scholarly journals Etiology of community-acquired pneumonia in patients with chronic heart failure

2019 ◽  
Vol 29 (3) ◽  
pp. 293-301 ◽  
Author(s):  
A. A. Bobylev ◽  
S. A. Rachina ◽  
S. N. Avdeev ◽  
R. S. Kozlov ◽  
M. V. Sukhorukova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Legionella Pneumophila ◽  
Bacterial Pathogens ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Urine Samples ◽  
Parainfluenza Virus ◽  
Type 3 ◽  
Systemic Antibiotics

Chronic heart failure (CHF) is one of the most common comorbidities in elderly patients with community-acquired pneumonia (CAP).The aim of this study was to investigate etiology of CAP in patients with concomitant CHF.Methods. This prospective observational study involved adult hospitalized patients with CAP and concomitant CHF. CAP was confirmed by chest X-ray. Sputum samples or oropharyngeal swabs, blood and urine samples were collected in all eligible patients before starting the therapy with systemic antibiotics. Sputum was cultured for «typical» bacterial pathogens, such as Streptococcus pneumoniae, Staphylococcus aureus, Enterobacterales, etc., in accordance with standard methods and procedures. Mycoplasma pneumoniae, Chlamydophila pneumoniae and respiratory viruses in sputum or oropharyngeal swabs were identified using the real-time polymerase chain reaction (PCR). Urine samples were used to determine serogroup 1 Legionella pneumophila and S. pneumoniae soluble antigens using bedside immunochromatography.Results. Fifty patients were enrolled in the study. The mean age was 72.2 ± 9.5 years, 27 (54%) were females. The etiology of CAP was identified in 23 cases (46%). S. pneumoniae was the most common pathogen (16/23; 69.7%) followed by respiratory viruses (3/23; 13.1%), such as type 3 parainfluenza virus, coronavirus, human metapneumovirus; Haemophilus influenzae (1/23; 4.3%), S. aureus (1/23; 4.3%), and Klebsiella pneumoniae (1/23; 4.3%). S. pneumoniae and parainfluenza virus co-infection was diagnosed in one of 23 patients (4.3%).Conclusion. S. pneumoniae and respiratory viruses were predominant causative pathogens of CAP in hospitalized adults with concomitant CHF. Therefore, bedside tests for urine pneumococcal antigens should be used more widely considering difficult sputum expectoration in elderly. Atypical bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) were not identified in this study, so the routine PCR-test and urine tests for L. pneumophila antigens are thought to be not useful. 

scholarly journals Respiratory virus monitoring in patients with community-acquired pneumonia during COVID-19 pandemic in Khabarovsk in 2020

2021 ◽  
pp. 21-27
Author(s):  
L. V. Butakova ◽  
E. Yu. Sapega ◽  
O. E. Trotsenko ◽  
L. A. Balakhontseva ◽  
E. N. Prisyazhnyuk ◽  
...  
Keyword(s):  
Virus Type ◽  
Respiratory Virus ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Parainfluenza Virus ◽  
Sample Collection ◽  
Chain Reaction ◽  
Khabarovsk Krai ◽  
Polymerase Chain ◽  
Type 3

Introduction. Emergence and spread of new coronavirus SARS-CoV-2 among population of the Khabarovsk krai influenced the growth of reported cases of community-acquired pneumonia in year 2020. Aim. To determine proportion of other respiratory viruses in development of viral pneumonia epidemic process in the Khabarovsk city in year 2020 during COVID-19 pandemic. Materials and methods. Sputum of 346 patients with community-acquired pneumonia that were hospitalized with suspected diagnosis of COVID-19 was analyzed during year 2020 in Khabarovsk city. Identification of viral agents was performed via real-time reverse-transcriptase polymerase chain reaction. Results. SARSCOV-2 RNA was identified in 183 (52.9%) out of 346 patients. Among other respiratory viruses parainfluenza virus type 3 and rhinoviruses were dominant mostly in SARS-CoV-2 negative examined people. It should be noted that etiology of pneumonia was identified only in 12.9% of all cases in this group (163 people). Co-infection with SARS-CoV-2 and other respiratory viruses such as parainfluenza virus type 3 virus, other coronaviruses and adenovirus was detected only in 2.2% of the cases. Conclusion. Low level of respiratory viruses detection in sputum can be caused by poor technique of sample collection in the hospital, disruption of storage and transportation conditions as well as development of secondary bacterial infection in certain patients. In order to evaluate influence of other respiratory viruses on the course of COVID-19 with underlying coinfection further investigation including analysis of patients’ clinical data is needed.

scholarly journals Adenovirus, parainfluenza virus and respiratory syncytial virus antibodies in the sera of Jamaicans

1972 ◽  
Vol 70 (3) ◽  
pp. 523-529 ◽  
Author(s):  
Roy Jennings
Keyword(s):  
Respiratory Syncytial Virus ◽  
Respiratory Virus ◽  
Respiratory Viruses ◽  
High Titre ◽  
Parainfluenza Virus ◽  
Age Group ◽  
Syncytial Virus ◽  
Almost All ◽  
Type 3

SUMMARYSurveys for respiratory virus antibodies in the Jamaican population have shown that adenovirus, respiratory syncytial virus and parainfluenza types 1 and 3 virus antibodies are acquired early in life. The incidence of haemagglutination-inhibiting antibodies to parainfluonza viruses increases rapidly with age and almost all adults possess parainfluenza type 3 antibody, usually in high titre. Parainfluenza type 1 antibodies are only slightly less common. Complement-fixing antibodies to the adenovirus group were also observed to increase in incidence with age.Complement-fixing antibody to respiratory syncytial virus was less common in Jamaican sera than antibody to the other respiratory viruses described here. The highest titres were observed in the youngest age-group.

scholarly journals Community-acquired pneumonia in patients with chronic heart failure: clinical manifestation and a diagnostic role of biomarkers

2019 ◽  
Vol 29 (4) ◽  
pp. 391-402
Author(s):  
A. A. Bobylev ◽  
S. A. Rachina ◽  
S. N. Avdeev ◽  
R. S. Kozlov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Course ◽  
Respiratory Infections ◽  
Community Acquired Pneumonia ◽  
Serum Biomarkers ◽  
Hospital Treatment ◽  
Tnf Α ◽  
Echocardiographic Parameters

The aims of this study were to evaluate clinical course of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) and to assess the time course of serum biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and brain natriuretic peptide (BNP), at baseline and after treatment in patients with CAP and CHF. Methods. This was a prospective observational study. Adult patients with CHF admitted to a hospital due to suspected CAP were recruited in the study. The diagnosis of CAP was confirmed by chest computed tomography (CT). Subsequently, patients were assigned to the group 1 (with confirmed CAP) or the group 2 (with respiratory infections other than CAP). Echocardiography was performed in all patients at baseline and in follow-up visits. In addition to the routine clinical examination and laboratory tests, serum biomarkers were measured in all patients at admission (Visit 1), at days 10 to 14 (Visit 2), and at days 28 to 42 (Visit 3). Standard statistical methods were used for data analysis. Results. Seventy patients who met the inclusion criteria were enrolled in this study; of them, 35 patients had confirmed CAP and 35 patients had respiratory infections other than CAP. Both groups were similar for demographic and clinical characteristics, as well as for laboratory, echocardiographic and radiological findings. CAP did not affect the clinical course of CHF and echocardiographic parameters did not differ significantly between the groups. Clinical signs of both diseases improved after the treatment in majority of patients. Echocardiographic parameters also improved in both groups that indicates the improvement in cardiac dysfunction under the treatment. During the follow-up, the most prominent changes were seen in CRP level which was significantly higher at baseline in CAP patients compared to patients with other respiratory infections. CRP level decreased at Visit 2 in both groups and in Visit 3 in CAP group. CRP levels differed significantly between the groups both at Visits 1 and 2. Other biomarkers, such as PCT, IL-6, and BNP, were significantly higher at Visit 1 compares to Visit 2. TNF-α level did not change significantly neither in any group during the study nor between the groups at any study time. Conclusion. CAP did not affect the clinical course of CHF. Inflammatory biomarkers, such as CRP, PCT, and IL-6, could be used additionally to the routine diagnostic procedures to differentiate between CAP and other respiratory infections in patients with CHF. CRP is the most promising biomarker. Serum levels of the biomarkers decreased significantly under the standard hospital treatment of CAP and CHF; this could be considered to evaluate treatment success and prognosis. 

The peculiarities of clinical course of community-acquired pneumonia in patients with concomitant chronic heart failure

2020 ◽  
Vol 27 (1) ◽  
pp. 76-85
Author(s):  
В. В. Дяченко ◽  
С. А. Бичкова ◽  
О. А. Желеховський ◽  
С. С. Таранухін ◽  
Е. М. Тумарова ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Clinical Course ◽  
Community Acquired Pneumonia

scholarly journals Etiology of severe community - acquired pneumonia in adults: results of the first Russian multicenter study

2020 ◽  
Vol 92 (1) ◽  
pp. 36-42
Author(s):  
I A Zakharenkov ◽  
S A Rachina ◽  
N N Dekhnich ◽  
R S Kozlov ◽  
A I Sinopalnikov ◽  
...  
Keyword(s):  
Bacterial Pathogens ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Influenza Viruses ◽  
High Rate ◽  
Endotracheal Aspirate ◽  
Causative Agents ◽  
Antigen Tests ◽  
Severe Community Acquired Pneumonia ◽  
Positive Results

Aim: to study the etiology of severe community - acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio - economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. Materials and methods. A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi - word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real - time PCR for identification of “atypical” bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. Results. Altogether 109 patients (60.6% male; mean age 50.8±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co - infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. Conclusion. S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono - infection should be taken into account.

scholarly journals Biomarker Value in the Diagnosis of Community-Acquired Pneumonia with Concomitant Chronic Heart Failure

2021 ◽  
Vol 10 (19) ◽  
pp. 4570
Author(s):  
Svetlana Rachina ◽  
Andrey Bobylev ◽  
Pavel Lazarev ◽  
Vladimir Mladov ◽  
Florence Carrouel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Roc Curves ◽  
Community Acquired Pneumonia ◽  
Control Group ◽  
Reactive Protein ◽  
Factor Α ◽  
Serum Crp ◽  
Necrosis Factor ◽  
Control Study

The diagnosis of community-acquired pneumonia (CAP) with chronic heart failure (CHF) is associated with objective difficulties. Our case–control study aims to establish whether established serum inflammatory biomarkers are relevant to the diagnosis of CAP in patients with CHF. Seventy inpatients with previously diagnosed CHF and suspected non-severe CAP were recruited and then stratified into two subgroups with confirmed and rejected diagnosis of CAP. C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor α (TNFα), interleukin-6 (IL-6) and brain natriuretic peptide (BNP) were measured. The value of biomarkers was determined using logistic regression, and their discriminatory efficacy was assessed by analyzing receiver operating characteristic (ROC) curves. Significantly higher levels of CRP 50.0 (35.5–98.5) mg/L, PCT 0.10 (0.05–0.54) ng/mL and IL-6 46.1(21.4–150.3) pg/mL in cases were identified as compared to the control group—15.0 (9.5–25.0) mg/L, 0.05 (0.05–0.05) ng/mL and 13.6 (9.5; 25.0) pg/mL, respectively. The Area Under the ROC Curve (95% CI) was the highest for CRP—0.91 (0.83–0.98), followed by PCT—0.81 (0.72–0.90) and IL-6—0.81 (0.71–0.91). A CRP value of >28.5 mg/L had an optimal sensitivity and specificity ratio (85.7/91.4%). In conclusion, the measurement of serum CRP, PCT and IL-6 levels can be useful for the diagnosis of CAP in patients with CHF. CRP showed optimal diagnostic utility in this population.

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