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1.
MMWR Morb Mortal Wkly Rep ; 68(53): 1201-1205, 2020 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-31945036

RESUMEN

Control of communicable diseases in children, including respiratory and diarrheal illnesses that affect U.S. school-aged children, might require public health preventive efforts both in the home and at school, a primary setting for transmission. National Health Interview Survey (NHIS) data on school absenteeism and gastrointestinal and respiratory illnesses in the United States during 2010-2016 were analyzed to examine their associations with income. Prevalence of gastrointestinal and respiratory illnesses (queried for the 2 weeks preceding the survey) increased as income decreased. The likelihood of missing any school days during the past year decreased with reduced income. However, among children who missed school, those from low-income households missed more days of school than did children from higher income households. Although the reason for absenteeism cannot be ascertained from this analysis, these data underscore the importance of preventive measures (e.g. hand hygiene promotion and education) and the opportunity for both homes and schools to serve as important points for implementation of public health preventive measures, including improved hand hygiene practices.


Asunto(s)
Absentismo , Enfermedades Gastrointestinales/epidemiología , Renta/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Instituciones Académicas , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Estados Unidos/epidemiología
2.
Medicine (Baltimore) ; 99(4): e18584, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977849

RESUMEN

To evaluate epidemiology and risk factors of severe adenovirus respiratory infection in hospitalized children in Guangzhou, China.A retrospective review study was conducted, and 542 children hospitalized for adenovirus respiratory infection, were included from January 2011 to December 2014. Patients were younger than 14 years. Disease severity was classified into severe and mild. Laboratory tests and clinical characteristics were analyzed for risk factors of adenovirus respiratory infection by multivariable logistic regression.Among these 542 children, 92.1% were aged < 6 years. Clinical diagnoses were upper respiratory infections in 11.6%, bronchiolitis in 16%, and mild pneumonia in 62.0% of children. Severe pneumonia rate was 10.3% (56/542) with a mortality rate of 0.9% (5/542). The cohort comprised 542 patients; 486 patients with mild adenovirus respiratory infection and 56 patients with severe adenovirus respiratory infection. Multivariable logistic regression was used to confirm associations between variables and adenovirus respiratory infection, after age and gender adjustment. Hospital stay, still significantly associated with adenovirus respiratory infection. Patients with longer hospital stay (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.13-1.28, P < .001), lower LYMPH (OR = 0.73 95% CI: 0.55-0.99, P = .039), and increased LDH (OR = 1.002, 95% CI: 1.001-1.003, P =  .001) had a higher risk of severe adenovirus respiratory infection.Adenovirus is a major pathogen in hospitalized children with respiratory infection. High serum LDH level and low lymphocyte count could be used as predictors of adenovirus respiratory infection severity in children.


Asunto(s)
Infecciones por Adenovirus Humanos/epidemiología , Niño Hospitalizado/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Infecciones por Adenovirus Humanos/mortalidad , Adolescente , Factores de Edad , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Tiempo de Internación , Modelos Logísticos , Masculino , Neumonía/epidemiología , Infecciones del Sistema Respiratorio/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales
3.
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
4.
Rev Soc Bras Med Trop ; 53: e20170498, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31859936

RESUMEN

INTRODUCTION: We report the results of the active surveillance of influenza infections in hospitalized patients and the evaluation of the seasonality and correlation with temperature and rainfall data. METHODS: During the 2-year study period, 775 patients were tested for 15 respiratory viruses (RVs). RESULTS: Most of the 57% of (n=444) virus-positive samples were human rhinovirus and respiratory syncytial virus. However, 10.4% (n=46) were influenza virus (80% FluA; 20% FluB). Age and SARI were significantly associated with influenza. FluB circulation was higher is 2013. CONCLUSIONS: In the post-epidemic period, influenza remains an important cause of hospitalization in SARI patients.


Asunto(s)
Gripe Humana/epidemiología , Infecciones del Sistema Respiratorio/virología , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Derivación y Consulta , Infecciones del Sistema Respiratorio/epidemiología , Estaciones del Año , Vigilancia de Guardia , Índice de Severidad de la Enfermedad , Adulto Joven
5.
Pan Afr Med J ; 33: 239, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692895

RESUMEN

Introduction: Streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is an important source of horizontal spread of these pathogens within the community. Methods: A questionnaire was addressed to parents for the collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of < 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. Results: A total of 637 children aged 1 to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was 47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus. Conclusion: These results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases in children.


Asunto(s)
Portador Sano/epidemiología , Nasofaringe/microbiología , Infecciones del Sistema Respiratorio/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Antibacterianos/administración & dosificación , Portador Sano/microbiología , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Niger , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Vacunas Neumococicas/administración & dosificación , Infecciones del Sistema Respiratorio/microbiología , Factores de Riesgo , Encuestas y Cuestionarios
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(10): 1056-1059, 2019 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-31607055

RESUMEN

We analyzed the influenza surveillance data of Children's Hospital of Suzhou University from 2016 to 2018 and estimated the hospitalization burden of children under 5 years old due to influenza infection in Suzhou. The results showed that the influenza virus positive rate of 1 451 severe acute respiratory infection (SARI) cases in Children's Hospital of Suzhou University was 13.6% (95%CI: 11.8%-15.3%; 197 cases), among which the influenza pandemic intensity in 2017-2018 was relatively high, and A/H1N1 was the main pandemic virus. It was estimated that the hospitalization rate of influenza-related SARI in children under 5 years old in Suzhou was 6.9‰ (95%CI: 6.6‰-7.2‰), among which the hospitalization rate of children aged<6 months was higher, up to 11.4‰ (95%CI: 9.9‰-12.8‰).


Asunto(s)
Gripe Humana/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Niño , Preescolar , China/epidemiología , Hospitalización , Humanos , Lactante , Subtipo H1N1 del Virus de la Influenza A
7.
Isr Med Assoc J ; 21(9): 595-598, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31542903

RESUMEN

BACKGROUND: Adenovirus is responsible for 2-7% of childhood viral respiratory infections, 5-11% of viral pneumonia and bronchiolitis. Most are self-limited but may cause severe respiratory infection. OBJECTIVES: To describe adenovirus respiratory infection in immunocompetent children in a pediatric intensive care unit (PICU). METHODS: Children with adenovirus respiratory infection in our PICU from 2007 to 2016 were included. Data were retrospectively retrieved, including background, clinical manifestation, and treatment. Adenovirus was diagnosed by polymerase chain reaction, immune fluorescence, or both. RESULTS: Of 9397 samples, 956 were positive for adenovirus in children hospitalized during the study period. In total, 49 patients (aged 2 months-11.5 years) were admitted to our PICU, five were immunocompromised and excluded from the study, 19/44 (43%) were referred from other hospitals. Twenty-eight (64%) had underlying conditions, 66% had fever and cough, 11% had conjunctivitis, and 34% received antibiotics before admission. White blood cell counts ranged from 790 to 34,300 (mean 14,600) and 36% had counts above 15,000. Chest X-ray was consistent with viral infection in 77% of patients and normal in three (13.6%). Viral co-infection was found in 9 patients, 7 had presumed bacterial super-infection, and 27 (61.4%) needed mechanical ventilation. Two patients received cidofovir, 33 (75%) steroids, and 37 (84 %) antibiotics. Four patients died. CONCLUSIONS: Adenovirus respiratory infection may cause severe disease necessitating PICU admission and mechanical ventilation, mostly in patients with underlying conditions. Many patients received steroids and antibiotics, which may be unnecessary. Mortality was 9%, mainly among young infants and those with underlying conditions.


Asunto(s)
Adenoviridae/aislamiento & purificación , Infecciones por Adenovirus Humanos/epidemiología , Huésped Inmunocomprometido , Unidades de Cuidado Intensivo Pediátrico , Infecciones del Sistema Respiratorio/epidemiología , Niño , Preescolar , Comorbilidad , Femenino , Humanos , Lactante , Israel/epidemiología , Masculino , Estudios Retrospectivos
8.
BMJ ; 366: l5021, 2019 09 10.
Artículo en Inglés | MEDLINE | ID: mdl-31506273

RESUMEN

Human respiratory syncytial virus (RSV) belongs to the recently defined Pneumoviridae family, Orthopneumovirus genus. It is a negative sense, single stranded RNA virus that results in epidemics of respiratory infections that typically peak in the winter in temperate climates and during the rainy season in tropical climates. Generally, one of the two genotypes (A and B) predominates in a single season, alternating annually, although regional variation occurs. RSV is a cause of disease and death in children, older people, and immunocompromised patients, and its clinical effect on adults admitted to hospital is clarified with expanded use of multiplex molecular assays. Among adults, RSV produces a wide range of clinical symptoms including upper respiratory tract infections, severe lower respiratory tract infections, and exacerbations of underlying disease. Here we discuss the latest evidence on the burden of RSV related disease in adults, especially in those with immunocompromise or other comorbidities. We review current therapeutic and prevention options, as well as those in development.


Asunto(s)
Carga Global de Enfermedades , Infecciones por Virus Sincitial Respiratorio/epidemiología , Virus Sincitiales Respiratorios/genética , Infecciones del Sistema Respiratorio/epidemiología , Adulto , Antivirales/uso terapéutico , Epidemias , Genotipo , Humanos , Huésped Inmunocomprometido , Inmunoglobulinas Intravenosas/uso terapéutico , Infecciones por Virus Sincitial Respiratorio/inmunología , Infecciones por Virus Sincitial Respiratorio/terapia , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/patogenicidad , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/terapia , Infecciones del Sistema Respiratorio/virología , Ribavirina/uso terapéutico , Estaciones del Año
9.
Adv Exp Med Biol ; 1222: 75-80, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31559569

RESUMEN

People most at risk of influenza complications are the elderly with impaired immunity. Clinical picture of influenza virus infection includes symptoms such as chills, increased body temperature, dry cough, chest pain, or dizziness as well as headaches and muscle aches. In the diagnosis of influenza, quick and effective tests are necessary. Sensitive diagnostic methods of molecular biology require more time, but the result firmly confirm or exclude the presence of the genetic material of influenza or other respiratory viruses. Influenza vaccination plays an important role in combating influenza infection. Unfortunately, the awareness of vaccination benefits is insufficient in Poland. In this study we demonstrate the results of examination of 4,507 people aged over 14 years toward the influenza infection in the epidemic season of 2017/18. Most of the confirmed infections were reported in older people aged over 65, a high-risk population group. A low percentage of the vaccinated population may affect an increased number of confirmed influenza viruses in the elderly. The findings demonstrate a need to increase awareness of vaccination benefits, which is particularly essential to avoid influenza infection in the elderly.


Asunto(s)
Epidemias , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/diagnóstico , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Estaciones del Año , Vigilancia de Guardia , Adulto Joven
10.
Adv Exp Med Biol ; 1222: 55-62, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31529287

RESUMEN

In uncomplicated bronchiolitis, chest radiography (CR) is not routinely recommended, yet it is still frequently made. This study seeks to evaluate the use of CR in children with bronchiolitis due to a lower respiratory tract infection (RSV-RTI) with respiratory syncytial virus (RSV) and the influence of CR on patient treatment during the 2010-2017 seasons. There were 581 children included into the study: 459 with bronchiolitis (390 RSV-RTI and 69 non-RSV), 65 with RSV pneumonia and 57 with RSV bronchitis. We found that CR was performed in 28.6% (166/581) patients. CR was much more frequent in patients with RSV than non-RSV infections (61% vs. 31%). CR prognostic sensitivity and specificity in guiding antibiotic treatment was low, 78% and 58%, respectively. Positive and negative predicted values of CR were 78% and 58%, respectively and the number needed to diagnose was 2.777. Children in whom CR was performed (irrespective of the result) were at 22.9-fold higher risk of antibiotic therapy (95%CI: 14.1-37.1; p < 0.01), while those with a positive CR were only at 4.4-fold higher risk of antibiotic therapy (95%CI: 2.2-8.9; p < 0.01). Children with CR required a longer hospital stay than those without it (10 vs. 8 days, respectively; p < 0.01). The percentage of CR decreased from 78% in 2010 to 33% in 2017, with the lowest value of 11% in 2015. The additional cost of CR, which had no influence on treatment, would have been €381 had it been performed in each patient, which amounts to 1% of the total hospitalization cost. We conclude that CR is overused and in most cases it has no influence on the patient management. The recognition of practical meaning of CR is essential to avoid unnecessary radiation of children.


Asunto(s)
Bronquiolitis/diagnóstico por imagen , Hospitalización/estadística & datos numéricos , Radiografía/métodos , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Bronquiolitis/epidemiología , Bronquiolitis/virología , Preescolar , Humanos , Lactante , Tiempo de Internación , Neumonía/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Virus Sincitial Respiratorio Humano/aislamiento & purificación , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/virología
11.
J Med Microbiol ; 68(11): 1614-1621, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31524582

RESUMEN

Introduction. Mycoplasma pneumoniae is regarded as the important infectious agent of acute respiratory infections (ARIs) in the world. However, there is little knowledge about the prevalence of M. pneumoniae in Iran. Therefore, the aim of this study was to investigate the prevalence of M. pneumoniae in Iran through a meta-analysis of included studies.Methods. A systematic search was done by using electronic databases from papers that were published by Iranian authors to the end of February 2019. Then, 12 publications, which met our inclusion criteria, were enrolled for data extraction and analysis by using the 'metaprop program' in stata version 14.0.Results. The pooled prevalence of M. pneumoniae was 9 % (95 % confidence intervals: 5-16 %) ranging from 1 to 26 %. There was a significant heterogeneity among the 12 studies (X2=128.29; P<0.001; I 2=91.43 %). The funnel plot for publication bias showed no evidence of asymmetry.Conclusions. The frequency of M. pneumoniae in Iran is comparable with other parts of the world. Although the overall prevalence of M. pneumoniae was low, awareness about the distribution of these agent is very important because of higher infection rates in susceptible groups. In addition, these results showed the rates of M. pneumoniae had variation based on location, type of infection and sample, gender and detection rate and there was evidence of publication bias.


Asunto(s)
Mycoplasma pneumoniae/aislamiento & purificación , Neumonía por Mycoplasma/epidemiología , Neumonía por Mycoplasma/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Irán/epidemiología , Masculino , Persona de Mediana Edad , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/fisiología , Prevalencia , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/microbiología , Adulto Joven
12.
BMC Infect Dis ; 19(1): 770, 2019 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-31481020

RESUMEN

BACKGROUND: We sought to assess reporting in China's Pneumonia of Unknown Etiology (PUE) passive surveillance system for emerging respiratory infections and to identify ways to improve the PUE surveillance system's detection of respiratory infections of public health significance. METHODS: From February 29-May 29, 2016, we actively identified and enrolled patients in two hospitals with acute respiratory infections (ARI) that met all PUE case criteria. We reviewed medical records for documented exposure history associated with respiratory infectious diseases, collected throat samples that were tested for seasonal and avian influenza, and interviewed clinicians regarding reasons for reporting or not reporting PUE cases. We described and analyzed the proportion of PUE cases reported and clinician awareness of and practices related to the PUE system. RESULTS: Of 2619 ARI admissions in two hospitals, 335(13%) met the PUE case definition; none were reported. Of 311 specimens tested, 18(6%) were seasonal influenza virus-positive; none were avian influenza-positive. < 10% PUE case medical records documented whether or not there were exposures to animals or others with respiratory illness. Most commonly cited reasons for not reporting cases were no awareness of the PUE system (76%) and not understanding the case definition (53%). CONCLUSIONS: Most clinicians have limited awareness of and are not reporting to the PUE system. Exposures related to respiratory infections are rarely documented in medical records. Increasing clinicians' awareness of the PUE system and including relevant exposure items in standard medical records may increase reporting.


Asunto(s)
Notificación de Enfermedades , Necesidades y Demandas de Servicios de Salud , Neumonía/epidemiología , Neumonía/etiología , Vigilancia de la Población , Adulto , China/epidemiología , Enfermedades Transmisibles Emergentes/diagnóstico , Enfermedades Transmisibles Emergentes/epidemiología , Diagnóstico Diferencial , Notificación de Enfermedades/métodos , Notificación de Enfermedades/normas , Femenino , Necesidades y Demandas de Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/normas , Hospitalización , Humanos , Gripe Humana/epidemiología , Masculino , Notificación Obligatoria , Exámenes Obligatorios/normas , Persona de Mediana Edad , Proyectos Piloto , Neumonía/diagnóstico , Vigilancia de la Población/métodos , Pautas de la Práctica en Medicina/organización & administración , Pautas de la Práctica en Medicina/normas , Evaluación de Programas y Proyectos de Salud , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/etiología , Compromiso Laboral
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 880-882, 2019 Aug 10.
Artículo en Chino | MEDLINE | ID: mdl-31484247

RESUMEN

The recent developed diarrhea and acute respiratory infections surveillance systems were a breakthrough of the infectious disease surveillance and monitoring in Shanghai. This series "Infectious Disease Surveillance in Shanghai" briefly introduced current experiences of the updated surveillance systems, in order to provide evidences for promotion in other disease surveillance and to enhance the connection between different surveillance systems.


Asunto(s)
Diarrea/epidemiología , Control de Infecciones/métodos , Vigilancia de la Población/métodos , Vigilancia en Salud Pública/métodos , Enfermedad Aguda , China/epidemiología , Enfermedades Transmisibles/epidemiología , Brotes de Enfermedades , Humanos , Infecciones del Sistema Respiratorio/epidemiología , Vigilancia de Guardia
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 904-910, 2019 Aug 10.
Artículo en Chino | MEDLINE | ID: mdl-31484252

RESUMEN

Objective: To analyze the etiologic and epidemiological characteristics of adult acute respiratory infections in Shanghai during 2015-2017. Methods: Data was collected from outpatients with acute respiratory infections who visited the Fever Clinics in three hospitals of different levels in three administrative regions of Shanghai, from 2015 to 2017. Basic information and nasopharyngeal swabs were collected from cases in line with the inclusion criteria. Multiplex RT-PCR and bacterial cultures were performed to detect the respiratory pathogens. Results: A total of 806 individuals were enrolled from 2015 to 2017. Respiratory pathogens were identified in 73.45% (592/806) of the cases, with the virus detection rate as 66.75% (538/806). It was found that the major respiratory pathogens for virus detection were influenza A in 326 (40.45%), influenza B in 116 (14.39%), rhinovirus/enterovirus in 39 (4.84%) of the cases. The overall detection rate of bacteria was 16.13% (130/806), including Klebsiella pneumoniae in 90 (11.17%) cases, Staphylococcus Aureus in 46 (5.71%) cases. Other kind of bacteria were not detected in our study. The detection rates on Mycoplasma pneumoniae was 5.33% (43/806) and on Chlamydia pneumonia was 0.37% (3/806). Co-infection with multiple pathogens was detected in 18.61% (150/806) of the cases, including 135 with double infection (accounting for 90.00%), 14 with triple infection and 1 with quadruple infection (accounted for 9.33% and 0.67%, respectively). Among the 150 cases with co-infections, the main identified pathogens were influenza A, Klebsiella pneumoniae, Staphylococcus aureus, and Mycoplasma pneumoniae. Pathogens of acute respiratory infections that identified among the outpatients from the Fever Clinics at different time, region or population, the characteristics were different (P<0.001). Conclusions: In 2015-2017, outpatients with acute respiratory infections in Shanghai were mainly caused by influenza virus or other viruses, however dynamically with its composition, time, region and characteristics of the population. It is necessary to strengthen and combine related medical and preventive services and to develop the appropriate strategies regarding clinical diagnosis and treatment.


Asunto(s)
Bacterias/aislamiento & purificación , Infecciones Bacterianas/diagnóstico , Gripe Humana/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex/métodos , Nasofaringe , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/etiología , Virosis/diagnóstico , Virus/aislamiento & purificación , Enfermedad Aguda , Adulto , Bacterias/genética , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , China/epidemiología , Coinfección/diagnóstico , Enterovirus/genética , Enterovirus/aislamiento & purificación , Monitoreo Epidemiológico , Humanos , Incidencia , Virus de la Influenza A/genética , Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/genética , Virus de la Influenza B/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/virología , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Mycoplasma pneumoniae , Nasofaringe/microbiología , Nasofaringe/virología , Vigilancia de la Población , Infecciones del Sistema Respiratorio/diagnóstico , Rhinovirus/genética , Rhinovirus/aislamiento & purificación , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificación , Virosis/epidemiología , Virosis/virología , Virus/genética
15.
BMC Infect Dis ; 19(1): 764, 2019 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-31477038

RESUMEN

BACKGROUND: Environmental bacteria, nontuberculous mycobacteria (NTM), are recognized as one of the major human infection pathogens. NTM are prone to be mistaken as multidrug-resistant Mycobacterium tuberculosis and challenge our fight against TB. In addition, treatment of NTM per se is intractable. Remarkably, the distribution of NTM pathogenic species is geographically specific. Thus, it is very important to summarize the prevalent features and clinical symptoms of NTM pulmonary disease. However, In Nanjing district, southeast China, there is no such a report. METHODS: Through investigating electronic medical records and analyzing data of clinical examination system (Lis), we retrospectively summarized the NTM species from 6012 clinical isolates from May 2017 to August 2018, and analyzed the association between NTM species and clinical symptoms. RESULTS: Of 6012 clinical specimens, 1461 (24.3%) could grow in the MGIT 960 broth. Among these positive isolates, 1213 (83%) were M. tuberculosis, 22 (1.5%) were M. bovis, and 226 (15.5%) were NTM. After deducting redundancy, those NTM specimens were confirmed from 154 patients, among which, 87 (56.5%) patients met the full ATS/IDSA NTM disease criteria. The most common etiologic agent was M. intracellulare (70.1%). NTM infection was associated with age, based on which 68.6% male patients and 77.8% female patients were over 50 years old. The older patients were more likely to have hemoptysis, but the younger patients were more likely to manifest chest congestion. Male patients were more likely to have shortness of breath and females were more likely to have hemoptysis. The most common radiographic presentation of NTM pulmonary disease was bronchiectasis, accounting for 39.1%. Remarkably, multiple and thin-walled cavities were outstanding. The most frequent comorbidity of NTM disease was previous tuberculosis (64%), followed by clinical bronchiectasis (19.5%), HIV (19.5%), and 6.9% chronic obstructive pulmonary disease (COPD). There was no association between NTM species and clinical symptoms. CONCLUSION: This study retrospectively investigated the prevalence of NTM pulmonary disease in Nanjing district, southeast China. Similar to Beijing area, north China, M. intracellulare was the major pathogenic NTM species. Clinical symptoms of the disease were not species-specific. Previous TB and HIV infection immensely enhanced risk of NTM disease.


Asunto(s)
Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/epidemiología , Infecciones por Micobacterias no Tuberculosas/diagnóstico , Infecciones por Micobacterias no Tuberculosas/epidemiología , Micobacterias no Tuberculosas/aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , Bronquiectasia/diagnóstico , Bronquiectasia/epidemiología , Bronquiectasia/microbiología , China/epidemiología , Comorbilidad , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/microbiología , Humanos , Enfermedades Pulmonares/microbiología , Masculino , Persona de Mediana Edad , Infecciones por Micobacterias no Tuberculosas/microbiología , Micobacterias no Tuberculosas/clasificación , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/microbiología , Estudios Retrospectivos , Adulto Joven
17.
BMC Infect Dis ; 19(1): 681, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31370781

RESUMEN

BACKGROUND: Human adenoviruses (HAdV) are important pathogens of pediatric respiratory tract infections in Taiwan. There were two major HAdV epidemics in southern Taiwan in 2011 and 2014, respectively. METHODS: The demographic, clinical characteristics, and risk factors for hospitalization of pediatric patients with HAdV infection in the two outbreaks were retrospectively compared. The epidemic was defined as > 7% HAdV detection rate for six consecutive weeks. HAdV infection was defined as positive HAdV isolates from respiratory tract specimens. HAdV genotype was determined by PCR-based hexon gene sequencing. RESULTS: A total of 1145 pediatric patients were identified (635 cases in 2011; 510 cases in 2014). HAdV genotype 3 and 7 contributed to both epidemics, although the proportion of HAdV3 decreased significantly (64.7% in 2011 to 25.5% in 2014, p < 0.001) and was replaced by other genotypes (type 1, 4, and 6) in the 2014 epidemic. Among the hospitalized patients, there were more patients hospitalized with bronchopneumonia/or pneumonia in the 2011 epidemic (10.6% vs 5.1%, p < 0.001), while more patients hospitalized with acute pharyngitis/pharyngoconjunctival fever (63.9% vs. 38.6%, p < 0.001) in the 2014 epidemic. In both epidemics, hospitalized patients had higher WBC and C-reactive protein (CRP) levels than non-hospitalized patients. Using multivariate regression analysis, underlying disease and elevated CRP levels were independent risk factors for hospitalization in both epidemics. CONCLUSION: There were significant differences in clinical, viral characteristics and risk factors of hospitalization between the 2011 and 2014 epidemics. Understanding changes in the epidemiological and clinical characteristics of HAdV epidemics is important from a public health perspective.


Asunto(s)
Infecciones por Adenovirus Humanos/epidemiología , Infecciones por Adenovirus Humanos/etiología , Infecciones del Sistema Respiratorio/epidemiología , Adenovirus Humanos/genética , Adenovirus Humanos/patogenicidad , Niño , Preescolar , Brotes de Enfermedades , Epidemias , Femenino , Genotipo , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Masculino , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Reacción en Cadena de la Polimerasa , Infecciones del Sistema Respiratorio/virología , Estudios Retrospectivos , Factores de Riesgo , Taiwán/epidemiología
18.
J Med Microbiol ; 68(10): 1408-1418, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31418679

RESUMEN

Respiratory tract infections are responsible for over 2.8 million deaths per year worldwide. Colonization is the first step in the process of microbes occupying the respiratory tract, which may lead to subsequent infection. Carriage, in contrast, is defined as the occupation of microbial species in the respiratory tract. The duration of carriage may be affected by host immunity, the composition and interactions between members of the microbial community, and the characteristics of colonizing bacteria, including physiology associated with being present in a bacterial biofilm. Numerous vaccines have been implemented to control infections caused by bacteria that can colonize and be subsequently carried. Such vaccines are often species-specific and may target a limited number of strains thereby creating a vacant niche in the upper respiratory tract. Epidemiological changes of bacteria found in both carriage and disease have therefore been widely reported, since the vacant niche is filled by other strains or species. In this review, we discuss the use of carriage-prevalence studies in vaccine evaluation and argue that such studies are essential for (1) examining the epidemiology of carriage before and after the introduction of new vaccines, (2) understanding the dynamics of the respiratory tract flora and (3) identifying the disease potential of emerging strains. In an era of increasing antibiotic resistance, bacterial carriage-prevalence studies are essential for monitoring the impact of vaccination programmes.


Asunto(s)
Infecciones Bacterianas/microbiología , Vacunas Bacterianas/inmunología , Portador Sano/microbiología , Infecciones del Sistema Respiratorio/microbiología , Animales , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/inmunología , Infecciones Bacterianas/prevención & control , Vacunas Bacterianas/administración & dosificación , Vacunas Bacterianas/genética , Portador Sano/epidemiología , Portador Sano/inmunología , Portador Sano/prevención & control , Humanos , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/prevención & control , Vacunación
19.
Internist (Berl) ; 60(11): 1136-1145, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31455974

RESUMEN

BACKGROUND: There are six human pathogenic coronaviruses (CoV), which mainly cause infections of the respiratory system. In everyday clinical practice, it is helpful to know the relevance and characteristics of these pathogens. OBJECTIVE: To present the epidemiology, clinical picture and differences of human pathogenic CoV and to provide information on the diagnostics and treatment of patients suspected of having CoV infections. MATERIAL AND METHODS: Selective literature search, presentation of results and discussion of fundamental works and expert recommendations, including publications by the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC) and the Robert Koch Institute. RESULTS: The four endemic human CoVs (HCoV-NL63, HCoV-229E, HCoV-OC43 and HCoV-HKU1) mainly cause mild respiratory tract infections. In addition to these four endemic HCoV, the two epidemic CoV, severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV can cause severe pneumonia. The SARS-CoV has not been detected in humans in the last 15 years and MERS-CoV has been circulating mainly on the Arabian Peninsula since 2012; however, neither a specific treatment nor approved vaccines exist for any of the six human pathogenic CoVs. CONCLUSION: All six human CoVs can be diagnosed using RT-PCR on respiratory specimens but this is rarely necessary for the four endemic strains. In current clinical practice SARS-CoV has no importance as it has not been detected in humans for 15 years; however, a possible MERS-CoV infection should be taken into account in patients with typical symptoms and travel history to endemic regions. In this case, rapid diagnostic and general hygiene practices are important to prevent further transmission.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Coronavirus , Infecciones del Sistema Respiratorio , Síndrome Respiratorio Agudo Grave/diagnóstico , Betacoronavirus , Coronavirus Humano 229E , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Coronavirus Humano NL63 , Coronavirus Humano OC43 , Humanos , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/virología
20.
BMC Infect Dis ; 19(1): 729, 2019 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-31429710

RESUMEN

BACKGROUND: No comparison data have been reported on viral and epidemiological profiles of hospitalized children with severe acute respiratory infection (SARI) in Beijing or Shanghai, China. METHODS: We collected 700 nasopharyngeal aspirates (NPA) from hospitalized children with SARI in Beijing (northern China) and Shanghai (southern China). Multiple respiratory viruses (including 15 common viruses) were screened by validated polymerase chain reaction (PCR) or real-time reverse transcription-PCR assays and confirmed by sequencing. Demographic data and the distribution of viral infections were also examined. RESULTS: Of 700 samples, 547 (78.1%) tested positive for viral infections. The picornaviruses (PIC), which included rhinovirus (RV) and enterovirus (EV), were the most common (34.0%), followed by respiratory syncytial virus (RSV) (28.3%), human bocavirus (HBoV) (19.1%), adenovirus (ADV) (13.7%), human coronaviruses (HCoV) (10.7%), influenza A and B (8.9%), parainfluenza virus (PIV 1-3) (7.9%), and human metapneumovirus (HMPV) (5.0%). PIC (RV/EV) and RSV were the most prevalent etiological agents of SARI in both cities. The total and age-matched prevalence of RSV, HCoV, and hMPV among SARI children under 5 years old were significantly higher in Beijing than in Shanghai. Different age and seasonal distribution patterns of the viral infections were found between Beijing and Shanghai. CONCLUSIONS: Viral infection was tested and shown to be the most prevalent etiological agent among children with SARI in either the Beijing or the Shanghai area, while showing different patterns of viral and epidemiological profiles. Our findings provide a better understanding of the roles of geographic location and climate in respiratory viral infections in hospitalized children with SARI.


Asunto(s)
Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Infecciones por Adenoviridae/epidemiología , Infecciones por Adenoviridae/virología , Beijing/epidemiología , Preescolar , China/epidemiología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Gripe Humana/epidemiología , Gripe Humana/virología , Masculino , Infecciones por Paramyxoviridae/epidemiología , Infecciones por Paramyxoviridae/virología , Infecciones por Parvoviridae/epidemiología , Infecciones por Parvoviridae/virología , Infecciones por Picornaviridae/epidemiología , Infecciones por Picornaviridae/virología , Prevalencia , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/virología , Infecciones por Respirovirus/epidemiología , Infecciones por Respirovirus/virología
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