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2.
J Zoo Wildl Med ; 50(4): 1012-1015, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926539

RESUMO

Adenoviruses have been reported to affect a broad range of host species, tend to be species specific, and often affect the respiratory system. This report describes the isolation of an adenovirus from deep nasal swabs of two wild North American porcupines (Erethizon dorsatum) with respiratory diseases that presented to a wildlife hospital. Partial sequences of the deoxyribonucleic acid polymerase gene of the isolated virus were identical to skunk adenovirus (SkAdV-1), also known as pygmy marmoset adenovirus. Both porcupines survived and were released back to the wild after successful medical treatment and rehabilitation. The significance of the adenovirus isolated from these porcupines is unknown; however, this is the first report of an adenovirus in porcupines, and the first report of SkAdV-1 in a rodent.


Assuntos
Infecções por Adenoviridae/veterinária , Adenoviridae/classificação , Porcos-Espinhos , Infecções Respiratórias/veterinária , Adenoviridae/isolamento & purificação , Infecções por Adenoviridae/tratamento farmacológico , Infecções por Adenoviridae/virologia , Animais , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Broncodilatadores/uso terapêutico , Enrofloxacina/uso terapêutico , Masculino , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/virologia , Terbutalina/uso terapêutico
3.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914021

RESUMO

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.


Assuntos
Adenoviridae/isolamento & purificação , Haemophilus influenzae/isolamento & purificação , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções por Adenoviridae/diagnóstico , Infecções por Adenoviridae/virologia , Bactérias/genética , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/virologia , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Prevalência , Sons Respiratórios/diagnóstico , Sons Respiratórios/etiologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/genética , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Staphylococcus aureus/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação , Vírus/genética
4.
Emerg Microbes Infect ; 9(1): 246-255, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996093

RESUMO

Human coronavirus NL63 (HCoV-NL63) is primarily associated with common cold in children, elderly and immunocompromised individuals. Outbreaks caused by HCoV-NL63 are rare. Here we report a cluster of HCoV-NL63 cases with severe lower respiratory tract infection that arose in Guangzhou, China, in 2018. Twenty-three hospitalized children were confirmed to be HCoV-NL63 positive, and most of whom were hospitalized with severe pneumonia or acute bronchitis. Whole genomes of HCoV-NL63 were obtained using next-generation sequencing. Phylogenetic and single amino acid polymorphism analyses showed that this outbreak was associated with two subgenotypes (C3 and B) of HCoV-NL63. Half of patients were identified to be related to a new subgenotype C3. One unique amino acid mutation at I507 L in spike protein receptor binding domain (RBD) was detected, which segregated this subgenotype C3 from other known subgenotypes. Pseudotyped virus bearing the I507 L mutation in RBD showed enhanced entry into host cells as compared to the prototype virus. This study proved that HCoV-NL63 was undergoing continuous mutation and has the potential to cause severe lower respiratory disease in humans.


Assuntos
Infecções por Coronavirus , Coronavirus Humano NL63/genética , Infecções Respiratórias/virologia , Pré-Escolar , China , Coronavirus Humano NL63/isolamento & purificação , Genótipo , Humanos , Lactente , Filogenia
5.
Rev Soc Bras Med Trop ; 53: e20170498, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31859936

RESUMO

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.


Assuntos
Influenza Humana/epidemiologia , Infecções Respiratórias/virologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Infecções Respiratórias/epidemiologia , Estações do Ano , Vigilância de Evento Sentinela , Índice de Gravidade de Doença , Adulto Jovem
6.
Rev Med Chil ; 147(7): 842-851, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31859982

RESUMO

BACKGROUND: Except for influenza pandemics, different observational studies have failed to demonstrate differences in mortality between various etiologies in adult patients hospitalized for respiratory infections. AIM: To compare clinical and mortality differences between different viral pathogens associated with severe acute respiratory infections (SARI) in hospitalized adults. MATERIAL AND METHODS: One-year prospective study in a sentinel center. We included 132 patients with SARI hospitalized for any of the nine viruses under study by PCR. Clinical variables were compared, excluding cases of coinfection. RESULTS: A viral coinfection was identified in 12% and influenza infection in 56% of cases. Eighty percent of patients were aged ≥ 65 years, with a high frequency of comorbidities, 27% were bedridden. Twenty four percent were admitted to critical care units, 20% required ventilatory assistance and 16% died. Cases occurred throughout the year, with an expected seasonal peak between autumn and spring and a predominance of infections not associated with influenza during summer months. In the multivariate analysis, only being bedridden was significantly associated with mortality at discharge (Odds ratio 23.46; 95% confidence intervals 3.33-165.12, p < 0.01), without association with age, comorbidity, viral pathogen involved, laboratory parameters, clinical presentation or CURB65 score. No major clinical dissimilarities were found between different viral pathogens. CONCLUSIONS: In our series of patients, mostly elderly, only bedridden status was significantly associated with mortality at discharge in patients hospitalized for SARI. Viral pathogens were not relevant.


Assuntos
Infecções Respiratórias/mortalidade , Infecções Respiratórias/virologia , Doença Aguda , Adulto , Idoso , Feminino , Hospitalização , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Estações do Ano , Índice de Gravidade de Doença
7.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1088-1093, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683392

RESUMO

Human adenovirus (HAdV) is one of the common pathogens causing human respiratory infections and HAdV infection can result in a variety of diseases. In recent years, outbreaks of HAdV infection have been detected from time to time in China and clustered severe cases have been reported in some regions. This technical guideline has been timely developed to provide technical support on the control and prevention of HAdV respiratory infections. It provides an overview of etiology, epidemiology, clinical manifestations, and treatment principles of HAdV infection, determines the definitions of laboratory-confirmed cases, clinically diagnosed cases, severe and critically severe HAdV pneumonia cases. Then the workflow of case detecting and reporting, and the outbreak epidemic disposal has been formulated. Finally, the control and prevention measures in places at high risk for HAdV transmission and individual preventive measures also has been introduced.


Assuntos
Infecções por Adenovirus Humanos/prevenção & controle , Adenovírus Humanos , Guias de Prática Clínica como Assunto , Infecções Respiratórias/prevenção & controle , Infecções por Adenovirus Humanos/virologia , China , Humanos , Infecções Respiratórias/virologia
8.
Medicine (Baltimore) ; 98(44): e17797, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689857

RESUMO

RATIONALE: Acute necrotizing encephalopathy (ANE) is a rapidly progressing disease associated with frequent neurologic sequelae and has poor prognosis. Currently, the diagnosis and treatment of ANE rely on neuroradiologic findings and offering supportive care. Here, we report the successful treatment of a teenager diagnosed with ANE using combination of high-dose methylprednisolone and oseltamivir. PATIENT CONCERNS: The patient, a 15-year-old female, presented with impaired consciousness and seizures secondary to acute upper respiratory tract infection. A series of brain magnetic resonance images (MRIs) were obtained toward establishing a possible diagnosis. DIAGNOSIS: Based on the history of presenting illness and subsequent brain MRI scans, the patient was diagnosed to be suffering from ANE. INTERVENTIONS: Following the diagnosis, the patient was placed on therapy comprising of high-dose methylprednisolone and oseltamivir. OUTCOMES: After treatment with methylprednisolone and oseltamivir for 15 days, the patient recovered nearly completely from ANE as confirmed by subsequent brain MRI scans. No complications or other emerging clinical symptoms were noted for the duration of follow-up that lasted 6 months. LESSONS: Contrary to common reports, ANE can occur beyond pediatric populations and its treatment should not be restricted to supportive care. Our case suggests that the use of high-dose corticosteroids and oseltamivir leads to promising prognosis.


Assuntos
Encéfalo/diagnóstico por imagem , Encefalite Viral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Infecções Respiratórias/complicações , Convulsões/diagnóstico por imagem , Adolescente , Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , Encéfalo/patologia , Encéfalo/virologia , China , Encefalite Viral/tratamento farmacológico , Encefalite Viral/virologia , Feminino , Humanos , Necrose/diagnóstico por imagem , Necrose/virologia , Oseltamivir/uso terapêutico , Prognóstico , Infecções Respiratórias/virologia , Convulsões/patologia , Convulsões/virologia
9.
Emerg Microbes Infect ; 8(1): 1701-1710, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31749410

RESUMO

We conducted this study to describe the dynamics of the acquisition of respiratory pathogens, their potential interactions and risk factors for possible lower respiratory tract infection symptoms (LRTI) among French pilgrims during the 2018 Hajj. Each participant underwent four successive systematic nasopharyngeal swabs before and during their stay in Saudi Arabia. Carriage of the main respiratory pathogens was assessed by PCR. 121 pilgrims were included and 93.4% reported respiratory symptoms during the study period. The acquisition of rhinovirus, coronaviruses and Staphylococcus aureus occurred soon after arrival in Saudi Arabia and rates decreased gradually after days 5 and 6. In contrast, Streptococcus pneumoniae and Klebsiella pneumoniae carriage increased progressively until the end of the stay in Saudi Arabia. Haemophilus influenzae and Moraxella catarrhalis carriage increased starting around days 12 and 13, following an initial clearance. Influenza viruses were rarely isolated. We observed an independent positive mutual association between S. aureus and rhinovirus carriage and between H. influenzae and M. catarrhalis carriage. Dual carriage of H. influenzae and M. catarrhalis was strongly associated with S. pneumoniae carriage (OR = 6.22). Finally, our model showed that M. catarrhalis carriage was negatively associated with K. pneumoniae carriage. Chronic respiratory disease was associated with symptoms of LRTI. K. pneumoniae, M. catarrhalis-S. aureus and H. influenzae-rhinovirus dual carriage was associated with LRTI symptoms. Our data suggest that RTIs at the Hajj are a result of complex interactions between a number of respiratory viruses and bacteria.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/microbiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Viroses/virologia , Vírus/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/genética , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Arábia Saudita , Viagem , Vírus/classificação , Vírus/genética
10.
Emerg Microbes Infect ; 8(1): 1438-1444, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571527

RESUMO

During 2014, enterovirus D68 (EV-D68) outbreaks were described globally, causing severe respiratory diseases in children and, in some cases, subsequent paralysis. In this study, the type characterization of enterovirus (EV) detected in respiratory illnesses and the epidemiology and clinical association of EV-D68 infections in Spain over a five-year period were described. A total of 546 EV-positive samples from hospitalized patients with respiratory infections were included. EV-D68 was the most frequently detected type (46.6%, 191/410 typed EV). Other EV from species A (25.1%), B (27.8%) and C (0.5%) were also identified. EV-D68 infections were more associated with bronchitis while EV-A/B types were more frequent in upper respiratory illness (p < 0.01). EV-D68 was also detected in patients with neurological symptoms (nine meningitis/meningoencephalitis and eight acute flaccid paralysis cases). Phylogenetic analysis of 3'-VP1 region showed most Spanish EV-D68 sequences from 2014 to 2016 belonged to subclades B2/B3, as other American and European strains circulating during the same period. However, those detected in 2017 and 2018 clustered to the emerged subclade D1. In summary, different EV can cause respiratory infections but EV-D68 was the most prevalent, with several strains circulating in Spain at least since 2014. Association between EV-D68 infection and neurological disease was also described.


Assuntos
Infecções por Enterovirus/complicações , Infecções por Enterovirus/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/virologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquite/epidemiologia , Bronquite/virologia , Pré-Escolar , Enterovirus Humano D/classificação , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Meningite/epidemiologia , Meningite/virologia , Pessoa de Meia-Idade , Paralisia/epidemiologia , Paralisia/virologia , Filogenia , Espanha/epidemiologia
11.
Molecules ; 24(19)2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31569633

RESUMO

Herbal medicine, including traditional Chinese medicine (TCM), is widely used worldwide. Herbs and TCM formulas contain numerous active molecules. Basically, they are a kind of cocktail therapy. Herb-drug, herb-food, herb-herb, herb-microbiome, and herb-disease interactions are complex. There is potential for both benefit and harm, so only after understanding more of their mechanisms and clinical effects can herbal medicine and TCM be helpful to users. Many pharmacologic studies have been performed to unravel the molecular mechanisms; however, basic and clinical studies of good validity are still not enough to translate experimental results into clinical understanding and to provide tough evidence for better use of herbal medicines. There are still issues regarding the conflicting pharmacologic effects, pharmacokinetics, drug interactions, adverse and clinical effects of herbal medicine and TCM. Understanding study validation, pharmacologic effects, drug interactions, indications and clinical effects, adverse effects and limitations, can all help clinicians in providing adequate suggestions to patients. At present, it would be better to use herbs and TCM formulas according to their traditional indications matching the disease pathophysiology and their molecular mechanisms. To unravel the molecular mechanisms and understand the benefits and harms of herbal medicine and TCM, there is still much work to be done.


Assuntos
Antivirais/química , Antivirais/farmacologia , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/farmacologia , Medicina Tradicional Chinesa , Animais , Biomarcadores , Gerenciamento Clínico , Composição de Medicamentos , Interações Ervas-Drogas , Humanos , Microbiota/efeitos dos fármacos , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/metabolismo , Infecções Respiratórias/virologia , Transdução de Sinais/efeitos dos fármacos
12.
Respir Res ; 20(1): 210, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519188

RESUMO

BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and asthma are associated with a variety of precipitating factors including infection. This study assessed the infective viral etiologies by real-time multiplex polymerase chain reaction of patients hospitalized with AECOPD and asthma exacerbations. In addition, infective etiologies were assessed for association with the clinical outcome of the patients. METHODS: Adults admitted with AECOPD and asthma exacerbations between August 2016 and July 2017 were recruited. Nasopharyngeal aspirate (NPA) samples were obtained from the patients within 1-2 days of admission and subjected to pathogen detection and human rhinovirus (HRV) typing. RESULTS: Altogether 402 patients with AECOPD, 80 stable COPD, 100 asthma exacerbation and 21 stable asthma subjects were recruited. Among those admitted for AECOPD and asthma exacerbations, 141(35.1%) and 45(45.0%) respectively had pathogens identified in the NPA specimens. The commonest virus identified was influenza A followed by HRV. HRV typing identified HRV-A and HRV-C as the more common HRV with a wide variety of genotypes. Identification of pathogens in NPA or HRV typing otherwise did not affect clinical outcomes including the hospital length of stay, readmission rates and mortality except that identification of pathogens in asthma exacerbation was associated with a lower rate of readmissions at 30 and 60 days. CONCLUSIONS: Many respiratory viruses were associated with AECOPD and asthma exacerbation. HRV-A and HRV-C were the more common HRV associated with exacerbations. Identification of pathogens in NPA was associated with less readmissions for asthma patients at 30 and 60 days. TRIAL REGISTRATION: ClinicalTrials.gov NCT02866357 .


Assuntos
Asma/microbiologia , Asma/virologia , Bactérias/química , Doença Pulmonar Obstrutiva Crônica/microbiologia , Doença Pulmonar Obstrutiva Crônica/virologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Rhinovirus/química , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Vírus da Influenza A , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Readmissão do Paciente/estatística & dados numéricos , Testes de Função Respiratória , Resultado do Tratamento
13.
Adv Exp Med Biol ; 1222: 55-62, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31529287

RESUMO

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.


Assuntos
Bronquiolite/diagnóstico por imagem , Hospitalização/estatística & dados numéricos , Radiografia/métodos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Bronquiolite/epidemiologia , Bronquiolite/virologia , Pré-Escolar , Humanos , Lactente , Tempo de Internação , Pneumonia/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia
14.
BMJ ; 366: l5021, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506273

RESUMO

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.


Assuntos
Carga Global da Doença , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sinciciais Respiratórios/genética , Infecções Respiratórias/epidemiologia , Adulto , Antivirais/uso terapêutico , Epidemias , Genótipo , Humanos , Hospedeiro Imunocomprometido , Imunoglobulinas Intravenosas/uso terapêutico , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/terapia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/patogenicidade , Infecções Respiratórias/imunologia , Infecções Respiratórias/terapia , Infecções Respiratórias/virologia , Ribavirina/uso terapêutico , Estações do Ano
15.
mSphere ; 4(5)2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533996

RESUMO

Both antiseptic hand rubbing (AHR) using ethanol-based disinfectants (EBDs) and antiseptic hand washing (AHW) are important means of infection control to prevent seasonal influenza A virus (IAV) outbreaks. However, previous reports suggest a reduced efficacy of ethanol disinfection against pathogens in mucus. We aimed to elucidate the situations and mechanisms underlying the reduced efficacy of EBDs against IAV in infectious mucus. We evaluated IAV inactivation and ethanol concentration change using IAV-infected patients' mucus (sputum). Additionally, AHR and AHW effectiveness against infectious mucus adhering to the hands and fingers was evaluated in 10 volunteers. Our clinical study showed that EBD effectiveness against IAV in mucus was extremely reduced compared to IAV in saline. IAV in mucus remained active despite 120 s of AHR; however, IAV in saline was completely inactivated within 30 s. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the time required for the ethanol concentration to reach an IAV inactivation level and thus for EBDs to completely inactivate IAV was approximately eight times longer in mucus than in saline. On the other hand, AHR inactivated IAV in mucus within 30 s when the mucus dried completely because the hydrogel characteristics were lost. Additionally, AHW rapidly inactivated IAV. Until infectious mucus has completely dried, infectious IAV can remain on the hands and fingers, even after appropriate AHR using EBD, thereby increasing the risk of IAV transmission. We clarified the ineffectiveness of EBD use against IAV in infectious mucus.IMPORTANCE Antiseptic hand rubbing (AHR) and antiseptic hand washing (AHW) are important to prevent the spread of influenza A virus (IAV). This study elucidated the situations/mechanisms underlying the reduced efficacy of AHR against infectious mucus derived from IAV-infected individuals and indicated the weaknesses of the current hand hygiene regimens. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the efficacy of AHR using ethanol-based disinfectant against mucus is greatly reduced until infectious mucus adhering to the hands/fingers has completely dried. If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW should be adopted to compensate for these weaknesses of AHR.


Assuntos
Desinfetantes/farmacologia , Desinfecção das Mãos/normas , Vírus da Influenza A/efeitos dos fármacos , Influenza Humana/prevenção & controle , Muco/virologia , Etanol/farmacologia , Desinfecção das Mãos/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Vírus da Influenza A/fisiologia , Influenza Humana/transmissão , Viabilidade Microbiana , Muco/efeitos dos fármacos , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia
16.
Clin Microbiol Rev ; 32(4)2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31511250

RESUMO

Patients undergoing solid-organ transplantation (SOT) or allogeneic hematopoietic cell transplantation (HCT) are at increased risk for infectious complications. Community-acquired respiratory viruses (CARVs) pose a particular challenge due to the frequent exposure pre-, peri-, and posttransplantation. Although influenza A and B viruses have a top priority regarding prevention and treatment, recent molecular diagnostic tests detecting an array of other CARVs in real time have dramatically expanded our knowledge about the epidemiology, diversity, and impact of CARV infections in the general population and in allogeneic HCT and SOT patients. These data have demonstrated that non-influenza CARVs independently contribute to morbidity and mortality of transplant patients. However, effective vaccination and antiviral treatment is only emerging for non-influenza CARVs, placing emphasis on infection control and supportive measures. Here, we review the current knowledge about CARVs in SOT and allogeneic HCT patients to better define the magnitude of this unmet clinical need and to discuss some of the lessons learned from human influenza virus, respiratory syncytial virus, parainfluenzavirus, rhinovirus, coronavirus, adenovirus, and bocavirus regarding diagnosis, prevention, and treatment.


Assuntos
Biodiversidade , Infecções Comunitárias Adquiridas/virologia , Infecções Respiratórias/virologia , Transplantados , Viroses/virologia , Vírus/classificação , Humanos , Infecções Respiratórias/terapia , Viroses/terapia , Fenômenos Fisiológicos Virais
17.
mSphere ; 4(5)2019 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511367

RESUMO

Serological assays are used to diagnose and characterize host immune responses against microbial pathogens. Microarray technologies facilitate high-throughput immunoassays of antibody detection against multiple pathogens simultaneously. To improve survey of influenza A virus (IAV), influenza B virus (IBV), respiratory syncytial virus (RSV), and adenovirus (AdV) antibody levels, we developed a microarray consisting of IAV H1N1, IAV H1N1pdm09 (vaccine), IAV H3N2, IBV Victoria, IBV Yamagata, RSV, AdV type 5 hexon protein, and control antigens printed on the bottom of a microtiter plate well. Bound IgG antibodies were detected with anti-human IgG-coated photon-upconverting nanoparticles and measured with a photoluminescence imager. The performance of the microarray immunoassay (MAIA) was evaluated with serum samples (n = 576) collected from children (n = 288) at 1 and 2 years of age and tested by standard enzyme immunoassays (EIAs) for antibodies to IAV vaccine and RSV. EIAs and MAIA showed substantial to almost perfect agreement (Cohen's κ, 0.62 to 0.83). Applying MAIA, we found seroprevalences of 55% for IAV H1N1, 54% for IAV vaccine, 30% for IAV H3N2, 24% for IBV Victoria, 25% for IBV Yamagata, 38% for RSV, and 26% for AdV in 1-year-old children (n = 768). By the age of 2 years, IgG seropositivity rates (n = 714) increased to 74% for IAV H1N1, 71% for IAV vaccine, 49% for IAV H3N2, 47% for IBV Yamagata, 49% for IBV Victoria, 68% for RSV, and 58% for AdV. By analyzing increases in antibody levels not biased by vaccinations, we found a reinfection rate of 40% for RSV and 31% for AdV in children between 1 and 2 years of age.IMPORTANCE The multiplex immunoassay was successfully used to simultaneously detect antibodies against seven different viruses. The developed serological microarray is a new promising tool for diagnostic, epidemiological, and seroprevalence analyses of virus infections.


Assuntos
Anticorpos Antivirais/sangue , Ensaios de Triagem em Larga Escala/métodos , Infecções Respiratórias/virologia , Testes Sorológicos/métodos , Vírus/imunologia , Adenoviridae/imunologia , Pré-Escolar , Estudos de Coortes , Humanos , Imunoensaio/métodos , Lactente , Vírus da Influenza A/imunologia , Vírus da Influenza B/imunologia , Análise em Microsséries , Estudos Observacionais como Assunto , Vírus Sinciciais Respiratórios/imunologia , Infecções Respiratórias/imunologia
18.
Arch Virol ; 164(12): 2919-2930, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31520220

RESUMO

Human bocavirus (HBoV) has been detected primarily in children with acute lower respiratory tract disease (LRTD), but its occurrence, clinical profile, and role as a causative agent of RTD are not clear. The aim of this study was to investigate the prevalence and the potential clinical relevance of HBoV. Using molecular tests, we tested 1352 nasopharyngeal samples obtained between October 1, 2017 and April 30, 2018 from children up to the age of 16 with RTD for the presence of HBoV DNA and 20 other respiratory pathogens at three different hospitals in Belgium. HBoV was detected in 77 children with a median age of 10.6 months. Consecutive samples were available for 15 HBoV-positive children and showed persistent HBoV positivity in four of them. Monoinfection was observed in six infants. Four of them were born prematurely and were infected during hospitalization at the neonatal intensive care unit (NICU). Only one of these six monoinfected children was diagnosed with recurrent wheezing due to HBoV. This child was carried to term and had a high viral load. Coinfections, most frequently with rhinovirus (52.1%) and adenovirus (49.3%), were observed in 72 patients. In seventeen of them in which HBoV was present at high viral load or higher viral load than its copathogens, bronchi(oli)tis (n = 8), recurrent wheezing (n = 8) or episodic wheezing (n = 1) were diagnosed. Our results suggest that HBoV infection at high viral load in infants is associated with wheezing (P = 0.013, Cramer's V = 0.613).


Assuntos
Bocavirus Humano/isolamento & purificação , Infecções por Parvoviridae/diagnóstico , Infecções Respiratórias/virologia , Adolescente , Bélgica/epidemiologia , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/virologia , DNA Viral/genética , Feminino , Bocavirus Humano/genética , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Nasofaringe/virologia , Infecções por Parvoviridae/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/virologia , Prevalência , Estudos Retrospectivos , Carga Viral
19.
Aerosp Med Hum Perform ; 90(10): 908-910, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558201
20.
Adv Respir Med ; 87(4): 209-216, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476008

RESUMO

INTRODUCTION: We performed a real-life clinical study to identify the main indications for the prescription of short-course treatment with systemic glucocorticosteroids (GCS) for steroid naive children with acute virus-induced wheezing as well as to analyze the influence of such treatment on patients' serum cortisol level, other blood tests results and the length of stay in the hospital. MATERIAL AND METHODS: The data of 44 patients who had acute wheezing, had no bacterial infection and were otherwise healthy were analyzed: 26 children received treatment with GCS and 18 children did not. Full blood count, biochemistry tests (Na, K, glucose) and blood cortisol levels of all patients were analyzed during treatment. RESULTS: The main indications for the short-term administration of systemic GCS were increased work of breathing, recurrent wheezing, clinical signs of atopy and a family history of asthma. Systemic GCS increased a sodium concentration (p = 0.014), decreased a cortisol level (p = 0.038), leukocyte (p = 0.043), neutrophil (p = 0.045), and eosinophil (p < 0.001) count in blood serum. The major reduction in the eosinophil count was observed in allergic children (p = 0.023). Older age was a risk factor for cortisol suppression (p = 0.018). The average length of stay in the hospital was longer in the intervention group (p = 0.039). CONCLUSION: Even short-course treatment with systemic GCS decreases the serum cortisol level and has a significant effect on other blood tests results. Systemic GCS used for acute virus-induced wheezing treatment did not prove to reduce the average length of stay in the hospital. Objective criteria for initiation of such treatment are still lacking, which might consequently lead to the overuse of corticosteroids.


Assuntos
Corticosteroides/uso terapêutico , Hospitalização/estatística & dados numéricos , Sons Respiratórios/etiologia , Infecções Respiratórias/tratamento farmacológico , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Contagem de Leucócitos , Masculino , Infecções Respiratórias/virologia
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