RATIONALE: In infancy, rhinovirus illnesses and severe RSV bronchiolitis indicate increased risk for recurrent wheezing and asthma, but there is less information about other viruses. We evaluated the frequency and severity of metapneumovirus (HMPV) and coronavirus (HCV) infections in a high-risk group of infants. METHODS: Nasal lavage samples were obtained in the first year of life during scheduled study visits and symptomatic respiratory illnesses as part of the Childhood Origins of Asthma Project (COAST). Samples (n 5 567) were analyzed by Respiratory Multicode Assay (RMA) for HMPV, HCV-229E, HCV-OC43, HCV-NL63 and HCV-SARS. RESULTS: HMPV was isolated in 10.7% of samples during illnesses (n 5 291), and also occurred with other respiratory viruses (4.8%). 47.8% of HMPV illnesses included wheezing. HCV were isolated in 19.2% of the samples during illnesses and included HCV-OC43 (10.0%) and HCV-NL63 (9.6%). In addition, HCV was commonly detected together with other respiratory viruses (6.5%). Of all HCV illnesses (n 5 42), 33.3% included wheezing; however, HCV-NL63 had a significantly higher wheezing rate compared to HCV-OC43 (37.5% vs. 4.5%, p 5 0.028). Children who had at least one HCV-NL63 illness during infancy were significantly more likely to have asthma at age 6 compared to those without HCV-NL63 illnesses (52.2% vs. 25.0%, p 5 0.007). Having either HCV-OC43 or HMPV was not a risk factor for asthma at age 6. CONCLUSIONS: Improvements in viral diagnostics has allowed for identification of viruses that are difficult to culture. In infancy, HCV-NL63, HCV-OC43 and HMPV were significant causes of wheezing illnesses, however, only HCV-NL63 was significantly associated with asthma development at age six.

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Aim and Objectives To investigate the knowledge, attitudes and practices towards antibiotic use among patients attending a tertiary referral urology unit in south Trinidad. We aimed to investigate the general level of awareness of antibiotics as well as identify patterns of antibiotic misuse which could potentially lead to antibiotic resistance. Results 150 patients were evaluated. Most patients (75.5%) were aware that antibiotics are used to treat bacterial infections. 57.9% also believed that antibiotics may be used to treat viral infections. 48.4% were aware of the potential deleterious effects of antibiotics on the body’s normal flora while 78% were aware of the concept of antibiotic resistance. 28.9% reported using antibiotics without a prescription. Overall, 23.3% reported having done so for a fever or cold while 12.6% did so for urinary symptoms. 68 persons (42.8%) stopped their antibiotics prior to completion of the course duration with most (76.5%) indicating that they did so because they felt better. Conclusion This study demonstrates that while most patients were aware of issues surrounding the use of antibiotics, a significant percentage still harboured several misconceptions. Also, high rates of self-medication with antibiotics were noted, among several worrying patterns of usage.