scholarly journals BioFire FilmArray Decreases Infection Control Isolation Times by 4 days in ICU, BMT and Respiratory Wards

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S353-S353 ◽  
Author(s):  
Titus Wong ◽  
Aleksandra Stefanovic ◽  
Kerstin Locher ◽  
Elizabeth Bryce ◽  
Jennifer M Grant ◽  
...  
Keyword(s):  
Infection Control ◽  
Influenza A ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Diagnostic Testing ◽  
Cost Benefit ◽  
Respiratory Pathogen ◽  
Duration Of Infection ◽  
The Impact ◽  
Research Grant

Abstract Background Novel, rapid, syndromic testing of patients presenting with respiratory infections has the potential to improve patient access and care by decreasing time to diagnosis. BioFire FilmArray (BioFire Diagnostics, bioMerieux) is a cartridge-based, multiplex PCR platform capable of detecting 17 viral and 3 bacterial targets in one hour. This study assessed the impact of implementing this technology on the duration of infection control isolation. Methods A randomized control trial in a 900-bed tertiary-care academic hospital was conducted between December 2016 and January 2017. Fifty consecutive samples of patients with respiratory infections on our ICU, BMT and Respiratory wards to received either BioFire FilmArray Respiratory Panel (BF) diagnostic testing or our routine diagnostic testing (RO) consisting of an influenza A/B/RSV PCR (in-house) followed by Luminex NxTag Respiratory Pathogen Panel that was batched at a reference lab. Five patient charts with missing data were excluded from analysis. Statistical analysis was completed using RStudio Version 1.0.136 – © 2009–2016 RStudio, Inc. Results Patients randomized to the BF arm remained on respiratory isolation precautions on average (42.3 ± 72.9 hours) over 100 hours less than patients randomized to the routine arm (151.3 ± 151.8 hours) (95% CI: 35.6–184.4 hours, P = 0.0052). Conclusion Implementing the BioFire FilmArray Respiratory Panel decreased infection control isolation time by approximately 4 days compared with routine testing; further study is warranted to determine the impact of this technology on patient outcomes and cost benefit. Disclosures T. Wong, bioMerieux: Investigator, Research grant A. Stefanovic, bioMerieux: Investigator, Research grant E. Bryce, bioMerieux: Investigator, Research grant J. M. Grant, bioMerieux: Investigator, Research grant D. Roscoe, bioMerieux: Investigator, Research grant

Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

2011 ◽  
Vol 140 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
N. ARINAMINPATHY ◽  
N. RAPHAELY ◽  
L. SALDANA ◽  
C. HODGEKISS ◽  
J. DANDRIDGE ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Pandemic Influenza ◽  
Summer School ◽  
Influenza A ◽  
Control Measures ◽  
Infection Control Measures ◽  
Influenza A H1n1 ◽  
Hygiene Measures ◽  
The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

scholarly journals Allergic inflammation hinders synergistic viral-bacterial co-infection in C57BL/6 mice

2019 ◽  
Author(s):  
Kim S. LeMessurier ◽  
Amy R. Iverson ◽  
Ti-Cheng Chang ◽  
Maneesha Palipane ◽  
Peter Vogel ◽  
...  
Keyword(s):  
Lung Disease ◽  
Influenza A ◽  
Respiratory Infections ◽  
Negative Impact ◽  
Influenza Pandemic ◽  
Severe Disease ◽  
Allergic Inflammation ◽  
Lung Microbiome ◽  
Severe Influenza ◽  
The Impact

AbstractAsthma is a chronic airways disease that can be exacerbated during respiratory infections. Our previous findings that the inflammatory state of allergic airways at the time of influenza A virus (IAV) infection in combination with epidemiologic findings that asthmatics were less likely to suffer from severe influenza during the 2009 pandemic suggest that additional complications of influenza, such as increased susceptibility to bacterial superinfection, may be mitigated in the allergic host. To test this hypothesis, we developed a murine model of ‘triple-disease’ in which mice were first rendered allergic to Aspergillus fumigatus and co-infected with IAV and Streptococcus pneumoniae seven days apart. Significant alterations to known synergistic effects of co-infection were noted in the allergic mice including reduced morbidity and mortality, bacterial burden, maintenance of alveolar macrophages, and reduced lung inflammation and damage. The lung microbiome of allergic mice differed from that of non-allergic mice during co-infection. To investigate the impact of the microbiome on the pathogenesis of lung disease, we induced a perturbation with a short course of fluoroquinolone antibiotic that is often prescribed for lung infections. A significant change in the microbiome was complemented with alterations to the inflammatory profile and a drastic increase in pro-inflammatory cytokines in allergic mice which were now susceptible to severe disease from IAV and S. pneumoniae co-infection. Our data suggest that responses to co-infection in allergic hosts likely depends on the immune and microbiome states and that antibiotics should be used with caution in individuals with underlying chronic lung disease.Author SummaryAsthma is a condition of the lungs that affects millions worldwide. Traditionally, respiratory infections are considered to have a negative impact on asthmatics. However, epidemiological data surrounding the 2009 influenza pandemic suggest that asthmatics may be better equipped to counter severe influenza including bacterial pneumonia. Herein, we introduce a novel mouse model system designed to recapitulate an influenza virus and Streptococcal co-infection in a host with fungal asthma. We found that underlying allergic asthma protects against severe disease induced by co-infection. Mice with underlying allergic inflammation had reduced damage to the lungs and did not show signs of respiratory distress. Among the differences noted in the allergic mice that were protected from viral and bacterial co-infection, was the lung microbiome. Allergic mice lost their protection from co-infection after we perturbed their lung microbiome with antibiotics suggesting that the lung microbiome plays a role in host immunity against invading pathogens.

scholarly journals 111 Common nutritional and infectious health challenges in nursery pigs

2019 ◽  
Vol 97 (Supplement_2) ◽  
pp. 62-63
Author(s):  
Eric R Burrough ◽  
Nicholas K Gabler
Keyword(s):  
Influenza A ◽  
Diagnostic Testing ◽  
Clinical Signs ◽  
Enterotoxigenic Escherichia Coli ◽  
Detection Methods ◽  
Respiratory Syndrome Virus ◽  
Common Source ◽  
Poor Growth ◽  
Nursery Pigs ◽  
The Impact

Abstract Poor starting nursery pigs are a common source of frustration for pork producers due to suboptimal lean tissue production and failure to thrive. This is generally a multifactorial issue with potential nutritional, infectious and management contributors. Commonly encountered respiratory and enteric pathogens include porcine reproductive and respiratory syndrome virus (PRRSV), influenza A virus (IAV), porcine enteric coronaviruses (TGEV/PEDV/PDCV), and group A, B, and C rotaviruses, as well as Salmonella typhimurium, enterotoxigenic Escherichia coli, Streptococcus suis, and Haemophilus parasuis. Infection with one or more of these agents can ultimately antagonize pig health and performance. However, while these specific pathogens may be causing an observed disease symptom, pigs may have been predisposed to infection due to various management, nutritional, and environmental risk factors. As many of these potential pathogens are endemic in production systems, it is important to remember that simply detecting a potential pathogen within a population is often not sufficient to assign cause for poor growth and production. To help fully interpret the impact of a detected agent, diagnostic efforts should focus on providing proof that the agent is actually causing disease. Molecular detection methods, such as PCR, are increasingly available for common pathogens and have high diagnostic sensitivity but lower diagnostic specificity. This paper will discuss the clinical signs and gross and microscopic lesions associated with common nursery pig pathogens, as well as proper sampling and diagnostic testing necessary to detect and confirm disease following infection with these agents.

scholarly journals Human Coronavirus-HKU1 Infection Among Adults in Cleveland, Ohio

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Anubhav Kanwar ◽  
Suresh Selvaraju ◽  
Frank Esper
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Supplemental Oxygen ◽  
Respiratory Pathogen ◽  
Disease Spectrum

Abstract Background Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. Methods Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive. Results Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A. Conclusions Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.

scholarly journals Maintenance Immunosuppression Is Associated With Better Outcome in the 2017/2018 Influenza Epidemic

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Klaus Stahl ◽  
Benjamin Seeliger ◽  
Markus Busch ◽  
Olaf Wiesner ◽  
Tobias Welte ◽  
...  
Keyword(s):  
Influenza A ◽  
Influenza Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Influenza Epidemic ◽  
Icu Admission ◽  
Maintenance Immunosuppression ◽  
Mortality Causes ◽  
The Impact ◽  
Aids Chemotherapy

Abstract Background The impact of immunosuppression on outcomes in influenza is insufficiently understood. We analyzed the morbidity and mortality of immunocompetent (IC) vs immunosuppressed (IS) patients with influenza A and B in the 2017/2018 season. Methods Patients with proven influenza in a German tertiary care hospital were analyzed for hospitalization, intensive care unit (ICU) admission, and mortality. Causes for IS were organ and bone marrow transplantation, AIDS, chemotherapy, and medical immunosuppression. Results In total, 227 patients were included in this analysis (IC, n = 118 [52%]; IS, n = 109 [48%]). Hospitalization (71% vs 91%; P < .001) and ICU admission (7% vs 23%; P = .001) were less frequent in the IS compared with the IC group. IC patients had a higher need for invasive ventilation (20% vs 5%; P = .001), vasopressors (19% vs 4%; P < .001), and renal replacement therapy (15% vs 3%; P = .002). Influenza-associated cardiomyopathy was found in 18% of IC vs 2% of IS patients (P < .001). The 30-day in-hospital mortality was 6.6%, 10.2% in the IC group and 2.8% in the IS group (hazard ratio IS group, 0.259; 95% confidence interval [CI], 0.113–0.855; P = .023). Immunosuppression was associated with reduced mortality (odds ratio, 0.25; 95% CI, 0.07–0.91; P = .036). Conclusions We observed that IS was not associated with a worse outcome in this influenza cohort. Due to the presence of both confounding and referral and selection bias, the conclusion that immunosuppression reduces mortality cannot be drawn. Prospective studies investigating the influence of baseline immunosuppression on severity of influenza infection are desirable.

scholarly journals Infections in a Tertiary Care Pediatric Center in Southern Poland during the SARS-CoV-2 Pandemic

2021 ◽  
Vol 12 (4) ◽  
pp. 938-949
Author(s):  
Joanna Klepacka ◽  
Zuzanna Zakrzewska ◽  
Małgorzata Czogała ◽  
Adriana Chromy-Czoniszwili ◽  
Szymon Skoczeń ◽  
...  
Keyword(s):  
Influenza A ◽  
Tertiary Care ◽  
Antifungal Drugs ◽  
Healthcare Facilities ◽  
Southern Poland ◽  
Preventative Measures ◽  
Socioeconomic System ◽  
The Impact ◽  
Pediatric Center ◽  
Pandemic Wave

The worldwide surge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic and led governments to control spread of the virus and provide care for the population affected by the infection. Although, in children, COVID-19 is usually asymptomatic or mild (except PIMS), the pandemic affected the whole socioeconomic system and led to the overwhelming of healthcare facilities. We report retrospective observations of the prevalence of various infectious diseases during the SARS-CoV-2 pandemic in a tertiary multidisciplinary pediatric center in Southern Poland. We retrospectively evaluated the impact of the SARS-CoV-2 pandemic on the number of other infections diagnosed in a pediatric tertiary care referral center. Our analysis included the period from the beginning of February to the end of April 2020 (spring pandemic wave), and from the beginning of September to the end of November 2020 (autumn pandemic wave). We compared them to the appropriate periods of 2019. The evaluation included blood, urine, stool and lover respiratory tract cultures as well as virological investigations. Additionally, the costs of antibiotics and antifungal drugs in selected departments were assessed. Our analysis showed considerable reduction in the majority of common infections except for influenza A and B. The microbiological data correspond with economical summary of antibiotic costs, which were significantly lower during the pandemic. One exception was the number of positive blood cultures, which increased even though the overall number of tests was lower. A general reduction of the number of infections diagnosed in children could result from the implemented preventative measures associated with the pandemic and the generally increased awareness of the risk of infection among parents and guardians. The treatment of the most serious diseases continued as it did before the pandemic. To our knowledge, this study is the first attempt to assess the impact of the COVID-19 pandemic on the prevalence of infections in a large pediatric center. Further research on the impact of the COVID-19 pandemic on the healthcare systems is necessary.

scholarly journals MOST EFFECTIVE TACTIC TO RESOLVE PROBLEMATIC INFECTION CONTROL PRACTICES IN DEVELOPING COUNTRIES: PERIODIC IN-SERVICE TRAINING SESSIONS.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Rituja Kaushal
Keyword(s):  
Infection Control ◽  
Practical Knowledge ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Training Session ◽  
P Value ◽  
High Turnover ◽  
Bottom Line ◽  
Significant Difference ◽  
The Impact

Background: Lack of Health Education Training Programs for in-service candidates in most of the health institutions of country is imposing a biggest hindrance in achieving the dream of skilled India. This all hits the institutions’ bottom line and there is no enhancement in skill development, experience and practical knowledge of the workers. In certain hospitals because of operational difficulties like high turnover of staff and insufficient time for training and monitoring their effectiveness, good service practices suffers. Methodology: This analytical cohort study was undertaken and was followed up, to assess the impact of specified training sessions, on the knowledge about skills of Infection Prevention over a group of nursing staffs of a tertiary care institution of Bhopal city in 2016. Total 30 nursing participants were evaluated statistically for assessing significant difference in their qualitative knowledge improvement level before and after the infection control training session. Results: Pretest & Posttest means & variances were calculated & Pearson Correlation between pre & posttest findings was also estimated. Here (t29 = -6.59, p value ≤ 1.59533*10-7) inference of the study is highly significant. Conclusion: It has been concluded that in order to get desired results in terms of infection control practices, intermittent and relevant training sessions are required.

scholarly journals Ageing, immunity and influenza: a role for probiotics?

2013 ◽  
Vol 73 (2) ◽  
pp. 309-317 ◽  
Author(s):  
Parveen Yaqoob
Keyword(s):  
Gut Microbiota ◽  
Older People ◽  
Influenza A ◽  
Respiratory Infections ◽  
Ageing Population ◽  
Susceptibility To Infection ◽  
Age Related ◽  
Randomised Controlled ◽  
Adjuvant Effects ◽  
The Impact

Influenza is a major cause of death in the over 65s. Increased susceptibility to infection and reduced response to vaccination are due to immunosenscence in combination with medical history and lifestyle factors. Age-related alterations in the composition of the gut microbiota have a direct impact on the immune system and it is proposed that modulation of the gut microbiota using pre- and probiotics could offer an opportunity to improve immune responses to infections and vaccination in older people. There is growing evidence that probiotics have immunomodulatory properties, which to some extent are strain-dependent, and are strongly influenced by ageing. Randomised controlled trials suggest that probiotics may reduce the incidence and/or severity of respiratory infections, although there is limited data on older people. A small number of studies have examined the potential adjuvant effects of selected probiotics for vaccination against influenza; however, the data is inconsistent, particularly in older people. This review describes the impact of age-related changes in the gut on the immune response to respiratory infections and evaluates whether restoration of gut microbial homoeostasis by probiotics offers an opportunity to modulate the outcome of respiratory infections and vaccination against influenza in older people. Although there is promising evidence for effects of probiotics on human health, there is a lack of consistent data, perhaps partly due to strain-specific differences and an influence of the age of the host. Further research is critical in evaluating the potential use of probiotics in respiratory infections and vaccination in the ageing population.

scholarly journals Etiology of Coinfections in Children with Influenza during 2015/16 Winter Season in Nepal

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Bishnu Prasad Upadhyay ◽  
Megha Raj Banjara ◽  
Ram Krishna Shrestha ◽  
Masato Tashiro ◽  
Prakash Ghimire
Keyword(s):  
Influenza Virus ◽  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Antimicrobial Agents ◽  
Respiratory Infections ◽  
Winter Season ◽  
Parainfluenza Virus ◽  
Respiratory Pathogen ◽  
Respiratory Pathogens ◽  
Syncytial Virus

Acute respiratory infections (ARIs) are one of the major public health problems in developing countries like Nepal. Besides the influenza, several other pathogens are responsible for acute respiratory infection in children. Etiology of infections is poorly characterized at the course of clinical management, and hence empirical antimicrobial agents are used. The objective of this study was to characterize the influenza and other respiratory pathogens by real-time PCR assay. A total of 175 throat swab specimens of influenza-positive cases collected at National Influenza Center, Nepal, during the 2015/16 winter season were selected for detecting other respiratory copathogens. Total nucleic acid was extracted using Pure Link viral RNA/DNA mini kit (Invitrogen), and multiplex RT-PCR assays were performed. Influenza A and B viruses were found in 120 (68.6%) and 55 (31.4%) specimens, respectively, among which coinfections were found in 106 (60.6%) specimens. Among the influenza A-positive cases, 25 (20.8%) were A/H1N1 pdm09 and 95 (79.2%) were A/H3 subtypes. Viruses coinfected frequently with influenza virus in children were rhinovirus (26; 14.8%), respiratory syncytial virus A/B (19; 10.8%), adenovirus (14; 8.0%), coronavirus (CoV)-HKU1 (14; 8.0%), CoV-OC43 (5; 2.9%), CoV-229E (2; 1.1%), metapneumovirus A/B (5; 2.9%), bocavirus (6; 3.4%), enterovirus (5; 2.9%), parainfluenza virus-1 (3; 1.7%), and parainfluenza virus-3 (2; 1.1%). Coinfection of Mycoplasma pneumoniae with influenza virus was found in children (5; 2.8%). Most of the viral infection occurred in young children below 5 years of age. In addition to influenza virus, nine different respiratory pathogens were detected, of which coinfections of rhinovirus and respiratory syncytial virus A/B were predominantly found in children. This study gives us better information on the respiratory pathogen profile and coinfection combinations which are important for diagnosis and treatment of ARIs.

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