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Background: Vertical transmission can result in neonatal infection and disease. Reducing the transmission of bacterial pathogens from mother to infant may be an effective means of preventing neonatal infection, including bacterial conjunctivitis.

Methods: In a double-blind, randomized trial, we assessed the effect of administering a single dose of oral azithromycin to women in labour on bacterial colonization of the neonate. A reduction in purulent neonatal conjunctivitis was a secondary objective of the trial. Ocular samples were collected from the lower fornix of infants presenting with clinical signs of purulent conjunctivitis during the first eight weeks of life. Incidence of purulent conjunctivitis was compared between trial arms. Bacterial infection was assessed using PCR and incidence of purulent conjunctivitis due to bacteria was also compared between arms.

Results: Forty of 843 infants (4.7%) presented clinical signs of purulent conjunctivitis. No significant difference in incidence of purulent conjunctivitis was seen between azithromycin and placebo arms [4.3% (18/419) versus 5.2% (22/424), OR = 0.82,95% CI (0.44,1.54), p=0.628]. S. aureus was the most commonly identified pathogen, detected in 38% of cases. Incidence of purulent-conjunctivitis due to bacterial infection was lower in the azithromycin arm [1.2% (5/419) versus 3.8% (16/424), OR = 0.31, 95% CI (0.12–0.82), p = 0.025)]. The incidence of gram-positive bacteria was also lower in the azithromycin arm [1.0% (4/419) versus 3.3% (14/424), OR = 0.28, 95%CI (0.10–0.82), p = 0.029].

Conclusions: Oral azithromycin given to women during labour may have the potential to reduce the incidence of bacterial neonatal conjunctivitis.

Kit used: FTD SPn/Staph/MC/Hi
FTD Vaginal Swab

Summary: Respiratory syncytial virus (RSV) is the most important cause of severe acute respiratory tract infection in young children. Alere i RSV is a novel molecular rapid test which identifies respiratory syncytial virus. The group evaluated the clinical performance of the Alere i RSV assay in a pediatric point-of-care setting during winter season 2016 / 2017. Test results from 518 nasopharyngeal swab samples were compared to FTD Respiratory pathogens 21 seen as reference standard. The overall sensitivity and specificity of the Alere i RSV test assay was 93% (CI95 89% – 96%) and 96% (CI95 93% – 98%), respectively. An optimal sensitivity of 98% (CI95 94% - 100%) and specificity of 96% (CI95 90% - 99%) was obtained in children < 6 months. In children ≥ 2 years, sensitivity and specificity remained at 87% (CI95 73% – 96%) and 98% (CI95 92% – 100%), respectively. False negative Alere i RSV test results mostly occurred in samples with low viral load (mean CT value 31.1; CI95 29.6 – 32.6).

Tables: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2855-1

Kit used: FTD Respiratory pathogens 21

Summary: The aim of the study was to determine the prevalence of Chikungunya virus (CHIKV), Dengue virus (DENV) and West Nile virus (WNV) in Bondo and Magugu wards in Handeni and Babati districts in Northern Tanzania, in a cross sectional analytical study.

This was cross sectional, community based study involving individuals aged 1-80 years of age. Reverse transcription Polymerase Chain Reaction (RT-PCR) was used to detect arboviruses in whole blood samples. Data was analyzed using SPSS 22.0. Chi square and logistic regression analyses were used to determine associations of explanatory factors and arbovirus infection.

Out of 128 participants recruited, 10 (7.8%) and 1 (0.8 %) were positive for CHIKV and DENV, respectively. None of the participants recruited was positive for WNV. Most cases of arboviruses were detected in Magugu with 8 (12.31%) and 1 (1.54%) individuals being positive for CHIKV and DENV respectively. Male sex was associated with CHIKV infection (χ2=9.126, p=0.003), with five times more odds of having CHIKV infection compared to females (OR: 5.30;(95%CI: 1.21-23.17), P=0.027). No WNV case was detected in any of the sites.

CHIKV is the most prevalent arbovirus in the Northern part of Tanzania. Magugu site has more arbovirus transmission than Bondo site. WNV could be a rare virus in the Northern part of Tanzania. Male sex is associated with higher CHIKV infection rates, with older children being more affected.

Kit used: FTD Tropical fever core

Summary: Mortality from acute bacterial meningitis (ABM) in sub-Saharan African adults and adolescents exceeds 50%. This group tested if Goal Directed Therapy (GDT) was feasible for adults and adolescents with clinically suspected ABM in Malawi.

Sequential patient cohorts of adults and adolescents with clinically suspected ABM were recruited in the emergency department of a teaching hospital in Malawi using a before/after design. Routine care was monitored in year one (P1). In year two (P2), nurses delivered protocolised GDT (rapid antibiotics, airway support, oxygenation, seizure control and fluid resuscitation) to a second cohort. The primary endpoint was composite mean number of clinical goals attained. Secondary endpoints were individual goals attained and death or disability from proven or probable ABM at day 40.

563 patients with suspected ABM were enrolled in the study; 273 were monitored in P1; 290 patients with suspected ABM received GDT in P2. 61% were male, median age 33 years and 90% were HIV co-infected. ABM was proven or probable in 132 (23%) patients. GDT attained more clinical goals compared to routine care: composite mean number of goals in P1 was 0·55 vs. 1·57 in P2 GDT (p<0·001); Death or disability by day 40 from proven or probable ABM occurred in 29/57 (51%) in P1 and 38/60 (63%) in P2 (p = 0·19).

Kit used: FTD Bacterial meningitis

Summary:Flu is a viral infection caused by influenza viruses. There are three types (A, B and C) and only A (A1H1N1 and AH3N2) and B (Victoria line and Yamagata line) are responsible for major seasonal epidemics with a circulation predominance for virus A. However, the 2015-2016 epidemic was different with an unusually high circulation of virus B (Victoria), leading to carry out a descriptive retrospective study at the university hospital (CHU) in Bordeaux.
A total of 110 patients with a positive PCR with a mean age of 53.3 years (16-90 years) were involved in the study. The positive diagnosis was made using a multiplex PCR with the kits available at the CHU de Bordeaux (Anyplex® II RV16, Allplex®Respiratory Panel and Fast Track®Flu Differentiation). Virus B positive sample subtyping was performed by the CNR de Lyon. Type A virus was mostly isolated in 57 patients (52%) with a predominance of subtype A (H1N1) in 50 patients (45% of the total). Type B viruses were isolated from 53 patients (48%) with the Victoria line virus in 47 patients (43% of the workforce). It was late onset epidemic (March-May), 23% of the patient were vaccinated. Same severity for type A (25%) and type B Victoria strain (23%).
Conclusion: The flu epidemic of 2015-2016 was different from the other years of an unusual overrepresentation of B / Victoria in hospital. There was a mismatch between vaccine lineage B / Yamagata and the circulating major strain Victoria with unprotected patients at risk. This study probably provides additional arguments to encourage seasonal influenza vaccination by a quadrivalent vaccine containing both subtypes A and the two B-line viruses (Victoria and Yamagata).

Kit used: FTD Flu differentiation