scholarly journals Outpatient Management of Acute Respiratory Infections in Children

2021 ◽  
pp. 363-370
Author(s):  
Radima A. Mukozheva ◽  
Tatyana V. Kulichenko ◽  
Tatyana V. Vilchanskaya ◽  
Mariya A. Lazareva ◽  
Olga V. Romanova ◽  
...  
Keyword(s):  
Viral Infection ◽  
Russian Federation ◽  
Antibacterial Therapy ◽  
Respiratory Infections ◽  
Acute Bronchitis ◽  
Community Acquired Pneumonia ◽  
Outpatient Clinics ◽  
Acute Respiratory Infections ◽  
Acute Respiratory Viral Infection ◽  
Tract Infections

Background. Antimicrobial resistance is one of the most crucial problems in human health care worldwide. The main cause of this crisis is the excessive and misuse of antibacterial drugs (ADs). The highest rate of improper antibiotics' prescriptions in pediatric practice is observed at treatment of respiratory tract infections in outpatient clinics. Objective. The aim of the study is to analyze the clinical practice of management of patients with acute respiratory infections (ARI) and the use of ADs in children's outpatient clinics across the regions of Russian Federation. Methods. Multicenter retrospective study was conducted. All ARI cases documented in 969 medical records (form 112/y) of children born in 2015–2017 yy. in 16 regions of Russian Federation (selected randomly) were analyzed. Results. Acute viral infection was diagnosed in 79.6% cases of referencing to doctor with ARI symptoms. Systemic ADs were prescribed in 23% cases of ARI. Antibacterial therapy was received by 14% of children diagnosed with acute respiratory viral infection, 35% with acute laryngotracheitis, 80% with acute bronchitis, 76% with acute rhinosinusitis, 94% with ARI associated with otitis media, 52% with tonsillopharyngitis, and 100% with community-acquired pneumonia. Amoxicillin (35%), amoxicillin/clavulanic acid (24%), azithromycin (20.2%) were prescribed most often. Parenteral administration of ADs was prescribed in 3.9% of cases, mostly for children with community-acquired pneumonia. Prescribed antibacterial therapy was unreasonable in 84% of analyzed cases. Polypragmasy occurred in 50.5% of cases. Clinical protocols violations were mostly common for management of patients with laryngotracheitis and tonsillopharyngitis. Conclusion. There is favorable trend towards the decrease in ADs prescribing frequency in outpatient clinics for children with ARI. Thus, polypragmasy and irrational choice of antibacterial therapy frequency remains quite high.

scholarly journals Clinical-epidemiological peculiarities of acute respiratory infections in children from 3 to 12 years and evaluation of effectiveness of antivirus therapy

2019 ◽  
Vol 11 (3) ◽  
pp. 38-45
Author(s):  
S. A. Khmilevskaya ◽  
N. I. Zryachkin ◽  
V. E. Mikhailova
Keyword(s):  
Viral Infections ◽  
Respiratory Infections ◽  
Molecular Genetic ◽  
Respiratory Viruses ◽  
Acute Respiratory Infections ◽  
Age Group ◽  
Leading Role ◽  
Respiratory Viral Infections ◽  
Acute Respiratory Viral Infection ◽  
Tract Infections

The aim: to study the etiological structure of acute respiratory infections in children aged 3 to 12 hospitalized in the early stages of the disease in the department of respiratory infections of the children’s hospital, and to reveal the features of their clinical course and the timing of DNA / RNA elimination of respiratory viruses from nasal secretions, depending on the method of therapy. Materials and methods: 100 children with acute respiratory infections aged 3 to 12 years were monitored. The nasal secrets on the DNA / RNA of respiratory viruses were studied by PCR. Depending on the method of therapy, patients were divided into 2 groups: patients of group 1 (comparison) received basic treatment (without the use of antiviral drugs), in patients of the 2nd group (main), along with basal therapy, the drug was used umifenovir in a 5-day course at the ageappropriate dosage. Results: In the etiologic structure of ARVI in children from 3 to 12 years, the leading place was taken by rhinovirus, influenza and metapneumovirus infections (isolated – 18%, 19% and 20% respectively, in the form of a mixed infection – 11%). The main syndromic diagnosis at the height of the disease was rhinopharyngitis. Complications were observed in 42% of cases, as often as possible with flu – 53% of cases. Features of metapneumovirus infection in children of this age group were: predominance of non-severe forms of the disease in the form of acute fever with symptoms of rhinopharyngitis, as well as a small incidence of lower respiratory tract infections. The use of the drug umiphenovir in children with acute respiratory viral infections of various etiologies contributed to significantly faster elimination of viral DNA / RNA from the nasal secretion, which was accompanied by a ecrease in the duration of the main clinical and hematological symptoms of the disease, a decrease in the incidence of complications, and reduced the duration of stay in hospital. Conclusion: application of modern molecular genetic methods of diagnostics made it possible to identify the leading role of influenza, metapneumovirus and rhinovirus infections in the etiology of acute respiratory viral infection in patients aged 3 to 12 years, and to determine a number of clinical features characteristic of this age group. The results of the study testify to the effectiveness of umiphenovir in the treatment of children with acute respiratory viral infections of various etiologies and allow us to recommend this drug as an effective and safe etiotropic agent.

scholarly journals Place of combination drugs in the therapy of acute bronchitis in children

2020 ◽  
pp. 42-47
Author(s):  
N. G. Kolosova ◽  
I. V. Grebeneva ◽  
V. D. Denisova ◽  
E. M. Maksimova
Keyword(s):  
Respiratory Tract ◽  
Respiratory Infections ◽  
Acute Bronchitis ◽  
Influenza Viruses ◽  
Human Bocavirus ◽  
Acute Respiratory Infections ◽  
Protective Function ◽  
Nonproductive Cough ◽  
Combination Drugs ◽  
Tract Infections

Acute respiratory tract infections accompanied by cough play a significant role in respiratory pathology in childhood. The incidence of acute respiratory infections among children is 4–5 times higher than among the adult population and accounts for more than 90% of all infectious and parasitic diseases registered in Russia. The highest rates of acute respiratory infections are observed among children of preschool age, especially in the first three years of life. As in adults, children’s cough, described as a symptom of «upper respiratory infection» or «acute bronchitis», is the most commonly diagnosed acute manifestation in primary care. These 2 diagnoses represent 75% of all cough cases. The most common etiological agents in acute bronchitis are respiratory viruses: adenovirus, influenza viruses and parainfluenza viruses, respiratory syncytial virus, rhinovirus, human Bocavirus, Coxsackievirus, herpes simplex virus, etc. Drug therapy for coughing is prescribed when there is a nonproductive cough that does not perform its protective function, meaning it does not contribute to the purification of the respiratory tract, and is aimed at dilution of sputum, reducing its adhesiveness (viscosity) and thus increase the effectiveness of coughing. The main groups of mucoactive drugs that are usually considered in this case are mucolytics, mucoregulators, mucokinetics, expectorants, and combination drugs. Combination drugs created to eliminate various elements of pathogenesis of respiratory diseases, accompanied by a nonproductive cough and bronchoobstruction, deserve close attention due to the possibility of using several active substances in fixed drug combinations with accurate dosages and proven clinical effectiveness, reducing the number of simultaneously taken drugs, reducing the risk of developing undesirable events. Oral administration of combined medicines becomes especially important in conditions when inhalation therapy is impossible.

Pneumonia and respiratory tract infections

2017 ◽  
pp. 621-628
Author(s):  
Adamantia Liapikou ◽  
Antoni Torres
Keyword(s):  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Functional Decline ◽  
Primary Source ◽  
Acute Bronchitis ◽  
Altered Mental Status ◽  
Community Acquired Pneumonia ◽  
Antimicrobial Treatment ◽  
Poor Functional Status ◽  
Tract Infections

Acute lower respiratory infections, such as acute bronchitis and pneumonia, are a leading cause of death worldwide and a primary source of morbidity and mortality in older adults. Clinically, elderly patients with community-acquired pneumonia often have non-specific clinical symptoms, altered mental status, or subtle functional decline, making an accurate diagnosis and early antimicrobial treatment difficult, and further worsening the prognosis. Older frail patients living in nursing homes have a high frequency of aspiration pneumonia caused by gram-negative bacilli and anaerobic pathogens. Over the last few years there has been a controversy over whether the higher mortality of pneumonia is due to inappropriate therapy or the poor functional status of these patients. Prevention strategies of respiratory infections in older people include the prevention and management of aspiration, reduction in the use of neuroleptic medication, influenza vaccination, and possibly the use of the newer antiviral drugs.

scholarly journals Epidemic process of respiratory infections and particulate matter as a route for transmission of multidrug-resistant microorganisms in medical organisations

2021 ◽  
Vol 6 (1) ◽  
pp. 47-52
Author(s):  
E. A. Chezganova ◽  
N. V. Medvedeva ◽  
V. M. Sakharova ◽  
E. B. Brusina
Keyword(s):  
Particulate Matter ◽  
Respiratory Infections ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
Acute Respiratory Infections ◽  
Healthcare Settings ◽  
Hospitalised Patients ◽  
High Prevalence ◽  
Biochemical Analyzer ◽  
Tract Infections

Aim. To study the trends in the prevalence of respiratory tract infections in the population of Kemerovo Region and to interrogate the particulate matter as a possible route for the transmission of multidrug-resistant microorganisms into medical organisations.Materials and Methods. We investigated the prevalence of acute respiratory infections and community-acquired pneumonia among the population of Kuzbass (Kemerovo Region) according to the offcial medical records collected from 2004 to 2020. The study included 10,320,384 cases of acute respiratory infections, 145,357 cases of community-acquired pneumonia, 344,703 hospitalisations of the adults (subjects ≥ 18 years of age) and 75,041 hospitalisations of children (< 18 years of age). Collection of particulate matter samples (n = 97) was performed using sterile gloves and containers from ventilation grilles and adjacent air ducts of the exhaust ventilation systems in various healthcare settings. Bacterial composition of the dust was examined using a VITEK 2 Compact biochemical analyzer. Viral diversity was screened by polymerase chain reaction.Results. Over the study period, respiratory infections were common in Kemerovo Region (average prevalence 22,155.9 per 100,000 population) and showed an increasing incidence. Frequency of respiratory infections among the hospitalised patients was 207.14 per 1,000, being 1.63-fold higher in children than in adults (304.15 and 186.02, respectively). In 2020, the proportion of cefotaxime-resistant Klebsiella spp. was 26.20% that was strikingly high compared to 2019. Hospital particulate matter frequently (71.13% samples) harboured multidrug-resistant microorganisms.Conclusions. High prevalence and morbidity from respiratory infections in Kemerovo Region are combined with high prevalence and biodiversity of airborne microorganisms, in particular multidrug-resistant microbes contaminating the hospital particulate matter.

Role of natural and synthetic immunotropic agents in the prevention of acute respiratory infections

2020 ◽  
Vol 18 (3) ◽  
pp. 131-138
Author(s):  
G.G. Maryin ◽  
◽  
A.V. Tutelyan ◽  
O.A. Gruzdeva ◽  
Yu.A. Goloverova ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Community Acquired Pneumonia ◽  
Economic Damage ◽  
Acute Respiratory Infections ◽  
Nonspecific Resistance ◽  
Poor Outcomes ◽  
Tract Infections

Respiratory tract infections (influenza, acute respiratory infections (ARIs), community-acquired pneumonia, etc.) pose a serious threat to organized groups (including military personnel, cadets, students of military universities, and schools). The most common complication of ARI is community-acquired pneumonia, severe forms of which may result in an unfavorable outcome. The use of some drugs, such as Carmolis ensures a 2.0–3.8 times reduction in the incidence of ARIs in organized groups and a 2.3–3.0 times reduction in the incidence of community-acquired pneumonia. Carmolis has a pronounced non-specific protective effect and increases resistance to respiratory tract infections by promoting nonspecific resistance of the organism. This prevents significant economic damage and reduces the number of complications and poor outcomes. Keywords: organized groups, biological and social emergencies, respiratory tract infections, community-acquired pneumonia, acute respiratory infections, coronavirus infection, Carmolis, non-specific resistance, non-specific prevention of acute respiratory infections, epidemiological effectiveness

An assessment of the effect of statin use on the incidence of acute respiratory infections in England during winters 1998–1999 to 2005–2006

2010 ◽  
Vol 138 (9) ◽  
pp. 1281-1288 ◽  
Author(s):  
D. M. FLEMING ◽  
N. Q. VERLANDER ◽  
A. J. ELLIOT ◽  
H. ZHAO ◽  
D. GELB ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Respiratory Infections ◽  
Acute Bronchitis ◽  
Acute Respiratory Infections ◽  
Logistic Regression Models ◽  
Influenza Pandemics ◽  
Primary Care Data ◽  
Chronic Morbidity ◽  
Tract Infections ◽  
Statin Use

SUMMARYStatins reduce cardiovascular mortality and related risks associated with pneumonia suggesting potentially beneficial use in influenza pandemics. We investigated the effect of current statin use on acute respiratory infections in primary care. Data from anonymized electronic medical records of persons aged ⩾45 years were examined for statin use, chronic morbidity, respiratory diagnoses, vaccination procedures, and immune suppression. Logistic regression models were used to calculate odds ratios (ORs) for statin users vs. non-users in respiratory infection outcomes. A total of 329 881 person-year observations included 18% statin users and 46% influenza vaccinees. Adjusted ORs for statin users vs. non-users were: influenza-like illness, 1·05 (95% CI 0·92–1·20); acute bronchitis, 1·08 (95% CI 1·01–1·15); pneumonia, 0·91 (95% CI 0·73–1·13); all acute respiratory infections, 1·03 (95% CI 0·98–1·07); and urinary tract infections, 0·91 (95% CI 0·85–0·98). We found no benefit in respiratory infection outcomes attributable to statin use, although uniformly higher ORs in non-vaccinated statin users might suggest synergism between statins and influenza vaccination.

scholarly journals 2018 recommendations for the management of community acquired pneumonia

2018 ◽  
Vol 44 (5) ◽  
pp. 405-423 ◽  
Author(s):  
Ricardo de Amorim Corrêa ◽  
Andre Nathan Costa ◽  
Fernando Lundgren ◽  
Lessandra Michelin ◽  
Mara Rúbia Figueiredo ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Scientific Evidence ◽  
Prognostic Score ◽  
Community Acquired Pneumonia ◽  
Lower Respiratory Tract Infections ◽  
Etiologic Agents ◽  
Tract Infections ◽  
Respiratory Microbiota

ABSTRACT Community-acquired pneumonia (CAP) is the leading cause of death worldwide. Despite the vast diversity of respiratory microbiota, Streptococcus pneumoniae remains the most prevalent pathogen among etiologic agents. Despite the significant decrease in the mortality rates for lower respiratory tract infections in recent decades, CAP ranks third as a cause of death in Brazil. Since the latest Guidelines on CAP from the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association) were published (2009), there have been major advances in the application of imaging tests, in etiologic investigation, in risk stratification at admission and prognostic score stratification, in the use of biomarkers, and in the recommendations for antibiotic therapy (and its duration) and prevention through vaccination. To review these topics, the SBPT Committee on Respiratory Infections summoned 13 members with recognized experience in CAP in Brazil who identified issues relevant to clinical practice that require updates given the publication of new epidemiological and scientific evidence. Twelve topics concerning diagnostic, prognostic, therapeutic, and preventive issues were developed. The topics were divided among the authors, who conducted a nonsystematic review of the literature, but giving priority to major publications in the specific areas, including original articles, review articles, and systematic reviews. All authors had the opportunity to review and comment on all questions, producing a single final document that was approved by consensus.

scholarly journals PROBLEMS OF PARASITIC SAFETY EVALUATION OF WATER IN SOURCES USED BY POPULATION

2019 ◽  
Vol 16 (31) ◽  
pp. 558-564
Author(s):  
K. Y. KUZNETSOVA ◽  
O. P. ZELYA ◽  
Z. V.; ZHNAKINA ◽  
T. R. MANIYA
Keyword(s):  
Russian Federation ◽  
Safety Evaluation ◽  
Community Acquired Pneumonia ◽  
Water Bodies ◽  
Upper Respiratory Tract ◽  
State Monitoring ◽  
Factors Affecting ◽  
Independent Expert ◽  
The Russian Federation ◽  
Tract Infections

The importance of state monitoring of water bodies on parasitological indicators is actualized in the article. It was established that summary reports of federal enterprises involved in the state monitoring of water bodies are formed without taking into account natural parasitic systems and insufficient detection of local parasitological pollution. At the same time, the incidence rate in the Russian Federation regarding giardiasis due to the water transport factor has been consistently high for several years. Cryptosporidiosis among the population is not detected due to the use of insensitive methods of diagnosis. With such an unexplored state of factors affecting public health, the level of unidentified etiological causes of acute intestinal infections, upper respiratory tract infections, and community-acquired pneumonia remains high in the Russian Federation: 70% and 90%, respectively. The article presents data on parasitic contamination of water bodies in the catchment area of the Moskva River, obtained with an independent expert survey.

scholarly journals Chronic Periodontitis and Acute Respiratory Infections: A Nationwide Cohort Study

2021 ◽  
Vol 11 (20) ◽  
pp. 9493
Author(s):  
Jae-Hong Lee ◽  
Seong-Nyum Jeong
Keyword(s):  
Cohort Study ◽  
Chronic Periodontitis ◽  
Respiratory Infections ◽  
Smoking Status ◽  
Acute Bronchitis ◽  
National Sample ◽  
Population Based ◽  
Acute Respiratory Infections ◽  
Acute Tonsillitis ◽  
Sociodemographic Variables

Chronic periodontitis (CP) may increase the risk of exacerbation of and hospitalization for respiratory infections. The aim of the present study was to determine whether CP is associated with acute respiratory infections by analyzing a population-based longitudinal database from the National Health Insurance Service—National Sample Cohort. Univariate and multivariate logistic regression analyses were conducted to assess the association between CP and acute respiratory infections, including acute nasopharyngitis, acute pharyngitis, acute tonsillitis, acute laryngitis and tracheitis, acute bronchitis, and acute bronchiolitis, while adjusting for the confounding effects of sociodemographic variables (sex, age, household income, and smoking status) and comorbidities (diabetes mellitus). Among 545,416 recruited participants, 98,490 (18.1%) had CP. Multivariate analysis, adjusted for sociodemographic variables and comorbidities, showed that except influenza and pneumonia, total acute respiratory infections (odds ratio (OR), 1.33; 95% confidence interval (CI), 1.28–1.38; p < 0.001), acute upper respiratory infections (OR, 1.26; 95% CI, 1.22–1.29; p < 0.001), and acute lower respiratory infections (OR, 1.23; 95% CI, 1.20–1.26; p < 0.001) were significantly associated with CP. The findings of the current cohort study suggest an association between CP and acute respiratory infections. Particularly, CP seems to increase the risk of acute upper and lower respiratory infections.

scholarly journals DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN

2020 ◽  
Vol 7 (1) ◽  
pp. 39-45
Author(s):  
M. Mishyna ◽  
M. Gonchar ◽  
O. Logvinova ◽  
H. Isaieva ◽  
M. Basiuk
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Acute Bronchitis ◽  
Community Acquired Pneumonia ◽  
Gram Positive ◽  
Gram Negative ◽  
Nasal Swabs ◽  
Causative Agents ◽  
Tract Infections

DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN. Mishyna М., Gonchar M., Logvinova O., Isaieva H., Basiuk M. The study aimed to investigate prevalence of microorganisms depending on the site of isolation and disease. The study involved 48 children aged 1 year to 17 years. Acute bronchitis (54, 17%), community-acquired pneumonia (CAP) (33, 33%), bronchial asthma (12, 50%) were diagnosed. Were isolated 173 strains of microorganisms. Gram-positive microorganisms were detected 106 strains (61, 3%), Gram-negative microorganisms - 49 strains (28, 3%), fungi - 18 strains (10, 4%). We investigated 100 samples from nose (nasal swabs), pharynx (throat swabs) and sputum. In 83 cases were isolated Gram-positive microorganisms, in 36 cases were isolated Gram-negative microorganisms, in 18 cases - fungi. Analysis reviled that Staphylococcus aureus most often isolated from patients with acute bronchitis; Gram-negative microorganisms most often detected from throat swabs, comparing with microorganisms detected from nose swabs and sputum. Keywords: microorganisms, biofilms, respiratory diseases, children.   Анотація ПОШИРЕНІСТЬ ЗБУДНИКІВ ІНФЕКЦІЙ ДИХАЛЬНИХ ШЛЯХІВ У ДІТЕЙ. Мішина М.М, Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Метою дослідження було вивчити переважання умовно-патогенних мікроорганізмів, які викликають захворювання органів дихання у дітей, в залежності від місця виділення та захворювання. У дослідженні було 48 дітей у віці від 1 року до 17 років. Пацієнти були з такими діагнозами: гострі бронхіти (54, 17%), негоспітальні пневмонії (33, 33%), бронхіальна астма (12, 50%). Було виділено 173 штама умовно-патогенних мікроорганізмів. Грампозитивних мікроорганізмів було виділено 106 штамів (61, 3%), грамнегативних мікроорганізмів – 49 штамів (28, 3%), грибів – 18 штамів (10, 4%). Було досліджено 100 зразків з зіву, носу, мокротиння. Грампозитивні мікроорганізми були виділені з 83 зразків, грамнегативні – з 36 зразків, гриби – з 18 зразків. Проведене дослідження довело, що Staphylococcus aureus найчастіше виділявся у пацієнтів з гострими бронхітами. Грамнегативні мікроорганізми частіш за все виділялись зі зразків із зіву в порівнянні з мазками з носу та мокротинням. Ключові слова: мікроорганізми, біоплівки, захворювання органів дихання, діти.   Абстракт РАСПРОСТРАНЕННОСТЬ ВОЗБУДИТЕЛЕЙ ИНФЕКЦИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ У ДЕТЕЙ. Мішина М.М., Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Целью исследования было изучить преобладание условно-патогенныхмикроорганизмов, вызывающих заболевания органов дыхания у детей, в зависимости от места забора материала и заболевания. Исследование включало 48 детей в возрасте от 1 года до 17 лет. Пациенты находились с такими заболеваниями: острые бронхиты (54, 17%), внегоспитальные пневмонии (33, 33%), бронхиальная астма (12, 50%). Всего было выделено 173 штамма условно-патогенных микроорганизмов. Грамположительных микроорганизмов было выделено 106 штаммов (61, 3%), грамотрицательных микроорганизмов – 49 штаммов (28, 3%), грибов – 18 штаммов (10, 4%). Было исследовано 100 образцов из зева, носа, мокроты. Грамположительные микроорганизмы были выделены из 83 образцов, грамотрицальные – из 36 образцов, грибы – из 18 образцов. В ходе исследования было доказано, что Staphylococcus aureus чаще всего выделялся от пациентов с острыми бронхитами. Грамотрицательные микроорганизмы чаще всего выделялись из мазков из зева по сравнению с мазками из носа и мокротой. Ключевые слова: микроорганизмы, биопленки, заболевания органов дыхания, дети.

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