RESUMO
We explored the changes of the initially highly upgraded cerebrospinal fluid matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of MMP 1 (TIMP-1) response during recovery of childhood bacterial meningitis and their association with outcome. The sizes of these changes varied substantially, but a steeper decrease in the MMP-9 and an increase of the TIMP-1 concentrations augured a better outcome.
Assuntos
Líquido Cefalorraquidiano/química , Metaloproteinase 9 da Matriz/líquido cefalorraquidiano , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/patologia , Inibidor Tecidual de Metaloproteinase-1/líquido cefalorraquidiano , Biomarcadores/líquido cefalorraquidiano , Pré-Escolar , Monitoramento de Medicamentos , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Resultado do TratamentoRESUMO
Pleural effusion (PE), a complication of community-acquired pneumonia (CAP), is usually attributed to a bacterial infection. Nonetheless, viral infections have not been investigated routinely. We searched for bacterial and viral infections among 277 children hospitalized with CAP. Among these children 206 (74%) had radiographic confirmation, of whom 25 (12%) had PE. The aetiology was established in 18 (72%) PE cases: bacterial (n = 5; 28%), viral (n = 9; 50%), and viral-bacterial (n = 4; 22%) infections were found. Infection by rhinovirus (n = 3), enterovirus, Streptococcus pneumoniae (n = 2 each), Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, influenza A virus, and respiratory syncytial virus (RSV) (n = 1 each) were detected as probable sole infections. Parainfluenza virus 1/3 + influenza A virus and RSV + influenza A virus (n = 1 each) were identified as mixed viral-viral infections. Probable viral non-bacterial infection was identified in a third of the cases with CAP and PE. It is advisable to investigate viral as well as bacterial infections among children with CAP and PE.
Assuntos
Infecções Comunitárias Adquiridas/virologia , Derrame Pleural/virologia , Pneumonia/virologia , Viroses/virologia , Brasil/epidemiologia , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Lactente , Masculino , Derrame Pleural/epidemiologia , Derrame Pleural/microbiologia , Pneumonia/epidemiologia , Pneumonia/microbiologia , Estatísticas não Paramétricas , Viroses/epidemiologia , Viroses/microbiologiaRESUMO
BACKGROUND: Limited information is available on the role of human metapneumovirus (HMPV) as the unique pathogen among children hospitalized for community-acquired pneumonia (CAP) in a tropical region. OBJECTIVE: We aimed to describe HMPV infection among children with CAP investigating bacterial and viral co-infections. PATIENTS AND METHODS: A prospective study was carried out in Salvador, North-East Brazil. Overall, 268 children aged <5 years hospitalized for CAP were enrolled. Human metapneumovirus RNA was detected in nasopharyngeal aspirates (NPA) by reverse transcription polymerase chain reaction. Sixteen other bacterial and viral pathogens were investigated by an expanded panel of laboratory methods. Chest X-ray taken on admission was read by an independent paediatric radiologist unaware of clinical information or the established aetiology. RESULTS: Human metapneumovirus RNA was detected in NPAs of 11 (4.1%) children, of which 4 (36%) had sole HMPV infection. The disease was significantly shorter among patients with sole HMPV infection in comparison with patients with mixed infection (4 ± 1 versus 7 ± 2 days, P = 0.03). Three of those four patients had alveolar infiltrates. CONCLUSION: Sole HMPV infection was detected in children with CAP in Salvador, North-East Brazil. HMPV may play a role in the childhood CAP burden.