scholarly journals Moraxella catarrhalisOuter Membrane Vesicles Carry β-Lactamase and Promote Survival ofStreptococcus pneumoniaeandHaemophilus influenzaeby Inactivating Amoxicillin

2011 ◽  
Vol 55 (8) ◽  
pp. 3845-3853 ◽  
Author(s):  
Viveka Schaar ◽  
Therése Nordström ◽  
Matthias Mörgelin ◽  
Kristian Riesbeck

ABSTRACTMoraxella catarrhalisis a common pathogen found in children with upper respiratory tract infections and in patients with chronic obstructive pulmonary disease during exacerbations. The bacterial species is often isolated together withStreptococcus pneumoniaeandHaemophilus influenzae. Outer membrane vesicles (OMVs) are released byM. catarrhalisand contain phospholipids, adhesins, and immunomodulatory compounds such as lipooligosaccharide. We have recently shown thatM. catarrhalisOMVs exist in patients upon nasopharyngeal colonization. As virtually allM. catarrhalisisolates are β-lactamase positive, the goal of this study was to investigate whetherM. catarrhalisOMVs carry β-lactamase and to analyze if OMV consequently can prevent amoxicillin-induced killing. Recombinant β-lactamase was produced and antibodies were raised in rabbits. Transmission electron microscopy, flow cytometry, and Western blotting verified that OMVs carried β-lactamase. Moreover, enzyme assays revealed thatM. catarrhalisOMVs contained active β-lactamase. OMVs (25 μg/ml) incubated with amoxicillin for 1 h completely hydrolyzed amoxicillin at concentrations up to 2.5 μg/ml. In functional experiments, preincubation of amoxicillin (10× MIC) withM. catarrhalisOMVs fully rescued amoxicillin-susceptibleM. catarrhalis,S. pneumoniae, and type b or nontypeableH. influenzaefrom β-lactam-induced killing. Our results suggest that the presence of amoxicillin-resistantM. catarrhalisoriginating from β-lactamase-containing OMVs may pave the way for respiratory pathogens that by definition are susceptible to β-lactam antibiotics.

2020 ◽  
Vol 98 (6) ◽  
pp. 36-39
Author(s):  
G. T. Tаshmetovа ◽  
I. V. Liverko

The objective: to study the prevalence of chronic obstructive pulmonary disease (COPD) in adult organized groups, to assess the structure and risk factors of its development.Subjects and methods. 3,000 people of the organized population working at various enterprises in Tashkent aged 20 to 60 years (1,400 (46.7%) women and 1,600 (53.3%) men) underwent the contemporary pulmonological screening.Results. The active pulmonological screening aimed to detect COPD among organized groups has been justified; examination of 3,000 people allowed detecting 198 (6.6%) new patients additionally to 65 cases that were already known at the time of screening. The chances of developing COPD increase with the presence of risk factors such as smoking, exposure to toxic substances and chemicals, and recurrent upper respiratory tract infections.


Author(s):  
Leda Al Muqsith ◽  
Rinto Rinto

Forest fires and peatlands affect the destruction of the ecosystem and the manhood of the flora and fauna that grows and lives in the forest. The smoke caused also becomes air pollution that can cause diseases of the respiratory tract such as upper respiratory tract infections (ISPA), asthma, chronic obstructive pulmonary disease. Also, smoke can interfere with visibility, especially for aviation transport. The BPBD of Katingan Regency became the hope of the government in the handling of forest and land fires, so that forest fires and peatlands can be reduced annually. This research aims to know the strategy of BPBD in Katingan Regency in the handling of fire and peat land in Katingan district downstream of Katingan Regency. The research approach used is qualitative. Results Adapaun shows that the BPBD strategy of Katingan Regency in the implementation of forest fire and peatland in the region of Katingan Hilir, by involving the human resources that exist in the BPBD regency of Katingan.


Author(s):  
Larissa May ◽  
Grant Tatro ◽  
Eduard Poltavskiy ◽  
Benjamin Mooso ◽  
Simson Hon ◽  
...  

Abstract Background Acute upper respiratory tract infections are a common cause of Emergency Department (ED) visits and often result in unnecessary antibiotic treatment.  Methods We conducted a randomized clinical trial to evaluate the impact of a rapid, multi-pathogen respiratory panel (RP) test versus usual care (control). Patients were eligible if they were ≥12 months old, had symptoms of upper respiratory infection or influenza like illness, and were not on antibiotics. The primary outcome was antibiotic prescription; secondary outcomes included antiviral prescription, disposition, and length of stay (ClinicalTrials.gov# NCT02957136). Results Of 191 patients enrolled, 93 (49%) received RP testing; 98 (51%) received usual care. Fifty-three (57%) RP and 7 (7%) control patients had a virus detected and reported during the ED visit (p=0.0001). Twenty (22%) RP patients and 33 (34%) usual care patients received antibiotics during the ED visit (-12% [95% CI -25%, 0.4%]; p=0.06/0.08); 9 RP patients received antibiotics despite having a virus detected. The magnitude of antibiotic reduction was greater in children (-19%) versus adults (-9%; post-hoc analysis). There was no difference in antiviral use, length of stay, or disposition. Conclusions Rapid RP testing was associated with a trend towards decreased antibiotic use, suggesting a potential benefit from more rapid viral tests in the ED. Future studies should determine if specific groups are more likely to benefit from testing and evaluate relative cost and effectiveness of broad testing, focused testing, and a combined diagnostic and antimicrobial stewardship approach.


2017 ◽  
Vol 94 (11) ◽  
pp. 851-860
Author(s):  
Aleksandr I. Sinopal’nikov

The advent of the first «respiratory» fluoroquinolone in the late 1990s gave rise to a dramatic growth in popularity ofantibiotics of this class. Levofloxacin like other fluoroquinolones is highly active with respect to Gram-positive, Gram-negative, and atypical pathogens including penicillin-resistant strains of Streptococcus pneumoniae. It is recommended for the treatment of community-acquired pneumonia, nosocomial pneumonia, and exacerbations of chronic obstructive pulmonary disease. Levofloxacin is safe and characterized by high bioavailability and high concentration at the site of inflammation. Therapy with its high doses (750 and 1000 mg/day) during 5 days improves the outcome of the treatment due to improved compliance and minimal risk of development of drug resistance. nosocomial pneumonia, exacerbations of chronic obstructive pulmonary disease.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Chen ◽  
Yulin Feng ◽  
Ke Wang ◽  
Jing Yang ◽  
Yuejun Du

Abstract Background We aimed to assess the association between inhaled corticosteroids (ICSs) and the risk of upper respiratory tract infection (URTI) in patients with chronic obstructive pulmonary disease (COPD). Methods PubMed, Embase, Cochrane Library and Clinical Trials.gov were searched from inception to October 2019. Randomized controlled trials (RCTs) of any ICSs vs control for COPD with reporting of URTI as an adverse event were included. The study was registered with PROSPERO prospectively (#CRD42020153134). Results Seventeen RCTs (20,478 patients) were included. ICSs significantly increased the risk of URTI in COPD patients (RR, 1.13; 95% CI 1.03–1.24; P = 0.01; heterogeneity: I2 = 7%). Futher subgroup analyses suggested that short-term use of ICSs increased the risk of URTI (RR, 1.29; 95% CI 1.06–1.56; P = 0.01; heterogeneity: I2 = 14%) but not for long-term use (RR, 1.08; 95% CI 0.97–1.2; P = 0.14; heterogeneity: I2 = 0%). Short-term use of high-dose fluticasone increased the risk of URTI (RR, 1.33; 95% CI 1.03–1.71; P = 0.03; heterogeneity: I2 = 0%) but not for long-term use (RR, 1.12; 95% CI 0.97–1.29; P = 0.13; heterogeneity: I2 = 50%). Medium-dose (RR, 0.97; 95% CI 0.71–1.32; P = 0.84; heterogeneity: I2 = 0%) and low-dose (RR, 1.39; 95% CI 0.92–2.1; P = 0.12; heterogeneity: I2 = 30%) fluticasone did not increase the risk of URTI regardless of duration. Neither mometasone (RR, 1.05; 95% CI 0.87–1.26; P = 0.61; heterogeneity: I2 = 0%) nor budesonide (RR, 1.08; 95% CI 0.77–1.5; P = 0.67; heterogeneity: I2 = 46%) increased the risk of URTI, regardless of dosage or duration. Conclusions Long-term use of ICSs does not increase the risk of URTI in patients with COPD. Short-term use of high-dose fluticasone increases the risk of URTI in patients with COPD, but not mometasone or budesonide.


2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Eric J Chow ◽  
Melissa A Rolfes ◽  
Ruth L Carrico ◽  
Stephen Furmanek ◽  
Julio A Ramirez ◽  
...  

Abstract Background Preventing severe complications of influenza such as hospitalization is a public health priority; however, estimates of influenza vaccine effectiveness (VE) against influenza-associated acute lower respiratory tract infection (LRTI) hospitalizations are limited. We examined influenza VE against influenza-associated LRTIs in hospitalized adult patients. Methods We retrospectively analyzed data from a randomized trial of oseltamivir treatment in adults hospitalized with LRTI in Louisville, Kentucky, from 2010 to 2013. Patients were systematically tested for influenza at the time of enrollment. We estimated VE as 1 – the adjusted odds ratio (aOR) of antecedent vaccination in influenza-positives vs negatives × 100%. Vaccination status was obtained by patient self-report. Using logistic regression adjusting for age, sex, season, timing of illness, history of chronic lung disease, and activities of daily living, we estimated VE against hospitalized influenza-associated LRTIs and community-acquired pneumonia (CAP) with radiographic findings of infiltrate. Results Of 810 patients with LRTI (median age, 62 years), 184 (23%) were influenza-positive and 57% had radiographically confirmed CAP. Among influenza-positives and -negatives, respectively, 61% and 69% were vaccinated. Overall, 29% were hospitalized in the prior 90 days and >80% had comorbidities. Influenza-negatives were more likely to have a history of chronic obstructive pulmonary disease than influenza-positives (59% vs 48%; P = .01), but baseline medical conditions were otherwise similar. Overall, VE was 35% (95% CI, 4% to 56%) against influenza-associated LRTI and 51% (95% CI, 13% to 72%) against influenza-associated radiographically confirmed CAP. Conclusions Vaccination reduced the risk of hospitalization for influenza-associated LRTI and radiographically confirmed CAP. Clinicians should maintain high rates of influenza vaccination to prevent severe influenza-associated complications.


2018 ◽  
Vol 56 (10) ◽  
Author(s):  
David M. Jacobs ◽  
Heather M. Ochs-Balcom ◽  
Jiwei Zhao ◽  
Timothy F. Murphy ◽  
Sanjay Sethi

ABSTRACT Little is known about interactions between nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, and Pseudomonas aeruginosa in the lower respiratory tract in chronic obstructive pulmonary disease (COPD) patients. We characterized colonization by these four bacterial species, determined species-specific interactions, and estimated the effects of host factors on bacterial colonization among COPD patients. We conducted a prospective cohort study in veterans with COPD that involved monthly clinical assessment and sputum cultures with an average duration of follow-up of 4.5 years. Cultures were used for bacterial identification. We analyzed bacterial interactions using generalized linear mixed models after controlling for clinical and demographic variables. The outcomes of interest were the relationships between bacteria based on clinical status (stable or exacerbation). One hundred eighty-one participants completed a total of 8,843 clinic visits, 30.8% of which had at least one of the four bacteria isolated. H. influenzae was the most common bacterium isolated (14.4%), followed by P. aeruginosa (8.1%). In adjusted models, S. pneumoniae colonization was positively associated with H. influenzae colonization (odds ratio [OR], 2.79; 95% confidence interval [CI], 2.03 to 3.73). We identified negative associations between P. aeruginosa and H. influenzae (OR, 0.15; 95% CI, 0.10 to 0.22) and P. aeruginosa and M. catarrhalis (OR, 0.51; 95% CI, 0.35 to 0.75). Associations were similar during stable and exacerbation visits. Recent antimicrobial therapy was associated with a lower prevalence of S. pneumoniae, H. influenzae, and M. catarrhalis, but not P. aeruginosa. Our findings support the presence of specific interspecies interactions between common bacteria in the lower respiratory tracts of COPD patients. Further work is necessary to elucidate the mechanisms of these complex interactions that shift bacterial species.


2020 ◽  
Vol 9 (12) ◽  
pp. 3979
Author(s):  
Javier de Miguel-Diez ◽  
Romana Albaladejo-Vicente ◽  
Domingo Palacios-Ceña ◽  
David Carabantes-Alarcon ◽  
José Javier Zamorano-Leon ◽  
...  

(1) Background: To examine trends in incidence and outcomes of urinary tract infections (UTIs) among men and women with or without chronic obstructive pulmonary disease (COPD), and to identify the predictors for in-hospital mortality (IHM). (2) Methods: We included patients (aged ≥40 years) who were hospitalized with UTIs between 2001 and 2018. Data were collected from the Spanish National Hospital Discharge Database. (3) Results: We identified 748,458 UTI hospitalizations, 6.53% with COPD. The UTIs incidence increased over time. It was 1.55 times higher among men COPD patients than among non-COPD men (incidence rate ratio (IRR) 1.55; 95% CI 1.53–1.56). The opposite happened in women with COPD compared to non-COPD women (IRR 0.30; 95% CI 0.28–0.32). IHM was higher in men with COPD than non-COPD men (5.58% vs. 4.47%; p < 0.001) and the same happened in women (5.62% vs. 4.92%; p < 0.001). The risk of dying increased with age and comorbidity, but the urinary catheter was a protective factor among men (OR 0.75; 95% CI 0.64–0.89). Multivariable analysis showed a significant reduction in the IHM over time for men and women with COPD. Suffering from COPD only increased the risk of IHM among men (OR 1.07; 95% CI 1.01–1.13). (4) Conclusions: The incidence of UTIs increased over time. Suffering COPD increased the risk of IHM among men, but not among women.


Sign in / Sign up

Export Citation Format

Share Document