scholarly journals Gram Positive Bacteria causing Lower Respiratory Tract Infections and their Resistance Patterns in Kathmandu University Hospital

2020 ◽  
Vol 22 (1-2) ◽  
pp. 22-26
Author(s):  
Jatan Bahadur Sherchan ◽  
S Humagain
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Resistance Pattern ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Tract Infections

Respiratory tract infection due to Gram positive bacteria is a common cause of morbidity and mortality worldwide. This study of one year duration was carried out to determine the antibiotic resistance pattern of Gram-positive bacteria from patients with lower respiratory tract infection visiting Kathmandu University Hospital. A total of 1,556 respiratory samples including sputum and endotracheal aspirates were processed following standard guidelines. Antibiotic resistance pattern was determined following Clinical Laboratory Standard Institute guidelines. Gram positive bacteria from total sample were 6.6%. Out of them 86.4% were Streptococcus pneumoniae and 13.6% were Staphylococcus aureus. Majority of S. pneumoniae, 53.9% were resistant to azithromycin, followed by cotrimoxazole 40.4%, ciprofloxacin 13.5% and Ceftriaxone 1.1% but all isolates were sensitive to penicillin. A total of 92.9% S. aureus were methicillin and Ciprofloxacin resistant, 64.3% were resistant to cotrimoxazole and 28.6% resistant to amikacin but all strains were sensitive to linezolid. Majority of multidrug resistant Staphylococcus were detected among patients of age more than 60 years. A total of 77.8% patients had lower respiratory tract infection with acute exacerbation of chronic obstructive pulmonary disease. Majority of diabetic patients had multidrug resistant organism. 70.69% patients of age above 60 had multidrug resistant isolates. Multidrug-resistant Gram positive bacteria were observed in respiratory samples. For effective management of lower respiratory tract infections detailed microbiological diagnosis and susceptibility testing is required.

scholarly journals Microbiology of lower respiratory tract infection in workers of garment industry of Kathmandu

2015 ◽  
Vol 10 (3) ◽  
pp. 14-22
Author(s):  
S Pant ◽  
KR Bhusal ◽  
S Manandhar
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Culture Media ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

By mistake the wrong PDF was loaded for this article. The correct PDF was loaded on 19th September 2016. OBJECTIVES This study was designed with the objectives of describing the distribution pattern of microorganisms responsible for causing LRTI in the workers of garment industries.MATERIALS AND METHODS A total of 198 cases of suspected person of Lower Respiratory Tract infection (LRTI) LRTI were included in this study. This study was conducted between November 2009 to April 2010. Specimen for the study was expectorated sputum. Gram-stain, Ziehl-Neelsen stains and culture were performed.RESULTS On direct microscopic examination, 20.51% were Gram positive bacteria, 79.48% were Gram negative bacteria and 4% were smear positive AFB. On culture sensitivity examination, 22% percent showed growth of different bacteria in different culture media. The bacteria isolated from the samples included Klebsiella pneumoniae (15.38%), Proteus mirabilis (15.38%) and Citrobacterfruendii (15.38%). Gram Negative bacteria were found most susceptible to Ciprofloxacin (92.30%, 24/26) and Amikacin (92.30%, 24/26). Similarly, Gram Positive bacteria were found most susceptible to Ciprofloxacin (100%, 8/8) followed by Cloxacillin and Cephalexin (87.5%, 7/8). Smear positive AFB was significantly associated with not using the protective measures (mask) by workers and presence of symptoms (cough for more than two weeks, night sweat, hemoptysis and anorexia) (p=0.031). Culture positivity was significantly associated with symptoms like production of purulent sputum (p=0.045).CONCLUSION There was insignificant association between LRTI and risk factors present in working room of garment industries. Most of the isolates were sensitive to Ciprofloxacin and resistance to Ampicillin and Cephalexin.Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 14-22

scholarly journals Anemia as a Risk Factor for Acute Lower Respiratory Tract Infection in Children Below Five Years of Age

2018 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
Henish Shakya ◽  
Saurav Singh ◽  
Ashish Lakhey
Keyword(s):  
Risk Factor ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
P Value ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Introduction: Lower respiratory tract infection is a major cause of death in children in a developing country and anemia is found to be one of the commonest associated cofactors. This study was aimed to determine association of anemia in children with lower respiratory tract infections.Materials and Methods: The retrospective study was done over a one-year period for children under 5 years of age, admitted in Pediatric Ward of a tertiary Hospital in Lalitpur. The study included 100 diagnosed cases of lower respiratory tract infections as per WHO criteria and 100 age and sex matched patients who did not have respiratory complaints as controls, excluding prematurity, chronic diseases, malnutrition and severe systemic illness. Appropriate clinical history, examination routine investigations like hemoglobin, peripheral smear, and Chest X-ray were included.Results: The age distribution maximum children were in the age group of 3 months to 23 months with significant association with prevalence of both pneumonia (p value 0.005) and anemia (p value 0.002). Anemia was found to be a significant risk factor for LRTI (p value < 0.001) with odds ratio of 2.68 and 95% CI (1.51 – 4.75).Conclusions: Anemia was significantly found to be associated with lower respiratory tract infections and these children were found to be 2.68 times more susceptible to lower respiratory tract infections. Early diagnosis and prevention of anemia is thus important to reduce the incidence of lower respiratory tract infections in children.Nepalese Medical Journal. vol.1, No. 1, 2018, page: 5-8

scholarly journals Levels of Gamma Interferon and Interleukin-4 Are Inversely Related to the Levels of Their Corresponding Autoantibodies in Patients with Lower Respiratory Tract Infection

1999 ◽  
Vol 67 (6) ◽  
pp. 3051-3054 ◽  
Author(s):  
Rihab ElKarim ◽  
Carl Granert ◽  
Lars Lindquist ◽  
Hans Link ◽  
Moiz Bakhiet
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Gamma Interferon ◽  
Interleukin 4 ◽  
Fab Fragments ◽  
Ifn Γ ◽  
Tract Infections

ABSTRACT To study the involvement of cytokines and their corresponding autoantibodies (Aabs) in inflammatory mechanisms in patients with lower respiratory tract infections, blood samples were taken from patients at the time of admission to the hospital and before treatment. Cell-released capturing enzyme-linked immunosorbent assay was used to measure the levels of gamma interferon (IFN-γ) and interleukin-4 (IL-4) produced spontaneously by peripheral mononuclear cells (PMNC). ELISA was used to measure Aabs to these cytokines in sera. The levels of both cytokines were inversely related to the levels of their corresponding Aabs. While a high level of IFN-γ was observed together with a low level of anti-IFN-γ Aab, decreased IL-4 levels were observed with increased levels of Aabs to IL-4. Immunoglobulins were purified, digested to obtain Fab fragments, and tested for specificity and cross-reactivity. The Aabs and their Fab fragments were tested in cytokine biological assays and showed neutralizing effects. Our data demonstrated increased levels of the proinflammatory cytokine IFN-γ and decreased release of the anti-inflammatory cytokine IL-4 during early presentation of lower respiratory tract infection. The levels of these cytokines were inversely related to the levels of their corresponding Aabs that exhibited regulatory effects on the cytokine biological function in vitro.

scholarly journals Epidemiology of Hyponatraemia among Elderly Patients with Lower Respiratory Tract Infection

2019 ◽  
Vol 31 (1) ◽  
pp. 13-17
Author(s):  
B Raju ◽  
A Rishab ◽  
K Vikram ◽  
T Vaibhav ◽  
T Sharat ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Elderly Patients ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Tertiary Care ◽  
Age Group ◽  
Cross Sectional ◽  
Tract Infections

Background: Decrease in serum sodium concentration is frequent observation among hospitalised elderly patients. The common causes for hyponatremia are degenerative physiology, dehydration, medications and infections. Hence the present study was undertaken to know the extent of hyponatremia among elderly with Lower Respiratory Tract Infections. Objectives: The present study was undertaken to assess the prevalence of hyponatremia in lower respiratory tract infection among geriatric age group and to determine the association between severity of hyponatraemia and LRTI. Methods: This was hospital based cross sectional study carried out in the Department of General Medicine of a tertiary care teaching hospital situated in north Karnataka, India during November 2016 to May 2018. 100 elderly patients (age e” 60 years) with history of cough for more than four to five days, clinical findings and X-ray findings suggestive of LRTI, were selected for the study. Results: In the present study 59% comprised of male whereas females constituted 41%. The prevalence of hyponatraemia among elderly patients with LRTI was 45%. The most common cause of hyponatraemia was GI loss (vomiting) 53.33%, Euvolemic hyponatramia 51.11%. The mean age was 69.99±8.44 years. Most of the patients were aged between 61 to 70 years. .Hyponatraemia was not associated with sex, age and type of LRTI. Duration of hospital stay was significantly longer in patients with hyponatraemia compared to those who did not develop hyponatraemia. Conclusion: Hyponatraemia among elderly individuals with LRTI is higher as compared to other age group hence leading to prolonged duration of hospitalisation. Bangladesh J Medicine Jan 2020; 31(1) : 13-17

scholarly journals Child Acute Lower Respiratory Tract Infection in Pediatrics Intensive Care Unit at University Hospital of Brazzaville (Congo)

2018 ◽  
Vol 08 (01) ◽  
pp. 32-41
Author(s):  
Engoba Moyen ◽  
Judicaël Kambourou ◽  
Annie Rachelle Okoko ◽  
Lori Bertrand Nguelongo ◽  
Verlem Bomelefa-Bomel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
University Hospital

scholarly journals Effectiveness of oseltamivir treatment on clinical failure in hospitalized patients with lower respiratory tract infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Timothy L. Wiemken ◽  
Stephen P. Furmanek ◽  
Ruth M. Carrico ◽  
Paula Peyrani ◽  
Daniel Hoft ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Influenza Infection ◽  
Standard Of Care ◽  
Hospitalized Patients ◽  
Clinical Failure ◽  
Tract Infections

Abstract Background Influenza is associated with excess morbidity and mortality of individuals each year. Few therapies exist for treatment of influenza infection, and each require initiation as early as possible in the course of infection, making efficacy difficult to estimate in the hospitalized patient with lower respiratory tract infection. Using causal machine learning methods, we re-analyze data from a randomized trial of oseltamivir versus standard of care aimed at reducing clinical failure in hospitalized patients with lower respiratory tract infection during the influenza season. Methods This was a secondary analysis of the Rapid Empiric Treatment with Oseltamivir Study (RETOS). Conditional average treatment effects (CATE) and 95% confidence intervals were computed from causal forest including 85 clinical and demographic variables. RETOS was a multicenter, randomized, unblinded, trial of adult patients hospitalized with lower respiratory tract infections in Kentucky from 2009 through 2012. Adult hospitalized patients with lower respiratory tract infection were randomized to standard of care or standard of care plus oseltamivir as early as possible after hospital admission but within 24 h of enrollment. After randomization, oseltamivir was initiated in the treatment arm per package insert. The primary outcome was clinical failure, a composite measure including failure to reach clinical improvement within 7 days, transfer to intensive care 24 h after admission, or rehospitalization or death within 30 days. Results A total of 691 hospitalized patients with lower respiratory tract infections were included in the study. The only subgroup of patients with a statistically significant CATE was those with laboratory-confirmed influenza infection with a 26% lower risk of clinical failure when treated with oseltamivir (95% CI 3.2–48.0%). Conclusions This study suggests that addition of oseltamivir to standard of care may decrease clinical failure in hospitalized patients with influenza-associated lower respiratory tract infection versus standard of care alone. These results are supportive of current recommendations to initiate antiviral treatment in hospitalized patients with confirmed or suspected influenza as soon as possible after admission. Trial registration Original trial: Clinical Trials.Gov; Rapid Empiric Treatment With Oseltamivir Study (RETOS) (RETOS); ClinicalTrials.gov Identifier: NCT01248715 https://clinicaltrials.gov/ct2/show/NCT01248715

scholarly journals Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age

2020 ◽  
Vol 7 (9) ◽  
pp. 1876
Author(s):  
Bhagat Ram Thakur ◽  
Pancham Kumar
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Study Group ◽  
Lower Respiratory Tract Infections ◽  
Nutritional Rickets ◽  
Tract Infections

Background: Frequency of nutritional rickets, its clinicobiochemical profile and its relationship to the lower respiratory tract infections in indoor patients from 2 to 60 months of age.Methods: Children aged 2 to 60 months admitted for the first time were included in the study and divided into two groups i.e. with and without clinical signs of rickets. Disease profile was studied in both groups. Incidence of lower respiratory tract infection was compared between two groups.  Children with clinicoradiological signs of rickets were also investigated for biochemical abnormalities.Results: During the one year study period a total of 393 children were admitted, 65 were found to have rickets constituted as study group and 328 were without rickets were included the controls. Rickets incidence was 16.5% of which majority (74.6%) were males and most rachitic children (64.6%) were below six months of age. Acute lower respiratory tract infection (64.6%) was commonest in study group and acute gastroenteritis (24.4%) in the controls. The rate of ALRTI was nearly three times in study group.  Frontal bossing (67.7%) was most common sign of rickets and increased alkaline phosphatase (93.8%) was the commonest biochemical abnormality.Conclusions: Nutritional rickets, a multifactorial disease, is easily preventable. The present study has revealed the high incidence of rickets i. e., 16.5% and also show the strong statistically significant association of nutritional rickets with acute lower respiratory tract infections.

scholarly journals Antimicrobial Susceptibility Pattern of Gram-Negative Bacteria Causing Lower Respiratory Tract Infections in Kathmandu University Hospital

2021 ◽  
Vol 18 (4) ◽  
pp. 661-666
Author(s):  
Jatan Bahadur Sherchan ◽  
Sanjay Humagain
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Multidrug Resistant ◽  
P Value ◽  
Diabetic Patients ◽  
Gram Negative Bacteria ◽  
Predisposing Factor ◽  
Gram Negative

Background: Respiratory tract infection due to Gram-negative bacteria is a common cause of morbidity and mortality worldwide. This study was carried out to determine the antimicrobial susceptibility pattern of Gram-negative bacteria from patients with lower respiratory tract infection visiting Kathmandu University Hospital.Methods: A total of 3,403 respiratory samples including sputum and endotracheal aspirates were processed and antibiotic resistance pattern was determined following Clinical Laboratory Standard Institute guidelines. Patients’ information was obtained after informed consent.Results: Growth of Gram-negative bacteria was 210 (6.17%). 83(39.52%) were Klebsiella pneumoniae followed by Escherichia coli, Pseudomonas aeruginosa, Acinetobacter species, Klebsiella oxytoca, Enterobacter species, Proteus mirabilis and Haemophilus influenzae. 151(71.90%) isolates were multidrug resistant. None of the strains were resistant to colistin. 51(24.29%) were resistant to carbapenem and out of these 3(1.43%) were metallo-? lactamase producers. 89(65.92%) of the patients having both pneumonia along with other respiratory illnesses were above 60 years of age indicating that old age might be a predisposing factor. (p value is less than 0.0001). 92(81.42%) of patients of age above 60 years had multidrug resistant isolates indicating that old age might be a predisposing factor for getting infection my multidrug resistant isolates. (p value equals 0.0012) Among 36 diabetic patients 33(91.67%) had multidrug resistant isolates. Whereas out of 174 non-diabetic patients only 118(67.82%) had multidrug resistant isolates (p value equals 0.0037).Conclusions: Multidrug-resistant Gram negative bacteria were observed in respiratory samples. Effective treatment of lower respiratory tract infection need detailed microbiological diagnosis and drug susceptibility testing.Keywords: ESBL; LRTI; MBL; MDR

scholarly journals An analysis of the clinical picture of respiratory tract infections in primary care patients

2020 ◽  
Vol 16 (4) ◽  
pp. 382-388
Author(s):  
Aneta Rzepka ◽  
◽  
Anna Mania ◽  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Upper Respiratory ◽  
Tract Infections

Aim: The aim of this study was to analyse the clinical picture of respiratory tract infections among adult patients visiting their general practitioners. Materials and methods: The analysis included 301 adult patients who reported to their general practitioners due to respiratory tract infection. W assessed clinical symptoms, age, final diagnosis, probable aetiology, additional tests, including Actim® Influenza A&B rapid test to confirm influenza infection, radiographic and laboratory findings, as well as comorbidities, treatment used, vaccinations against influenza, and smoking habits. Results: Upper respiratory tract infections accounted for the vast majority of cases (74%), and these primarily included viral infections (62%), some of which required a change of therapy (23%) due to suspected secondary bacterial infection; lower respiratory tract infections accounted for 26% of cases. The main symptoms reported by the patients included cough, pharyngeal pain, fever, rhinitis, general malaise, nasal obstruction, headache, muscle pain and dysphonia. Acute pharyngitis was the dominant diagnosis (27%), followed by acute upper respiratory tract infection of multiple sites (13.6%), acute nasopharyngitis (known as common cold) (10%), purulent tonsillitis (11.6%), acute bronchitis (11%) and influenza (11%). Antibiotic therapy was used in 60% of patients with upper respiratory tract infection and 68% of patients with lower respiratory tract infection. Conclusions: The majority of patients were diagnosed with viral infections. The highest incidence of respiratory tract infections was observed in elderly individuals and patients with chronic cardiovascular diseases, lung diseases, diabetes mellitus and cancer. Smokers are more likely to develop lower respiratory tract infections (confirmed by additional tests) compared to other groups of patients. Individuals vaccinated against influenza account for a small proportion of patients.

Sign in / Sign up

Export Citation Format

Share Document