were identified by maternal reports at the child age of 12 or 24 months. The Edinburgh Postnatal Depression Scale, Symptom Checklist-90 anxiety subscale, the Pregnancy-Related Anxiety Questionnaire-Revised 2, and the Revised Dyadic Adjustment Scale were used to assess maternal symptoms and parental relationship quality at 34 weeks of gestation. Adjustment for maternal postnatal depressive and anxiety symptoms was performed. RESULTS: Maternal prenatal Edinburgh Postnatal Depression Scale (OR, 1.24; 95% CI, 1.08-1.44), Symptom Checklist-90/Anxiety (OR, 1.40; 95% CI, 1.01-1.76), Pregnancy-Related Anxiety Questionnaire-Revised 2 (OR, 1.28; 95% CI, 1.11-1.47), and Revised Dyadic Adjustment Scale (OR, 1.32; 95% CI, 1.01-1.58) total sum scores were associated with child RRIs by the age of 24 months. Greater number of siblings, shorter duration of breastfeeding, and the level of maternal education were also identified as risk factors for child RRIs. CONCLUSIONS: Maternal prenatal psychological distress is linked with a higher risk for child RRIs.

16.
Acta Paediatr ; 108(2): 288-294, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30126046

RESUMO

AIM: This study examined associations between recurrent respiratory tract infections (RTI) and acute otitis media (AOM) during the first one and two years of life and vocabulary size at 13 and 24 months of age. METHODS: We studied 646 children born between January 2008 and April 2010 and followed up from birth to two years of age with daily diary and study clinic visits during RTIs and AOM. The families were recruited from maternity health care clinics or delivery wards in south-west Finland. Parents completed the MacArthur Communicative Development Inventory at 13 and 24 months, and the vocabularies of children with high rates of RTIs or AOM were compared to children without recurrent issues. RESULTS: Of the 646 children, 9.6% had recurrent RTIs and 9.9% had recurrent AOM from 0 to 24 months. Children with high rates of RTIs or AOM did not have smaller vocabularies than children without recurrent RTIs or AOM. Girls had larger vocabularies and higher parental socioeconomic status was associated with a larger expressive vocabulary at 24 months. CONCLUSION: The child's gender and parental socioeconomic status played a more critical role in vocabulary development in the first two years than a high burden of RTIs or AOM.

18.
J Voice ; 33(5): 801.e21-801.e25, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29506899

RESUMO

OBJECTIVES: Health-related factors are part of the multifactorial background of dysphonia in children. Respiratory tract infections affect the same systems and structures that are used for voice production. The purpose of this study was to investigate if the number of respiratory tract infections or the viral etiology were significant predictors for a more hoarse voice quality. METHODS: The participants were 4-year-old children who participated in the multidisciplinary STEPS study (Steps to the Healthy Development and Well-being of Children) where they were followed up from pregnancy or birth to 4 years of age. Data were collected through questionnaires and a health diary filled in by the parents. Some of the children were followed up more intensively for respiratory tract infections during the first 2 years of life, and nasal swab samples were taken at the onset of respiratory symptoms. Our participants were 489 of these children who had participated in the follow-up for at least 1 year and for whom data on respiratory tract infections and data on voice quality were available. RESULTS: The number of hospitalizations due to respiratory tract infections was a significant predictor for a more hoarse voice quality. Neither the number of rhinovirus infections nor the number of respiratory syncytial virus infections was statistically significant predictors for a more hoarse voice quality. CONCLUSIONS: Based on our results, we would suggest including questions on the presence of respiratory tract infections that have led to hospitalization in the pediatric voice anamnesis. Whether the viral etiology of respiratory tract infections is of importance or not requires further research.


Assuntos
Rouquidão/etiologia , Infecções por Picornaviridae/complicações , Infecções por Vírus Respiratório Sincicial/complicações , Infecções Respiratórias/complicações , Qualidade da Voz , Fatores Etários , Pré-Escolar , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Hospitalização , Humanos , Masculino , Infecções por Picornaviridae/diagnóstico , Infecções por Picornaviridae/terapia , Infecções por Picornaviridae/virologia , Prognóstico , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/terapia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/patogenicidade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/terapia , Infecções Respiratórias/virologia , Rhinovirus/patogenicidade , Medição de Risco , Fatores de Risco
19.
J Microbiol Immunol Infect ; 52(4): 526-533, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29254653

RESUMO

BACKGROUND/PURPOSE: Influenza vaccine has been recommended in Finland since 2007 for all children of 6-35 months of age and in 2009 for those ≥6 months against pandemic influenza. We investigated the incidence of influenza and vaccine effectiveness in a birth cohort of children in 2008-2011. METHODS: We followed 923 children from birth to 2 years of age for respiratory tract infections. A nasal swab sample for PCR for influenza A and B viruses was taken at the onset of acute respiratory infections. Samples were collected either at the study clinic or at home by parents. Vaccination data was retrieved from the health registries. RESULTS: Vaccination coverage of children aged 6-23 months was 22-47% against seasonal influenza and 80% against the A(H1N1)pdm09 virus in the pandemic season 2009-2010. During 3 influenza seasons, 1607 nasal swab samples were collected. Influenza was confirmed in 56 (6.1%) of 923 children (16 A(H1N1), 14 A(H3N2), and 26 B viruses). The incidence of influenza was 5.1% in 2008-2009, 2.7% in 2009-2010, and 5.0% in 2010-2011. Effectiveness of the adjuvanted vaccine against the pandemic influenza A(H1N1)pdm09 was 97% (95% confidence interval, 76-100%). Three children with influenza were hospitalized. CONCLUSION: The yearly incidence of seasonal influenza was 5% in this cohort of very young children with variable influenza vaccine coverage. Adjuvanted vaccine against the pandemic influenza was highly effective. Both seasonal and pandemic influenza cases were mostly non-severe.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Adjuvantes Imunológicos , Finlândia , Humanos , Incidência , Lactente , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/imunologia , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza B/imunologia , Vírus da Influenza B/isolamento & purificação , Vacinas contra Influenza/imunologia , Influenza Humana/imunologia , Influenza Humana/virologia , Estudos Prospectivos , Infecções Respiratórias/virologia , Estações do Ano , Resultado do Tratamento , Vacinação
20.
PLoS One ; 13(9): e0203650, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30192872

RESUMO

BACKGROUND: An association between maternal prenatal stress and increased rates of respiratory tract infections in the offspring has been described earlier. Data regarding the father's role is lacking. In this study our aim was to evaluate, whether mothers' and fathers' depressive symptoms and loneliness during pregnancy predict higher rates of respiratory tract infections in the offspring. METHODS: In this longitudinal cohort study we gathered information on parental psychological risk during gestational week 20 using the BDI-II and UCLA loneliness scale questionnaires for the parents of 929 children. Loneliness was divided into social and emotional components, the former describing patterns of social isolation and the latter a perceived lack of intimate attachments. Episodes of acute otitis media, physician visits due to respiratory tract infections, and antibiotic consumption relating to respiratory tract infections were documented in the infants, excluding twins, from birth until 10 months of age using study diaries. Analyses were carried out by structural equation modeling, which provides dynamic estimates of covariances. RESULTS: Maternal depressive symptoms during pregnancy predicted higher rates of acute otitis media in the infant and maternal emotional loneliness predicted higher rates of physician visits. Acute otitis media, physician visits and antibiotic consumption in the infant were slightly less frequent for families who reported social loneliness in the father or mother. Associations remained when taking into account confounders. CONCLUSIONS: Maternal prenatal depression and emotional loneliness predicted a higher burden of respiratory tract infections in the offspring. The protective influence of parental social loneliness on the burden of respiratory tract infections in infants was not in line with our study hypothesis, but could be explained by reduced use of healthcare services in these socially isolated families.


Assuntos
Depressão , Solidão , Exposição Materna/efeitos adversos , Parto , Complicações na Gravidez/psicologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Gravidez , Infecções Respiratórias/etiologia , Adulto Jovem
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