1.
Ear Nose Throat J. 2020 Mar 17:145561320908480. doi: 10.1177/0145561320908480. [Epub ahead of print]
Dry Eye and Dry Nose Caused by the Effect of Allergic Rhinitis on Tear and Nasal Secretion Osmolarity.
Abstract
OBJECTIVE:
Allergic rhinitis is a type 1 hypersensitivity reaction of immunoglobulin E in the rhino-ocular mucosa. This study was planned to demonstrate in patients with allergic rhinitis to evaluate changes in tear, nasal secretions, and blood osmolarity compared to healthy individuals.
METHOD:
Forty allergic rhinitis patients, 25 patients with acute upper respiratory tract infections, and 26 healthy participants were included in the study. Positive patients with allergic symptoms and skin prick test results were included in the allergic rhinitis group. Tear, nasal secretion, and blood osmolarity values were examined for the 3 groups.
RESULT:
In patients with allergic rhinitis, tear and nasal secretion osmolarity values were significantly higher in patients with acute upper respiratory tract infections and those of the healthy participants (P = .001, P = .038). In blood osmolarity measurements, there was no statistical difference between the groups (P = .489). In patients with allergic rhinitis, Schirmer test results were significantly shorter than patients who had acute upper respiratory tract infection and those of the healthy participants (P = .001, P = .001). Patients with allergic rhinitis and acute upper respiratory tract infections had significantly shorter Schirmer test results than in healthy participants (P = .001, P = .001).
CONCLUSION:
Tear osmolarity was increased in allergic rhinitis patients, and this was thought to lead to dry eye findings. In the presence of allergic rhinitis, nasal secretions were found more hyperosmolar than tears. Nasal secretion osmolarity was higher in allergic rhinitis patients than in patients with acute upper respiratory tract infections and control group.
KEYWORDS:
Schirmer test; allergic rhinitis; blood; dry eye; nasal secretion; osmolarity; tear
2.
Cureus. 2019 Feb 7;11(2):e4035. doi: 10.7759/cureus.4035.
Morgagni-Larrey Hernia: A Possible Cause of Recurrent Lower Respiratory Tract Infections.
Abstract
Morgagni-Larrey hernia is an exceedingly rare presentation of congenital diaphragmatic hernia. Despite its rarity, it is associated with significant risk of morbidity and mortality. Herein, we describe a unique case report of an elderly woman who presented with left-sided chest pain, dyspnea, and chronic history of recurrent respiratory tract infections. On the basis of her medical history, general physical examination and imaging studies, she was operated for a presumptive diagnosis of thymolipoma. However, the intra-operative findings revealed that it was an unusual variant of a diaphragmatic hernia and the hernia sac appeared through the retrosternal foramen of Morgagni. Hence we concluded that it was a Morgagni-Larrey hernia compressing the lungs and heart. Consequently, the hernia was reduced and the defect was repaired. During the postoperative period, the patient had an uneventful recovery. To conclude, the possibility of a Morgagni-Larrey hernia should be strongly considered while evaluating a patient with recurrent chest infections, dyspnea, and vague chest pain.
Copyright © 2019, Hashmi et al.
KEYWORDS:
congenital diaphragmatic hernia; larrey hernia; morgagni hernia; omentum; recurrent respiratory tract infections; sternocostal triangle
3.
Res Vet Sci. 2020 Mar 10;130:144-152. doi: 10.1016/j.rvsc.2020.03.016. [Epub ahead of print]
APEC infection affects cytokine-cytokine receptor interaction and cell cycle pathways in chicken trachea.
Abstract
Avian pathogenic Escherichia coli (APEC) can lead to extraintestinal disease in avian species via respiratory tract infection. However, the regulatory mechanism of APEC on the pathogenicity of chicken trachea epithelium remains unknown. In this study, we examined pathological changes in chicken trachea at different infection times (4, 8, 12 and 24 h). The RNA sequencing of APEC infection group and the PBS group (negative control) of chicken trachea epithelium were analysed. Our studies revealed that the oedema, heterophil infiltration and hyperaemia appeared at 8 and 12 h post APEC infection. And the hyperaemia phenomenon and heterophilic granulocyte infiltration disappeared at 24 h post infection. Then RNA sequencing showed many genes were dynamically expressed in the APEC infection group. At 4, 8 and 12 h post infection, the mRNA of differentially expressed genes were enriched by cytokine-cytokine receptor interaction and the toll-like receptor signalling pathway. The cell cycle pathway was enriched at 24 h post infection. Altogether, these findings suggest that APEC infection induces pathological change in the chicken trachea, the mRNA of differentially expressed genes participating in inflammation and hyperplasia signalling pathways. Which not only provide more evidence for regulatory mechanism of APEC on the pathogenicity of chicken trachea epithelium, but also facilitate the effective management of APEC infections in poultry through trachea.
Copyright © 2020. Published by Elsevier Ltd.
KEYWORDS:
Avian pathogenic Escherichia coli; Cell cycle; Chicken trachea epithelium; Cytokine–cytokine receptor interaction; Pathogenicity
4.
Infect Control Hosp Epidemiol. 2020 Mar 17:1-8. doi: 10.1017/ice.2020.42. [Epub ahead of print]
Evaluation of clinicians' knowledge, attitudes, and planned behaviors related to an intervention to improve acute respiratory infection management.
Abstract
BACKGROUND:
Acute respiratory tract infections (ARIs) are commonly diagnosed and major drivers of antibiotic prescribing. Clinician-focused interventions can reduce unnecessary antibiotic prescribing for ARIs. We elicited clinician feedback to design sustainable interventions to improve ARI management by understanding the mental framework of clinicians surrounding antibiotic prescribing within Veterans' Health Administration clinics.
METHODS:
We conducted one-on-one interviews with clinicians (n = 20) from clinics targeted for intervention at 5 facilities. The theory of planned behavior guided interview questions. Interviews were audio recorded and transcribed for qualitative analysis. An iterative coding approach identified 6 themes.
RESULTS:
Emergent themes: (1) barriers to appropriate prescribing are multifactorial and include challenges of behavior change; (2) antibiotic prescribing decisions are perceived as autonomous yet, diagnostic uncertainty and perceptions of patient demand can make prescribing decisions difficult; (3) clinicians perceive variation in peer prescribing practices and influences; (4) clinician-focused interventions are valuable if delivered with sensitivity; (5) communication strategies for educating patients are preferred to a shared decisions process; and (6) team standardization of practice and communication are key to facilitate appropriate prescribing. Clinicians perceived audit-and-feedback with peer comparison, academic detailing, and enhanced patient communication strategies as viable approaches to improving appropriate prescribing.
CONCLUSION:
Implementation strategies that enable clinicians to overcome diagnostic uncertainty, perceived patient demand, and improve patient education are desired. Implementation strategies were welcomed, and some were more readily accepted (eg, audit feedback) than others (eg, shared decision making). Implementation strategies should address clinicians' perceptions of antibiotic prescribing practices and should enhance their patient communication skills.
5.
Microbiome. 2020 Mar 17;8(1):39. doi: 10.1186/s40168-020-00803-2.
Characterization of antibiotic resistance and host-microbiome interactions in the human upper respiratory tract during influenza infection.
Zhang L1, Forst CV2, Gordon A3, Gussin G1, Geber AB1, Fernandez PJ1, Ding T1, Lashua L1, Wang M2, Balmaseda A4,5, Bonneau R1, Zhang B2, Ghedin E6,7.
Abstract
BACKGROUND:
The abundance and diversity of antibiotic resistance genes (ARGs) in the human respiratory microbiome remain poorly characterized. In the context of influenza virus infection, interactions between the virus, the host, and resident bacteria with pathogenic potential are known to complicate and worsen disease, resulting in coinfection and increased morbidity and mortality of infected individuals. When pathogenic bacteria acquire antibiotic resistance, they are more difficult to treat and of global health concern. Characterization of ARG expression in the upper respiratory tract could help better understand the role antibiotic resistance plays in the pathogenesis of influenza-associated bacterial secondary infection.
RESULTS:
Thirty-seven individuals participating in the Household Influenza Transmission Study (HITS) in Managua, Nicaragua, were selected for this study. We performed metatranscriptomics and 16S rRNA gene sequencing analyses on nasal and throat swab samples, and host transcriptome profiling on blood samples. Individuals clustered into two groups based on their microbial gene expression profiles, with several microbial pathways enriched with genes differentially expressed between groups. We also analyzed antibiotic resistance gene expression and determined that approximately 25% of the sequence reads that corresponded to antibiotic resistance genes mapped to Streptococcus pneumoniae and Staphylococcus aureus. Following construction of an integrated network of ARG expression with host gene co-expression, we identified several host key regulators involved in the host response to influenza virus and bacterial infections, and host gene pathways associated with specific antibiotic resistance genes.
CONCLUSIONS:
This study indicates the host response to influenza infection could indirectly affect antibiotic resistance gene expression in the respiratory tract by impacting the microbial community structure and overall microbial gene expression. Interactions between the host systemic responses to influenza infection and antibiotic resistance gene expression highlight the importance of viral-bacterial co-infection in acute respiratory infections like influenza. Video abstract.
KEYWORDS:
Antibiotic resistance; Influenza infection; Metatranscriptome; Microbiome; Upper respiratory tract infection
6.
Emerg Microbes Infect. 2020 Dec;9(1):605-615. doi: 10.1080/22221751.2020.1737578.
Super-dominant pathobiontic bacteria in the nasopharyngeal microbiota as causative agents of secondary bacterial infection in influenza patients.
Qin T1,2, Geng T3, Zhou H1, Han Y3, Ren H1, Qiu Z3, Nie X1, Du T3, Liang J1, Du P4, Jiang W3, Li T3, Xu J1,2,5,6.
Abstract
The source of secondary lower respiratory tract bacterial infections in influenza patients is not fully understood. A case-control study was conducted during the 2017-2018 influenza epidemic period in Beijing, China. Nasopharyngeal swabs were collected from 52 virologically confirmed influenza patients and 24 healthy medical staff. The nasopharyngeal microbiota taxonomic composition was analysed using high-throughput sequencing of the 16S rRNA gene V3-V4 regions. The super-dominant pathobiontic bacterial genus (SDPG) was defined as that accounting for >50% of sequences in a nasopharyngeal swab. We attempted to isolate bacteria of this genus from both nasopharyngeal swabs and lower-respiratory tract samples and analyse their genetic similarities. We observed a significantly lower taxonomy richness in influenza cases compared with healthy controls. A SDPG was detected in 61% of severe cases but in only 24% of mild cases and 29% of healthy controls. In 10 cases, the species isolated from lower-respiratory tract infection sites were identified as belonging to the nasopharyngeal microbiota SDPG. Genetically identical strains were isolated from both nasopharyngeal swabs and lower-respiratory tract infection sites, including 23 Acinetobacter baumannii strains from six severe cases, six Klebsiella pneumoniae strains from two severe cases, five Pseudomonas aeruginosa strains from one severe and one mild case, and four Corynebacterium striatum strains from two severe cases. The SDPG in the nasopharyngeal microbiota are the likely cause of subsequent infection in influenza patients.
KEYWORDS:
16S rRNA V3–V4; Influenza patients; lower-respiratory tract infection; nasopharyngeal microbiota; super-dominant pathobiontic genus
7.
Emerg Microbes Infect. 2020 Dec;9(1):597-600. doi: 10.1080/22221751.2020.1738905.
Era of molecular diagnosis for pathogen identification of unexplained pneumonia, lessons to be learned.
Abstract
Unexplained pneumonia (UP) caused by a novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) emerged in China in late December 2019 and has infected more than 9000 cases by 31 January 2020. Shanghai reported the first imported case of COVID-19 (Coronavirus Disease 2019) in 20 January 2020. A combinative approach of real-time RT-PCR, CRISPR-based assay and metagenomic next-generation sequencing (mNGS) were used to diagnose this unexplained pneumonia patient. Real-time RT-PCR and CRISPR-based assay both reported positive. This sample belonged to Betacoronavirus and shared a more than 99% nucleotide (nt) identity with the Wuhan SARS-CoV-2 isolates. We further compared pros and cons of common molecular diagnostics in UP. In this study, we illustrated the importance of combining molecular diagnostics to rule out common pathogens and performed mNGS to obtain unbiased potential pathogen result for the diagnosis of UP.
KEYWORDS:
COVID-19; SARS-CoV-2; Unexplained pneumonia; diagnosis; molecular
8.
Emerg Microbes Infect. 2020 Dec;9(1):558-570. doi: 10.1080/22221751.2020.1736644.
A tug-of-war between severe acute respiratory syndrome coronavirus 2 and host antiviral defence: lessons from other pathogenic viruses.
Abstract
World Health Organization has declared the ongoing outbreak of coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern. The virus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses. Human infection with SARS-CoV-2 leads to a wide range of clinical manifestations ranging from asymptomatic, mild, moderate to severe. The severe cases present with pneumonia, which can progress to acute respiratory distress syndrome. The outbreak provides an opportunity for real-time tracking of an animal coronavirus that has just crossed species barrier to infect humans. The outcome of SARS-CoV-2 infection is largely determined by virus-host interaction. Here, we review the discovery, zoonotic origin, animal hosts, transmissibility and pathogenicity of SARS-CoV-2 in relation to its interplay with host antiviral defense. A comparison with SARS-CoV, Middle East respiratory syndrome coronavirus, community-acquired human coronaviruses and other pathogenic viruses including human immunodeficiency viruses is made. We summarize current understanding of the induction of a proinflammatory cytokine storm by other highly pathogenic human coronaviruses, their adaptation to humans and their usurpation of the cell death programmes. Important questions concerning the interaction between SARS-CoV-2 and host antiviral defence, including asymptomatic and presymptomatic virus shedding, are also discussed.
KEYWORDS:
2019 novel coronavirus; COVID-19; Coronavirus; SARS-CoV; SARS-CoV-2; host antiviral response; type I interferon
9.
Emerg Microbes Infect. 2020 Dec;9(1):582-585. doi: 10.1080/22221751.2020.1735265.
Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0).
Li T1.
Abstract
Since December 2019, China has been experiencing an outbreak of a new infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical features include fever, coughing, shortness of breath, and inflammatory lung infiltration. China rapidly listed SARS-CoV-2-related pneumonia as a statutory infectious disease. To standardize the diagnosis and treatment of this new infectious disease, an operational recommendation for the diagnosis and management of SARS-CoV-2 infection is developed by Peking Union Medical College Hospital.
KEYWORDS:
Coronavirus disease 2019; SARS-CoV-2; diagnosis; pneumonia; treatment
11.
Euro Surveill. 2020 Mar;25(9). doi: 10.2807/1560-7917.ES.2020.25.9.2000152.
Evaluation of a quantitative RT-PCR assay for the detection of the emerging coronavirus SARS-CoV-2 using a high throughput system.
Abstract
Facing the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), high-volume respiratory testing is demanded in laboratories worldwide. We evaluated the performance of a molecular assay for the detection of SARS-CoV-2 on a high-throughput platform, the cobas 6800, using the 'open channel' for integration of a laboratory-developed assay. We observed good analytical performance in clinical specimens. The fully automated workflow enables high-throughput testing with minimal hands-on time, while offering fast and reliable results.
KEYWORDS:
COVID-19; SARS-CoV-2; automation; high-throughput PCR; molecular diagnostic
Comment on
- Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. [Euro Surveill. 2020]
12.
Medicine (Baltimore). 2020 Mar;99(10):e19185. doi: 10.1097/MD.0000000000019185.
Non-HIV talaromycosis: Radiological and clinical analysis.
Abstract
To investigate the characteristics of spiral computed tomography (CT), positron emission tomography-computed tomography (PET/CT) and clinical manifestations of talaromycosis to improve the diagnostic level and deepen its recognition in radiology.Radiological, clinical, and pathological manifestations of 15 patients of non-HIV talaromycosis confirmed by bronchofiberscope lung biopsy and/or abscess puncture fluid culture and/or blood culture and/or sputum culture were analyzed retrospectively. All patients underwent chest CT, among them, six had a brain MRI, and six had a PET/CT scan before treatment.On plain CT scan, there were multiple patches and massive consolidation in 6 patients, multiple patchy consolidations and patchy ground-glass opacities in 3 patients, solitary or multiple nodules and masses in 3 patients, multiple cavities and small nodules in 3 patients. Multiple lymphadenectasis appeared in bilateral hila, mediastinum, and neck in 10 patients. In contrast CT scan, the parenchyma of the lesions had a slight enhancement in 10 patients, moderate enhancement in 3 patients, obvious enhancement in 2 patients. Seven cases had bone destruction and hyperplasia, cranial involvement in 1 patient and liver involvement in 3 patients, respectively. On PET/CT, five patients showed elevated standard uptake value (SUV).The radiological manifestations of non-HIV talaromycosis show multiple consolidations, ground-glass opacities, multiple nodules or masses in bilateral lungs, deep-seated enlarged lymph nodes and bone destruction in multiple systems. The final diagnosis should be based on the culture of talaromycosis.
13.
Emerg Microbes Infect. 2020 Dec;9(1):545-547. doi: 10.1080/22221751.2020.1738279.
Is SARS-CoV-2 originated from laboratory? A rebuttal to the claim of formation via laboratory recombination.
14.
Emerg Microbes Infect. 2020 Dec;9(1):542-544. doi: 10.1080/22221751.2020.1737580.
Timely development of vaccines against SARS-CoV-2.
Lu S1.
15.
East Mediterr Health J. 2020 Feb 24;26(2):136-137. doi: 10.26719/2020.26.2.136.
Coronavirus Disease 2019 outbreak: preparedness and readiness of countries in the Eastern Mediterranean Region.
Abstract
On 31 December 2019, a cluster of acute respiratory illness was reported from China and later confirmed as novel coronavirus on 7 January 2020. This virus is the same member of the coronavirus family that caused the severe acute respiratory syndrome (SARS-CoV) reported in China 2003, and Middle East respiratory syndrome (MERS-CoV) reported in Saudi Arabia in 2012. The initial cases have been linked to a live seafood market in Wuhan, China, and the specific animal source is yet to be determined. The detection of this new virus in humans without knowing the source of the infection has raised greatly heightened concerns not only in China, but also internationally. To date, the outbreak has spread to most provinces in China and 25 other countries within a relatively short period. Consequent to its spread, Dr Tedros Ghebreyesus, Director General of the World Health Organization (WHO), declared the outbreak a Public Health Emergency of International Concern (PHEIC) on 30 January 2020.
Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
16.
N Engl J Med. 2020 Mar 5;382(10):e19. doi: 10.1056/NEJMe2004244.
Audio Interview: What Clinicians Need to Know in Diagnosing and Treating Covid-19.
17.
N Engl J Med. 2020 Mar 5;382(10):893-902. doi: 10.1056/NEJMoa1901814.
Treatment of Highly Drug-Resistant Pulmonary Tuberculosis.
Conradie F1, Diacon AH1, Ngubane N1, Howell P1, Everitt D1, Crook AM1, Mendel CM1, Egizi E1, Moreira J1, Timm J1, McHugh TD1, Wills GH1, Bateson A1, Hunt R1, Van Niekerk C1, Li M1, Olugbosi M1, Spigelman M1; Nix-TB Trial Team.
Abstract
BACKGROUND:
Patients with highly drug-resistant forms of tuberculosis have limited treatment options and historically have had poor outcomes.
METHODS:
In an open-label, single-group study in which follow-up is ongoing at three South African sites, we investigated treatment with three oral drugs - bedaquiline, pretomanid, and linezolid - that have bactericidal activity against tuberculosis and to which there is little preexisting resistance. We evaluated the safety and efficacy of the drug combination for 26 weeks in patients with extensively drug-resistant tuberculosis and patients with multidrug-resistant tuberculosis that was not responsive to treatment or for which a second-line regimen had been discontinued because of side effects. The primary end point was the incidence of an unfavorable outcome, defined as treatment failure (bacteriologic or clinical) or relapse during follow-up, which continued until 6 months after the end of treatment. Patients were classified as having a favorable outcome at 6 months if they had resolution of clinical disease, a negative culture status, and had not already been classified as having had an unfavorable outcome. Other efficacy end points and safety were also evaluated.
RESULTS:
A total of 109 patients were enrolled in the study and were included in the evaluation of efficacy and safety end points. At 6 months after the end of treatment in the intention-to-treat analysis, 11 patients (10%) had an unfavorable outcome and 98 patients (90%; 95% confidence interval, 83 to 95) had a favorable outcome. The 11 unfavorable outcomes were 7 deaths (6 during treatment and 1 from an unknown cause during follow-up), 1 withdrawal of consent during treatment, 2 relapses during follow-up, and 1 loss to follow-up. The expected linezolid toxic effects of peripheral neuropathy (occurring in 81% of patients) and myelosuppression (48%), although common, were manageable, often leading to dose reductions or interruptions in treatment with linezolid.
CONCLUSIONS:
The combination of bedaquiline, pretomanid, and linezolid led to a favorable outcome at 6 months after the end of therapy in a high percentage of patients with highly drug-resistant forms of tuberculosis; some associated toxic effects were observed. (Funded by the TB Alliance and others; ClinicalTrials.gov number, NCT02333799.).
Copyright © 2020 Massachusetts Medical Society.
Comment in
- Triumph and Tragedy of 21st Century Tuberculosis Drug Development. [N Engl J Med. 2020]
18.
Int J Oral Sci. 2020 Mar 3;12(1):9. doi: 10.1038/s41368-020-0075-9.
Transmission routes of 2019-nCoV and controls in dental practice.
Abstract
A novel β-coronavirus (2019-nCoV) caused severe and even fetal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV was different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The person-to-person transmission routes of 2019-nCoV included direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal, and eye mucous membranes. 2019-nCoV can also be transmitted through the saliva, and the fetal-oral routes may also be a potential person-to-person transmission route. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Here we recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.
19.
Emerg Microbes Infect. 2020 Dec;9(1):534. doi: 10.1080/22221751.2020.1732232.
Public's early response to the novel coronavirus-infected pneumonia.
20.
Emerg Microbes Infect. 2020 Dec;9(1):505-507. doi: 10.1080/22221751.2020.1733440.
No credible evidence supporting claims of the laboratory engineering of SARS-CoV-2.
- PMID:
- 32102621
- PMCID:
- PMC7054935
- DOI:
- 10.1080/22221751.2020.1733440
- [Indexed for MEDLINE]
21.
Commun Dis Intell (2018). 2020 Feb 26;44. doi: 10.33321/cdi.2020.44.17.
COVID-19, Australia: Epidemiology Report 4 (Reporting week ending 19:00 AEDT 22 February 2020).
Abstract
This is the fourth epidemiological report for coronavirus disease 2019 (COVID-19), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 22 February 2020. It includes data on COVID-19 cases diagnosed in Australia, the international situation and a review of current evidence.
© Commonwealth of Australia CC BY-NC-ND.
KEYWORDS:
2019-nCoV; Australia; COVID-19; SARS-CoV-2; acute respiratory disease; case definition; coronavirus disease 2019; epidemiology; novel coronavirus
22.
J Korean Med Sci. 2020 Feb 24;35(7):e88. doi: 10.3346/jkms.2020.35.e88.
Letter to the Editor: Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR.
Kim JY1.
Comment on
- PMID:
- 32080992
- PMCID:
- PMC7036343
- DOI:
- 10.3346/jkms.2020.35.e88
- [Indexed for MEDLINE]
23.
Nihon Ronen Igakkai Zasshi. 2020;57(1):45-52. doi: 10.3143/geriatrics.57.45.
[Aspiration pneumonia in elderly stroke patients in a convalescent rehabilitation ward: Risk factors and effects on recovery after stroke].
[Article in Japanese]
Abstract
AIM:
To clarify risk factors for aspiration pneumonia and the effects of aspiration pneumonia on the recovery after stroke in elderly stroke patients in a convalescent rehabilitation ward.
METHODS:
We conducted a retrospective study of 463 stroke patients with dysphagia who were ≥65 years of age (mean age, 80.2±8.1 years) who were admitted to our convalescent rehabilitation ward. Information was obtained from medical charts. A multivariate analysis was performed to clarify risk factors for aspiration pneumonia and the association between aspiration pneumonia and increased functional oral intake scale and functional independence measure motor scores. For the increase in functional independence measure motor score, values of ≥16 points and ≤15 points were coded as 1 and 0, respectively.
RESULTS:
Aspiration pneumonia developed in 52 patients. The multivariate analysis revealed that male sex (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.59-5.95, p<0.001), geriatric nutritional risk index (OR for one unit increase 0.94, 95% CI 0.90-0.97, p<0.001) and tube feeding (OR 3.89, 95% CI 1.71-8.83, p=0.001) on admission were significant predictors of aspiration pneumonia. Aspiration pneumonia was associated with increased functional oral intake scale scores (OR 0.29, 95% CI 0.12-0.66, P=0.003) and increased functional independence measure motor scores (OR 0.23, 95% CI 0.09-0.55, P=0.001).
CONCLUSIONS:
Male sex, undernutrition and tube feeding on admission are risk factors for aspiration pneumonia. Aspiration pneumonia is suggested to be associated with recovery of the oral intake of food and activities of daily living.
KEYWORDS:
Aspiration pneumonia; Convalescent rehabilitation ward; Dysphagia; Functional independence measure; Stroke
24.
Commun Dis Intell (2018). 2020 Feb 20;44. doi: 10.33321/cdi.2020.44.15.
COVID-19, Australia: Epidemiology Report 3 (Reporting week ending 19:00 AEDT 15 February 2020).
Abstract
This is the third epidemiological report for coronavirus disease 2019 (COVID-19), previously known as novel coronavirus (2019-nCoV), from the virus now known as SARS-CoV-2, reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 15 February 2020. It includes data on the COVID-19 Australian cases, the international situation and current information on the severity, transmission and spread.
© Commonwealth of Australia CC BY-NC-ND.
KEYWORDS:
2019-nCoV; Australia; COVID-19; SARS-CoV-2; acute respiratory disease; case definition; coronavirus disease 2019; epidemiology; novel coronavirus
25.
Am J Clin Pathol. 2020 Mar 9;153(4):420-421. doi: 10.1093/ajcp/aqaa029.
Three Emerging Coronaviruses in Two Decades.
KEYWORDS:
2019-nCoV; COVID-19; Coronavirus; MERS-CoV; SARS-CoV; SARS-CoV-2
26.
Commun Dis Intell (2018). 2020 Feb 12;44. doi: 10.33321/cdi.2020.44.14.
COVID-19, Australia: Epidemiology Report 2 (Reporting week ending 19:00 AEDT 8 February 2020).
Abstract
This is the second epidemiological report for coronavirus disease (COVID-19), previously known as novel coronavirus (2019-nCoV), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 8 February 2020. It includes data on Australian cases notified during the week ending 19:00 AEDT 8 February 2020, the international situation and current information on the severity, transmission and spread of the COVID-19 infection.
© Commonwealth of Australia CC BY-NC-ND.
KEYWORDS:
2019-nCoV; Australia; COVID-19; acute respiratory disease; case definition; epidemiology; novel coronavirus
27.
Commun Dis Intell (2018). 2020 Feb 6;44. doi: 10.33321/cdi.2019.44.13.
2019-nCoV acute respiratory disease, Australia: Epidemiology Report 1 (Reporting week 26 January - 1 February 2020).
Abstract
This is the first epidemiological report of novel coronavirus (2019-nCoV) acute respiratory disease infections reported in Australia at 19:00 Australian Eastern Daylight Time [AEDT] 1 February 2020. It includes data on Australian cases notified during the week 26 January to 1 February 2020 and in the previous week (19 to 25 January 2020), the international situation and current information on the severity, transmission and spread of the 2019-nCoV infection.
© Commonwealth of Australia CC BY-NC-ND.
KEYWORDS:
Australia; case definition; epidemiology; novel coronavirus (2019-nCoV); respiratory disease
28.
J Med Virol. 2020 Apr;92(4):403-407. doi: 10.1002/jmv.25695. Epub 2020 Feb 10.
Updates on Wuhan 2019 novel coronavirus epidemic.
Comment on
29.
J Med Virol. 2020 Apr;92(4):448-454. doi: 10.1002/jmv.25693. Epub 2020 Feb 14.
Potential of large "first generation" human-to-human transmission of 2019-nCoV.
Abstract
To investigate the genetic diversity, time origin, and evolutionary history of the 2019-nCoV outbreak in China and Thailand, a total of 12 genome sequences of the virus with known sampling date (24 December 2019 and 13 January 2020) and geographic location (primarily Wuhan city, Hubei Province, China, but also Bangkok, Thailand) were analyzed. Phylogenetic and likelihood-mapping analyses of these genome sequences were performed. On the basis of our results, the star-like signal and topology of 2019-nCoV may be indicative of potentially large "first generation" human-to-human virus transmission. We estimated that 2019-nCoV likely originated in Wuhan on 9 November 2019 (95% credible interval: 25 September 2019 and 19 December 2019), and that Wuhan is the major hub for the spread of the 2019-nCoV outbreak in China and elsewhere. Our results could be useful for designing effective prevention strategies for 2019-nCoV in China and beyond.
© 2020 Wiley Periodicals, Inc.
KEYWORDS:
2019-nCoV; Bangkok; TMRCA; Wuhan; outbreak
Comment on
30.
Nature. 2020 Jan;577(7792):607. doi: 10.1038/d41586-020-00190-6.
This scientist hopes to test coronavirus drugs on animals in locked-down Wuhan.
KEYWORDS:
Diseases; Infection; Virology
31.
Nature. 2020 Jan;577(7792):605-607. doi: 10.1038/d41586-020-00166-6.
China coronavirus: Six questions scientists are asking.
KEYWORDS:
Epidemiology; Medical research; Virology
32.
BMC Public Health. 2019 Dec 30;19(1):1750. doi: 10.1186/s12889-019-8085-2.
Invasive group A Streptococcus disease in Australian children: 2016 to 2018 - a descriptive cohort study.
Oliver J1,2, Thielemans E3,4, McMinn A3, Baker C3, Britton PN5,6, Clark JE7, Marshall HS8, Blyth CC9,10,11, Francis J12,13, Buttery J3,14, Steer AC3, Crawford NW3,15; PAEDS investigators.
Abstract
OBJECTIVES:
Invasive group A Streptococcus (iGAS) disease is serious and sometimes life-threatening. The Paediatric Active Enhanced Disease Surveillance (PAEDS) Network collects voluntary notifications from seven major Australian paediatric hospitals on patients with certain conditions, including iGAS disease. Our aims were to: 1) Describe the epidemiological distribution of paediatric iGAS disease in Australia and correlate this with influenza notifications, 2) Identify GAS strains commonly associated with invasive disease in children.
METHODS:
IGAS and influenza notification data were obtained (from the PAEDS Network and the Australian Institute of Health and Welfare, respectively, for the period 1 July 2016 to 30 June 2018). Included iGAS patients had GAS isolated from a normally sterile body site. Data were described according to selected clinical and demographic characteristics, including by age group and Australian State, with proportions and minimum incidence rates estimated.
RESULTS:
A total of 181 patients were identified, with most (115, 63.5%) <5 years old. The mean annual minimum incidence rate was 1.6 (95% confidence interval: 1.1-2.3) per 100,000 children across the study period. An epidemiological correlation with the seasonal burden of influenza was noted. Contact prophylaxis was not consistently offered. Of 96 patients with emm-typing results available, 72.9% showed emm-1, -4 or - 12.
CONCLUSIONS:
Robust surveillance systems and cohesive patient management guidelines are needed. Making iGAS disease nationally notifiable would help facilitate this. Influenza vaccination may contribute to reducing seasonal increases in iGAS incidence. The burden of disease emphasises the need for ongoing progress in GAS vaccine development.
KEYWORDS:
Child health; Group A Streptococcus; Infectious diseases; Invasive; Public health
- PMID:
- 31888568
- PMCID:
- PMC6937995
- DOI:
- 10.1186/s12889-019-8085-2
- [Indexed for MEDLINE]
33.
BMC Public Health. 2019 Dec 21;19(1):1715. doi: 10.1186/s12889-019-7993-5.
The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018.
Abstract
BACKGROUND:
Tuberculosis (TB) makes a big challenge to public health, especially in high TB burden counties of China and Greater Mekong Subregion (GMS). The aim of this study was to identify the spatial-temporal dynamic process and high-risk region of notified pulmonary tuberculosis (PTB), sputum smear-positive tuberculosis (SSP-TB) and sputum smear-negative tuberculosis (SSN-TB) cases in Yunnan, the south-western of China between years of 2005 to 2018. Meanwhile, to evaluate the similarity of prevalence pattern for TB among GMS.
METHODS:
Data for notified PTB were extracted from the China Information System for Disease Control and Prevention (CISDCP) correspond to population information in 129 counties of Yunnan between 2005 to 2018. Seasonally adjusted time series defined the trend cycle and seasonality of PTB prevalence. Kulldorff's space-time scan statistics was applied to identify temporal, spatial and spatial-temporal PTB prevalence clusters at county-level of Yunnan. Pearson correlation coefficient and hierarchical clustering were applied to define the similarity of TB prevalence among borders with GMS.
RESULT:
There were a total of 381,855 notified PTB cases in Yunnan, and the average prevalence was 59.1 per 100,000 population between 2005 to 2018. A declined long-term trend with seasonality of a peak in spring and a trough in winter for PTB was observed. Spatial-temporal scan statistics detected the significant clusters of PTB prevalence, the most likely cluster concentrated in the northeastern angle of Yunnan between 2011 to 2015 (RR = 2.6, P < 0.01), though the most recent cluster for PTB and spatial cluster for SSP-TB was in borders with GMS. There were six potential TB prevalence patterns among GMS.
CONCLUSION:
This study detected aggregated time interval and regions for PTB, SSP-TB, and SSN-TB at county-level of Yunnan province. Similarity prevalence pattern was found in borders and GMS. The localized prevention strategy should focus on cross-boundary transmission and SSN-TB control.
KEYWORDS:
Greater Mekong subregion; Scan statistics; Spatial-temporal cluster; Tuberculosis; Yunnan
- PMID:
- 31864329
- PMCID:
- PMC6925503
- DOI:
- 10.1186/s12889-019-7993-5
- [Indexed for MEDLINE]
34.
Nihon Ronen Igakkai Zasshi. 2019;56(4):516-524. doi: 10.3143/geriatrics.56.516.
[Is intensive and comprehensive dysphagia rehabilitation effective in preventing hospital-acquired pneumonia in a convalescent rehabilitation ward?]
[Article in Japanese]
Abstract
AIM:
To evaluate the effect of intensive and comprehensive dysphagia rehabilitation on the prevention of hospital-acquired pneumonia.
PATIENTS AND METHODS:
In this non-randomized retrospective observational study, we compared two patient groups in a convalescent rehabilitation ward. One included patients after the introduction of an intensive and comprehensive rehabilitative program including various measures, such as nutritional support and respiratory physical therapy (intensive program group); the other included patients who had been admitted before the introduction of the above measures (control group). The primary endpoint was the onset of pneumonia during the hospital stay. A multivariate logistic regression analysis was used to determine the adjusted odds ratio for the relationship between dysphagia rehabilitation and pneumonia onset.
RESULTS:
In the intensive program group, 5 of 291 patients were diagnosed with pneumonia, while in the control group, 13 of 460 were diagnosed with pneumonia. The adjusted odds ratio for intensive and comprehensive dysphagia rehabilitation with respect to hospital-acquired pneumonia was 0.326 (95% confidence interval: 0.112-0.949, p=0.040).
CONCLUSION:
This intensive and comprehensive dysphagia rehabilitation program was thought to be effective in preventing hospital-acquired pneumonia in a convalescent rehabilitation ward.
KEYWORDS:
Convalescent rehabilitation ward; Deglutition disorders; Dysphagia rehabilitation; Healthcare associated pneumonia; Pneumonia prevention and control
35.
Rev Esp Salud Publica. 2019 Nov 18;93. pii: e201911095.
[Influenza vaccination coverages and related factors among splenectomy patients from a health sector in Zaragoza (Spain)].
[Article in Spanish; Abstract available in Spanish from the publisher]
Abstract
OBJECTIVE:
Influenza vaccination coverage in risk groups has been put forward as a healthcare quality indicator. Our objective was to determine the vaccination rate in splenectomized patients.
METHODS:
We carried out a cross-sectional study that included splenectomized patients in the Zaragoza III Sector from January 2012 to December 2016. The patients were identified through the database of the Clinical Documentation and File Management Services of the Sector Hospital under code 41.5 of the ICD-9. The variables (sociodemographic and surgical variables, and having received information and advice regarding vaccination when they were admitted to the Immunization Unit) were obtained after a review of the patients' records in the Specialized and Primary Care Services. The association with being vaccinated during the campaign corresponding to the surgery date was studied with bivariate analysis and multiple logistic regression model.
RESULTS:
81 patients were analyzed; 60.5% were men, with an average age of 56.3 years. Neoplasms and hematological diseases were the most common motives for surgery (64.2%). The vaccination rate was 58%. Having been advised to vaccinate (OR=6.53; 95%CI=1.88-22.69) and having been vaccinated in the previous season (OR=4.79; 95%CI= 1.48-15.57) were associated with vaccination.
CONCLUSIONS:
The coverage rate ranks in an intermediate position when compared with other countries. It is necessary to improve the referral system of these patients to the Immunization Unit because the information obtained by this service leads to better results.
KEYWORDS:
Influenza; Spain; Splenectomy; Vaccination coverage
36.
Rev Esp Salud Publica. 2019 Nov 20;93. pii: e201911061.
[Utility of clinical criteria for the adequate diagnosis of the pharingoamigdalitis in the pediatric emergency service].
[Article in Spanish; Abstract available in Spanish from the publisher]
Abstract
OBJECTIVE:
There are two scales (Centor and McIsaac) that describe the frequent signs and symptoms in pharyngotonsillitis and determine the attitude to be followed for diagnosis and treatment; among them, the McIsaac criteria are one of the most widely used scales. The goal of the study was to determine the predictive value of the McIsaac criteria in the diagnosis of pharyngotonsillitis due to EbhGA in a Pediatric Emergency Service. The predictive value of these criteria is decisive in the adequate use of TDR test and antibiotics as a treatment.
METHODS:
Cross-sectional study. The target population were all patients between 0 and 14 years old treated in the Pediatric Emergency Service of the Casa de Salud Hospital of Valencia during 2016, with discharge diagnoses, tonsillitis, pharyngotonsillitis or pharyngitis and with the TDR performed. Two groups were set up according to whether TDR was positive or negative. The presence of the McIsaac criteria was studied in both groups. A sensitivity and specificity study was carried out and the Total and Bayes Probability theorems were applied as well as the likelihood ratio measures.
RESULTS:
A negative result of TDR was obtained in 58.1% (n=330) and was obtained a positive result in 41.9% (n=238). At least three criteria met 48.3% (n=115) with TDR+ of which the most frequent was age >3 years (97.4%); and 46.7% (n=154) of children with TDR- where the most frequent was the absence of catarrh (91.6%). The output from the predictive analysis of meeting the McIsaac criteria was a sensitivity (P(+/E)=48.3%), a specificity (P(-/NE)=53.3%), a positive predictive value P(E/+)=42.7% and likelihood ratios LR+=1.04 and LR-=0.97.
CONCLUSIONS:
The results indicate a poor predictive value of the McIsaac criteria in the population being studied. The TDR test should be implanted more frequently and the McIsaac criteria should be re-evaluated for the correct diagnosis of pharyngotonsillitis due to EbhGA and with it an adequate treatment to avoid the overprescription of antibiotics.
KEYWORDS:
Diagnostic techniques; McIsaac criteria; Pharyngitis; Spain; TDR Test; Tonsillitis
37.
Diagn Microbiol Infect Dis. 2019 Dec;95(4):114880. doi: 10.1016/j.diagmicrobio.2019.114880. Epub 2019 Aug 2.
FilmArray respiratory panel assay: An effective method for detecting viral and atypical bacterial pathogens in bronchoscopy specimens.
Locher K1, Roscoe D2, Jassem A3, Wong T2, Hoang LMN3, Charles M2, Bryce E2, Grant J2, Stefanovic A2.
Abstract
The BioFire FilmArray Respiratory Panel (FA RP) is a rapid multiplexed molecular assay approved for detection of viral and atypical bacterial pathogens in nasopharyngeal specimens. This study aimed to evaluate the performance of the BioFire FilmArray Respiratory Panel v1.7 on bronchoscopy specimens. We tested 133 bronchial specimens (87 archived and 46 prospectively collected) with the FA RP and compared the results to the Luminex NxTAG Respiratory Pathogen Panel (NxTAG RPP). After discordant analysis, 123 specimens gave concordant results using the FA RP and the NxTAG RPP for an overall agreement of 93.9% (kappa = 0.88 [95% CI 0.80-0.96]), a positive percent agreement of 93.7% (95% CI 83.7-97.7) and a negative percent agreement of 94.1% (95% CI 84.9-98.1). In conclusion, the BioFire FilmArray RP performed reliably to detect a broad range of respiratory pathogens in bronchoscopy specimens.
Copyright © 2019 Elsevier Inc. All rights reserved.
KEYWORDS:
Bronchoscopy; FilmArray respiratory panel; NxTag respiratory panel; Syndromic respiratory testing
38.
Nature. 2019 Sep;573(7774):S49. doi: 10.1038/d41586-019-02750-x.
Influenza.
KEYWORDS:
Diseases; Drug discovery; Therapeutics; Vaccines
39.
Nature. 2019 Sep;573(7774):S56-S57. doi: 10.1038/d41586-019-02754-7.
A sticking point for rapid flu tests?
KEYWORDS:
Diseases; Health care; Medical research
40.
Nature. 2019 Sep;573(7774):S58-S59. doi: 10.1038/d41586-019-02755-6.
Real-time flu tracking.
KEYWORDS:
Computer science; Diseases; Epidemiology; Health care
41.
Nature. 2019 Sep;573(7774):S62-S63. doi: 10.1038/d41586-019-02757-4.
Flu on the farm.
KEYWORDS:
Diseases; Ecology; Health care; Medical research
42.
Nature. 2019 Sep;573(7774):S54-S55. doi: 10.1038/d41586-019-02753-8.
The push for better flu therapies.
KEYWORDS:
Diseases; Drug discovery; Microbiology; Therapeutics
43.
Diagn Microbiol Infect Dis. 2019 Dec;95(4):114869. doi: 10.1016/j.diagmicrobio.2019.114869. Epub 2019 Jul 26.
Improvement in turnaround time for rapid respiratory virus testing using Xpert® Flu/RSV: a retrospective cohort study during a high incidence influenza season.
Abstract
Seasonal influenza like illness results in increased hospital presentations and unnecessary antibiotic use. Recent availability of rapid respiratory virus PCR testing allows rapid, accurate influenza diagnosis. A retrospective audit of turnaround time from sample collection to result availability after introduction of Xpert® Flu/RSV in a tertiary healthcare institution during a high incidence influenza season is described.
Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Influenza; Molecular Diagnostics; Respiratory Virus
44.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Oct;136(5):349-353. doi: 10.1016/j.anorl.2019.04.013. Epub 2019 Aug 16.
Premaxillary abscess without bony erosion: An unusual complication of pediatric acute maxillary sinusitis.
Luscan R1, Truffert E1, Simon F1, Belhous K2, Verillaud B3, Garabedian N1, Leboulanger N1, Couloigner V4.
Abstract
OBJECTIVES:
To report an unusual complication of pediatric acute maxillary sinusitis: premaxillary abscess. To describe clinical, radiological and biological presentation, treatment strategy and progression.
MATERIAL AND METHODS:
A retrospective study included all pediatric patients treated for premaxillary abscess complicating acute maxillary sinusitis in two ENT reference centers between 1999 and 2017. Disease history, clinical presentation, biological and radiological findings, treatment modalities and progression were studied.
RESULTS:
Ten patients were included, with a mean age of 10±4.2 years. All presented with fever, rhinorrhea and premaxillary edema. Contrast-enhanced CT scan systematically found complete opacity of the maxillary sinus, without bone lysis, and extensive effusion along the intersinonasal wall up to the premaxillary region, extending in 3 cases back toward the parapharyngeal space. Bacteriology isolated Streptococcus anginosus most frequently (n=4; 40%). Treatment comprised intravenous wide-spectrum antibiotics, with surgical drainage of the abscess if>10mm (n=9; 90%). Seven of these 9 patients (78%) had recurrent abscess requiring surgical revision and 3 (33%) required a third drainage. All patients were cured without sequelae at 1 month.
CONCLUSION:
In case of acute maxillary sinusitis with premaxillary edema, premaxillary abscess should be suspected. The high recurrence rate argues for maximalist surgery associated to close clinical monitoring with radiological examination.
Copyright © 2019 Elsevier Masson SAS. All rights reserved.
KEYWORDS:
Acute sinusitis; Complication; Infection; Parapharyngeal abscess; Premaxillary abscess
45.
Am J Med Sci. 2019 Nov;358(5):e19. doi: 10.1016/j.amjms.2019.06.003. Epub 2019 Jun 12.
DRESS Syndrome and Chronic Renal Failure Induced by Ethambutol.
46.
Pediatr Pulmonol. 2019 Jun;54(6):907-913. doi: 10.1002/ppul.24336. Epub 2019 Apr 21.
Do combined upper airway cultures identify lower airway infections in children with chronic cough?
Abstract
BACKGROUND:
Obtaining lower airway specimens is important for guiding therapy in chronic lung infection but is difficult in young children unable to expectorate. While culture-based studies have assessed the diagnostic accuracy of nasopharyngeal or oropharyngeal specimens for identifying lower airway infection, none have used both together. We compared respiratory bacterial pathogens cultured from nasopharyngeal and oropharyngeal swabs with bronchoalveolar lavage (BAL) cultures as the "gold standard" to better inform the diagnosis of lower airway infection in children with chronic wet cough.
METHODS:
Nasopharyngeal and oropharyngeal swabs and BAL fluid specimens were collected concurrently from consecutive children undergoing flexible bronchoscopy for chronic cough and cultured for bacterial pathogens.
RESULTS:
In cultures from 309 children (median age, 2.3 years) with chronic endobronchial suppuration, all main pathogens detected (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) were more prevalent in nasopharyngeal than oropharyngeal swabs (37%, 34%, and 23% vs 21%, 6.2%, and 3.2%, respectively). Positive and negative predictive values for lower airway infection by any of these three pathogens were 63% (95% confidence interval [95% CI] 55, 70) and 85% (95% CI, 78, 91) for nasopharyngeal swabs, 65% (95% CI, 54, 75), and 66% (95% CI, 59, 72) for oropharyngeal swabs, and 61% (95% CI, 54,68), and 88% (95% CI, 81, 93) for both swabs, respectively.
CONCLUSIONS:
Neither nasopharyngeal nor oropharyngeal swabs, alone or in combination, reliably predicted lower airway infection in children with chronic wet cough. Although upper airway specimens may be useful for bacterial carriage studies and monitoring antimicrobial resistance, their clinical utility in pediatric chronic lung disorders of endobronchial suppuration is limited.
© 2019 Wiley Periodicals, Inc.
KEYWORDS:
bacterial pathogens; bronchiectasis; chronic suppurative lung disease; nasopharyngeal; oropharyngeal; protracted bacterial bronchitis
47.
Pediatr Pulmonol. 2019 Jun;54(6):901-906. doi: 10.1002/ppul.24321. Epub 2019 Mar 21.
Giant lung cysts following necrotizing pneumonia: Resolution with conservative treatment.
Gross I1,2, Gordon O1,3, Cohen-Cymberknoh M1,4, Reiter J1,4, Tsabari R1,4, Gileles-Hillel A1,4, Erlichman I1,5, Hevroni A1,4,6, Shoseyov D1,4, Kerem E1,4.
Abstract
RATIONALE:
Necrotizing pneumonia is characterized by destruction and liquefaction of the lung tissue and loss of the normal pulmonary parenchymal architecture. During the course of resolution areas of hyperlucency are formed, sometimes with the development of giant lung cysts that can be a field with fluid resembling lung abscess. There is no consensus on the management of these abnormalities.
OBJECTIVE:
To assess the prevalence of giant lung cysts as a complication of necrotizing pneumonia and to report our experience with conservative treatment that achieved complete resolution.
METHODS:
Medical chart reviews of all children aged 0 to 18 years hospitalized with necrotizing pneumonia in a single tertiary center from 2015 to 2017, demographic data, and clinical course during and after hospitalization as well as serial chest imaging were collected.
RESULTS:
During the study period, 761 children were diagnosed with community-acquired pneumonia, 16 of 761 (2.3%) had necrotizing pneumonia and 6 of 16 (37.5%) with necrotizing pneumonia complicated by a giant lung cyst or lung abscess. All were closely observed and showed complete clinical and radiographic resolution with antibiotic treatment.
CONCLUSIONS:
Treatment of giant lung cyst formation following necrotizing pneumonia by a conservative approach with prolonged antibiotics results in complete recovery with no need for invasive procedures.
© 2019 Wiley Periodicals, Inc.
KEYWORDS:
Streptococcus pneumoniae; children; complicated pneumonia; lung abscess; lung cyst; necrotizing pneumonia; pneumatocele
Comment in
- Management of necrotizing pneumonia in children: Time for a patient-oriented approach. [Pediatr Pulmonol. 2019]
48.
Pediatr Pulmonol. 2019 Jun;54(6):894-900. doi: 10.1002/ppul.24318. Epub 2019 Mar 18.
Comparison of heated humidified high-flow nasal cannula flow rates (1-L·kg·min-1 vs 2-L·kg·min -1 ) in the management of acute bronchiolitis.
Abstract
OBJECTIVE:
We aimed to compare the heated humidified high-flow nasal cannula (HHHFNC) flow rate of 1-L·kg·min-1 (1 L) with 2-L·kg·min -1 (2 L) in patients with severe bronchiolitis presenting to the pediatric emergency department.
STUDY DESIGN:
We performed a study in which all patients were allocated to receive these two flow rates. The primary outcome was admitted as treatment failure, which was defined as a clinical escalation in respiratory status. Secondary outcomes covered a decrease of respiratory rate (RR), heart rate (HR), the clinical respiratory score (CRS), rise of peripheral capillary oxygen saturation (SpO2 ), and rates of weaning, intubation, and intensive care unit (ICU) admission.
RESULTS:
One hundred and sixty-eight cases (88 received the 1-L flow rate and 80, the 2-L flow rate) were included in the analyses. Treatment failure was 11.4% (10 of 88) in the 1-L group, and 10% (8 of 80) in the 2-L group (P = .775). Significant variation in the intubation rate or the ICU admission rate was not determined. At the 2nd hour, the rate of weaning (53.4% vs 35%; P = .017), the falling down of the CRS (-2.1 vs -1.5; P < .001), RR (-15.2 vs -11.8; P < .001), and HR (- 24.8 vs - 21.2; P < .001), and the increase of SpO 2 (4.8 vs 3.6; P < .001) were significantly more evident in the 1-L group.
CONCLUSION:
HHHFNC with the 1-L·kg·min-1 flow rate, which provides a more frequent earlier effect, reached therapy success as high as the 2-L·kg·min -1 flow rate in patients with severe acute bronchiolitis.
© 2019 Wiley Periodicals, Inc.
KEYWORDS:
bronchiolitis; emergency deparment; flow rate; high flow nasal cannula
49.
Mol Pharm. 2019 Apr 1;16(4):1723-1731. doi: 10.1021/acs.molpharmaceut.9b00080. Epub 2019 Feb 22.
Spray-Dried Particles of Nitric Oxide-Modified Glutathione for the Treatment of Chronic Lung Infection.
Abstract
Antibiotic resistance in pathogenic bacteria has emerged as a big challenge to human and animal health and significant economy loss worldwide. Development of novel strategies to tackle antibiotic resistance is of the utmost priority. In this study, we combined glutathione (GSH), a master antioxidant in all mammalian cells, and nitric oxide, a proven biofilm-dispersing agent, to produce GSNO. The resazurin biofilm viability assay, crystal violet biofilm assay, and confocal microscopy techniques showed that GSNO disrupted biofilms of both P. aeruginosa PAO1 and multidrug resistant A. baumaunii (MRAB 015069) more efficiently than GSH alone. In addition, GSNO showed a higher reduction in biofilm viability and biomass when combined with antibiotics. This combination treatment also inhibited A. baumaunii (MRAB 015069) growth and facilitated human foreskin fibroblast (HFF-1) confluence and growth simultaneously. A potentially inhalable GSNO powder with reasonable aerosol performance and antibiofilm activity was produced by spray drying. This combination shows promise as a novel formulation for treating pulmonary bacterial infections.
KEYWORDS:
S-nitrosoglutathione; aerosol; antibiotic resistance; biofilm; glutathione; lung infection; nitric oxide; spray drying
50.
J Med Virol. 2019 May;91(5):877-880. doi: 10.1002/jmv.25387. Epub 2019 Jan 10.
A sandwich ELISA for detecting the hemagglutinin of avian influenza A (H10N8) virus.
Abstract
Novel influenza A virus (H10N8) infected human with fatality in China during 2013-2014. It is important to detect such nonprevalent subtype influenza A virus in clinic and regular surveillance in the early stage for effective control and prevention from the potential pandemic. Unavailability of convenient rapid diagnosis for this subtype virus in resources-limited setting is an obstacle for timely recognizing human case. In the present study, a panel of mouse H10 specific monoclonal antibodies (mAbs) was generated, two of which were used to develop a sandwich enzyme-linked immunosorbent assay (ELISA) for detecting the hemagglutinin of avian influenza A (H10N8) virus. ELISA results showed high sensitivity with the lowest detection limit of 0.5HAU/50 μL for live virus, which laid a foundation for clinic use as a promising diagnostic methodology.
© 2018 Wiley Periodicals, Inc.
KEYWORDS:
H10 subtype; hemagglutinin; monoclonal antibody; sandwich ELISA
51.
J Med Virol. 2019 Apr;91(4):588-597. doi: 10.1002/jmv.25358. Epub 2018 Dec 2.
Umifenovir susceptibility monitoring and characterization of influenza viruses isolated during ARBITR clinical study.
Abstract
Antiviral drugs can play a significant role in the control of influenza. Umifenovir (Arbidol) is licensed and widely used in Russia for the prophylaxis and/or treatment of influenza. We evaluated the susceptibility to umifenovir of reference influenza A and B viruses and influenza A viruses isolated from patients in the ARBITR clinical trial in 2012-2014 seasons. Using an MDCK cell-based enzyme-linked immunosorbent assay (ELISA), we showed that the replication of antigenically dominant human influenza A and B viruses was efficiently inhibited by umifenovir. The wild-type А/Perth/265/2009 (H1N1)pdm09, A/Fukui/45/2004 (H3N2), and B/Perth/211/2001 viruses and their oseltamivir-resistant counterparts were susceptible to umifenovir among in vitro laboratory assays. All 18 clinical isolates of influenza A viruses obtained before and during therapy were susceptible to umifenovir with 50% effective concentration (EC 50 ) ranging from 8.4 ± 1.1 to 17.4 ± 5.4 µM. No molecular markers of umifenovir resistance were identified in influenza viruses isolate d from patients at 3, 5, and 7 days after initiation of therapy. None of the viruses isolated before and during umifenovir therapy displayed reduced susceptibility to neuraminidase (NA) inhibitors. Thus, umifenovir is effective against influenza viruses circulating in 2012-2014 seasons, and therapy did not lead to the emergence of drug-resistant variants.
© 2018 Wiley Periodicals, Inc.
KEYWORDS:
chemotherapy; drug specificity; influenza virus; resistance
52.
J Med Virol. 2019 Apr;91(4):564-569. doi: 10.1002/jmv.25350. Epub 2018 Nov 19.
Detection of six common human paramyxoviruses in patients with acute febrile respiratory symptoms using a novel multiplex real-time RT-PCR assay.
Abstract
Human metapneumovirus (hMPV), respiratory syncytial virus type A (RSV-A), RSV-B, and human parainfluenza viruses 1, 2, and 3 (HPIV-1, HPIV-2, and HPIV-3) are common respiratory paramyxoviruses. Here, we developed a two-tube triplex one-step real-time reverse-transcription polymerase chain reaction (real-time RT-PCR) and evaluated its performance using clinical samples. The data showed that this novel assay was 100% consistent with the monoplex real-time RT-PCR assay (in-house), which was superior to the commercial routine multiplex-ligation-NAT-based assay. Meanwhile, the clinical nasopharyngeal swabs of 471 patients with the acute febrile respiratory syndrome (AFRS) were analyzed using the established method. The results showed that 52 (11.7%) cases were positive for paramyxovirus. Among them, HPIVs and RSV-A had the highest detection rate. The age and seasonal distribution of human paramyxovirus infection were analyzed. In conclusion, we developed a novel multiplex real-time RT-PCR assay for the rapid detection of six common human paramyxoviruses, which were dominant in patients with AFRS in Qinghai.
© 2018 Wiley Periodicals, Inc.
KEYWORDS:
acute febrile respiratory syndrome; detection; human paramyxoviruses; real-time reverse-transcription polymerase chain reaction
53.
J Med Virol. 2019 Apr;91(4):570-581. doi: 10.1002/jmv.25347. Epub 2018 Nov 21.
Demographic and seasonal characteristics of respiratory pathogens in neonates and infants aged 0 to 12 months in the Central-East region of Tunisia.
Brini Khalifa I1,2,3,4, Hannachi N1,2, Guerrero A4, Orth-Höller D5, Bhiri S6, Bougila J7, Boughamoura L7, Merchaoui SN8, Sboui H8, Mahdhaoui N8, Schiela B4, Laer DH4, Boukadida J1,2, Stoiber H4.
Abstract
BACKGROUND:
This study aimed to characterize the epidemiology of pathogenic respiratory agents in patients aged 0 to 12 months and hospitalized for acute respiratory infections in Tunisia between 2013 and 2014.
METHODS:
A total of 20 pathogens, including viruses, Mycoplasma pneumoniae, and Streptococcus pneumoniae, were detected using molecular sensitive assays, and their associations with the patient's demographic data and season were analyzed.
RESULTS:
Viral infectious agents were found in 449 (87.2%) of 515 specimens. Dual and multiple infectious agents were detected in 31.4% and 18.6% of the samples, respectively. Viral infection was predominant in the pediatric environment (90.8%, P < 0.001), male patients (88.0%), and spring (93.8%). Rhinovirus was the most detected virus (51.8%) followed by respiratory syncytial virus A/B (34.4%), coronavirus group (18.5%), adenovirus (17.9%), and parainfluenza viruses 1-4 (10.9%). Respiratory Syncytial virus A/B was significantly associated with gender (38.0% male cases vs 28.3% female cases, P = 0.02). Infections by Adenovirus, Bocavirus, and Metapneumovirus A/B increased with increasing age of patients (predominated cases aged 6-12 months, P < 0.001). S. pneumoniae was detected in 30.9% of th tested samples. In 18.2% of the negative viral infections, only S. pneumoniae was identified.
CONCLUSION:
A predominance of the rhinovirus infection was observed in this study. Coronavirus subtypes were described for the first time in Tunisia. The observed different pathogenic profiles across age groups could be helpful to avoid the misclassification of patients presenting with ARIs at the triage level when no standardized protocol is available. This study will provide clues for physicians informing decisions regarding preventive strategies and medication in Tunisia.
© 2018 The Authors. Journal of Medical Virology Published by Wiley Periodicals, Inc.
KEYWORDS:
demography; infants; molecular assays; neonates; respiratory agents; seasonality
54.
J Med Virol. 2019 Apr;91(4):582-587. doi: 10.1002/jmv.25344. Epub 2018 Nov 13.
Comparing the Cobas Liat Influenza A/B and respiratory syncytial virus assay with multiplex nucleic acid testing.
Abstract
Influenza virus and respiratory syncytial virus (RSV) detection with short turn-around-time (TAT) is pivotal for rapid decisions regarding treatment and infection control. However, negative rapid testing results may come from poor assay sensitivity or from influenza-like illnesses caused by other community-acquired respiratory viruses (CARVs). We prospectively compared the performance of Cobas Liat Influenza A/B and RSV assay (LIAT) with our routine multiplexNAT-1 (xTAG Respiratory Pathogen Panel; Luminex) and multiplexNAT-2 (ePlex-RPP; GenMark Diagnostics) using 194 consecutive nasopharyngeal swabs from patients with influenza-like illness during winter 2017/2018. Discordant results were reanalyzed by specific in-house quantitative nucleic acid amplification testing (NAT). LIAT was positive for influenza virus-A, -B, and RSV in 18 (9.3%), 13 (6.7%), and 55 (28.4%) samples, and negative in 108 samples. Other CARVs were detected by multiplexNAT in 66 (34.0%) samples. Concordant results for influenza and RSV were seen in 190 (97.9%), discordant results in 4 (2.1%), which showed low-level RSV (<40 000 copies/mL). Sensitivity and specificity of LIAT for influenza-A, -B, and RSV were 100%, 100% and 100%, and 100%, 99.5% and 100%, respectively. The average TAT of LIAT was 20 minutes compared to 6 hours and 2 hours for the multiplexNAT-1 and -2, respectively. Thus, LIAT demonstrated excellent sensitivity and specificity for influenza and RSV, which together with the simple sample processing and short TAT renders this assay suitable for near-patient testing.
© 2018 Wiley Periodicals, Inc.
KEYWORDS:
influenza virus; nucleic acid amplification testing; point-of-care test; respiratory syncytial virus; turn-around time
55.
Clin Infect Dis. 2019 Feb 1;68(4):623-631. doi: 10.1093/cid/ciy541.
Assessment of Human-to-Human Transmissibility of Avian Influenza A(H7N9) Virus Across 5 Waves by Analyzing Clusters of Case Patients in Mainland China, 2013-2017.
Wang X1, Wu P2, Pei Y1, Tsang TK3, Gu D1, Wang W1, Zhang J1, Horby PW4, Uyeki TM5, Cowling BJ2, Yu H1.
Abstract
BACKGROUND:
The 2016-17 epidemic of human infections with avian influenza A(H7N9) virus was alarming, due to the surge in reported cases across a wide geographic area and the emergence of highly-pathogenic A(H7N9) viruses. Our study aimed to assess whether the human-to-human transmission risk of A(H7N9) virus has changed across the 5 waves since 2013.
METHODS:
Data on human cases and clusters of A(H7N9) virus infection were collected from the World Health Organization, open access national and provincial reports, informal online sources, and published literature. We compared the epidemiological characteristics of sporadic and cluster cases, estimated the relative risk (RR) of infection in blood relatives and non-blood relatives, and estimated the bounds on the effective reproductive number (Re) across waves from 2013 through September 2017.
RESULTS:
We identified 40 human clusters of A(H7N9) virus infection, with a median cluster size of 2 (range 2-3). The overall RR of infection in blood relatives versus non-blood relatives was 1.65 (95% confidence interval [CI]: 0.88, 3.09), and was not significantly different across waves (χ2 = 2.66, P = .617). The upper limit of Re for A(H7N9) virus was 0.12 (95% CI: 0.10, 0.14) and was not significantly different across waves (χ2 = 1.52, P = .822).
CONCLUSIONS:
The small cluster size and low Re suggest that human-to-human transmissibility of A(H7N9) virus has not changed over time and remains limited to date. Continuous assessment of A(H7N9) virus infections and human case clusters is of crucial importance for public health.
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