scholarly journals Impact of Nasal Swabs on Empiric Treatment of Respiratory Tract Infections (INSERT-RTI)

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 101
Author(s):  
Vanessa Huffman ◽  
Diana Carolina Andrade ◽  
Jared Ham ◽  
Kyle Brown ◽  
Leonid Melnitsky ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Length ◽  
Primary Objective ◽  
Hospital Length Of Stay ◽  
Significant Difference ◽  
Nasal Swabs ◽  
Before And After ◽  
The Difference ◽  
Tract Infections

Methicillin-resistant Staphylococcus aureus (MRSA) polymerase-chain-reaction nasal swabs (PCRNS) are a rapid diagnostic tool with a high negative predictive value. A PCRNS plus education “bundle” was implemented to inform clinicians on the utility of PCRNS for anti-MRSA therapy de-escalation in respiratory tract infections (RTI). The study included patients started on vancomycin with a PCRNS order three months before and after bundle implementation. The primary objective was the difference in duration of anti-MRSA therapy (DOT) for RTI. Secondary objectives included hospital length of stay (LOS), anti-MRSA therapy reinitiation, 30-day readmission, in-hospital mortality, and cost. We analyzed 62 of 110 patients screened, 20 in the preintervention and 42 in the postintervention arms. Mean DOT decreased after bundle implementation by 30.3 h (p = 0.039); mean DOT for patients with a negative PCRNS decreased by 39.7 h (p = 0.014). Median cost was lower after intervention [USD$51.69 versus USD$75.30 (p < 0.01)]. No significant difference in LOS, mortality, or readmission existed. The bundle implementation decreased vancomycin therapy and cost without negatively impacting patient outcomes.

scholarly journals Acceptability of a Sublingual Drug Formulation for Respiratory Tract Infections in Children Aged 3 to 5 Years

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 294
Author(s):  
Andrzej Emeryk ◽  
Thibault Vallet ◽  
Ewelina Wawryk-Gawda ◽  
Arkadiusz Jędrzejewski ◽  
Frederic Durmont ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Drug Formulation ◽  
Reference Framework ◽  
Significant Difference ◽  
Key Factor ◽  
Treatment Safety ◽  
The Many ◽  
Tract Infections ◽  
Recurrent Respiratory Tract Infections

In pediatrics, acceptability has emerged as a key factor for compliance, and consequently for treatment safety and efficacy. Polyvalent mechanical bacterial lysate (PMBL) in 50-mg sublingual tablets is indicated in children and adults for the prophylaxis of recurrent respiratory tract infections. This medication may be prescribed in children over 3 years of age; the appropriateness of this sublingual formulation should thus be demonstrated amongst young children. Using a multivariate approach integrating the many aspects of acceptability, standardized observer reports were collected for medication intake over the course of treatment (days 1, 2, and 10) in 37 patients aged 3 to 5 years, and then analyzed in an intelligible model: the acceptability reference framework. According to this multidimensional model, 50-mg PMBL sublingual tablets were classified as “positively accepted” in children aged 3 to 5 years on all three days of evaluation. As the acceptability evaluation should be relative, we demonstrated that there was no significant difference between the acceptability of these sublingual tablets and a score reflecting the average acceptability of oral/buccal medicines in preschoolers. These results highlight that sublingual formulations could be appropriate for use in preschoolers.

scholarly journals Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Li ◽  
Lanfang Min ◽  
Xin Zhang
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Abstract Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

Infection Rates Before and After Diagnosis of IgA Vasculitis in Childhood: A Population-wide Study Using Non-exposed Matched Controls

2019 ◽  
Vol 47 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Johannes C. Nossent ◽  
Warren Raymond ◽  
Helen Keen ◽  
David B. Preen ◽  
Charles A. Inderjeeth
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Iga Vasculitis ◽  
Upper Respiratory Tract ◽  
Serious Infection ◽  
Serious Infections ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Objective.Clinical data suggest that infections can trigger IgA vasculitis (IgAV), but longterm observations are lacking. We compared rates, types, and microorganisms for serious infection before and after diagnosis for children with IgAV and non-exposed controls.Methods.Using population-based administrative linked health datasets we estimated incidence rates (IR) for serious infection per 1000 person-months for patients with IgAV (n = 504, age 5 yrs, 59.1% males) and controls matched for age, sex, and year of presentation (n = 1281, age 6 yrs, 66% males). Time zero (T0) was the date of IgAV diagnosis or equivalent date in controls, lookback (median 38 mos) was the period prior to T0, and followup (median 239 mos) was the period after T0.Results.During lookback, prevalence of serious infection was similar in patients with IgAV and controls (11.5% vs 9.5%, respectively), but patients with IgAV had a higher rate of upper respiratory tract infections [incidence rate ratio (IRR) 1.79; 95% CI 1.39–2.31] with shorter time between first serious infection and T0 (27 vs 43 mos; p = 0.02). During followup, patients were at a constant increased risk for serious infections (IRR 1.46, 95% CI 1.35–1.58). These rates were higher during followup: sepsis (IRR 12.6), pneumonia (IRR 6.19), upper respiratory tract infections (IRR 2.36), and skin infections (IRR 1.85). There was little overlap between patients with serious infections in the lookback and followup periods.Conclusion.In patients with childhood IgAV there is an increased longterm risk for a broader spectrum of infections, which is unrelated to serious infections prior to diagnosis or treatment. This suggests disease-specific factors may have a lasting effect on immune competence in childhood IgAV.

scholarly journals 2194. Procalcitonin-Guided Antibiotic Strategy for Lower Respiratory Tract Infections: Outcomes and Safety of Withholding Antibiotics

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S747-S747
Author(s):  
Don Bambino Geno Tai ◽  
Robert Goldstein
Keyword(s):  
Respiratory Tract ◽  
Hospital Mortality ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Standard Of Care ◽  
Lower Respiratory Tract Infections ◽  
Case Mix Index ◽  
Significant Difference ◽  
The Mean ◽  
Tract Infections

Abstract Background Procalcitonin (PCT) is a promising and well-studied marker in differentiating viral from bacterial lower respiratory tract infections (LRTI). Antibiotics are not recommended when PCT is normal (< 0.25 μg/L). Despite this, it has not been the standard of care due to safety concerns of relying on PCT to withhold antibiotics. Methods We retrospectively reviewed all non-critical LRTI patients with normal PCT admitted in our institution from October 2018 to March 2019. They were divided into adherent group in whom antibiotics were discontinued within 24 hours and non-adherent group in whom antibiotics were continued. Cases of Legionella, Mycoplasma, and other infectious syndromes necessitating antibiotics were excluded. Complexity of cases was measured based on Centers for Medicare and Medicaid Services (CMS) case-mix index (CMI). Outcomes compared were the length of stay (LOS), in-hospital mortality, and 30-day all-cause readmissions. Results A total of 78 patients were included in the analysis, 52% (n = 41) were in adherent group and 48% (n = 37) in the non-adherent group. The mean age was 74, and majority were females (59%, n = 46). The were no significant differences between the two groups in terms of age, gender, CMI, underlying COPD/asthma, CHF (see Table 1). The adherent group had statistically shorter LOS compared with the non-adherent group after adjusting for CMI. There was no significant difference in In-hospital mortality and readmissions (see Table 2). Furthermore, the adherent group’s LOS was statistically similar to CMS average LOS (5.08 vs. 3.8, P = 0.08); compared with the non-adherent group which had statistically longer LOS compared with CMS average LOS (8.3 vs. 4.6, p Conclusion PCT is a safe tool in deciding when to withhold antibiotics on LRTI patients. It shortens LOS with no difference in mortality or readmission. Disclosures All authors: No reported disclosures.

scholarly journals DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN

2020 ◽  
Vol 7 (1) ◽  
pp. 39-45
Author(s):  
M. Mishyna ◽  
M. Gonchar ◽  
O. Logvinova ◽  
H. Isaieva ◽  
M. Basiuk
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Acute Bronchitis ◽  
Community Acquired Pneumonia ◽  
Gram Positive ◽  
Gram Negative ◽  
Nasal Swabs ◽  
Causative Agents ◽  
Tract Infections

DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN. Mishyna М., Gonchar M., Logvinova O., Isaieva H., Basiuk M. The study aimed to investigate prevalence of microorganisms depending on the site of isolation and disease. The study involved 48 children aged 1 year to 17 years. Acute bronchitis (54, 17%), community-acquired pneumonia (CAP) (33, 33%), bronchial asthma (12, 50%) were diagnosed. Were isolated 173 strains of microorganisms. Gram-positive microorganisms were detected 106 strains (61, 3%), Gram-negative microorganisms - 49 strains (28, 3%), fungi - 18 strains (10, 4%). We investigated 100 samples from nose (nasal swabs), pharynx (throat swabs) and sputum. In 83 cases were isolated Gram-positive microorganisms, in 36 cases were isolated Gram-negative microorganisms, in 18 cases - fungi. Analysis reviled that Staphylococcus aureus most often isolated from patients with acute bronchitis; Gram-negative microorganisms most often detected from throat swabs, comparing with microorganisms detected from nose swabs and sputum. Keywords: microorganisms, biofilms, respiratory diseases, children.   Анотація ПОШИРЕНІСТЬ ЗБУДНИКІВ ІНФЕКЦІЙ ДИХАЛЬНИХ ШЛЯХІВ У ДІТЕЙ. Мішина М.М, Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Метою дослідження було вивчити переважання умовно-патогенних мікроорганізмів, які викликають захворювання органів дихання у дітей, в залежності від місця виділення та захворювання. У дослідженні було 48 дітей у віці від 1 року до 17 років. Пацієнти були з такими діагнозами: гострі бронхіти (54, 17%), негоспітальні пневмонії (33, 33%), бронхіальна астма (12, 50%). Було виділено 173 штама умовно-патогенних мікроорганізмів. Грампозитивних мікроорганізмів було виділено 106 штамів (61, 3%), грамнегативних мікроорганізмів – 49 штамів (28, 3%), грибів – 18 штамів (10, 4%). Було досліджено 100 зразків з зіву, носу, мокротиння. Грампозитивні мікроорганізми були виділені з 83 зразків, грамнегативні – з 36 зразків, гриби – з 18 зразків. Проведене дослідження довело, що Staphylococcus aureus найчастіше виділявся у пацієнтів з гострими бронхітами. Грамнегативні мікроорганізми частіш за все виділялись зі зразків із зіву в порівнянні з мазками з носу та мокротинням. Ключові слова: мікроорганізми, біоплівки, захворювання органів дихання, діти.   Абстракт РАСПРОСТРАНЕННОСТЬ ВОЗБУДИТЕЛЕЙ ИНФЕКЦИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ У ДЕТЕЙ. Мішина М.М., Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Целью исследования было изучить преобладание условно-патогенныхмикроорганизмов, вызывающих заболевания органов дыхания у детей, в зависимости от места забора материала и заболевания. Исследование включало 48 детей в возрасте от 1 года до 17 лет. Пациенты находились с такими заболеваниями: острые бронхиты (54, 17%), внегоспитальные пневмонии (33, 33%), бронхиальная астма (12, 50%). Всего было выделено 173 штамма условно-патогенных микроорганизмов. Грамположительных микроорганизмов было выделено 106 штаммов (61, 3%), грамотрицательных микроорганизмов – 49 штаммов (28, 3%), грибов – 18 штаммов (10, 4%). Было исследовано 100 образцов из зева, носа, мокроты. Грамположительные микроорганизмы были выделены из 83 образцов, грамотрицальные – из 36 образцов, грибы – из 18 образцов. В ходе исследования было доказано, что Staphylococcus aureus чаще всего выделялся от пациентов с острыми бронхитами. Грамотрицательные микроорганизмы чаще всего выделялись из мазков из зева по сравнению с мазками из носа и мокротой. Ключевые слова: микроорганизмы, биопленки, заболевания органов дыхания, дети.

scholarly journals Assessment of Toll Like receptor 2 Gene Polymorphism in Children with B Cell Defects and Respiratory Tract Infections

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N A A Mahana ◽  
S M Reda ◽  
T B Kamel ◽  
R A Elfeky ◽  
D M Erfan ◽  
...  
Keyword(s):  
Risk Factor ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Pulmonary Function Tests ◽  
Additional Risk Factor ◽  
Healthy Controls ◽  
Nucleotide Polymorphisms ◽  
Cross Sectional ◽  
Significant Difference ◽  
Tract Infections

Abstract Acute respiratory tract infections are the most common illnesses in childhood. Respiratory defenses against infection involve a diverse and complex system. Toll-like receptors (TLRs) are a type of pattern recognition receptors (PRRs), recognize pathogen-associated molecular patterns (PAMPs), resulting in initiation of innate immune response and promotion of adaptive immunity. TLR single nucleotide polymorphisms (SNPs) impair the ability to respond properly to TLR ligands and increase susceptibility to infectious or inflammatory diseases. The aim of the work: To examine TLR2 Arginine 677Tryptophan (Arg 677Trp) and Arginine753Glutamine (Arg753Gln) gene polymorphisms in patients with recurrent or chronic respiratory tract infections with or without predominantly antibody deficiency (PAD). Subjects and methods: This cross-sectional case-control study included 30 patients with known PAD with/ or without respiratory tract infections, 20 non-PAD patients with recurrent chest infections and 20 age and sex-matched healthy controls. All children included in the study were subjected to full history taking, complete physical examination and laboratory investigations including CBC, serum immunoglobulins levels and genetic analysis of the TLR2 Arg677Trp and Arg753Gln polymorphisms. Computed tomography (CT) scan of the chest with contrast, pulmonary function tests (PFTs) and Bronchoalveolar lavage (BAL) fluid culture and sensitivity were performed to patients with recurrent and/or chronic chest infections. Results: There was a significant difference in the expression of Arg753Gln polymorphism (p 0.04) between PAD patients with and without recurrent chest infections. Patients with mutant or heterozygote state of this polymorphism had a short diagnosis lag (time elapsed between onset of symptoms and date of diagnosis). There was a significant relationship between this polymorphism and the duration of hospital admission (longer hospital stay in patients with mutant allele). A significant difference between non-PAD patients with recurrent chest infections and healthy controls regarding Arg 677 Trp polymorphism (p 0.04) was elicited. Conclusion: Our results suggest that Arg 677 Trp polymorphism could be a risk factor for increased susceptibility to recurrent and /or chronic respiratory tract infections in patients without PAD, while Arg753Gln polymorphism might be an additional risk factor for severe infections in PAD patients.

scholarly journals Application of PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections

2021 ◽  
Author(s):  
Li Yang ◽  
Min Lanfang ◽  
Zhang Xin
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Group A ◽  
Tract Infections

Objective There is a lack of studies comparing Procalcitonin (PCT), C-reactive protein (CRP) and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory infections. It is necessary to explore the correlation between above markers and different types of acute respiratory tract infections (ARTI). Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasma infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (P <0.05). The positive rate of combined detection of PCT, CRP and WBC was significantly higher than that of single detection. There was no significant difference of PCT, CRP and WBC levels between the group of Gram-positive (G+) bacteria infection and Gram-negative (G-) bacteria infection (P >0.05). ROC curve results showed that the area under the curve (AUC) of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be used as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

scholarly journals Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections.

2019 ◽  
Author(s):  
Karolina Pieniawska-Śmiech ◽  
Kamil Bar ◽  
Mateusz Babicki ◽  
Karol Śmiech ◽  
Aleksandra Lewandowicz-Uszyńska
Keyword(s):  
Birth Weight ◽  
Respiratory Tract ◽  
Primary Immunodeficiency ◽  
Respiratory Tract Infections ◽  
Physical Growth ◽  
Control Group ◽  
Healthy Children ◽  
Significant Difference ◽  
Tract Infections ◽  
Recurrent Respiratory Tract Infections

Abstract Background Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 300 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 207 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics ward of J.Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with primary immunodeficiency (PID) and children with recurrent respiratory tract infections (RRTI) by assessment of their height and weight. All of parameters were evaluated using centile charts suitable best for the Polish population. Results The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 20% of them had their height situated below 3rd percentile. No statistically relevant differences have been found between them and RRTI group. The statistically significant difference was between the nutritional status of PID patients and the control group. Conclusions There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.

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