Background: Gut microbiota plays a critical role in many important physiological processes and is linked with various pulmonary infectious diseases. The relationship between pulmonary tuberculosis (PTB) and gut microbiota has been poorly studied. The present study aimed to characterize gut microbiota in pediatric patients with PTB.Methods: A case-controlled study was executed for the characterization of gut microbiota in pediatric PTB patients. Fecal samples were collected from the PTB patients and healthy controls upon admission. In addition, a one-month follow-up assessment was performed to investigate alterations in the gut microbiota post anti-tuberculosis treatment. 16SrDNA sequencing analysis of fecal DNA was completed on the Illumina MiSeq platform.Results: Compared with healthy controls, the gut microbiota of pediatric patients with PTB was characterized by decreased microbial diversity. PTB patients further presented an up-regulation of the pro-inflammatory bacteriaPrevotella,the opportunistic pathogenEnterococcus,as well as a reduction of beneficial bacteria includingRuminococcaceae,Bifidobacteriaceaeandprausnitzii.One-month after anti-tuberculosis therapy, the richness of gut microbiota in PTB patients was distinctly depleted.Conclusions: The gut microbiota of pediatric patients with PTB was significantly distinct from healthy controls. Additionally, the richness of gut microbiota in PTB patients decreased after one-month anti-tuberculosis treatment. It is hypothesized that the homeostasis of gut microbiota in PTB patients may affect the pathogenies of PTB by de-regulation of the hosts’ immune status through the gut-lung axis.

Pertussis (Whooping Cough) is a respiratory infection caused by Bordetella pertussis. Pertussis usually occurs in childhood; severe infections are most common in infants. It can be fatal with severe complications such as pulmonary hypertension, heart failure, and encephalitis. We sought to synthesize the existing literature on severe pertussis in infants and inform further study. A scoping review was performed based on the methodological framework developed by Arksey & O'Malley. Search in Pubmed and Embase databases, with no restrictions on the language and date of publication. Of the 1299 articles retrieved, 64 were finally included. The selected articles were published between 1979 and 2022, with 90.6% (58/64) of the studies in the last two decades. The studies covered epidemiology, pathology, clinical characteristics, risk factors, treatments, and burden of disease. The literature reviewed suggests that studies on severe pertussis in infants covered a variety of clinical concerns. However, these studies were observational, and experimental studies are needed to provide high-quality evidence.

Background: In recent years, the impact of Helicobacter pylori (H pylori) on the gut microbiota has attracted more attention; however, the relationship in pediatric population rarely was reported.Methods: Endoscopic gastric mucosal biopsy specimens from 55 children with gastrointestinal symptoms were collected, 37 of them were H pylori‐positive (23 nonpeptic ulcer and 14 peptic ulcer) and 18 were H pylori‐negative. In addition, 11 specimens were collected from H pylori‐positive children who performed second endoscopy in 4 weeks after therapy. Microbial abundance and compositions were analyzed by 16S ribosomal RNA amplification and microbial functions were predicted using the software PICRUSt.Results: The gastric microbiota of H pylori‐positive children were mainly dominated by Helicobacter in genus (95.43%). The microbiota richness and diversity of H pylori‐positive children were lower than that of H pylori‐negative children. No difference was found in microbiota structure between H pylori‐positive children with or without peptic ulcer. The richness and compositions after therapy were closer to the characteristics of H pylori‐negative children. For predicted functions, higher abundance in pathways of infection diseases, cancer and lower abundance in the pathways of amino acid, lipid, and carbohydrate metabolism were found in H pylori‐positive group than H pylori‐negative group.Conclusion: The characteristics of gastric microbiota were affected by H pylori infection rather than disease states, and the richness and diversity of gastric species were inverse correlation with H pylori infection in children. Eradication therapy was helpful to restore shifted gastric microbiota.

Background.There are no treatments with established efficacy for this disorder so far.Aim.To systematically review the efficacy of acotiamide in the treatment of patients with FD.Methods.We searched main electronic databases through November 2013. RCTs evaluating the efficacy of acotiamide versus placebo in FD patients were included. Pooled risk ratio (RR) with 95% confidential interval (CI) was calculated.Results.Six publications including seven RCTs were eligible for inclusion. The summary RR of overall improvement of FD symptoms in patients receiving acotiamide versus placebo was 1.29 (95% CI, 1.19–1.40,P<0.00001;I2=15%). Acotiamide improved the symptoms of patients with postprandial distress syndrome (PDS) (RR, 1.29; 95% CI, 1.09–1.53,P=0.003;I2=0%), and the summary RR for patients with epigastric pain syndrome (EPS) was 0.92 (95% CI, 0.76–1.11,P=0.39;I2=0%). Acotiamide showed a significantly beneficial effect on the elimination of some individual FD symptoms compared with placebo. Adverse events were not significantly different between acotiamide and placebo groups. Subgroup analyses suggested that acotiamide 100 mg three times daily (tid) showed consistent efficacy not only for the overall improvement but also for the elimination of some individual symptoms in FD patients.Conclusions.Acotiamide has the potential to improve the symptoms of patients with FD, particularly of patients with PDS, without major adverse effects. The dosage of acotiamide 100 mg tid might be the appropriate dose in the treatment of FD.

Background: Pediatric bacterial meningitis (PBM) remains a devastating disease that causes substantial neurological morbidity and mortality worldwide. However, there are few large-scale studies on the pathogens causing PBM and their antimicrobial resistance (AMR) patterns in China. The present multicenter survey summarized the features of the etiological agents of PBM and characterized their AMR patterns. Methods: Patients diagnosed with PBM were enrolled retrospectively at 13 children’s hospitals in China from 2016 to 2018 and were screened based on a review of cerebrospinal fluid (CSF) microbiology results. Demographic characteristics, the causative organisms and their AMR patterns were systematically analyzed. Results: Overall, 1193 CSF bacterial isolates from 1142 patients with PBM were obtained. The three leading pathogens causing PBM were Staphylococcus epidermidis (16.5%), Escherichia coli (12.4%) and Streptococcus pneumoniae (10.6%). In infants under 3 months of age, the top 3 pathogens were E. coli (116/523; 22.2%), Enterococcus faecium (75/523; 14.3%), and S. epidermidis (57/523; 10.9%). However, in children more than 3 months of age, the top 3 pathogens were S. epidermidis (140/670; 20.9%), S. pneumoniae (117/670; 17.5%), and Staphylococcus hominis (57/670; 8.5%). More than 93.0% of E. coli isolates were sensitive to cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, amikacin and carbapenems, and the resistance rates to ceftriaxone, cefotaxime and ceftazidime were 49.4%, 49.2% and 26.4%, respectively. From 2016 to 2018, the proportion of methicillin-resistant coagulase-negative Staphylococcus isolates (MRCoNS) declined from 80.5 to 72.3%, and the frequency of penicillin-resistant S. pneumoniae isolates increased from 75.0 to 87.5%. The proportion of extended-spectrum β-lactamase (ESBL)-producing E. coli fluctuated between 44.4 and 49.2%, and the detection rate of ESBL production in Klebsiella pneumoniae ranged from 55.6 to 88.9%. The resistance of E. coli strains to carbapenems was 5.0%, but the overall prevalence of carbapenem-resistant K. pneumoniae (CRKP) was high (54.5%). Conclusions: S. epidermidis, E. coli and S. pneumoniae were the predominant pathogens causing PBM in Chinese patients. The distribution of PBM causative organisms varied by age. The resistance of CoNS to methicillin and the high incidence of ESBL production among E. coli and K. pneumoniae isolates were concerning. CRKP poses a critical challenge for the treatment of PBM.

Paragonimiasis infection has no specific symptoms or typical radiologic findings, leading to the possibility of misdiagnosis. Thus, the objective of this study was to analyze clinical and radiological features, and treatment outcome of paragonimiasis in children in Southwest China to improve the awareness of this disease. We retrospectively reviewed the records of children diagnosed with paragonimiasis in West China Second University Hospital between 2005 and 2016. The confirmed diagnosis of paragonimiasis was based on epidemiology history and seropositivity for paragonimiasis and/or detection of paragonimus eggs. Clinical, laboratory, and imaging findings of patients were examined in order to summarize risk factors, clinical characteristics, and treatment outcomes of these patients. A total of 123 patients were included; of them 112 (91.1%) lived in villages and 72 (58.5%) had a history of consuming freshwater crabs. Patients with paragonimiasis most frequently showed respiratory symptoms, including cough (26.0%, 32/123) and tachypnea (16.3%, 20/123), and gastrointestinal symptoms, including abdominal pain (26.8%, 33/123), abdominal distention (22.8%, 28/123), and vomiting (13.0%, 16/123). Laboratory examination showed elevated white blood cell (WBC) counts in the peripheral blood in 89 (72.4%) patients and eosinophilia in 102 (82.9%) patients. Tuberculosis (TB) coinfection was found in 4 (3.3%) patients. Main imaging findings included: effusions (90.4%), lymphadenopathy (40.4%), pulmonary ground-glass opacities (36.2%), cystic lesions (18.1%), and pleural thickening (17.0%). Twenty-nine patients (23.6%) received more than 1 course of praziquantel (PZQ). Additionally, 4 (19.0%) of 21 patients who were discharged from the hospital without complete treatment required rehospitalization for residual serous effusions. Moreover, patients from pericardial effusion group showed longer hospital stays and less elevated WBC counts than those from nonpericardial effusion group. Paragonimiasis should be considered in patients from endemic areas, especially in those with gastrointestinal and/or respiratory symptoms, elevated WBC count, eosinophilia, and serous effusions. Additionally, longer hospital stay may be necessary in cases of paragonimiasis associated with pericardial effusions.