Objective:This study aimed to explore the possible pathogenesis of OSA from the perspective of microbiology by evaluate the change in pharyngeal microbiome of OSA children, and provide new ideas for clinical prevention, diagnosis and treatment. Methods:Randomly enrolled 20 children with OSA as OSA group and 20 children without OSA as control group. The swallow swab of each children been collected. Using 16srDNA sequencing to investigate the characteristics of pharyngeal microbiome. Results:The α-diversity showed that the Chao1and Observe-Otus index has significantly increased in the OSA group, and the β-diversity was significantly different between the two groups. The relative abundance of Haemophilus（Proteobacteria） increased but that of Veillonella（member of Firmicutes） and Prevotella-7 and Prevotella（member of Bacteroidota） decreased in the OSA group compared to control group. Conclusion:The pharyngeal microbial richness are decreased significantly and composition are disrupted in children with OSA. This microbiome analysis provides a new understanding about the pathogenesis of OSA in children.
Humans ; Sleep Apnea, Obstructive/microbiology* ; Microbiota ; Child ; Pharynx/microbiology* ; Male ; Female ; Prevotella/isolation & purification* ; Haemophilus/isolation & purification* ; Veillonella/isolation & purification* ; RNA, Ribosomal, 16S/genetics* ; Child, Preschool ; Proteobacteria/isolation & purification*

BACKGROUNDThe accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children.

METHODSThe prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection: bacterial detection by culture, Mycoplasma pneumoniae (Mp) detection by polymerase chain reaction assay and virus (influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus) detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years (n = 194) and >3 years (n = 294).

RESULTSWe collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age >3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children >3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age >3 years.

CONCLUSIONSNPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in "rule out" lower airway infection; however, a positive result does not reliably "rule in" the presence of pathogens.

Acinetobacter baumannii ; isolation & purification ; pathogenicity ; Adolescent ; Child ; Child, Preschool ; Clinical Laboratory Techniques ; methods ; Enterobacter aerogenes ; isolation & purification ; pathogenicity ; Escherichia coli ; isolation & purification ; pathogenicity ; Female ; Haemophilus influenzae ; isolation & purification ; pathogenicity ; Humans ; Infant ; Male ; Nasopharynx ; microbiology ; Prospective Studies ; Pseudomonas aeruginosa ; isolation & purification ; pathogenicity ; Respiratory Tract Infections ; diagnosis ; microbiology ; Sensitivity and Specificity ; Staphylococcus aureus ; isolation & purification ; pathogenicity ; Streptococcus pneumoniae ; isolation & purification ; pathogenicity

BACKGROUNDRecent studies have indicated that an imbalance of gut microbiota is associated with the development of type 1 diabetes mellitus (T1DM) and there is no literature regarding it in Chinese children yet. The aim of this study was to evaluate the alteration of gut microbiota between children with newly diagnosed T1DM and healthy controls and to determine if gut microbiota could partly explain the etiology of this disease.

METHODSA case-control study was carried out with 15 children with T1DM and 15 healthy children. The fecal bacteria composition was investigated by high-throughput sequencing of the V3-V4 region of the 16S rDNA gene and analyzed by the estimators of community richness (Chao) indexes.

RESULTSThere was a notable lower richness of fecal bacteria in T1DM group than controls (156.53 ± 36.96 vs. 130.0 ± 32.85, P = 0.047). At the genus level, the composition of Blautia was increased in T1DM group than control group whereas the composition of Haemophilus, Lachnospira, Dialister, and Acidaminococcus was decreased. In addition, we found that the percentage of Blautia was correlated positively with HbA1c (ρ = 0.40, P = 0.031), the numbers of T1DM autoantibodies (ρ = 0.42, P = 0.023), and the titers of tyrosine phosphatase autoantibodies (IA-2) (ρ = 0.82, P = 0.000) in the study.

CONCLUSIONSThis study showed that gut microbiota was associated with the development of T1DM by affecting the autoimmunity, and the results suggested a potential therapy for T1DM via modulating the gut microbiota.

Adolescent ; Autoantibodies ; immunology ; Case-Control Studies ; Child ; Computational Biology ; Diabetes Mellitus, Type 1 ; immunology ; microbiology ; Feces ; microbiology ; Female ; Gastrointestinal Microbiome ; genetics ; physiology ; Haemophilus ; genetics ; isolation & purification ; Humans ; Male ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; genetics

OBJECTIVETo analyze the clinical characteristics of protracted bacterial bronchitis (PBB) in children.

METHODThe clinical data of patients seen from October, 2010 to March, 2014 in Department of Respiratory Diseases of our hospital were retrospectively analyzed. Inclusion criteria were over 4 weeks cough, receiving fiberoptic bronchoscopy, positive bacterial culture and (or) the increased percentage of neutral granulocytes in bronchoalveolar lavage fluid (BALF).

RESULTTwenty eight patients were involved, 26 were male (93%) and two were female (7%). The median age of patients was 8.5 months. The median duration of cough was four weeks. The average length of hospital stay was (8.3 ± 3.9)days. The main clinical feature was wet cough in 28 cases, wet cough with wheezing was seen in 21 cases. The wet cough phase distribution was irregular in 21 cases. The crackles with wheeze (in 21 cases) was main signs of PBB. The percentage of CD3⁻ CD16⁺ 56⁺ cells increased in peripheral blood. The fiberoptic bronchoscopic manifestations of PBB were luminal mucosal edema. Eleven patients also had airway malacia. The neutrophil median in BALF was 0.2. The positive rate of bacterial culture of BALF was 36%. The main bacteria were Streptococcus pneumoniae (50%) and Haemophilus influenzae (30%). The main treatment for PBB patients included amoxycillin/clavulanate potassium and second-generation cephalosporins. The average duration of treatment was (17.3 ± 3.2)days, the prognosis was good.

CONCLUSIONPBB is common in male infants. Persistent wet cough with wheezing was the main characteristic of PBB. PBB is commonly accompanied by immune dysfunction and airway malacia, and the pathogens were Streptococcus pneumoniae and Haemophilus influenzae.

Bacterial Infections ; drug therapy ; pathology ; Bronchitis ; drug therapy ; microbiology ; pathology ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Cough ; Female ; Haemophilus influenzae ; isolation & purification ; Humans ; Infant ; Male ; Respiratory Sounds ; Retrospective Studies ; Streptococcus pneumoniae ; isolation & purification

OBJECTIVETo investigate the basic clinical characteristics and drug resistance of Haemophilus influenzae (Hi) infection in hospitalized children in the past two years.

METHODSA retrospective cross-sectional study was conducted to analyze Hi strains isolated from the sputum and pharyngeal swabs of children aged 0-17 years who were hospitalized in the Third People's Hospital of Chengdu between June 2011 and May 2013.

RESULTSA total of 117 strains were isolated from 111 hospitalized children. There were 102 cases (91.9%) of respiratory infection and 9 cases (8.1%) of other diseases. The positive rates of Hi in children with bronchopneumonia or pneumonia (50.8%, 30/59) and in children with acute laryngotracheobronchitis (50.0%, 2/4) were relatively high, followed by in children with capillary bronchitis (34.6%, 9/26), in children with acute bronchitis (24.2%, 32/132), in children with herpangina (19.0%, 4/21), in children with asthmatoid bronchitis (17.9%, 5/28), in children with acute upper respiratory tract infection (11.8%, 9/76), in children with acute tonsillitis (8.2%, 7/85), and in children with neonatal pneumonia (5.6%, 3/54). There were significant differences in the rates of resistance to amoxicillin-clavulanate (15% vs 23%; P=0.010) and chloramphenicol (25% vs 8%; P=0.015) between the two survey years. The frequencice of β-lactamase-nonproducing-ampicillin-resistant (BLNAR) strains and β-lactamase-producing-amoxicilli/clavulanate-resistant (BLPACR) strains increased from 12% to 21% and from 13% to 19% respectively during the two survey years (P>0.05).

CONCLUSIONSHi plays an important role in the respiratory tract infection of children aged 0-17 years. The increasing trend of BLNAR and BLPACR rates makes it harder for antibiotic selection in clinical practice.

Adolescent ; Amoxicillin-Potassium Clavulanate Combination ; pharmacology ; Child ; Child, Hospitalized ; Child, Preschool ; Cross-Sectional Studies ; Drug Resistance, Bacterial ; Haemophilus influenzae ; drug effects ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies

OBJECTIVETo investigate the distribution of pathogens of children with community acquired pneumonia (CAP) from the Chongqing area.

METHODSNasopharyngeal specimens and blood specimens of 1 613 children with CAP were collected between January 2014 and December 2014 for bacterial culture and detection of 7 respiratory viruses and antibodies against Mycoplasma pneumoniae (MP).

RESULTSThe overall positive rate of bacteria was 50.22% (810 cases). Hemophilus parainfluenzae (40.8%), Streptococcus pneumonia (29.7%) and Moraxelle catarrhalis (7.3%) were the predominant ones. Among the viruses, the top detected virus was respiratory syncytial virus (RSV, 58.3%), followed by parainfluenza virus type3 (17.4%) and adenovirus (14.3%). A total of 481 cases (29.82%) were MP-positive. The co-infection rate was 32.18% (519 cases), and the mixed infections of bacteria and viruses were common (47.4%).

CONCLUSIONSRSV and Hemophilus parainfluenzae are the major pathogens of CAP in children from the Chongqing area. MP is also an important pathogen. The co-infection of bacteria and viruses is prevalent.

Adolescent ; Child ; Child, Preschool ; Community-Acquired Infections ; etiology ; Female ; Haemophilus parainfluenzae ; isolation & purification ; Hospitalization ; Humans ; Infant ; Male ; Mycoplasma pneumoniae ; isolation & purification ; Pneumonia ; etiology ; Respiratory Syncytial Viruses ; isolation & purification

OBJECTIVE: To research the prevalences of four kinds of bacteria including Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis in children with chronic otitis media with effusion (SOM) of the middle ear effusion, and the reproduction of the nasopharynx, so as to explore their meaning for the children with SOM. METHOD: Alloiococcus otitidis, Streptococcus pneumonia, Haemophilus influenza, and Moraxella catarrhal were investigated in the samples obtained from middle ear effusion and nasopharyn- geal swabs, using PCR and conventional bacterial culture methods. RESULT: By bacterial culture, the pathogen detection rate from middle ear effusion was 3.6%,while the nasopharynx was 54.0%, the detection rate of Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis was 10.8%, 27.0%, 4.5%, respectively, the drug susceptibility results for 51 samples of bacterial culture positive showed that 39 cases was sensitivite to the β-lactam antibiotic; By PCR, the number of detecting various kinds of bacteria simultaneously in middle ear effusion or in the nasopharynx were 6 and 34. The bacteria prevalences of S. pneumoniae, H. influenzae, M. catarrhalis, and A. otitidis are 5.4%, 5.4%, 3.6%, and 42.3% in the middle ear effusion, are 25.2%, 27.0%,13.5% and 34.2% in nasopharyngeal, respectively. CONCLUSION (1) PCR method is more sensitively detecting the bacteria than conventional bacterial culture methods. (2) The chronic SOM of children may be a combination of mixed bacterial infection, A. otitidis may be the most common pathogen of children SOM. (3) For children of SOM, if antibiotics are chosen to be used early in the disease, we suggest using the β-lactam antibiotics.
Bacteria ; Bacterial Infections ; complications ; Child ; Haemophilus influenzae ; isolation & purification ; Humans ; Moraxella (Branhamella) catarrhalis ; isolation & purification ; Nasopharynx ; Otitis Media with Effusion ; complications ; microbiology ; Polymerase Chain Reaction ; Prevalence ; Streptococcus pneumoniae ; isolation & purification

No abstract available.
Acute Disease ; Adolescent ; Alkaline Phosphatase/*blood ; Anti-Bacterial Agents/*therapeutic use ; Arthritis, Infectious/*drug therapy/*enzymology/microbiology ; *Bacterial Infections/drug therapy/enzymology/microbiology ; Child ; Child, Preschool ; Haemophilus influenzae type b/isolation & purification ; Humans ; Infant ; Osteomyelitis/*drug therapy/*enzymology/microbiology ; Staphylococcus aureus/isolation & purification ; Streptococcus pneumoniae/isolation & purification ; Streptococcus pyogenes/isolation & purification

OBJECTIVETo establish multiplex PCR-based assays for detecting H.influenzae and H.parainfluenzae. And the PCR-based assays were applied to detect the carriage rates of H.influenzae and H.parainfluenzae in nasopharyngeal swab specimens which were collected from healthy children.

METHODSMultiplex primers for species-specific PCR were designed by using DNAstar soft based on the sequences of 16S rRNA genes from genus Haemophilus to detect H.influenzae and H.parainfluenzae.

RESULTSThe sensitivity of the 16S rRNA PCR assay for detecting H.influenzae and H.parainfluenzae was 97.53% and 100% respectively, and the specificity was 95.89% and 96.63% respectively. Youden's Index on the ability to detect H.influenzae and H.parainfluenzae was 0.9342 and 0.9663 respectively. 666 nasopharyngeal swab specimens were collected from healthy children. The detection rates of H.influenzae and H.parainfluenzae were 14.11% and 16.07% respectively by using isolation and culture methods. The detection rates of H.influenzae and H.parainfluenzae were 43.54% and 57.96% respectively by 16S rRNA PCR assays. The carriage rates of serotypes a, b, c, d, e, f and non-typeable isolates were 0% (0/666), 0.15% (1/666), 1.20% (8/666), 0.15% (1/666), 1.20% (8/666), 1.80% (12/666), 95.50% (636/666) respectively.

CONCLUSIONThe multiplex PCR assays were very rapid, reliable and feasible methods for detection of H.influenzae and H.parainfluenzae in pharyngeal swab specimens which were compared to conventional isolation and culture methods. 95.5% of H.influenzae strains in healthy children were nontypeable. The encapsulated or typable strains were mainly three serotypes which was c, e, and f serotype.

Haemophilus influenzae ; classification ; genetics ; isolation & purification ; Haemophilus parainfluenzae ; classification ; genetics ; isolation & purification ; Humans ; Multiplex Polymerase Chain Reaction ; methods ; Nasopharynx ; microbiology ; RNA, Bacterial ; genetics ; RNA, Ribosomal, 16S ; genetics ; Sensitivity and Specificity

OBJECTIVEThis research was to explore the difference between children with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the composition and antibiotic-resistance of pathogenic bacteria.

METHODS241 CAP and 116 HAP with positive sputum culture who were hospitalized from January to December in 2008 in Children's Hospital Affiliated to Suzhou University were selected in this study. The bacteria were identified by traditionally manual method and antibiotic sensitivity tests were performed by K-B method. The chi-square or Fisher's exact test were used for statistical test.

RESULTSIn 241 CAP, Streptococcus pneumoniae and haemophilus influenza accounted for (42.2%, 106/251) and (12.4%, 31/251) infection, respectively; however in 116 HAP, Enterobacteriaceae and Non-fermenters accounted for (88.2%, 127/144). In addition, methicillin-resistant Staphylococcus aureus weren't isolated, however, its detection rate was 66.7% in HAP. The drug resistance was 1.5 times higher in HAP than that in CAP for several types of antibiotics, such as ceftazidime (37.5% (6/16) vs 75.6% (31/41)), cefepime (37.5% (6/16) vs 78.0% (32/41)), aztreonam (50.0% (8/16) vs 90.2% (37/41)), cefoperazone/sulbactam (12.5% (2/16) vs 51.2% (21/41)) and piperacillin/tazobactam (12.5% (2/16) vs 56.0% (23/41)). Klebsiella pneumoniae isolated from HAP had higher drug resistance than that isolated from CAP against some antibiotics, for example, gentamicin (0 vs 63.6% (7/11)), SMZ + TMP (20.0% (1/5) vs 63.6% (7/11)) and cefoperazone/sulbactam (0 vs 54.5% (6/11)). We also found Enterobacter cloacae isolated from HAP showed high drug resistance than that isolated from CAP against imipenem (0 vs 46.7% (7/15)), aztreonam (9.1% (1/11) vs 60.0% (9/15)) and cefoperazone (18.2% (2/11) vs 80.0% (12/15)) and Pseudomonas aeruginosa from HAP had higher resistance than that from CAP against gentamicin (0 vs 50.0% (9/18)), amikacin (0 vs 38.9% (7/18)), ceftazidime (0 vs 55.6% (10/18)), cefepime (0 vs 50.0% (9/18)) and cefoperazone (33.3% (2/6) vs 94.4% (17/18)). The detection rates of ESBLs for Escherichia coli were 84.6% (11/13) and 93.3% (14/15) in CAP and HAP, respectively (χ(2) = 0.553, P > 0.05); while for Klebsiella pneumoniae, they were 81.3% (13/16) and 95.1% (39/41), respectively (χ(2) = 2.767, P > 0.05).

CONCLUSIONCAP was mainly comprised of Streptococcus pneumoniae and haemophilus influenza; while HAP was mainly comprised of Enterobacteriaceae and Non-fermenters. The drug resistance of gram-negative bacilli was higher in HAP than that in CAP.

Child ; Child, Preschool ; Community-Acquired Infections ; microbiology ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Female ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Haemophilus influenzae ; drug effects ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Male ; Microbial Sensitivity Tests ; Pneumonia, Bacterial ; microbiology ; Pseudomonas aeruginosa ; drug effects ; isolation & purification