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1.
Rev Esp Quimioter ; 34(2): 81-92, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-33749214

RESUMO

From a microbiological point of view, both empirical and targeted antimicrobial treatment in respiratory infection is based on the sensitivity profile of isolated microorganisms and the possible resistance mechanisms that they may present. The latter may vary in different geographic areas according to prescription profiles and vaccination programs. Beta-lactam antibiotics, fluoroquinolones, and macrolides are the most commonly used antimicrobials during the exacerbations of chronic obstructive pulmonary disease and community-acquired pneumonia. In their prescription, different aspects such as intrinsic activity, bactericidal effect or their ability to prevent the development of resistance must be taken into account. The latter is related to the PK/PD parameters, the mutant prevention concentration and the so-called selection window. More recently, the potential ecological impact has grown in importance, not only on the intestinal microbiota, but also on the respiratory one. Maintaining the state of eubiosis requires the use of antimicrobials with a low profile of action on anaerobic bacteria. With their use, the resilience of the bacterial populations belonging to the microbiota, the state of resistance of colonization and the collateral damage related to the emergence of resistance to the antimicrobials in pathogens causing the infections and in the bacterial populations integrating the microbiota.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Infecções Respiratórias/tratamento farmacológico , Administração Oral , Antibacterianos/administração & dosagem , Chlamydophila pneumoniae/efeitos dos fármacos , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Progressão da Doença , Microbioma Gastrointestinal/efeitos dos fármacos , Haemophilus influenzae/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Moraxella catarrhalis/efeitos dos fármacos , Mycoplasma pneumoniae/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Doença Pulmonar Obstrutiva Crônica/microbiologia , Infecções Respiratórias/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Streptococcus pneumoniae/efeitos dos fármacos
2.
PLoS One ; 16(3): e0248750, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33750952

RESUMO

BACKGROUND: Severe acute respiratory infection (SARI) results in a tremendous disease burden worldwide. Available research on active surveillance among hospitalized adult patients suffering from SARI in China is limited. This pilot study aimed to identify associated etiologies and describe the demographic, epidemiological and clinical profiles of hospitalized SARI patients aged over 16 years in Jinshan, Shanghai. METHODS: Active surveillance was conducted at 1 sentinel hospital in Jinshan district, Shanghai, from April 2017 to March 2018. Hospitalized SARI patients aged over 16 years old were enrolled, and nasopharyngeal swabs were collected within 24 hours of admission and tested for multiple respiratory viruses (including 18 common viruses) and Mycoplasma pneumoniae with real-time polymerase chain reaction. Demographic, epidemiological and clinical information was obtained from case report forms. RESULTS: In total, 397 SARI patients were enrolled; the median age was 68 years, and 194 (48.9%) patients were male. A total of 278 (70.0%) patients had at least one underlying chronic medical condition. The most frequent symptoms were cough (99.2%) and sputum production (88.4%). The median duration of hospitalization was 10 days. A total of 250 infection patients (63.0%) were positive for at least one pathogen, of whom 198 (49.9%) were positive for a single pathogen and 52 (13.1%) were positive for multiple pathogens. The pathogens identified most frequently were M. pneumoniae (23.9%, 95/397), followed by adenovirus (AdV) (11.6%, 46/397), influenza virus A/H3N2 (Flu A/H3N2) (11.1%, 44/397), human rhinovirus (HRhV) (8.1%, 32/397), influenza virus B/Yamagata (Flu B/Yamagata) (6.3%, 25/397), pandemic influenza virus A/H1N1 (Flu A/pH1N1) (4.0%, 16/397), parainfluenza virus (PIV) type 1 (2.0%, 8/397), human coronavirus (HCoV) type NL63 (2.0%, 8/397), HCoV 229E (1.5%, 6/397), HCoV HKU1 (1.5%, 6/397), PIV 3 (1.5%, 6/397), human metapneumovirus (HMPV) (1.5%, 6/397), PIV 4 (1.3%, 5/397), HCoV OC43 (1.0%, 4/397), influenza virus B/Victoria (Flu B/Victoria) (0.5%, 2/397), respiratory syncytial virus (RSV) type B (0.5%, 2/397), and human bocavirus (HBoV) (0.3%, 1/397). The seasonality of pathogen-confirmed SARI patients had a bimodal distribution, with the first peak in the summer and the second peak in the winter. Statistically significant differences were observed with respect to the rates of dyspnea, radiographically diagnosed pneumonia and the presence of at least one comorbidity in patients who were infected with only M. pneumoniae, AdV, HRhV, Flu A/H3N2, Flu A /pH1N1 or Flu B/Yamagata. The differences in the positivity rates of the above 6 pathogens among the different age groups were nonsignificant. CONCLUSIONS: M. pneumoniae, AdV and Flu A/H3N2 were the main pathogens detected in hospitalized SARI patients aged over 16 years old in Jinshan district, Shanghai. Our findings highlight the importance of sustained multipathogen surveillance among SARI patients in sentinel hospitals, which can provide useful information on SARI etiologies, epidemiology, and clinical characteristics.


Assuntos
Vírus de DNA/isolamento & purificação , Mycoplasma pneumoniae/isolamento & purificação , Vírus de RNA/isolamento & purificação , Infecções Respiratórias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , China , Tosse/etiologia , Feminino , Glucocorticoides/uso terapêutico , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/microbiologia , Nasofaringe/virologia , Projetos Piloto , Prognóstico , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Adulto Jovem
3.
BMC Infect Dis ; 21(1): 152, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546631

RESUMO

BACKGROUND: Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms. METHODS: BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified. RESULTS: The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens. CONCLUSION: Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.


Assuntos
Líquido da Lavagem Broncoalveolar/microbiologia , Líquido da Lavagem Broncoalveolar/virologia , Infecções Respiratórias/diagnóstico , Adolescente , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Criança , Criança Hospitalizada , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/microbiologia , Coinfecção/virologia , Testes Diagnósticos de Rotina , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Vírus/classificação , Vírus/genética , Vírus/isolamento & purificação
4.
BMC Infect Dis ; 21(1): 230, 2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33639884

RESUMO

BACKGROUND: Respiratory tract infections (RTIs) are the common diseases in children and the routine detection methods frequently fail to identify the infectious pathogens especially for viruses. The Filmarray respiratory panel (FARP) can reliably and rapidly identify viruses and bacteria pathogens. This study is to evaluate the performance and clinical significance of FARP in children. METHODS: Children diagnosed with RTIs in pediatric intensive care unit (PICU) were enrolled in this study. Nasopharyngeal secretion (NPS) samples of these children were collected and the FARP assay for 17 pathogens and routine microbiological methods were performed. Clinical data of all patients was also collected and evaluated. RESULTS: A total of 90 children were enrolled into this study and 58 patients (64.4%) were positive for 13 pathogens by FARP, with 18 being detected positive with multiple-virus (31.3%, 18/58). Human rhinovirus/enterovirus (21.0%%, 17/58) were the predominant pathogen, followed by adenovirus (18.5%). Higher proportions of various pathogens were identified in the infant and toddler (0-2 years) groups with human rhinovirus/enterovirus being mostly virus. Adenovirus were common in the group aged 3-5 years, but only three pathogens including M.pneumoniae, respiratory syncytial virus, and adenovirus were also found in age group (6-14 years). Among 58 FARP positive patients, significant differences were found in antibiotic prescription and use of glucocorticoid between the single-organism-positive group and the multi-organism-positive group (P < 0.05). Furthermore, there was significant difference in use of anti-virus and usage of glucocorticoid between severe respiratory infections group and non severe respiratory infections group (P < 0.05). CONCLUSIONS: This study demonstrated that FARP can provide the rapid detection of respiratory virus and atypical bacteria for children, especially with severe respiratory tract infections.


Assuntos
Técnicas Microbiológicas/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Infecções Respiratórias/diagnóstico , Virologia/métodos , Adolescente , Idade de Início , Bactérias/genética , Bactérias/isolamento & purificação , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica , Masculino , Nasofaringe/microbiologia , Nasofaringe/virologia , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estudos Retrospectivos , Vírus/genética , Vírus/isolamento & purificação
5.
J Clin Virol ; 135: 104737, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33497932

RESUMO

The GenMark Dx ePlex Respiratory Pathogen Panel (RP) is a multiplexed nucleic acid test for the qualitative detection of common viral and a few bacterial causes of respiratory tract infections. The ePlex RP has received FDA clearance for nasopharyngeal swab (NPS) specimens collected in viral transport media. In this study, we evaluated the performance of the ePlex RP panel in comparison to the NxTAG Respiratory Pathogen Panel (NxTAG-RPP) from Luminex in use in our laboratory, not only for NPS but also for bronchoalveolar lavage specimens (BAL). We also evaluated the impact of implementing the ePlex RP on the test turn-around time (TAT). The newest panel from GenMark Dx, the ePlex Respiratory Pathogen Panel 2 (RP2), which added the SARS-CoV-2 target to the RP was also evaluated for NPS. Verification of the performance of the ePlex RP for both NPS and BAL showed 93.3 % and 84.9 % total agreement with the NxTAG-RPP respectively. An overall comparison of the TAT after implementing the ePlex RP as compared to the NxTAG-RPP assay showed an average decrease of almost seven-fold.


Assuntos
Testes Diagnósticos de Rotina/métodos , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Infecções Respiratórias/diagnóstico , Lavagem Broncoalveolar/métodos , Humanos , Nasofaringe/microbiologia , Nasofaringe/virologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , /genética
6.
Med Sci Monit ; 27: e929783, 2021 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-33388738

RESUMO

BACKGROUND This retrospective study aimed to investigate co-infections with common respiratory pathogens and SARS-CoV-2 and laboratory biochemistry findings in patients with COVID-19 in the Zhuzhou area of China, in order to provide a reference for the disease assessment and clinical treatment of COVID-19. MATERIAL AND METHODS The clinical data of COVID-19 patients admitted to the hospital of Zhuzhou City from January 28 to March 15, 2020, as well as laboratory test results for respiratory pathogens and biochemical indicators, were collected to conduct correlation analyses. All patients were diagnosed based on fluorescence-based PCR assay for SARS-CoV-2. RESULTS Eleven of the 78 patients (14.1%) were co-infected with other respiratory pathogens, among which Mycoplasma pneumoniae (n=5, 45.5%) and respiratory syncytial virus (n=4, 36.4%) were the most frequent. There were 8 patients co-infected with 1 other pathogen and 3 patients co-infected with 2 other pathogens. Compared with mono-infected COVID-19 patients, patients with co-infections had significantly higher levels of procalcitonin (P=0.002). CONCLUSIONS The findings showed that Mycoplasma pneumonia and respiratory syncytial virus were the most common co-infections in patients with COVID-19 pneumonia. Increased levels of PCT in patients with COVID-19 pneumonia were associated with co-infection.


Assuntos
/epidemiologia , Coinfecção/epidemiologia , Pandemias , Infecções Respiratórias/epidemiologia , /isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/uso terapêutico , Biomarcadores , Proteína C-Reativa/análise , /diagnóstico , Criança , Pré-Escolar , China/epidemiologia , Creatina Quinase/sangue , Estudos Transversais , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/epidemiologia , Pró-Calcitonina/sangue , Infecções por Vírus Respiratório Sincicial/sangue , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/sangue , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
7.
Pediatr Infect Dis J ; 40(1): e36-e39, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33044434

RESUMO

The clinical presentation of human coronavirus (HCoV) infections in children varies strongly. We show that children with an HCoV-associated lower respiratory tract infection more frequently had respiratory syncytial virus codetected and higher abundance of Haemophilus influenzae/haemolyticus than asymptomatic HCoV carriers as well as children with a non-HCoV-associated lower respiratory tract infection. Viral and bacterial cooccurrence may drive symptomatology of HCoV-associated infections including coronavirus disease 2019.


Assuntos
Coinfecção/microbiologia , Coinfecção/virologia , Infecções por Coronavirus/patologia , Infecções Respiratórias/patologia , Bactérias/classificação , Bactérias/isolamento & purificação , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/patologia , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/microbiologia , Infecções por Coronavirus/virologia , Feminino , Haemophilus/classificação , Haemophilus/isolamento & purificação , Humanos , Lactente , Masculino , Países Baixos/epidemiologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Estações do Ano , Índice de Gravidade de Doença
8.
PLoS One ; 15(12): e0244681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378384

RESUMO

BACKGROUND: Inhaled corticosteroids (ICS) are the mainstay of asthma treatment, but evidence suggests a link between ICS usage and increased rates of respiratory infections. We assessed the composition of the asthmatic airways microbiome in asthma patients taking low and high dose ICS and the stability of the microbiome over a 2 week period. METHODS: We prospectively recruited 55 individuals with asthma. Of these, 22 were on low-dose ICS and 33 on high-dose ICS (16 on budesonide, 17 on fluticasone propionate). Sputum from each subject underwent DNA extraction, amplification and 16S rRNA gene sequencing of the bacterial component of the microbiome. 19 subjects returned for further sputum induction after 24 h and 2 weeks. RESULTS: A total of 5,615,037 sequencing reads revealed 167 bacterial taxa in the asthmatic airway samples, with the most abundant being Streptococcus spp. No significant differences in sputum bacterial load or overall community composition were seen between the low- and high-dose ICS groups. However, Streptococcus spp. showed significantly higher relative abundance in subjects taking low-dose ICS (p = 0.002). Haemophilus parainfluenzae was significantly more abundant in subjects on high-dose fluticasone propionate than those on high-dose budesonide (p = 0.047). There were no statistically significant changes in microbiota composition over a 2-week period. DISCUSSION: Whilst no significant differences were observed between the low- and high-dose ICS groups, increased abundance of the potential pathogen H. parainfluenzae was observed in patients taking high-dose fluticasone propionate compared to those taking high-dose budesonide. The microbiota were stable over fourteen days, providing novel evidence of the established community of bacteria in the asthmatic airways. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02671773.


Assuntos
Corticosteroides/administração & dosagem , Antiasmáticos/administração & dosagem , Asma/microbiologia , Microbiota/efeitos dos fármacos , Infecções Respiratórias/induzido quimicamente , Escarro/microbiologia , Administração por Inalação , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antiasmáticos/efeitos adversos , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Budesonida/administração & dosagem , Budesonida/efeitos adversos , Budesonida/uso terapêutico , Relação Dose-Resposta a Droga , Fluticasona/administração & dosagem , Fluticasona/efeitos adversos , Fluticasona/uso terapêutico , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Respiratórias/microbiologia , Adulto Jovem
9.
Medicine (Baltimore) ; 99(51): e23544, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371078

RESUMO

ABSTRACT: The risk factors for the pulmonary infections after hypertensive cerebral hemorrhage remains unclear. We aimed to investigate the potential risk factors for the postoperative pulmonary infection in patients with hypertensive cerebral hemorrhage.Patients with hypertensive cerebral hemorrhage undergone surgery from January 2018 to December 2019 were included. Related personal and medical information were collected. Univariate and multivariate logistic regression analyses were performed to identify the potential risk factors for the postoperative pulmonary infection.A total of 264 patients were included, and the incidence of pulmonary infection for patients with hypertensive cerebral hemorrhage after surgery was 19.70%. Escherichia coli is the most common bacteria of pulmonary infection. Multivariate regression analysis revealed that the preoperative hypoalbuminemia (OR2.89, 1.67∼4.78), tracheotomy (OR5.31, 1.24∼11.79), diabetes (OR4.92, 1.32∼9.80), preoperative GCS (OR5.66, 2.84∼11.21), and the duration of mechanical ventilation (OR2.78, 2.32∼3.61) were the independent risk factors for the pulmonary infection in patients with hypertensive cerebral hemorrhage (all P < .05).Patients with hypertensive intracerebral hemorrhage after surgery have a higher risk of postoperative pulmonary infections, and there are many related risk factors, which should be taken seriously in clinical practice.


Assuntos
Hemorragia Intracraniana Hipertensiva/cirurgia , Complicações Pós-Operatórias/epidemiologia , Infecções Respiratórias/epidemiologia , Adulto , Diabetes Mellitus/epidemiologia , Escala de Coma de Glasgow , Humanos , Hipoalbuminemia/epidemiologia , Incidência , Modelos Logísticos , Pessoa de Meia-Idade , Respiração Artificial/estatística & dados numéricos , Infecções Respiratórias/microbiologia , Estudos Retrospectivos , Fatores de Risco
10.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33372741
11.
Molecules ; 25(21)2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33105830

RESUMO

Inflammation is a biological response to the activation of the immune system by various infectious or non-infectious agents, which may lead to tissue damage and various diseases. Gut commensal bacteria maintain a symbiotic relationship with the host and display a critical function in the homeostasis of the host immune system. Disturbance to the gut microbiota leads to immune dysfunction both locally and at distant sites, which causes inflammatory conditions not only in the intestine but also in the other organs such as lungs and brain, and may induce a disease state. Probiotics are well known to reinforce immunity and counteract inflammation by restoring symbiosis within the gut microbiota. As a result, probiotics protect against various diseases, including respiratory infections and neuroinflammatory disorders. A growing body of research supports the beneficial role of probiotics in lung and mental health through modulating the gut-lung and gut-brain axes. In the current paper, we discuss the potential role of probiotics in the treatment of viral respiratory infections, including the COVID-19 disease, as major public health crisis in 2020, and influenza virus infection, as well as treatment of neurological disorders like multiple sclerosis and other mental illnesses.


Assuntos
Infecções por Coronavirus/terapia , Influenza Humana/terapia , Transtornos Mentais/terapia , Esclerose Múltipla/terapia , Pneumonia Viral/terapia , Probióticos/uso terapêutico , Infecções Respiratórias/terapia , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/patogenicidade , Betacoronavirus/fisiologia , Encéfalo/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/microbiologia , Infecções por Coronavirus/virologia , Microbioma Gastrointestinal/imunologia , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/microbiologia , Humanos , Imunomodulação , Influenza Humana/imunologia , Influenza Humana/microbiologia , Influenza Humana/virologia , Pulmão/imunologia , Transtornos Mentais/imunologia , Transtornos Mentais/microbiologia , Consórcios Microbianos/imunologia , Esclerose Múltipla/imunologia , Esclerose Múltipla/microbiologia , Orthomyxoviridae/efeitos dos fármacos , Orthomyxoviridae/patogenicidade , Orthomyxoviridae/fisiologia , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/microbiologia , Pneumonia Viral/virologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/microbiologia , Simbiose/imunologia
12.
Gac. sanit. (Barc., Ed. impr.) ; 34(5): 474-479, sept.-oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198870

RESUMO

OBJETIVO: Describir si la información microbiológica del virus respiratorio sincitial (VRS) facilitada semanalmente por cuatro hospitales captura adecuadamente la estacionalidad del VRS en toda la comunidad. MÉTODO: Estudio descriptivo retrospectivo. Se compararon las detecciones de VRS en muestras respiratorias de pacientes (ingresados y no), de todos los grupos de edad, de los cuatro hospitales que forman parte del sistema de vigilancia microbiológica (SVM), con datos del Conjunto Mínimo Básico de Datos de hospitalización por bronquiolitis causada por VRS u otro microorganismo infeccioso, en pacientes menores de 5 años ingresados en cualquier hospital público de Galicia (temporadas 2008/2009 a 2016/2017). Se consideró como periodo de onda epidémica cuando la positividad de detecciones de VRS en el total de muestras respiratorias del SVM superó el 10%. Se calculó la sensibilidad del SVM como el porcentaje de ingresos ocurridos en la onda epidémica. RESULTADOS: La sensibilidad del SVM fue del 92% (86-96%) para los ingresos por bronquiolitis por VRS en cada temporada y del 79% (75-84%) para los ingresos por bronquiolitis totales. CONCLUSIONES: El SVM del VRS, basado en información de solo cuatro hospitales, mostró muy buena sensibilidad para predecir el inicio y el final de la onda anual de VRS en toda la comunidad autónoma. Estos resultados respaldan la utilización de esta información para alertar a todo el sistema sanitario del inicio de la onda


OBJECTIVE: To describe whether the microbiological information of the respiratory syncytial virus (RSV), provided by four hospitals on a weekly basis, adequately captures the seasonality of the RSV in the entire community. METHOD: Retrospective descriptive study. We compared the detection of RSV in respiratory samples of patients (hospitalized and not) from all age groups, from the 4 hospitals that are part of the microbiological surveillance system (MSS), with data from the Minimum Basic Data Set of hospitalization for bronchiolitis by RSV or another infectious organism, in patients under 5 years of age, admitted to any public hospital in Galicia (seasons 2008/2009 to 2016/2017). An epidemic wave period was considered when the positivity of RSV detections in the total respiratory samples of the SVM exceeded 10%. The sensitivity of the MSS was calculated as a percentage of admissions occurring in the epidemic wave. RESULTS: MSS sensitivity was 92% (86%-96%) for RSV bronchiolitis admissions in each season and 79% (75%-84%) for total bronchiolitis admissions. CONCLUSIONS: The RSV microbiological surveillance system, based on data from only 4 hospitals, showed very good sensitivity to predict the start and end of the annual RSV wave throughout the Galician region. These results support the use of this information to alert the entire health system of the onset of the wave


Assuntos
Humanos , Vírus Sinciciais Respiratórios/patogenicidade , Infecções por Vírus Respiratório Sincicial/microbiologia , Bronquiolite/microbiologia , Serviços de Vigilância Epidemiológica , Técnicas Microbiológicas/métodos , Espanha/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/microbiologia , Sensibilidade e Especificidade , Estudos Retrospectivos
13.
Cir. pediátr ; 33(4): 160-165, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195125

RESUMO

OBJETIVOS: Analizar la eficacia diagnóstica del lavado broncoalveolar y su impacto en el manejo terapéutico en pacientes pediátricos. MATERIAL Y MÉTODOS: Estudio retrospectivo incluyendo a los pacientes a los que se les realizó un lavado broncoalveolar por parte del Servicio de Cirugía Pediátrica entre 2009 y 2019. Se ha dividido la muestra en dos grupos: pacientes hemato-oncológicos y no hemato-oncológicos. Se han recogido variables demográficas, el resultado del lavado broncoalveolar y la actitud terapéutica posterior. RESULTADOS: Se realizaron 45 lavados broncoalveolares en 38 pacientes. El grupo hemato-oncológico constaba de 25 lavados broncoalveolares. Los pacientes tenían una edad media de 9,99 ± 2,34 años. El 80% de los pacientes tenían tratamiento antiinfeccioso previo al lavado broncoalveolar. El cultivo del lavado broncoalveolar fue positivo en el 52% de los casos. El resultado del lavado broncoalveolar influyó en un cambio de manejo terapéutico en un 24% (6/25). Se produjeron 3 complicaciones posoperatorias, todas leves. En el grupo no hemato-oncológico (n = 20) la edad media era de 6,70 ± 5,17 años. El lavado broncoalveolar fue positivo en el 25% y supuso un cambio de manejo en un 5% de los pacientes. Este grupo tuvo una tasa de complicación del 30%, dos pacientes requirieron ventilación mecánica. CONCLUSIONES: Según nuestros resultados, el lavado broncoalveolar en los pacientes hemato-oncológicos ayuda al diagnóstico microbiológico en procesos respiratorios infecciosos y es relativamente bien tolerado. En los no hemato-oncológicos, tiene una baja rentabilidad diagnóstico-terapéutica, con una tasa de complicaciones no desdeñable. Sería necesario individualizar el balance beneficio-riesgo en cada paciente


OBJECTIVE: To analyze bronchoalveolar lavage diagnostic effectiveness and impact on therapeutic management in pediatric patients. MATERIALS AND METHODS: Retrospective study of patients undergoing bronchoalveolar lavage at the pediatric surgery department from 2009 to 2019. The sample was divided into two groups: hemato-oncological patients and non-hemato-oncological patients. Demographic variables, bronchoalveolar lavage result, and subsequent therapeutic attitude were collected. RESULTS: 45 bronchoalveolar lavages were carried out in 38 patients. The hemato-oncological group consisted of 25 bronchoalveolar lavages. Patient mean age was 9.99 ± 2.34 years. 80% of patients had received anti-infective treatment prior to bronchoalveolar lavage. Bronchoalveolar lavage culture was positive in 52% of cases. Bronchoalveolar lavage results translated into therapeutic management change in 24% of cases (6/25). 3 postoperative complications were recorded, all mild. In the non-hemato-oncological group (n = 20), mean age was 6.70 ± 5.17 years. Bronchoalveolar lavage was positive in 25% of cases, and translated into management change in 5% of patients. Complication rate in this group was 30%. 2 patients required mechanical ventilation. CONCLUSIONS: According to our results, bronchoalveolar lavage in hemato-oncological patients helps achieve microbiological diagnosis in infectious respiratory conditions and is relatively well-tolerated. In non-hemato-oncological patients, diagnostic and therapeutic usefulness is low, and complication rate is not negligible. The risk-benefit balance should be individually considered in each patient


Assuntos
Humanos , Masculino , Feminino , Criança , Análise Custo-Benefício , Lavagem Broncoalveolar/métodos , Infecções Oportunistas/terapia , Estudos Retrospectivos , Lavagem Broncoalveolar/estatística & dados numéricos , Respiração Artificial/métodos , Broncoscopia , Infecções Respiratórias/microbiologia
14.
Diagn Microbiol Infect Dis ; 98(4): 115199, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32979617

RESUMO

COVID-19 positive (194) and negative (212) pneumonia patients were selected to analyze bacterial pathogens coinfection. Results showed that 50% of COVID-19 patients were coinfected or carried bacterial pathogens. Bordetella pertussis infection rate was significantly higher in positive patients. Consequently, preventions should be taken to control bacterial pathogens coinfection in COVID-19 patients.


Assuntos
Coinfecção/epidemiologia , Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Infecções por Pseudomonas/epidemiologia , Coqueluche/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Bordetella pertussis/isolamento & purificação , Criança , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/patologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pandemias , Pseudomonas aeruginosa/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/patologia , Adulto Jovem
15.
Ann Ist Super Sanita ; 56(3): 359-364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32959802

RESUMO

Current literature shows that secondary bacterial infections, although less frequent than in previous influenza pandemics, affect COVID-19 patients. Mycoplasma pneumoniae, Staphylococcus aureus, Legionella pneumophila, Streptococcus pneumoniae, Haemophilus and Klebsiella spp. are the main species isolated. Of note, Mycobacterium tuberculosis-COVID-19 coinfections are also reported. However, bacterial coinfection rates increase in patients admitted in the intensive care units, and those diseases can be due to super-infections by nosocomial antibiotic-resistant bacteria. This highlights the urgency to revise frequent and empiric prescription of broad-spectrum antibiotics in COVID-19 patients, with more attention to evidence-based studies and respect for the antimicrobial stewardship principles.


Assuntos
Infecções Bacterianas/epidemiologia , Betacoronavirus , Coinfecção/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Gestão de Antimicrobianos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Infecções Bacterianas/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Resistência Microbiana a Medicamentos , Diagnóstico Precoce , Humanos , Unidades de Terapia Intensiva , Itália/epidemiologia , Micoses/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Especificidade da Espécie , Tuberculose/epidemiologia
17.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32934151

RESUMO

OBJECTIVES: Although the airway microbiota is a highly dynamic ecology, the role of longitudinal changes in airway microbiota during early childhood in asthma development is unclear. We aimed to investigate the association of longitudinal changes in early nasal microbiota with the risk of developing asthma. METHODS: In this prospective, population-based birth cohort study, we followed children from birth to age 7 years. The nasal microbiota was tested by using 16S ribosomal RNA gene sequencing at ages 2, 13, and 24 months. We applied an unsupervised machine learning approach to identify longitudinal nasal microbiota profiles during age 2 to 13 months (the primary exposure) and during age 2 to 24 months (the secondary exposure) and examined the association of these profiles with the risk of physician-diagnosed asthma at age 7 years. RESULTS: Of the analytic cohort of 704 children, 57 (8%) later developed asthma. We identified 4 distinct longitudinal nasal microbiota profiles during age 2 to 13 months. In the multivariable analysis, compared with the persistent Moraxella dominance profile during age 2 to 13 months, the persistent Moraxella sparsity profile was associated with a significantly higher risk of asthma (adjusted odds ratio, 2.74; 95% confidence interval, 1.20-6.27). Similar associations were observed between the longitudinal changes in nasal microbiota during age 2 to 24 months and risk of asthma. CONCLUSIONS: Children with an altered longitudinal pattern in the nasal microbiota during early childhood had a high risk of developing asthma. Our data guide the development of primary prevention strategies (eg, early identification of children at high risk and modification of microbiota) for childhood asthma. These observations present a new avenue for risk modification for asthma (eg, microbiota modification).


Assuntos
Asma/etiologia , Microbiota , Nariz/microbiologia , Aerococcaceae/isolamento & purificação , Fatores Etários , Asma/diagnóstico , Asma/microbiologia , Criança , Pré-Escolar , Feminino , Finlândia , Seguimentos , Perfilação da Expressão Gênica/métodos , Haemophilus/isolamento & purificação , Humanos , Incidência , Lactente , Recém-Nascido , Aprendizado de Máquina , Masculino , Microbiota/genética , Moraxella/isolamento & purificação , Análise Multivariada , Estudos Prospectivos , RNA Ribossômico 16S/genética , Infecções Respiratórias/complicações , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Risco , Streptococcus/isolamento & purificação
18.
PLoS One ; 15(9): e0238932, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915869

RESUMO

Pertussis, a severe respiratory infection caused by Bordetella pertussis, is distributed globally. Vaccination has been crucial to annual reductions in the number of cases. However, disease reemergence has occurred over the last decade in several countries, including Brazil. Here we describe the clinical and epidemiological aspects of suspected pertussis cases in Salvador, Brazil, and evaluate factors associated with case confirmation. This descriptive and retrospective study was conducted in the five hospitals in Salvador that reported the highest number of pertussis cases between 2011-2016. Demographic and clinical data were recorded for each patient. Bivariate analysis was performed to evaluate differences between groups (confirmed vs. unconfirmed cases) using Pearson's Chi-square test or Fisher's exact test. Results: Of 529 suspected pertussis cases, 29.7% (157/529) were confirmed by clinical, clinical-epidemiological or laboratory criteria, with clinical criteria most frequently applied (63.7%; 100/157). Unvaccinated individuals (43.3%; 68/157) were the most affected, followed by age groups 2-3 months (37.6%; 59/157) and <2 months (31.2%; 49/157). Overall, ≤50% of the confirmed cases presented a complete vaccination schedule. All investigated cases presented cough in association with one or more symptoms, especially paroxysmal cough (66.9%; 105/529) (p = 0.001) or cyanosis (66.2%; 104/529) (p<0.001). Our results indicate that pertussis occurred mainly in infants and unvaccinated individuals in Salvador, Brazil. The predominance of clinical criteria used to confirm suspected cases highlights the need for improvement in the laboratory tools used to perform rapid diagnosis. Fluctuations in infection prevalence demonstrate the importance of vaccination strategies in improving the control and prevention of pertussis.


Assuntos
Bordetella pertussis/patogenicidade , Infecções Respiratórias/prevenção & controle , Coqueluche/epidemiologia , Bordetella pertussis/isolamento & purificação , Brasil/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Vacina contra Coqueluche/administração & dosagem , Infecções Respiratórias/microbiologia , Estudos Retrospectivos , Fatores de Tempo , Vacinação/métodos , Coqueluche/microbiologia , Coqueluche/prevenção & controle
19.
Appl Microbiol Biotechnol ; 104(19): 8089-8104, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32813065

RESUMO

Interspecies transmissions of viruses between animals and humans may result in unpredictable pathogenic potential and new transmissible diseases. This mechanism has recently been exemplified by the discovery of new pathogenic viruses, such as the novel severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) pandemic, Middle-East respiratory syndrome-coronavirus epidemic in Saudi Arabia, and the deadly outbreak of Ebola in West Africa. The. SARS-CoV-2 causes coronavirus disease-19 (COVID-19), which is having a massive global impact in terms of economic disruption, and, above all, human health. The disease is characterized by dry cough, fever, fatigue, myalgia, and dyspnea. Other symptoms include headache, sore throat, rhinorrhea, and gastrointestinal disorders. Pneumonia appears to be the most common and severe manifestation of the infection. Currently, there is no vaccine or specific drug for COVID-19. Further, the development of new antiviral requires a considerable length of time and effort for drug design and validation. Therefore, repurposing the use of natural compounds can provide alternatives and can support therapy against COVID-19. In this review, we comprehensively discuss the prophylactic and supportive therapeutic role of probiotics for the management of COVID-19. In addition, the unique role of probiotics to modulate the gut microbe and assert gut homeostasis and production of interferon as an antiviral mechanism is described. Further, the regulatory role of probiotics on gut-lung axis and mucosal immune system for the potential antiviral mechanisms is reviewed and discussed.Key points• Gut microbiota role in antiviral diseases• Factors influencing the antiviral mechanism• Probiotics and Covid-19.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Probióticos/uso terapêutico , Animais , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Trato Gastrointestinal/microbiologia , Humanos , Imunidade nas Mucosas , Pulmão/imunologia , Pulmão/microbiologia , Pulmão/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Probióticos/metabolismo , Infecções Respiratórias/microbiologia , Viroses/prevenção & controle , Viroses/terapia , Viroses/transmissão , Vitamina D/fisiologia , Zinco/metabolismo
20.
Emerg Microbes Infect ; 9(1): 1958-1964, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32815458

RESUMO

Objectives Severe or critical COVID-19 is associated with intensive care unit admission, increased secondary infection rate, and would lead to significant worsened prognosis. Risks and characteristics relating to secondary infections in severe COVID-19 have not been described. Methods Severe and critical COVID-19 patients from Shanghai were included. We collected lower respiratory, urine, catheters, and blood samples according to clinical necessity and culture and mNGS were performed. Clinical and laboratory data were archived. Results We found 57.89% (22/38) patients developed secondary infections. The patient receiving invasive mechanical ventilation or in critical state has a higher chance of secondary infections (P<0.0001). The most common infections were respiratory, blood-stream and urinary infections, and in respiratory infections, the most detected pathogens were gram-negative bacteria (26, 50.00%), following by gram-positive bacteria (14, 26.92%), virus (6, 11.54%), fungi (4, 7.69%), and others (2, 3.85%). Respiratory Infection rate post high flow, tracheal intubation, and tracheotomy were 12.90% (4/31), 30.43% (7/23), and 92.31% (12/13) respectively. Secondary infections would lead to lower discharge rate and higher mortality rate. Conclusion Our study originally illustrated secondary infection proportion in severe and critical COVID-19 patients. Culture accompanied with metagenomics sequencing increased pathogen diagnostic rate. Secondary infections risks increased after receiving invasive respiratory ventilations and intravascular devices, and would lead to a lower discharge rate and a higher mortality rate.


Assuntos
Bacteriemia/patologia , Infecções Bacterianas/patologia , Infecções por Coronavirus/patologia , Fungemia/patologia , Micoses/patologia , Infecções Oportunistas/patologia , Pneumonia Viral/patologia , Infecções Respiratórias/patologia , Infecções Urinárias/patologia , Idoso , Bacteriemia/microbiologia , Bacteriemia/mortalidade , Bacteriemia/virologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/mortalidade , Infecções Bacterianas/virologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/microbiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Estado Terminal , Feminino , Fungemia/microbiologia , Fungemia/mortalidade , Fungemia/virologia , Fungos/patogenicidade , Bactérias Gram-Negativas/patogenicidade , Bactérias Gram-Positivas/patogenicidade , Humanos , Unidades de Terapia Intensiva , Pulmão/microbiologia , Pulmão/patologia , Pulmão/virologia , Masculino , Pessoa de Meia-Idade , Micoses/microbiologia , Micoses/mortalidade , Micoses/virologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/mortalidade , Infecções Oportunistas/virologia , Pandemias , Pneumonia Viral/microbiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Respiração Artificial/efeitos adversos , Infecções Respiratórias/microbiologia , Infecções Respiratórias/mortalidade , Infecções Respiratórias/virologia , Estudos Retrospectivos , Risco , Índice de Gravidade de Doença , Análise de Sobrevida , Infecções Urinárias/microbiologia , Infecções Urinárias/mortalidade , Infecções Urinárias/virologia
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