Child ; Consensus ; Haemophilus Infections ; diagnosis ; therapy ; Haemophilus influenzae ; Humans ; Infant

To establish a novel colloidal gold immunochromatography assay (GICA) for rapid, sensitive and accurate detection of Haemophilus influenzae infection by using the outer membrane protein P6 as detection target. First, the linear antigen epitope located in the extracellular domain of the P6 protein (GenBank accession number: AGH02799) was predicted by bioinformatics analysis. The region (62-75 aa of the protein) with strong antigen specificity was chosen and synthesized. Two rabbits were then immunized by the polypeptides (14 aa) for production of polyclonal antibodies. Then, the recombinant P6 proteins were also obtained to produce polyclonal antibodies. Finally, based on the two antibodies, a novel colloidal GICA for detection of Haemophilus influenzae infection was established and the specificity, sensitivity, repeatability and stability of this method were evaluated. At the same time, the method was tested in clinical simulation, and the plate culture method was used to verify its accuracy. The test strip for Haemophilus influenzae infection was successfully prepared. The detection limit of the test strip was as low as 1×105 CFU/mL and the whole process can be completed within 15 minutes. The strip specifically recognized Haemophilus influenzae and did not react with nine of other common respiratory pathogens such as Streptococcus pneumoniae, Moraxella catarrhalis, Mycoplasma pneumonia, and Legionella pneumophila. And the strips could be stored at 25 °C for at least 6 months without losing sensitivity or specificity. The coincidence rate between the results of 200 clinical samples and the plate culture method was 90.5%. Haemophilus influenzae protein P6, which possessed a high degree of surface antigen accessibility and antigencity, could be used as a marker for Haemophilus influenzae detection. The immunochromatographic colloidal gold test strip which bears the features of rapidity, convenience and sensitivity provides a unique tool for the on-site surveillance and diagnosis of Haemophilus influenzae infection in clinical test.
Animals ; Chromatography, Affinity ; instrumentation ; Diagnostic Tests, Routine ; standards ; Gold Colloid ; chemistry ; Haemophilus Infections ; diagnosis ; Haemophilus influenzae ; Humans ; Limit of Detection ; Rabbits ; Sensitivity and Specificity

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

Adenocarcinoma ; surgery ; Candidiasis ; etiology ; Cardiac Tamponade ; diagnosis ; etiology ; Echocardiography ; Electrocardiography ; Esophageal Fistula ; complications ; diagnostic imaging ; Fever ; etiology ; Gastrectomy ; Haemophilus Infections ; etiology ; Heart Diseases ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pericardial Effusion ; diagnostic imaging ; etiology ; Pericarditis ; diagnostic imaging ; etiology ; Postoperative Complications ; diagnostic imaging ; Staphylococcal Infections ; etiology ; Stomach Neoplasms ; surgery ; Streptococcal Infections ; etiology ; Tomography, X-Ray Computed

Bronchiolitis ; diagnosis ; Haemophilus Infections ; diagnosis ; Humans ; Silicosis ; diagnosis

Diffuse panbronchiolitis (DPB) is a bronchiolitis affecting the whole lung fields which can be treated by macrolide. Especially East Asian patients are more susceptible to diffuse panbronchiolitis. As asthma and DPB both can cause airway obstruction, differential diagnosis is important for the 2 diseases. Here we report 5 patients with DPB clinically presenting as severe asthma in Korea, who were well treated by macrolide. Among the 5 patients, 2 could stop their asthma inhalers and the other 3 could reduce asthma medications after diagnosis and treatment of DPB. In conclusion, considering DPB as differential diagnosis for asthmatics in Asian ethnic groups is important.
Adult ; Aged ; Anti-Asthmatic Agents/*therapeutic use ; Asthma/*diagnosis/*drug therapy ; Bronchiolitis/*diagnosis/*drug therapy ; Diagnosis, Differential ; Female ; Haemophilus Infections/*diagnosis/*drug therapy ; Humans ; Macrolides/*administration & dosage ; Male ; Middle Aged ; Severity of Illness Index ; Treatment Outcome

Prosthetic valve endocarditis (PVE) caused by Haemophilus parainfluenzae (H. parainfluenzae) is very rare. Here, we report a case of H. parainfluenzae PVE that developed following the Bentall procedure complicated by a pseudoaneurysm and cerebral emboli. A diagnosis was delayed in this case because of the slow-growing nature of the organism and the unusual clinical presentation.
Aneurysm, False* ; Diagnosis ; Endocarditis* ; Haemophilus parainfluenzae* ; Heart Valve Prosthesis ; Intracranial Embolism ; Paramyxoviridae Infections

Prosthetic valve endocarditis (PVE) caused by Haemophilus parainfluenzae (H. parainfluenzae) is very rare. Here, we report a case of H. parainfluenzae PVE that developed following the Bentall procedure complicated by a pseudoaneurysm and cerebral emboli. A diagnosis was delayed in this case because of the slow-growing nature of the organism and the unusual clinical presentation.
Aneurysm, False* ; Diagnosis ; Endocarditis* ; Haemophilus parainfluenzae* ; Heart Valve Prosthesis ; Intracranial Embolism ; Paramyxoviridae Infections

Haemophilus aphrophilus is an aerobic, gram-negative oropharyngeal bacterium, commonly isolated from cases of HACEK endocarditis. In addition, H. aphrophilus has also been shown to cause invasive bone and joint infections. Although multiple cases of H. aphrophilus endocarditis have been described, no cases of invasive bone and joint infections caused by H. aphrophilus have been reported in Korea. Here we report the case of a 69-year old woman with a diagnosis of vertebral osteomyelitis and spinal epidural abscess with compressive myelopathy caused by H. aphrophilus, in which there was no objective evidence of infective endocarditis. She was successfully treated with intravenous administration of cefotaxime and drainage of the epidural abscess by laminectomy of the T3-7 vertebrae.
Administration, Intravenous ; Aged ; Aggregatibacter aphrophilus* ; Cefotaxime ; Diagnosis ; Drainage ; Endocarditis ; Epidural Abscess* ; Female ; Haemophilus Infections ; Haemophilus* ; Humans ; Joints ; Korea ; Laminectomy ; Osteomyelitis* ; Spinal Cord Compression ; Spine ; Spondylitis

BACKGROUND AND OBJECTIVES: Acute otitis media (AOM) is one of the most common forms of bacterial infection in children. The aim of this study was to investigate the clinical characteristics and the common pathogens of AOM children who visited three different centers. SUBJECTS AND METHOD: We have conducted a retrospective study of 133 children under 15 years with the diagnosis of AOM that had been seen between January 2010 and January 2011. We examined of AOM children's symptoms, signs and culture results. RESULTS: The most common symptoms were in the order of crying or irritability, otalgia and fever. Otorrhea was significantly higher under 2 years old and drum injection was over 2 years old. The most common pathogens were Streptococcus pneumoniae (26.6%), followed by Moraxella catarrhalis (19.0%), Haemophilus influenzae (11.4%) and Staphylococcus aureus (11.4%). Among the total pathogens, about 71% of pathogens were resistant to amoxicillin, 78% to macroride, and 55.2% to clindamycin. About 58.3% of H. influenza and M. catarrhalis were positive to beta-lactamase. CONCLUSION: More than half of pathogens were resistant to standard dose amoxicillin. For the appropriate treatment of AOM, decisions were made based on the common symptoms, signs and antibiotic resistances of pathogens.
Acute Disease ; Amoxicillin ; Bacterial Infections ; beta-Lactamases ; Child* ; Clindamycin ; Crying ; Diagnosis ; Earache ; Fever ; Haemophilus influenzae ; Humans ; Influenza, Human ; Moraxella (Branhamella) catarrhalis ; Otitis Media* ; Otitis* ; Retrospective Studies ; Staphylococcus aureus ; Streptococcus pneumoniae