The Journal of Infectious Diseases最新文献

{"title":"Respiratory Syncytial Virus Is the Leading Cause of United States Infant Hospitalizations, 2009-2019: A Study of the National (Nationwide) Inpatient Sample.","authors":"Mina Suh,&nbsp;Naimisha Movva,&nbsp;Xiaohui Jiang,&nbsp;Lauren C Bylsma,&nbsp;Heidi Reichert,&nbsp;Jon P Fryzek,&nbsp;Christopher B Nelson","doi":"10.1093/infdis/jiac120","DOIUrl":"https://doi.org/10.1093/infdis/jiac120","url":null,"abstract":"<p><strong>Background: </strong>This study describes leading causes of hospitalization, including respiratory syncytial virus (RSV), in United States infants (<1 year) from 2009 through 2019.</p><p><strong>Methods: </strong>Within the National (Nationwide) Inpatient Sample (NIS) data, hospitalizations were determined by primary diagnosis using International Classification of Diseases, Ninth or Tenth Revision codes. RSV was defined as 079.6, 466.11, 480.1, B97.4, J12.1, J20.5, or J21.0. Bronchiolitis was defined as 466.19, J21.8, or J21.9. Leading causes overall and by sociodemographic variables were identified. The Kids' Inpatient Database (KID) was used for confirmatory analyses.</p><p><strong>Results: </strong>Acute bronchiolitis due to RSV (code 466.11 or J21.0) was the leading primary diagnosis, accounting for 9.6% (95% confidence interval [CI], 9.4%-9.9%) and 9.3% (95% CI, 9.0%-9.6%) of total infant hospitalizations from January 2009 through September 2015 and October 2015 through December 2019, respectively; it was the leading primary diagnosis in every year accounting for >10% of total infant hospitalizations from December through March, reaching >15% in January-February. From 2009 through 2011, acute bronchiolitis due to RSV was the leading primary diagnosis in every birth month. Acute bronchiolitis due to RSV was the leading cause among all races/ethnicities, except Asian/Pacific Islanders, and all insurance payer groups. KID analyses confirmed these results.</p><p><strong>Conclusions: </strong>Acute bronchiolitis due to RSV is the leading cause of US infant hospitalizations.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S154-S163"},"PeriodicalIF":6.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/3e/jiac120.PMC9377046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Syncytial Virus During the COVID-19 Pandemic Compared to Historic Levels: A Retrospective Cohort Study of a Health System.","authors":"Naimisha Movva,&nbsp;Mina Suh,&nbsp;Heidi Reichert,&nbsp;Bradley Hintze,&nbsp;Mark P Sendak,&nbsp;Zachary Wolf,&nbsp;Shannon Carr,&nbsp;Tom Kaminski,&nbsp;Meghan White,&nbsp;Kimberley Fisher,&nbsp;Charles T Wood,&nbsp;Jon P Fryzek,&nbsp;Christopher B Nelson,&nbsp;William F Malcolm","doi":"10.1093/infdis/jiac220","DOIUrl":"https://doi.org/10.1093/infdis/jiac220","url":null,"abstract":"<p><strong>Background: </strong>Surveillance in 2020-2021 showed that seasonal respiratory illnesses were below levels seen during prior seasons, with the exception of interseasonal respiratory syncytial virus (RSV).</p><p><strong>Methods: </strong>Electronic health record data of infants aged <1 year visiting the Duke University Health System from 4 October 2015 to 28 March 2020 (pre-COVID-19) and 29 March 2020 to 30 October 2021 (COVID-19) were assessed. International Classification of Diseases-Tenth Revision (ICD-10) codes for RSV (B97.4, J12.1, J20.5, J21.0) and bronchiolitis (RSV codes plus J21.8, J21.9) were used to detail encounters in the inpatient (IP), emergency department (ED), outpatient (OP), urgent care (UC), and telemedicine (TM) settings.</p><p><strong>Results: </strong>Pre-COVID-19, 88% of RSV and 92% of bronchiolitis encounters were seen in ambulatory settings. During COVID-19, 94% and 93%, respectively, occurred in ambulatory settings. Pre-COVID-19, the highest RSV proportion was observed in December-January (up to 38% in ED), while the peaks during COVID-19 were seen in July-September (up to 41% in ED) across all settings. RSV laboratory testing among RSV encounters was low during pre-COVID-19 (IP, 51%; ED, 51%; OP, 41%; UC, 84%) and COVID-19 outside of UC (IP, 33%; ED, 47%; OP, 47%; UC, 87%). Full-term, otherwise healthy infants comprised most RSV encounters (pre-COVID-19, up to 57% in OP; COVID-19, up to 82% in TM).</p><p><strong>Conclusions: </strong>With the interruption of historical RSV epidemiologic trends and the emergence of interseasonal disease during COVID-19, continued monitoring of RSV is warranted across all settings as the changing RSV epidemiology could affect the distribution of health care resources and public health policy.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S175-S183"},"PeriodicalIF":6.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/74/jiac220.PMC9377040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40698977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis.","authors":"Diana M Bowser,&nbsp;Katharine R Rowlands,&nbsp;Dhwani Hariharan,&nbsp;Raíssa M Gervasio,&nbsp;Lauren Buckley,&nbsp;Yara Halasa-Rappel,&nbsp;Elizabeth L Glaser,&nbsp;Christopher B Nelson,&nbsp;Donald S Shepard","doi":"10.1093/infdis/jiac172","DOIUrl":"https://doi.org/10.1093/infdis/jiac172","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available on the economic costs of respiratory syncytial virus (RSV) infections among infants and young children in the United States.</p><p><strong>Methods: </strong>We performed a systematic literature review of 10 key databases to identify studies published between 1 January 2014 and 2 August 2021 that reported RSV-related costs in US children aged 0-59 months. Costs were extracted and a systematic analysis was performed.</p><p><strong>Results: </strong>Seventeen studies were included. Although an RSV hospitalization (RSVH) of an extremely premature infant costs 5.6 times that of a full-term infant ($10 214), full-term infants accounted for 82% of RSVHs and 70% of RSVH costs. Medicaid-insured infants were 91% more likely than commercially insured infants to be hospitalized for RSV treatment in their first year of life. Medicaid financed 61% of infant RSVHs. Paying 32% less per hospitalization than commercial insurance, Medicaid paid 51% of infant RSVH costs. Infants' RSV treatment costs $709.6 million annually, representing $187 per overall birth and $227 per publicly funded birth.</p><p><strong>Conclusions: </strong>Public sources pay for more than half of infants' RSV medical costs, constituting the highest rate of RSVHs and the highest expenditure per birth. Full-term infants are the predominant source of infant RSVHs and costs.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S225-S235"},"PeriodicalIF":6.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/7a/jiac172.PMC9377037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40699946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Literature Review of Respiratory Syncytial Virus Laboratory Testing Practices and Incidence in United States Infants and Children <5 Years of Age.","authors":"Naimisha Movva,&nbsp;Mina Suh,&nbsp;Lauren C Bylsma,&nbsp;Jon P Fryzek,&nbsp;Christopher B Nelson","doi":"10.1093/infdis/jiac203","DOIUrl":"https://doi.org/10.1093/infdis/jiac203","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) can cause serious illness in those aged <5 years in the United States, but uncertainty remains around which populations receive RSV testing. We conducted a systematic literature review of RSV testing patterns in studies published from 2000 to 2021.</p><p><strong>Methods: </strong>Studies of RSV, medically attended RSV lower respiratory tract infections (LRTIs), and bronchiolitis were identified using standard methodology. Outcomes were clinical decisions to test for RSV, testing frequency, and testing incidence proportions in inpatient (IP), emergency department (ED), outpatient (OP), and urgent care settings.</p><p><strong>Results: </strong>Eighty good-/fair-quality studies, which reported data from the period 1988-2020, were identified. Twenty-seven described the clinical decision to test, which varied across and within settings. Two studies reported RSV testing frequency for multiple settings, with higher testing proportions in IP (n = 2, range: 83%-85%, 1996-2009) compared with ED (n = 1, 25%, 2006-2009) and OP (n = 2, 15%-25%, 1996-2009). Higher RSV testing incidence proportions were observed among LRTI infant populations in the ED (n = 1, 74%, 2007-2008) and OP (n = 2, 54%-69%, 1995-2008). Incidence proportions in LRTI populations were not consistently higher in the IP setting (n = 13). Across studies and time, there was heterogeneity in RSV testing patterns, which may reflect varying detection methods, populations, locations, time periods, and healthcare settings.</p><p><strong>Conclusions: </strong>Not all infants and children with LRTI are tested for RSV, highlighting underestimation of RSV burden across all settings.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S213-S224"},"PeriodicalIF":6.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/d7/jiac203.PMC9377029.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40699945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Syncytial Virus Burden and Healthcare Utilization in United States Infants <1 Year of Age: Study of Nationally Representative Databases, 2011-2019.","authors":"Mina Suh,&nbsp;Naimisha Movva,&nbsp;Xiaohui Jiang,&nbsp;Heidi Reichert,&nbsp;Lauren C Bylsma,&nbsp;Jon P Fryzek,&nbsp;Christopher B Nelson","doi":"10.1093/infdis/jiac155","DOIUrl":"https://doi.org/10.1093/infdis/jiac155","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is the leading cause of hospitalizations in United States infants aged <1 year, but research has focused on select populations.</p><p><strong>Methods: </strong>National (Nationwide) Inpatient Sample and National Emergency Department (ED) Sample data (2011-2019) were used to report RSV hospitalization (RSVH), bronchiolitis hospitalization (BH), and ED visit counts, percentage of total hospitalizations/visits, and rates per 1000 live births along with inpatient mortality, mechanical ventilation (MV), and total charges (2020 US dollars).</p><p><strong>Results: </strong>Average annual RSVH and RSV ED visits were 56 927 (range, 43 845-66 155) and 131 999 (range, 89 809-177 680), respectively. RSVH rates remained constant over time (P = .5), whereas ED visit rates increased (P = .004). From 2011 through 2019, Medicaid infants had the highest average rates (RSVH: 22.3 [95% confidence interval {CI}, 21.5-23.1] per 1000; ED visits: 55.9 [95% CI, 52.4-59.4] per 1000) compared to infants with private or other/unknown insurance (RSVH: P < .0001; ED visits: P < .0001). From 2011 through 2019, for all races and ethnicities, Medicaid infants had higher average RSVH rates (up to 7 times) compared to infants with private or other/unknown insurance. RSVH mortality remained constant over time (P = .8), whereas MV use (2019: 13% of RSVH, P < .0001) and mean charge during hospitalization (2019: $21 513, P < .0001) increased. Bronchiolitis patterns were similar.</p><p><strong>Conclusions: </strong>This study highlights the importance of ensuring access to RSV preventive measures for all infants.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S184-S194"},"PeriodicalIF":6.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/46/jiac155.PMC9377028.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase 2 Study of Pimodivir (JNJ-63623872) in Combination With Oseltamivir in Elderly and Nonelderly Adults Hospitalized With Influenza A Infection: OPAL Study.","authors":"Brian O'Neil,&nbsp;Michael G Ison,&nbsp;Marie Charlotte Hallouin-Bernard,&nbsp;Anna C Nilsson,&nbsp;Antoni Torres,&nbsp;John M Wilburn,&nbsp;Wilbert van Duijnhoven,&nbsp;Ilse Van Dromme,&nbsp;David Anderson,&nbsp;Sofie Deleu,&nbsp;Teddy Kosoglou,&nbsp;Johan Vingerhoets,&nbsp;Stefaan Rossenu,&nbsp;Lorant Leopold","doi":"10.1093/infdis/jiaa376","DOIUrl":"https://doi.org/10.1093/infdis/jiaa376","url":null,"abstract":"<p><strong>Background: </strong>Both the elderly and individuals with comorbidities are at increased risk of developing influenza-related complications. Novel influenza antivirals are required, given limitations of current drugs (eg, resistance emergence and poor efficacy). Pimodivir is a first-in-class antiviral for influenza A under development for these patients.</p><p><strong>Methods: </strong>Hospitalized patients with influenza A infection were randomized 2:1 to receive pimodivir 600 mg plus oseltamivir 75 mg or placebo plus oseltamivir 75 mg twice daily for 7 days in this phase 2b study. The primary objective was to compare pimodivir pharmacokinetics in elderly (aged 65-85 years) versus nonelderly adults (aged 18-64 years). Secondary end points included time to patient-reported symptom resolution.</p><p><strong>Results: </strong>Pimodivir pharmacokinetic parameters in nonelderly and elderly patients were similar. Time to influenza symptom resolution was numerically shorter with pimodivir (72.45 hours) than placebo (94.15 hours). There was a lower incidence of influenza-related complications in the pimodivir group (7.9%) versus placebo group (15.6%). Treatment was generally well tolerated.</p><p><strong>Conclusions: </strong>No apparent relationship was observed between pimodivir pharmacokinetics and age. Our data demonstrate the need for a larger study of pimodivir in addition to oseltamivir to test whether it results in a clinically significant decrease in time-to-influenza-symptom alleviation and/or the frequency of influenza complications.</p><p><strong>Clinical trials registration: </strong>NCT02532283.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"109-118"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/infdis/jiaa376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38101416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Homologous and Variant-Specific Memory B-Cell and Antibody Response Over Time After Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccination.","authors":"Iana H Haralambieva,&nbsp;Jonathon M Monroe,&nbsp;Inna G Ovsyannikova,&nbsp;Diane E Grill,&nbsp;Gregory A Poland,&nbsp;Richard B Kennedy","doi":"10.1093/infdis/jiac042","DOIUrl":"https://doi.org/10.1093/infdis/jiac042","url":null,"abstract":"<p><p>The durability of protective humoral immunity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and infection is largely dependent on the generation and persistence of antigen-specific isotype-switched memory B cells (MBCs) and long-lived plasma cells that reside in the bone marrow and secrete high-affinity neutralizing antibodies. The reactivity of vaccine-induced MBCs to emerging clinically significant SARS-CoV-2 variants of concern (VoCs) is largely unknown. In a longitudinal cohort study (up to 6 months following coronavirus disease 2019 messenger RNA vaccination), we measured MBCs in concert with other functional antibody measures. We found statistically significant differences between the frequencies of MBCs responding to homologous and VoC (Beta, Gamma, and Delta) receptor-binding domains after vaccination that persisted over time. In concert with a waning antibody response, the reduced MBC response to VoCs could translate to a weaker subsequent recall immune response and increased susceptibility to the emerging SARS-CoV-2 variant strains after vaccination.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"23-31"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39902132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Burden Estimates of Respiratory Syncytial Virus related Acute Respiratory Infections in Adults With Comorbidity: A Systematic Review and Meta-Analysis.","authors":"Ting Shi,&nbsp;Sophie Vennard,&nbsp;Francis Jasiewicz,&nbsp;Rory Brogden,&nbsp;Harish Nair","doi":"10.1093/infdis/jiab040","DOIUrl":"https://doi.org/10.1093/infdis/jiab040","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus related acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in adults with comorbidities. We aimed to identify all studies investigating the disease burden of RSV-ARI in this group.</p><p><strong>Methods: </strong>We estimated the incidence, hospitalization rate, and in-hospital case fatality ratio (hCFR) of RSV-ARI in adults with comorbidities based on a systematic review of studies published between January 1996 and March 2020. We also investigated the association between RSV-ARI and any comorbidity in adults. Meta-analyses based on random effects model were carried out.</p><p><strong>Results: </strong>Overall, 20 studies were included. The annual incidence rate of RSV-ARI in adults with any comorbidity was 37.6 (95% confidence interval [CI], 20.1-70.3) per 1000 persons per year in industrialized countries and the seasonal incidence rate was 28.4 (11.4-70.9) per 1000 persons per season. The hCFR in industrialized countries was 11.7% (5.8%-23.4%). There were no studies in developing countries. There were insufficient data to generate the meta-estimate of hospitalization rate. The likelihood of experiencing RSV-ARI for those with any comorbidity compared to those without was estimated to be 4.1 (odds ratio [OR], 1.6-10.4) and 1.1 (OR, 0.6-1.8) from studies using univariable and multivariable analysis respectively.</p><p><strong>Conclusion: </strong>The disease burden of RSV-ARI among adults with comorbidity is substantial with limited data available.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S17-S21"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39419206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-analysis of Animal Studies Investigating the Relationship Between Serum Antibody, T Lymphocytes, and Respiratory Syncytial Virus Disease.","authors":"Joseph McGinley, Ryan Thwaites, Will Brebner, Lewis Greenan-Barrett, Jeroen Aerssens, Deniz Öner, Louis Bont, Joanne Wildenbeest, Federico Martinón-Torres, Harish Nair, Andrew J Pollard, Peter Openshaw, Simon Drysdale","doi":"10.1093/infdis/jiab370","DOIUrl":"10.1093/infdis/jiab370","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) infections occur in human populations around the globe, causing disease of variable severity, disproportionately affecting infants and older adults (>65 years of age). Immune responses can be protective but also contribute to disease. Experimental studies in animals enable detailed investigation of immune responses, provide insights into clinical questions, and accelerate the development of passive and active vaccination. We aimed to review the role of antibody and T-cell responses in relation to RSV disease severity in animals.</p><p><strong>Methods: </strong>Systematic review and meta-analysis of animal studies examining the association between T-cell responses/phenotype or antibody titers and severity of RSV disease. The PubMed, Zoological Record, and Embase databases were screened from January 1980 to May 2018 to identify animal studies of RSV infection that assessed serum antibody titer or T lymphocytes with disease severity as an outcome. Sixty-three studies were included in the final review.</p><p><strong>Results: </strong>RSV-specific antibody appears to protect from disease in mice, but such an effect was less evident in bovine RSV. Strong T-cell, Th1, Th2, Th17, CD4/CD8 responses, and weak Treg responses accompany severe disease in mice.</p><p><strong>Conclusions: </strong>Murine studies suggest that measures of T-lymphocyte activity (particularly CD4 and CD8 T cells) may be predictive biomarkers of severity. Further inquiry is merited to validate these results and assess relevance as biomarkers for human disease.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S117-S129"},"PeriodicalIF":0.0,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39416848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Breadth of Group A Streptococcus Antibody Responses in Children With Acute Rheumatic Fever Compared to Precursor Pharyngitis and Skin Infections.","authors":"Alana L Whitcombe,&nbsp;Reuben McGregor,&nbsp;Julie Bennett,&nbsp;Jason K Gurney,&nbsp;Deborah A Williamson,&nbsp;Michael G Baker,&nbsp;Nicole J Moreland","doi":"10.1093/infdis/jiac043","DOIUrl":"https://doi.org/10.1093/infdis/jiac043","url":null,"abstract":"<p><strong>Background: </strong>Group A Streptococcus (GAS) causes superficial pharyngitis and skin infections as well as serious autoimmune sequelae such as acute rheumatic fever (ARF) and subsequent rheumatic heart disease. ARF pathogenesis remains poorly understood. Immune priming by repeated GAS infections is thought to trigger ARF, and there is growing evidence for the role of skin infections in this process.</p><p><strong>Methods: </strong>We utilized our recently developed 8-plex immunoassay, comprising antigens used in clinical serology for diagnosis of ARF (SLO, DNase B, SpnA), and 5 conserved putative GAS vaccine antigens (Spy0843, SCPA, SpyCEP, SpyAD, Group A carbohydrate), to characterize antibody responses in sera from New Zealand children with a range of clinically diagnosed GAS disease: ARF (n = 79), GAS-positive pharyngitis (n = 94), GAS-positive skin infection (n = 51), and matched healthy controls (n = 90).</p><p><strong>Results: </strong>The magnitude and breadth of antibodies in ARF was very high, giving rise to a distinct serological profile. An average of 6.5 antigen-specific reactivities per individual was observed in ARF, compared to 4.2 in skin infections and 3.3 in pharyngitis.</p><p><strong>Conclusions: </strong>ARF patients have a unique serological profile, which may be the result of repeated precursor pharyngitis and skin infections that progressively boost antibody breadth and magnitude.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"167-176"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/7e/jiac043.PMC9373162.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39597350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}