scholarly journals 1467. Association between Pathogen Load in the Upper Respiratory Tract and Severe Acute Respiratory Infections in Guatemalan Adults: Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, Streptococcus pneumoniae, Klebsiella pneumoniae

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S735-S736
Author(s):  
Sarah Hamid ◽  
Jennifer Milucky ◽  
Nong Shang ◽  
Bernard Wolff ◽  
Chris Van Beneden ◽  
...  

Abstract Background The causal attribution of bacterial pathogens to severe acute respiratory infections (SARI) is challenging because many bacteria are frequently detected in the upper respiratory tract of asymptomatic persons. Quantification of pathogen load may help differentiate asymptomatic pathogen carriage from clinically significant infection. We aimed to determine whether real-time PCR (rt-PCR) cycle threshold (Ct) values, as a proxy for bacterial load, differ between adults with SARI and asymptomatic adults. Methods Adults with SARI (acute onset of fever and cough, requiring hospitalization) were frequency matched to asymptomatic adults (enrolled from trauma and orthopedic inpatient wards) by age group, catchment area, and enrollment date at three surveillance sites in Guatemala. Nasopharyngeal and oropharyngeal specimens were collected from all participants and tested for pathogens using rt-PCR. Using the Wilcoxon rank sum test, we compared the distributions and median Ct values between ill and asymptomatic adults in whom Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, Streptococcus pneumoniae, and Klebsiella pneumoniae were detected. Results Between October 2013 and October 2015, 304 adults with SARI and 174 asymptomatic adults were enrolled (Table). M. catarrhalis, S. aureus, and S. pneumoniae were detected with similar frequency in both groups. H. influenzae and K. pneumoniae were detected more frequently in asymptomatic adults. We found the greatest difference in Ct value distributions between ill (median Ct=30.8) and asymptomatic adults (median Ct=35.6) with S. pneumoniae detections (p< 0.01) (Figure). Median Ct values of H. influenzae (29.3 vs 31.1, p=0.04) and M. catarrhalis (29.2 vs 31.5, p=0.05) were also lower among adults with SARI. Frequency of select bacterial pathogen detection among adults with SARI and among asymptomatic adults, Guatemala, 2013-2015 Distributions of Ct values among adults with SARI and asymptomatic adults in whom a given bacterial pathogen was detected Conclusion Pathogen loads of S. pneumoniae, H. influenzae, and M. catarrhalis were higher among adults with SARI than among asymptomatic adults, suggesting that Ct values may provide insight into SARI etiology for some pathogens, despite the similar frequency of detection among both ill and asymptomatic adults. Future work will normalize Ct values to account for variation in testing and analysis and explore the use of Ct values to estimate population attributable fractions of respiratory infections. Disclosures All Authors: No reported disclosures

2021 ◽  
Vol 26 (1) ◽  
pp. 150-155
Author(s):  
Yu.K. Bolbot ◽  
T.A. Bordiі ◽  
Ya.V. Vilenskyi

Allergic diseases of the respiratory system seriously affect the psychological, physical and social aspects of the live of sick children, morally and financially exhausting members of their families as well. It is known that exacerbations of allergic diseases of the respiratory tract occur due to interaction with numerous triggers, one of which is a respiratory viral infection. At the same time, it is widely known that patients with allergic respiratory diseases are more prone to to acute respiratory infections. One of the reasons for this tendency often is an insufficient activity of non-specific factors of local immunity of the respiratory system – endogenous amphiphilic antimicrobial peptides, in particular the most studied their representatives - the family of defensins and human cathelicidin. Current research proves that these antimicrobial peptides are characterized by broad antiviral, antimicrobial and immunomodulatory activity. The aim of this study was to study the concentrations of local immune factors - human HbD-2 and LL-37 - in the secretion of the mucous membranes of the upper respiratory tract in children with asthma and allergic rhinitis and to clarify their role in protection against respiratory viral infections in this contingent of patients. We performed laboratory and clinical examinations of 76 children aged 7 to 18 years, of whom 24 were diagnosed with allergic rhinitis, 28 children - bronchial asthma, and 24 - bronchial asthma and allergic rhinitis. The control group consisted of 20 healthy children of the appropriate sex and age. In addition to general clinical methods, patterns of respiratory morbidity were analyzed and concentrations of antimicrobial peptides were determined: by ELISA human cathelicidin (LL-37), β-defensin 2 (HbD-2) in the secretion of the upper respiratory tract, statistical analysis was performed. It was found that children with allergic diseases of the respiratory tract are characterized by a higher frequency of acute respiratory infections with more frequent involvement of the lower respiratory tract, which led to an increase in the duration of the disease compared to their healthy peers. In children with allergic rhinitis and bronchial asthma, there was revealed a significant decrease in the concentrations of antimicrobial peptides in the secretion of the upper respiratory tract compared with the control group.


2021 ◽  
Vol 19 (1) ◽  
pp. 64-70
Author(s):  
S.S. Smirnova ◽  
◽  
E.V. Lelenkova ◽  
A.Yu. Markaryan ◽  
I.V. Vyalykh ◽  
...  

Objective. To study the clinical, epidemiological and etiological characteristics of severe acute respiratory infections (SARI) in in-patients in Ekaterinburg during the epidemic season 2017–2018. Patients and methods. 403 individual medical records were studied. Etiological decoding was carried out by isolating RNA or DNA of respiratory viruses from nasopharyngeal swabs by polymerase chain reaction. Results. SARI in hospitalized patients were caused by both influenza viruses (В Yamagata – 25.2% and А(H1N1)pdm09 – 11.0%) and viruses of non-influenza etiology (respiratory syncytial virus (RS-virus) – 13.3%, rhinovirus – 12.9%, metapneumovirus – 11.0%). It was found that viruses were more often secreted in children than in adults; among children of the younger age group (0–2 years old) viruses of non-influenza etiology were detected significantly more often, and in children 7–14 years old, influenza viruses were more often isolated. Patients with upper respiratory tract infections were significantly more likely to have influenza viruses (78.9%) than patients with lower respiratory tract infections (21.1%). Conclusion. The results of the study indicate the importance of hospital surveillance for SARI from the point of view of the etiological diagnosis of respiratory infections, the study of epidemiology and typical clinical manifestations for the timely diagnosis and development of additional preventive and anti-epidemic measures. Key words: hospital surveillance, influenza, PCR diagnostics, respiratory infections, epidemiology, etiology


2020 ◽  
Vol 12 (4) ◽  
pp. 87-92
Author(s):  
A. E. Zobov ◽  
A. A. Panov ◽  
A. A. Kuzin ◽  
A. A. Kucherov ◽  
S. N. Nikishov ◽  
...  

The article sets out the views on the causes of the incidence of various categories of military personnel with acute respiratory infections of the upper respiratory tract (hereinafter – ARI URT), as having the greatest military and epidemiological significance for almost all military contingents.According to the results of a study of literature data, two groups of reasons for the formation of the incidence of acute respiratory infections of the airborne diseases are identified: external (associated with the exposure of military personnel to specific factors of military service) and internal (associated with the characteristics of individual susceptibility to this group of infections).Based on the results of a retrospective epidemiological analysis of the incidence of military servicemen on conscription, the development features of the epidemic process of ARI URT in military units and compounds are shown.According to the results of a retrospective epidemiological analysis of the incidence rate of cadets at the S.M. Kirov Military Medical Academy for 2011-2017 and a comparative analysis of the reversal rate for completed cases, the presence and relatively stable proportion of military personnel exposed to frequent ARI diseases of the airborne diseases throughout the entire 6-year period has been shown period of study.The results of a combined socio-psychological study in groups of often and rarely ill cadets are shown, showing individual signs and psychological characteristics, according to which individual military personnel can be assigned to the risk contingents of increased susceptibility to ARI URT for the purpose of organizing personalized sanitary-antipyretic (preventive) measures.


2019 ◽  
pp. 60-66 ◽  
Author(s):  
V. M. Deliagin

Acute respiratory infections – the most common diseases in childhood, accompanied by cough. Treatment of cough is determined by the disease, the nature of sputum, the the general condition of the patient. The choice can be considered justified, depending on these conditions, herbal preparations or preparations of allo-medicine, their combination. In respiratory infections of the upper respiratory tract, it is possible to use eucaball, the active components of which are thyme and plantain. For infections of the lower respiratory tract with a viscous difficult-to-expelled sputum, Espa-nac (acetylcysteine) is indicated.


1994 ◽  
Vol 15 (5) ◽  
pp. 185-191
Author(s):  
Floyd W. Denny

Acute infections of the upper respiratory tract, including those of the tonsils and pharynx, are the most common affliction of humans; their tendency to occur with much greater frequency in children makes them especially important to the pediatrician. A host of microbial agents can cause these infections, but only a few are responsive to antimicrobial agents. Because of the paucity of definitive laboratory tools that allow easy recognition of the cause of most acute respiratory infections, it is important for the practicing pediatrician to have other methods to aid in the clinical management of children who have these infections. This review will discuss the etiology and epidemiology of acute respiratory infections that involve primarily the tonsils and pharynx, with emphasis on how this knowledge can guide clinicians in their management. The groundwork for this approach will be laid by suggesting a classification of upper respiratory tract infections that involve the tonsils and pharynx. Causative agents will be enumerated and put into perspective. The major factors associated with the occurrence of acute upper respiratory tract infections will be discussed. Finally, treatment of the patient who has tonsillopharyngitis will be presented. Uncomplicated acute tonsillopharyngitis will be emphasized primarily and the role of complications only mentioned.


Author(s):  
D. D. Siukaeva ◽  
I. A. Narkevich ◽  
V. N. Timchenko ◽  
O. D. Nemyatyh ◽  
N. A. Maslova

The aim is to characterize the use of medications in pediatric inpatients with community-acquired pneumonia.Materials and methods. Medical records of 547 children treated for community-acquired pneumonia in 4 medical organizations in St. Petersburg over 2015-2017 were analyzed.The results of this retrospective study (N = 547) showed that children aged 1 to 3 years were most vulnerable (31.44%). Along with that, 45.70% of  patients had concomitant diseases; among those, acute respiratory infections of the upper respiratory tract prevailed (32.20%). As for the medications, the category J drugs “Antimicrobials of systemic action” were most commonly used (30.30%) and contributed the largest part in the total drug costs (80.22%). Specifically, the greatest contribution was made by the J01D group «Beta-lactam antibacterial drugs, other» (64.54%); their cost took 77.22% of the expenses and covered 48.97% of the drug list. 


2018 ◽  
pp. 146-149
Author(s):  
W. M. Delyagin

The incidence of acute respiratory infections (ARI) of the upper respiratory tract in children of the first 3 years of life can reach 3796.29: 1,000. Pre-school children from organized groups register up to 6–10 episodes of ARI annually, and 7–12 in primary school children. The frequency of bacterial complications (otitis, sinusitis, tracheobronchitis, pneumonia) in different age groups and socioeconomic conditions is 10–60%, which requires the appointment of antibiotics. In the case of a severe course of complications, with previously prescribed drugs of the 1st line, an unfavorable premorbid background the treatment with cefixime is preferable.


Author(s):  
A. Panov ◽  
A. Zobov ◽  
A. Kuzin ◽  
A. Kucherov ◽  
S. Nikishov

Here we provide insights into conditions behind developing morbidity pattern in various categories of military personnel (a call-up for military service in military units and compounds, as well as cadets in military educational organizations of the Ministry of Defense of the Russian Federation) with acute respiratory infections of the upper respiratory tract, having the greatest military-epidemiological importance for almost all military contingents.After investigating literary data, two groups of conditions for emerging disease patterns of acute respiratory infections of the upper respiratory tract have been identified: external (related to the impact of specific factors of military service on military personnel) and internal (related to the peculiarities of individual susceptibility to infections). Based on the results of the retrospective epidemiological analysis on incidence of acute respiratory infections of the upper respiratory tract, the peculiarities of the course of the epidemic process for infectious diseases among military personnel performing military service on conscription in military units and compounds, as well as in the Military Medical Academy named after S.M.Kirov for in the years 2011-2017 are shown. It is shown that the intra-annual dynamics of morbidity (according to the average monthly indicators) was uneven and formed two clearly shaped seasonal rises, significantly exceeding the upper limit of the year-round morbidity. At the same time, differences in the organization of educational and performance activities of different categories of military personnel have been identified, which have different effects on shaping morbidity. According to the 2011-2017 results of retrospective epidemiological analysis of personalized morbidity for cadets of the Military Medical Academy named after S.M.Kirov and comparative attendance analysis on revealed cases, the presence and relatively stable portion of military personnel who were more likely to have acute respiratory infections of the upper respiratory tract during entire 6-year training period is shown.Based on the results of the analysis of the calculated average annual incidence of diseases with acute respiratory infections of the upper respiratory tract, it was established that the distribution of cadets within the examined faculties of the S.M.Kirov Military Medical Academy was uneven in accordance with the four selected groups on the average annual disease incidence. There were highlighted cadets often sick and rarely acute respiratory infections of the upper respiratory tract. The results of the combined socio-psychological study in groups of frequent and rare sick cadets are presented, showing individual signs and behavioural features, according to which individual soldiers can be classified as contingents of increased susceptibility risk to acute respiratory infections of the upper respiratory tract for organizing personalized sanitary and anti-epidemic (preventive) measures.


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