Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 467
Filtrar
1.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914021

RESUMEN

We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.


Asunto(s)
Adenoviridae/aislamiento & purificación , Haemophilus influenzae/aislamiento & purificación , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Infecciones por Adenoviridae/diagnóstico , Infecciones por Adenoviridae/virología , Bacterias/genética , Preescolar , Coinfección/microbiología , Coinfección/virología , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Gripe Humana/diagnóstico , Gripe Humana/virología , Masculino , Prevalencia , Ruidos Respiratorios/diagnóstico , Ruidos Respiratorios/etiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/genética , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Staphylococcus aureus/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Virus/genética
2.
Orv Hetil ; 160(40): 1574-1583, 2019 Oct.
Artículo en Húngaro | MEDLINE | ID: mdl-31565975

RESUMEN

Introduction: Despite advancements in diagnostic capabilities and the availability of effective antimicrobial agents, community-acquired infections of the central nervous system (CNS) are still associated with high mortality rates. Aim: To assess the epidemiological and clinical characteristics of community-acquired CNS infections treated in the West Pannonian region between 2010 and 2016. Method: Clinical data of 176 patients were retrospectively analysed in two age cohorts: 15 to 65 and more than 65 years of age. Results: Neuroinfections were found to be bacterial in 81, viral in 91, parasitic in 1 and mixed in 3 cases during the observation period. The most frequent bacterial pathogens isolated were Streptococcus pneumoniae (20%) and Borrelia burgdorferi (16%). The most frequent viral pathogens isolated were tick-borne encephalitis virus (37%), herpes simplex virus (10%) and enterovirus (7%). Aetiology was unknown in 40 percent of all cases. The average incidence rate was 9.8/100 000 person/year with a mortality rate of 12%. In the cohort of patients aged >65 years, significantly higher frequencies of immunocompromising factors, lower Glasgow Coma Scale values at admission and confusion were observed (p-values: 0.008, 0.017, and 0.050, respectively). Prognosis was negatively influenced by low Glasgow Coma Scale values at admission (OR = 1.6 CI95%: 1.3-1.9; p<0.001), old age (OR = 6.5 CI95%: 2.5-17.1; p<0.001) and immunodeficiency (OR = 3.1 CI95%: 1.2-8.1; p = 0.019). Conclusions: S. pneumoniae remains the most frequently observed causative bacterial pathogen associated with community-acquired CNS infections. Incidence of tick-borne encephalitis in our county is higher than the national average (2.3 versus 0.35/100 000 person/year). Orv Hetil. 2019; 160(40): 1574-1583.


Asunto(s)
Infecciones Bacterianas del Sistema Nervioso Central/microbiología , Infecciones del Sistema Nervioso Central/epidemiología , Enfermedades Virales del Sistema Nervioso Central/virología , Infecciones Comunitarias Adquiridas , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Borrelia burgdorferi/aislamiento & purificación , Infecciones Bacterianas del Sistema Nervioso Central/diagnóstico , Infecciones del Sistema Nervioso Central/diagnóstico , Estudios de Cohortes , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Encefalitis , Encefalitis Transmitida por Garrapatas/epidemiología , Enterovirus/aislamiento & purificación , Infecciones por Enterovirus/epidemiología , Femenino , Humanos , Hungría/epidemiología , Incidencia , Enfermedad de Lyme/epidemiología , Masculino , Persona de Mediana Edad , Infecciones Neumocócicas/epidemiología , Estudios Retrospectivos , Simplexvirus/aislamiento & purificación , Streptococcus pneumoniae , Adulto Joven
4.
Can Respir J ; 2019: 4301039, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31007805

RESUMEN

Introduction: Influenza A H1N1 community-acquired pneumonia (CAP) is a quite frequent respiratory disease. Despite being considered more serious than other CAPs, there are very few studies comparing its characteristics with noninfluenza CAP. We aim to establish the differences between pneumonia due to H1N1 virus and pneumonia not caused by H1N1 influenza virus and to determine the probability that a pneumonia is due to an H1N1 virus infection based on the most relevant variables. Methods: We used a case-control study where cases were H1N1 CAP patients with confirmed microbiological diagnosis and controls were patients with CAP admitted to hospital. H1N1 and other influenza types were discarded among controls. We calculated the probability of being a case or control using multivariate logistic regression. Results: We included 99 cases and 270 controls. Cases were younger than controls (53 vs 71 years, respectively). Mortality was much higher for H1N1 patients (13% vs 0.3%), and admission to intensive care unit was more frequent for H1N1 cases. The variables most associated with presenting H1N1 CAP were bilateral affectation on chest X-rays (OR: 5.70; 95% CI 2.69-10.40), followed by presence of arthromyalgias, with cases presenting close to three times more arthromyalgias compared to controls. Low leukocytes count and high AST values were also significantly associated with H1N1 CAP. H1N1 CAPs are characterized by bilateral affectation, low leukocyte count, presence of arthromyalgias, and high AST. Conclusions: A few and easy to obtain clinical parameters might be extremely useful to distinguish H1N1 CAP from CAPs of other origin.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Neumonía Viral/virología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/virología , Femenino , Humanos , Gripe Humana/virología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neumonía Viral/mortalidad , Factores de Riesgo , España/epidemiología
5.
Rev Inst Med Trop Sao Paulo ; 61: e24, 2019 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-31017185

RESUMEN

The cytological and biochemical examination of cerebrospinal fluid (CSF) has been used for the presumed diagnosis of bacterial meningitis until the final microbiological results are achieved. We assessed the ability of CSF lactate in comparison with other CSF parameters to discriminate bacterial and enteroviral community acquired meningitis. We included 1,187 CSF samples of acute community-acquired meningitis, being 662 cases of bacterial and 525 of enteroviral meningitis. Lactate concentration (mg/dL), leukocyte count/mm3, protein (mg/dL), and glucose (mg/dL) were compared between bacterial and viral meningitis. Receiver operator characteristic (ROC) curves were used to assess diagnostic performance. CSF leukocytes, CSF protein and CSF lactate were significantly higher in bacterial meningitis cases (P<0.0001). CSF glucose was significantly lower in bacterial meningitis cases (P<0.0001). CSF lactate showed the best predictive ability with an area under the curve of 0.944 (95% CI 0.929 - 0.959). Considering a cut off of CSF lactate of 30 mg/dL, the sensitivity and specificity for bacterial meningitis were 84.1% and 99%, respectively. In the cytological and biochemical CSF analysis, CSF lactate was the most accurate marker for bacterial meningitis.


Asunto(s)
Infecciones Comunitarias Adquiridas/líquido cefalorraquídeo , Infecciones por Enterovirus/diagnóstico , Ácido Láctico/líquido cefalorraquídeo , Meningitis Bacterianas/diagnóstico , Meningitis Viral/diagnóstico , Biomarcadores/líquido cefalorraquídeo , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Infecciones por Enterovirus/líquido cefalorraquídeo , Humanos , Meningitis Bacterianas/líquido cefalorraquídeo , Meningitis Viral/líquido cefalorraquídeo , Curva ROC , Sensibilidad y Especificidad
7.
PLoS One ; 14(3): e0210102, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30840626

RESUMEN

Pneumonia severity index (PSI) is an important scoring system that can assess the severity of community acquired pneumonia and determine admission status. However, there is a lack of research on whether this scoring system can be applied to viral community acquired pneumonia. The purpose of this study was to evaluate the usefulness of PSI in viral community acquired pneumonia. This retrospective cohort study included 1,434 adult patients (aged ≥18 years) who were admitted to the emergency department of a university hospital during 2013-2015 because of community-acquired pneumonia. Viral infections were diagnosed by multiplex PCR. Patients diagnosed with non-viral community-acquired pneumonia were included in the control group (N = 1,173). The main outcome was 30-day all-cause mortality. multivariate Cox regression analyses were performed to calculate the risk of death. Respiratory viruses were detected in 261 (18.2%) patients with community-acquired pneumonia. Two types of respiratory viruses were detected in 7 cases. Of the 254 cases detected with only one virus, 62 were influenza A, 18 were influenza B, 65 were rhinovirus, 35 were respiratory syncytial virus, 25 were metapneumovirus, 20 were parainfluenza, 17 were coronavirus, 7 were bocavirus, and 5 were adenovirus. Mortality was not significantly different between patients with respiratory virus and those without respiratory virus; the 30-day all-cause mortality rates were 20.3% and 22.4%, respectively (P = 0.45). Mortality rate increased with an increasing PSI score with or without respiratory viral infection. Pulmonary severity index was significantly associated with mortality adjusted for respiratory virus detection (hazard ratio = 1.024, 95% confidence interval = 1.020-1.028). Pneumonia severity index score is an important factor for assessing the prognosis of patients with community-acquired pneumonia, regardless of respiratory virus detection.


Asunto(s)
Infecciones Comunitarias Adquiridas/mortalidad , Neumonía Viral/mortalidad , Pneumovirus/patogenicidad , Infecciones del Sistema Respiratorio/mortalidad , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/virología , Pneumovirus/clasificación , Pneumovirus/aislamiento & purificación , Pronóstico , República de Corea/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Estudios Retrospectivos , Tasa de Supervivencia
8.
Diagn Microbiol Infect Dis ; 94(1): 50-54, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30578007

RESUMEN

Bacterial and viral coinfected community-acquired pneumonia (CAP) is poorly characterized in adults. The aim of this study was to investigate the influence of bacterial and viral coinfection in patients with CAP. A total of 235 adults who requested molecular tests of pneumonia and were diagnosed with CAP were enrolled in this study. Microbiological tests included blood and sputum cultures, PCR for bacterial and viral pathogens, antigen test for Streptococcus pneumoniae and the influenza virus, and antibody detection of Mycoplasma pneumonia. Of the 235 patients, 32 (13.6%) patients were coinfected with bacteria and virus. Among 64 severe CAP patients, the concurrent infections were confirmed in 14 patients (21.9%). The proportion of severe pneumonia was significantly higher in patients with coinfection, and they showed a significantly higher mortality rate. In conclusion, bacterial and viral coinfection in CAP is not a rare occurrence in adults. Viral and bacterial coinfections have an adverse impact on the severity of the pneumonia, and increase morbidity and mortality in patients with CAP.


Asunto(s)
Coinfección/epidemiología , Infecciones Comunitarias Adquiridas/epidemiología , Neumonía Bacteriana/complicaciones , Neumonía Viral/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Técnicas de Laboratorio Clínico , Coinfección/microbiología , Coinfección/patología , Coinfección/virología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/patología , Infecciones Comunitarias Adquiridas/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Supervivencia , Adulto Joven
9.
Int J Infect Dis ; 80: 46-53, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30550945

RESUMEN

BACKGROUND: Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality among adults worldwide. However, the distribution of the etiology of CAP varies from one country to another, with limited data from rural areas. METHODS: A prospective hospital-based study on adult CAP was conducted in Leyte, Central Philippines from May 2010 to May 2012. Blood, sputum, and nasopharyngeal samples obtained from patients were used to identify pathogens using standard microbiological culture methods and PCR. RESULTS: Of the 535 patients enrolled, 38% were younger than 50 years old. More than half of the patients had an underlying disease, including pulmonary tuberculosis (22%). The detection rate was higher for bacteria (40%) than viruses (13%). Haemophilus influenzae (12%) was the most commonly detected bacterium and influenza virus (5%) was the most commonly detected virus. The proportion of CAP patients with Mycobacterium tuberculosis infection was higher in the younger age group than in the older age group. Among CAP patients, 14% died during hospitalization, and drowsiness on admission and SpO2 <90% were independent risk factors for mortality. CONCLUSIONS: Bacterial infections contribute substantially to the number of hospitalizations among CAP patients in rural Philippines. This study also highlights the importance of treatment of tuberculosis in reducing the burden of adult CAP in the country.


Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Hospitalización , Neumonía/epidemiología , Adolescente , Adulto , Anciano , Bacterias/clasificación , Bacterias/aislamiento & purificación , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Haemophilus influenzae/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Nasofaringe/microbiología , Nasofaringe/virología , Orthomyxoviridae/aislamiento & purificación , Filipinas/epidemiología , Neumonía/microbiología , Neumonía/virología , Estudios Prospectivos , Factores de Riesgo , Esputo/microbiología , Esputo/virología , Tuberculosis Pulmonar/epidemiología , Adulto Joven
11.
12.
Emerg Infect Dis ; 25(1): 15-24, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30560776

RESUMEN

Clinical features of human metapneumovirus (HMPV) infection have not been well documented for adults. We investigated clinical and radiologic features of HMPV infection in 849 adults in a tertiary hospital in South Korea. We classified patients into groups on the basis of underlying diseases: immunocompetent patients, solid tumor patients, solid organ transplantation recipients, hematopoietic stem cell transplant recipients, hematologic malignancy patients, and patients receiving long-term steroid treatment. Of 849 HMPV-infected patients, 756 had community-acquired infections, 579 had pneumonia, and 203 had infections with other pathogens. Mortality rates were highest in hematopoietic stem cell transplantation recipients (22% at 30 days). Older age, current smoking, and underlying disease were associated with HMPV pneumonia. Body mass index and an immunocompromised state were associated with 30-day mortality rates in HMPV-infected patients. Bronchial wall thickening, ground-glass opacity, and ill-defined centrilobular nodules were common computed tomography findings for HMPV pneumonia. Macronodules and consolidation were observed in <50% of patients.


Asunto(s)
Infecciones Comunitarias Adquiridas/diagnóstico por imagen , Metapneumovirus/fisiología , Infecciones por Paramyxoviridae/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Anciano , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/virología , Femenino , Neoplasias Hematológicas/diagnóstico por imagen , Neoplasias Hematológicas/mortalidad , Neoplasias Hematológicas/virología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Huésped Inmunocomprometido , Masculino , Persona de Mediana Edad , Trasplante de Órganos/efectos adversos , Infecciones por Paramyxoviridae/mortalidad , Infecciones por Paramyxoviridae/virología , Neumonía Viral/mortalidad , Neumonía Viral/virología , República de Corea/epidemiología , Centros de Atención Terciaria , Tomografía Computarizada por Rayos X
13.
Emerg Infect Dis ; 24(11): 2063-2067, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30334714
14.
J Clin Virol ; 108: 1-5, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30195090

RESUMEN

BACKGROUND: PCR-based techniques for the diagnosis of community- acquired severe lower respiratory tract infections are becoming the standard of care. However, their relative ability to identify either atypical bacteria or viruses that cause LRTI from clinical samples from various sources is yet to be determined. OBJECTIVES AND STUDY DESIGN: The aim of our study was to compare the diagnostic yield of nasopharyngeal aspirates with that of pulmonary samples for the etiological diagnosis of severe acute lower respiratory tract infections by multiplex PCR. Patients were adults with community-acquired pneumonia or acute exacerbation of chronic obstructive pulmonary disease. RESULTS: We obtained concordant results for 81 (79%) of the 103 pairs of samples. In 14 of the 22 discordant results, more pathogens were evidenced in the lower respiratory tract samples. CONCLUSIONS: Pulmonary samples had a similar diagnostic sensitivity for virus detection by multiplex PCR as nasopharyngeal aspirates. In contrast, in our study, the diagnostic efficacy of pulmonary samples for Legionella pneumophila over simple aspirates was clearly superior.


Asunto(s)
Bacterias/aislamiento & purificación , Infecciones Comunitarias Adquiridas/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex , Infecciones del Sistema Respiratorio/diagnóstico , Virus/aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nasofaringe , Neumonía/diagnóstico , Neumonía/microbiología , Neumonía/virología , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Sensibilidad y Especificidad , Succión , Adulto Joven
15.
BMC Infect Dis ; 18(1): 451, 2018 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-30180811

RESUMEN

BACKGROUND: The impact of different classes of microbial pathogens on mortality in severe community-acquired pneumonia is not well elucidated. Previous studies have shown significant variation in the incidence of viral, bacterial and mixed infections, with conflicting risk associations for mortality. We aimed to determine the risk association of microbial aetiologies with hospital mortality in severe CAP, utilising a diagnostic strategy incorporating molecular testing. Our primary hypothesis was that respiratory viruses were important causative pathogens in severe CAP and was associated with increased mortality when present with bacterial pathogens in mixed viral-bacterial co-infections. METHODS: A retrospective cohort study from January 2014 to July 2015 was conducted in a tertiary hospital medical intensive care unit in eastern Singapore, which has a tropical climate. All patients diagnosed with severe community-acquired pneumonia were included. RESULTS: A total of 117 patients were in the study. Microbial pathogens were identified in 84 (71.8%) patients. Mixed viral-bacterial co-infections occurred in 18 (15.4%) of patients. Isolated viral infections were present in 32 patients (27.4%); isolated bacterial infections were detected in 34 patients (29.1%). Hospital mortality occurred in 16 (13.7%) patients. The most common bacteria isolated was Streptococcus pneumoniae and the most common virus isolated was Influenza A. Univariate and multivariate logistic regression showed that serum procalcitonin, APACHE II severity score and mixed viral-bacterial infection were associated with increased risk of hospital mortality. Mixed viral-bacterial co-infections were associated with an adjusted odds ratio of 13.99 (95% CI 1.30-151.05, p = 0.03) for hospital mortality. CONCLUSIONS: Respiratory viruses are common organisms isolated in severe community-acquired pneumonia. Mixed viral-bacterial infections may be associated with an increased risk of mortality.


Asunto(s)
Infecciones Comunitarias Adquiridas/diagnóstico , Neumonía Bacteriana/diagnóstico , Neumonía Viral/diagnóstico , Anciano , Calcitonina/sangre , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Mortalidad Hospitalaria , Humanos , Virus de la Influenza B/aislamiento & purificación , Unidades de Cuidados Intensivos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/complicaciones , Neumonía Bacteriana/microbiología , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Singapur , Streptococcus pneumoniae/aislamiento & purificación
16.
Virol J ; 15(1): 123, 2018 08 07.
Artículo en Inglés | MEDLINE | ID: mdl-30086789

RESUMEN

BACKGROUND: Pneumonia is a serious public health issue and is concerned around the world. This study is to investigate the association between viral load in children with human adenovirus (HAdV) pneumonia and disease severity. METHODS: A total of 1313 cases of children hospitalized in Hunan Provincial People's Hospital due to community acquired pneumonia (CAP) from April 2011 to May 2014 were enrolled in this study. Samples of nasopharyngeal aspirate were collected for the cohort. WHO criteria for CAP grading was emerged for pneumonia severity classification. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect 12 kinds of respiratory viruses. HAdV types were identified by nested PCR. The relationship between HAdV load and severity of disease was there by analyzed. RESULTS: Finally, 174 cases (174/1313, 13.3%) were positive for HAdV, and HAdV type 7 (HAdV-7) was the main serotype (76/174, 43.7%). Among the 174 cases, 70 cases were with HAdV infection alone and 104 cases were accompanied by other viruses. The patients were divided into mild pneumonia group (n = 108 cases) and severe pneumonia group (n = 66 cases). HAdV load of children in severe pneumonia group was higher than that in mild pneumonia group. Similar result was obtained in the 70 cases with HAdV infection alone after subgrouping. Relevant factors analysis results showed that severe pneumonia children presented lower onset age, more prone to fever, longer fever time, and longer hospital stay compared with that of mild pneumonia children. Children with HAdV-7 infection developed more frequently severe pneumonia. Multivariate regression analysis showed that HAdV load, age, and fever time were risk factors for pneumonia severity. CONCLUSION: The severity of HAdV infection is significantly correlated with viral load and serotype.


Asunto(s)
Infecciones por Adenovirus Humanos/virología , Adenovirus Humanos/fisiología , Neumonía/virología , Sistema Respiratorio/virología , Carga Viral , Adenovirus Humanos/genética , Adolescente , Niño , Preescolar , Coinfección , Infecciones Comunitarias Adquiridas/virología , Femenino , Humanos , Lactante , Masculino , Sistema Respiratorio/metabolismo , Infecciones del Sistema Respiratorio/virología , Índice de Severidad de la Enfermedad
17.
Arch Virol ; 163(10): 2855-2860, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29961119

RESUMEN

We developed a panel of multiplex quantitative real-time reverse transcription polymerase chain reaction (mqRT-PCR) assay consisting of seven internally controlled qRT-PCR assays to detect 16 different respiratory viruses. We compared the new mqRT-PCR with a previously reported two-tube mRT-PCR assay using 363 clinical sputum specimens. The mqRT-PCR assay performed comparably with the two-tube assay for most viruses, offering the advantages of quantitative analysis, easier performance, lower susceptibility to contamination, and shorter turnaround time in laboratories equipped with conventional real-time PCR instrumentation, and it could therefore be a valuable tool for routine surveillance of respiratory virus infections in China.


Asunto(s)
Infecciones Comunitarias Adquiridas/virología , Reacción en Cadena de la Polimerasa Multiplex/métodos , Neumonía/virología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Infecciones del Sistema Respiratorio/virología , Virus/aislamiento & purificación , Infecciones Comunitarias Adquiridas/diagnóstico , Humanos , Neumonía/diagnóstico , Infecciones del Sistema Respiratorio/diagnóstico , Virus/clasificación , Virus/genética
18.
J Clin Virol ; 105: 77-83, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29908521

RESUMEN

BACKGROUND: Community-acquired pneumonia (CAP) causes a major burden to the health care system among children under-5 years worldwide. Information on respiratory viruses in non-severe CAP cases is scarce. OBJECTIVES: To estimate the frequency of respiratory viruses among non-severe CAP cases. STUDY DESIGN: Prospective study conducted in Salvador, Brazil. Out of 820 children aged 2-59 months with non-severe CAP diagnosed by pediatricians (respiratory complaints and radiographic pulmonary infiltrate/consolidation), recruited in a clinical trial (ClinicalTrials.gov Identifier NCT01200706), nasopharyngeal aspirate samples were obtained from 774 (94.4%) patients and tested for 16 respiratory viruses by PCRs. RESULTS: Viruses were detected in 708 (91.5%; 95%CI: 89.3-93.3) cases, out of which 491 (69.4%; 95%CI: 65.9-72.7) harbored multiple viruses. Rhinovirus (46.1%; 95%CI: 42.6-49.6), adenovirus (38.4%; 95%CI: 35.0-41.8), and enterovirus (26.5%; 95%CI: 23.5-29.7) were the most commonly found viruses. The most frequent combination comprised rhinovirus plus adenovirus. No difference was found in the frequency of RSVA (16.1% vs. 14.6%; P = 0.6), RSVB (10.9% vs. 13.2%; P = 0.4) influenza (Flu) A (6.3% vs. 5.1%; P = 0.5), FluB (4.5% vs. 1.8%; P = 0.09), parainfluenza virus (PIV) 1 (5.1% vs. 2.8%; P = 0.2), or PIV4 (7.7% vs. 4.1%; P = 0.08), when children with multiple or sole virus detection were compared. Conversely, rhinovirus, adenovirus, enterovirus, bocavirus, PIV2, PIV3, metapneumovirus, coronavirus OC43, NL63, 229E were significantly more frequent among cases with multiple virus detection. CONCLUSIONS: Respiratory viruses were detected in over 90% of the cases, out of which 70% had multiple viruses. Several viruses are more commonly found in multiple virus detection whereas other viruses are similarly found in sole and in multiple virus detection.


Asunto(s)
Infecciones Comunitarias Adquiridas/virología , Neumonía Viral/epidemiología , Virosis/epidemiología , Virus/aislamiento & purificación , Brasil/epidemiología , Preescolar , Coinfección/epidemiología , Coinfección/virología , Infecciones Comunitarias Adquiridas/epidemiología , Coronavirus/genética , Coronavirus/aislamiento & purificación , Femenino , Humanos , Lactante , Masculino , Metapneumovirus/genética , Metapneumovirus/aislamiento & purificación , Nasofaringe/virología , Neumonía Viral/diagnóstico , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Virus Sincitiales Respiratorios/genética , Virus Sincitiales Respiratorios/aislamiento & purificación , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Rhinovirus/genética , Rhinovirus/aislamiento & purificación , Virosis/diagnóstico , Virus/genética
19.
Oncol Res Treat ; 41(6): 406-410, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29734194

RESUMEN

Infections remain a threat for patients with haematological malignancies. In accordance with the European Hematology Association roadmap we provide a concise overview regarding the most relevant current challenges in infectious diseases for haematologists. These include bacterial infections and the need for antibiotic stewardship as well as infections with community-acquired respiratory viruses, infections in patients receiving targeted therapies, re-activations of latent infections and vaccination strategies. The following review intends to summarise the most relevant information for clinicians currently caring for patients with haematological malignancies. Recommendations given are based on the guidelines published by the Infectious Diseases Working Party of the German Society of Haematology and Medical Oncology.


Asunto(s)
Infecciones Bacterianas/terapia , Enfermedades Transmisibles/terapia , Infecciones Comunitarias Adquiridas/terapia , Neoplasias Hematológicas/terapia , Hematología/métodos , Gripe Humana/terapia , Antibacterianos/uso terapéutico , Antineoplásicos/uso terapéutico , Infecciones Bacterianas/microbiología , Enfermedades Transmisibles/metabolismo , Enfermedades Transmisibles/virología , Infecciones Comunitarias Adquiridas/virología , Neoplasias Hematológicas/microbiología , Neoplasias Hematológicas/virología , Humanos , Gripe Humana/virología , Vacunación/métodos
20.
BMC Pulm Med ; 18(1): 84, 2018 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-29788952

RESUMEN

BACKGROUND: Bronchiectasis is a chronic respiratory condition. Persistent bacterial colonisation in the stable state with increased and sometimes altered bacterial burden during exacerbations are accepted as key features in the pathophysiology. The extent to which respiratory viruses are present during stable periods and in exacerbations is less well understood. METHODS: This study aimed to determine the incidence of respiratory viruses within a cohort of bronchiectasis patients with acute exacerbations at a teaching hospital and, separately, in a group of patients with stable bronchiectasis. In the group of stable patients, a panel of respiratory viruses were assayed for using real time quantitative PCR in respiratory secretions and exhaled breath. The Impact of virus detection on exacerbation rates and development of symptomatic infection was evaluated. RESULTS: Routine hospital-based viral PCR testing was only requested in 28% of admissions for an exacerbation. In our cohort of stable bronchiectasis patients, viruses were detected in 92% of patients during the winter season, and 33% of patients during the summer season. In the 2-month follow up period, 2 of 27 patients presented with an exacerbation. CONCLUSIONS: This pilot study demonstrated that respiratory viruses are commonly detected in patients with stable bronchiectasis. They are frequently detected during asymptomatic viral periods, and multiple viruses are often present concurrently.


Asunto(s)
Bronquiectasia/fisiopatología , Bronquiectasia/virología , Pulmón/fisiopatología , Pulmón/virología , Virosis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/virología , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Retrospectivos , Estaciones del Año , Espirometría , Virosis/complicaciones , Virosis/diagnóstico , Virus/genética , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA