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Sample records for acute respiratory tract

  1. [Antibiotic prescribing in acute respiratory tract infections in general practice].

    Science.gov (United States)

    Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

    2015-06-01

    Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  2. Acute otitis media complicating upper respiratory tract infection ...

    African Journals Online (AJOL)

    Background: Upper respiratory tract infections (UTRIs), which may be complicated by acute otitis media (AOM), account for a large number of visits to the primary physician especially in the developed world. Materials and Methods: This study aims to determine the knowledge and treatment outcomes of UTRIs complicated ...

  3. Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections

    NARCIS (Netherlands)

    Jansen, Rogier R.; Schinkel, Janke; dek, Irene; Koekkoek, Sylvie M.; Visser, Caroline E.; de Jong, Menno D.; Molenkamp, Richard; Pajkrt, Dasja

    2010-01-01

    Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory

  4. Risk Factors for Acute Respiratory Tract Infections in Children

    OpenAIRE

    Pavić, Ivan; Jurković, Marija; Paštar, Zrinjka

    2012-01-01

    Acute respiratory tract infections (ARTI) are the most common cause of childhood morbidity and an important public health problem. The aim of this study was to identify the significant risk factors for ARTI in children. The study took place in Ivankovo which is a rural area of Eastern Slavonia and with small socio-economic differences. The study population were 159 children who were 3–5 years old at the time of the study, and who were registrated at doctor’s office Ivankovo. The s...

  5. Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

    Directory of Open Access Journals (Sweden)

    Kwofie Theophilus B

    2012-04-01

    Full Text Available Abstract Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2% were positive for one or more viruses. Respiratory Syncytial Virus (RSV was detected in 18(14.1%, 95%CI: 8.5% to 21.3% patients followed by Adenoviruses (AdV in 13(10.2%, 95%CI: 5.5% to 16.7%, Parainfluenza (PIV type: 1, 2, 3 in 4(3.1%, 95%CI: 0.9% to 7.8% and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3. Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36 of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.

  6. Acute respiratory tract infections: a potential trigger for the acute coronary syndrome

    NARCIS (Netherlands)

    Harskamp, Ralf E.; van Ginkel, Margreet W.

    2008-01-01

    Clinical studies suggest that acute respiratory tract infection (ARTI) may be a risk factor for the acute coronary syndrome (ACS). ARTI is associated with an increased risk for ACS up to 2 weeks prior to a cardiac event. The mechanism that may underlie this association is unclear. Infections are

  7. Probiotics for preventing acute upper respiratory tract infections.

    Science.gov (United States)

    Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

    2015-02-03

    Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio 0.83; 95% CI 0.66 to 1.05, P value = 0.12, very low

  8. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle

    2017-01-01

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear...... if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456...... prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second...

  9. Vitamin D supplementation effective in preventing acute respiratory tract infections.

    Science.gov (United States)

    2017-03-31

    Studies have consistently shown low levels of vitamin D make people more susceptible to respiratory infections. Acute respiratory infections are a major cause of ill health and mortality. Observational studies have shown that people with low levels of 25-hydroxyvitamin D, the major circulating vitamin D metabolite, are susceptible to respiratory infection.

  10. Aetiology of Acute Respiratory Tract Infections in Hospitalised Children in Cyprus

    OpenAIRE

    Richter, Jan; Panayiotou, Christakis; Tryfonos, Christina; Koptides, Dana; Koliou, Maria; Kalogirou, Nikolas; Georgiou, Eleni; Christodoulou, Christina

    2016-01-01

    In order to improve clinical management and prevention of viral infections in hospitalised children improved etiological insight is needed. The aim of the present study was to assess the spectrum of respiratory viral pathogens in children admitted to hospital with acute respiratory tract infections in Cyprus. For this purpose nasopharyngeal swab samples from 424 children less than 12 years of age with acute respiratory tract infections were collected over three epidemic seasons and were analy...

  11. Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

    2017-01-01

    Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...... with acute respiratory tract infections and to identify where there is a need for future quality improvements....

  12. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Larsen, Hans Henrik; Eugen-Olsen, Jesper

    2004-01-01

    The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p infected children required respiratory support. hMPV is present in young.......6%) ARTI episodes by real-time reverse transcription-polymerase chain reaction using primers targeting the hMPV N gene and the RSV L gene. Two children were co-infected with hMPV and RSV. They were excluded from statistical analysis. Hospitalization for ARTI caused by hMPV was restricted to very young...

  13. Childhood acute lower respiratory tract infections in Northern Nigeria

    African Journals Online (AJOL)

    2015-03-02

    Mar 2, 2015 ... than five years worldwide in 2010, infectious diseases caused 68 percent (5·970 million), with the largest ... lower respiratory tract infection was diagnosed in a child with history of fever, cough, fast or difficult breathing, ..... Another earlier report found vitamin D deficiency in infants exclusively breast fed29.

  14. Psychosocial factors and susceptibility to or outcome of acute respiratory tract infections [Review article

    National Research Council Canada - National Science Library

    Falagas, M.E; Karamanidou, C; Kastoris, A.C; Karlis, G; Rafailidis, P.I

    2010-01-01

    OBJECTIVE: To perform a systematic review of the literature to assess the possible effect that psychosocial variables may have on the susceptibility and/or outcome of acute respiratory tract infections (ARTIs).METHODS...

  15. Saline nasal irrigation for acute upper respiratory tract infections.

    Science.gov (United States)

    King, David; Mitchell, Ben; Williams, Christopher P; Spurling, Geoffrey K P

    2015-04-20

    Acute upper respiratory tract infections (URTIs), including the common cold and rhinosinusitis, are common afflictions that cause discomfort and debilitation and contribute significantly to workplace absenteeism. Treatment is generally by antipyretic and decongestant drugs and sometimes antibiotics, even though most infections are viral. Nasal irrigation with saline is often employed as an adjunct treatment for URTI symptoms despite a relative lack of evidence for benefit in this clinical setting. This review is an update of the Cochrane review by Kassel et al, which found that saline was probably effective in reducing the severity of some symptoms associated with acute URTIs. To assess the effects of saline nasal irrigation for treating the symptoms of acute URTIs. We searched CENTRAL (2014, Issue 7), MEDLINE (1966 to July week 5, 2014), EMBASE (1974 to August 2014), CINAHL (1982 to August 2014), AMED (1985 to August 2014) and LILACS (1982 to August 2014). Randomised controlled trials (RCTs) comparing topical nasal saline treatment to other interventions in adults and children with clinically diagnosed acute URTIs. Two review authors (DK, BM) independently assessed trial quality with the Cochrane 'Risk of bias' tool and extracted data. We analysed all data using the Cochrane Review Manager software. Due to the large variability of outcome measures only a small number of outcomes could be pooled for statistical analysis. We identified five RCTs that randomised 544 children (three studies) and 205 adults (exclusively from two studies). They all compared saline irrigation to routine care or other nose sprays, rather than placebo. We included two new trials in this update, which did not contribute data of sufficient size or quality to materially change the original findings. Most trials were small and we judged them to be of low quality, contributing to an unclear risk of bias. Most outcome measures differed greatly between included studies and therefore could not be

  16. Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

    Science.gov (United States)

    Warren‐Gash, Charlotte; Fragaszy, Ellen; Hayward, Andrew C.

    2012-01-01

    Please cite this paper as: Warren‐Gash et al. (2012) Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12015. Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low‐quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower–middle‐income setting. There was high‐quality evidence of a small reduction in respiratory infection in childcare settings. There was high‐quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low‐income setting. There was moderate‐ to high‐quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance. PMID:23043518

  17. Viral etiology and epidemiology of acute lower respiratory tract infections in Korean children.

    Science.gov (United States)

    Yun, B Y; Kim, M R; Park, J Y; Choi, E H; Lee, H J; Yun, C K

    1995-12-01

    Viral etiologic agents of acute lower respiratory tract infections were studied from November, 1990, through April, 1994, in Korean children. From 712 children who visited or were admitted to Seoul National University Children's Hospital because of acute lower respiratory tract infections, 804 nasal aspirates were collected; viral agents were detected by virus isolation and virus antigen was detected by indirect immunofluorescent staining. One or more viral agents were identified in 369 (45.9%) cases; of which 3.3% were mixed infections. The pathogens identified were respiratory syncytial virus (27.2%), parainfluenza virus type 3 (7.8%), influenza A virus (3.9%), adenovirus (3.9%), parainfluenza virus type 1 (1.7%), influenza B virus (1.4%), parainfluenza virus type 2 (0.5%), measles virus (0.1%) and others (0.9%). The clinical patterns of viral lower respiratory tract included pneumonia (56.6%), bronchiolitis (35.2%), croup (6.5%) and tracheo-bronchitis (1.6%). Infections with respiratory syncytial virus, parainfluenza virus types 1 and 3 and influenza A and B virus occurred in epidemics, whereas adenovirus was isolated sporadically throughout the study period. The data expand our understanding of the epidemiology of acute viral lower respiratory tract infections in Korean children and may be helpful to the clinicians and researchers interested in the control of viral respiratory tract infections.

  18. Assessment of a new algorithm in the management of acute respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Seyed Ahmad Tabatabaei

    2012-01-01

    Full Text Available Objectives: To assess the practicability of a new algorithm in decreasing the rate of incorrect diagnoses and inappropriate antibiotic usage in pediatric Acute Respiratory Tract Infection (ARTI. Materials and Methods: Children between 1 month to15 years brought to outpatient clinics of a children′s hospital with acute respiratory symptoms were managed according to the steps recommended in the algorithm. Results: Upper Respiratory Tract Infection, Lower Respiratory Tract Infection, and undifferentiated ARTI accounted for 82%, 14.5%, and 3.5% of 1 209 cases, respectively. Antibiotics were prescribed in 33%; for: Common cold, 4.1%; Sinusitis, 85.7%; Otitis media, 96.9%; Pharyngotonsillitis, 63.3%; Croup, 6.5%; Bronchitis, 15.6%; Pertussis-like syndrome, 82.1%; Bronchiolitis, 4.1%; and Pneumonia, 50%. Conclusion: Implementation of the ARTIs algorithm is practicable and can help to reduce diagnostic errors and rate of antibiotic prescription in children with ARTIs.

  19. Prevalence of respiratory syncytial virus infection among hospitalized children presenting with acute lower respiratory tract infections.

    Science.gov (United States)

    Gupta, Soham; Shamsundar, Ranjani; Shet, Anita; Chawan, Rashmi; Srinivasa, Hiresave

    2011-12-01

    To evaluate the prevalence of RSV among hospitalized young children presenting with ALRI in Bangalore, India. Respiratory syncytial virus (RSV) antigen detection was performed by direct fluorescent antibody (DFA) staining on 77 nasopharyngeal wash samples collected from hospitalized children below 2 years of age with a diagnosis of acute lower respiratory tract infection (ALRI). Out of 77 samples tested for RSV with DFA, 17 (22.1%) were found RSV-positive with a mean age of 8.24 ± 7.21 months (M:F = 1.8:1). Three children had congenital cardiac disease and one child had a history of prematurity. One child had re-infection within one month of primary infection. RSV-infected children were more likely to have a diagnosis of bronchiolitis than RSV-negative children (p infection is a significant cause of morbidity among children presenting with ALRI in southern India. In resource-limited settings, DFA can be used as an important tool for rapid detection of RSV and can potentially eliminate prolonged hospitalization and unnecessary use of antibiotics.

  20. Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review.

    Science.gov (United States)

    Warren-Gash, Charlotte; Fragaszy, Ellen; Hayward, Andrew C

    2013-09-01

    Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low-quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower-middle-income setting. There was high-quality evidence of a small reduction in respiratory infection in childcare settings. There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate- to high-quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance. © 2012 John Wiley & Sons Ltd.

  1. Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR

    Directory of Open Access Journals (Sweden)

    Bassant Meligy

    2016-03-01

    Conclusions: RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.

  2. Risk Factors for Acute Respiratory Tract Infections in Under‑five ...

    African Journals Online (AJOL)

    Background: Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under‑five children of the developing world. The prevalence of ARIs is determined individually or collectively by a number of factors which may be prevalent in our environment. Aim: The present study is aimed ...

  3. Risk Factors for Acute Respiratory Tract Infections in Under-five ...

    African Journals Online (AJOL)

    hanumantp

    Paediatrician, College of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria. Abstract. Background: Acute respiratory tract infections (ARIs) constitute the major causes of mortality and morbidity among under‑five children of the developing world. The prevalence of ARIs is determined individually or collectively by a ...

  4. Viral respiratory tract infections among patients with acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, Hoang Lan; Nga, Tran T. T.; van Doornum, Gerard J.; Groen, Jan; Binh, Tran Q.; Giao, Phan T.; Hung, Le Q.; Nams, Nguyen V.; Kager, P. A.; de Vries, Peter J.

    2010-01-01

    To investigate the proportion of viral respiratory tract infections among acute undifferentiated fevers (AUFs) at primary health facilities in southern Vietnam during 2001-2005, patients with AUF not caused by malaria were enrolled at twelve primary health facilities and a clinic for malaria control

  5. Acute bacterial infections of the lower respiratory tract in children from low-income countries

    NARCIS (Netherlands)

    Fleer, A; Wolf, B.H.M.

    Acute bacterial infection of the lower respiratory tract is a major cause of morbidity and mortality in children and is responsible for 4 million childhood deaths each year. Most of these deaths are caused by pneumonia and occur in the youngest children in the poorest parts of the world. Severe

  6. Profiling acute respiratory tract infections in children from Assam, India

    Directory of Open Access Journals (Sweden)

    Farzana Islam

    2013-01-01

    Full Text Available Background: Acute respiratory infections (ARI are leading global cause of under-five mortality and morbidity. Objective: To elicit the prevalence and risk factors associated with ARI among under-five children. Materials and Methods: A community-based cross-sectional study was undertaken in 21 registered urban slums of Guwahati in Assam to determine the prevalence and risk factors associated with ARI among 370 under-five children from 184 households and 370 families. Results: The prevalence of ARI was found to be 26.22%; infants and female children were more affected. Majority of the ARI cases were from nuclear families (84.54%, living in kutcha houses (90.72% with inadequate ventilation (84.54%, overcrowded living condition (81.44%, with kitchen attached to the living room (65.98% and using biomass fuel for cooking (89.69%. ARI was significantly associated with ventilation, location of kitchen in household; presence of overcrowding, nutritional status, and primary immunization status also had impacts on ARI. Conclusion: The present study had identified a high prevalence of the disease among under-fives. It also pointed out various socio-demographic, nutritional, and environmental modifiable risk factors which can be tackled by effective education of the community.

  7. Human Respiratory Syncytial Virus load normalized by cell quantification as predictor of acute respiratory tract infection.

    Science.gov (United States)

    Gómez-Novo, Miriam; Boga, José A; Álvarez-Argüelles, Marta E; Rojo-Alba, Susana; Fernández, Ana; Menéndez, María J; de Oña, María; Melón, Santiago

    2018-01-05

    Human respiratory syncytial virus (HRSV) is a common cause of respiratory infections. The main objective is to analyze the prediction ability of viral load of HRSV normalized by cell number in respiratory symptoms. A prospective, descriptive and analytical study was performed. From 7307 respiratory samples processed between December 2014 to April 2016, 1019 HRSV-positive samples, were included in this study. Low respiratory tract infection was present in 729 patients (71.54%). Normalized HRSV load was calculated by quantification of HRSV genome and human β-globin gene and expressed as log10 copies/1000 cells. HRSV mean loads were 4.09 ± 2.08 and 4.82 ± 2.09 log10 copies/1000 cells in the 549 pharyngeal and 470 nasopharyngeal samples, respectively (p respiratory tract infection and 4.22 ± 2.28 log10 copies/1000 cells with upper respiratory tract infection or febrile syndrome (p < 0.05). A possible cut off value to predict LRTI evolution was tentatively established. Normalization of viral load by cell number in the samples is essential to ensure an optimal virological molecular diagnosis avoiding that the quality of samples affects the results. A high viral load can be a useful marker to predict disease progression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Prevalence of human coronaviruses in adults with acute respiratory tract infections in Beijing, China.

    Science.gov (United States)

    Ren, Lili; Gonzalez, Richard; Xu, Jin; Xiao, Yan; Li, Yongjun; Zhou, Hongli; Li, Jianguo; Yang, Qingqing; Zhang, Jing; Chen, Lan; Wang, Wei; Vernet, Guy; Paranhos-Baccalà, Gláucia; Wang, Zhong; Wang, Jianwei

    2011-02-01

    Human coronaviruses (HCoVs) are a common etiological agent of acute respiratory tract infections. HCoV infections, especially those caused by the two HCoVs identified most recently, NL63 and HKU-1, have not been characterized fully. To evaluate the prevalence and clinical presentations of HKU1 and NL63 in adults with acute respiratory tract infections, an investigation of HCoV infections in Beijing, China from 2005 to 2009 was performed by using reverse transcriptase PCR assays and sequencing analysis. Among 8,396 respiratory specimens studied, 87 (1%) clinical samples were positive for HCoVs, of which 50 samples (0.6% of the total) were positive for HCoV-OC43, 15 (0.2%) for HCoV-229E, 14 (0.2%) for HCoV-HKU1, and 8 (0.1%) for HCoV-NL63. The prevalence of HCoV infection in adults exhibited distinct seasonal fluctuations during the study period. In addition, patients positive for HCoV-229E infections were more likely to be co-infected with other respiratory viruses. Enterovirus, rhinovirus, and parainfluenza virus type 3 were the most common viruses found in patients with HCoV infections. The demographic and clinical data present in this study of HCoV infections in adults with acute respiratory tract infections should improve our understanding of the pathogenesis of HCoVs. 2010 Wiley-Liss, Inc.

  9. [Risk factors for acute respiratory syncytial virus infection of lower respiratory tract in hospitalized infants].

    Science.gov (United States)

    Zhang, Xiaobo; Liu, Lijuan; Shi, Peng; Jiang, Gaoli; Jia, Pin; Wang, Chuankai; Wang, Libo; Qian, Liling

    2014-05-01

    To investigate the clinical epidemiologic characteristics and analyze risk factors for acute respiratory syncytial virus (RSV) infection in hospitalized infants with acute lower respiratory tract infection (ALRI). ALRI infants admitted to Children's Hospital of Fudan University from March 1st, 2011 to February 29th, 2012, were enrolled in this study. Patient information included demographic characteristics, feeding history, family status, clinical presentation, accessory examination, treatment and prognosis. According to the etiology of ALRI infants, we compared the seasonal distribution, demographic characteristics, household characteristics and underlying diseases between RSV-positive patients and RSV-negative patients. Univariate and multiple Logistic regression analyses were used to determine factors that were associated with risk of RSV infection. Among 1 726 ALRI infants, there were 913 RSV-positive infants (52.9%). The occurrence of RSV infection had a seasonal variation, with a peak in winter (59.1%). The median (P25, P75) age of RSV infants was 64 (21-155) days. The gestational age (GA) and body weight (BW) was (37.5 ± 2.4) weeks and (3.07 ± 0.66) kg, respectively. The male/female ratio among these was 1.9: 1. RSV infection was more popular among infants in the families with smoking members, crowded living conditions, history of atopic mother. Differences of the proportion of patients with underlying disease between RSV-positive and negative groups were statistically significant (59.4% vs. 54.2%, P infection were: GAinfection (OR = 1.351, 95%CI: 1.024-1.783; OR = 1.713, 95%CI: 1.332-2.204). Multivariate logistic regression determined the factors increasing the risk of RSV infection were: underlying CHD (OR = 1.298, 95%CI: 1.002-1.681), mother with atopic diseases (OR = 1.766, 95%CI: 1.237-2.520), autumn or winter infection (OR = 1.481, 95%CI: 1.105-1.985; OR = 1.766, 95%CI: 1.358-2.296). The prevalence of RSV infection was the highest in winter, while

  10. Molecular epidemiology of WU polyomavirus in hospitalized children with acute respiratory tract infection in China.

    Science.gov (United States)

    Zhu, Teng; Lu, Qing-Bin; Zhang, Shu-Yan; Wo, Ying; Zhuang, Lu; Zhang, Pan-He; Zhang, Xiao-Ai; Wei, Wei; Liu, Wei

    2017-05-01

    To explore the molecular epidemiology and clinical characteristics of Washington University polyomavirus (WUPyV) infection in pediatric patients with acute respiratory tract infections in China. A laboratory surveillance was performed to recruit pediatric patients with acute respiratory tract infections. WUPyV was detected using real-time PCR and complete genome was sequenced for randomly selected positive nasopharyngeal aspirate. Altogether 122 (7.5%) of 1617 children found to be infected with WUPyV and 88 (72.1%) were coinfected with other viruses during 2012-2015. The phylogenetic analysis showed that 14 strains from our study formed two new clusters (Id and IIIc) within the Branch I and Branch III, respectively. WUPyV is persistently circulating in China. Surveillance on WUPyV infection in wider areas and long persistence is warranted.

  11. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults.

    Directory of Open Access Journals (Sweden)

    James R Sabetta

    Full Text Available Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections. This study was done to determine if serum 25-hydroxyvitamin D concentrations correlated with the incidence of acute viral respiratory tract infections.In this prospective cohort study serial monthly concentrations of 25-hydroxyvitamin D were measured over the fall and winter 2009-2010 in 198 healthy adults, blinded to the nature of the substance being measured. The participants were evaluated for the development of any acute respiratory tract infections by investigators blinded to the 25-hydroxyvitamin D concentrations. The incidence of infection in participants with different concentrations of vitamin D was determined. One hundred ninety-five (98.5% of the enrolled participants completed the study. Light skin pigmentation, lean body mass, and supplementation with vitamin D were found to correlate with higher concentrations of 25-hydroxyvitamin D. Concentrations of 38 ng/ml or more were associated with a significant (p<0.0001 two-fold reduction in the risk of developing acute respiratory tract infections and with a marked reduction in the percentages of days ill.Maintenance of a 25-hydroxyvitamin D serum concentration of 38 ng/ml or higher should significantly reduce the incidence of acute viral respiratory tract infections and the burden of illness caused thereby, at least during the fall and winter in temperate zones. The findings of the present study provide direction for and call for future interventional studies examining the efficacy of vitamin D supplementation in reducing the incidence and severity of specific viral infections, including influenza, in the general population and in subpopulations with lower 25-hydroxyvitamin D concentrations, such as pregnant women, dark skinned individuals, and the obese.

  12. Detection and genotyping of human respiratory viruses in clinical specimens from children with acute respiratory tract infections.

    Science.gov (United States)

    Culebras, Esther; Betriu, Carmen; Vázquez-Cid, Emilia; López-Varela, Elisa; Rueda, Santiago; Picazo, Juan J

    2013-03-01

    Respiratory virus infections are a major health concern and represent the primary cause of testing consultation and hospitalization for young children. The application of nucleic acid amplification technology, particularly multiplex PCR coupled with fluidic or fixed microarrays, provides an important new approach for the detection of multiple respiratory viruses in a single test. The aim of this study was to analyze respiratory samples from children with acute respiratory tract infection (ARTI) using a commercial array-based method (CLART(®) PneumoVir Genomica, Coslada, Spain). These tests were used to identify viruses in 281 nasopharyngeal samples obtained from children affected by ARTI. Samples were obtained form October 2008 to April 2009. Viruses were identified in 80% of the studied ARTI providing useful information on clinical features and epidemiology of specific agents affecting children in cold months. Multiple viral infections were found in 33.45% of the specimens.

  13. Viral aetiology in adults with acute upper respiratory tract infection in Jinan, Northern China.

    Science.gov (United States)

    Lu, Yanqin; Tong, Jiabei; Pei, Fengyan; Yang, Yanping; Xu, Dong; Ji, Mingyu; Xing, Chunyan; Jia, Pingdong; Xu, Chao; Wang, Yunshan; Li, Gongchao; Chai, Zhenbin; Liu, Yan; Han, Jinxiang

    2013-01-01

    Our study investigated the epidemiology of respiratory viruses in adult patients with upper respiratory tract infection (URTI) between August 2009 and September 2010 in Jinan, northern China. Nasal and throat swabs (n = 596) were collected from adult patients with URTIs. Nine respiratory-related viruses, including IFV, PIV, HRV, HMPV, HBoV, HCoV, ADV, RSV, and EV, were detected in all samples by conventional and reverse transcription polymerase chain reactions. Positive detection rate for respiratory virus was 38.76% and codetection rate was 4.70% in adults with acute respiratory tract infections. IFV (20.81%) was the dominant agent detected and IFVB had a higher incidence (12.58%) than IFVA (7.72%). Detection rates of 8.22%, 5.03%, 3.69%, and 2.52% were observed for HBoV, HRV, EV, and RSV, respectively. HCoV had the lowest detection rate of 0.50%. HBoV, HRV, EV, and ADV infection rates were higher in the 14-25-year-old group than in the 26-65-year-old group. Codetection rates were higher (7.52%) in the 14-25-year-old group than in the older age group (2.64%). The spectrum of respiratory virus infection in adult patients with URTIs was different in Jinan compared with other cities in China.

  14. USE OF A NEW FORM OF IBUPROFEN IN CHILDREN WITH FEVER AND ACUTE RESPIRATORY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    E. E. Lokshina

    2013-01-01

    Full Text Available Aim: to study clinical efficacy, tolerance and safety of a new pelleted ibuprofen form for children in treatment of fever in patients with acute respiratory tract infection. Patients and methods: children aged from 6 to 12 years old with clinical manifestation of respiratory tract infections and requiring antipyretic treatment were included into the study. Children (n = 50 were administered ibuprofen at a single dose of 5–10 mg/kg of body weight, not more than 3–4 times per day. The efficacy assessment included time needed for temperature decrease (assessment was performed in 15, 30 and 60 minutes and duration of the antipyretic effect (assessment in 6, 8 and 12 hours. Rapidity of analgesic effect in children with ear ache, headache and myalgias was performed in 15, 30, 60 minutes and 6, 8 and 12 hours after the drug intake. Results: antipyretic effect of pelleted ibuprofen for children begins in 15 minutes after its intake. Stable temperature decrease during the first 6 hours was observed in 58% of children (the mean temperature was 37,1 ± 0,3 and maintained up for 12 hours. Relief of pain intensity was established in 62,1% of patients during the first 3 hours, and in 37,9% the pain syndrome was arrested completely. Conclusions: the new pelleted form of ibuprofen for children was proved to have high clinical efficacy and safety in treatment of fever in children with acute respiratory tract infections.

  15. Prevalence of antibiotic use for pediatric acute upper respiratory tract infections in Korea.

    Science.gov (United States)

    Shin, Sun Mi; Shin, Ju-Young; Kim, Mi Hee; Lee, Shin Haeng; Choi, Sohyun; Park, Byung-Joo

    2015-05-01

    This study was conducted to estimate the prevalence of antimicrobial prescribing for acute upper respiratory tract infections (URI) among pediatric outpatients and to identify the national patterns of its use from 2009 to 2011 in Korea. Using National Patients Sample database from 2009 to 2011, we estimated the frequency of antibiotics prescribing for URI in pediatric outpatients with diagnoses of acute nasopharyngitis (common cold), acute sinusitis, acute pharyngitis, acute tonsillitis, acute laryngitis/tracheitis, acute obstructive laryngitis/epiglottitis, and acute upper respiratory infections of multiple and unspecified sites. The proportions of each antibiotic class were calculated by year and absolute and relative differences were estimated. Also, we investigated daily amount of prescribed antibiotics per defined population according to the type of medical care institution, physician specialty, and geographic region. The overall antibiotic prescribing proportion was 58.7% and its annual proportion slightly decreased (55.4% in 2011 vs. 60.5% in 2009; adjusted odds ratio, 0.82; 95% confidence interval, 0.82-0.83). Variations by the type of medical care institution were observed. Tertiary hospitals (45.0%) were less likely to prescribe antibiotics than primary care clinics (59.4%), hospitals (59.0%), and general hospitals (61.2%); they showed different tendencies in choosing antibiotics. Variations by physician specialty and region were also observed. Prevalence of antimicrobial prescribing for pediatric URI is still considered higher than that of western countries and varies by the type of medical care institution, physician specialty, and geographic region.

  16. Burden and Seasonality of Viral Acute Respiratory Tract Infections among Outpatients in Southern Sri Lanka.

    Science.gov (United States)

    Shapiro, David; Bodinayake, Champica K; Nagahawatte, Ajith; Devasiri, Vasantha; Kurukulasooriya, Ruvini; Hsiang, Jeremy; Nicholson, Bradley; De Silva, Aruna Dharshan; Østbye, Truls; Reller, Megan E; Woods, Christopher W; Tillekeratne, L Gayani

    2017-07-01

    In tropical and subtropical settings, the epidemiology of viral acute respiratory tract infections varies widely between countries. We determined the etiology, seasonality, and clinical presentation of viral acute respiratory tract infections among outpatients in southern Sri Lanka. From March 2013 to January 2015, we enrolled outpatients presenting with influenza-like illness (ILI). Nasal/nasopharyngeal samples were tested in duplicate using antigen-based rapid influenza testing and multiplex polymerase chain reaction (PCR) for respiratory viruses. Monthly proportion positive was calculated for each virus. Bivariable and multivariable logistic regression were used to identify associations between sociodemographic/clinical information and viral detection. Of 571 subjects, most (470, 82.3%) were ≥ 5 years of age and 53.1% were male. A respiratory virus was detected by PCR in 63.6% ( N = 363). Common viral etiologies included influenza (223, 39%), human enterovirus/rhinovirus (HEV/HRV, 14.5%), respiratory syncytial virus (RSV, 4.2%), and human metapneumovirus (hMPV, 3.9%). Both ILI and influenza showed clear seasonal variation, with peaks from March to June each year. RSV and hMPV activity peaked from May to July, whereas HEV/HRV was seen year-round. Patients with respiratory viruses detected were more likely to report pain with breathing (odds ratio [OR] = 2.60, P = 0.003), anorexia (OR = 2.29, P respiratory viruses detected. ILI showed clear seasonal variation in southern Sri Lanka, with most activity during March to June; peak activity was largely due to influenza. Targeted infection prevention activities such as influenza vaccination in January-February may have a large public health impact in this region.

  17. Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults

    Science.gov (United States)

    Sabetta, James R.; DePetrillo, Paolo; Cipriani, Ralph J.; Smardin, Joanne; Burns, Lillian A.; Landry, Marie L.

    2010-01-01

    Background Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections. This study was done to determine if serum 25-hydroxyvitamin D concentrations correlated with the incidence of acute viral respiratory tract infections. Methodology/Findings In this prospective cohort study serial monthly concentrations of 25-hydroxyvitamin D were measured over the fall and winter 2009–2010 in 198 healthy adults, blinded to the nature of the substance being measured. The participants were evaluated for the development of any acute respiratory tract infections by investigators blinded to the 25-hydroxyvitamin D concentrations. The incidence of infection in participants with different concentrations of vitamin D was determined. One hundred ninety-five (98.5%) of the enrolled participants completed the study. Light skin pigmentation, lean body mass, and supplementation with vitamin D were found to correlate with higher concentrations of 25-hydroxyvitamin D. Concentrations of 38 ng/ml or more were associated with a significant (prespiratory tract infections and with a marked reduction in the percentages of days ill. Conclusions/Significance Maintenance of a 25-hydroxyvitamin D serum concentration of 38 ng/ml or higher should significantly reduce the incidence of acute viral respiratory tract infections and the burden of illness caused thereby, at least during the fall and winter in temperate zones. The findings of the present study provide direction for and call for future interventional studies examining the efficacy of vitamin D supplementation in reducing the incidence and severity of specific viral infections, including influenza, in the general population and in subpopulations with lower 25-hydroxyvitamin D concentrations, such as pregnant women, dark skinned individuals, and the obese. PMID:20559424

  18. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults.

    Science.gov (United States)

    Sabetta, James R; DePetrillo, Paolo; Cipriani, Ralph J; Smardin, Joanne; Burns, Lillian A; Landry, Marie L

    2010-06-14

    Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections. This study was done to determine if serum 25-hydroxyvitamin D concentrations correlated with the incidence of acute viral respiratory tract infections. In this prospective cohort study serial monthly concentrations of 25-hydroxyvitamin D were measured over the fall and winter 2009-2010 in 198 healthy adults, blinded to the nature of the substance being measured. The participants were evaluated for the development of any acute respiratory tract infections by investigators blinded to the 25-hydroxyvitamin D concentrations. The incidence of infection in participants with different concentrations of vitamin D was determined. One hundred ninety-five (98.5%) of the enrolled participants completed the study. Light skin pigmentation, lean body mass, and supplementation with vitamin D were found to correlate with higher concentrations of 25-hydroxyvitamin D. Concentrations of 38 ng/ml or more were associated with a significant (prespiratory tract infections and with a marked reduction in the percentages of days ill. Maintenance of a 25-hydroxyvitamin D serum concentration of 38 ng/ml or higher should significantly reduce the incidence of acute viral respiratory tract infections and the burden of illness caused thereby, at least during the fall and winter in temperate zones. The findings of the present study provide direction for and call for future interventional studies examining the efficacy of vitamin D supplementation in reducing the incidence and severity of specific viral infections, including influenza, in the general population and in subpopulations with lower 25-hydroxyvitamin D concentrations, such as pregnant women, dark skinned individuals, and the obese.

  19. [A three-year review of acute respiratory tract infections caused by Streptococcus milleri group].

    Science.gov (United States)

    Fujiki, Rei; Kawayama, Tomotaka; Rikimaru, Toru; Oizumi, Kotaro

    2002-03-01

    The objective of our study is to understand the clinical features of patients with acute respiratory tract infection associated with Streptococcus milleri group (SMG). Fifteen patients with SMG respiratory tract infection visited our hospital from July, 1997 through May, 2000. There were seven cases of pneumonia, two pulmonary abscess, three thoracic empyema and three acute bronchitis. The mean age of the patients was 57.8 years (range 16-87), twelve were males, and seven were smokers. The moderately to severe underlying diseases existed in thirteen patients (86.7%) and included the following: respiratory diseases (20.0%), history of the esophageal or gastric surgery (26.7%), central nerve system diseases (13.3%), alcohol intake (60.0%), hepatitis and pancreatitis (33.3%), diabetes mellitus (13.3%) and malignancy (6.7%). The species of SMG detected were as follows: S. constellatus, 8, S. anginosus, 6 and S. intermedius, 1. Anaerobic organism and other microorganisms were detected in five patients. A patient with SMG nosocominal pneumonia who previously had thoracic surgery for esophageal cancer died. Antibiotics therapy with carbapenem or combination therapy, drainage and no surgery, were successful in 14 of the 15 cases (93.3%). The number of intermediately or complete resistant strains against penicillin G, ampicillin and cefmetazole were 5 (33.3%), 8 (53.3%) and 12 (80.0%), respectively in this series. Recently, it is seemed that acute respiratory tract infections caused by SMG are increasing in the patients with moderately to severe underlying diseases, and several clinical strains of SMG are acquiring a tolerance to antibiotics.

  20. Human bocavirus infection as a cause of severe acute respiratory tract infection in children.

    Science.gov (United States)

    Moesker, F M; van Kampen, J J A; van der Eijk, A A; van Rossum, A M C; de Hoog, M; Schutten, M; Smits, S L; Bodewes, R; Osterhaus, A D M E; Fraaij, P L A

    2015-10-01

    In 2005 human bocavirus (HBoV) was discovered in respiratory tract samples of children. The role of HBoV as the single causative agent for respiratory tract infections remains unclear. Detection of HBoV in children with respiratory disease is frequently in combination with other viruses or bacteria. We set up an algorithm to study whether HBoV alone can cause severe acute respiratory tract infection (SARI) in children. The algorithm was developed to exclude cases with no other likely cause than HBoV for the need for admission to the paediatric intensive care unit (PICU) with SARI. We searched for other viruses by next-generation sequencing (NGS) in these cases and studied their HBoV viral loads. To benchmark our algorithm, the same was applied to respiratory syncytial virus (RSV)-positive patients. From our total group of 990 patients who tested positive for a respiratory virus by means of RT-PCR, HBoV and RSV were detected in 178 and 366 children admitted to our hospital. Forty-nine HBoV-positive patients and 72 RSV-positive patients were admitted to the PICU. We found seven single HBoV-infected cases with SARI admitted to PICU (7/49, 14%). They had no other detectable virus by NGS. They had much higher HBoV loads than other patients positive for HBoV. We identified 14 RSV-infected SARI patients with a single RSV infection (14/72, 19%). We conclude that our study provides strong support that HBoV can cause SARI in children in the absence of viral and bacterial co-infections. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  1. Assessment of the role of microorganisms of respiratory tract in patients with progressive acute respiratory viral infections

    Directory of Open Access Journals (Sweden)

    Burgasova О.А.

    2014-06-01

    Full Text Available The article presents the review of literature for the period from 1987 till 2012. It has been shown that the spread of acute respiratory viral infections (ARI and the incidence of complications is of great social and economic importance worldwide. Therefore, the identification of etiological factors and associated development of ARI is an urgent task for practical health care. It is of great importance to determine both the type of pathogen and the presence of its pathogenic factors. The etiological agent of bacterial complications of ARI becomes Moraxella catarrhalis, featuring a large set of markers of virulence. In the development of the pathological process in the respiratory tract, adhesins, a number of enzymes and toxins produced by M.catarrhalis are important. It allows to persist and multiply in the body of the patient. Dangerous strains of M.catarrhalis, resistant to (3-lactam antibiotics and characterized by multiresistance greatly reduce the effectiveness of the therapy. Lack of laboratory studies in acute inflammatory diseases of the respiratory tract leads to the reduction of the etiological interpretation of these diseases, inadequate etiotropic treatment and as a consequence — the development of complications that reduces the effectiveness of therapy. In conclusion it is necessary to improve the system of microbiological diagnostics and tactics of treatment of ARI patients.

  2. Detection of respiratory viruses and Bordetella bronchiseptica in dogs with acute respiratory tract infections.

    Science.gov (United States)

    Schulz, B S; Kurz, S; Weber, K; Balzer, H-J; Hartmann, K

    2014-09-01

    Canine infectious respiratory disease (CIRD) is an acute, highly contagious disease complex caused by a variety of infectious agents. At present, the role of viral and bacterial components as primary or secondary pathogens in CIRD is not fully understood. The aim of this study was to investigate the prevalence of canine parainfluenza virus (CPIV), canine adenovirus type 2 (CAV-2), canine influenza virus (CIV), canine respiratory coronavirus (CRCoV), canine herpes virus-1 (CHV-1), canine distemper virus (CDV) and Bordetella bronchiseptica in dogs with CIRD and to compare the data with findings in healthy dogs. Sixty-one dogs with CIRD and 90 clinically healthy dogs from Southern Germany were prospectively enrolled in this study. Nasal and pharyngeal swabs were collected from all dogs and were analysed for CPIV, CAV-2, CIV, CRCoV, CHV-1, CDV, and B. bronchiseptica by real-time PCR. In dogs with acute respiratory signs, 37.7% tested positive for CPIV, 9.8% for CRCoV and 78.7% for B. bronchiseptica. Co-infections with more than one agent were detected in 47.9% of B. bronchiseptica-positive, 82.6% of CPIV-positive, and 100% of CRCoV-positive dogs. In clinically healthy dogs, 1.1% tested positive for CAV-2, 7.8% for CPIV and 45.6% for B. bronchiseptica. CPIV and B. bronchiseptica were detected significantly more often in dogs with CIRD than in clinically healthy dogs (P infections with several pathogens were common. In conclusion, clinically healthy dogs can carry respiratory pathogens and could act as sources of infection for susceptible dogs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Primary pneumocystis infection in infants hospitalized with acute respiratory tract infection

    DEFF Research Database (Denmark)

    Larsen, Hans Henrik; von Linstow, Marie-Louise; Lundgren, Bettina

    2007-01-01

    with 431 episodes of acute respiratory tract infection (RTI) by using a real-time PCR assay. In 68 episodes in 67 infants, P. jirovecii was identified. The odds ratio (95% confidence interval) of a positive signal compared with the first quartile of age (7-49 days) was 47.4 (11.0-203), 8.7 (1......Acquisition of Pneumocystis jirovecii infection early in life has been confirmed by serologic studies. However, no evidence of clinical illness correlated with the primary infection has been found in immunocompetent children. We analyzed 458 nasopharyngeal aspirates from 422 patients hospitalized...

  4. [Genotypes of rhinoviruses in children and adults patients with acute respiratory tract infections].

    Science.gov (United States)

    Demirkan, Eda; Kırdar, Sevin; Ceylan, Emel; Yenigün, Ayşe; Kurt Ömürlü, İmran

    2017-10-01

    Rhinovirus (RV) is one of the most frequent causative agent of acute respiratory tract infections in the world. The virus may cause a mild cold, as well as more serious clinical symptoms in patients with immune system deficiency or comorbidities. Rhinoviruses have been identified by molecular methods under three types: RV-A, RV-B and RV-C. In most of the cases, it was reported that RV-A and RV-C were related with lower respiratory tract infections and asthma exacerbations, while RV-B was rarely reported in lower respiratory tract infections. The main objective of this study was to investigate RV species by sequence analysis in nasopharyngeal samples in pediatric and adult patients who were admitted to hospital with acute respiratory tract infections and to establish the relationship between species and age, gender and clinical diagnosis of the patients. Secondly, it was planned to emphasize the efficiency of the sequence analysis method in the determination of RV species. One hundred twenty seven patients (children and adults) who were followed up with acute respiratory tract infections in our university hospital were evaluated between January 2014 and January 2016. Viral loads were determined by quantitative real-time PCR in RV positive patients detected by a commercial kit in nasopharyngeal swab specimens. Thirty-one samples whose viral loads could not be determined were excluded from the study. The remaining 96 samples (50 children and 46 adults) were retested by conventional PCR using the target of VP4/VP2 gene region. A total of 65 samples (32 adults and 33 children) with the bands (549 bp) corresponding to the VP4/VP2 gene regions after the conventional PCR were analyzed by DNA sequencing. A phylogenetic tree was constructed using the neighbour-joining method. After sequence analysis it was determined that 28 (43.07%) were RV-A, 7 (10.76%) were RV-B and 28 (43.07%) were RV-C; and moreover one of each enterovirus (EV) species EV-D68 (1.53%) and EV-C (1

  5. [Different species of human rhinovirus infection in children with acute respiratory tract infections in Beijing].

    Science.gov (United States)

    Song, Ming-hui; Zhao, Lin-qing; Qian, Yuan; Zhu, Ru-nan; Deng, Jie; Wang, Fang; Sun, Yu; Tian, Run

    2013-12-01

    To understand the clinical characteristics of different groups human rhinovirus (HRV)-A, B and C infection in children with acute respiratory tract infections (ARI) in Beijing. Respiratory tract specimens (n = 1412) collected from children with ARI during Jan. 2011 to Dec. 2012 were tested for HRV by using semi-nested PCR. Gene fragments of VP4/VP2 capsid protein amplified from HRV positive specimens were sequenced for HRV genotype confirmation. Then epidemiological characteristics of these HRV-positive cases were analyzed. Among these 1412 specimens tested, 103 (7.3%) were HRV positive, including 54 (52.4%) positive for HRV-A, 14 (13.6%) for HRV-B, 35 (34.0%) for HRV-C determined by sequence analysis. The positive rates of HRV-A, B and C (2.5%, 16/638; 0.3%, 2/638 and 1.3%, 8/638) in children with acute upper respiratory tract infections (URI) were lower than those (5.8%, 36/623; 1.8%, 11/623 and 3.9%, 24/623) in children with acute lower respiratory tract infections (LRI) (P = 0.003, 0.011, 0.003). In children with LRI, the positive rates of HRV-A, C were similar to each other (P = 0.112), and both were higher than that of HRV-B (P = 0.000, P = 0.026). The severity of ARI among children positive for different groups HRV showed no significant difference evaluated by Kruskal-Wallis H test (Hc = 0.044, P > 0.05), as well as that between children co-infected with HRV and other viruses and those infected with HRV only evaluated by Wilcoxon rank sum test (Zc = 0.872, P > 0.05). HRV is one of important pathogens for children with ARI, especially LRI in Beijing. The positive rates of HRV-A and HRV-C are similar to each other, and both are higher than that of HRV-B. No significant difference was shown among children with different HRV genotypes by evaluation of the severity of ARI, and co-infections of HRV with other viruses do not significantly increase the severity of ARI.

  6. Prevalence and clinical characteristics of human respiratory syncytial virus in Chinese adults with acute respiratory tract infection.

    Science.gov (United States)

    Xiang, Zichun; Gonzalez, Richard; Ren, Lili; Xiao, Yan; Chen, Lan; Zhang, Jing; Wang, Wei; Yang, Qingqing; Li, Jianguo; Zhou, Hongli; Vernet, Guy; Paranhos-Baccalà, Gláucia; Wang, Zhong; Wang, Jianwei

    2013-02-01

    Respiratory syncytial virus (RSV) is a leading cause of respiratory tract illnesses worldwide. Although the prevalence and clinical manifestations of the two subtypes, RSV-A and RSV-B, have been studied in some detail in infants and young children, they have not been determined in adults. To evaluate the prevalence of the RSV subtypes and disease severity between RSV-A and RSV-B infections in adults, nasal and throat swabs that were collected from patients ≥15 years old who sought medical care for acute respiratory infections at the Fever Clinic of the Peking Union Medical College Hospital in Beijing, China between May 2005 and April 2010. The samples were tested for RSV infection using PCR and sequencing analysis. RSV was detected in 95 (1%) of the adult patients, of whom 53 (55.8%) were positive for RSV-A and 42 (44.2%) for RSV-B. The incidence of RSV infections increased with age (χ(2) = 37.17, P = 1.66E-07). Demographic data and clinical manifestations of RSV-A were similar to those of RSV-B. Although RSV-A and RSV-B co-circulated during the 2005-2006 and 2008-2009 seasons, RSV-A was predominant in the 2006-2008 seasons, whereas RSV-B was predominant in the 2009-2010 season. Upper respiratory tract infections were diagnosed in most RSV-infected patients (n = 80, 84.2%), and three patients suffered from pulmonary infection. This is the first study to provide data on the prevalence and clinical manifestations of RSV subgroups among Chinese adults with fever and acute illness, over five successive epidemic seasons. Copyright © 2012 Wiley Periodicals, Inc.

  7. Viruses as Sole Causative Agents of Severe Acute Respiratory Tract Infections in Children.

    Science.gov (United States)

    Moesker, Fleur M; van Kampen, Jeroen J A; van Rossum, Annemarie M C; de Hoog, Matthijs; Koopmans, Marion P G; Osterhaus, Albert D M E; Fraaij, Pieter L A

    2016-01-01

    Respiratory syncytial virus (RSV) and influenza A viruses are known to cause severe acute respiratory tract infections (SARIs) in children. For other viruses like human rhinoviruses (HRVs) this is less well established. Viral or bacterial co-infections are often considered essential for severe manifestations of these virus infections. The study aims at identifying viruses that may cause SARI in children in the absence of viral and bacterial co-infections, at identifying disease characteristics associated with these single virus infections, and at identifying a possible correlation between viral loads and disease severities. Between April 2007 and March 2012, we identified children (acute respiratory tract infection (ARTI) (controls). Data were extracted from the clinical and laboratory databases of our tertiary care paediatric hospital. Patient specimens were tested for fifteen respiratory viruses with real-time reverse transcriptase PCR assays and we selected patients with a single virus infection only. Typical bacterial co-infections were considered unlikely to have contributed to the PICU or MC admission based on C-reactive protein-levels or bacteriological test results if performed. We identified 44 patients admitted to PICU with SARI and 40 patients admitted to MC with ARTI. Twelve viruses were associated with SARI, ten of which were also associated with ARTI in the absence of typical bacterial and viral co-infections, with RSV and HRV being the most frequent causes. Viral loads were not different between PICU-SARI patients and MC-ARTI patients. Both SARI and ARTI may be caused by single viral pathogens in previously healthy children as well as in children with a medical history. No relationship between viral load and disease severity was identified.

  8. Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections.

    Science.gov (United States)

    Kronman, Matthew P; Zhou, Chuan; Mangione-Smith, Rita

    2014-10-01

    Antimicrobials are frequently prescribed for acute respiratory tract infections (ARTI), although many are viral. We aimed to determine bacterial prevalence rates for 5 common childhood ARTI - acute otitis media (AOM), sinusitis, bronchitis, upper respiratory tract infection, and pharyngitis- and to compare these rates to nationally representative antimicrobial prescription rates for these ARTI. We performed (1) a meta-analysis of English language pediatric studies published between 2000 and 2011 in Medline, Embase, and the Cochrane library to determine ARTI bacterial prevalence rates; and (2) a retrospective cohort analysis of children age prevalence was 64.7% (95% confidence interval [CI], 50.5%-77.7%); Streptococcus pyogenes prevalence during pharyngitis was 20.2% (95% CI, 15.9%-25.2%). No URI or bronchitis studies met inclusion criteria, and 1 sinusitis study met inclusion criteria, identifying bacteria in 78% of subjects. Based on these condition-specific bacterial prevalence rates, the expected antimicrobial rescribing rate for ARTI overall was 27.4% (95% CI, 26.5%-28.3%). However, antimicrobial agents were prescribed in NAMCS during 56.9% (95% CI, 50.8%-63.1%) of ARTI encounters, representing an estimated 11.4 million potentially preventable antimicrobial prescriptions annually. An estimated 27.4% of US children who have ARTI have bacterial illness in the post-pneumococcal conjugate vaccine era. Antimicrobials are prescribed almost twice as often as expected during outpatient ARTI visits, representing an important target for ongoing antimicrobial stewardship interventions. Copyright © 2014 by the American Academy of Pediatrics.

  9. CLINICAL PROFILE OF ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN BETWEEN 2MONTHS TO 5 YEARS

    Directory of Open Access Journals (Sweden)

    Amitoj Singh Chhina

    2015-08-01

    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  10. Pteropine orthoreovirus infection among out-patients with acute upper respiratory tract infection in Malaysia.

    Science.gov (United States)

    Voon, Kenny; Tan, Yeh Fong; Leong, Pooi Pooi; Teng, Cheong Lieng; Gunnasekaran, Rajasekaran; Ujang, Kamsiah; Chua, Kaw Bing; Wang, Lin-Fa

    2015-12-01

    This study aims to assess the incidence rate of Pteropine orthreovirus (PRV) infection in patients with acute upper respiratory tract infection (URTI) in a suburban setting in Malaysia, where bats are known to be present in the neighborhood. Using molecular detection of PRVs directly from oropharyngeal swabs, our study demonstrates that PRV is among one of the common causative agents of acute URTI with cough and sore throat as the commonest presenting clinical features. Phylogenetic analysis on partial major outer and inner capsid proteins shows that these PRV strains are closely related to Melaka and Kampar viruses previously isolated in Malaysia. Further study is required to determine the public health significance of PRV infection in Southeast Asia, especially in cases where co-infection with other pathogens may potentially lead to different clinical outcomes. © 2015 Wiley Periodicals, Inc.

  11. Viral Co-Infections in Pediatric Patients Hospitalized with Lower Tract Acute Respiratory Infections

    Science.gov (United States)

    Cebey-López, Miriam; Herberg, Jethro; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Gormley, Stuart; Sumner, Edward; Fink, Colin; Martinón-Torres, Federico

    2015-01-01

    Background Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques. Methods A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1–4), rhinovirus, adenovirus (A—F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011–2013. The results were corroborated in an independent cohort collected in the UK. Results A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12–24 months age group. The most frequently observed co-infection patterns were RSV—Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV—bocavirus / bocavirus—influenza (5 patients, 5.2%, UK cohort). Conclusion The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12–24 months of age. The clinical significance of these findings is unclear but should warrant further analysis. PMID:26332375

  12. Viral Co-Infections in Pediatric Patients Hospitalized with Lower Tract Acute Respiratory Infections.

    Science.gov (United States)

    Cebey-López, Miriam; Herberg, Jethro; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Salas, Antonio; Martinón-Sánchez, José María; Gormley, Stuart; Sumner, Edward; Fink, Colin; Martinón-Torres, Federico

    2015-01-01

    Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques. A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1-4), rhinovirus, adenovirus (A-F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011-2013. The results were corroborated in an independent cohort collected in the UK. A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12-24 months age group. The most frequently observed co-infection patterns were RSV-Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV-bocavirus / bocavirus-influenza (5 patients, 5.2%, UK cohort). The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12-24 months of age. The clinical significance of these findings is unclear but should warrant further analysis.

  13. PROPHYLAXIS OF ACUTE RESPIRATORY TRACT INFECTIONS IN CHILDREN WITH RECURRENT BRONCHOPULMONARY DISORDERS

    Directory of Open Access Journals (Sweden)

    A. Yu. Simonova

    2013-01-01

    Full Text Available One of the most urgent problems of Russian pediatrics — high prevalence of acute respiratory infections — is analyzed in this article. The author characterizes a special group of «frequently ill children». Patients of this group are the most prone to recurrent bronchopulmonary diseases, due to special features of their immunological statuses. The article also contains a short literature review on pidotimod trials, which have proved this drug to be effective and safe in acute and recurrent bronchopulmonary diseases as well as in bronchial asthma. In the patients who were administered pidotimod the frequency of relapses of acute respiratory tract infections decreased, the duration of the disease course shortened significantly, as well as these patients required antibacterial and antifebrile agents more rarely and did not have complications of allergic diseases. Children with recurrent bronchopulmonary diseases and bronchial asthma receiving pidotimod were shown to have lower rate of relapses and normalization of immunological characteristics. It is important to mention that pidotimod do not affect results of peak flowmetry and improve results of «Asthma Control Test». Pidotimod usage during vaccination guaranteed uneventful course of post-vaccination period and stimulation of immune response. Long-term study of clinical efficacy and safety of pidotimod allowed to recommend this drug as preventive and medicinal measure in pediatric practice.

  14. [Molecular biology in the diagnosis of acute bacterial infection of the respiratory tract].

    Science.gov (United States)

    Marimón, José María; Cilla, Gustavo; Pérez-Trallero, Emilio

    2008-07-01

    The bacteriological methods traditionally used in the diagnosis of acute respiratory infections (ARI) have limited sensitivity (culture, direct antigen detection, etc.) or require long periods to obtain results (appearance of antibodies). In the last few years, nucleic acid amplification techniques (NAAT) have been developed that allow pathogen-specific genetic targets to be detected in clinical samples. These techniques have been proven to be more sensitive than culture or direct detection and, unlike serological tests, are effective in the acute phase of the infection. However, NAAT also have certain limitations, such as the occasional presence of amplification inhibitors in clinical samples, the persistence of Mycoplasma pneumoniae or Chlamydophila pneumoniae in the mucosa of some individuals, and the lack of discrimination between pathogen infection and colonization in bacteria forming part of normal respiratory tract flora (Streptococcus pneumoniae). Recently developed real-time NAAT have raised expectations that some of these obstacles will be resolved, since these techniques allow bacterial load to be quantified. In the etiological diagnosis of ARI due to S. pneumoniae, the use of NAAT is still in an experimental phase. In M. pneumoniae and C. pneumoniae, combining NAAT with serological tests could potentially improve diagnosis. NAAT show good sensitivity and specificity in the detection of Legionella; however, the practical utility of these techniques should be weighed against that of antigenuria. NAAT provide advantages over other techniques in Bordetella pertussis. At present, these techniques are not useful in the diagnosis of Coxiella burnetii acute infections.

  15. Randomized comparative study of ceftibuten versus cefaclor in the treatment of acute lower respiratory tract infections.

    Science.gov (United States)

    Kammer, R B; Ress, R

    1991-01-01

    In a randomized, single-blind trial, ceftibuten in doses of 200 mg and 300 mg administered b.i.d., was compared with cefaclor 500 mg t.i.d. in acute lower respiratory tract infections. A total 545 patients were enrolled, of which 263 were evaluable for efficacy. All patients were adults with a diagnosis of either bacterial pneumonia or bronchitis. The infective organism was eliminated in 83% of the patients in the ceftibuten 200-mg b.i.d. treatment group and in 85% of patients in the 300-mg b.i.d. treatment group. The organisms were eliminated in 79% of cefaclor-treated patients. Satisfactory clinical responses were obtained in 91% of patients in the ceftibuten 200-mg b.i.d. treatment group and in 92% of patients in the ceftibuten 300-mg b.i.d. group. Satisfactory clinical responses were obtained in 91% of cefaclor-treated patients. Predominant pathogens isolated were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, and strains of Enterobacteriaceae. Adverse experiences reported were similar for the ceftibuten and cefaclor treatment groups. Gastrointestinal side effects occurred in 6% of patients treated with ceftibuten 200 mg BID, 9% in those treated with 300 mg BID, and 7% of cefaclor-treated patients. Ceftibuten 200 and 300 mg twice daily was as effective as cefaclor bacteriologically and clinically in the treatment of lower respiratory tract infections.

  16. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice: a retrospective registry based cohort study.

    Science.gov (United States)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle; Bjerrum, Lars

    2017-05-19

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456,532 antibiotic prescriptions issued between July 2012 and June 2013. Pneumonia was the most common indication with 178,354 prescriptions (39%), followed by acute tonsillitis (21%) and acute otitis media (19%). In total, penicillin V accounted for 58% of all prescriptions, followed by macrolides (18%) and amoxicillin (15%). The use of second-line agents increased with age for all indications, and comprised more than 40% of the prescriptions in patients aged >75 years. Women were more often prescribed antibiotics regardless of clinical indication. This is the first Danish study to characterise antibiotic prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second-line agents like macrolides and amoxicillin with or without clavulanic acid are overused. Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted. TRACKING THE OVERUSE OF ANTIBIOTICS: Better adherence to guidelines for prescribing antibiotics for different respiratory tract infections are warranted in Danish general practice. The over-use of antibiotics, particularly so

  17. Signs and symptoms that differentiate acute sinusitis from viral upper respiratory tract infection.

    Science.gov (United States)

    Shaikh, Nader; Hoberman, Alejandro; Kearney, Diana H; Colborn, D Kathleen; Kurs-Lasky, Marcia; Jeong, Jong H; Haralam, Mary Ann; Bowen, A'Delbert; Flom, Lynda L; Wald, Ellen R

    2013-10-01

    Differentiating acute bacterial sinusitis from viral upper respiratory tract infection (URI) is challenging; 20% to 40% of children diagnosed with acute sinusitis based on clinical criteria likely have an uncomplicated URI. The objective of this study was to determine which signs and symptoms could be used to identify the subgroup of children who meet current clinical criteria for sinusitis but who nevertheless have a viral URI. We obtained sinus radiographs in consecutive children meeting a priori clinical criteria for acute sinusitis. We considered the subgroup of children with completely normal sinus radiographs to have an uncomplicated URI despite meeting the clinical diagnostic criteria for sinusitis. We examined the utility of signs and symptoms in identifying children with URI. Of 258 children enrolled, 54 (20.9%) children had completely normal radiographs. The absence of green nasal discharge, the absence of disturbed sleep and mild symptoms were associated with a diagnosis of URI. No physical exam findings were particularly helpful in distinguishing between children with normal versus abnormal radiographs. Among children meeting current criteria for the diagnosis of acute sinusitis, those with mild symptoms are significantly more likely to have a URI than those with severe symptoms. In addition to assessing overall severity of symptoms, practitioners should ask about sleep disturbance and green nasal discharge when assessing children with suspected sinusitis; their absence favors a diagnosis of URI.

  18. Maternal agency influences the prevalence of diarrhea and acute respiratory tract infections among young Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Shankar, Anita V; Ayuningtyas, Azalea; Achadi, Endang L; Shankar, Anuraj H

    2015-05-01

    To examine the relationship between measures of mother's caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002-2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother' caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1-4) and the prevalence of diarrhea and ARTIs in the youngest child prevalence in children prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.

  19. [Antibiotic prescribing patterns for pediatric inpatients with acute respiratory tract infection].

    Science.gov (United States)

    Escorihuela Esteban, R; Fernández Merchán, J A; Millán Jiménez, A; Carrión Mera, T; Gadea Gironés, I

    2000-02-01

    Children with acute respiratory tract infection (ARTI) represent an important target group for efforts aimed at reducing unnecessary antibiotic use. To present the epidemiological data and evaluate the effect of clinical, laboratory, radiological and microbiological data on the decision to prescribe antibiotics to pediatric patients with ARTI as well as to seek criteria that would justify antibiotic use. A retrospective review was made of the clinical histories of 147 previously healthy children, consecutively admitted to our hospital with ARTI for 1 year (May 1996-April 1997). Patients were divided in two groups: those not treated with antibiotics (n = 92) and those treated (n = 55). Data from the two groups were compared with a statistical computer program (R-Sigma). Of the 147 patients studied, mean age was 2.5 years (range 0-14 years) and 85 (58%) males. One-hundred-and-five patients (72%) had previously been attended to in the emergency room, and 45 patients (30%) had been treated with antibiotics. Upper respiratory tract infection was diagnosed in 81 patients (54%), bronchitis in 28 (18%), bronchiolitis in 23 (15%) and pneumonia in 15 (10%). Ninety-seven patients (66%) had viral infection and only two (1%) had bacterial infection. Syncytial respiratory virus was isolated in 41 patients (28%) and adenovirus in 30 (20%). In the untreated group, the longer duration of symptoms before admission, lymphocytosis, clinical diagnosis of bronchiolitis and normal thorax X-ray, were statistically significant. In the treated group, fever, leukocytosis, neutrophilia and a diagnosis of pneumonia were statistically significant. Length of stay was longer in this group than in the untreated group. It is difficult to prescribe antibiotics on the basis of bacteriologic data. Laboratory, analytic and radiological data can be helpful in the rational use of antibiotics.

  20. Prevalence of adenovirus in children with acute respiratory tract infection in Lanzhou, China.

    Science.gov (United States)

    Jin, Yu; Zhang, Rong-fang; Xie, Zhi-ping; Yan, Kun-long; Gao, Han-chun; Song, Jing-rong; Yuan, Xin-Hui; Hou, Yun-de; Duan, Zhao-jun

    2013-08-29

    Human adenovirus (HAdV) is an important agent causing respiratory tract infection in children. Information on the epidemiological and clinical features of HAdV is limited in children with acute respiratory tract infections (ARTIs) in China, especially those of a novel genotype, Ad55. In total, 1169 nasopharyngeal aspirates were collected from children younger than 14 years with ARTIs between November 2006 and November 2009. The polymerase chain reaction (PCR) was used to screen HAdVs. All PCR-positive products were sequenced. 74 of 1169 (6.33%) specimens were positive for HAdVs. Among positive cases, AdV3 (58/74) was detected most frequently, followed by AdV11 (10/74), AdV2 (2/74), AdV7 (2/69), AdV6 (1/74), and AdV1 (1/74). AdV55 was found in one case. The incidence of HAdV infection peaked in children aged 3-7 years. The most common clinical diagnosis was upper respiratory infection, and the most common syndrome was fever and cough.The comparison of HAdV and RSV group revealed that Children infected with group AdV were significant older than children infected with group RSV, had more fever but less frequently wheezing, and cough, crackles, and cyanosis, The duration of hospitalization between the AdV group and RSV group was not significant, but a greater frequency of LRTIs was observed in RSV group. HAdV is an important viral agent in children with ARTIs in Lanzhou City, China. Multiple HAdV serotypes co-circulated with Ad3, which was predominant in this 3-year study. The novel AdV55 genotype was found in one case. No fixed seasonal rhythm could be identified.

  1. Adenovirus infection in children with acute lower respiratory tract infections in Beijing, China, 2007 to 2012.

    Science.gov (United States)

    Liu, Chunyan; Xiao, Yan; Zhang, Jing; Ren, Lili; Li, Jianguo; Xie, Zhengde; Xu, Baoping; Yang, Yan; Qian, Suyun; Wang, Jianwei; Shen, Kunling

    2015-10-01

    Human adenoviruses (HAdV) play a significant role in pediatric respiratory tract infections. To date, over 60 types of HAdV have been identified. Here, HAdV types are characterized in children in the Beijing area with acute lower respiratory tract infections (ALRTIs) and the clinical features and laboratory findings of hospitalized HAdV-infected cases are described. Respiratory specimens were collected from pediatric patients with ALRTIs in the emergency department or from those admitted to Beijing Children's Hospital between March 2007 and December 2012. Infections with common respiratory viruses were determined by PCR or RT-PCR. HAdV positive samples were further typed by PCR and sequencing. Among 3356 patients with ALRTIs, 194 (5.8 %) were found to have HAdV infection. HAdV infection was primarily confined to children (88.35 %) less than 5 years of age. A total of 11 different types of HAdV were detected throughout the study period, with HAdV-B7 (49.0 %) and HAdV-B3 (26.3 %) as the most prevalent types, followed by HAdV-C2 (7.7 %) and HAdVC1 (4.6 %). Newly emerging and re-emergent types or variants, HAdV-B55 (n = 5), HAdV-C57 (n = 3), and HAdV-B14p1 (n = 1), were identified. Results also included the reported first case of co-infection with HAdV-C2 and HAdV-C57. Clinical entities of patients with single HAdV infection (n = 49) were similar to those with mixed HAdV/respiratory syncytial virus (RSV) infections (n = 41). Patients with HAdV-B7 infection had longer duration of fever and higher serum levels of muscle enzymes than HAdV-B3-infected patients. During the study period, HAdV-B7 and HAdV-B3 were the predominant types identified in pediatric ALRTIs. HAdV-B7 infection tends to have more severe clinical consequences. The presence of newly emerging types or variants and co-infection with different types of HAdV highlights the need for constant and close surveillance of HAdV infection.

  2. [Prevalence and seasonal distribution of respiratory viruses in patients with acute respiratory tract infections, 2002-2014].

    Science.gov (United States)

    Çiçek, Candan; Arslan, Ayşe; Karakuş, Haydar Soydaner; Yalaz, Mehmet; Saz, Eylem Ulaş; Pullukçu, Hüsnü; Çok, Gürsel

    2015-04-01

    The aim of this study was to investigate the prevalence and seasonal distribution of respiratory viruses in pediatric and adult outpatients and inpatients who were admitted to hospital with the symptoms of upper and lower respiratory tract infections, during a 12-year period. A total of 5102 clinical samples (4372 nasopharyngeal swabs, 316 bronchoalveolar lavages, 219 transtracheal aspirates, 163 nasopharyngeal aspirates, 20 sputum, 10 nasal swabs) examined in our laboratory between January 1st 2002 and July 17th 2014, were evaluated retrospectively. Of the specimens, 1107 (21.7%) were obtained from outpatients and 3995 (78.3%) from hospitalized patients. Of the patients, 2851 (55.9%) were male and 2251 (44.1%) were female, while 1233 (24.2%) were adults and 3869 (75.8%) were children (age range: 1 day - 93 years; median: 3 years). Respiratory samples were investigated for the presence of respiratory syncytial virus (RSV), influenza virus type A and B (INF-A, INF-B), adenovirus (AdV), parainfluenza viruses (PIV types 1-4), human rhinoviruses (HRV), human coronaviruses (HCoV), human metapneumovirus (HMPV) and human bocavirus (HBoV). All specimens were tested by both direct immunofluorescence antibody (DFA) and shell vial cell culture (SVCC) methods. In DFA assay the samples were initially screened by fluorescent-labeled polyclonal antibodies, and the positive ones were typed by using monoclonal antibodies (Light Diagnostics, Merck Millipore, USA). In SVCC, HEp-2, MDCK, A-549 and Vero cell lines were used for the isolation of viruses. In addition to these methods, real-time multiplex PCR methods (RealAccurate®, Respiratory RT PCR, PathoFinder, Netherlands and Seeplex® RV15 ACE Detection, Seegene, South Korea) were used for the detection of respiratory viruses in samples (n= 2104) obtained from 2007 to 2014. Respiratory viruses were detected in a total of 1705 (33.4%) patients, of them 967 (19%) were male and 738 (14.4%) were female. Three hundred and eighteen (18

  3. Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study.

    Science.gov (United States)

    Alan, Serdar; Erdeve, Omer; Cakir, Ufuk; Akduman, Hasan; Zenciroglu, Aysegul; Akcakus, Mustafa; Tunc, Turan; Gokmen, Zeynel; Ates, Can; Atasay, Begum; Arsan, Saadet

    2016-01-01

    To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs). A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions. The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU. RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU.

  4. Oral purified bacterial extracts in acute respiratory tract infections in childhood: a systematic quantitative review.

    Science.gov (United States)

    Steurer-Stey, Claudia; Lagler, Leonie; Straub, Daniel A; Steurer, Johann; Bachmann, Lucas M

    2007-04-01

    Recurrent acute respiratory tract infections (ARTI) are a common problem in childhood. Some evidence suggests a benefit regarding the prevention of ARTI in children treated with the immunomodulator OM-85 BV (Bronchovaxom). We summarised the evidence on the effectiveness of the immunomodulator OM-85 BV in the prevention of ARTI in children. We searched randomised comparisons of oral purified bacterial extracts against inactive controls in children with respiratory tract diseases in nine electronic databases and reference lists of included studies. We extracted salient features of each study, calculated relative risks (RR) or weighted mean differences (WMD) and performed meta-analyses using random-effects models. Thirteen studies (2,721 patients) of low to moderate quality tested OM-85 BV. Patients and outcomes differed substantially, which impeded pooling results of more than two trials. Two studies (240 patients) reporting on the number of patients with less than three infections over 6 month of follow-up in children not in day care showed a trend for benefit RR 0.82 (95% CI, 0.65-1.02). One out of two studies examining the number of children not in day care without infections over 4-6 month reported a significant RR of 0.42 (95% CI, 0.21-0.82) whereas the smaller, second study did not [RR 0.92 (95% CI, 0.58-1.46)]. Two studies reporting the number of antibiotic courses indicated a benefit for the intervention arm [WMD 2.0 (95% CI, 1.7-2.3)]. Two out of the three studies showed a reduction of length of episodes of 4-6 days whereas a third study showed no difference between the two groups. Evidence in favour of OM-85 BV in the prevention of ARTI in children is weak. There is a trend for fewer and shorter infections and a reduction of antibiotic use.

  5. 158 Efficacy of Immnunotherapy with an Oral Bacterial Lysate and Vitamin C in the Primary Prevention of Acute Respiratory Tract Infections in Children

    OpenAIRE

    Socci, Miguel; Slullitel, Pablo; Cortigiani, Luciano

    2012-01-01

    Background Airway infections are of great importance worldwide and nearly half of the pediatric consultations in industrialized countries are caused by respiratory tract infections (RTIs). Acute respiratory tract infections (ARTIs) are among the main causes of morbidity and mortality in children and recurrent infections of the respiratory tract are the most frequent cause of pharmacotherapy in pediatric practice. The aim of this study was to evaluate the efficacy and tolerability of immunothe...

  6. [Relationship between viral load of human bocavirus and clinical characteristics in children with acute lower respiratory tract infection].

    Science.gov (United States)

    Ding, Xiao-Fang; Zhang, Bing; Zhong, Li-Li; Xie, Le-Yun; Xiao, Ni-Guang

    2017-03-01

    To investigate the prevalence of human bocavirus (HBoV) in children with acute lower respiratory tract infection and to explore the relationship between the viral load of HBoV and the clinical characteristics of acute lower respiratory tract infection in children. A total of 1 554 nasopharyngeal aspirates from children who were hospitalized due to acute lower respiratory tract infection between March 2011 and March 2014 were collected. Quantitative real-time PCR was used to detect 12 RNA and 2 DNA viruses, adenovirus (ADV) and HBoV, and to measure the viral load of HBoV in HBoV-positive children. A comprehensive analysis was performed with reference to clinical symptoms and indicators. In the 1 554 specimens, 1 212 (77.99%) were positive for viruses, and 275 (17.70%) were HBoV-positive. In HBoV-positive cases, 94.9% were aged infection, and 230 (83.64%) had mixed infection. There was no significant difference in viral load between children with single infection and mixed infection (P>0.05). The patients with fever had a significantly higher viral load than those without fever (Pacute lower respiratory tract infection (P>0.05). HBoV is one of the important pathogens of acute lower respiratory tract infection in children. Children with a higher viral load of HBoV are more likely to experience symptoms such as fever and wheezing. However, the severity of disease and mixed infection are not significantly related to viral load.

  7. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

    Science.gov (United States)

    Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

    2016-12-01

    Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

  8. Epidemiology of human respiratory viruses in children with acute respiratory tract infections in Jinan, China.

    Science.gov (United States)

    Lu, Yanqin; Wang, Shifu; Zhang, Lehai; Xu, Chao; Bian, Cuirong; Wang, Zhaoxia; Ma, Yanhui; Wang, Ke; Ma, Lixia; Meng, Chen; Ni, Caiyun; Tong, Jiabei; Li, Gongchao; Han, Jinxiang

    2013-01-01

    The viral etiologies of UTRIs and LTRIs in children in Jinan city were investigated between July 2009 and June 2010. Nasal and throat swabs were collected from 397 children with URTIs and bronchoalveolar lavage fluid specimens were collected from 323 children with LRTIs. RT-PCR/PCR was used to examine all samples for IFV, PIV, RSV, RV, hMPV, HBoV, CoV, ADV, RSV, and EV. Viral pathogens were detected in 47.10% of URTI samples and 66.57% samples, and the incidence of viral coinfection was 5.29% and 21.05%, respectively. IFV was the most common virus in URTIs, with a detection rate of 19.40%, followed by PIV (10.83%), RV (10.58%), and EV (6.30%). For LRTIs, PIV and RV were both detected in 27% of samples, followed by RSV (9.91%), HBoV (8.36%), IFV (5.57%), and hMPV (5.57%). RSV and HBoV were more prevalent in the youngest children of no more than six months. Meanwhile, RV, PIV, and RSV were the most frequent viruses combined with bacterial pathogens in LRTIs. In conclusion, the spectrum of respiratory virus infections in URTIs and LRTIs differed in terms of the most common pathogens, seasonal distribution, and coinfection rate.

  9. Epidemiology of Human Respiratory Viruses in Children with Acute Respiratory Tract Infections in Jinan, China

    Directory of Open Access Journals (Sweden)

    Yanqin Lu

    2013-01-01

    Full Text Available The viral etiologies of UTRIs and LTRIs in children in Jinan city were investigated between July 2009 and June 2010. Nasal and throat swabs were collected from 397 children with URTIs and bronchoalveolar lavage fluid specimens were collected from 323 children with LRTIs. RT-PCR/PCR was used to examine all samples for IFV, PIV, RSV, RV, hMPV, HBoV, CoV, ADV, RSV, and EV. Viral pathogens were detected in 47.10% of URTI samples and 66.57% samples, and the incidence of viral coinfection was 5.29% and 21.05%, respectively. IFV was the most common virus in URTIs, with a detection rate of 19.40%, followed by PIV (10.83%, RV (10.58%, and EV (6.30%. For LRTIs, PIV and RV were both detected in 27% of samples, followed by RSV (9.91%, HBoV (8.36%, IFV (5.57%, and hMPV (5.57%. RSV and HBoV were more prevalent in the youngest children of no more than six months. Meanwhile, RV, PIV, and RSV were the most frequent viruses combined with bacterial pathogens in LRTIs. In conclusion, the spectrum of respiratory virus infections in URTIs and LRTIs differed in terms of the most common pathogens, seasonal distribution, and coinfection rate.

  10. Association of vitamin D deficiency with acute lower respiratory tract infections in newborns.

    Science.gov (United States)

    Dinlen, Nurdan; Zenciroglu, Aysegul; Beken, Serdar; Dursun, Arzu; Dilli, Dilek; Okumus, Nurullah

    2016-03-01

    To determine the association between serum 25-hydroxy vitamin D [25(OH)D] levels and acute respiratory tract infections (ALRTI) in newborns. The study group consisted of 30 term newborns with ALRTI who were admitted to our neonatal intensive care unit. Controls were 30 healthy newborns with the same age as the study group. Newborns and their mothers were tested for serum 25(OH)D levels, with a low level defined as ≤15 ng/mL. The groups were similar in gestational week, birthweight, postnatal age and gender. Forty-three of the 60 infants (including study and control) had low 25(OH)D levels. The median 25(OH)D levels were lower [9.5 ng/mL (IQR = 7.9-12.2)] in the study group than those of the control group [15.5 ng/mL (IQR: 12-18)] (p = 0.0001). The median serum 25(OH)D levels in the mothers of the study group were also lower than those in the mothers of the control group [11.6 ng/mL (IQR = 9.4-15.8) and 17.3 ng/mL (IQR = 13.7-20.6), respectively] (p = 0.0001). Lower blood 25(OH)D levels might be associated with increased risk of ALRTI in term newborn babies. Appropriate vitamin D supplementation during pregnancy and early childhood may enhance newborns' respiratory health.

  11. Vitamin D status and hospitalisation for childhood acute lower respiratory tract infections in Nigeria.

    Science.gov (United States)

    Ahmed, Patience; Babaniyi, I B; Yusuf, K K; Dodd, Caitlin; Langdon, Gretchen; Steinhoff, Mark; Dawodu, Adekunle

    2015-05-01

    Acute lower respiratory tract infection (ALRTI) is the leading cause of childhood deaths in most developing countries, including Nigeria. Vitamin D is associated with innate immunity and may play a role in the control of infections. Case-control studies, including a small study from Nigeria, show inconsistent results for the association between vitamin D status and risk of ALRTI. To examine the relationship between vitamin D status and hospitalization for ALRTI in Nigerian children. Fifty children aged 2-60 months hospitalised with ALRTI were studied prospectively. ALRTI was diagnosed on the basis of modified WHO criteria. Each patient was matched with controls for age and gender. The controls were enrolled either from children attending well-child clinics or general clinics without evidence of respiratory infection or admitted to the hospital for elective surgery. A structured questionnaire collected data on demography, health, diet, duration of exposure to sunlight and percentage of body surface exposed to sunlight (according to type of clothing) while outdoors, and potential risk factors for ALRTI. Serum 25-hydroxyvitamin D [25(OH)D] concentration was measured using a chemiluminescenceimmuno-assay. The differences between cases and controls in serum 25(OH)D concentrations, association between vitamin D status and ALRTI and risk factors for vitamin D deficiency were assessed. Mean (SD) 25(OH)D concentrations in patients and controls were similar [61·5 (25·8) vs 63·1 (22·9) nmol/L,P = 0·95].25% of all 100 subjects studied had serum 25(OH)Dvitamin D supplement use (P = 0·009) were independent determinants of vitamin D deficiency in the overall study population. ALRTI was not associated with vitamin D status, but was associated with less exposure to sunlight. Exposure to sunlight and vitamin D supplementation contributed to vitamin D status in this population.

  12. Role of Vitamin D in Hospitalized Children With Lower Tract Acute Respiratory Infections.

    Science.gov (United States)

    Cebey-López, Miriam; Pardo-Seco, Jacobo; Gómez-Carballa, Alberto; Martinón-Torres, Nazareth; Rivero-Calle, Irene; Justicia, Antonio; Redondo, Lorenzo; Martinón-Sánchez, José María; Martínez-Padilla, María Del Carmen; Giménez-Sánchez, Francisco; Salas, Antonio; Martinón-Torres, Federico

    2016-03-01

    Vitamin D is known to have modulatory actions in the immune system. Its influence on the severity of lower tract acute respiratory infections (LT-ARIs) is unclear. The aim of the present study was to evaluate the role of vitamin D on LT-ARI in paediatric patients. Children admitted to hospital with LT-ARI were prospectively recruited through the GENDRES network (March 2009-May 2013). The 25-hydroxyvitamin D (25-OHD) levels were measured by immunoassay. The severity of the illness was evaluated according to clinical scales, length of hospital stay, ventilatory requirements, and pediatric intensive care unit admission. A total of 347 patients with a median (interquartile range) age of 8.4 (2.6-21.1) months were included. The mean (SD) 25-OHD levels in our series were 27.1 (11.3) ng/mL. In this study, a cutoff value of ≥30 ng/mL was considered optimal vitamin status. Patients with 25-OHD levels respiratory difficulties (OR 5.065, 95% confidence interval 1.998-12.842; P = 0.001) than patients with normal values, and had a 117% higher risk of oxygen necessity and 217% higher risk of ventilatory requirement than those patients with normal values. An inverse correlation was found between 25-OHD levels and the severity in the evaluated scales. 25-OHD levels did not influence PICU admission rate or length of hospital stay. 25-OHD levels of children admitted because of a LT-ARI are infection needs further evaluation.

  13. [Detection and Analysis of Human Parainfluenza Virus Infection in Hospitalized Adults with Acute Respiratory Tract Infections].

    Science.gov (United States)

    Li, Xing-Qiao; Liu, Xue-Wei; Zhou, Tao; Pei, Xiao-Fang

    2017-11-01

    To investigate the prevalence and gene characteristics of different groups of human parainfluenza virus (HPIV) infection in hospitalized adults with acute respiratory tract infections (ARI). RT-PCR was used to detect HPIV hemagglutinin (HA) DNA,which was extracted from sputum samples of 1 039 adult patients with ARI from March,2014 to June,2016. The HA gene amplified from randomly selected positive samples were sequenced to analyze the homology and variation. 10.6% (110/1 039) of these samples were positive for HPIV,including 8 cases of HPIV-1,22 cases of HPIV-2,46 cases of HPIV-3 and 34 cases of HPIV-4. Detectable rate varied among different groups of HPIV according to seasons of the year and ages of patients. No significant differences were found between the positive samples and the reference sequences. Compared with different reference strains of different regions,the genetic distance of nucleotide is the smallest between the strains tested in this study and the reference strains of other provinces and cities in China. In Chengdu region,HPIV virus is highly detected in ARI,all subtypes were detected with HPIV-3 being the main subtype.

  14. Efficacy of passively transferred antibodies in cats with acute viral upper respiratory tract infection.

    Science.gov (United States)

    Friedl, Yvonne; Schulz, Bianka; Knebl, Anne; Helps, Chris; Truyen, Uwe; Hartmann, Katrin

    2014-09-01

    A commercial hyperimmune serum, containing antibodies against feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), and feline panleukopenia virus, is available for treatment of cats with feline upper respiratory tract disease (FURTD), but its efficacy has not been rigorously evaluated in scientific studies. The aim of this randomised, placebo-controlled, double-blind clinical trial was to evaluate the efficacy of passive immunisation in cats with acute viral FURTD caused by FCV and/or FHV-1 infection. All cats received symptomatic treatment during the study period. Hyperimmune serum was administered to one group (n = 22) and an equivalent amount of saline was administered to the control group (n = 20) as placebo, for 3 consecutive days. In the treatment group, cats ≤12 weeks old received 2 mL, cats >12 weeks old received 4 mL, subcutaneously once daily and topically into eyes, nostrils, and mouth every 8 h. Clinical signs, including a 'FURTD score' and general health status, were recorded daily for 8 days and again on day 21. FCV shedding was determined by quantitative PCR on days 0 and 21. Clinical signs and health status in both groups improved significantly over time (P < 0.001). Cats receiving hyperimmune serum significantly improved in terms of 'FURTD score' (P = 0.046) and general health status (P = 0.032) by day 3, while cats in the placebo group only improved significantly by day 7. There was no significant difference in the number of cats shedding FCV between the two groups. Thus, administration of hyperimmune serum led to a more rapid improvement of clinical signs in cats with acute viral FURTD, but by day 7, clinical signs had improved equally in both groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data.

    Science.gov (United States)

    Martineau, Adrian R; Jolliffe, David A; Hooper, Richard L; Greenberg, Lauren; Aloia, John F; Bergman, Peter; Dubnov-Raz, Gal; Esposito, Susanna; Ganmaa, Davaasambuu; Ginde, Adit A; Goodall, Emma C; Grant, Cameron C; Griffiths, Christopher J; Janssens, Wim; Laaksi, Ilkka; Manaseki-Holland, Semira; Mauger, David; Murdoch, David R; Neale, Rachel; Rees, Judy R; Simpson, Steve; Stelmach, Iwona; Kumar, Geeta Trilok; Urashima, Mitsuyoshi; Camargo, Carlos A

    2017-02-15

    Objectives  To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect. Design  Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials. Data sources  Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015. Eligibility criteria for study selection  Randomised, double blind, placebo controlled trials of supplementation with vitamin D 3 or vitamin D 2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome. Results  25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96.6%) participants. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit. Systematic review registration  PROSPERO CRD42014013953. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Prevalence of human rhinovirus in children admitted to hospital with acute lower respiratory tract infections in Changsha, China.

    Science.gov (United States)

    Zeng, Sai-Zhen; Xiao, Ni-Guang; Xie, Zhi-Ping; Xie, Guang-Cheng; Zhong, Li-Li; Wang, Juan; Huang, Han; Zhang, Bing; Duan, Zhao-Jun

    2014-11-01

    Human rhinovirus (HRV) is a causative agent of acute respiratory tract infections. This study analyzed the prevalence and clinical characteristics of three HRV groups (HRV-A, -B, and -C) among 1,165 children aged 14 years or younger who were hospitalized with acute lower respiratory tract infection in China. PCR or reverse transcription-PCR was performed to detect 14 respiratory viruses in nasopharyngeal aspirates collected from September 2007 to August 2008 in Changsha, China. HRV was detected in 202 (17.3%) of the 1,165 children; 25.3% of the HRV-positive children were 13-36 months of age (χ(2)  = 22.803, P = 0.000). HRV was detected year round and peaked between September and December. Fifty-three percent of the HRV-positive samples were also positive for other respiratory viruses; respiratory syncytial virus (RSV) was the most common secondary virus. Phylogenetic analysis using the VP4/VP2 region grouped the HRV-positive strains as follows: 101 HRV-A (50.0%), 21 HRV-B (10.4%), and 80 HRV-C (39.6%). HRV-A infections occurred predominantly in spring and autumn, and the peak prevalence of HRV-C was in early winter and late autumn. HRV-B infections were less common in spring (χ(2)  = 31.914, P = 0.000). No significant difference in clinical severity or presentation was found between patients with HRV single infection and HRV co-detections. Furthermore, the clinical characterizations did not differ among the three HRV species. These results suggest that HRV-C is an important viral agent along with HRV-A and HRV-B and that among hospitalized children with acute lower respiratory tract infection in China, the three HRV genotypes have similar clinical characteristics. © 2014 Wiley Periodicals, Inc.

  17. Inhalation Forms of Ambroxol in the Therapy of Respiratory Tract Secretory-Evacuation Disorders in Acute Bronchitis in Children

    Directory of Open Access Journals (Sweden)

    L.S. Ovcharenko

    2014-04-01

    Full Text Available The mucoactive therapy of children aged 1 to 5 years with acute bronchitis using drug Lasolvan solution for oral and inhalation use or syrup for oral use Lasolvan is highly effective and safe method for management of respiratory tract secretory-evacuation disorders. Given the chance of inhalation therapy, effective treatment of choice, while maintaining a high safety profile, is inhalation of Lasolvan solution for oral and inhalation use by nebulizer. More rapid decline in the clinical severity of acute bronchitis in children treated with inhaled Lasolvan associated with accelerated recovery of disturbed secretory-evacuation mechanisms of bronchial tree.

  18. Clinical Characteristic and Outcome of Acute Lower Respiratory Tract Infection in Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Krystle Gabriela

    2015-09-01

    Full Text Available Background: Acute Lower Respiratory Tract Infection (ALRTI is the leading cause of deaths in children under 5 years of age worldwide, and has high morbidity and mortality in children with Congenital Heart Disease (CHD. The objective of this study was to obtain the incidence, clinical characteristic, and outcome of ALRTI children with CHD. Methods: A retrospective hospital-based study was conducted from January 2007–December 2011 to medical record of child patients with ALRTI and CHD in the Department of Child Health of Dr. Hasan Sadikin General Hospital, Bandung. The diagnosis of CHD was determined by echocardiography. The collected data was analyzed and presented in percentage shown in tables. Results : From 3,897 children who had ALRTI, there were 149 children with CHD (3.8%, with 11.4% of whom founded with recurrent episodes. This happened often in girls than boys with quite similar ratio of 1.37: 1.The majority of children (80% was under 1 year old of age, 72.5% with malnutrition, and 24.8% with severe malnutrition. Clinical symptoms mostly found were difficulty of breathing (98%, fever (85.2%, cough (75.2%, and runny nose (63.1%. The most common types of CHD were Patent Ductus Arteriosus (47.6%, followed by Ventricular Septal Defect (47%. Bronchopneumonia (86.6% was the common type of ALRTI. The length of stay was mostly less than 10 days (70.5%. From all the children 43.7% had complications, and 6.7% died. Conclusions: The ALRTI in children with CHD is not common and has good outcome. The majority for CHD lesions are Patent Ductus Arteriosus and Ventricular Septal Defect while for ALRTI is Bronchopneumonia.

  19. Prevalence of human metapneumovirus in adults with acute respiratory tract infection in Beijing, China.

    Science.gov (United States)

    Li, Jianguo; Wang, Zhong; Gonzalez, Richard; Xiao, Yan; Zhou, Hongli; Zhang, Jing; Paranhos-Baccala, Glaucia; Vernet, Guy; Jin, Qi; Wang, Jianwei; Hung, Tao

    2012-01-01

    To evaluate the prevalence and clinical manifestations of human metapneumovirus (hMPV) in immunocompetent Chinese adults with acute respiratory tract infections (ARTIs). A reverse transcription PCR (RT-PCR) assay targeting the P gene was developed in this study and used to detect hMPV in nasal and throat swabs collected from 2936 immunocompetent adult patients with ARTIs in Beijing, China between July 2008 and June 2010. Among the 2936 patients studied, 49 (1.7%) were positive for hMPV, of whom 14 (28.6%) were positive for hMPV_A2b, 19 (38.8%) for hMPV_B1, and 16 (32.6%) for hMPV_B2. hMPV_A1 was not detected. An average detection rate of 6.6% was observed in the peak months of the two epidemic seasons studied. The hMPV prevalence was higher in the sampled elderly (>65 years, 3.2%) than in middle aged adults (25-65 years; 2.0%) and teenagers (14-25 years; 0.9%). During the study period, hMPV infections showed a biennial rhythm of seasonality, peaking from November to March in 2008/09 and from March to June in 2010. hMPV infection plays an important role in immunocompetent adults in its epidemic season. The demographic and clinical data presented in this study improves our understanding of the pathogenesis and clinical burden of hMPV infection in adults. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. Prevalence and Phylogenetic Characterization of Enterovirus D68 in Pediatric Patients with Acute Respiratory Tract Infection in Thailand.

    Science.gov (United States)

    Thongpan, Ilada; Wanlapakorn, Nasamon; Vongpunsawad, Sompong; Linsuwanon, Piyada; Theamboonlers, Apiradee; Payungporn, Sunchai; Poovorawan, Yong

    2016-09-21

    Enterovirus D68 (EV-D68) is associated with severe lower respiratory tract infection and neurological abnormalities including acute myelitis and cranial nerve dysfunction. To determine whether an increased incidence of EV-D68 occurs in Southeast Asia, we retrospectively tested specimens collected from Thai pediatric patients who were less than 5 years of age and presented with acute respiratory tract infections between 2012 and 2014. Reverse transcription-polymerase chain reaction and nucleotide sequencing of the 5'-UTR/VP2 region were used to identify EV-D68. We also examined the epidemiological pattern of EV-D68 since 2009, when it was first identified in Thailand, and compiled records of clinical manifestations in children with confirmed EV-D68 infection. From 837 samples, 5 samples (0.6%) tested positive for EV-D68. All patients presented with viral pneumonia and required hospitalization. Phylogenetic analysis of the VP4/VP2 regions revealed that EV-D68 strains circulating in Thailand between 2012 and 2014 were closely related to strains reported in Japan, United Kingdom, China, and France. Continued surveillance of probable EV-D68-associated severe respiratory tract infection and the development of a rapid diagnostic test for EV-D68 are essential in supporting awareness and facilitating disease prevention and control.

  1. Acute Bacterial Sinusitis Complicating Viral Upper Respiratory Tract Infection in Young Children

    Science.gov (United States)

    Marom, Tal; Alvarez-Fernandez, Pedro E.; Jennings, Kristofer; Patel, Janak A.; McCormick, David P.; Chonmaitree, Tasnee

    2014-01-01

    Background Acute bacterial sinusitis (ABS) is a common complication of viral upper respiratory tract infections (URI). Clinical characteristics of URIs complicated by ABS in young children have not been well studied. Methods We identified ABS episodes in a prospective, longitudinal cohort study of 294 children (6 to 35 months of age at enrollment), who were followed-up for one year to capture all URI episodes and complications. At the initial URI visit seen by the study personnel (median day=4 from symptoms onset), nasopharyngeal samples were obtained for bacterial cultures and viral studies. Results Of 1295 documented URI episodes, 103 (8%) episodes (in 73 children) were complicated by ABS, 32 of which were concurrent with acute otitis media. The majority (72%) of ABS episodes were diagnosed based on persistent symptoms or a biphasic course. Average age at ABS diagnosis was 18.8±7.2 months; white children were more likely to have ABS episodes than blacks (p=0.01). Hispanic/Latino ethnicity (p<0.0001) was negatively associated, and adequate PCV-7 immunization status (p=0.001) appeared to increase the risk of ABS. Girls had more ABS episodes than boys (0.5±0.8 vs 0.3±0.6 episodes/year, respectively, p=0.03). Viruses were detected in 63% during the initial URI visit; rhinovirus detection was positively correlated with ABS risk (p=0.01). Bacterial cultures were positive in 82/83 (99%) available samples obtained at the initial URI visit; polymicrobial (56%), Moraxella catarrhalis (20%) and Streptococcus pneumoniae (10%) were the most common cultures. Presence of pathogenic bacteria overall and presence of M. catarrhalis during URI were positively correlated with the risk for ABS (p=0.04 for both). Conclusion ABS complicates 8% of URI in young children. Girls have more frequent ABS episodes than boys. Presence of rhinovirus and M. catarrhalis during URI are positively correlated with the risk for ABS complication. PMID:24717966

  2. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections

    NARCIS (Netherlands)

    Schuetz, Philipp; Wirz, Yannick; Sager, Ramon; Christ-Crain, Mirjam; Stolz, Daiana; Tamm, Michael; Bouadma, Lila; Luyt, Charles E; Wolff, Michel; Chastre, Jean; Tubach, Florence; Kristoffersen, Kristina B; Burkhardt, Olaf; Welte, Tobias; Schroeder, Stefan; Nobre, Vandack; Wei, Long; Bucher, Heiner C; Bhatnagar, Neera; Annane, Djillali; Reinhart, Konrad; Branche, Angela; Damas, Pierre; Nijsten, Maarten W N; de Lange, Dylan W|info:eu-repo/dai/nl/304815497; Deliberato, Rodrigo O; Lima, Stella Ss; Maravić-Stojković, Vera; Verduri, Alessia; Cao, Bin; Shehabi, Yahya; Beishuizen, Albertus; Jensen, Jens-Ulrik S; Corti, Caspar; van Oers, Jos A; Falsey, Ann R; de Jong, Evelien; Oliveira, Carolina F; Beghe, Bianca; Briel, Matthias; Mueller, Beat

    2017-01-01

    BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about

  3. Human bocavirus isolated from children with acute respiratory tract infections in Korea, 2010-2011.

    Science.gov (United States)

    Ahn, Jong Gyun; Choi, Seong Yeol; Kim, Dong Soo; Kim, Ki Hwan

    2014-12-01

    Human bocavirus (HBoV) was first recognized in respiratory samples in 2005. The clinical importance of HBoV infection remains unclear. This report describes the clinical features and molecular phylogeny of HBoV isolates in children with acute respiratory infections. Nasopharyngeal aspirates were obtained from 1,528 children with acute respiratory infections between 2010 and 2011. Respiratory samples were screened for HBoV by multiplex PCR. A phylogenetic analysis of the HBoV VP1/VP2 gene was also undertaken. HBoV was detected in 187 (12.2%) of the 1,528 patients with a peak incidence of infection observed in patients aged 12-24 months. Coinfection with other respiratory viruses was observed in 107 (57.2%) of the HBoV-positive children. The peak of HBoV activity occurred during the month of June in both 2010 and 2011. A higher previous history of wheezing (P = 0.016), a higher frequency of chest retraction (P respiratory symptom score (P = 0.002), and a longer duration of hospital stay (P = 0.021) were observed in HBoV-positive children compared with the HBoV-negative group. Phylogenetic analysis showed all 187 HBoV-positive isolates were identified as HBoV 1, indicating minimal sequence variations among the isolates. A single lineage of HBoV 1 was found to have circulated in children with acute respiratory infections between 2010 and 2011 and was associated with several clinical characteristics including age, seasonality, and clinical severity with retraction, wheezing, and longer hospitalization. The clinical relevance of the minimal sequence variations of HBoV remains to be determined. © 2014 Wiley Periodicals, Inc.

  4. The development and validation of a multidimensional sum-scaling questionnaire to measure patient-reported outcomes in acute respiratory tract infections in primary care: the Acute Respiratory Tract Infection Questionnaire: ARTIQ

    DEFF Research Database (Denmark)

    Aabenhus, R.; Thorsen, H.; Siersma, V.

    2013-01-01

    interviews and field testing among adults with an ARTI were conducted to ascertain a high degree of face and content validity of the questionnaire. Subsequently, a draft version of the Acute Respiratory Tract Infection Questionnaire (ARTIQ) was statistically validated by using the partial credit Rasch model......, and Medicine) and five single items. All final dimensions were confirmed to fit the Rasch model, thus enabling sum-scaling of responses. The ARTIQ scores in participants with an ARTI were significantly higher than in those without ARTI (known groups' validity). CONCLUSION: A self-administered, multidimensional...

  5. [Lung function measurements using body plethysmography in young children with acute lower respiratory tract infection].

    Science.gov (United States)

    Zhang, Xiaobo; Jiang, Gaoli; Wang, Libo; Liu, Lijuan; Shi, Peng; Wan, Chengzhou; Qian, Liling

    2014-07-01

    Body plethysmography is a typical method to measure functional residual capacity (FRC) and airway resistance (Raw). The aim of the study was to test the feasibility of measuring lung function with the body plethysmography in young children with acute lower respiratory tract infection (ALRI) by evaluating changes and prognosis of lung function for infants with ALRI with or without wheezing via body plethysmograph. Pulmonary function tests (PFTs) were performed by using body plethysmography in 444 children with ALRI, aged 1-36 months, to assess their tidal breathing parameters such as ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE), plethysmographic functional residual capacity (FRCP), FRCP per kilogram (FRCP/kg), specific effective airway resistance (sReff), effective airway resistance (Reff), Reff per kilogram (Reff/kg), etc. According to whether there was wheezing or not, children who had ALRI with wheezing were classified as Group-W, or without wheezing as Group-N. Changes or correlations of tidal breathing parameters and plethysmographic parameters were compared.One hundred and three contemporaneous healthy controls aged 1-36 months underwent the same tests for comparison. And 36 wheezing children accepted PFTs at follow-up in recovery phase. Mean values of TPTEF/TE in Group-W,Group-N and the Control respectively were (20.5 ± 6.7)%,(22.8 ± 6.5)%,(34.6 ± 5.0)% (F = 110.500, P children with ALRI had normal values of tidal breathing parameters, they already had increased FRCP, FRCP /kg, sReff, Reff and Reff/kg (t = 2.221, 1.997, 2.502, 2.587, 2.539, all P children with wheezing who accepted PFTs at follow-up had shown significant decline in the specific parameters of plethysmography such as FRCP, FRCP/kg, sReff, Reff and Reff/kg (Z = -1.999, -2.195, -2.038, -1.823, -2.054, all P function with the body plethysmography in young children with ALRI is

  6. Analysis of risk factors for acute respiratory tract infections (ARI) of Toddlers in Ingin Jaya community health centre of Aceh Besar district

    Science.gov (United States)

    Safitri, Faradilla; Hayati, Risna; Marniati

    2017-09-01

    Acute Respiratory Infections (ARI) is a disease in developing countries 25% that caused the death of children under five. In Aceh province disease is always on the list of 10 biggest disease each year which amounted to 47.258 cases. In Ingin Jaya Community Health Centre cases of acute respiratory tract infections in infants in 2014 were 112 cases, while in 2015 an increase of as many as 123 cases. Objective: To analyze the risk factors of acute respiratory diseases in health centers of Toddlers Ingin Jaya, Aceh Besar district. Analytical research the design of case control, case-control comparison of 1: 1 ie the sample of 60 cases and 60 control, retrieval of data taken from the register space IMCI Health Center. The study was conducted in 2016. Results: Factor toddler age (OR=11.811), gender (OR=3.512), birth weight (OR=8.805), immunization status (OR=4.846), exclusive breastfeeding (OR=2.529). Conclusions and Recommendations: Toddlers aged>2 years has the opportunity 11.811 times of acute respiratory tract infections. Male Toddler has a chance 3.512 times of acute respiratory tract infections. Toddlers are born with a normal weight does not have a chance of 8.805 times of acute respiratory tract infections. Toddlers who do not get complete immunization has the opportunity 4.846 times of acute respiratory tract infections. Toddlers who did not receive exclusive breastfeeding has 2,529 times greater chance of respiratory tract infections. Health workers and the Aceh Provincial Health Office can provide information through health education each month for each work area of health centers, or create a billboard on the causes of the ispa in infants.

  7. Accuracy of an Extubation Readiness Test in Predicting Successful Extubation in Children With Acute Respiratory Failure From Lower Respiratory Tract Disease.

    Science.gov (United States)

    Faustino, Edward Vincent S; Gedeit, Rainer; Schwarz, Adam J; Asaro, Lisa A; Wypij, David; Curley, Martha A Q

    2017-01-01

    Identifying children ready for extubation is desirable to minimize morbidity and mortality associated with prolonged mechanical ventilation and extubation failure. We determined the accuracy of an extubation readiness test (Randomized Evaluation of Sedation Titration for Respiratory Failure extubation readiness test) in predicting successful extubation in children with acute respiratory failure from lower respiratory tract disease. Secondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial, a pediatric multicenter cluster randomized trial of sedation. Seventeen PICUs in the intervention arm. Children 2 weeks to 17 years receiving invasive mechanical ventilation for lower respiratory tract disease. Extubation readiness test in which spontaneously breathing children with oxygenation index less than or equal to 6 were placed on FIO2 of 0.50, positive end-expiratory pressure of 5 cm H2O, and pressure support. Of 1,042 children, 444 (43%) passed their first extubation readiness test. Of these, 295 (66%) were extubated within 10 hours of starting the extubation readiness test, including 272 who were successfully extubated, for a positive predictive value of 92%. Among 861 children who were extubated for the first time within 10 hours of performing an extubation readiness test, 788 passed their extubation readiness test and 736 were successfully extubated for a positive predictive value of 93%. The median time of day for extubation with an extubation readiness test was 12:15 hours compared with 14:54 hours for extubation without an extubation readiness test within 10 hours (p respiratory failure from lower respiratory tract disease, an extubation readiness test, as described, should be considered at least daily if the oxygenation index is less than or equal to 6. If the child passes the extubation readiness test, there is a high likelihood of successful extubation.

  8. [The impact of viruses in lower respiratory tract infections of the adult. Part II: acute bronchitis, acute exacerbated COPD, pneumonia, and influenza].

    Science.gov (United States)

    Ott, S R; Rohde, G; Lepper, P M; Hauptmeier, B; Bals, R; Pletz, M W R; Schumann, C; Steininger, C; Kleines, M; Geerdes-Fenge, H

    2010-01-01

    In industrialized countries respiratory tract infections are one of the most common reasons for medical consultations. It is assumed that almost one third of these infections affect the lower respiratory tract (LRTI), e. g. acute bronchitis, acute exacerbation of chronic obstructive pulmonary disease (COPD), community- or hospital-acquired pneumonia and influenza. Due to a lack of sufficient and valid investigations on the epidemiology of respiratory viruses, their impact on the pathogenesis of LRTI has probably been underestimated for a long time. Therefore, there might have been many cases of needless antibiotic treatment, particularly in cases of acute bronchitis or acute exacerbations of COPD, because of an assumed bacteriological aetiology. Following the introduction of diagnostic procedures with increased sensitivity, such as polymerase chain reaction, it is possible to reliably detect respiratory viruses and to illuminate their role in the pathogenesis of LRTI of the adult. We have reviewed the current literature to elucidate the role of viruses in the pathogenesis of LRTI. The first part of this series described frequent viral pathogens, pathogenesis of viral LRTI, and diagnostic procedures. In this 2 (nd) part the aetiological role of viruses in the most frequent forms of LRTI will be highlighted, and the third and last part will provide an overview of therapeutic and preventive options. Georg Thieme Verlag KG Stuttgart New York.

  9. Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China.

    Science.gov (United States)

    Liu, Ti; Li, Zhong; Zhang, Shengyang; Song, Shaoxia; Julong, Wu; Lin, Yi; Guo, Nongjian; Xing, Chunyan; Xu, Aiqiang; Bi, Zhenqiang; Wang, Xianjun

    2015-10-14

    The dominant viral etiologies responsible for acute respiratory infections (ARIs) are poorly understood, particularly among hospitalized patients. Improved etiological insight is needed to improve clinical management and prevention of ARIs. Clinical and demographic information and throat swabs were collected from 607 patients from 2011 to 2013 in Shandong Province, China. Multiplex RT-PCR (SeeplexTM RV detection, Seegene) was performed to detected 12 respiratory viral pathogens. A total of 607 hospitalized patients were enrolled from 2011 to 2013. Viruses were identified in 35.75 % (217/607) of cases, including 78 influenza virus A and B (IVA and IVB), 47 para-influenza viruses (PIVs), 41 respiratory syncytial virus (RSV) and 38 adenovirus (ADV). For the children under 15 year old, the common detected viruses were influenza viruses, RSV, PIVS and ADV, while the principal respiratory viruses were human coronaviruses (HCoV), PIVs, influenza viruses for the old adults. Co-infections with multiple viruses were detected in 15.67 % of patients. Children under 5 years were more likely to have one or more detectable virus associated with their ARI. The peak of ARI caused by the respiratory viruses occurred in winter. This study demonstrated respiratory viruses were the major cause of hospitalized ARI patients in Shandong Province, influenza virus was the most common detected, RSV was the highest incidence among the young children (≤5 years). These findings also gave a better understand of virus distribution among different age and seasons, which help to consider potential therapeutic approaches and develop effective prevention strategies for respiratory virus infection.

  10. The development and validation of a multidimensional sum-scaling questionnaire to measure patient-reported outcomes in acute respiratory tract infections in primary care: the acute respiratory tract infection questionnaire.

    Science.gov (United States)

    Aabenhus, Rune; Thorsen, Hanne; Siersma, Volkert; Brodersen, John

    2013-01-01

    Patient-reported outcomes are seldom validated measures in clinical trials of acute respiratory tract infections (ARTIs) in primary care. We developed and validated a patient-reported outcome sum-scaling measure to assess the severity and functional impacts of ARTIs. Qualitative interviews and field testing among adults with an ARTI were conducted to ascertain a high degree of face and content validity of the questionnaire. Subsequently, a draft version of the Acute Respiratory Tract Infection Questionnaire (ARTIQ) was statistically validated by using the partial credit Rasch model to test dimensionality, objectivity, and reliability of items. Test of known groups' validity was conducted by comparing participants with and without an ARTI. The final version of the ARTIQ consisted of 38 items covering five dimensions (Physical-upper, Physical-lower, Psychological, Sleep, and Medicine) and five single items. All final dimensions were confirmed to fit the Rasch model, thus enabling sum-scaling of responses. The ARTIQ scores in participants with an ARTI were significantly higher than in those without ARTI (known groups' validity). A self-administered, multidimensional, sum-scaling questionnaire with high face and content validity and adequate psychometric properties for assessing severity and functional impacts from ARTIs in adults is available to clinical trials and audits in primary care. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

  11. [Detection of etiologic agents and antibiotic resistance in children with acute lower respiratory tract infection in Wenzhou City].

    Science.gov (United States)

    Dong, Lin; Zhou, Xiao-Cong; Chen, Xiao-Fang; Yang, Jin-Hong; Lin, Jian; Zhang, Hai-Lin; Cai, Xiao-Hong; Luo, Yun-Chun; Zhang, Zheng-Xia; Li, Chang-Chong

    2006-10-01

    The etiology of acute lower respiratory tract infection (LRTI) in children in Wenzhou City remains poorly defined. This study investigated the etiological agents responsible for acute LRTI and patterns of the antibiotic resistant bacterial pathogens in children with acute LRTI from Wenzhou City. Lower respiratory tract secretions were obtained from 454 children with acute LRTI (aged 1 month to 10 years, median age 6 months) within 24 hrs after admission for bacterial culture. Meanwhile respiratory viruses were detected by the Direct immunofluorescence (DIF) assay. The K-B method was applied for the drug susceptibility test. Etiological agents were identified in 297 cases out of 454 patients (65.4%. Viral pathogens were identified in 229 cases (50.4%), bacteria in 135 cases (29.7%) and mixed viral-bacterial infections in 67 cases (14.8%). The isolating rate of Respiratory syncytial virus (RSV) was the highest (180 cases, 39.6%) in all of the samples. The isolating rates of other viral pathogens were as follows: Parainfluenza virus 3 type (PIV3) (6.6%), Adenovirus (2.2%), Influenza A (0.9%) and Influenza B (0.7%). Of the 135 strains of bacterial pathogens, 19 kinds of bacterial pathogens were isolated. The predominant isolate was Klebsiella pneumoniae (K. pneumoniae) (9.9%), followed by Escherichia coli (E.coli) (4.4%), Streptococcus pneumoniae (S. pneumoniae) (4.2%) and Staphylococcus aureus (S. aureus) (4.2%). The isolating rates of K. pneumoniae and E.coli with extended-spectrum beta-lactamases strains (ESBLs) positive were 42.2% and 65.0%, respectively. The pathogens isolated of the first 5 places in children with acute LRTI under six months were RSV, K. pneumoniae, PIV3, E.coli and S. aureus in turn. RSV, PIV3, S. pneumoniae, K. pneumoniae and E.coli were found to be the pathogens of the first 5 places in children with acute LRTI between six months and three years. The resistant rates of K. pneumoniae and E.coli to ampicillin were 97.8% and 75.0%, respectively

  12. Plasma cytokines eotaxin, MIP-1α, MCP-4, and vascular endothelial growth factor in acute lower respiratory tract infection

    DEFF Research Database (Denmark)

    Relster, Mette Marie; Holm, Anette; Pedersen, Court

    2017-01-01

    ), monocyte chemoattractant protein 4 (MCP-4), and vascular endothelial growth factor (VEGF) in 40 patients hospitalized with acute lower respiratory tract infections (LRTI). The cytokines contribute to the pathogenesis of several inflammatory respiratory diseases, indicating a potential as markers for LRTI....... Patients were stratified according to etiology and severity of LRTI, based on baseline C-reactive protein and CURB-65 scores. Using a multiplex immunoassay of plasma, levels of eotaxin and MCP-4 were shown to increase from baseline until day 6 after admission to hospital. The four cytokines were unable...... the full potential of eotaxin, MCP-4, MIP-1α, and VEGF as biomarkers for LRTI because of their low predictive power and a high interindividual variation of cytokine levels....

  13. [Prevalence and clinical characteristics of coronavirus NL63 infection in children hospitalized for acute lower respiratory tract infections in Changsha].

    Science.gov (United States)

    Zhang, Fei; Zhang, Bing; Xie, Zhi-Ping; Gao, Han-Chun; Zhao, Xin; Zhong, Li-Li; Zhou, Qiong-Hua; Hou, Yun-De; Duan, Zhao-Jun

    2012-04-01

    The main objective of this study was to explore the prevalence and clinical characteristics of human coronavirus NL63 infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha. Nasopharyngeal aspirates (NPA) samples were collected from 1185 hospitalized children with ALRTI at the People's Hospital of Hunan province, between September 2008 and October 2010. Reverse transcriptase polymerase chain reaction (RT-PCR) was employed to screen for coronavirus NL63, which is a 255 bp fragment of a part of N gene. All positive amplification products were confirmed by sequencing and compared with those in GenBank. The overall frequency of coronavirus NL63 infection was 0.8%, 6 (60%) out of the coronavirus NL63 positive patients were detected in summer, 2 in autumn, 1 in spring and winter, respectively. The patients were from 2 months to two and a half years old. The clinical diagnosis was bronchopneumonia (60%), bronchiolitis (30%), and acute laryngotracheal bronchitis (10%). Four of the 10 cases had critical illness, 4 cases had underlying diseases, and 7 cases had mixed infection with other viruses. The homogeneity of coronavirus NL63 with those published in the GenBank at nucleotide levels was 97%-100%. Coronavirus NL63 infection exists in hospitalized children with acute lower respiratory tract infection in Changsha. Coronavirus NL63 infections are common in children under 3 years of age. There is significant difference in the infection rate between the boys and the girls: the boys had higher rate than the girls. The peak of prevalence of the coronavirus NL63 was in summer. A single genetic lineage of coronavirus NL63 was revealed in human subjects in Changsha. Coronavirus NL63 may also be one of the lower respiratory pathogen in China.

  14. Vitamin A, D and zinc serum levels in children with and without acute respiratory tract infection in two university hospitals

    Directory of Open Access Journals (Sweden)

    Shima Javadi-Nia

    2014-03-01

    Conclusion: According to finding in this trial, there is a correlation between lower levels of zinc in serum, and chance of respiratory tract infection in children. Future larger studies could provide the correlation between serum levels of vitamins A & D and chance of respiratory tract infection.

  15. Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age.

    Science.gov (United States)

    Chen, H; Zhuo, Q; Yuan, W; Wang, J; Wu, T

    2008-01-23

    Vitamin A supplements are effective for preventing diarrhoea. There are theoretical reasons it might also be effective for acute lower respiratory tract infections (LRTIs), also very common in children, especially in low income countries. To assess the effectiveness and safety of vitamin A for preventing acute LRTIs in children up to seven years of age. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2); MEDLINE (1966 to July 2007); EMBASE (1974 to July 2007); and the Chinese Biomedicine Database (CBM) (1976 to July 2007). Randomised controlled trials (RCTs) that assessed the effectiveness of vitamin A in the prevention of acute LRTI in children up to seven years of age. The review authors independently extracted data and assessed trial quality. Study authors were contacted for additional information. Most studies found no significant effect of vitamin A on the incidence of acute LRTI, or prevalence of symptoms of acute LRTI. Vitamin A caused an increased incidence of acute LRTI in one study; an increase in cough and fever; and increased symptoms of cough and rapid breathing in two others. Three reported no differences and no protective effect of vitamin A. Two studies reported that vitamin A significantly reduced the incidence of acute LRTI with children with poor nutritional status or weight, but increased it in normal children. This unexpected result is outside our current understanding of the use of vitamin A for preventing acute LRTIs. Accordingly, vitamin A should not be given to all children to prevent acute LRTIs. There is evidence for vitamin A supplements to prevent acute LRTIs in children with low serum retinol or those with a poor nutritional status.

  16. Detection of bocavirus in children suffering from acute respiratory tract infections in Saudi Arabia.

    Directory of Open Access Journals (Sweden)

    Ahmed S Abdel-Moneim

    Full Text Available Human bocavirus (HBoV was recently discovered in children with respiratory distress and/or diarrhea. To our knowledge, no previous study has reported the existence of bocavirus in Saudi Arabia. Swabs samples from 80 children with respiratory tract infections were examined for the presence of HBoV. Real-time polymerase chain reaction was used as a sensitive method to detect the HBoV. Direct gene sequencing was used to determine the genotype of the detected virus isolates. HBoV was detected in 22.5% of the examined patients. The NP1 partial gene sequence from all patients showed that the circulated strains were related to HBoV-1 genotype. Most of HBoV infected patients showed evidence of mixed coinfection with other viral pathogens. The current study clearly demonstrated that genetically conserved HBoV1 circulates in Saudi Arabia. Interestingly, most of the HBoV1 infected cases were associated with high rates of co-infections with other viruses.

  17. The myocardium functional reserve indicators in junior children with recurrent acute upper respiratory tract infection

    Directory of Open Access Journals (Sweden)

    L.S. Ovcharenko

    2017-02-01

    Full Text Available Background. The problem of early diagnosis of cardiovascular diseases in children is relevant throughout the world and in Ukraine, as in childhood the health and quality of life of an adult are formed. The psychoemotional stress in junior children as well as increasingly complicating school curriculum, information overload with electronic gadgets, increased frequency of colds in children cause physical inactivity. In addition, infectious agents have a toxic effect on the myocardium, altering its functional state. All these together adversely affect the formation and development of the cardiovascular and respiratory systems of children. The aim was to study the functional reserve of the myocardium in junior children, depending on the frequency of upper respiratory tract infection (URTI. Materials and methods. The study examined 1109 children aged 6 to 9 years old. The URTI incidence was analyzed depending on the age. In the study, the children were divided into two groups. Group 1 consisted of the children with URTI — 210. Group 2 involved the children with occasional URTI — 899. Results. Among 210 surveyed children with upper respiratory infections 171 schoolboys (81.4 % had reduced functional reserve of the myocardium, which is consistent with findings from other studies. In children aged 7 and 9 years old, the number of reduced functional reserve of the myocardium varies from 70 to 82 % in seven-year children, among the schoolboys aged 6 and 8 years old the incidence of reduced functional reserve of the myocardium increased from 83 to 100 % in six-year children. Conclusions. Children with URTI have a reduced functional reserve of the myocardium. Children with episodic URTI have higher rates of functional reserve of the myocardium, therefore reducing the incidence of URTI will lead to the improvement of the myocardium functional state.

  18. Clinical features of human metapneumovirus genotypes in children with acute lower respiratory tract infection in Changsha, China.

    Science.gov (United States)

    Zeng, Sai-Zhen; Xiao, Ni-Guang; Zhong, Li-Li; Yu, Tian; Zhang, Bing; Duan, Zhao-Jun

    2015-11-01

    To explore the epidemiological and clinical features of different human metapneumovirus (hMPV) genotypes in hospitalized children. Reverse transcription polymerase chain reaction (RT-PCR) or PCR was employed to screen for both hMPV and other common respiratory viruses in 2613 nasopharyngeal aspirate specimens collected from children with lower respiratory tract infections from September 2007 to February 2011 (a period of 3.5 years). The demographics and clinical presentations of patients infected with different genotypes of hMPV were compared. A total of 135 samples were positive for hMPV (positive detection rate: 5.2%). Co-infection with other viruses was observed in 45.9% (62/135) of cases, and human bocavirus was the most common additional respiratory virus. The most common symptoms included cough, fever, and wheezing. The M gene was sequenced for 135 isolates; of these, genotype A was identified in 72.6% (98/135) of patients, and genotype B was identified in 27.4% (37/135) of patients. The predominant genotype of hMPV changed over the 3.5-year study period from genotype A2b to A2b or B1 and then to predominantly B1. Most of clinical features were similar between patients infected with different hMPV genotypes. These results suggested that hMPV is an important viral pathogen in pediatric patients with acute lower respiratory tract infection in Changsha. The hMPV subtypes A2b and B1 were found to co-circulate. The different hMPV genotypes exhibit similar clinical characteristics. © 2015 Wiley Periodicals, Inc.

  19. Detection of human bocavirus from children and adults with acute respiratory tract illness in Guangzhou, southern China

    Directory of Open Access Journals (Sweden)

    Liu Wen-Kuan

    2011-12-01

    Full Text Available Abstract Background Human bocavirus (HBoV is a newly discovered parvovirus associated with acute respiratory tract illness (ARTI and gastrointestinal illness. Our study is the first to analyze the characteristics of HBoV-positive samples from ARTI patients with a wide age distribution from Guangzhou, southern China. Methods Throat swabs (n=2811 were collected and analyzed from children and adults with ARTI over a 13-month period. The HBoV complete genome from a 60 year-old female patient isolate was also determined. Results HBoV DNA was detected in 65/2811 (2.3% samples, of which 61/1797 were from children (Mycoplasma pneumoniae had the highest frequency of 16.9% (11/65. Upper and lower respiratory tract illness were common symptoms, with 19/65 (29.2% patients diagnosed with pneumonia by chest radiography. All four adult patients had systemic influenza-like symptoms. Phylogenetic analysis of the complete genome revealed a close relationship with other HBoVs, and a more distant relationship with HBoV2 and HBoV3. Conclusions HBoV was detected from children and adults with ARTI from Guangzhou, southern China. Elderly people were also susceptive to HBoV. A single lineage of HBoV was detected among a wide age distribution of patients with ARTI.

  20. Prescriber and Patient Responsibilities in Treatment of Acute Respiratory Tract Infections — Essential for Conservation of Antibiotics

    Directory of Open Access Journals (Sweden)

    Antonio C. Pignatari

    2013-06-01

    Full Text Available Inappropriate antibiotic use in normally self-limiting acute respiratory tract infections (RTIs, such as sore throat and the common cold, is a global problem and an important factor for increasing levels of antibiotic resistance. A new group of international experts—the Global Respiratory Infection Partnership (GRIP—is committed to addressing this issue, with the interface between primary care practitioners and their patients as their core focus. To combat the overuse of antibiotics in the community, and facilitate a change from prescribing empiric antibiotic treatment towards cautious deferment combined with symptomatic relief, there is a need to introduce and enhance evidence-based dialogue between primary care practitioners and their patients. Communication with patients should focus on the de-medicalisation of self-limiting viral infections, which can be achieved via a coherent globally endorsed framework outlining the rationale for appropriate antibiotic use in acute RTIs in the context of antibiotic stewardship and conservancy. The planned framework is intended to be adaptable at a country level to reflect local behaviours, cultures and healthcare systems, and has the potential to serve as a model for change in other therapeutic areas.

  1. Detection of Human Metapneumovirus in Hospitalized Children with Acute Respiratory Tract Infection Using Real-time RT-PCR in a Hospital in Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Chun Chan

    2007-01-01

    Conclusion: Metapneumovirus circulates in children in northern Taiwan during spring and early summer. hMPV was the most common respiratory pathogen in children aged between 18 and 24 months hospitalized with acute respiratory tract infection. Real-time RT-PCR is a sensitive method for investigating the epidemiology and diseases associated with hMPV. [J Formos Med Assoc 2007;106(1:16-24

  2. Efficacy, safety and tolerability of 3 day azithromycin versus 10 day co-amoxiclav in the treatment of children with acute lower respiratory tract infections

    NARCIS (Netherlands)

    A. Ferwerda (Annemarie); H.A. Moll (Henriëtte); W.C.J. Hop (Wim); J.M. Kouwenberg (Jan); C.V. Tjon Pian Gi

    2001-01-01

    textabstractTo compare the efficacy, safety and tolerability of a 3 day course of azithromycin with a 10 day course of co-amoxiclav in the treatment of children with acute lower respiratory tract infection (LRTI), 118 patients with community-acquired LRTI were

  3. High prevalence of acute respiratory tract infections among Warao Amerindian children in Venezuela in relation to low immunization coverage and chronic malnutrition.

    NARCIS (Netherlands)

    Verhagen, L.M.; Warris, A.; Hermans, P.W.M.; Nogal, B. del; Groot, R. de; Waard, J.H. de

    2012-01-01

    BACKGROUND: Higher prevalence rates of acute respiratory tract infections (ARTIs) have been described in Australian and Canadian indigenous populations than in nonindigenous age-matched counterparts. Few studies on ARTIs in South American indigenous populations have been published. We performed a

  4. Detection of Mycoplasma pneumoniae by two polymerase chain reactions and role of M. pneumoniae in acute respiratory tract infections in pediatric patients

    NARCIS (Netherlands)

    Ieven, M; Ursi, D; Van Bever, H; Quint, W; Niesters, H G; Goossens, H

    Mycoplasma pneumoniae and viruses in acute respiratory tract infections in children were studied during the winter of 1992-1993 in Antwerp, Belgium. M. pneumoniae was diagnosed in nasopharyngeal aspirates by culture and polymerase chain reaction (PCR). For this, amplification of a fragment of the PI

  5. Effectiveness of multifaceted interventions on rational use of antibiotics for patients with upper respiratory tract infections and acute diarrhea.

    Science.gov (United States)

    Boonyasiri, Adhiratha; Thamlikitkul, Visanu

    2014-03-01

    To implement multifaceted interventions to promote rational use of antibiotics for out-patients with upper respiratory tract infection (URI) and acute diarrhea. The present study was conducted at ambulatory care facility for patients under Social Security Healthcare Benefit Scheme and Universal Health Coverage Scheme of Siriraj Hospital from January to April 2012. Multifaceted interventions were: Training responsible healthcare personnel on rational use of antibiotics, Clinical practice guidelines, Preprinted medical record forms for patients, Throat swab or stool culture to be taken from the patients (if responsible physicians needed these); and provision of brochures containing causes, necessity and harm of antibiotics for URI and acute diarrhea to patients as well as their relatives while waiting for receiving care. Pre-printed medical records were collected every day. Each patient was called on day 3 after receiving care by an investigator to determine clinical responses. There were 1,241 episodes of URI and 210 episodes of acute diarrhea during the study period. Rates of antibiotic prescriptions were 13.0% for URI and 19.1% for acute diarrhea. Throat swab cultures recovered group A beta-hemolytic streptococci in 3.8% of URI patients and non-typhoidal Salmonella spp. in 14.6% of acute diarrhea patients. Clinical responses of the patients on day 3 after receiving care revealed that more than 97% of the patients who received antibiotics and who did not receive antibiotics were cured or improved. Multifaceted interventions are very effective for promoting rational use of antibiotics for out-patients with URI and acute diarrhea at Siriraj Hospital.

  6. Antibiotic prescribing practice for acute, uncomplicated respiratory tract infections in primary care settings in New Delhi, India.

    Science.gov (United States)

    Kotwani, Anita; Holloway, Kathleen

    2014-07-01

    To obtain information on prescribing rates and choice of antibiotics for acute, uncomplicated respiratory tract infections (RTIs) in the community. Antibiotic use in acute, uncomplicated RTIs consisting of common cold/sore throat/cough for not more than five days was surveyed in the community (December 2007-November 2008) using patient exit interviews at public and private facilities from four localities in New Delhi. Data were collected from 10 public sector facilities and 20 private clinics over one year. The percentage of acute, uncomplicated RTIs patients receiving antibiotics in general and using the Anatomical Therapeutic Chemical classification and the Defined Daily Dose (ATS/DDD) were analysed. At public and private facilities, 45% (746/1646) and 57% (259/457) of acute, uncomplicated RTI patients were prescribed at least one antibiotic, respectively. The main antibiotic class calculated as percentage of total antibiotics DDDs/1000 prescribed to acute, uncomplicated RTI patients at private clinics was cephalosporins, J01DA (39%), followed by fluoroquinolones, J01MA (24%), penicillins, J01C (19%) and macrolides, J01FA (15%). Newer members from each class were prescribed; older antibiotics such as co-trimoxazole or tetracyclines were rarely prescribed. At public facilities, the main class of antibiotic prescribed was penicillins (31%), followed by macrolides (25%), fluoroquinolones (20%) and cephalosporins (10%). Study clearly shows overuse and inappropriate choice of antibiotics for the treatment of acute, uncomplicated RTIs which are mainly due to virus and do not require antibiotic treatment. Results of the study warrant interventional strategies to promote rational use of antibiotics to decrease the overgrowing threat of antibiotic resistance. © 2014 John Wiley & Sons Ltd.

  7. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections.

    Science.gov (United States)

    Schuetz, Philipp; Müller, Beat; Christ-Crain, Mirjam; Stolz, Daiana; Tamm, Michael; Bouadma, Lila; Luyt, Charles E; Wolff, Michel; Chastre, Jean; Tubach, Florence; Kristoffersen, Kristina B; Burkhardt, Olaf; Welte, Tobias; Schroeder, Stefan; Nobre, Vandack; Wei, Long; Bhatnagar, Neera; Bucher, Heiner C; Briel, Matthias

    2013-07-01

    Acute respiratory infections (ARIs) comprise a large and heterogeneous group of infections including bacterial, viral and other aetiologies. In recent years, procalcitonin - the prohormone of calcitonin - has emerged as a promising marker for the diagnosis of bacterial infections and for improving decisions about antibiotic therapy. Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with acute respiratory infections and different settings ranging from primary care to emergency departments (EDs), hospital wards and intensive care units (ICUs). The aim of this systematic review based on individual patient data was to assess the safety and efficacy of using procalcitonin for starting or stopping antibiotics over a large range of patients with varying severity of ARIs and from different clinical settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2011, Issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to May 2011) and EMBASE (1974 to May 2011) to identify suitable trials. We included RCTs of adult participants with ARIs who received an antibiotic treatment either based on a procalcitonin algorithm or usual care/guidelines. Trials were excluded if they exclusively focused on paediatric patients or if they used procalcitonin for another purpose than to guide initiation and duration of antibiotic treatment. Two teams of review authors independently evaluated the methodology and extracted data from primary studies. The primary endpoints were all-cause mortality and treatment failure at 30 days. For the primary care setting, treatment failure was defined as death, hospitalisation, ARI-specific complications, recurrent or worsening infection, and patients reporting any symptoms of an ongoing respiratory infection at follow-up. For the ED setting, treatment failure was defined

  8. Comparison of virological profiles of respiratory syncytial virus and rhinovirus in acute lower tract respiratory infections in very young Chilean infants, according to their clinical outcome.

    Science.gov (United States)

    Luchsinger, Vivian; Ampuero, Sandra; Palomino, M Angélica; Chnaiderman, Jonás; Levican, Jorge; Gaggero, Aldo; Larrañaga, Carmen E

    2014-09-01

    Respiratory syncytial virus (RSV) and rhinovirus (HRV) are the main cause of acute lower respiratory tract infections (ALRTIs) in infants. Viral and host-related risk factors for severe disease have also not been clearly established. To assess whether certain viral features of RSV and, or HRV are associated with severe ALRTI. RSV and HRV were studied in nasopharyngeal samples of infants by immunofluorescence, Luminex(®) and/or real-time RT-PCR assays. Quantitation and genotyping of RSV and HRV by PCR were done. Of 124 virus positive specimens, 74 (59.7%) had RSV; 22 (17.7%) HRV and 28 (22.6%) RSV-HRV co-infection. Hospitalization was required in 57/74 RSV infants (77.0%); in 10/22 HRV cases (45.5%) (p=0.006) and in 15/28 co-infected by both viruses (53.6%) (p=0.003). Severe cases were 33/74 (44.6%) RSV infections, 2/22 HRV cases (9.1%), (pinfected by RSV-HRV (pinfection does not increase the severity of illness. NA1 RSV genotype was associated with major frequency of hospitalization, severe respiratory disease and higher viral load. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Pitfalls in interpretation of CT-values of RT-PCR in children with acute respiratory tract infections.

    Science.gov (United States)

    Wishaupt, Jérôme O; Ploeg, Tjeerd van der; Smeets, Leo C; Groot, Ronald de; Versteegh, Florens G A; Hartwig, Nico G

    2017-05-01

    The relation between viral load and disease severity in childhood acute respiratory tract infections (ARI) is not fully understood. To assess the clinical relevance of the relation between viral load, determined by cycle threshold (CT) value of real-time reverse transcription-polymerase chain reaction assays and disease severity in children with single- and multiple viral ARI. 582 children with ARI were prospectively followed and tested for 15 viruses. Correlations were calculated between CT values and clinical parameters. In single viral ARI, statistically significant correlations were found between viral loads of Respiratory Syncytial Virus (RSV) and hospitalization and between viral loads of Human Coronavirus (HCoV) and a disease severity score. In multiple-viral ARI, statistically significant correlations between viral load and clinical parameters were found. In RSV-Rhinovirus (RV) multiple infections, a low viral load of RV was correlated with a high length of hospital stay and a high duration of extra oxygen use. The mean CT value for RV, HCoV and Parainfluenza virus was significantly lower in single- versus multiple infections. Although correlations between CT values and clinical parameters in patients with single and multiple viral infection were found, the clinical importance of these findings is limited because individual differences in host-, viral and laboratory factors complicate the interpretation of statistically significant findings. In multiple infections, viral load cannot be used to differentiate between disease causing virus and innocent bystanders. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Systematic Review of Clinical Trials Assessing the Effectiveness of Ivy Leaf (Hedera Helix for Acute Upper Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Felix Holzinger

    2011-01-01

    Full Text Available Introduction. Among nonantibiotic cough remedies, herbal preparations containing extracts from leaves of ivy (Hedera helix enjoy great popularity. Objective. A systematic review to assess the effectiveness and tolerability of ivy for acute upper respiratory tract infections (URTIs. Methods. We searched for randomized controlled trials (RCTs, nonrandomized controlled clinical trials and observational studies evaluating the efficacy of ivy preparations for acute URTIs. Study quality was assessed by the Jadad score or the EPHPP tool. Results. 10 eligible studies were identified reporting on 17463 subjects. Studies were heterogeneous in design and conduct; 2 were RCTs. Three studies evaluated a combination of ivy and thyme, 7 studies investigated monopreparations of ivy. Only one RCT (=360 investigating an ivy/thyme combination used a placebo control and showed statistically significant superiority in reducing the frequency and duration of cough. All other studies lack a placebo control and show serious methodological flaws. They all conclude that ivy extracts are effective for reducing symptoms of URTI. Conclusion. Although all studies report that ivy extracts are effective to reduce symptoms of URTI, there is no convincing evidence due to serious methodological flaws and lack of placebo controls. The combination of ivy and thyme might be more effective but needs confirmation.

  11. Epidemiology of viral-associated acute lower respiratory tract infection among children prevalence setting, South Africa, 2009-2012.

    Science.gov (United States)

    Cohen, Cheryl; Walaza, Sibongile; Moyes, Jocelyn; Groome, Michelle; Tempia, Stefano; Pretorius, Marthi; Hellferscee, Orienka; Dawood, Halima; Chhagan, Meera; Naby, Fathima; Haffejee, Summaya; Variava, Ebrahim; Kahn, Kathleen; Nzenze, Susan; Tshangela, Akhona; von Gottberg, Anne; Wolter, Nicole; Cohen, Adam L; Kgokong, Babatyi; Venter, Marietjie; Madhi, Shabir A

    2015-01-01

    Data on the epidemiology of viral-associated acute lower respiratory tract infection (LRTI) from high HIV prevalence settings are limited. We aimed to describe LRTI hospitalizations among South African children aged prevalence among tested children was 12% (705/5964). The overall prevalence of respiratory viruses identified was 78% (6517/8393), including 37% rhinovirus, 26% respiratory syncytial virus (RSV), 7% influenza and 5% human metapneumovirus. Four percent (253/6612) tested positive for pneumococcus. The annual incidence of LRTI hospitalization ranged from 2530 to 3173/100,000 population and was highest in infants (8446-10532/100,000). LRTI incidence was 1.1 to 3.0-fold greater in HIV-infected than HIV-uninfected children. In multivariable analysis, compared to HIV-uninfected children, HIV-infected children were more likely to require supplemental-oxygen [odds ratio (OR): 1.3, 95% confidence interval (CI): 1.1-1.7)], be hospitalized >7 days (OR: 3.8, 95% CI: 2.8-5.0) and had a higher case-fatality ratio (OR: 4.2, 95% CI: 2.6-6.8). In multivariable analysis, HIV-infection (OR: 3.7, 95% CI: 2.2-6.1), pneumococcal coinfection (OR: 2.4, 95% CI: 1.1-5.6), mechanical ventilation (OR: 6.9, 95% CI: 2.7-17.6) and receipt of supplemental-oxygen (OR: 27.3, 95% CI: 13.2-55.9) were associated with death. HIV-infection was associated with an increased risk of LRTI hospitalization and death. A viral pathogen, commonly RSV, was identified in a high proportion of LRTI cases.

  12. Prevalence and clinical characteristics of human CoV-HKU1 in children with acute respiratory tract infections in China.

    Science.gov (United States)

    Jin, Yu; Song, Jing-Rong; Xie, Zhi-Ping; Gao, Han-Chun; Yuan, Xin-Hui; Xu, Zi-Qian; Yan, Kun-Long; Zhao, Yang; Xiao, Ni-Guang; Hou, Yun-De; Duan, Zhao-Jun

    2010-10-01

    Human CoV-HKU1 (HCoV-HKU1) has been isolated from a 71-year-old man with pneumonia; however, the impact and role of emerging HCoV-HKU1 have not been defined in children with acute respiratory tract infection (ARTI). To investigate the Prevalence and clinical characteristics of HCoV-HKU1 in children with ARTI in Lanzhou, China. The reverse transcription polymerase chain reaction (RT-PCR) or PCR was employed to screen HCoV-HKU1 and other common respiratory viruses in 645 nasopharyngeal aspirate (NPA) specimens collected from children with ARTI from November 2006 to October 2008. All PCR positive products were sequenced. And the demographic and clinical data were collected for all patients. Nineteen of 645 (2.95%) specimens tested positive for HCoV-HKU1, and all HCoV-HKU1 positive specimens were distributed in the winter and spring season. The HCoV-HKU1 co-infection rate with other respiratory viruses was 47.37% (9/19). There was no statistically significant difference in the detection rate between groups by age or gender, except between patients with and without underlying diseases. The phylogenetic analysis indicated that HCoV-HKU1 genotype B was circulating in the years 2007 and 2008 in children with ARTI in Lanzhou, China. HCoV-HKU1 is an uncommon virus existing among Chinese children with ARTI. Children with underlying diseases are more vulnerable to viral infection. Only HCoV-HKU1 genotype B circulated locally. Copyright © 2010. Published by Elsevier B.V.

  13. High prevalence of acute respiratory tract infections among Warao Amerindian children in Venezuela in relation to low immunization coverage and chronic malnutrition.

    Science.gov (United States)

    Verhagen, Lilly M; Warris, Adilia; Hermans, Peter W M; del Nogal, Berenice; de Groot, Ronald; de Waard, Jacobus H

    2012-03-01

    Higher prevalence rates of acute respiratory tract infections (ARTIs) have been described in Australian and Canadian indigenous populations than in nonindigenous age-matched counterparts. Few studies on ARTIs in South American indigenous populations have been published. We performed a cross-sectional survey to describe the prevalence of upper respiratory tract infections and acute lower respiratory tract infections (ALRTIs) and associations with malnutrition and immunization status. From December 1, 2009 to May 31, 2010, 487 Warao Amerindian children 0 to 59 months of age living in the Delta Amacuro in Venezuela were included in a cross-sectional survey. Data were obtained through parent questionnaires, vaccination cards, and physical examinations including anthropometric measurements. Of the 487 children, 47% presented with an ARTI. Of these, 60% had upper respiratory tract infections and 40% were ALRTI. Immunization coverage was low, with only 27% of all children presenting a vaccination card being fully immunized. The prevalence of malnutrition was high (52%), with stunting (height-for-age prevalence diminished with increasing age (odds ratio for ALRTI in children 25-59 months of age vs. children younger than 12 months, 0.49; 95% confidence interval, 0.26-0.93). Furthermore, significant differences in ARTI prevalence were seen between villages. No significant associations between immunization status or malnutrition and ARTI or ALRTI prevalence were identified. A high prevalence of ARTIs and chronic malnutrition in combination with a low immunization status highlights the need for an integrated approach to improve the health status of indigenous Venezuelan children.

  14. Effect of Oral Prednisolone on Symptom Duration and Severity in Nonasthmatic Adults With Acute Lower Respiratory Tract Infection: A Randomized Clinical Trial.

    Science.gov (United States)

    Hay, Alastair D; Little, Paul; Harnden, Anthony; Thompson, Matthew; Wang, Kay; Kendrick, Denise; Orton, Elizabeth; Brookes, Sara T; Young, Grace J; May, Margaret; Hollinghurst, Sandra; Carroll, Fran E; Downing, Harriet; Timmins, David; Lafond, Natasher; El-Gohary, Magdy; Moore, Michael

    2017-08-22

    Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence. To assess the effects of oral corticosteroids for acute lower respiratory tract infection in adults without asthma. Multicenter, placebo-controlled, randomized trial (July 2013 to final follow-up October 2014) conducted in 54 family practices in England among 401 adults with acute cough and at least 1 lower respiratory tract symptom not requiring immediate antibiotic treatment and with no history of chronic pulmonary disease or use of asthma medication in the past 5 years. Two 20-mg prednisolone tablets (n = 199) or matched placebo (n = 202) once daily for 5 days. The primary outcomes were duration of moderately bad or worse cough (0 to 28 days; minimal clinically important difference, 3.79 days) and mean severity of symptoms on days 2 to 4 (scored from 0 [not affected] to 6 [as bad as it could be]; minimal clinically important difference, 1.66 units). Secondary outcomes were duration and severity of acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, and adverse events. Among 401 randomized patients, 2 withdrew immediately after randomization, and 1 duplicate patient was identified. Among the 398 patients with baseline data (mean age, 47 [SD, 16.0] years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range [IQR], 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = .36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, -0.20; 95% CI, -0.40 to 0.00; P = .05

  15. Upper respiratory tract (image)

    Science.gov (United States)

    ... mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that secretes mucus. The mucus traps smaller particles like pollen or smoke. Hairlike structures called cilia line the mucous membrane ...

  16. Impact of clinical decision support on receipt of antibiotic prescriptions for acute bronchitis and upper respiratory tract infection.

    Science.gov (United States)

    McCullough, J Mac; Zimmerman, Frederick J; Rodriguez, Hector P

    2014-01-01

    Antibiotics are commonly recognized as non-indicated for acute bronchitis and upper respiratory tract infection (URI), yet their widespread use persists. Clinical decision support in the form of electronic warnings is hypothesized to prevent non-indicated prescriptions. The purpose of this study was to identify the effect of clinical decision support on a common type of non-indicated prescription. Using National Ambulatory Medical Care Survey data from 2006 to 2010, ambulatory visits with a primary diagnosis of acute bronchitis or URI and orders for antibiotic prescriptions were identified. Visits were classified on the basis of clinician report of decision-support use. Generalized estimating equations were used to assess the effect of decision support on likelihood of antibiotic prescription receipt, controlling for patient, provider, and practice characteristics. Clinician use of decision support increased sharply between 2006 (16% of visits) and 2010 (55%). Antibiotic prescribing for acute bronchitis and URI increased from ∼35% of visits in 2006 to ∼45% by 2010. Use of decision support was associated with a 19% lower likelihood of receiving an antibiotic prescription, controlling for patient, provider, and practice characteristics. In spite of the increased use of decision-support systems and the relatively fewer non-indicated antibiotic prescriptions resulting from the use of decision support, a secular upward trend in non-indicated antibiotic prescribing offset these improvements. The overall effect of decision support suggests an important role for technology in reducing non-indicated prescriptions. Decision support alone may not be sufficient to eliminate non-indicated prescriptions given secular trends. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Epidemiology of respiratory syncytial virus-associated acute lower respiratory tract infection hospitalizations among HIV-infected and HIV-uninfected South African children, 2010-2011.

    Science.gov (United States)

    Moyes, Jocelyn; Cohen, Cheryl; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Walaza, Sibongile; Haffejee, Sumayya; Chhagan, Meera; Naby, Fathima; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Madhi, Shabir A

    2013-12-15

    There are limited data on respiratory syncytial virus (RSV) infection among children in settings with a high prevalence of human immunodeficiency virus (HIV). We studied the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) hospitalizations among HIV-infected and HIV-uninfected children in South Africa. Children aged infection among HIV-infected and uninfected children were examined. The relative risk of hospitalization in HIV-infected and HIV-uninfected children was calculated in 1 site with population denominators. Of 4489 participants, 4293 (96%) were tested for RSV, of whom 1157 (27%) tested positive. With adjustment for age, HIV-infected children had a 3-5-fold increased risk of hospitalization with RSV-associated ALRTI (2010 relative risk, 5.6; [95% confidence interval (CI), 4.5-6.4]; 2011 relative risk, 3.1 [95% CI, 2.6-3.6]). On multivariable analysis, HIV-infected children with RSV-associated ALRTI had higher odds of death (adjusted odds ratio. 31.1; 95% CI, 5.4-179.8) and hospitalization for >5 days (adjusted odds ratio, 4.0; 95% CI, 1.5-10.6) than HIV-uninfected children. HIV-infected children have a higher risk of hospitalization with RSV-associated ALRTI and a poorer outcome than HIV-uninfected children. These children should be targeted for interventions aimed at preventing severe RSV disease.

  18. Acute lower respiratory tract infection due to respiratory syncytial virus in a group of Egyptian children under 5 years of age

    Directory of Open Access Journals (Sweden)

    El-kholy Amany A

    2011-04-01

    Full Text Available Abstract Background and aim Respiratory syncytial virus (RSV is one of the most important causes of acute lower respiratory tract infections (ALRTI in infants and young children. This study was conducted to describe the epidemiology of ALRTI associated with RSV among children ≤ 5 years old in Egypt. Patients and Methods We enrolled 427 children ≤ 5 years old diagnosed with ALRTI attending the outpatient clinic or Emergency Department (ED of Children Hospital, Cairo University during a one- year period. Nasopharyngeal aspirates were obtained from the patients, kept on ice and processed within 2 hours of collection. Immunoflourescent assay (IFA for RSV was performed. Results 91 cases (21.3% had viral etiology with RSV antigens detected in 70 cases (16.4%. The RSV positive cases were significantly younger than other non-RSV cases (mean age 8.2 months versus 14.2 months, p Conclusion RSV is the most common viral etiology of ALRTI in children below 5 years of age, especially in young infants below 6 months of age. It is more prevalent in winter and tends to cause severe infection.

  19. Respiratory tract infection during Hajj

    Directory of Open Access Journals (Sweden)

    Alzeer Abdulaziz

    2009-01-01

    Full Text Available Respiratory tract infection during Hajj (pilgrimage to Mecca is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.

  20. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China.

    Science.gov (United States)

    Liu, Jia; Ai, Hongwu; Xiong, Ying; Li, Fu; Wen, Zhou; Liu, Weiyong; Li, Tongya; Qin, Kai; Wu, Jianguo; Liu, Yingle

    2015-01-01

    Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children's Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for pathogens in children with

  1. Biodiversity and clinico-demographic characteristics of human rhinoviruses from hospitalized children with acute lower respiratory tract infections in Malaysia.

    Science.gov (United States)

    Etemadi, Mohammad Reza; Othman, Norlijah; Savolainen-Kopra, Carita; Sekawi, Zamberi; Wahab, NoraAbd; Sann, Lye Munn

    2013-12-01

    There is accumulating evidence that human rhinovirus (HRV) causes acute lower respiratory tract infections (ALRTI). Recently, HRV-C was identified as a new species of HRV, but its spectrum of clinical disease is not well understood. We investigated the molecular epidemiology, demographic and clinical characteristics of HRVs among hospitalized children with ALRIs. One hundred and sixty-five nasopharangeal aspirates taken from children respiratory viruses were also investigated using semi-nested multiplex RT-PCR assay. Clinical parameters were analyzed between HRV, RSV and IFV-A mono-infections and between HRV species. HRV was detected in 54 (33%) patients for both single (36 samples) and multiple (18 samples) infections, 61.1% (22/36) represents HRV-A strains while the remaining 14 HRV-C. Strain P51 was the first reported representative of HRV98. The majority of the single HRV cases were in the second half of infancy; HRV-C occurred among older children compared with HRV-A. HRV children were admitted significantly earlier and less febrile than RSV and IFV-A infection. HRV-C infected children were more likely to have rhonchi and vomiting as compared to HRV-A. Pneumonia was the most common discharge diagnosis followed by bronchiolitis and post-viral wheeze in HRV patients. Our study showed high prevalence of HRVs and detection of HRV-C among hospitalized children with ALRTIs in Malaysia. Analysis of clinical parameters suggested specific features associated with HRVs infections and specific HRV groups. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Is acute idiopathic pericarditis associated with recent upper respiratory tract infection or gastroenteritis? A case–control study

    Science.gov (United States)

    Rey, Florian; Delhumeau-Cartier, Cecile; Meyer, Philippe; Genne, Daniel

    2015-01-01

    Objectives The aim of this study was to assess the association of a clinical diagnosis of acute idiopathic pericarditis (AIP), and a reported upper respiratory tract infection (URTI) or gastroenteritis (GE) in the preceding month. Design Patients who were hospitalised with a first diagnosis of AIP were retrospectively compared with a control group of patients admitted with deep vein thrombosis (DVT), matched by gender and age. Setting Primary and secondary care level; one hospital serving a population of about 170 000. Participants A total of 51 patients with AIP were included, of whom 46 could be matched with 46 patients with control DVT. Only patients with a complete review of systems on the admission note were included in the study. Main outcome measure Conditional logistic regression was used to assess the association of a clinical diagnosis of AIP and an infectious episode (URTI or GE) in the month preceding AIP diagnosis. Results Patients with AIP had more often experienced a recent episode of URTI or GE than patients with DVT (39.1% vs 10.9%, p=0.002). The multivariate conditional regression showed that AIP was independently associated with URTI or GE in the last month preceding diagnosis (OR=37.18, 95% CI=1.91 to 724.98, p=0.017). Conclusions This is, to the best of our knowledge, the first study demonstrating an association between a recent episode of URTI or GE and a clinical diagnosis of AIP. PMID:26603247

  3. Clinical characteristics and viral load of respiratory syncytial virus and human metapneumovirus in children hospitaled for acute lower respiratory tract infection.

    Science.gov (United States)

    Yan, Xiao-Li; Li, Yu-Ning; Tang, Yi-Jie; Xie, Zhi-Ping; Gao, Han-Chun; Yang, Xue-Mei; Li, Yu-Mei; Liu, Li-Jun; Duan, Zhao-Jun

    2017-04-01

    Respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) are two common viral pathogens in acute lower respiratory tract infections (ALRTI). However, the association of viral load with clinical characteristics is not well-defined in ALRTI. To explore the correlation between viral load and clinical characteristics of RSV and HMPV in children hospitalized for ALRTI in Lanzhou, China. Three hundred and eighty-seven children hospitalized for ALRTI were enrolled. Nasopharyngeal aspirates (NPAs) were sampled from each children. Real-time PCR was used to screen RSV, HMPV, and twelve additional respiratory viruses. Bronchiolitis was the leading diagnoses both in RSV and HMPV positive patients. A significantly greater frequency of wheezing (52% vs. 33.52%, P = 0.000) was noted in RSV positive and negative patients. The RSV viral load was significant higher in children aged infections (P = 0.000). No difference was found in the clinical features of HMPV positive and negative patients. The HMPV viral load had no correlation with any clinical characteristics. The incidences of severe disease were similar between single infection and coinfection for the two viruses (RSV, P = 0.221; HMPV, P = 0.764) and there has no statistical significance between severity and viral load (P = 0.166 and P = 0.721). Bronchiolitis is the most common disease caused by RSV and HMPV. High viral load or co-infection may be associated with some symptoms but neither has a significant impact on disease severity for the two viruses. J. Med. Virol. 89:589-597, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Acute respiratory distress syndrome

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  5. β2-Adrenergic receptor promoter haplotype influences the severity of acute viral respiratory tract infection during infancy: a prospective cohort study.

    Science.gov (United States)

    Wu, Pingsheng; Larkin, Emma K; Reiss, Sara S; Carroll, Kecia N; Summar, Marshall L; Minton, Patricia A; Woodward, Kimberly B; Liu, Zhouwen; Islam, Jessica Y; Hartert, Tina V; Moore, Paul E

    2015-09-14

    Despite the significant interest in β2-Adrenergic receptor (ADRB2) polymorphisms related to asthma, whether ADRB2 genetic variants are similarly associated with acute respiratory tract infections have not been studied. We hypothesized that genetic variants in ADRB2 associated with a response to asthma therapy during an asthma exacerbation were also associated with severity of acute respiratory tract infections. To test this hypothesis, we genotyped 5 common polymorphisms in the promoter region and coding block of the ADRB2 gene (loci -2387, -2274, -1343, +46, and +79) from 374 Caucasian and African American term infants who were enrolled at the time of acute respiratory illness over four respiratory viral seasons. Severity of respiratory tract infections was measured using a bronchiolitis severity score (BSS; range = 0-12, clinically significant difference = 0.5) with a higher score indicating more severe disease. We assigned the promoter, coding and combined promoter and coding haplotypes to the unphased genotype data. The associations between each of these five single-nucleotide polymorphisms (SNPs) as well as the haplotypes and infant BSS were analyzed using nonparametric univariate analysis and multivariable proportional odds model separately in Caucasians and African Americans. There was no significant association between infant BSS and each of the SNPs in both Caucasians and African Americans. However, promoter haplotype CCA was associated with a decreased BSS in African Americans in a dose dependent manner. The median (interquartile range) BSS of infants with no copies of the CCA haplotype, one copy, and two copies of the CCA haplotype were 5.5 (2.0, 8.0), 4.0 (1.0, 7.5), and 3.0 (1.0, 4.0), respectively. This dose dependent relationship persisted after adjusting for infant age, gender, daycare exposure, secondhand smoke exposure, prior history of breastfeeding, siblings at home, and enrollment season (adjusted odds ratio: 0.59, 95% confidence

  6. Cost-effectiveness analysis of oral versus intravenous drip infusion of levofloxacin in the treatment of acute lower respiratory tract infection in Chinese elderly patients.

    Science.gov (United States)

    Zhang, Libin; Hu, Ping

    2017-01-01

    Pharmacoeconomic cost-effectiveness analysis of two different dosage regimens of levofloxacin in the treatment of acute lower respiratory tract infection in elderly patients. A total of 108 elderly patients with acute lower respiratory tract infection who visited by our hospital between September 2013 and September 2014 were randomly divided into Group A and Group B, with 54 patients in each group. In Group A, levofloxacin injection was given for continuous intravenous infusion treatment, whereas in Group B, levofloxacin injection and levofloxacin capsule were given as sequential therapy (ST). The period of treatment for both the groups was 10 days, and minimum cost analysis was used to analyze the treatment. Groups A and B had cure rates of 61.1% and 59.3% (P>0.05), effective rates of 88.9% and 83.3% (P>0.05), bacterial clearance rates of 96.3% and 92.6% (P>0.05), and incidence rates of adverse reactions of 7.4% and 3.7% (P>0.05), respectively. Treatment costs of Groups A and B were 1,588 RMB and 1,150 RMB, respectively, whereas the cost-effectiveness of the two groups was at 17.86 and 13.81, respectively (PLevofloxacin ST had relatively higher cost-effectiveness ratio for the treatment of acute lower respiratory tract infection in elderly patients, especially Chinese.

  7. Detection of human bocavirus in children with acute respiratory tract infections in Lanzhou and Nanjing, China.

    Science.gov (United States)

    Wu, Jian Jun; Jin, Yu; Lin, Na; Xie, Zhi Ping; Yu, Jie Mei; Li, Jin Song; Cao, Chang Qing; Yuan, Xin Hui; Song, Jin Rong; Zhang, Jing; Zhao, Yang; Gao, Xiao Qian; Duan, Zhao Jun

    2014-11-01

    The aim of this study was to explore the prevalent characteristics of HBoV1 and its co-infection. PCR was used to detect HBoV1-DNA (HBoV1) and other viruses. A multivariate logistic regression model was used to explore possibility of co-detected for related viruses. The positivity rates in Nanjing and Lanzhou were 9.38% (74/789) and 11.62% (161/1386), respectively (P>0.05). The HBoV1 positive group was younger than negative group (Pinfection in December and July. HBoV1-positive children [72.34% (169/235)] were co-infected with other respiratory viruses. Multifactorial analysis showed no correlations between HBoV1 and the clinical classification, region, gender, age, or treatment as an outpatient or in a hospital. Correlations were identified between HBoV1 infections with ADV (OR=1.53, 95% CI 1.03-2.28), RSV (OR=0.71, 95% CI 0.52-0.98), and IFVA (OR=1.77, 95% CI 1.00-3.13). Presence of HBoV1 in nasopharyngeal aspirates did not correlate with region or gender, although the prevalence of HBoV1 was higher in younger children. There were no correlations between HBoV1 and other variables, except for the season and ADV, RSV, or IFVA infections. Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  8. The microbiota of the respiratory tract : Gatekeeper to respiratory health

    NARCIS (Netherlands)

    Man, Wing Ho; De Steenhuijsen Piters, Wouter A.A.|info:eu-repo/dai/nl/413982653; Bogaert, Debby|info:eu-repo/dai/nl/264105834

    2017-01-01

    The respiratory tract is a complex organ system that is responsible for the exchange of oxygen and carbon dioxide. The human respiratory tract spans from the nostrils to the lung alveoli and is inhabited by niche-specific communities of bacteria. The microbiota of the respiratory tract probably acts

  9. Association of indoor air pollution with acute lower respiratory tract infections in children under 5 years of age.

    Science.gov (United States)

    Ramesh Bhat, Y; Manjunath, N; Sanjay, D; Dhanya, Y

    2012-08-01

    Indoor air pollution is an important risk factor for acute lower respiratory tract infections (ALRTI) in developing countries. To determine the relationship of indoor air pollution with ALRTI in children under 5 years of age. A prospective, case-control study of risk factors, particularly indoor air pollution, for developing ALRTI in children under 5 years of age was conducted in Udupi District Hospital. The WHO definition of ALRTI was used. Healthy children attending immunisation services were enrolled as controls. Data pertaining to important factors causing indoor air pollution such as cooking fuel other than liquid petroleum gas (LPG) and passive smoking were collected along with potential socio-demographic factors and nutrition in both groups and analysed. A total of 202 children including 101 cases and 101 controls were studied. The proportions of infants (1-12 months) among cases and controls were 62.4% and 71.3%, respectively. Of those with ALRTI, 24.8% had pneumonia, 45.5% had severe pneumonia and 29.7% had very severe disease. Exposure to passive smoking was not associated with ALRTI. Cooking fuel other than LPG was significantly associated with ALRTI (OR 26.3, 95% CI 10.5-65.7). On logistic regression analysis of multiple risk factors, cooking fuel other than LPG emerged as a significant risk factor for developing ALRTI (adjusted OR 4.73, 95% CI 1.67-13.45) along with poor socio-economic status (adjusted OR 3.38, 95% CI 1.63-7.03). Other than LPG, the main fuels used were wood (95%), kerosene and dung and crop residues. Indoor air pollution caused by using cooking fuel other than LPG and socio-economic factors are significantly associated with ALRTI.

  10. Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians.

    Science.gov (United States)

    Tillekeratne, L Gayani; Bodinayake, Champica K; Dabrera, Thushani; Nagahawatte, Ajith; Arachchi, Wasantha Kodikara; Sooriyaarachchi, Anoji; Stewart, Kearsley; Watt, Melissa; Østbye, Truls; Woods, Christopher W

    2017-03-16

    Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment. Semi-structured interviews were conducted with 50 outpatients with ARTIs and five physicians in the Outpatient Department (OPD) at a large, public tertiary care hospital in southern Sri Lanka. Interviews were audio-recorded, transcribed, and analyzed for themes related to ARTI diagnosis and treatment. Patients frequently sought ARTI care in the public sector due to the receipt of free care and the perception that government hospitals carried a sense of responsibility for patients' health. Patients reported multiple medical visits for their illnesses of short duration and many indicated that they were seeking care in the OPD while at the hospital for another reason. While patients generally expected to receive medication prescriptions at their visit, most patients were not specifically seeking an antibiotic prescription. However, more than 70% of patients received antibiotic prescriptions at their OPD visit. Physicians incorrectly perceived that patients desired antibiotics or "capsules," a common formulation of antibiotics dispensed in this outpatient setting, and cited patient demand as an important cause of antibiotic overuse. Physicians also indicated that high patient volume and fear of bacterial superinfection drove antibiotic overuse. Patients in this study were seeking medication prescriptions for their ARTIs, but physicians incorrectly perceived that antibiotic prescriptions were desired. High patient volume and fear of bacterial superinfection were also important factors in antibiotic overuse. Training of

  11. Cost-effectiveness of procalcitonin-guided antibiotic therapy for outpatient management of acute respiratory tract infections in adults.

    Science.gov (United States)

    Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Fine, Michael J; Smith, Kenneth J

    2014-04-01

    Two clinical trials suggest that procalcitonin-guided antibiotic therapy can safely reduce antibiotic prescribing in outpatient management of acute respiratory tract infections (ARTIs) in adults. Yet, it remains unclear whether procalcitonin testing is cost-effective in this setting. To evaluate the cost-effectiveness of procalcitonin-guided antibiotic therapy in outpatient management of ARTIs in adults. Cost-effectiveness model based on results from two published European clinical trials, with all parameters varied widely in sensitivity analyses. Two hypothetical cohorts were modeled in separate trial-based analyses: adults with ARTIs judged by their physicians to require antibiotics and all adults with ARTIs. Procalcitonin-guided antibiotic therapy protocols versus usual care. Costs and cost per antibiotic prescription safely avoided. We estimated the health care system willingness-to-pay threshold as $43 (range $0–$333) per antibiotic safely avoided, reflecting the estimated cost of antibiotic resistance per outpatient antibiotic prescribed. In the cohort including all adult ARTIs judged to require antibiotics by their physicians, procalcitonin cost $31 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored compared to usual care was 58.4 % in a probabilistic sensitivity analysis. In the analysis that included all adult ARTIs, procalcitonin cost $149 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored was 2.8 %. Procalcitonin-guided antibiotic therapy for outpatient management of ARTIs in adults would be cost-effective when the costs of antibiotic resistance are considered and procalcitonin testing is limited to adults with ARTIs judged by their physicians to require antibiotics.

  12. Infection biomarkers in primary care patients with acute respiratory tract infections-comparison of Procalcitonin and C-reactive protein.

    Science.gov (United States)

    Meili, Marc; Kutz, Alexander; Briel, Matthias; Christ-Crain, Mirjam; Bucher, Heiner C; Mueller, Beat; Schuetz, Philipp

    2016-03-24

    There is a lack of studies comparing the utility of C-reactive protein (CRP) with Procalcitonin (PCT) for the management of patients with acute respiratory tract infections (ARI) in primary care. Our aim was to study the correlation between these markers and to compare their predictive accuracy in regard to clinical outcome prediction. This is a secondary analysis using clinical and biomarker data of 458 primary care patients with pneumonic and non-pneumonic ARI. We used correlation statistics (spearman's rank test) and multivariable regression models to assess association of markers with adverse outcome, namely days with restricted activities and persistence of discomfort from infection at day 14. At baseline, CRP and PCT did not correlate well in the overall population (r(2) = 0.16) and particularly in the subgroup of patients with non-pneumonic ARI (r(2) = 0.08). Low correlation of biomarkers were also found when comparing cut-off ranges, day seven levels or changes from baseline to day seven. High baseline levels of CRP (>100 mg/dL, regression coefficient 1.6, 95 % CI 0.5 to 2.6, sociodemographic-adjusted model) as well as PCT (>0.5ug/L regression coefficient 2.0, 95 % CI 0.0 to 4.0, sociodemographic-adjusted model) were significantly associated with larger number of days with restricted activities. There were no associations of either biomarker with persistence of discomfort at day 14. CRP and PCT levels do not well correlate, but both have moderate prognostic accuracy in primary care patients with ARI to predict clinical outcomes. The low correlation between the two biomarkers calls for interventional research comparing these markers head to head in regard to their ability to guide antibiotic decisions. Current Controlled Trials, ISRCTN73182671.

  13. Clinical predictors of hypoxemia in Indian children with acute respiratory tract infection presenting to pediatric emergency department.

    Science.gov (United States)

    Rao, Yashwant Kumar; Midha, Tanu; Kumar, Pankaj; Tripathi, Virendra Nath; Rai, Om Prakash

    2012-08-01

    In developing countries, facilities for measuring arterial oxygen saturation are not available in most settings, which make it difficult for health providers to detect hypoxemia in children with acute respiratory tract infection (ARI). Most health providers rely on symptoms and signs to identify hypoxemia and start oxygen therapy. Therefore, this study was conducted to determine the clinical predictors of hypoxemia in children with ARI. It was a cross-sectional study carried out at the Pediatric Emergency Department of GSVM Medical College, Kanpur, India in children in the age group between 2 months and 5 years, presenting with ARI. All children with ARI attending the pediatric emergency department from April 2007 to September 2008 were included in the study. Clinical signs and symptoms including fever, cough, nasal flaring, inability to feed/drink, cyanosis, chest wall retraction, wheezing, grunting, tachypnea and crepitations were noted and oxygen saturation (SpO(2)) was measured. Hypoxemia was defined as SpO(2) hypoxemia. Chest wall retraction (sensitivity=90%), crepitations (sensitivity=87%), nasal flaring (sensitivity=84%), tachypnea (sensitivity=81%) and inability to feed (sensitivity=81%) were observed to be the most sensitive indicators of hypoxemia while the best predictors were cyanosis [positive predictive value (PPV)=88%] and nasal flaring (PPV=53%). Chest wall retraction was found to be the most sensitive indicator, and cyanosis was the most specific indicator for hypoxemia. Of all the clinical signs and symptoms of hypoxemia, none had all the attributes of being a good predictor. A new hypoxemia score has been designed using a combination of clinical signs and symptoms to predict the need for supplemental oxygen therapy.

  14. Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections.

    Science.gov (United States)

    Gerber, Jeffrey S; Ross, Rachael K; Bryan, Matthew; Localio, A Russell; Szymczak, Julia E; Wasserman, Richard; Barkman, Darlene; Odeniyi, Folasade; Conaboy, Kathryn; Bell, Louis; Zaoutis, Theoklis E; Fiks, Alexander G

    2017-12-19

    Acute respiratory tract infections account for the majority of antibiotic exposure in children, and broad-spectrum antibiotic prescribing for acute respiratory tract infections is increasing. It is not clear whether broad-spectrum treatment is associated with improved outcomes compared with narrow-spectrum treatment. To compare the effectiveness of broad-spectrum and narrow-spectrum antibiotic treatment for acute respiratory tract infections in children. A retrospective cohort study assessing clinical outcomes and a prospective cohort study assessing patient-centered outcomes of children between the ages of 6 months and 12 years diagnosed with an acute respiratory tract infection and prescribed an oral antibiotic between January 2015 and April 2016 in a network of 31 pediatric primary care practices in Pennsylvania and New Jersey. Stratified and propensity score-matched analyses to account for confounding by clinician and by patient-level characteristics, respectively, were implemented for both cohorts. Broad-spectrum antibiotics vs narrow-spectrum antibiotics. In the retrospective cohort, the primary outcomes were treatment failure and adverse events 14 days after diagnosis. In the prospective cohort, the primary outcomes were quality of life, other patient-centered outcomes, and patient-reported adverse events. Of 30 159 children in the retrospective cohort (19 179 with acute otitis media; 6746, group A streptococcal pharyngitis; and 4234, acute sinusitis), 4307 (14%) were prescribed broad-spectrum antibiotics including amoxicillin-clavulanate, cephalosporins, and macrolides. Broad-spectrum treatment was not associated with a lower rate of treatment failure (3.4% for broad-spectrum antibiotics vs 3.1% for narrow-spectrum antibiotics; risk difference for full matched analysis, 0.3% [95% CI, -0.4% to 0.9%]). Of 2472 children enrolled in the prospective cohort (1100 with acute otitis media; 705, group A streptococcal pharyngitis; and 667, acute sinusitis), 868

  15. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial.

    Science.gov (United States)

    Graat, Judith M; Schouten, Evert G; Kok, Frans J

    2002-08-14

    Immune response in elderly individuals has been reported to improve after micronutrient supplementation. However, efficacy trials evaluating infectious diseases as outcomes are scarce and inconclusive. To investigate the effect of daily multivitamin-mineral and vitamin E supplementation on incidence and severity of acute respiratory tract infections in elderly individuals. A randomized, double blind, placebo-controlled, 2 x 2 factorial trial. A total of 652 noninstitutionalized individuals aged 60 years or older enrolled from 2 community-based sampling strategies in the Wageningen area of the Netherlands, conducted from 1998 to 2000. At baseline, 6% of participants had suboptimal ascorbic acid and 1.3% had suboptimal alpha-tocopherol plasma concentration. Physiological doses of multivitamin-minerals, 200 mg of vitamin E, both, or placebo. Incidence and severity of self-reported acute respiratory tract infections at 15 months, as assessed by a nurse (telephone contact), home visits, and microbiological and serological testing in subsets of patients. During a median observation period of 441 days, 443 (68%) of 652 participants recorded 1024 respiratory tract infection episodes. The incidence rate ratio of acute respiratory tract infection for multivitamin-mineral supplementation was 0.95 (95% confidence interval, 0.75-1.15; P =.58) and for vitamin E supplementation, 1.12 (95% confidence interval, 0.88-1.25; P =.21). Severity of infections was not influenced by multivitamin-mineral supplementation. For vitamin E vs no vitamin E, severity was worse: median (interquartile range) for illness-duration was 19 (9-37) vs 14 (6-29) days, P =.02; number of symptoms, 6 (3-8) vs 4 (3-8), P =.03; presence of fever, 36.7% vs 25.2%, P =.009; and restriction of activity, 52.3% vs 41.1%, P =.02. Neither daily multivitamin-mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favorable effect on incidence and severity of acute respiratory tract infections in

  16. The microbiota of the respiratory tract: gatekeeper to respiratory health.

    Science.gov (United States)

    Man, Wing Ho; de Steenhuijsen Piters, Wouter A A; Bogaert, Debby

    2017-05-01

    The respiratory tract is a complex organ system that is responsible for the exchange of oxygen and carbon dioxide. The human respiratory tract spans from the nostrils to the lung alveoli and is inhabited by niche-specific communities of bacteria. The microbiota of the respiratory tract probably acts as a gatekeeper that provides resistance to colonization by respiratory pathogens. The respiratory microbiota might also be involved in the maturation and maintenance of homeostasis of respiratory physiology and immunity. The ecological and environmental factors that direct the development of microbial communities in the respiratory tract and how these communities affect respiratory health are the focus of current research. Concurrently, the functions of the microbiome of the upper and lower respiratory tract in the physiology of the human host are being studied in detail. In this Review, we will discuss the epidemiological, biological and functional evidence that support the physiological role of the respiratory microbiota in the maintenance of human health.

  17. Severe respiratory tract infections with human bocavirus in children

    Directory of Open Access Journals (Sweden)

    Halise Akça, Nilden Tuygun, Emine Polat, Can Demir Karacan

    2016-09-01

    Full Text Available Acute respiratory tract infection remains a major cause of childhood hospitalization and mortality in young children. Human bocavirus (HBoV is a virus belonging to the Parvoviridae family, which has been newly discovered to be associated with respiratory tract infection in children. Human bocavirus infection is usually seen as form of co-infection. The frequent associations of HBoV with other respiratory viruses might be explained by the persistence of HBoV in the respiratory tract. HBoV primary events generally associated with mild respiratory illness. Here, we reported three patients who developed an extremely severe acute life-threatening respiratory failure due to HBoV infection. J Microbiol Infect Dis 2016; 6(3: 145-147

  18. Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial.

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Moore, Michael; Coenen, Samuel; Butler, Christopher C; Godycki-Cwirko, Maciek; Mierzecki, Artur; Chlabicz, Slawomir; Torres, Antoni; Almirall, Jordi; Davies, Mel; Schaberg, Tom; Mölstad, Sigvard; Blasi, Francesco; De Sutter, An; Kersnik, Janko; Hupkova, Helena; Touboul, Pia; Hood, Kerenza; Mullee, Mark; O'Reilly, Gilly; Brugman, Curt; Goossens, Herman; Verheij, Theo

    2013-02-01

    Lower-respiratory-tract infection is one of the most common acute illnesses managed in primary care. Few placebo-controlled studies of antibiotics have been done, and overall effectiveness (particularly in subgroups such as older people) is debated. We aimed to compare the benefits and harms of amoxicillin for acute lower-respiratory-tract infection with those of placebo both overall and in patients aged 60 years or older. Patients older than 18 years with acute lower-respiratory-tract infections (cough of ≤28 days' duration) in whom pneumonia was not suspected were randomly assigned (1:1) to either amoxicillin (1 g three times daily for 7 days) or placebo by computer-generated random numbers. Our primary outcome was duration of symptoms rated "moderately bad" or worse. Secondary outcomes were symptom severity in days 2-4 and new or worsening symptoms. Investigators and patients were masked to treatment allocation. This trial is registered with EudraCT (2007-001586-15), UKCRN Portfolio (ID 4175), ISRCTN (52261229), and FWO (G.0274.08N). 1038 patients were assigned to the amoxicillin group and 1023 to the placebo group. Neither duration of symptoms rated "moderately bad" or worse (hazard ratio 1.06, 95% CI 0.96-1.18; p=0.229) nor mean symptom severity (1.69 with placebo vs 1.62 with amoxicillin; difference -0.07 [95% CI -0.15 to 0.007]; p=0.074) differed significantly between groups. New or worsening symptoms were significantly less common in the amoxicillin group than in the placebo group (162 [15.9%] of 1021 patients vs 194 [19.3%] of 1006; p=0.043; number needed to treat 30). Cases of nausea, rash, or diarrhoea were significantly more common in the amoxicillin group than in the placebo group (number needed to harm 21, 95% CI 11-174; p=0.025), and one case of anaphylaxis was noted with amoxicillin. Two patients in the placebo group and one in the amoxicillin group needed to be admitted to hospital; no study-related deaths were noted. We noted no evidence of

  19. Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years in Kampala city, Uganda

    Directory of Open Access Journals (Sweden)

    Moses Ocan

    2017-09-01

    Full Text Available Abstract Background Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years in households in Nakawa division, Kampala city. Methods This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days was used in during data collection. Results The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2. The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390, cough, 83.1% (324/390, and undefined fever, 69.7% (272/390. Medicines commonly given to children included, paracetamol 53.1% (207/390, Coartem 29.7% (116/390, cough linctus 20.8% (81/390, amoxicillin 18.9% (74/390, Co-trimoxazole 18.5% (72/390, and diphenhydramine 15.4% (60/390. The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390. Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390 of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85, medicines at home (PR: 1.8, CI: 0.83-1.198 and type of medicine (antimalarial (PR: 2.8, CI: 1.17-6.68. Conclusion Children are commonly given multiple medicines during episodes of acute upper respiratory

  20. Association between HIV and proven viral lower respiratory tract ...

    African Journals Online (AJOL)

    range of respiratory viruses. Virally infected patients can now be diagnosed early and more accurately in the acute phase of illness. Objectives. To examine the association between HIV status and mortality in children with viral lower respiratory tract infection (LRTI) and to delineate the profile of identified viruses. Methods.

  1. Therapy for respiratory tract infections caused by respiratory syncytial virus

    NARCIS (Netherlands)

    van Woensel, J.; Kimpen, J.

    2000-01-01

    Respiratory syncytial virus (RSV) is the most common viral cause of lower respiratory tract infection (LRTI) in infancy and young children. No effective treatment for RSV lower respiratory tract infection (RSV-LRTI) exists. Ribavirin initially proved to be an effective anti-viral drug for RSV-LTRI.

  2. Therapy for respiratory tract infections caused by respiratory syncytial virus

    NARCIS (Netherlands)

    van Woensel, J; Kimpen, J

    Respiratory syncytial virus (RSV) is the most common viral cause of lower respiratory tract infection (LRTI) in infancy and young children. No effective treatment for RSV lower respiratory tract infection (RSV-LRTI) exists. Ribavirin initially proved to be an effective anti-viral drug for RSV-LTRI.

  3. Respiratory tract infections and concomitant pericoronitis of the wisdom teeth.

    OpenAIRE

    Meurman, J. H.; Rajasuo, A.; Murtomaa, H.; Savolainen, S.

    1995-01-01

    OBJECTIVE--To discover if there is an association between respiratory tract infections and pericoronitis of erupting third molars in young adults. DESIGN--Data from male military conscripts' medical records were collected over five years and the incidence of respiratory tract infection before and after acute pericoronitis (191 cases) and before and after standard (722 cases) and operative (741) extractions compared with that in controls (n = 703) who had no infections in the third molar regio...

  4. Homeopathic medicine for acute cough in upper respiratory tract infections and acute bronchitis: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Zanasi, Alessandro; Mazzolini, Massimiliano; Tursi, Francesco; Morselli-Labate, Antonio Maria; Paccapelo, Alexandro; Lecchi, Marzia

    2014-02-01

    Cough is a frequent symptom associated to upper respiratory tract infections (URTIs) and, although being self-limiting, it might deeply affect the quality of life. Homeopathic products are often employed by patients to treat cough, but the evidence on their efficacy is scarce. Thus, we tested the efficacy of a homeopathic syrup in treating cough arising from URTIs with a randomized, double blind, placebo controlled clinical trial. Patients were treated with either the homeopathic syrup or a placebo for a week, and recorded cough severity in a diary by means of a verbal category-descriptive score for two weeks. Sputum viscosity was assessed with a viscosimeter before and after 4 days of treatment; patients were also asked to provide a subjective evaluation of viscosity. Eighty patients were randomized to receive placebo (n = 40) or the homeopathic syrup (n = 40). All patients completed the study. In each group cough scores decreased over time, however, after 4 and 7 days of treatment, cough severity was significantly lower in the homeopathic group than in the placebo one (p acute cough induced by URTIs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. [The detection and clinical feature of HcoV-nL63 in children with acute respiratory tract infection in Lanzhou city].

    Science.gov (United States)

    Jin, Yu; Zhang, Rong-Fang; Xie, Zhi-Ping; Gao, Han-Chun; Yan, Kun-Long; Yuan, Xin-Hui; Song, Jing-Rong; Hou, Yun-De; Duan, Zhao-Jun

    2012-12-01

    To investigate the prevalence and clinical characterization of HCoV-NL63 (NL63) in children with acute respiratory tract infections (ARTIs) in Lanzhou with other respiratory viruses. The prevalence of HBoV1 in ALRTI was obviously city,China. From November 2006 to October 2009,1169 nasopharyngeal aspirates (NPA) were collected from children under 14 years old with ARTIs. Samples were screened for NL63 using a reverse transcription-polymerase chain reaction (RT-PCR) and sequencing. Demography and clinical information were recorded. NL63 was detected in 35 (2.99%) of the 1169 children. The peak of the positive rate were in August, September 2007, July, August 2008 (23.53%,17.65%, 50%, 33.33% separately). There are no NL63 positive samples was detected in December, 2007 to February 2009. 25 (25/35, 71.43%) were co-infected with other respiratory viruses, and human rhinovirus (HRV) were the most common additional respiratory virus. No significant differences of infective rate of NL63 was found between 3 years age group. Bronchiolitis and pneumonia were the most frequent diagnoses in NL63 positive patients and the major symptoms were fever and cough in our study. Between the monoinfection group and the coinfection group of NL63-positive patients, no differences were found in symptoms and clinical diagnoses except symptoms of gastrointestinal. HCoV-NL63 is an important pathogen of acute respiratory tract infection in children in Lanzhou city. The peak of HCoV-NL63 infections was in summer. There were annual differences in the prevalence of HCoV-NL63. HCoV-NL63 infections existed a high rate of mixed infection, and mixed infection does not increase the severity of the disease.

  6. Predictors of severe disease in a hospitalized population of children with acute viral lower respiratory tract infections.

    Science.gov (United States)

    Pedraza-Bernal, Angela M; Rodriguez-Martinez, Carlos E; Acuña-Cordero, Ranniery

    2016-05-01

    Although predictors of severe viral acute lower respiratory infections (ALRIs) in children have been reported, there have been few research studies performed in low- and middle-income countries (LMIC). The aim of the present study was to determine predictors of disease severity in a population of Colombian children disease conditions and the infecting respiratory viruses as predictor variables of severe disease. We defined severe disease as the necessity of pediatric intensive care unit admission. Of a total of 1,180 patients admitted with a diagnosis of ALRI, 416 (35.3%) were included because they were positive for any kind of respiratory virus. After controlling for potential confounders, it was found that a history of pulmonary hypertension (RR 3.62; CI 95% 2.38-5.52; P disease. The present study shows that respiratory viruses are significant causes of ALRI in infants and young children in Colombia, a typical tropical LMIC, especially during the rainy season. Additionally, the results of the present study show that clinical variables such as a history of pulmonary hypertension and a history of recurrent wheezing are more relevant for predicting ALRI severity than the infecting respiratory viruses. © 2015 Wiley Periodicals, Inc.

  7. [Acute, atraumatic changes of the lower respiratory tract in the child in thoracic roentgen imaging. Recognition and appreciation of radiological changes].

    Science.gov (United States)

    Puig, S; Hörmann, M; Sandström, S; Schibany, N; Ponhold, W

    2002-03-01

    The diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies.

  8. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Bruun Lauridsen, Gitte; Sejr Sørensen, Mette; Hansen, Malene Plejdrup

    2017-01-01

    Introduction: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners’ misinter......­pretation of patients’ expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients’ expectations when consulting a general prac­titioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. Methods: A questionnaire survey...... was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic prescription and patients...

  9. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners......' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infection, and to determine predictors for these expectations. METHODS......: A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  10. Prevalence factors associated with equine herpesvirus type 1 infection in equids with upper respiratory tract infection and/or acute onset of neurological signs from 2008 to 2014.

    Science.gov (United States)

    Pusterla, N; Mapes, S; Akana, N; Barnett, C; MacKenzie, C; Gaughan, E; Craig, B; Chappell, D; Vaala, W

    2016-01-16

    The objective of the present case-control study was to determine prevalence factors associated with the detection of equine herpesvirus type 1 (EHV-1) by quantitative PCR (qPCR) in horses presented to veterinarians with clinical signs related to an upper respiratory tract infection and/or acute onset of neurological disease from March 2008 to December 2014. Nasal secretions and whole blood from 4228 equids with acute onset of fever, respiratory signs and/or neurological deficits were tested by qPCR for EHV-1. Categorical analyses were performed to determine the association between observations and EHV-1. A total of 117/4228 (2.7 per cent) equids tested qPCR-positive for EHV-1, with most of the isolates belonging to the non-neuropathogenic genotype (N752). EHV-1 PCR-positive equids were over-represented in racing horses. Depression, anorexia, nasal discharge and coughing were significantly less frequently reported in the EHV-1 qPCR-positive equids compared with the EHV-1 qPCR-negative cases. Neurological deficits were more frequently reported in the EHV-1 qPCR-positive cases. This study provides contemporary information on the frequency of EHV-1 detection by qPCR in blood and nasal secretions from horses with fever, respiratory signs and neurological deficits. British Veterinary Association.

  11. The respiratory tract microbial biogeography in alcohol use disorder.

    Science.gov (United States)

    Samuelson, Derrick R; Burnham, Ellen L; Maffei, Vincent J; Vandivier, R William; Blanchard, Eugene E; Shellito, Judd E; Luo, Meng; Taylor, Christopher M; Welsh, David A

    2018-01-01

    Individuals with alcohol use disorders (AUDs) are at an increased risk of pneumonia and acute respiratory distress syndrome. Data of the lung microbiome in the setting of AUDs are lacking. The objective of this study was to determine the microbial biogeography of the upper and lower respiratory tract in individuals with AUDs compared with non-AUD subjects. Gargle, protected bronchial brush, and bronchoalveolar lavage specimens were collected during research bronchoscopies. Bacterial 16S gene sequencing and phylogenetic analysis was performed, and the alterations to the respiratory tract microbiota and changes in microbial biogeography were determined. The microbial structure of the upper and lower respiratory tract was significantly altered in subjects with AUDs compared with controls. Subjects with AUD have greater microbial diversity [ P respiratory tract displayed greater similarity in subjects with AUDs. Alcohol use is associated with an altered composition of the respiratory tract microbiota. Subjects with AUDs demonstrate convergence of the microbial phylogeny and taxonomic communities between distinct biogeographical sites within the respiratory tract. These results support a mechanistic pathway potentially explaining the increased incidence of pneumonia and lung diseases in patients with AUDs.

  12. Associations of hand-washing frequency with incidence of acute respiratory tract infection and influenza-like illness in adults: a population-based study in Sweden.

    Science.gov (United States)

    Merk, Hanna; Kühlmann-Berenzon, Sharon; Linde, Annika; Nyrén, Olof

    2014-09-18

    Frequent hand-washing is standard advice for avoidance of respiratory tract infections, but the evidence for a preventive effect in a general community setting is sparse. We therefore set out to quantify, in a population-based adult general population cohort, the possible protection against acute respiratory tract infections (ARIs) conferred by a person's self-perceived hand-washing frequency. During the pandemic influenza season from September 2009 through May 2010, a cohort of 4365 adult residents of Stockholm County, Sweden, reported respiratory illnesses in real-time. A questionnaire about typical contact and hand-washing behaviour was administered at the end of the period (response rate 70%). There was no significant decrease in ARI rates among adults with increased daily hand-washing frequency: Compared to 2-4 times/day, 5-9 times was associated with an adjusted ARI rate ratio (RR) of 1.08 (95% confidence interval [CI] 0.87-1.33), 10-19 times with RR = 1.22 (CI 0.97-1.53), and ≥20 times with RR = 1.03 (CI 0.81-1.32). A similar lack of effect was seen for influenza-like illness, and in all investigated subgroups. We found no clear effect modification by contact behaviour. Health care workers exhibited rate ratio point estimates below unity, but no dose-risk trend. Our results suggest that increases in what adult laymen perceive as being adequate hand-washing may not significantly reduce the risk of ARIs. This might have implications for the design of public health campaigns in the face of threatening outbreaks of respiratory infections. However, the generalizability of our results to non-pandemic circumstances should be further explored.

  13. Respiratory tract infections and concomitant pericoronitis of the wisdom teeth.

    Science.gov (United States)

    Meurman, J H; Rajasuo, A; Murtomaa, H; Savolainen, S

    1995-04-01

    To discover if there is an association between respiratory tract infections and pericoronitis of erupting third molars in young adults. Data from male military conscripts' medical records were collected over five years and the incidence of respiratory tract infection before and after acute pericoronitis (191 cases) and before and after standard (722 cases) and operative (741) extractions compared with that in controls (n = 703) who had no infections in the third molar regions. 14,500 male military conscripts aged 20. Garrisons in Valkeala and Kouvola, Finland. The incidence of respiratory tract infection was significantly higher during the two weeks before acute pericoronitis was diagnosed compared with that in controls. The highest incidence was observed in the three days before pericoronitis (odds ratio 6.8; 95% confidence interval 3.0 to 15.0). The incidence was also increased in the first week after pericoronitis (odds ratio 3.7; 1.6 to 8.4) and three days before (odds ratio 2.6; 0.9 to 7.5) and during the first week after extraction of third molars (odds ratio 2.6; 1.3 to 5.3). Respiratory tract infection may precipitate and occur concomitantly with acute pericoronitis. Third molar surgery for pericoronitis, on the other hand, may trigger respiratory tract infection.

  14. Exercise, immunology and upper respiratory tract infections.

    Science.gov (United States)

    Peters, E M

    1997-03-01

    The literature reveals a paradoxical response of the immune and host defense systems to endurance exercise apparent stimulation following long-term regular training and suppression in response to acute exposure to exhaustive endurance exercise. Several epidemiological surveys have confirmed a clinical manifestation of immunosuppression in the form of increased incidence of upper respiratory tract infection symptoms following participation in competitive marathon and ultramarathon running events. Prerace training status and racing intensity have been related to the incidence of this symptomatology during the postrace fortnight. Nutritional intervention studies have shown the antioxidant nutrient, vitamin C, to be effective in reducing the incidence of upper respiratory tract infection symptoms following competitive distance events. Laboratory studies have revealed this vitamin to be the first line of defense in neutralizing the auto-oxidative activity of phagocytes. It is hypothesized that exercise-induced neuroendocrine stimulation of the oxidative burst in neutrophils increases the rate of release of reactive oxygen species and that these are, in turn, neutralized by high plasma ascorbate levels. Enhancing intrinsic antioxidant defense by increasing exogenous antioxidant intake is thus theorized to be of long-term benefit to serious endurance athletes engaged in heavy training and competition.

  15. Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children.

    Science.gov (United States)

    Inamo, Yasuji; Hasegawa, Maki; Saito, Katsuya; Hayashi, Rika; Ishikawa, Teruaki; Yoshino, Yayoi; Hashimoto, Koji; Fuchigami, Tatsuo

    2011-04-01

    Vitamin D is an immunomodulatory molecule related to innate immunity that may contribute to the increased occurrence of acute lower respiratory infection (ALRI) in children, one of the most common reasons for hospitalization and intensive care unit admission. In the present study, the association between vitamin D deficiency and the severity of respiratory infection was evaluated by determining serum concentrations of 25-hydroxyvitamin D (25(OH)D) in a group of hospitalized children with ALRI. Of the 28 children admitted to Nihon University Nerima-Hikarigaoka Hospital with ALRI over the period November 2008–May 2009, 26 were diagnosed as having bronchiolitis and two were found to have pneumonia. A competitive protein binding radioimmunoassay was used to determine serum 25(OH)D concentrations. Mean 25(OH)D concentrations in breast-fed children with ALRI (n = 7) were significantly lower than those in children with ALRI who were bottle fed/weaned (n = 6) or on a regular diet (n = 15; 14.6 ± 9.7, 28.9 ± 6.9 and 24.6 ± 8.8 ng/mL, respectively). There was a significant correlation between vitamin D deficiency (vitamin D deficient. These findings suggest that the immunomodulatory properties of vitamin D may influence the severity of ALRI.

  16. Severe acute respiratory syndrome (SARS)

    Science.gov (United States)

    SARS; Respiratory failure - SARS ... Complications may include: Respiratory failure Liver failure Heart failure ... 366. McIntosh K, Perlman S. Coronaviruses, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). ...

  17. Early Fluid Overload Prolongs Mechanical Ventilation in Children With Viral-Lower Respiratory Tract Disease

    NARCIS (Netherlands)

    Ingelse, Sarah A.; Wiegers, Hanke M. G.; Calis, Job C.; van Woensel, Job B.; Bem, Reinout A.

    2017-01-01

    Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid

  18. Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection

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    Eduardo A. Ferone

    2014-01-01

    Full Text Available OBJECTIVE: To characterize and compare clinical, epidemiological, and laboratory aspects ofinfants with acute lower respiratory infection (ALRI associated with the detection of adenovirus(ADV or respiratory syncytial virus (RSV. METHODS: A preliminary respiratory infection surveillance study collected samples of nasopharyngeal aspirate (NPA for viral research, linked to the completion of a standard protocol, from children younger than two years admitted to a university hospital with ALRI, between March of 2008 and August of 2011. Polymerase chain reaction (PCR was used for eight viruses: ADV, RSV, metapneumovirus, Parainfluenza 1, 2, and 3, and Influenza A and B. Cases with NPA collectedduring the first 24 hours of admission, negative results of blood culture, and exclusive detection of ADV (Gadv group or RSV (Grsv group were selected for comparisons. RESULTS: The preliminary study included collection of 1,121 samples of NPA, 813 collected in thefirst 24 hours of admission, of which 50.3% were positive for at least one virus; RSV was identifiedin 27.3% of cases surveyed, and ADV was identified in 15.8%. Among the aspects analyzed inthe Gadv (n = 58 and Grsv (n = 134 groups, the following are noteworthy: the higher meanage, more frequent prescription of antibiotics, and the highest median of total white blood cellcount and C-reactive protein values in Gadv. CONCLUSIONS: PCR can detect persistent/latent forms of ADV, an aspect to be considered wheninterpreting results. Additional studies with quantitative diagnostic techniques could elucidatethe importance of the high frequency observed.

  19. Identification of Human Bocavirus type 4 in a child asymptomatic for respiratory tract infection and acute gastroenteritis – Goiânia, Goiás, Brazil

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    Teresinha Teixeira de Sousa

    2017-07-01

    The aim of this study was to detect and characterize HBoV from fecal samples collected from hospitalized children aged less than five years old with no symptoms of respiratory tract infection (RTI or acute gastroenteritis (AGE. The study involved 119 children and one fecal sample was collected from each participant between 2014 and 2015. HBoV was detected using Nested-PCR, and the viral type identified by genomic sequencing. HBoV-4 was identified from one sample obtained from a hospitalized child with soft tissue tumor of the submandibular region. This is the first report of HBoV-4 identification in Brazil, but we consider that this type may be circulating in the country similar to the other types and new investigations are necessary.

  20. Concurrent acute illness and comorbid conditions poorly predict antibiotic use in upper respiratory tract infections: a cross-sectional analysis

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    Perencevich Eli N

    2007-05-01

    Full Text Available Abstract Background Inappropriate antibiotic use promotes resistance. Antibiotics are generally not indicated for upper respiratory infections (URIs. Our objectives were to describe patterns of URI treatment and to identify patient and provider factors associated with antibiotic use for URIs. Methods This study was a cross-sectional analysis of medical and pharmacy claims data from the Pennsylvania Medicaid fee-for-service program database. We identified Pennsylvania Medicaid recipients with a URI office visit over a one-year period. Our outcome variable was antibiotic use within seven days after the URI visit. Study variables included URI type and presence of concurrent acute illnesses and chronic conditions. We considered the associations of each study variable with antibiotic use in a logistic regression model, stratifying by age group and adjusting for confounders. Results Among 69,936 recipients with URI, 35,786 (51.2% received an antibiotic. In all age groups, acute sinusitis, chronic sinusitis, otitis, URI type and season were associated with antibiotic use. Except for the oldest group, physician specialty and streptococcal pharyngitis were associated with antibiotic use. History of chronic conditions was not associated with antibiotic use in any age group. In all age groups, concurrent acute illnesses and history of chronic conditions had only had fair to poor ability to distinguish patients who received an antibiotic from patients who did not. Conclusion Antibiotic prevalence for URIs was high, indicating that potentially inappropriate antibiotic utilization is occurring. Our data suggest that demographic and clinical factors are associated with antibiotic use, but additional reasons remain unexplained. Insight regarding reasons for antibiotic prescribing is needed to develop interventions to address the growing problem of antibiotic resistance.

  1. Changes in early-career family physicians' antibiotic prescribing for upper respiratory tract infection and acute bronchitis: a multicentre longitudinal study.

    Science.gov (United States)

    Magin, Parker J; Morgan, Simon; Tapley, Amanda; Henderson, Kim M; Holliday, Elizabeth G; Ball, Jean; Davis, Joshua S; Dallas, Anthea; Davey, Andrew R; Spike, Neil A; McArthur, Lawrie; Stewart, Rebecca; Mulquiney, Katie J; van Driel, Mieke L

    2016-08-01

    Inappropriate antibiotic prescription and subsequent antibacterial resistance are major threats to health worldwide. We aimed to establish whether early-career 'apprenticeship-model' experience in family practice influences antibiotic prescribing for respiratory tract infections and to also establish other associations of antibiotic prescribing changes during this early-career experience. A longitudinal analysis (2010-2014) of a cohort study of Australian GP registrars' (vocational trainees') consultations. Registrars from five regional training programs recorded data from 60 consecutive consultations, once each 6-month training Term, including the diagnoses managed and medications prescribed. The outcomes were whether an antibiotic was prescribed for the diagnoses 'upper respiratory tract infection (URTI)' and 'acute bronchitis/bronchiolitis'. Generalized linear mixed modelling was used to account for repeated measures on registrars and to include the time component: 'Term'. A total of 856 registrars recorded 108759 consultations, including 8715 'URTI' diagnoses (5.15% of diagnoses) and 2110 'acute bronchitis/bronchiolitis' diagnoses (1.25%). Antibiotics were prescribed in 16.3% [95% confidence interval (CI) 14.9-17.8] of URTI and 72.2% (95% CI 69.6-74.6) of acute bronchitis/bronchiolitis diagnoses. Moving from an earlier to later term did not significantly influence registrars' antibiotic prescribing for URTI [adjusted odds ratio (OR) 0.95; 95% CI 0.87, 1.04, P = 0.27] or acute bronchitis/bronchiolitis [OR 1.01 (95% CI 0.90-1.14), P = 0.86]. Significant associations of antibiotic prescribing for URTIs were the registrar being non-Australian educated, greater patient age, practices not privately billing patients, pathology being ordered, longer consultation duration and the registrar seeking in-consultation information or advice (including from their supervisor). Early-career experience/training failed to produce rational antibiotic prescribing for URTI and acute

  2. Prospective open randomized study comparing efficacies and safeties of a 3-day course of azithromycin and a 10-day course of erythromycin in children with community-acquired acute lower respiratory tract infections

    NARCIS (Netherlands)

    Roord, JJ; Goossens, MMHT; Kimpen, JLL; Wolf, B.H.

    1996-01-01

    The efficacies and safeties of a 3-day, 3-dose course of azithromycin (10 mg/kg of body weight per day) and a 10-day, 30-dose course of erythromycin (40 mg/kg/day) for the treatment of acute lower respiratory tract infections in children were compared in an open randomized multicenter study.

  3. Consultation expectations among patients with respiratory tract infection symptoms

    DEFF Research Database (Denmark)

    Lauridsen, Gitte Bruun; Sørensen, Mette Sejr; Hansen, Malene Plejdrup

    2017-01-01

    : A questionnaire survey was conducted in Danish primary care during 2014. Patients aged ≥ 18 years were asked about their expectations to the consultation when consulting with symptoms of acute respiratory tract infections. Associations between socio-demographic characteristics, self-reported antibiotic...

  4. Antibiotic prescribing for acute lower respiratory tract infections (LRTI - guideline adherence in the German primary care setting: An analysis of routine data.

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    Eva Maria Kraus

    Full Text Available Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care.Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine.Antibiotics were prescribed in 41% of consultations. General practitioners' decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73% and acute bronchitis (78% were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28% were not congruent to the guidelines.Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.

  5. SYMPTOMATIC THERAPY OF COUGH DURING SEASONAL INCREASE OF ACUTE RESPIRATORY INFECTIONS PREVALENCE

    OpenAIRE

    K. S. Volkov; L. S. Namazova-Baranova; N. I. Voznesenskaya; V. A. Barannik; K. E. Efendieva

    2014-01-01

    Cough is the main symptom of the respiratory tract disorders. Mostly it occurs in viral, bacterial and mixed (viral and bacterial) respiratory tract infections. The highest rates of respiratory tract infections are among children: it is known that children have respiratory tract infections 3–4 times as much as adults. Available drugs used in acute respiratory tract infections are numerous and various and cover almost all methods of influence on the infectious process. Nowadays the problem of ...

  6. [Viral etiology in children with acute lower respiratory tract infections plus platelet disorders in Changsha, China: an analysis of 255 cases].

    Science.gov (United States)

    Liu, Hua; He, Xiang-Ling; Zhang, Bing; Xiao, Ni-Guang; You, Ya-Lan; Duan, Zhao-Jun

    2014-04-01

    To investigate the viral etiology in hospitalized children with acute lower respiratory tract infections (ALRTI) plus platelet disorders. A total of 255 children with ALRTI plus platelet disorders and 442 children with ALRTI and normal platelets, all of whom were hospitalized between March 2010 and February 2011, were included in the study. Their nasopharyngeal aspirate samples were collected, and RT-PCR or PCR was performed to detect 14 viruses. Of 255 ALRTI patients with platelet disorders, thrombocytosis was found in 253 cases (99.2%) and thrombocytopenia in 2 cases (0.8%). Among ALRTI patients with platelet disorders, 173 (67.8%) were infected with at least one virus, with human rhinovirus as the most common one, followed by parainfluenza virus type 3 (PIV3) and respiratory syncytial virus (RSV). The detection rate of PIV3 in the abnormal platelet group was significantly higher than in the normal platelet group (PThrombocytosis is often found in children with ALRTI caused by viruses, especially PIV3, but infection with IFVB seldom causes platelet disorders. Hospitalized children with ALRTI under one year tend to develop platelet disorders.

  7. [Cycloferon, as an agent in the therapy and urgent prophylaxis of influenza and acute respiratory tract viral infection (multicentre randomized controlled comparative study)].

    Science.gov (United States)

    Sologub, T V; Shul'diakov, A A; Romantsov, M G; Zhekalov, A N; Petlenko, S V; Erofeeva, M K; Maksakova, V L; Isakov, V A; Zarubaev, V V; Gatsan, V V; Kovalenko, A L

    2009-01-01

    Data on the study of the efficacy of the tablets of cycloferon, an early inductor of types 1 and 2 interferon, in the treatment of influenza and acute respiratory tract viral infections in adults are presented. The study enrolled 522 patients with moderate influenza of type A (H1N1) verified in 61% of the patients and type A (H3N2) verified in 7.5% of the cases. The patients were randomized with the envelope procedure. In the patients treated with cycloferon the intensity and period of the fever were stopped earlier and averaged from 1.8 to 3 days vs. 5 days in the reference group (symptomatic therapy). The improvement signs in the general state of the patients treated with cycloferon were noted on the 2nd day. The influenza complication as pneumonia was recorded in 2.2% of the patients treated with cycloferon, whereas in the patients under the symptomatic therapy the complications as bronchitis, pneumonia, angina were stated in 21.4% of the cases. For urgent prophylaxis of the influenza and respiratory tract viral infections (epidemiologic study) a group of 3717 subjects randomized with the table of random numbers was observed. 2080 patients were treated with cycloferon and 1637 patients were under the symptomatic therapy. The results were evaluated by the efficacy index and the protection estimate (T. A. Semenenko, 1991). The total efficacy index and the protection estimate in all the patients of the group were 4.9 and 79.8% respectively. The complicated forms of the disease were recorded in 1.5% of the patients treated with cycloferon and in 10.5 and 11.3% of the patients not treated with cycloferon.

  8. The 2009 pandemic influenza A(H1N1) coincides with changes in the epidemiology of other viral pathogens causing acute respiratory tract infections in children.

    Science.gov (United States)

    Gröndahl, B; Ankermann, T; von Bismarck, P; Rockahr, S; Kowalzik, F; Gehring, S; Meyer, C; Knuf, M; Puppe, W

    2014-04-01

    In Germany, the outbreak of the novel pandemic 2009 influenza A(H1N1) virus A(H1N1)pdm09 caused a wave of high activity between November 2009 and January 2011. The aim of this study was to investigate the prevalence of 19 respiratory pathogens in children hospitalized for lower respiratory tract infections during the winter influenza seasons of 2009/2010 and 2010/2011 and to observe a possible impact of influenza A(H1N1)pdm09 on the epidemiology of other epidemic viruses. Specimens were nasopharyngeal aspirates which had been collected from children admitted to the participating hospitals in the area of Mainz, Wiesbaden, and Kiel, Germany, with acute community-acquired lower respiratory tract infections. The specimens were subjected to a previously described multiplex reverse transcription PCR assay to detect the following microorganisms: enterovirus, influenza virus types A and B, respiratory syncytial virus (RSV), parainfluenzavirus types 1-4, adenovirus, Mycoplasma pneumoniae, Chlamydophila pneumoniae, rhinovirus, human metapneumovirus (hMPV), coronavirus OC43 and 229E, influenza A(H1N1)pdm09, Bordetella pertussis, Bordetella parapertussis, and Legionella pneumophila. A total of 3,998 clinical specimens were collected from July 2009 to March 2011, of which 296 were positive for A(H1N1)pdm09. An epidemic of seasonal influenza A or B was not observed in the 2009/2010 season, but a minor epidemic of seasonal influenza B was observed in January/February 2011. Influenza A(H1N1)pdm09 coincided with the absence of the seasonal influenza A of former years. The RSV and hMPV epidemics of 2009/2010 erupted several weeks later than expected based on data collected in the PID-ARI-Network during the past 10 years, whereas in the 2010/2011 influenza season they occurred as expected. The emergence of the novel influenza A(H1N1)pdm09 virus may have been influenced the epidemiology of other epidemic viruses, such as the RSV and hMPV. No epidemic of seasonal influenza was

  9. ARDS (Acute Respiratory Distress Syndrome)

    Science.gov (United States)

    ... Topics / ARDS ARDS What Is ARDS, or acute respiratory distress syndrome, is a lung condition that leads ... treat ARDS. Other Names Acute lung injury Adult respiratory distress syndrome Increased-permeability pulmonary edema Noncardiac pulmonary ...

  10. Adenovirus Respiratory Tract Infections in Peru

    Science.gov (United States)

    Ampuero, Julia S.; Ocaña, Víctor; Gómez, Jorge; Gamero, María E.; Garcia, Josefina; Halsey, Eric S.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Methods/Principal Findings Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. Conclusions/Significance HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness. PMID:23056519

  11. Antibiotics in respiratory tract infections in hospital pediatric emergency departments.

    Science.gov (United States)

    Guzmán Molina, Claudia; Rodríguez-Belvís, Marta Velasco; Coroleu Bonet, Albert; Vall Combelles, Oriol; García-Algar, Oscar

    2014-09-01

    Respiratory tract infections are one of the most frequent problems in pediatric clinics and generate an elevated prescription of antibiotics. The aim of this study was to find out the standard of care practice about antibiotic use in these infections in a pediatric emergency department and to evaluate compliance with clinical guidelines. A pediatric emergency department database was reviewed from July 2005 to October 2007 under the category "respiratory infection", including variables such as age, antibiotic prescription and compliance with current clinical recommendations. Out of the 23,114 reviewed reports, 32.7% (7,567) were upper respiratory tract infections (URTI) (cold, acute otitis media [AOM], sinusitis and tonsillopharyngitis) or lower respiratory tract infections (LRTI) (laryngitis, bronchitis, bronchiolitis and pneumonia). Children under the age of 2 were the most represented age group. Amongst URTI, rhinopharyngitis was the most frequent infection, while bronchitis was the most frequent among LRTI. Antibiotic therapy (mainly amoxicillin) was prescribed in 30.8% of URTI (5.7% rhinopharyngitis, 96.5% AOM, and 36.7% tonsillopharyngitis) and in 12.4% of LRTI. The percentage of respiratory tract infections was similar to previous studies and the antibiotic prescriptions followed current guidelines, except for cases diagnosed with AOM. Prescription compliance and clinical course of the cases should be monitored. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  12. Characterization of human coronavirus etiology in Chinese adults with acute upper respiratory tract infection by real-time RT-PCR assays.

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    Roujian Lu

    Full Text Available BACKGROUND: In addition to SARS associated coronaviruses, 4 non-SARS related human coronaviruses (HCoVs are recognized as common respiratory pathogens. The etiology and clinical impact of HCoVs in Chinese adults with acute upper respiratory tract infection (URTI needs to be characterized systematically by molecular detection with excellent sensitivity. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we detected 4 non-SARS related HCoV species by real-time RT-PCR in 981 nasopharyngeal swabs collected from March 2009 to February 2011. All specimens were also tested for the presence of other common respiratory viruses and newly identified viruses, human metapneumovirus (hMPV and human bocavirus (HBoV. 157 of the 981 (16.0% nasopharyngeal swabs were positive for HCoVs. The species detected were 229E (96 cases, 9.8%, OC43 (42 cases, 4.3%, HKU1 (16 cases, 1.6% and NL63 (11 cases, 1.1%. HCoV-229E was circulated in 21 of the 24 months of surveillance. The detection rates for both OC43 and NL63 were showed significantly year-to-year variation between 2009/10 and 2010/11, respectively (P<0.001 and P = 0.003, and there was a higher detection frequency of HKU1 in patients aged over 60 years (P = 0.03. 48 of 157(30.57% HCoV positive patients were co-infected. Undifferentiated human rhinoviruses and influenza (Flu A were the most common viruses detected (more than 35% in HCoV co-infections. Respiratory syncytial virus (RSV, human parainfluenza virus (PIV and HBoV were detected in very low rate (less than 1% among adult patients with URTI. CONCLUSIONS/SIGNIFICANCE: All 4 non-SARS-associated HCoVs were more frequently detected by real-time RT-PCR assay in adults with URTI in Beijing and HCoV-229E led to the most prevalent infection. Our study also suggested that all non-SARS-associated HCoVs contribute significantly to URTI in adult patients in China.

  13. [Detection and clinical analysis of acute lower respiratory tract infection with human coronaviruses in children in Beijing area 2007-2015].

    Science.gov (United States)

    Qian, Yi; Xie, Zhengde; Ren, Lili; Liu, Chunyan; Xiao, Yan; Xu, Baoping; Yang, Yan; Qian, Suyun; Geng, Rong; Shen, Kunling

    2015-09-01

    To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children. Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in respiratory viruses including HCoVs (including HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1), respiratory syncytial virus (RSV) and so on. Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period. (1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23%), in which 147 cases were positive for HCoVs infection (positive rate 3.36%). (2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11%, 3.79%, 4.69%, 4.31%, 2.38% 2.10%, 0.77% and 2.65%, respectively. The mean positive rates of HCoVs for each month from January to December were 2.53%, 2.12%, 3.63%, 6.68%, 1.53%, 3.77%, 3.92%, 3.00%, 2.15%, 5.26%, 3.01% and 2.80%. (3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were: 48 cases positive for HCoV-OC43(1.10%), 32 cases positive for HCoV-229E(0.73%), 25 cases positive for HCoV-NL63 (0.57%), 27 cases positive for HCoV-HKU1 (0.62%). (4) Positive rates of HCoVs infection in infection of HCoVs in this study, of which 12 cases were diagnosed as bronchopneumonia, 3 cases developed acute laryngeal obstruction, 2 cases had acute bronchial asthma attack. Common clinical manifestations included cough (14 cases), gasping (13 cases), dyspnea (9 cases), fever (6 cases), hoarseness (4 cases), laryngeal stridor (4 cases) and abnormality on chest X-ray (including fuzzy lung texture, patchy shadow and consolidation) (12 cases). (6) There were no

  14. Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing

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    Carlos Bada

    Full Text Available CONTEXT AND OBJECTIVE: Many children with acute lower respiratory tract infections (ALRI present to the emergency ward with concurrent wheezing. A chest x-ray is often requested to rule out pneumonia. We assessed inter-observer agreement in interpreting x-rays on such children. DESIGNS AND SETTING: Prospective consecutive case study at Instituto de Salud del Niño, Lima, Peru. METHODS: Chest x-rays were obtained from eligible children younger than two years old with ALRI and concurrent wheezing who were seen in the emergency ward of a nationwide pediatric referral hospital. The x-rays were read independently by three different pediatric residents who were aware only that the children had a respiratory infection. All the children had received inhaled beta-adrenergic agonists before undergoing chest x-rays. Lobar and complicated pneumonia cases were excluded from the study. RESULTS: Two hundred x-rays were read. The overall kappa index was 0.2. The highest individual kappa values for specific x-ray findings ranged from 0.26 to 0.34 for rib horizontalization and from 0.14 to 0.31 for alveolar infiltrate. Inter-observer variation was intermediate for alveolar infiltrate (kappa 0.14 to 0.21 and for air bronchogram (kappa 0.13 to 0.23. Reinforcement of the bronchovascular network (kappa 0.10 to 0.16 and air trapping (kappa 0.05 to 0.20 had the lowest agreement. CONCLUSIONS: There was poor inter-observer agreement for chest x-ray interpretation on children with ALRI and concurrent wheezing seen at the emergency ward. This may preclude reliable diagnosing of pneumonia in settings where residents make management decisions regarding sick children. The effects of training on inter-observer variation need further studies.

  15. Rationale, design and organization of the delayed antibiotic prescription (DAP) trial: a randomized controlled trial of the efficacy and safety of delayed antibiotic prescribing strategies in the non-complicated acute respiratory tract infections in general practice

    Science.gov (United States)

    2013-01-01

    Background Respiratory tract infections are an important burden in primary care and it’s known that they are usually self-limited and that antibiotics only alter its course slightly. This together with the alarming increase of bacterial resistance due to increased use of antimicrobials calls for a need to consider strategies to reduce their use. One of these strategies is the delayed prescription of antibiotics. Methods Multicentric, parallel, randomised controlled trial comparing four antibiotic prescribing strategies in acute non-complicated respiratory tract infections. We will include acute pharyngitis, rhinosinusitis, acute bronchitis and acute exacerbation of chronic bronchitis or chronic obstructive pulmonary disease (mild to moderate). The therapeutic strategies compared are: immediate antibiotic treatment, no antibiotic treatment, and two delayed antibiotic prescribing (DAP) strategies with structured advice to use a course of antibiotics in case of worsening of symptoms or not improving (prescription given to patient or prescription left at the reception of the primary care centre 3 days after the first medical visit). Discussion Delayed antibiotic prescription has been widely used in Anglo-Saxon countries, however, in Southern Europe there has been little research about this topic. The DAP trial wil evaluate two different delayed strategies in Spain for the main respiratory infections in primary care. Trial registration This trial is registered with ClinicalTrials.gov, number http://NCT01363531. PMID:23682979

  16. Patterns of Human Respiratory Viruses and Lack of MERS-Coronavirus in Patients with Acute Upper Respiratory Tract Infections in Southwestern Province of Saudi Arabia

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    Ahmed A. Abdulhaq

    2017-01-01

    Full Text Available We undertook enhanced surveillance of those presenting with respiratory symptoms at five healthcare centers by testing all symptomatic outpatients between November 2013 and January 2014 (winter time. Nasal swabs were collected from 182 patients and screened for MERS-CoV as well as other respiratory viruses using RT-PCR and multiplex microarray. A total of 75 (41.2% of these patients had positive viral infection. MERS-CoV was not detected in any of the samples. Human rhinovirus (hRV was the most detected pathogen (40.9% followed by non-MERS-CoV human coronaviruses (19.3%, influenza (Flu viruses (15.9%, and human respiratory syncytial virus (hRSV (13.6%. Viruses differed markedly depending on age in which hRV, Flu A, and hCoV-OC43 were more prevalent in adults and RSV, hCoV-HKU1, and hCoV-NL63 were mostly restricted to children under the age of 15. Moreover, coinfection was not uncommon in this study, in which 17.3% of the infected patients had dual infections due to several combinations of viruses. Dual infections decreased with age and completely disappeared in people older than 45 years. Our study confirms that MERS-CoV is not common in the southwestern region of Saudi Arabia and shows high diversity and prevalence of other common respiratory viruses. This study also highlights the importance and contribution of enhanced surveillance systems for better infection control.

  17. The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study

    Directory of Open Access Journals (Sweden)

    Nasser Mostafavi

    2015-01-01

    Full Text Available Background: To investigate the prevalence of antibiotic usage in children aged <5 years with acute respiratory tract illness (ARTI in Iran. Materials and Methods: Data were collected from a national health survey conducted in 2010 (Iran′s Multiple Indicator Demographic and Health Survey. Participants of this cross-sectional study were selected by multistage stratified cluster-random sampling from 31 provinces of Iran. Parents of children with <5 years of age responded to questions about the occurrence of any cough during the previous 2 weeks, referral to private/governmental/other health care systems, and utilization of any oral/injection form of antibiotics. Data were analyzed using SPSS software18. The chi-square test was used to determine antibiotic consumption in various gender and residency groups and also a place of residence with the referral health care system. Results: Of the 9345 children under 5 years who participated in the study, 1506 cases (16.2% had ARTI during 2 weeks prior to the interview, in whom 1143 (75.9% were referred to urban or rural health care centers (43.4 vs. 30.4%; P < 0.001. Antibiotics were utilized by 715 (62.6% of affected children. Injection formulations were used for 150 (13.1% patients. The frequency of receiving antibiotics was higher in urban than in rural inhabitants (66.0% vs. 57.7%; P < 0.05. Conclusion: The prevalence of total and injection antibiotics usage in children <5 years with ARTI is alarmingly high in Iran. Therefore, interventions to reduce antibiotic use are urgently needed.

  18. Recent trends in antibiotic prescriptions for acute respiratory tract infections in pediatric ambulatory care in Taiwan, 2000-2009: A nationwide population-based study.

    Science.gov (United States)

    Lee, Ming-Luen; Cho, Ching-Yi; Hsu, Chien-Lun; Chen, Chun-Jen; Chang, Lo-Yi; Lee, Yu-Sheng; Soong, Wen-Jue; Jeng, Mei-Jy; Wu, Keh-Gong

    2016-08-01

    Antibiotic resistance is a global problem, and the inappropriate overuse of antibiotics is the major cause. Among children seeking medical help, acute respiratory tract infections (ARTIs) are the most common tentative diagnosis made by physicians and the leading condition for which antibiotics are prescribed. This study aimed to examine the trends of prescribing antibiotics in pediatric ambulatory care in Taiwan over a 10-year period. Children younger than 18 years old and being diagnosed as having ARTIs [International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 460, 465, and 466] during ambulatory visits from 2000 to 2009 were retrieved from the systematic random sampling datasets of the National Health Insurance Research Database (NHIRD) in Taiwan. The annual and monthly case numbers were recorded and the children's demographic characteristics, including sex, age, seasonality, location, level of medical institution, physician specialty, and their ambulatory prescriptions of antibiotics were collected and analyzed. Among 565,065 enrolled ambulatory children, 39,324 were prescribed antibiotics. The average antibiotics prescription rate was 7.0% during the 10-year period. There were marked descending trends in case numbers and antibiotic dispensing rates from 2000 to 2009. Female patients, elder ages (≥6 years old), summer and autumn, middle and southern areas of Taiwan, medical centers and regional hospitals, and physicians of pediatric specialty were associated with significantly lower antibiotic dispensing rates than other conditions (p ambulatory children with ARTIs was 7.0% and it decreased gradually from 2000 to 2009 in Taiwan. Through understanding the annual trends in antibiotic prescriptions, it may be possible to design interventions to improve the judicious use of antibiotics in children. Copyright © 2014. Published by Elsevier B.V.

  19. SYMPTOMATIC THERAPY OF COUGH DURING SEASONAL INCREASE OF ACUTE RESPIRATORY INFECTIONS PREVALENCE

    Directory of Open Access Journals (Sweden)

    K. S. Volkov

    2014-01-01

    Full Text Available Cough is the main symptom of the respiratory tract disorders. Mostly it occurs in viral, bacterial and mixed (viral and bacterial respiratory tract infections. The highest rates of respiratory tract infections are among children: it is known that children have respiratory tract infections 3–4 times as much as adults. Available drugs used in acute respiratory tract infections are numerous and various and cover almost all methods of influence on the infectious process. Nowadays the problem of usage of effective and at the same time safe agents in acute respiratory tract infections in children is very topical. The modern approaches to treatment of acute respiratory tract infections in children are discussed in the article. A special attention is given to symptomatic therapy. The authors describe the approaches to treatment of cough according to its character, intensity and other characteristics.

  20. Acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Marco Confalonieri

    2017-04-01

    Full Text Available Since its first description, the acute respiratory distress syndrome (ARDS has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foster geographic variability and contrasting outcome data. A large international multicentre prospective cohort study including 50 countries across five continents reported that ARDS is underdiagnosed, and there is potential for improvement in its management. Furthermore, epidemiological data from low-income countries suggest that a revision of the current definition of ARDS is needed in order to improve its recognition and global clinical outcome. In addition to the well-known risk-factors for ARDS, exposure to high ozone levels and low vitamin D plasma concentrations were found to be predisposing circumstances. Drug-based preventive strategies remain a major challenge, since two recent trials on aspirin and statins failed to reduce the incidence in at-risk patients. A new disease-modifying therapy is awaited: some recent studies promised to improve the prognosis of ARDS, but mortality and disabling complications are still high in survivors in intensive care.

  1. Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Carmen Sílvia Valente Barbas

    2012-01-01

    Full Text Available This paper, based on relevant literature articles and the authors' clinical experience, presents a goal-oriented respiratory management for critically ill patients with acute respiratory distress syndrome (ARDS that can help improve clinicians' ability to care for these patients. Early recognition of ARDS modified risk factors and avoidance of aggravating factors during hospital stay such as nonprotective mechanical ventilation, multiple blood products transfusions, positive fluid balance, ventilator-associated pneumonia, and gastric aspiration can help decrease its incidence. An early extensive clinical, laboratory, and imaging evaluation of “at risk patients” allows a correct diagnosis of ARDS, assessment of comorbidities, and calculation of prognostic indices, so that a careful treatment can be planned. Rapid administration of antibiotics and resuscitative measures in case of sepsis and septic shock associated with protective ventilatory strategies and early short-term paralysis associated with differential ventilatory techniques (recruitment maneuvers with adequate positive end-expiratory pressure titration, prone position, and new extracorporeal membrane oxygenation techniques in severe ARDS can help improve its prognosis. Revaluation of ARDS patients on the third day of evolution (Sequential Organ Failure Assessment (SOFA, biomarkers and response to infection therapy allows changes in the initial treatment plans and can help decrease ARDS mortality.

  2. Study protocol: the effects of air pollution exposure and chronic respiratory disease on pneumonia risk in urban Malawian adults--the Acute Infection of the Respiratory Tract Study (The AIR Study).

    Science.gov (United States)

    Jary, Hannah; Mallewa, Jane; Nyirenda, Mulinda; Faragher, Brian; Heyderman, Robert; Peterson, Ingrid; Gordon, Stephen; Mortimer, Kevin

    2015-08-20

    Pneumonia is the 2nd leading cause of years of life lost worldwide and is a common cause of adult admissions to hospital in sub-Saharan Africa. Risk factors for adult pneumonia are well characterised in developed countries, but are less well described in sub-Saharan Africa where HIV is a major contributing factor. Exposure to indoor and outdoor air pollution is high, and tobacco smoking prevalence is increasing in sub-Saharan Africa, yet the contribution of these factors to the burden of chronic respiratory diseases in sub-Saharan Africa remains poorly understood. Furthermore, the extent to which the presence of chronic respiratory diseases and exposure to air pollution contribute to the burden of pneumonia is not known. The Acute Infection of the Respiratory Tract Study (The AIR Study) is a case-control study to identify preventable risk factors for adult pneumonia in the city of Blantyre, Malawi. Cases will be adults admitted with pneumonia, recruited from Queen Elizabeth Central Hospital, the largest teaching hospital in Malawi. Controls will be adults without pneumonia, recruited from the community. The AIR Study will recruit subjects and analyse data within strata defined by positive and negative HIV infection status. All participants will undergo thorough assessment for a range of potential preventable risk factors, with an emphasis on exposure to air pollution and the presence of chronic respiratory diseases. This will include collection of questionnaire data, clinical samples (blood, urine, sputum and breath samples), lung function data and air pollution monitoring in their home. Multivariate analysis will be used to identify the important risk factors contributing to the pneumonia burden in this setting. Identification of preventable risk factors will justify research into the effectiveness of targeted interventions to address this burden in the future. The AIR Study is the first study of radiologically confirmed pneumonia in which air pollution exposure

  3. Respiratory syncytial virus: co-infection and paediatric lower respiratory tract infections.

    Science.gov (United States)

    Yoshida, Lay-Myint; Suzuki, Motoi; Nguyen, Hien Anh; Le, Minh Nhat; Dinh Vu, Thiem; Yoshino, Hiroshi; Schmidt, Wolf-Peter; Nguyen, Thi Thuy Ai; Le, Huu Tho; Morimoto, Konosuke; Moriuchi, Hiroyuki; Dang, Duc Anh; Ariyoshi, Koya

    2013-08-01

    Comprehensive population-based data on the role of respiratory viruses in the development of lower respiratory tract infections (LRTIs) remain unclear. We investigated the incidence and effect of single and multiple infections with respiratory viruses on the risk of LRTIs in Vietnam. Population-based prospective surveillance and a case-control study of hospitalised paediatric patients with acute respiratory infection (ARI) were conducted from April 2007 through to March 2010. Healthy controls were randomly recruited from the same community. Nasopharyngeal samples were collected and tested for 13 respiratory viruses using multiplex PCRs. 1992 hospitalised ARI episodes, including 397 (19.9%) with LRTIs, were enrolled. Incidence of hospitalised LRTIs among children aged respiratory syncytial virus (20.1%) and influenza A virus (12.0%) were the most common and 9.5% had multiple-viral infections. Respiratory syncytial virus and human metapneumovirus infections independently increased the risk of LRTIs. Respiratory syncytial virus further increased the risk, when co-infected with human rhinovirus, human metapneumovirus and parainfluenza virus-3 but not with influenza A virus. The case-control analysis revealed that respiratory syncytial virus and influenza A virus increased the risk of ARI hospitalisation but not human rhinovirus. Respiratory syncytial virus is the leading pathogen associated with risk of ARI hospitalisation and LRTIs in Vietnam.

  4. Management of respiratory tract infections in children

    Directory of Open Access Journals (Sweden)

    Paul SP

    2014-12-01

    Full Text Available Siba Prosad Paul,1 Rachel Wilkinson,2 Christine Routley3 1Southmead Hospital, Bristol, 2St Richard's Hospital, Chichester, 3Paediatric Services, Yeovil District Hospital, Yeovil, UK Abstract: Respiratory tract infections (RTIs in children are one of the most common reasons for parents consulting health professionals. Most RTIs are self-limiting viral illnesses that will resolve with time and supportive management. However, it is important for the health professional to identify any RTI that may have more serious implications for the child and require medical intervention. Diagnosis can usually be made from the history and presenting symptoms such as cough, wheeze, tachypnea, fever, or stridor. Exclusion of "red flag" symptoms will enable health professionals to appropriately reassure parents and advise symptomatic management with antipyretics and adequate fluid administration. With the expanding role of nurses in ambulatory settings, many children are now being seen by health professionals other than doctors, (eg, advanced nurse practitioners, some of whom are trained in pediatrics while others have limited knowledge of nursing sick children. It is therefore vital that these professionals remain aware of any risk factors and that they can recognize "red flags" in a sick child rapidly and escalate further management appropriately. Some children will require admission to hospital for respiratory support and other therapies, such as intravenous antibiotics and fluids. With advancement of the "non-medical prescriber" within the nursing profession, awareness of when to give or not give antibiotic therapy needs careful consideration, especially in light of the problems that may arise from overuse of antibiotic treatment. Nurses have a vital role, not only in administering medications and supporting other medical interventions, but also in supporting the child and family over the period of illness. The education of the parents and the child, in some

  5. Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children

    NARCIS (Netherlands)

    Agustina, R.; Kok, F.J.; Rest, van de O.; Fahmida, U.; Firmansyah, A.; Lukito, W.; Feskens, E.J.M.; Heuvel, van den E.G.H.M.; Albers, R.; Bovee-Oudenhoven, I.M.J.

    2012-01-01

    OBJECTIVE: To investigate the effects of calcium and probiotics on the incidence and duration of acute diarrhea and acute respiratory tract infections (ARTIs) in low-socioeconomic communities of Jakarta, Indonesia. METHODS: We conducted a 6-month, double-blind, placebo-controlled study in 494

  6. 'Recurrent lower respiratory tract infections' - going around in circles, respiratory medicine style.

    Science.gov (United States)

    Everard, Mark L

    2012-09-01

    Recurrent lower respiratory tract infections are very common in childhood, particularly the pre-school years. The term lower respiratory tract infection [LTRI] is, as with many terms used in respiratory medicine, used very loosely and carries little more information than the often decried term 'chest infections'. LRTIs should more accurately be characterised by the type of infection [viral or bacterial], the site of infection [conducting airways, or respiratory compartment or both - bronchitis/pneumonia/bronchopneumonia], the nature of the episode [acute or acute on chronic (exacerbation)], the interaction with co-morbidities such as asthma. The limited nature of the responses of the lower airways to any insult whether it is infective or irritation due to inhaled or aspirated chemicals means that almost any aetiology can lead to cough, shortness of breath and noisy breathing. We lack good non-invasive techniques to study the nature of the inflammation in the lower airways and hence the cause of chronic and recurrent symptoms in patients is frequently mis-diagnosed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Interference between respiratory syncytial virus and rhinovirus in respiratory tract infections in children.

    Science.gov (United States)

    Karppinen, S; Toivonen, L; Schuez-Havupalo, L; Waris, M; Peltola, V

    2016-02-01

    An acute viral respiratory tract infection might prevent infections by other viruses because of the antiviral innate immune response. However, with the use of PCR methods, simultaneous detection of two or more respiratory viruses is frequent. We analysed the effect of respiratory syncytial virus (RSV) infection on the occurrence of simultaneous rhinovirus (RV) infection in children within a birth cohort study setting. We used PCR for virus detection in nasal swabs collected from children with an acute respiratory tract infection at the age of 0-24 months and from healthy control children, who were matched for age and date of sample collection. Of 226 children with RSV infections, 18 (8.0%) had co-infections with RV, whereas RV was detected in 31 (14%) of 226 control children (p 0.049 by chi-square test). Adjustment for sex, number of siblings and socio-economic status strengthened the negative association between RSV and RV (OR 0.46, 95% CI 0.24-0.90; p 0.02). The median durations of symptoms (cough, rhinorrhoea, or fever) were 11 days in children with single RSV infections and 14 days in children with RSV-RV co-infections (p 0.02). Our results suggest that the presence of RSV reduces the probability of RV infection, but that, if a co-infection occurs, both viruses cause clinical symptoms. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Antigen-specific H1N1 influenza antibody responses in acute respiratory tract infections and their relation to influenza infection and disease course.

    Science.gov (United States)

    Haran, John Patrick; Hoaglin, David C; Chen, Huaiqing; Boyer, Edward W; Lu, Shan

    2014-08-01

    Early antibody responses to influenza infection are important in both clearance of virus and fighting the disease. Acute influenza antibody titers directed toward H1-antigens and their relation to infection type and patient outcomes have not been well investigated. Using hemagglutination inhibition (HI) assays, we aimed to characterize the H1-specific antibody titers in patients with influenza infection or another respiratory infection before and after the H1N1-pandemic influenza outbreak. Among patients with acute influenza infection we related duration of illness, severity of symptoms, and need for hospitalization to antibody titers. There were 134 adult patients (average age 34.7) who presented to an urban academic emergency department (ED) from October through March during the 2008-2011 influenza seasons with symptoms of fever and a cough. Nasal aspirates were tested by viral culture, and peripheral blood serum was run in seven H1-subtype HI assays. Acutely infected influenza patients had markedly lower antibody titers for six of the seven pseudotype viruses. For the average over the seven titers (log units, base 2) their mean was 7.24 (95% CI 6.88, 7.61) compared with 8.60 (95% CI 8.27, 8.92) among patients who had a non-influenza respiratory illness, pinfection, titers of some antibodies correlated with severity of symptoms and with total duration of illness (pacute respiratory infections, lower concentrations of H1-influenza-specific antibodies were associated with influenza infection. Among influenza-infected patients, higher antibody titers were present in patients with a longer duration of illness and with higher severity-of-symptom scores. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. The management of upper respiratory tract infections.

    Science.gov (United States)

    Teng, C L; Shajahan, Y; Khoo, E M; Nurjahan, I; Leong, K C; Yap, T G

    2001-06-01

    Upper respiratory tract infections are the commonest reason for consultation in primary care. Group A beta-haemolytic Streptococcus (GABHS), the most important bacterial pathogen in this condition, can be cultured from about 30% of patients, more so in children than adults. Clinical features that are predictive of positive GABHS culture are absence of cough, fever, cervical adenopathy, tonsillar enlargement and tonsillar exudate. Use of a sore throat score can help in the detection of streptococcal throat infection. Symptomatic therapies which are useful include anticholinergic, antihistamine, decongestant, humified hot air and Vitamin C. Antibiotics are universally over-prescribed in this condition as a result of high patient expectation and faulty clinical decision making. Oral Penicillin V for 10 days is the drug of choice. Effective intervention to reduce inappropriate antibiotic prescription probably require a multifaceted approach targeted at both the patients and the prescribers.

  10. Cost Analysis of Medications Used in Upper Respiratory Tract ...

    African Journals Online (AJOL)

    Purpose: To conduct a cost analysis, a narrow cost-utility study, for upper respiratory tract infection medications in University Sans Malaysia's clinics. Methods: Retrospective analysis was done for all medical claims of upper respiratory tract infections in the period 2008 - 2009. The study was done in the clinics under ...

  11. Bovine coronaviruses from the respiratory tract: Antigenic and genetic diversity

    Science.gov (United States)

    Bovine corona viruses (BoCV) isolated from respiratory tract, nasal swab and broncho alveolar washing fluid samples were evaluated for genetic and antigenic differences. These BoCV from the respiratory tract of healthy and clinically ill cattle with BRD signs were compared to reference and vaccine ...

  12. Activity of Bryophyllum pinnatum S. Kurz extracts on respiratory tract ...

    African Journals Online (AJOL)

    The activity of this plant's extracts against the test bacteria coupled with the various phytochemical compounds present in the fractions is a pointer to the plant's potential as a source of drugs that can be used against respiratory tract pathogens. Keywords: Bryophyllum pinnatum, respiratory tract pathogens, phytochemical ...

  13. The clinical management of lower respiratory tract infections.

    Science.gov (United States)

    Liapikou, Adamantia; Torres, Antoni

    2016-03-16

    The 2010 Global Burden of Disease Study reported that lower respiratory tract infections, including pneumonia, are the fourth most common cause of death globally. The etiology of acute bronchitis and asthma exacerbations is mostly viral and the therapy is symptomatic. Management decisions in community acquired pneumonia regarding site of care, extent of assessment, and level of treatment are based primarily on disease severity (outpatient, inpatient, ICU admission). Antibiotics are the main choice of treatment for patients with pneumonia, acute exacerbations (AE) of COPD (including increased sputum purulence and worsening shortness of breath) and AE of non-CF bronchiectasis. Inhaled antibiotics may represent a more optimal approach for the treatment and prevention of AE of non-CF bronchiectasis. Approved strategies for the prevention of exacerbations include smoking cessation and rehabilitation programs, drug therapy and vaccination.

  14. Acute effects of low-level sulphur dioxide and nitrogen dioxide exposures on the respiratory tract of susceptible subjects in cold environments

    Energy Technology Data Exchange (ETDEWEB)

    Salonen, R.O.; Randell, J.T.; Haelinen, A.I.; Pennanen, A.S. [National Public Health Inst., Kuopio (Finland). Div. of Environmental Health; Kosma, V.M. [Kuopio Univ. (Finland). Dept. of Pathology; Pekkarinen, H. [Kuopio Univ. (Finland). Dept. of Physiology; Ruuskanen, J. [Kuopio Univ. (Finland). Dept. of Environmental Sciences; Tukiainen, H. [Kuopio Univ. (Finland). Dept. of Pulmonary Diseases

    1995-12-31

    Several recent epidemiological studies from Finland have suggested that sulphur dioxide (SO{sub 2}) and nitrogen dioxide (NO{sub 2}) cause adverse health effects in susceptible population groups, such as children and asthmatic patients, at much smaller concentrations than the present guideline values of the World Health Organization. One possible explanation of these findings is that the relatively long winter-time increases the sensitivity of the respiratory tract to irritant pollutants. This hypothesis is supported by experimental human and animal studies, which have shown obstruction and inflammatory changes in the conducting airways after ventilation of cold and dry air. Asthmatic patients are much more sensitive than healthy subjects to the irritating effects of cold and dry air and of air pollutants. The airways of many non-asthmatic a topic subjects are also sensitive to cold air, but these subjects are poorly defined as a potential susceptible population group to air pollutants. The aims of this project are: (1) to construct experimental human and animal facilities and protocols for short-term studies on SO{sub 2} and NO{sub 2} exposures at subfreezing temperatures, (2) to apply advanced lung function methodologies and symptom assessment for characterisation of short-term respiratory responses of asthmatic and a topic subjects to these exposures, (3) to apply well-established pulmonary physiological, cytological and morphological methods for characterisation of short-term responses to and mechanisms of these exposures in the guinea-pig lower airways. (author)

  15. Viral coinfection in childhood respiratory tract infections.

    Science.gov (United States)

    Martínez-Roig, A; Salvadó, M; Caballero-Rabasco, M A; Sánchez-Buenavida, A; López-Segura, N; Bonet-Alcaina, M

    2015-01-01

    The introduction of molecular techniques has enabled better understanding of the etiology of respiratory tract infections in children. The objective of the study was to analyze viral coinfection and its relationship to clinical severity. Hospitalized pediatric patients with a clinical diagnosis of respiratory infection were studied during the period between 2009-2010. Clinical and epidemiological data, duration of hospitalization, need for oxygen therapy, bacterial coinfection and need for mechanical ventilation were collected. Etiology was studied by multiplex PCR and low-density microarrays for 19 viruses. A total of 385 patients were positive, 44.94% under 12 months. The most frequently detected viruses were RSV-B: 139, rhinovirus: 114, RSV-A: 111, influenza A H1N1-2009: 93 and bocavirus: 77. Coinfection was detected in 61.81%, 36.36% with 2 viruses, 16.10% and 9.35% with 3 to 4 or more. Coinfection was higher in 2009 with 69.79 vs. 53.88% in 2010. Rhinovirus/RSV-B on 10 times and RSV-A/RSV-B on 5 times were the most detected coinfections. Hospitalization decreased with greater number of viruses (Prespiratory disease and its correlation with the clinical severity. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Equal virulence of rhinovirus and respiratory syncytial virus in infants hospitalized for lower respiratory tract infection

    NARCIS (Netherlands)

    van Leeuwen, J.C.; Goossens, L.K.; Hendrix, R.; van der Palen, Jacobus Adrianus Maria; Lusthusz, A.; Thio, B.J.

    2012-01-01

    Respiratory syncytial virus (RSV) and rhinovirus (RV) are predominant viruses associated with lower respiratory tract infection in infants. We compared the symptoms of lower respiratory tract infection caused by RSV and RV in hospitalized infants. RV showed the same symptoms as RSV, so on clinical

  17. A touchdown nucleic acid amplification protocol as an alternative to culture backup for immunofluorescence in the routine diagnosis of acute viral respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Feeney Susan A

    2004-10-01

    Full Text Available Abstract Background Immunofluorescence and virus culture are the main methods used to diagnose acute respiratory virus infections. Diagnosing these infections using nucleic acid amplification presents technical challenges, one of which is facilitating the different optimal annealing temperatures needed for each virus. To overcome this problem we developed a diagnostic molecular strip which combined a generic nested touchdown protocol with in-house primer master-mixes that could recognise 12 common respiratory viruses. Results Over an 18 month period a total of 222 specimens were tested by both immunofluorescence and the molecular strip. The specimens came from 103 males (median age 3.5 y, 80 females (median age 9 y and 5 quality assurance scheme specimens. Viruses were recovered from a number of specimen types including broncho-alveolar lavage, nasopharyngeal secretions, sputa, post-mortem lung tissue and combined throat and nasal swabs. Viral detection by IF was poor in sputa and respiratory swabs. A total of 99 viruses were detected in the study from 79 patients and 4 quality control specimens: 31 by immunofluorescence and 99 using the molecular strip. The strip consistently out-performed immunofluorescence with no loss of diagnostic specificity. Conclusions The touchdown protocol with pre-dispensed primer master-mixes was suitable for replacing virus culture for the diagnosis of respiratory viruses which were negative by immunofluorescence. Results by immunofluorescence were available after an average of 4–12 hours while molecular strip results were available within 24 hours, considerably faster than viral culture. The combined strip and touchdown protocol proved to be a convenient and reliable method of testing for multiple viruses in a routine setting.

  18. Principles of judicious antibiotic prescribing for upper respiratory tract infections in pediatrics.

    Science.gov (United States)

    Hersh, Adam L; Jackson, Mary Anne; Hicks, Lauri A

    2013-12-01

    Most upper respiratory tract infections are caused by viruses and require no antibiotics. This clinical report focuses on antibiotic prescribing strategies for bacterial upper respiratory tract infections, including acute otitis media, acute bacterial sinusitis, and streptococcal pharyngitis. The principles for judicious antibiotic prescribing that are outlined focus on applying stringent diagnostic criteria, weighing the benefits and harms of antibiotic therapy, and understanding situations when antibiotics may not be indicated. The principles can be used to amplify messages from recent clinical guidelines for local guideline development and for patient communication; they are broadly applicable to antibiotic prescribing in general.

  19. Pressing Issues of Rational Antibiotic Therapy for Inflammatory Diseases of the Lower Respiratory Tract in Pediatric Practice

    National Research Council Canada - National Science Library

    Ye.N. Okhotnikova; Ye.V. Ponochevnaia; Ye.V. Sharikadze; Ye.I. Usova

    2015-01-01

    Over the past 30 years, high incidence of acute lower respiratory tract infections of bacterial origin, primarily pneumonia and bronchitis, treatment of which under the spread of antibiotic resistance...

  20. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

  1. Microbiologic Methods in the Diagnostics of Upper Respiratory Tract Pathogens.

    Science.gov (United States)

    Kompanikova, J; Zumdick, A; Neuschlova, M; Sadlonova, V; Novakova, E

    2017-01-01

    Upper respiratory tract infection (URI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, and larynx above the vocal cords. The aim of this study was to provide a summary of the most common pathogens of URI and to compare advantages and disadvantages of traditional and new rapid microbiological tests used to identify them. Blood samples were simultaneously examined by the enzyme-linked immunosorbent assay (ELISA) and by the FilmArray Respiratory Panel for eight different pathogens in a total of 15 tests performed in nasopharyngeal swabs. The ELISA method is unable to identify the pathologic agent until the host's immune system elicits a response. The method is readily available in many laboratories at a low cost, which puts less strain on economic resources. The FilmArray ® Panel, on the other hand, is more expensive, but it is fast and exact in the identification of a broad spectrum etiologic agents. Nonetheless, since most repiratory tract infections are viral in origin and there is no treatment available, the diagnosis provided by the FilmArray Panel does not provide any additional clinical benefit and thus should be used only whenever necessary on the individual basis.

  2. Severe Acute Respiratory Syndrome- SARS

    Indian Academy of Sciences (India)

    Table of contents. Severe Acute Respiratory Syndrome- SARS · PowerPoint Presentation · Slide 3 · Global pattern of SARS epidemic · Slide 5 · SARS – clinical features ... SARS virus · SARS – Koch´Postulates proved. SARS – virus jumps species · How infectious is SARS virus · SARS – Global Distribution- 10th July 2003.

  3. Microdistribution and Long-Term Retention of 239Pu (NO3)4 in the Respiratory Tracts of an Acutely Exposed Plutonium Worker and Experimental Beagle Dogs

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Christopher E.; Wilson, Dulaney A.; Brooks, Antone L.; McCord, Stacey; Dagle, Gerald E.; James, Anthony C.; Tolmachev, Sergei Y.; Thrall, Brian D.; Morgan, William F.

    2012-11-01

    The long-term retention of inhaled soluble forms of plutonium raises concerns as to the potential health effects in persons working in nuclear energy or the nuclear weapons program. The distributions of long-term retained inhaled plutonium-nitrate [239Pu (NO3)4] deposited in the lungs of an accidentally exposed nuclear worker (Human Case 0269) and in the lungs of experimentally exposed beagle dogs with varying initial lung depositions were determined via autoradiographs of selected histological lung, lymph node, trachea, and nasal turbinate tissue sections. These studies showed that both the human and dogs had a non-uniform distribution of plutonium throughout the lung tissue. Fibrotic scar tissue effectively encapsulated a portion of the plutonium and prevented its clearance from the body or translocation to other tissues and diminished dose to organ parenchyma. Alpha radiation activity from deposited plutonium in Human Case 0269 was observed primarily along the sub-pleural regions while no alpha activity was seen in the tracheobronchial lymph nodes of this individual. However, relatively high activity levels in the tracheobronchial lymph nodes of the beagles indicated the lymphatic system was effective in clearing deposited plutonium from the lung tissues. In both the human case and beagle dogs, the appearance of retained plutonium within the respiratory tract was inconsistent with current biokinetic models of clearance for soluble forms of plutonium. Bound plutonium can have a marked effect on the dose to the lungs and subsequent radiation exposure has the potential increase in cancer risk.

  4. Fluorescence diagnosis of upper respiratory tract infections

    Science.gov (United States)

    Blanco, Kate C.; Inada, Natalia M.; Kurachi, Cristina; Bagnato, Vanderlei S.

    2015-06-01

    The pharyngitis and laryngitis are respiratory tract infections highly common. Pharyngitis can be accompanied by fever, especially if caused by a systemic infection. Laryngitis is an inflammation of your voice box (larynx) from irritation or infection. The conventional treatment is the antibiotics administration, which may be responsible by an increase of identification of bacterial strains resistant to drug. This fact associated to high incidence of these infections become important to develop new technologies for diagnosis. This study aims to evaluate the use of widefield fluorescence imaging for the characterization of oropharynx infections, in order to diagnose the bacteria colonization. The imaging system for wide field fluorescence visualization is Evince® (MMOptics, São Carlos, SP, Brazil) coupled to an Apple iPhone® cell phone device. The system consists of Light Emitting Diodes (LEDs) operating in the violet blue region centered at green-red spectrum 450 nm and optical filters that allow viewing of fluorescence. A tongue depressor was adapted to Evince® for mouth opening. The same images were captured with white light and fluorescence with an optical system. The red fluorescence may be a bacterial marker for physiological monitoring of oropharynx infection processes. The bacterial biofilm on tissue were assigned to the presence of protoporphyrin IX. This work indicates that the autofluorescence of the tissue may be used as a non-invasive technique to aid in the oropharynx infection diagnostic.

  5. [Risk Factors for Post-operative Respiratory Failure and Respiratory Tract Infections Following Cardiovascular Surgery].

    Science.gov (United States)

    Tabuchi, Yui; Morimoto, Yosuke; Yano, Yudai; Tawara, Yuichi; Sato, Shuntaro; Tanigawa, Kazuyoshi; Eishi, Kiyoyuki; Kozu, Ryo

    2017-12-01

    Respiratory failure and respiratory tract infections are frequently observed as post-operative pulmonary complications, and significantly contribute to morbidity and mortality. However, the risk factors of post-operative respiratory failure and respiratory tract infections are controversial, and how these factors affect on incidence of complications is still unclear. To identify risk factors of post-operative respiratory failure and respiratory tract infections, and evaluate its impact on incidences after cardiovascular surgery. From June 2013 to May 2015, adult patients undergoing cardiovascular surgery in the department of cardiovascular surgery and post-operative rehabilitation of Nagasaki University Hospital (Nagasaki, Japan) were retrospectively investigated. Fifty-two of 416 patients(12.5%)suffered from post-operative respiratory failure and respiratory tract infections. Identified risk stratification indicates the relevant operative factors were more important than pre-operative factors. The operative time (OR 1.696, 95% CI 1.302~2.211), post-operative water balance( OR 1.025, 95% CI 1.004~1.046)and emergency operation( OR 3.607, 95% CI 1.492~8.716)were significant independent risk factors in the development of post-operative respiratory failure and respiratory tract infections. These results indicated that the operative factors are more important as onset of post-operative respiratory failure and respiratory tract infections after cardiovascular surgery.

  6. Antitussive effect of a fixed combination of Justicia adhatoda, Echinacea purpurea and Eleutherococcus senticosus extracts in patients with acute upper respiratory tract infection: A comparative, randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Barth, Anders; Hovhannisyan, Areg; Jamalyan, Kristina; Narimanyan, Mikael

    2015-12-01

    Kan Jang® oral solution (KJ) is a fixed combination of aqueous ethanolic extracts of Justicia adhatoda L. leaf, Echinacea purpurea (L.) Moench root, and Eleutherococcus senticosus (Rupr. & Maxim.) Harms root. It is approved in Scandinavia as an herbal medicinal product for respiratory tract infection treatment. The present clinical trial aimed to compare the antitussive effect of KJ with placebo (PL) and bromhexine (BH) among patients of 18-65 years old with non-complicated upper respiratory infections (URI; i.e., common cold). We performed a parallel-group, randomized, double-blinded, placebo-controlled trial in in 177 patients with acute URI over a 5 day period. We investigated the antitussive effects of a KJ (30 ml/day; 762 mg genuine extracts with standardized contents of 0.2 mg/ml vasicine, 0.8 mg/ml chicoric acid, and 0.03 mg/ml eleutherosides B and E), bromhexine hydrochloride (24 mg/30 ml/day) and PL on cough and blood markers. The primary outcome was cough relief, which was assessed as the change of cough frequency from baseline (cough index). Secondary outcomes were safety with regards to reported adverse events (AEs) and hematological data. Both KJ and BH relieved cough more effectively than placebo. On the third and fourth days of treatment, we observed faster improvement in the group receiving KJ compared to in the groups receiving BH (100%) or PL (100%), indicating a slightly shorter recovery time in the KJ group. KJ showed a good tolerability and safety profile. KJ exerted significant antitussive effects in URI. The present data further support the therapeutic use of KJ in upper respiratory tract infections. Copyright © 2015 The Authors. Published by Elsevier GmbH.. All rights reserved.

  7. Pediatric recurrent respiratory tract infections: when and how to ...

    African Journals Online (AJOL)

    Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases). Mohammed El-Azami-El-Idrissi, Mounia Lakhdar-Idrissi, Sanae Chaouki, Samir Atmani, Abdelhak Bouharrou, Moustapha Hida ...

  8. Enabling factors for antibiotic prescribing for upper respiratory tract infections

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Radzeviciene Jurgute, Ruta; Bjerrum, Lars

    2013-01-01

    for political leadership to encourage clinically grounded antibiotic use; over-the-counter sale of antibiotics; designation of antibiotics as reimbursable medications; supervision by external oversight institutions; lack of guidelines for the treatment of upper respiratory tract infections; and pharmaceutical...

  9. Vitamin D, innate immunity and upper respiratory tract infection.

    Science.gov (United States)

    Bartley, J

    2010-05-01

    At the turn of the twentieth century, ultraviolet light was successfully used to treat tuberculosis of the skin. Upper respiratory tract infections had been inversely associated with sun exposure. During the last decade, basic scientific research demonstrated that vitamin D has an important anti-infective role. Review of the relevant literature on the influence of vitamin D on innate immunity and respiratory tract infection. Vitamin D is involved in the production of defensins and cathelicidin - antimicrobial peptides that provide a natural defence against potential microbiological pathogens. Vitamin D supplementation increases cathelicidin production. Low vitamin D levels are associated with an increased incidence of upper respiratory tract infections. Vitamin D appears to play an important role in the regulation of innate immunity in the upper respiratory tract. Optimal vitamin D levels and appropriate dosing schedules have yet to be determined.

  10. Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS).

    Science.gov (United States)

    Bonizzoli, Manuela; Arvia, Rosaria; di Valvasone, Simona; Liotta, Francesco; Zakrzewska, Krystyna; Azzi, Alberta; Peris, Adriano

    2016-08-01

    Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). ARDS and pneumonia are closely related to critically ill patients; however, the etiologic agent is not always identified. The presence of human herpes simplex virus 1, human cytomegalovirus and Epstein-Barr virus in respiratory samples of critically ill patients is increasingly reported even without canonical immunosuppression. The main aim of this study was to better understand the significance of herpesviruses finding in lower respiratory tract of ARDS patients hospitalized in ICU. The presence of this group of herpesviruses, in addition to the research of influenza viruses and other common respiratory viruses, was investigated in respiratory samples from 54 patients hospitalized in ICU, without a known microbiological causative agent. Moreover, the immunophenotype of each patient was analyzed. Herpesviruses DNA presence in the lower respiratory tract seemed not attributable to an impaired immunophenotype, whereas a significant correlation was observed between herpesviruses positivity and influenza virus infection. A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. In conclusion, these results indicate that herpesviruses lower respiratory tract infection, which occurs more frequently following influenza virus infection, can be a negative prognostic marker. An independent risk factor for ICU patients with ARDS is an impaired immunophenotype.

  11. Parental knowledge, attitudes and practices regarding antibiotic use for acute upper respiratory tract infections in children: a cross-sectional study in Palestine.

    Science.gov (United States)

    Zyoud, Sa'ed H; Abu Taha, Adham; Araj, Khulood F; Abahri, Islam A; Sawalha, Ansam F; Sweileh, Waleed M; Awang, Rahmat; Al-Jabi, Samah W

    2015-11-11

    In primary health care centres, upper respiratory tract infections (URTIs) in children are commonly encountered by physicians. Viruses cause most URTIs, but parents' attitudes often represent an important reason for antibiotic abuse, which leads to the development and spread of antimicrobial resistance. The goal of this study was to examine parents' knowledge, attitudes, and practices (KAP) about antibiotic use for children with URTIs in Palestine. A cross-sectional study was performed in primary health care centres in Nablus city from 1 June to 31 October 2012. A questionnaire was developed and administered to determine parents' KAP regarding antibiotic use for their children with URTIs. Three hundred and eighty-five parents completed the questionnaire. A total of 79.7% of the parents were attentive to the truth that antibiotic misuse is responsible for bacterial resistance. Only 18.9% of parents thought that antibiotics did not have any harmful side effects. Fifty nine per cent of parents did not agree that URTIs are mostly viral in origin and are self-limited. Almost 73% of parents choose antibiotics as a treatment for URTIs, while earache (68%) and fever (64%) were the most common reasons for which parents expected antibiotics. However, more than 38% of the parents never asked the paediatrician to prescribe antibiotics, and only 6% congratulated their paediatricians for not prescribing antibiotics. Although there is a trusted relationship between parents and paediatricians, Palestinian parents have insufficient knowledge related to antibiotic use for URTIs in children, which results in inappropriate attitudes and practices. Educational interventions for both parents and physicians will reduce unnecessary antibiotic use and resistance.

  12. Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore.

    Science.gov (United States)

    Lee, Magdalene Hui Min; Pan, Darius Shaw Teng; Huang, Joyce Huixin; Chen, Mark I-Cheng; Chong, Joash Wen Chen; Goh, Ee Hui; Jiang, Lili; Leo, Yee Sin; Lee, Tau Hong; Wong, Chia Siong; Loh, Victor Weng Keong; Lim, Fong Seng; Poh, Adrian Zhongxian; Tham, Tat Yean; Wong, Wei Mon; Yu, Yue

    2017-05-01

    We investigated the efficacy of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) among adults in the private primary care setting in Singapore. Our randomized controlled trial enrolled patients aged 21 years and above presenting at general practitioner (GP) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the etiology of URTIs, the role of antibiotics in treating URTIs, and the consequences of inappropriate antibiotic use. Control arm patients were educated on influenza vaccinations. Both arms were compared regarding the proportions prescribed antibiotics and the patients' postconsultation views. A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). The demographics of patients in both arms were similar, and 19.1% were prescribed an antibiotic, but this varied from 0% to 70% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR], 1.20; 95% confidence interval [CI], 0.83-1.73) except in patients of Indian ethnicity (OR, 0.28; 95% CI, 0.09-0.93). Positive associations between the intervention and the view that antibiotics were not needed most of the time for URTIs ( P = 0.047) and on being worried about the side effects of antibiotics ( P = 0.018) were restricted to the Indian subgroup. GPs in limited liability partnerships or clinic chains prescribed less (OR, 0.36; 95% CI, 0.14 to 0.92), while certain inappropriate patient responses were associated with the receipt of antibiotics. Follow-up studies to investigate differences in responses to educational programs between ethnicities and to explore GP-targeted interventions are recommended. Copyright © 2017 Lee et al.

  13. The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: difference of the diagnostic performance between acute pneumonia and bronchitis.

    Science.gov (United States)

    Hoshina, Takayuki; Nanishi, Etsuro; Kanno, Shunsuke; Nishio, Hisanori; Kusuhara, Koichi; Hara, Toshiro

    2014-10-01

    The aim of this study is to investigate the utility of several biomarkers in differentiating bacterial community-acquired lower respiratory tract infection (CA-LRTI) from non-bacterial CA-LRTI in children and the difference of their diagnostic performance between pneumonia and bronchitis. A retrospective cohort study composed of 108 pediatric patients hospitalized for CA-LRTI was performed during 2010-2013. Based on the findings of chest X-ray and sputum samples, patients were divided into 4 categories, group of bacterial pneumonia or bronchitis, and non-bacterial (viral or etiology-unknown) pneumonia or bronchitis. Peripheral white blood cell and neutrophil counts, and serum C-reactive protein (CRP) and procalcitonin (PCT) levels were compared among the 4 groups. Finally, 54 patients were the subject of this study. In the patients with pneumonia, serum CRP and PCT levels were significantly elevated in the group of bacterial pneumonia (CRP: p = 0.02, PCT: p = 0.0008). The area under the receiver operating characteristic curve for PCT for distinguishing between bacterial and non-bacterial pneumonia was the largest, and sensitivity, specificity, positive predictive value and negative predictive value of PCT were best among 4 markers. On the other hand, in the patients with bronchitis, neutrophil count was significantly decreased in non-bacterial bronchitis whereas no significant differences of WBC count, CRP level or PCT level were seen. In conclusion, PCT was the most useful marker to differentiate bacterial pneumonia whereas neutrophil count contributed most to the discrimination of bacterial bronchitis. The diagnostic performance of biomarkers may be different between pneumonia and bronchitis. Copyright © 2014. Published by Elsevier Ltd.

  14. Frequent respiratory tract infections in children. The role of environmental and genetic factors.

    NARCIS (Netherlands)

    Ruskamp, J.M.

    2009-01-01

    Respiratory tract infections (RTI), presenting as common cold, pharyngitis, tonsillitis, acute otitis media, bronchitis or pneumonia are a major health problem in children. In this thesis common environmental and host factors, as well as plausible genetic factors were evaluated in a large birth

  15. Burden of Recurrent Respiratory Tract Infections in Children: A Prospective Cohort Study.

    Science.gov (United States)

    Toivonen, Laura; Karppinen, Sinikka; Schuez-Havupalo, Linnea; Teros-Jaakkola, Tamara; Vuononvirta, Juho; Mertsola, Jussi; He, Qiushui; Waris, Matti; Peltola, Ville

    2016-12-01

    The burden of recurrent respiratory infections is unclear. We identified young children with recurrent respiratory infections in order to characterize the clinical manifestations, risk factors and short-term consequences. In this prospective cohort study, 1089 children were followed from birth to 2 years of age for respiratory infections by a daily symptom diary. Nasal swabs taken during respiratory infections were analyzed for viruses from 714 children. Nasopharyngeal swabs collected at 2 months of age were cultured for bacteria. The 10% of children with the highest number of annual respiratory illness days were defined to have recurrent respiratory tract infections. The 90th percentile in the number of annual respiratory illness days was 98. Children above this limit (n = 109) had a median of 9.6 acute respiratory infections per year. Rhinovirus was detected in 58% of their infections. Of the children with recurrent infections, 60% were diagnosed with at least 3 episodes of acute otitis media, 73% received at least 3 antibiotic treatments and 21% were hospitalized for an acute respiratory infection. Tympanostomy was performed for 35% and adenoidectomy for 13% of the children. Asthma was diagnosed in 12% by 24 months of age. Older siblings increased the risk of recurrent respiratory infections. Early nasopharyngeal colonization with Streptococcus pneumoniae was common in children who later developed recurrent infections. Children with recurrent respiratory infections frequently use health care services and antibiotics, undergo surgical procedures and are at risk for asthma in early life. Having older siblings increases the risk of recurrent infections.

  16. Vaccinations against respiratory tract infections at Hajj.

    Science.gov (United States)

    Alqahtani, A S; Rashid, H; Heywood, A E

    2015-02-01

    The transmission of respiratory tract infections (RTIs) is very high among the Hajj congregation in Mecca, Saudi Arabia. Despite recommendations for vaccinations, pilgrims remain at increased risk of RTIs. In this paper we systematically reviewed available studies assessing the uptake and effectiveness of vaccinations against RTIs among Hajj pilgrims and enumerated important demographic factors, if described, associated with vaccine uptake. Of the 42 included studies, 29 reported on the uptake and effectiveness of influenza vaccine among pilgrims, eight studies reported the uptake of other vaccines, notably pneumococcal, diphtheria and bacillus Calmette-Guérin vaccines, and the remaining five studies described both influenza and non-influenza vaccines. The uptake of seasonal influenza vaccine ranged from 0.7% to 100% across the study populations, with coverage highest in the elderly and those with pre-existing co-morbidities. The effectiveness of influenza vaccine was variable across studies but was significantly effective against laboratory-confirmed influenza (risk ratio 0.56; 95% CI 0.41-0.75; p Hajj pilgrims found the presence of pre-Hajj immunity to be significantly protective against disease. Despite favourable evidence of effectiveness, our review shows variable uptake of vaccines across a number of studies with few data available on the uptake of non-influenza vaccines. Mixed-method studies are needed to gauge knowledge, attitudes and practices of Hajj pilgrims regarding vaccination, and randomized controlled trials are required to confirm the efficacy of vaccines and improve uptake in this vulnerable travelling population. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Incidence of respiratory tract infections and antibiotic use in primary health care

    Directory of Open Access Journals (Sweden)

    Małgorzata Pietrzykowska

    2016-09-01

    Full Text Available Background . Respiratory tract infections are of viral etiology in around 70% of cases. The most popular treatment method is the empirical approach based on a medical interview and a physical examination, using the doctor’s personal experience. Contrary to ecommendations, antibiotic overuse is prevalent. The excessive use of antibiotics is a major factor contributing to the growing antibiotic resistance of bacteria, leading to epidemiological risk. Objectives. This study aimed to establish the incidence of respiratory tract infection and analyze the structure of antibiotic prescription in primary health care (PHC . Material and methods. Retrospective medical records of 500 adult patients treated for respiratory tract infection in the first quarter of 2014, in a PHC facility in Pomeranian province were examined. The age median was 51 (range: 18 to 100. The study was focused on the incidence of disease diagnosis as classified by IC D-10 and on the treatment method used with respect to various antibiotic groups. Results . Acute upper respiratory tract infection with multiple or unspecified sites was diagnosed in 286 (57.2% patients. Acute bronchitis was the second most common diagnosis (10.2%. Two patients were diagnosed with influenza (0.4%. As many as 67.2% of all patients were treated with antibiotics. Semisynthetic penicillin – such as amoxicillin or amoxicillin with clavulanic acid – (46.43% in total and macrolides (36.31% were the most frequently prescribed. Conclusions . 1. Acute upper respiratory tract infection with multiple or unspecified sites was diagnosed most frequently. 2. Despite increasing awareness of the risks associated with the excessive use of antibiotics, antimicrobials were often prescribed. Semisynthetic penicillins and macrolides were used most often. 3. Implementation of uniform national standards for the diagnosis and treatment of respiratory tract infections is essential. 4. Systematic training in effective and

  18. Relationship between hyposalivation and acute respiratory infection in dental outpatients.

    Science.gov (United States)

    Iwabuchi, Hiroshi; Fujibayashi, Takashi; Yamane, Gen-yuki; Imai, Hirohisa; Nakao, Hiroyuki

    2012-01-01

    Hyposalivation may affect respiratory disease because the mouth serves as the entrance to the respiratory apparatus, as well as to the digestive tract. Patients with acute respiratory infection generally have a favorable prognosis and a short natural course. However, in cases in which the host has lowered resistance, such as in elderly patients, the infection may develop into pneumonia. A prospective study was performed to examine the relationship between hyposalivation, which is common in elderly patients, and acute respiratory infection, which tends to become severe in elderly patients. The subjects were 323 male and female patients ≥40 years old who lived in Utsunomiya City and surrounding areas and regularly visited the Department of Dentistry and Oral Surgery, Tochigi National Hospital. A 6-month follow-up survey was performed to examine development of acute respiratory infection. Age, sex, and known risk factors were also investigated. Hyposalivation was defined as a saliva production (saliva secretion rate) of ≤0.6 ml/min. Multivariate analysis adjusted for age and sex was performed to examine potential risk factors associated with the development of acute respiratory infection. Data were analyzed for 278 subjects who completed the follow-up survey. The incidence of acute respiratory infection was 60.4%, while hyposalivation was present in 96 subjects (35.5%). Multivariate analysis showed that the incidence of acute respiratory infection was higher in subjects with hyposalivation than in those without hyposalivation (adjusted odds ratio 1.761, p = 0.048). The results of this study suggest that hyposalivation may be a risk factor for acute respiratory infection. This also suggests that improvement of hyposalivation might prevent acute respiratory infection. Copyright © 2011 S. Karger AG, Basel.

  19. [Manifestations of sarcoidosis in the upper respiratory tract].

    Science.gov (United States)

    Aguilar-García, J; de la Torre-Lima, J; Prada-Pardal, J L

    2006-02-01

    Sarcoidosis is a multisystemic disease having unknown cause, characterized by non-caseating granulomatous inflammation of the organs involved. It predominantly affects the respiratory tract, with preference for the lower tract and less frequently affects the upper respiratory tract (nose, paranasal sinuses and larynx). It manifests non-specifically, with symptoms secondary to the obstruction of the airway. It can be confused with other more common disorders in our setting, such as tuberculosis. We conduct a review, fundamentally focusing on the diagnosis and treatment due to their difficulty.

  20. Antiviral effects of bovine interferons on bovine respiratory tract viruses.

    OpenAIRE

    Fulton, R W; Downing, M M; Cummins, J M

    1984-01-01

    The antiviral effects of bovine interferons on the replication of bovine respiratory tract viruses were studied. Bovine turbinate monolayer cultures were treated with bovine interferons and challenged with several bovine herpesvirus 1 strains, bovine viral diarrhea virus, parainfluenza type 3 virus, goat respiratory syncytial virus, bovine respiratory syncytial virus, bovine adenovirus type 7, or vesicular stomatitis virus. Treatment with bovine interferons reduced viral yield for each of the...

  1. Association between HIV and proven viral lower respiratory tract ...

    African Journals Online (AJOL)

    Background. Acute viral respiratory infections are common within the paediatric population. Nucleic acid amplification tests can identify a wide range of respiratory viruses. Virally infected patients can now be diagnosed early and more accurately in the acute phase of illness. Objectives. To examine the association between ...

  2. Coronavirus Infections in the Central Nervous System and Respiratory Tract Show Distinct Features in Hospitalized Children.

    Science.gov (United States)

    Li, Yuanyuan; Li, Haipeng; Fan, Ruyan; Wen, Bo; Zhang, Jian; Cao, Xiaoying; Wang, Chengwu; Song, Zhanyi; Li, Shuochi; Li, Xiaojie; Lv, Xinjun; Qu, Xiaowang; Huang, Renbin; Liu, Wenpei

    2016-01-01

    Coronavirus (CoV) infections induce respiratory tract illnesses and central nervous system (CNS) diseases. We aimed to explore the cytokine expression profiles in hospitalized children with CoV-CNS and CoV-respiratory tract infections. A total of 183 and 236 hospitalized children with acute encephalitis-like syndrome and respiratory tract infection, respectively, were screened for anti-CoV IgM antibodies. The expression profiles of multiple cytokines were determined in CoV-positive patients. Anti-CoV IgM antibodies were detected in 22/183 (12.02%) and 26/236 (11.02%) patients with acute encephalitis-like syndrome and respiratory tract infection, respectively. Cytokine analysis revealed that the level of serum granulocyte colony-stimulating factor (G-CSF) was significantly higher in both CoV-CNS and CoV-respiratory tract infection compared with healthy controls. Additionally, the serum level of granulocyte macrophage colony-stimulating factor (GM-CSF) was significantly higher in CoV-CNS infection than in CoV-respiratory tract infection. In patients with CoV-CNS infection, the levels of IL-6, IL-8, MCP-1, and GM-CSF were significantly higher in their cerebrospinal fluid samples than in matched serum samples. To the best of our knowledge, this is the first report showing a high incidence of CoV infection in hospitalized children, especially with CNS illness. The characteristic cytokine expression profiles in CoV infection indicate the importance of host immune response in disease progression. © 2017 S. Karger AG, Basel.

  3. The burden of hospitalized lower respiratory tract infection due to respiratory syncytial virus in rural Thailand.

    Directory of Open Access Journals (Sweden)

    Alicia M Fry

    Full Text Available BACKGROUND: We describe the epidemiology of hospitalized RSV infections for all age groups from population-based surveillance in two rural provinces in Thailand. METHODS: From September 1, 2003 through December 31, 2007, we enrolled hospitalized patients with acute lower respiratory tract illness, who had a chest radiograph ordered by the physician, from all hospitals in SaKaeo and Nakhom Phanom Provinces. We tested nasopharyngeal specimens for RSV with reverse transcriptase polymerase chain reaction (RT-PCR assays and paired-sera from a subset of patients with IgG enzyme immunoassay. Rates were adjusted for enrollment. RESULTS: Among 11,097 enrolled patients, 987 (8.9% had RSV infection. Rates of hospitalized RSV infection overall (and radiographically-confirmed pneumonia were highest among children aged<1 year: 1,067/100,000 (534/100,000 radiographically-confirmed pneumonia and 1-4 year: 403/100,000 (222/100,000, but low among enrolled adults aged≥65 years: 42/100,000. Age<1 year (adjusted odds ratio [aOR]=13.2, 95% confidence interval [CI] 7.7, 22.5 and 1-4 year (aOR=8.3, 95% CI 5.0, 13.9 were independent predictors of hospitalized RSV infection. CONCLUSIONS: The incidence of hospitalized RSV lower respiratory tract illness among children<5 years was high in rural Thailand. Efforts to prevent RSV infection could substantially reduce the pneumonia burden in children aged<5 years.

  4. Acute Interstitial Pneumonia (Hamman-Rich Syndrome as a Cause of Idiopathic Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Jackrapong Bruminhent

    2011-01-01

    Full Text Available Hamman-Rich syndrome, also known as acute interstitial pneumonia, is a rare and fulminant form of idiopathic interstitial lung disease. It should be considered as a cause of idiopathic acute respiratory distress syndrome. Confirmatory diagnosis requires demonstration of diffuse alveolar damage on lung histopathology. The main treatment is supportive care. It is not clear if glucocorticoid therapy is effective in acute interstitial pneumonia. We report the case of a 77-year-old woman without pre-existing lung disease who initially presented with mild upper respiratory tract infection and then progressed to rapid onset of hypoxic respiratory failure similar to acute respiratory distress syndrome with unknown etiology. Despite glucocorticoid therapy, she did not achieve remission and expired after 35 days of hospitalization. The diagnosis of acute interstitial pneumonia was supported by the histopathologic findings on her lung biopsy.

  5. Emerging novel and antimicrobial-resistant respiratory tract infections: new drug development and therapeutic options.

    Science.gov (United States)

    Zumla, Alimuddin; Memish, Ziad A; Maeurer, Markus; Bates, Matthew; Mwaba, Peter; Al-Tawfiq, Jaffar A; Denning, David W; Hayden, Frederick G; Hui, David S

    2014-11-01

    The emergence and spread of antimicrobial-resistant bacterial, viral, and fungal pathogens for which diminishing treatment options are available is of major global concern. New viral respiratory tract infections with epidemic potential, such as severe acute respiratory syndrome, swine-origin influenza A H1N1, and Middle East respiratory syndrome coronavirus infection, require development of new antiviral agents. The substantial rise in the global numbers of patients with respiratory tract infections caused by pan-antibiotic-resistant Gram-positive and Gram-negative bacteria, multidrug-resistant Mycobacterium tuberculosis, and multiazole-resistant fungi has focused attention on investments into development of new drugs and treatment regimens. Successful treatment outcomes for patients with respiratory tract infections across all health-care settings will necessitate rapid, precise diagnosis and more effective and pathogen-specific therapies. This Series paper describes the development and use of new antimicrobial agents and immune-based and host-directed therapies for a range of conventional and emerging viral, bacterial, and fungal causes of respiratory tract infections. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Early Fluid Overload Prolongs Mechanical Ventilation in Children With Viral-Lower Respiratory Tract Disease.

    Science.gov (United States)

    Ingelse, Sarah A; Wiegers, Hanke M G; Calis, Job C; van Woensel, Job B; Bem, Reinout A

    2017-03-01

    Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure. In this study, we aimed to investigate the relation of early fluid overload with adverse outcomes in mechanically ventilated children with viral-lower respiratory tract disease in a retrospective dataset. Retrospective cohort study. Single, tertiary referral PICU. One hundred thirty-five children (mechanical ventilation admitted to the PICU of the Academic Medical Center, Amsterdam between 2008 and 2014. None. The cumulative fluid balance on day 3 of mechanical ventilation was compared against duration of mechanical ventilation (primary outcome) and daily mean oxygen saturation index (secondary outcome), using uni- and multivariable linear regression. In 132 children, the mean cumulative fluid balance on day 3 was + 97.9 (49.2) mL/kg. Higher cumulative fluid balance on day 3 was associated with a longer duration of mechanical ventilation in multivariable linear regression (β = 0.166; p = 0.048). No association was found between the fluid status and oxygen saturation index during the period of mechanical ventilation. Early fluid overload is an independent predictor of prolonged mechanical ventilation in young children with viral-lower respiratory tract disease. This study suggests that avoiding early fluid overload is a potential target to reduce duration of mechanical ventilation in these children. Prospective testing in a clinical trial is warranted to support this hypothesis.

  7. RESPIRATORY SYNCYTIAL VIRUS INFECTION AMONG YOUNG CHILDREN WITH ACUTE RESPIRATORY INFECTION

    Directory of Open Access Journals (Sweden)

    M. Milani

    2003-08-01

    Full Text Available Respiratory syncytial virus (RSV is the major cause of lower respiratory tract infections in infants,and also an important factor for hospitalization during the winter months. To determine the prevalence and importance of RSV as a cause of acute lower respiratory tract infection, we carried out a prospective study during 5 months period from November to March 1998 in 6 pediatric hospitals. A nasopharyngeal aspirate was obtained for detection of RSV in all cases. Sociodemographic data, clinical signs, diagnosis and hospital admissions were documented. During this study period, 365 young infants (51.5% male, 48.5% female with respiratory tract infection were visited in 6 hospitals. The median age of patients was 24 months (range: 1 month to 5 years.RSV infection was found in 70 out of 365 patients (19.18%.Among the 70 children with RSV infection, 29 patients (41.42% were under 12 months of age.The main clinical manifestations of RSV infection were cough (88.57% and coryza (78.57%. There were no significant differences between patients who were tested positive for RSV and those who were tested negative with regard to demographic variables and clinical diagnoses. This study indicates that RSV is an important cause of respiratory tract infection in infants and young children .Distinguishing RSV from other respiratory infection is difficult because of the similarity in clinical presentation among children.

  8. Lower respiratory tract viral infections: Diagnostic role of exfoliative cytology.

    Science.gov (United States)

    Martínez-Girón, Rafael; Pantanowitz, Liron

    2017-07-01

    Viral lower respiratory tract infections (VLRTI) remain one of the most common causes of morbidity and mortality worldwide. For many years, the diagnosis of VLRTI was based on laboratory techniques such as viral isolation in cell culture, antigen detection by direct fluorescent antibody staining, and rapid enzyme immunoassay. Radiological imaging and morphology also play an important role in diagnosing these infections. Exfoliative cytology provides a simple, rapid, inexpensive, and valuable means to diagnose and manage VLRTI. Here we review viral-associated cytomorphological changes seen in exfoliated cells of the lower respiratory tract. Diagn. Cytopathol. 2017;45:614-620. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Mucosal immunity of the respiratory tract in chickens

    OpenAIRE

    Kurtyak B.M.; Maslyanko R.P.; Levkivsky D.M.; Pundyak T.O.; Sobko G.V.

    2014-01-01

    This review article presents fundamental mechanisms of the local mucosal immunity m selected regions of the respiratory tract in healthy birds and in some pathological conditions. The respiratory system whose mucosa come into direct contact with microorganisms contaminating inhaled an, has some associated structures, such as Harderian gland (HG), conjunctive-associated lymphoid tissue (CALT) and paranasal glands (PG), whose participation in local mechanisms of the mucosal immunity has been co...

  10. Lower respiratory tract infection caused by respiratory syncytial virus : current management and new therapeutics

    NARCIS (Netherlands)

    Mazur, Natalie; Martinon-Torres, Federico; Baraldi, Eugenio; Fauroux, Brigitte; Greenough, Anne; Heikkinen, Terho; Manzoni, Paolo; Mejias, Asuncion; Nair, Harish; Papadopoulos, Nikolaos G.; Polack, Fernando P.; Ramilo, Octavio; Sharland, Mike; Stein, Renato; Madhi, Shabir A.; Bont, Louis

    2015-01-01

    Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and

  11. Seasonality of long term wheezing following respiratory syncytial virus lower respiratory tract infection

    NARCIS (Netherlands)

    Bont, L; Steijn, M; van Aalderen, WMC; Brus, F; Draaisma, JMT; Van Diemen-Steenvoorde, RAAM; Pekelharing-Berghuis, M; Kimpen, JLL

    Background: It is well known that respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) is associated with subsequent wheezing episodes, but the precise natural course of wheezing following RSV LRTI is not known. This study aimed to determine the continuous development of

  12. Microbial flora variations in the respiratory tract of mice

    Directory of Open Access Journals (Sweden)

    Cangemi de Gutierrez Rosa

    1999-01-01

    Full Text Available A stable microbial system in the respiratory tract acts as an important defense mechanism against pathogenic microorganisms. Perturbations in this system may allow pathogens to establish. In an ecological environment such as the respiratory tract, there are many diverse factors that play a role in the establishment of the indigenous flora. In the present work we studied the normal microbial flora of different areas of the respiratory tract of mice and their evolution from the time the mice were born. Our interest was to know which were the dominant groups of microorganisms in each area, which were the first capable of colonizing and which dominated over time to be used as probiotic microorganisms. Our results show that Gram negative facultatively anaerobic bacilli and strict anaerobic microorganisms were the last ones to appear in the bronchia, while aerobic and Gram positive cocci were present in all the areas of the respiratory tract. The number of facultative aerobes and strict anaerobes were similar in the nasal passage, pharynx instilled and trachea, but lower in bronchia. The dominant species were Streptococcus viridans and Staphylococcus saprophyticcus, followed by S. epidermidis, Lactobacilli and S. cohnii I which were present on every studied days but at different proportions. This paper is the first part of a research topic investigating the protective effect of the indigenous flora against pathogens using the mice as an experimental model.

  13. Tetratrichomonads from the oral cavity and respiratory tract of humans

    Czech Academy of Sciences Publication Activity Database

    Kutišová, K.; Kulda, J.; Čepička, I.; Flegr, J.; Koudela, Břetislav; Teras, J.; Tachezy, J.

    2005-01-01

    Roč. 131, č. 1 (2005), s. 1-11 ISSN 0031-1820 Grant - others:Grantová agentura Karlovy univerzity v Praze(CZ) 264/1999 Institutional research plan: CEZ:AV0Z60220518 Keywords : Tetratrichomonas spp. * human respiratory tract * oral cavity Subject RIV: EE - Microbiology, Virology Impact factor: 1.703, year: 2005

  14. Aetiology of Lower Respiratory Tract Infection in Benin City, Nigeria ...

    African Journals Online (AJOL)

    Patients with respiratory tract infections (RTI), Pneumonia inclusive account for a large proportion of a primary care physicians (PCP) work load and a frequent cause for prescription of antibacterial agents. The study was aimed at analyzing the various isolated organisms obtained from sputum and to test their susceptibility ...

  15. Bacterial aetiology in lower respiratory tract infections : Relevance in outpatients

    NARCIS (Netherlands)

    Teepe, J.

    2017-01-01

    Lower respiratory tract infection (LRTI) is one of the leading reasons for consulting in primary care. Today, a general practitioner faces the challenge of distinguishing between patients with a mild self-limiting disease to whom antibiotics would do more harm than good and those who would benefit

  16. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

    NARCIS (Netherlands)

    Piters, Wouter A. A. de Steenhuijsen; Huijskens, Elisabeth G. W.; Wyllie, Anne L.; Biesbroek, Giske; van den Bergh, Menno R.; Veenhoven, Reinier H.; Wang, Xinhui; Trzcinski, Krzysztof; Bonten, Marc J.; Rossen, John W. A.; Sanders, Elisabeth A. M.; Bogaert, Debby

    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently

  17. Knowledge of Upper Respiratory Tract Infection In Elementary School Children.

    Science.gov (United States)

    McCann-Sanford, Thurma; And Others

    1982-01-01

    This study assessed elementary school students' knowledge of upper respiratory tract infection and correlated it with parental socioeconomic status, ethnic background, and school absences. Schools chosen for the study represented different socioeconomic and ethnic populations. Students had a general knowledge of the etiology, symptoms, treatment,…

  18. Prescription status of Respiratory tract infection – a survey report

    African Journals Online (AJOL)

    strengthened. Keywords: Respiratory tract infection, prescription, self-medication, patient counseling, role of pharmacist. [Afr J Health Sci. ... nutrition, lack of rest, alcohol use, smoking, inhaling saliva from infected persons, shaking .... care system and improve the quality of life, through which he can realize the dream of WHO ...

  19. Prescription status of Respiratory tract infection – a survey report ...

    African Journals Online (AJOL)

    ... of the key person for prevention of communicable and non-communicable diseases and also improving patient compliance. These types of problems can be prevented by patient education should be strengthened. Keywords: Respiratory tract infection, prescription, self-medication, patient counseling, role of pharmacist.

  20. Management of upper respiratory tract infections in children

    African Journals Online (AJOL)

    Peat JK, Keena V, Harakeh Z, Marks G. Parental smoking and respiratory tract infections in children. Paediatr Respir Rev 2001;2(3):207–13. 39. Sharma S. Nicotine addiction. In: EMedicine; 2006. More info needed. 40. Fiore AE, Shay DK, Haber P, et al. Prevention and control of influenza: Recommendations of the advisory ...

  1. Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil

    2013-01-01

    increase for hospitalization with pneumonia associated with diabetes. The increase of risk for tuberculosis is of similar magnitude in highly developed countries, and possibly higher in low-income countries. Poor glycemic control and long diabetes duration predict higher risk for both pneumonia...... and tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk......This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...

  2. Vitamin D and respiratory tract infections in childhood.

    Science.gov (United States)

    Esposito, Susanna; Lelii, Mara

    2015-10-28

    Respiratory tract infections (RTIs) remain among of the most important causes of morbidity and mortality among children. Several studies have associated vitamin D deficiency with an increased risk of RTIs, and vitamin D supplementation has been proposed as a possible preventive measure against RTIs in children. The main aim of this review is to summarize the current evidence from the literature about the link between vitamin D and RTIs in children. Several recent studies have shown that vitamin D has different immunomodulatory properties associated with the risk of RTIs in childhood. In this regard, it is very important to understand the definition of deficiency and insufficiency of vitamin D and when and how to treat this condition. Unfortunately, there is no consensus, although a level of at least 10 ng/mL 25-hydroxycholecalciferol (25[OH]D) is thought to be necessary to promote bone mineralization and calcium homeostasis, and a concentration between 20 ng/mL and 50 ng/mL is considered adequate to provide an immunomodulatory effect. Available data support a role for vitamin D deficiency in the risk of pediatric tuberculosis, recurrent acute otitis media, and severe bronchiolitis, whereas further studies are needed to confirm an association in children with recurrent pharyngotonsillitis, acute rhinosinusitis and community-acquired pneumonia. Maintenance of adequate vitamin D status may be an effective and inexpensive prophylactic method against some RTIs, but the supplementation regimen has not been clearly defined. Further clinical trials are needed to determine the 25(OH)D concentrations associated with an increased risk of RTIs and optimal vitamin D supplementation regimen according to the type of RTI while also taking into consideration vitamin D receptor polymorphisms.

  3. Limited Evidence on the Management of Respiratory Tract Infections in Down's Syndrome : A Systematic Review

    NARCIS (Netherlands)

    Manikam, Logan; Reed, Kate; Venekamp, Roderick P; Hayward, Andrew; Littlejohns, Peter; Schilder, Anne; Lakhanpaul, Monica

    2016-01-01

    AIMS: To systematically review the effectiveness of preventative and therapeutic interventions for respiratory tract infections (RTIs) in people with Down's syndrome. METHODS: Databases were searched for any published and ongoing studies of respiratory tract diseases in children and adults with

  4. Exposure to Cigarette Smoke Reduces Vitamin D3 in the Blood Stream and Respiratory Tract

    Science.gov (United States)

    ... blood stream and respiratory tract Share | Exposure to cigarette smoke reduces vitamin D3 in the blood stream and respiratory tract Published Online: April 2, 2014 Cigarette smoking and exposure to secondhand smoke have long ...

  5. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.

    NARCIS (Netherlands)

    Aardweg, M.T. van den; Boonacker, C.W.; Rovers, M.M.; Hoes, A.W.; Schilder, A.G.M.

    2011-01-01

    OBJECTIVE: To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. DESIGN: Open randomised controlled trial. SETTING: 11 general hospitals and two academic centres. PARTICIPANTS: 111 children aged 1-6 with recurrent upper respiratory tract

  6. Significance of Moraxella catarrhalis as a causative organism of lower respiratory tract infections

    Directory of Open Access Journals (Sweden)

    M.O. Ramadan

    2017-07-01

    Conclusion: This study shows that when microbiological and clinical criteria are met, M. catarrhalis when isolated should be considered as a pathogen causing lower respiratory tract infections. M. catarrhalis, lower respiratory tract infections.

  7. Assessment of the humoral immune system in adults with respiratory tract disease

    NARCIS (Netherlands)

    Kessel, D.A. van; Rijkers, G.T.; Zanen, P.

    2017-01-01

    Recurrent respiratory tract infections are a common problem, and can have various causes, including an underlying immunodeficiency. This thesis investigates the value of humoral immune status assessment in patients with respiratory tract infections, lung transplant candidates/recipients and the

  8. CFD heat transfer simulation of the human upper respiratory tract for oronasal breathing condition

    Directory of Open Access Journals (Sweden)

    Kambiz Farahmand

    2012-01-01

    Full Text Available Injuries due to inhalation of hot gas are commonly encountered when dealing with fire and combustible material, which is harmful and threatens human life. In the literature, various studies have been conducted to investigate heat and mass transfer characteristics in the human respiratory tract (HRT. This study focuses on assessing the injury taking place in the upper human respiratory tract and identifying acute tissue damage, based on level of exposure. A three-dimensional heat transfer simulation is performed using Computational Fluid Dynamics (CFD software to study the temperature profile through the upper HRT consisting of the nasal cavity, oral cavity, trachea, and the first two generations of bronchi. The model developed is for the simultaneous oronasal breathing during the inspiration phase with a high volumetric flow rate of 90 liters/minute and the inspired air temperature of 100 degrees Celsius. The geometric model depicting the upper HRT is generated based on the data available and literature cited. The results of the simulation give the temperature distribution along the center and the surface tissue of the respiratory tract. This temperature distribution will help to assess the level of damage induced in the upper respiratory tract and appropriate treatment for the damage. A comparison of nasal breathing, oral breathing, and oronasal breathing is performed. Temperature distribution can be utilized in the design of the respirator systems where inlet temperature is regulated favoring the human body conditions.

  9. The Antioxidant System in the Respiratory Tract The Intracellular Antioxidant Protection in the Respiratory Tract (Part 1

    Directory of Open Access Journals (Sweden)

    A.Ye. Abaturov

    2016-08-01

    Full Text Available The literature review presents modern data on the intracellular antioxidant protection in the respiratory tract. The induction of the enzyme synthesis of antioxidant system is described. The article details the characteristics of the intracellular forms of superoxide dismutases. The induction of the synthesis, catalytic loop and physiological function of superoxide dismutases are presented.

  10. Do children's upper respiratory tract infections benefit from probiotics?

    Science.gov (United States)

    Esposito, Susanna; Rigante, Donato; Principi, Nicola

    2014-04-10

    The microbiota of the gastrointestinal tract have profound influence at multiple levels, even on the development and maintenance of lung immunity and inflammation. Aim of this review is to evaluate the current knowledge about the specific impact on children's respiratory tract infections from probiotics, live microbes with the power to modify intestinal microbial populations and exert subsequent benefits for the host. The role of probiotics in gastrointestinal and allergic diseases has been largely assessed, but the number of studies performed so far in the field of respiratory tract infections is small, though some data show that probiotic administration might display clinical advantages. Probiotic strain identity and host genetic differences may account for differential modulation of immune responses by probiotics. Current laboratory and clinical data regarding the possibility of the role of probiotics on preventing the development of respiratory tract infections are contradictory, and are somewhat insufficient to recommend strongly their routine use. Further study of gastrointestinal-respiratory interactions is likely to yield important insights into the pathogenesis of different pulmonary diseases, and improve our knowledge in the prophylactic role of probiotics in children affected by recurrent upper respiratory tract infections. A better understanding of the effects of different probiotic strains and a deeper insight into their mechanisms of action are needed for the validation of specific strains carrying a potential to modify the frequency and severity of RTIs in infants and children. No data have been collected in pediatric patients with chronic underlying diseases, and yet there are no published data concerning treatment of RTIs with probiotics. The very few studies published so far do not indicate which micro-organism or administration regimen might exert beneficial effects as a prevention tool of RTIs both in healthy children and in those with recurrent

  11. NORMAL NASOPHARYNGEAL MICROFLORA AS A RESERVOIR OF MULTIRESISTANT STRAINS OF UPPER RESPIRATORY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    Minukhin V.V.

    2015-05-01

    Full Text Available Nasopharinheal carriage of bacteria may play a central role in the development and spread of respiratory infections. In addition, so-called "healthy" carriage is often transformed under the influence of various factors into an active infection.It is necessary to take into account not only the range of possible pathogens, but also trends in the development of antibiotic resistance of leading etiologic agents while choosing tactics of antimicrobial therapy. The investigation was designed to study the role of normal microflora of the nasopharynx as a reservoir of resistant strains of respiratory infections. Materials and Methods. Fifty three healthy individuals and 168 patients with acute upper respiratory tract infections who had been treated in CEHC "Kharkiv Municipal Clinical Hospital № 30" were examined. Microbiological study included isolation and identification of pathogens in accordance with the Order of the Ministry of Health Care № 535 from 22.04.1985., determination of the sensitivity of microorganisms to antibiotics by diffusion method according to the Order of the Ministry of Health Care of Ukraine № 167 from 05.04.2007. Results and discussion. Bacteriological study of nasal swabs of healthy people showed that the composition of the microflora of the nasopharynx contained potentially pathogenic microorganisms. Among the isolated microorganisms essential place was occupied by S. epidermidis and S. aureus, both in monoculture and association. Epidermal staphylococcus was isolated in 36 % and Staphylococcus aureus in 27% of cases. Pneumococcus and hemolytic streptococcus of group A were isolated in 23 and 14% of cases, respectively. One hundred and eighty strains of opportunistic microorganisms were isolated in the study of nasopharyngeal microflora of patients with acute upper respiratory tract infection. The leading role belonged to S. pyogenes (40.5% and S.epidermidis (33,3%. S. aureus (12,8% and S.pneumoniae (10,6% were next

  12. Do pollution and climate influence respiratory tract infections in children?

    Directory of Open Access Journals (Sweden)

    Saulo Duarte Passos

    2014-06-01

    Full Text Available To review if pollution and climate changes can influence respiratory tract infections in children. Data source: articles published on the subject in PubMed, SciELO, Bireme, EBSCO and UpTodate were reviewed. The following inclusion criteria were considered: scientific papers between 2002 and 2012, study design, the pediatric population, reference documents such as the CETESB and World Health Organization Summary of the data: We analyzed research that correlated respiratory viruses and climate and/or pollution changes. Respiratory syncytial virus has been the virus related most to changes in climate and humidity. Other "old and new" respiratory viruses such as Human Bocavirus, Metapneumovirus, Parechovirus and Parainfuenza would need to be investigated owing to their clinical importance. Although much has been studied with regard to the relationship between climate change and public health, specific studies about its influence on children's health remain scarce.

  13. Aerosol deposition in the human respiratory tract

    Science.gov (United States)

    Winchester, John W.; Jones, Donald L.; Mu-tian, Bi

    1984-04-01

    Rising sulfur dioxide emissions from increased coal combustion present risks, not only of acid rain, but also to health by inhalation of the SO 2 and acid to the lung. We are investigating human inhalation of ppm SO 2 concentrations mixed with aerosol of submicrometer aqueous salt droplets to determine the effects on lung function and body chemistry. Unlike some investigators, we emphasize ammonium sulfate and trace element aerosol composition which simulates ambient air; aerosol pH, relative humidity, and temperature control to reveal gas-particle reaction mechanisms; and dose estimates from length of exposure, SO 2 concentration, and a direct measurement of respiratory deposition of aerosol as a function of particle size by cascade impactor sampling and elemental analysis by PIXE. Exposures, at rest or during exercise, are in a walk-in chamber at body temperature and high humidity to simulate Florida's summer climate. Lung function measurement by spirometry is carried out immediately after exposure. The results are significant in relating air quality to athletic performance and to public health in the southeastern United States.

  14. Rhinovirus genome variation during chronic upper and lower respiratory tract infections.

    Directory of Open Access Journals (Sweden)

    Caroline Tapparel

    Full Text Available Routine screening of lung transplant recipients and hospital patients for respiratory virus infections allowed to identify human rhinovirus (HRV in the upper and lower respiratory tracts, including immunocompromised hosts chronically infected with the same strain over weeks or months. Phylogenetic analysis of 144 HRV-positive samples showed no apparent correlation between a given viral genotype or species and their ability to invade the lower respiratory tract or lead to protracted infection. By contrast, protracted infections were found almost exclusively in immunocompromised patients, thus suggesting that host factors rather than the virus genotype modulate disease outcome, in particular the immune response. Complete genome sequencing of five chronic cases to study rhinovirus genome adaptation showed that the calculated mutation frequency was in the range observed during acute human infections. Analysis of mutation hot spot regions between specimens collected at different times or in different body sites revealed that non-synonymous changes were mostly concentrated in the viral capsid genes VP1, VP2 and VP3, independent of the HRV type. In an immunosuppressed lung transplant recipient infected with the same HRV strain for more than two years, both classical and ultra-deep sequencing of samples collected at different time points in the upper and lower respiratory tracts showed that these virus populations were phylogenetically indistinguishable over the course of infection, except for the last month. Specific signatures were found in the last two lower respiratory tract populations, including changes in the 5'UTR polypyrimidine tract and the VP2 immunogenic site 2. These results highlight for the first time the ability of a given rhinovirus to evolve in the course of a natural infection in immunocompromised patients and complement data obtained from previous experimental inoculation studies in immunocompetent volunteers.

  15. Rhinovirus Genome Variation during Chronic Upper and Lower Respiratory Tract Infections

    Science.gov (United States)

    Tapparel, Caroline; Farinelli, Laurent; Van Belle, Sandra; Soccal, Paola M.; Aubert, John-David; Zdobnov, Evgeny; Kaiser, Laurent

    2011-01-01

    Routine screening of lung transplant recipients and hospital patients for respiratory virus infections allowed to identify human rhinovirus (HRV) in the upper and lower respiratory tracts, including immunocompromised hosts chronically infected with the same strain over weeks or months. Phylogenetic analysis of 144 HRV-positive samples showed no apparent correlation between a given viral genotype or species and their ability to invade the lower respiratory tract or lead to protracted infection. By contrast, protracted infections were found almost exclusively in immunocompromised patients, thus suggesting that host factors rather than the virus genotype modulate disease outcome, in particular the immune response. Complete genome sequencing of five chronic cases to study rhinovirus genome adaptation showed that the calculated mutation frequency was in the range observed during acute human infections. Analysis of mutation hot spot regions between specimens collected at different times or in different body sites revealed that non-synonymous changes were mostly concentrated in the viral capsid genes VP1, VP2 and VP3, independent of the HRV type. In an immunosuppressed lung transplant recipient infected with the same HRV strain for more than two years, both classical and ultra-deep sequencing of samples collected at different time points in the upper and lower respiratory tracts showed that these virus populations were phylogenetically indistinguishable over the course of infection, except for the last month. Specific signatures were found in the last two lower respiratory tract populations, including changes in the 5′UTR polypyrimidine tract and the VP2 immunogenic site 2. These results highlight for the first time the ability of a given rhinovirus to evolve in the course of a natural infection in immunocompromised patients and complement data obtained from previous experimental inoculation studies in immunocompetent volunteers. PMID:21713005

  16. Antibiotic treatment failure when consulting patients with respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Bordado Sköld, Margrethe; Aabenhus, Rune; Guassora, Ann Dorrit

    2017-01-01

    Background: Prescribing antibiotics for acute respiratory tract infections (RTIs) is common in primary healthcare although most of these infections are of viral origin and antibiotics may not be helpful. Some of these prescriptions will not be associated with a quick recovery, and might be regarded...... definition of ATF. Studies describing patients’ views are still missing. General practitioners’ experiences and views on antibiotic treatment failure in acute respiratory infections or its effects on the doctor–patient relationship have not been studied previously....... as cases of antibiotic treatment failure (ATF). Objectives: We studied antibiotic treatment failure in patients with acute RTIs from a general practitioner (GP) perspective, aiming to explore (i) GPs’ views of ATF in primary care; (ii) how ATF influences the doctor-patient relationship; and (iii) GPs...

  17. Acute respiratory infections at children

    OpenAIRE

    Delyagin, V.

    2009-01-01

    The common signs of virus respiratory diseases, role of pathological inclination to infections, value of immunodeficiency are presented at lecture. Features of most often meeting respiratory virus infections are given.

  18. Composition and immunological significance of the upper respiratory tract microbiota.

    Science.gov (United States)

    Schenck, Louis Patrick; Surette, Michael G; Bowdish, Dawn M E

    2016-11-01

    The intestinal microbiota is essential for nutrient acquisition, immune development, and exclusion of invading pathogens. The upper respiratory tract (URT) microbiota is less well studied and does not appear to abide by many of the paradigms of the gastrointestinal tract. Decades of carriage studies in children have demonstrated that microbe-microbe competition and collusion occurs in the URT. Whether colonization with common pathogens (e.g., Staphylococcus aureus and Streptococcus pneumoniae) alters immune development or susceptibility to respiratory conditions is just beginning to be understood. Herein, we discuss the biogeography of the URT microbiota, the succession and evolution of the microbiota through the life course, and discuss the evidence for microbe-microbe interactions in colonization and infection. © 2016 Federation of European Biochemical Societies.

  19. Evaluating the child with recurrent lower respiratory tract infections.

    Science.gov (United States)

    Brand, Paul L P; Hoving, M F Paulien; de Groot, Eric P

    2012-09-01

    We review the limited available evidence on underlying causes of recurrent pneumonia in children, supplemented by our own clinical experience. Diagnosing recurrent pneumonia in children is difficult. Diagnostic confusion is possible with recurrent upper respiratory tract infections and asthma. In our series of children with recurrent pneumonia, we never identified asthma as an underlying cause. Because the frequency or severity of recurrent pneumonia does not always justify additional invasive investigations, the diagnostic work-up may be incomplete in a number of cases. This may help to explain why an underlying cause for recurrent pneumonia cannot be found in approximately 30% of cases. Finally, the paradigm that recurrent pneumonia in the same lung lobe has a differential diagnosis different from those recurring in multiple lobes was not borne out in our case series. A stepwise and pragmatic approach to evaluating children with recurrent lower respiratory tract infections is recommended. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study.

    Science.gov (United States)

    Tromp, Ilse; Kiefte-de Jong, Jessica; Raat, Hein; Jaddoe, Vincent; Franco, Oscar; Hofman, Albert; de Jongste, Johan; Moll, Henriëtte

    2017-01-01

    The protection of breastfeeding against respiratory tract infections in the first year of life has often been suggested. Few studies examined the effect of breastfeeding on respiratory tract infections after infancy. To examine the association between breastfeeding with lower respiratory tract infections (LRTI) and upper respiratory tract infections (URTI) after infancy up to 4 years of age (n = 5322). This study was embedded in The Generation R study, a Dutch population-based prospective cohort study from fetal life until young adulthood. Information on breastfeeding duration (never; respiratory tract infections persist after infancy therefore supporting current recommendations for breastfeeding for at least 6 months.

  1. Vitamin D and respiratory tract infections in childhood

    OpenAIRE

    Esposito, S.; Lelii, M.

    2015-01-01

    Background Respiratory tract infections (RTIs) remain among of the most important causes of morbidity and mortality among children. Several studies have associated vitamin D deficiency with an increased risk of RTIs, and vitamin D supplementation has been proposed as a possible preventive measure against RTIs in children. The main aim of this review is to summarize the current evidence from the literature about the link between vitamin D and RTIs in children. Discussion Several recent studies...

  2. Vitamin C and sex differences in respiratory tract infections

    OpenAIRE

    Hemilä, Harri

    2008-01-01

    In their systematic review of sex differences in respiratory tract infections (RTIs), Falagas et al. concluded that males develop RTIs more frequently than females, in particular lower RTIs, and the course of the infection is often more severe in males than in females. ... It is obvious that the findings of the common cold trials with British males and pneumonia trials with males cannot be extrapolated to the general population of the western countries. Nevertheless, further vitamin C trials ...

  3. Phytotherapy of Acute Respiratory Viral Diseases

    Directory of Open Access Journals (Sweden)

    I.B. Ershova

    2016-11-01

    Full Text Available Nowadays phytotherapy is increasingly being implemented into medical practice, especially for the prevention and treatment of many diseases. Acute respiratory viral infections are most common in childhood and in adults. Acute rhinitis, pharyngitis, tonsillitis, sinusitis, nasopharyngitis and acute laryngitis refer to diseases of the upper respiratory tract. The main reason for respiratory diseases in recurrent respiratory infection child is disorders of mucociliary and immune protection. The therapeutic value of medicinal plants is determined by their biologically active substances. The method of application of phytotherpy is an integral part of traditional medicine. Herbal medicine can be used at home and does not require special equipment. The main indications for the herbal medicine use in pediatrics are the initial stage of the disease as a primary method of treatment due to mild and low toxicity; as a supporting treatment for enhancing the protective forces of the child’s body during the disease deterioration. During the recovery period herbal medicine again occupies a leading position, especially in case of chronic diseases because it can be used for a long time and is well combined with synthetic drugs. The terms of appointment of herbs for children: prescription of medicinal plants for children must be individual according to indications, taking into account the child’s age; it is recommended to take into account the form and nature of the course of the main disease and comorbidities as well; at the initial stage of the treatment it is better to use some medicinal plants or species consisting of 2–3 plants and in the future a more complex composition; therapy with medicinal plants requires a long period to be used use, especially in chronic diseases; in the treatment of chronic diseases a good effect preventive courses of herbal medicine was revealed, which are appointed during seasonal exacerbations; in case of intolerance

  4. Metagenomic analysis of viral diversity in respiratory samples from patients with respiratory tract infections in Kuwait.

    Science.gov (United States)

    Madi, Nada; Al-Nakib, Widad; Mustafa, Abu Salim; Habibi, Nazima

    2018-03-01

    A metagenomic approach based on target independent next-generation sequencing has become a known method for the detection of both known and novel viruses in clinical samples. This study aimed to use the metagenomic sequencing approach to characterize the viral diversity in respiratory samples from patients with respiratory tract infections. We have investigated 86 respiratory samples received from various hospitals in Kuwait between 2015 and 2016 for the diagnosis of respiratory tract infections. A metagenomic approach using the next-generation sequencer to characterize viruses was used. According to the metagenomic analysis, an average of 145, 019 reads were identified, and 2% of these reads were of viral origin. Also, metagenomic analysis of the viral sequences revealed many known respiratory viruses, which were detected in 30.2% of the clinical samples. Also, sequences of non-respiratory viruses were detected in 14% of the clinical samples, while sequences of non-human viruses were detected in 55.8% of the clinical samples. The average genome coverage of the viruses was 12% with the highest genome coverage of 99.2% for respiratory syncytial virus, and the lowest was 1% for torque teno midi virus 2. Our results showed 47.7% agreement between multiplex Real-Time PCR and metagenomics sequencing in the detection of respiratory viruses in the clinical samples. Though there are some difficulties in using this method to clinical samples such as specimen quality, these observations are indicative of the promising utility of the metagenomic sequencing approach for the identification of respiratory viruses in patients with respiratory tract infections. © 2017 Wiley Periodicals, Inc.

  5. Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

    NARCIS (Netherlands)

    Mazur, Natalie I; Bont, Louis; Cohen, Adam L; Cohen, Cheryl; von Gottberg, Anne; Groome, Michelle J; Hellferscee, Orienka; Klipstein-Grobusch, Kerstin; Mekgoe, Omphile; Naby, Fathima; Moyes, Jocelyn; Tempia, Stefano; Treurnicht, Florette K; Venter, Marietje; Walaza, Sibongile; Wolter, Nicole; Madhi, Shabir A

    2017-01-01

    Background.: Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort.

  6. Concurrent bacterial infection and prolonged mechanical ventilation in infants with respiratory syncytial virus lower respiratory tract disease

    NARCIS (Netherlands)

    Kneyber, MCJ; van Oud-Alblas, HB; van Vliet, M; Uiterwaal, CSPM; Kimpen, JLL; van Vught, AJ

    Objective: To identify demographic, clinical, and laboratory variables predictive for a concurrent bacterial pulmonary infection in ventilated infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) and investigate antimicrobial drug use. Design and setting:

  7. ANTIBACTERIAL THERAPY IN OUTPATIENT TREATMENT OF RESPIRATORY TRACT INFECTIONS IN CHILDREN

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    V. N. Turchina

    2014-01-01

    Full Text Available The study was aimed at analyzing prescriptions of antibacterial drugs for outpatient treatment of respiratory tract infections in children. Patients and methods. The study involved patients with acute respiratory tract infections: 158 children were undergoing outpatient treatment, whereas 30 children were being treated at the polyclinic day hospital. The children aged from 3 months to 15 years. Acute rhinopharyngitis, acute laryngitis, acute bronchitis, tonsillitis and pneumonia were registered in 66.5, 2.6, 18.1, 11.7 and 1.1% of cases. We appraised indications for antibacterial therapy, prescription terms, therapy duration and choice of an antibacterial drug. Results. Antibacterial therapy prescription was found unreasonable in 44.0% of acute rhinopharyngitis cases, 41.1% of acute bronchitis cases and 60.0% of acute laryngitis cases. In the first day of diagnosis establishment, antibiotics were prescribed in 63.8 and 100% of cases at pediatric divisions and day hospitals, respectively. The unreasonable antibiotic prescription rate in infants was 66.7% - significantly higher than in 1-7-year-old children (p < 0.05. The most frequently (66.4% prescribed class of antibacterial drugs at pediatric divisions was penicillins (amoxicillin, amoxicillin clavulanate; at day hospitals, they were prescribed in 23.3% of cases (p < 0.01. Use of cephalosporin antibiotics as the initial therapy was significantly higher at day hospitals than at pediatric divisions (P < 0.01; the drug was administered parenterally in 90% of cases. Antibiotic prescription courses did not exceed 5 days in most cases (60.1%. Conclusions. We revealed high rate of unreasonable antibiotic use for outpatient treatment of acute rhinopharyngitis, laryngitis and acute bronchitis, especially at day hospitals and in infants. 

  8. The antioxidant system of the respiratory tract. The intracellular antioxidant protection in the respiratory tract (part 6

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    A.E. Abaturov

    2017-03-01

    Full Text Available The literature review presents the current data about peroxiredoxin system in the functioning of the intracellular antioxidant protection in the respiratory tract. We present a model of the molecular structure of certain peroxiredoxins. The peroxiredoxin-dependent oxidation reactions, antiapoptotic action and other physiological effects of peroxiredoxins system are considered in detail. Model of the molecular structure and biological function of the antioxidant factors with an indirect effect (APEX nuclease 1/Ref-1 are described.

  9. Submersion and acute respiratory failure

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    Yu-Jang Su

    2014-01-01

    Conclusions: Submersion patients who are hypothermic on arrival of emergency department (ED are risky to respiratory failure and older, more hypothermic, longer hospital stay in suicidal submersion patients.

  10. Frequent respiratory pathogens of respiratory tract infections in children attending daycare centers.

    Science.gov (United States)

    Bonfim, Caroline M; Nogueira, Maurício L; Simas, Paulo Vítor M; Gardinassi, Luis Gustavo A; Durigon, Edison L; Rahal, Paula; Souza, Fátima Pereira

    2011-01-01

    To identify and characterize respiratory viruses that infect children from daycare centers with symptoms of respiratory infection and to evaluate the association of clinical and epidemiological disease data with the identified virus. We conducted a study between 2003 and 2005 in 176 children with respiratory infection symptoms attending a municipal daycare center. Samples from nasopharyngeal secretion were tested by reverse transcriptase polymerase chain reaction and positive samples for picornavirus were sequenced. All 782 collected samples were analyzed and 31.8% were positive for at least one of the studied respiratory viruses. Respiratory infections were characterized by the presence of mild symptoms of the upper respiratory tract, the most common of which were runny nose and cough. In the 2 years of study, most cases of infection occurred in autumn and winter, but respiratory viruses were detected throughout all the study period. Respiratory viruses and respiratory infections caused by them are part of the daily life of children attending daycare centers. Our results show the great impact that respiratory infections have on these children and suggest that more attention must be paid to viral pathogens.

  11. The neurology of acutely failing respiratory mechanics.

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    Wijdicks, Eelco F M

    2017-04-01

    Forces involved in breathing-which effectively pull in air-are the diaphragmatic, intercostal, spine, and neck muscles. Equally important is the bulbar musculature maintaining the architecture of a patent airway conduit and abdominal wall and internal intercostal muscles providing cough. Acute injury along a neural trajectory from brainstem to muscle will impair the coordinated interaction between these muscle groups. Acutely failing respiratory mechanics can be caused by central and peripheral lesions. In central lesions, the key lesion is in the nucleus ambiguus innervating the dilator muscles of the soft palate, pharynx, and larynx, but abnormal respiratory mechanics rarely coincide with abnormalities of the respiratory pattern generator. In peripheral lesions, diaphragmatic weakness is a main element, but in many neuromuscular disorders mechanical upper airway obstruction from oropharyngeal weakness contributes equally to an increased respiratory load. The neurology of breathing involves changes in respiratory drive, rhythm, mechanics, and dynamics. This review focuses on the fundamentals of abnormal respiratory mechanics in acute neurologic conditions, bedside judgment, interpretation of additional laboratory tests, and initial stabilization, with practical solutions provided. Many of these respiratory signs are relevant to neurologists, who in acute situations may see these patients first. Ann Neurol 2017;81:485-494. © 2017 American Neurological Association.

  12. Compliance with Recommendations on Outpatient Antibiotic Prescribing for Respiratory Tract Infections

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    Malo, Sara; Bjerrum, Lars; Feja, Cristina

    2015-01-01

    Inappropriate antibiotic use in primary care, such as in Respiratory Tract Infections (RTIs), is an important cause of bacterial resistance. This study aimed at describing the current pattern of outpatient antibiotic use in acute RTIs in Spain and evaluating adherence to national recommendations......, and adherence to recommendations for antibiotic prescribing was assessed. One third of patients with a RTI were prescribed an antibiotic, with young adults (aged 15-64 years) being the most treated. High prescribing rates were observed in patients with acute otitis, sinusitis and acute tonsillitis (about 70......%), whereas low rates were found in acute bronchitis (50%) and non-specific upper RTIs (24%) episodes. A high prescription of broad-spectrum agents and antibiotics not recommended as first choice was observed. In accordance with Spanish guidelines, there exists a potential over-prescribing of antibiotics...

  13. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting

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    Aabenhus, Rune; Jensen, Jens Ulrik Stæhr

    2011-01-01

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection......, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...... concentrations in primary care are low and can be used primarily to rule out serious infection. However, procalcitonin measurement should not be used as the sole basis for clinical decisions; clinical skills are prerequisites for the correct use of this new tool in practice. At present there is no point...

  14. Diagnosis of Upper and Lower Respiratory Tract Bacterial Infections with the Use of Multiplex PCR Assays

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    Jenny Kourea-Kremastinou

    2013-03-01

    Full Text Available The investigation of respiratory infections by molecular techniques provides important information about the epidemiology of respiratory disease, especially during the post-vaccination era. The objective of the present study was the detection of bacterial pathogens directly in clinical samples from patients with upper and lower respiratory tract infections using multiplex polymerase chain reaction (PCR assays developed in our laboratory. Clinical samples taken over a three-year period (2007–2009 and obtained from 349 patients (adults (n = 66; children (n = 283 with signs and symptoms of certain upper or lower respiratory tract infections, consisted of: bronchoalveolar lavages (BAL, n = 83, pleural fluids (n = 29, and middle-ear aspirates (n = 237. Overall, 212 samples (61% were confirmed by culture and/or PCR. Among the positive samples, Streptococcus pneumoniae (mainly serotype 3 was predominant (104/212; 49.0%, followed by non-typable Haemophilus influenzae (NTHi 59/212; 27.8% and Streptococcus pyogenes (47/212; 22%. Haemophilus influenzae type b was detected in only three samples. The underlying microbiology of respiratory infections is gradually changing in response to various selective pressures, such as vaccine use and antibiotic consumption. The application of multiplex PCR (mPCR assays is particularly useful since it successfully identified the microorganisms implicated in acute otitis media or lower respiratory tract infections in nearly 75% of patients with a positive result compared to conventional cultures. Non-culture identification of the implicated pneumococcal serotypes is also an important issue for monitoring pneumococcal infections in the era of conjugate pneumococcal vaccines.

  15. Respiratory syncytial virus subtype ON1/NA1/BA9 predominates in hospitalized children with lower respiratory tract infections.

    Science.gov (United States)

    Fan, Ruyan; Fan, Chuping; Zhang, Jian; Wen, Bo; Lei, Yefei; Liu, Chan; Chen, Lijuan; Liu, Wenpei; Wang, Chuan; Qu, Xiaowang

    2017-02-01

    Respiratory syncytial virus (RSV) infection is the leading cause of acute respiratory tract disease in children less than 5 years old. The aim of this study was to further elucidate the molecular properties and clinical characteristics of RSV infection. The study sample included 238 patients respiratory tract infection (URTI or LRTI) in the Pediatric Department at the First People's Hospital of Chenzhou, South China in 2014. We subjected nasopharyngeal aspirate (NPA) or nasal swab (NS) samples from the patients to indirect fluorescence assay screens. RSV G genes were amplified by reverse transcription-PCR (RT-PCR) and sequenced. Of the 238 patients screened, 64 (26.8%) were confirmed to have RSV infections. Of those 64 confirmed RSV infection cases, 39 (60.9%) had subtype BA9, 13 (20.3%) had the recently identified subtype ON1, 11 (17.2%) had subtype NA1, and 1 (1.6%) had subtype GB2. The predominant presentation was LRTI with coughing, sputum production, fever, and wheezing. RSV subtype NA1 and BA9 infections were found mostly in infants, whereas the age distribution of subtype ON1 infections was more uniform across the age bands. Phylogenetic analysis indicated that, compared with the prototype strain A2, all ON1 and most NA1 isolates had lost one potential N-glycosylation site at amino acid 251 and 249 due to T251K and N249Y substitution, respectively. These findings suggest that NA1, BA9, and ON1 are the dominant RSV subtypes causing respiratory tract infections in young children presenting to the hospital in South China. J. Med. Virol. 89:213-221, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections

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    Francesco Martines

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. OBJECTIVE: To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. METHODS: A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. RESULTS: Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p < 0.05; children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p < 0.05. Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p < 0.05; the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. CONCLUSIONS

  17. The penetration of ceftibuten into the respiratory tract.

    Science.gov (United States)

    Krumpe, P; Lin, C C; Radwanski, E; Cayen, M N; Affrime, M B

    1999-08-01

    To determine the penetration of ceftibuten into various respiratory tissues and fluids. Single-dose, open-label, pharmacokinetic study. Veterans Administration Medical Center. Twelve hospitalized men aged 34 to 75 years with a variety of noninfectious pulmonary symptoms/diseases. Patients received a single oral dose of ceftibuten, 200 mg, prior to undergoing diagnostic fiberoptic bronchoscopy. Plasma samples for the determination of ceftibuten concentrations were collected pretreatment and up to 12 h postdosing. Nasal secretions, tracheal secretions, BAL fluid, and lung tissue from a biopsy were obtained at bronchoscopy from 2 to 7 h postdosing. Mean pharmacokinetic parameters for ceftibuten in plasma were the following: maximum observed plasma concentration (Cmax), 8.77 microg/mL; time to reach Cmax, 2.2 h; area under the plasma concentration-time curve extraploated to infinity, 49.21 microg/h/mL; and terminal elimination half-life, 3.17 h. These parameters were similar to those obtained in studies using healthy volunteers. Mean penetration of ceftibuten into nasal, tracheal, and bronchial secretions was 47%, 50%, and 30%, respectively. Mean penetration into BAL fluid was 81%, whereas penetration into lung tissue was 39%. No patient experienced any adverse effects related to ceftibuten. Ceftibuten penetrates well into various tissues and fluids of the upper and lower respiratory tracts. The results support the activity of ceftibuten in the treatment of upper and lower respiratory tract infections.

  18. Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis

    Science.gov (United States)

    Wu, Ruo-Han; Logue, Martin; Blondel, Clara; Lai, Lily Yuen Wan; Stuart, Beth; Flower, Andrew; Fei, Yu-Tong; Moore, Michael; Shepherd, Jonathan; Liu, Jian-Ping

    2017-01-01

    Introduction Antimicrobial resistance (AMR) is a substantial threat to public health. Safe and effective alternatives are required to reduce unnecessary antibiotic prescribing. Andrographis Paniculata (A. Paniculata, Chuān Xīn Lián) has traditionally been used in Indian and Chinese herbal medicine for cough, cold and influenza, suggesting a role in respiratory tract infections (RTIs). This systematic review aimed to evaluate the clinical effectiveness and safety of A. Paniculata for symptoms of acute RTIs (ARTIs). Materials and methods English and Chinese databases were searched from their inception to March 2016 for randomised controlled trials (RCTs) evaluating oral A. Paniculata without language barriers (Protocol ID: CRD42016035679). The primary outcomes were improvement in ARTI symptoms and adverse events (AEs). A random effects model was used to pool the mean differences and risk ratio with 95% CI reported. Methodological quality was evaluated using the Cochrane risk of bias tool; two reviewers independently screened eligibility and extracted data. Results Thirty-three RCTs (7175 patients) were included. Most trials evaluated A. Paniculata (as a monotherapy and as a herbal mixture) provided commercially but seldom reported manufacturing or quality control details. A. Paniculata improved cough (n = 596, standardised mean difference SMD: -0.39, 95% confidence interval CI [-0.67, -0.10]) and sore throat (n = 314, SMD: -1.13, 95% CI [-1.37, -0.89]) when compared with placebo. A. Paniculata (alone or plus usual care) has a statistically significant effect in improving overall symptoms of ARTIs when compared to placebo, usual care, and other herbal therapies. Evidence also suggested that A. Paniculata (alone or plus usual care) shortened the duration of cough, sore throat and sick leave/time to resolution when compared versus usual care. No major AEs were reported and minor AEs were mainly gastrointestinal. The methodological quality of included trials was

  19. Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671

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    Bucher Heiner C

    2005-08-01

    Full Text Available Abstract Background Acute respiratory tract infections (ARTI are among the most frequent reasons for consultations in primary care. Although predominantly viral in origin, ARTI often lead to the prescription of antibiotics for ambulatory patients, mainly because it is difficult to distinguish between viral and bacterial infections. Unnecessary antibiotic use, however, is associated with increased drug expenditure, side effects and antibiotic resistance. A novel approach is to guide antibiotic therapy by procalcitonin (ProCT, since serum levels of ProCT are elevated in bacterial infections but remain lower in viral infections and inflammatory diseases. The aim of this trial is to compare a ProCT-guided antibiotic therapy with a standard approach based on evidence-based guidelines for patients with ARTI in primary care. Methods/Design This is a randomised controlled trial in primary care with an open intervention. Adult patients judged by their general practitioner (GP to need antibiotics for ARTI are randomised in equal numbers either to standard antibiotic therapy or to ProCT-guided antibiotic therapy. Patients are followed-up after 1 week by their GP and after 2 and 4 weeks by phone interviews carried out by medical students blinded to the goal of the trial. Exclusion criteria for patients are antibiotic use in the previous 28 days, psychiatric disorders or inability to give written informed consent, not being fluent in German, severe immunosuppression, intravenous drug use, cystic fibrosis, active tuberculosis, or need for immediate hospitalisation. The primary endpoint is days with restrictions from ARTI within 14 days after randomisation. Secondary outcomes are antibiotic use in terms of antibiotic prescription rate and duration of antibiotic treatment in days, days off work and days with side-effects from medication within 14 days, and relapse rate from the infection within 28 days after randomisation. Discussion We aim to include 600

  20. Antibiotic knowledge and self-care for acute respiratory tract infections in Mexico Conocimiento y automedicación de antibióticos para infecciones respiratorias en México

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    Ralph Gonzales

    2012-04-01

    Full Text Available OBJECTIVE: To examine knowledge of and self-treatment with antibiotics among medically-insured adults in Mexico. MATERIALS AND METHODS: We conducted a cross-sectional, interviewer-administered survey among 101 adult patients seeking care for acute respiratory tract infections in a family medicine clinic in Mexico. Knowledge scores were calculated as a composite of correct, incorrect and don't know responses. Factors associated with antibiotic knowledge and antibiotic self-treatment were explored with bivariate analyses. RESULTS: 47% of participants were taking antibiotics prior to the visit, 20% were self-treating. Antibiotic knowledge was highly variable. Many participants believed common non-antibiotic treatments for colds and coughs were antibiotics, such as ambroxol (45%, Desenfriol (45% and paracetamol (44%. Older participants (>40 years had better knowledge scores. DISCUSSION: Self-treatment with and misperceptions about antibiotics are common among medically insured adults seeking medical attention in Mexico.OBJETIVO: Examinar el conocimiento y automedicación de antibióticos en adultos asegurados en México. MATERIAL Y MÉTODOS: Llevamos a cabo un estudio transversal mediante la administración de un cuestionario a 101 pacientes adultos que solicitaban atención médica por infección respiratoria aguda en una clínica de medicina familiar en México. La puntuación de conocimiento estuvo compuesta por respuestas correctas, incorrectas y "no sé", los factores asociados con conocimiento y automedicación de antibióticos fueron explorados mediante análisis bivariado. RESULTADOS: 47% de los participantes tomaron antibióticos previamente y 20% fueron automedicados. La puntuación de conocimiento fue muy variable. Muchos de los participantes creyeron que tratamientos comunes para resfriado y tos eran antibióticos, como ambroxol (45%, Desenfriol (45% y paracetamol (44%. Los participantes con mayor edad (>40 años obtuvieron mejores

  1. The Role of Human Parainfluenza Virus Infections in the Immunopathology of the Respiratory Tract.

    Science.gov (United States)

    Pawełczyk, Malgorzata; Kowalski, Marek Leszek

    2017-03-01

    Viral infections are leading causes of both upper and lower airway acute illness in all age groups of healthy persons, and have also been implicated in the acute exacerbations of chronic respiratory disorders like asthma and COPD. Human rhinovirus, respiratory syncytial virus, influenza virus and coronavirus have been considered as the most important respiratory pathogens and relatively little attention has been paid to the role of parainfluenza viruses (hPIVs). Human parainfluenza viruses are single-stranded RNA viruses belonging to the paramyxovirus family that may evoke lower respiratory infections in infants, children and immunocompromised individuals. Among non-immune compromised adults, hPIV infection typically causes mild disease manifested as upper respiratory tract symptoms and is infrequently associated with severe croup or pneumonia. Moreover, hPIV infection may be associated with viral exacerbations of chronic airway diseases, asthma or COPD or chronic rhinosinusitis. In this review, we summarized the basic epidemiology and immunology of hPIVs and addressed the more recent data implicating the role of parainfluenza viruses in the exacerbation of chronic airway disorders.

  2. Pressing Issues of Rational Antibiotic Therapy for Inflammatory Diseases of the Lower Respiratory Tract in Pediatric Practice

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    Ye.N. Okhotnikova

    2015-03-01

    Full Text Available Over the past 30 years, high incidence of acute lower respiratory tract infections of bacterial origin, primarily pneumonia and bronchitis, treatment of which under the spread of antibiotic resistance is often a difficult task, cause alarm. Bronchitis — one of the most common respiratory diseases in childhood after acute respiratory viral infections. Application of antibiotics for acute bronchitis in children is not recommended, but they are prescribed for severe intoxication and prolonged hyperthermia (over 3 days, especially in infants, children with poor premorbid background and high risk of pneumonia. Antibiotic therapy is considered as the only science-based treatment of pneumonia. Taking into account the broad spectrum of modern antibiotics, monotherapy is most suitable. If it is necessary to extend their effect, combination of amoxicillin/clavulanate with macrolides, to which all the major respiratory pathogens are sensitive, is preferred.

  3. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial

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    Henzen Christoph

    2007-07-01

    Full Text Available Abstract Background: Lower respiratory tract infections like acute bronchitis, exacerbated chronic obstructive pulmonary disease and community-acquired pneumonia are often unnecessarily treated with antibiotics, mainly because of physicians' difficulties to distinguish viral from bacterial cause and to estimate disease-severity. The goal of this trial is to compare medical outcomes, use of antibiotics and hospital resources in a strategy based on enforced evidence-based guidelines versus procalcitonin guided antibiotic therapy in patients with lower respiratory tract infections. Methods and design: We describe a prospective randomized controlled non-inferiority trial with an open intervention. We aim to randomize over a fixed recruitment period of 18 months a minimal number of 1002 patients from 6 hospitals in Switzerland. Patients must be >18 years of age with a lower respiratory tract infections Discussion: Use of and prolonged exposure to antibiotics in lower respiratory tract infections is high. The proposed trial investigates whether procalcitonin-guidance may safely reduce antibiotic consumption along with reductions in hospitalization costs and antibiotic resistance. It will additionally generate insights for improved prognostic assessment of patients with lower respiratory tract infections. Trial registration: ISRCTN95122877

  4. Airway CD8(+) T Cells Are Associated with Lung Injury during Infant Viral Respiratory Tract Infection.

    Science.gov (United States)

    Connors, Thomas J; Ravindranath, Thyyar M; Bickham, Kara L; Gordon, Claire L; Zhang, Feifan; Levin, Bruce; Baird, John S; Farber, Donna L

    2016-06-01

    Infants and young children are disproportionately susceptible to severe complications from respiratory viruses, although the underlying mechanisms remain unknown. Recent studies show that the T cell response in the lung is important for protective responses to respiratory infections, although details on the infant/pediatric respiratory immune response remain sparse. The objectives of the present study were to characterize the local versus systemic immune response in infants and young children with respiratory failure from viral respiratory tract infections and its association to disease severity. Daily airway secretions were sampled from infants and children 4 years of age and younger receiving mechanical ventilation owing to respiratory failure from viral infection or noninfectious causes. Samples were examined for immune cell composition and markers of T cell activation. These parameters were then correlated with clinical disease severity. Innate immune cells and total CD3(+) T cells were present in similar proportions in airway aspirates derived from infected and uninfected groups; however, the CD8:CD4 T cell ratio was markedly increased in the airways of patients with viral infection compared with uninfected patients, and specifically in infected infants with acute lung injury. T cells in the airways were phenotypically and functionally distinct from those in blood with activated/memory phenotypes and increased cytotoxic capacity. We identified a significant increase in airway cytotoxic CD8(+) T cells in infants with lung injury from viral respiratory tract infection that was distinct from the T cell profile in circulation and associated with increasing disease severity. Airway sampling could therefore be diagnostically informative for assessing immune responses and lung damage.

  5. Respiratory syncytial virus infection of the lower respiratory tract: radiological findings in 108 children

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    Kern, S.; Uhl, M. [Dept. of Diagnostic Radiology, University Hospital Freiburg (Germany); Berner, R.; Schwoerer, T. [Dept. of Pediatrics, University Hospital Freiburg (Germany); Langer, M. [Dept. of Diagnostic Radiology, University Hospital Freiburg (Germany)

    2001-12-01

    For years the typical appearance of respiratory syncytial virus (RSV)-induced infection of the lower respiratory tract has been discussed. All available studies have led to different results. The aim of this study was to control these results, with 108 children. The age range was 1 day to 10 years (median 7 months). Within 72 h of admission, all children developed an RSV infection of the lower respiratory tract. Chest X-rays (pa-view) of 55 children under, and 53 children over, the age of 6 months (10/53>24 months) were evaluated. The diagnosis of RSV and the chest X-ray were mostly done on the same day. The major radiological findings of the two age-groups were compared by Wilcoxon's unpaired rank sum test. Major radiological findings were: normal chest X-ray (30%), central pneumonia (32%) or peribronchitis (26%). There was no statistical significance between the age-groups. Other findings were emphysema (11%), pleural effusion (6%), lobar- or broncho-pneumonia (each 6%), atelectasis (5%) or pneumothorax in one case. Therefore, the most common radiological findings in RSV-induced infection of the lower respiratory tract, supported by our results (RSV infection without bacterial superinfection) are central pneumonia, peribronchitis or normal chest X-ray. Thus an age-group separation into under or over 6 months is no longer necessary. (orig.)

  6. Etiology, seasonality, and clinical characteristics of respiratory viruses in children with respiratory tract infections in Eastern India (Bhubaneswar, Odisha).

    Science.gov (United States)

    Panda, Swagatika; Mohakud, Nirmal Kumar; Suar, Mrutyunjay; Kumar, Subrat

    2017-03-01

    Acute respiratory tract infections (ARTIs) are a leading cause of morbidity and mortality in young children in low and middle income countries. To analyse the overall burden of respiratory viruses responsible for ARTIs in paediatrics population in eastern India, this study was performed. Clinical information, demographic information and nasal/oral swabs were collected from 332 paediatric patients (aged from 1 month to 12 years old) with the symptoms of ARTI, enrolled from the outpatient department from Nov 2012 to Oct 2014. Multiplex PCR was performed to detect eight respiratory viral pathogens. Seasonal, as well as age-wise prevalence of respiratory viruses was analysed. Of these 332 cases, 32.53% (108/332) were positive for at least one pathogen. Human rhinovirus (HRV) was the most frequently detected pathogen (24.7%, 82/332) followed by respiratory syncytial virus (RSV) (4.22%, 14/332), PIV (2.11%, 7/332), and hMPV (2.11%, 7/332). Single infection was detected in 92.6% (100/108) of positive cases. Respiratory virus infections showed seasonal variation, with peaks during the rainy season followed by winter season, and were most common in patients under 1 year of age. Phylogenetic analysis of HMPV positive samples confirmed the circulation of A2 subgroup in the study area. The present study is first of its kind and adds to our knowledge of the epidemiological characteristics of these common respiratory viruses among patients with ARTIs in the study area. J. Med. Virol. 89:553-558, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. [Application of FilmArray assay for detection of respiratory tract infections in immunocompromised persons].

    Science.gov (United States)

    Dzieciatkowski, Tomasz; Przybylski, Maciej; Sulowska, Agata; Rynans, Sylwia; Mlynarczyk, Grazyna; Swoboda-Kopec, Ewa

    2013-01-01

    A variety of viruses and bacteria are responsible for acute upper and lower respiratory tract infections worldwide. Severe and even fatal disease can occur especially in group ofimmunocompromised individuals. Accurate pathogen identification allows clinicians to determine the need for ancillary diagnostic testing, antibacterial and/or antiviral therapy and can motivate decisions regarding hospitalization and infection control measures. We compared the diagnostic performance of FilmArray Respiratory Panel highly multiplexed nucleic acid amplification test with previous used direct immunofluorescence assay. Both assays were performed on a panel of 6 nasopharyngeal-secretion specimens and 6 BALF samples, collected from 12 patients, subjected to allogeneic haematological stem cells transplantation, with lower respiratory tract symptoms. Among viruses detectable by both assays were especially influenzaA virus, parainfluenza viruses type 3 and respiratory syncytial virus. In conclusion, the FilmArray assay is rapid and extremely user-friendly system, with results available in just over one hour with almost no labor involved. In few laboratories its low throughput and qualitative results may be a disadvantage in some clinical settings.

  8. Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

    Science.gov (United States)

    Brook, Itzhak

    2012-04-01

    Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice

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    Sigurðardóttir, Nanna Rún; Nielsen, Anni Brit Sternhagen; Munck, Anders

    2015-01-01

    Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland. Design: A cross-sectional study. Settings and subjects. General practitioners (GPs...... antibiotics (Iceland = 75.8% vs. Denmark = 59.3%), but Danish GPs had a higher percentage of inappropriate antibiotic prescribing for sinusitis, and Icelandic GPs for pharyngotonsillitis. No differences were found for acute otitis media (AOM). The different antibiotic prescribing patterns between Denmark...

  10. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anette; Nexoe, Joergen; Bistrup, Lene A

    2007-01-01

    BACKGROUND: Knowledge of predominant pathogens and their association with outcome are of importance for the management of lower respiratory tract infection (LRTI). As antibiotic therapy is indicated in pneumonia and not in acute bronchitis, a predictor of pneumonia is needed. AIM: To describe....... Primary outcome measure was hospitalisation within 4 weeks. RESULTS: Pneumonia was radiographically verified in 48 of 364 patients (13%). Bacterial infection was seen more often in patients with pneumonia (33% versus 17%, Pinfection more often in non-pneumonic patients (26% versus 13......%, Pinfection compared with patients without pneumococcal infection (26 versus 4%, P = 0.001). The positive predictive value of GPs' diagnosis...

  11. Antibiotic prescriptions for suspected respiratory tract infection in primary care in South America

    DEFF Research Database (Denmark)

    Cordoba, Gloria; Caballero, Lidia; Sandholdt, Håkon

    2017-01-01

    OBJECTIVES: To describe and compare antibiotic prescribing patterns for primary care patients with respiratory tract infections (RTIs) in four South American countries. METHODS: This was a prospective observational study. General practitioners (GPs) from Argentina, Bolivia, Paraguay and Uruguay......%) of these received an antibiotic prescription. There was a wide variation across countries in the use and selection of antibiotics. For example, 94% of patients with acute bronchitis were prescribed antibiotics in Bolivia, while in Uruguay only 21% received antibiotics. Amoxicillin was the most commonly prescribed...

  12. [Sampling procedure for a survey of an interventional study on acute respiratory infections].

    Science.gov (United States)

    Ramón Bravo, J; González Ochoa, E

    1993-01-01

    A description is made of the methodology used for obtaining a sample made up of 500 children under 5 years and 500 adults 65 year old and more, in order to carry out an intervention study on acute respiratory tract infections in an urban zone in Havana City and in a rural zone in Matanzas province, where different intervention stops will be taken with regards sanitary education about management of acute respiratory tract infections for the population and training for primary care medical personnel. We show the way the selected sample fits was planned with a very homogeneous distribution in the 8 areas under study, which allows for great reliability in the results.

  13. Acute Respiratory Insufficiency After Adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Öznur Şen

    2013-12-01

    Full Text Available Adenotonsillectomy is one of the frequently performed surgical procedures in children and the most common complications of this procedure are bleeding and respiratory insufficiency. Here, we present a 20-month-old boy who was born prematurely. He underwent adenotonsillectomy and bilateral grommet insertion due to recurrent tonsilitis, snoring, and obstructive sleep apnea syndrome. The patient required a prolonged intensive care unit stay due to postoperative respiratory insufficiency. In this paper, we aimed to evaluate the potential complications of adenotonsillectomy. (The Medical Bulletin of Haseki 2013;51:193-6

  14. Role of vitamin D in children with respiratory tract infection.

    Science.gov (United States)

    Esposito, S; Baggi, E; Bianchini, S; Marchisio, P; Principi, N

    2013-01-01

    It has recently been shown that vitamin D (VitD) plays an important role in host defences, inflammation and immunity. We reviewed PubMed and selected all of the studies published over the last 15 years concerning VitD deficiency and VitD supplementation in children with respiratory tract infections. Our analysis showed that VitD seems to be very important because of its part in the complexity of the immune system. However, there are few pediatric studies and most have various limitations. First of all, the literature mainly refers to studies concerning the prevalence of VitD insufficiency and deficiency in specific pathologies. Secondly, it is extremely difficult to identify a common specific range of normal, insufficient and deficient VitD levels. Thirdly, the available studies of VitD supplementation often combined VitD with the use of other micronutrients, thus obscuring the role of VitD itself. Finally, different doses have been used for VitD supplementation. These observations clearly highlight the fact that further studies are needed to evaluate the impact of VitD deficiency and insufficiency in terms of the epidemiology and outcomes of pediatric respiratory tract infection, and whether VitD supplementation favours a positive outcome.

  15. Prevention of paediatric respiratory tract infections: emphasis on the role of OM-85

    Directory of Open Access Journals (Sweden)

    U. B. Schaad

    2005-12-01

    Full Text Available The burden of respiratory tract infections in paediatrics is extremely high, in both industrialised and developing countries. Because adequate diagnosis and causative therapies of these often recurrent respiratory tract infections bear substantial limits, preventive measures deserve priority. The mainstays are parent education, active immunisation strategies and nonspecific immunostimulation with bacterial products. This article summarises the five key studies on the use of the immunoactive agent OM-85 (Broncho-Vaxom for prevention of recurrent respiratory tract infections in children. Such bacterial immunostimulants are especially indicated for young infants and children who are known and/or expected to suffer from at least three respiratory tract infections per winter season.

  16. Evaluation of the prescriptions written for upper respiratory tract infections.

    Science.gov (United States)

    Ozdemir, Serdar; Ozturk, Tuba Cimilli; Metiner, Yasin; Ak, Rohat; Ocal, Oktay

    2015-01-01

    We aimed to determine frequency of antibiotic use and retrospectively evaluate prescriptions written for the patients with diagnosis of acute pharyngitis, acute nasopharyngitis and acute tonsillitis by our hospital emergency department physicians in January 2014. Records of the patients who were admitted to the education and research hospital between January 1st, 2014 to January 31st 2014 were analyzed in this study. Records of all the patients with the diagnosis of acute nasopharyngitis (J.00), acute pharyngitis (J.02) and acute tonsillitis (J.03) were analyzed, and patients with a second diagnosis or haven't any prescription were excluded from the study. Frequency of antibiotic and other symptomatic medications use were analyzed in prescriptions of 5261 patients. Antibiotics were prescribed for 63.5% of the patients included in the study, and the most preferred antibiotics were penicilin and beta-lactamase combination (38.8%) and cephalosporins (26.2%). Combined preparations were the most preferred medications in symptomatic treatment (65.9%). Dexketoprofen was the most preferred among nonsteroidal anti-inflammatory drugs (63%). In each prescription, average number of 3.26 drugs were prescribed. Excessive and improrer use of antibiotics in the treatment of respiratuary tract infection is a global problem. The use of excess agents in symptomatic medication leads to polypharmacy. Training of physicians and patients on principles of rational drug use will contribute to the solution of this problem.

  17. Current perspectives for management of acute respiratory insufficiency in premature infants with acute respiratory syndrome.

    Science.gov (United States)

    Chen, Peng; Zhang, Ying; Li, Long-Yun

    2014-09-01

    Current perspectives for management of acute respiratory insufficiency in premature infants with acute respiratory syndrome and the pathology of acute respiratory insufficiency in the preterm infant, including the current therapy modalities on disposition are presented. Since the therapeutical challenge and primary clinical goal are to normalize ventilation ratio and lung perfusion, when respiratory insufficiency occurs, it is very important to introduce the respiratory support as soon possible, in order to reduce development of pulmonary cyanosis and edema, and intrapulmonary or intracardial shunts. A characteristic respiratory instability that reflects through fluctuations in gas exchange and ventilation is often present in premature infants. Adapting the respiratory support on a continuous basis to the infant's needs is challenging and not always effective. Although a large number of ventilation strategies for the neonate are available, there is a need for additional consensus on management of acute respiratory distress syndrome in pediatric population lately redefined by Berlin definition criteria, in order to efficiently apply various modes of respiratory support in daily pediatrician clinical use.

  18. Carbon Nanotubes in the Human Respiratory Tract-Clearance Modeling.

    Science.gov (United States)

    Sturm, Robert

    2017-03-01

    Clearance of single-wall carbon nanotubes (SWCNT, diameter: 5 nm) and multi-wall carbon nanotubes (MWCNT, diameter: 50 nm) in the respiratory tract was predicted for various age groups (infants, children, adolescents, and adults). The model was founded on the assumption that lung clearance takes place in three distinct phases: (i) fast mucociliary clearance, (ii) slow bronchial clearance, and (iii) alveolar clearance. To each of these phases a specific fraction of deposited particles was attributed, the amount of which depended on particles' geometry and particles' deposition sites in the respiratory system. Clearance velocities were expressed by respective clearance half-times ranging from several hours in the case of fast clearance to tens of days in the case of slow clearance. Results of the simulations clearly demonstrate that for the specific deposition scenario (sitting, nasal breathing) considered here fast clearance fraction exhibits a slight decrease with increasing age, but total clearance times (i.e. time spans, within which 100% of the deposited particulate mass are removed) are rather constant among the age groups. Nanotubes deposited in the respiratory bronchioles and alveoli are usually subject to a long-term storage in these structures and, thus, may trigger malignant transformations in adjacent cells and tissues. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  19. Environmental determinants of acute respiratory symptoms and ...

    African Journals Online (AJOL)

    Environmental determinants of acute respiratory symptoms and diarrhoea in young coloured children living in urban and peri-urban areas of South Africa. ... access to essential environmental health services in urban areas and improvements in the educational status of women are urgently needed if childhood infections are ...

  20. Environmental determinants of acute respiratory symptoms and ...

    African Journals Online (AJOL)

    1991-04-20

    Apr 20, 1991 ... acute respiratory symptoms in South African coloured child- ren. A multistage ... epidemiological assessment of the effects of urban environments .... Flush inside. 908. 74,7. Flush outside. 207. 17,0. Communal flush. 23. 1,9. Own bucket system. 60. 4,9. Communal bucket system. 7. 0,6. Pit latrine. 6. 0,5.

  1. Meditation or Exercise May Help Acute Respiratory Infections

    Science.gov (United States)

    ... R S T U V W X Y Z Meditation or Exercise May Help Acute Respiratory Infections, Study ... According to a recent study, exercising or practicing meditation may be effective in reducing acute respiratory infections. ...

  2. Noninvasive ventilation for acute respiratory failure.

    Science.gov (United States)

    Jasmer, R M; Matthay, M A

    2000-01-01

    Noninvasive ventilation refers to any form of ventilatory support applied without the use of an endotracheal tube. It offers the potential to provide primary treatment for acute respiratory failure while avoiding complications associated with mechanical ventilation with endotracheal intubation. Noninvasive ventilation has been most commonly studied in hypercapnic respiratory failure. A review of randomized, controlled studies shows mixed results and methodologic limitations affect the interpretation of current evidence. Patient selection is clearly the most important issue in considering noninvasive ventilation for acute respiratory failure. Unfortunately, patients who benefit from noninvasive ventilation represent only a minority of the total group with any one disease, and thus it is difficult to make broad conclusions concerning applicability of this treatment modality. Future studies are needed to focus on determining the specific patient populations who will benefit the most, evaluating the optimal ventilatory mode and mask for providing noninvasive ventilation, and clarifying its impact on clinical outcomes.

  3. Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

    Science.gov (United States)

    Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

    2016-01-01

    Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (potitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0

  4. Cefditoren in upper and lower community-acquired respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Francisco Soriano

    2011-02-01

    Full Text Available Francisco Soriano1, María-José Giménez1,2, Lorenzo Aguilar1,21PRISM-AG, Madrid, Spain; 2Microbiology Department, School of Medicine, University Complutense, Madrid, SpainAbstract: This article reviews and updates published data on cefditoren in the evolving scenario of resistance among the most prevalent isolates from respiratory tract infections in the community (Streptococcus pyogenes, Haemophilus influenzae, and Streptococcus pneumoniae. By relating the in vitro activity of cefditoren (in national and multinational surveillance and against isolates with emerging resistant genotypes/phenotypes to its pharmacokinetics, the cefditoren pharmacodynamic activity predicting efficacy (in humans, animal models, and in vitro simulations is analyzed prior to reviewing clinical studies (tonsillopharyngitis, sinusitis, acute exacerbations of chronic bronchitis, and community-acquired pneumonia and the relationship between bacterial eradication and clinical efficacy. The high in vitro activity of cefditoren against the most prevalent respiratory isolates in the community, together with its pharmacokinetics (enabling a twice daily regimen leading to adequate pharmacodynamic indexes covering all S. pyogenes, H. influenzae, and at least 95% S. pneumoniae isolates, makes cefditoren an antibiotic that will play a significant role in the treatment of respiratory tract infections in the community. In the clinical setting, studies carried out with cefditoren showed that treatments with the 400 mg twice daily regimen were associated with high rates of bacteriological response, even against penicillin-nonsusceptible S. pneumoniae, with good correlation between bacteriological efficacy/response and clinical outcome.Keywords: cefditoren, Streptococcus pyogenes, Haemophilus influenzae, Streptococcus pneumoniae, community-acquired respiratory tract infections

  5. Simultaneous influenza and respiratory syncytial virus infection in human respiratory tract

    Science.gov (United States)

    Pinky, Lubna Jahan Rashid; Dobrovolny, Hana

    2015-03-01

    Studies have shown that simultaneous infection of the respiratory tract with at least two viruses is not uncommon in hospitalized patients, although it is not clear whether these infections are more or less severe than single infections. We use mathematical models to study the dynamics of simultaneous influenza (flu) and respiratory syncytial virus (RSV) infection, two of the more common respiratory viruses, in an effort to understand simultaneous infections. We examine the roles of initial viral inoculum, relative starting time, and cell regeneration on the severity of the infection. We also study the effect of antiviral treatment on the course of the infection. This study shows that, unless treated with antivirals, flu always takes over the infection no matter how small the initial dose and how delayed it starts with respect to RSV.

  6. PREVENTION OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    O.V. Karneeva

    2009-01-01

    Full Text Available The issue of inflammatory diseases of the upper airways and eardrum remains relevant and associated both with high prevalence of this pathology and likelihood of developing complications. Inflammation of nasal cavity’s mucosal lining causes discomfort, while chronic dysfunction of nasal breathing significantly reduces the patient’s quality of life. Difficulty in nasal breathing of newborns and infants results in quite severe complications. Nearly 70% of acute respiratory infections cases in children are complicated with acute inflammation of eardrum, 90% of children under 3 years once develop secretory otitis media, 50% of them have several cases of eardrum inflammation.Key words: acute respiratory infections, otitis, treatment, children.

  7. SMART phones and the acute respiratory patient.

    LENUS (Irish Health Repository)

    Gleeson, L

    2012-05-01

    Definition of Respiratory Failure using PaO2 alone is confounded when patients are commenced on oxygen therapy prior to arterial blood gas (ABG) measurement. Furthermore, classification of Respiratory Failure as Type 1 or Type 2 using PaCO2 alone can give an inaccurate account of events as both types can co-exist. 100 consecutive presentations of acute respiratory distress were assessed initially using PaO2, and subsequently PaO2\\/FiO2 ratio, to diagnose Respiratory Failure. Respiratory Failure cases were classified as Type 1 or Type 2 initially using PaCO2, and subsequently alveolar-arterial (A-a) gradient. Any resultant change in management was documented. Of 100 presentations, an additional 16 cases were diagnosed as Respiratory Failure using PaO2\\/FiO2 ratio in place of PaO2 alone (p = 0.0338). Of 57 cases of Respiratory Failure, 22 cases classified as Type 2 using PaCO2 alone were reclassified as Type 1 using A-a gradient (p < 0.001). Of these 22 cases, management changed in 18.

  8. SMART phones and the acute respiratory patient.

    Science.gov (United States)

    Gleeson, L; Alam, J; Lane, S

    2012-05-01

    Definition of Respiratory Failure using PaO2 alone is confounded when patients are commenced on oxygen therapy prior to arterial blood gas (ABG) measurement. Furthermore, classification of Respiratory Failure as Type 1 or Type 2 using PaCO2 alone can give an inaccurate account of events as both types can co-exist. 100 consecutive presentations of acute respiratory distress were assessed initially using PaO2, and subsequently PaO2/FiO2 ratio, to diagnose Respiratory Failure. Respiratory Failure cases were classified as Type 1 or Type 2 initially using PaCO2, and subsequently alveolar-arterial (A-a) gradient. Any resultant change in management was documented. Of 100 presentations, an additional 16 cases were diagnosed as Respiratory Failure using PaO2/FiO2 ratio in place of PaO2 alone (p = 0.0338). Of 57 cases of Respiratory Failure, 22 cases classified as Type 2 using PaCO2 alone were reclassified as Type 1 using A-a gradient (p < 0.001). Of these 22 cases, management changed in 18.

  9. Atypical presentation of human bocavirus: Severe respiratory tract infection complicated with encephalopathy.

    Science.gov (United States)

    Akturk, Hacer; Sık, Guntulu; Salman, Nuran; Sutcu, Murat; Tatli, Burak; Ciblak, Meral Akcay; Erol, Oguz Bulent; Torun, Selda Hancerli; Citak, Agop; Somer, Ayper

    2015-11-01

    Human bocavirus (HBOV) has been reported as a worldwide distributed respiratory pathogen. It has also been associated with encephalitis recently by detection of the virus in cerebrospinal fluid (CSF) of patients presented with encephalitis. This retrospective study aimed to present clinical features of HBOV infections in children with respiratory symptoms and describe unexplained encephalopathy in a subgroup of these patients. Results of 1,143 pediatric nasal samples from mid-December 2013 to July 2014 were reviewed for detection of HBOV. A multiplex real time polymerase chain reaction assay was used for viral detection. Medical records of the patients were retrospectively analyzed. HBOV was detected in 30 patients (2.6%). Median age was 14 months (5-80). Clinical diagnoses were upper respiratory tract infection (n = 10), bronchopneumonia (n = 9), acute bronchiolitis (n = 5), pneumonia (n = 4), acute bronchitis (n = 1), and asthma execarbation (n = 1). Hospitalization was required in 16 (53.3%) patients and 10 (62.5%) of them admitted to pediatric intensive care unit (PICU). Noninvasive mechanical ventilation modalities was applied to four patients and mechanical ventilation to four patients. Intractable seizures developed in four patients while mechanically ventilated on the 2nd-3rd days of PICU admission. No specific reason for encephalopathy was found after a thorough investigation. No mortality was observed, but two patients were discharged with neurological sequela. HBOV may lead to respiratory infections in a wide spectrum of severity. This report indicates its potential to cause severe respiratory infections requiring PICU admission and highlights possible clinical association of HBOV and encephalopathy, which developed during severe respiratory infection. © 2015 Wiley Periodicals, Inc.

  10. Current Antibiotic Treatment and Outcome for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Alasdair P MacGowan

    1998-01-01

    Full Text Available A number of national guidelines have been published to aid the antimicrobial management of community-acquired pneumonia. However, data on prescriptions for lower respiratory tract infection (LRTI indicate considerable variation in the choice of first-line and subsequent therapy at national and local levels. Outcomes research in LRTI, whether based on clinical, economic or patient-focused criteria, is still evolving. Clinical outcomes are best studied for both pneumonia and exacerbation of chronic obstructive pulmonary disease. Economic evaluations often do not encompass all of the costs, for example, time off from work or the economic impact of antibacterial resistance. Duration of hospital stay is a good marker of costs for hospital providers and may be affected by age. marital status and comorbidities. Antibiotic choice may have an impact on the duration of hospital stay by increasing side effects, predisposing patients to hospitalacquired infection or reduced clinical efficacy. Patient expectation is largely unstudied in pulmonary infection.

  11. Considering Respiratory Tract Infections and Antimicrobial Sensitivity: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Amin, R.

    2009-01-01

    Full Text Available This study was conducted to observe the sensitivity and resistance of status of antibiotics for respiratory tract infection (RTI. Throat swab culture and sensitivity report of 383 patients revealed sensitivity profiles were observed with amoxycillin (7.9%, penicillin (33.7%, ampicillin (36.6%, co-trimoxazole (46.5%, azithromycin (53.5%, erythromycin (57.4%, cephalexin (69.3%, gentamycin (78.2%, ciprofloxacin (80.2%, cephradine (81.2%, ceftazidime (93.1%, ceftriaxone (93.1%. Sensitivity to cefuroxime was reported 93.1% cases. Resistance was found with amoxycillin (90.1%, ampicillin (64.1%, penicillin (61.4%, co-trimoxazole (43.6%, erythromycin (39.6%, and azithromycin (34.7%. Cefuroxime demonstrates high level of sensitivity than other antibiotics and supports its consideration with patients with upper RTI.

  12. Velocity profiles in idealized model of human respiratory tract

    Directory of Open Access Journals (Sweden)

    Jicha M.

    2013-04-01

    Full Text Available This article deals with numerical simulation focused on velocity profiles in idealized model of human upper airways during steady inspiration. Three r gimes of breathing were investigated: Resting condition, Deep breathing and Light activity which correspond to most common regimes used for experiments and simulations. Calculation was validated with experimental data given by Phase Doppler Anemometry performed on the model with same geometry. This comparison was made in multiple points which form one cross-section in trachea near first bifurcation of bronchial tree. Development of velocity profile in trachea during steady inspiration was discussed with respect for common phenomenon formed in trachea and for future research of transport of aerosol particles in human respiratory tract.

  13. CLINICAL EFFICACY OF IBUPROFEN IN THERAPY FOR VIRAL UPPER RESPIRATORY TRACT INFECTIONS IN INFANTS

    Directory of Open Access Journals (Sweden)

    I.O. Skugarevskaya

    2006-01-01

    Full Text Available A study of use of ibuprofen in cases of viral upper respiratory tract infections (Vuri in children of early childhood has proved its' safety and efficacy. This medical agent has not only terminate fever but also diminished some other symptoms of Vuri.Key words: ibuprofen, viral upper respiratory tract infections, children.

  14. An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

    Science.gov (United States)

    Kariya, Shin; Okano, Mitsuhiro; Nishizaki, Kazunori

    2014-01-01

    Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions. PMID:24587622

  15. PRINCIPLES OF ANTIBIOTIC TREATMENT OF OUT-OF-HOSPITAL UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    A. L. Zaplatnikov

    2012-01-01

    Full Text Available Special features of etiology of respiratory tract bacterial infections in children in depending of localization of involvement are analyzed in this study. In the article the main principles of rational antibacterial therapy of infectious and inflammatory diseases of respiratory tract in paediatrician practice are discussed. The authors offer the algorithms of first-line antibiotics choosing according to various entities of upper and lower respiratory tract infections in children. There are also suggested the regimens of antibacterial agents dosing in out-patient clinics in children with bacterial respiratory infections.

  16. Respiratory syncytial virus in hematopoietic cell transplant recipients: factors determining progression to lower respiratory tract disease.

    Science.gov (United States)

    Kim, Yae-Jean; Guthrie, Katherine A; Waghmare, Alpana; Walsh, Edward E; Falsey, Ann R; Kuypers, Jane; Cent, Anne; Englund, Janet A; Boeckh, Michael

    2014-04-15

    Respiratory syncytial virus (RSV) lower respiratory tract disease (LRD) is a life-threatening complication in hematopoietic cell transplant (HCT) recipients. Lymphopenia has been associated with an increased risk of progression from upper respiratory tract infection (URI) to LRD. This study retrospectively analyzed the significance of lymphocyte engraftment dynamics, lung function, smoking history, corticosteroids, antiviral treatment, viral subtypes, and RSV-specific neutralizing antibodies for the progression to LRD in 181 HCT recipients with RSV URI. In multivariable models, smoking history, conditioning with high-dose total body irradiation, and an absolute lymphocyte count (ALC) ≤100/mm(3) at the time of URI onset were significantly associated with disease progression. No progression occurred in patients with ALCs of >1000/mm(3) at URI onset. Lymphocyte engraftment dynamics were similar in progressors and nonprogressors. Pre- and posttransplant donor and posttransplant recipient RSV subtype-specific neutralizing antibody levels, RSV viral subtypes, and corticosteroids also were not significantly associated with LRD progression. Host and transplant related factors appear to determine the risk of progression to LRD more than viral factors. Dysfunctional cell-mediated immunity appears to be important in the pathogenesis of progressive RSV disease after HCT. A characterization of RSV-specific T-cell immunity is warranted.

  17. Nasopharyngeal Protein Biomarkers of Acute Respiratory Virus Infection

    Directory of Open Access Journals (Sweden)

    Thomas W. Burke

    2017-03-01

    Full Text Available Infection of respiratory mucosa with viral pathogens triggers complex immunologic events in the affected host. We sought to characterize this response through proteomic analysis of nasopharyngeal lavage in human subjects experimentally challenged with influenza A/H3N2 or human rhinovirus, and to develop targeted assays measuring peptides involved in this host response allowing classification of acute respiratory virus infection. Unbiased proteomic discovery analysis identified 3285 peptides corresponding to 438 unique proteins, and revealed that infection with H3N2 induces significant alterations in protein expression. These include proteins involved in acute inflammatory response, innate immune response, and the complement cascade. These data provide insights into the nature of the biological response to viral infection of the upper respiratory tract, and the proteins that are dysregulated by viral infection form the basis of signature that accurately classifies the infected state. Verification of this signature using targeted mass spectrometry in independent cohorts of subjects challenged with influenza or rhinovirus demonstrates that it performs with high accuracy (0.8623 AUROC, 75% TPR, 97.46% TNR. With further development as a clinical diagnostic, this signature may have utility in rapid screening for emerging infections, avoidance of inappropriate antibacterial therapy, and more rapid implementation of appropriate therapeutic and public health strategies.

  18. Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia.

    Science.gov (United States)

    Hakim, Hana; Dallas, Ronald; Zhou, Yinmei; Pei, Dequing; Cheng, Cheng; Flynn, Patricia M; Pui, Ching-Hon; Jeha, Sima

    2016-03-01

    Knowledge regarding the incidence, clinical course, and impact of respiratory viral infections in children with acute lymphoblastic leukemia (ALL) is limited. A retrospective cohort of patients with newly diagnosed ALL who were treated on the Total Therapy XVI protocol at St Jude Children's Research Hospital between 2007 and 2011 was evaluated. Of 223 children, 95 (43%) developed 133 episodes of viral acute respiratory illness (ARI) (incidence, 1.1 per 1000 patient-days). ARI without viral etiology was identified in 65 patients (29%) and no ARI was detected in 63 patients (28%). There were no significant associations noted between race, sex, age, or ALL risk group and the development of ARI. Children receiving induction chemotherapy were found to be at the highest risk of viral ARI (incidence, 2.3 per 1000 patient-days). Influenza virus was the most common virus (38%) followed by respiratory syncytial virus (33%). Of 133 episodes of viral ARI, 61% of patients were hospitalized, 26% experienced a complicated course, 80% had their chemotherapy delayed, and 0.7% of patients died. Twenty-four patients (18%) developed viral lower respiratory tract infections (LRTI), 5 of whom (21%) had complications. Patients with viral LRTI had a significantly lower nadir absolute lymphocyte count; were sicker at the time of presentation; and were more likely to have respiratory syncytial virus, to be hospitalized, and to have their chemotherapy delayed for longer compared with those with viral upper respiratory tract infections. Despite the low incidence of viral ARI in children with ALL, the associated morbidity, mortality, and delay in chemotherapy remain clinically significant. Viral LRTI was especially associated with high morbidity requiring intensive care-level support. Cancer 2016;122:798-805. © 2015 American Cancer Society. © 2015 American Cancer Society.

  19. Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain

    DEFF Research Database (Denmark)

    Llor, Carles; Cots, Josep Maria; Hernández, Silvia

    2014-01-01

    To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).......To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI)....

  20. Chlamydiae in febrile children with respiratory tract symptoms and age-matched controls, Ghana

    Directory of Open Access Journals (Sweden)

    H. Bühl

    2018-03-01

    Full Text Available Members of the Chlamydiales order are obligate intracellular pathogens causing acute and chronic infectious diseases. Chlamydiaceae are established agents of community- and zoonotically acquired respiratory tract infections, and emerging pathogens among the Chlamydia-related bacteria have been implicated in airway infections. The role of both in airway infections in Africa is underexplored. We performed a case -control study on the prevalence of Chlamydiaceae and Chlamydia-related emerging pathogens in children with febrile respiratory tract infections in West Africa, Ghana. Using a pan-Chlamydiales broad-range real-time PCR, we detected chlamydial DNA in 11 (1.9% of 572 hospitalized febrile children with respiratory tract symptoms and in 24 (4.3% of 560 asymptomatic age-matched controls (p 0.03. Chlamydiaceae were found to be common among both symptomatic and healthy Ghanaian children, with Chlamydia pneumoniae being the most prevalent species. Parachlamydiaceae were detected in two children without symptoms but not in the symptomatic group. We identified neither Chlamydia psittaci nor Simkania negevensis but a member of a new chlamydial family that shared 90.2% sequence identity with the 16S rRNA gene of the zoonotic pathogen Chlamydia pecorum. In addition, we found a new Chlamydia-related species that belonged to a novel family sharing 91.3% 16S rRNA sequence identity with Candidatus Syngnamydia venezia. The prevalence and spectrum of chlamydial species differed from previous results obtained from children of other geographic regions and our study indicates that both, Chlamydiaceae and Chlamydia-related bacteria, are not clearly linked to clinical symptoms in Ghanaian children.

  1. Upper respiratory tract diseases in workers exposed to chrysotile-asbestos dust

    Energy Technology Data Exchange (ETDEWEB)

    Ostapkovich, E.V.

    A study of morbidity and temporary incapacity to work among workers exposed to chrysotile-asbestos dust combined with examinations of their upper respiratory tract provided the basis for developing scientifically based methods of effective monitoring and treatment for all persons working under dusty conditions. It was found that a 2 mg/m/sup 3/ concentration of chrysotile-asbestos dust causes development of pathologies of the upper respiratory tract in the first years of worker exposure and the pathological processes intensify according to the length of service. The study made it possible to classify workers according to findings from examination of the upper respiratory tract. The classification includes 1 group of workers with low risk of development of upper respiratory pathology from working under dusty conditions and 3 groups which had experienced specific changes in the upper respiratory tract. Group 2 includes persons with catarrhal processes in the upper respiratory tract, chronic tonsillitis and chronic sinusitis; group 3 includes workers with allergic and dystrophic processes in the upper respiratory tract and group 4 includes workers with diffuse hyperplasia (pre-cancerous processes) of the throat. Development of serious changes in the upper respiratory tract of workers exposed to dust must be considered to be an occupational disease, especially in workers with long service. 12 references.

  2. Neisseria models of infection and persistence in the upper respiratory tract.

    Science.gov (United States)

    Weyand, Nathan J

    2017-04-01

    The Gram-negative bacteria genus Neisseria includes both pathogenic and commensal species that are found primarily in the upper respiratory tract of humans and animals. The development of animal models to study neisserial pathogenesis has focused almost exclusively on two species that cause disease in humans. These include Neisseria meningitidis, an obligate commensal that can cause invasive disease, and N. gonorrhoeae, the causative agent of gonorrhea. Both pathogens can persist in the upper respiratory tract. This article will give a brief overview of the genus Neisseria. The anatomy of the upper respiratory tract and its use as a niche for bacteria will be discussed. Next, studies that provide insight about the first stage of upper respiratory tract infection, namely colonization, will be reviewed. Most studies of upper respiratory tract infection have focused on N. meningitidis infections of laboratory mice. This review will also discuss models of respiratory tract persistence by Neisseria species, including commensals, in mice, non-human primates and human volunteers. The article includes a section that discusses the future utility of upper respiratory tract models in informing the development of effective antimicrobial therapies. Such knowledge is needed to minimize the dissemination of antimicrobial resistance from respiratory reservoirs. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Impact of meteorological factors on lower respiratory tract infections in children.

    Science.gov (United States)

    Liu, Yonglin; Liu, Juan; Chen, Fenglian; Shamsi, Bilal Haider; Wang, Qiang; Jiao, Fuyong; Qiao, Yanmei; Shi, Yanhua

    2016-02-01

    To evaluate retrospectively the relationship between meteorological factors in Shenmu County, Yulin City, Shaanxi Province, China and the incidence of lower respiratory tract infections in children. Meteorological data (air temperature, atmospheric pressure, rainfall, hours of sunlight, wind speed and relative humidity) for Shenmu County and medical data from hospitalized patients aged ≤16 years were collected between January 2009 and December 2012. The association between meteorological factors and rate of hospitalization due to lower respiratory tract infections was investigated; the total hospitalization rate was compared with the rate of lower respiratory tract disease-related hospitalizations. The leading bacterial causes of lower respiratory tract infections were Streptococcus pneumoniae and Haemophilus influenzae type B; the main viral cause was respiratory syncytial virus. Lower respiratory tract infection hospitalization rate was significantly correlated with air temperature (R = -0.651), atmospheric pressure (R = 0.560), rainfall (R = -0.614) and relative humidity (R = -0.470), but not with hours of sunlight (R = -0.210) or wind speed (R = 0.258). Using multiple linear regression, lower respiratory tract infection hospitalization rate decreased with a gradual increase in air temperature (F = 38.30) and relative humidity (F = 15.58). Air temperature and relative humidity were major influencing meteorological factors for hospital admissions in children due to lower respiratory tract infections. © The Author(s) 2015.

  4. PREVENTION OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN

    OpenAIRE

    O.V. Karneeva

    2009-01-01

    The issue of inflammatory diseases of the upper airways and eardrum remains relevant and associated both with high prevalence of this pathology and likelihood of developing complications. Inflammation of nasal cavity’s mucosal lining causes discomfort, while chronic dysfunction of nasal breathing significantly reduces the patient’s quality of life. Difficulty in nasal breathing of newborns and infants results in quite severe complications. Nearly 70% of acute respiratory infections cases in c...

  5. Evaluation of the BioFire FilmArray respiratory panel and the GenMark eSensor respiratory viral panel on lower respiratory tract specimens.

    Science.gov (United States)

    Ruggiero, Phyllis; McMillen, Tracy; Tang, Yi-Wei; Babady, N Esther

    2014-01-01

    We evaluated the performance characteristics of the FilmArray respiratory panel and the eSensor respiratory viral panel on clinical and spiked lower respiratory tract specimens (LRTS). The overall agreement between the two methods was 89.5% (51/57). The lower limit of detection of both assays for all targets in LRTS was comparable to that for nasopharyngeal swab specimens.

  6. Risk factors and features of recurrent bacterial complications of upper respiratory tract viral infections in children

    Directory of Open Access Journals (Sweden)

    Karpenko A.V.

    2017-10-01

    Full Text Available The aim of the study was to determine risk factors for recurrent bacterial complications of the upper respiratory tract viral infection (URTI in children, as well as the clinical and immunological features of the course of such complications. We enrolled 214 children aged 3-18 years with URTIs complicated with acute otitis media or acute bacterial rhinosinusitis. Frequency of bacterial complications of URI in 128 children was low (group I and in 86 children it met the criteria of recurrent course (group II. In addition to the standard examination, lysozyme levels in the oropharyngeal secretion were determined three times during the disease. It was found that children of group II were characterized by an early debut of respiratory morbidity (at the age of 6.00 (4.00, 12.00 months against 13.00 (4.50, 16.00 months in children of group I (p<0,0001, as well as a longer duration of catarrhal and intoxication syndromes in similar forms of the disease. The most significant risk factors for the formation of the recurring complication pattern were maternal smoking (OR=2.73, 95% CI [1.34, 5.48], along with gastroenterological pathology and frequent URTI in the mother and a shortened period of breastfeeding. In children with recurrent bacterial complications of URTI, there was an impaired local resistance of the upper respiratory tract mucous membranes (as a decrease in the concentrations of lysozyme in all periods of the disease, which persisted after recovery.

  7. Differential expression of the Middle East respiratory syndrome coronavirus receptor in the upper respiratory tracts of humans and dromedary camels

    NARCIS (Netherlands)

    W. Widagdo; V.S. Raj (Stalin); D. Schipper (Debby); K. Kolijn (Kimberley); G.J.H.L. Leenders (Geert); B.J. Bosch (Berend Jan); A. Bensaid (Albert); J. Segalés (Joaquim); W. Baumgärtner (Wolfgang); A.D.M.E. Osterhaus (Albert); M.P.G. Koopmans D.V.M. (Marion); J.M.A. van den Brand (Judith); B.L. Haagmans (Bart)

    2016-01-01

    textabstractMiddle East respiratory syndrome coronavirus (MERS-CoV) is not efficiently transmitted between humans, but it is highly prevalent in dromedary camels. Here we report that the MERS-CoV receptor-dipeptidyl peptidase 4 (DPP4)-is expressed in the upper respiratory tract epithelium of camels

  8. Local interferon-gamma levels during respiratory syncytial virus lower respiratory tract infection are associated with disease severity

    NARCIS (Netherlands)

    Bont, L; Heijnen, CJ; Kavelaars, A; van Aalderen, WMC; Brus, F; Draaisma, JMT; Pekelharing-Berghuis, M; van Diemen-Steenvoorde, RAAM; Kimpen, JLL

    2001-01-01

    To investigate the role of cell-mediated immunity during respiratory syncytial virus (RSV) infection, interferon (IFN)-gamma and interleukin (IL)-10 levels in nasopharyngeal secretions were measured in infants with lower respiratory tract infection (LRTI) caused by RSV. A novel technique was used to

  9. [Dirithromycin in the treatment of infections of the lower respiratory tract].

    Science.gov (United States)

    Belousov, Iu B; Bykov, A V; Komirova, V P; Malikov, V E; Minaev, V I

    1995-07-01

    Good results of the treatment of patients with lower respiratory tract infections with dirithromycin (Eli Lilly, USA), a new semisynthetic macrolide, were recorded. The trial included 15 patients: 6 with acute bronchitis (AB) and 9 with exacerbation of chronic bronchitis (AB) and 9 with exacerbation of chronic bronchitis (ECB). The antibiotic was administered orally in a single dose of 500 mg once a day for 7 days. The treatment efficacy was estimated by the clinical results and laboratory findings. The sputum specimens were investigated bacteriologically with testing the microflora for the drug susceptibility by using the diffusion disks. 50 per cent of the patients with AB isolated Streptococcus viridans with low (the diameter of the growth inhibition zones treatment in another 2 patients with ECB. In all the other patients the pathogen was shown to be eradicated. In the patients isolating the new pathogen the symptomatic recovery was stated in the posttherapeutic period. Therefore, diritromycin proved to be efficient in 13 out of the 15 patients with lower respiratory tract infections. It should be noted that the drug tolerance was excellent. None of the patients showed any adverse reactions.

  10. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update.

    Science.gov (United States)

    Seto, W H; Conly, J M; Pessoa-Silva, C L; Malik, M; Eremin, S

    2013-01-01

    Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.

  11. Numerical simulation of migration behavior of uranium ore dust particles in the human respiratory tract

    Science.gov (United States)

    Ye, Yong-jun; Yin, An-song; Li, Zhi; Lei, Bo; Ding, De-xin

    2017-04-01

    There is a certain concentration of radioactive dust particles in the air of workplace of underground uranium mines. Some small diameter particles will pass through the masks and enter the respiratory tract which will cause radiation damage to the human body. In order to study deposition regularity of uranium dust in the human respiratory tract, in this paper, we firstly use the RNG turbulence model to simulate the gas flow field in the human respiratory tract Z0 ∼ Z3 level under different respiratory intensity. Then we use DPM discrete phase model to simulate the concentration, particle size distribution, deposition rate and deposition share of uranium dust particles after being filtered through the masks in the human respiratory tract Z0 to Z3 bronchus. According to the simulation results, we have got the following conclusions: the particles’ number concentration of uranium dust after being filtered through the mask in the human respiratory tract basically decreases with the increasing of particle size under different respiratory intensities on the environment of uranium mine. In addition, the intensity of respiration and the mass concentration of particles have an important influence on the deposition rate and the deposition of particles in the respiratory tract.

  12. [Mycoplasma sp. in the respiratory tract of hospitalized children].

    Science.gov (United States)

    García-Ramos, E; Gutiérrez, A G; Ortega-Palma, O; Pizarro-Suárez, E

    1993-01-01

    Mycoplasma pneumoniae is one of the most common bacteria causing respiratory diseases in other countries, specially in older children, adolescents and young adults and less frequently in the age group studied here, nevertheless the determination of its presence in this group was considered important. Two hundred and fifty throat swabs were taken from children, under five years of age, hospitalized with a diagnosis of acute respiratory infections (ARI) and to 50 children, same age, with no ARI (controls). The samples were placed in transport media and were incubated at 37 degrees C during 7 to 15 days. They were reinoculated in PPLO agar and typical colonies were looked for, 5 to 8 days later. The organisms were identified by biochemical tests. Eight Mycoplasma sp (3.2%) were obtained, five of them were M. pneumoniae (2.0%) and three M. hominis (1.2%). Only in 2 cases adenoviruses with M. hominis were found in the absence of other pathogens. It was shown that M. pneumoniae also infects children under five years old, so its present should be suspected, specially when the patient's health does not improve with the installed treatment. Some important suggestions for the isolation of mycoplasma are given.

  13. Etiology of Acute Respiratory Infections in Infants: A Prospective Birth Cohort Study.

    Science.gov (United States)

    Kumar, Prawin; Medigeshi, Guruprasad R; Mishra, Vishnu S; Islam, Mojahidul; Randev, Shivani; Mukherjee, Aparna; Chaudhry, Rama; Kapil, Arti; Ram Jat, Kana; Lodha, Rakesh; Kabra, Sushil K

    2017-01-01

    There is paucity of studies on etiology of acute respiratory infections (ARI) in infants. The objective of this study is to document incidence and etiology of ARI in infants, their seasonal variability and association of clinical profile with etiology. A birth cohort was followed for the first year of life; for each episode of ARI, nasopharyngeal aspirates were collected to identify the causative respiratory virus(es) using multiplex real-time polymerase chain reaction assay. For lower respiratory tract infections blood culture, serum procalcitonin, serum antibodies to Mycoplasma and Chlamydia and urinary Streptococcus pneumoniae antigen were also assayed. A total of 503 ARI episodes were documented in 310 infants for an incidence rate of 1.8 episodes per infant per year. Of these, samples were processed in 395 episodes (upper respiratory tract infection: 377; lower respiratory tract infection: 18). One or more viruses were detected in 250 (63.3%) episodes and viral coinfections in 72 (18.2%) episodes. Rhinovirus was the most common virus [105 (42%)] followed by respiratory syncytial virus [50 (20%)], parainfluenza virus [42 (16.8%)] and coronavirus [44 (17.6%)]. In lower respiratory tract infections, viral infections were detected in 12 (66.7%) episodes, bacterial infections in 17 (94.4%) episodes and mixed bacterial-viral infections in 8 (44.4%) episodes. Peak incidence of viruses was observed during February-March and September-November. There was no significant difference in symptom duration with virus types. In this cohort of infants, ARI incidence was 1.8 episodes per year per infant; 95% were upper respiratory tract infections. Viruses were identified in 63.3% episodes, and the most common viruses detected were rhinovirus, respiratory syncytial virus and parainfluenza virus.

  14. Mathematical justification of the acoustic method for measuring the impedance of the respiratory tract.

    Science.gov (United States)

    Bogomolov, A V; Dragan, S P

    2015-01-01

    A new method for measuring a complex frequency-dependent acoustic impedance of the respiratory tract based on two-microphone method was developed. The measuring device consists of a waveguide connected through a mouthpiece to the patient's mouth. A sound field with a frequency range from 5 to 100 Hz is created in the waveguide. The impedance of the respiratory tract is determined at free respiration of the patient in the set frequency range; the duration of examination does not exceed 15 s. The criteria for the recognition of respiratory tract pathologies are proposed.

  15. Providing evidence for use of Echinacea supplements in Hajj pilgrims for management of respiratory tract infections.

    Science.gov (United States)

    Daneshmehr, Mohammad Ali; Tafazoli, Ali

    2016-05-01

    To evaluate potential applicability of Echinacea use for management of respiratory tract infections in Hajj travelers. The PubMed database was explored with Mesh terms "Echinacea" and "Respiratory Tract Infections". A hundred journal articles were yielded but only 66 most relevant ones used for the review. There is a considerable amount of evidence that shows effectiveness of Echinacea products in prevention and treatment of respiratory tract infections in this setting. Although there are some controversial findings, utilization of standardized products with adequate dose or combinations with other immune-stimulants in controlled and well-designed trials will be highly encouraging. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. [Respiratory insufficiency in acute bronchiolitis in infancy].

    Science.gov (United States)

    Grubbauer, H M; Haim, M; Zach, M; Zobel, G

    1989-06-01

    Forty-one infants with acute viral bronchiolitis were hospitalized in our paediatric intensive care unit during the seven year period from 1980 to 1987. In 14 out of 27 evaluated patients, Respiratory Syncitial Virus (RSV) was detected in the nasal secretions. Twenty-three children required only supportive care and monitoring. Eighteen infants had to be ventilated because of respiratory failure. The major indication for mechanical ventilation was an arterial or capillary pCO2 of more than 64 mmHg; other criteria were repeated apnoea, respiratory acidosis, and clinical deterioration. In all cases the type of the mechanical ventilation was an intermittent mandatory ventilation (IMV) with flow and time cycled respirators; muscle relaxation was not required in any case. The average duration of mechanical ventilation was 40 hours. All the children recovered uneventfully. These data suggest that even the most severe cases of acute bronchiolotis can be treated successfully, and that the mortality rate of this disease entity can be reduced to zero.

  17. Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

    Science.gov (United States)

    de Steenhuijsen Piters, Wouter A A; Huijskens, Elisabeth G W; Wyllie, Anne L; Biesbroek, Giske; van den Bergh, Menno R; Veenhoven, Reinier H; Wang, Xinhui; Trzciński, Krzysztof; Bonten, Marc J; Rossen, John W A; Sanders, Elisabeth A M; Bogaert, Debby

    2016-01-01

    Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease. We compared oropharyngeal microbiota of elderly pneumonia patients (n=100) with healthy elderly (n=91) by 16S-rRNA-based sequencing and verified our findings in young adult pneumonia patients (n=27) and young healthy adults (n=187). Microbiota profiles differed significantly between elderly pneumonia patients and healthy elderly (PERMANOVA, Ppneumonia patients and their healthy controls. Clustering resulted in 11 (sub)clusters including 95% (386/405) of samples. We observed three microbiota profiles strongly associated with pneumonia (Ppneumoniae (n=42). In contrast, three other microbiota clusters (in total n=183) were correlated with health (Ppneumonia patients from healthy individuals. These results suggest that pneumonia in elderly and young adults is associated with dysbiosis of the URT microbiome with bacterial overgrowth of single species and absence of distinct anaerobic bacteria. Whether the observed microbiome changes are a cause or a consequence of the development of pneumonia or merely coincide with disease status remains a question for future research. PMID:26151645

  18. Pattern of acute respiratory infections in hospitalized children under ...

    African Journals Online (AJOL)

    Pattern of acute respiratory infections in hospitalized children under five years of age in Jos Nigeria. ... Abstract. Background: Acute respiratory infections are the commonest cause of acute morbidity in children especially those under five in the developing countries. ... prevalence of 43.5/1000 person per year (39/897).

  19. Ventilator induced lung injury (VILI) in acute respiratory distress ...

    African Journals Online (AJOL)

    Acute respiratory distress syndrome is the most severe manifestation of acute lung injury and it is associated with high mortality rate. ARDS is characterized by the acute onset of diffuse neutrophilic alveolar infiltrates protein-rich edema due to enhanced alveolar-capillary permeability and hypoxemic respiratory failure.

  20. Acute hypoxemic respiratory failure in immunocompromised patients

    DEFF Research Database (Denmark)

    Azoulay, Elie; Pickkers, Peter; Soares, Marcio

    2017-01-01

    BACKGROUND: In immunocompromised patients with acute hypoxemic respiratory failure (ARF), initial management aims primarily to avoid invasive mechanical ventilation (IMV). METHODS: To assess the impact of initial management on IMV and mortality rates, we performed a multinational observational...... prospective cohort study in 16 countries (68 centers). RESULTS: A total of 1611 patients were enrolled (hematological malignancies 51.9%, solid tumors 35.2%, systemic diseases 17.3%, and solid organ transplantation 8.8%). The main ARF etiologies were bacterial (29.5%), viral (15.4%), and fungal infections (14.......54-0.87), day-1 SOFA excluding respiratory score (1.12/point, 1.08-1.16), PaO2/FiO2

  1. Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

    Science.gov (United States)

    Quick, Melissa

    2015-01-01

    Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio: 0.83; 95% CI = 0.66-1.05, P = .12, very low quality evidence) and adverse

  2. An association of serum vitamin D concentrations respiratory tract infection in young Finnish men.

    Science.gov (United States)

    Laaksi, Ilkka; Ruohola, Juha-Petri; Tuohimaa, Pentti; Auvinen, Anssi; Haataja, Riina; Pihlajamäki, Harri; Ylikomi, Timo

    2007-09-01

    The effects of vitamin D in regulating bone mineralization are well documented. The action of vitamin D as a key link between Toll-like receptor activation and antibacterial responses in innate immunity has recently been shown. The data suggest that differences in the ability of human populations to produce vitamin D may contribute to susceptibility to microbial infection. We aimed to explore whether an association exists between vitamin D insufficiency and acute respiratory tract infection in young Finnish men. Young Finnish men (n = 800) serving on a military base in Finland were enrolled for this study. Their serum 25-hydroxyvitamin [25(OH)D] concentrations were measured in July 2002. They were followed for 6 mo, and the number of days of absence from duty due to respiratory infection were counted. The mean (+/- SD) serum 25(OH)D concentrations were 80.2 +/- 29.3 nmol/L (n = 756). Subjects with serum 25(OH)D concentrations respiratory infection (median: 4; quartile 1-quartile 3: 2-6) than did control subjects (2; 0-4; n = 628; incidence rate ratio 1.63; 95% CI: 1.15, 2.24). We found a significant (P = 0.004) association between serum 25(OH)D concentrations and the amount of physical exercise before induction into military service. We also found significantly (P vitamin D supplementation are needed to investigate whether it enhances immunity to microbial infections.

  3. Human coronavirus and severe acute respiratory infection in Southern Brazil.

    Science.gov (United States)

    Trombetta, Hygor; Faggion, Heloisa Z; Leotte, Jaqueline; Nogueira, Meri B; Vidal, Luine R R; Raboni, Sonia M

    2016-05-01

    Human coronaviruses (HCoVs) are an important cause of respiratory tract infection and are responsible for causing the common cold in the general population. Thus, adequate surveillance of HCoV is essential. This study aimed to analyze the impact of HCoV infections and their relation to severe acute respiratory infection (SARI) in a hospitalized population in Southern Brazil. A cross-sectional study was conducted at a tertiary care hospital, and assessed inpatients under investigation for SARI by the hospital epidemiology department, and all patients who had nasopharyngeal aspirates collected from January 2012 to December 2013 to detect respiratory viruses (RVs). Viral infection was detected by multiplex reverse transcriptase polymerase chain reaction (RT-PCR), with primers specific to the subtypes HCoV-229E/NL63 and OC43/HKU1. The overall positivity rate was 58.8% (444/755), and HCoVs were detected in 7.6% (n = 34) of positive samples. Children below two years of age were most frequently affected (62%). Comorbidities were more likely to be associated with HCoVs than with other RVs. Immunosuppression was an independent risk factor for HCoV infection (OR = 3.5, 95% CI 1.6-7.6). Dyspnea was less frequently associated with HCoV infection (p infected with HCoV (9%) died from respiratory infection. HCoVs are important respiratory pathogens, especially in hospitalized children under 2 years of age and in immunosuppressed patients. They may account for a small proportion of SARI diagnoses, increased need for mechanical ventilation, intensive care unit admission, and death.

  4. Incidência de infecção viral do trato respiratório em asma aguda atendida em sala de emergência Incidence of viral infection of the respiratory tract in acute asthma patients treated in the emergency room

    Directory of Open Access Journals (Sweden)

    Ivete Terezinha Machado da Rocha

    2005-10-01

    respiratory syncytial virus, adenovirus and influenza, as well as for parainfluenza types 1, 2, 3 and 4. Data were collected regarding demographic characteristics, medical history, the attack that led to the current emergency room visit, and clinical outcomes. RESULTS: From March to July of 2004, 49 patients were examined for viral infection of the respiratory tract. Respiratory viruses were identified in 6 patients (3 with adenovirus, 2 with influenza A, 1 with parainfluenza type 1. The mean age of the patients with viral infection of the respiratory tract was 61.7 ± 11.5 years, compared with 41.7 ± 20.9 years for the patients without such infection (p = 0.027. There were no other significant differences in clinical characteristics or outcomes. CONCLUSION: The incidence of viral infection of the respiratory tract in acute asthma patients 12 years and older treated in an emergency room was 12.2%, which confirms that viral infection is a significant precipitant of acute asthma for patients in this age bracket.

  5. [Evaluation of clinical and laboratory findings of pediatric patients with adenovirus-associated respiratory tract infections].

    Science.gov (United States)

    Biçer, Suat; Küçük, Oznur; Giray, Tuba; Cöl, Defne; Ciler Erdağ, Gülay; Gürol, Yeşim; Yılmaz, Gülden; Vitrinel, Ayça

    2013-04-01

    Upper respiratory tract infections caused by adenoviruses present long lasting fever for five days and elevated acute phase reactant levels. They are generally misdiagnosed as bacterial infections and are mistreated with antibiotics. The diagnosis of adenovirus infections mainly depends on direct antigen tests, virus isolation and detection of viral DNA using polymerase chain reaction (PCR). The aim of this study was to evaluate the clinical and laboratory findings of the children diagnosed as adenoviral respiratory tract infection by multiplex PCR (mPCR). A total of 27 children (18 male, 9 female; age range: 1-7 years, mean age: 4.4 years) whose nasopharyngeal swab samples were found positive for adenovirus DNA with a commercial mPCR method (Seeplex® RV15 ACE Detection Kit, Seegene Inc, Korea) were included in the study. The throat cultures of the patients revealed no bacterial pathogens and EBV VCA-IgM antibodies were negative. The clinical and laboratory data of the children with long lasting high fever diagnosed as adenovirus infection were evaluated retrospectively in terms of their complaints on admission, symptoms detected in physical examination, laboratory findings and therapy protocols. The patients were categorized according to hospitalization period ( 2) and the presence of upper or lower respiratory tract findings were evaluated if there were a difference by means of hospitalization rate and period. The most common complaint of the patients with adenoviral respiratory diseases was fever (27/27; 100%), and the most common admittance season was april-may-june period (20/27; 74%). The mean temperature was 38.4°C (range: 38-39.8°C) and the fever continued for 1-5 days after hospitalization. The most common physical examination finding was tonsillary hyperemia and hypertrophy (63%), followed by lower respiratory tract disease symptoms (37%), otitis media (14.8%), conjunctivitis (7.4%), and rash (3.7%). Laboratory tests could be performed for 24 cases and

  6. Cigarette Smoke Exposure and the Acute Respiratory Distress Syndrome

    OpenAIRE

    Calfee, CS; Matthay, MA; Kangelaris, KN; Siew, ED; Janz, DR; Bernard, GR; May, AK; Jacob, P; Havel, C; Benowitz, NL; Ware, LB

    2015-01-01

    © 2015 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. The association between cigarette smoke exposure and the acute respiratory distress syndrome in patients with the most common acute respiratory distress syndrome risk factors of sepsis, pneumonia, and aspiration has not been well studied. The goal of this study was to test the association between biomarker-confirmed cigarette smoking and acute respiratory distress syndrome in a diverse cohort. Design: Prospective ...

  7. Inappropriate antibiotic prescription for respiratory tract indications : most prominent in adult patients

    NARCIS (Netherlands)

    Dekker, Anne R. J.; Verheij, Theo J. M.; van der Velden, Alike W.

    Background. Numerous studies suggest overprescribing of antibiotics for respiratory tract indications (RTIs), without really authenticating inappropriate prescription; the strict criteria of guideline recommendations were not taken into account as information on specific diagnoses, patient

  8. Antibiotics for respiratory, ear and urinary tract disorders and consistency among GPs.

    NARCIS (Netherlands)

    Ong, D.S.Y.; Kuyvenhoven, M.M.; Dijk, L. van; Verheij, T.J.M.

    2008-01-01

    Objectives: To describe specific diagnoses for which systemic antibiotics are prescribed, to assess adherence of antibiotic choice to national guidelines and to assess consistency among general practitioners (GPs) in prescribed volumes of antibiotics for respiratory, ear and urinary tract disorders.

  9. Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Sigurðardóttir, Nanna Rún; Nielsen, Anni Brit Sternhagen; Munck, Anders

    2015-01-01

    Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland. Design: A cross-sectional study. Settings and subjects. General practitioners (GPs...

  10. Antibiotic treatment and the diagnosis of Streptococcus pneumoniae in lower respiratory tract infections in adults

    DEFF Research Database (Denmark)

    Korsgaard, Jens; Møller, Jens Kjølseth; Kilian, Mogens

    2005-01-01

    OBJECTIVE: To analyze the possible influence of antibiotic treatment on the results of different diagnostic tests for the diagnosis of lower respiratory tract infections with Streptococcus pneumoniae. MATERIAL AND METHODS: A prospective cohort of 159 unselected adult immunocompetent patients...

  11. The effect of vitamin D on lower respiratory tract infections in children

    National Research Council Canada - National Science Library

    Şişmanlar, Tuğba; Aslan, Ayşe Tana; Gülbahar, Özlem; Özkan, Seçil

    2016-01-01

    .... Vitamin D deficiency and lower respiratory tract infection are common health problems in children in our country and no clinical study investigating the relationship between these problems has been conducted so far...

  12. Prevention of paediatric respiratory tract infections: emphasis on the role of OM-85

    OpenAIRE

    Schaad, U B

    2005-01-01

    The burden of respiratory tract infections in paediatrics is extremely high, in both industrialised and developing countries. Because adequate diagnosis and causative therapies of these often recurrent respiratory tract infections bear substantial limits, preventive measures deserve priority. The mainstays are parent education, active immunisation strategies and nonspecific immunostimulation with bacterial products. This article summarises the five key studies on the use of the immunoactive a...

  13. Ethnic variations in morbidity and mortality from lower respiratory tract infections: a retrospective cohort study.

    Science.gov (United States)

    Simpson, Colin R; Steiner, Markus Fc; Cezard, Genevieve; Bansal, Narinder; Fischbacher, Colin; Douglas, Anne; Bhopal, Raj; Sheikh, Aziz

    2015-10-01

    There is evidence of substantial ethnic variations in asthma morbidity and the risk of hospitalisation, but the picture in relation to lower respiratory tract infections is unclear. We carried out an observational study to identify ethnic group differences for lower respiratory tract infections. A retrospective, cohort study. Scotland. 4.65 million people on whom information was available from the 2001 census, followed from May 2001 to April 2010. Hospitalisations and deaths (any time following first hospitalisation) from lower respiratory tract infections, adjusted risk ratios and hazard ratios by ethnicity and sex were calculated. We multiplied ratios and confidence intervals by 100, so the reference Scottish White population's risk ratio and hazard ratio was 100. Among men, adjusted risk ratios for lower respiratory tract infection hospitalisation were lower in Other White British (80, 95% confidence interval 73-86) and Chinese (69, 95% confidence interval 56-84) populations and higher in Pakistani groups (152, 95% confidence interval 136-169). In women, results were mostly similar to those in men (e.g. Chinese 68, 95% confidence interval 56-82), although higher adjusted risk ratios were found among women of the Other South Asians group (145, 95% confidence interval 120-175). Survival (adjusted hazard ratio) following lower respiratory tract infection for Pakistani men (54, 95% confidence interval 39-74) and women (31, 95% confidence interval 18-53) was better than the reference population. Substantial differences in the rates of lower respiratory tract infections amongst different ethnic groups in Scotland were found. Pakistani men and women had particularly high rates of lower respiratory tract infection hospitalisation. The reasons behind the high rates of lower respiratory tract infection in the Pakistani community are now required. © The Royal Society of Medicine.

  14. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis

    OpenAIRE

    Jaykaran Charan; Goyal, Jagdish P.; Deepak Saxena; Preeti Yadav

    2012-01-01

    Objectives : To explore the effect of vitamin D supplementation in prevention of respiratory tract infections on the basis of published clinical trials. Materials and Methods : Clinical trials were searched from various electronic databases. Five clinical trials were suitable for inclusion. Outcome was events of respiratory tract infections in vitamin D group and placebo group. Data was reported as odds ratio with 95% confidence interval. Both random and fixed model was used for analysis. Ana...

  15. Periodontitis and nosocomial lower respiratory tract infection: preliminary findings.

    Science.gov (United States)

    Gomes-Filho, Isaac Suzart; Santos, Carla M L; Cruz, Simone S; Passos, Johelle de S; Cerqueira, Eneida de M M; Costa, Maria da Conceição N; Santana, Teresinha C; Seymour, Gregory J; Santos, Carlos Antonio de S T; Barreto, Maurício L

    2009-05-01

    To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). A case-control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [OR(crude)=1.70; 95% confidence interval:(0.60-4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [OR(adjusted)=3.67 (1.01-13.53); p=0.049]. A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

  16. Acute Respiratory Failure in Acute Poisoning by Neutrotropic Substances

    Directory of Open Access Journals (Sweden)

    A. N. Lodyagin

    2008-01-01

    Full Text Available Objective: to evaluate the efficiency of methods for diagnosing and treating critically ill patients with acute respiratory failure (ARF in acute poisoning by neurotropic substances. Subjects and methods. Two hundred and thirty-three patients with acute severe intoxication with neurotropic poisons were examined. All the patients were admitted for toxic-hypoxic coma and ARF; in this connection all the patients underwent artificial ventilation (AV. The patients were divided into 3 groups: 1 those in whom the traditional treatments (AV, detoxifying therapy, and infusional and cardiotropic support could restore the basic parameters of vital functions, as judged from the recovered oxygenation index; these patients had no metabolic shifts; 2 those who had signs of pulmonary hyperhydration, low cardiac output and moderate metabolic disorders, as suggested by elevated lactate levels; 3 seriously ill patients in whom the interval between the time of poisoning to care delivery was more than 20 hours; the patients of this group had the most significant metabolic disorders. Results. Correction of ARF in critically ill patients with acute poisoning should include, in addition to the rational parameters of AV and detoxifying therapy, agents for targeted therapy for sequels of hypoxia and energy deficiency states. For maximally rapid and effective oxygen transport recovery, the addition of perfluorane to the complex therapy cardinally improves the results of treatment and reduces mortality rates. Conclusion. The complexity of the pathogenesis of ARF and its sequels is a ground for diagnosing and correcting not only ventilation disturbances, but also pulmonary microcirculatory disorders and metabolic disturbances. Key words: acute intoxication with neu-rotropic poisons, acute respiratory failure, pulmonary hyperhydration, hypoxia, metabolic disturbances.

  17. Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes

    Directory of Open Access Journals (Sweden)

    Ran Li

    2017-01-01

    Full Text Available The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O3, nitrogen dioxide (NO2, carbon monoxide (CO, sulfur dioxide (SO2, and particulate matter (PM2.5 and PM10. We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI, acute bronchitis (AB, community-acquired pneumonia (CAP, acute exacerbation of chronic obstructive pulmonary disease (AECOPD, acute exacerbation of asthma (AE-asthma, and acute exacerbation of bronchiectasis (AEBX. A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM2.5, PM10, NO2, SO2, and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM10, SO2, and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O3 was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants.

  18. Treatment of adults with community-acquired respiratory tract infections: results of a multicentric clinical trial with gatifloxacin

    Directory of Open Access Journals (Sweden)

    Medeiros Eduardo Alexandrino Servolo

    2002-01-01

    Full Text Available Respiratory tract infections have an important clinical and economic impact and they are the most common indication for antibiotic use in outpatient practice. This prospective, multicenter non-controlled trial assessed the efficacy and safety of gatifloxacin in the treatment of community-acquired respiratory tract infections. Patients were treated with a daily oral dose of gatifloxacin 400 mg for 7-14 days. The diagnosis of respiratory infection was made based on the clinical condition and/or radiologic findings. A total of 5,044 adult patients with community-acquired respiratory infections was treated with gatifloxacin in different centers in Brazil between March 1, 2001, and October 31, 2001. Among the 5,044 patients treated, 1,501 patients (29.76% had community-acquired pneumonia, 756 (14.99% had acute exacerbation of chronic bronchitis and 2,787 (55.25% had acute sinusitis. Of the total of patients treated, 3,607 (71.51% were considered cured, 1,261 (25% progressed with some clinical improvement, 28 (0.56% presented a relapse, 56 (1.11% failed to treatment and 92 (1.82% were unable to be evaluated. Adverse events were described in 634 (12.57% patients. The most common adverse events were: nausea (2.24%; dyspepsia (1.86%; diarrhea (0.79%; change in taste (0.46%; insomnia and irritability (0.22%; dizziness (0.77%; headache (0.42%; allergic reaction (0.18%; Central Nervous System alterations - insomnia, agitation, anxiety - (0.46%. This study showed that the treatment of respiratory tract infections with gatifloxacin was safe and efficient and had a low incidence of adverse events.

  19. Hospital admissions for lower respiratory tract infections among infants in the Canadian Arctic: a cohort study.

    Science.gov (United States)

    Banerji, Anna; Panzov, Val; Young, Michael; Robinson, Joan; Lee, Bonita; Moraes, Theo; Mamdani, Muhammad; Giles, B Louise; Jiang, Depeng; Bisson, Danny; Dennis, Marguerite; Morel, Johanne; Hall, Judith; Hui, Charles; Paes, Bosco; Mahony, James B

    2016-01-01

    It is unknown whether this burden of disease of lower respiratory tract infections is comparable across the Canadian Arctic. The objectives of this surveillance study were to compare the rates of hospital admission for lower respiratory tract infection and the severity of infection across Arctic Canada, and to describe the responsible viruses. We performed a prospective multicentre surveillance study of infants less than 1 year of age admitted in 2009 with lower respiratory tract infection to all hospitals (5 regional, 4 tertiary) in the Northwest Territories, Nunavut and Nunavik to assess for regional differences. Nasopharyngeal aspirates were processed by means of a polymerase chain reaction respiratory viral panel, testing for 20 respiratory viruses and influenza A (H1N1). The role of coinfection was assessed by means of regression analysis for length of stay (short: 14 d). Outcomes compared included rates of lower respiratory tract infection, respiratory syncytial virus infection, transfer to tertiary hospital and severe lower respiratory tract infection (respiratory failure, intubation and mechanical ventilation, and/or cardiopulmonary resuscitation). There were 348 admissions for lower respiratory tract infection in the population of interest in 2009. Rates of admission per 1000 live births varied significantly, from 39 in the Northwest Territories to 456 in Nunavik (p respiratory tract infection per 1000 live births in the Northwest Territories were 5.6 and 1.4, respectively, compared to 55.9 and 17.1, respectively, in Nunavut and 52.0 and 20.0, respectively, in Nunavik (p ≤ 0.001). Respiratory syncytial virus was the most common virus identified (124 cases [41.6% of those tested]), and coinfection was detected in 51 cases (41.1%) of infection with this virus. Longer length of stay was associated with coinfection (odds ratio [OR] 2.64) and underlying risk factors (OR 4.39). Length of stay decreased by 32.2% for every 30-day increase in age (OR 0

  20. Acute Respiratory Viral Infection in Children: Modern Approaches to Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Alexander A. Baranov

    2017-01-01

    Full Text Available The article is devoted to acute respiratory viral infections (ARVI in children. ARVI take one of the leading places in a childhood morbidity structure. The article provides an overview of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» for acute respiratory infections in children. These guidelines summarize the experience of the leading world and domestic specialists, contain scientific and practical data that correspond to the most relevant trends in the management of children with this pathology. The authors present modern information on the etiology, pathogenesis, classification, clinical findings and differential diagnosis of various nosological forms of acute respiratory tract infections in the pediatric population. The general (strategic principles of drug-free and drug treatment are discussed in detail.

  1. Acute respiratory failure following ovarian hyperstimulation syndrome

    Directory of Open Access Journals (Sweden)

    Antonello Nicolini

    2013-03-01

    Full Text Available Ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiological complication that may be encountered in patients who undergo controlled ovarian hyperstimulation cycles. The syndrome is typically associated with regimes of exogenous gonadotropins, but it can be seen, albeit rarely, when clomiphene is administered during the induction phase. Although this syndrome is widely described in scientific literature and is well known by obstetricians, the knowledge of this pathological and potentially life-threatening condition is generally less than satisfactory among physicians. The dramatic increase in therapeutic strategies to treat infertility has pushed this condition into the realm of acute care therapy. The potential complications of this syndrome, including pulmonary involvement, should be considered and identified so as to allow a more appropriate diagnosis and management. We describe a case of a woman with an extremely severe (Stage 6 ovarian hyperstimulation syndrome who presented ascites, bilateral pleural effusion and severe respiratory failure treated with non-invasive ventilation. The patient was admitted to the intensive care unit because of severe respiratory failure, ascites, and bilateral pleural effusion due to ovarian hyperstimulation syndrome. Treatment included non-invasive ventilation and three thoracentesis procedures, plus the administration of albumin, colloid solutions and high-dose furosemid. Severe form of ovarian hyperstimulation syndrome is observed in 0.5-5% of the women treated, and intensive care may be required for management of thromboembolic complications, renal failure and severe respiratory failure. Pulmonary intensive care may involve thoracentesis, oxygen supplementation and, in more severe cases, assisted ventilation. To our knowledge, there have been only two studies in English language medical literature that describe severe respiratory failure treated with non

  2. Survival of severe acute respiratory syndrome coronavirus.

    Science.gov (United States)

    Lai, Mary Y Y; Cheng, Peter K C; Lim, Wilina W L

    2005-10-01

    The primary modes of transmission of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) appear to be direct mucus membrane contact with infectious droplets and through exposure to formites. Knowledge of the survival characteristics of the virus is essential for formulating appropriate infection-control measures. Survival of SARS-CoV strain GVU6109 was studied in stool and respiratory specimens. Survival of the virus on different environmental surfaces, including a laboratory request form, an impervious disposable gown, and a cotton nondisposable gown, was investigated. The virucidal effects of sodium hypochlorite, house detergent, and a peroxygen compound (Virkon S; Antec International) on the virus were also studied. SARS-CoV GVU6109 can survive for 4 days in diarrheal stool samples with an alkaline pH, and it can remain infectious in respiratory specimens for >7 days at room temperature. Even at a relatively high concentration (10(4) tissue culture infective doses/mL), the virus could not be recovered after drying of a paper request form, and its infectivity was shown to last longer on the disposable gown than on the cotton gown. All disinfectants tested were shown to be able to reduce the virus load by >3 log within 5 min. Fecal and respiratory samples can remain infectious for a long period of time at room temperature. The risk of infection via contact with droplet-contaminated paper is small. Absorbent material, such as cotton, is preferred to nonabsorptive material for personal protective clothing for routine patient care where risk of large spillage is unlikely. The virus is easily inactivated by commonly used disinfectants.

  3. Exploratory mixed methods study of respiratory physiotherapy for patients with lower respiratory tract infections.

    Science.gov (United States)

    Oliveira, A; Marques, A

    2016-03-01

    To assess the outcomes of respiratory physiotherapy for patients with lower respiratory tract infections (LRTI). Parallel group mixed-methods study. Patients were recruited from a general hospital. Respiratory physiotherapy took place in a community setting. Fifty-four patients aged ≥18 years and diagnosed with LRTI completed the study. Twenty-seven patients were allocated to the control group {CG: 10 male, mean age 53.3 [standard deviation (SD) 17.4] years} and 27 patients were allocated to the experimental group [EG: 10 male, mean age 58.6 (SD 17.2) years]. The CG received conventional medical treatment and the EG received conventional medical treatment plus respiratory physiotherapy for 3 weeks. Patients in both groups undertook the 6-minute walk test (6MWT), modified Borg scale (MBS), modified Medical Research Council questionnaire (mMRC), and Breathlessness, Cough and Sputum scale (BCSS) before and after the intervention. A telephone follow-up survey was performed 3 months after the first hospital visit. Interviews were conducted immediately after the intervention in the EG. In the EG, the distance walked in the 6MWT increased by more than the minimally important difference (P=0.001), and significantly more than the CG {EG: mean change 76m [standard deviation (SD) 63], 95% confidence interval (CI) 51 to 101; CG: mean change 27m (SD 56), 95% CI 5 to 49; mean difference between groups: 49m 95% CI 16 to 82; partial η(2)=0.15}. No differences in the MBS, mMRC and BCSS were found between the two groups. The EG reported high levels of satisfaction with the intervention (27/27; 100%) and with the physiotherapist (20/27; 74%). The intervention improved patients' symptoms (19/27; 70%) and their self-management skills to control/prevent future LRTI (19/27; 70%). Health service use was significantly less in the EG (P=0.04). Respiratory physiotherapy appears to be effective for the management of patients with LRTI. CLINICALTRIAL. NCT02053870. Copyright © 2015

  4. Ambulatory antibiotic prescribing for acute bronchitis and cough and hospital admissions for respiratory infections: time trends analysis.

    Science.gov (United States)

    Mainous, Arch G; Saxena, Sonia; Hueston, William J; Everett, Charles J; Majeed, Azeem

    2006-07-01

    To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory infections for adults between 1996 and 2003 in the USA. USA: ambulatory prescribing behaviour was derived from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey while hospitalizations in acute care hospitals were assessed in the National Hospital Discharge Survey. Adults 18-64 years old. None. Proportion of visits for acute bronchitis/cough receiving a prescription for antibiotics and hospitalization for respiratory infections. Ambulatory antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections exhibited non-linear patterns over the 8 year period. However, antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections had a weak/moderate negative association. For three of the seven yearly changes in prescribing and hospitalizations as one increased the other decreased (P<0.01). Ambulatory antibiotic prescribing for respiratory tract infections was inversely associated with hospital admissions for respiratory tract infections.

  5. Is radiological appearance of lower respiratory tract infection due to respiratory syncytial virus a predictor of clinical outcome?

    Science.gov (United States)

    Alkan Ozdemir, Senem; Ozer, Esra Arun; Pekcevik, Yeliz; Ilhan, Ozkan; Sutcuoglu, Sumer

    2015-01-01

    Respiratory syncytial virus (RSV) lower respiratory tract infection is the most common viral infection in childhood. RSV-infected infants demonstrate various radiographic findings. The aim of the study is to evaluate whether assessment of radiological characteristics of lower tract infection due to RSV may be a predictor of clinical outcome in newborns. The study included 36 newborn infants hospitalized for lower tract infection. In order to detect RSV, RSV Respi-Strip (Coris Bioconcept Organization) test kits were used on admission. Chest X-rays and clinical characteristics of the study group were reviewed. Of 36 patients hospitalized for lower tract infection from October 2012 to April 2013, 18 (50%) newborns were infected with RSV. The study included 36 neonates. Patients with RSV-positive infants at admission had greater need for respiratory support, supplemental oxygen and prolonged stay in the NICU. Newborns with an atelectasis pattern on admission chest radiograph had greater at RSV-positive infants. Chest radiological patterns with lower respiratory tract infection in newborn infants due to RSV are a predictor of clinical outcome.

  6. The Recent Severe Acute Respiratory Syndrome (SARS) Epidemic ...

    African Journals Online (AJOL)

    It is a syndrome characterized by fever, cough, sore throat , shortness of breath and malaise which may deteriorate very rapidly to respiratory failure and death. The symptoms of SARS are quite similar to those of common cold, malaria and respiratory tract infections all of which are common in our environment. SARS, being ...

  7. Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet?

    DEFF Research Database (Denmark)

    Aabenhus, R.; Jensen, J.U.

    2011-01-01

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection......, could greatly improve patient care and limit excessive antibiotic prescriptions. Procalcitonin is a new marker of suspected bacterial infection that has shown promise in guiding antibiotic therapy in acute respiratory tract infections in hospitals without compromising patient safety. Procalcitonin...... concentrations in primary care are low and can be used primarily to rule out serious infection. However, procalcitonin measurement should not be used as the sole basis for clinical decisions; clinical skills are prerequisites for the correct use of this new tool in practice. At present there is no point...

  8. Dual infections of PRRSV / influenza or PRRSV / Actinobacillus pleuropneumoniae in the respiratory tract

    NARCIS (Netherlands)

    Pol, J.M.A.; Leengoed, van L.A.M.G.; Stockhofe, N.; Kok, G.; Wensvoort, G.

    1997-01-01

    To study the effect of a previous porcine respiratory and reproductive syndrome-infection (PRRS) of the respiratory tract on influenza virus and Actinobacillus pleuropneumoniae (App) infections, 3-week-old specific-pathogen-free (spf) piglets were intranasally infected with PRRS virus. One week

  9. Effects of ambient air pollution on respiratory tract complaints and airway inflammation in primary school children

    NARCIS (Netherlands)

    Altug, Hicran; Gaga, Eftade O.; Dogeroglu, Tuncay; Brunekreef, Bert|info:eu-repo/dai/nl/067548180; Hoek, Gerard|info:eu-repo/dai/nl/069553475; Van Doorn, Wim

    2014-01-01

    Respiratory health effects of ambient air pollution were studied in 605 school children 9 to 13 years in Eskisehir, Turkey. Each child performed a fractional exhaled nitric oxide (FENO) measurement and a lung function test (LFT). Self-reported respiratory tract complaints (having cold, complaints of

  10. [Viral respiratory co-infections in pediatric patients admitted for acute respiratory infection and their impact on clinical severity].

    Science.gov (United States)

    Martínez, Pamela; Cordero, Jaime; Valverde, Cristián; Unanue, Nancy; Dalmazzo, Roberto; Piemonte, Paula; Vergara, Ivonne; Torres, Juan P

    2012-04-01

    Respiratory viruses are the leading cause of acute respiratory tract infection (ARI) in children. It has been reported that viral respiratory co-infection could be associated with severe clinical course. To describe the frequency of viral co-infection in children admitted for AlRI and evaluate whether this co-infection was associated with more severe clinical course. Prospective, descriptive study in pediatric patients who were hospitalized for ARI, with molecular detection of at least 1 respiratory virus in nasopharyngeal sample studied by PCR-Microarray for 17 respiratory viruses. 110 out of 147 patients with detection of > 1 respiratory virus were included. Viral co-infection was detected in 41/110 (37%). 22/110 children (20%) were classified as moderate to severe clinical course and 88/110 (80%) were classified as mild clinical course. In the group of moderate to severe clinical course, viral respiratory co-infection was detected in 6/22 (27.3%), compared to 35/88 (39.8 %) in the mild clinical course group. No statistically significant difference was found regarding the presence of co-infection between groups (p = 0.33). We detected high rates of viral co-infection in children with ARI. It was not possible to demonstrate that viral co-infections were related with severe clinical course in hospitalized children.

  11. Self-Reported Mental Health Predicts Acute Respiratory Infection.

    Science.gov (United States)

    Maxwell, Lizzie; Barrett, Bruce; Chase, Joseph; Brown, Roger; Ewers, Tola

    2015-06-01

    Poor mental health conditions, including stress and depression, have been recognized as a risk factor for the development of acute respiratory infection. Very few studies have considered the role of general mental health in acute respiratory infection occurrence. The aim of this analysis is to determine if overall mental health, as assessed by the mental component of the Short Form 12 Health Survey, predicts incidence, duration, or severity of acute respiratory infection. Data utilized for this analysis came from the National Institute of Health-funded Meditation or Exercise for Preventing Acute Respiratory Infection (MEPARI) and MEPARI-2 randomized controlled trials examining the effects of meditation or exercise on acute respiratory infection among adults aged > 30 years in Madison, Wisconsin. A Kendall tau rank correlation compared the Short Form 12 mental component, completed by participants at baseline, with acute respiratory infection incidence, duration, and area-under-the-curve (global) severity, as assessed by the Wisconsin Upper Respiratory Symptom Survey. Participants were recruited from Madison, Wis, using advertisements in local media. Short Form 12 mental health scores significantly predicted incidence (P = 0.037) of acute respiratory infection, but not duration (P = 0.077) or severity (P = 0.073). The Positive and Negative Affect Schedule (PANAS) negative emotion measure significantly predicted global severity (P = 0.036), but not incidence (P = 0.081) or duration (P = 0.125). Mindful Attention Awareness Scale scores significantly predicted incidence of acute respiratory infection (P = 0.040), but not duration (P = 0.053) or severity (P = 0.70). The PHQ-9, PSS-10, and PANAS positive measures did not show significant predictive associations with any of the acute respiratory infection outcomes. Self-reported overall mental health, as measured by the mental component of Short Form 12, predicts acute respiratory infection incidence.

  12. Urinary Tract Infection in Children with Acute Glomerulonephritis in ...

    African Journals Online (AJOL)

    This is a prospective study of 47 cases of acute glomerunephritis seen in paediatric ward of Aminu Kano Teaching Hospital, Kano over a 5year period; they were evaluated for prevalence of urinary tract infection, urine specimen were obtained by midstream urine following careful cleaning of the orifices with chlorhexidine.

  13. Determinants of acute respiratory infections in Soweto - a population ...

    African Journals Online (AJOL)

    Background. Acute respiratory infections (ARIs) are an important cause of infant morbidity in both developing and developed countries, and they are the leading cause of death in poorer parts of the world. Respiratory viruses appear to be the most frequent microbiological pathogens, especially respiratory syncytial virus.

  14. Chinese herbal medicine for severe acute respiratory syndrome

    DEFF Research Database (Denmark)

    Liu, Jianping; Manheimer, Eric; Shi, Yi

    2004-01-01

    To review randomized controlled trials (RCTs) evaluating the effects of Chinese herbal medicine for treating severe acute respiratory syndrome (SARS) systematically.......To review randomized controlled trials (RCTs) evaluating the effects of Chinese herbal medicine for treating severe acute respiratory syndrome (SARS) systematically....

  15. Clustering of acute respiratory infection hospitalizations in childcare facilities

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Benn, Christine Stabell; Simonsen, Jacob

    2010-01-01

    To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics.......To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics....

  16. RATIONAL ANTIVIRAL TREATMENT OF ACUTE RESPIRATORY INFECTIONS IN OUTPATIENT CLINIC

    OpenAIRE

    M.G. Lukashevich

    2008-01-01

    An epidemiology and clinical symptomatology of frequently occurred acute respiratory viral infections (ARVI) and opportunities of treatment of patients with these diseases in outpatient clinics are described. New information about effectiveness and safety of antiviral medications in treatment and prophylaxis of ARVI in children are discussed.Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.

  17. RATIONAL ANTIVIRAL TREATMENT OF ACUTE RESPIRATORY INFECTIONS IN OUTPATIENT CLINIC

    Directory of Open Access Journals (Sweden)

    M.G. Lukashevich

    2008-01-01

    Full Text Available An epidemiology and clinical symptomatology of frequently occurred acute respiratory viral infections (ARVI and opportunities of treatment of patients with these diseases in outpatient clinics are described. New information about effectiveness and safety of antiviral medications in treatment and prophylaxis of ARVI in children are discussed.Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.

  18. Recurrent respiratory tract infections in pediatric age: a population-based survey of the therapeutic role of macrolides.

    Science.gov (United States)

    Principi, N; Esposito, S; Cavagna, R; Bosis, S; Droghetti, R; Faelli, N; Tosi, S; Begliatti, E

    2003-02-01

    In order to evaluate the efficacy of macrolides in pediatric patients with recurrent respiratory tract infections (RRTIs), we enrolled 1,706 children (783 females) aged between 6 months and 14 years (median: 4 years) with an acute respiratory infection and a history of RRTIs (> or = 8 episodes per year if aged or = 6 episodes per year if aged > or = 3 years). The therapies were chosen by the primary care pediatricians and their effects on respiratory relapses were blindly analyzed. Regardless of age and clinical diagnosis, the children treated with macrolides showed a significantly higher rate of short- and long-term clinical success than those receiving beta-lactams (pmacrolide therapy of acute respiratory infections influences the natural history of RRTIs, probably because of their elective activity on atypical bacteria. They also suggest the possible importance of these pathogens in causing recurrences of respiratory infections in children and show that the infections they cause may have a more complicated course unless treated with adequate antibacterial drugs.

  19. The Bordetella Bps polysaccharide is critical for biofilm development in the mouse respiratory tract.

    Science.gov (United States)

    Sloan, Gina Parise; Love, Cheraton F; Sukumar, Neelima; Mishra, Meenu; Deora, Rajendar

    2007-11-01

    Bordetellae are respiratory pathogens that infect both humans and animals. Bordetella bronchiseptica establishes asymptomatic and long-term to life-long infections of animal nasopharynges. While the human pathogen Bordetella pertussis is the etiological agent of the acute disease whooping cough in infants and young children, it is now being increasingly isolated from the nasopharynges of vaccinated adolescents and adults who sometimes show milder symptoms, such as prolonged cough illness. Although it has been shown that Bordetella can form biofilms in vitro, nothing is known about its biofilm mode of existence in mammalian hosts. Using indirect immunofluorescence and scanning electron microscopy, we examined nasal tissues from mice infected with B. bronchiseptica. Our results demonstrate that a wild-type strain formed robust biofilms that were adherent to the nasal epithelium and displayed architectural attributes characteristic of a number of bacterial biofilms formed on inert surfaces. We have previously shown that the Bordetella Bps polysaccharide encoded by the bpsABCD locus is critical for the stability and maintenance of three-dimensional structures of biofilms. We show here that Bps is essential for the formation of efficient nasal biofilms and is required for the colonization of the nose. Our results document a biofilm lifestyle for Bordetella in mammalian respiratory tracts and highlight the essential role of the Bps polysaccharide in this process and in persistence of the nares.

  20. A case of lower respiratory tract infection caused by Neisseria weaveri and review of the literature.

    Science.gov (United States)

    Panagea, S; Bijoux, R; Corkill, J E; Al Rashidi, F; Hart, C A

    2002-02-01

    Neisseria weaveri (formerly CDC [Centers for Disease Control and Prevention] group M-5 is part of the normal canine oral flora. Infections in humans are usually associated with dog bite wounds. Very rarely the organism has been isolated from sites other than wounds, or from deep seated infections. A 60-year-old man was admitted to our hospital because of an acute exacerbation of his bronchiectasis. Gram stain of bronchial washings and expectorated sputum showed numerous polymorphs and Gram-negative bacilli. Routine bacterial culture yielded a heavy pure growth of a Gram-negative rod-shaped organism that was strongly oxidase and catalase positive, indole negative, non-motile and did not ferment carbohydrates. The organism was identified as N. weaveri by using 16S rRNA sequencing. The patient was treated with a 3 weeks course of ofloxacin and had a good response. Sputum culture after treatment yielded normal respiratory flora only. To our knowledge, this is the first reported case of lower respiratory tract infection caused by N. weaveri. Copyright 2002 The British Infection Society.

  1. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies.

    Science.gov (United States)

    Jolliffe, David A; Griffiths, Christopher J; Martineau, Adrian R

    2013-07-01

    Vitamin D metabolites enhance immunity to a wide range of respiratory pathogens in vitro. Numerous observational studies have investigated whether vitamin D deficiency is a risk factor for acute respiratory infection, and a number of clinical trials of vitamin D supplementation for the prevention of acute respiratory infection have recently been conducted. Syntheses of this literature are lacking. We therefore conducted a systematic review of clinical studies investigating the association between vitamin D deficiency and susceptibility to acute respiratory infection in humans. A total of 39 studies (4 cross-sectional studies, 8 case-control studies, 13 cohort studies and 14 clinical trials) satisfying review eligibility criteria were identified. Observational studies predominantly reported statistically significant associations between low vitamin D status and increased risk of both upper and lower respiratory tract infections. Results from randomised controlled trials were conflicting however, reflecting heterogeneity in dosing regimens and baseline vitamin D status in study populations. Further trials of vitamin D supplementation for the prevention of acute respiratory infection should be conducted in populations with a high prevalence of vitamin D deficiency at baseline, using doses sufficient to induce sustained elevation of serum 25-hydroxyvitamin D concentrations, and powered to detect clinically important sub-group effects. This article is part of a Special Issue entitled 'Vitamin D Workshop'. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Acute Respiratory Distress Syndrome: 30 Years Later?

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    Olivier Lesur

    1999-01-01

    Full Text Available Acute respiratory distress syndrome (ARDS was first described about 30 years ago. Modern definitions and statements have recently been proposed to describe ARDS accurately, but none is perfect. Diffuse alveolar damage is the basic pathological pattern most commonly observed in ARDS, and the term includes permeability edema. The alveolar epithelium of the alveolar-capillary barrier is clearly a key component requiring repair, given its multipotent functional activity. Lung inflammation and neutrophil accumulation are essential markers of disease in ARDS, and a wide variety of pro- and anti-inflammatory cytokines have been described in the alveolar fluid and blood of patients. These molecules still have to prove their value as diagnostic or prognostic biomarkers of ARDS.

  3. Clinical and laboratory characteristics of viral lower respiratory tract infections in preschool children.

    Science.gov (United States)

    Berce, Vojko; Unuk, Sibila; Duh, Darja; Homšak, Matjaž; Vičič, Maja

    2015-12-01

    Viral lower respiratory tract infections are the leading cause of hospitalizations in preschool children. Clinical pictures of different viral causes are not well characterized. The aim of this study was to establish the differences in clinical and laboratory characteristics between the different viral causes of lower respiratory tract infections in preschool children. We included 278 preschool children hospitalized because of lower respiratory tract infection. White blood cell count and C-reactive protein values were determined and chest X-ray was performed in most patients. Polymerase chain reaction assay was used for the detection of viral pathogens from nasopharyngeal swab. Pneumonia was present in 71.4 % of all coronavirus infections, 35.1 % of all respiratory syncytial virus infections, and 13.0 % of all rhinovirus infections. Coronavirus (p = 0.03) and respiratory syncytial virus (p infections and in only 33.3 % of all adenovirus infections. Rhinovirus (p infections mean C-reactive protein value was 72.4 mg/L and white blood cell count 19.000/µl, both significantly higher than in other viruses (p respiratory tract infections significantly differ. With the advance of viral detection methods and increase of knowledge it becomes possible to characterize different respiratory viral infections and to improve the differential diagnosis.

  4. The influence of Streptococcus pneumoniae nasopharyngeal colonization on the clinical outcome of the respiratory tract infections in preschool children.

    Science.gov (United States)

    Petraitiene, Sigita; Alasevicius, Tomas; Staceviciene, Indre; Vaiciuniene, Daiva; Kacergius, Tomas; Usonis, Vytautas

    2015-09-30

    Streptococcus pneumoniae (SPn) is an important pathogen causing a variety of clinical manifestations. The effects of SPn nasopharyngeal colonization on respiratory tract infections are poorly studied. We evaluated the association of SPn colonization with features of respiratory tract infections. Children under the age of 6 years who visited a primary care physician because of respiratory tract infections were enrolled in the study. History was taken, children were clinically assessed by the physician, and nasopharyngeal swabs were obtained and cultured for SPn. Positive samples were serotyped. Associations of SPn colonization with clinical signs and symptoms, recovery duration, absence from day care centre, frequencies of specific diagnoses, and treatment with antimicrobials were evaluated. In total 900 children were enrolled. The prevalence of SPn colonization was 40.8 % (n = 367). There were minor differences between male and female subjects (199 of 492, 40.4 % vs 168 of 408, 41.2 %, p = 0.825). Children with and without siblings had similar colonization rates (145 of 334, 43.4 % vs 219 of 562, 39.0 %, p = 0.187). Clinical signs and symptoms were not associated with SPn colonization. Children colonized with SPn had longer recovery duration compared to non-colonized children (114 of 367, 31.1 % vs 98 of 533, 18.4 %, p respiratory tract infection, likely because of SPn being the cause of the disease or a complicating factor. It is also associated with and may be responsible for higher frequencies of bronchitis, pneumonia, acute otitis media, sinusitis and the need of antimicrobial treatment.

  5. Pathogenesis of Acute Respiratory Distress Syndrome

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    A. M. Golubev

    2012-01-01

    Full Text Available Acute respiratory distress syndrome (ARDS is a common complication of many diseases. Its polyetiological pattern determines the specific features of lung morphological changes and the clinical course of ARDS. Objective: to analyze the pathogenesis of ARDS in the context of the general pathological processes underlying its development. Material and methods. More than 200 lungs from the people who had died from severe concomitant injury or ARDS-complicated pneumonia were investigated. More than 150 rat experiments simulated various types of lung injury: ventilator-induced lung injury with different ventilation parameters; reperfusion injuries (systemic circulation blockade due to 12-minute vascular fascicle ligation, followed by the recovery of cardiac performance and breathing; microcirculatory disorder (injection of a thromboplastin solution into the jugular vein; blood loss; betaine-pepsin aspiration; and closed chest injury. Different parts of the right and left lungs were histologically examined 1 and 3 hours and 1 and 3 days after initiation of the experiment. Lung pieces were fixed in 10% neutral formalin solution and embedded in paraffin. Histological sections were stained with hematoxylin and eosin and using the van Gieson and Weigert procedures; the Schiff test was used. Results. The influence of aggression factors (trauma, blood loss, aspiration, infection, etc. results in damage to the lung and particularly air-blood barrier structures (endothelium, alveolar epithelium, their basement membrane. In turn the alteration of cellular and extracellular structures is followed by the increased permeability of hemomicrocirculatory bed vessels, leading to the development of non-cardiogenic (interstitial, alveolar pulmonary edema that is a central component in the pathogenesis of ARDS. Conclusion. The diagnosis of the early manifestations of ARDS must account for the nature of an aggression factor, the signs confirming the alteration of the lung

  6. The effect of vitamin D on lower respiratory tract infections in children.

    Science.gov (United States)

    Şişmanlar, Tuğba; Aslan, Ayşe Tana; Gülbahar, Özlem; Özkan, Seçil

    2016-06-01

    Lower respiratory tract infections including mainly pneumonia represent an important public health problem leading to high mortality and mobidity rates in children aged below five years in developing countries including our country. Vitamin D deficiency has been associated with increased risk of rickets/osteomalacia, various cancers, autoimmune diseases, hyperproliferative skin diseases, cardiovascular system diseases and infectious diseases. Vitamin D has an important role in cellular and humoral immunity and pulmonary functions. Vitamin D deficiency and lower respiratory tract infection are common health problems in children in our country and no clinical study investigating the relationship between these problems has been conducted so far. In this case-control study, we aimed to assess the association between vitamin D level and lower respiratory tract infection in children. Sixty-three children aged between six months and five years with lower respiratory infections and 59 age-matched children who had no history of respiratory symptoms in the last month and no accompanying chronic disease were compared in terms of vitamin D levels. The children in the patient group were also evaluated by the clinical picture. No significant correlation was found between vitamin D levels and lower respiratory tract infection in terms of disease and its severity. However, it was found that vitamin D deficiency/ insufficiency was observed with a high rate in all children included in the study. Although no correlation was found between vitamin D level and lower respiratory tract infection, it is recommended that vitamin D level should be measured in children with lower respiratory tract infection and vitamin D supplementation should be given to all children especially in winter months based on the fact that the level of vitamin D was lower than normal in approximately half of the children included in the study and considering the effects of vitamin D on infections, pulmonary

  7. Middle East respiratory syndrome coronavirus (MERS-CoV) causes transient lower respiratory tract infection in rhesus macaques

    OpenAIRE

    De Wit, Emmie; Rasmussen, Angela L; Falzarano, Darryl; Bushmaker, Trenton; Feldmann, Friederike; Brining, Douglas L; Fischer, Elizabeth R.; Martellaro, Cynthia; Okumura, Atsushi; Chang, Jean; Scott, Dana; Arndt G. Benecke; Katze, Michael G.; Feldmann, Heinz; Munster, Vincent J.

    2013-01-01

    The Middle East respiratory syndrome coronavirus (MERS-CoV) is the latest emerged coronavirus causing severe respiratory disease with a high case fatality rate in humans. To better understand the disease caused by MERS-CoV, we developed a rhesus macaque model. Infection of rhesus macaques with MERS-CoV resulted in the rapid development of a transient pneumonia, with MERS-CoV replication largely restricted to the lower respiratory tract. This affinity of MERS-CoV for the lungs partly explains ...

  8. Distribution of respiratory viruses which cause lower respiratory tract infection in pediatric age group

    Directory of Open Access Journals (Sweden)

    Selim Dereci

    2015-07-01

    Full Text Available Objective: To determine the appropriate treatment regimen and the clinical course of the lower respiratory tract infections( RTI s and to detect the common viral causes of lower RTI s. Methods: The present study included a total of 255 pediatric patients aged less than 7 years old and admitted to the Department of Pediatrics of Rize Training and Research Hospital between January 2014 and January 2015 with clinical pre-diagnosis of lower RTI . Nasopharyngeal swab specimens collected from these patients were tested for viral pathogens by using multiplex RT- PCR kit the ResPlex II plus Panel PRE (Qiagen, Germany. Results: A total of 212 out of 255 (83.1% specimens revealed positive for one or more viral pathogens. The most common detected pathogens were respiratory syncytial virus ( RSV A/B in 110 samples (43.1%, rhinovirus in 51 samples (20.0%, adenovirus in 36 samples (14.1%, influenzae virus A in 32 samples (12.5%, and coronavirus in 24 samples (9.4%. In 76 samples (29.8%, more than one viral pathogen were detected. RSV was seen in more than 50% patients in the first 2 years. RSV was the most common pathogen in each year of the first 5 years but rhinovirus, influenza A and adenovirus were seen more than RSV after the fifth year. A total of 95.8% of the viral detections were seen between November and April without a significant peak amongst these months. The distribution of the pathogens by months of the year showed no significance. Conclusions: These findings can contribute to epidemiological data of Turkey. Detection of the viral pathogens causing lower RTIs can be critical in management of the disease, decrease inappropriate antibiotic treatment, and lower the morbidity and mortality rates in such diseases.

  9. PROPHYLAXIS OF RECURRENT RESPIRATORY INFECTIONS IN CHILDREN WITH ALLERGIC DISEASES OF RESPIRATORY TRACT

    Directory of Open Access Journals (Sweden)

    L.F. Kaznacheeva

    2010-01-01

    Full Text Available Infections of airways are one of significant causes of morbidity in children. Approximately 70% of infections affect upper airways, ear, nose and throat. The problem is special for children with allergic pathology because any intercurrent virus disease can cause exacerbation of allergy. Open uncontrolled study of effectiveness of pidotimod in children with combined forms of allergy (bronchial asthma, allergic rhinitis, atopic dermatitis and severe acute respiratory disease was performed in 2008–2010 in Novosibirsk. Pidotimod as a component of complex treatment decreased trigger role of infections and eased clinical course of main disease. This drug decreased the rate of relapses and load of medications in patients. Key words: children with frequent diseases, immunomudulators, pidotimod.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:64-66

  10. Disease Course of Lower Respiratory Tract Infection With a Bacterial Cause.

    Science.gov (United States)

    Teepe, Jolien; Broekhuizen, Berna D L; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Goossens, Herman; Little, Paul; Butler, Christopher C; Coenen, Samuel; Godycki-Cwirko, Maciek; Verheij, Theo

    2016-11-01

    Bacterial pathogens are assumed to cause an illness course different from that of nonbacterial causes of acute cough, but evidence is lacking. We evaluated the disease course of lower respiratory tract infection (LRTI) with a bacterial cause in adults with acute cough. We conducted a secondary analysis of a multicenter European trial in which 2,061 adults with acute cough (28 days' duration or less) were recruited from primary care and randomized to amoxicillin or placebo. For this analysis only patients in the placebo group (n = 1,021) were included, reflecting the natural course of disease. Standardized microbiological and serological analyses were performed at baseline to define a bacterial cause. All patients recorded symptoms in a diary for 4 weeks. The disease course between those with and without a bacterial cause was compared by symptom severity in days 2 to 4, duration of symptoms rated moderately bad or worse, and a return consultation. Of 1,021 eligible patients, 187 were excluded for missing diary records, leaving 834 patients, of whom 162 had bacterial LRTI. Patients with bacterial LRTI had worse symptoms at day 2 to 4 after the first office visit (P = .014) and returned more often for a second consultation, 27% vs 17%, than those without bacterial LRTI (P = .004). Resolution of symptoms rated moderately bad or worse did not differ (P = .375). Patients with acute bacterial LRTI have a slightly worse course of disease when compared with those without an identified bacterial cause, but the relevance of this difference is not meaningful. © 2016 Annals of Family Medicine, Inc.

  11. Comparison of azithromycin versus clarithromycin in the treatment of patients with upper respiratory tract infections.

    Science.gov (United States)

    Müller, O

    1993-06-01

    well-tolerated as a ten-day course of clarithromycin in adults with acute upper respiratory tract infections.

  12. The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections.

    Science.gov (United States)

    Blasi, Francesco; Page, Clive; Rossolini, Gian Maria; Pallecchi, Lucia; Matera, Maria Gabriella; Rogliani, Paola; Cazzola, Mario

    2016-08-01

    In airway infections, biofilm formation has been demonstrated to be responsible for both acute and chronic events, and constitutes a genuine challenge in clinical practice. Difficulty in eradicating biofilms with systemic antibiotics has led clinicians to consider the possible role of non-antibiotic therapy. The aim of this review is to examine current evidence for the use of N-acetylcysteine (NAC) in the treatment of biofilm-related respiratory infections. Electronic searches of PUBMED up to September 2015 were conducted, searching for 'biofilm', 'respiratory tract infection', 'N-acetylcysteine', 'cystic fibrosis', 'COPD', 'bronchiectasis', 'otitis', and 'bronchitis' in titles and abstracts. Studies included for review were primarily in English, but a few in Italian were also selected. Biofilm formation may be involved in many infections, including ventilator-associated pneumonia, cystic fibrosis, bronchiectasis, bronchitis, and upper respiratory airway infections. Many in vitro studies have demonstrated that NAC is effective in inhibiting biofilm formation, disrupting preformed biofilms (both initial and mature), and reducing bacterial viability in biofilms. There are fewer clinical studies on the use of NAC in disruption of biofilm formation, although there is some evidence that NAC alone or in combination with antibiotics can decrease the risk of exacerbations of chronic bronchitis, chronic obstructive pulmonary disease, and rhinosinusitis. However, the usefulness of NAC in the treatment of cystic fibrosis and bronchiectasis is still matter of debate. Most of the studies published to date have used oral or intramuscular NAC formulations. Evidence from in vitro studies indicates that NAC has good antibacterial properties and the ability to interfere with biofilm formation and disrupt biofilms. Results from clinical studies have provided some encouraging findings that need to be confirmed and expanded using other routes of administration of NAC such as

  13. Pentraxin 3 as a clinical marker in children with lower respiratory tract infection.

    Science.gov (United States)

    Kim, Hwan Soo; Won, Sulmui; Lee, Eu Kyoung; Chun, Yoon Hong; Yoon, Jong-Seo; Kim, Hyun Hee; Kim, Jin Tack

    2016-01-01

    Pentraxin 3 (PTX-3) is an acute-phase protein that increases in the plasma during inflammation. We aimed to evaluate the usefulness of PTX-3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX-3 with other biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). We enrolled 117 consecutive patients admitted to Seoul St. Mary's Hospital with LRTI using the WHO criteria. We recorded data on fever duration and peak temperature before admission, duration of fever after admission, respiratory rate, heart rate, oxygen saturation upon admission, duration of oxygen supplementation, and duration of hospital stay. Upon admission, white blood cell (WBC) count, erythrocyte sedimentation rate, CRP level were measured. Multiplex respiratory virus polymerase chain reaction was performed using nasal swabs. PTX-3, PCT, and various cytokines were measured after the study had been completed. We found that there was no significant difference in the level of PTX-3 according to the type of viral infection. PTX-3 levels showed a significant correlation with PCT levels, but not with levels of CRP. The level of PTX-3 showed a significant correlation with peak temperature and duration of fever before admission as well as interleukin (IL)-6 levels. PCT levels showed a significant correlation with IL-6 and granulocyte-colony stimulating factor levels, peak temperature, and duration of fever before admission, and duration of hospital stay. CRP levels showed a significant correlation with duration of fever before admission, total WBC count, and neutrophil count. PCT levels significantly predicted a hospital stay of 7 days or more. PTX-3, PCT, and CRP levels showed no correlation with any other clinical features. PTX-3 reflected disease severity but failed to predict length of hospital stay. Further studies evaluating the use of PTX-3 as a biomarker in mild LRTI would be useful. © 2015 Wiley Periodicals, Inc.

  14. Human parainfluenza virus type 4 infection in Chinese children with lower respiratory tract infections: a comparison study.

    Science.gov (United States)

    Ren, Lili; Gonzalez, Richard; Xie, Zhengde; Xiong, Zhaohui; Liu, Chunyan; Xiang, Zichun; Xiao, Yan; Li, Yongjun; Zhou, Hongli; Li, Jianguo; Yang, Qingqing; Zhang, Jing; Chen, Lan; Wang, Wei; Vernet, Guy; Paranhos-Baccalà, Gláucia; Shen, Kunling; Wang, Jianwei

    2011-07-01

    Human parainfluenza viruses (HPIVs) are a leading cause of acute respiratory tract infections (ARTIs). Although HPIV-4 has been associated with mild ARTIs for years, recent investigations have also associated HPIV-4 infection with severe respiratory syndromes and with outbreaks of ARTIs in children. To characterize the role of HPIV-4 and its clinical features in children with acute lower respiratory tract infections (ALRTIs) in Beijing, China. Nasopharyngeal aspirates were collected from 2009 hospitalized children with ALRTIs between March 2007 and April 2010. RT-PCR and PCR analyses were used to identify HPIV types and other known respiratory viruses. HPIVs were detected in 246 (12.2%) patients, of whom 25 (10.2%) were positive for HPIV-4, 11 (4.5%) for HPIV-2, 51 (20.7%) for HPIV-1, 151 (61.4%) for HPIV-3, and 8 (3.3%) were co-detected with different types of HPIVs. Like HPIV-3, HPIV-4 was detected in spring, summer, and late fall over the study period. Seasonal incidence varied for HPIV-1 and -2. The median patient age was 20 months for HPIV-4 infections and 7-11 months for HPIV-1, -2, and -3 infections, but the clinical manifestations did not differ significantly between HPIV-1, -2, -3, and -4 infections. Moreover, co-detection of HPIV-4 (44%) with other respiratory viruses was lower than that of HPIV-1 (62.7%), HPIV-2 (63.6%), and HPIV-3 (72.7%). HPIV-4 plays an important role in Chinese paediatric ALRTIs. The epidemiological and clinical characteristics reported here improve our understanding of the pathogenesis associated with HPIV-4. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Prevention of Pneumococcal Infection in Children with Chronic Diseases of the Nasopharynx Reduces the Incidence of Other Respiratory Tract Infections: Results of a Comparative Prospective Study

    Directory of Open Access Journals (Sweden)

    V. P. Vavilova

    2015-01-01

    Full Text Available Background: A promising approach to solving the problem of widespread infections of the respiratory tract in children is the use ofspecific prophylaxis against the pneumococcus.Objective: Our aim was to examine the clinical efficacy of PCV13 of children with chronic foci of infection in the nasopharynx and the changes of local factors of protection of the upper respiratory tract.Methods: We have evaluated the incidence of respiratory tract and ENT infections in children with chronic diseases of the nasopharynx. Research period: January 2011 — January 2015. Upper airway function examination included cytologic analysis — counting the main cell populations ratio in the common cytoplasm, lysozym activity and secretory immunoglobulin of class A (sIgA in nasal secretions.Results: The study involved 876 children 2–5 years old. Main group (PCV13 amounted to 448 patients, and the control group (unvaccinated 428. Annual dynamic observation showed a significant reduction of acute morbidity by 2 times (p < 0.001, pneumonia by 2.4 times (p = 0.042, acute bronchitis by 2.5 times (p = 0.008, concomitant ENT pathology (acute otitis media and acute exacerbations of chronic sinusitis by 2.2 times (p = 0.001 and 2.3 times (p = 0.004, respectively. There was a positive effect of vaccination on the level of local factors of protection of the upper respiratory tract (lysozyme, sIgA, the somatic cell count in nasal secretions.Conclusion: PCV13 vaccination reduces the risk of developing acute respiratory infections and ENT infections in children with chronic diseases of the nasopharynx. This is against the background of recovery in the levels of factors of local immunity.

  16. BACTERIAL PROFILE, ANTIBIOTIC SENSITIVITY AND RESISTANCE OF LOWER RESPIRATORY TRACT INFECTIONS IN UPPER EGYPT

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    Gamal Agmy

    2013-09-01

    Full Text Available BACKGROUND: Lower respiratory tract infections (LRTI account for a considerable proportion of morbidity and antibiotic use. We aimed to identify the causative bacteria, antibiotic sensitivity and resistance of hospitalized adult patients due to LRTI in Upper Egypt. METHODS: A multicentre prospective study was performed at 3 University Hospitals for 3 years. Samples included sputum or bronchoalveolar lavage (BAL for staining and culture, and serum for serology. Samples were cultured on 3 bacteriological media (Nutrient, Chocolate ,MacConkey's agars.Colonies were identified via MicroScan WalkAway-96. Pneumoslide IgM kit was used for detection of atypical pathogens via indirect immunofluorescent assay. RESULTS: The predominant isolates in 360 patients with CAP were S.pneumoniae (36%, C. pneumoniae (18%, and M. pneumoniae (12%. A higher sensitivity was recorded for moxifloxacin, levofloxacin, macrolides, and cefepime. A higher of resistance was recorded for doxycycline, cephalosporins, and β-lactam-β-lactamase inhibitors. The predominant isolates in 318 patients with HAP were, methicillin-resistant Staphylococcus aureus; MRSA (23%, K. pneumoniae (14%, and polymicrobial in 12%. A higher sensitivity was recorded for vancomycin, ciprofloxacin, and moxifloxacin. Very high resistance was recorded for β-lactam-β-lactamase inhibitors and cephalosporins. The predominant organisms in 376 patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD were H. influnzae (30%, S. pneumoniae (25%, and M. catarrhalis(18%. A higher sensitivity was recorded for moxifloxacin, macrolides and cefepime. A higher rate of resistance was recorded for aminoglycosides and cephalosporins CONCLUSIONS: The most predominant bacteria for CAP in Upper Egypt are S. pneumoniae and atypical organisms, while that for HAP are MRSA and Gram negative bacteria. For acute exacerbation of COPD,H.influnzae was the commonest organism. Respiratory quinolones

  17. Guideline for the Management of Upper Respiratory Tract Infections ...

    African Journals Online (AJOL)

    URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS). Method.

  18. Structure, material characteristics and function of the upper respiratory tract of the pygmy sperm whale.

    Science.gov (United States)

    Davenport, John; Cotter, Liz; Rogan, Emer; Kelliher, Denis; Murphy, Colm

    2013-12-15

    Cetaceans are neckless, so the trachea is very short. The upper respiratory tract is separate from the mouth and pharynx, and the dorsal blowhole connects, via the vestibular and nasopalatine cavities, directly to the larynx. Toothed cetaceans (Odontoceti) are capable of producing sounds at depth, either for locating prey or for communication. It has been suggested that during dives, air from the lungs and upper respiratory tract can be moved to the vestibular and nasal cavities to permit sound generation to continue when air volume within these cavities decreases as ambient pressure rises. The pygmy sperm whale, Kogia breviceps, is a deep diver (500-1000 m) that is known to produce hunting clicks. Our study of an immature female shows that the upper respiratory tract is highly asymmetrical: the trachea and bronchi are extremely compressible, whereas the larynx is much more rigid. Laryngeal and tracheal volumes were established. Calculations based on Boyle's Law imply that all air from the lungs and bronchi would be transferred to the larynx and trachea by a depth of 270 m and that the larynx itself could not accommodate all respiratory air mass at a depth of 1000 m. This suggests that no respiratory air would be available for vocalisation. However, the bronchi, trachea and part of the larynx have a thick vascular lining featuring large, thin-walled vessels. We propose that these vessels may become dilated during dives to reduce the volume of the upper respiratory tract, permitting forward transfer of air through the larynx.

  19. Thrombocytosis in pediatric patients is associated with severe lower respiratory tract inflammation.

    Science.gov (United States)

    Vlacha, Vasiliki; Feketea, Gavriela

    2006-08-01

    Secondary thrombocytosis is associated with a variety of clinical conditions. The aim of this study was to determine the incidence and to analyze the clinical significance and prognostic value of thrombocytosis in lower respiratory tract infection. A total of 102 pediatric patients were hospitalized with lower respiratory tract infection during a period of 30 months. Forty nine (48%) of those patients had platelet counts >500 x 10(9)/L. The median age of the thrombocytotic patients was 31 months as opposed to 61 months for the non-thrombocytotic ones. The patients with thrombocytosis had more serious illness. This is indicated by three factors: more severe clinical condition on admission, presence of respiratory distress and longer hospitalization. Sedimentation rate >70 mm/h was observed in 44.4% patients of the thrombocytotic group compared to only 27.7% of the non-thrombocytotic ones. Almost all patients with pleural effusion were thrombocytotic. The children with very high platelet counts >650 x 10(9)/L presented with respiratory distress on admission and required longer hospitalization time. No other significant clinical or laboratory differences were demonstrated between these patients and the remainder of the thrombocytotic patients. Thrombocytosis is a common finding among patients with lower respiratory tract infection. Thrombocytotic patients have a more severe clinical condition. Importantly, thrombocytosis occurs almost exclusively in patients with pleural effusion. The platelet count may be a useful clinical marker associated with the severity of the lower respiratory tract infection.

  20. Viral etiology among the elderly presenting acute respiratory infection during the influenza season

    Directory of Open Access Journals (Sweden)

    Aripuanã Sakurada Aranha Watanabe

    2011-02-01

    Full Text Available INTRODUCTION: Acute respiratory tract infections are the most common illness in all individuals. Rhinoviruses have been reported as the etiology of more than 50% of respiratory tract infections worldwide. The study prospectively evaluated 47 elderly individuals from a group of 384 randomly assigned for acute respiratory viral infections (cold or flu and assessed the occurrence of human rhinovirus (HRV, influenza A and B, respiratory syncytial virus and metapneumovirus (hMPV in Botucatu, State of São Paulo, Brazil. METHODS: Forty-nine nasal swabs collected from 47 elderly individuals following inclusion visits from 2002 to 2003 were tested by GenScan RT-PCR. HRV-positive samples were sequenced for phylogenetic analysis. RESULTS: No sample was positive for influenza A/B or RSV. HRV was detected in 28.6% (14/47 and hMPV in 2% (1/47. Of 14 positive samples, 9 isolates were successfully sequenced, showing the follow group distribution: 6 group A, 1 group B and 2 group C HRVs. CONCLUSIONS: The high incidence of HRV during the months of the influenza season requires further study regarding HRV infection impact on respiratory complications among this population. Infection caused by HRV is very frequent and may contribute to increasing the already high demand for healthcare during the influenza season.

  1. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice:

    DEFF Research Database (Denmark)

    Plejdrup, Malene; Bjerrum, Lars; Gahrn-Hansen, Bente

    Objective: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice.  Material and methods: A modified 2-round Delphi study was conducted from April to July 2008. A panel of 27 experts (13 countries) comprising mainly general...... indicators focusing on the decision about antibiotic treatment and for 27 indicators focusing on the choice of antibiotics. Conclusion: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These indicators may be used to strengthen general...... practitioners' focus on their management of patients with respiratory tract infections and to identify where it is possible to make improvements....

  2. Respiratory Tract Infections and its Preventive Measures among Hajj Pilgrims, 2010: A Nested Case Control Study.

    Science.gov (United States)

    Emamian, Mohammad Hassan; Hassani, Ali Mohammad; Fateh, Mansooreh

    2013-09-01

    Respiratory tract infections are very common among the Hajj pilgrims. Some preventive measures including Influenza vaccination, using face mask and salt water gargling have been considered to control these infections and the reports show conflicting results about the effects of each one of these measures. This study is trying to assess the effects of these recommendations on respiratory tract infections. According to nested case-control design, in a cohort consisting of 338 Iranian pilgrims, the outcome examined, was all types of respiratory tract infections other than common colds. With occurrence of any patient in convoy, data collection form was completed for that person. On the same day, two people were randomly selected as control group from among pilgrims who have not affected so far. During Hajj, 32 pilgrims (9.5%) were affected by respiratory tract infections other than common colds. In univariable logistic regression analysis, salt water gargling (OR = 2.4, P = 0.08), existence of other patient in the room (OR = 2.14, P = 0.19), age over 60 years (OR = 1.84, P = 0.15) and the education more than or equal to 3 years (OR = 1.93, P = 0.16) were effective in the respiratory tract infections (P < 0.2). However, multivariable logistic regression analysis showed that none of the above mentioned factors are significantly associated with these infections. This study showed that measures such as seasonal influenza vaccination, use of face masks and personal prayer carpet have no effect on the incidence of respiratory tract infections. However, washing throat and mouth with salt water can be considered the most effective preventive measures.

  3. Evaluation of the association between atypical bacteria infections and respiratory tract diseases with emphasis on bronchial asthma exacerbations in children.

    Science.gov (United States)

    Szczepanik, Agnieszka; Kozioł-Montewka, Maria; Tuszkiewicz-Misztal, Ewa; Niedzielska, Grazyna; Górnicka, Grazyna; Niedźwiadek, Justyna; Niedzielski, Artur

    2004-01-01

    Mycoplasma pneumoniae and Chlamydia pneumonie are important etiological agents responsible for human respiratory tract diseases. Recently, these atypical microorganisms received much attention regarding their role in bronchial asthma pathogenesis, which is one of the most frequent chronic diseases in children. The aim of the study was to investigate the association between infections caused by these pathogens and respiratory tract diseases in children. Levels of M. pneumoniae and C. pneumoniae-specific antibodies were determined in serum samples obtained from 30 patients suffering from bronchial asthma exacerbations, 10 patients with pneumonia, 28 patients with chronic otitis media with effusion (COME) and 22 sinusitis patients. Specific anti-M. pneumoniae antibodies were detected more frequently in the patients enrolled in the study than in control subjects. The highest percentage of the serum samples, which demonstrated the presence of M. pneumoniae-specific antibodies was demonstrated in patients with asthma (60%) and it was twofold higher than in control subjects. Serologic profile of 26.6% patients with asthma, 50% of patients with pneumonia, 39.2% of patients with COME, 45.4% of patients with sinusitis and 10% of control subjects was consistent with a possible acute infection caused by M. pneumoniae. The presence of specific anti-C. pneumoniae antibodies was demonstrated in a smaller percentage of patients--in 13.3% of children with asthma, 10% of children with pneumonia and in 7.1% of patients with COME; the level of specific antiobodies was suggestive of acute chlamydial infection only in COME patients. Analysis of serologic markers for atypical bacteria infections indicates a possible association between infections caused by M. pneumoniae and bronchial asthma exacerbations and other respiratory tract disorders including pneumonia, sinusitis and COME.

  4. Minimally Invasive Management of Acute Biliary Tract Disease during Pregnancy

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    Luis Tomás Chiappetta Porras

    2009-01-01

    Full Text Available Background. Acute biliary diseases during pregnancy have been classically managed conservatively. Advances in minimally invasive surgery and the high recurrence rate of symptoms observed changed this management. Methods. This is a prospective observational study. Initial management was medical. Unresponsive patients were treated with minimally invasive techniques including gallbladder percutaneous aspiration or cholecystostomy, endoscopic retrograde cholangiography, and laparoscopic cholecystectomy, depending on the pregnancy trimester and underlying diagnosis. Results. 122 patients were admitted. 69 (56.5% were unresponsive to medical treatment. Recurrent gallbladder colic was the most frequent indication for minimally invasive intervention, followed by acute cholecystitis, choledocholithiasis, and acute biliary pancreatitis. 8 patients were treated during the first trimester, 54 during the second, and 7 during the last trimester. There was no fetal morbidity or mortality. Maternal morbidity was minor with no mortality. Conclusion. Acute biliary tract diseases during pregnancy may be safely treated with minimally invasive procedures according to the underlying diagnosis and to the trimester of pregnancy.

  5. Acute respiratory distress syndrome: epidemiology and management approaches

    Directory of Open Access Journals (Sweden)

    Walkey AJ

    2012-07-01

    Full Text Available Allan J Walkey,1 Ross Summer,1 Vu Ho,1 Philip Alkana21The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; 2Asthma Research Center, Brigham and Women's Hospital, Boston, MA, USAAbstract: Acute lung injury and the more severe acute respiratory distress syndrome represent a spectrum of lung disease characterized by the sudden onset of inflammatory pulmonary edema secondary to myriad local or systemic insults. The present article provides a review of current evidence in the epidemiology and treatment of acute lung injury and acute respiratory distress syndrome, with a focus on significant knowledge gaps that may be addressed through epidemiologic methods.Keywords: acute lung injury, acute respiratory distress syndrome, review, epidemiology

  6. Spectrum of antibiogram against pathogens related to respiratory tract infections with a special reference to ceftibuten: a multicentric study.

    Science.gov (United States)

    Sengupta, S; Deodhar, L; Kapoor, H; Badrinath, S; Menon, S S

    2000-04-01

    In a multicentric study at several leading hospitals of this country, microbiological assessment was carried out in 500 specimens from patients suffering from respiratory tract infections (RTIs; both upper and lower) for a period of 6 months from January, 1999 to June, 1999. The antibiotic sensitivity study was done in 201 isolates from 500 different specimens of throat swab, postpharyngeal swab, sinusitis drainage fluid, sputum, broncho-alveolar lavage (BL), etc. Ceftibuten, an orally active third generation cephalosporin showed encouraging results when compared with seven other selected antibiotics used for RTI. The majority of the patients with acute or chronic RTIs showed an excellent in vitro response to ceftibuten in the analysis of the isolates. Seventy to ninety per cent of the isolated respiratory pathogens were found to be sensitive to ceftibuten in vitro; which offers a promising alternative to other antibiotics included in this study.

  7. Early adaptive immune responses in the respiratory tract of foot-and-mouth disease virus-infected cattle.

    Science.gov (United States)

    Pega, J; Bucafusco, D; Di Giacomo, S; Schammas, J M; Malacari, D; Capozzo, A V; Arzt, J; Pérez-Beascoechea, C; Maradei, E; Rodríguez, L L; Borca, M V; Pérez-Filgueira, M

    2013-03-01

    Foot-and-mouth disease (FMD) is a highly contagious viral disease which affects both domestic and wild biungulate species. This acute disease, caused by the FMD virus (FMDV), usually includes an active replication phase in the respiratory tract for up to 72 h postinfection, followed by hematogenous dissemination and vesicular lesions at oral and foot epithelia. The role of the early local adaptive immunity of the host in the outcome of the infection is not well understood. Here we report the kinetics of appearance of FMDV-specific antibody-secreting cells (ASC) in lymphoid organs along the respiratory tract and the spleen in cattle infected by aerosol exposure. While no responses were observed for up to 3 days postinfection (dpi), all animals developed FMDV-ASC in all the lymphoid organs studied at 4 dpi. Tracheobronchial lymph nodes were the most reactive organs at this time, and IgM was the predominant isotype, followed by IgG1. Numbers of FMDV-ASC were further augmented at 5 and 6 dpi, with an increasing prevalence in upper respiratory organs. Systemic antibody responses were slightly delayed compared with the local reaction. Also, IgM was the dominant isotype in serum at 5 dpi, coinciding with a sharp decrease of viral RNA detection in peripheral blood. These results indicate that following aerogenous administration, cattle develop a rapid and vigorous genuine local antibody response throughout the respiratory tract. Time course and isotype profiles indicate the presence of an efficient T cell-independent antibody response which drives the IgM-mediated virus clearance in cattle infected by FMDV aerosol exposure.

  8. [Acute disorders of the biliary tract in geriatric patients].

    Science.gov (United States)

    Pannella, A; Ragaglia, G; Laboranti, F; Fossa, M; Picchio, G L; Zambianchi, M; Zanotto, P

    1992-09-30

    Acute pathologies of the biliary tract in geriatric patients were examined in this study taking into account the major causes, treatment used and results obtained. All patients aged over 65 who had been hospitalised during the past 17 years for acute pathologies of the biliary tract (564 cases, equivalent to 34.2% of all in-patients suffering from acute biliary pathologies) were included in the study. These patients were then subdivided into 3rd and 4th age groups (65-74 and lithiasic disease of the cholecystus (61.2%) and VBP (17.7%), whereas 45 patients, equivalent to 49.5%, presented tumours with jaundice. Out of a total of 179 cases in patients in the 4th age group, equivalent to 39.3%, 119 (66.5%) were suffering from lithiasic cholecystitis and 16 (8.9%) from calcolosis of the VBP with jaundice. Cancer of the pancreas head was diagnosed in 27 patients (58.7%), whereas 9 (19.6%) had obstruent cancer of the biliary tract. The Authors conclude that both the preoperative preparation, the choice of operation and postoperative treatment give satisfactory results with a very low early mortality (0.8% in non-tumour cases and 6.9% in tumour cases).

  9. Nontypeable Haemophilus influenzae invasion and persistence in the human respiratory tract

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    Cara eClementi

    2011-11-01

    Full Text Available Nontypeable Haemophilus influenzae (NTHI is an opportunistic bacterial pathogen of the human respiratory tract and is a leading cause of respiratory infections in children and adults. NTHI is considered to be an extracellular pathogen, but has consistently been observed within and between human respiratory epithelial cells and macrophages, in vitro and ex vivo. Until recently, few studies have examined the internalization, trafficking, and fate of NTHI in host cells. It is important to clarify this interaction because of a possible correlation between intracellular NTHI and symptomatic infection, and because NTHI infections frequently persist and recur despite antibiotic therapy and the development of bactericidal antibodies, suggesting a possible intracellular state or reservoir for NTHI. How do NTHI enter host cells? Can NTHI survive intracellularly and, if so, for how long? Strides have been made in the identification of host receptors, signaling, endocytosis, and trafficking pathways involved in the entry and persistence of NTHI in the respiratory tract.

  10. [The response of the upper respiratory tract to the impact of atmospheric pollution].

    Science.gov (United States)

    Mukhamadiev, R A; Ismagilov, Sh M

    2015-01-01

    The present literature review characterizes the environmental conditions in the Russian Federation in general and the Republic of Tatarstan in particular with special reference to the influence of atmospheric pollution on the development and the clinical picture of the diseases of the respiratory organs including pathology of the upper respiratory tract in the populations of the industrial centres and other environmentally unfriendly areas. The views of the domestic and foreign authors concerning the role of the environmental factors in the clinical picture of the upper respiratory tract disorders are described in detail. The authors emphasize the necessity of the further investigationsinto this problem and the development of the methods for the prevention of diseases of the upper respiratory react.

  11. Relationship between common viral upper respiratory tract infections and febrile seizures in children from Suzhou, China.

    Science.gov (United States)

    Tang, Jihong; Yan, Wenhua; Li, Yan; Zhang, Bingbing; Gu, Qing

    2014-10-01

    This study aimed to determine the potential predisposing factors for the development of febrile seizures among children with upper respiratory tract infection in the eastern Chinese region. Participants were individuals aged 6 months and 6 years (n = 189) who were diagnosed with febrile seizure, complicated with upper respiratory tract infection, and 174 age-matched children who had upper respiratory tract infection without seizures as controls. The viral antigens including influenza A and B, parainfluenza, adenovirus, and respiratory syncytial virus were detected from nasopharyngeal aspirates. The incidence of influenza A infection was much higher in patients with febrile seizure than controls, especially those children aged >36 months. Patients with influenza A infection had higher body temperatures at seizure occurrence, shorter seizure duration, and shorter fever duration before seizure onset. Influenza A infections are frequently associated with febrile seizure in children with upper respiratory tract infection. During an influenza epidemic, effective vaccination of children, especially those with a past history of febrile seizure, may minimize the development of febrile seizure. © The Author(s) 2014.

  12. Respiratory tract infections during the annual Hajj: potential risks and mitigation strategies.

    Science.gov (United States)

    Al-Tawfiq, Jaffar A; Zumla, Alimuddin; Memish, Ziad A

    2013-05-01

    Mass gatherings such as religious pilgrimages, sporting events and music concerts are becoming larger and more frequent. The scale and frequency of large-scale international events pose substantial risks to the spread of infectious diseases. The available literature on respiratory tract infections at the Hajj pilgrimage - annually attended by 3 million pilgrims from all over the globe - are reviewed. The most common respiratory tract infection viruses are influenza and rhinovirus. Despite the occurrence of the Hajj during the 2009 H1N1 pandemic the available literature did not show an increased rate of infection. In hospitalized patients, pneumonia is a significant cause of admission accounting for 20-50% of such admissions. The use of masks may reduce exposure to droplet nuclei, the main mode of transmission of most respiratory tract infections. The practice of social distancing, hand hygiene, and contact avoidance was associated with reduced risk of respiratory illness. In addition, utilizing the recommended vaccines would decrease the risk of acquiring respiratory tract pathogens.

  13. Radiologic findings of childhood lower respiratory tract infection by influenza virus

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ho Taek; Park, Choong Ki; Shin, Hee Jung; Choi, Yo Won; Jeon, Seok Chol; Hahm, Chang Kok; Hern, Ahn You [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2002-08-01

    After the RS (respiratory syncytial) virus, the influenza virus is the most common cause of childhood lower respiratory tract infection. We assessed the radiologic findings of childhood lower respiratory tract infection by the influenza virus. A total of 105 pediatric patients (76 males and 29 females; mean age, 2.4 years) with symptoms of respiratory tract infection were examined between March 1997 and April 2000. Nasopharyngeal aspirates were obtained and influenza virus infection was confirmed by direct or indirect immunofluorescent assays. Peribronchial infiltration, hyperinflation, atelectasis, pulmonary consolidation, and hilar lymphadenopathy were evaluated retrospectively at simple chest radiography. Bilateral perihiler peribronchial infiltration was noted in 78.1% of patients (n=82), hyperinflation in 63.8% (n=67), atelectasis in 3.8% (n=4, segmental 50%, lobar 50%), and pulmonary consolidation in 16.2% [n=17; segmental 70.6% (n=12), lobar 29.4% (n=5)]. Hilar lymphadenopathy was noted in one patient in whom there was no pleural effusion, and subglottic airway narrowing in 12 of 14 in whom the croup symptom complex was present. The major radiologic findings of influenza virus infection were bilateral perihilar peribronchial infiltration and hyperinflation. In some patients, upper respiratory tract infection was combined with subgolttic airway narrowing. Atelectasis or pleural effusion was rare.

  14. Acute Respiratory Distress: from syndrome to disease.

    Science.gov (United States)

    Cardinal-Fernández, P; Correger, E; Villanueva, J; Rios, F

    2016-04-01

    The acute respiratory distress syndrome (ARDS) is currently one of the most important critical entities given its high incidence, rate of mortality, long-term sequelae and non-specific pharmacological treatment. The histological hallmark of ARDS is diffuse alveolar damage (DAD). Approximately 50% of ARDS patients present DAD, the rest is made up of a heterogeneous group of histological patterns, many of which correspond to a well-recognized disease. For that reason, if these patterns could be diagnosed, patients could benefit from a treatment. Recently, the effect of DAD in clinical and analytical evolution of ARDS has been demonstrated, so the classical approach to ARDS as an entity defined solely by clinical, radiological and gasometrical variables should be reconsidered. This narrative review aims to examine the need to evolve from the concept of ARDS as a syndrome to ARDS as a specific disease. So we have raised 4 critical questions: a) What is a disease?; b) what is DAD?; c) how is DAD considered according to ARDS definition?, and d) what is the relationship between ARDS and DAD? Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  15. A population-based study of childhood respiratory morbidity after severe lower respiratory tract infections in early childhood.

    Science.gov (United States)

    Szabo, Shelagh M; Gooch, Katherine L; Korol, Ellen E; Bradt, Pamela; Mitchell, Ian; Vo, Pamela; Levy, Adrian R

    2014-07-01

    To estimate the risk of childhood chronic respiratory morbidity among those hospitalized for severe lower respiratory tract infection (LRTI) in early childhood, and to determine whether severe LRTI is an independent predictor. The population-based Régie de l'Assurance Maladie du Québec datasets were used to identify LRTI hospitalizations before age 2 years in a birth cohort from 1996-1997 and a comparison cohort of children without an LRTI hospitalization. The incidence rate and incidence rate ratio of chronic respiratory morbidity before age 10 years were calculated, and multivariable logistic regression was performed to estimate the impact of LRTI hospitalization on chronic respiratory morbidity. Population-attributable risks of chronic respiratory morbidity due to severe LRTI were estimated, and similar analyses were performed for respiratory syncytial virus LRTI. Among the birth cohort, 7104 patients (4.9%) were hospitalized for LRTI before age 2 years. By age 10 years, 52.5% of the LRTI cohort and 27.9% of the nonhospitalized cohort had developed chronic respiratory morbidity; the incidence rate ratio was 1.81 (95% CI, 1.76-1.86) for males and 1.91 (95% CI, 1.84-1.99) for females. The OR for chronic respiratory morbidity based on LRTI hospitalization before age 2 years was 2.79 (95% CI, 2.66-2.93). The population-attributable risk of chronic respiratory morbidity due to any LRTI was approximately 25%, and that for respiratory syncytial virus LRTI was similar. Hospitalization of young children for LRTIs is associated with two-fold increased risk of childhood chronic respiratory morbidity, demonstrating the ongoing impact of LRTI in infancy. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. [The curative action of Monticelli Term's water in upper respiratory tract diseases (author's transl)].

    Science.gov (United States)

    Turchi, R; Jemmi, G; Barani, B

    1976-01-01

    The Authors study the action of the sodio bromide-iodic water of Monticelli Terme in upper respiratory tract disease and particularly assert that is not to neglect the organic ground on which establishes mucosa's disease. Therman treatment gives the best therapeutic results in every patient presenting chronic inflammatory processes of the upper respiratory trach alternating periods of quiescency and of activity, and poor therapeutic action in patients presenting chronic inveterate diseases with great alterations in vascular and glandular components of the mucosa.

  17. Risk factors for severe RSV-induced lower respiratory tract infection over four consecutive epidemics

    OpenAIRE

    Rossi, Giovanni A.; Medici, Maria Cristina; Arcangeletti, Maria Cristina; Lanari, Marcello; Merolla, Rocco; Paparatti, Umberto Di Luzio; Silvestri, Michela; Pistorio, Angela; Chezzi, Carlo

    2007-01-01

    Variability in severity among different respiratory syncytial virus (RSV) seasons may influence hospital admission rates for RSV-induced lower respiratory tract infection (LRTI) in young children. The aim of the present study was to identify through logistic regression analysis, risk factors associated with higher likelihood to acquire RSV-induced LRTI, in children with symptoms severe enough to lead to hospital admission. Over four consecutive RSV seasons (2000?2004), records from children

  18. Incidence of respiratory viruses in Peruvian children with acute respiratory infections.

    Science.gov (United States)

    del Valle Mendoza, Juana; Cornejo-Tapia, Angela; Weilg, Pablo; Verne, Eduardo; Nazario-Fuertes, Ronald; Ugarte, Claudia; del Valle, Luis J; Pumarola, Tomás

    2015-06-01

    Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses. © 2015 Wiley Periodicals, Inc.

  19. ACUTE RESPIRATORY DISEASE AS THE DEBUT OF SYSTEMIC LUPUS ERYTHEMATOSUS

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    A. Yu. Ischenko

    2015-01-01

    Full Text Available Systemic lupus erythematosus — a chronic autoimmune disease that is often associated with infectious processes. The paper presents two clinical cases of systemic lupus erythematosus , debuted with acute respiratory infection.

  20. Acute effects of winter air pollution on respiratory health

    NARCIS (Netherlands)

    Zee, van der S.

    1999-01-01

    In this thesis, acute respiratory health effects of exposure to winter air pollution are investigated in panels of children (7-11 yr) and adults (50-70 yr) with and without chronic respiratory symptoms, living in urban and non-urban areas in the Netherlands. The study was performed during

  1. Acute respiratory acidosis and alkalosis – A modern quantitative interpretation

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    Andraž Stožer

    2014-03-01

    Full Text Available Background: Three different approaches for assessing the acid-base status of a patient exist, i.e. the Boston, Copenhagen, and Stewart´s approach, and they employ different parameters to assess a given acid-base disturbance. Students, researchers, and clinicians are getting confused by heated debates about which of these performs best and by the fact that during their curricula, they typically get acquainted with one of the approaches only, which prevents them to understand sources employing other approaches and to critically evaluate the advantages and drawbacks of each approach. In this paper, the authors introduce and define the basic parameters characterizing each of the approaches and point out differences and similarities between them. Special attention is devoted to how the different approaches assess the degree of change in the concentration of plasma bicarbonate that occurs during primary respiratory changes; proper understanding of these is necessary to correctly interpret chronic respiratory and metabolic acid-base changes.Conclusion: During acute respiratory acidosis the concentration of bicarbonate rises and during acute respiratory alkalosis it falls, depending on the buffering strength of non-bicarbonate buffers. During acute respiratory acid-base disturbances, buffer base (employed by the Copenhagen approach, apparent and effective strong ion difference, as well as strong ion gap (employed by the Stewart approach remain unchanged; the anion gap (employed by the Boston and Copenhagen approach falls during acute respiratory acidosis and rises during acute respiratory alkalosis.

  2. STUDY ON CAMPHOR-FREE NATURAL TOPICAL MEDICINE FOR UPPER RESPIRATORY TRACT INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Zubair Ali

    2016-12-01

    Full Text Available Upper respiratory tract infections (URTI are the most common acute illnesses that are often of viral origin. Cough and chest congestion are the common symptoms of this disease. Children are prescribed with drugs that are considered to relive the symptoms of this disease. The topical medications contain vegetable camphor for more than a century that relieve chest congestion and cough caused by URTI. The use of camphor in such products remains questionable especially in children who are more sensitive to its side effects. Herbion “Chest Rub” for children is a camphor-free formulation that contains eucalyptus oil mixture, menthol,turpentine and clove oils and is used to relieve symptoms of URTI.The objective of the present investigationwas to determine the effectiveness of the chest rub inchildren suffering with congestion and cough caused by URTI. The study compared the results of the chest rub applied to a group of infected children with a placebo group. Patients were selected randomly on the basis of the criteria set for the study. The results indicated that the chest rub was quite effective in majority of the cases in relieving the symptoms of URTI as compared to the placebo group.

  3. Effect of upper respiratory tract infection on AIR inhaled insulin pharmacokinetics and glucodynamics in healthy subjects.

    Science.gov (United States)

    Gern, J E; Stone, C K; Nakano, M; Muchmore, D B; de la Peña, A; Park, S; Suri, A; Tibaldi, F; Soon, D; Busse, W W

    2008-02-01

    The suitability of employing AIR Inhaled Insulin (AIR Insulin; AIR is a registered trademark of Alkermes) during acute upper respiratory tract infection (URI) has not been determined. Twenty-one healthy, non-diabetic subjects were enrolled in a single-sequence, two-period, euglycemic clamp study. Subjects received a single 12 U-equivalent dose of AIR Insulin before rhinovirus (RV16) inoculation and during symptomatic infection. Spirometry was used to evaluate pulmonary safety. AIR Insulin exposure (the area under the immunoreactive insulin (IRI) concentration vs time curve from time zero until the IRI concentrations returned to the predose baseline value (AUC(0-t'))) and glucodynamic response (total amount of glucose infused (G(tot))) were comparable before and during RV infection (AUC(0-t') 46,300 vs 52,600 pmol min/l, P=0.21; G(tot) 61,800 vs 68,700 mg, P=0.42, respectively). Variability of pharmacokinetic and pharmacodynamic parameters did not change during URI; either did the number or intensity of adverse events. No significant change in forced expiratory volume or forced vital capacity was observed following AIR Insulin administration or during URI. The AIR Insulin system provides similar pharmacokinetic and glucodynamic responses under conditions of an experimentally induced RV infection and is regarded as suitable for use in diabetic patients during URIs.

  4. Management of upper respiratory tract infections in children

    African Journals Online (AJOL)

    Bacterial complications such as otitis media and acute sinusitis and inflammatory sequelae .... A review of safety and efficacy of six CAM studies for prevention and treatment of .... For older infants and adults, clarithromycin can also be used.54.

  5. Acute respiratory failure as a first manifestation of syringomyelia

    Directory of Open Access Journals (Sweden)

    Al Bashapshe Ali

    2010-01-01

    Full Text Available A 40 year old woman presented with a short history of acute onset of breathlessness to the ER of our hospital and after initial evaluation for acute pulmonary embolism which was ruled out after carrying out the appropriate investigations, she was diagnosed to be afflicted with syringomyelia based on her neurological symptoms and clinical findings, which was confirmed by doing an MRI scan, which was her basic diagnosis that was complicated by acute hypercapnic respiratory failure. This case is being reported to highlight syringomyelia as an unusual cause of acute respiratory failure, which manifested clinically in this patient as its first presentation and the underlying neurological diagnosis has been found to be present in very few reported cases (less than 0.01% of case reports in the available literature as the basic disease in the absence of its classical presenting features. Problems associated with acute respiratory failure in the setting of syringomyelia are discussed.

  6. OBSTRUCTION OF THE RESPIRATORY TRACT DURING THE GENERAL ANESTHESIA AT CHILDRENS AGE

    Directory of Open Access Journals (Sweden)

    Verica Djordjevic

    2001-01-01

    Full Text Available The respiratory complications before, during and after applying the generalanesthesia still represent -despicable the introduction of new anesthetics and new musclerelaxants, modern monitoring and treatment - an importanl potential causc ofmorbidilv and mortality. This particularly refers to the pediatric patients having highminulc ventilation with regard to the functional residual capacity coupled with greatoxygen use; it very quickly leads to hypoxemia. Thc causcs of the respiratorycomplications can be various, but in essence they involve venlilation depression.respiratory tract obstruction or an inadequate oxygen supplv. These sales appeareither individually or in any combination. The causcs of thc respiratory tractobstruction ore numerous and various: they can be divided into physiological andpathological.

  7. Clinical relevance of prevention of respiratory syncytial virus lower respiratory tract infection in preterm infants born between 33 and 35 weeks gestational age

    NARCIS (Netherlands)

    Carbonell-Estrany, X.; Bont, L.; Doering, G.; Gouyon, J-B; Lanari, M.

    2008-01-01

    Premature infants are vulnerable to severe respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) resulting in hospitalisation and the potential for longer-term respiratory morbidity. Whilst the severity and consequence of RSV LRTI are generally accepted and recognised in infants

  8. Influenza A (H10N7 Virus Causes Respiratory Tract Disease in Harbor Seals and Ferrets.

    Directory of Open Access Journals (Sweden)

    Judith M A van den Brand

    Full Text Available Avian influenza viruses sporadically cross the species barrier to mammals, including humans, in which they may cause epidemic disease. Recently such an epidemic occurred due to the emergence of avian influenza virus of the subtype H10N7 (Seal/H10N7 in harbor seals (Phoca vitulina. This epidemic caused high mortality in seals along the north-west coast of Europe and represented a potential risk for human health. To characterize the spectrum of lesions and to identify the target cells and viral distribution, findings in 16 harbor seals spontaneously infected with Seal/H10N7 are described. The seals had respiratory tract inflammation extending from the nasal cavity to bronchi associated with intralesional virus antigen in respiratory epithelial cells. Virus infection was restricted to the respiratory tract. The fatal outcome of the viral infection in seals was most likely caused by secondary bacterial infections. To investigate the pathogenic potential of H10N7 infection for humans, we inoculated the seal virus intratracheally into six ferrets and performed pathological and virological analyses at 3 and 7 days post inoculation. These experimentally inoculated ferrets displayed mild clinical signs, virus excretion from the pharynx and respiratory tract inflammation extending from bronchi to alveoli that was associated with virus antigen expression exclusively in the respiratory epithelium. Virus was isolated only from the respiratory tract. In conclusion, Seal/H10N7 infection in naturally infected harbor seals and experimentally infected ferrets shows that respiratory epithelial cells are the permissive cells for viral replication. Fatal outcome in seals was caused by secondary bacterial pneumonia similar to that in fatal human cases during influenza pandemics. Productive infection of ferrets indicates that seal/H10N7 may possess a zoonotic potential. This outbreak of LPAI from wild birds to seals demonstrates the risk of such occasions for mammals

  9. Poor outcome of acute respiratory infection in young children with underlying health condition in Brazil.

    Science.gov (United States)

    Durigon, Giuliana Stravinskas; Oliveira, Danielle Bruna Leal; Felicio, Maria Carolina Calahani; Finelli, Cristiane; Pereira, Maria Fernanda Badue; Storni, Juliana Gamo; Caldeira, Raquel Negrão; Berezin, Reni Chehter; Durigon, Edison Luiz; Berezin, Eitan Naaman

    2015-05-01

    It is well established that respiratory viruses are an important cause of hospitalizations in young children worldwide, but data are limited on the contribution of specific viruses to severe illness in South America. We describe clinical and laboratory findings from prospective surveillance for acute respiratory infections at a tertiary hospital in São Paulo, Brazil. We screened children acute respiratory tract infections admitted to an urban tertiary hospital for respiratory viruses from March 2008 through February 2010, using polymerase chain reaction assays. Respiratory viruses were identified in 378 (53%) of the 715 samples analyzed. Respiratory syncytial virus was the most commonly identified virus (52%), followed by adenovirus (27%) and Human metapneumovirus (12%). More than one virus was identified in 19% of specimens. Almost half of the samples (46%) were from children with underlying health conditions. We demonstrated that compared to the previously healthy group, those with comorbidities had a worse outcome in terms of severity, with prolonged hospital stay and more need of intensive care. Identification of this high-risk population along with strategies for fast diagnosis might each help to reduce morbidity and mortality in this group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Incidence of respiratory syncytial virus infection in infants and young children referred to the emergency departments for lower respiratory tract diseases in Italy.

    Science.gov (United States)

    Medici, Maria Cristina; Arcangeletti, Maria Cristina; Merolla, Rocco; Chezzi, Carlo

    2004-04-01

    Respiratory Syncytial Virus (RSV) is the leading cause of emergency visits and hospitalization for acute lower respiratory tract infections (LRTI) in infants and young children worldwide. To collect specific epidemiological data on the incidence of RSV infection among infants referred to Emergency Departments (ED) for LRTI in a Mediterranean country, an Italian multicenter epidemiological surveillance program was established. Eight pediatric centers throughout Italy participated in this study. The study population included 272 children 2 years of age. Data regarding medical history and physical examination were recorded for each child, whereas an immunoenzymatic RSV test (TestPack RSV, Abbott) was performed on nasal and pharyngeal secretions. Out of 272 tested children, 85 were positive for RSV. The peak of the RSV epidemic occurred in February, with an earlier start and end of the RSV season in the northern and central regions, compared to the southern regions. Major risk factors for RSV infection were younger age (p 2 years of age. RSV positivity was associated with a higher rate of hospitalization in the whole study population (p<0.01) and especially in the children < or =12 months of age (p<0.01). Clinical evidence of lower respiratory tract involvement, was also more frequently observed in RSV positive than in RSV negative children, both in the whole study population (p<0.01) and in the < or =12 months of age subgroup (p<0.01). These data confirm that the patterns of RSV infection in Italy are similar to those reported for other countries in the northern hemisphere: RSV is associated with a higher risk of hospitalization and clinically evident LRTI involvement than respiratory infections of other etiologies, especially in infants.

  11. Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars; Munck, Anders

    2014-01-01

    explicitly requested an antibiotic prescription. METHODS: Spanish GPs registered all cases of respiratory tract infections over a 3-week period before and after an intervention undertaken in 2008 and 2009. Patients with acute sinusitis, pneumonia, and exacerbations of COPD were excluded. Two types......BACKGROUND: General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who...... test); and the partial intervention group underwent all of the above interventions except for the workshop and access to point-of-care tests. RESULTS: A total of 210 GPs were assigned to the full intervention group and 71 to the partial intervention group. A total of 25,479 subjects with respiratory...

  12. The Recent Severe Acute Respiratory Syndrome (SARS) Epidemic ...

    African Journals Online (AJOL)

    The symptoms of SARS are quite similar to those of common cold, malaria and respiratory tract infections all of which are common in our environment. SARS, being a new disease, has as yet neither a definite diagnostic test nor treatment. With the international transmission of SARS first reported in March 2003, it became ...

  13. Views on respiratory tract symptoms and antibiotics of Dutch general practitioners, practice staff and patients.

    NARCIS (Netherlands)

    Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Verheij, T.J.M.

    2006-01-01

    OBJECTIVES: To explore views on respiratory tract symptoms (cough, sore throat and earache) and antibiotics of GPs, practice staff, and patients. METHODS: In a nationwide study, 181 GPs, 204 practice staff members and 1250 patients from 90 practices participated by answering 14 items relating to

  14. Role of patients' and doctors' views on the management of respiratory tract infections

    NARCIS (Netherlands)

    Duijn, Huig Jacob van

    2006-01-01

    The vast majority of respiratory tract (RT) symptoms such as cough, sore throat and earache are self-limiting (viral) infections. Despite this self-limiting character, in the Netherlands antibiotics are prescribed in about one out of every three RT episodes. A further rationalisation of antibiotic

  15. Prediction of complicated lower respiratory tract infections in older patients with diabetes

    NARCIS (Netherlands)

    Venmans, Leonie M A J; Bont, Jettie; Gorter, Kees J; Verheij, Theo J M; Rutten, Guy E H M; Hak, Eelko

    BACKGROUND: Patients with diabetes have an elevated risk of developing complicated lower respiratory tract infections (LRTIs). However, up until now, GPs have not had the tools to assess individual risks. AIM: To assess the applicability of an existing prediction rule for complicated LRTI among

  16. Diagnosis of IgE-mediated allergy in the upper respiratory tract

    NARCIS (Netherlands)

    Blok, G. J.; Flikweert, D. C.; Nauta, J. J.; Leezenberg, J. A.; Snel, A. M.; van der Baan, S.

    1991-01-01

    A statistical analysis was made of data concerning diagnosis of IgE-mediated allergy in the upper respiratory tract in 292 patients. A study was made of: skin test, total and specific IgE (RAST), X-sinus, red blood investigation, and cytology of nasal smear. It appears that screening for the

  17. Disordered microbial communities in the upper respiratory tract of cigarette smokers.

    Directory of Open Access Journals (Sweden)

    Emily S Charlson

    2010-12-01

    Full Text Available Cigarette smokers have an increased risk of infectious diseases involving the respiratory tract. Some effects of smoking on specific respiratory tract bacteria have been described, but the consequences for global airway microbial community composition have not been determined. Here, we used culture-independent high-density sequencing to analyze the microbiota from the right and left nasopharynx and oropharynx of 29 smoking and 33 nonsmoking healthy asymptomatic adults to assess microbial composition and effects of cigarette smoking. Bacterial communities were profiled using 454 pyrosequencing of 16S sequence tags (803,391 total reads, aligned to 16S rRNA databases, and communities compared using the UniFrac distance metric. A Random Forest machine-learning algorithm was used to predict smoking status and identify taxa that best distinguished between smokers and nonsmokers. Community composition was primarily determined by airway site, with individuals exhibiting minimal side-of-body or temporal variation. Within airway habitats, microbiota from smokers were significantly more diverse than nonsmokers and clustered separately. The distributions of several genera were systematically altered by smoking in both the oro- and nasopharynx, and there was an enrichment of anaerobic lineages associated with periodontal disease in the oropharynx. These results indicate that distinct regions of the human upper respiratory tract contain characteristic microbial communities that exhibit disordered patterns in cigarette smokers, both in individual components and global structure, which may contribute to the prevalence of respiratory tract complications in this population.

  18. Neonatal total IgE and respiratory tract infections in children with intrauterine smoke exposure.

    NARCIS (Netherlands)

    Ruskamp, J.; Smit, H.; Rovers, M.M.; Hoekstra, M.O.; Schilder, A.G.M.; Brunekreef, B.; Wijga, A.; Kerkhof, M.; de Jongste, J.; Sanders, E.A.M.

    2010-01-01

    BACKGROUND: Exposure to environmental tobacco smoke (ETS) is known to increase the risk of respiratory tract infections (RTI). Some children, however, may be more susceptible to the harmful effects of ETS than others. We examined whether early atopic status (defined by elevated neonatal total IgE

  19. Neonatal total IgE and respiratory tract infections in children with intrauterine smoke exposure

    NARCIS (Netherlands)

    Ruskamp, Jopje; Smit, Henriette; Rovers, Maroeska; Hoekstra, Maarten; Schilder, Anne; Brunekreef, Bert; Wijga, Alet; Kerkhof, Marjan; de Jongste, Johan; Sanders, Elisabeth

    Background Exposure to environmental tobacco smoke (ETS) is known to increase the risk of respiratory tract infections (RTI). Some children, however, may be more susceptible to the harmful effects of ETS than others. We examined whether early atopic status (defined by elevated neonatal total IgE

  20. Effect of formaldehyde on the upper respiratory tract _ormal flora of ...

    African Journals Online (AJOL)

    Background: Formaldehyde is a chemical that is used to fix a tissue after death or removal from the body to prevent autolysis and putrefaction. Exposure to formaldehyde can occur as a result of occupation. Objective: To determine the effect of the formaldehyde on the throat and nasal flora of upper respiratory tract of rabbits ...

  1. Prescribing antibiotics for respiratory tract infections by GPs: management and prescriber characteristics

    NARCIS (Netherlands)

    A.E. Akkerman (Annemiek); M.M. Kuyvenhoven (Marijke); J.C. van der Wouden (Hans); T.J. Verheij

    2005-01-01

    textabstractBACKGROUND: Due to clinical and non-clinical factors, considerable variation exists in the prescribing of antibiotics for respiratory tract infections (RTIs) by GPs based in the Netherlands. AIM: To assess, in patients with RTIs in Dutch general practice: the

  2. External Validation of Prediction Models for Pneumonia in Primary Care Patients with Lower Respiratory Tract Infection

    DEFF Research Database (Denmark)

    Schierenberg, Alwin; Minnaard, Margaretha C; Hopstaken, Rogier M

    2016-01-01

    for prediction of pneumonia in primary care were externally validated in the individual patient data (IPD) of previously performed diagnostic studies. METHODS AND FINDINGS: S&S models for diagnosing pneumonia in adults presenting to primary care with lower respiratory tract infection and IPD for validation were...

  3. Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

    2013-01-01

    Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...

  4. Prognosis of primary care patients aged 80 years and older with lower respiratory tract infection

    NARCIS (Netherlands)

    van de Nadort, Christiana; Smeets, Hugo M; Bont, Jettie; Zuithoff, N Peter A; Hak, Eelko; Verheij, Theo J M

    BACKGROUND: Predictors for a complicated course of a lower respiratory tract infection (LRTI) episode among patients aged > or =80 years are unknown. AIM: To determine prognostic factors for hospital admission or death within 30 days after first onset of LRTI among primary care patients aged > or

  5. Lower respiratory tract infections in the elderly: Prognostic studies in primary care

    NARCIS (Netherlands)

    Bont, J.

    2008-01-01

    Lower respiratory tract infections (LRTI) are among the most common diseases presented in primary care. When the general practitioner (GP) diagnoses an LRTI he or she is confronted with important clinical dilemmas concerning treatment and prognosis. Especially elderly are of importance, as the

  6. The Mechanism of Activated Nitrogen-Containing Metabolites in the Respiratory Tract: Proinflammatory Effect (Part 3

    Directory of Open Access Journals (Sweden)

    O.Ye. Abaturov

    2016-04-01

    Full Text Available The literature review presents current data about modulating action of nitrogen monoxide on the inflammatory response and the apoptotic process depending on its concentration. There is demonstrated a dual action of nitric oxide in the respiratory tract — prevention of infection and strengthening the destruction of lung tissue.

  7. Predicting nosocomial lower respiratory tract infections by a risk index based system

    NARCIS (Netherlands)

    Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

    2017-01-01

    Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

  8. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis.

    Science.gov (United States)

    Charan, Jaykaran; Goyal, Jagdish P; Saxena, Deepak; Yadav, Preeti

    2012-10-01

    To explore the effect of vitamin D supplementation in prevention of respiratory tract infections on the basis of published clinical trials. Clinical trials were searched from various electronic databases. Five clinical trials were suitable for inclusion. Outcome was events of respiratory tract infections in vitamin D group and placebo group. Data was reported as odds ratio with 95% confidence interval. Both random and fixed model was used for analysis. Analysis was done with the help of Comprehensive meta-analysis software 2. Events of respiratory tract infections were significantly lower in vitamin D group as compared to control group [Odds ratio = 0.582 (0.417 - 0.812) P = 0.001] according to random model. Results were similar in fixed model. On separate analysis of clinical trials dealing with groups of children and adults, beneficial effect of vitamin D was observed in both, according to fixed model [Odds ratio = 0.579 (0.416 - 0.805), P = 0.001 and Odd ratio = 0.653 (0.472 - 0.9040, P = 0.010 respectively]. On using random model beneficial effect persisted in children's group but became nonsignificant in adults group [Odds ratio = 0.579 (0.416 - 0.805), P = 0.001 and Odd ratio = 0.544 (0.278 - 1.063) P = 0.075 respectively]. Vitamin D supplementation decreases the events related to respiratory tract infections. There is need of more well conducted clinical trials to reach to a certain conclusion.

  9. Vitamin D3 Supplementation and Upper Respiratory Tract Infections in a Randomized, Controlled Trial

    OpenAIRE

    Rees, Judy R.; Hendricks, Kristy; Barry, Elizabeth L.; Peacock, Janet L.; Mott, Leila A.; Sandler, Robert S.; Bresalier, Robert S.; Goodman, Michael; Bostick, Roberd M.; Baron, John A.

    2013-01-01

    In a trial substudy of 1000 IU vitamin D3 supplementation, 759 participants completed daily health diaries for up to 17 months. Supplementation provided no significant reduction in upper respiratory tract infections, colds, or influenza-like illness during winter or overall.

  10. Functional and genetic predisposition to rhinovirus lower respiratory tract infections in prematurely born infants

    NARCIS (Netherlands)

    Drysdale, Simon B.; Alcazar, Mireia; Wilson, Theresa; Smith, Melvyn; Zuckerman, Mark; Hodemaekers, Hennie M.; Janssen, Riny; Bont, Louis; Johnston, Sebastian L.; Greenough, Anne

    2016-01-01

    Term born infants are predisposed to human rhinovirus (HRV) lower respiratory tract infections (LRTI) by reduced neonatal lung function and genetic susceptibility. Our aim was to investigate whether prematurely born infants were similarly predisposed to HRV LRTIs or any other viral LRTIs. Infants

  11. Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections

    NARCIS (Netherlands)

    van den Aardweg, M.T.A.|info:eu-repo/dai/nl/314096922

    2013-01-01

    This thesis focuses on the effects of adenoidectomy in children with recurrent upper respiratory tract infections (URTIs).Despite being one of the most frequent operations performed in children, evidence for the effectiveness of adenoidectomy is scarce and guidance in particular for children with

  12. Epidemiology of respiratory tract infections in Dutch general practice: a historical analysis.

    NARCIS (Netherlands)

    Schellevis, F.G.; Donker, G.

    2007-01-01

    Aims: To describe time trends in the incidence of respiratory tract infections in general practice in the Netherlands and its relation to sex and age. Design and Methods: Data will be presented from several morbidity surveys conducted in general practices in the Netherlands: the Intermittent

  13. Mental health of Polish students and the occurrence of respiratory tract infections.

    Science.gov (United States)

    Baran, Sylwia; Teul-Swiniarska, Iwona; Dzieciolowska-Baran, Edyta; Lorkowski, Jacek; Gawlikowska-Sroka, Aleksandra

    2013-01-01

    The aim of the paper was to examine the association between the psychological status and the occurrence of respiratory tract infections which constitute the most common group of disorders in the student population. The study comprised 500 Polish students aged 19-21. Two psychological scales were utilized: the Goldberg GHQ-12 scale to examine the general psychological status and the CES-D scale to evaluate the symptoms of depression. In addition a pro-health questionnaire in the examined group of students was performed. We found an increased stress level in 51% of students and the symptoms of depression in 22%. An association between distress and the occurrence of respiratory tract infections was found, based on statistical analyses. The highest stress level and related high distress index were observed in the students suffering from lower respiratory tract infections (7.1 scale value). This group self-evaluated their health status as poor, based on the pro-health questionnaire. In the same group of students, lack of sleep (5.4), lack of regular eating habits (4.2) and lack of physical activity (3.9) were also observed. The study shows that the Polish student population is exposed to increased stress level, which, in turn, increases the occurrence of respiratory tract infections.

  14. [Mold hypersensitivity in children with frequent respiratory tract infection and prolonged cough attacks].

    Science.gov (United States)

    Sahin, Ozlem Naciye; Yaprak, Pınar; Gülen, Figen; Perçin, Alp Korkut

    2014-01-01

    This study aims to investigate pollen, mite and mold sensitivities among children with frequent respiratory tract infection living in damp apartments and to evaluate the effects of separated parents, education status, ethnicity, the presence of siblings, and their atopy status on the development of atopy. Between June 2012 and September 2013, 63 children (28 girls, 35 boys; mean age 80.2 years; range 24 to 97 years) who were admitted to Acıbadem Bodrum Hospital with at least six respiratory tract infection per year with mold exposure and prolonged cough attacks and underwent skin prick test (SPT) were included. Skin prick test-positive patients were further divided into groups according to the upper respiratory tract (URT) or lower respiratory tract (LRT) involvement and were assessed for mold, mite and pollen sensitivities. One-third of the patients were SPT positive. The parents of these patients had physician-diagnosed allergy (pmold sensitivity presented with LRT findings (pmolds than non-atopic children. Mold exposure may also cause inflammation at LRT without causing immunoglobulin E-dependent sensitization.

  15. Acute respiratory illnesses in the first 18 months of life

    Directory of Open Access Journals (Sweden)

    Ilse M. López Bravo

    1997-01-01

    Full Text Available To help assess the causes and frequency of acute respiratory illnesses (ARI during the first 18 months of life in Chile, a cohort of 437 children born in good health between May 1991 and April 1992 was followed at an urban health clinic in northern Santiago. Information was obtained from medical checkups performed at the clinic, from emergency health care services, from private physicians, and from interviews with each child's mother when the child was enrolled in the study and when it was 6, 12, and 18 months old. Followup was completed for 379 (87% of the children. ARI accounted for 67% of all 3762 episodes of illness recorded for these children in the 18-month study period, 1384 (55% of the ARI episodes affecting the upper respiratory tract and the remaining 1144 (45% affecting the lower. The overall rate of ARI observed was 33 episodes per 100 child-months of observation. The incidences of upper, lower, and total ARI episodes decreased significantly in the third six months of life. A statistically significant association was found between upper ARI ( > or = 2 episodes and maternal smoking ( > or = 5 cigarettes per day, but no significant associations were found with any of the other risk factors studied. However, lower ARI ( > or = 2 episodes was significantly associated with maternal schooling ( or = 4 episodes was significantly associated with these factors and also with the existence of one or more siblings, birth in a cold season, limited breast-feeding (<4 months, and low socioeconomic status. Significant associations were found between obstructive bronchitis episodes and most of the risk factors studied (gender, siblings, season of birth, duration of breast-feeding, maternal schooling, smoking, use of polluting fuels in the home, and a family history of atopic allergy; similarly, significant associations were found between the occurrence of pneumonia and many risk factors (including siblings, season of birth, duration of breast

  16. [Viral respiratory tract infections in the Neonatal Intensive Care Unit].

    Science.gov (United States)

    Gonzalez-Carrasco, E; Calvo, C; García-García, M L; Beato, M; Muñoz-Archidona, C; Pozo, F; Casas, I

    2015-04-01

    Viral respiratory infections cause major morbidity and mortality in preterm infants. We have performed a prospective study in our neonatal intensive care unit (NICU) to determine the incidence of respiratory infections, their impact and the epidemiology and outcome in high risk neonates. From September 2011 to May 2013 a prospective study was conducted in all preterm infants respiratory symptoms a new NPA was collected in this moment. A clinical form was filled by the physician. A total of 60 infants were analyzed: 30 (50%) had a gestational age infection (2 patients had two different episodes with negative control between them). The most frequently identified virus was rhinovirus in (19) 79% of cases. The most frequent clinical data was the presence or increased of apneas (75%) and the needed of oxygenotherapy. HRV infections are prevalent in the NICU, and preterm infants have a high risk of infections with clinical relevance. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  17. Epidemiology of coronavirus respiratory infections.

    OpenAIRE

    Isaacs, D; Flowers, D; Clarke, J R; Valman, H B; MacNaughton, M R

    1983-01-01

    Human coronaviruses were found by enzyme linked immunosorbent assay in upper respiratory tract secretions taken during 30% of 108 acute respiratory infections experienced by 30 children under age 6 years with recurrent respiratory infections (index group), and during 29% of 51 acute infections experienced by their siblings. Lower respiratory tract infection--predominantly wheezy bronchitis--occurred in 30% of the index children's coronavirus positive infections but in none of their siblings' ...

  18. Emergency thyroidectomy: Due to acute respiratory failure

    Directory of Open Access Journals (Sweden)

    Zulfu Bayhan

    2014-01-01

    CONCLUSION: Respiratory failure due to giant nodular goiter is a life-threatening situation and should be treated immediately by performing awake endotracheal intubation following emergency total thyroidectomy.

  19. Respiratory muscle strength and muscle endurance are not affected by acute metabolic acidemia.

    NARCIS (Netherlands)

    Nizet, T.A.C.; Heijdra, Y.F.; Elshout, F.J.J. van den; Ven, M.J.T. van de; Bosch, F.H.; Mulder, P.H.M. de; Folgering, H.T.M.

    2009-01-01

    Respiratory muscle fatigue in asthma and chronic obstructive lung disease (COPD) contributes to respiratory failure with hypercapnia, and subsequent respiratory acidosis. Therapeutic induction of acute metabolic acidosis further increases the respiratory drive and, therefore, may diminish

  20. Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial.

    Science.gov (United States)

    Meydani, Simin Nikbin; Leka, Lynette S; Fine, Basil C; Dallal, Gerard E; Keusch, Gerald T; Singh, Maria Fiatarone; Hamer, Davidson H

    2004-08-18

    Respiratory tract infections are prevalent in elderly individuals, resulting in increased morbidity, mortality, and use of health care services. Vitamin E supplementation has been shown to improve immune response in elderly persons. However, the clinical importance of these findings has not been determined. To determine the effect of 1 year of vitamin E supplementation on respiratory tract infections in elderly nursing home residents. A randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Mass, area. A total of 617 persons aged at least 65 years and who met the study's eligibility criteria were enrolled; 451 (73%) completed the study. Vitamin E (200 IU) or placebo capsule administered daily; all participants received a capsule containing half the recommended daily allowance of essential vitamins and minerals. Incidence of respiratory tract infections, number of persons and number of days with respiratory tract infections (upper and lower), and number of new antibiotic prescriptions for respiratory tract infections among all participants randomized and those who completed the study. Vitamin E had no significant effect on incidence or number of days with infection for all, upper, or lower respiratory tract infections. However, fewer participants receiving vitamin E acquired 1 or more respiratory tract infections (60% vs 68%; risk ratio [RR], 0.88; 95% confidence interval [CI], 0.76-1.00; P =.048 for all participants; and 65% vs 74%; RR, 0.88; 95% CI, 0.75-0.99; P =.04 for completing participants), or upper respiratory tract infections (44% vs 52%; RR, 0.84; 95% CI, 0.69-1.00; P =.05 for all participants; and 50% vs 62%; RR, 0.81; 95% CI, 0.66-0.96; P =.01 for completing participants). When common colds were analyzed in a post hoc subgroup analysis, the vitamin E group had a lower incidence of common cold (0.67 vs 0.81 per person-year; RR, 0.83; 95% CI, 0.68-1.01; P =.06 for all

  1. Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children.

    Science.gov (United States)

    Agustina, Rina; Kok, Frans J; van de Rest, Ondine; Fahmida, Umi; Firmansyah, Agus; Lukito, Widjaja; Feskens, Edith J M; van den Heuvel, Ellen G H M; Albers, Ruud; Bovee-Oudenhoven, Ingeborg M J

    2012-05-01

    To investigate the effects of calcium and probiotics on the incidence and duration of acute diarrhea and acute respiratory tract infections (ARTIs) in low-socioeconomic communities of Jakarta, Indonesia. We conducted a 6-month, double-blind, placebo-controlled study in 494 healthy children aged 1 to 6 years who received low-lactose milk with low calcium content (LC; ∼50 mg/day; n = 124), regular calcium content (RC; ∼440 mg/day; n = 126), RC with 5.10(8) colony-forming units per day of Lactobacillus casei CRL431 (casei; n = 120), or RC with 5.10(8) colony-forming units per day of Lactobacillus reuteri DSM17938 (reuteri; n = 124). Number and duration of diarrhea and ARTIs episodes were primary and secondary outcomes, respectively. Incidence of World Health Organization-defined diarrhea (≥3 loose/liquid stools in 24 hours) was not significantly different between RC and LC (relative risk [RR]: 0.99 [95% confidence interval (CI): 0.62-1.58]), between casei and RC (RR: 1.21 [95% CI: 0.76-1.92]), or between reuteri and RC (RR: 0.76 [95% CI: 0.46-1.25]) groups. Incidence of all reported diarrhea (≥2 loose/liquid stools in 24 hours) was significantly lower in the reuteri versus RC group (RR: 0.68 [95% CI: 0.46-0.99]). Irrespective of the definition used, reuteri significantly reduced diarrhea incidence in children with lower nutritional status (below-median height-and-weight-for-age z score). None of the interventions affected ARTIs. RC milk, alone or with L casei, did not reduce diarrhea or ARTIs in Indonesian children. L reuteri may prevent diarrhea, especially in children with lower nutritional status.

  2. ACUTE RESPIRATORY SYNCYTIAL VIRUS INFECTION IN CHILDREN IN THE AGE ASPECT

    Directory of Open Access Journals (Sweden)

    V. B. Rovny

    2013-01-01

    Full Text Available The clinical features of laboratory-confirmed acute respiratory syncytial virus infection (ARSVI are described in 221 children of the age from 1 month to 5 years. Febrile fever has been recorded in 76% of patients with ARSVI, and significantly more often in children in the second year of life (92%, but the difference in the temerature or duration has not been found. 98% of children have had symptoms of the lower respiratory tract lesions. The most common ARSVI manifestations in the patients of the first year of life were obstructive diseases of the lower respiratory tract (obstructive bronchitis in 53% and bronchiolitis in 11% of children, in the patients of the second year of life — pneumonia (28%, p < 0,05 and catarrhal otitis (26%; p < 0,05. Bronchial obstruction syndrome in children of the first year of life was characterized by the significantly higher frequency (73% and the maximal duration (9,7 ± 1,08 days. The largest number of cases of the severe respiratory failure has been recorded among patients of the second year of life (3 degree of respiratory failure in 22% of patients, p < 0,05.

  3. The effect of using an interactive booklet on childhood respiratory tract infections in consultations: Study protocol for a cluster randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Nuttall Jacqueline

    2008-04-01

    Full Text Available Abstract Background Respiratory tract infections in children result in more primary care consultations than any other acute condition, and are the most common reason for prescribing antibiotics (which are largely unnecessary. About a fifth of children consult again for the same illness episode. Providing parents with written information on respiratory tract infections may result in a reduction in re-consultation rates and antibiotic prescribing for these illnesses. Asking clinicians to provide and discuss the information during the consultation may enhance effectiveness. This paper outlines the protocol for a study designed to evaluate the use of a booklet on respiratory tract infections in children within primary care consultations. Methods/Design This will be a cluster randomised controlled trial. General practices will be randomised to provide parents consulting because their child has an acute respiratory tract infection with either an interactive booklet, or usual care. The booklet provides information on the expected duration of their child's illness, the likely benefits of various treatment options, signs and symptoms that should prompt re-consultation, and symptomatic treatment advice. It has been designed for use within the consultation and aims to enhance communication through the use of specific prompts. Clinicians randomised to using the interactive booklet will receive online training in its use. Outcomes will be assessed via a telephone interview with the parent two weeks after first consulting. The primary outcome will be the proportion of children who re-consult for the same illness episode. Secondary outcomes include: antibiotic use, parental satisfaction and enablement, and illness costs. Consultation rates for respiratory tract infections for the subsequent year will be assessed by a review of practice notes. Discussion Previous studies in adults and children have shown that educational interventions can result in reductions

  4. Epidemiology of Respiratory Pathogens in Children with Lower Respiratory Tract Infections in Shanghai, China, from 2013 to 2015.

    Science.gov (United States)

    Liu, Pengcheng; Xu, Menghua; He, Leiyan; Su, Liyun; Wang, Aimin; Fu, Pan; Lu, Lijuan; Wang, Chuanqing; Xu, Jin

    2018-01-23

    This study aimed to explore the epidemiology of pathogens in children who were hospitalized with lower respiratory tract infections (LRTIs) at the Children's Hospital of Fudan University, Shanghai, China. Children aged less than 18 years who were hospitalized with LRTIs were enrolled from January 2013 to December 2015. Respiratory specimens were collected for the detection of common respiratory viruses, atypical bacteria, and other bacteria using current laboratory diagnostic tests. The epidemiological characteristics of the respiratory pathogens were analyzed. Of the 10,123 specimens obtained from the patients, 5,966 (58.7%) were positive for at least 1 pathogen. Mycoplasma pneumoniae (M.pneumoniae) was the most commonly detected pathogen (15.7%), followed by respiratory syncytial virus (RSV) (13.9%). Co-infections were found in 11.4% of patients. Of these co-infections, viral-bacterial co-infections were the most common. The detection rates for the respiratory pathogens varied considerably by age. RSV was the most common pathogen in children aged less than 24 months. Clear seasonal peaks were observed for RSV, M. pneumoniae, parainfluenza virus, human metapneumovirus, Moraxella catarrhalis, and Haemophilus influenza infections. Our findings demonstrate specific epidemiological patterns in children with LRTIs in Shanghai, China.

  5. Clinical significance of different virus load of human bocavirus in patients with lower respiratory tract infection.

    Science.gov (United States)

    Jiang, Wujun; Yin, Fang; Zhou, Weifang; Yan, Yongdong; Ji, Wei

    2016-02-01

    To assess the impact of human bocavirus (HBoV) virus load on epidemiologic and clinical characteristics in children with lower respiratory tract infection (LRTI). Clinical records of a total of 654 patients with HBoV infection during January 2013 and December 2014 were retrospectively reviewed. Patients with high HBoV virus load infection had a similar age distribution with the total HBoV infection, which had a peak age group of 6-24 months. Patients with high virus load are significantly younger (P infection was found significantly more frequently among patients with low virus load than those with high virus load (57.0% vs 38.9%; P infections are found in an important proportion of the hospitalized children with respiratory illnesses (8.85% in our series). A high HBoV virus load could be an etiologic agent for LRTI, which may lead to more severe lower respiratory tract symptom and severe disease.

  6. Exposure to environmental tobacco smoke and respiratory tract infections in pre-school children – a cross-sectional study in Poland

    Directory of Open Access Journals (Sweden)

    Dorota Bielska

    2015-09-01

    The majority of the 3-year-old children who had lower respiratory tract infections required antibiotics and hospitalization. Living in a home where no tobacco rules were established may cause an increase of respiratory tract infections.

  7. Postrace upper respiratory tract 'infections' in ultra- marathoners ...

    African Journals Online (AJOL)

    Enrique

    the endocrine,43,44,64,72 cytokine,36,48-51 acute phase protein,6,7,81 and enzymatic66 milieu in the circulation favours an inflam- matory response (Fig. 4). In three consecutive studies following the 90 km ultrama- rathon, we have confirmed systemic evidence of a pro- inflammatory response.55-57 Not only are markers ...

  8. The Diagnosis, Evaluation and Treatment of Acute and Recurrent Pediatric Urinary Tract Infections

    Science.gov (United States)

    Becknell, Brian; Schober, Megan; Korbel, Lindsey; Spencer, John David

    2015-01-01

    Urinary tract infection is one of the most common bacterial infections encountered by pediatricians. Currently, the diagnosis and management of acute urinary tract infection and recurrent urinary tract infection in children remains controversial. Recently published guidelines and large clinical trials have attempted to clarify UTI diagnostic and management strategies. In this manuscript, we review the diagnosis and management of acute and recurrent urinary tract infection in the pediatric population. PMID:25421102

  9. Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care

    DEFF Research Database (Denmark)

    Bagger, Kathrine; Nielsen, Anni Brit Sternhagen; Siersma, Volkert

    2015-01-01

    Background: Unnecessary prescribing of antibiotics is a major public health concern. General practitioners (GPs) prescribe most antibiotics, often for upper respiratory tract infections (URTIs), and have in general been shown to prescribe antibiotics more often to women. No studies have examined...... of a cross-sectional study including 15 022 patients with URTI (acute rhinitis, acute otitis media, acute sinusitis, acute pharyngotonsillitis) from Argentina, Denmark, Lithuania, Russia, Spain and Sweden (HAPPY AUDIT Project). The association between gender and unnecessary antibiotic prescriptions....... Women with acute otitis media received an unnecessary antibiotic twice as often as men (14.4% versus 7.1%). In Danish patients with acute pharyngotonsillitis, there was a gender difference in unnecessary prescriptions for antibiotics (women 29.1% versus men 48.6%). Some 14% of patients receiving...

  10. Unravelling the transcriptome profile of the Swine respiratory tract mycoplasmas.

    Directory of Open Access Journals (Sweden)

    Franciele Maboni Siqueira

    Full Text Available The swine respiratory ciliary epithelium is mainly colonized by Mycoplasma hyopneumoniae, Mycoplasma flocculare and Mycoplasma hyorhinis. While colonization by M. flocculare is virtually asymptomatic, M. hyopneumoniae and M. hyorhinis infections may cause respiratory disease. Information regarding transcript structure and gene abundance provides valuable insight into gene function and regulation, which has not yet been analyzed on a genome-wide scale in these Mycoplasma species. In this study, we report the construction of transcriptome maps for M. hyopneumoniae, M. flocculare and M. hyorhinis, which represent data for conducting comparative studies on the transcriptional repertory. For each species, three cDNA libraries were generated, yielding averages of 415,265, 695,313 and 93,578 reads for M. hyopneumoniae, M. flocculare and M. hyorhinis, respectively, with an average read length of 274 bp. The reads mapping showed that 92%, 98% and 96% of the predicted genes were transcribed in the M. hyopneumoniae, M. flocculare and M. hyorhinis genomes, respectively. Moreover, we showed that the majority of the genes are co-expressed, confirming the previously predicted transcription units. Finally, our data defined the RNA populations in detail, with the map transcript boundaries and transcription unit structures on a genome-wide scale.

  11. Do children’s upper respiratory tract infections benefit from probiotics?

    Science.gov (United States)

    2014-01-01

    Background The microbiota of the gastrointestinal tract have profound influence at multiple levels, even on the development and maintenance of lung immunity and inflammation. Aim of this review is to evaluate the current knowledge about the specific impact on children’s respiratory tract infections from probiotics, live microbes with the power to modify intestinal microbial populations and exert subsequent benefits for the host. Discussion The role of probiotics in gastrointestinal and allergic diseases has been largely assessed, but the number of studies performed so far in the field of respiratory tract infections is small, though some data show that probiotic administration might display clinical advantages. Probiotic strain identity and host genetic differences may account for differential modulation of immune responses by probiotics. Current laboratory and clinical data regarding the possibility of the role of probiotics on preventing the development of respiratory tract infections are contradictory, and are somewhat insufficient to recommend strongly their routine use. Further study of gastrointestinal-respiratory interactions is likely to yield important insights into the pathogenesis of different pulmonary diseases, and improve our knowledge in the prophylactic role of probiotics in children affected by recurrent upper respiratory tract infections. Summary A better understanding of the effects of different probiotic strains and a deeper insight into their mechanisms of action are needed for the validation of specific strains carrying a potential to modify the frequency and severity of RTIs in infants and children. No data have been collected in pediatric patients with chronic underlying diseases, and yet there are no published data concerning treatment of RTIs with probiotics. The very few studies published so far do not indicate which micro-organism or administration regimen might exert beneficial effects as a prevention tool of RTIs both in healthy

  12. [Gas exchange in acute respiratory distress syndrome].

    Science.gov (United States)

    Raimondi, Guillermo A

    2003-01-01

    The hypoxemia of acute respiratory distress syndrome (ARDS) depends chiefly upon shunt and ventilation-perfusion (VA/Q) inequality produced by fluid located in the interstitial space, alveolar collapse and flooding. Variables other tham inspired oxygen fraction and the underlying physiological abnormality can influence arterial oxygen partial pressure (PaO2). Changes in cardiac output, hemoglobin concentration, oxygen consumption and alcalosis can cause changes in PaO2 through their influence on mixed venous PO2. Gas exchange (GE) in ARDS may be studied using the inert gas elimination technique (MIGET) which enables to define the distribution of ventilation and perfusion without necessarily altering the FIO2 differentiating shunt from lung units with low VA/Q ratios and dead space from lung units with high VA/Q ratios. Different ventilatory strategies that increase mean airway pressure (positive end-expiratory pressure, high tidal volumes, inverse inspiratory-expiratory ratio, etc) improve PaO2 through increasing lung volume by recruiting new open alveoli and spreading the intra-alveolar fluid over a large surface area. Also prone-position ventilation would result in a marked improvement in GE enhancing dorsal lung ventilation by the effects on the gravitional distribution of pleural pressure and the reduction in the positive pleural pressure that develops in dorsal regions in ARDS. Inhaled nitric oxide (NO) has been shown to increase PaO2 in ARDS patients by inducing vasodilation predominantly in ventilated areas redistributing pulmonary blood flow away from nonventilated toward ventilated areas of the lung thus resulting in a shunt reduction. On the same way inhaled prostaglandins (PGI2 or PGE1) causes selective pulmonary vasodilation improving pulmonary GE. Intravenous almitrine, a selective pulmonary vasoconstrictor, has been shown to increase PaO2 by increasing hypoxic pulmonary vasoconstriction. A synergistic effect was found between inhaled NO and almitrine

  13. Human Metapneumovirus Infection and Acute Respiratory Distress Syndrome During Pregnancy.

    Science.gov (United States)

    Fuchs, Alina; McLaren, Rodney; Saunders, Paul; Karakash, Scarlett; Minkoff, Howard

    2017-09-01

    Human metapneumovirus has recently been recognized as an important cause of severe respiratory viral infections and of viral infections in patients admitted to intensive care units. Little is known about the course of this infection in pregnancy. A late-preterm primigravid woman was admitted to the intensive care unit for acute respiratory distress syndrome and subsequently diagnosed with human metapneumovirus. Because of worsening maternal respiratory status, she was intubated and a primary cesarean delivery was performed. The patient's respiratory status continued to decline postpartum, and she ultimately required extracorporeal membrane oxygenation. She was treated supportively until her respiratory status improved, at which time she was extubated and weaned off extracorporeal membrane oxygenation and subsequently discharged home. Human metapneumovirus can lead to severe respiratory illness during pregnancy.

  14. Is there still room for novel viral pathogens in pediatric respiratory tract infections?

    Directory of Open Access Journals (Sweden)

    Blanca Taboada

    Full Text Available Viruses are the most frequent cause of respiratory disease in children. However, despite the advanced diagnostic methods currently in use, in 20 to 50% of respiratory samples a specific pathogen cannot be detected. In this work, we used a metagenomic approach and deep sequencing to examine respiratory samples from children with lower and upper respiratory tract infections that had been previously found negative for 6 bacteria and 15 respiratory viruses by PCR. Nasal washings from 25 children (out of 250 hospitalized with a diagnosis of pneumonia and nasopharyngeal swabs from 46 outpatient children (out of 526 were studied. DNA reads for at least one virus commonly associated to respiratory infections was found in 20 of 25 hospitalized patients, while reads for pathogenic respiratory bacteria were detected in the remaining 5 children. For outpatients, all the samples were pooled into 25 DNA libraries for sequencing. In this case, in 22 of the 25 sequenced libraries at least one respiratory virus was identified, while in all other, but one, pathogenic bacteria were detected. In both patient groups reads for respiratory syncytial virus, coronavirus-OC43, and rhinovirus were identified. In addition, viruses less frequently associated to respiratory infections were also found. Saffold virus was detected in outpatient but not in hospitalized children. Anellovirus, rotavirus, and astrovirus, as well as several animal and plant viruses were detected in both groups. No novel viruses were identified. Adding up the deep sequencing results to the PCR data, 79.2% of 250 hospitalized and 76.6% of 526 ambulatory patients were positive for viruses, and all other children, but one, had pathogenic respiratory bacteria identified. These results suggest that at least in the type of populations studied and with the sampling methods used the odds of finding novel, clinically relevant viruses, in pediatric respiratory infections are low.

  15. Man-made mineral fibers and the respiratory tract.

    Science.gov (United States)

    Costa, Roser; Orriols, Ramon

    2012-12-01

    Man-made mineral fibers are produced using inorganic materials and are widely used as thermal and acoustic insulation. These basically include continuous fiberglass filaments, glass wool (fiberglass insulation), stone wool, slag wool and refractory ceramic fibers. Likewise, in the last two decades nanoscale fibers have also been developed, among these being carbon nanotubes with their high electrical conductivity, mechanical resistance and thermal stability. Both man-made mineral fibers and carbon nanotubes have properties that make them inhalable and potentially harmful, which have led to studies to assess their pathogenicity. The aim of this review is to analyze the knowledge that currently exists about the ability of these fibers to produce respiratory diseases. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Asymptomatic colonization of upper respiratory tract by potential bacterial pathogens.

    Science.gov (United States)

    Dhakal, Rupak; Sujatha, S; Parija, S C; Bhat, B V

    2010-07-01

    To screen for asymptomatic respiratory carriage of S. pneumoniae, H. influenzae and Group A Streptococcus (GAS) in children attending JIPMER, correlate carriage rate with different socio-demographic factors and to detect antimicrobial resistance among the isolates. Throat swabs were collected from both in patients and out patients (1 organism. Antibiotic resistance was highest in S. pneumoniae with 66.7% of strains resistant to penicillin. MDR strains were also encountered. Erythromycin resistance was observed in both H. influenzae (28.4%) and GAS (22%). No statistically significant association was found between the carriage rate of these organisms and different socio-demographic factors. S. pneumoniae carriage rate was comparatively higher in the Community and its antimicrobial resistance is an issue to address.

  17. Extended-Release Guaifenesin/Pseudoephedrine Hydrochloride for Symptom Relief in Support of a Wait-and-See Approach for the Treatment of Acute Upper Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Edward J. Septimus, MD, FIDSA, FACP, FSHEA

    2017-01-01

    Conclusions: The study found that a wait and see approach was associated with decreased antibiotic use. In addition, the use of a guaifenesin pseudoephedrine combination product provided an effective symptom control compared to a placebo and a well-tolerated first-line strategy for the management of URTIs. This study was not designed to assess the effects of guaifenesin or pseudoephedrine individually. Other limitations include the need for better clinical methods to assess the effectiveness of treatments for acute symptoms of patients with URTIs. ClinicalTrials.gov identifier: NCT01202279.

  18. The epidemiology of respiratory syncytial virus (RSV) infections in ...

    African Journals Online (AJOL)

    South African' or 'children' and 'respiratory syncytial virus' or 'acute respiratory tract infections' as text words were retrieved. We analysed the data on respiratory virus activity from January 1990 to June 1996. Data were obtained from the National ...

  19. Low Request of Antibiotics from Patients with Respiratory Tract Infections in Six Countries: Results from the Happy Audit Study

    Directory of Open Access Journals (Sweden)

    Carl Llor

    2013-11-01

    Full Text Available A total of 59,535 patients with respiratory tract infections were registered in the Happy Audit project, an audit-based, before-and-after study conducted in primary care centres of six countries (Argentina, Denmark, Lithuania, Russia, Spain, and Sweden in 2008 and 2009. An antibiotic was explicitly requested by the patient in 1,255 cases (2.1%, with a great variation across countries ranging from 0.4%–4.9%. Antibiotics were significantly more often prescribed to patients requesting them compared to those who did not (64% vs. 28%; p < 0.001. Patients with acute exacerbations of chronic bronchitis/chronic obstructive pulmonary disease were most likely to request antibiotics while those with common colds were least likely (3.9% vs. 1.2%, respectively. The presence of tonsillar exudates and dyspnoea were more commonly associated with a demand for antibiotics. Even though physicians very often perceive that patients demand an antibiotic, the results of this study clearly show that patients only request antibiotics in a low percentage of cases. Patients were most likely to request antibiotics when they had symptoms of lower respiratory tract infections and when they came with more severe symptoms. Furthermore, there were considerable differences between countries, suggesting that the different backgrounds and traditions largely explain this variability in patients’ requests for antibiotics.

  20. Low Request of Antibiotics from Patients with Respiratory Tract Infections in Six Countries: Results from the Happy Audit Study

    Science.gov (United States)

    Llor, Carl; Bjerrum, Lars; Strandberg, Eva Lena; Radzeviciene, Ruta; Reutskiy, Anatoliy; Caballero, Lidia

    2013-01-01

    A total of 59,535 patients with respiratory tract infections were registered in the Happy Audit project, an audit-based, before-and-after study conducted in primary care centres of six countries (Argentina, Denmark, Lithuania, Russia, Spain, and Sweden) in 2008 and 2009. An antibiotic was explicitly requested by the patient in 1,255 cases (2.1%), with a great variation across countries ranging from 0.4%–4.9%. Antibiotics were significantly more often prescribed to patients requesting them compared to those who did not (64% vs. 28%; p < 0.001). Patients with acute exacerbations of chronic bronchitis/chronic obstructive pulmonary disease were most likely to request antibiotics while those with common colds were least likely (3.9% vs. 1.2%, respectively). The presence of tonsillar exudates and dyspnoea were more commonly associated with a demand for antibiotics. Even though physicians very often perceive that patients demand an antibiotic, the results of this study clearly show that patients only request antibiotics in a low percentage of cases. Patients were most likely to request antibiotics when they had symptoms of lower respiratory tract infections and when they came with more severe symptoms. Furthermore, there were considerable differences between countries, suggesting that the different backgrounds and traditions largely explain this variability in patients’ requests for antibiotics. PMID:27029315

  1. The Nucleus of the Solitary Tract and the coordination of respiratory and sympathetic activities

    Directory of Open Access Journals (Sweden)

    Daniel B. Zoccal

    2014-06-01

    Full Text Available It is well known that breathing introduces rhythmical oscillations in the heart rate and arterial pressure levels. Sympathetic oscillations coupled to the respiratory activity have been suggested as an important homeostatic mechanism optimizing tissue perfusion and blood gas uptake/delivery. This respiratory-sympathetic coupling is strengthened in conditions of blood gas challenges (hypoxia and hypercapnia as a result of the synchronized activation of brainstem respiratory and sympathetic neurons, culminating with the emergence of entrained cardiovascular and respiratory reflex responses. Studies have proposed that the ventrolateral region of the medulla oblongata is a major site of synaptic interaction between respiratory and sympathetic neurons. However, other brainstem regions also play a relevant role in the patterning of respiratory and sympathetic motor outputs. Recent findings suggest that the neurons of the nucleus of the solitary tract (NTS, in the dorsal medulla, are essential for the processing and coordination of respiratory and sympathetic responses to hypoxia. The NTS is the first synaptic station of the cardiorespiratory afferent inputs, including peripheral chemoreceptors, baroreceptors and pulmonary stretch receptors. The synaptic profile of the NTS neurons receiving the excitatory drive from afferent inputs is complex and involves distinct neurotransmitters, including glutamate, ATP and acetylcholine. In the present review we discuss the role of the NTS circuitry in coordinating sympathetic and respiratory reflex responses. We also analyze the neuroplasticity of NTS neurons and their contribution for the development of cardiorespiratory dysfunctions, as observed in neurogenic hypertension, obstructive sleep apnea and metabolic disorders.

  2. Human papillomavirus infections of the oral mucosa and upper respiratory tract.

    Science.gov (United States)

    Nguyen, Harrison P; McNiece, Kayla L; Duong, Angela A; Khan, Farhan

    2014-01-01

    Human papillomaviruses (HPVs) are frequently detected in a variety of lesions in the oral mucosa and upper respiratory tract. The pathogenesis in these areas is not as clearly elucidated as in other anatomical regions, but most experts agree that HPVs are responsible for the commonly observed benign lesions, such as squamous papillomas, verruca vulgaris and recurrent respiratory papillomatosis. Transformation of these benign lesions is well described, but it is not clear what role the virus plays, if any, in carcinogenesis. HPV types 6 and 11 are most frequently detected in oral cavity and respiratory tract lesions, though several other types have also been reported. Despite an opaque understanding of these lesions' pathogeneses, it is essential for the clinician to recognize these diseases, to provide appropriate treatment and to promote patient awareness of potential oral transmission. In this paper, we review the major HPV-associated diseases of the oral mucosa and upper respiratory tract, focusing specifically on clinical features, histopathological characteristics and disease management. © 2014 S. Karger AG, Basel.

  3. The role and regulation of catalase in respiratory tract opportunistic bacterial pathogens.

    Science.gov (United States)

    Eason, Mia M; Fan, Xin

    2014-09-01

    Respiratory tract bacterial pathogens are the etiologic agents of a variety of illnesses. The ability of these bacteria to cause disease is imparted through survival within the host and avoidance of pathogen clearance by the immune system. Respiratory tract pathogens are continually bombarded by reactive oxygen species (ROS), which may be produced by competing bacteria, normal metabolic function, or host immunological responses. In order to survive and proliferate, bacteria have adapted defense mechanisms to circumvent the effects of ROS. Bacteria employ the use of anti-oxidant enzymes, catalases and catalase-peroxidases, to relieve the effects of the oxidative stressors to which they are continually exposed. The decomposition of ROS has been shown to provide favorable conditions in which respiratory tract opportunistic bacterial pathogens such as Haemophilus influenzae, Mycobacterium tuberculosis, Legionella pneumophila, and Neisseria meningitidis are able to withstand exposure to highly reactive molecules and yet survive. Bacteria possessing mutations in the catalase gene have a decreased survival rate, yet may be able to compensate for the lack of catalatic activity if peroxidatic activity is present. An incomplete knowledge of the mechanisms by which catalase and catalase-peroxidases are regulated still persists, however, in some bacterial species, a regulatory factor known as OxyR has been shown to either up-regulate or down-regulate catalase gene expression. Yet, more research is still needed to increase the knowledge base in relation to this enzyme class. As with this review, we focus on major respiratory tract opportunistic bacterial pathogens in order to elucidate the function and regulation of catalases. The importance of the research could lead to the development of novel treatments against respiratory bacterial infections. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Chloroquine-Azithromycin Combination Antimalarial Treatment Decreases Risk of Respiratory- and Gastrointestinal-Tract Infections in Malawian Children

    Science.gov (United States)

    Gilliams, Elizabeth A.; Jumare, Jibreel; Claassen, Cassidy W.; Thesing, Phillip C.; Nyirenda, Osward M.; Dzinjalamala, Fraction K.; Taylor, Terrie; Plowe, Christopher V.; Tracy, LaRee A.; Laufer, Miriam K.

    2014-01-01

    Background. Chloroquine-azithromycin is being evaluated as combination therapy for malaria. It may provide added benefit in treating or preventing bacterial infections that occur in children with malaria. Objective. We aim to evaluate the effect of treating clinical malaria with chloroquine-azithromycin on the incidence of respiratory-tract and gastrointestinal-tract infections compared to treatment with chloroquine monotherapy. Methods. We compared the incidence density and time to first events of respiratory-tract and gastrointestinal-tract infections among children assigned to receive chloroquine-azithromycin or chloroquine for all symptomatic malaria episodes over the course of 1 year in a randomized longitudinal trial in Blantyre, Malawi. Results. The incidence density ratios of total respiratory-tract infections and gastrointestinal-tract infections comparing chloroquine-azithromycin to chloroquine monotherapy were 0.67 (95% confidence interval [CI], .48, .94) and 0.74 (95% CI, .55, .99), respectively. The time to first lower-