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Parikh KS, Fuleihan A, Acharya S, Sathi T, Hasan T, Yao KH, Yazdi Y. Health Care Innovation for Low-Resource Settings: The Value of Local Immersion and Partnership. IEEE Pulse 2024; 15:9-14. [PMID: 38619927 DOI: 10.1109/mpuls.2024.3370429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Health Care Innovation is the creation, development, and translation of new and better solutions to health care challenges. At its core, this endeavor does not require extending the frontiers of science or the creation of new fundamental technologies. Rather, it is primarily focused on the use of existing science and established technologies in the design of new solutions to problems in health care. Successfully innovating for low- and middle-income countries (LMICs) requires a needs and stakeholder-driven approach to enable development and adoption of available, accessible, and acceptable solutions tailored to the specific need and context of care.
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Guo LY, Li Y, Zhu L, Dong F, Ji YQ, Yao KH, Gang L. The First Community-acquired Klebsiella variicola Bacterial Meningitis Identified by Metagenomic Next Generation Sequencing. Pediatr Infect Dis J 2023; 42:e186-e188. [PMID: 36795558 DOI: 10.1097/inf.0000000000003851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- Ling-Yun Guo
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Beijing, China
| | - Yue Li
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Liang Zhu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Beijing, China
| | - Fang Dong
- Department of Clinical Microbiology Laboratory, Beijing Children's Hospital, Capital Medical University National Center for Children's Health, Beijing, China
| | - Yuan-Qi Ji
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Kai-Hu Yao
- MOE Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Liu Gang
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Beijing, China
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Yao KH, Guo MY, Lai Y, Deng JH. [Paying attention to the epidemic of group A Streptococcus infections in multiple European and American countries]. Zhongguo Dang Dai Er Ke Za Zhi 2023; 25:333-338. [PMID: 37073835 PMCID: PMC10120339 DOI: 10.7499/j.issn.1008-8830.2302013] [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] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/10/2023] [Indexed: 04/20/2023]
Abstract
At the end of 2022, the World Health Organization reported an increase in group A Streptococcus (GAS) infections, such as scarlet fever, in multiple countries. The outbreak primarily affected children under 10 years old, and the number of deaths was higher than anticipated, causing international concern. This paper reviews the current state of the GAS disease outbreak, its causes, and response measures. The authors aim to draw attention from clinical workers in China and increase their awareness and vigilance regarding this epidemic. Healthcare workers should be aware of the potential epidemiological changes in infectious diseases that may arise after the optimization of control measures for coronavirus disease 2019 to ensure children's health.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health (Capital Medical University)/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Meng-Yang Guo
- National Center for Children's Health (Capital Medical University)/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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N'Dah KJ, Tia WM, Lagou DA, Guei MC, Abouna AD, Touré I, Oka KH, Kobenan A, Diopo S, Delma S, Cherif I, Amékoudi E, Ouattara BS, Yao KH, Ackoundou NC, Adonis KL, Yao GV, Gnionsahié DA, Diomandé M. Kidney biopsy in subsaharan Africa. Nephrol Ther 2023; 19:99-108. [PMID: 37098711 DOI: 10.1684/ndt.2023.9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Kidney biopsy (KB) is a significant advance in the management of nephropathies. In sub-Saharan Africa, few studies have been carried out. The objective of our study was to evaluate the indication, to determine the epidemiological and histological characteristics of the nephropathies diagnosed in sub-Saharan Africa. Materials and methods We carried out a retrospective and descriptive study on biopsies examined between January 2015 and December 2019, in the pathological departments of University Teaching Hospital of Bouaké and Cocody-Abidjan. The KB came from four countries (Côte d'Ivoire, Togo, Guinea-Conakry and Burkina Faso). Optical microscopy and/or direct immunofluorescence techniques were used. All biopsy samples including epidemiological, clinical and pathological data and an optical microscopy and/or direct immunofluorescence study were included. The parameters studied were indications for KB, epidemiological profile, clinic, proteinuria and pathological aspects. Results Over the study period, we collected 179 KB, i.e. 35.8 KB/year. The mean age of the patients was 32.9 ±13.8 years (range 11-70 years). The sex ratio (M/F) was 1.03. Pure nephrotic syndrome was the main indication (64.2 %, n = 115) for KB, followed by impure nephrotic syndrome (11.7 %, n = 21), acute renal failure (ARF) (7.8 %, n = 14) and rapidly progressive glomerulonephritis (RPGN) (7.8 %, n = 14). Glomerulonephritis (GN) occurred in 86 % (n = 158), vascular nephropathy in 11.7 % (n = 21) and tubulointerstitial nephritis in 2.2 % (n = 4). The nephropathies were preferentially focal segmental glomerulosclerosis (34.6 %, n = 62), nephroangiosclerosis (10.6 %, n = 19), membranous GN (10 %, n = 18), post-infectious GN (8.9 %, n = 16) and lupus GN (7.3 %, n = 13). Conclusion The KB is an essential step in the diagnosis of nephropathies. Focal segmental glomerulosclerosis is frequent in our study. The establishment of a Kidney registry would allow better knowledge of renal pathologies in sub-Saharan Africa.
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Affiliation(s)
- K J N'Dah
- CHU de Bouaké, service d’anatomie et cytologie pathologiques, Bouaké, Côte d’Ivoire
| | - W M Tia
- CHU de Bouaké, service de néphrologie, Bouaké, Côte d’Ivoire
| | - D A Lagou
- CHU de Yopougon, service de néphrologie, Abidjan, Côte d’Ivoire
| | - M C Guei
- CHU de Yopougon, service de néphrologie, Abidjan, Côte d’Ivoire
| | - A D Abouna
- CHU de Cocody, service d’anatomie et cytologie pathologiques, Abidjan, Côte d’Ivoire
| | - I Touré
- CHU de Bouaké, service d’anatomie et cytologie pathologiques, Bouaké, Côte d’Ivoire
| | - K H Oka
- CHU de Bouaké, service d’anatomie et cytologie pathologiques, Bouaké, Côte d’Ivoire
| | - Aar Kobenan
- CHU de Bouaké, service d’anatomie et cytologie pathologiques, Bouaké, Côte d’Ivoire
| | - S Diopo
- CHU de Treichville, service de néphrologie, Abidjan, Côte d’Ivoire
| | - S Delma
- CHU Blaise Compaoré, service de néphrologie, Ouagadougou, Burkina Faso
| | - I Cherif
- CHU Donka, service de néphrologie, Conakry, Guinée
| | - E Amékoudi
- CHU Sylvanus Olympio, service de néphrologie, Lomé, Togo
| | - B S Ouattara
- CHU de Cocody, service d’anatomie et cytologie pathologiques, Abidjan, Côte d’Ivoire
| | - K H Yao
- CHU de Treichville, service de néphrologie, Abidjan, Côte d’Ivoire
| | - N C Ackoundou
- CHU de Yopougon, service de néphrologie, Abidjan, Côte d’Ivoire
| | - K L Adonis
- CHU de Yopougon, service de néphropédiatrie, Abidjan, Côte d’Ivoire
| | - G V Yao
- CHU de Bouaké, service d’anatomie et cytologie pathologiques, Bouaké, Côte d’Ivoire
| | - D A Gnionsahié
- CHU de Bouaké, service de néphrologie, Bouaké, Côte d’Ivoire
| | - Mijm Diomandé
- CHU de Cocody, service d’anatomie et cytologie pathologiques, Abidjan, Côte d’Ivoire
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Guo MY, Shi XH, Gao W, Tian JL, Yuan L, Yang J, Wumaier D, Cao J, Abulimiti R, Zhang WL, Yao KH. The dynamic change of serotype distribution and antimicrobial resistance of pneumococcal isolates since PCV13 administration and COVID-19 control in Urumqi, China. Front Cell Infect Microbiol 2023; 13:1110652. [PMID: 36844410 PMCID: PMC9951612 DOI: 10.3389/fcimb.2023.1110652] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
Objective This study aims to analyze the serotype distribution and drug resistance of Streptococcus pneumoniae isolated from children aged 8 days to 7 years in Urumqi, China, between 2014 to 2021, during which PCV13 was introduced in the private sector's immunization program and COVID-19 control was administrated in the last 2 years. Methods Serotypes of S. pneumoniae isolates were determined by Quellung reaction, and their susceptibility against 14 antimicrobials were tested. According to the start year of PCV13 administration (2017) and COVID-19 control (2020), the study period was divided into three stages: 2014-2015, 2018-2019, and 2020-2021. Results A total of 317 isolates were involved in this study. The most common serotypes were type 19F (34.4%), followed by 19A (15.8%), 23F (11.7%), 6B (11.4%), and 6A(5.0%). The coverage rate of both PCV13 and PCV15 was 83.0%. The coverage of PCV20 was a little higher at 85.2%. The resistance rate against penicillin was 28.6% according to the breakpoints of oral penicillin, which would reach up to 91.8% based on the breakpoints of parenteral penicillin for meningitis. The resistance rates to erythromycin, clindamycin, tetracycline, and sulfamethoxazole-trimethoprim were 95.9%, 90.2%, 88.9%, and 78.8%, respectively. The PCV13 isolate was more resistant to penicillin than the non-PCV13 ones. There was not any significant change found in the serotype distribution since the PCV13 introduction and the COVID-19 control. The resistance rate against oral penicillin slightly elevated to 34.5% in 2018-2019 from 30.7% in 2014-2015 and then decreased significantly to 18.1% in 2020-2021 (χ 2 = 7.716, P < 0.05), while the resistance rate to ceftriaxone (non-meningitis) continuously declined from 16.0% in 2014-2015 to 1.4% in 2018-2019 and 0% in 2020-2021 (Fisher = 24.463, P < 0.01). Conclusion The common serotypes of S. pneumoniae isolated from children in Urumqi were types 19F, 19A, 23F, 6B, and 6A, which we found to have no marked change since the PCV13 introduction and the COVID-19 control However, the resistance rate to oral penicillin and ceftriaxone significantly declined in the COVID-19 control stage.
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Affiliation(s)
- Meng-Yang Guo
- Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Xing-Hai Shi
- Medical Laboratory, Urumqi Children’s Hospital, Beijing, China
| | - Wei Gao
- Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Ju-Ling Tian
- Medical Laboratory, Urumqi Children’s Hospital, Beijing, China
| | - Lin Yuan
- Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Juan Yang
- Medical Laboratory, Urumqi Children’s Hospital, Beijing, China
| | | | - Jiang Cao
- Medical Laboratory, Urumqi Children’s Hospital, Beijing, China
| | | | - Wen-Li Zhang
- Medical Laboratory, Urumqi Children’s Hospital, Beijing, China,*Correspondence: Wen-Li Zhang, ; Kai-Hu Yao,
| | - Kai-Hu Yao
- Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China,*Correspondence: Wen-Li Zhang, ; Kai-Hu Yao,
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Yao KH. [Interpretation of "Clinical Considerations for Monkeypox in Children and Adolescents" released by the US Centers for Disease Control and Prevention]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:1078-1084. [PMID: 36305106 PMCID: PMC9628006 DOI: 10.7499/j.issn.1008-8830.2208118] [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] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
In order to cope with monkeypox in children and adolescents, the US Centers for Disease Control and Prevention released "Clinical Considerations for Monkeypox in Children and Adolescents", which is specially written for pediatric health workers serving children and adolescents under the age of 18 years to standardize the clinical management of children and adolescents with exposure to monkeypox (human monkeypox or animal monkeypox) or with suspected or confirmed monkeypox. This document highlights the characteristics of children and adolescents and gives some valuable suggestions to the special issues in pediatric clinical practice, and it is worth studying by pediatric health workers who are preparing for a possible epidemic of monkeypox.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Yao KH, Hu YH, Yuan L. [Clinical features and epidemiological significance of pertussis in infants]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:955-959. [PMID: 36111710 PMCID: PMC9495244 DOI: 10.7499/j.issn.1008-8830.2205033] [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] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Infantile pertussis is clear evidence for the persistent transmission of pertussis in communities. Infants are the most vulnerable population for pertussis infection and are also important nodes in pertussis transmission networks in communities, and therefore, the prevention of infantile pertussis is the core of prevention and control measures against pertussis including vaccine immunization. Although the cases of pertussis reported in China are mainly infants with pertussis, the actual number of infants with pertussis might be higher than the reported number. It is necessary in clinical practice to improve the awareness of this disease and promote related laboratory tests. On the basis of emphasizing the identification of pertussis in infants, timely diagnosis and treatment, follow-up visits, and standard management of the close contacts of infants with pertussis should be performed to reduce and block the community transmission of pertussis.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Ya-Hong Hu
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Lin Yuan
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Yao KH, DU QQ, Hu YH. [Diagnosis and treatment of human monkeypox]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:960-966. [PMID: 36111711 PMCID: PMC9495245 DOI: 10.7499/j.issn.1008-8830.2207088] [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] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
The guideline for the diagnosis and treatment of monkeypox (2022 edition) issued by National Health Commission of the People's Republic of China introduces the key knowledge of the diagnosis and treatment of human monkeypox (HMPX) and does not systematically introduce the sampling methods and requirements of specimens for HMPX etiology testing and the discrepancy in diagnostic criteria between China and overseas. However, the doctors who are not engaged in dermatology lack understanding of the sampling methods and requirements of specimens for laboratory diagnosis of HMPX, and there are few relevant references available. This article collects the information on the diagnosis and treatment of HMPX, so as to provide a reference for learning, understanding, and application of this guideline.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Qian-Qian DU
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Ya-Hong Hu
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Yu D, Liu Y, Zhao MT, Yao KH, Qin MQ, Ma L. Clinical characteristics of herpes zoster in a pediatric hospital in China from 2007 to 2020. World J Pediatr 2022; 18:574-578. [PMID: 35532882 DOI: 10.1007/s12519-022-00525-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Dan Yu
- Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Liu
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Mu-Tong Zhao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Kai-Hu Yao
- Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Mao-Quan Qin
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Disease in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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Abstract
In 2022, the outbreak of human monkeypox (HMPX) occurred in many non-endemic countries. World Health Organization (WHO) assesses that this outbreak is "atypical". The history of monkeypox and HMPX must be reviewed to clearly recognize the "typical" outbreaks to fully understand this comment. Therefore, this paper reviews the epidemiological history of monkeypox, especially HMPX, and discusses and analyzes the atypical manifestations and the possible causes of the present outbreak based on the recent views of WHO, other organizations/institutions, and experts. The text describes the thought-provoking history of the interaction between the monkeypox virus and the human being in the past 64 years, and provides various information and views on the outbreak of HMPX, which is helpful to understand risk assessment and the potential impact of this outbreak on clinical and public health in future.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Yao KH, Meng QH, Yu D. [The investigation on the acute, severe hepatitis of unknown origin in children]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:604-613. [PMID: 35652425 PMCID: PMC9250394 DOI: 10.7499/j.issn.1008-8830.2205024] [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] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
In April 2022, the United Kingdom notified the World Health Organization (WHO) of an unexpected increase of acute hepatitis of unknown origin in children. Subsequent investigations have found more than 400 cases in more than 20 countries and regions around the world. Although the potential role of adenovirus type 41 in the pathogenesis of these cases is one hypothesis, but it is probably not the only pathogenic factor, and other infectious and non-infectious causes cannot be completely ruled out. For hepatitis caused by non-hepatitis A, B, C, D and E viruses, there is a lack of systematic monitoring and research, and many unknowns still exist. According to the current etiology speculation and epidemiological characteristics of adenovirus in China, cases of acute hepatitis with unknown origin may be found in China in the future. There is also a risk of imported cases. This article systematically sorts out the reports and studies on child acute hepatitis of unknown origin, hoping to attract the attention of pediatric clinicians in China, raise awareness and vigilance, and calmly prepare for possible abnormal situations.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Qing-Hong Meng
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Dan Yu
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Jiang M, Wang X, Zhu L, Yang YH, Yao KH, Dong F, Shi W, Wang Q, Song WQ, Liu G. Clinical characteristics, antimicrobial resistance, and risk factors for mortality in paediatric invasive pneumococcal disease in Beijing, 2012-2017. BMC Infect Dis 2022; 22:338. [PMID: 35382757 PMCID: PMC8981664 DOI: 10.1186/s12879-022-07179-8] [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] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 02/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background To analyse clinical characteristics, antibiotic susceptibility, and risk factors for mortality in paediatric invasive pneumococcal disease (IPD) in Beijing. Methods Paediatric IPD patients in our hospital were retrospectively collected from 2012 to 2017. Clinical manifestations, laboratory tests, antimicrobial susceptibility and serotype of isolates, and risk factors for mortality of IPD were analysed. Results Overall, 186 IPD cases were enrolled. The major manifestations were meningitis (76), pneumonia with bacteraemia (60), bacteraemia without focus (21), and pneumonia with empyaema (22). Of 72 cases with underlying diseases, leukaemia (18.0%), congenital heart disease (15.3%), primary immunodeficiency disease (12.5%), nephrotic syndrome (12.5%), and cerebrospinal fluid leakage (12.5%) were most common. In total 96.9% of isolates would have been covered by the pneumococcal conjugate vaccine (PCV13), including 19F (32.8%), 19A (23.4%), 4 (17.2%), and 23F (9.4%). Nonsusceptibility rates of penicillin, cefotaxime, and cefepime among nonmeningitis patients increased between 2012 and 2017; The mortality rate was 21.5%. Meningitis, respiratory failure, multiple organ failure, and white blood cell count < 4000 cells/μL were independent risk factors for mortality. Conclusion Meningitis was the most common clinical manifestation of IPD, and was frequently associated with death. Strains in the PCV13 vaccine would cover most of the cases, and so wider use of PCV13 should be considered.
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Affiliation(s)
- Man Jiang
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China.,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518035, China
| | - Xi Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China
| | - Liang Zhu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China
| | - Yong-Hong Yang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Fang Dong
- Department of Laboratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Qing Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children's Health, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wen-Qi Song
- Department of Laboratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Gang Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, National Center for Children's Health, China, Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, China.
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Li RB, He XH, Fang BL, Yang Y, Yao KH, Qian SY. [Clinical and molecular characteristics of Streptococcus pneumoniae-associated hemophagocytic lymphohistiocytosis in children]. Zhonghua Er Ke Za Zhi 2022; 60:209-214. [PMID: 35240740 DOI: 10.3760/cma.j.cn112140-20211027-00908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To summarize the clinical features of Streptococcus pneumoniae-associated hemophagocytic syndrome (SP-HLH), and the serotypes and drug-resistant characteristics of the isolated strains. Methods: There were 15 children with SP-HLH admitted to the Pediatric Intensive Care Unit (PICU) of Beijing Children's Hospital, Capital Medical University from January 2013 to December 2020 were included in this study. Clinical data including children's general characteristics, clinical features, laboratory examinations, treatments, prognosis and the outcomes of follow-up by May 2021 were analyzed retrospectively. The serotypes and drug resistance of the isolated strains were identified. All children were divided into the clinical improvement group and the death group. Mann-Whitney U test, Fisher's exact test were used to compare the data of the two groups. Results: Among the 15 children with SP-HLH, 8 were males and 7 were females. The age of these children was 1.0 (1.0, 2.5) years. Regarding the primary infection, there were 9 cases of severe pneumonia, 3 cases of meningitis and 3 cases of blood stream infection. None of these children had received pneumoniae conjugate vaccine (PCV) and all of them were admitted to the PICU. Respiratory failure was observed in 10 patients, acute renal injury in 5, and hemolytic uremic syndrome in 3 patients. All children received glucocorticoids and high-dose intravenous immunogloblin (IVIG) in addition to anti-infective treatment. Eight of the children were cured while the other 7 died. The neutrophil count in the death group was lower than that in the clinical improvement group ((5.0 (1.7, 9.3) × 109 vs. 5.2 (3.4, 10.5) ×109/L, Z =-2.43, P<0.015), and the length of hospital stay and days of PICU stay in the death group were both shorter than those in the improvement group statistically (3 (1, 11) vs. 39 (34, 48) d, 2 (1, 4) vs. 19 (12, 31) d, Z=-3.25, -3.24, both P=0.001). Ten serotypes of Streptococcus pneumoniae were identified, including 4 strains of 19F, 3 of 19A, 1 of 23F, 1 of 15A and 1 of 14, among which 9 strains (9/10) were covered by PCV13. All strains were resistant to erythromycin yet sensitive to vancomycin and linezolid. Conclusions: SP-HLH is more common in children under the age of 3, with a high mortality rate. The death cases have lower neutrophil count and rapid disease progression. The comprehensive treatment is anti-infective combined with glucocorticoids and high-dose IVIG. The predominant serotypes are 19F and 19A and all isolated strains were susceptible to vancomycin and linezolid.
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Affiliation(s)
- R B Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - X H He
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - B L Fang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y Yang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - K H Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Laboratory of Drmatology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Y Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Du QQ, Shi W, Yu D, Yao KH. Epidemiology of non-vaccine serotypes of Streptococcus pneumoniae before and after universal administration of pneumococcal conjugate vaccines. Hum Vaccin Immunother 2021; 17:5628-5637. [PMID: 34726580 DOI: 10.1080/21645515.2021.1985353] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The universal administration of pneumococcal conjugate vaccines (PCVs) had been demonstrated as an effective way to prevent Streptococcus pneumoniae infection. However, the immunity induced by PCVs protected against the infections caused by vaccine serotypes, which were usually more frequent than non-vaccine serotypes (NVTs). The prevalence and pathogenicity of NVTs after universal vaccination have caused widespread concern. We reviewed the epidemiology of non-PCV13 S. pneumoniae before and after PCV13 introduction, and explored the potential reasons for the spread of NVTs. Emerging and spreading NVTs can be regarded as the focus for future serotype epidemiological survey and vaccine optimization.AbbreviationsIPD: invasive pneumococcal disease PCV: pneumococcal conjugate vaccines VT: vaccine serotypeNVT: non-vaccine serotype.
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Affiliation(s)
- Qian-Qian Du
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics, Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics, Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Dan Yu
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics, Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics, Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Du QQ, Zeng HL, Yuan L, Tang P, Gao W, Xu JJ, Shi W, Leng T, Hu KX, Yao KH. One cross-sectional investigation revealed that non-vaccine serotypes of Streptococcus pneumoniae could be identified more frequently in elderly Chinese people. Vaccine 2021; 39:3304-3309. [PMID: 33980399 DOI: 10.1016/j.vaccine.2021.02.053] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To analyze the serotype distribution and drug resistance of Streptococcus pneumoniae isolated from hospitalized patients of all ages in Zhongjiang county, Sichuan province, where the young children have just begun to vaccinate the PCV13 in private sector. METHODS Serotypes were determined for 387 isolates of S. pneumoniae by Quellung reaction. Antibiotic susceptibility was tested with the E-test or disc diffusion method. RESULTS The most common serotypes were type 19F and confirmed for 88 isolates (22.7%), followed by 19A (15.0%), 6B (7.8%), 16F (7.8%), 23F (7.0%) and 15A (4.4%). The coverage rates of PCV13 and PPSV23 were 63.3% and 65.1%. With the increase of age, the proportion of PCV13 types decreased significantly, from 71.3% (<2 years old) to 41.9% (≥60 years old). The intermediate rate and resistance rate of the isolates to oral penicillin were 48.6% and 45.2%, respectively. The resistance rate of erythromycin was high (94.4%). The PCV13 isolates was more resistant to penicillin than the non-PCV13 ones. CONCLUSION The PCV13 coverage rate in pediatric isolates was higher than those in adult isolates. The adults, especially the elderly, may be the reservoir of non-PCV13 types. It is necessary to investigate the serotype distribution of S. pneumoniae based on all age population to assess potential epidemics of non-vaccine serotype associated with PCVs administration.
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Affiliation(s)
- Qian-Qian Du
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Hai-Lin Zeng
- Zhongjiang County People's Hospital, Sichuan 618100,China
| | - Lin Yuan
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Ping Tang
- Zhongjiang County People's Hospital, Sichuan 618100,China
| | - Wei Gao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Jiao-Jiao Xu
- Zhongjiang County People's Hospital, Sichuan 618100,China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Tian Leng
- Zhongjiang County People's Hospital, Sichuan 618100,China
| | - Kuan-Xiu Hu
- Zhongjiang County People's Hospital, Sichuan 618100,China.
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
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Yao KH, Qin T, Meng QH. [The origin of the name "100-day cough"]. Zhonghua Yi Shi Za Zhi 2021; 50:355-359. [PMID: 33596612 DOI: 10.3760/cma.j.cn112155-20200506-00061] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Many studies in modern times claim that the name " 100-day cough" is from traditional Chinese medicine, and even think that there is a description of pertussis as early as the Sui Dynasty classics. By reviewing the original texts of the classics, we found that these interpretations are not exactly. The description of the pertussis and the chronological distribution of the literature in traditional Chinese books are similar to those of Western medicine. They started about 500 years ago, and then become more detailed and specific. The domestic medical community has a variety of nomenclature for this disease, and there is no sign or evidence to uniformly use "100-day cough" as the disease name. The literature records suggest that "100-day cough" first became a more recognized disease name in Japan, and through the direct input of medical education, entered the modern medical textbooks of western medicine in China.
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Affiliation(s)
- K H Yao
- Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health, Beijing 100045, China
| | - T Qin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Q H Meng
- Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University; National Center for Children's Health, Beijing 100045, China
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Yang Y, Hua CZ, Fang C, Xie YP, Li W, Fu Y, Gao F, Yao KH. Properties of Mucoid Serotype 3 Streptococcus pneumoniae From Children in China. Front Cell Infect Microbiol 2021; 11:648040. [PMID: 33842394 PMCID: PMC8024565 DOI: 10.3389/fcimb.2021.648040] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the characteristics of hosts, antimicrobial susceptibility, and molecular epidemiology of mucoid serotype 3 Streptococcus pneumoniae (S. pneumoniae) isolated from children in China. Method S. pneumoniae isolates collected between January 2016 and December 2019 were analyzed. S. pneumoniae isolates with mucoid phenotype were selected visually, and serotype 3 isolates were confirmed by Quellung reaction. The antimicrobial susceptibility was measured by E-test. Multilocus sequence typing was used for clonal analysis. Results Twenty (3.04%) isolates of mucoid serotype 3 S. pneumoniae were identified from 657 clinical isolates, and all of them were noninvasive strains. The mean age of the hosts was 5.69 ± 3.28 years. The isolates included: 50.0% from the dissected tonsil or adenoid tissue in children with obstructive sleep apnea-hypopnea syndrome, 45.0% from sputum or bronchial lavages in children with pneumonia, and 5.0% from vaginal secretions of one patient with vulvovaginitis. All isolates were susceptible to penicillin, cefuroxime, ceftriaxone, meropenem, vancomycin, levofloxacin, trimethoprim/sulfamethoxazole, and rifampin but resistant to erythromycin. Sequence type (ST)505 and its clonal complex (CC) were the main genotypes (95%). Antimicrobial susceptibility of ST180 and ST505 were compared, and the minimum inhibitory concentration (MIC) of ST505 isolates was significantly higher than that of ST180 for tetracycline, trimethoprim/sulfamethoxazole, and meropenem. Conclusions Mucoid serotype 3 Streptococcus pneumoniae can be isolated from various body parts, among which the respiratory system is the most common. It can cause noninvasive infection in children, and it has high susceptibility to a variety of antibiotics, especially β-lactams, but is resistant to macrolides. CC505 is the novel clonal complex found in China, which may be related to the worldwide mainstream clonal complex (CC180) but has its own biological characteristics.
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Affiliation(s)
- Ying Yang
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.,Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Chun-Zhen Hua
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Chao Fang
- Clinical Laboratory Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Yong-Ping Xie
- Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Wei Li
- Clinical Laboratory Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Yong Fu
- Department of Otolaryngology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Feng Gao
- Department of Neurology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China
| | - Kai-Hu Yao
- Department of Microbiology, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Meng QH, Cheng XP, Liu DD, Chen CH, Yao KH. One single-center cross-sectional investigation on varicella antibody level of all age groups in Chinese people. Hum Vaccin Immunother 2021; 17:358-362. [PMID: 32966147 PMCID: PMC7899669 DOI: 10.1080/21645515.2020.1784653] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022] Open
Abstract
Varicella outbreaks were mainly reported in developed regions with high vaccine coverage, but not in undeveloped areas. It is still not clear that whether the published data of varicella epidemiology could reflect the reality in China or not. In 2019, 657 subjects from People's Hospital of Chongqing Youyang County were included. Anti-varicella-zoster virus (VZV) IgG antibodies were determined by ELISA. The anti-VZV IgG levels were categorized as positive when values were ≥100 mIU/mL. Our results showed that the rates of anti-VZV IgG seropositivity (χ2 = 328.957, P < .0001) and geometric mean titers (P < .0001) were significantly influenced by age. The seropositivity declined dramatically from 84.5% in subjects ≤3 m of age, to 7.9% in subjects of >3 m-1 y (P < .0001). Then, the positivity rate increased slowly as age to 26.7% in >1-<3 y (P = .0006), and 34.5% in 3-<7 y (P = .4294). A steady rise (45.6%) in positivity was observed in subjects aged 7-<18 y. After then, the positivity began to increase robustly. A total of 87.8% of adults aged 18-<40 y had acquired VZV-specific immunity (P < .0001). The highest positivity rate was found in 40-<60 y (98.3%) and ≥60 y (98.2%) group. In conclusion, most subjects of >3 m-<7 y age were susceptible to VZV. The proportion of subjects with natural infection-induced immunity increased with age. Nearly all subjects over 40 ages had positive anti-VZV IgG antibodies, which proved that they were infected by this virus in the past. These results suggested that VarV should be included in the national immunization program in China.
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Affiliation(s)
- Qing-Hong Meng
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Xiao-Ping Cheng
- Youyang Hospital, The First Affiliated Hospital of Chongqing Medical University; People’s Hospital of Chongqing Youyang County, Chongqing, China
| | - Dan-Dan Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chang-Hui Chen
- Youyang Hospital, The First Affiliated Hospital of Chongqing Medical University; People’s Hospital of Chongqing Youyang County, Chongqing, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline, Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
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Yao KH, Shi W, Yuan L, Gao W. [A comparative analysis of the Chinese and English descriptions of typical pertussis manifestations and recommendations for the diagnosis of pertussis-like or pertussis syndrome]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:679-683. [PMID: 32669160 PMCID: PMC7389631 DOI: 10.7499/j.issn.1008-8830.2004021] [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] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
The Chinese and English names of pertussis or whooping cough show the important clinical features of the disease in terms of its course and cough characteristics respectively. In the clinical description of typical pertussis, the meanings of the Chinese and English words are not completely consistent, such as spastic cough versus paroxysmal cough, spasmodic stage/phase versus paroxysmal stage/phase, and "back-hook" versus whoop, and some descriptions in English are not seen in Chinese. This article aims to provide more comprehensive information for the understanding of pertussis by comparing the descriptions of typical clinical manifestations of pertussis in Chinese and English literatures and to put forward suggestions for the diagnosis of pertussis syndrome based on typical clinical manifestations.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China.
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20
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Yao KH, Shi W, Yuan L, Gao W. [A comparative analysis of the Chinese and English descriptions of typical pertussis manifestations and recommendations for the diagnosis of pertussis-like or pertussis syndrome]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:679-683. [PMID: 32669160 PMCID: PMC7389631] [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] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/14/2020] [Indexed: 11/12/2023]
Abstract
The Chinese and English names of pertussis or whooping cough show the important clinical features of the disease in terms of its course and cough characteristics respectively. In the clinical description of typical pertussis, the meanings of the Chinese and English words are not completely consistent, such as spastic cough versus paroxysmal cough, spasmodic stage/phase versus paroxysmal stage/phase, and "back-hook" versus whoop, and some descriptions in English are not seen in Chinese. This article aims to provide more comprehensive information for the understanding of pertussis by comparing the descriptions of typical clinical manifestations of pertussis in Chinese and English literatures and to put forward suggestions for the diagnosis of pertussis syndrome based on typical clinical manifestations.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China.
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Sun C, Wang Q, Li WT, Wen DN, Chen CH, Yang X, Shi W, Meng QH, Yao KH, Qian SY. Molecular characteristics and antimicrobial susceptibility of Staphylococcus aureus among children with respiratory tract infections in southwest China. World J Pediatr 2020; 16:284-292. [PMID: 31620982 DOI: 10.1007/s12519-019-00317-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/24/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The molecular characteristics and antimicrobial susceptibility of Staphylococcus aureus (S. aureus) in general pediatric wards and county-level hospitals were rarely reported in China. METHODS Staphylococcus aureus was isolated from children hospitalized with respiratory tract infection (RTI) in Zhongjiang and Youyang counties in 2015. All isolates were typed by multilocus sequence, staphylococcal protein A, accessory gene regulator (agr), and staphylococcal cassette chromosome mec [SCCmec, for methicillin-resistant S. aureus (MRSA) only]. Polymerase chain reaction was used to screen 21 super-antigen (SAg) genes and panton-valentine leukocidin (pvl). Antimicrobial susceptibility testing was performed by E test. RESULTS A total of 2136 children were enrolled. Overall, 125 (5.9%) children carried S. aureus, among which MRSA accounted for 42.4%. ST59-SCCmec type IV-t437-agr group I (58.5%) was the most prevalent genotype in MRSA, and ST188-t189-agr group I (22.2%) was the top genotype in methicillin-sensitive S. aureus (MSSA). The pvl carriage rate in MRSA and MSSA was 15.1% and 9.7%, respectively (P = 0.4112). About 96.8% of S. aureus isolates were positive for at least one SAg gene. The most common SAg gene profile in the dominant ST59 clone was seb-sek-seq (42.8%). All S. aureus isolates were resistant to penicillin and erythromycin (minimum inhibitory concentration 90 was > 32 and 256 mg/L to penicillin and erythromycin, respectively), but usually susceptible to other tested non-β-lactam antimicrobials. CONCLUSIONS Staphylococcus aureus and MRSA were detected with a high frequency in children with RTI in county-level hospitals of China. ST59-SCCmec type IV-t437-agr group I was the dominant MRSA clone. The S. aureus isolates exhibited high resistance to penicillin and erythromycin.
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Affiliation(s)
- Chen Sun
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, NanLiShi Road 56, Xicheng District, Beijing, 100045, China
| | - Qing Wang
- Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wen-Ting Li
- Respiratory Department, Qilu Children's Hospital, Shandong University, Jinan, 250022, China
| | - De-Nian Wen
- Department of Pediatrics, People's Hospital of Zhongjiang County, No. 96 Da-bei Street, Deyang, 618100, China
| | - Chang-Hui Chen
- Youyang Hospital, The First Affiliated Hospital of Chongqing Medical University, People's Hospital of Chongqing Youyang County, Chongqing, 409899, China
| | - Xin Yang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, NanLiShi Road 56, Xicheng District, Beijing, 100045, China
| | - Wei Shi
- Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Qing-Hong Meng
- Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Kai-Hu Yao
- Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Su-Yun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, NanLiShi Road 56, Xicheng District, Beijing, 100045, China.
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Wang CL, Liu S, Shao ZJ, Yin ZD, Chen QJ, Ma X, Ma C, Wang Q, Wang LH, Deng JK, Li YX, Zhao ZX, Wu D, Wu J, Zhang L, Yao KH, Gao Y, Xie X. [Guidelines for the use of post-traumatic tetanus vaccines and passive immune preparation]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:167-172. [PMID: 32164124 DOI: 10.3760/cma.j.issn.0254-6450.2020.02.006] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rateof tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, the National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, and the latest research progress both at home and abroad. The guidelines focus on the basic procedures for the prevention and treatment of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and pre-exposure immunization in high-risk populations of trauma.
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Affiliation(s)
- C L Wang
- Emergency Department/Trauma Center, Peking University People's Hospital, Beijing 100044, China
| | - S Liu
- Emergency Department, First Hospital of Peking University, Beijing 100034, China
| | - Z J Shao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z D Yin
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q J Chen
- Emergency Department, Beijing Hepingli Hospital, Beijing 100013, China
| | - X Ma
- National Institutes for Food and Drug Control, Beijing 102629, China
| | - C Ma
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China
| | - L H Wang
- Emergency of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - J K Deng
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Y X Li
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z X Zhao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - D Wu
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J Wu
- Beijing Center for Disease Prevention and Control,Beijing 100013, China
| | - L Zhang
- Shandong Center for Disease Control and Prevention, Jinan 250012, China
| | - K H Yao
- Beijing Children's Hospital, Capital Medical University/Beijing Pediatric Research Institute, Beijing 100045, China
| | - Y Gao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Xie
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
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23
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Zhang JS, Wang HM, Yao KH, Liu Y, Lei YL, Deng JK, Yang YH. Clinical characteristics, molecular epidemiology and antimicrobial susceptibility of pertussis among children in southern China. World J Pediatr 2020; 16:185-192. [PMID: 31493136 DOI: 10.1007/s12519-019-00308-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing numbers of pertussis cases have been reported in recent years. The reported cases from Shenzhen Children's Hospital were close to one tenth of all cases in China. The epidemiology of antigenic genotype and antibiotic resistance of circulating strains in children have been unknown in Shenzhen, southern China. The aim of this study was to describe the clinical features and explore the genotypes and antimicrobial susceptibility of circulating Bordetella pertussis among children in Shenzhen. METHODS Data of hospitalized children with pertussis in Shenzhen Children's Hospital from August 2015 to April 2017 were collected. The genetic variability of isolates was investigated and Etest was performed for phenotypic susceptibility to erythromycin, azithromycin, clarithromycin, clindamycin, and trimethoprim/sulfamethoxazole. RESULTS 469 children with pertussis confirmed by real-time quantitative polymerase chain reaction were hospitalized and strains were isolated from 105 patients. White blood cell count ≥ 20 × 109/L and lymphocyte proportion ≥ 60% were observed in 39.29% of infants younger than 3 months. The two predominant profiles of virulence-associated allelic genes were ptxA1/ptxC1/ptxP1/prn1 (48.6%) and ptxA1/ptxC2/ptxP3/prn2 (44.8%). Among the isolates, 48.6% (51/105) were found resistant to macrolides. CONCLUSIONS These findings indicate that leukocytosis is not a sensitive indicator of pertussis. Isolates with the gene profile ptxP3/prn2 were highly circulating in Shenzhen and less resistant to macrolides, different from patterns observed in other parts of China.
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Affiliation(s)
- Jiao-Sheng Zhang
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China.,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Hong-Mei Wang
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Kai-Hu Yao
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China
| | - Ying Liu
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China
| | - Yan-Ling Lei
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Yong-Hong Yang
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China. .,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China.
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24
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Yao KH. [Immunization to prevent non-neonatal tetanus]. Zhonghua Er Ke Za Zhi 2020; 58:259-261. [PMID: 32135606 DOI: 10.3760/cma.j.issn.0578-1310.2020.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- K H Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Laboratory of Dermatology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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25
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Wang LJ, Yang X, Qian SY, Liu YC, Yao KH, Dong F, Song WQ. Identification of hemolytic activity and hemolytic genes of Methicillin-resistant Staphylococcus aureus isolated from Chinese children. Chin Med J (Engl) 2020; 133:88-90. [PMID: 31923109 PMCID: PMC7028192 DOI: 10.1097/cm9.0000000000000571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- Li-Juan Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Xin Yang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Su-Yun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Ying-Chao Liu
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Kai-Hu Yao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045 China
| | - Fang Dong
- Bacteriology Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Wen-Qi Song
- Bacteriology Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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26
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Wang CL, Liu S, Shao ZJ, Yin ZD, Chen QJ, Ma X, Ma C, Wang Q, Wang LH, Deng JK, Li YX, Zhao ZX, Wu D, Wu J, Zhang L, Yao KH, Gao Y, Xie X. [Guidelines for the use of post-traumatic tetanus vaccines and passive immune preparation]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:1212-1217. [PMID: 31795577 DOI: 10.3760/cma.j.issn.0253-9624.2019.12.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.
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Affiliation(s)
- C L Wang
- Emergency Department/Trauma Center, Peking University People's Hospital, Beijing 100044, China
| | - S Liu
- Emergency Department, Peking University First Hospital, Beijing 100034, China
| | - Z J Shao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z D Yin
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q J Chen
- Emergency Department, Beijing Hepingli Hospital, Beijing 100013, China
| | - X Ma
- Division of Quality Control of DTP vaccine and Toxin, National Institutes for Food and Drug Control, Beijing 102629, China
| | - C Ma
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q Wang
- Division ofImmunization Programme Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China
| | - L H Wang
- Emergency of infectious disease, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - J K Deng
- Division of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Y X Li
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z X Zhao
- Division of Immunization Programme, Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - D Wu
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J Wu
- Immuziation department Beijing Municipal Center for Disease Control and Prevention, Beijing 1000013, China
| | - L Zhang
- Division of Immunization Programme Shandong Center for Disease Control and Prevention, Jinan 250012, China
| | - K H Yao
- Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Y Gao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Xie
- Division of Immunization Programme, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
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27
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Wu DX, Chen Q, Yao KH, Li L, Shi W, Ke JW, Wu AM, Huang P, Shen KL. Pertussis detection in children with cough of any duration. BMC Pediatr 2019; 19:236. [PMID: 31299934 PMCID: PMC6626350 DOI: 10.1186/s12887-019-1615-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/04/2019] [Indexed: 11/24/2022] Open
Abstract
Background The diagnosis of pertussis in clinical practice continues to be a challenge worldwide as the symptoms are variable. We aimed to determine the prevalence of pertussis in Chinese children irrespective of cough duration and explore the clinical characteristics of children with pertussis with different cough durations. Methods This was a prospective study of children 1 month to 11 years of age with different cough durations in one large Chinese hospital. Bilateral deep posterior nasopharyngeal swabs and venepuncture for full blood count, CRP and serology and sputum were obtained when possible for investigation. E-test strips were used for testing the susceptibility of the B.pertussis isolates against erythromycin, azithromycin, sulphamethoxazole/trimethoprim, levofloxacin, amoxicillin and doxycycline. Demographic, clinical and laboratory information on culture and antimicrobial susceptibility testing was collected from children, and analyzed using SAS v.10 (SAS Institute Inc., USA). Results After exclusions we analyzed 312 children. Ninety-seven (31.1%) children had laboratory evidence of pertussis. When grouped by cough duration, few characteristics were significant between children with and without pertussis. Of the 36 isolates, 72.2% (26/36)could not be inhibited by erythromycin and azithromycin at all. The MIC50 and MIC90 to amoxicillin were 0.75 mg/L and 1 mg/L respectively, sensitive to amoxicillin by the EUCAST points. Conclusions The “one-size-fits-all” clinical pertussis case definition is no longer optimal to recognize this disease. A large comprehensive study of children with all types of cough is required to make substantial inroads into increasing both the sensitivity and specificity in pertussis diagnosis, which will have a beneficial impact on public health. Amoxicillin maybe an alternative for children with marolide-resistant B.pertussis infection; however, local sensitivities are required to inform clinical practice.
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Affiliation(s)
- Dan-Xia Wu
- Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan-Li-Shi Road, Beijing, 100045, China.,Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Qiang Chen
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Kai-Hu Yao
- Beijing Institute of Pediatrics, Beijing Children's Hospital, Beijing, China
| | - Lan Li
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Wei Shi
- Beijing Institute of Pediatrics, Beijing Children's Hospital, Beijing, China
| | - Jiang-Wei Ke
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Ai-Min Wu
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Peng Huang
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Kun-Ling Shen
- Beijing Children's Hospital Affiliated to Capital Medical University, No. 56 Nan-Li-Shi Road, Beijing, 100045, China.
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28
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Jia J, Yuan L, Gao W, Yao KH. [Complications of pertussis]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:713-717. [PMID: 31315774 PMCID: PMC7389100 DOI: 10.7499/j.issn.1008-8830.2019.07.018] [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] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/29/2019] [Indexed: 06/10/2023]
Abstract
Patients with pertussis can have a variety of complications, including pneumonia and subconjunctival hemorrhage. Severe complications, such as pulmonary hypertension and encephalopathy, can be life-threatening. Younger children with pertussis may lack the characteristic clinical manifestations of pertussis, and therefore, a deeper understanding of the complications of pertussis may help to improve the diagnosis, treatment, and prognosis of pertussis. However, there is still no standard for the diagnosis and treatment of pertussis complications, and there are great differences in diagnostic name, basis, and data used in different reports. This article reviews the complications of pertussis which have been reported so far, such as pulmonary complications (pneumonia, pulmonary hypertension, pneumothorax, and mediastinal or subcutaneous emphysema), fractures, hernias, circulatory system complications, nervous system complications (convulsion, encephalopathy, hemorrhage, and hematoma), urinary system complications, and secondary infections, so as to provide a reference for the clinical diagnosis and treatment of pertussis complications, scientific research on pertussis complications, and the promotion of standardized diagnosis and treatment of pertussis complications.
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Affiliation(s)
- Ju Jia
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Beijing Pediatric Research Institute/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China.
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29
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Su QR, Yao KH. [Epidemiological and clinical features of vaccine-preventable diseases in vaccine era]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:195-198. [PMID: 30907338 PMCID: PMC7389355 DOI: 10.7499/j.issn.1008-8830.2019.03.001] [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] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
In countries and regions with high vaccination coverage, several vaccine-preventable diseases have been resurged in recent years, such as measles, varicella, pertussis and mumps. Some studies have found that the clinical manifestation and epidemiological characteristics of these diseases were different from those in pre-vaccine era. This article reviewed the clinical and epidemiological features of vaccine-preventable diseases before and after wide immunization implementation, focusing on the situation in China, in order to attract the attention of clinicians, raise awareness, strengthen prevention and control, and promote in-depth research for these diseases.
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Affiliation(s)
- Qi-Ru Su
- Department of Pediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, Guangdong 518038, China.
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30
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Li LJ, Liu Y, Jia J, Yuan L, Shi W, Meng QH, Yao KH. [Antimicrobial susceptibility and antigen genotypes of Bordetella pertussis strains isolated from neonates]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:208-213. [PMID: 30907341 PMCID: PMC7389359 DOI: 10.7499/j.issn.1008-8830.2019.03.004] [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] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/11/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate the alternative antimicrobial drugs for the treatment of neonatal pertussis and the antigen genotypes of Bordetella pertussis (B. pertussis) strains. METHODS A total of 32 B. pertussis strains isolated from neonates between May 2013 and July 2018 were used in this study. E-test stripes were used to measure the minimal inhibitory concentration (MIC) of 18 antimicrobial drugs including erythromycin, sulfamethoxazole-trimethoprim (SMZ) and ampicillin. The 23S rRNA gene of isolated strains was amplified and sequenced to identify the mutation site of erythromycin resistance gene, and the seven antigen genotypes of B. pertussis strains (ptxA, ptxC, ptxP, prn, fim2, fim3 and tcfA2) were analyzed. RESULTS Of the 32 B. pertussis strains, 25 (78%) were resistant to erythromycin, azithromycin, clarithromycin and clindamycin, with an MIC of >256 mg/L, and A2047G mutation was observed in the 23S rRNA gene. All strains had an MIC of ≤0.064 mg/L for SMZ. The MIC of ampicillin, amoxicillin, amoxicillin-clavulanic acid and ceftriaxone ranged from 0.032 to 1 mg/L. The strains resistant to macrolide antibiotics had an antigen genotype of ptxA1/ptxC1/ptxP1/prn1/fim2-1/fim3-1/tcfA2. CONCLUSIONS B. pertussis strains from neonates are often resistant to macrolides, and the in vitro test shows that off-label use of sulfonamides is a reliable regimen for the treatment of neonates with macrolide-resistant pertussis. The prevalence of drug-resistant strains further emphasizes the importance of immunoprophylaxis.
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Affiliation(s)
- Li-Jun Li
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/National Clinical Research Center for Respiratory Diseases/Key Laboratory of Major Diseases in Children, Ministry of Education/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China.
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31
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Wu DX, Chen Q, Li L, Shen KL, Yao KH. [Prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:18-23. [PMID: 30675858 PMCID: PMC7390172] [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] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/12/2018] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To investigate the prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features. METHODS A total of 106 children who were treated at the outpatient service or hospitalized from January 1, 2016 to May 31, 2017 were enrolled. Their nasopharyngeal swabs and venous blood samples were collected for Bordetella pertussis culture, multiple PCR and serum anti-pertussis toxin antibody detection. According to these results, the children were divided into pertussis group with 26 children and control group with 80 children, and clinical features were analyzed for both groups. E-test stripes were used to determine the sensitivity of Bordetella pertussis strains to erythromycin, azithromycin, doxycycline, levofloxacin, sulfamethoxazole/trimethoprim and amoxicillin. RESULTS Of the 106 children with chronic cough, 26 (24.5%) were found to have Bordetella pertussis infection. There were no significant differences in the incidence rates of typical symptoms of pertussis between the pertussis and control groups (P>0.05). E-test showed that erythromycin and azithromycin had a minimal inhibitory concentration (MIC) of >256 mg/L against five Bordetella pertussis strains, while amoxicillin had an MIC of 0.5-1 mg/L. CONCLUSIONS The presence of Bordetella pertussis infection in children with chronic cough should be taken seriously by clinicians, and children with chronic cough and Bordetella pertussis infection may not have the typical symptoms of pertussis and are mainly manifested as chronic cough. Amoxicillin may be an alternative drug for macrolide-resistant Bordetella pertussis infection.
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Affiliation(s)
- Dan-Xia Wu
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang 330006, China.
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32
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Wu DX, Chen Q, Li L, Shen KL, Yao KH. [Prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:18-23. [PMID: 30675858 PMCID: PMC7390172 DOI: 10.7499/j.issn.1008-8830.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate the prevalence of Bordetella pertussis infection in children with chronic cough and its clinical features. METHODS A total of 106 children who were treated at the outpatient service or hospitalized from January 1, 2016 to May 31, 2017 were enrolled. Their nasopharyngeal swabs and venous blood samples were collected for Bordetella pertussis culture, multiple PCR and serum anti-pertussis toxin antibody detection. According to these results, the children were divided into pertussis group with 26 children and control group with 80 children, and clinical features were analyzed for both groups. E-test stripes were used to determine the sensitivity of Bordetella pertussis strains to erythromycin, azithromycin, doxycycline, levofloxacin, sulfamethoxazole/trimethoprim and amoxicillin. RESULTS Of the 106 children with chronic cough, 26 (24.5%) were found to have Bordetella pertussis infection. There were no significant differences in the incidence rates of typical symptoms of pertussis between the pertussis and control groups (P>0.05). E-test showed that erythromycin and azithromycin had a minimal inhibitory concentration (MIC) of >256 mg/L against five Bordetella pertussis strains, while amoxicillin had an MIC of 0.5-1 mg/L. CONCLUSIONS The presence of Bordetella pertussis infection in children with chronic cough should be taken seriously by clinicians, and children with chronic cough and Bordetella pertussis infection may not have the typical symptoms of pertussis and are mainly manifested as chronic cough. Amoxicillin may be an alternative drug for macrolide-resistant Bordetella pertussis infection.
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Affiliation(s)
- Dan-Xia Wu
- Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang 330006, China.
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33
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Wang LJ, Dong F, Qian SY, Yao KH, Song WQ. Clinical and Molecular Epidemiology of Invasive Staphylococcus aureus Infections in Chinese Children: A Single-center Experience. Chin Med J (Engl) 2018; 130:2889-2890. [PMID: 29176152 PMCID: PMC5717874 DOI: 10.4103/0366-6999.219158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Li-Juan Wang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Fang Dong
- Bacteriology Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Sun-Yun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Kai-Hu Yao
- Ministry of Education Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Wen-Qi Song
- Bacteriology Laboratory, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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34
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Yao KH. [Some thoughts on influenza vaccine and regular influenza vaccination for healthcare workers]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:881-886. [PMID: 30477616 PMCID: PMC7389024 DOI: 10.7499/j.issn.1008-8830.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/20/2018] [Indexed: 06/09/2023]
Abstract
It has been 100 years since the 1918 influenza pandemic but influenza is still an uncontrolled infectious disease. In some developed countries, the coverage rate of influenza vaccine can reach as high as 60%-70%, and even up to 90% or higher in some specific population, such as the elderly and healthcare workers. The coverage rate of influenza vaccination in Chinese people, however, is very low, only about 2%-3% per year. The limitations of influenza vaccine, and the purpose and significance of influenza vaccination, the imbalance of vaccine information and the importance of inoculation for healthcare workers are discussed in this paper. The resistance to popularize influenza vaccination is explored from different perspectives. It is hoped that more people will recognize the objective epidemiological data, and get rid of misunderstandings based on their experiences. Healthcare workers in particular, and the general population, should be encouraged to have an influenza vaccination.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China.
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35
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Yao KH. [Some thoughts on influenza vaccine and regular influenza vaccination for healthcare workers]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:881-886. [PMID: 30477616 PMCID: PMC7389024] [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] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/20/2018] [Indexed: 11/12/2023]
Abstract
It has been 100 years since the 1918 influenza pandemic but influenza is still an uncontrolled infectious disease. In some developed countries, the coverage rate of influenza vaccine can reach as high as 60%-70%, and even up to 90% or higher in some specific population, such as the elderly and healthcare workers. The coverage rate of influenza vaccination in Chinese people, however, is very low, only about 2%-3% per year. The limitations of influenza vaccine, and the purpose and significance of influenza vaccination, the imbalance of vaccine information and the importance of inoculation for healthcare workers are discussed in this paper. The resistance to popularize influenza vaccination is explored from different perspectives. It is hoped that more people will recognize the objective epidemiological data, and get rid of misunderstandings based on their experiences. Healthcare workers in particular, and the general population, should be encouraged to have an influenza vaccination.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases/Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing 100045, China.
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Meng QH, Liu Y, Yu JQ, Li LJ, Shi W, Shen YJ, Li L, Zhan SN, Yang F, Wang YJ, Yao KH. Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing. Sci Rep 2018; 8:13021. [PMID: 30158679 PMCID: PMC6115429 DOI: 10.1038/s41598-018-31283-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 01/08/2018] [Accepted: 08/09/2018] [Indexed: 01/05/2023] Open
Abstract
Maternal antibodies contribute to the protection of young infants from infectious diseases during the early life. However, vaccinations for women of child-bearing age are not routine in China. Therefore, we investigated the level of protective immunity against vaccine preventable diseases in pregnant women and newborns in China. A total of 194 paired maternal and cord blood samples were collected in Beijing from 2016 to 2017. Antibodies specific for the antigens covered by diphtheria-tetanus-pertussis (DTP) and measles-mumps-rubella (MMR) vaccine were determined by ELISA (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria), >0.1 IU/ml (anti-tetanus), >40 IU/ml (anti-pertussis toxin), ≥200 IU/l (anti-measles), ≥45 RU/ml (anti-mumps) and ≥10 IU/ml (anti-rubella) were used to assess the percentage of newborns with protective IgG concentrations, respectively. The results revealed that 61.3%, 73.2%, 97.4%, 30.4%, 65.5% and 17.0% of newborns had no protection against diphtheria, tetanus, pertussis, measles, mumps and rubella. Only 1.0% and 23.7% of newborns had protection against all three components of DTP or MMR, respectively. The finding suggested that most of newborns were susceptible to diphtheria, tetanus, pertussis and mumps, almost one-third of this population had no immune protection against measles, and about one-sixth of them were under threat of rubella infection. These data supported the immunization program for DTP and MMR vaccine in women at child-bearing age.
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Affiliation(s)
- Qing-Hong Meng
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Ying Liu
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jin-Qian Yu
- Department of Neonatology, Shunyi Women and Children's Hospital of Beijing Children's Hospital, Beijing, 101300, China
| | - Li-Jun Li
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wei Shi
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Ying-Jie Shen
- Department of Neonatology, Shunyi Women and Children's Hospital of Beijing Children's Hospital, Beijing, 101300, China
| | - Li Li
- Department of Neonatology, Shunyi Women and Children's Hospital of Beijing Children's Hospital, Beijing, 101300, China
| | - Shi-Na Zhan
- Department of Neonatology, Shunyi Women and Children's Hospital of Beijing Children's Hospital, Beijing, 101300, China
| | - Fan Yang
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Ya-Juan Wang
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Kai-Hu Yao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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Yao KH. [Update the concept for evaluating disease burden and devote much attention to the diseases caused by Streptococcus pneumoniae]. Zhonghua Er Ke Za Zhi 2018; 56:561-563. [PMID: 30078234 DOI: 10.3760/cma.j.issn.0578-1310.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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38
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Liu Y, Yao KH. [Research progress on pertussis resurgence]. Zhonghua Er Ke Za Zhi 2018; 56:313-316. [PMID: 29614576 DOI: 10.3760/cma.j.issn.0578-1310.2018.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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39
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Tian HL, Shi W, Zhou HF, Yuan L, Yao KH, Rexiati D, Xu AM. [Serotype distribution and drug resistance of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolated from nasopharynx of Uygur children]. Zhonghua Er Ke Za Zhi 2018; 56:279-283. [PMID: 29614568 DOI: 10.3760/cma.j.issn.0578-1310.2018.04.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the serotype distribution and antimicrobial susceptibility pattern of Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae) and Moraxella catarrhalis (M. catarrhalis) isolates collected from nasopharyngeal swabs from Uygur children in Kashi. Methods: Nasopharyngeal swabs were collected from inpatient Uygur children aged from 1 month to 5 years with respiratory infections from the pediatric department, the First People's Hospital of Kashi, Xinjiang Uygur Autonomous Region. Antimicrobial susceptibilities of the isolates were determined with E-test and KB disk diffusion methods. The production of β-lactamase was detected for H. influenzae and M. catarrhalisisolates using nitrocefin disc method. Quellung test and latex agglutination test were adopted to identify serotypes of S. pneumoniae and H. influenzae isolates. Results: Forty-seven S. pneumoniae, 13 H. influenzae and 16 M. catarrhalis isolates were detected. All of the 47 S. pneumoniae isolates were sensitive to parenteral penicillin, amoxicillin-clavulanic acid, vancomycin and levofloxacin; the susceptibility rates to cefotaxime, imipenem and chloramphenicol were 94% (44/47), 89% (42/47), and 98% (46/47). The resistance rate to erythromycin was 74% (35/47). The most common serotype of S. pneumoniae was serotype 19A (10 strains, 21%). The coverage rate of 13-valent conjugate vaccine (PCV13) was 70% (33/47). None of the 13 H. influenzae isolates could be typed. They were highly susceptible to tested β-lactams antibiotics, except ampicillin. Only one H. influenzae isolate could produce β-lactamase, and two isolates were identified as β-lactamase-negative-ampicillin-resistant ones. The sixteen M. catarrhalis isolates were all positive in β-lactamase detection, but sensitive to amoxicillin-clavulanic acid, cephalosporins and meropenem. Conclusions: In Kashi, Xinjiang Uygur Autonmous Region, S. pneumoniae isolates from Uygur children were highly sensitive to parenteral penicillin and other β-lactams antibiotics. H. influenzae isolates from Uygur children were highly susceptible to amoxicillin-clavulanic acid, cephalosporins and ciprofloxacin. All M. catarrhalis isolates from Uygur children could produce β-lactamase, but were sensitive to the enzyme inhibitors and cephalosporins.
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Affiliation(s)
- H L Tian
- Pediatric Department, First People's Hospital of Kashi, Xinjiang Uygur Autonomous Region, Kashi 844000, China
| | - W Shi
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Laboratory of Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
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Meng QH, Shi W, Li LJ, Yao KH. "Cleaved Lymphocytes" Could Be Induced by Pertussis Toxin Injection in Mice, and Are Actually Not Lymphocytes. Clin Infect Dis 2018; 66:639-640. [PMID: 29028968 DOI: 10.1093/cid/cix871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qing-Hong Meng
- Ministry of Education Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wei Shi
- Ministry of Education Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Li-Jun Li
- Ministry of Education Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Kai-Hu Yao
- Ministry of Education Key Laboratory of Major Diseases in Children, National Key Discipline of Pediatrics (Capital Medical University), National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Yao KH, Jia J. [Enhance research, prevention and control of pertussis for protecting public confidence in vaccination: focus on the adverse events of vaccine with insufficient potency and its long-term impacts]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:1-4. [PMID: 29335073 PMCID: PMC7390315 DOI: 10.7499/j.issn.1008-8830.2018.01.001] [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] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/08/2017] [Indexed: 06/07/2023]
Abstract
On November 3, 2017, the China Food and Drug Administration reported that the potency indexes of two batches of diphtheria-pertussis-tetanus vaccines produced by two companies did not reach the requirements. Insufficient potency could affect the protection effect of these vaccines immunization. Currently, pertussis cases have already showed an increasing trend in China and could last for several years. Such an increase could be linked to these adverse events of vaccine with insufficient potency, which could become an evidence to challenge or deny the effectiveness of vaccination, and brings a persistent inhibition of the public's acceptance for vaccination. The wider global context of pertussis resurgence, previous underestimate on the domestic pertussis, the promotion of detection methods, the change of knowledge about pertussis, the confirmation of pertussis in elder children and adults, the antigenicity variation of pertussis strains could lead to a significant increase of pertussis cases. Health researchers and clinical workers should raise awareness about these factors, and assess rationally the impact of vaccine titer deficiency on pertussis epidemiology for maintaining and promoting public confidence in vaccination.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/National Clinical Research Center for Respiratory Diseases/Key Laboratory of Major Diseases in Children, Ministry of Education/Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases, Beijing 100045, China.
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Lyu S, Hu HL, Yang YH, Yao KH. A systematic review about Streptococcus Pneumoniae serotype distribution in children in mainland of China before the PCV13 was licensed. Expert Rev Vaccines 2017; 16:997-1006. [PMID: 28745918 DOI: 10.1080/14760584.2017.1360771] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Streptococcus pneumoniae (S. pneumoniae) is a major pathogen of infectious diseases in children. Surveillance of the distribution of pneumococcus serotypes is important for immunization strategies of pneumococcal polysaccharide conjugate vaccines (PCVs). Areas covered: This article is a systematic review of studies conducted from 2006 to 2016 that document serotypes of S. pneumoniae isolated from children less than 14 years old in the mainland of China. A total of 40 studies were included in this review. Serotypes 19F, 19A, 23F, 14 and 6B were the most common. Serotype prevalence and percentage varied by region and associated strains. The serotype coverage rate of PCV13 was higher than that of PCV10 due to the prevalence of serotype 19A, and there were no significant difference between the coverage rate of PCV13 and PPSV23. Expert commentary: To prevent Chinese children from S. pneumoniae infection, it is necessary for the universal immunization of PCV13 or develop new vaccines that include all the prevalent serotypes in China.
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Affiliation(s)
- Shuang Lyu
- a Paediatrics Department , Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Hui-Li Hu
- b Infectious Diseases Department, Beijing Children's Hospital , Capital Medical University, National Center for Children's Health , Beijing , China
| | - Yong-Hong Yang
- c Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases , National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health , Beijing , China
| | - Kai-Hu Yao
- c Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases , National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health , Beijing , China
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Yao KH, Deng JK, Dawuti R. [Pertussis diagnosis: the limitation of the currently used criteria and the suggestion of Global Pertussis Initiative]. Zhongguo Dang Dai Er Ke Za Zhi 2016; 18:891-896. [PMID: 27655550 PMCID: PMC7389966 DOI: 10.7499/j.issn.1008-8830.2016.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/11/2016] [Indexed: 06/06/2023]
Abstract
It has been recognized that pertussis is a disease that affects all age groups. There are obvious limitations in the currently used diagnostic criteria with "one-size-fits-all" definition, which is not advantageous to start individual treatment and perform strategies for preventing the transmission. Therefore, the expert group of Global Pertussis Initiative gives a suggestion for the diagnosis of pertussis. Based on the related published studies, the present article analyzes the limitations of the current criteria, and introduces the GPI's suggestion in detail.
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Affiliation(s)
- Kai-Hu Yao
- Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
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44
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Tang P, Shi W, Zeng HL, Ding W, Wang C, Yao KH, Wen DN. [Prevalence of Moraxella catarrhalis in the nasopharyngeal specimen from 1 082 hospitalized children with respiratory infection and the drug resistance of the isolates]. Zhongguo Dang Dai Er Ke Za Zhi 2016; 18:707-712. [PMID: 27530786 PMCID: PMC7399511 DOI: 10.7499/j.issn.1008-8830.2016.08.007] [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] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the prevalence of Moraxella catarrhalis in the nasopharyngeal region of children with respiratory infection and the sensitivity of Moraxella catarrhalis isolates to common antimicrobial drugs. METHODS Nasopharyngeal swabs were collected from 1 082 children with respiratory infection, and Moraxella catarrhalis strains were isolated. The E-test method and disc diffusion test were used to determine the sensitivity of these strains to 11 common antimicrobial drugs. The test results were interpreted with reference to the standards of European Committee on Antimicrobial Susceptibility Testing (EUCAST), Clinical and Laboratory Standards Institute (CLSI), and British Society for Antimicrobial Chemotherapy (BSAC). The nitrocefin disc method was used to detect whether the isolated strains produced β-lactamase. RESULTS Among the 1 082 children with respiratory infection, 77 (77/1 082, 7.12%) carried Moraxella catarrhalis in the nasopharyngeal region. All the strains produced β-lactamase. With reference to all the three standards, all the strains were sensitive to amoxycillin-clavulanate and had a susceptibility rate of >95% towards ciprofloxacin and tetracycline. According to the EUCAST and CLSI standards, the susceptibility rate of the strains towards sulfamethoxazole-trimethoprim was as high as 98.7%, and more than 80% of all strains were sensitive to the three cephalosporins detected; however, with reference to the BSAC standard, only 2.6% of the strains were sensitive to cefuroxime, with an intermediate rate of 44.2% and a drug resistance rate of 53.2%. The rate of resistance to ampicillin was 81.8%. According to the CLSI standard, the non-susceptibility rate of the strains to erythromycin was 79.2%, and according to the EUCAST or BSAC standards, their non-susceptibility rate reached 90.9%; more than one third of the strains (27/77, 35.1%) had a minimal inhibitory concentration of >256 mg/L. CONCLUSIONS All of the Moraxella catarrhalis isolates in the nasopharyngeal region of children with respiratory infection produce β-lactamase and are sensitive to amoxycillin-clavulanate. These isolates have high susceptibility rates to the third- and fourth-generation cephalosporins and sulfamethoxazole-trimethoprim, but most of the isolates are resistant to ampicillin, cefuroxime, and erythromycin.
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Affiliation(s)
- Ping Tang
- Department of Laboratory Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan 618100, China.
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Yu SJ, Gao W, Shi W, Yuan L, Shen AD, Yao KH, Yang YH. [Nasopharyngeal carriage rate, antimicrobial resistance and serotype distribution of Streptococcus pneumoniae among children with upper respiratory infection]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:988-992. [PMID: 25344177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate nasopharyngeal carriage rate, antimicrobial resistance and serotype distribution of Streptococcus pneumoniae among children with upper respiratory infection. METHODS Nasopharygeal swabs were collected from children with upper respiratory infection visiting the outpatient department of Beijing Children′s Hospital between March 2013 and February 2014. The antibiotic susceptibility was tested by Etest method, and the serotype was determined by Quellung reaction. RESULTS The nasopharyngeal carriage rate for Streptococcus pneumoniae was 23.8% (699/2 941). One hundred isolates were randomly chosen for antimicrobial susceptiblity test and serotyping. Up to 98.0% isolates were susceptible to parenteral penicillin. The susceptible rate against oral penicillin, however, was 33.0%. The non-susceptible rate to erythromycin and azithromycin was 97.0%. The multi-drug resistance rate was up to 86.0%. The common serotypes were 6A(12.0%), 19F(12.0%), 6B(10.0%), 23F(9.0%) and 14(8.0%). The coverage rates of 7-, 10- and 13-valent pneumococcal conjugate vaccine were 41.0%, 42.0% and 59.0% respectively. CONCLUSIONS About 25% of children with upper respiratory infection are nasopharyngeal colonized by Streptococcus pneumoniae. The isolates show a high antimicrobial resistance. The 13-valent pneumococcal conjugate vaccine covers about 60.0% of the isolates.
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Affiliation(s)
- Sang-Jie Yu
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, Microbiological Laboratory in Beijing Pediatric Research Institute, Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China.
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Yao KH, Yang YH. [The ambitious but achievable goal: to end preventable childhood deaths due to pneumonia by 2025]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:967-969. [PMID: 25344172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Globally, pneumonia is the leading cause of childhood mortality. Pneumonia is the second killer of children less than 5 years of age in China. The World Heath Organization and United Nations Children′s Fund launched the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) in 2013. The ambitious goal is to end preventable childhood deaths due to pneumonia by 2025. Countries or regions should achieve the following goals: (1) reduce mortality from pneumonia in children less than 5 years of age to fewer than 3 per 1 000 live births; (2) reduce the incidence of severe pneumonia by 75% in children less than 5 years of age compared to 2010 levels. If the implementation of key interventions is accelerated, the mortality rate of childhood pneumonia will drop substantially every year, which makes the goal achievable.
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47
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Tong JJ, Yao KH, Yang YH. [Research advance in prevention policies of neonatal group B Streptococcus infection]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:1075-1080. [PMID: 25344196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Group B Streptococcus (GBS) is responsible for two distinct clinical syndromes in the newborn period categorised as either early- or late-onset GBS disease. Maternal GBS colonization of gastrointestinal tract or vaginal is the major risk factor for GBS diseases. There are two main strategies for identifying women at risk of giving birth to a GBS-infected infant: universal screening strategy and risk-based assessment. In the United States and other countries, the implementation of maternal intrapartum antibiotic prophylaxis policies has significantly reduced the incidence of early-onset neonatal GBS disease, but has little effect on the incidence of late-onset GBS disease. Penicillin is the first choice for antibiotic prophylaxis treatment. GBS strains which are isolated from pregnant women who are allergic to penicillin should undergo antibiotic susceptibility testing. Antibiotic prophylaxis measures have some disadvantages, so researchers should actively develop other precautions to prevent GBS infection.
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Affiliation(s)
- Jing-Jing Tong
- Beijing Pediatric Research Institute, Beijing Children′s Hospital Affiliated to Capital Medical University, Beijing 100045, China.
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Luo J, Wang HX, Yuan L, Gu S, Jiang M, Ding YJ, Guo D, Yao KH, Wang YJ. [Clinical characteristics of whooping cough in neonates and antimicrobial resistance of the pathogenic bacteria]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:975-978. [PMID: 25344174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the clinical characteristics of whooping cough in neonates and the antimicrobial resistance of the bacterial isolates. METHODS Clinical information of 7 neonates with whooping cough confirmed by bacterial culture was collected. The antimirobial resistance of the isolates was tested using E-test and disk diffusion methods. RESULTS The children′s mothers or other family members had cough for more than 10 days in 6 neonates, in which four neonates contacted with 3 or more family members with cough. All the neonates had rhinobyon and slight cough at the beginning of the disease. Five cases presented typical spasmodic cough after 4-7 days of the onset. Five cases displayed cyanosis, four cases occurred apnea, three cases suffered breath holding, and only two cases had fever. Nares flaring and three depression signs were found in the physical examination. No bacteriostatic ring around the erythromycin disks were found for five bacterial isolates. The minimal inhibitory concentration (MIC) for erythromycin, azithromycin, clarithromycin and clindamycin were all >256 mg/L against the five isolates. CONCLUSIONS Whooping cough should be considered for neonates with respiratory symptoms and a history of close contact with respiratory infection patients. Macrolide-resistant Bordetella pertussis is common in children with whooping cough.
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Affiliation(s)
- Jie Luo
- Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China.
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49
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Yao KH, Yang YH. [Adverse events following immunization and causality assessment of an adverse event following immunization]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:1-4. [PMID: 24461168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Several fatal events occurred in Hunan, Guangdong and Sichuan Province in December, 2013. The events were reported by the news media, which followed growing public concern. Currently, more and more vaccines were developed and the immunization was adopted for more objectives. The clinicians, especially pediatricians will face a growing number of clinical problems related to the vaccine. The clinicians should pay attention to learn more knowledge about vaccines. This article describes the definition and classification of "adverse events following immunization" and "serious vaccine product-related reactions", and the signifcance and conclusion of causality assessment following immunization.
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Affiliation(s)
- Kai-Hu Yao
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
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50
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Yao KH. [Common pediatric infectious diseases following natural disasters]. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15:435-439. [PMID: 23791057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Natural disasters may lead to the outbreaks of infectious diseases because they increase the risk factors for infectious diseases. This paper reviews the risk factors for infectious diseases after natural disasters, especially earthquake, and the infectious diseases following disasters reported in recent years. The infectious diseases after earthquake include diarrhea, cholera, viral hepatitis, upper respiratory tract infection, tuberculosis, measles, leptospirosis, dengue fever, tetanus, and gas gangrene, as well as some rare infections. Children are vulnerable to infectious diseases, so pediatricians should pay more attention to the research on relationship between infectious diseases and natural disasters.
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Affiliation(s)
- Kai-Hu Yao
- Department of Microbiology and Immunology, Capital Medical University, Beijing, China.
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