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1.
Article in Chinese | WPRIM | ID: wpr-920390

ABSTRACT

Objective To investigate the viral infection subtypes and epidemiological characteristics of upper respiratory tract infection (URTI) in Beijing area in 2020, and to provide references for URTI specific treatment and vaccination. Methods A total of 22 318 patients with URTI in Beijing area from January 2020 to December 2020 were enrolled in the study. Basic demographic information and clinical characteristics of the patients were collected, and their respiratory tract samples were collected. Eight major respiratory viruses (including respiratory syncytial virus, parainfluenza virus, adenovirus, coronavirus, influenza virus, rhinovirus, bocavirus, and metapneumovirus) in the respiratory samples were detected by PCR. The pathogen composition and epidemiological characteristics of URTI were analyzed. Results ① Among the 22 318 cases of URTI, most of them were children under 5 years old and elderly patients over 70 years old, accounting for 25.02% and 19.43%, respectively; ② URTI mainly occurred in spring (35.71%) and winter (37.35%); ③ The total positive rate of respiratory virus was 49.35%, among which 45.42% were infected with single virus, 3.30% were infected with two viruses, and 0.63% were infected with three or more viruses; ④ Respiratory syncytial virus (49.35%) had the highest detection rate, followed by parainfluenza virus (12.98%), rhinovirus (9.48%), influenza virus (8.40%), adenovirus (6.01%), bocavirus (4.43%), coronavirus (3.97%), and metapneumovirus (2.90%); ⑤ The detection rates of respiratory syncytial virus and parainfluenza virus in children aged 0-5 years old and the elderly aged over 71 years old were higher than those in other age groups, while the detection rates of other pathogens of all age groups were similar; ⑥ Among 22,318 URTI patients, 290 cases were complicated with pneumonia, with a complication rate of 1.300%. The complication rate of pneumonia in patients with positive virus pathogens was significantly higher than that in patients with negative virus pathogens (χ2=18.011, P2=884.085, P<0.05). Conclusion Children under 5 years old and the elderly over 70 years old are the high-risk population of URTI, and URTI mainly occurs in spring and winter. Respiratory syncytial virus and parainfluenza virus are the main pathogens leading to URTI, and patients with virus infection and mixed virus infection suffer a higher risk of pneumonia.

2.
Article in Chinese | WPRIM | ID: wpr-876480

ABSTRACT

Objective To understand the status of acute upper respiratory tract viral and bacterial infections in children in Chengdu and to analyze its epidemiological characteristics. Methods From April 2018 to April 2020, 1,324 children with acute upper respiratory tract infection admitted to Chengdu Second People's Hospital were enrolled in the study. Pathogens from throat swab specimens were cultured, isolated, and identified. Results Among 1 324 specimens, the detection rate of bacterial and viral infection was 76.44% (1 012/1 324). The detection rate of simple viral infection was 50.40%, the detection rate of simple bacterial infection was 16.21%, and the detection rate of mixed infection was 33.40%. Haemophilus influenzae was the main bacterial type and respiratory syncytial virus A was the main virus type. The positive rate of upper respiratory tract viral infection among children with different ages was significantly different (P<0.05). The positive rate of viral and bacterial upper respiratory tract infection showed a statistically significant difference among different infection seasons (P<0.05). In addition, the positive rate of viral upper respiratory tract infection among children from different districts had statistically significant difference (P<0.05). Conclusion Children with upper respiratory tract infections in Chengdu area are mainly viral infections. Haemophilus influenzae and respiratory syncytial virus A are the main pathogens of upper respiratory tract infections in children. 0~1 year old is the age with the highest incidence of upper respiratory tract bacterial infection, while 1~4 years old is the age with the highest incidence of virus infection. Children in urban areas and in winter have higher positive rates of upper respiratory tract infections.

3.
Braz. j. biol ; 81(2): 351-360, 2021. tab, ilus
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1153372

ABSTRACT

Lower respiratory tract infections (LRTIs) caused by Pseudomonas aeruginosa are the most common infection among hospitalized patients, associated with increased levels of morbidity, mortality and attributable health care costs. Increased resistant Pseudomonas worldwide has been quite meaningful to patients, especially in intensive care unit (ICUs). Different species of Pseudomonas exhibit different genetic profile and varied drug resistance. The present study determines the molecular epidemiology through DNA fingerprinting method and drug resistance of P. aeruginosa isolated from patients with LTRIs admitted in ICU. A total of 79 P. aeruginosa isolated from patients with LRTIs admitted in ICU were characterized by Restriction Fragment Length Polymorphism (RFLP), Random Amplified Polymorphic DNA (RAPD) and Repetitive Extrapalindromic PCR (REP-PCR). Antibiotic resistance was determined by minimum inhibitory concentration (MIC) assay while MDR genes, viz, blaTEM, blaOXA, blaVIM, blaCTX-M-15 were detected by polymerase chain reaction (PCR). Of the 137 Pseudomonas sp isolated from ICU patients, 57.7% of the isolates were reported to be P. aeruginosa. The overall prevalence of P. aeruginosa among the all included patients was 34.5%. The RAPD analysis yielded 45 different patterns with 72 clusters with 57% to 100% similarity level. The RFLP analysis yielded 8 different patterns with 14 clusters with 76% to 100% similarity level. The REP PCR analysis yielded 37 different patterns with 65 clusters with 56% to 100% similarity level. There was no correlation among the different DNA patterns observed between the three different methods. Predominant of the isolates (46.8%) were resistant to amikacin. Of the 79 isolates, 60.8% were positive for blaTEM gene and 39.2% were positive for blaOXA gene. P. aeruginosa was predominantly isolated from patients with LRTIs admitted in ICU. The difference in the similarity level observed between the three DNA fingerprinting methods indicates that there is high inter-strain variability. The high genetic variability and resistance patterns indicates that we should continuously monitor the trend in the prevalence and antibiotic resistance of P. aeruginosa especially in patients with LRTIs admitted in ICU.


Infecções do trato respiratório inferior (ITRIs) são as infecções mais comuns entre pacientes internados em unidade de terapia intensiva (UTI). Pseudomonas aeruginosa é a causa mais comum de ITRIs e está associada ao aumento da mortalidade. Diferentes espécies de Pseudomonas exibem diferentes perfis genéticos e resistência variada as drogas. O presente estudo determina a epidemiologia molecular através do método de fingerprinting de DNA e resistência as drogas de P. aeruginosa isoladas de pacientes com LTRIs internados em UTI. Um total de 79 P. aeruginosa isoladas de pacientes com ITRIs internados em UTI foram caracterizados por Polimorfismo de Comprimento de Fragmentos de Restrição (RFLP), DNA Polimórfico Amplificado ao Acaso (RAPD) e PCR Extrapalindrômico Repetitivo (REP-PCR). A resistência aos antibióticos foram determinadas pelos ensaios de concentrações inibitória mínima (MIC), enquanto os genes MDR, blaTEM, blaOXA, blaVIM, blaCTX-M-15 foram detectados pela reação em cadeia da polimerase (PCR). Das 137 Pseudomonas sp isoladas de pacientes de UTI, 57,7% dos isolados foram relatados como P. aeruginosa. A prevalência geral de P. aeruginosa entre os pacientes incluídos foram de 34,5%. A análise RAPD renderam 45 padrões diferentes com 72 clusters com nível de similaridade de 57% a 100%. A análise RFLP renderam 8 padrões diferentes com 14 clusters com 76% a 100% de similaridade. A análise de PCR do REP produziram 37 padrões diferentes com 65 clusters com nível de similaridade de 56% a 100%. Não houveram correlações entre os diferentes padrões de DNA observados entre os três diferentes métodos. Predominantes dos isolados (46,8%) eram resistentes à amicacina. Dos 79 isolados, 60,8% foram positivos para o gene blaTEM e 39,2% foram positivos para o gene blaOXA. P. aeruginosa foi predominantemente isolado de pacientes com ITRIs internados em UTI. A diferença no nível de similaridade observado entre os três métodos de fingerprinting do DNA indica que há alta variabilidade inter-strain. A alta variabilidade genética e os padrões de resistência indicam que devemos monitorar continuamente a tendência na prevalência e resistência a antibióticos de P. aeruginosa, especialmente em pacientes com ITRIs internados em UTI.


Subject(s)
Humans , Pseudomonas aeruginosa/genetics , Pseudomonas Infections/epidemiology , Respiratory System/microbiology , Microbial Sensitivity Tests , Molecular Epidemiology , Random Amplified Polymorphic DNA Technique , Intensive Care Units
4.
Chinese Journal of Neurology ; (12): 1067-1070, 2021.
Article in Chinese | WPRIM | ID: wpr-911837

ABSTRACT

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

5.
Article in Chinese | WPRIM | ID: wpr-910879

ABSTRACT

Objective:To investigate the clinical and epidemiological features of acute respiratory adenovirus infection in children.Methods:Clinical data of 488 children with acute respiratory tract human adenovirus (HAdV) infection admitted in Children’s Hospital of Zhejiang University School of Medicine from September 2018 to August 2019 were retrospectively analyzed. Nasopharyngeal swabs or nasopharyngeal aspirates (NPAs) were collected and tested by direct immunofluorescence assay. Kruskal Wallis H test was used for quantitative data without normal distribution, and P<0.05 was considered to be statistically significant. The qualitative data were compared by chi-square test or Fisher’s exact test. Bonfereoni chi-square segmentation was performed for comparison between groups, and P<0.007 was considered statistically significant after correction. Results:A total of 488 HAdV positive cases were detected from 7 072 patients with acute respiratory tract infection (6.9%), including 305 males (62.5%) and 183 females (37.5%). The median age of HAdV positive children was 43 months (39 days to 12 years). The detection rate in 6 m-<2 y age group(8.7%, 123/1 408)was significantly higher than those in <6 m group (3.0%, 6/197)and ≥5 y group(4.6%, 89/1 948)( χ2=7.57, 23.98, P all <0.007). The detection rate in 2-<5 y group(7.7%, 270/3 519)was significantly higher than those in <6 m group and ≥5 y group ( χ2=5.809, 19.688, P all <0.007). The peak rate was detected in the winter [12.9%(238/1 840)] which was significantly higher than those in spring (4.7%), summer (3.9%), and autumn(5.5%)( χ2=103.477, 58.986 and 49.926, P<0.007). The average length of hospital stay was (6±4)d(1-41 d). 486 cases (99.5%) were discharged from hospital after treatment, and 2 cases died. There were 111 cases (22.7%) of acute upper respiratory tract infection, 34 cases (7.0%) of bronchitis and 343 cases (70.3%) of pneumonia; and severe pneumonia was diagnosed in 86 cases (25.1%, 86/343). The common clinical manifestations were fever 93.4% (456/488), cough 94.7% (462/488), wheezing 26.2% (128/488) and shortness of breath 14.8% (72/488). 138 cases (28.3%) had extrapulmonary symptoms, 78 cases (16.0%) had underlying diseases, among which congenital heart disease was most common (16, 3.3%). The average duration of fever was(8.8±2.4)d(5-17 d)in 456 fever cases, the duration between 7-10 d in 277 cases and >10 d in 96 cases; and 439 cases had hyperpyrexia(≥39 ℃). The single infection occurred in 275 (56.4%) cases and mixed infection in 213(43.6%) cases. The proportions of fever, hyperpyrexia, fever duration >10 d, severe pneumonia, wheezing and length of hospital stay in mixed infection group were significantly higher than those in the single infection group ( χ2/ Z=11.960, 6.494, 37.209, 72.841 and -8.805, P all <0.05). The length of hospital stay, proportion of fever time>10 d, wheezing, shortness of breath, hypersomnia/poor spirits, serous effusion, extrapulmonary symptoms, mixed infection, and underlying diseases in severe pneumonia group were significantly higher than those in the mild pneumonia group ( χ2/ Z=-9.182, 23.825, 49.094, 143.627, 219.659, 81.327, 8.080, 21.546 and 10.556, P all <0.05). The proportion of severe pneumonia in 6 m to <2 y group was higher than that in 2-<5 y group and ≥5 y group( χ2=20.709, 8.603, P all <0.007). Conclusions:HAdV is an important pathogen of acute respiratory infection in children. HAdV infection occurs mainly in children aged from 6 month to 2 years and has a high detection rate in winter. Children aged 6 months to 2 years with wheezing, shortness of breath, underlying diseases, extrapulmonary symptoms and mixed infections are more likely to develop severe pneumonia.

6.
Article in Chinese | WPRIM | ID: wpr-907916

ABSTRACT

Next-generation sequencing (NGS), also known as high-throughput sequencing, is more efficient compared with Sanger sequencing that has become the standard method of clinical DNA sequencing, and can obtain a large amount of information in a relatively short time at a lower cost.NGS has broad prospects in such aspects as diagnosing the pathogen of lower respiratory tract infection in children, identifying the pathogen of cross-infection in hospital, drug resistance research and vaccine development.It is still worth conducting further studies on the approach to improve the specificity and sensitivity of diagnosis and to optimize NGS.

7.
Article in Chinese | WPRIM | ID: wpr-906377

ABSTRACT

Objective:To explore the clinical diagnosis and treatment characteristics as well as the optimal schemes of Lianhua Qingwen Capsule in the treatment of upper respiratory tract infection (URTI) in the real world. Method:The information of 454 patients receiving Lianhua Qingwen Capsule for URTI was collected from the electronic medical data warehouse constructed by the Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, which covered 16 large-scale tertiary Class A hospital information systems (HISs). The harvested information was subjected to descriptive analysis, Apriori algorithm-based analysis and Louvain (BGLL) algorithm-based complex network analysis to explore the clinical medication schemes. Result:The commonly adopted medication schemes were heat-clearing and detoxicating Chinese medicinal injections combined with expectorants, analgesic-antipyretic drugs, or antibacterial agents in western medicine. Besides, the combination with heat-clearing and phlegm-resolving Chinese medicinals, vitamins, or hypotensive, lipid-lowering, hypoglycemic, coronary circulation-improving, or antiplatelet aggregation drugs targeting the underlying diseases was also detectable. Conclusion:The complex network analysis based on BGLL clustering method can be used to find out the medication rules of Lianhua Qingwen Capsule for URTI. The traditional Chinese medicine has been widely employed for resolving phlegm and relieving cough due to its good efficacy. The combination with antibiotics follows the guidelines for the use of antimicrobial agents. Drug safety is one of the most concerned aspects in clinical drug combination. The uncovering of these rules has provided a direction for exploring the optimal treatments.

8.
Article in Chinese | WPRIM | ID: wpr-862741

ABSTRACT

Objective To investigate the virus epidemiological characteristics in patients with acute upper respiratory tract infection, so as to provide a basis for clinical treatment. Methods A total fo 1 306 inpatients or outpatients with acute upper respiratory tract infection in our hospital from January 2017 to January 2020 were enrolled. The respiratory viruses in nasopharyngeal swab samples were detected by fluorescence immunoassay. The detection rate, clinical characteristics, seasonal distribution, and age distribution of each virus were analyzed. Results In 1 306 patients with acute upper respiratory tract infection, 679 cases were positive for virus culture, with a total positive detection rate of 51.99%. Among the single virus infections, 463 cases were positive for FluV, with a positive detection rate of 35.45%. Five different virus infections showed significant difference among 0 ~ years old, 14 ~ years old, 50 ~ years old and 65 ~ years old groups (P<0.05). The positive detection rates of FluV, PIV, RSV, and RV were the highest in the 0 ~ years old group, while ADV detection rate was the highest in the 65 ~years old group. The distribution of the 5 different viruses in spring, autumn and winter was significantly different (P<0.05). Conclusion Acute upper respiratory tract infection is mainly caused by a single virus, and different viruses has significant differences in age and seasonal distribution.

9.
Afr. J. Clin. Exp. Microbiol ; 22(4): 465-472, 2021.
Article in English | AIM, AIM | ID: biblio-1342117

ABSTRACT

Background: AmpC or class C or group 1 beta lactamases are class C cephalosporinases that hydrolyse a wide variety of beta-lactam antibiotics including alpha methoxy beta-lactams (cefoxitin), narrow and broad spectrum cephalosporins. This study was conducted to characterize plasmid-mediated AmpC producing enteric Gram- negative bacteria from patients with lower respiratory tract infections in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ile Ife, Osun State, Nigeria Methodology: A total of 149 patients with clinical features of lower respiratory tract infections (LRTI) were selected by simple random sampling for the study. All Gram-negative isolates recovered from standard microbiological cultures of respiratory specimens of these patients were tested against cefoxitin, third generation cephalosporins (3GCs), and other antibiotics using the disc diffusion AST method, and also screened for production of AmpC beta-lactamases phenotypically by the CLSI method. Plasmid DNA extraction was carried out on twenty-nine cefoxitin-resistant selected isolates using the Kado and Lin method, while genotypic detection of plasmid-mediated AmpC gene was carried out by the polymerase chain reaction (PCR) assay. Results: The results showed that 204 (43.3%) of 471 isolates recovered from the 149 selected patients were resistant to 3GC in the AST assay, among which 121 (59.3%) were resistant to cefoxitin, and 189 of the 471 isolates (40.1%) were AmpC producers. The AmpC producers concurrently showed multiple resistance pattern to other antibiotics tested in this study. Ninety six percent of the 29 selected isolates for plasmid analysis contained plasmids, 45% of which amplified positive on PCR for CMY, 38% for FOX, and 31% for ACC types of AmpC genes. Conclusion: This study showed a high degree of antibiotic resistance among enteric Gram-negative bacteria recovered from patients with LRTIs, as well as high degree of plasmid-encoded AmpC genes responsible for this high antibiotic resistance among the isolates. Proper antibiotic policy and regulation are required to limit the spread of plasmid mediated AmpC ß-lactamase


Subject(s)
Humans , Plasmids , Respiratory Tract Infections , Polymerase Chain Reaction , Tertiary Care Centers , Nigeria
10.
Article | IMSEAR | ID: sea-204710

ABSTRACT

Background: Acute respiratory infections (ARIs) are the leading cause of death among children less than 5 years in India. Poverty and malnutrition underlie both the high incidence and deaths of young children from pneumonia in SEAR countries.Methods: A hospital based prospective observational study was conducted in a tertiary care hospital. A total of 200 children admitted with signs of ALRI were included in the study. A portable oximeter was used to measure oxygen saturation with an appropriately sized sensor on the finger or the toe. Weight was recorded on a standardized digital weighing scale and plotted on standard WHO weight for age chart. Chi-square test was used to test the significance.Results: Out of 200 children studied hypoxemia was present in 90 children with a percentage of 45% and absent in 110 children with a percentage of 55%. Out of 90 children who had hypoxemia, 40 children had weight less than 3rd centile. Out 110 children who had did not have hypoxemia, only 24 children had weight less than 3rd centile. It was observed that children with Weight for age less than 3rd centile according to standard WHO charts had higher incidence of hypoxemia. This correlation was statistically significant at p value of 0.001.Conclusions: Based on the results of this study hypoxemia is widely prevalent in children aged between six months to five years presenting with acute lower respiratory tract infection. There was significant correlation with weight and hypoxemia in children aged between six months to five years with acute lower respiratory tract infection.

11.
Article | IMSEAR | ID: sea-204685

ABSTRACT

Background: Vitamin D plays important role in immunity and its deficiency might be associated with increased risk of lower respiratory tract infection. This study aimed to determine whether vitamin D deficiency is commoner in infants with acute lower respiratory tract infection as compared to normal infants and to correlate the severity of vitamin D deficiency with severity of ALRTI.Methods: A hospital based prospective case-control study was conducted in a tertiary care hospital. A total of 208 infants (109 cases and 99 controls) older than 7 days to 12 months of age, were enrolled. Cases were selected according to the definition of ALRTI given by WHO (2). Controls were chosen from children attending paediatric outpatients department for immunization or minor short duration aliments. Primary outcome measured as serum 25-hydroxy vitamin D3 (25OHD3) levels and severity of ALRTI was independent variable.Results: Among 109 cases suffering from ALRTI, vitamin D deficiency was present in 65.11%, 92.3%, 88.9% children of ‘pneumonia, severe pneumonia and very severe pneumonia group respectively. It was found that vitamin D deficiency was commoner in cases as compared to controls (80.70 % vs 25.50% ) with OR of 12.40 (95 % CI was 6.13 - 25.38). There was inverse relationship between the severity of ALRTI and Vitamin D levels (p value <0.001 and Pearson correlation coefficient -0.32).Conclusions: Vitamin D levels were significantly lower in ALRI cases as compared to controls and had negative correlation between vitamin D levels and severity of pneumonia.

12.
Article | IMSEAR | ID: sea-204682

ABSTRACT

Background: Anemia and ALRI are quite common in infants and toddlers in developing countries. ALRI is a leading cause of mortality in children below 5 years of age and it is important to prevent risk factors for development of ALRI. Present study was conducted to know the prevalence of anemia in children between 6 m to 23 m with ALRI and the relation between ALRI and anemia.Methods: This is a prospective case control study, conducted at Level 2 hospital situated in   backward district over a period of 1 year. Two hundred cases who had ALRI as per WHO criteria and 200 controls  were taken as the study group. Children were divided in to 3 different age groups. Haemoglobin level was estimated in all.Anemia was defined and classified according to WHO criteria.Results: Out of total 200 children both in cases and controls, 128 (64%) were males and 72 (36%) were females. Overall 190 (95%) of cases and 187 (93.5%) of controls had anemia. The prevalence of anemia was uniform in both sexes and all age groups. Children in the age group 6m -11m were more likely to develop ALRI.Conclusions: Prevalance of anemia in children between 6 m to 23 m with ALRI and without ALRI was 93.5% and 95% respectively. Authors cannot declare with affirmation that there was no association between Hb levels and ALRI as prevalence of anemia was very high in control group. Screening all children for anemia and taking proper intervention measures is necessary while treating for other ailments like ALRI.

13.
Arch. argent. pediatr ; 118(3): 193-201, jun. 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1104196

ABSTRACT

Introducción. La infección respiratoria aguda baja por adenovirus es una importante causa de morbimortalidad en niños. Objetivos: Describir el patrón clínico-epidemiológico y los factores asociados en niños hospitalizados.Métodos. Estudio transversal en niños ingresados por infección respiratoria aguda baja al Hospital de Niños Ricardo Gutiérrez, Buenos Aires, en 2000-2018. El diagnóstico viral se realizó mediante inmunofluorescencia indirecta en secreciones nasofaríngeas. Se compararon características clínico-epidemiológicas de infección por adenovirus con otros virus respiratorios (virus sincicial respiratorio, influenza y parainfluenza). Se utilizó regresión logística múltiple para identificar predictores independientes de infección.Resultados. De 16018 pacientes con infección respiratoria aguda baja, 13545 fueron testeados para virus respiratorios y 6047 (el 45 %) fueron positivos. Adenovirus fue el agente menos frecuente [el 4,4 % (265) de los casos]; presentó una tendencia en descenso durante todo el período estudiado (pico en 2003) y circuló durante todo el año (pico en julio). El 63,8 % eran varones; mediana de edad: 11 meses (rango intercuartílico: 6-20). La presentación clínica más frecuente fue neumonía (el 63 %). El 50 % tenía internaciones previas por causa respiratoria; el 15,6 % eran reingresos; el 58,3 % tenía comorbilidades. El 19,2 % requirió asistencia ventilatoria; el 44 %registró complicaciones. La letalidad fue del 7,7 %. La infección por adenovirus se asoció a edad ≥ 12 meses, sexo masculino, presentación clínica de neumonía, internaciones previas por causas respiratorias y reinternaciones.Conclusiones. Los adenovirus fueron detectados con menor frecuencia que los otros virus respiratorios, aunque presentaron un importante perfil de morbimortalidad


Introduction. Acute lower respiratory tract infection (ALRTI) caused by adenovirus is a major cause of morbidity and mortality in children.Objectives. To describe the clinical and epidemiological pattern and associated factors in hospitalized children.Methods. Cross-sectional study in children admitted due to ALRTI to Hospital de Niños "Ricardo Gutiérrez," in the Autonomous City of Buenos Aires, between 2000 and 2018. Viral diagnosis was done by indirect immunofluorescence in nasopharyngeal secretions. The clinical and epidemiological characteristics of adenovirus infection were compared to other respiratory viruses (respiratory syncytial virus, influenza, and parainfluenza). A multiple logistic regression was done to identify independent predictors of infection.Results. Out of 16 018 patients with ALRTI, 13 545 were tested for respiratory viruses; 6047 (45 %) had a positive result. Adenovirus was the least common agent (4.4 % [265] of cases); it tended towards a reduction over the study period (peak in 2003) and circulated throughout the year (peak in July). In total, 63.8 % of patients were males; median age: 11 months (interquartile range: 6-20). The most common clinical presentation was pneumonia (63 %). Prior admissions due to respiratory conditions were seen in 50 %; 15.6 %were readmissions; 58.3 % had comorbidities. Ventilatory support was required by 19.2 %and complications were recorded in 44 %. The fatality rate was 7.7 %. Adenovirus infection was associated with age ≥ 12 months, male sex, clinical presentation of pneumonia, prior admissions due to respiratory conditions, and readmissions.Conclusions. Adenoviruses were less common than other respiratory viruses, although their morbidity and mortality were important


Subject(s)
Humans , Male , Female , Infant , Respiratory Tract Infections/epidemiology , Adenoviridae Infections/epidemiology , Pneumonia , Respiratory Tract Infections/virology , Epidemiologic Studies , Child, Hospitalized , Cross-Sectional Studies , Adenoviridae Infections/diagnosis , Fluorescent Antibody Technique, Indirect
14.
Article | IMSEAR | ID: sea-212238

ABSTRACT

Background: Authors define acute bronchitis as a self-limiting infection of large airways, which is characterized by cough without pneumonia. NSAIDS (Non-steroidal anti-inflammatory drugs) are prescribed in patients with Lower Respiratory Tract Infections (LRTI). In cough, fever and chest pain it is common practice to prescribe NSAIDS or antibiotics. Authors have conducted assessment of effect of medications in the resolution of cough of patients with uncomplicated acute bronchitis.Methods: It was a single blinded randomized clinical trial conducted in patients admitted to pulmonary medicine department of government medical college Shivpuri. Patients were from age group 18 to 70 years presenting with respiratory tract infection of less than one week’s duration, with cough as the predominant symptom and diagnosed with non-complicated acute bronchitis. Patients were randomized into two groups, group A and B according to medications.Results: Among 120 participants were randomized (60 to ibuprofen and 60 to antibiotic). The median number of days with frequent cough was slightly lower among patients of group A (12 days) compared with those receiving amoxicillin-clavulanic acid (14 days). No significant difference was found. Adverse effect was seen in 24 patients, which was most common in group B (15.25%) than group A (9.15%). p<0.05).Conclusions: No significant differences were observed in the number of days with cough between patients with uncomplicated acute bronchitis treated with ibuprofen or amoxicillin-clavulanic acid.

15.
Article | IMSEAR | ID: sea-204508

ABSTRACT

Background: Anemia has been widely studied as an important factor in the immunity composition of under five children. The incidence of infections in children can be attributed to some extend to the prevalence of anemia among them. Hence this study aimed at exploring the association between anemia and lower respiratory tract infection (LRTI) among the 6 months to 5 years old children as an effort to establish anemia as an independent risk factor for LRTI.Methods: A case-control study was conducted among 200 children in the age group of 6 months'5 years who attended the out-patient and in-patient unit of the department of paediatrics during July to September 2019. Accordingly 100 cases of LRTI and 100 normal controls were age and gender matched and their parents were interviewed using a semi-structured questionnaire. Blood investigations were done and documented in a proforma. The association between anemia and LRTI was studied statistically.Results: Anemia was associated strongly with LRTI [odds ratio=4.96 (2.72, 9.1)] with 68% of the cases with LRTI manifesting anemia. The highest level of anemia was recorded among those with LRTI in the 25-42 months age group (80.8%) which was significantly (p<0.001) higher than controls. The mean hemoglobin level was 9.6'0.8 gm% among the cases which was significantly lower (p<0.001) than that of the controls (11.7'1.1 gm%). The mean iron level was 40'7.3 ?g/dL among cases and 72'12.1?g/dL among the non-LRTI group (p<0.001).Conclusions: Anemia was significantly associated with LRTI group compared to the control group proving it to be an independent risk factor for LRTI.

16.
Article | IMSEAR | ID: sea-211959

ABSTRACT

Background: Pulmonary Tuberculosis (PTB) still remains a global public health problem. Diabetes Mellitus (DM), is a metabolic disorder characterized by hyperglycaemia. Diabetes along with poor glycaemic control leads to an immune compromised state. As prevalence of both TB and DM is increasing in India, this association of PTB and DM may prove a threat to TB control program. Aims and objectives of the study was to detect prevalence of pulmonary tuberculosis in patients with DM and Lower Respiratory Tract Infection (LRTI).Methods: Sputum specimen from consecutive 250 known diabetic adult patients with type 2 diabetes and clinical evidence of LRTI were processed for microscopy, solid culture and Xpert MTB/RIF assay. Clinical findings, duration of DM, regularity of treatment and recent fasting blood glucose level were noted.Results: TB was detected in 31(12.8%) patients. Microscopy, culture and Xpert assay were positive in 14(5.6%), 29(11.6%) and 24(9.5%) cases respectively. Culture detected seven cases more than Xpert assay. Two additional cases were detected by Xpert assay than culture. Rifampicin resistance was detected in seven (29.17%) cases by Xpert assay. TB detection rate was higher in patients with more than two weeks of cough (14.38%), history of tuberculosis (15.9%), hyperglycemia (13.9%) and significantly higher in those with irregular anti-diabetic treatment (35.7%).Conclusions: Irregular anti-diabetic treatment, hyperglycaemia and history of tuberculosis were strongly associated with pulmonary TB. Xpert assay should be used as the initial diagnostic test for detection of tuberculosis as well as rifampicin resistance in diabetic patients by TB control programme.

17.
Article | IMSEAR | ID: sea-200537

ABSTRACT

Background: Antibiotics are frequently used for various infectious diseases e.g., acute lower respiratory tract infection (ALRTI). But, injudicious use of antibiotics often leads to antibiotic resistance which is an emerging problem. The objective of this study was taken up to analyse the antimicrobial sensitivity pattern of pathogens isolated from the sputum samples of admitted patients suffering from ALRTI in a tertiary care teaching hospital.Methods: It is a hospital record-based study with a sample size of 393.Results: Klebsiella (52.16%) was the most common organism followed by Acinetobacter (13.49%) and Pseudomonas (13.23%) isolated from the sputum sample. Imipenem, piperacillin/tazobactam combination and gentamicin was sensitive against Klebsiella and Pseudomonas and the association were statistically significant. Acinetobacter was resistant to ceftriaxone.Conclusions: The commonest pathogens isolated from the sputum samples were Klebsiella followed by Acinetobacter and Pseudomonas. Imipenem, piperacillin/tazobactam combination and gentamicin was sensitive against Klebsiella and Pseudomonas.

18.
Article in Chinese | WPRIM | ID: wpr-793266

ABSTRACT

Objective To analyze the pathogenic epidemiological characteristics of acute lower respiratory tract infection(ALRTI) in children in Gansu Province from 2012 to 2015. Methods The surveillance data of 458 children infected with ALRTI in 10 sentinel hospitals in Gansu province from 2012 to 2015 were collected, and infection status and epidemiological characteristics of each virus and bacteria were analyzed by descriptive study methods. Results The male to female ratio of the 458 children with ALRTI was 1.81:1, and the positive detection rate of the virus was 33.62%(95% CI:29.28%-37.97%), among which the positive detection rate of respiratory syncytial virus was the highest (12.23%).The positive detection rate of bacteria was 24.84%(95% CI:20.04%-29.65%),among which the positive detection rate of streptococcus pneumoniae was the highest (18.47%).There was significant no difference in the positive detection rate of virus and bacteria between children of different genders (P>0.05).There was significant no difference in the positive detection rate of virus among children of different age groups ( 2=5.980,P=0.050), but the positive detection rate of bacteria was different ( 2=12.078,P=0.002).Positive detection rates of virus infection and bacterial infection were different in distinct seasons (all P<0.05). By using logistics regression analysis, season, age and sentinel hospital were the influencing factors of ALRTI virus infection in children (all P<0.05), and sentinel hospital and years were the influencing factors of ALRTI bacterial infection in children (all P<0.05). Conclusion Respiratory syncytial virus, influenza virus and parainfluenza were the main causes of ALRTI virus infection in children aged 0-14 years in Gansu province, and the main bacterial infections were streptococcus pneumoniae and haemophilus influenzae, the number of virus infection was more than that of bacterial infection. Viral and bacterial infection had the same peak incidence.

19.
Med. infant ; 26(4): 364-367, dic. 2019. ilus, Tab
Article in Spanish | LILACS | ID: biblio-1047049

ABSTRACT

Introducción: La Oxigenoterapia de Alto Flujo (OAF) es una técnica de soporte respiratorio no invasiva, que ofrece un flujo de aire y oxígeno, caliente y humidificado, por encima del flujo pico inspiratorio del paciente, a través de una cánula nasal. En este artículo se presenta la experiencia con OAF en una sala de pediatría de mediana y baja complejidad para el tratamiento de bronquiolitis/ infección respiratoria aguda baja (IRAB). Materiales y métodos: Se diseñó un protocolo para la implementación de OAF. Criterios de inclusión: Pacientes cursando bronquiolitis/ IRAB con: Score de Tal modificado ≥6, Sat O2 < 92% y/o mala mecánica ventilatoria, a pesar de recibir más de 2 lt/ min de O2 por cánula nasal ó FiO2 >40%. Criterios de exclusión, pCO2 ≥55 mmHg; pH: < 7,20; Apneas ≥20 segundos; Glasgow ≤10; Peso >15 kg. Inestabilidad hemodinámica; Alteraciones craneofaciales. Resultados: En el periodo 2017- 2018 se internaron 441 pacientes con infección respiratoria aguda baja. Se administró OAF a 54 pacientes (12%). La mediana de edad mediana 7,4 meses (r: 27 días-36 meses). Los pacientes ingresados no presentaban comorbilidades asociadas. El 22,2% (12/54) fueron trasladados a UTIP (2,7% del total de los internados). El 64.8% de los pacientes que permanecieron en sala de internación, mostró mejoría en FC y FR a las 4 hs. Por el contrario, en el 75% de los pacientes que requirieron UTIP no se evidenció mejoría en estos parámetros. Conclusiones: La OAF es una alternativa terapéutica que podría disminuir el ingreso a UTIP en pacientes con dificultad respiratoria moderada. En nuestra experiencia resultó fácil de implementar, sin efectos adversos graves (AU)


Introduction: High-flow oxygen (HFO) therapy is a non-invasive oxygen support technique that provides hot and humidified air and oxygen flow above the peak inspiratory flow of the patient through a nasal cannula. In this study we present our experience with HFO on a intermediate and low complexity ward for the treatment of bronchiolitis/acute lower respiratory tract infection (LRTI). Material and methods: A protocol for the implementation of HFO was designed. Inclusion criteria: Patients with bronchiolitis/ALRI with: Modified Tal score ≥6, Sat O2 < 92%, and/or poor ventilatory mechanism, in spite of receiving more than 2 L/ min O2 by nasal cannula or FiO2 >40%. Exclusion criteria: pCO2 ≥55 mmHg; pH: < 7.20; Apnea ≥20 seconds; Glasgow score ≤10; Peso >15 kg. Hemodynamic instability; Craniofacial abnormalities. Results: During 2017- 2018, 441 patients were admitted with LRTI. HFO was administered to 54 patients (12%). Median age was 7.4 months (r: 27 days-36 months). The patients that were included in the study did not have associated morbidities. Overall, 22.2% (12/54) were transferred to the PICU (2.7% of all hospitalized patients). Of the patients who remained on the ward, 64.8% improved FC and FR after 4 hours. On the other hand, in 75% of the patients that required PICU admission these parameters did not improve. Conclusions: HFO is a therapeutic option to decrease PICU admission of patients with moderate respiratory difficulties. The protocol was easy to implement and was not associated with severe adverse effects (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Oxygen Inhalation Therapy/instrumentation , Oxygen Inhalation Therapy/methods , Respiratory Tract Infections/therapy , Bronchiolitis/therapy , Retrospective Studies , Cannula
20.
Article | IMSEAR | ID: sea-194518

ABSTRACT

Background: Scientific literature advocates the need for combination therapies in combatting lower respiratory tract infection (LRTI). Cefixime (400 mg) and moxifloxacin (400 mg) fixed dose combination (FDC) is currently approved in India for the management of LRTI, but data related to its real world usage is lacking. The present study was designed to understand the real world use (effectiveness and safety) of this FDC in LRTI.Methods: This retrospective study was conducted at out-patient departments of 5 hospitals between August 2018 and January 2019. After ethics committee approval, data of adults LRTI patients who received FDC of cefixime (400 mg) and moxifloxacin (400 mg) for at least 72 hours was collected. Improvement in LRTI symptoms (cough, sputum volume and purulence, fever, dyspnea, pleuritic chest pain, sleep disturbance, fatigue) were scored at baseline and follow-up using a 5-point severity scale. White blood cell (WBC) counts at baseline and end-of-treatment were compared.Results: Data of 190 patients having mean age 42.33+16.15 years was evaluated. Majority were males (61.58%), with commonest LRTI infection being community acquired pneumonia (CAP) (84.21%). Commonest clinical symptom reported (97.37%) was cough. All patients showed improvement in symptoms and significant improvement in all mean symptom scores were noted (p<0.05). Of the 30 patients having WBC above normal range, 29 showed a decrease in count at end of treatment. No adverse events were reported.Conclusions: Oral FDC of cefixime (400 mg) and moxifloxacin (400 mg) was efficacious in improving all symptoms reported by LRTI patients without causing any adverse event.

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