101.
Int J Infect Dis. 2020 Mar;92:241-246. doi: 10.1016/j.ijid.2020.01.021. Epub 2020 Jan 21.
Increased prevalence of levofloxacin-resistant Mycobacterium tuberculosis in China is associated with specific mutations within the gyrA gene.
Abstract
OBJECTIVES:
To compare the prevalence of levofloxacin (LFX) resistance and the population structure of Mycobacterium tuberculosis (MTB) with different mutations conferring LFX resistance between 2005 and 2015.
METHODS:
A total 542 MTB isolates were randomly selected from pulmonary tuberculosis (TB) patients in 2005 and 2015 and analyzed regarding minimum inhibitory concentrations (MICs) and quinolone resistance-determining regions (QRDR).
RESULTS:
One hundred and eleven of the 542 MTB isolates analyzed (20.5%) were resistant to LFX. There were 42 and 69 LFX-resistant isolates from 2005 and 2015, respectively, and MIC high-level LFX resistance was significantly higher in 2015 (40.6%, 28/69) than in 2005 (16.7%, 7/42) (p = 0.02). There were 87 (78.4%) mutations of these 111 LFX-resistant isolates. In addition, a significant difference in proportion was observed in the isolates with mutations in codon 90 of the gyrA gene between 2005 and 2015 (11.9% in 2005 versus 29.0% in 2015, p = 0.04).
CONCLUSIONS:
There was an alarming increase in prevalence of LFX-resistant TB in China between 2005 and 2015. This dynamic change is mostly attributed to the increase in high-level LFX resistance. Moreover, a significant difference was noted in the proportion of LFX-resistant isolates harboring specific mutations within the gyrA gene between 2005 and 2015.
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:
China; Drug resistance; Levofloxacin; Tuberculosis; gyrA
102.
Int J Biometeorol. 2020 Apr;64(4):561-569. doi: 10.1007/s00484-019-01842-7. Epub 2019 Dec 17.
Weather factors, PCV intervention and childhood pneumonia in rural Bangladesh.
Abstract
Available evidence is limited on the association between weather factors and childhood pneumonia, especially in developing countries. This study examined the effects of weather variability on childhood pneumonia after the introduction of pneumococcal conjugate vaccines (PCV) intervention in rural Bangladesh. Data on pneumonia cases and weather variables (temperature and relative humidity) between the 1st January 2012 and the 31st December 2016 were collected from Matlab Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh, and Bangladesh Meteorological Department, respectively. Time series cross-correlation functions were applied to identify the time lags of the effect of each weather factor on pneumonia. Generalized linear regression model with Poisson link was used to quantify the association between weather factors and childhood pneumonia after adjustment of PCV intervention. The annual incidence rate of pneumonia reduced from 5691/100,000 to 2000/100,000 after PCV intervention. Generalized linear regression model suggested that temperature had a negative association with childhood pneumonia (relative risk, 0.985; 95% confidence interval (CI), 0.974-0.997), and PCV intervention was a protective factor with the relative risk estimate of 0.489 (95% CI, 0.435-0.551). However, no substantial association was found with relative humidity. PCV intervention appeared protective against childhood pneumonia, and temperature might be associated with this disease in children. Our findings may help inform public health policy, including the potential of development of early warning systems based on weather factors and PCV for the control and prevention of pneumonia in lower middle-income country like Bangladesh.
KEYWORDS:
Childhood pneumonia; Early warning; PCV intervention; Time series; Weather factors
103.
Intern Med. 2019;58(24):3509-3519. doi: 10.2169/internalmedicine.2696-19. Epub 2019 Dec 15.
Viral Pneumonia Requiring Differentiation from Acute and Progressive Diffuse Interstitial Lung Diseases.
Ishiguro T1, Kobayashi Y2, Uozumi R3, Takata N4, Takaku Y1, Kagiyama N1, Kanauchi T4, Shimizu Y2, Takayanagi N1.
Abstract
Objective The clinical characteristics and chest imaging findings of viral pneumonia and several interstitial lung diseases (ILDs) overlap, and viral pneumonia may be underrecognized and misdiagnosed as certain ILDs. To clarify the frequency of viral pneumonia among patients with acute progressive clinical courses that required a differential diagnosis between ILDs and pneumonia, and to determine the most frequent ILDs misdiagnosed in cases of viral pneumonia. Patients and Methods We retrospectively analyzed patients hospitalized from 2010 to 2017 with an acute clinical course (≤30 days) who underwent bronchoalveolar lavage (BAL) for the differential diagnosis of infection and ILDs. We performed a multiplex PCR for respiratory viruses using the patients' preserved BAL fluid. The final diagnosis was made by a multidisciplinary approach and after considering the PCR results. The diagnosis at discharge was compared to the final diagnosis. Results Among the 109 patients, 53 were diagnosed with viral pneumonia. Viral pneumonia and other diseases showed some differences in symptoms and laboratory data; however, the differences were small or overlapped. Viral pneumonia was misdiagnosed on discharge as acute fibrinous organizing pneumonia, cryptogenic organizing pneumonia, or chronic eosinophilic pneumonia (AFOP/COP/CEP) (n=22), acute interstitial pneumonia (n=5), connective tissue disease-related ILDs (n=3), unclassifiable interstitial pneumonia (n=2), drug-induced ILD (n=1), and pneumonia (n=20). Conclusion Approximately half of the patients who underwent BAL had viral pneumonia. The most common ILD-related misdiagnoses were AFOP/COP/CEP. Differences in symptoms and laboratory findings between viral pneumonia and other diseases were small, and viral pneumonia should be included in the differential diagnosis when physicians encounter cases in which the abovementioned ILDs are suspected.
KEYWORDS:
acute lung injury; interstitial pneumonia; organizing pneumonia; viral pneumonia; virus
- PMID:
- 31839671
- PMCID:
- PMC6949447
- DOI:
- 10.2169/internalmedicine.2696-19
- [Indexed for MEDLINE]
104.
Adv Exp Med Biol. 2020;1251:107-113. doi: 10.1007/5584_2019_454.
Virological and Epidemiological Situation in the Influenza Epidemic Seasons 2016/2017 and 2017/2018 in Poland.
Hallmann-Szelińska E1, Łuniewska K2, Szymański K2, Kowalczyk D2, Sałamatin R3, Masny A2, Brydak LB2.
Abstract
The World Health Organization estimates that influenza virus infects 3-5 million people worldwide every year, of whom 290,000 to 650,000 die. In the 2016/2017 epidemic season in Poland, the incidence of influenza was 1,692 per 100,000 population. The influenza A virus, subtype A/H3N2/, was the predominant one in that season. However, in the most recent 2017/2018 epidemic season, the incidence exceeded 1,782 per 100,000 already by August of 2018. In this season, influenza B virus predominated, while the A/H1N1/pdm09 strain was most frequent among the influenza A subtypes. The peak incidence, based on the number of clinical specimens tested, was in weeks 4-5 of 2017 and week 8 of 2018 in the 2016/2017 and 2017/2018 epidemic seasons, respectively. As of the 2017/2018 season, a quadrivalent vaccine, consisting of two antigens of influenza A subtypes and another two of influenza B virus, was available in Poland. Nonetheless, the vaccination rate remained at one of the lowest level in Europe, fluctuating between 3% and 4% of the general Polish population.
KEYWORDS:
Disease incidence; Epidemic season; Epidemiology; Infection; Influenza; Vaccination rate; Viral subtypes
105.
PLoS One. 2019 Nov 7;14(11):e0224999. doi: 10.1371/journal.pone.0224999. eCollection 2019.
Chronic bronchitis without airflow obstruction, asthma and rhinitis are differently associated with cardiovascular risk factors and diseases.
Ferrari M1, Piccinno E1, Marcon A2, Marchetti P2, Cazzoletti L2, Pirina P3, Battaglia S4, Grosso A5, Squillacioti G6, Antonicelli L7, Verlato G2, Pesce G8.
Abstract
BACKGROUND AND OBJECTIVES:
Cardiovascular and respiratory diseases can frequently coexist. Understanding their link may improve disease management. We aimed at assessing the associations of chronic bronchitis (CB), asthma and rhinitis with cardiovascular diseases and risk factors in the general population.
METHODS:
We used data collected in the Gene Environment Interactions in Respiratory Diseases study, an Italian multicentre, multicase-control study. Among 2463 participants (age 21-86, female 50%) who underwent standardized interviews, skin prick and lung function tests, we identified 254 cases of CB without airflow obstruction, 418 cases of asthma without CB, 959 cases of rhinitis alone, and 832 controls. The associations of respiratory diseases with reported cardiovascular risk factors (lifestyles, hypertension, dyslipidaemia), heart disorders (myocardial infarction, coronary thrombosis, angina, aorta or heart surgery) and intermittent claudication were estimated through relative risk ratios (RRR) by multinomial logistic regression models.
RESULTS:
Compared to controls, CB cases were more likely to be heavy smokers, alcohol consumers, physically inactive, and to suffer from hypertension or dyslipidaemia; rhinitis cases were less obese but more likely to have hypertension. Asthma was significantly associated with current smoking. After adjusting for cardiovascular risk factors, heart disorders were associated with CB (RRR[95%CI]: 1.58[1.12-2.22]) and rhinitis (1.35[0.98-1.85]) and intermittent claudication was associated with CB (3.43[2.52-4.67]), asthma (1.51[1.04-2.21]) and rhinitis (2.03[1.34-3.07]).
CONCLUSIONS:
CB, asthma and rhinitis were associated with cardiovascular risk factors and diseases. In particular, CB shared with cardiovascular diseases almost all risk factors and was strongly associated with a higher risk of heart disorders and intermittent claudication.
- PMID:
- 31697758
- PMCID:
- PMC6837508
- DOI:
- 10.1371/journal.pone.0224999
- [Indexed for MEDLINE]
106.
PLoS One. 2019 Nov 7;14(11):e0224752. doi: 10.1371/journal.pone.0224752. eCollection 2019.
Impact of negative tuberculin skin test on growth among disadvantaged Bangladeshi children.
Abstract
Millions of children are suffering from tuberculosis (TB) worldwide and often end-up with fatal outcome especially in resource-poor settings. Tuberculin skin test (TST) is a conventionally used diagnostic test, less sensitive but highly specific for the diagnosis of clinical TB especially in undernourished children. However, we do not have any data on the role of TST positivity among the children who received nutritional intervention. Our aim was to examine the growth differences between TST-positive and TST-negative undernourished children aged 12 to 18 months who received nutritional intervention prospectively for 90 feeding days. Our further aim was to explore the determinants of TST positivity at enrollment. TB screening as one of the secondary causes of malnutrition was performed on 243 stunted [length for age Z score (LAZ) <-2 standard deviations] or at-risk of stunting (LAZ score between <-1 and -2 standard deviations) children in a community-based intervention study designed to improve their growth parameters. Differences of growth between TST-positives (n = 29) and TST-negatives (n = 214) were compared using paired samples t-test and multivariable linear regression from anthropometric data collected before and after nutritional intervention. Multivariable logistic regression was used to find out possible predictors of TST positivity using baseline sociodemographic data. Of the 243 children screened, 29 (11.9%) were TST-positive and 11 (4.5%) had clinically diagnosed pulmonary TB. Statistically significant improvement of LAZ and weight for age Z-score (WAZ) were observed among the TST-negative participants at the end of intervention period (p = 0.03 for LAZ and p = 0.01 for WAZ). However, we did not find any association between TST status and response to nutritional intervention in our multivariable linear regression models. Our study findings demonstrated a positive impact of nutritional intervention on growth parameters among TST-negative participants.
- PMID:
- 31697726
- PMCID:
- PMC6837307
- DOI:
- 10.1371/journal.pone.0224752
- [Indexed for MEDLINE]
107.
PLoS One. 2019 Nov 7;14(11):e0224683. doi: 10.1371/journal.pone.0224683. eCollection 2019.
Effectiveness of four types of neuraminidase inhibitors approved in Japan for the treatment of influenza.
Mawatari M1, Saito R1, Hibino A1, Kondo H1, Yagami R1, Odagiri T1,2, Tanabe I1, Shobugawa Y1; Japanese Influenza Collaborative Study Group.
Abstract
BACKGROUND:
Neuraminidase inhibitors (NAIs) effectively treat influenza. The clinical effectiveness of four NAIs (oseltamivir, zanamivir, laninamivir, and peramivir) was evaluated against influenza A/H1N1pdm09, A/H3N2, and B viruses. Additionally, fever duration in patients infected with oseltamivir-resistant influenza A/H1N1pdm09 with the H275Y mutation was evaluated.
METHODS:
Patients aged <20 years who visited outpatient clinics in Japan with influenza-like illnesses were enrolled during 4 influenza seasons from 2012/2013 to 2015/2016. After obtaining informed consent, patients who tested positive for influenza with rapid tests received one of the four NAIs. Patients recorded their body temperature daily for 8 days from the first visit. The influenza strain was identified using real-time polymerase chain reaction. Univariate and multivariable analyses were used to evaluate factors influencing fever duration. In children aged ≤5 years treated with oseltamivir, fever duration in oseltamivir-resistant A/H1N1pdm09-infected patients was compared to that in oseltamivir-sensitive A/H1N1pdm09-infected patients.
RESULTS:
Of the 1,368 patients analyzed, 297 (21.7%), 683 (49.9%), and 388 (28.4%) were infected with influenza A/H1N1pdm09, A/H3N2, and B, respectively. In multivariable analysis factors associated with significantly prolonged fever duration included: treatment with laninamivir (hazard ratio [HR]: 0.78, p = 0.006, compared to oseltamivir), influenza B (HR: 0.58, p<0.001, compared to influenza A/H1N1pdm09), and a higher body temperature at the clinic visit (HR: 0.87 per degree Celsius, p<0.001). Increasing age was associated with a significantly shorter duration of fever (HR: 1.31 for 6-9 years old, p<0.001; and HR: 1.65 for 10-19 years old, p<0.001, respectively, compared to 0-5 years old). Following treatment with oseltamivir, fever duration was significantly longer for oseltamivir-resistant A/H1N1pdm09-infected patients (n = 5) than for oseltamivir-sensitive A/H1N1pdm09 infected patients (n = 111) (mean, 89 versus 40 hours, p<0.001).
CONCLUSIONS:
Our results revealed characteristic information on the effectiveness of the four NAIs and also on oseltamivir-resistant viruses that may affect patients' clinical care.
- PMID:
- 31697721
- PMCID:
- PMC6837752
- DOI:
- 10.1371/journal.pone.0224683
- [Indexed for MEDLINE]
108.
PLoS One. 2019 Nov 1;14(11):e0224702. doi: 10.1371/journal.pone.0224702. eCollection 2019.
Early signal detection of adverse events following influenza vaccination using proportional reporting ratio, Victoria, Australia.
Abstract
INTRODUCTION:
Timely adverse event following immunisation (AEFI) signal event detection is essential to minimise further vaccinees receiving unsafe vaccines. We explored the proportional reporting ratio (PRR) ability to detect two known signal events with influenza vaccines with the aim of providing a model for prospective routine signal detection and improving vaccine safety surveillance in Australia.
METHODS:
Passive AEFI surveillance reports from 2008-2017 relating to influenza vaccines were accessed from the Australian SAEFVIC (Victoria) database. Proportional reporting ratios were calculated for two vaccine-event categories; fever and allergic AEFI. Signal detection sensitivity for two known signal events were determined using weekly data; cumulative data by individual year and; cumulative for all previous years. Signal event thresholds of PRR ≥2 and Chi-square ≥4 were applied.
RESULTS:
PRR provided sensitive signal detection when calculated cumulatively by individual year or by all previous years. Known signal events were detected 15 and 11 days earlier than traditional methods used at the time of the actual events.
CONCLUSION:
Utilising a single jurisdiction's data, PRR improved vaccine pharmacovigilance and showed the potential to detect important safety signals much earlier than previously. It has potential to maximise immunisation safety in Australia. This study progresses the necessary work to establish national cohesion for passive surveillance signal detection and strengthen routine Australian vaccine pharmacovigilance.
- PMID:
- 31675362
- PMCID:
- PMC6824574
- DOI:
- 10.1371/journal.pone.0224702
- [Indexed for MEDLINE]
109.
PLoS One. 2019 Nov 1;14(11):e0224668. doi: 10.1371/journal.pone.0224668. eCollection 2019.
Respiratory health and inflammatory markers - Exposure to respirable dust and quartz and chemical binders in Swedish iron foundries.
Andersson L1,2, Bryngelsson IL1, Hedbrant A2,3, Persson A2,3, Johansson A1, Ericsson A1, Lindell I1, Stockfelt L4, Särndahl E2,3, Westberg H1,2,3.
Abstract
PURPOSE:
To study the relationship between respirable dust, quartz and chemical binders in Swedish iron foundries and respiratory symptoms, lung function (as forced expiratory volume FEV1 and vital capacity FVC), fraction of exhaled nitric oxide (FENO) and levels of club cell secretory protein 16 (CC16) and CRP.
METHODS:
Personal sampling of respirable dust and quartz was performed for 85 subjects in three Swedish iron foundries. Full shift sampling and examination were performed on the second or third day of a working week after a work free weekend, with additional sampling on the fourth or fifth day. Logistic, linear and mixed model analyses were performed including, gender, age, smoking, infections, sampling day, body mass index (BMI) and chemical binders as covariates.
RESULTS:
The adjusted average respirable quartz and dust concentrations were 0.038 and 0.66 mg/m3, respectively. Statistically significant increases in levels of CC16 were associated with exposure to chemical binders (p = 0.05; p = 0.01) in the regression analysis of quartz and respirable dust, respectively. Non-significant exposure-responses were identified for cumulative quartz and the symptoms asthma and breathlessness. For cumulative chemical years, non-significant exposure-response were observed for all but two symptoms. FENO also exhibited a non significant exposure-response for both quartz and respirable dust. No exposure-response was determined for FEV1 or FVC, CRP and respirable dust and quartz.
CONCLUSIONS:
Our findings suggest that early markers of pulmonary effect, such as increased levels of CC16 and FENO, are more strongly associated with chemical binder exposure than respirable quartz and dust in foundry environments.
- PMID:
- 31675355
- PMCID:
- PMC6824619
- DOI:
- 10.1371/journal.pone.0224668
- [Indexed for MEDLINE]
110.
MSMR. 2019 Oct;26(10):22.
Surveillance snapshot: Influenza immunization among U.S. Armed Forces healthcare workers, August 2014-April 2019.
[No authors listed]
111.
Am J Public Health. 2019 Dec;109(12):1707-1710. doi: 10.2105/AJPH.2019.305355. Epub 2019 Oct 17.
Communicable Disease Outbreaks in Michigan Child Care Centers Compared With State and Regional Epidemics, 2014-2017.
Abstract
The Michigan Child Care Related Infections Surveillance Program (MCRISP) is a novel, online illness surveillance system used by a collection of southeast Michigan child care centers. Recently established, MCRISP has not been assessed epidemiologically. We created MCRISP epidemic curves for both respiratory and gastrointestinal disease over three seasons, comparing these to data from an established statewide surveillance system. Results suggest that online child care center-based disease surveillance is timely, functional, and has potential as an early sentinel system for community epidemics.
112.
Am J Public Health. 2019 Dec;109(12):1776-1783. doi: 10.2105/AJPH.2019.305328. Epub 2019 Oct 17.
Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial.
Abstract
Objectives. To evaluate the effectiveness of point-of-care informational interventions in general practitioner clinics to improve influenza and pneumococcal vaccination uptake among elderly patients.Methods. We conducted a pragmatic, cluster-randomized crossover trial in 22 private general practitioner clinics in Singapore, from November 2017 to July 2018. We included all patients aged 65 years or older. Clinics were assigned to a 3-month intervention (flyers and posters encouraging vaccination) plus 1-month washout period, and a 4-month control period (usual care). Primary outcomes were differences in vaccination uptake rates between periods. Secondary outcomes were identification of other factors associated with vaccination uptake.Results. A total of 4378 and 4459 patients were included in the intervention and control periods, respectively. Both influenza (5.9% vs 4.8%; P = .047) and pneumococcal (5.7% vs 3.7%; P = .001) vaccination uptake rates were higher during the intervention period compared with the control period. On multilevel logistic regression analysis, follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 was associated with uptake of both vaccines.Conclusions. Point-of-care informational interventions likely contributed to increased influenza and pneumococcal vaccination uptake. Patients on follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 were more likely to receive influenza and pneumococcal vaccination and should be actively engaged by physicians.Trial Registration. ClinicalTrials.gov Identifier: NCT03445117.
Comment in
- Roger E. Thomas Comments. [Am J Public Health. 2019]
- PMID:
- 31622142
- PMCID:
- PMC6836784
- DOI:
- 10.2105/AJPH.2019.305328
- [Indexed for MEDLINE]
113.
Int J Pediatr Otorhinolaryngol. 2020 Jan;128:109706. doi: 10.1016/j.ijporl.2019.109706. Epub 2019 Oct 8.
Systemic bevacizumab for end-stage juvenile recurrent respiratory papillomas: A case report.
Abstract
We report on two cases of severe recurrent respiratory papillomatosis (RRP) involvement where the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab IV has been administered for treatment. Notably, there have not been any episodes of urgent transfer to the hospital for obstructive events since the bevacizumab was started. It is important to note however, that the disease has not been eliminated. While some pulmonary nodules continue to grow, they have become cavitated. Overall, the number and size of pulmonary lesions has decreased. Therefore, VEGF-targeted therapies, Bevacizumab, could prove to be a promising novel approach for long-term treatment of severe RRP.
Copyright © 2019 Elsevier B.V. All rights reserved.
KEYWORDS:
Bevacizumab; RRP; Tracheal papillomas
114.
Microb Pathog. 2019 Dec;137:103784. doi: 10.1016/j.micpath.2019.103784. Epub 2019 Oct 7.
Imaging of bioluminescent Acinetobacter baumannii in a mouse pneumonia model.
Abstract
Bioluminescence imaging is a non-invasive tool for in vivo real-time monitoring of infectious disease progression in animal models. However, no bioluminescence imaging assay has been developed to monitor Acinetobacter baumannii infections. In the current study, bioluminescent strains of A. baumannii ATCC 17978 and its isogenic ΔompA mutant were constructed by integrating the promoter of the ompA gene and the luxCDABE luciferase gene into the bacterial chromosome. In an acute murine pneumonia model, bioluminescence of the two reporter strains was clearly visible in the lungs and the bioluminescent signal increased over time. Bioluminescence was correlated with bacterial burden and histopathology in reporter strain-infected mice, suggesting that bioluminescent bacteria are useful for monitoring A. baumannii infections in animal models.
Copyright © 2019 Elsevier Ltd. All rights reserved.
KEYWORDS:
Acinetobacter baumannii; Bioluminescence; Lux gene; OmpA; Pneumonia
115.
Am J Trop Med Hyg. 2019 Nov;101(5):1034-1041. doi: 10.4269/ajtmh.18-0656.
A Community-Based Survey on Health-Care Utilization for Pneumonia in Children in Peri-Urban Slums of Karachi, Pakistan.
Abstract
Pneumonia, as defined by WHO, is a syndromic diagnosis characterized by presence of cough or difficult breathing. Presentation to health-care provider depends on timely identification of signs and symptoms by caretakers. We explored patterns of health-care utilization among caretakers of a randomly selected sample of 1,152 children aged 2-59 months, residing in low-income settlements of Karachi, Pakistan. Information on household demographics, occurrence of pneumonia-specific symptoms, care seeking, air quality, and knowledge regarding preventive measures for pneumonia was collected. Predictors of care seeking were estimated using weighted logistic regression. Prevalence of pneumonia with cough and rapid or difficulty in breathing was found to be 40.8% and 37.1% in infants (2-11 months) and children (12-59 months), respectively. Ninety-five percentage of caretakers sought care, 68.5% privately. Odds ratios (ORs) for independent predictors of care-seeking were as follows: younger age of child (infants compared with children), 3.60 (95% CI = 2.65-4.87); caretaker with primary education compared with none, 3.40 (2.46-4.70); vaccine awareness, 1.65 (1.45-1.87); and breastfeeding awareness, 1.32 (1.13-1.53). Presence of symptoms such as fever OR, 1.51 (1.30-1.76); tachypnea, 1.57 (1.35-1.83); chest indrawing, 2.56 (2.05-3.18); persistent vomiting, 1.69 (1.37-2.09); and recurrent illness, 2.57 (2.23-2.97) were also predictive. There is high health-care utilization for pneumonia with the skewed presentation toward private services. Strategies should be focused on making pneumonia care standardized, efficient and affordable, especially in the private sector.
116.
Kardiol Pol. 2019 Oct 25;77(10):969-971. doi: 10.33963/KP.14940. Epub 2019 Aug 27.
Right ventricular systolic pressure as a predictive factor for postoperative pneumonia in patients with valvular heart disease.
117.
Nat Nanotechnol. 2019 Jul;14(7):719-727. doi: 10.1038/s41565-019-0472-4. Epub 2019 Jun 24.
Long-term pulmonary exposure to multi-walled carbon nanotubes promotes breast cancer metastatic cascades.
Lu X1, Zhu Y1, Bai R2, Wu Z3, Qian W1, Yang L1, Cai R2, Yan H4, Li T5, Pandey V6, Liu Y2, Lobie PE6, Chen C7, Zhu T8.
Abstract
Anthropogenic carbon nanotubes, with a fibrous structure and physical properties similar to asbestos, have recently been found within human lung tissues. However, the reported carbon-nanotube-elicited pulmonary pathologies have been mostly confined to inflammatory or neoplastic lesions in the lungs or adjacent tissues. In the present study, we demonstrate that a single pulmonary exposure to multi-walled carbon nanotubes dramatically enhances angiogenesis and the invasiveness of orthotopically implanted mammary carcinoma, leading to metastasis and rapid colonization of the lungs and other organs. Exposure to multi-walled carbon nanotubes stimulates local and systemic inflammation, contributing to the formation of pre-metastatic and metastatic niches. Our study suggests that nanoscale-material-elicited pulmonary lesions may exert complex and extended influences on tumour progression. Given the increasing presence of carbon nanotubes in the environment, this report emphasizes the urgent need to escalate efforts assessing the long-term risks of airborne nanomaterial exposure in non-lung cancer progression.
118.
COPD. 2019 Feb;16(1):18-24. doi: 10.1080/15412555.2019.1593342. Epub 2019 Apr 4.
Clinical Decision Support System: A Pragmatic Tool to Improve Acute Exacerbation of COPD Discharge Recommendations.
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant mortality, morbidity and increased risk for further exacerbations. Therefore, appropriate measures for prevention of further exacerbations should be initiated before discharge. Unfortunately, this opportunity for treatment review and change in disease course is often missed. We designed a decision support tool to automatically generate discharge recommendations for COPD patients based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report. A pre- and post-intervention study was conducted including data from 24 months before and 18 months after the implementation of the tool. The rate of adherence of the discharge recommendations to the report was measured. Overall, 536 patients were included in the pre-intervention cohort and 367 in the intervention cohort. Demographic and clinical features were similar between the two groups. After introduction of the tool, the percentage of patients discharged with long-acting medications increased from 42% to 84%, recommendations for smoking cessation increased from 32% to 91%, for vaccination from 13% to 92%, and for follow-up visit in a pulmonology clinic from 72% to 98%. Of the patients given prescriptions for long-acting bronchodilators, 54% purchased these after discharge versus 20% of the patients without such prescriptions. Decision-support tools can significantly improve adherence to guidelines among patients discharged after hospitalization due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and potentially improve their clinical course.
KEYWORDS:
COPD; clinical decision support systems; guideline adherence; quality improvement
119.
Pediatr Infect Dis J. 2019 Apr;38(4):e79. doi: 10.1097/INF.0000000000002127.
A Lower-limb Skin Lesion in a 10-year-old Girl.
120.
Pediatr Infect Dis J. 2019 Apr;38(4):439-443. doi: 10.1097/INF.0000000000002257.
Integrated Safety Profile of a New Approved, Fully Liquid DTaP5-HB-IPV-Hib Vaccine.
Abstract
BACKGROUND:
DTaP5-HB-IPV-Hib is a fully liquid, hexavalent vaccine containing a 5-antigen pertussis component, approved since 2016 in Europe [Vaxelis; DTaP5-HB-IPV-Hib vaccine: Diphtheria, tetanus, pertussis (5 acellular components: pertussis toxoid [PT], filamentous haemagglutinin [FHA], pertactin (PRN), and fimbriae Types 2 and 3 [FIM]), hepatitis B (recombinant DNA: rDNA), poliomyelitis (inactivated) and Haemophilus influenzae type b conjugate vaccine (adsorbed); MCM Vaccine B.V., The Netherlands] for primary and booster vaccination in infants and toddlers against diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive diseases caused by Haemophilus influenzae type b. The comparator vaccine (control) was INFANRIX hexa (GlaxoSmithKline Biologics S.A., Rixensart, Belgium) (DTaP3-IPV-HepB/Hib) in European studies and PENTACEL (DTaP5-IPV/Hib) (Sanofi Pasteur, Swiftwater, PA) in US studies.
METHODS:
Data from 6 studies were integrated and analyzed to provide a comprehensive safety profile. Numbers and proportions of subjects with adverse events (AEs) were summarized by treatment group. Group differences in proportion of AEs were calculated.
RESULTS:
Among the DTaP5-HB-IPV-Hib (N = 5223) and 2295 control (N = 2295) groups, solicited injection-site and systemic AEs were very common. Serious AEs were reported by 3.9% of DTaP5-HB-IPV-Hib and 3.7% of control subjects. Vaccine-related serious AEs occurred infrequently, 0.2% for both groups. Most AEs were mild-to-moderate and did not lead to subject withdrawal. Group differences for solicited systemic AEs were small (<3%) and not statistically significant, except for pyrexia (estimated difference 9.4% [95% CI: 6.7%-12%]). The difference was driven by the 2 US studies where the PENTACEL control group had a lower fever rate. Among European studies, there was no significant difference in rates of pyrexia between DTaP5-HB-IPV-Hib and INFANRIX hexa.
CONCLUSIONS:
The safety of DTaP5-HB-IPV-Hib is consistent with the safety profile of its components and similar to comparator vaccines, including INFANRIX hexa. The vaccine provides a new, fully liquid and convenient hexavalent vaccination option for use with various vaccination schedules in Europe.
121.
Pediatr Infect Dis J. 2019 Apr;38(4):419-421. doi: 10.1097/INF.0000000000002057.
Transient Tachypnea of the Newborn Is Associated With an Increased Risk of Hospitalization Due to Respiratory Syncytial Virus Bronchiolitis.
Abstract
BACKGROUND:
Transient tachypnea of the newborn (TTN) is a self-limiting respiratory disorder, resulting from a failure to clear the lungs of perinatal fluid. As similar pathophysiologic features are present in children with respiratory syncytial virus (RSV) bronchiolitis, we hypothesized that these two conditions may be connected.
METHODS:
This was a population-based cohort study that included all children born in term (≥37 weeks of gestation) without congenital malformations in Finland between 1996 and 2015. Children diagnosed with TTN (International Statistical Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] code P22.1) after birth and children hospitalized because of RSV bronchiolitis (ICD-10 code J21.0) during first year of life were identified from the Medical Birth Register and National Hospital Discharge Register, respectively, and the data were linked. Logistic regression was used to analyze the association between these two conditions.
RESULTS:
Of the 1,042,045 children included in the study cohort, 16,327 (1.57%) were diagnosed with TTN at birth and 12,345 (1.18%) were hospitalized because of RSV bronchiolitis during the first year of life. The rate of RSV hospitalization was higher in children with a history of TTN compared with children without TTN diagnosis [260/16,327 (1.59%) vs. 12,085/1,025,718 (1.18%), respectively; P value <0.0001]. After adjusting for gestational age at birth, mode of delivery, gender, birth weight, multiple births, older siblings and maternal smoking, TTN was associated with increased risk for RSV hospitalization (odds ratio: 1.31, 95% confidence interval: 1.16-1.48).
CONCLUSIONS:
TTN diagnosis after birth was associated with increased risk for RSV hospitalization during the first year of life.
Comment in
- Comment on Transient Tachypnea of the Newborn Is Associated With an Increased Risk of Hospitalization Due to Respiratory Syncytial Virus Bronchiolitis. [Pediatr Infect Dis J. 2019]
- In Reply: Viral Etiology of Bronchiolitis Among Pediatric Patients. [Pediatr Infect Dis J. 2019]
- Viral Etiology of Bronchiolitis Among Pediatric Patients. [Pediatr Infect Dis J. 2019]
122.
Pediatr Infect Dis J. 2019 Apr;38(4):370-376. doi: 10.1097/INF.0000000000002160.
Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance.
Abstract
BACKGROUND:
The global resurgence of pertussis in countries with high vaccination coverage has been a concern of public health.
METHODS:
Nasopharyngeal swabs were collected for Bordetella pertussis culture from children with suspected pertussis. Clinical and vaccination information were reviewed through electronic medical chart and immunization record. Antibiotics susceptibility was evaluated using E-test for erythromycin, azithromycin, clarithromycin and sulfamethoxazole/trimethoprim. The MLST genotypes and 7 antigenic genes (ptxP, ptxA, ptxC, Prn, fim3, fim2 and tcfA) of Bordetella pertussis were identified by polymerase chain reaction amplification and sequencing.
RESULTS:
During January 2016 to September 2017, a total of 141 children 1-48 months of age were culture-confirmed with pertussis, of whom 98 (69.5%) were younger than 6 months, 25 (17.7%) had completed at least 3 doses of DTaP and 75 (53.2%) had a clear exposure to household members with persistent cough. Fully vaccinated cases manifested milder disease than unvaccinated and not-fully vaccinated cases. All strains were MLST2. High-virulent strains characteristic of ptxP3/prn2/ptxC2 constituted 41.1% (58/141) and were all susceptible to macrolides while low-virulent strains characteristic of ptxP1/prn1/ptxC1 constituted 58.9% (83/141) and 97.6% (81/83), respectively, were highly resistant to macrolides.
CONCLUSIONS:
Pertussis is resurging among infants and young children in Shanghai, and household transmission is the main exposure pathway. The high-virulent strains harboring ptxP3/prn2/ptxC2 and the macrolide-resistant Bordetella pertussis strains are quite prevalent. These issues impose a public health concern in Shanghai. Our findings are important to modify the DTaP vaccination strategy and the management guideline of pertussis in China.
123.
Pediatr Infect Dis J. 2019 Apr;38(4):362-369. doi: 10.1097/INF.0000000000002164.
Characteristics and Outcomes of Young Children Hospitalized With Laboratory-confirmed Influenza or Respiratory Syncytial Virus in Ontario, Canada, 2009-2014.
Buchan SA1,2, Chung H3, Karnauchow T4,5, McNally JD4, Campitelli MA3, Gubbay JB2,6,7, Katz K6,8, McGeer AJ1,6,9, Richardson DC10, Richardson SE6,7, Simor A6,11, Smieja M12, Zahariadis G13,14, Tran D7,15, Crowcroft NS1,2,6, Rosella LC1,2,3, Kwong JC1,2,3,16,17.
Abstract
BACKGROUND:
Respiratory illnesses are a major contributor to pediatric hospitalizations, with influenza and respiratory syncytial virus (RSV) causing substantial morbidity and cost each season. We compared the characteristics and outcomes of children 0-59 months of age who were hospitalized with laboratory-confirmed influenza or RSV between 2009 and 2014 in Ontario, Canada.
METHODS:
We included hospitalized children who were tested for influenza A, influenza B and RSV and were positive for a single virus. We characterized individuals by their demographics and healthcare utilization patterns and compared their hospital outcomes, in-hospital cost and postdischarge healthcare use by virus type and by presence of underlying comorbidities.
RESULTS:
We identified and analyzed 7659 hospitalizations during which a specimen tested positive for influenza or RSV. Children with RSV were the youngest whereas children with influenza B were the oldest [median ages 6 months (interquartile range: 2-17 months) and 25 months (interquartile range: 10-45 months), respectively]. Complex chronic conditions were more prevalent among children with all influenza (sub)types than RSV (31%-34% versus 20%). In-hospital outcomes were similar by virus type, but in children with comorbidities, postdischarge outcomes varied. We observed no differences in in-hospital cost between viruses or by presence of comorbidities [overall median cost: $4150 Canadian dollars (interquartile range: $3710-$4948)].
CONCLUSIONS:
Influenza and RSV account for large numbers of pediatric hospitalizations. RSV and influenza were similar in terms of severity and cost in hospitalized children. Influenza vaccination should be promoted in pregnant women and young children, and a vaccine against RSV would mitigate the high burden of RSV.
124.
Pediatr Infect Dis J. 2019 Apr;38(4):355-361. doi: 10.1097/INF.0000000000002165.
The Risk of Serious Bacterial Infection in Febrile Infants 0-90 Days of Life With a Respiratory Viral Infection.
Abstract
BACKGROUND:
Molecular diagnostic methods enhance the sensitivity and broaden the spectrum of detectable respiratory viruses in febrile infants ≤90 days of life. We describe the occurrence of respiratory viruses in this population, as well as the rates of serious bacterial infection (SBI) and respiratory viral coinfection with regard to viral characteristics.
METHODS:
This was a prospective observational cohort study performed in the emergency department that included previously healthy febrile infants ≤90 days of life. Clinical and historical characteristics were documented, and a respiratory nasal wash specimen was obtained from each patient. This sample was tested for 17 common respiratory pathogens, and a chart review was conducted to ascertain whether the infant was diagnosed with an SBI.
RESULTS:
In a 12-month period, 67% of the 104 recruited febrile infants were positive for a respiratory virus. The most commonly detected viruses were rhinovirus, respiratory syncytial virus, enterovirus and influenza. The rate of respiratory viral and SBI coinfection was 9% overall, and infants with either a systemic respiratory virus or negative viral testing were 3 times more likely to have an SBI than those with viruses typically restricted to the respiratory mucosa (95% confidence interval: 1.1, 9.7).
CONCLUSIONS:
Respiratory viruses are readily detectable via nasopharyngeal wash in febrile infants ≤90 days of life. With the enhanced sensitivity of molecular respiratory diagnostics, rates of coinfection of respiratory viruses and SBI may be higher than previously thought. Further investigation utilizing molecular diagnostics is needed to guide usage in febrile infants ≤90 days.
125.
Pediatr Infect Dis J. 2019 Apr;38(4):344-350. doi: 10.1097/INF.0000000000002155.
Population-based Incidence of Childhood Pneumonia Associated With Viral Infections in Bangladesh.
Abstract
BACKGROUND:
The contribution of respiratory viruses to childhood pneumonia in tropical low- and middle-income countries is poorly understood. We used population-based respiratory illness surveillance in children 5 years of age or younger in Dhaka, Bangladesh, to characterize these illnesses.
METHODS:
We conducted weekly home visits to children who were referred to clinic for fever or respiratory symptoms. Standardized clinical data were collected. Nasopharyngeal washes were collected for one fifth of children diagnosed with a febrile or respiratory syndrome, with virus isolation testing for influenza and reverse transcription polymerase chain reaction testing for other viruses. Pneumonia was defined as age-specific tachypnea and crepitations on chest auscultation by study physicians.
RESULTS:
From April 2004 to February 2008, 17,584 children were followed for 17,644 child-years; 6335 children had 12,499 clinic visits with eligible illnesses, including 6345 pneumonia episodes (incidence of 36 episodes/100 child-years). Annual incidence of pneumonia/100 child-years ranged from 88.3 for children 0-6 months of age to 13.1 for those 36-60 months of age. Of 1248 pneumonia visits with laboratory testing, 803 (64%) had detection of viral pathogens, including 274 respiratory syncytial virus (22% of pneumonia visits with laboratory testing; incidence 7.9/100 child-years), 244 adenovirus (19%; 7.0/100 child-years), 198 human metapneumovirus (16%; 5.7/100 child-years), 174 parainfluenza (14.0%; 5.0/100 child-years), and 81 influenza (6.5%; 2.3/100 child years).
CONCLUSIONS:
Viral pathogens contribute to a majority of childhood pneumonia episodes in Bangladesh, a setting with high pneumonia rates, especially in children 2 years of age or younger. Developing effective prevention strategies targeting these children is a high priority. Given less sensitive laboratory method used for influenza detection, influenza rates may be underestimated.
126.
Am J Epidemiol. 2019 Jul 1;188(7):1404-1406. doi: 10.1093/aje/kwz044.
RE: "REASSESSING THE GLOBAL MORTALITY BURDEN OF THE 1918 INFLUENZA PANDEMIC".
Comment in
- THE AUTHORS REPLY. [Am J Epidemiol. 2019]
Comment on
- Reassessing the Global Mortality Burden of the 1918 Influenza Pandemic. [Am J Epidemiol. 2018]
127.
Am J Epidemiol. 2019 Jul 1;188(7):1405-1406. doi: 10.1093/aje/kwz041.
THE AUTHORS REPLY.
Comment on
- Reassessing the Global Mortality Burden of the 1918 Influenza Pandemic. [Am J Epidemiol. 2018]
- RE: "REASSESSING THE GLOBAL MORTALITY BURDEN OF THE 1918 INFLUENZA PANDEMIC". [Am J Epidemiol. 2019]
128.
Respir Med. 2019 Jan;146:81-86. doi: 10.1016/j.rmed.2018.12.002. Epub 2018 Dec 12.
Utility of fiber-optic bronchoscopy in pulmonary infections among abdominal solid-organ transplant patients: A comprehensive review.
Abstract
Pulmonary infections are frequent complications in abdominal solid-organ transplantation (aSOT) which may threaten patient and allograft survival. Accurate diagnosis and treatment of pulmonary infections in this population can be challenging. Immunosuppressive therapy not only increases the risk of acquiring opportunistic and non-opportunistic infections, but it also impairs the inflammatory responses associated with microbial invasion which in an otherwise normal host produce clinical and radiologic responses that allow for early identification of the offending pathogen. Serologic testing is not a reliable diagnostic modality. Direct microbiological sampling is often necessary to make a definitive diagnosis early in the clinical course to optimize timely, targeted therapy while reducing the risk of developing antimicrobial resistance, and minimize adverse effects of therapy, if any. Fiber-optic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) or transbronchial lung biopsy (TBB) offers such diagnostic advantage and possesses a potential therapeutic value too. This comprehensive review discusses the potential benefits of FOB alongside its risks and complications, indications and contraindications, and techniques. Additionally, the essay highlights FOB's utility and yield specifically with regard to type and timing of infections in aSOT patients.
Copyright © 2018 Elsevier Ltd. All rights reserved.
KEYWORDS:
Abdominal solid-organ transplantation; Fiber-optic bronchoscopy; Pulmonary infections
129.
Gastroenterol Nurs. 2019 Jul/Aug;42(4):370-374. doi: 10.1097/SGA.0000000000000321.
Utilizing Information Technology to Improve Influenza Vaccination in Pediatric Patients With Inflammatory Bowel Disease.
Abstract
Pediatric patients with inflammatory bowel disease are undervaccinated against influenza. Gastroenterology nurses are ideally situated to assist in improving vaccination in this population. The objective of this quality improvement project was to evaluate the implementation of information technology prompts within the electronic medical record to improve influenza vaccination during specialty clinic visits. The proportion of patients with yearly influenza vaccination was evaluated at baseline, Year 1, and Year 2 following implementation. At baseline, only 10% of a random sample had documented influenza vaccination. Vaccination documentation improved to 39% (96/246) by Year 1 and to 61% (175/287) by Year 2 (p < .001). Vaccine counseling improved from 27% to 77% by Year 2 for unvaccinated patients (p < .001). Among patients seen by gastroenterology nurses, the proportion of patients with either documented vaccination or counseling was 94% by Year 2 compared with 70% if seen only by a physician (p < .001). Documentation of influenza vaccination improved with the use of customized prompts. Patients seen by a gastroenterology nurse had higher vaccination documentation and vaccine counseling than those who were seen by a physician alone.
130.
Proteomics. 2019 Feb;19(3):e1800202. doi: 10.1002/pmic.201800202. Epub 2019 Jan 18.
Intact Glycopeptide Analysis of Influenza A/H1N1/09 Neuraminidase Revealing the Effects of Host and Glycosite Location on Site-Specific Glycan Structures.
Abstract
Influenza H1N1 virus has posed a serious threat to human health. The glycosylation of neuraminidase (NA) could affect the infectivity and virulence of the influenza virus, but detailed site-specific glycosylation information of NA is still missing. In this study, intact glycopeptide analysis is performed on an influenza NA (A/H1N1/California/2009) that is expressed in human 293T and insect Hi-5 cells. The data indicate that three of four potential N-linked glycosylation sites are glycosylated, including one partial glycosylation site from both cell lines. The NA expressed in human cells has more complex glycans than that of insect cells, suggesting the importance of selecting an appropriate expression system for the production of functional glycoproteins. Different types of glycans are identified from different glycosites of NA expressed in human cells, which implies the site-dependence of glycosylation on NA. This study provides valuable information for the research of influenza virus as well as the functions of viral protein glycosylation.
© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
KEYWORDS:
glycosylation; intact glycopeptide; mass spectrometry; neuraminidase
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