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With the atypical rise of infection (MPI) in 2023, prompt studies are needed to determine the current epidemic features and risk factors with emerging trends of MPI to furnish a framework for subsequent investigations. This multicentre, retrospective study was designed to analyse the epidemic patterns of MPI before and after the COVID-19 pandemic, as well as genotypes and the macrolide-resistance-associated mutations in sampled from paediatric patients in Southern China. Clinical data was collected from 1,33,674 patients admitted into investigational hospitals from 1 June 2017 to 30 November 2023. Metagenomic next-generation sequencing (mNGS) data were retrieved based on sequence positive samples from 299 paediatric patients for macrolide-resistance-associated mutations analysis. was used to compare categorical variables between different time frames. The monthly average cases of paediatric common respiratory infection diseases increased without enhanced public health measures after the pandemic, especially for influenza, respiratory syncytial virus infection, and MPI. The contribution of MPI to pneumoniae was similar to that in the outbreak in 2019. Compared to mNGS data between 2019-2022 and 2023, the severity of did not grow stronger despite higher rates of macrolide-resistance hypervariable sites, including loci 2063 and 2064, were detected in childhood samples of 2023. Our findings indicated that ongoing surveillance is necessary to understand the impact of post pandemic on transmission disruption during epidemic season and the severity of clinical outcomes in different scenarios.

Background The incidence of hand foot and mouth disease (HFMD) has increased in recent years, making it a very common childhood illness worldwide. The relationship between different enterovirus genotypes and disease severity is not clearly understood. Given that enteroviruses are transmitted through the gastrointestinal tract, we hypothesized that variation in intestinal microorganisms of the host might play a role in the prognosis of HFMD. Methods We carried out a meta-transcriptomic-wide association study of fecal samples obtained from a cohort of children (254 patients, 227 tested positive for enterovirus, including 16 patients co-infectied with 2 kinds of enterovirus) with mild and severe HFMD and healthy controls. Results We found there was no significant difference in the amount of each virus type between the mild and severe cases. Genes of enterovirus 71 (EV71) and coxsackievirus A (CV-A) from the severe and mild cases did not show significant clustering. Clostridium sp. L2-50 and Bacteroides stercoris ATCC 43183 were enriched in the guts of children with severe HFMD and KEGG enrichment was found between mild and severe cases. Conclusions Intestinal microorganisms appear to interact with enterovirus to determine the progression of HFMD. Genes of Bacteroides and Clostridium may be used as predictive markers for a more efficient prognosis and intervention. The enrichment of intestinal bacteria genes with functions may facilitate the development of severe symptoms for HFMD patients.

目的 总结钠牛磺胆酸共转运多肽(NTCP)缺陷病的临床和基因突变特征。 方法 选取2020年6月—2021年6月于广州市妇女儿童医疗中心经基因检测确诊的10例NTCP缺陷病患儿(年龄 < 18岁)，分析一般资料(性别、年龄、身高、体质量、家族史和既往病史)、临床表现、病情转归、实验室检查(血常规、肝功能、嗜肝病毒、自身免疫性肝炎筛查)及基因突变检测结果。 结果 10例患儿生长发育均正常，其中男8例，女2例；确诊年龄3~37个月。首次就诊病因包括新生儿黄疸延长(5/10，50%)、转氨酶升高(2/10，20%)、体检(2/10，20%)和肺炎(1/10，10%)。所有患儿确诊时血清TBA水平均明显升高；ALT、AST水平升高2例；TBil水平升高1例，且以DBil水平升高为主(DBil/TBil＞50%)。经第二代基因测序，10例患儿均为SLC10A1基因纯合突变：c.800C＞T(p.Ser267Phe，chr14∶70245193)。 结论 尽管NTCP缺乏症往往无明显症状，但部分患儿早期可表现为婴儿胆汁淤积症，对于显著而持续的高胆汁酸血症，且血清总TBA水平与其他肝功能指标的变化趋势不一致时，应考虑NTCP缺陷病可能。