Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
Respir Med ; 109(1): 137-45, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25464905

ABSTRACT

BACKGROUND: Infections with non-tuberculous mycobacteria (NTM) represent an increasing problem. Their clinical relevance is still largely unknown as well as predictors for mortality in affected patients. The objective was to describe prevalence and clinical relevance of different NTM and to identify risk factors for mortality. METHODS: Retrospective cohort study of 124 patients with NTM detection between January 2001 and December 2011. Clinical characteristics like symptoms and radiological appearance were assessed at presentation. The primary outcome was all cause mortality during the follow-up period. Univariate and multivariate survival analyses using Cox proportional hazard models were employed for statistical analysis. RESULTS: Over the study period, the frequency of NTM isolation varied from 4 to 12 patients per year. Twenty-nine out of 124 patients (23%) had a clinically relevant infection, according to the criteria of the American Thoracic Society (ATS). Mycobacterium avium was isolated most frequently, but Mycobacterium kansasii, Mycobacterium malmoense and Mycobacterium xenopi had the highest clinical relevance. Symptoms were mostly diverse and non-specific. On radiology, cavities were observed more frequently than a nodular-bronchiectatic variant or consolidation. In 75% of all patients, follow up time was more than two years. Median survival was 6.5 years (95%CI = 2.7-10.3). Factors significantly influencing survival time were haemoptysis (HR = 0.2, 95%CI = 0.1-0.6) and a consolidation on imaging (HR = 5.1, 95%CI 1.4-18.2). CONCLUSIONS: The presentation of an infection with NTM can be diverse and depends mainly on the causative NTM pathogen. The most important predictor for increased mortality is the radiological appearance of a consolidation.


Subject(s)
Lung Diseases/mortality , Mycobacterium Infections, Nontuberculous/mortality , Respiratory Tract Infections/mortality , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Cohort Studies , Female , Humans , Lung Diseases/diagnostic imaging , Lung Diseases/drug therapy , Lung Diseases/microbiology , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/diagnostic imaging , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium avium/isolation & purification , Mycobacterium kansasii/isolation & purification , Netherlands/epidemiology , Prognosis , Respiratory Tract Infections/diagnostic imaging , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/microbiology , Retrospective Studies , Risk Factors , Survival Analysis , Tomography, X-Ray Computed
2.
J Clin Virol ; 61(2): 265-9, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25132398

ABSTRACT

BACKGROUND: Respiratory infections are a major cause of morbidity and mortality worldwide. A high percentage of all respiratory tract infections are caused by RNA viruses. Real-time PCR is a highly sensitive method for the detection of respiratory viruses in clinical samples. A good RNA isolation protocol is of high importance, since RNA is more unstable than DNA and many clinical samples contain RNAses. OBJECTIVES: To evaluate the performance of three different RNA extraction protocols for the extraction of respiratory viral RNA from sputum samples obtained from patients with the suspicion of a viral respiratory tract infection. STUDY DESIGN: A total of 50 sputum samples, PCR positive for a respiratory RNA virus, were used for viral RNA isolation with the phenol/chloroform method, RTP(®) DNA/RNA virus mini kit and the automated MagNa Pure LC (MPLC) extraction system. After isolation, real-time PCR was performed for the detection of viral RNA in the sputum samples. RESULTS: The MPLC extraction increased the detection probability from 82% (phenol/chloroform) and 86% (RTP(®) DNA/RNA virus mini kit) to 94%. In 16% the RTP(®) DNA/RNA virus mini kit resulted in lower Ct values compared to the phenol/chloroform method, while in 32% the phenol/chloroform resulted in lower Ct values. CONCLUSIONS: The extraction of viral RNA performed with the MPLC extraction method was superior to the extraction with the RTP(®) DNA/RNA virus mini kit and to the extraction with phenol/chloroform. In general, there was no difference in the detection of viral RNA between the phenol/chloroform extraction method and the RTP(®) DNA/RNA virus mini kit.


Subject(s)
RNA, Viral/isolation & purification , Specimen Handling/methods , Sputum/virology , Humans , RNA Virus Infections/diagnosis , RNA Virus Infections/virology , Real-Time Polymerase Chain Reaction/methods , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , Retrospective Studies
3.
J Med Virol ; 85(10): 1836-41, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23861144

ABSTRACT

Acanthamoeba polyphaga mimivirus (APMV) belongs to the amoebae-associated microorganisms. Antibodies to APMV have been found in patients with pneumonia suggesting a potential role as a respiratory pathogen. In addition, positive serology for APMV was associated with an increased duration of mechanical ventilation and intensive care unit stay in patients with ventilator-associated pneumonia. The aim of the present study was to assess the presence of APMV in bronchoalveolar lavage fluid samples of critically ill patients suspected of ventilator-associated pneumonia. The study was conducted in the intensive care unit of the Maastricht University Medical Centre. All consecutive bronchoalveolar lavage fluid samples obtained between January 2005 and October 2009 from patients suspected of ventilator-associated pneumonia were eligible for inclusion. All samples were analyzed by real-time PCR targeting the APMV. A total of 260 bronchoalveolar lavage fluid samples from 214 patients (139 male, 75 female) were included. Bacterial ventilator-associated pneumonia was confirmed microbiologically in 105 out of 260 (40%) suspected episodes of ventilator-associated pneumonia (86 patients). The presence of APMV DNA could not be demonstrated in the bacterial ventilator-associated pneumonia positive or in the bacterial ventilator-associated pneumonia negative bronchoalveolar lavage fluid samples. Although suspected, APMV appeared not to be present in critically ill patients suspected of ventilator-associated pneumonia, and APMV does not seem to be a frequent cause of ventilator-associated pneumonia.


Subject(s)
DNA Virus Infections/epidemiology , DNA Virus Infections/virology , Mimiviridae/isolation & purification , Pneumonia, Ventilator-Associated/epidemiology , Pneumonia, Ventilator-Associated/virology , Academic Medical Centers , Adult , Aged , Aged, 80 and over , Bronchoalveolar Lavage Fluid/virology , Critical Illness , Female , Humans , Male , Middle Aged , Netherlands/epidemiology , Retrospective Studies
4.
Respir Med ; 106(12): 1690-4, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22990040

ABSTRACT

INTRODUCTION: Antibodies against mimivirus, a recently discovered giant virus, have been found in patients presenting with pneumonia suggesting a potential role for this virus as a respiratory pathogen. Several bacterial and viral pathogens have been associated with the occurrence of acute exacerbations in COPD. However, a large part of these exacerbations have an unknown cause. In the present study we evaluated the presence of mimivirus in sputum samples of COPD patients. METHODS: From March 2009 until January 2010 all sputum samples collected during stable conditions and during exacerbations of COPD patients, referred for pulmonary rehabilitation, were included. All sputum samples were analysed by real-time PCR targeting mimivirus. Furthermore, serum samples were analysed for the presence of antibodies against mimivirus. RESULTS: A total of 220 sputum samples from 109 patients were eligible for inclusion. None of the sputum samples showed the presence of mimivirus DNA. Antibodies against mimivirus were detected in 3 serum samples from 3 patients, of which one showed an increase in antibody-titre. CONCLUSIONS: Although mimivirus was suggested as a potential respiratory pathogen, its presence could not be confirmed in the present study-population of patients with COPD.


Subject(s)
DNA Virus Infections/virology , Mimiviridae/isolation & purification , Pulmonary Disease, Chronic Obstructive/virology , Sputum/virology , Adult , Aged , Aged, 80 and over , Antibodies, Viral/blood , DNA Virus Infections/immunology , Female , Humans , Male , Middle Aged , Mimiviridae/immunology , Reverse Transcriptase Polymerase Chain Reaction
SELECTION OF CITATIONS
SEARCH DETAIL
...