Risk Factors of Hyponatremia in Children with Lower Respiratory Tract Infection (LRTI)

Abstract Data are limited regarding risk factors for lower respiratory tract infection (LRTI) caused by seasonal human coronaviruses (HCoVs) and the significance of virologic documentation by bronchoalveolar lavage (BAL) on outcomes in hematopoietic cell transplant (HCT) recipients. We retrospectively analyzed patients undergoing allogeneic HCT (4/2008-9/2018) with HCoV (OC43/NL63/HKU1/229E) detected by polymerase chain reaction during conditioning or post-HCT. Risk factors for all manifestations of LRTI and progression to LRTI among those presenting with HCoV upper respiratory tract infection (URTI) were analyzed by logistic regression and Cox proportional hazard models, respectively. Mortality rates following HCoV LRTI were compared according to virologic documentation by BAL. A total of 297 patients (61 children and 236 adults) developed HCoV infection as follows: 254 had URTI alone, 18 presented with LRTI, and 25 progressed from URTI to LRTI (median, 16 days; range, 2-62 days). Multivariable logistic regression analyses showed that male sex, higher immunodeficiency scoring index, albumin <3 g/dL, glucose >150 mg/dL, and presence of respiratory copathogens were associated with occurrence of LRTI. Hyperglycemia with steroid use was associated with progression to LRTI (P < .01) in Cox models. LRTI with HCoV detected in BAL was associated with higher mortality than LRTI without documented detection in BAL (P < .01). In conclusion, we identified factors associated with HCoV LRTI, some of which are less commonly appreciated to be risk factors for LRTI with other respiratory viruses in HCT recipients. The association of hyperglycemia with LRTI might provide an intervention opportunity to reduce the risk of LRTI.

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Prevalence of Moraxella catarrhalis in patients of lower respiratory tract infection with underlying risk factors

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20171038 ◽

2017 ◽

Vol 4 (2) ◽

pp. 442

Author(s):

Alex Aiswariya ◽

Kundoly Velayudhan Suseela ◽

Das Subi

Keyword(s):

Risk Factors ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Moraxella Catarrhalis ◽

Lower Respiratory Tract ◽

Care Hospital ◽

Tract Pathogen ◽

Underlying Risk

Background: Moraxella catarrhalis is a Gram-negative diplococcus, commonly found as a normal flora in the human upper respiratory tract. Recently, M. catarrhalis has emerged as an important and common human respiratory tract pathogen. This study was aimed to determine the rate of isolation of M. Catarrhalis in patients attending a tertiary care hospital with lower respiratory tract infection (LRTI), antibiotic susceptibility pattern and predisposing factors responsible for their infection.Methods: A prospective study was carried out in 1001 lower respiratory specimens from patients (above 20 years’ age) with suspected LRTI. The study investigated by microscopic examination, culture and antibiotic sensitivity test according to the standard guidelines. Assessment of clinical significance of M. Catarrhalis was ascertained on the basis of preformed criteria.Results: A total of 60 clinically significant M. Catarrhalis were isolated from the 930 culture positive samples. The isolates showed maximum sensitivity to second and third generation cephalosporins (95%), azithromycin (90%) followed by amoxicillin clavulanic acid (85%). Rate of isolation was more in males (70%) and elderly people above 60 years (63.33%) were found to be more affected. Patients (58.33%) with Chronic Obstructive Pulmonary Diseases (COPD) were found to be more prone to get infection by M. Catarrhalis.Conclusions: Moraxella catarrhalis should be considered as significant lower respiratory tract pathogen especially in elderly patients with underlying risk factors like COPD.

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