scholarly journals Characterization of the microflora of ventilator-associated respiratory tract infections in patients with severe trauma

2015 ◽  
Vol 20 (1) ◽  
pp. 8-13
Author(s):  
O. A Orlova ◽  
V. G Akimkin

Rationale The relevance of ventilator-associated respiratory tract infections in severe injury patients (SIP) is associated with both features of causative pathogens and the initial severity of the state of patients. Among causative pathogens nosocomial flora is dominant. Purpose - to perform an analysis of the microbiological monitoring of ventilator-associated respiratory tract infections in SIP. The analysis was based on the results of a prospective epidemiological, clinical, and instrumental study of 100 SIP with ventilator-associated respiratory tract infections, stayed in the surgical intensive care unit. The proportion of ventilator-associated respiratory infections in the structure of nosocomial infections in these patients is between 90 - 95%, at that there was revealed the prevalence of nosocomial pneumonia (61%). Ventilator-associated respiratory tract infection most commonly occurs during the first 10 days of mechanical ventilation. The prevailing flora was represented by Gram negative Acinetobacter baumamnnii (40.3 ± 2.1%) and Pseudomonas aeruginosa (38.4% ± 3.2%). Isolated microorganisms possessed multiple antibiotic resistance, with the greatest extent to aminoglycosides - 69.5%, fluoroquinolones - 40.3%, penicillin - 37.6%; cephalosporins (third generation) - 33.8%. There is noted marked preponderance of microbial associations compared with monocultures 57.1 ± 5.3%.

2015 ◽  
Vol 20 (2) ◽  
pp. 37-42
Author(s):  
O. A Orlova ◽  
V. G Akimkin

The urgency of the problem of ventilator-associated respiratory tract infections is stipulated by the ever-increasing number of diseases caused by nosocomial polyantibiotic-resistant strains and high mortality rate. Purpose - to give an assessment of the intensity of the epidemic process of ventilator-associated respiratory tract infections in patients of the surgical intensive care unit. In the base of the analysis there were put the results of a comprehensive epidemiological, clinical, and instrumental study of 137 patients (100 patients with severe injuries and 37 patients with diseases of the abdomen and thorax) with ventilator - associated respiratory tract infections received medical treatment in the surgical intensive care unit. The proportion of respiratory tract infections in the structure of nosocomial infections in these patients varies from 34.6 to 58.9 %, in that there was revealed the prevalence of nosocomial pneumonias (63.5 %). When using a ventilator with viral-bacterial filters signs of nosocomial respiratory tract infections were manifested on the 10th day and later in 50.8 % of patients. In cases with the duration of artificial ventilation more than 10 days the risk of the development of these infections in patients with diseases of the abdominal cavity and thorax was 2.1 times higher than in patients with injuries. There was shown the necessity of the development of a set of measures for the prevention of nosocomial infections of the respiratory tract.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Lei ◽  
Lisong Yang ◽  
Cheong Tat Lou ◽  
Fan Yang ◽  
Kin Ian SiTou ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.


Author(s):  
Zeynep Onay ◽  
Deniz Mavi ◽  
Yetkin Ayhan ◽  
Sinem Can Oksay ◽  
Gulay Bas ◽  
...  

Background: COVID-19 outbreak lead to nationwide lockdown on the March 16th, 2020 in Turkey. We aimed to quantitively determine the change in frequency of upper and lower respiratory tract infections and asthma in pediatric population associated with COVID-19. Methods: The electronic medical record data of pediatric population admitted to the emergency department (ED), outpatient and inpatient clinics and pediatric intensive care unit (PICU) were analyzed with the diagnosis of Influenza, upper and lower respiratory tract infections (URTI, LRTI) acute bronchiolitis and asthma. The data of the first year of the pandemic was compared with the previous year. Results: In total 112496 admissions were made between April 1, 2019 and March 31, 2021 in our hospital. A decline was observed in ED admissions (-73%) and outpatient clinic (-70%) visits, hospitalizations (-41.5%) and PICU admissions (-42%). The admissions with the diagnosis of Influenza and URTI had a decline from 4.26% to 0.37% (p=0.0001), and from 81.54% to 75.62% (p=0.0001), respectively. An increase was observed in the LRTI, acute bronchiolitis and asthma (from 8.22% to 10.01% (p=0.0001), from 2.76% to 3.07% (p=0.027) and from 5.96% to 14% (p=0.0001), respectively). Conclusions: A dramatic decrease was observed in the number of admissions to ED and inpatient clinics and outpatient clinic visits and PICU admissions, and, when the rates of admissions were compared, the general rate of admissions to ED showed a decrease while inpatient, outpatient clinics and PICU admissions demonstrated an increase during the pandemic.


2019 ◽  
Author(s):  
Laura K Certain ◽  
Miriam B Barshak

Upper respiratory tract infections are the most common maladies experienced by humankind.1 The majority are caused by respiratory viruses. A Dutch case-controlled study of primary care patients with acute respiratory tract infections found that viruses accounted for 58% of cases; rhinovirus was the most common (24%), followed by influenza virus type A (11%) and corona­viruses (7%). Group A streptococcus (GAS) was responsible for 11%, and 3% of patients had mixed infections. Potential pathogens were detected in 30% of control patients who were free of acute respiratory symptoms; rhinovirus was the most common.2 Given the increasing problem of antibiotic resistance and the increasing awareness of the importance of a healthy microbiome, antibiotic use for upper respiratory infections should be reserved for those patients with clear indications for treatment. A recent study of adult outpatient visits in the United States found that respiratory complaints accounted for 150 antibiotic prescriptions per 1,000 population annually, yet the expected “appropriate” rate would be 45.3 In other words, most antibiotic prescriptions for these complaints are unnecessary. Similarly, a study in the United Kingdom found that general practitioners prescribed antibiotics to about half of all patients presenting with an upper respiratory infection, even though most of these infections are viral.4 This review contains 5 figures, 16 tables, and 82 references. Keywords: infection, airway, sinusitis, otitis media, otitis externa, pharyngitis, epiglottitis, abscess


2014 ◽  
Vol 27 (3) ◽  
pp. 199-201
Author(s):  
Adrian Jarzynski ◽  
Agata Dubas ◽  
Malgorzata Polz-Dacewicz

ABSTRACT Viruses that cause respiratory tract infections are the most common agents of infectious diseases in humans throughout the world. A virus that infects the respiratory system, may induce various clinical symptoms. What is more, the same symptoms may be caused by different viruses. The aim of the study was to analyze the prevalence of enteroviruses that cause respiratory infections in patients with influenzavirus A/H1N1 hospitalized in the Lublin province. The experimental material was throat and nose swabs taken from patients hospitalized in Lublin and Tomaszow Lubelski. In the group of 44 patients (20 women and 24 men) infected with influenza A/H1N1, the genetic material of enteroviruses was detected in 13 patients (29.5%). Respiratory viruses co-infections are very common in hospitalized patients. Studies show that co-infection with influenza virus and enterovirus are more common in children than in adults. Moreover, viral respiratory tract infections are independent from the patients’ gender.


2018 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Aleksandra Paź ◽  
Magdalena Arimowicz

An estimated 50% of antibiotic prescriptions may be unjustified in the outpatient setting. Viruses are responsible for most acute respiratory tract infections. The viral infections are often self-limiting and only symptomatic treatment remains effective. Bacteria are involved in a small percentage of infections etiology in this area. In the case of a justified or documented suspicion of a bacterial infection, antibiotic therapy may be indicated. Based on the Polish „Recommendations for the management of non-hospital respiratory infections 2016”, the indications, the rules of choice, the appropriate dosing schedules and the therapy duration, in the most frequent upper respiratory tract infections in adults, have been presented. Implementation of the presented recommendations regarding our Polish epidemiological situation, will significantly reduce the tendency to abuse antibiotics, and thus will limit the spread of drug-resistant microorganisms.


2009 ◽  
Vol 53 (5) ◽  
pp. 1921-1925 ◽  
Author(s):  
J. Blackman Northwood ◽  
M. Del Grosso ◽  
L. R. Cossins ◽  
M. D. Coley ◽  
R. Creti ◽  
...  

ABSTRACT The macrolide efflux mechanism of resistance, mef, was characterized in community-acquired respiratory tract infections with Streptococcus pyogenes. Fifty-four (4.6%) M phenotype isolates were screen tested as negative for mef(A). Of these 54 isolates, 5 (0.4%), 27 (2.3%), and 1 (0.1%) were considered to be mef(I) positive, a novel mosaic variant of mef, or a novel subclass of mef, respectively. This study shows (i) the definitive presence of mef(E) in S. pyogenes and its global distribution, (ii) the presence of a mosaic variant of mef composed of mef(A) and mef(E), (iii) the previously undescribed presence of mef(I) in S. pyogenes, and (iv) the presence of a novel subclass of mef in S. pyogenes.


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