scholarly journals Detection of Chlamydia pneumonia and Mycoplasma pneumonia in hospitalised children with community acquired pneumonia

2018 ◽  
Vol 5 (4) ◽  
pp. 1310
Author(s):  
Kannan Ramamoorthy ◽  
Agora Shivan Shanmuga Sundaram
Keyword(s):  
Low Income ◽  
Chlamydia Pneumoniae ◽  
Radiological Feature ◽  
Community Acquired Pneumonia ◽  
Low Income Countries ◽  
Study Objective ◽  
Igm Elisa ◽  
Atypical Pathogens ◽  
Mycoplasma Pneumonia ◽  
Chest X Ray

Background: Mycoplasma pneumoniae and Chlamydia pneumoniae are atypical pathogens responsible for community acquired pneumonia (CAP) and are a leading cause of morbidity and mortality in low income countries. The study objective was to determine the prevalence of C. pneumoniae and M. pneumonia in hospitalized children with CAP.Methods: This study was performed on ninety-four children admitted with radiologically confirmed diagnosis of pneumonia in Government Rajah Mirasudar Hospital, Thanjavur, during the period of July 2005 to April 2006. The diagnosis of infections with C. pneumonia and M. pneumonia was determined by detection of IgM antibody by using ELISA method. In this study clinical and radiological feature of these infections were also looked for.Results: Among 94 children, 9 children (9.6%) were detected positive for M. pneumonia and 8 children (8.5%) were detected positive for C. pneumonia. Infection rate was highest among 5-12 years and least among 1 month to 24 months age group. The most common symptoms observed in patients with these pathogens are cough, fever, crepitations and rhonchi. Pulmonary infiltrates were the most common chest X-ray features of both C. pneumoniae pneumonia and M. pneumoniae pneumonia.Conclusions: This study has shown that C. pneumonia and M. pneumonia play a significant role in paediatric CAP. Identification and confirmation of these organisms by IgM ELISA helps in better management that would decrease the need for hospitalization and IV antibiotics.

scholarly journals Atypical pathogens in hospitalized patients with community-acquired pneumonia: a worldwide perspective

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Andrea Gramegna ◽  
◽  
Giovanni Sotgiu ◽  
Marta Di Pasquale ◽  
Dejan Radovanovic ◽  
...  
Keyword(s):  
Low Income ◽  
Univariate Analysis ◽  
Real Life ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Adult Patients ◽  
Low Income Countries ◽  
Atypical Pathogen ◽  
Atypical Pathogens ◽  
The Impact

Abstract Background Empirical antibiotic coverage for atypical pathogens in community-acquired pneumonia (CAP) has long been debated, mainly because of a lack of epidemiological data. We aimed to assess both testing for atypical pathogens and their prevalence in hospitalized patients with CAP worldwide, especially in relation with disease severity. Methods A secondary analysis of the GLIMP database, an international, multicentre, point-prevalence study of adult patients admitted for CAP in 222 hospitals across 6 continents in 2015, was performed. The study evaluated frequency of testing for atypical pathogens, including L. pneumophila, M. pneumoniae, C. pneumoniae, and their prevalence. Risk factors for testing and prevalence for atypical pathogens were assessed through univariate analysis. Results Among 3702 CAP patients 1250 (33.8%) underwent at least one test for atypical pathogens. Testing varies greatly among countries and its frequency was higher in Europe than elsewhere (46.0% vs. 12.7%, respectively, p < 0.0001). Detection of L. pneumophila urinary antigen was the most common test performed worldwide (32.0%). Patients with severe CAP were less likely to be tested for both atypical pathogens considered together (30.5% vs. 35.0%, p = 0.009) and specifically for legionellosis (28.3% vs. 33.5%, p = 0.003) than the rest of the population. Similarly, L. pneumophila testing was lower in ICU patients. At least one atypical pathogen was isolated in 62 patients (4.7%), including M. pneumoniae (26/251 patients, 10.3%), L. pneumophila (30/1186 patients, 2.5%), and C. pneumoniae (8/228 patients, 3.5%). Patients with CAP due to atypical pathogens were significantly younger, showed less cardiovascular, renal, and metabolic comorbidities in comparison to adult patients hospitalized due to non-atypical pathogen CAP. Conclusions Testing for atypical pathogens in patients admitted for CAP in poorly standardized in real life and does not mirror atypical prevalence in different settings. Further evidence on the impact of atypical pathogens, expecially in the low-income countries, is needed to guidelines implementation.

scholarly journals Pediatric pleural empyema: one of the management challenges in children of Democratic Republic of Congo

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Kibwe Alphonse Simbi ◽  
Valentin Kazadi ◽  
Louis-Marie Aissi ◽  
François Mbahewaka Katsuva ◽  
Numbi Oscar Luboya ◽  
...  
Keyword(s):  
Low Income ◽  
Democratic Republic Of Congo ◽  
Pleural Empyema ◽  
Low Income Countries ◽  
British Thoracic Society ◽  
Rapid Improvement ◽  
Chest X Ray ◽  
Basic Medical ◽  
Severe Lung

Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo. Chest X-ray showed a massive empyema that was resolved by immediate drainage and antibiotiocs. Results were rapid improvement and discharge after 3 weeks. A classic medical and imaging approach is a winning return in low-income countries. According to the British Thoracic Society guidelines, pleural effusion with compromising respiratory function can be managed by drainage and antibiotics.

scholarly journals A multicenter, randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin versus ceftriaxone and/or cefuroxime axetil in treatment of adults with community-acquired pneumonia.

1997 ◽  
Vol 41 (9) ◽  
pp. 1965-1972 ◽  
Author(s):  
T M File ◽  
J Segreti ◽  
L Dunbar ◽  
R Player ◽  
R Kohler ◽  
...  
Keyword(s):  
Adverse Events ◽  
Legionella Pneumophila ◽  
Chlamydia Pneumoniae ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Cefuroxime Axetil ◽  
Community Acquired Pneumonia ◽  
Respiratory Pathogens ◽  
Efficacy And Safety ◽  
Atypical Pathogens

Five hundred ninety patients were enrolled in a prospective, multicenter, randomized trial comparing the efficacy and safety of 7 to 14 days of levofloxacin treatment with that of ceftriaxone and/or cefuroxime axetil in the management of community-acquired pneumonia in adults. Patients received either intravenous and/or oral levofloxacin (500 mg once daily) or the comparative agents, parenteral ceftriaxone (1 to 2 g once to twice daily) and/or oral cefuroxime axetil (500 mg twice daily). Erythromycin or doxycycline could be added to the comparator arm at the investigator's discretion. The decision to use an intravenous or oral antimicrobial agent for initial therapy was made by the investigator. Clinical and microbiological evaluations were completed at the baseline, during treatment, 5 to 7 days posttherapy, and 3 to 4 weeks posttherapy. Four hundred fifty-six patients (226 given levofloxacin and 230 administered ceftriaxone and/or cefuroxime axetil) were evaluable for clinical efficacy. Streptococcus pneumoniae and Haemophilus influenzae were isolated in 15 and 12%, respectively, of clinically evaluable patients. One hundred fifty atypical pathogens were identified: 101 were Chlamydia pneumoniae, 41 were Mycoplasma pneumoniae, and 8 were Legionella pneumophila. Clinical success at 5 to 7 days posttherapy was superior for the levofloxacin group (96%) compared with the ceftriaxone and/or cefuroxime axetil group (90%) (95% confidence interval [CI] of -10.7 to -1.3). Among patients with typical respiratory pathogens who were evaluable for microbiological efficacy, the overall bacteriologic eradication rates were superior for levofloxacin (98%) compared with the ceftriaxone and/or cefuroxime axetil group (85%) (95% CI of -21.6 to -4.8). Levofloxacin eradicated 100% of the most frequently reported respiratory pathogens (i.e., H. influenzae and S. pneumoniae) and provided a >98% clinical success rate in patients with atypical pathogens. Both levofloxacin and ceftriaxone-cefuroxime axetil eradicated 100% of the S. pneumoniae cells detected in blood culture. Drug-related adverse events were reported in 5.8% of patients receiving levofloxacin and in 8.5% of patients administered ceftriaxone and/or cefuroxime axetil. Gastrointestinal and central and peripheral nervous system adverse events were the most common events reported in each treatment group. In conclusion, these results demonstrate that treatment with levofloxacin is superior to ceftriaxone and/or cefuroxime axetil therapy in the management of community-acquired pneumonia in adults.

scholarly journals Aetiological agent in community acquired pneumonia in patients requiring hospitalization

2008 ◽  
Vol 2 (1) ◽  
pp. 41-49
Author(s):  
Abdullah Mustafa Qader ◽  
Mushrik K. Abood ◽  
Tural Yelderim Baker
Keyword(s):  
Chlamydia Pneumoniae ◽  
Bacterial Species ◽  
Bacterial Pathogen ◽  
Community Acquired Pneumonia ◽  
Mixed Infections ◽  
Blood Samples ◽  
Atypical Pathogens ◽  
Common Causes ◽  
Medical City ◽  
Etiological Agents

This study was carried out to determine the etiological agents in patients withcommunity-acquired pneumonia (CAP). Ninety-three patients with radiologicallyconfirmed pneumonia admitted to the Medical City, Baghdad Teaching Hospitalthrough the period extended from October 2001 till March 2002. Also to investigate apossible correlation between etiological agents in patients with CAP and comorbidfactors including age. The etiological agents were identified from 50 (53.8%) patientswith CAP, while no agents were detected in 43 (46.2%) patients. Blood samples weretaken from all patients for identification of Chlamydia pneumoniae and Mycoplasmapneumoniae infection. Sputum samples for culture were taken from 76 (81.7%)patients; bacterial species were isolated from 22 (23.7%) samples. Streptococcuspneumoniae was the most frequent typical bacterial pathogen isolated from 17 (18.3%)patients. Atypical pathogens (C. pneumoniae and M. pneumoniae) using ELISAtechnique were identified in 22 (23.6%) and 20 (21.5%) respectively. Atypical pathogenswere a most common causes of CAP identified from (39.8%) cases. Sixteen (17.2%) ofthe patients had mixed infections (two pathogens were identified in 12 (75%) and threepathogens in 4 (25%) patients). C. pneumoniae and S. pneumoniae were the mostcommon mixed organisms found in 6 (37.5%) of patients.

scholarly journals Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

1998 ◽  
Vol 9 (suppl e) ◽  
pp. 23E-26E
Author(s):  
Arne C Rodloff
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chlamydia Pneumoniae ◽  
Good Alternative ◽  
Community Acquired Pneumonia ◽  
Lower Respiratory Tract Infections ◽  
Atypical Pathogens ◽  
Clinical Trial Program ◽  
Tract Infections

The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which includeStreptococcus pneumoniaeand “atypical” pathogensLegionellaspecies. MycoplasmapneumoniaeandChlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls), four about community-acquired pneumonia (CAP) and two about acute bacterial exacerbations of chronic bronchitis (ABECB) . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

scholarly journals Phenotypic Divergence Analysis in Pigeonpea [Cajanus cajan (L.) Millspaugh] Germplasm Accessions

Agronomy ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1682
Author(s):  
Esnart Nyirenda Yohane ◽  
Hussein Shimelis ◽  
Mark Laing ◽  
Isack Mathew ◽  
Admire Shayanowako
Keyword(s):  
Genetic Diversity ◽  
Grain Yield ◽  
Low Income ◽  
Cajanus Cajan ◽  
Seed Weight ◽  
Principal Component ◽  
Low Income Countries ◽  
Study Objective ◽  
Lattice Design ◽  
Early Maturing

Pigeonpea (Cajanus cajan (L.) Millspaugh) is an important source of grain protein for low-income countries such as Malawi. Knowledge of the genetic diversity in pigeonpea is essential for an effective breeding program. The study objective was to assess the genetic diversity among diverse pigeonpea accessions to select complementary and unique genotypes for breeding. Eighty-one pigeonpea accessions were evaluated in six environments in Malawi using a 9 × 9 alpha-lattice design with two replications. The cross-tabulation analysis revealed a significant genotype variation on plant growth, flower, and seed traits. The combined analysis of variance identified genotypes MWPLR 14, ICEAP 01170, ICEAP 871091, and ICEAP 01285 as early maturing varieties, while Kachangu, MWPLR 16, TZA 5582, No. 40, and MWPLR 14 were identified as high-yielding genotypes. The correlation analysis revealed a significant positive correlation between grain yield and a hundred seed weight (HSWT) (r = 0.50, p < 0.01), suggesting the usefulness of this trait for selection. The nonlinear principal component analysis identified grain yield (GDY), days to 50% flowering (DTF), days to 75% maturity (DTM), number of pods per plant (NPP), number of racemes per plant (NRP), 100 seed weight (HSWT), leaf hairiness (LH), and number of seeds per pod (NSP) as the most discriminated traits among the test genotypes. The cluster analysis using morphological traits delineated the accessions into three clusters. The selected high-yielding and early-maturing genotypes may be recommended as parental lines for breeding and grain yield improvement in Malawi or similar agro-ecologies.

scholarly journals Role and place of levofloxacin in the treatment of community-acquired pneumonia

2021 ◽  
Vol 3 (2) ◽  
pp. 41-48
Author(s):  
D V Dmytriiev ◽  
O A Nazarchuk ◽  
Yu M Babina
Keyword(s):  
Low Income ◽  
Alternative Therapy ◽  
Treatment Method ◽  
Community Acquired Pneumonia ◽  
Low Income Countries ◽  
Development Of Resistance ◽  
Antibiotics Use ◽  
Potential Alternative ◽  
Tract Infections ◽  
Short Courses

Lower respiratory tract infections are the third mortality cause in the world and the first mortality cause in low-income countries. Community-acquired pneumonia (CAP) is a dangerous infectious pathology, especially in children younger than 5 years, elderly people and patients with compromised immunity. Antibiotic therapy is a standard treatment method for CAP. But an increase in antibiotics use caused a development of resistance in bacteria and onset of adverse events in humans. A new class of fluorchinolones is widely used nowadays in clinical practice. They have good activity against Gram-negative bacteria, as early chinolones, as well as against Gram-positive bacteria, such as pneumococci and atypical bacteria. An increasing amount of penicillin-resistant streptococcal pneumonia leads to more intensive studies of the use of new chinolones. In this review the data of 750 mg levofloxacin is presented. It is used in short courses for the treatment of severe and moderate CAP. Taking into account the broad spectrum of activity of levofloxacin ad bactericidal activity of this antibiotic, it can be a potential alternative therapy for the treatment of children and adults with CAP, especially with a tendency of an increase in antibiotic resistance of pneumococcus.

scholarly journals Air due to Glue: Spontaneous Pneumothorax in a Young Adult with Glue Sniffing

2018 ◽  
Vol 56 (210) ◽  
pp. 621-624
Author(s):  
Deebya Raj Mishra ◽  
Narendra Bhatta ◽  
Bidesh Bista ◽  
Puru Koirala ◽  
Ramhari Ghimire
Keyword(s):  
Low Income ◽  
Low Cost ◽  
Low Income Countries ◽  
Alveolar Pressure ◽  
Pulmonary Barotrauma ◽  
X Ray ◽  
Neuropsychological Effects ◽  
History Of ◽  
Chest X Ray ◽  
Solvent Abuse

Solvent abuse, as inhalant specially, in the form of low cost adhesives like dendrite is common in low income countries among children and the teens. This habit is often a stepping stone to harder drugs. The neurological and neuropsychological effects of solvent abuse are well explored. But the respiratory effects are often overlooked. In this report, we present a case of a 19 year old gentleman, with regular history of sniffing of commercial “glue” compounds. This patient presented with right sided chest pain and chest x-ray showed a right sided pneumothorax. The pulmonary barotrauma, possibly due to increased intra-alveolar pressure, during the sniffing process can lead to alveolar rupture and in turn, pneumothorax. In the absence of other risk factors for Pneumothorax, the link between inhalant abuse and respiratory complications has to be explored in patients with history of such abuse.

Three Cases of Joubert Syndrome in a Consanguineous Syrian Family and a Interesting Case of Multinational Collaboration

2021 ◽  
Author(s):  
Davor Petrović ◽  
Vida Čulić ◽  
Zofia Swinderek-Alsayed
Keyword(s):  
Low Income ◽  
Autosomal Recessive ◽  
Autosomal Recessive Disorder ◽  
Joubert Syndrome ◽  
Interesting Case ◽  
Low Income Countries ◽  
Ocular Motor ◽  
Quality Health Care ◽  
Quality Health ◽  
Motor Apraxia

AbstractJoubert syndrome (JS) is a rare congenital, autosomal recessive disorder characterized by a distinctive brain malformation, developmental delay, ocular motor apraxia, breathing abnormalities, and high clinical and genetic heterogeneity. We are reporting three siblings with JS from consanguineous parents in Syria. Two of them had the same homozygous c.2172delA (p.Trp725Glyfs*) AHI1 mutation and the third was diagnosed prenatally with magnetic resonance imaging. This pathogenic variant is very rare and described in only a few cases in the literature. Multinational collaboration could be of benefit for the patients from undeveloped, low-income countries that have a low-quality health care system, especially for the diagnosis of rare diseases.

Reviewing the Development of Rural Finance in Vietnam

2013 ◽  
pp. 121-136
Author(s):  
Duong Pham Bao
Keyword(s):  
Low Income ◽  
Financial System ◽  
Low Income Countries ◽  
Supply Side ◽  
New Paradigm ◽  
Rural Finance ◽  
Market Mechanisms ◽  
Rural Credit ◽  
Rural Organizations ◽  
Doi Moi

The objective of this article is to review the development of the rural financial system in Vietnam in recent years, especially, after Doi moi. There are two opposite schools of thought in the literature on rural credit policies in developing countries. One is the conventional supply-side (government-led) approach while the other is called “a new paradigm” that emphasizes the importance of the viability of financial providers and the well functioning of rural credit markets. Conventional theories of rural finance contend that rural finance in low-income countries is generally accompanied by many failures. Contrary to these theories, rural finance in Vietnam does not encounter the above-mentioned failures so far. Up to the present time, it is progressing well. Using a supply-side approach, methodologically, this study reviews the development of the rural financial system in Vietnam. The significance of this study is to challenge the extreme view of dichotomizing between the old and the new credit paradigms. Analysis in this study contends that a rural financial market that, (1) is initiated and spurred by government; (2) operates principally under market mechanisms; and (3) is strongly supported by rural organizations (semi-formal/informal institutions) can progress stably and well. Therefore, the extremely dichotomizing approach must be avoided.

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