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Henares D, Lo SW, Perez-Argüello A, Redin A, Ciruela P, Garcia-Garcia JJ, Brotons P, Yuste J, Sá-Leão R, Muñoz-Almagro C. Comparison of next generation technologies and bioinformatics pipelines for capsular typing of Streptococcus pneumoniae. J Clin Microbiol 2023; 61:e0074123. [PMID: 38092657 PMCID: PMC10729682 DOI: 10.1128/jcm.00741-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/01/2023] [Indexed: 12/20/2023] Open
Abstract
Whole genome sequencing (WGS)-based approaches for pneumococcal capsular typing have become an alternative to serological methods. In silico serotyping from WGS has not yet been applied to long-read sequences produced by third-generation technologies. The objective of the study was to determine the capsular types of pneumococci causing invasive disease in Catalonia (Spain) using serological typing and WGS and to compare the performance of different bioinformatics pipelines using short- and long-read data from WGS. All invasive pneumococcal pediatric isolates collected in Hospital Sant Joan de Déu (Barcelona) from 2013 to 2019 were included. Isolates were assigned a capsular type by serological testing based on anticapsular antisera and by different WGS-based pipelines: Illumina sequencing followed by serotyping with PneumoCaT, SeroBA, and Pathogenwatch vs MinION-ONT sequencing coupled with serotyping by Pathogenwatch from pneumococcal assembled genomes. A total of 119 out of 121 pneumococcal isolates were available for sequencing. Twenty-nine different serotypes were identified by serological typing, with 24F (n = 17; 14.3%), 14 (n = 10; 8.4%), and 15B/C (n = 8; 6.7%) being the most common serotypes. WGS-based pipelines showed initial concordance with serological typing (>91% of accuracy). The main discrepant results were found at the serotype level within a serogroup: 6A/B, 6C/D, 9A/V, 11A/D, and 18B/C. Only one discrepancy at the serogroup level was observed: serotype 29 by serological testing and serotype 35B/D by all WGS-based pipelines. Thus, bioinformatics WGS-based pipelines, including those using third-generation sequencing, are useful for pneumococcal capsular assignment. Possible discrepancies between serological typing and WGS-based approaches should be considered in pneumococcal capsular-type surveillance studies.
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Affiliation(s)
- Desiree Henares
- Department of RDI Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Stephanie W. Lo
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, United Kingdom
- Milner Center for Evolution, Life Sciences Department, University of Bath, Bath, United Kingdom
| | - Amaresh Perez-Argüello
- Department of RDI Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Alba Redin
- Department of RDI Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Pilar Ciruela
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Surveillance and Public Health Emergency Response, Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain
| | - Juan Jose Garcia-Garcia
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Surgery and Medical-Surgical Specialties, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Pedro Brotons
- Department of RDI Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Yuste
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Instituto de salud Carlos III, Madrid, Spain
| | - Raquel Sá-Leão
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Carmen Muñoz-Almagro
- Department of RDI Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
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Shaw D, Abad R, Amin-Chowdhury Z, Bautista A, Bennett D, Broughton K, Cao B, Casanova C, Choi EH, Chu YW, Claus H, Coelho J, Corcoran M, Cottrell S, Cunney R, Cuypers L, Dalby T, Davies H, de Gouveia L, Deghmane AE, Demczuk W, Desmet S, Domenech M, Drew R, du Plessis M, Duarte C, Erlendsdóttir H, Fry NK, Fuursted K, Hale T, Henares D, Henriques-Normark B, Hilty M, Hoffmann S, Humphreys H, Ip M, Jacobsson S, Johnson C, Johnston J, Jolley KA, Kawabata A, Kozakova J, Kristinsson KG, Krizova P, Kuch A, Ladhani S, Lâm TT, León ME, Lindholm L, Litt D, Maiden MCJ, Martin I, Martiny D, Mattheus W, McCarthy ND, Meehan M, Meiring S, Mölling P, Morfeldt E, Morgan J, Mulhall R, Muñoz-Almagro C, Murdoch D, Murphy J, Musilek M, Mzabi A, Novakova L, Oftadeh S, Perez-Argüello A, Pérez-Vázquez M, Perrin M, Perry M, Prevost B, Roberts M, Rokney A, Ron M, Sanabria OM, Scott KJ, Sheppard C, Siira L, Sintchenko V, Skoczyńska A, Sloan M, Slotved HC, Smith AJ, Steens A, Taha MK, Toropainen M, Tzanakaki G, Vainio A, van der Linden MPG, van Sorge NM, Varon E, Vohrnova S, von Gottberg A, Yuste J, Zanella R, Zhou F, Brueggemann AB. Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium. Lancet Digit Health 2023; 5:e582-e593. [PMID: 37516557 PMCID: PMC10914672 DOI: 10.1016/s2589-7500(23)00108-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. METHODS For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. FINDINGS Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. INTERPRETATION COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. FUNDING Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.
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Affiliation(s)
- David Shaw
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Raquel Abad
- National Reference Laboratory for Meningococci, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Zahin Amin-Chowdhury
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | | | - Desiree Bennett
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Karen Broughton
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Carlo Casanova
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yiu-Wai Chu
- Department of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China
| | - Heike Claus
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | - Juliana Coelho
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Mary Corcoran
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Robert Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lize Cuypers
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Tine Dalby
- Statens Serum Institut, Department of Infectious Disease Epidemiology & Prevention, Copenhagen, Denmark
| | - Heather Davies
- Meningococcal Reference Laboratory, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ala-Eddine Deghmane
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Stefanie Desmet
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Mirian Domenech
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Richard Drew
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Clinical Innovation Unit, Rotunda, Dublin, Ireland
| | - Mignon du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Helga Erlendsdóttir
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Norman K Fry
- Immunisation and Vaccine Preventable Diseases Division and Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Kurt Fuursted
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Desiree Henares
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Birgitta Henriques-Normark
- Karolinska Institutet, Karolinska University Hospital, Public Health Agency of Sweden, Stockholm, Sweden
| | - Markus Hilty
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Steen Hoffmann
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Hilary Humphreys
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Susanne Jacobsson
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | | | | | | | - Jana Kozakova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Karl G Kristinsson
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | - Thiên-Trí Lâm
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | | | - Laura Lindholm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | | | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Delphine Martiny
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium; Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | | | - Noel D McCarthy
- Population Health Medicine, Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Mary Meehan
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Paula Mölling
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Julie Morgan
- Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
| | - Robert Mulhall
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Carmen Muñoz-Almagro
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain; Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alexandre Mzabi
- Ministère de la Santé - Direction de la santé, Luxembourg, Luxembourg
| | - Ludmila Novakova
- National Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Shahin Oftadeh
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia
| | - Amaresh Perez-Argüello
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Maria Pérez-Vázquez
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Benoit Prevost
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium
| | | | - Assaf Rokney
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Merav Ron
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Kevin J Scott
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK
| | - Carmen Sheppard
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Lotta Siira
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Vitali Sintchenko
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | | | - Andrew J Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Anneke Steens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Muhamed-Kheir Taha
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Anni Vainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mark P G van der Linden
- Department of Medical Microbiology, German National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
| | - Nina M van Sorge
- Department of Medical Microbiology and Infection Prevention, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Sandra Vohrnova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jose Yuste
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosemeire Zanella
- National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
| | - Fei Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Angela B Brueggemann
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
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3
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Bru S, Brotons P, Jordan I, Alsina L, Henares D, Carballar R, de Sevilla MF, Barrabeig I, Fumado V, Baro B, Martínez-Láinez JM, Garcia-Garcia JJ, Bassat Q, Balaguer A, Clotet J, Launes C, Muñoz-Almagro C. Association between soluble angiotensin-converting enzyme 2 in saliva and SARS-CoV-2 infection: a cross-sectional study. Sci Rep 2023; 13:5985. [PMID: 37045853 PMCID: PMC10092936 DOI: 10.1038/s41598-023-31911-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
This study aimed to investigate the association between saliva soluble angiotensin-converting enzyme 2 (sACE2) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adults. We selected a convenience sample of adults with post-acute SARS-CoV-2 infection and their household children living in quarantined family households of the metropolitan Barcelona region (Spain) during the spring 2020 pandemic national lockdown. Participants were tested for saliva sACE2 quantification by western blot and nasopharyngeal SARS-CoV-2 RT-PCR detection. A total of 161 saliva samples [82 (50.9%) from children; 79 (49.1%) from females] yielded valid western blot and RT-PCR results. Saliva sACE2 was detected in 79 (96.3%) children and 76 (96.2%) convalescent adults. Twenty (24.4%) children and 20 (25.3%) convalescent adults were positive for SARS-CoV-2 in nasopharynx by RT-PCR. SARS-CoV-2 RT-PCR-negative children had a significantly higher mean proportional level of saliva sACE2 (0.540 × 10-3%) than RT-PCR-positive children (0.192 × 10-3%, p < 0.001) and convalescent adults (0.173 × 10-3%, p < 0.001). In conclusion, children negative for nasopharyngeal SARS-CoV-2 RT-PCR appear to exhibit a higher concentration of saliva sACE2 than SARS-CoV-2 RT-PCR-positive children and convalescent adults. Release of adequate levels of sACE2 in saliva could play a protective role against SARS-CoV-2.
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Affiliation(s)
- Samuel Bru
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain.
- Department of Medicine, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain.
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Laia Alsina
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Paediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Desiree Henares
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Reyes Carballar
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
| | - Mariona Fernandez de Sevilla
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Irene Barrabeig
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
- Agència de Salut Pública de Catalunya, Roc Boronat 81, 08005, Barcelona, Spain
| | - Victoria Fumado
- Infectious Diseases Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Rosselló 132, 08036, Barcelona, Spain
| | - Joan Marc Martínez-Láinez
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
| | - Juan J Garcia-Garcia
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Quique Bassat
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Rosselló 132, 08036, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Rua 12, 1229, Manhiça, Mozambique
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Lluís Companys 23, 08010, Barcelona, Spain
| | - Albert Balaguer
- Department of Medicine, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
| | - Josep Clotet
- Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
| | - Cristian Launes
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain
- Department of Medicine, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Inmaculada, 22, 28029, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud (CIBERESP), Instituto de Salud Carlos III, Monforte de Lemos 3-5, 28029, Madrid, Spain
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Penela-Sánchez D, Rocafort M, Henares D, Jordan I, Brotons P, Cabrerizo M, Launes C, Muñoz-Almagro C. Impact of the bacterial nasopharyngeal microbiota on the severity of genus enterovirus lower respiratory tract infection in children: A case-control study. Pediatr Pulmonol 2023; 58:1728-1737. [PMID: 36988404 DOI: 10.1002/ppul.26393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Rhinoviruses (RV) and enteroviruses (EV) are among the main causative etiologies of lower respiratory tract infection (LRTI) in children. The clinical spectrum of RV/EV infection is wide, which could be explained by diverse environmental, pathogen-, and host-related factors. Little is known about the nasopharyngeal microbiota as a risk factor or disease modifier for RV/EV infection in pediatric patients. This study describes distinct nasopharyngeal microbiota profiles according to RV/EV LRTI status in children. METHODS Cross-sectional case-control study, conducted at Hospital Sant de Déu (Barcelona, Spain) from 2017 to 2020. Three groups of children <5 years were included: healthy controls without viral detection (Group A), mild or asymptomatic controls with RV/EV infection (Group B), and cases with severe RV/EV infection admitted to the pediatric intensive care unit (PICU) (Group C). Nasopharyngeal samples were collected from participants for viral DNA/RNA detection by multiplex-polymerase chain reaction and bacterial microbiota characterization by 16S rRNA gene sequencing. RESULTS A total of 104 subjects were recruited (A = 17, B = 34, C = 53). Children's nasopharyngeal microbiota composition varied according to their RV/EV infection status. Richness and diversity were decreased among children with severe infection. Nasopharyngeal microbiota profiles enriched in genus Dolosigranulum were related to respiratory health, while genus Haemophilus was specifically predominant in children with severe RV/EV LRTI. Children with mild or asymptomatic RV/EV infection showed an intermediate profile. CONCLUSIONS These results suggest a close relationship between the nasopharyngeal microbiota and different clinical presentations of RV/EV infection.
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Affiliation(s)
- Daniel Penela-Sánchez
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- Pediatrics Intensive Care Unit, Hospital Sant Joan de Deu, Barcelona, Spain
- Departament de Medicina i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Muntsa Rocafort
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Desiree Henares
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Iolanda Jordan
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- Pediatrics Intensive Care Unit, Hospital Sant Joan de Deu, Barcelona, Spain
- Departament de Medicina i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Brotons
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - María Cabrerizo
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Enterovirus and Viral Gastroenteritis Unit, Centro Nacional de Microbiología, Instituto Carlos III, Madrid, Spain
| | - Cristian Launes
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- Departament de Medicina i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Pediatric Infectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Deu, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
- RDI Microbiology Department, Hospital Sant Joan de Deu, Barcelona, Spain
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5
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Armero G, Penela-Sánchez D, Belmonte J, Gómez-Barroso D, Larrauri A, Henares D, Vallejo V, Jordan I, Muñoz-Almagro C, Brotons P, Launes C. Concentrations of nitrogen compounds are related to severe rhinovirus infection in infants. A time-series analysis from the reference area of a pediatric university hospital in Barcelona. Pediatr Pulmonol 2022; 57:2180-2188. [PMID: 35652447 PMCID: PMC9543680 DOI: 10.1002/ppul.26021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/17/2022] [Accepted: 05/29/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND There is scarce information focused on the effect of weather conditions and air pollution on specific acute viral respiratory infections, such as rhinovirus (RV), with a wide clinical spectrum of severity. OBJECTIVE The aim of this study was to analyze the association between episodes of severe respiratory tract infection by RV and air pollutant concentrations (NOx and SO2 ) in the reference area of a pediatric university hospital. METHODS An analysis of temporal series of daily values of NOx and SO2 , weather variables, circulating pollen and mold spores, and daily number of admissions in the pediatric intensive care unit (PICU) with severe respiratory RV infection (RVi) in children between 6 months and 18 years was performed. Lagged variables for 0-5 days were considered. The study spanned from 2010 to 2018. Patients with comorbidities were excluded. RESULTS One hundred and fifty patients were admitted to the PICU. Median age was 19 months old (interquartile range [IQR]: 11-47). No relationship between RV-PICU admissions and temperature, relative humidity, cumulative rainfall, or wind speed was found. Several logistic regression models with one pollutant and two pollutants were constructed but the best model was that which included average daily NOx concentrations. Average daily NOx concentrations were related with the presence of PICU admissions 3 days later (odds ratio per IQR-unit increase: 1.64, 95% confidence interval: 1.20-2.25)). CONCLUSIONS This study has shown a positive correlation between NOx concentrations at Lag 3 and children's PICU admissions with severe RV respiratory infection. Air pollutant data should be taken into consideration when we try to understand the severity of RVis.
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Affiliation(s)
- Georgina Armero
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Jordina Belmonte
- Botanic Unit of Animal Biology, Vegetal Biology and Ecology Department, Science and Ambiental Technology Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Desiree Henares
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Violeta Vallejo
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Iolanda Jordan
- Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pedro Brotons
- Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristian Launes
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
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6
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Rocafort M, Henares D, Brotons P, Launes C, Fernandez de Sevilla M, Fumado V, Barrabeig I, Arias S, Redin A, Ponomarenko J, Mele M, Millat-Martinez P, Claverol J, Balanza N, Mira A, Garcia-Garcia JJ, Bassat Q, Jordan I, Muñoz-Almagro C. Impact of COVID-19 Lockdown on the Nasopharyngeal Microbiota of Children and Adults Self-Confined at Home. Viruses 2022; 14:v14071521. [PMID: 35891502 PMCID: PMC9315980 DOI: 10.3390/v14071521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 01/25/2023] Open
Abstract
The increased incidence of COVID-19 cases and deaths in Spain in March 2020 led to the declaration by the Spanish government of a state of emergency imposing strict confinement measures on the population. The objective of this study was to characterize the nasopharyngeal microbiota of children and adults and its relation to SARS-CoV-2 infection and COVID-19 severity during the pandemic lockdown in Spain. This cross-sectional study included family households located in metropolitan Barcelona, Spain, with one adult with a previous confirmed COVID-19 episode and one or more exposed co-habiting child contacts. Nasopharyngeal swabs were used to determine SARS-CoV-2 infection status, characterize the nasopharyngeal microbiota and determine common respiratory DNA/RNA viral co-infections. A total of 173 adult cases and 470 exposed children were included. Overall, a predominance of Corynebacterium and Dolosigranulum and a limited abundance of common pathobionts including Haemophilus and Streptococcus were found both among adults and children. Children with current SARS-CoV-2 infection presented higher bacterial richness and increased Fusobacterium, Streptococcus and Prevotella abundance than non-infected children. Among adults, persistent SARS-CoV-2 RNA was associated with an increased abundance of an unclassified member of the Actinomycetales order. COVID-19 severity was associated with increased Staphylococcus and reduced Dolosigranulum abundance. The stringent COVID-19 lockdown in Spain had a significant impact on the nasopharyngeal microbiota of children, reflected in the limited abundance of common respiratory pathobionts and the predominance of Corynebacterium, regardless of SARS-CoV-2 detection. COVID-19 severity in adults was associated with decreased nasopharynx levels of healthy commensal bacteria.
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Affiliation(s)
- Muntsa Rocafort
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
| | - Desiree Henares
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Medicine Department, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
| | - Cristian Launes
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Mariona Fernandez de Sevilla
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Victoria Fumado
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Irene Barrabeig
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Epidemiological Surveillance Unit, Department of Health, Generalitat de Catalunya, 08907 Barcelona, Spain
| | - Sara Arias
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (P.M.-M.); (N.B.)
| | - Alba Redin
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- Medicine Department, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
| | - Julia Ponomarenko
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08003 Barcelona, Spain;
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Maria Mele
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Pere Millat-Martinez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (P.M.-M.); (N.B.)
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
| | - Nuria Balanza
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (P.M.-M.); (N.B.)
| | - Alex Mira
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Department of Health and Genomics, Center for Advanced Research in Public Health, Fundacion para el Fomento de la Investigacion Sanitaria y Biomedica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain
| | - Juan J. Garcia-Garcia
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Quique Bassat
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (P.M.-M.); (N.B.)
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça Maputo 1929, Mozambique
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Deu, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.R.); (D.H.); (P.B.); (C.L.); (M.F.d.S.); (V.F.); (A.R.); (M.M.); (J.C.); (J.J.G.-G.); (I.J.)
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (I.B.); (A.M.); (Q.B.)
- Medicine Department, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
- Correspondence: ; Tel.: +34-673302405; Fax: +34-932803626
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Henares D, Rocafort M, Brotons P, de Sevilla MF, Mira A, Launes C, Cabrera-Rubio R, Muñoz-Almagro C. Rapid Increase of Oral Bacteria in Nasopharyngeal Microbiota After Antibiotic Treatment in Children With Invasive Pneumococcal Disease. Front Cell Infect Microbiol 2021; 11:744727. [PMID: 34712623 PMCID: PMC8546175 DOI: 10.3389/fcimb.2021.744727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction Antibiotics are commonly prescribed to young children for treating bacterial infections such as invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae. Despite the obvious benefits of antibiotics, little is known about their possible side effects on children’s nasopharyngeal microbiota. In other ecological niches, antibiotics have been described to perturb the balanced microbiota with short- and long-term effects on children’s health. The present study aims to evaluate and compare the nasopharyngeal microbiota of children with IPD and different degree of antibiotic exposure. Methods We investigated differences in nasopharyngeal microbiota of two groups of children <18 years with IPD: children not exposed to antibiotics before sample collection (n=27) compared to children previously exposed (n=54). Epidemiological/clinical data were collected from subjects, and microbiota was characterized by Illumina sequencing of V3-V4 amplicons of the 16S rRNA gene. Results Main epidemiological/clinical factors were similar across groups. Antibiotic-exposed patients were treated during a median of 4 days (IQR: 3–6) with at least one beta-lactam (100.0%). Higher bacterial richness and diversity were found in the group exposed to antibiotics. Different streptococcal amplicon sequence variants (ASVs) were differentially abundant across groups: antibiotic use was associated to lower relative abundances of Streptococcus ASV2 and Streptococcus ASV11 (phylogenetically close to S. pneumoniae), and higher relative abundances of Streptococcus ASV3 and Streptococcus ASV12 (phylogenetically close to viridans group streptococci). ASVs assigned to typical bacteria from the oral cavity, including Veillonella, Alloprevotella, Porphyromonas, Granulicatella, or Capnocytophaga, were associated to the antibiotic-exposed group. Common nosocomial genera such as Staphylococcus, Acinetobacter, and Pseudomonas were also enriched in the group exposed to antibiotics. Conclusion Our results point toward a reduction of S. pneumoniae abundance on the nasopharynx of children with IPD after antibiotic treatment and a short-term repopulation of this altered niche by oral and nosocomial bacteria. Future research studies will have to evaluate the clinical implications of these findings and if these populations would benefit from the probiotic/prebiotic administration or even from the improvement on oral hygiene practices frequently neglected among hospitalized children.
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Affiliation(s)
- Desiree Henares
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Muntsa Rocafort
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mariona F de Sevilla
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Pediatric Department, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
| | - Alex Mira
- CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Health and Genomics, Center for Advanced Research in Public Health, Fundacion para el Fomento de la Investigacion Sanitaria y Biomedica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Cristian Launes
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Pediatric Department, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
| | - Raul Cabrera-Rubio
- Teagasc Food Research Centre (TEAGASC), Moorepark, Fermoy, Ireland.,APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
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8
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Henares D, Brotons P, de Sevilla MF, Fernandez-Lopez A, Hernandez-Bou S, Perez-Argüello A, Mira A, Muñoz-Almagro C, Cabrera-Rubio R. Differential nasopharyngeal microbiota composition in children according to respiratory health status. Microb Genom 2021; 7. [PMID: 34699345 PMCID: PMC8627214 DOI: 10.1099/mgen.0.000661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Acute respiratory infections (ARIs) constitute one of the leading causes of antibiotic administration, hospitalization and death among children <5 years old. The upper respiratory tract microbiota has been suggested to explain differential susceptibility to ARIs and modulate ARI severity. The aim of the present study was to investigate the relation of nasopharyngeal microbiota and other microbiological parameters with respiratory health and disease, and to assess nasopharyngeal microbiota diagnostic utility for discriminating between different respiratory health statuses. We conducted a prospective case-control study at Hospital Sant Joan de Deu (Barcelona, Spain) from 2014 to 2018. This study included three groups of children <18 years with gradual decrease of ARI severity: cases with invasive pneumococcal disease (IPD) (representative of lower respiratory tract infections and systemic infections), symptomatic controls with mild viral upper respiratory tract infections (URTI), and healthy/asymptomatic controls according to an approximate case-control ratio 1:2. Nasopharyngeal samples were collected from participants for detection, quantification and serotyping of pneumococcal DNA, viral DNA/RNA detection and 16S rRNA gene sequencing. Microbiological parameters were included on case-control classification models. A total of 140 subjects were recruited (IPD=27, URTI=48, healthy/asymptomatic control=65). Children's nasopharyngeal microbiota composition varied according to respiratory health status and infection severity. The IPD group was characterized by overrepresentation of Streptococcus pneumoniae, higher frequency of invasive pneumococcal serotypes, increased rate of viral infection and underrepresentation of potential protective bacterial species such as Dolosigranulum pigrum and Moraxella lincolnii. Microbiota-based classification models differentiated cases from controls with moderately high accuracy. These results demonstrate the close relationship existing between a child's nasopharyngeal microbiota and respiratory health, and provide initial evidence of the potential of microbiota-based diagnostics for differential diagnosis of severe ARIs using non-invasive samples.
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Affiliation(s)
- Desiree Henares
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mariona F de Sevilla
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Pediatric Department, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | | | | | - Alex Mira
- CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO, Valencia, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.,CIBER Center for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Raul Cabrera-Rubio
- Teagasc Food Research Centre (TEAGASC), Moorepark, Fermoy, Cork, Ireland.,APC Microbiome Institute, University College Cork, County Cork, Ireland
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9
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Penela-Sánchez D, González-de-Audicana J, Armero G, Henares D, Esteva C, de-Sevilla MF, Ricart S, Jordan I, Brotons P, Cabrerizo M, Muñoz-Almagro C, Launes C. Lower Respiratory Tract Infection and Genus Enterovirus in Children Requiring Intensive Care: Clinical Manifestations and Impact of Viral Co-Infections. Viruses 2021; 13:v13102059. [PMID: 34696489 PMCID: PMC8541154 DOI: 10.3390/v13102059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022] Open
Abstract
Infection by rhinovirus (RV) and enterovirus (EV) in children ranges from asymptomatic infection to severe lower respiratory tract infection (LRTI). This cohort study evaluates the clinical impact of RV/EV species, alone or in codetection with other viruses, in young children with severe LRTI. Seventy-one patients aged less than 5 years and admitted to the Paediatric Intensive Care Unit (PICU) of a reference children’s hospital with RV or EV (RV/EV) LRTI were prospectively included from 1/2018 to 3/2020. A commercial PCR assay for multiple respiratory pathogens was performed in respiratory specimens. In 22/71, RV/EV + respiratory syncytial virus (RSV) was found, and 18/71 had RV/EV + multiple viral detections. Patients with single RV/EV detection required invasive mechanical ventilation (IMV) as frequently as those with RSV codetection, whereas none of those with multiple viral codetections required IMV. Species were determined in 60 samples, 58 being RV. No EV-A, EV-C, or EV-D68 were detected. RV-B and EV-B were only found in patients with other respiratory virus codetections. There were not any associations between RV/EV species and severity outcomes. To conclude, RV/EV detection alone was observed in young children with severe disease, while multiple viral codetections may result in reduced clinical severity. Differences in pathogenicity between RV and EV species could not be drawn.
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Affiliation(s)
- Daniel Penela-Sánchez
- Paediatrics Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.P.-S.); (G.A.); (M.-F.d.-S.); (S.R.)
- Paediatrics Intensive Care Unit, Hospital Sant Joan de Déu, 08195 Barcelona, Spain;
| | - Jon González-de-Audicana
- Enterovirus and Viral Gastroenteritis Unit, Centro Nacional de Microbiología, Instituto Carlos III, 28222 Madrid, Spain; (J.G.-d.-A.); (M.C.)
| | - Georgina Armero
- Paediatrics Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.P.-S.); (G.A.); (M.-F.d.-S.); (S.R.)
- Paediatrics Intensive Care Unit, Hospital Sant Joan de Déu, 08195 Barcelona, Spain;
| | - Desiree Henares
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Molecular Microbiology Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Cristina Esteva
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Molecular Microbiology Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain
| | - Mariona-Fernández de-Sevilla
- Paediatrics Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.P.-S.); (G.A.); (M.-F.d.-S.); (S.R.)
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Paediatrics Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Silvia Ricart
- Paediatrics Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.P.-S.); (G.A.); (M.-F.d.-S.); (S.R.)
- Paediatrics Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Iolanda Jordan
- Paediatrics Intensive Care Unit, Hospital Sant Joan de Déu, 08195 Barcelona, Spain;
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Paediatrics Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Pedro Brotons
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - María Cabrerizo
- Enterovirus and Viral Gastroenteritis Unit, Centro Nacional de Microbiología, Instituto Carlos III, 28222 Madrid, Spain; (J.G.-d.-A.); (M.C.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carmen Muñoz-Almagro
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Molecular Microbiology Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Cristian Launes
- Paediatrics Department, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.P.-S.); (G.A.); (M.-F.d.-S.); (S.R.)
- Grupo de Investigación en Enfermedades Infecciosas Pediátricas, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, 08195 Barcelona, Spain; (D.H.); (C.E.); (P.B.); (C.M.-A.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Paediatrics Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08007 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-253-21-00
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10
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Brotons P, Jordan I, Bassat Q, Henares D, Fernandez de Sevilla M, Ajanovic S, Redin A, Fumado V, Baro B, Claverol J, Varo R, Cuadras D, Hecht J, Barrabeig I, Garcia-Garcia JJ, Launes C, Muñoz-Almagro C. The Positive Rhinovirus/Enterovirus Detection and SARS-CoV-2 Persistence beyond the Acute Infection Phase: An Intra-Household Surveillance Study. Viruses 2021; 13:v13081598. [PMID: 34452462 PMCID: PMC8402816 DOI: 10.3390/v13081598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 12/23/2022] Open
Abstract
We aimed to assess the duration of nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA persistence in adults self-confined at home after acute infection; and to identify the associations of SARS-CoV-2 persistence with respiratory virus co-detection and infection transmission. A cross-sectional intra-household study was conducted in metropolitan Barcelona (Spain) during the time period of April to June 2020. Every adult who was the first family member reported as SARS-CoV-2-positive by reverse transcription polymerase chain reaction (RT-PCR) as well as their household child contacts had nasopharyngeal swabs tested by a targeted SARS-CoV-2 RT-PCR and a multiplex viral respiratory panel after a 15 day minimum time lag. Four-hundred and four households (404 adults and 708 children) were enrolled. SARS-CoV-2 RNA was detected in 137 (33.9%) adults and 84 (11.9%) children. Rhinovirus/Enterovirus (RV/EV) was commonly found (83.3%) in co-infection with SARS-CoV-2 in adults. The mean duration of SARS-CoV-2 RNA presence in adults’ nasopharynx was 52 days (range 26–83 days). The persistence of SARS-CoV-2 was significantly associated with RV/EV co-infection (adjusted odds ratio (aOR) 9.31; 95% CI 2.57–33.80) and SARS-CoV-2 detection in child contacts (aOR 2.08; 95% CI 1.24–3.51). Prolonged nasopharyngeal SARS-CoV-2 RNA persistence beyond the acute infection phase was frequent in adults quarantined at home during the first epidemic wave; which was associated with RV/EV co-infection and could enhance intra-household infection transmission.
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Affiliation(s)
- Pedro Brotons
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
| | - Iolanda Jordan
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Quique Bassat
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça 1929, Mozambique
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (B.B.); (R.V.)
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| | - Desiree Henares
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
| | - Mariona Fernandez de Sevilla
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Sara Ajanovic
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (B.B.); (R.V.)
| | - Alba Redin
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
| | - Vicky Fumado
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Pediatrics Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Barbara Baro
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (B.B.); (R.V.)
| | - Joana Claverol
- Clinical Research Unit, Fundació Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (J.C.); (D.C.)
| | - Rosauro Varo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain; (S.A.); (B.B.); (R.V.)
| | - Daniel Cuadras
- Clinical Research Unit, Fundació Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (J.C.); (D.C.)
| | - Jochen Hecht
- Centre for Genomic Regulation (CRG), Genomics Unit, 08003 Barcelona, Spain;
| | - Irene Barrabeig
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Epidemiological Surveillance Unit, Department of Health, Generalitat de Catalunya, 08907 Barcelona, Spain
| | - Juan Jose Garcia-Garcia
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Cristian Launes
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Pediatrics Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (P.B.); (I.J.); (D.H.); (M.F.d.S.); (A.R.); (V.F.); (J.J.G.-G.); (C.L.)
- Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Sant Cugat, 08195 Barcelona, Spain
- Consorcio de Investigacion Biomédica en Red Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain; (Q.B.); (I.B.)
- Department of Molecular Epidemiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
- Correspondence:
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11
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Brotons P, Launes C, Buetas E, Fumado V, Henares D, de Sevilla MF, Redin A, Fuente-Soro L, Cuadras D, Mele M, Jou C, Millat P, Jordan I, Garcia-Garcia JJ, Bassat Q, Muñoz-Almagro C. Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Children and Adults: A Seroprevalence Study of Family Households in the Barcelona Metropolitan Region, Spain. Clin Infect Dis 2021; 72:e970-e977. [PMID: 33180914 PMCID: PMC7717181 DOI: 10.1093/cid/ciaa1721] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023] Open
Abstract
Background Susceptibility of children and adults to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and persistence of antibody response to the virus after infection resolution remain poorly understood, despite their significant public health implications. Methods A prospective cross-sectional seroprevalence study with volunteer families that included at least 1 first-reported adult case positive by SARS-CoV-2 by polymerase chain reaction (PCR) and at least 1 child aged <15 years living in the same household under strict home confinement was conducted in the metropolitan Barcelona Health Region, Spain, during the pandemic period 28 April 2020–3 June 2020. All household members were tested at home using a rapid SARS-CoV-2 antibody assay with finger prick–obtained capillary blood. Results A total of 381 family households including 381 first-reported PCR-positive adult cases and 1084 contacts (672 children, 412 adults) were enrolled. SARS-CoV-2 seroprevalence rates were 17.6% (118 of 672) in children and 18.7% (77 of 335) in adult contacts (P = .64). Among first-reported cases, seropositivity rates varied from 84.0% in adults previously hospitalized and tested within 6 weeks since the first positive PCR result to 31.5% in those not hospitalized and tested after that lag time (P < .001). Nearly all (99.9%) positive children were asymptomatic or had mild symptoms. Conclusions Children appear to have similar probability as adults to become infected by SARS-CoV-2 in quarantined family households but remain largely asymptomatic. Adult antibody protection against SARS-CoV-2 seems to be weak beyond 6 weeks post-infection confirmation, especially in cases that have experienced mild disease.
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Affiliation(s)
- Pedro Brotons
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Cristian Launes
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Elena Buetas
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - Vicky Fumado
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Desiree Henares
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Mariona Fernandez de Sevilla
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Alba Redin
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain
| | | | - Daniel Cuadras
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - Maria Mele
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Cristina Jou
- Department of Pathology and Biobank, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - Pere Millat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Juan Jose Garcia-Garcia
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Quique Bassat
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats, Pg. Lluís Companys 23, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Deu, Esplugues, Barcelona, Spain
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12
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Jullien S, Sharma R, Lhamu Mynak M, Henares D, Muñoz-Almagro C, Bassat Q. Pneumococcal nasopharyngeal carriage among Bhutanese children hospitalized with clinical pneumonia: serotypes and viral co-infection. BMC Infect Dis 2020; 20:940. [PMID: 33297987 PMCID: PMC7725031 DOI: 10.1186/s12879-020-05674-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/30/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Pneumococcal nasopharyngeal colonization (PNC) generally precedes pneumococcal disease. The purpose of this study was to determine the prevalence of PNC and to identify the pneumococcal serotypes circulating among Bhutanese children under five years of age admitted with clinical pneumonia, before the introduction of pneumococcal conjugate vaccine (PCV13) in the country. We also aimed to contribute to the understanding of the interplay between PNC and viral co-infection among this population. METHODS This was a prospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital in Bhutan over 12 consecutive months. Children aged 2 to 59 months admitted with WHO-defined clinical pneumonia were eligible for recruitment. We collected blood for bacterial culture and molecular identification of S. pneumoniae, and nasopharyngeal washing for screening of respiratory viruses, and for the detection and capsular typing of S. pneumoniae by real-time polymerase chain reaction (RT-PCR). RESULTS Overall, 189 children were recruited, and PNC was tested in 121 of them (64.0%). PNC was found in 76/121 children (62.8%) and S. pneumoniae was identified in blood (both by culture and RT-PCR) in a single child. Respiratory viruses were detected in a similar proportion among children with (62/70; 88.6%) and without PNC (36/40; 90.0%; p = 1.000), but rhinovirus detection was less common among children with PNC (20/70; 28.6% versus 19/40; 47.5%; p = 0.046). Capsular typing identified 30 different serotypes. Thirty-nine children (51.3%) were colonised with two to five different serotypes. A third of the children presented with serotypes considered highly invasive. Over half of the children (44/76; 57.9%) were carrying at least one serotype included in PCV13. CONCLUSIONS This study provides baseline information on the status of PNC among Bhutanese children admitted with clinical pneumonia prior to the introduction of PCV13, which is valuable to monitor its potential impact. PCV13 could theoretically have averted up to 58% of the pneumococcal infections among the children in this study, suggesting a future role for the vaccine to significantly reduce the burden associated with S. pneumoniae in Bhutan.
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Affiliation(s)
- Sophie Jullien
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain. .,Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
| | - Ragunath Sharma
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Mimi Lhamu Mynak
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Desiree Henares
- Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Instituto de Recerca Pediatrica, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain.,Department of Medicine, Universitat Internacional of Catalunya, Barcelona, Spain
| | - Quique Bassat
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.,CIBER of Epidemiology and Public Health CIBERESP, Madrid, Spain.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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13
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Garcia-Garcia S, Perez-Arguello A, Henares D, Timoneda N, Muñoz-Almagro C. Rapid identification, capsular typing and molecular characterization of Streptococcus pneumoniae by using whole genome nanopore sequencing. BMC Microbiol 2020; 20:347. [PMID: 33187472 PMCID: PMC7666501 DOI: 10.1186/s12866-020-02032-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whole genome sequencing has emerged as a useful tool for identification and molecular characterization of pathogens. MinION (Oxford Nanopore) is a real-time third generation sequencer whose portability, affordability and speed in data production make of it an attractive device for whole genome sequencing. The objective of this study is to evaluate MinION sequencer for pathogen identification and molecular characterization of Streptococcus pneumoniae isolated at a children's Hospital. Whole genome sequencing of 32 Streptococcus pneumoniae invasive isolates, previously characterized by standard methods (Quellung reaction, Multiplex PCR and Sanger-MLST), were performed. DNA was extracted using ZymoBIOMICS DNA Microprep kit. Quantification and purity of DNA was assessed by Qubit and Nanodrop, respectively. Library preparation was performed using the Rapid Barcoding Kit. Real-time workflow EPI2ME platform "What's it in my pot" was used for species identification. Fast5 sequences were converted into FASTQ by Albacore software. Reads were assembled using CANU software. PathogenWatch, genomic epidemiology and pubmlst online tools were used for capsular typing and/or whole genome-MLST profile. RESULTS Rapid identification of Streptococcus pneumoniae was achieved by "What's in my pot". Capsular typing was correctly assigned with PathogenWatch in all 32 isolates at serogroup level and 24 at serotype level. Whole genome-MLST results obtained by genomic epidemiology and pubmlst were consistent with double locus variant clonal complex obtained by Sanger-MLST in 31 isolates. CONCLUSION MinION sequencer provides a rapid, cost-effective and promising pathway for performing WGS by a pocked-sized device for epidemiological purposes but improving its sequencing accuracy will make it more appealing to be used in clinical microbiology laboratories.
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Affiliation(s)
- S Garcia-Garcia
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain.
| | - A Perez-Arguello
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain
| | - D Henares
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain
- CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - N Timoneda
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain
- CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - C Muñoz-Almagro
- Institut de Recerca Sant Joan de Deu, Hospital Sant Joan de Deu, Barcelona, Spain
- CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
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14
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Melé M, Henares D, Pino R, Asenjo S, Matamoros R, Fumadó V, Fortuny C, García-García JJ, Jordan I, Brotons P, Muñoz-Almagro C, de-Sevilla MF, Launes C. Low impact of SARS-CoV-2 infection among paediatric acute respiratory disease hospitalizations. J Infect 2020; 82:414-451. [PMID: 33098956 PMCID: PMC7577222 DOI: 10.1016/j.jinf.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022]
Abstract
Objective This study describes the characteristics of children requiring admission with an acute lower-respiratory disease (ALRD) during the SARS-CoV-2 pandemics. Methods Epidemiological, clinical, and microbiological data from patients with ALRD (pneumonia, bronchiolitis, bronchospasm) admitted to a reference paediatric hospital in Spain during the pandemic peak (week 11–20/2020) were prospectively analysed. Results 110 patients were included. 7 were SARS-CoV-2(+) and they were older in comparison to SARS-CoV-2(-). Among SARS-CoV-2(+) patients, pneumonia was the main clinical diagnosis (6/7) and bronchospasm was absent. Only 1 of 29 infants diagnosed with bronchiolitis was SARS-CoV-2(+). Lower values of leucocytes, lymphocytes, neutrophils, and platelets and higher values of creatinine were found in SARS-CoV-2(+). Human-rhinovirus/enterovirus was the main detection (11/32). There were not differences in PICU admission rates between SARS-CoV-2(+) and (-). Conclusions Most of the ALRD episodes identified during the pandemics were not related to SARS-CoV-2 infection. SARS-CoV-2 was mainly found causing pneumonia in older children.
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Affiliation(s)
- Maria Melé
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | | | - Rosa Pino
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | - Silvia Asenjo
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | - Rocío Matamoros
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | - Victoria Fumadó
- Paediatric Infectious Diseases Department, HSJD, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Claudia Fortuny
- Paediatric Infectious Diseases Department, HSJD, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Juan-José García-García
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iolanda Jordan
- University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Paediatric Intensive Care Unit, HSJD, Barcelona, Spain
| | - Pedro Brotons
- Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Paediatric Intensive Care Unit, HSJD, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Molecular Microbiology Department, HSJD, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mariona-Fernández de-Sevilla
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristian Launes
- Paediatrics Department, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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15
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Ciruela P, Broner S, Izquierdo C, Pallarés R, Muñoz-Almagro C, Hernández S, Grau I, Domínguez A, Jané M, Ciruela P, Izquierdo C, Broner S, Hernández S, Jané M, Muñoz-Almagro C, Esteva C, de Sevilla M, Henares D, Pallarés R, Ardanuy C, Grau I, Marco F, Margall N, González-Cuevas A, Díaz A, Martin M, Llaberia J, Curriu M, Gallés C, Capdevila E, Gassiot P, Martínez-Zurita M, Martí C, Morta M, Sauca G, Gassós A, Sanfeliu E, Ballester F, Pujol I, Olsina M, Raga X, Gómez-Bertomeu F, Pérez-Moreno M, Vilamala A, Navarro M, Ribelles M, Garcia M, Padilla E, Prim N, Fontanals D, Sanfeliu I, Benitez M, Jou E, Sanjosé C, Giménez M, Quesada M, de la Fuente J, Calderon A, Ayala P, Vega L, Pérez-Jové J, Blanco A, Balado C, Valle I, Bastida M, Gonzalez-Moreno O, Ubanell A, Fenoll A, Yuste J. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults. Int J Infect Dis 2019; 86:122-130. [DOI: 10.1016/j.ijid.2019.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 12/29/2022] Open
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16
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Brotons P, Bassat Q, Lanaspa M, Henares D, Perez-Arguello A, Madrid L, Balcells R, Acacio S, Andres-Franch M, Marcos MA, Valero-Rello A, Muñoz-Almagro C. Nasopharyngeal bacterial load as a marker for rapid and easy diagnosis of invasive pneumococcal disease in children from Mozambique. PLoS One 2017; 12:e0184762. [PMID: 28910402 PMCID: PMC5599037 DOI: 10.1371/journal.pone.0184762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Current diagnostic methods for detection of Streptococcus pneumoniae in children with suspected invasive pneumococcal disease have limitations of accuracy, timeliness, and patient convenience. This study aimed to determine the performance of pneumococcal load quantified with a real-time polymerase-chain reaction in nasopharyngeal samples to diagnose invasive pneumococcal disease in children. METHODS Matched case-control study of patients <5 years of age with invasive pneumococcal disease admitted to the Manhiça District Hospital (Mozambique) and asymptomatic controls recruited in different periods between 2006 and 2014. Cases were confirmed by a positive bacterial culture for S. pneumoniae in blood or cerebrospinal fluid. Nasopharyngeal aspirates were collected from cases and controls and pneumococcal density was quantified by lytA real-time polymerase-chain reaction. RESULTS Thirty cases (median age 12.8 months) and sixty controls (median age 11.7 months) were enrolled and 70% of them were male. Nasopharyngeal pneumococcal carriage was high in both groups: 28/30 (93.3%) for cases vs. 53/60 (88.3%) for controls (p = 0.71). Mean nasopharyngeal pneumococcal load was identified as a marker for invasive pneumococcal disease (7.0 log10 copies/mL in cases vs. 5.8 log10 copies/mL in controls, p<0.001) and showed good discriminatory power (AUC-ROC: 82.1%, 95% CI 72.5%-91.8%). A colonization density of 6.5 log10 copies/mL was determined as the optimal cut-off value to distinguish cases from controls (sensitivity 75.0%, specificity 73.6%). CONCLUSION Use of non-invasive nasopharyngeal aspirates coupled with rapid and accurate quantification of pneumococcal load by real-time polymerase chain reaction has the potential to become a useful surrogate marker for early diagnosis of invasive pneumococcal disease in children.
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Affiliation(s)
- Pedro Brotons
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Quique Bassat
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
- Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Deu (University of Barcelona), Barcelona, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Miguel Lanaspa
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
| | - Desiree Henares
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
| | - Amaresh Perez-Arguello
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
| | - Lola Madrid
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
| | | | | | - Maria Andres-Franch
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Angeles Marcos
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Ana Valero-Rello
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Molecular Microbiology Department, Institut de Recerca Sant Joan de Déu, University Hospital Sant Joan de Déu, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
- * E-mail:
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17
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Henares D, Brotons P, Buyse X, Latorre I, de Paz HD, Muñoz-Almagro C. Evaluation of the eazyplex MRSA assay for the rapid detection of Staphylococcus aureus in pleural and synovial fluid. Int J Infect Dis 2017; 59:65-68. [PMID: 28450195 DOI: 10.1016/j.ijid.2017.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/07/2017] [Accepted: 04/13/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Loop-mediated isothermal amplification (LAMP) is a simple and sensitive technique for rapid microbiological diagnosis. The aim of this study was to evaluate the analytical and diagnostic performance of the LAMP eazyplex MRSA test for the direct detection and differentiation of methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in synovial/pleural fluid. METHODS Analytical validation included the determination of the limit of detection (LoD) and analytical specificity of the eazyplex MRSA test. A diagnostic evaluation of the eazyplex test against bacterial culture was performed on routine pleural/synovial samples collected prospectively from patients aged less than 18 years with complicated pneumonia with empyema or arthritis admitted to the Children's Hospital Sant Joan de Déu in Barcelona, Spain, between April 2015 and May 2016. RESULTS The new system appropriately detected a quality control panel of clinical samples with DNA of MSSA, MRSA, and other pathogens. The LoD was established at 6.4×103 CFU/ml for S. aureus and 1.0×104 CFU/ml for MRSA. Diagnostic validation of the eazyplex MRSA assay was performed on 51 prospective clinical invasive samples, resulting in sensitivity and specificity values of 83.3% and 97.8%, respectively, for S. aureus detection. The mean turnaround time was 70min. CONCLUSIONS The eazyplex MRSA assay was found to be a useful test for the rapid detection of S. aureus in invasive samples such as pleural/synovial fluid.
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Affiliation(s)
- D Henares
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - P Brotons
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - X Buyse
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - I Latorre
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; Institut d'Investigació Germans Trias i Pujol, Badalona, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - H D de Paz
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - C Muñoz-Almagro
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Internacional de Catalunya, School of Medicine, Barcelona, Spain.
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18
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Brotons P, Henares D, Latorre I, Cepillo A, Launes C, Muñoz-Almagro C. Comparison of NxTAG Respiratory Pathogen Panel and Anyplex II RV16 Tests for Multiplex Detection of Respiratory Pathogens in Hospitalized Children. J Clin Microbiol 2016; 54:2900-2904. [PMID: 27629904 PMCID: PMC5121377 DOI: 10.1128/jcm.01243-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/22/2016] [Indexed: 12/21/2022] Open
Abstract
Multiplex molecular techniques can detect a diversity of respiratory viruses and bacteria that cause childhood acute respiratory infection rapidly and conveniently. However, currently available techniques show high variation in performance. We sought to compare the diagnostic accuracy of the novel multiplex NxTAG respiratory pathogen panel (RPP) RUO test versus a routine multiplex Anyplex II RV16 assay in respiratory specimens collected from children <18 years of age hospitalized with nonspecific symptoms of acute lower respiratory infection. Parallel testing was performed on nasopharyngeal aspirates prospectively collected at referral Children's Hospital Sant Joan de Déu (Barcelona, Spain) between June and November 2015. Agreement values between the two tests and kappa coefficients were assessed. Bidirectional sequencing was performed for the resolution of discordant results. A total of 319 samples were analyzed by both techniques. A total of 268 (84.0%) of them yielded concordant results. Positive percent agreement values ranged from 83.3 to 100%, while the negative percent agreement was more than 99% for all targets except for enterovirus/rhinovirus (EV/RV; 94.4%). Kappa coefficients ranged from 0.83 to 1.00. Discrepancy analysis confirmed 66.0% of NxTAG RPP RUO results. A total of 260 viruses were detected, with EV/RV (n = 105, 40.4%) being the most prevalent target. Viral coinfections were found in 44 (14.2%) samples. In addition, NxTAG RPP RUO detected single bacterial and mixed viral-bacterial infections in seven samples. NxTAG RPP RUO showed high positive and negative agreement with Anyplex II RV16 for main viruses that cause acute respiratory infections in children, coupled with an additional capability to detect some respiratory bacteria.
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Affiliation(s)
- Pedro Brotons
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP Epidemiologia y Salud Pública, Madrid, Spain
| | - Desiree Henares
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Irene Latorre
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- Institut d'Investigació Germans Trias i Pujol, CIBERES Enfermedades Respiratorias, Badalona, Spain
| | - Antonio Cepillo
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristian Launes
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP Epidemiologia y Salud Pública, Madrid, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP Epidemiologia y Salud Pública, Madrid, Spain
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Montero R, Yubero D, Villarroya J, Henares D, Jou C, Rodríguez MA, Ramos F, Nascimento A, Ortez CI, Campistol J, Perez-Dueñas B, O'Callaghan M, Pineda M, Garcia-Cazorla A, Oferil JC, Montoya J, Ruiz-Pesini E, Emperador S, Meznaric M, Campderros L, Kalko SG, Villarroya F, Artuch R, Jimenez-Mallebrera C. GDF-15 Is Elevated in Children with Mitochondrial Diseases and Is Induced by Mitochondrial Dysfunction. PLoS One 2016; 11:e0148709. [PMID: 26867126 PMCID: PMC4750949 DOI: 10.1371/journal.pone.0148709] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/20/2016] [Indexed: 02/04/2023] Open
Abstract
Background We previously described increased levels of growth and differentiation factor 15 (GDF-15) in skeletal muscle and serum of patients with mitochondrial diseases. Here we evaluated GDF-15 as a biomarker for mitochondrial diseases affecting children and compared it to fibroblast-growth factor 21 (FGF-21). To investigate the mechanism of GDF-15 induction in these pathologies we measured its expression and secretion in response to mitochondrial dysfunction. Methods We analysed 59 serum samples from 48 children with mitochondrial disease, 19 samples from children with other neuromuscular diseases and 33 samples from aged-matched healthy children. GDF-15 and FGF-21 circulating levels were determined by ELISA. Results Our results showed that in children with mitochondrial diseases GDF-15 levels were on average increased by 11-fold (mean 4046pg/ml, 1492 SEM) relative to healthy (350, 21) and myopathic (350, 32) controls. The area under the curve for the receiver-operating-characteristic curve for GDF-15 was 0.82 indicating that it has a good discriminatory power. The overall sensitivity and specificity of GDF-15 for a cut-off value of 550pg/mL was 67.8% (54.4%-79.4%) and 92.3% (81.5%-97.9%), respectively. We found that elevated levels of GDF-15 and or FGF-21 correctly identified a larger proportion of patients than elevated levels of GDF-15 or FGF-21 alone. GDF-15, as well as FGF-21, mRNA expression and protein secretion, were significantly induced after treatment of myotubes with oligomycin and that levels of expression of both factors significantly correlated. Conclusions Our data indicate that GDF-15 is a valuable serum quantitative biomarker for the diagnosis of mitochondrial diseases in children and that measurement of both GDF-15 and FGF-21 improves the disease detection ability of either factor separately. Finally, we demonstrate for the first time that GDF-15 is produced by skeletal muscle cells in response to mitochondrial dysfunction and that its levels correlate in vitro with FGF-21 levels.
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Affiliation(s)
- Raquel Montero
- Clinical Biochemistry Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
| | - Delia Yubero
- Clinical Biochemistry Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
| | - Joan Villarroya
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Biochemistry and Molecular Biology Department, Biomedical Institute University of Barcelona (IBUB), Center for Biomedical Research on Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Desiree Henares
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Cristina Jou
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Pathology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Maria Angeles Rodríguez
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Federico Ramos
- Neuropaediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Andrés Nascimento
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Carlos Ignacio Ortez
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Jaume Campistol
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuropaediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Belen Perez-Dueñas
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuropaediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mar O'Callaghan
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuropaediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mercedes Pineda
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
| | - Angeles Garcia-Cazorla
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuropaediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jaume Colomer Oferil
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Julio Montoya
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Department, University of Zaragoza, Zaragoza, Spain
| | - Eduardo Ruiz-Pesini
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Department, University of Zaragoza, Zaragoza, Spain
- Fundación ARAID, Universidad de Zaragoza, Zaragoza, Spain
| | - Sonia Emperador
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Biochemistry and Molecular Biology Department, University of Zaragoza, Zaragoza, Spain
| | - Marija Meznaric
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Laura Campderros
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Biochemistry and Molecular Biology Department, Biomedical Institute University of Barcelona (IBUB), Center for Biomedical Research on Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Susana G. Kalko
- Bioinformatics Core Facility, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Francesc Villarroya
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Biochemistry and Molecular Biology Department, Biomedical Institute University of Barcelona (IBUB), Center for Biomedical Research on Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Rafael Artuch
- Clinical Biochemistry Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
| | - Cecilia Jimenez-Mallebrera
- Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Pediatric Research Sant Joan de Déu, Barcelona, Spain
- Neuromuscular Unit, Neuropaediatrics Department, Hospital Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- * E-mail:
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