Respiratory Tract Infections In Patients Research Articles

Genotype and genetic characteristics of human respiratory syncytial virus circulating in Quanzhou, 2018-2019

Objective: To study the prevalence and genetic characteristics of human respiratory syncytial virus (HRSV) in Quanzhou city, from 2018 to 2019. Methods: A total of 141 throat swabs were collected from children patients of lower respiratory tract infection in Quanzhou children Hospital, Fujian Province from November 2018 to May 2019. RT-PCR was used to amplify the 3 'end of G gene HRSV. Sequencer 5.0 and MEGA5.05 softwares were used for sequence editing, phylogenetic tree construction and genotyping analysis. Results: Twenty-five samples were positive for HRSV. Seventeen samples succeeded to obtain the target gene, including 13 of HRSVA and 4 of HRSVB. Two genotypes were identified: ON1 genotype (13 samples, HRSVA) and BA9 genotype (4 samples, HRSVB). Five strains of ON1 genotype sequences were clustered with the ON1 sequences prevalent in Beijing, Changchun and Zhejiang from 2012 to 2015 (cluster1); one strain (FJ19-02) was clustered with the sequences of ON1 genotype circulating in many regions of China from 2012 to 2015 (cluster2); Seven strains were clustered independently (cluster FJ). FJ18-02, FJ19-14 and FJ19-15 of HRSVB were clustered with the BA9 genotype sequences prevalent in Changchun, Jilin Province in 2015, while FJ19-13 was closely related to the BA9 genotype sequences prevalent in Guangzhou and Zhejiang Province in 2013. Both the ON1 and BA9 genotypes showed variations of nucleotide and amino acid in 72 and 60 insertion segments. Amino acid mutation (H266L) only occurred among the sequence of cluster-FJ, and the mutations of H261Q and Q265L only appeared in strain FJ19-13. Conclusion: BA9 and ON1 genotypes were prevalent in Quanzhou city, from 2018 to 2019. Cluster-FJ was a newly discovered independent transmission chain, which may continue to circulate in local Quanzhou area.

Assay System for Simultaneous Detection of SARS-CoV-2 and Other Respiratory Viruses.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggers disease with nonspecific symptoms that overlap those of infections caused by other seasonal respiratory viruses (RVs), such as the influenza virus (Flu) or respiratory syncytial virus (RSV). A molecular assay for accurate and rapid detection of RV and SARS-CoV-2 is crucial to manage these infections. Here, we compared the analytical performance and clinical reliability of Allplex™ SARS-CoV-2/FluA/FluB/RSV (SC2FabR; Seegene Inc., Seoul, South Korea) kit with those of four commercially available RV detection kits. Upon testing five target viral strains (SARS-CoV-2, FluA, FluB, RSV A, and RSV B), the analytical performance of SC2FabR was similar to that of the other kits, with no significant difference (p ≥ 0.78) in z-scores. The efficiency of SC2FabR (E-value, 81–104%) enabled reliable SARS-CoV-2 and seasonal RV detection in 888 nasopharyngeal swab specimens processed using a fully automated nucleic acid extraction platform. Bland–Altman analyses revealed an agreement value of 95.4% (SD ± 1.96) for the kits, indicating statistically similar results for all five. In conclusion, SC2FabR is a rapid and accurate diagnostic tool for both SARS-CoV-2 and seasonal RV detection, allowing for high-throughput RV analysis with efficiency comparable to that of commercially available kits. This can be used to help manage respiratory infections in patients during and after the coronavirus disease 2019 pandemic.

The Antimicrobial Activity of Peripheral Blood Neutrophils Is Altered in Patients with Primary Ciliary Dyskinesia

The airways of patients with primary ciliary dyskinesia (PCD) contain persistently elevated neutrophil numbers and CXCL8 levels. Despite their abundance, neutrophils fail to clear the airways from bacterial infections. We investigated whether neutrophil functions are altered in patients with PCD. Neutrophils from patients and healthy controls (HC) were isolated from peripheral blood and exposed to various bacterial stimuli or cytokines. Neutrophils from patients with PCD were less responsive to low levels of fMLF in three different chemotaxis assays (p < 0.05), but expression of the fMLF receptors was unaltered. PCD neutrophils showed normal phagocytic function and expression of adhesion molecules. However, PCD neutrophils produced less reactive oxygen species upon stimulation with bacterial products or cytokines compared to HC neutrophils (p < 0.05). Finally, the capacity to release DNA, as observed during neutrophil extracellular trap formation, seemed to be reduced in patients with PCD compared to HC (p = 0.066). These results suggest that peripheral blood neutrophils from patients with PCD, in contrast to those of patients with cystic fibrosis or COPD, do not show features of over-activation, neither on baseline nor after stimulation. If these findings extend to lung-resident neutrophils, the reduced neutrophil activity could possibly contribute to the recurrent respiratory infections in patients with PCD.

Respiratory Tract Infection Pathogen Spectrum Study of 376 Pneumoconiosis Inpatients in Chengdu

To investigate the status of infections caused by respiratory pathogens and the patterns of infections caused by pathogens in different seasons, age groups and stages of pneumoconiosis so as to explore the pathogen spectrum of respiratory tract infections in pneumoconiosis patients. The sputum samples of 376 pneumoconiosis patients admitted to an occupational disease hospital in Chengdu between January, 2017 and October, 2019 were collected. Clinical information of the patients was collected and lab tests were conducted to check for 23 kinds of common respiratory viruses, bacteria and fungi in the sputum. The relationship between seasons, ages, and different stages of pneumoconiosis and the pathogen detection rate was analyzed. In the 376 sputum samples, the detection rates of pathogens, viruses, bacteria and fungi were 42.29% (159/376), 32.98% (124/376), 9.57% (36/376) and 6.12% (23/376), respectively. The six pathogens with the highest detection rates were parainfluenza virus, rhinovirus, influenza virus, Candida albicans, Klebsiella pneumoniae and Candida krousei. The severity of respiratory tract infection did not show significant difference in different seasons, age groups, and pneumoconiosis stages. The pathogen spectrum of respiratory tract infections in patients with pneumoconiosis is complicated and the proportion of viral infection is high. However, the severity of the infection is not associated with age, seasonal, or pneumoconiosis staging differences.

Neurological manifestations in COVID-19: an overview

The novel coronavirus disease 2019 (COVID-19) is a causative agent of severe lower respiratory tract infection in patients. Since its discovery in December 2019, COVID-19 has spread to five continents and to this date, affected approximately 6,260,000 people. COVID-19 patients typically present with symptoms related to the respiratory system while neurological manifestations have scarcely been reported. Neurological presentations of COVID-19 infection are classified into two groups: CNS symptoms and peripheral nervous system (PNS) symptoms. CNS symptoms include headache, dizziness, loss of consciousness, convulsion, ataxia and acute cerebrovascular disease. The PNS symptoms consist of hypoplasia, hyposmia, hypogeusia and neuralgia. The association between COVID-19 and neurological problems needs further clarification and warrants detailed microbiological and pathological studies to better understand the virus and its impact on the brain and nervous system.

Antibiotic prescribing for respiratory tract infection in patients with suspected and proven COVID-19: results from an antibiotic point prevalence survey in Scottish hospitals.

BackgroundBacterial co-infection is infrequently observed with SARS-CoV-2/COVID-19 infection outside of critical care, however, antibiotics are commonly prescribed.ObjectivesTo examine factors associated with antibiotic prescribing for suspected respiratory tract infection (RTI) and evaluate the nature and dynamics of prescribing in hospitalized patients with suspected and proven COVID-19 infection.MethodsAn antibiotic point prevalence survey in hospitalized adult patients was conducted in designated COVID-19 clinical areas (including critical care) in 15 Scottish hospitals. Antibiotics prescribed for RTI and factors associated with prescribing were investigated.ResultsOf 820 surveyed patients, 272 (prevalence 33.3%) received antibiotics for suspected RTI on the survey day and 58.8% were SARS-CoV-2 positive. Antibiotics were empirical in 91.9% and amoxicillin (24.6%), doxycycline (20.5%) and co-amoxiclav (15%) were most frequently prescribed. Oral antibiotics were prescribed in 54.5% and duration was recorded in 76.7% on wards for a median of 5 days. IV to oral switch occurred after a median of 2 days. Prescribing for RTI was independently and positively associated with COPD/chronic lung disease, purulent/bloody sputum, abnormal chest X-ray, and CRP ≥ 100 mg/L. Probable and definite hospital-acquired COVID-19 and diabetes were associated with a lower odds of receiving an antibiotic for RTI.ConclusionsAntibiotic prescribing for suspected RTI was commonly observed and predominantly empirical in suspected or proven COVID-19. Initiatives to reinforce stewardship principles including clinical review, effective use of microbiological diagnostics and better understanding of the role of biomarkers are central to further limit unnecessary antibiotic therapy in COVID-19.

Impact of Septoplasty on Oxidative DNA Damage Levels in Patients with Marked Nasal Septal Deviation

Objectives:Nasal septal deviation (NSD) is a common dilemma which cause nasal obstruction. Septoplasty is usually accomplished to solve nasal obstruction in patients with NSD. NSD is related strongly with hypoxia. Hypoxic conditions increase oxidative DNA damage in cells. This study aimed to investigate the effect of septoplasty on the level of antioxidant agents in patients with marked NSD. Methods: Sixty-one patients who submitted to septoplasty were involved in our prospective investigation. Results: The difference between the pre- and postoperative levels of MDA and 8-OHdG/106 dG was statistically significant. Conclusions: Septoplasty is an elective surgery performed to prevent the decrease in quality of life due to nasal obstruction and frequent respiratory tract infections in patients with NSD. As seen in this study, septoplasty is an urgent surgery that should be performed urgently to prevent DNA damage in patients with NSD

Respiratory viruses and clinical- epidemiological characteristics in episodes of acute respiratory infection.

The aim of the study was to determine the viral frequency and clinical-epidemiological characteristics in the episodes of acute respiratory infection in patients of the Instituto Nacional de Salud del Niño San Borja in Lima, the information of the episodes of patients who required at least one direct Immunofluorescence test from January 1, 2017 to December 31, 2018 was analyzed. 1153 episodes were identified in 707 patients. The median age was 1 year and 55% were male. The viral frequency was 13.4%; respiratory syncytial virus was identified in 10.7% of the episodies. The viral frequency was higher in children under 1 year of age (16.2%); in those with congenital disease respiratory (38.9%) and during the autumn (24.2%). The most common symptoms were cough (70.3%) and fever (53.4%); and the main diagnoses, viral pneumonia (31.8) and bronchiolitis (23.4%). It is concluded that the respiratory viral frequency was related to age, seasonality and pre-existing pathology.

Evaluation of Nasal Mucociliary Activity in Patients with Familial Mediterranean Fever

Objective: The aim of this study was to evaluate nasal airway resistance and nasal mucociliary activity in Familial Mediterranean Fever (FMF) patients using anterior rhinomanometry and saccharin clearance test. Methods: 30 patients with FMF disease and 30 healthy individuals were included in this prospective, cross-sectional study. Nasal airway resistance was measured via active anterior rhinomanometry and a saccharin test was carried out for the measurement of nasal mucociliary clearance (NMC) times of all participants. Results: Mean values for NMC time in the FMF patient group and control group were found as 14.6 ± 4.7 (range, 8-30) min. and 9.7 ± 2.3 (range, 6-14) min. respectively. Nasal mucociliary clearance time in the FMF patients was significantly prolonged in comparison to that of healthy controls (p &amp;lt; 0.001). We identified no significant correlation between the disease duration and NMC time (p=0.921, r = 0.019). When the mean nasal airway resistance values of both groups were compared, there was no significant difference was detected (p = 0.371). Conclusion: The results of our study have revealed that NMC time was longer in patients with FMF than healthy controls. However, there was no statistically significant correlation between nasal mucociliary clearance time and disease duration. Disruption of NMC increases the risk of infection in the upper and lower respiratory tract. Caution should be exercised against upper and lower respiratory infections in patients with FMF.

Prevalence of respiratory tract infections and influencing factors: A cross-sectional survey in Anhui Province, China.

This study used available data to analyze the prevalence and influencing factors of various Respiratory tract infections (RTIs), to better our understanding of the local and national epidemiology, and to inform future prevention and control programs. We used a structured questionnaire to solicit information about social demographics and symptoms of the last RTI administered with stratified clustered randomized sampling. Descriptive analysis was used to investigate the reported symptoms, and multivariate logistic regression models to identify relationships between the prevalence and influencing factors of common RTIs. The study documented a prevalence rate of 1.5% for common cold, 0.5% for influenza, and 0.9% for 9-AURTIs (nine acute upper RTIs, including acute pharyngitis, sore throat, acute tonsillitis, acute suppurative tonsillitis, acute laryngitis, acute bronchitis, acute pharyngitis, acute upper RTI, and viral upper RTI), adding up to 3.4% of overall RTIs in the past 2weeks. Results also revealed a L-shaped trend along age-axis for all the RTIs, and marginal to moderate associations between RTIs and other commonly researched factors (education, body mass index, sex, and annual income), as well as environmental and behavior factors. RTIs in Anhui, China are common and associated with a variety of socio-demographic, behavioral, and environmental factors. RTIs merit better epidemiological understanding and added interventions tailored to efforts in reducing their health and economic burden. These understandings and efforts are especially relevant for public health nurses since most RTI patients are treated in community settings.

Respiratory infections during lithium and valproate medication: a within-individual prospective study of 50,000 patients with bipolar disorder

BackgroundIn vitro studies have demonstrated that lithium has antiviral properties, but evidence from human studies is scarce. Lithium is used as a mood stabilizer to treat patients with bipolar disorder. Here, the aim was to investigate the association between lithium use and the risk of respiratory infections in patients with bipolar disorder. To rule out the possibility that a potential association could be due to lithium’s effect on psychiatric symptoms, we also studied the effect of valproate, which is an alternative to lithium used to prevent mood episodes in bipolar disorder.MethodWe followed 51,509 individuals diagnosed with bipolar disorder in the Swedish Patient register 2005–2013. We applied a within-individual design using stratified Cox regression to estimate the hazard ratios (HRs) of respiratory infections during treated periods compared with untreated periods.ResultsDuring follow-up, 5,760 respiratory infections were documented in the Swedish Patient Register. The incidence rate was 28% lower during lithium treatment (HR 0.73, 95% CI 0.61–0.86) and 35% higher during valproate treatment (HR 1.35, 95% CI 1.06–1.73) compared with periods off treatment.ConclusionsThis study provides real-world evidence that lithium is associated with decreased risk for respiratory infections and suggests that the repurposing potential of lithium for potential antiviral or antibacterial effects is worthy of investigation.

Respiratory Tract Infections in Inflammatory Bowel Disease Patients Taking Vedolizumab: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The ongoing COVID-19 pandemic has raised concerns about the risk of SARS-CoV-2 infection in patients with Crohn’s disease (CD) and patients with ulcerative colitis (UC) taking immunosuppressants or biologics. We conducted a systematic review and meta-analysis to assess the risk of respiratory infections in patients with inflammatory bowel disease (IBD) treated with vedolizumab. We searched PubMed, EMBASE and Scopus to identify randomized controlled trials (RCT) comparing vedolizumab to placebo in patients with IBD. Outcomes were the rate of respiratory tract infections (RTI), upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI) among patients receiving vedolizumab as compared with placebo. Pooled rates were reported as Odds Ratios (OR) with 95% Confidence Interval (CI). Eight RCT involving 3,287 patients (1873 CD and 1415 UC) were analyzed; 2,493 patients received vedolizumab and 794 received placebo. The rates of RTI and URTI were statistically higher in vedolizumab-treated patients compared to placebo [OR = 1.63; 95% CI (1.07–2.49); OR = 1.64 95% CI (1.07–2.53) respectively]. UC patients, but not CD patients, receiving vedolizumab had a higher risk to develop RTI and URTI [OR = 1.98; 95% CI (1.41–2.77); OR = 2.02; 95% CI (1.42–2.87)] compared to placebo-treated patients. The number of LRTI was small in both treatment groups. Data confirm the good safety profile of vedolizumab even though RTI were more frequent in patients receiving vedolizumab and the risk of URTIs was significantly higher in patients with UC.

Topical antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving mechanical ventilation.

Topical antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving mechanical ventilation.

Complete Genome Sequence of Achromobacter xylosoxidans Myophage Mano.

Achromobacter spp. are ubiquitous Gram-negative bacteria, some of which can cause respiratory tract infections in patients with autoimmune disorders and cystic fibrosis. Bacteriophages have therapeutic and biotechnological potential to combat Achromobacter sp. infections. This announcement details the 42.5-kb genome sequence of the temperate Achromobacter xylosoxidans myophage Mano.

Effect of acute lower respiratory tract infection on pulmonary artery pressure in children with post-tricuspid left-to-right shunt.

We sought to examine the influence of clinically severe lower respiratory tract infection on pulmonary artery pressure in children having CHD with post-tricuspid left-to-right shunt, as it may have physiological and clinical implications. In a prospective single-centre observational study, 45 children with post-tricuspid left-to-right shunt and clinically severe lower respiratory tract infection were evaluated during the illness and 2 weeks after its resolution. Pulmonary artery systolic pressure was estimated non-invasively using shunt gradient by echocardiography and systolic blood pressure measured non-invasively.Median pulmonary artery systolic pressure during lower respiratory tract infection was only mildly (although statistically significantly) elevated during lower respiratory tract infection [60 (42-74) versus 53 (40-73) mmHg, (p < 0.0001)]. However, clinically significant change in pulmonary artery systolic pressure defined as the increase of >10 mmHg was present in only 9 (20%) patients. In the absence of hypoxia or acidosis, only a small minority (9%, n = 4) showed significant pulmonary artery systolic pressure rise >10 mmHg. In the absence of hypoxia or acidosis, severe lower respiratory tract infection in patients with acyanotic CHD results in only mild elevation of pulmonary artery systolic pressure in most of the patients.

Risk of respiratory infection in patients with plaque psoriasis

To the Editor: Understanding the risk of respiratory infection in psoriasis and the impact of immunosuppressive treatment is important to inform preventive measures for COVID-19. Therefore, we report data on respiratory infection in patients with psoriasis from a study linking an inception cohort1 to population-based health care registers on outpatient care, inpatient care (The National Patient Register2), and prescriptions (The Prescribed Drug Register3).

P134 SARS-CoV-2 infection in cystic fibrosis during the first pandemic wave in Italy: a multi-centre prospective study with a control group

Background: Patients with cystic fibrosis (CF) are at high risk of developing severe forms of viral respiratory infections. This study aimed at comparing symptoms and clinical course of SARS-CoV2 infection with other respiratory infections in patients with CF. Methods: We carried out a prospective multicentre cohort study within the Italian CF Society involving 32 CF centres following 6,597 patients. CF centres were contacted to collect baseline and follow-up data of all patients who had reported symptoms suggestive of COVID-19 or who had had contact with a positive/suspected case between the end of February and July 2020. Symptoms and clinical course of the infection were compared between patients who tested positive by molecular testing (cases) and those who tested negative (controls). Results: Thirty patients were reported from the centres, 16 of whom tested positive and 14 negative. Fever, cough, asthenia and dyspnea were the most frequently reported symptoms and their frequency were not significant different between groups. Eight cases (50%) were hospitalised but none required ICU admission. Two adults with a history of lung transplant required non-invasive ventilation;none required ICU admission. All patients fully recovered without short-term sequelae. Changes in FEV1 (percent of predicted) after recovery were not significantly different between groups (median, interquartile range: 3.0%, –1.5, 5.5 among cases and –3.0%, –8.5, 6.3 among controls, P = 0.48). Conclusions: Symptoms and clinical course of SARS-CoV-2 infection in our patients was not significantly different from other respiratory infections. The clinical course of COVID-19 was relatively favourable, however CF patients with severely impaired respiratory function and organ transplant may develop complications and a negative outcome. The study is ongoing, and we are recruiting patients during the second wave of the pandemic.

Utilisation of healthcare services for respiratory tract infections in patients with and without diabetes in Qatar: a cross-sectional study

ObjectivePeople with diabetes mellitus have a high risk of acquiring respiratory tract infections (RTIs), yet little is known about their utilisation of healthcare services compared with people without diabetes. This...

COMPARISON OF THE EFFECTIVENESS OF LATERAL POSITION AND SUPINE POSITION ON PHYSIOLOGICAL PARAMETERS AND COMFORT AMONG PATIENTS WITH RESPIRATORY TRACT INFECTION

Background:Standard nursing care for critically ill patients includes lateral positioning. A therapeutic regimen of lateral positioning may reduce the adverse effects of prolonged bed rest and to improve oxygenation in patients with unilateral lung disease and decrease the length of stay in the intensive care unit. Physiological adaptations mainly due to the effect of gravity occurs during changes of position and can influence the symptoms of various diseases involving not only the circulatory system but also other systems like respiratory system and digestive system. Objectives:1) To assess the effectiveness of lateral position on physiological parameters and comfort among clients with respiratory tract infection.2).To assess the effectiveness of supine position on physiological parameters and comfort among clients with respiratory tract infection.3) To compare the effectiveness of lateral position and supine position on physiological parameters and comfort among clients with respiratory tract infection. Methods:The research approach adopted for the study was quantitative comparative experimental approach study, the research design used was Repeated Measure design. By using non probability purposive sampling 40 respiratory patients admitted in ICUs of Wanless Hospital .The content validity and reliability of the tool was done , which was suggested that the tool was reliable(r=0.70). Result:The major findings revealed that, Effectiveness of lateral position followed by supine position to see the physiological parameter is done by observational checklist (heart rate, respiratory rate, spo2, tidal volume)was significant but BP was not significant. Comfort by Likert scale was highly significant (p&lt;0.0001). Statistical analysis is done by (paired and unpaired t test) Result showed that lateral position had significantly higher mean Pao2 than the supine position (p&lt;0.0001) Thus findings reveals that H1 is accepted and null hypothesis is rejected. Conclusion:Lateral position was found to be effective in respiratory tract infection patients which gave a significant change in physiological parameters and comfort compared to supine position.

Association between inhaled corticosteroids and upper respiratory tract infection in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials

BackgroundWe aimed to assess the association between inhaled corticosteroids (ICSs) and the risk of upper respiratory tract infection (URTI) in patients with chronic obstructive pulmonary disease (COPD).MethodsPubMed, Embase, Cochrane Library and Clinical Trials.gov were searched from inception to October 2019. Randomized controlled trials (RCTs) of any ICSs vs control for COPD with reporting of URTI as an adverse event were included. The study was registered with PROSPERO prospectively (#CRD42020153134).ResultsSeventeen RCTs (20,478 patients) were included. ICSs significantly increased the risk of URTI in COPD patients (RR, 1.13; 95% CI 1.03–1.24; P = 0.01; heterogeneity: I2 = 7%). Futher subgroup analyses suggested that short-term use of ICSs increased the risk of URTI (RR, 1.29; 95% CI 1.06–1.56; P = 0.01; heterogeneity: I2 = 14%) but not for long-term use (RR, 1.08; 95% CI 0.97–1.2; P = 0.14; heterogeneity: I2 = 0%). Short-term use of high-dose fluticasone increased the risk of URTI (RR, 1.33; 95% CI 1.03–1.71; P = 0.03; heterogeneity: I2 = 0%) but not for long-term use (RR, 1.12; 95% CI 0.97–1.29; P = 0.13; heterogeneity: I2 = 50%). Medium-dose (RR, 0.97; 95% CI 0.71–1.32; P = 0.84; heterogeneity: I2 = 0%) and low-dose (RR, 1.39; 95% CI 0.92–2.1; P = 0.12; heterogeneity: I2 = 30%) fluticasone did not increase the risk of URTI regardless of duration. Neither mometasone (RR, 1.05; 95% CI 0.87–1.26; P = 0.61; heterogeneity: I2 = 0%) nor budesonide (RR, 1.08; 95% CI 0.77–1.5; P = 0.67; heterogeneity: I2 = 46%) increased the risk of URTI, regardless of dosage or duration.ConclusionsLong-term use of ICSs does not increase the risk of URTI in patients with COPD. Short-term use of high-dose fluticasone increases the risk of URTI in patients with COPD, but not mometasone or budesonide.