scholarly journals Caesarean section and severe upper and lower respiratory tract infections during infancy: Evidence from two UK cohorts

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246832
Author(s):  
Neora Alterman ◽  
Jennifer J. Kurinczuk ◽  
Maria A. Quigley
Keyword(s):  
Caesarean Section ◽  
Respiratory Tract ◽  
Hospital Admission ◽  
Gestational Age ◽  
Lower Respiratory Tract ◽  
Hazard Ratio ◽  
Upper Respiratory Tract ◽  
Emergency Caesarean ◽  
Increased Risk ◽  
Tract Infections

Background Several studies have reported that birth by caesarean section is associated with increased risk of lower respiratory tract infections in the child, but it is unclear whether this applies to any caesarean section or specifically to planned caesareans. Furthermore, although infections of the upper respiratory tract are very common during childhood, there is a scarcity of studies examining whether caesarean is also a risk factor for this site of infection. Methods We obtained data from two UK cohorts: the Millennium Cohort Study (MCS) and linked administrative datasets of the population of Wales through the Secure Anonymised Information Linkage (SAIL) databank. The study focused on term-born singleton infants and included 15,580 infants born 2000–2002 (MCS) and 392,145 infants born 2002–2016 (SAIL). We used information about mode of birth (vaginal delivery, assisted vaginal delivery, planned caesarean and emergency caesarean) from maternal report in the MCS and from hospital birth records in SAIL. Unplanned hospital admission for lower respiratory tract infection (LRTI) was ascertained from maternal report in the MCS and from hospital record ICD codes in SAIL. Information about admissions for upper respiratory tract infection (URTI) was available from SAIL only. Cox regression was used to estimate hazard ratios for each outcome and cohort separately while accounting for a wide range of confounders. Gestational age at birth was further examined as a potential added, indirect risk of planned caesarean birth due to the early delivery. Findings The rate of hospital admission for LRTI was 4.6 per 100 child years in the MCS and 5.9 per 100 child years in SAIL. Emergency caesarean was not associated with LRTI admission during infancy in either cohort. In the MCS, planned caesarean was associated with a hazard ratio of 1.39 (95% CI 1.03, 1.87) which further increased to 1.65 (95% CI 1.24, 2.19) when gestational age was not adjusted for. In SAIL, the adjusted hazard ratio was 1.10 (95% CI 1.05, 1.15), which increased to 1.17 (95% CI 1.12, 1.22) when gestational age was not adjusted for. The rate of hospital admission for URTI was 5.9 per 100 child years in SAIL. Following adjustments, emergency caesarean was found to have a hazard ratio of 1.09 (95% CI 1.05, 1.14) for hospital admission for URTI. Planned caesarean was associated with a hazard ratio of 1.11 (95% CI 1.06, 1.16) which increased to 1.17 (95% CI 1.12, 1.22) when gestational age was not adjusted for. Conclusions The risk of severe LRTIs during infancy is moderately elevated in infants born by planned caesarean compared to those born vaginally. Infants born by any type of caesarean may also be at a small increased risk of severe URTIs. The estimated effect sizes are stronger if including the indirect effect arising from planning the caesarean birth for an earlier gestation than would have occurred spontaneously. Further studies are needed to confirm these results.

scholarly journals The Safety of Delayed Versus Immediate Antibiotic Prescribing for Upper Respiratory Tract Infections

2020 ◽  
Author(s):  
Tjeerd Pieter van Staa ◽  
Victoria Palin ◽  
Benjamin Brown ◽  
William Welfare ◽  
Yan Li ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Admission ◽  
Respiratory Tract Infections ◽  
Population Based ◽  
Upper Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Background This study aimed to evaluate the clinical safety of delayed antibiotic prescribing for upper respiratory tract infections (URTIs), which is recommended in treatment guidelines for less severe cases. Methods Two population-based cohort studies used the English Clinical Practice Research Databank and Welsh Secure Anonymized Information Linkage, containing electronic health records from primary care linked to hospital admission records. Patients with URTI and prescriptions of amoxicillin, clarithromycin, doxycycline, erythromycin, or phenoxymethylpenicillin were identified. Patients were stratified according to delayed and immediate prescribing relative to URTI diagnosis. Outcome of interest was infection-related hospital admission after 30 days. Results The population included 1.82 million patients with an URTI and antibiotic prescription; 91.7% had an antibiotic at URTI diagnosis date (immediate) and 8.3% had URTI diagnosis in 1–30 days before (delayed). Delayed antibiotic prescribing was associated with a 52% increased risk of infection-related hospital admissions (adjusted hazard ratio, 1.52; 95% confidence interval, 1.43–1.62). The probability of delayed antibiotic prescribing was unrelated to predicted risks of hospital admission. Analyses of the number needed to harm showed considerable variability across different patient groups (median with delayed antibiotic prescribing, 1357; 2.5% percentile, 295; 97.5% percentile, 3366). Conclusions This is the first large population-based study examining the safety of delayed antibiotic prescribing. Waiting to treat URTI was associated with increased risk of hospital admission, although delayed antibiotic prescribing was used similarly between high- and low-risk patients. There is a need to better target delayed antibiotic prescribing to URTI patients with lower risks of complications.

scholarly journals Occupation And Occurrence of Respiratory Infections Among Adults With Newly Diagnosed Asthma

2021 ◽  
Author(s):  
Maritta S. Jaakkola ◽  
Taina K. Lajunen ◽  
Aino K. Rantala ◽  
Rachel Nadif ◽  
Jouni J.K. Jaakkola
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Newly Diagnosed ◽  
Lower Respiratory Tract Infections ◽  
Increased Risk ◽  
Study Population ◽  
Tract Infections

Abstract Background: Work environments are potential areas for spreading respiratory infections. We hypothesized that certain occupations increase susceptibility to respiratory infections among adults with asthma. Our objective was to compare the occurrence of respiratory infections among different occupations in adults with newly diagnosed asthma.Methods: We analysed a study population of 492 working-age adults with newly diagnosed asthma who were living in the geographically defined Pirkanmaa Area in Southern Finland during a population-based Finnish Environment and Asthma Study (FEAS). The determinant of interest was occupation at the time of diagnosis of asthma. We assessed potential relations between occupation and occurrence of both upper respiratory tract infections and lower respiratory tract infections during the past 12 months. The measures of effect were incidence rate ratio (IRR) and risk ratio (RR) adjusted for age, gender, and smoking habits. Professionals, clerks, and administrative personnel formed the reference group. Results: The mean number of common colds in the study population was 1.85 (95% CI 1.70, 2.00) infections in the last 12 months. The following occupational groups showed increased risk of common colds: forestry and related workers (aIRR 2.20, 95% CI 1.15-4.23) and construction and mining (aIRR 1.67, 95% CI 1.14-2.44). The risk of lower respiratory tract infections was increased in the following groups: glass, ceramic, and mineral workers (aRR 3.82, 95% CI 2.54-5.74), fur and leather workers (aRR 2.06, 95% CI 1.01-4.20) and metal workers (aRR 1.80, 95% CI 1.04-3.10).Conclusions: We provide evidence that the occurrence of respiratory infections is related to certain occupations.

scholarly journals The association between training load indices and upper respiratory tract infections (URTIs) in elite soccer players

2021 ◽  
pp. 174795412110204
Author(s):  
Caoimhe Tiernan ◽  
Thomas Comyns ◽  
Mark Lyons ◽  
Alan M Nevill ◽  
Giles Warrington
Keyword(s):  
Respiratory Tract ◽  
Signs And Symptoms ◽  
Training Load ◽  
Soccer Players ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Load Indices ◽  
And Training

This study aimed to investigate the association between training load indices and Upper Respiratory Tract Infection (URTI) across different lag periods in elite soccer players. Internal training load was collected from 15 elite soccer players over one full season (40 weeks). Acute, chronic, Acute:Chronic Workload Ratio (ACWR), Exponentially Weighted Moving Averages (EWMA) ACWR, 2, 3 and 4-week cumulative load, training strain and training monotony were calculated on a rolling weekly basis. Players completed a daily illness log, documenting any signs and symptoms, to help determine an URTI. Multilevel logistic regression was used to analyze the associations between training load indices and URTIs across different lag periods (1 to 7-days). The results found a significant association between 2-week cumulative load and an increased likelihood of a player contracting an URTI 3 days later (Odds Ratio, 95% Confidence Interval: OR = 2.07, 95% CI = 0.026-1.431). Additionally, a significant association was found between 3-week cumulative load and a players’ increased risk of contracting an URTI 4 days later (OR = 1.66, 95% CI = 0.013–1.006). These results indicate that accumulated periods of high training load (2- and 3-week) associated with an increased risk of a player contracting an URTI, which may lead to performance decrements, missed training sessions or even competitions.

scholarly journals Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Lei ◽  
Lisong Yang ◽  
Cheong Tat Lou ◽  
Fan Yang ◽  
Kin Ian SiTou ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Pediatric Patients ◽  
Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Viral Etiology ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Background Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. Methods A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. Results Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. Conclusions This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

scholarly journals Lower Respiratory Tract Infections Associated with Rhinovirus during Infancy and Increased Risk of Wheezing during Childhood. A Cohort Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69370 ◽  
Author(s):  
Cristina O’Callaghan-Gordo ◽  
Quique Bassat ◽  
Núria Díez-Padrisa ◽  
Luis Morais ◽  
Sónia Machevo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Increased Risk ◽  
Tract Infections

scholarly journals Serum IgM and C-Reactive Protein Binding to Phosphorylcholine of NontypeableHaemophilus influenzaeIncreases Complement-Mediated Killing

2019 ◽  
Vol 87 (8) ◽  
Author(s):  
Jeroen D. Langereis ◽  
Eva S. van der Pasch ◽  
Marien I. de Jonge
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Classical Pathway ◽  
Upper Respiratory Tract ◽  
C Reactive Protein ◽  
Surface Binding ◽  
Specific Antibodies ◽  
Bacterial Surface ◽  
Reactive Protein ◽  
Tract Infections

ABSTRACTNontypeableHaemophilus influenzae(NTHi) colonizes the human upper respiratory tract without causing disease symptoms, but it is also a major cause of upper and lower respiratory tract infections in children and elderly, respectively. NTHi synthesizes various molecules to decorate its lipooligosaccharide (LOS), which modulates the level of virulence. The presence of phosphorylcholine (PCho) on NTHi LOS increases adhesion to epithelial cells, which is an advantage for the bacterium enabling nasopharyngeal colonization. However, when PCho is incorporated on the LOS of NTHi, it is recognized by the acute-phase C-reactive protein (CRP) and PCho-specific antibodies, both potent initiators of the classical pathway of complement activation. We determined the presence of PCho and binding of IgG and IgM to the bacterial surface for 319 NTHi strains collected from the nasopharynx/oropharynx, middle ear, and lower respiratory tract. PCho detection was higher for NTHi strains collected from the nasopharynx/oropharynx, which was associated with increased binding of IgM and IgG to the bacterial surface. Binding of CRP and IgM to the bacterial surface of PChohighNTHi strains increased complement-mediated killing, which was largely dependent on PCho-specific IgM. The levels of PCho-specific IgM varied in sera from 12 healthy individuals, and higher PCho-specific IgM levels were associated with increased complement-mediated killing of a PChohighNTHi strain. In conclusion, incorporation of PCho on the LOS of NTHi marks the bacterium for binding of CRP and IgM, resulting in complement-mediated killing. Therefore, having a lower PCho might be beneficial in situations where sufficient PCho-specific antibodies and complement are present.

Consumption of gold kiwifruit reduces severity and duration of selected upper respiratory tract infection symptoms and increases plasma vitamin C concentration in healthy older adults

2011 ◽  
Vol 108 (7) ◽  
pp. 1235-1245 ◽  
Author(s):  
Denise C. Hunter ◽  
Margot A. Skinner ◽  
Frances M. Wolber ◽  
Chris L. Booth ◽  
Jacelyn M. S. Loh ◽  
...  
Keyword(s):  
Vitamin C ◽  
Respiratory Tract ◽  
Immune Function ◽  
Washout Period ◽  
Community Dwelling ◽  
Plasma Vitamin ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

In the elderly, immunosenescence and malnourishment can contribute to increased risk and severity of upper respiratory tract infections (URTI). Gold kiwifruit (Actinidia chinensis ‘Hort16A’) contains nutrients important for immune function and mitigation of symptoms of infection, including vitamins C and E, folate, polyphenols and carotenoids. The objective of the present study was to evaluate whether regular consumption of gold kiwifruit reduces symptoms of URTI in older people, and determine the effect it has on plasma antioxidants, and markers of oxidative stress, inflammation and immune function. A total of thirty-two community-dwelling people ( ≥ 65 years) participated in a randomised crossover study, consuming the equivalent of four kiwifruit or two bananas daily for 4 weeks, with treatments separated by a 4-week washout period. Participants completed the Wisconsin Upper Respiratory Symptom Survey-21 daily, and blood samples were collected at baseline and at the end of each treatment and washout period. Gold kiwifruit did not significantly reduce the overall incidence of URTI compared with banana, but significantly reduced the severity and duration of head congestion, and the duration of sore throat. Gold kiwifruit significantly increased plasma vitamin C, α-tocopherol and lutein/zeaxanthin concentrations, and erythrocyte folate concentrations, and significantly reduced plasma lipid peroxidation. No changes to innate immune function (natural killer cell activity, phagocytosis) or inflammation markers (high-sensitivity C-reactive protein, homocysteine) were detected. Consumption of gold kiwifruit enhanced the concentrations of several dietary plasma analytes, which may contribute to reduced duration and severity of selected URTI symptoms, offering a novel tool for reducing the burden of URTI in older individuals.

scholarly journals Clinical study of lower respiratory tract infections in children attending a tertiary care hospital

2017 ◽  
Vol 4 (5) ◽  
pp. 1733
Author(s):  
Venkata Krishna Munagala ◽  
Ramisetty M. Uma Mahesh ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Pathogens ◽  
Tertiary Care ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Cross Sectional ◽  
Tract Infections

Background: WHO estimated burden of respiratory tract infections in 2010, estimates four and half million deaths due to respiratory tract infections among children every year. In India, 1.2 million deaths have been reported among children due to RTI among 5.9 million deaths globally. Lower respiratory tract infections are most common causes of death than upper respiratory tract infections. Pneumonia and Bronchiolitis are most common types of LRTI in children. Pneumonia accounts for most of the deaths in children < 5 years of age. The present study was undertaken with an objective to know the various types of lower respiratory tract infections in children less than 12 years of age. The study also aims to know the various bacterial agents causing respiratory tract infections with their antibiotic susceptibility.Methods: Hospital based, prospective cross-sectional study was conducted for a period of one year and 375 children were enrolled. Demographic, clinical history and examination was done and signs and symptoms noted. All necessary investigations were performed and followed regularly for management and outcome.Results: Incidence of LRTI in the study was 9.76% with male preponderance (65.33%) and most common among children in 1-4 years age group. Ratio of males to females was 1.9:1. 73.6% of cases were in low socio-economic group, 35.2% were found with PEM-I grade and 18.13% had no immunization coverage. Cough and breathlessness were the major symptoms and respiratory distress and clubbing were major signs in the study. Bronchopneumonia was the commonest cause (38.7%) followed by bronchiolitis and Allergic bronchitis. 18.45 of cases had anemia and Leucocytosis was also present. Pulmonary infiltration was the major finding in the X-ray of chest. Streptococcus pneumoniae and Klebsiella pneumoniae were the common bacterial pathogens isolated.Conclusions: To conclude, our study clearly highlighted the various types of clinical presentations, risk factors and different types of LRTI in children <12 years of age. Understanding a clear knowledge of the etiology and bacterial pathogens clearly provides guidance for the physician in management and clinical outcome. 

scholarly journals Whole Cell Euglena Gracilis Supplementation Reduces Upper Respiratory Tract Infection Symptoms in Healthy Adults (P19-009-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Janaki Iyer ◽  
Paul Falcone ◽  
Kelli Herrlinger ◽  
Joanne Lasrado ◽  
Emily Pankow Fritz ◽  
...  
Keyword(s):  
Immune System ◽  
Respiratory Tract ◽  
Euglena Gracilis ◽  
Illness Severity ◽  
Healthy Adults ◽  
Upper Respiratory Tract ◽  
Whole Cell ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Objectives Upper respiratory tract infections (URTI) cause cold and flu-like symptoms, with roughly 70% of the general population experiencing at least one episode annually. The resultant lost productivity has a drastic impact with an estimated 40 M work or school days missed each year, translating to over $40B USD in lost potential. Certain populations, such as athletes and stressed workers are at an increased risk of URTIs. While diet, sleep, low stress and exercise are all important for a healthy functioning immune system, supplementation with natural ingredients could provide additional support. Euglena gracilis is a nutrient-rich natural microalgae (commonly consumed in Japan), containing immunomodulating beta 1,3-glucans, protein, some essential vitamins, and minerals. This double-blind, placebo-controlled, parallel study aimed at investigating the immunomodulating effects of a patented whole cell algae fermentate (WCF) in healthy active adults. Methods Thirty-four, healthy, active (1.5–3 hours/day of an aerobic sport, 5–6 days/week) participants were randomized to either WCF or placebo for 90 days. URTI symptoms were assessed Day (D) 1 to 90 using the Wisconsin Upper Respiratory Symptom Survey. Data are shown for the a priori defined per protocol population (n = 27). Results Participants supplemented with WCF reported a lower number of URTI symptoms from D1 to 30 (P = 0.042) and from D1 to 90 (P = 0.029), lower mean number of sick days between D1 and 30 (P = 0.047) and D1 and 90 (P = 0.041), lower mean number of URTI episodes per person (P = 0.032), and lower mean number of days with at least 1 reported URTI symptom per person (P = 0.019) between D1 and 90 compared to taking placebo. Evaluation of global illness severity found that the mean total AUC for daily symptoms was significantly lower in the WCF group compared to placebo at D1 to D30 (P = 0.043) and D1 to D90 (P = 0.049). Conclusions Supplementation with WCF positively influences the immune system by reducing URTI incidence, duration, and severity in healthy adults. It is noteworthy that in the absence of the intervention, active young adults reported more URTI episodes, sick days, and global illness severity, respectively. These data suggest the ability of WCF supplementation to strengthen the immune response as evidenced by reduced cold and flu symptoms. Funding Sources Kemin Foods L.C.

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