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Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children.

Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy.

Patients and methods During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively.

Results Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes.

Conclusions This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

The paediatric roots of chronic obstructive pulmonary disease.

Early disturbances in pulmonary development seem to favour the occurrence of the functional impairments observed in COPD. In utero exposure to maternal smoking is the most commonly documented antenatal factor. Early life events such as the bronchopulmonary dysplasia are responsible for hypoalveolisation. The effects of passive smoking during childhood are prolonged into adulthood.

The role of viral respiratory infections in early childhood remains a subject for debate. Finally the role of genes implied in pulmonary development both pre and post natally is beginning to be recognized. The decline of the respiratory function that occurs in adulthood leads then more rapidly to the functional criteria of COPD, particularly in the event of active smoking. There thus exist epidemiological and fundamental arguments, which support the idea that the COPD has at least, in part, a paediatric origin.

Scientists warn about future flu strains

Conclusion The researchers raise important questions about the possibility of a future flu pandemic caused by the H2N2 virus, and about whether vaccination programme planning could be used to prevent it. However, many issues need further consideration, including a detailed assessment of the probability of the H2N2 strain jumping to humans, whether it would pose a serious health threat, how long it would take to emerge and which groups of people would be vulnerable. It is important to note that infection with the H1N1 virus, although dangerous for some population groups, did not make most people seriously ill.

As the researchers point out, there are concerns over whether it makes sense to expose individuals to vaccines for a virus that is not currently circulating in humans, although they s...

Clinical performance of three rapid diagnostic tests for influenza virus in nasopharyngeal specimens to detect novel swine-origin influenza viruses

Influenza is an important public health problem. The aim of this study was to evaluate and compare the sensitivity and specificity of three rapid diagnostic tests (SEKISUI, QuickVue Influenza A + B, and SD BIOLINE) for novel swine-origin influenza viruses (S-OIV) and seasonal influenza.

Materials and methods  A total of 210 nasopharyngeal swabs from unique clinical specimens were previously tested by real-time reverse transcription polymerase chain reaction (RT-PCR) assay and tested again in this study.

Results and discussion  Of these, 164 (78%) were influenza A-positive and 46 (22%) were influenza A-negative by RT-PCR. From 115 positive swabs, 80 (69.6%), 66 (57.4%), and 46 (40.0%) showed S-OIV by SEKISUI...

National swine flu adult assessment guidelines: retrospective validation of objective criteria in three proxy datasets

Conclusions The objective criteria of the proposed DH assessment tool do not perform particularly well in predicting relevant clinical outcomes in feasible proxy conditions for pandemic influenza.

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