Characterization of the nasopharyngeal microbiota in health and during rhinovirus challenge.

Background: The bacterial communities of the nasopharynx play an important role in upper respiratory tract infections (URTIs). Our study represents the first survey of the nasopharynx during a known, controlled viral challenge. We aimed to gain a better understanding of the composition and dynamics of the nasopharyngeal microbiome during viral infection.

The lack of specificity of tracheal aspirates in the diagnosis of pulmonary infection in intubated children.

Objectives: Ventilator-associated pneumonia is the first or second most commonly diagnosed nosocomial infection in the PICU. Centers for Disease Control diagnostic criteria include clinical signs or symptoms in conjunction with a "positive" tracheal aspirate, defined as more than 10 colony-forming units/mL of bacteria on quantitative culture and/or more than 25 polymorphonuclear neutrophils per low-power field on Gram stain. We hypothesized that tracheal aspirate cultures and Gram stains would not correlate with clinical signs and symptoms and would therefore not distinguish between colonization and infection.

Bacteria in the nose of young adults during wellness and rhinovirus colds: detection by culture and microarray methods in 100 nasal lavage specimens.

Background: Patients  with  viral respiratory infections/viral rhinitis/common colds are often treated with antibiotic; however, there is little information on whether or how bacterial microbiota in the nose and nasopharynx might influence the course of viral illnesses.

Methods: To initiate investigation of possible interaction between viral respiratory illness and microbiota of the nose/nasopharynx, we used microarray technology to examine 100 nasal lavage fluid (NLF) samples for bacterial species and recorded the bacterial titer of culturable bacteria. Rhinovirus illnesses were induced by self-inoculation using the "finger to nose or eye natural transmission route" in 10 otherwise healthy young adults.

Gold nanoparticle-oligonucleotide conjugates for the profiling of malignant melanoma phenotypes.

This chapter discusses the preparation and subsequent profiling capabilities of gold nanoparticle-oligonucleotide conjugates for multiple melanoma mRNA targets. We will outline the attachment of DNA hairpins modified with a thiol for facile attachment to gold nanoparticle surfaces through gold-sulfur bond formation. Furthermore, the ability of these conjugates to detect and distinguish phenotypic variations utilizing -several melanoma cell lines and the nonmalignant cell line, HEp-2, will be investigated using flow cytometry and RT-PCR analytical techniques.

Occurrence of group A β-hemolytic streptococcal pharyngitis in the four months after treatment of an index episode with amoxicillin once-daily or twice-daily or with cephalexin.

Background: Prospective studies using bacterial eradication as the endpoint have demonstrated that once-daily amoxicillin is as effective as twice-daily amoxicillin for treatment of group A β-hemolytic streptococcal (GABHS) pharyngitis.

Objective: The aim of this study was to determine, in a retrospective study, whether treatment of symptomatic GABHS pharyngitis with once-daily amoxicillin was as effective in preventing clinical recurrences as twice-daily amoxicillin or cephalexin in pediatric office practice, using patient-initiated return visits for streptococcal pharyngitis as a pragmatic, clinical endpoint.

Methods: The charts of consecutive patients 2 years of age and older with laboratory-proven GABHS pharyngitis for a period of 2 years were reviewed to identify index cases of streptococcal pharyngitis and subsequent episodes.

Bacterial pathogens of acute sinusitis in the osteomeatal complex during common colds and wellness.

Background: Pathogenic bacteria have been cultured from the osteomeatal complex (OMC) in one-third of adults with apparent acute bacterial sinusitis; however, it is not known whether bacteria are present in the OMC during uncomplicated viral colds in adults.

Methods: Adult volunteers were recruited for a study during wellness and at the time of acute common cold. Swab cultures were obtained from the OMC and from the nasopharynx by 2 routes (through the nose and through the mouth).

Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander?

Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens.

Occurrence of acute otitis media during colds in children younger than four years.

To determine how frequently acute otitis media (AOM) occurs, we enrolled children between 6 months and 3 years of age who returned several weeks before and 6 to 10 times during a cold for tympanometry and photography of the tympanic membrane. American Academy of Pediatrics (AAP) criteria were used to diagnose AOM. Children visited their physicians at their discretion.

Decreased rhinovirus shedding after intranasal oxymetazoline application in adults with induced colds compared with intranasal saline.

Background: Intranasal oxymetazoline (OMZ) is used as a decongestant during common colds. Recently, intracellular adhesion molecule (ICAM) 1 receptor expression in vitro has been shown to be diminished by OMZ. ICAM-1 is the major receptor used by rhinovirus to gain entry to human cells.

The diagnostic dilemma of ventilator-associated pneumonia in critically ill children.

Objective: A review of the existing literature on ventilator-associated pneumonia in children with emphasis on problems in diagnosis.

Data Sources: A systematic literature review from 1947 to 2010 using Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, and ISI Web of Science using key words "ventilator associated pneumonia" and "children." Where pediatric data were lacking, appropriate adult studies were reviewed and similarly referenced.

Respiratory viral RNA on toys in pediatric office waiting rooms.

Background: Toys in pediatric office waiting rooms may be fomites for transmission of viruses.

Methods: Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B.

Location of bacterial biofilm in the mucus overlying the adenoid by light microscopy.

Objective: To determine the location of bacteria and biofilm in adenoid tissue and in mucus overlying the adenoid.

Design: Adenoids removed in 1 piece were oriented to the cephalic and caudal ends. Mucus was fixed by the gradual addition of Carnoy fluid.

Rate of concurrent otitis media in upper respiratory tract infections with specific viruses.

Objective: To estimate the coincidence of new otitis media (OM) for first nasopharyngeal detections of the more common viruses by polymerase chain reaction (PCR). New OM episodes are usually coincident with a viral upper respiratory tract infection (vURTI), but there are conflicting data regarding the association between specific viruses and OM.

Design: Longitudinal (October-March), prospective follow-up of children for coldlike illness (CLI) by diary, middle ear status by pneumatic otoscopy, and vURTI by PCR.

Cytokine polymorphisms predict the frequency of otitis media as a complication of rhinovirus and RSV infections in children.

Previous studies suggested that the otitis media (OM) complication rate of viral upper respiratory infection (vURI) is conditioned by genes affecting cytokine production. Two hundred and thirty children (114 male; 187 White, 25 Black; aged 1-9.3 years, average=3.

Upper respiratory virus detection without parent-reported illness in children is virus-specific.

Background: Viral upper respiratory tract infection (vURI) may or may not present with a cold/flu-like illness (CFLI).

Objectives: For common upper respiratory viruses that cause vURIs, to determine the relative frequencies of virus detection by PCR in subjects with and without CFLIs.

Study Design: Prospective follow-up of 170 children aged 1-8.

Symptom profile of common colds in school-aged children.

Background: Signs and symptoms of a common cold reported in young children are those perceived by caretakers. Objective signs include cough, fever, and sneezing. Subjective symptoms include nasal congestion, feverishness, headache, and sore throat.

Middle ear pressure in preschool age children: influence of respiratory illness, season, and picornavirus or bacteria in the nasopharynx.

Conclusion: Middle ear pressure was affected by respiratory illness and season; picornavirus (without illness) or pathogenic bacteria in the nasopharynx had no or minor effect.

Objective: To examine the effect of respiratory illness, season, and nasopharyngeal microbial flora on middle ear pressure.

Subjects And Methods: Thirteen children were followed longitudinally with daily recording of respiratory symptoms, weekly tympanometry, and weekly testing of nasal aspirate/washes for Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis by culture and for picornavirus by RT-PCR.

Environmental contamination with rhinovirus and transfer to fingers of healthy individuals by daily life activity.

Rhinovirus infection may be acquired by inoculation of virus on fingertips to conjunctiva or nose (self-inoculation). The virus contaminating the fingertips may come from hand contact with someone with a cold or from virus in mucus on environmental surfaces. This study was designed to assess rhinovirus contamination of surfaces by adults with colds and rhinovirus transfer from surfaces to fingertips during normal daily activities.

Temporal relationships between colds, upper respiratory viruses detected by polymerase chain reaction, and otitis media in young children followed through a typical cold season.

Introduction: Otitis media is a frequent complication of a viral upper respiratory tract infection, and the reported co-incidence of those diseases increases with assay sensitivity and sampling density. We determined the incidence of otitis-media complications in young children when referenced to cold-like illnesses and to concurrent virus recovery from the nasopharynx.

Methods: A total of 60 children from 24 families were followed from October 2003 through April 30, 2004, by daily parental recording of illness signs, weekly pneumatic otoscopic examinations, and periodic polymerase chain reaction assay of collected nasal fluids for common viruses.

Picornavirus infections in children diagnosed by RT-PCR during longitudinal surveillance with weekly sampling: Association with symptomatic illness and effect of season.

RT-PCR is more sensitive for rhinovirus detection than cell culture, but healthy controls are frequently rhinovirus (or picornavirus) positive in cross-sectional studies. Fifteen healthy children were followed over at least three seasons of the year with weekly sampling of nasal/nasopharyngeal secretion for RT-PCR testing for picornavirus and daily recording of respiratory symptoms. One sample positive for picornavirus was diagnosed as an infection; consecutive positive weekly samples constituted a single infection.

Virucidal hand treatments for prevention of rhinovirus infection.

Rhinovirus infections are associated with substantial morbidity and economic cost. The available common cold remedies are of limited utility and specific antiviral approaches have been unsuccessful. Viral contamination of the hands appears to play an important role in the transmission of rhinovirus from person-to-person.

Weekly point prevalence of Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis in the upper airways of normal young children: effect of respiratory illness and season.

The aim was to determine the effect of respiratory illness and season on carriage rates in the upper airways of Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis in normal children. Sixteen healthy children, 1-10 years old, amenable to weekly sampling were followed longitudinally for at least three seasons of the year. Respiratory symptoms were recorded daily; weekly nasal aspirate/wash samples were cultured on selective agars.

Viral titers in nasal lining fluid compared to viral titers in nasal washes during experimental rhinovirus infection.

Background: The concentration of rhinovirus in nasal wash specimens from infected volunteers peaks at 48-72 h after inoculation. The volume of expelled nasal fluid peaks at the same time, raising the question of whether the viral concentration in nasal wash reflects viral replication in nasal cells or merely the production of an increased volume of nasal fluid during a cold.

Objectives: To determine the amount of rhinovirus in nasal lining fluid during colds before the nasal fluid has been diluted in a nasal wash.