scholarly journals The Basics and the Advancements in Diagnosis of Bacterial Lower Respiratory Tract Infections

Diagnostics ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 37 ◽  
Author(s):  
Stephanie Noviello ◽  
David Huang
Keyword(s):  
Respiratory Tract ◽  
Cause Of Death ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Point Of Care ◽  
Patient Treatment ◽  
Resistant Bacteria ◽  
Lower Respiratory Tract Infections ◽  
Reactive Protein ◽  
Tract Infections

Lower respiratory tract infections (LRTIs) are the leading infectious cause of death and the sixth-leading cause of death overall worldwide. Streptococcus pneumoniae, with more than 90 serotypes, remains the most common identified cause of community-acquired acute bacterial pneumonia. Antibiotics treat LRTIs with a bacterial etiology. With the potential for antibiotic-resistant bacteria, defining the etiology of the LRTI is imperative for appropriate patient treatment. C-reactive protein and procalcitonin are point-of-care tests that may differentiate bacterial versus viral etiologies of LRTIs. Major advancements are currently advancing the ability to make rapid diagnoses and identification of the bacterial etiology of LRTIs, which will continue to support antimicrobial stewardship, and is the focus of this review.

scholarly journals Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections

2018 ◽  
Vol 51 (3) ◽  
pp. 1701656 ◽  
Author(s):  
Anne-Sophie Moreau ◽  
Ignacio Martin-Loeches ◽  
Pedro Povoa ◽  
Jorge Salluh ◽  
Alejandro Rodriguez ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Multidrug Resistant ◽  
Hazard Ratio ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Immunocompromised Patients ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53–0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45–0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54–0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78–4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.

scholarly journals A Pilot Study on the Diagnostic Accuracy of Proadrenomedullin and Proatrial Natriuretic Peptide in Lower Respiratory Tract Infections

2014 ◽  
Vol 8 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Agustín Ruiz-González ◽  
Aureli Esquerda ◽  
José M Porcel ◽  
Silvia Bielsa ◽  
Horacio Valencia ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Natriuretic Peptide ◽  
Plasma Levels ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Developed Countries ◽  
C Reactive Protein ◽  
Lower Respiratory Tract Infections ◽  
Reactive Protein ◽  
Tract Infections

Background : Pneumonia is the leading cause of death among infectious diseases in developed countries. However, the severity of pneumonia requiring hospitalization often makes the initial diagnosis difficult because of an equivocal clinical picture or interpretation of the chest film. The objective of the present study was to assess the usefulness of the plasma levels of mid-regional proadrenomedullin (MR-proADM) and mid-regional proatrial natriuretic peptide (MR-proANP) in differentiating pneumonia from other lower respiratory tract infections (LRTIs). Methods : A retrospective study was conducted. The plasma levels of MR-proADM and MR-proANP were measured in 85 patients hospitalized for LRTIs, 56 of whom with diagnosis of pneumonia and 29 with other LRTIs. Results : The patients with pneumonia had increased MR-proADM levels (median 1.46 nmol/L [IQR 25-75, 0.82-2.02 nmol/L]) compared with the patients with other LRTIs (median 0.88 nmol/mL [0.71-1.39 nmol/L]) (p= 0.04). However, the MR-proANP levels did not show differences between the groups. The optimal threshold of MR-proADM to predict pneumonia was 1.5 nmol/L, which yielded a sensitivity of 51.7% (95% CI, 38.0-65.3), a 79.3% specificity (95% CI, 60.3-92.0), and an odds ratio of 6.64 (95% CI, 1.32-32.85). The combination of this parameter with C-reactive protein in an “and” rule increased the specificity for detecting pneumonia significantly. Conclusion : MR-proADM levels (but not MR-proANP levels) are increased in patients with pneumonia although its discriminatory power is moderate.

scholarly journals Mycoplasma pneumoniae P1 genotype indicates severity of lower respiratory tract infections in children

2021 ◽  
Author(s):  
Jasna Rodman Berlot ◽  
Uroš Krivec ◽  
Tatjana Mrvič ◽  
Rok Kogoj ◽  
Darja Keše
Keyword(s):  
Respiratory Tract ◽  
Regression Model ◽  
Mycoplasma Pneumoniae ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
C Reactive Protein ◽  
Lower Respiratory Tract Infections ◽  
Pathogenic Potential ◽  
Reactive Protein ◽  
Tract Infections

Background. Mycoplasma pneumoniae (M. pneumoniae) strains can be classified into two major genetic groups, P1 type 1 (P1-1) and P1 type 2 (P1-2). It remains unknown if clinical manifestations of lower respiratory tract infections (LRTI) in children differ between the two genotypes. We aimed to determine if M. pneumoniae P1 genotype is associated with severity of LRTI in children. Methods. Medical charts of 420 children (≤ 15 years-old) with signs of acute LRTI who were PCR-positive for M. pneumoniae from pharyngeal swabs in a recent M. pneumoniae epidemic were analyzed. We used a culture and pyrosequencing approach for genotyping PCR-positive samples. We compared epidemiological and clinical data of children with either P1-1 or P1-2 LRTI. Results. P1-2-infected children presented with a significantly higher median baseline C-reactive protein level and were admitted to the hospital more often. P1 genotype had a significant predictive value in a multiple linear regression model predicting C-reactive protein levels in our study sample. Moreover, P1 genotype significantly affected the likelihood of hospital admission in a logistic regression model. Our modelling results were also confirmed on an additional, independent sample of children with M. pneumoniae LRTI. Conclusions. Results from our large patient group indicate that the two M. pneumoniae P1 genotypes may have different pathogenic potential and that LRTI with P1-2 strains may have a more severe disease course than those with P1-1 strains in children. P1 genotyping is not routinely performed, but could be used as a predictor of M. pneumoniae LRTI severity, enabling patient-tailored treatments.

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