Background: Respiratory syncytial virus (RSV) is a global cause of severe respiratory morbidity and mortality in infants. While preventive and therapeutic interventions are being developed, including antivirals, vaccines and monoclonal antibodies, little is known about the global molecular epidemiology of RSV. INFORM is a prospective, multicenter, global clinical study performed by ReSViNET to investigate the worldwide molecular diversity of RSV isolates collected from children less than 5 years of age. Methods: The INFORM study is performed in 17 countries spanning all inhabited continents and will provide insight into the molecular epidemiology of circulating RSV strains worldwide. Sequencing of > 4000 RSV-positive respiratory samples is planned to detect temporal and geographical molecular patterns on a molecular level over five consecutive years. Additionally, RSV will be cultured from a subset of samples to study the functional implications of specific mutations in the viral genome including viral fitness and susceptibility to different monoclonal antibodies. Discussion: The sequencing and functional results will be used to investigate susceptibility and resistance to novel RSV preventive or therapeutic interventions. Finally, a repository of globally collected RSV strains and a database of RSV sequences will be created.

RationaleDirect visualisation of ciliary beat pattern (CBP) and ciliary beat frequency (CBF) has been recommended as firstline diagnostic test in patients suspected of having primary ciliary dyskinesia (PCD). However, the test procedure is not yet completely standardised and centers measure the CBF at different temperatures.ObjectivesIt was the aim of the study to compare CBF at different temperatures, to establish normative values, to check for age dependency and to measure the temperature on the nasal mucosa of the participants.MethodsHigh-speed video-microscopy analysis with a SAVA system was used to determine CBP and CBF in the participants.MeasurementsNasal brushings were taken and CBF was measured in randomised order at the three temperatures 25°C, 32°C and 37°C.Main Results100 healthy young adults (74f, 26 m), aged 20,2–31,9 years, were included in the study. We found a highly significant difference among the groups, the median CBF was 7,0 Hz at 25°C, 7,6 Hz at 32°C and 8,0 Hz at 37°C. The maximum time period ex vivo was 65 min and did not differ significantly. However, CBF was significantly higher when the cilia were kept at a higher temperature before the measurements were made. We found no correlation between CBF and the age of the participants. The median nasal mucosal temperature in our study participants was 30,2°C (range 24,7–35,8) comparable to 30,2–34,4°C described in the literature.ConclusionsThe most appropriate temperature to measure CBF is 32°C. In our study the 95% confidence interval for this temperature was 6,3–9,0 Hz.

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BackgroundThe clinical diagnosis of pneumonia is usually based on crackles at auscultation but it is not yet clear what kind of crackles are the characteristic features of pneumonia in children. Lung sound monitoring can be used as a “longtime stethoscope”. Therefore, it was the aim of this pilot study to use a lung sound monitor system to detect crackles and to differentiate between fine and coarse crackles in children with acute pneumonia. The change of crackles during the course of the disease shall be investigated in a follow-up study.Patients and methodsCrackles were recorded overnight from 22.00 to 06.00 h in 30 children with radiographically confirmed pneumonia. The data of a total of 28 800 recorded 30-second-epochs were audiovisually analysed for fine and coarse crackles.ResultsFine crackles and coarse crackles were recognised in every patient with pneumonia but the number of epochs with and without crackles varied widely among the different patients: Fine crackles were detected in 40% (mean, sd 22), coarse crackles in 76% (sd 20). The predominant localisation of crackles as recorded during overnight monitoring was in accordance with the radiographic infiltrates and the classical auscultation in most patients. The distribution of crackles was fairly equal throughout the night. However, there were time periods without any crackle in the single patients so that the diagnosis of pneumonia might be missed at sporadic auscultation.ConclusionNocturnal monitoring can be beneficial to reliably detect fine and coarse crackles in children with pneumonia.