scholarly journals Rapid Molecular Tests for Detecting Respiratory Pathogens Reduced the Use of Antibiotics in Children

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 283
Author(s):  
Yu Kyung Kim ◽  
Jong Ho Lee ◽  
Sae Yoon Kim ◽  
Ji Young Ahn ◽  
Kwang Hae Choi ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
Turnaround Time ◽  
University Hospital ◽  
Respiratory Pathogens ◽  
Detection Rates ◽  
Molecular Tests ◽  
Specificity And Sensitivity

Multiplex polymerase chain reaction (mPCR) is increasingly being used to diagnose infections caused by respiratory pathogens in pediatric inpatient facilities. mPCR assays detect a broader array of viruses, with higher specificity and sensitivity and faster turnaround than previous assays. We adapted the FilmArray Respiratory Panel (FA-RP) for diagnosing respiratory infections. FA-RP is an in vitro mPCR assay that simultaneously and rapidly (in about 1 h) detects 20 pathogens directly from respiratory specimens. Here, we studied the clinical efficacy of FA-RP in children who underwent testing for respiratory pathogens at Yeungnam University Hospital from November 2015 to August 2018. From November 2015 to June 2016, routine mPCR testing was performed on nasopharyngeal swabs using the routine mPCR kit. From November 2016 to July 2018, mPCR testing was performed using FA-RP. A total of 321 tests by routine mPCR and 594 tests by FA-RP were included. The positive detection rates for routine mPCR and FA-RP were 71.3% and 83.3%, respectively. FA-RP reduced the lead time, waiting time, turnaround time, intravenous (IV) antibiotic use, and length of hospital stay for pediatric patients. The decreased use of antibiotics is expected to reduce antibiotic resistance in children.

scholarly journals Epidemiology and Clinical Symptoms Related to Seasonal Coronavirus Identified in Patients with Acute Respiratory Infections Consulting in Primary Care over Six Influenza Seasons (2014–2020) in France

Viruses ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 630
Author(s):  
Shirley Masse ◽  
Lisandru Capai ◽  
Natacha Villechenaud ◽  
Thierry Blanchon ◽  
Rémi Charrel ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Epidemiological Data ◽  
Influenza Surveillance ◽  
Respiratory Pathogens ◽  
Detection Rates ◽  
Representative Samples

There is currently debate about human coronavirus (HCoV) seasonality and pathogenicity, as epidemiological data are scarce. Here, we provide epidemiological and clinical features of HCoV patients with acute respiratory infection (ARI) examined in primary care general practice. We also describe HCoV seasonality over six influenza surveillance seasons (week 40 to 15 of each season) from the period 2014/2015 to 2019/2020 in Corsica (France). A sample of patients of all ages presenting for consultation for influenza-like illness (ILI) or ARI was included by physicians of the French Sentinelles Network during this period. Nasopharyngeal samples were tested for the presence of 21 respiratory pathogens by real-time RT-PCR. Among the 1389 ILI/ARI patients, 105 were positive for at least one HCoV (7.5%). On an annual basis, HCoVs circulated from week 48 (November) to weeks 14–15 (May) and peaked in week 6 (February). Overall, among the HCoV-positive patients detected in this study, HCoV-OC43 was the most commonly detected virus, followed by HCoV-NL63, HCoV-HKU1, and HCoV-229E. The HCoV detection rates varied significantly with age (p = 0.00005), with the age group 0–14 years accounting for 28.6% (n = 30) of HCoV-positive patients. Fever and malaise were less frequent in HCoV patients than in influenza patients, while sore throat, dyspnoea, rhinorrhoea, and conjunctivitis were more associated with HCoV positivity. In conclusion, this study demonstrates that HCoV subtypes appear in ARI/ILI patients seen in general practice, with characteristic outbreak patterns primarily in winter. This study also identified symptoms associated with HCoVs in patients with ARI/ILI. Further studies with representative samples should be conducted to provide additional insights into the epidemiology and clinical features of HCoVs.

scholarly journals National and Regional Assessment of Antimicrobial Resistance among Community-Acquired Respiratory Tract Pathogens Identified in a 2005-2006 U.S. Faropenem Surveillance Study

2007 ◽  
Vol 51 (12) ◽  
pp. 4382-4389 ◽  
Author(s):  
Ian A. Critchley ◽  
Steven D. Brown ◽  
Maria M. Traczewski ◽  
Glenn S. Tillotson ◽  
Nebojsa Janjic
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Respiratory Infections ◽  
Empirical Therapy ◽  
The United States ◽  
Respiratory Pathogens ◽  
Study Objective ◽  
Tract Infections ◽  
Resistance Rates

ABSTRACT Surveillance studies conducted in the United States over the last decade have revealed increasing resistance among community-acquired respiratory pathogens, especially Streptococcus pneumoniae, that may limit future options for empirical therapy. The objective of this study was to assess the scope and magnitude of the problem at the national and regional levels during the 2005-2006 respiratory season (the season when community-acquired respiratory pathogens are prevalent) in the United States. Also, since faropenem is an oral penem being developed for the treatment of community-acquired respiratory tract infections, another study objective was to provide baseline data to benchmark changes in the susceptibility of U.S. respiratory pathogens to the drug in the future. The in vitro activities of faropenem and other agents were determined against 1,543 S. pneumoniae isolates, 978 Haemophilus influenzae isolates, and 489 Moraxella catarrhalis isolates collected from 104 U.S. laboratories across six geographic regions during the 2005-2006 respiratory season. Among S. pneumoniae isolates, the rates of resistance to penicillin, amoxicillin-clavulanate, and cefdinir were 16, 6.4, and 19.2%, respectively. The least effective agents were trimethoprim-sulfamethoxazole (SXT) and azithromycin, with resistance rates of 23.5 and 34%, respectively. Penicillin resistance rates for S. pneumoniae varied by region (from 8.7 to 22.5%), as did multidrug resistance rates for S. pneumoniae (from 8.8 to 24.9%). Resistance to β-lactams, azithromycin, and SXT was higher among S. pneumoniae isolates from children than those from adults. β-Lactamase production rates among H. influenzae and M. catarrhalis isolates were 27.4 and 91.6%, respectively. Faropenem MICs at which 90% of isolates are inhibited were 0.5 μg/ml for S. pneumoniae, 1 μg/ml for H. influenzae, and 0.5 μg/ml for M. catarrhalis, suggesting that faropenem shows promise as a treatment option for respiratory infections caused by contemporary resistant phenotypes.

scholarly journals Relationship between Antibiotic Use and Incidence of MexXY-OprM Overproducers among Clinical Isolates of Pseudomonas aeruginosa

2008 ◽  
Vol 52 (3) ◽  
pp. 1173-1175 ◽  
Author(s):  
Didier Hocquet ◽  
Arno Muller ◽  
Karine Blanc ◽  
Patrick Plésiat ◽  
Daniel Talon ◽  
...  
Keyword(s):  
Time Series ◽  
Pseudomonas Aeruginosa ◽  
Time Series Analysis ◽  
Significant Relationship ◽  
Antibiotic Use ◽  
Clinical Isolates ◽  
University Hospital ◽  
In Vitro Experiments ◽  
Clinical Strains

ABSTRACT In a university hospital, time-series analysis revealed a significant relationship between antibiotic (aminoglycoside, fluoroquinolone, and cefepime) use and incidence of MexXY-OprM-overproducing Pseudomonas aeruginosa. In vitro experiments confirm that such mutants were readily selected from both PAO1 and clinical strains when grown in the presence of these antibiotics.

scholarly journals A between-Species Comparison of Antimicrobial Resistance in Enterobacteria in Fecal Flora

2000 ◽  
Vol 44 (6) ◽  
pp. 1479-1484 ◽  
Author(s):  
Monica Österblad ◽  
Antti Hakanen ◽  
Raija Manninen ◽  
Tiina Leistevuo ◽  
Reijo Peltonen ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
University Hospital ◽  
Fecal Flora ◽  
E Coli ◽  
Defined Daily Doses ◽  
Hospital Patients ◽  
Resistance Patterns ◽  
Resistance Data

ABSTRACT Enterobacteria in fecal flora are often reported to be highly resistant. Escherichia coli is the main species; resistance data on other species are rare. To assess the effect of the host's environment, antimicrobial resistance was determined in fecal species of the family Enterobacteriaceae from three populations: healthy people (HP)(n = 125) with no exposure to antimicrobials for 3 months preceding sampling, university hospital patients (UP) (n = 159) from wards where the antibiotic use was 112 defined daily doses (DDD)/bed/month, and geriatric long-term patients (LTP) (n = 74) who used 1.8 DDD/bed/month. The mean length of hospital stay was 5 days for the UP and 22 months for the LTP. The isolates were identified to at least genus level, and MICs of 16 antimicrobials were determined. From the university hospital, resistance data on clinicalEnterobacteriaceae isolates were also collected. Resistance data for on average two different isolates per sample (range, 1 to 5) were analyzed: 471 E. coli isolates and 261 otherEnterobacteriaceae spp. Resistance was mainly found amongE. coli; even in HP, 18% of E. coli isolates were resistant to two or more antimicrobial groups, with MIC patterns indicative of transferable resistance. Other fecal enterobacteria were generally susceptible, with little typically transferable multiresistance. Clinical Klebsiella andEnterobacter isolates were significantly more resistant than fecal isolates. The resistance patterns at both hospitals mirrored the patterns of antibiotic use, but LTP E. coli isolates were significantly more resistant than those from UP. Conditions permitting an efficient spread may have been more important in sustaining high resistance levels in the LTP. E. coli was the main carrier of antimicrobial resistance in fecal flora; resistance in other species was rare in the absence of antimicrobial selection.

scholarly journals Collective assessment of antimicrobial susceptibility among the most common Gram-negative respiratory pathogens driving therapy in the ICU

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Pamela A Moise ◽  
Marcela Gonzalez ◽  
Irina Alekseeva ◽  
Diego Lopez ◽  
Brune Akrich ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Vitro Activity ◽  
Surveillance Program ◽  
Antibiotic Prescribing ◽  
Respiratory Pathogens ◽  
In Vitro Activity ◽  
First Line ◽  
Icu Patients ◽  
Gram Negative

Abstract Objectives To describe the pathogen predominance and to evaluate the probability of covering the most common Gram-negative pathogens collectively in both empirical and early adjustment prescribing scenarios in ICU patients with respiratory infections. Methods Data were collected from an international cohort of hospitals as part of the SMART Surveillance Program (2018). Susceptibility testing (mg/L) was performed by broth microdilution methods. Results 7171 Gram-negative respiratory isolates from adult ICU patients across 209 hospitals from 56 different countries were studied. Overall, the most common ICU respiratory pathogens isolated were Pseudomonas aeruginosa (25%), Klebsiella pneumoniae (18%), Acinetobacter baumannii (14%), and Escherichia coli (11%), with inter-regional differences among these pathogens. Among Enterobacterales, 36% were ESBL positive. When the collective susceptibility profile of this set of pathogens (P. aeruginosa plus Enterobacterales; comprising 78% of all organisms isolated) was performed, ceftolozane/tazobactam (84%), followed by meropenem (81%), provided the most reliable in vitro activity in the empirical prescribing scenario compared with other β-lactam antibiotics. P. aeruginosa co-resistance was common among first-line β-lactam antibiotics. If P. aeruginosa was non-susceptible to piperacillin/tazobactam, less than one-third were susceptible to meropenem or ceftazidime. In contrast, ceftolozane/tazobactam offered in vitro coverage in over two-thirds of these resistant pathogens. Conclusions Ceftolozane/tazobactam demonstrated high cumulative susceptibility levels and in vitro activity in both empirical and adjustment antibiotic prescribing scenarios. High frequency of co-resistance undermines reliable coverage for Gram-negative pathogens already resistant to first-line agents. Ceftolozane/tazobactam would offer additional coverage in this setting.

scholarly journals Official statements of the board of experts on the use of topical thiamphenicol in patients with communityacquired respiratory infections

2021 ◽  
Vol 23 (2) ◽  
pp. 195-196
Author(s):  
Sergey N. Avdeev ◽  
T.I. Garashchenko ◽  
N.A. Geppe ◽  
I.A. Dronov ◽  
Andrey A. Zaitsev ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Antibiotic Use ◽  
Antiviral Effect ◽  
Respiratory Pathogens ◽  
Treatment Regimens ◽  
Steady Growth ◽  
Causative Agents ◽  
Potential Use

Currently, there is a steady growth antimicrobial resistance (AMP) worldwide. This is especially true now when antibiotic use has become uncontrolled due to its use in COVID-19 treatment regimens. Antibiotics do not have antiviral effect, their appointment is justified only with complicated forms of COVID-19. Moreover, such a massive use antibiotics creates the prerequisites for the formation antibiotic resistance, including among the causative agents of community-acquired infections. Due to the relentless the growth of antibiotic resistance of community-acquired pathogens of respiratory diseases, it becomes necessary to revise approaches to antibacterial therapy (ABT) and assessing the potential use of thiamphenicol for the treatment of community-acquired infections caused by respiratory pathogens.

scholarly journals Evaluation of Molecular Point-of-Care Testing for Respiratory Pathogens in Children With Respiratory Infections: A Retrospective Case-Control Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Nan Shen ◽  
Yuanjie Zhou ◽  
Yajuan Zhou ◽  
Lijuan Luo ◽  
Wenjuan Chen ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Respiratory Infections ◽  
Point Of Care ◽  
Antibiotic Use ◽  
Respiratory Pathogens ◽  
Retrospective Case ◽  
Routine Testing ◽  
Intravenous Antibiotics ◽  
The Cost ◽  
Testing Group

ObjectivesOveruse of antibiotics and antibiotic resistance are global healthcare problems. In pediatric patients with respiratory infections, viral and bacterial etiologies are challenging to distinguish, leading to irrational antibiotic use. Rapid and accurate molecular diagnostic testing methods for respiratory pathogens has been shown to facilitate effective clinical decision-making and guide antibiotic stewardship interventions in the developed regions, but its impacts on pediatric patient care in the developing countries remain unclear.MethodsIn this single-center, retrospective case-control study, we compared demographics, clinical characteristics, especially microbiological findings, and antibiotic usage between pediatric patients with respiratory infection receiving FilmArray Respiratory Panel (FilmArray RP) testing and a matched routine testing control group. Our primary outcome was the duration of intravenous antibiotics treatment (DOT) during hospitalization.ResultsEach group consisted of 346 children with a respiratory infection. In the FilmArray RP testing group, the DOT was shorter than that in the routine testing group (6.41 ± 3.67 days versus 7.23 ± 4.27 days; p = 0.006). More patients in the FilmArray RP testing group de-escalated antibiotic treatments within 72 hours of hospitalization (7.80%, 27/346 versus 2.60%, 9/346; p = 0.002). By contrast, fewer patients in the FilmArray RP testing group had escalated antibiotic treatments between 72 hours and seven days (7.80% versus 14.16%; p = 0.007). The cost of hospitalization was significantly lower in the FilmArray RP testing group ($ 1413.51 ± 1438.01 versus $ 1759.37 ± 1929.22; p = 0.008). Notably, the subgroup analyses revealed that the FilmArray RP test could shorten the DOT, improve early de-escalation of intravenous antibiotics within 72 hours of hospitalization, decline the escalation of intravenous antibiotics between 72 hours and seven days, and reduce the cost of hospitalization for both patient populations with or without underlying diseases.ConclusionsMolecular point-of-care testing for respiratory pathogens could help to reduce intravenous antibiotic use and health care costs of pediatric patients with respiratory infections in developing countries.

scholarly journals Vitamin D Modulation of the Innate Immune Response to Paediatric Respiratory Pathogens Associated with Acute Lower Respiratory Infections

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 276
Author(s):  
Amy S. Bleakley ◽  
Paul V. Licciardi ◽  
Michael J. Binks
Keyword(s):  
Vitamin D ◽  
Immune Responses ◽  
Immune Cell ◽  
Respiratory Infections ◽  
Cell Types ◽  
Innate Immune ◽  
Respiratory Pathogens ◽  
Acute Lower Respiratory Infections ◽  
Syncytial Virus

Vitamin D is an essential component of immune function and childhood deficiency is associated with an increased risk of acute lower respiratory infections (ALRIs). Globally, the leading childhood respiratory pathogens are Streptococcus pneumoniae, respiratory syncytial virus and the influenza virus. There is a growing body of evidence describing the innate immunomodulatory properties of vitamin D during challenge with respiratory pathogens, but recent systematic and unbiased synthesis of data is lacking, and future research directions are unclear. We therefore conducted a systematic PubMed literature search using the terms “vitamin D” and “Streptococcus pneumoniae” or “Respiratory Syncytial Virus” or “Influenza”. A priori inclusion criteria restricted the review to in vitro studies investigating the effect of vitamin D metabolites on human innate immune cells (primary, differentiated or immortalised) in response to stimulation with the specified respiratory pathogens. Eleven studies met our criteria. Despite some heterogeneity across pathogens and innate cell types, vitamin D modulated pathogen recognition receptor (PRRs: Toll-like receptor 2 (TLR2), TLR4, TLR7 and nucleotide-binding oligomerisation domain-containing protein 2 (NOD2)) expression; increased antimicrobial peptide expression (LL-37, human neutrophil peptide (HNP) 1-3 and β-defensin); modulated autophagosome production reducing apoptosis; and modulated production of inflammatory cytokines (Interleukin (IL) -1β, tumour necrosis factor-α (TNF-α), interferon-ɣ (IFN-ɣ), IL-12p70, IFN-β, Regulated on Activation, Normal T cell Expressed (RANTES), IL-10) and chemokines (IL-8 and C-X-C motif chemokine ligand 10 (CXCL10)). Differential modulation of PRRs and IL-1β was reported across immune cell types; however, this may be due to the experimental design. None of the studies specifically focused on immune responses in cells derived from children. In summary, vitamin D promotes a balanced immune response, potentially enhancing pathogen sensing and clearance and restricting pathogen induced inflammatory dysregulation. This is likely to be important in controlling both ALRIs and the immunopathology associated with poorer outcomes and progression to chronic lung diseases. Many unknowns remain and further investigation is required to clarify the nuances in vitamin D mediated immune responses by pathogen and immune cell type and to determine whether these in vitro findings translate into enhanced immunity and reduced ALRI in the paediatric clinical setting.

scholarly journals Revisiting cefditoren for the treatment of community-acquired infections caused by human-adapted respiratory pathogens in adults

2018 ◽  
Vol 13 ◽  
Author(s):  
María-José Giménez ◽  
Lorenzo Aguilar ◽  
Juan José Granizo
Keyword(s):  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Community Acquired Pneumonia ◽  
Intrinsic Activity ◽  
Published Data ◽  
Oral Antibiotic ◽  
Respiratory Pathogens ◽  
Tract Infections

Fifteen years after its licensure, this revision assesses the role of cefditoren facing the current pharmacoepidemiology of resistances in respiratory human-adapted pathogens (Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and Moraxella catarrhalis). In the era of post- pneumococcal conjugate vaccines and in an environment of increasing diffusion of the ftsI gene among H. influenzae isolates, published studies on the cefditoren in vitro microbiological activity, pharmacokinetic/pharmcodynamic (PK/PD) activity and clinical efficacy are reviewed. Based on published data, an overall analysis is performed for PK/PD susceptibility interpretation. Further translation of PK/PD data into clinical/microbiological outcomes obtained in clinical trials carried out in the respiratory indications approved for cefditoren in adults (tonsillitis, sinusitis, acute exacerbation of chronic bronchitis and community-acquired pneumonia) is commented. Finally, the role of cefditoren within the current antibiotic armamentarium for the treatment of community respiratory tract infections in adults is discussed based on the revised information on its intrinsic activity, pharmacodynamic adequacy and clinical/bacteriological efficacy. Cefditoren remains an option to be taken into account when selecting an oral antibiotic for the empirical treatment of respiratory infections in the community caused by human-adapted pathogens, even when considering changes in the pharmacoepidemiology of resistances over the last two decades.

scholarly journals In Vitro Activity of HSR-903, a New Oral Quinolone, against Bacteria Causing Respiratory Infections

1999 ◽  
Vol 43 (7) ◽  
pp. 1767-1768 ◽  
Author(s):  
Akira Watanabe ◽  
Yutaka Tokue ◽  
Hiroshi Takahashi ◽  
Tohru Kikuchi ◽  
Takao Kobayashi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Streptococcus Pneumoniae ◽  
Respiratory Infections ◽  
The Other ◽  
Vitro Activity ◽  
Respiratory Pathogens ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Resistant Strains

ABSTRACT The in vitro activity of HSR-903, an oral quinolone, against 196 recent clinical isolates of respiratory pathogens was evaluated. HSR-903 was 2 to 32 times more active than ofloxacin, ciprofloxacin, and sparfloxacin against Staphylococcus aureus, including methicillin-resistant strains, and Streptococcus pneumoniaeand was at least as active as the other quinolones against gram-negative pathogens.

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