Infección respiratoria baja en neonatos asociados a ventilación mecánica

Introducción: la infección respiratoria baja constituye una importante causa de mortalidad y morbilidad en el recién nacido. Objetivo: identificar los factores de riesgo para la infección respiratoria baja asociada a la ventilación mecánica artificial invasiva y no invasiva en los recién nacidos ingresados en la UCIN del servicio de Neonatología del Hospital General Docente Carlos Manuel de Céspedes de enero 2017 hasta diciembre del 2019. Métodos: se realizó un estudio analítico de casos y controles. Los grupos de estudio estuvieron conformados por 25 casos y 50 controles respectivamente. Resultados: las variables edad gestacional antes las 37 semanas de gestación, el bajo peso al nacer poseen dos veces o más riesgos de padecer una infección respiratoria baja asociada a la ventilación mecánica de forma significativa con una p<0,05; la estadía mayor de 3 días en ventilación mostró significancia con una p: 0,031; entre los diagnósticos que llevaron a la ventilación mecánica fue la enfermedad de la membrana hialina con una p: 0,025. Conclusiones: La edad gestacional menor de 37 semanas, el peso al nacer menor de 2 500 gramos, el tiempo ventilatorio de más de 3 días y el diagnóstico de la enfermedad de la membrana hialina fueron las variables significativas.

Introduction: lower respiratory infection is an important cause of mortality and morbidity in the newborn. Objective: to identify the risk factors for lower respiratory infection associated with invasive and non-invasive artificial mechanical ventilation in newborns admitted to the NICU of the Neonatology service of the Carlos Manuel de Céspedes Teaching General Hospital from January 2017 to December 2019. Methods: an analytical case-control study was conducted. The study groups consisted of 25 cases and 50 controls, respectively. Results: the variables gestational age before 37 weeks of gestation, low birth weight have twice or more risks of suffering a lower respiratory infection associated with mechanical ventilation significantly with a p<0.05; The stay longer than 3 days in ventilation showed significance with a p: 0.031; Among the diagnoses that led to mechanical ventilation was hyaline membrane disease with a p: 0.025. Conclusions: Gestational age less than 37 weeks, birth weight less than 2 500 grams, ventilatory time of more than 3 days and diagnosis of hyaline membrane disease were the significant variables.

Introdução: a infecção respiratória inferior é uma importante causa de mortalidade e morbidade no recém-nascido. Objetivo: identificar os fatores de risco para infecção respiratória inferior associados à ventilação mecânica artificial invasiva e não invasiva em recém-nascidos internados na UTIN do serviço de Neonatologia do Hospital Geral Universitário Carlos Manuel de Céspedes no período de janeiro de 2017 a dezembro de 2019. Métodos: foi realizado um estudo analítico caso-controle. Os grupos de estudo foram constituídos por 25 casos e 50 controles, respectivamente. Resultados: as variáveis idade gestacional antes de 37 semanas de gestação, baixo peso ao nascer apresentam duas ou mais vezes ou mais riscos de sofrer uma infecção respiratória inferior associada à ventilação mecânica significativamente com p<0,05; A permanência superior a 3 dias em ventilação mostrou significância com p: 0,031; Entre os diagnósticos que levaram à ventilação mecânica estava a doença da membrana hialina com p: 0,025. Conclusões: Idade gestacional inferior a 37 semanas, peso ao nascer inferior a 2.500 gramas, tempo ventilatório superior a 3 dias e diagnóstico de doença da membrana hialina foram as variáveis significativas.

Current situation and prospect of respiratory syncytial virus surveillance system / 预防医学

@#Respiratory syncytial virus（RSV）is the most common pathogen of lower respiratory infection among infants,leading to serious burden of disease all over the world. The surveillance of RSV plays an important role in preventing and controlling its epidemic. At present,the surveillance systems of RSV are not as global as that of influenza,which have been established much more and earlier in the developed countries. The RSV surveillance system are manifested in two types：specific and standard surveillance systems established by very few developed countries and surveillance systems based on the influenza surveillance established by most other countries. This article reviews the current status and prospect of RSV surveillance systems to provide reference for the development of RSV surveillance system in the future.

Respiratory syncytial virus infections in India: Epidemiology and need for vaccine

Respiratory syncytial virus (RSV) has been identified as a leading cause of lower respiratory tract infections in young children and elderly. It is an enveloped negative-sense RNA virus belonging to Genus Orthopneumovirus. The clinical features of RSV infection range from mild upper-respiratory-tract illnesses or otitis media to severe lower-respiratory-tract illnesses. Current estimates show that about 33.1 million episodes of RSV-acute lower respiratory infection (ALRI) occurred in young children in 2015, of these majority that is, about 30 million RSV-ALRI episodes occurred in low-middle-income countries. In India, the rates of RSV detection in various hospital- and community-based studies mostly done in children vary from 5% to 54% and from 8% to 15%, respectively. Globally, RSV epidemics start in the South moving to the North. In India, RSV mainly peaks in winter in North India and some correlation with low temperature has been observed. Different genotypes of Group A (GA2, GA5, NA1 and ON1) and Group B (GB2, SAB4 and BA) have been described from India. The burden of RSV globally has kept it a high priority for vaccine development. After nearly 50 years of attempts, there is still no licensed vaccine and challenges to obtain a safe and effective vaccine is still facing the scientific community. The data in this review have been extracted from PubMed using the keywords RSV and Epidemiology and India. The data have been synthesised by the authors.

Correlation between serum cytokines and clinical feature of children with mild lower respiratory infection

PURPOSE: Acute lower respiratory infection (ALRI), which is frequently encountered in pediatric patients, is the leading cause of hospitalization. We aimed to identify particular cytokines that correlated with ALRI clinical characteristics. We also aimed to identify any differences in cytokines between respiratory syncytial virus (RSV)-related ALRI and non-RSV-related ALRI. METHODS: Cytokine levels were measured in the sera sampled from 103 pediatric patients diagnosed with ALRI and admitted to Seoul St. Mary's Hospital between May 2012 and April 2013. The correlations between cytokine levels and the length of hospitalization, the number of days with fever, body temperature, pulse rate, respiration rate, oxygen saturation upon admission, and duration of oxygen supplementation were analyzed. RESULTS: In children with ALRI, the level of interleukin (IL)-6, granulocyte-colony stimulating factor (G-CSF), and IL-10 were correlated with a higher body temperature on admission. In addition, the IL-8 level was correlated with pulse rate and respiration rate, and IL-1β level was related with oxygen saturation on admission. In children with RSV-related ALRI, the IL-6 was correlated the with duration of fever, and the IL-1β, IL-2, and IL-8 levels were related to pulse rate and respiration rate. In addition, the increase in interferon-gamma-inducible protein-10 (IP-10) level was correlated with a higher body temperature on admission and a longer duration of hospitalization in children with RSV-related ALRI. CONCLUSION: In children with ALRI, the levels of IL-6, IL-8, IL-1β, G-CSF, and IP-10 were correlated with its clinical features. In children with RSV-related ALRI, the IL-1β, IL-2, IL-6, IL-8, and IP-10 level was correlated with the severity of the disease.

Severe lower respiratory infections in children related to human Bocavirus 1 / 国际儿科学杂志

Human bocavirus 1 ( HBoV1 ) is closely related to lower respiratory infections in children. Respiratory symptoms elicited by HBoV1 include cough, tachypnea, wheezing and dyspnea, which are of mild degree and haven′t found to be distinguished. Few single infected patients with dyspnea needing mechanical ven-tilation were reported,however,the number of severe cases caused by HBoV1 is increasing in recent years. Here we reviewed the epidemiological characteristics, clinical manifestations, treatment and prognosis of HBoV1 in-duced severe lower respiratory infections.

Pathogenic analysis of acute lower respiratory infections and its correlation with asthma exacerbations / 天津医药

Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI), and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods A total of 231 hospitalized children with acute LRTI were investigated from May 2013 to April 2014. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction, including respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV) and rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific immunoglobulin E level measured using immunofluorescence experiment was over 0.35 IU/mL. Results RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infections were more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

A comparative study of upper and lower respiratory aspirates on pathogen detection of lower respiratory tract in-fection in children / 临床儿科杂志

Objective To study the pathogenic etiology between nasopharyngeal aspirates (NPA) and bronchoalveolar lavage lfuid (BALF) in children with lower respiratory infection. Methods Multiple pathogen in NPA and BALF from 210 cases with lower respiratory tract infection was detected. Seven common respiratory virus (respiratory syncytial virus, adenovirus, in-lfuenza virus A, inlfuenza virus B, parainlfuenza 1, parainlfuenza 2, parainlfuenza 3) were detected by direct immunolfuorescence assay. MP, CP and HBoV were detected by lfuorescence quantitative PCR.HRV and hMPV were detected by RT-PCR. Aspirates were cultured for bacteria. The results of pathogen detection in secretions of upper and lower respiratory tract were analyzed. Results Total positive detection rate of NPA and BALF in 210 cases was 91.9%(193/210), which is higher than that in NPA 75.2%(158/210) and that in BALF 85.2%(179/210). Bacteria detection rate in NPA was 13.3%(28/210), and 8.6%(18/210) in BALF, without signiifcant difference (P=0.118). Bacteria detection rate in NPA and BALF was of poor consistency (Kappa=0.262). Virus detection rate in NPA was 24.3%, which is higher than that in BALF15.2%. BALF-MP detection rate was 77.6%(163/210), signiifcantly higher than that in NPA 53.3%(112/210). There are 95.5%(107/112) cases with positive results in NPA-MP detec-tioncan also be detected in the BALF-MP. MP copies in BALF were signiifcantly higher than that in NPA (4.28×106 vs. 1.31×105), and its positive rate in NPA was still higher than that in BALF. MP detection rate in NPA in children with clinical course of longer than two weeks was much lower than those with clinical course of two weeks or less. Conclusions The pathogen detection of virus and MP in NPA can be used as a reference for lower respiratory tract infection. The joint detection of NPA and BALF can improve the detection power. The sensitivity of virus detection in NPA is higher than that in BALF. NPA pathogen detection of virus and MP is of great important evidence-based medicine in the diagnosis of lower respiratory infection. MP detection rate and its copies in BALF are signiifcantly higher than that in NPA. BALF detection is the supplement of pathogen diagnosis in severe or refractory lower respiratory infections.

Analysis on pathogens isolated from lower respiratory tract sputum samples of tracheotomy patients and nurses′hands surface samples / 国际检验医学杂志

Objective To investigate the distribution of pathogens isolated from lower respiratory tract sputum samples of trach‐eotomy patients who suffered from severe craniocerebral injury and nurses′hands surface samples ,and analyze the correlation be‐tween them .Methods Lower respiratory tract sputum samples of 97 tracheotomy patients suffered from severe craniocerebral inju‐ry and hands surface samples from nurses who just washed their hands after the sample collection were collected .Then the samples were sent to the microbiological lab for pathogen isolation and identification ,the results were statistically analyzed by using WHO‐NET5.4software.Results 388sampleswerecollectedaltogether,including194sputumsamplesand194nurses′handssurface samples .633 pathogens were isolated altogether ,including 452 strains of G- bacteria (71 .41% ) ,134 strains of G+ bacteria (21 .17% ) and 47 strains of fungi(7 .42% ) .The top five species of G- bacteria which took the largest proportion and caused the lower respiratory tract infection were Peudomonas aeruginosa(12 .16% ) ,Acinetobacter baumannii(9 .63% ) ,Klebsiella pneumoniae bacteria(7 .10% ) ,Stenotrophomonas maltophilia(5 .21% ) ,Escherichia coli(4 .89% );the primary species of G+ bacteria were coag‐ulase negative staphylococcus(6 .79% ) ,Staphylococcus aureus(2 .36% );the primary fungus was Monilia albicans(4 .24% ) .The top five G- bacteria species which took the largest proportion and isolated from hands surface samples were Pseudomonas aeruginosa (6 .79% ) ,Acinetobacter baumannii(5 .84% ) ,Escherichia coli(4 .91% ) ,Klebsiella pneumoniae(3 .94% ) ,Stenotrophomonas malto‐philia(3 .79% );the primary species of G+ bacteria were coagulase negative staphylococcus (9 .63% ) ,Staphylococcus aureus (2 .36% ) .The primary fungus was Monilia albicans(3 .00% ) .Conclusion Tracheotomy patients who suffered from severe cranio‐cerebral injury with lower respiratory infection are very possible to have cross‐infection ,sanitary management of nurses′hands asep‐tic manipulation procedures should be strengthened .

Biapenem versus meropenem in the treatment of bacterial infections: a multicenter, randomized, controlled clinical trial.

Background & objectives: Biapenem is a newly developed carbapenem to treat moderate and severe bacterial infections. This multicenter, randomized, parallel-controlled clinical trial was conducted to compare the clinical efficacy, bacterial eradication rates and safety of biapenem and meropenem in the treatment of bacterial lower respiratory tract infections and urinary tract infections (UTIs) at nine centres in China. Methods: Patients diagnosed with bacterial lower respiratory tract infections or UTIs were randomly assigned to receive either biapenem (300 mg every 12 h) or meropenem (500 mg every 8 h) by intravenous infusion for 7 to 14 days according to their disease severity. The overall clinical efficacy, bacterial eradication rates and drug-related adverse reactions of biapenem and meropenem were analyzed. Results: A total of 272 enrolled cases were included in the intent-to-treat (ITT) analysis and safety analysis. There were no differences in demographics and baseline medical characteristics between biapenem group and meropenem group. The overall clinical efficacies of biapenem and meropenem were not significantly different, 94.70 per cent (125/132) vs. 93.94 per cent (124/132). The overall bacterial eradication rates of biapenem and meropenem showed no significant difference, 96.39 per cent (80/83) vs. 93.75 per cent (75/80). Drug-related adverse reactions were comparable in biapenem and meropenem groups with the incidence of 11.76 per cent (16/136) and 15.44 per cent (21/136), respectively. The most common symptoms of biapenem-related adverse reactions were rash (2.2%) and gastrointestinal distress (1.5%). Interpretation & conclusions: Biapenem was non-inferior to meropenem and was well-tolerated in the treatment of moderate and severe lower respiratory tract infections and UTIs.

Zinc and respiratory tract infection in children / 国际儿科学杂志

Zinc is an important trace element,and zinc deficiency will lead to a series of metabolic disorders and pathological changes.Zinc deficiency is still a problem among Chinese children.In recent years,the relationship between zinc and respiratory infection disease is becoming a hot issue.This article reviews the impact of zinc supplementation on the morbidity,mortality and the duration of common cold and lower respiratory infections,as well as the possible mechanism of zinc on respiratory diseases.

Antibacterial-processed Endotracheal Tube on Prevention of Ventilator Associated Lower Respiratory Infection / 中华医院感染学杂志

OBJECTIVE To reduce the occurrence of ventilator associated lower respiratory infection(VALRI) with the simple effective method.METHODS All studied patients who received mechanical ventilation(MV) in ICU were divided into the study group(antibacterial-processed endotracheal tube group) and the control group.Bacterial culture of samples from endotracheal tube inwall and lower respiratory tract were obtained periodically.The clinical data such as the duration of MV,the time of occurrence of VALRI,and the case fatality rate were recorded and analyzed.RESULTS In patients with MV

Clinical Features of Human Metapneumovirus and Respiratory Syncytial Virus Infection in Hospitalized Children / 소아알레르기및호흡기학회지

PURPOSE:To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. METHODS:The participants of our study were 1,104 children who were admitted to Bungdang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. RESULTS:The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age or =2 years, while in the RSV group, 19% were age > or =2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. CONCLUSION:hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children.

Detection of Legionella pneumophila infection in children with lower respiratory infections by ELISA and PCR / 中华急诊医学杂志

Objective To investigate the infection rate of Legionella pneumophila(LP)in children younger than 5 years with lower respiratory infections by ELISA and PCR.Method Serum LP-IgM and IgG were measured by ELISA,and LP DNA in sputum or throat swab were detected by PCR in 300 children less than 5 years with lower respiratory infections.The data were analyzed by chi-square test and the consistency of the two methods was analyzea by NcNemar test.Results Serum antibody detected by ELISA was positive in 17 cases(5.67%),including 10 positive of IgM and 7 positiile of lgG.In these 17 eases,11 were males and 6 were females with similar positive rates(5.76%vs 5.5%).Four cases(2.53%)were positive in children aged from 27 days to 1 year,while 7(7.37%)and 6 cases(12.77%)were positive in children aged 1-3 years and 3-5 years,respectively.Seven cases(5.19%)found in the winter and spring seasons and 10 cases(6.06%)in summer and autumn seasons.Eleven children(11.83%)were from urban area and only 6(2.9%)from countryside.DNA in sputum or throat swab detected by PCR was positive in 16 cases(5.33%),included 10 males and 6 females with similar positive rates(5.24%vs 5.5%).Five cases(3.16%)were positive in children aged from 27 days to 1 year,while 6(6.32%)and 5 cases(10.64%)were positive in children aged 1-3 years and 3-5 years,respectively.Three cases(2.22%)found in the winter and spring seasons and 13 cases(7.88%)in sunmmr and alltumll seasons.Nine children(9.68%)were from urban area and only 7(3.38%)from countryside.McNemar test was used to compare the data of ELISA and PCR results with a Qm of 0.037 and a Pr of 0.8474.Conclusions LP might contribute partly to the lower respiratory infections in children less than 5 years.The infection rate of LP increases with age increasing.Urban children have a higher infection rate than those living in countryside.Both methods have a good consistency.

Drug-resistance of Staphylococcus aureus Causing Lower Respiratory Infection / 中华医院感染学杂志

OBJECTIVE To investigate the distribution and characteristics of drug-resistance of Staphylococcus aureus (SAU) causing lower respiratory infection, for rational using of antibiotics in clinical practice. METHODS A retrospective analysis on S. aureus isolates and their drug-resistance characteristics were carried out. These strains were isolated from lower respiratory specimens in clinical laboratory of Renmin Hospital of Wuhan University from Jan 2007 to Dec 2007. RESULTS Among 94 strains, 69 were meticillin-resistant S. aureus(MRSA), accounting for 73.40%. All MRSA strains were resistant to penicillin G, while sensitive to vancomycin and teicoplanin. Resistant rate to chloramphenicol was 7.24 %. The average resistance rate of MRSA to quinolones, macrolides and aminoglycosides were relatively high (56.52-98.55%). And resistant rate of MRSA was higher than the meticillin-sensitive S. aureus (MSSA) in average level. CONCLUSIONS Hospitals at all levels are proposed to strengthen drug resistance supervising so as to prevent the infection breaks.

Analysis of Viral Pathogens in Hospitalized Children with Lower Respiratory Infection in Beijing Area from Dec.2005 to Apr.2006 / 实用儿科临床杂志

Objective To explore the characteristics viral pathogens in hospitalized children with lower respiratory infection,and to provide reference data for diagnosis and treatment.Methods Nasopharyngeal secretion(NPS) samples were collected from hospitalized patients with lower respiratory infection(LRI) from Dec.2005 to Apr.2006.The NPS samples were detected for 7 respiratory virus antigens including respiratory syncytial virus(RSV),influenza virus A and B(IVA and IVB),parainfluenza virus 1,2,3(PIV 1,2,3) and adenovirus(ADV) by indirect immunofluorescent assay.Results Nine hundred and thirty-five NPS samples were collected from children(597 boys,338 girls) with LRI.The mean age was 7.5 months(range from 1 day to 6 years).Viral pathogens were identified in 516(55.2%) samples.The positive rate of RSV decreased with increasing of age,whereas the positive rate of IV and PIV increased.ADV was only detected in children less than 3 years of age,accounting for 0.6%-6.2%.Conclusions Viral pathogens are the main etiology of LRI in young children in Beijing area from Dec.2005 to Apr.2006.RSV is the most frequent viral pathogens,followed by IV and PIV.

Hospital Onset of Lower Respiratory Infection and Drug Resistance:Analysis of 141 cases / 中华医院感染学杂志

OBJECTIVE To investigate the epidemiological characteristic of lower respiratory infection among the hospitalized patients in Tianlin Community Health Service Center so as to take effective measures to control the infection and reduce the emergence of drug resistant strains.METHODS Totally 6150 cases of patients discharged from our Center during from Jan 2004 to Sept 2006 were collected and among them 141 cases occurred hospital onset of lower respiratory infection and drug resistance was analyzed through contrasting.RESULTS The incidence rate of hospital onset of lower respiratory infection and drug resistance were 2.29% and 58.62%.Among the 141 cases,the incidence rate of ESBLs was 28.36% which mainly produced from Escherichia coli and Klebsiella pneumoniae.CONCLUSIONS Primary affection should actively treated and antibiotics should use rationally according to the drug sensitive cultivation to control the abuse of antibiotics and reduce the emergence of drug resistant strains.

Distribution and Resistance of Bacteria from Lower Respiratory Tract Infection in Elderly Patients / 中华医院感染学杂志

OBJECTIVE To analyze distribution and resistance of bacteria from lower respiratory tract infection in elderly patients,and provide reference for rationl use of agents in clinics.METHODS To collect phlegm specimens from lower respiratory tract infection in elderly patients from Jan 2003 to Jun 2005 in our hospital,to identify pathogens and drug sensitivity test,the results of examination were judged according to NCCLS standard.RESULTS Among 752 pathogens strains,Gram-negative bacteria and Gram-positive cocci were 70.9% and 17.6%,respectively;the most common pathogens of them were Klebsiella pneumoniae(ESBLs 27.7%)14.89%,Pseudomonas aeruginosa 14.36%,Escherichia coli(ESBLs 35.4%)12.77%,Staphylococcus aureus(MRSA 59.0%)11.70%,and fungi 11.57%.CONCLUSIONS The bacteria from lower respiratory tract infection in elderly patients are distributed extensively.In Gram-positive cocci,resistance to vancomycin is not found elsely.Gram-negative bacteria are especially sensitive to imipenem,but with some resistant strains.

Epidemiology of Respiratory Syncytial Virus Lower Respiratory Tract Infection and Analysis of Risk Factors in Severe Infections from 1995 to 2004 / 소아알레르기및호흡기학회지

PURPOSE: Respiratory syncytial virus (RSV) infection is the one of the leading causes of hospitalization of infants in the worldwide. In particular, children younger than 6 weeks of age prematurity, bronchopulmonary dysplasia, congenital heart disease, neuromuscular disease, or immunosuppressive states are likely to have severe RSV infection. This study aims to review the epidemiologic characteristics of RSV infection and to examine the relationship of risk factors for severe disease courses and length of hospital stay. METHODS: A total of 294 patients with acute lower respiratory tract infections by RSV who were hospitalized in Samsung Medical Center from December 1995 to June 2004 were enrolled in this study. The medical records were retrospectively reviewed. RSV was detected with rapid RSV antigen test or viral culture of nasopharyngeal aspirates. RESULTS: The male to female ratio was 1.7: 1. Children under 2 years old made up 86 percent; bronchiolitis and pneumonia patients made up 90 percent. Outbreaks of RSV occurred in September through February. One or more risk factor for severe RSV infection were present in 40 percent. The group with risk factors had longer length of hospital stay (P< 0.05), were more likely to be admitted to the pediatric intensive care unit (PICU) and required oxygen therapy and mechanical ventilation (P< 0.05) compared to the groups without risk factors. CONCLUSION: Infants and children with high risk factors are likely to develop severe RSV infection. Early detection and proper management is necessary in Korea, especially in fall and winter.

Detection of Drug Resistance of Gram Negative Bacilli in Patients with Lower Respiratory Infection and Application of Antibacterials / 中国药房

OBJECTIVE: To probe into the drug resistance of gram negative bacilli in patients with lower respiratory infection and to analyze the application of antibacterials in the department of respiratory disease.METHODS: Routine drug susceptibility test was conducted by K-B disk agar diffusion method,and the DDDs and consumption sum of the antibacterials were analyzed as well.RESULTS: Pseudomonas aeruginosa which was susceptible to Meropenem took the lead with 22.1% among all the gram negative bacilli in patients with lower respiratory infection,followed by E.coli(20.7%) and Klebsiella(15.1%).Quinolone and third generation cephalosporins took the lead on the DDDs list in the treatment of gram negative bacilli in patients with lower respiratory infection.CONCLUSION: Hospital should intensify the monitoring of gram negative bacilli in patients with lower respiratory infection and analyzing of the application of antibacterials so as to guide clinicians for a rational use of antibacterials.

Surveillance for Respiratory Viruses in Children with Acute Lower Respiratory Infections in Chongqing between 2003 and 2007 / 实用儿科临床杂志

Objective To investigate the clinical spectrum of respiratory viruses in infants and young children with acute lower respiratory infection(ALRI) in Chongqing area from 2003-2007.And to assess the clinical diagnostic value of virus detection in nasopharyngeal secretions(NPS) and serum viral antibody detection for ALRI.Methods Cases of 2 529 specimens of NPS in hospitalized children with ALRI from Apr.2003 to Oct.2007 were taken for detecting 7 common respiratory virus antigens by immunofluorescence assay including respiratory syncytial virus (RSV),adenovirus(ADV),influenza A(IA),influenza B (IB),parainfluenza virus1-3 (PIV1,PIV2,PIV3).Fifty-five thousand eight hundred and eighty-seven samples were tested for ADV-IgM by ELISA.Among those,45 159 cases were further tested for RSV-IgM by ELISA.Results Respiratory virus pathogens were detected in 778 samples out of 2 529(30.76%) including RSV positive in 668 samples (85.86%),PIV3 positive in 75 samples (9.64%),IA positive in 22 samples (2.57%),ADV positive in 15 samples ( 1.93%),only 1 sample ( 0.13%) positive for both PIV1 and RSV. And the positive rate of RSV-IgM was 0.9%-15.2%,and the positive rate for ADV-IgM was about 0.6%-10.6%.RSV infection occured mainly in winter and spring.Conclusions Respiratory virus is the most common pathogen in children with ALRI during the survey period in Chongqing area,especially for RSV infection.The pattern of RSV circulation varied every year with seasonality.It is suggest that this year is peak one for RSV infection from the monthly positive results,especially in Feburary(50%) in 2007.But the infection rate of PIV3,IA,ADV and PIV1 are lower,particularly IB and PIV2 infection have not been seen for the last 5 years.It is fast and accurate to detect RSV antigen and suit to clinical diagnosis by using immunofluorescence assay than other antibody detection.