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Manikam, Logan Nishant. "Respiratory tract infections in children with Down's Syndrome." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/1561679/.
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BACKGROUND: Children with Down’s Syndrome (DS) are prone to respiratory tract infections (RTIs), yet there is little evidence to guide clinical practice. AIMS: For children with and without DS, this thesis aims to use routinely collected data to identify RTI-related healthcare utilisation, those most at risk of RTI-related healthcare utilisation, and the effects of antibiotics in preventing RTI-related hospitalisation. METHODS: A systematic review of existing interventions and a retrospective cohort study based on routinely collected primary and secondary care data (CALIBER). KEY FINDINGS: The CALIBER cohort comprised 992 children with DS and 4874 controls. Children with DS consulted their GP for RTIs twice as often as controls, were prescribed antibiotics twice as often, and were hospitalized six times as often. In children with DS, younger age, congenital heart disease and asthma were risk factors for RTI-related healthcare utilisation. Using multivariate analysis, this study found that for infants with DS, the prescription of antibiotics significantly reduced subsequent RTI-related hospitalisation - the number needed to treat is 11.9. Separate analysis, inverse probability of treatment weighting, found that the protective effect for infants with DS was not significant. When prescriptions were analysed by type of RTI, the prescription of antibiotics for upper RTIs did not reduce the risk of hospitalization for children with DS or controls. This was also the case for lower RTIs, although with a small sample. CONCLUSION: For children with DS over the age of one presenting with RTIs to primary care, antibiotic treatment does not prevent subsequent RTI-related hospitalisation. There is conflicting evidence from two separate analysis methods as to whether treating infants with DS with antibiotics prevents RTI-related hospitalisation, so further research is recommended. Further prescribing strategies (i.e. rescue antibiotics) should be explored to broaden the evidence base for this at-risk group.
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Petersson, Christer. "Preschool children day-care, diseases and drugs : studies of risk factors for respiratory tract infections /." Lund : Dept. of Community Health Sciences, Lund University, 1994. http://books.google.com/books?id=Vs9sAAAAMAAJ.
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Granbom, Elin. "Respiratory tract infections in children with congenital heart disease." Licentiate thesis, Umeå universitet, Pediatrik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-128024.
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Respiratory Syncytial Virus (RSV) infection is common among young children. Congenital Heart Disease (CHD) is a risk factor of severe illness and hospitalization. Palivizumab prophylaxis reduces the severity of RSV infection and reduces the risk of hospitalization for children at high risk of severe illness, such as children born premature or with CHD. The aim of this thesis was to evaluate compliance with national guidelines for prophylactic treatment and to study the Relative Risk (RR) of hospitalization due to RSV and unspecified Respiratory Tract Infection (RTI) for children with CHD. In a prospective study, questionnaires were sent to all paediatric cardiology centres in Sweden with questions about prophylactic treatment. Hospitalization rates were retrieved from the national inpatient registry. Heart defects were grouped according to type and the relative risk of hospitalization was calculated for each group and for summer and winter seasons. Half of the patients received prophylactic treatment later than recommended in the guidelines. The risk of hospitalization due to RSV infection was increased (RR=2.06 95% CI 1.6-2.6; p < 0.0001) for children with CHD compared to children without CHD. The RR of hospitalization was also increased for all CHD subgroups, and was further increased during summer for children with the more severe CHD. We conclude that guidelines for prophylactic treatment were not followed and that the risk of hospitalization due to RSV and unspecified RTI was increased for all subgroups of CHD. The risk was increased both during winter and summer and we therefore argue that information to health personnel and parents should include that the risk of severe RTI is present all year round for children with CHD.Respiratoriskt syncytialvirus (RSV) är det vanligaste förkylningsviruset och de allra flesta barn drabbas före två års ålder. RSV kan leda till allvarlig luftvägsinfektion hos alla barn, men speciellt hos dem med medfött hjärtfel. Någon botande läkemedelsbehandling finns inte för RSV, utan de medicinska insatserna får inriktas mot att mildra sjukdomsförloppet och för svårt sjuka barn krävs sjukhusvård för att exempelvis erhålla syrgasbehandling. Det finns inget vaccin mot RSV, men barn som riskerar att bli svårt sjuka kan behandlas profylaktiskt med en monoklonal antikropp (Palivizumab) som ges som injektion en gång per månad under vintersäsong. Vissa barn med svårt hjärtfel får denna profylaktiska behandling enligt nationella riktlinjer. Vår första studie visade att ungefär hälften av barnen med medfött hjärtfel, aktuella för profylax mot RSV, fick behandlingen senare än vad de nationella riktlinjerna rekommenderade. Denna studie genomfördes via en enkät till alla landets barnkliniker under två vintersäsonger. Vi såg även att något fler barn än förväntat (4.6%) fick RSV-infektion trots profylaktisk behandling och för cirka en tredjedel av dessa barn fördröjdes tiden till hjärtoperation. Behovet av sjukhusvård kan användas som mått på hur svårt ett sjukdomsförlopp är, och baserat på Socialstyrelsens slutenvårdsregister studerade vi alla barn under två års ålder och fann att den relativa risken för sjukhusvård på grund av RSV var högre för barn med hjärtfel än för barn utan hjärtfel (RR=2.06 95% CI 1.6-2.6; p < 0.0001). I vår andra studie, baserad på slutenvårdsregistret, beräknade vi den relativa risken för sjukhusvård på grund av RSV, för barn med olika former av hjärtfel och uppdelat i sommar- och vintersäsong. Risken för sjukhusvård var ökad för alla barn oavsett typ av hjärtfel, och detta gällde såväl under vintern som under sommaren. Barn med de allvarligaste formerna av hjärtfel hade högre risk för sjukhusvård under sommaren jämfört med deras risk under vintern, medan barn med vad som anses vara lättare hjärtfel hade ökad risk för sjukhusvård under hela året, utan någon större skillnad i risk mellan vinter och sommar. Att barn med hjärtfel riskerar att bli svårt sjuka i RSV är väl känt, men våra resultat visar att denna risk även existerar under sommarhalvåret, då det inte är RSV-säsong och då profylax inte ges. Vi fann också att barn med vad som anses vara lättare hjärtfel löper lika stor risk att drabbas av svårare sjukdomsförlopp med sjukhusvård under vintern, som barn med svårare hjärtfel. Att denna information sprids till såväl sjukvårdspersonal som arbetar med denna patientgrupp som till föräldrar med hjärtsjuka barn är viktigt, för att belysa att även dessa barn behöver skyddas, och detta inte bara under vintern och RSV-säsongen.
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Regêncio, Maria Manuel Almeida. "Computerised respiratory sounds in infants with lower respiratory tract infections : a comparative study." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/14582.
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Mestrado em FisioterapiaBackground: Lower respiratory tract infections (LRTI) are the main cause of health burden in the first years of age. To enhance the diagnosis and monitoring of infants with LRTI, researchers have been trying to use the large advantages of conventional auscultation. Computerised respiratory sound analysis (CORSA) is a simple method to detect and characterise Normal Respiratory Sounds (NRS) and Adventitious Respiratory Sounds (ARS). However, if this measure is to be used in the paediatric population, reference values have to be established first. Aim: To compare and characterise NRS and ARS in healthy infants and infants with LRTI. Methods: A cross-sectional descriptive-comparative study was conducted in three institutions. Infants were diagnosed by the paediatrician as presenting or not presenting an LRTI, healthy volunteers were recruited from the institutions. Socio-demographic, anthropometric and cardio-respiratory parameters were collected. Respiratory sounds were recorded with a digital stethoscope. Frequency at maximum intensity (Fmax), maximum intensity (Imax) and mean intensity (Imean) over the whole frequency range were collected to characterise NRS. Location, mean number, type, duration and frequency were collected to characterise ARS. All analysis was performed per breathing phase (i.e., inspiration and expiration). Results: Forty nine infants enrolled in this study: 25 healthy infants (G1) and 24 infants with LRTI. Inspiratory Fmax (G1: M 116.1 Hz IQR [107.2-132.4] vs G2: M 118.9Hz IQR [113.2-128.7], p=0.244) and expiratory frequencies (G1: M 107.3Hz IQR [102.9-116.9] vs G2: M 112.6Hz IQR [106.6-122.6], p= 0.083) slightly higher than their healthy peers. Wheeze occupation rate was statistically significantly different between groups in inspiration (G1: M 0 IQR [0-0.1] vs G2: M 0.2 IQR [0-5.2] p= 0.032) and expiration (G1: M 0 IQR [0-1.9] vs G2: M 1.5 IQR [0.2-6.7] p= 0.015), being the infants with LRTI the ones presenting more wheezes. Conclusion: Computerised respiratory sounds in healthy infants and infants with LRTI presented differences. The main findings indicated that NRS have Fmax higher in infants with LRTI than in healthy infant and Wh% was the characteristic that differ the most between infant with LRTI and healthy infant.
Enquadramento: As infeções respiratórias do trato inferior (IRTI) constituem o principal problema de saúde nos primeiros anos de vida das crianças. Desta forma, a investigação tem-se focado no desenvolvimento de medidas objetivas para o diagnóstico de IRTI, utilizando essencialmente as vantagens da auscultação convencional incorporadas numa análise computorizada e automática. Contudo, apesar da análise computorizada de sons respiratórios ser um método simples de deteção e caraterização dos sons respiratórios normais (SRN) e adventícios (SRA), desconhecem-se quais os valores de referência dos sons respiratórios em crianças, o que limita a sua aplicação na prática clínica Objetivos: Caraterizar e comparar os SRN e os SRA em crianças saudáveis e com IRTI. Métodos: Estudo descritivo, comparativo e transversal realizado em três instituições. Eram elegíveis crianças diagnosticadas pelo pediatra com IRTI e voluntários para crianças saudáveis. Foram recolhidos dados sócio demográficos, antropométricos e parâmetros cardiorrespiratórios. Os sons respiratórios foram registados com um estetoscópio digital. Foram analisados diversos parâmetros para os SRN: a frequência na intensidade máxima (Fmax), a intensidade máxima (Imax) e a média da intensidade ao longo de toda a faixa de frequência (Imean). Nos SRA foram analisados: a taxa de ocupação por wheezes (Wh%), a média wheezes (Wh), o número e o tipo Wh, a frequência e a localização Wh por região; o número crackles (Cr), o tipo e a frequência Cr, a duração da deflexão inicial, da maior deflexão e dos dois ciclos de deflexão dos Cr. Todos estes dados foram analisados por fase do ciclo respiratório (i.e., inspiração e expiração). Resultados: Quarenta e nove crianças foram incluídas neste estudo: 25 saudáveis (G1) e 24 com IRTI (G2). A Fmax inspiratória (G1: M 116,1 Hz IQR [107,2-132,4] vs G2: M 118.9Hz IQR [113,2-128,7], p = 0,244) e expiratória (G1: M 107.3Hz IQR [102,9-116,9] vs G2: M 112.6Hz IQR [106,6-122,6], p = 0,083) foi superior nas crianças com IRTI relativamente às crianças saudáveis. A Wh% foi significativamente superior nas crianças com IRTI, relativamente às crianças saudáveis na inspiração (G1: M 0 IQR [0-0,1] vs G2: M 0,2 IQR [0-5,2] p = 0,032) e na expiração (G1: M 0 IQR [0-1,9] vs G2: M 1,5 IQR [0,2-6,7] p = 0,015). Conclusão: Os sons respiratórios computorizados de crianças saudáveis e com IRTI apresentam diferenças. Os principais resultados indicam que os sons respiratórios normais apresentam uma Fmax maior em crianças com IRTI do que em saudáveis e que Wh% é a característica que mais difere entre os dois grupos.
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Novas, Anabela M. P. C. "Tennis training, upper respiratory tract infections and salivary immunoglobulin A." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/36789/1/36789_Digitised%20Thesis.pdf.
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Upper respiratory tract infections (URTI) are one of the most common illnesses affecting the general population and particularly athletes, often reducing the individual capacity of physical performance. Epidemiological data suggest that intensive exercise, training and competition may increase susceptibility to respiratory infections. On the other hand, some studies defend that less active subjects may reduce their risk of URTI by engaging in moderate exercise training. Nevertheless, reports are not unanimous and frequently contained various limitations. The higher incidence of infections in elite athletes has been widely attributed to immune suppression induced by exhaustive exercise, however this has not been clearly demonstrated. The present series of studies aimed to investigate the relationship between physical activity and the incidence of URTI in young healthy females with a range of physical activity levels, from sedentary to elite athletes (tennis players). Additionally, it was intended to explore the temporal association between specific characteristics of tennis training and competition, the incidence of URTI, and salivary lgA levels (μg.mr1 ; μg.min-1 ) and changes, in elite female tennis players over a 12-week period. To accomplish the objectives described, a practical method for quantifying tennis play was validated and applied. Major findings of this research include the greater incidence of URTI symptomatology in girls with low or extremely high levels of physical activity as compared to those with moderate levels. Moreover, the incidence of URTI in elite tennis players was directly correlated with the training load and competition level, on a weekly basis. In the subsequent study, one hour of intense tennis play produced a significant drop in salivary lgA secretion rate (S-lgA), and the magnitude of the immune suppression was directly associated with the amount of training undertaken during the previous day and week (P<0.05). Nevertheless, tennis training did not seem to suppress chronically salivary lgA as positive correlations were found between resting salivary lgA levels of concentration and secretion rate, and the amount of training undertaken previously. Finally, it was noted a sharper post-exercise drop in S-lgA in occasions preceding an URTI episode compared to occasions when the infection did not develop subsequently (within 7 days). However, this parameter was not a specific predictor of URTI, in this cohort of athletes.
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Almond, Elizabeth Jennifer Philippa. "Epstein-Barr virus infection of the lower respiratory tract." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1989. http://hub.hku.hk/bib/B31208484.
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Sung, Rita Yn-Tz. "Acute bronchiolitis in Hong Kong Chinese infants." Thesis, Cardiff University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339352.
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André, Malin. "Rules of thumb and management of common infections in general practice /." Linköping : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5183.
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Johnston, Sebastian L. "The association of upper respiratory tract infections with exacerbations of asthma." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295871.
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Page, K. "The modulatory effects of commensal neisseriae on upper respiratory tract infections." Thesis, University of the West of England, Bristol, 2014. http://eprints.uwe.ac.uk/22932/.
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The human nasopharynx is a reservoir of both commensal and pathogenic bacteria that can be easily transmitted from one individual to another. It has long been hypothesised that host commensal flora give protection from carriage of pathogens and invasive disease. The commensal Neisseria lactamica has previously been associated with protection against the closely related human pathogen Neisseria meningitidis, which is thought to be due to the acquisition of cross-reactive immunity to N. meningitidis. The objective of this study was to identify the extent of protection by N. lactamica in the absence of host immune cells, using an in vitro model of the human nasopharyngeal epithelium with the Detroit 562 (D562) cell line. N. lactamica has been demonstrated to attenuate the induction of innate inflammatory cytokines and chemokines from D562 cells challenged with N. meningitidis. For the first time in this study, N. lactamica was found to attenuate the induction of IL6, IL8 and TNFα from D562 cells challenged with the unrelated Gram-positive human pathogen Streptococcus pneumoniae. Attenuation by N. lactamica did not extend to suppression of MAPK pathways when stimulated with chemical agonists, but was able to suppress inflammation induced through the intracellular PAMP receptor TLR3, which is not involved in meningococcal or pneumococcal inflammation. This suggests a global mechanism of attenuation in host cells by N. lactamica. N. lactamica was further demonstrated to reduce association with and invasion of D562 epithelial cells by N. meningitidis serogroup B (MenB) by up to 60% and 90%, respectively. This suppression was dependent on live N. lactamica and did not require invasion of host cells by the commensal, suggesting an active mechanism employed by N. lactamica. The occasional human commensal coloniser Neisseria polysaccharea was found to reduce adhesion and invasion of MenB to a similar degree, however the related commensal Neisseria cinerea was not. The reduction in MenB association with host cells protected host cells from MenB-induced apoptosis, which was mediated by activation of caspase 3. This study demonstrates that commensal Neisseria spp. N. lactamica and N. polysaccharea protect the host at the nasopharyngeal epithelium from experimental colonisation and invasive disease by MenB. Additionally, commensal neisseriae protect against inflammation and cell death induced by the unrelated pathogen S. pneumoniae. Therefore, commensal neisseriae warrant further study to evaluate their effectiveness for use as probiotics to protect against bacterial pathogens responsible for meningitis.
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Ong, G. M. L. "The study of the prevalence of Chlamydophila pneumoniae and respiratory viral co-infections in acute respiratory tract infections and atheroma." Thesis, Queen's University Belfast, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403183.
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Nurhaeni, Nani. "Assessment of the feasibility of modifying risk factors for acute respiratory infection in children under five years of age in West Java, Indonesia /." St. John's, NF : [s.n.], 2001.
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Borrego, Luís Miguel Nabais. "Crianças com sibilância recorrente: estudo de função respiratória, avaliação imunológica e polimorfismos genéticos." Doctoral thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2008. http://hdl.handle.net/10362/5149.
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RESUMO
Nos últimos anos têm sido identificados vários factores de risco para asma brônquica
em crianças com sibilância recorrente, não se encontrando clara a importância da
avaliação funcional respiratória nestas crianças. De igual modo, têm sido documentados resultados contraditórios na avaliação imunológica das populações de células reguladoras bem como na expressão de polimorfismos para a asma. O objectivo deste
estudo consistiu na avaliação e comparação de parâmetros de avaliação funcional
respiratória, imunológica e de polimorfismos genéticos em crianças entre 8 e 20 meses
de idade, com três ou mais episódios de sibilância (n=50), sem qualquer terapêutica
anti-inflamatória prévia, diagnosticados por um médico, com e sem factores de risco
para asma brônquica (história de asma parental ou história pessoal de eczema ou pelo menos dois dos seguintes: história pessoal de rinite alérgica, sibilância fora do contexto infeccioso e contagem de eosinófilos no sangue periférico > 4%), comparados com um grupo controlo (n=30). Nestas crianças foram efectuadas provas de função respiratória em volume corrente e em volume aumentado através de técnicas de compressão torácica, avaliação de populações celulares por citometria de fluxo, expressão de citocinas por mARN em culturas de células estimuladas com PMA (leitura às 24 horas)
e com extractos de ácaros do pó doméstico (leitura ao 7º dia) e expressão de
polimorfismos para alguns genes associados a asma (ADAM 33, DPP10, GPRA). Na comparação entre as crianças com sibilância recorrente em relação ao grupo controlo foram observadas reduções significativas nos Z-scores para FVC (diferença média [95%
IC]: -0,7 [-1,2; -0,1], p=0,01), FEV0.5 (-1,0 [-1,5; -0,5], p=0,0001), FEF75 (-0,6
[-1,0; -0,2], p=0,0001) e FEF25-75 (-0,8 [-1,2; -0,4], p=0,0001), bem como valores
significativamente mais baixos para a quantificação do número absoluto de
CD4+CD25forte (-47,9 [-89,6; -6,1], p=0,03), do número absoluto e percentual de
CD4+CD25+CTLA-4 (p=0,0001) e da expressão de CTLA-4 (p=0,03) e IFN- (p=0,04)
nas culturas com extractos de ácaros. As crianças sibilantes com alto risco para asma
tinham, em relação ao grupo sem factores de risco, Z-scores significativamente mais
baixos para FVC (-0,7 [-1,4; -0,04], p=0,04) e FEF25-75 (-0,6 [-1,2; -0,1], p=0,03),2
valores significativamente inferiores do número absoluto das populações CD4+CD25+
(-118,8 [-210,0; -27,5], p=0,01) e CD4+CD25forte (-56,2 [-109,9; -2,5], p=0,04) e ainda uma expressão diminuída de IFN- (p=0,03) em culturas de células estimuladas com extractos de ácaros. Foram encontradas diferenças na expressão de polimorfismos para
os genes GPRA e ADAM 33, não sendo possível tecer extrapolações pelo reduzido número de crianças em estudo. As crianças com sibilância recorrente e alto risco de
asma apresentavam alterações na avaliação funcional respiratória, bem como no número
absoluto de populações celulares com função reguladora e na expressão de IFN- em
culturas celulares estimuladas com extractos de ácaros. Estes resultados realçam a
eventual importância da avaliação das provas de função respiratória e de parâmetros
imunológicos, em crianças com sibilância recorrente e alto risco clínico para asma, nos primeiros dois anos de vida, apesar da sua controversa aplicabilidade individual. O
seguimento prospectivo destas crianças poderá aferir o seu valor preditivo para asma em idade escolar.
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Hemilä, Harri. "Do vitamins C and E affect respiratory infections?" Helsinki : [H. Hemilä], 2006. http://ethesis.helsinki.fi/julkaisut/laa/kansa/vk/hemila/.
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Da, Cruz Manco Sonia. "Streptococcus pneumoniae : involvement of neuraminidase, autolysin and superoxide dismutase in respiratory tract infections." Thesis, University of Leicester, 2010. http://hdl.handle.net/2381/7948.
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Bailey, Julia Vivian. "Doctor-patient communication in consultations for upper respiratory tract infections : a discourse analysis." Thesis, King's College London (University of London), 2007. https://kclpure.kcl.ac.uk/portal/en/theses/doctorpatient-communication-in-consultations-for-upper-respiratory-tract-infections-a-discourse-analysis(48b873c4-38a4-4e73-b619-10cfa3a9504c).html.
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Illnesses such as upper respiratory tract infections (URTls(coughs and colds) are positioned within medical discourse as 'minor' and 'trivial', and consulting doctors with cough and cold symptoms is morally accountable. In this thesis I explore different methodological approaches to understanding doctor-patient consultations for URTls. I critically review quantitative and qualitative approaches to URTI consultation research, and explore qualitative discursive approaches through analyses of consultation data. Data comprise 33 video-taped consultations and post-consultation interviews with inner London general practitioners and patients with cough and cold symptoms, supplemented with ethnographic data. I draw from a range of discursive methodological approaches including conversation analysis, socio-Iinguistic analysis of institutional talk and discursive psychology. I show how discursive approaches can illuminate the complexity and meaning of doctor-patient interaction, exploring the way that coughing is used by patients as an interactional resource. In a detailed micro-analysis, I show that coughing is associated with interactional problems such as misunderstanding and disagreement, and how it also functions as a resource to assert patients' legitimacy. ,. In another detailed analysis, I show that the 'minor' status of coughs and colds (and consequent 'no problem' diagnosis) is associated with interactional difficulty for both doctors and patients: I show how doctors' and patients'legitimacy and 'face' are at stake in a contest to define the meaning of cough and cold symptoms (as significant and treatable, or alternatively, 'no problem'). I discuss conflicts between doctors' and patients' interests: for example, prescribing antibiotics may legitimise the patient but discredit the doctor. . I discuss the way that discourse analytic approaches can contribute richer understandings of doctor-patient interaction through detailed analysis of social transactions in consultation (such as the negotiation of identity and face). I contend that discursive approaches represent valuable and under-utilised resources for research and practice in primary care.
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Yip, Chik-yan, and 葉植恩. "Epidemiology of novel viruses associated with human respiratory tract infections in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41508713.
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Bella, Sinclair, Wallnäs Felicia, Belin Stella, Olby Erik, and Söderberg Hampus. "A Prediction of Antibiotic Resistance with Regard to Urinary and Respiratory Tract Infections." Thesis, Uppsala universitet, Institutionen för biologisk grundutbildning, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352287.
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In this project we set out to find when the resistance level against first line antibiotics would reach 20%. This was executed by first defining relevant bacteria and antibiotics for urinary and respiratory tract infections (UTI's, RTI's). The data was collected from the European Center for Disease Control (ECDC) and the Center for Disease Dynamics, Economics & Policy (CDDEP). The data included the level of resistance for specific years for countries in Europe, as well as for the USA. A prediction model was made using the programming language R. A linear model was used to make a five and ten year prediction. The accuracy was tested. The results were then visualized using R and MATLAB. The results show a big variation between different bacteria and antibiotic combinations. For the two E. coli combinations the resistance is already near 20% for many countries and the resistance is increasing. For the three K. pneumoniae combinations the resistance is high in Southern Europe, meaning many countries have reached or are near 20%. For the two P. aeruginosa combinations there is also a higher resistance in Southern Europe but the resistance is decreasing in most countries. The resistance for E. faecalis is also decreasing and is generally very low in all of Europe. For the only RTI relevant combination, S. pneumoniae and penicillins, the resistance is low and many countries except for Sweden show a decrease in resistance. The USA did not have data for the same time span as Europe and was therefore analyzed separately. For many combinations the USA are near the 20% limit. Only for two combinations the USA showed a decrease in resistance level, and for one of those combinations the prediction is too uncertain to make any assumptions about. For the USA there were two more combinations for RTI than for Europe. For the S. pneumoniae and penicillins combination they have, just as most of Europe, a decreasing resistance. The two combinations with Acinetobacter spp. have a high resistance that is increasing. The main challenge during this project was finding relevant data with a long timespan and with high certainty. The data found is based on invasive isolates which means that the disease which the samples are taken from is not known. The timespan and the certainty of the data affected the accuracy of the prediction model and how long period that could be predicted. The prediction model generated 202 predictions that were visualized. An ethical analysis was made concerning both research ethics and general ethics on the topic of antibiotic resistance. This analysis is meant to acknowledge these questions since we believe they are important when discussing antibiotic resistance. The objective of this project turned out to be more difficult to attain than first believed. This was because of the lack of quality data. Even though we cannot give a clear answer when each country will reach a resistance of 20% this report gives a good understanding of how the situation looks for UTI and RTI relevant bacteria.
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Mortazhejri, Sameh. "Reducing Unnecessary Antibiotic Use for Upper Respiratory Tract Infections by Focusing On Patients." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38088.
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Background: Antibiotics are prescribed frequently for upper respiratory tract infections (URTIs) despite the fact that most of them do not require antibiotics. This over-prescription contributes to antibiotic resistance which is a major health problem. Physicians perceive that patients’ expectations influence their antibiotic prescribing practice.
Methods: As the first phase of the thesis, we conducted a systematic review to determine the effectiveness of patient-oriented interventions to reduce unnecessary use of antibiotics for URTIs. As the second phase, we conducted a qualitative descriptive study to explore patients’ views about URTIs and identify ways they manage them by using semi-structured interviews based on Common Sense-Self-Regulation Model (CS-SRM).
Results: Our systematic review included 14 studies which based on their interventions were classified into two major categories: delayed prescriptions and patient/public information and education interventions. Our meta-analysis revealed that almost all studies with delayed prescription significantly reduced use of antibiotics for URTIs. Our subgroup analysis showed that prescriptions that were given at a later time and prescriptions that were given at the index consultation had similar effects regarding antibiotic use. The small number of included studies in the patient/public information and education group did not allow us to make a definite conclusion on their effectiveness. For the qualitative study, 15 individuals were interviewed. almost all participants mentioned that they only visited their doctor if their symptoms got progressively worse and they could no longer self-manage URTI symptoms. When visiting a doctor, most participants reported that they expected to receive an examination and an explanation for their symptoms.
Discussion: Patient-oriented interventions (especially delayed prescriptions) may be effective in reducing antibiotic use or prescription for URTIs in patients. Further research is needed to investigate the costs and feasibilities of implementing these interventions as part of routine clinical practice. Our participants reported good knowledge regarding the likely lack of benefit from antibiotics for URTIs. The results suggest a discrepancy between our participants’ reported reasons for visiting doctors and doctors’ perceptions about patients’ reason for their visit identified in previous studies. Focusing on interventions that facilitate the communication between patients and doctors, instead of providing more education to public may help in reducing the use of unnecessary antibiotics.
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Yip, Chik-yan. "Epidemiology of novel viruses associated with human respiratory tract infections in Hong Kong." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41508713.
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Bello, Ortí Bernardo. "Haemophilus parasuis host-pathogen interactions in the respiratory tract." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/312855.
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En el sector veterinario, la enfermedad de Glässer es un proceso patogénico frecuente que conduce a pérdidas económicas considerables. Esta enfermedad es causada por Haemophilus parasuis. Aunque se ha llevado a cabo un esfuerzo importante hacia la comprensión de los factores que intervienen en la evolución de la enfermedad, la falta de completa protección de las vacunas comerciales sugieren que debe dirigirse más trabajo hacia el estudio de este proceso patogénico.
Para aumentar el conocimiento en patogénesis desarrollamos una serie de experimentos. Es bien sabido que existen diferentes cepas de H. parasuis, desde no virulentas a altamente virulentas. Ciertos mecanismos patogénicos se atribuyen a la virulencia de algunas cepas, mientras que las cepas no virulentas solamente colonizan el tracto respiratorio superior y no son capaces de causar enfermedad. Estos diferentes grados de virulencia podrían ser apreciados durante los primeros pasos de la infección. De este modo, usando muestras de las vías respiratorias de lechones infectados con dos cepas virulentas (Nagasaki y IT29755) y dos cepas no virulentas (SW114 y F9), se desarrollaron métodos de inmunohistoquímica e inmunofluorescencia, así como una doble tinción de H. parasuis y macrófagos/neutrófilos. Nuestros resultados revelaron que las cepas virulentas de H. parasuis estaban presentes en cornete nasal, tráquea y pulmón. Detalles adicionales mostraron que las cepas virulentas de H. parasuis no solo se asociaron a macrófagos y neutrófilos del pulmón, sino también a células tipo neumocitos. Por lo tanto, las cepas virulentas de H. parasuis fueron capaces de adherirse al epitelio de las vías respiratorias, invadir y diseminarse en el huésped. Por el contrario, las cepas no virulentas apenas se detectan en el tracto respiratorio.
La cepa virulenta Nagasaki mostró patrones de biofilm en tráquea, que nos hizo cuestionar el papel de la formación de biofilm en la infección. Dado que la literatura publicada anteriormente indicaba que la formación de biofilm se presentaba principalmente en cepas no virulentas, se realizó una investigación adicional en esta dirección para comparar la formación de biofilm en cepas virulentas y no virulentas de H. parasuis. Nuestros resultados confirmaron que la capacidad de formar biofilm in vitro se presenta principalmente en cepas no virulentas. Por tanto, se secuenció el transcriptoma de la cepa no virulenta F9 durante su crecimiento en biofilm utilizando un modelo in vitro. Los resultados sugieren que bajo condiciones de biofilm, H. parasuis muestra un metabolismo reducido, demostrado por el perfil de expresión génica. Además, algunos de los genes inducidos en condiciones de biofilm eran específicos de las cepas no virulentas, como la hemaglutinina filamentosa fhaB, previamente asociada a la formación de biofilm en otras bacterias.
Finalmente, la observación de cepas virulentas de H. parasuis en pulmón durante la infección motivó la secuenciación del transcriptoma de una cepa patógena en esta ubicación. Se determinó la expresión génica después de una infección corta in vivo y tras la inoculación de pulmón ex vivo. Los resultados mostraron tendencias comunes en la expresión génica de H. parasuis bajo infección pulmonar in vivo y ex vivo, como la reducción del metabolismo y la expresión de genes implicados en la adquisición de nutrientes, lo que podría indicar una estrategia de supervivencia en estas condiciones. Durante la infección pulmonar también se detectaron genes únicos de cepas virulentas de H. parasuis que codifican para proteínas de membrana externa. Estos genes requerirán una mayor caracterización como factores de virulencia, pudiendo ser también útiles para desarrollar nuevos antibióticos y vacunas. Nuestros resultados también apoyan el uso de explantes de pulmón como modelo para estudios de patogenicidad de otras bacterias respiratorias.In the veterinary field, Glässer’s disease is a common pathogenic process that leads to considerable economic losses. This disease is caused by Haemophilus parasuis. Although considerable effort has been focused towards understanding the factors involved in disease outcome, evidences of lack of complete protection of commercial vaccine formulations suggest that more work should be addressed towards understanding this pathogenic process. To fill this gap in pathogenesis knowledge we developed a series of experiments. It is well known that different H. parasuis strains exist, ranging from non-virulent to highly virulent. Particular pathogenic mechanisms are attributed to virulence strains, while non-virulent strains only colonize the upper respiratory tract and are unable to cause disease. It is expected that these different virulence degrees can be appreciated also during the early steps of infection. Using samples from the respiratory tract of piglets infected with two virulent strains (Nagasaki and IT29755) and two non-virulent strains (SW114 and F9), immunohistochemistry and immunofluorescence methods were developed, as well as a double staining targeting H. parasuis and macrophage/neutrophil cells. Our results revealed that H. parasuis virulent strains were present in nasal, trachea and lung locations. Additional details showed that virulent H. parasuis was associated to macrophages and neutrophils in lung, but also to pneumocyte-like cells. Thus, virulent H. parasuis was able to attach to respiratory tract epithelia, invade and disseminate into the host. On the contrary, non-virulent strains were barely detected in the respiratory tract. Biofilm-like patterns were displayed by virulent Nagasaki strain in trachea and this made us question the role of biofilm formation in infection. Since previously published reports indicated that biofilm formation was mainly present in non-virulent strains, we performed additional research in this direction to compare biofilm formation with virulent and non-virulent H. parasuis strains. Our results confirmed that the capacity to form biofilm in vitro was mainly presented by non-virulent strains. Thus, we sequenced the transcriptome of non-virulent F9 strain under biofilm growth using an in vitro model. Results suggested that under biofilm conditions H. parasuis showed a low metabolic state, as indicated by the gene expression profile. Some of the genes induced under biofilm conditions were specific of non-virulent strains, as the filamentous hemagglutinin fhaB, which has been associated to biofilm formation in other bacteria. Additionally, the observation of virulent H. parasuis strains in the lung during infection inspired us to sequence the transcriptome of a pathogenic strain in this location. Gene expression was determined after a short in vivo infection and after ex vivo lung inoculation. Results showed common trends in H. parasuis gene expression under in vivo and ex vivo lung infection, such as reduced metabolism and higher expression of genes involved in nutrient acquisition, which could indicate a survival strategy under these conditions. Genes unique of virulent H. parasuis strains coding for outer membrane proteins were also detected during lung infection. These genes would require further characterization as virulent factors and could be also useful to develop new antimicrobials and vaccines. Our results also support the use of lung explants as models for pathogenicity studies of respiratory bacteria.
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Obodai, Evangeline [Verfasser]. "Molecular Epidemiology of Respiratory Viruses associated with Acute Lower Respiratory Tract Infections in Children from Ghana / Evangeline Obodai." Berlin : Freie Universität Berlin, 2016. http://d-nb.info/1112133402/34.
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Gibson, Roger L. "Primary prevention of acute respiratory infection among United States Air Force recruits through the use of antimicrobial handwipes : a randomized clinical trial /." Thesis, Connect to this title online; UW restricted, 1996. http://hdl.handle.net/1773/10905.
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Al-sultan, Muhammed S. "Using the medical expenditure panel survey (MEPS) to assess antibiotic utilization in acute respiratory tract infections /." View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3112112.
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Juvonen, R. (Raija). "Respiratory infections and cold exposure in asthmatic and healthy military conscripts." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514287633.
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Abstract
The purpose was to study respiratory infections in a cold environment among young Finnish men. The seasonal variation in the occurrence of respiratory tract infections is well-known, but the impact of cold exposure is obscure. The burden of respiratory tract infections is especially apparent during military service, but the possible risk factors for infections are not.
A total of 892 young military conscripts, 224 men with physician-diagnosed asthma, from the intake groups of July 2004 and January 2005 in Kainuu Brigade, were recruited for the study. In Kajaani area, the average daily temperature is above 10°C only from June to August and all conscripts serve during the cold season, too. The previous history of respiratory tract symptoms, infections, smoking habits and cold sensations were obtained with a questionnaire. Blood samples were taken for determination of the markers of inflammation and infection and peak expiratory flow, height and weight were measured. Data on respiratory tract infections requiring a physician consultation and results of a 12-min running test were collected. The temperature data was obtained from the nearest meteorological station located ca. 15 km from the garrison.
At the beginning of the service, asthmatic men reported to have experienced more respiratory tract symptoms and were in poorer physical condition according to the 12-min running test compared to non-asthmatic men. However, 48% of men with asthma were without medication. After the 180–362 -day service, both men with and without asthma had enhanced their physical fitness as determined with the 12-min running test. At the same time, the levels of high sensitive C-reactive protein as a marker of low-grade inflammation, decreased.
Infection episodes requiring physician consultation were more common among men with, rather than without, asthma. Chlamydia pneumoniae infections were mostly mild upper respiratory tract infections, common cold and sinusitis, and were as common in asthmatic as in non-asthmatic men. However, prolonged Chlamydia pneumoniae infections were more common among asthmatic men. Obesity and previous respiratory tract infections were independent risk factors for frequent infections among men with 180-day service.
There was a typical seasonal variation in respiratory tract infections among conscripts: most infections occurred in the wintertime. The men with 180-day service had most infections during the first three months of the service, both in the July and January intake groups. Temperature was significantly associated with the occurrence of respiratory infection episodes. The most common temperature for the onset of an episode was in the outdoor temperature range of 0°C to –5°C. Respiratory tract infections were preceded by linearly decreasing outdoor temperature, the coldest day being the day before physician consultation.
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Cheung, Wai-yee Betty. "Factors affecting the severity and duration of outbreaks of upper respiratory tract infection in kindergartens in Hong Kong case-control study /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994652.
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Pascoal, LÃvia Maia. "DiagnÃsticos de enfermagem respiratÃrios em crianÃas com infecÃÃo respiratÃria aguda: um estudo longitudinal." Universidade Federal do CearÃ, 2011. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7380.
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nÃo hÃNo Ãmbito da enfermagem, os estudos de acurÃcia contribuem com a melhoria da qualidade da assistÃncia por permitir a identificaÃÃo de caracterÃsticas definidoras com bom poder preditivo e influenciar diretamente na escolha do diagnÃstico de enfermagem adequado a cada situaÃÃo clÃnica. Devido à importÃncia de pesquisas relacionadas a essa temÃtica, este estudo foi realizado com o objetivo de analisar a capacidade preditiva das caracterÃsticas definidoras dos diagnÃsticos de enfermagem âPadrÃo respiratÃrio ineficaz (PRI), DesobstruÃÃo ineficaz das vias aÃreas (DIVA) e Troca de gases prejudicada (TGP)â em crianÃas com infecÃÃo respiratÃria aguda (IRA). Foi desenvolvido um estudo de coorte aberta, nos meses de janeiro a junho de 2011, em dois hospitais infantis da rede pÃblica do municÃpio de Fortaleza-CE. A amostra foi composta por 136 crianÃas as quais foram acompanhadas por um perÃodo mÃnimo de seis e mÃximo de dez dias. Para a coleta de dados, foi utilizado um instrumento baseado nas caracterÃsticas dos diagnÃsticos estudados e na literatura pertinente acerca da avaliaÃÃo pulmonar. Os dados foram coletados atravÃs de exame fÃsico da crianÃa e entrevista com os responsÃveis. As informaÃÃes obtidas foram analisadas pela pesquisadora para determinar a presenÃa ou ausÃncia das caracterÃsticas de PRI, DIVA e TGP e posteriormente foram encaminhados para enfermeiros diagnosticadores que executaram o processo de inferÃncia diagnÃstica. Foram utilizados os softwares Excel e PASW para organizaÃÃo e anÃlise estatÃstica dos dados. O nÃvel de significÃncia adotado foi de 5%. A anÃlise da evoluÃÃo temporal dos diagnÃsticos DIVA, TGP e PRI mostrou uma tendÃncia curvilÃnea, com reduÃÃo ao longo do perÃodo de acompanhamento. Para DIVA e PRI, verificou-se uma distribuiÃÃo semelhante apesar de terem ocorrido em proporÃÃes diferentes, mas DIVA manteve altos valores nos dez dias de seguimento. Quanto Ãs medidas de acurÃcia, as caracterÃsticas mais acuradas para predizer a ocorrÃncia de DIVA, TGP e PRI foram RuÃdos adventÃcios respiratÃrios, Hipoxemia e Uso de musculatura acessÃria para respirar, respectivamente. Todas as crianÃas avaliadas desenvolveram DIVA atà o final do tempo de acompanhamento e nenhuma relaÃÃo estatisticamente significante foi encontrada entre o tempo de sobrevida e as variÃveis analisadas. Do total de crianÃas acompanhadas, 86,76% desenvolveram TGP durante o perÃodo de acompanhamento. O tempo de internamento foi a Ãnica variÃvel que apresentou correlaÃÃo estatisticamente significante com o tempo de sobrevida. A mediana do tempo de sobrevida para PRI foi de um dia e do total de crianÃas acompanhadas, 86,76% desenvolveram este diagnÃstico durante o perÃodo de seguimento. Com base na anÃlise de correspondÃncias mÃltiplas, as caracterÃsticas que melhor auxiliam na diferenciaÃÃo entre os diagnÃsticos estudados sÃo: ExpectoraÃÃo, Tosse ausente, VocalizaÃÃo dificultada e RuÃdos respiratÃrios adventÃcios para DIVA; AgitaÃÃo e Irritabilidade para TGP e AlteraÃÃo na profundidade respiratÃria, Uso de musculatura acessÃria para respirar e RespiraÃÃo anormal para PRI. Estudos desta natureza sÃo importantes por fornecer informaÃÃes sobre a capacidade preditiva das caracterÃsticas definidoras bem como a evoluÃÃo temporal e as particularidades dos diagnÃsticos de enfermagem respiratÃrios em crianÃas com infecÃÃo respiratÃria aguda.
Through nursing subject, studies of accuracy contribute to improve the quality of care by allowing the identification of defining characteristics (DC) with good predictive power and directly influence the choice of nursing diagnosis appropriate to each clinical situation. Because the importance of research related to this subject, this study was made with the goal to analyze the predictive ability of the DC of nursing diagnoses Ineffective Breathing Pattern (IBP), Ineffective airway clearance (IAC) and Impaired gas exchange (IGE) in children with acute respiratory infection (ARI). It was developed an open cohort study in the months January to June 2011, two children hospitals in the public network in Fortaleza-CE. The sample was consisted of 136 children, who were followed for a minimum period of six and maximum of ten days. To collect the data, it was used an instrument based on the characteristics of the diagnostics studied and some relevant literature about the lung evaluation. The data were collected through examination of the child and interview with their responsibles. The information obtained was analyzed by the researcher to determine the presence or ausence of the characteristics of IBP, IAC and IGE and lately were sent to nurses diagnosticians that performed the diagnostic inference process. It was used Excel and PASW software for organizing and analyzing statistical data. The level of significance was 5%. The temporal evolution of the diagnostics IAC, IBP and IGE showed a curvilinear trend, with reduction over the monitoring period. For IAC and IBP, there was a similar distribution although they occurred in different proportions, but IAC maintained high values in ten days of follow-up. The measures of accuracy, the characteristics more accurated for predicting the occurrence of IAC, IGE and IBP were respiratory rales, hypoxemia and use of accessory muscles to breathe, respectively. All children evaluated IAC developed by the end of follow-up time and no statistically significant relationship was found between survival time and the variables analyzed. Of the total number of children followed, 86.76% developed IGE during the follow-up period. The time of hospital staying was the only variable that showed a correlation statistically significant with survival time. The median survival time for IBP was a day of total and accompanied children, 86.76% developed this diagnosis during the study period. Based on the analysis of multiple matches, the best characteristics that assist in differentiating between the diagnoses studied are: expectoration, cough absent, Speech and difficult to IAC adventitious breath sounds, agitation and irritability for IGE and Change in the depth of breathing, use of accessory muscles breathing and anormal breathing for IBP. Studies of this nature are important for providing information about the predictive ability of the defining characteristics and the temporal evolution and characteristics of the respiratory nursing diagnoses in children with acute respiratory infection.
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Chorazy, Margaret Lynn. "Polymicrobial respiratory tract infections in a hospital-based pediatric population, with particular emphasis on the role of human rhinoviruses." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/788.
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Pediatric acute respiratory tract infections (ARTIs) are a leading cause of morbidity and mortality. The objectives of this study were to describe the epidemiology of polymicrobial ARTI in a hospital-based pediatric population and to investigate the association of polymicrobial infection and severity of illness.
We conducted a retrospective study of 559 archived respiratory specimens from 421 children under the age of 10 years collected from March 28, 2008 through June 30, 2009 and stored by the University of Iowa Hospital and Clinics Clinical Microbiology Laboratory. Specimens were tested by immunofluorescence assay and/or viral culture at the time of collection (influenza A and B, parainfluenza [PIV] 1-3, respiratory syncytial virus [RSV], adenovirus [Ad]) and uniformly by RT-PCR (human metapneumovirus [hMPV], rhinovirus [HRV], human bocavirus [HBoV]) and PCR (Ad) for the current study. Demographic and clinical data were abstracted from electronic medical records.
Results from this study suggest that polymicrobial respiratory tract infections are common in this population. A virus was identified in 61.3% of 349 respiratory specimens from children with confirmed or suspected ARTI. HRV (27.5%), RSV (18.9%), HBoV (8.3%), hMPV (7.7%), and PIV (6.6%) were the most common viruses detected. A viral coinfection was identified in 21.5% of the 214 virus-positive specimens and was most often detected for Ad (53.3% of 15 Ad-positive specimens), HBoV (51.7% of 29 HBoV-positive specimens), PIV (43.5% of 23 PIV-positive specimens), HRV (35.4% of 96 HRV-positive specimens), and RSV (34.8% of 66 RSV-positive specimens). Among the 46 specimens with dual or triple viral coinfections detected, the most frequent virus-virus combination was HRV-RSV (n=12).
We hypothesized that certain host-specific risk factors were associated with the likelihood of viral coinfection. While none of the covariates in the final model were significant, the results were suggestive. Male gender (OR 1.70, 95% CI 0.83-3.46), age between 6 months to 1 year (as compared to children less than 6 months old, OR 2.15, 95% CI 0.75-6.19), and history of any chronic condition that may result in immunosuppression (OR 2.05, 95% CI 0.99-4.23) were each associated with increased odds of viral coinfection (p > 0.05).
We also hypothesized that children with coinfections would be more likely to have severe ARTI. Children with viral-bacterial coinfection, as compared to children with viral mono-infection, were more likely to be admitted to an intensive care unit (OR 6.00, 95% CI 2.51-14.33) even after controlling for age, history of prematurity, urban/rural residence, and leukocytosis.
This study will inform medical and public health professionals with regard to the epidemiology of polymicrobial infections and their potential importance as a cause of severe acute respiratory tract infection in children. Furthermore, results of this study may contribute to the ongoing discussion of the importance of diagnostic ability to reliably detect multiple concurrent pathogens in a single individual.
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Neumark, Thomas. "Treatment of Respiratory Tract Infections in Primary Care with special emphasis on Acute Otitis Media." Doctoral thesis, Linköpings universitet, Allmänmedicin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-54832.
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Background and aims: Most respiratory tract infections (RTI) are self-limiting. Despite this, they are associated with high antibiotic prescription rates in general practice in Sweden. The aim of this thesis was to evaluate the management of respiratory tract infections (RTIs) with particular emphasis on acute otitis media (AOM). Methods: Paper I: A prospective, open, randomized study of 179 children presenting with AOM and performed in primary care. Paper II & III: Study of 6 years data from primary care in Kalmar County on visits for RTI, retrieved from electronic patient records. Paper IV: Observational, clinical study of 71 children presenting with AOM complicated by perforation, without initial use of antibiotics. Results: Children with AOM who received PcV had some less pain, used fewer analgesics and consulted less, but the PcV treatment did not affect the recovery time or complication rate (I). Between 1999 and 2005, 240 445 visits for RTI were analyzed (II & III). Antibiotics were prescribed in 45% of visits, mostly PcV (60%) and doxycycline (18%). Visiting rates for AOM and tonsillitis declined by >10%/year, but prescription rates of antibiotics remained unchanged. For sore throat, 65% received antibiotics. Patients tested but without presence of S.pyogenes received antibiotics in 40% of cases. CRP was analyzed in 36% of consultations for RTI. At CRP<50mg/l antibiotics, mostly doxycycline, were prescribed in 54% of visits for bronchitis. Roughly 50% of patients not tested received antibiotics over the years.Twelve of 71 children with AOM and spontaneous perforation completing the trial received antibiotics during the first nine days due to lack of improvement, one child after 16 days due to recurrent AOM and six had new incidents of AOM after 30 days (IV). Antibiotics were used more frequently when the eardrum appeared pulsating and secretion was purulent and abundant. All patients with presence of S.pyogenes received antibiotics. Results: Children with AOM who received PcV had some less pain, used fewer analgesics and consulted less, but the PcV treatment did not affect the recovery time or complication rate (I). Between 1999 and 2005, 240 445 visits for RTI were analyzed (II & III). Antibiotics were prescribed in 45% of visits, mostly PcV (60%) and doxycycline (18%). Visiting rates for AOM and tonsillitis declined by >10%/year, but prescription rates of antibiotics remained unchanged. For sore throat, 65% received antibiotics. Patients tested but without presence of S.pyogenes received antibiotics in 40% of cases. CRP was analyzed in 36% of consultations for RTI. At CRP<50mg/l antibiotics, mostly doxycycline, were prescribed in 54% of visits for bronchitis. Roughly 50% of patients not tested received antibiotics over the years.Twelve of 71 children with AOM and spontaneous perforation completing the trial received antibiotics during the first nine days due to lack of improvement, one child after 16 days due to recurrent AOM and six had new incidents of AOM after 30 days (IV). Antibiotics were used more frequently when the eardrum appeared pulsating and secretion was purulent and abundant. All patients with presence of S.pyogenes received antibiotics.
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Idahosa, Lewis. "Treatment of Respiratory Tract Infections with a Pelargonium sidoides Extract (EPs® 7630) : - Literature study." Thesis, Umeå universitet, Kemiska institutionen, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-71125.
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Nelson, Andrew. "An investigtion of the polymicrobial nature of lower respiratory tract infections in cystic fibrosis patients." Thesis, Northumbria University, 2011. http://nrl.northumbria.ac.uk/5842/.
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Cystic fibrosis (CF) is a genetically inherited condition most prevalent amongst Caucasians. In previous studies, it has been demonstrated that bacterial, fungal and viral pathogens cause lung function decline and ultimately result in death due to respiratory failure. Patients with CF produce sputum daily, which makes it an ideal infection to study in terms of access to samples. However, it is unknown how transport of the samples from the patient to the laboratory will affect the results of molecular microbiological analysis. We found that the bacterial community profiles were significantly different in samples stored at room temperature from those which were refrigerated. Furthermore, a significant increase in bacterial load and numbers of Pseudomonas spp. and a significant decrease in number of H. influenzae were seen in the samples stored at room temperature. In this study we also aimed to characterise the factors which have an effect on the bacterial and fungal communities present in the CF lung in patients who possessed the F508del CFTR allele. We found that gender was a significant factor in the assembly of bacterial communities, due to a reduction in bacterial diversity and community evenness. Furthermore, we identified that P. aeruginosa colonisation affected bacterial community composition. We have also identified that bacterial community assembly in the CF lung appears to be stochastic. However, our data also shows that gender and P. aeruginosa colonisation affect assembly suggesting that, in some respects, a deterministic community assembly is also being observed. Our data also suggests that fungal communities are more diverse than is currently recognised. Additionally, we have found that patients who are homozygous for the F508del CFTR mutation harbour more rich fungal communities than patients who are heterozygous. A further objective was to follow these patients longitudinally to determine the stability of the CF lung microbiota, to determine the effects of antibiotic therapy, and to assess if any changes occurred in the CF lung during times of pulmonary exacerbation which could be identified as the causative agent. We did not find a significant relationship between exacerbations and the bacterial communities present in CF. However, in one patient we found that a particular bacterial taxa was present when the patient presented with an exacerbation but was absent when the patient was stable, suggesting that acquisition of a new bacterial taxa can potentially cause an exacerbation. We also found that an increase in bacterial load was not the cause of exacerbations in our cohort. Furthermore, the presence and abundance of fungal species was found not to be the cause of exacerbations.
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Cannings-John, Rebecca. "Examining the inter-relationships between antibiotic prescribing, complications and resistance in acute respiratory tract infections." Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/47245/.
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The threat to public health from antibiotic resistance has increased, with growing evidence that antibiotic use is a major driver of resistance. This has led to campaigns to reduce prescribing of antibiotics by GPs, particular for respiratory tract infections (RTIs). These are among the most common reasons for prescribing antibiotics in primary care, in spite of the fact that there is evidence that most RTIs recover at a similar rate without antibiotic treatment, rarely resulting in complications if untreated. There are concerns, that a ‘blanket’ reduction in prescribing may occur, with reductions in prescribing that may benefit patients, leading to an increase in complications that can arise from untreated RTIs. The aim of this thesis was to explore the relationships between community antibiotic dispensing, complications from RTIs and resistance. We showed that decreasing rates of antibiotic dispensing in Wales coincided with increases in hospital diagnosed complications such as pneumonia and septicaemia from 1996-2006. At a practice level, there was evidence of a negative association between dispensing and complications. While a positive association was found between lagged dispensing and resistance, no clear pattern was found between change in dispensing and resistance for any of the organism/ antibiotic combinations examined possibly due to a lack of power. At an individual patient level, antibiotics are not justified to reduce the risk of a complication in those diagnosed with an acute RTI or sore throat. However, for patients presenting with a chest infection, the risk of developing a complication is higher and antibiotics appear to reduce the risk of complications; GPs should therefore consider prescribing for these patients. Further research is required to examine different lag periods of dispensing and their association with resistance and also to identify subgroups of patients at high risk of complications to help GPs target their prescribing of antibiotics.
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Kiessig, Michael, and Michael Kiessig. "The effect of "fusafungine" on the incidence of upper respiratory tract symptoms in ultradistance runners." Master's thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/25545.
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Fusafungine is an antibiotic of fungal origin with a potent local anti-inflammatory action (German-Fattal, 1995; German-Fattal, 1996). It is administered locally to the nasal and pharyngeal mucosa by spray. It can be hypothesised that the anti-inflammatory action of fusafungine may decrease the development of mucosa! inflammation in such a manner that the incidence of symptoms of upper respiratory tract infection may be reduced if it is administered before, during and after completion of an ultramarathon. Furthermore, fusafungine could also reduce the risk of secondary bacterial infection. The potential value of fusafungine in reducing the symptoms of upper respiratory tract infections or the development of bacterial upper respiratory infection is the focus of this thesis.
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Cranston, Tracy E. "The effect of exercise training on the severity and duration of an upper respiratory tract infection." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941357.
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Although upper respiratory tract infections (URTI) are the most frequent illness among humans, insufficient evidence exists to determine if exercise training during an URTI may prolong or intensify an URTI. The purpose of this investigation was to determine the effect of exercise training on the severity and duration of URTI symptoms. Following serological screening, those subjects who were rhinovirus 16 (RV 16) antibody-free completed a graded exercise test. Thirty-four individuals (ages 18-29 years) of moderate fitness (between 32 ml/kg"1/miri 1- 60 ml/kg 1/min"1) were randomly assigned to the exercise group (EX) while 16 individuals of similar age served as a nonexercise control group (CTL). All subjects were inoculated with RV 16 on two consecutive days. EX subjects completed 40 minutes of supervised exercise at 70% of heart rate reserve within 18 hours of each inoculation and then exercised every other day for the next eight days (total of six exercise sessions). Immediately following each exercise period subjects completed a symptom checklist. EX subjects were strongly encouraged to abstain from any additional physical activity while the CTL group was encouraged to be as sedentary as possible for ten days beginning the first day of inoculation. Prior to the first inoculation and every 12 hours afterwards all subjects completed a 13 item symptom severity checklist and a physical activity log (e.g., minutes of walking, and hours of work). Used facial tissues were collected and weighed during these same reporting periods. One-way analysis of variance indicated that there! was no significant difference between groups with respect to additional physical activity. Two-way analysis of variance indicated that there were no significant differences in either the severity or duration of an URTI (symptom scores, mucous weights) between the EX and CTL groups for any given day. Further, no significant differences were observed between the pre and post exercise symptom scores for the EX group. These results suggests that moderate exercise training during a rhinovirus-caused URTI does not appear to alter the severity and duration of the illness. This was the first study to examine the influence of exercise on symptom severity and duration during an URTI. Additional studies should be performed utilizing various exercise prescriptions (e.g. intensity, frequency and duration), subject populations (e.g. younger and older), and fitness levels (e.g. sedentary, and highly fit).School of Physical Education
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De, Kwaadsteniet Michele. "Characterization of nisin F and its role in the control of respiratory tract and skin infections." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1285.
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Thesis (PhD (Microbiology))--University of Stellenbosch, 2009.Multidrug resistant strains of Staphylococcus aureus is presenting an increasing threat, especially immune compromised individuals. Many of these strains have developed resistance to newly approved drugs such as quinupristin-dalfopristin, linezolid and daptomycin. The search for alternative treatment, including bacteriocins (ribosomally synthesized antimicrobial peptides) of lactic acid bacteria is increasing . Lactococcus lactis subsp. lactis F10, isolated from freshwater catfish, produced a new nisin variant active against clinical strains of S. aureus. The operon encoding nisin F is located on a plasmid and the structural gene has been sequenced. The lantibiotic is closely related to nisin Z, except at position 30 where valine replaced isoleucine. The antimicrobial activity of nisin F against S. aureus was tested in the respiratory tract of Wistar rats. Non-immunosuppressed and immunosuppressed rats were intranasally infected with S. aureus K and then treated with either nisin F or sterile physiological saline. Nisin F protected immunosuppressed rats against S. aureus, as symptoms of an infection were only detected in the trachea and lungs of immunosuppressed rats treated with saline. The safety of intranasally administered nisin F was also evaluated and proved to have no adverse side effects. The potential of nisin F as an antimicrobial agent to treat subcutaneous skin infections was evaluated by infecting C57BL/6 mice with a bioluminescent strain of S. aureus (Xen 36). Immunosuppressed mice were treated with either nisin F or sterile physiological saline 24 h and 48 h after infection with subcutaneously injected S. aureus Xen 36. Histology and bioluminescence flux measurements revealed that nisin F was ineffective in the treatment of deep dermal staphylococcal infections. Non-infected and infected mice treated with nisin F had an influx of polymorphonuclear cells in the deep stroma of the skin tissue. This suggested that nisin F, when injected subcutaneously, may have modulated the immune system. Nisin F proved an effective antimicrobial agent against S. aureus-related infections in the respiratory tract, but not against subcutaneous infections. The outcome of nisin F treatment thus depends on the route of administration and site of infection.
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Promwong, Charuporn. "The effect of viral respiratory tract infections on inflammatory cell responses in acute exacerbations of asthma." Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242109.
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Vieira, Margarida Clara Rodrigues Mota. "Acute respiratory tract infections in children at 24 month of age: cumulative incidence and risk factors." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55391.
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Thors, Valtyr Stefansson. "Effects of viral infections on upper respiratory tract bacterial colonisation in children - observational and interventional studies." Thesis, University of Bristol, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702186.
Full textAbstract:
Prevalence of the common nasopharyngeal colonisers, S. pneumoniae, S. pyogenes, N. meningitidis, M. catarrhalis, H. influenzae and S. aureus depends on several factors. The aim was to explore associations between viral infections (URTI) and prevalence and density of bacteria in the nasopharynx, first in an observational cohort study (2011-12) and subsequently in a randomised, laboratory blinded intervention study (2012-13) using nasal flu vaccine (LAIV). Quantitative PCR (qPCR) assays were developed and validated to efficiently detect and quantify target organisms. 161 healthy children were recruited to the first study and 151 to the second, all attending nurseries in Bristol, UK. All had repeated nasopharyngeal swabs taken and stored in STGG broth. qPCR was used for detecting respiratory viruses and six bacterial species. t-tests and logistic regression models were used for analysis. Carriage rates of S. pneumoniae, M. catarrhalis and H. influenzae were high (78.8%, 85.7% and 85.0%, respectively) in both studies, remained stable throughout the study period and were more frequently found at higher density (>1000 gene copies/ml) in comparison with other species. Younger age was associated with higher density which was explained by more frequent respiratory viruses and nasal discharge which both were independently associated with higher bacterial density of S. pneumoniae, M. catarrhalis and H. influenzae. In the randomised controlled study, LAIV led to a delayed six-fold increase in pneumococcal density when compared to controls. Multivariable analyses showed that LAIV was also associated with increases in M. catarrhalis, H. influenzae and S. aureus density. The observed effects of LAIV provide a valuable potential tool for studying transmission of bacteria. Further studies of the biology of respiratory bacteria and viruses, including bacterial and host transcriptomics, may provide valuable information to inform vaccine design and epidemiological models to predict the indirect effects and thus overall effectiveness of both viral and bacterial vaccines.
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De, Kwaadsteniet Michèle. "Characterization of nisin F and its role in the control of respiratory tract and skin infections /." Link to the online version, 2009. http://hdl.handle.net/10019.1/1285.
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Montes, Mary Elizabeth. "Decreasing Antibiotic Overuse in Upper Respiratory Tract Infections Through an Educational Intervention Aimed at Nurse Practitioners." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/265342.
Full textAbstract:
The purpose of the study was to evaluate the effect of an educational intervention, aimed at nurse practitioners, on increasing knowledge and decreasing prescribing habits of antibiotics in upper respiratory tract infections. The Centers for Disease Control and Prevention currently estimates that nearly fifty percent of antibiotics prescribed in the outpatient setting are unnecessary. The world health organization states that antibiotic overuse is becoming a growing problem worldwide. Numerous studies have been completed targeting physicians and patients, but no long term decrease in antibiotic prescribing has been seen. As the number and role of nurse practitioners increase, this intervention was aimed to target a specially this specially educated group. Research has shown that nurse practitioners have equal outcomes and equal to higher patient satisfaction ratings when compared to physician counterparts. Thus, this group may help to decrease antibiotic overuse. Lewin's three step change theory served as the conceptual framework. The theory uses initial unfreezing, then finding a new equilibrium and finally refreezing, thus creating a new baseline for participants. A sample of fifty one nurse practitioners participated in the one group pretest/posttest/4-week posttest measuring knowledge and intention. Knowledge was measure using the questionnaire results; intention was measured by reviewing Likert-type rankings. Change in knowledge was found to be statistically significant, demonstrating that education will affect knowledge. However, intention was not found to be statistically significant. Intention did increase during the study, but not enough to show that there was an overall statistically significant effect.
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Vieira, Margarida Clara Rodrigues Mota. "Acute respiratory tract infections in children at 24 month of age: cumulative incidence and risk factors." Dissertação, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/55391.
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Turnberg, Wayne L. "Respiratory infection control practices among healthcare workers in primary care and emergency department settings /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/8475.
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Andrade, Livia Zulmyra Cintra. "AvaliaÃÃo do espectro e da acurÃcia dos indicadores clÃnicos de desobstruÃÃo ineficaz de vias aÃreas em crianÃas com infecÃÃo respiratÃria aguda." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11291.
Full textAbstract:
A falta de familiaridade dos enfermeiros assistencialistas com os sistemas de classificaÃÃo de diagnÃsticos de enfermagem, assim como, a subjetividade inerente ao processo de raciocÃnio diagnÃstico, dificultam a implementaÃÃo desta ferramenta no ambiente de trabalho. Isto corrobora para uma maior incerteza e inseguranÃa na determinaÃÃo e diferenciaÃÃo das respostas humanas. Assim, estudos de testes diagnÃsticos em populaÃÃes especÃficas podem contribuir para facilitar o uso destes fenÃmenos de enfermagem na prÃtica clÃnica. Objetivou-se avaliar a acurÃcia e o espectro de manifestaÃÃo dos indicadores clÃnicos do diagnÃstico de enfermagem DesobstruÃÃo ineficaz de vias aÃreas (DIVA), em crianÃas com infecÃÃo respiratÃria aguda (IRA). Foi desenvolvido um estudo transversal, em um hospital infantil da rede pÃblica do municÃpio de Fortaleza (CE), nos meses de abril a agosto de 2013. A amostra foi composta por 192 crianÃas com IRA. Para a coleta dos dados, realizou-se uma avaliaÃÃo pulmonar das crianÃas e entrevista com os responsÃveis. Estes dados foram analisados pela pesquisadora para determinaÃÃo da presenÃa ou ausÃncia dos indicadores de DIVA, bem como de seus espectros de manifestaÃÃo, com base em um protocolo de pesquisa. Posteriormente, essas informaÃÃes foram encaminhadas a enfermeiros diagnosticadores, para inferir a probabilidade subjetiva de ocorrÃncia do diagnÃstico de enfermagem. Para a anÃlise estatÃstica, foram utilizados os pacotes estatÃsticos SPSS e R, e adotado um nÃvel de significÃncia de 5%. A maior parte das crianÃas era do sexo masculino (59,4%), com idade mÃdia de 23,13 meses. Pneumonia (67,7%) e Bronquiolite (20,8%) foram as principais infecÃÃes respiratÃrias encontradas. DIVA esteve definitivamente presente em 71,9% das crianÃas, e, definitivamente ausente em 7,3% das avaliadas. Os indicadores com maior prevalÃncia foram: Tosse ineficaz (93,2%), RuÃdos adventÃcios respiratÃrios (82,8%), Dispneia (67,8%), Quantidade excessiva de muco (67,7%), Ortopneia (50,5%), MudanÃas no ritmo respiratÃrio (47,4%) e MudanÃas na frequÃncia respiratÃria (46,9%). Dispneia, InquietaÃÃo, Ortopneia, Quantidade excessiva de muco, RuÃdos adventÃcios respiratÃrios e Tosse ineficaz apresentaram relaÃÃo linear significativa com a identificaÃÃo de DIVA. Ademais, a manifestaÃÃo de espectros mais graves de Dispneia, Ortopneia, RuÃdos adventÃcios respiratÃrios e Tosse ineficaz foram associados à maior probabilidade de ocorrÃncia do diagnÃstico DIVA. Quanto Ãs medidas de acurÃcia, RuÃdos adventÃcios respiratÃrios, Tosse ineficaz, Dispneia, Ortopneia, InquietaÃÃo, Quantidade excessiva de muco e Sons respiratÃrios diminuÃdos, foram os indicadores mais importantes para DIVA, segundo atitude de baixo e moderado conservadorismo apresentado pelo diagnosticador. Diagnosticadores mais conservadores atribuÃram maior importÃncia para os indicadores RuÃdos adventÃcios respiratÃrios, Quantidade excessiva de muco, Tosse ineficaz e InquietaÃÃo. Acredita-se que a investigaÃÃo dos indicadores clÃnicos de DIVA e a anÃlise estatÃstica das medidas de acurÃcia destes indicadores, em crianÃas com IRA, podem contribuir para embasar o raciocÃnio diagnÃstico e a assistÃncia de enfermagem prestada a estes pacientes. No entanto, destaca-se que o comportamento dos indicadores clÃnicos sofrem variaÃÃes, de acordo com peculiaridades de cada populaÃÃo. Assim, acredita-se que novos estudos sÃo necessÃrios.
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Deangelis, Julie Ann. "To treat or not to treat : the role of antibiotics in the management of community-acquired respiratory tract infections in an ambulatory setting /." View online ; access limited to URI, 2008. http://0-digitalcommons.uri.edu.helin.uri.edu/dissertations/AAI3314453.
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Wheeler, Anthony John. "Upper respiratory tract infections, adenotonsillar hypertrophy and atopy in children : can adenotonsillectomy be avoided with medical treatment?" Thesis, University College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428549.
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Goto, Masashi. "Influence of loxoprofen use on recovery from naturally acquired upper respiratory tract infections : a randomized controlled trial." Kyoto University, 2007. http://hdl.handle.net/2433/135776.
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Guo, Jing, and 郭婧. "Effect of vitamin D supplementation on prevention of upper respiratory tract infections : a systematic review of randomized controlled trials / y Guo Jing." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193840.
Full textAbstract:
Background
The prevention of chronic diseases has always been a major focus in the medical field as a measure to improve public health. As a potential prevention to one of the most common chronic diseases, vitamin D was previously reported to show some signs of positive effect on the prevention of upper respiratory tract infections. Although trials were performed to demonstrate the association between the effectiveness of vitamin D and upper respiratory tract infections in the past few years, the number of randomized controlled trials was limited. Only one systematic review with meta-analysis was carried out to study the effect of vitamin D supplementation on prevention of respiratory tract infections (Charan et al., 2012).
Aim
A systematic review of the existing evidence was carried out with the aim to examine the effectiveness of vitamin D supplementation as an intervention in prevention of upper respiratory tract infections.
Method
Studies were selectively chosen based on the inclusion and exclusion criteria. Retrieval of studies was performed and identified from MEDLINE (Ovid) and PUBMED. MeSH terms of “Vitamin D” and “Upper respiratory tract infections” were applied in the search. Only randomized controlled trials were selected. Non-English publications, reviews, discussions, conference papers, and publications with outcomes being not incidence of URTI, were excluded. The quality of each study was evaluated using the Jadad scale (Jadad et al., 1996). Data from the trials was extracted into the meta-analysis, and odds ratios and confidence intervals were used as measures of the association between vitamin D supplementation and incidence of upper respiratory tract infections across studies.
Result
Five randomized controlled trials were included in this review. In this meta-analysis, the number of events of upper respiratory tract infections in vitamin D group was lower than that in the placebo group (OR=0.53), suggesting that a 47% lower odds of falling in vitamin D groups than in controls. The 95% confidence interval ranged from 0.30to 0.93and did not include 1, suggesting that the effect of vitamin D on prevention of upper respiratory tract infections was significant. However, when the trials were divided into children and adult groups, the results were significantly different. The result of the trials with two children gave an OR of 0.33(95%CI: 0.13, 0.83), meaning a positive effect of vitamin D could be observed in the vitamin D group, compared to the placebo group. Meanwhile, three trials on adults had an OR of 0.78 (95%CI: 0.56, 1.09), which was insufficient to suggest the two groups were different.
Conclusion
While the positive effect of vitamin D supplementation for the prevention of upper respiratory tract infections is evident on children in this review, it is much less significant on adults due to inconsistencies in the results. Therefore, more research and trials with improved methodologies would be required in the future to increase our understanding and provide more certainty on this matter.published_or_final_version
Public Health
Master
Master of Public Health
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Piedade, Cátia Marina Rodrigues da. "Etiologia das infeções respiratórias virais em crianças em idade pré-escolar." Master's thesis, Faculdade de Ciências Médicas. UNL, 2013. http://hdl.handle.net/10362/9999.
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RESUMO: Os vírus respiratórios continuam a ocupar um papel relevante na morbilidade e mortalidade infantil, tendo na última década sido alargado o espectro de vírus potencialmente causadores das infeções respiratórias. O diagnóstico destas infeções
pode ser efetuado por várias metodologias, sendo as técnicas de biologia molecular
consideradas as mais sensíveis para este fim.
No âmbito do Projeto Ambiente e Saúde em Creches e Infantários (ENVIRH) foi efetuada uma comparação da prevalência dos principais vírus respiratórios em crianças em idade pré-escolar, com critérios de infeção respiratória, recorrendo a técnicas de biologia molecular, em duas populações: crianças que se encontravam na escola/domicilio e crianças que recorreram a uma urgência hospitalar.
O estudo decorreu em dois períodos, de Fevereiro a Maio de 2011 e de Outubro
de 2011 a Abril de 2012. Foram efetuadas duas colheitas de zaragatoas, uma nasal e
outra orofaríngea. A metodologia utilizada para a identificação viral nas amostras foi a
PCR e RT-PCR multiplex em tempo real. Os vírus pesquisados foram: Influenza A e B,
Parainfluenza 1-4, Metapneumovirus humano, Vírus Sincicial respiratório (VSR),
Rinovírus, Enterovírus, Coronavírus e Bocavirus.
Foram realizadas 100 colheitas em crianças com idades compreendidas entre os
5 meses e os 5 anos. Foram obtidas 64 amostras dos infantários/domicílios, das quais 47 foram positivas. Da urgência Hospitalar obtiveram-se 36 amostras, em que 32 foram positivas. O vírus da gripe A (H3) foi o mais frequentemente detetado nas duas
populações, mas apenas durante o surto de 2012. O VSR e os adenovírus foram mais
frequentes nas crianças que recorreram ao hospital, ao contrário dos enterovirus e dos
coronavírus, que não foram detetados nesta população. Os bocavirus nunca foram
detetados isoladamente.
Este estudo reforça a importância de se utilizarem técnicas de biologia molecular
para o diagnóstico etiológico das infeções respiratórias, devido à elevada sensibilidade
das mesmas, o que se reflete na elevada percentagem de amostras positivas. O facto de
se utilizarem técnicas “multiplex”, que permitem a pesquisa simultânea de vários vírus, facilita a deteção de um maior espectro destes agentes. A elevada prevalência de Influenza A H3N2 deveu-se ao facto de grande parte do estudo ter coincidido com um período de surto por este vírus. O sistema de alerta montado durante o projeto ENVIRH pareceu promissor para uma eventual utilização futura em períodos de atividade gripal.--------------ABSTRACT: In the last decade, as respiratory viruses keep representing a relevant factor in
child morbidity and mortality, the spectrum of viruses that may potentially cause
respiratory infections has been widened. Within the several methodologies that may be
applied in the diagnosis of these types of infections, the ones that use molecular biology
are considered to be the most sensitive.
The Environment and Health in Daycares and Nurseries Project (ENVIRH)
arranged for a study, by means of molecular biology techniques, on the main respiratory
viruses' influence in pre-school aged children with respiratory infection symptoms. This study compared children in two different populations: children at school or at home and children that were taken to a hospital emergency service.
The study was conducted in two different time periods, one from February to May 2011 and the other from October 2011 to April 2012. During this time, two swab collections were held, one nasal and one oropharyngeal. PCR and RT-PCR multiplex in real time techniques were used for viral identification of the samples, searching for the viruses Influenza A and B, Parainfluenza 1-4, human Metapneumovirus, Respiratory
Sincytial Virus (RSV), Rhinovirus, Enterovirus, Coronavirus and Bocavirus.
One hundred (100) collections were held in children between the ages of 5 months and 5 years, sixty-four (64) at home/school and thirty-six (36) at the hospital's emergency service. From a total of seventy-nine (79) positive samples, forty-seven (47)
were obtained at home/school and thirty-two (32) at the hospital. The virus detected the
most in both populations was the Influenza A (H3), but only during the outbreak of
2012. Unlike the enteroviruses and coronaviruses, that were not detected within this population, the RSV and the adenoviruses were most common within the children at the hospital. Bocaviruses were never detected isolated from other viruses.
The high percentage of positive samples reinforces the significance of using
molecular biology techniques for the etiological diagnosis of respiratory infections. The use of multiplex techniques, that make the simultaneous search for multiple viruses possible, enhances the detection of a larger spectrum of such agents. Most of the study coincided with an outbreak of the Influenza A H3N2 virus, thus explaining the high number of its cases identified. The alert system set up during the ENVIRH project looked promising enough for eventual periods of flu activity in the future.
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Сміян, Олександр Іванович, Александр Иванович Смиян, Oleksandr Ivanovych Smiian, and Є. В. Дмітрова. "Верифікація збудників ГРВІ серед дитячого населення м. Сум за епідсезон 2014 року." Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/41443.
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Lam, Sun-yee, and 藍新兒. "Detection of human parechovirus and Saffold virus from hospitalized patients with respiratory tract infection in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206510.
Full textAbstract:
Background: Respiratory tract infection is one of the major diseases to cause morbidity and mortality worldwide. Undiagnosed respiratory infection remains unclear. Picornavirus is most common to cause respiratory infection after the influenza virus and RSV. There were numerous notorious pathogens in the Picornaviridae family, for instance, human parechovirus and Saffold virus. These emerging and novel viruses are reported sporadically in respiratory infection and amongst children in particular. This study is aimed to assess the potential role of HPeV and SAFV in respiratory infection in Hong Kong.
Methods: Between May 2013 and April 2014, nasopharyngeal aspirates (NPA) were collected from hospitalized patients who have respiratory infection. The collected samples were tested negative for respiratory syncytial virus, adenovirus, influenza A and B viruses, parainfluenza viruses types 1, 2 and 3 by direct immunofluorescence. RT-PCR was used to target the HPeV and SAFV corresponding region of 5'UTR and analyze by the BioEdit sequence Alignment Editor and Basic Local Alignment Search Tool.
Results: 597 female and 603 male were included in 1200 NPA samples. 20% of these samples were under the age of 5. However, there were no HPeV and SAFV detected in all 1200 NPA samples.
Conclusion: To reveal the possible association between viruses and respiratory infection, the sampling size and district area should be expanded. The single detection method may not be able to detect all the viruses in the current study.published_or_final_version
Microbiology
Master
Master of Medical Sciences