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PubMed1979

Influence of a mycoplasma respiratory tract infection on sheep erythrocyte and complement receptor-bearing cell composition in the respiratory tract of swine.

Pulmonic and peripheral blood lymphocyte subpopulations in healthy and Mycoplasma suipneumoniae-infected pigs were compared. The T- and the B-lymphocyte populations were counted, the B cells by the complement receptor (zymosan-complement rosettes) technique and the T cells by the ED-rosette technique (sheep RBC-dextran rosettes). The T cells were found to predominate among pulmonic, as well as blood, lymphocytes. Pulmonic B-cell and blood T-cell percentages were increased after mycoplasma respiratory tract infection. However, blood B-cell and pulmonic T-cell percentages were not significantly affected. A significant (P less than 0.001) correlation between pulmonic and blood T-lymphocyte compositions was found; conversely, no correlation was observed between blood and pulmonic B-cell percentages. These data could imply that pulmonic B cells are predominantly involved in local immune reactions after a mycoplasma respiratory tract infection.

Animals↗
PubMed1993

Clinical and endoscopic study to estimate the incidence of distal respiratory tract infection in thoroughbred foals on Ontario breeding farms.

Respiratory tract infections are prevalent in foals, yet the frequency with which the distal airways are affected in clinical episodes of respiratory tract disease has not been evaluated to our knowledge. The objective of the study was to determine the incidence of distal respiratory tract infection (DRTI) in foals on a sample of Thoroughbred breeding farms (n = 10) in Ontario. In a pilot study, clinical criteria commonly used to select foals for antimicrobial treatment (detection of abnormal lung sounds, plus nasal discharge, cough, fever, tachypnea, and/or lethargy) were found to segregate foals with and without endoscopically confirmed DRTI. Mucopurulent exudate and bronchial erythema were observed more frequently (P < 0.005), bronchial lavage total cell count and neutrophil concentration were significantly (P < 0.005) higher, and intracellular cocci were recovered significantly (P < 0.01) more often from bronchial lavage samples of affected foals (n = 8) than of controls (n = 8). These clinical criteria were used to identify cases in a cohort of Thoroughbred foals (n = 219) from May 1 to October 30, 1991. Case morbidity adjusted for clustering was 82 +/- 5% (95% confidence limits, 72 to 92%). Most (74%) episodes of clinical DRTI were detected in July and August, and equal numbers were detected before (53%) and after (47%) weaning of foals. Of 178 cases, 66 (48%) were selected at random for endoscopy and bronchial lavage. Grade-II pharyngeal lymphoid hyperplasia was observed commonly (60% of foals); auditory tube diverticulum (guttural pouch) discharge was observed in 18 of 86 (21%) foals, and guttural pouch infection was confirmed in 6 of 7 foals examined endoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2002

Treatment of community-acquired lower respiratory tract infections in adults.

Community-acquired lower respiratory tract infection (LRTI) is a common cause of acute illness in adults. The spectrum of disease ranges from a mild mucosal colonisation or infection, acute bronchitis or acute exacerbation of chronic bronchitis/chronic obstructive pulmonary disease (AE-CB/COPD), to an overwhelming parenchymal infection with the patient presenting with severe community-acquired pneumonia (CAP). Although the great majority of LRTIs are self-limiting viral infections, CAP is most often a bacterial disease with a substantial mortality. Thus, antibiotic treatment is rarely indicated for acute bronchitis and is only indicated for the more severe cases of AE-CB/COPD, but it is nearly always indicated for CAP, for which a delay in treatment may increase the risk of a fatal outcome. It may be difficult to differentiate between a viral and a bacterial LRTI, or between bronchitis/AE-CB/COPD and CAP. This may be one reason why antibiotics are prescribed to more than two-thirds of patients with LRTIs in Europe and the USA. Considering the worldwide development of antibiotic resistance, this is not an acceptable situation. Since an empirical approach is nearly always necessary in the management of LRTI, greater emphasis must be placed on the decision of whether or not to prescribe an antibiotic at all. This decision should be based on an assessment of the severity of the disease, including underlying risk factors, and on markers for bacterial/parenchymal/ invasive LRTI. The choice of empirical therapy must be based on the same data together with epidemiological information. The choice of antibiotic must always cover Streptococcus pneumoniae, which remains the main pathogen of morbidity and mortality in CAP. In hospital, attempts should be made to obtain an aetiological diagnosis in order to be able to switch to a specific treatment or to evaluate a failure of empirical therapy. Several guidelines for the management of community-acquired pneumonia have been published during the last 10 yrs. Some reports indicate that the implementation of such guidelines has resulted in lowered costs, length of stay in hospital and mortality. However, the results from these studies are not consistent and the evidence is still weak.

Adult↗
PubMed1977

Erythromycin in respiratory tract infection.

One of the main uses of erythromycin in respiratory tract infection has been in the treatment of acute streptococcal tonsillitis as an alternative to penicillin. Studies on the quantitative bacteriology of tonsils obtained at tonsillectomy have shown large numbers of both haemolytic streptococci and Haemophilus species in most samples and these organisms can be effectively reduced in number by preoperative treatment with antibiotics such as erythromycin. Such investigations suggest that erythromycin might have wider use in the treatment of respiratory tract infections, particularly where Haemophilus influenzae and other Haemophilus species are involved. Apart from specific infections such as those due to Mycoplasma pneumoniae, erythromycin is effective in the treatment of acute pneumonia due to organisms such as the pneumococcus, and this paper reports the further use of erythromycin in the treatment of acute exacerbations of chronic bronchitis where the clinical and bacteriological effects of treatment with this antibiotic are compared with those of ampicillin.

Ampicillin↗
PubMed1987

Correlation between Branhamella catarrhalis adherence to oropharyngeal cells and seasonal incidence of lower respiratory tract infections.

Bacterial colonization of the oropharynx is the initial event in most lower respiratory tract infections. To study the role of bacterial adherence in lower respiratory tract infections caused by Branhamella catarrhalis (B. catarrhalis) in winter, in vitro adherence assays of the organism to human oropharyngeal cells were carried out in winter, spring, summer and autumn. A total of 57 adults of both sexes were studied from January to December 1985. Forty eight persons of 57 had chronic pulmonary diseases and the remaining 9 persons had other clinical entities and served as the control group. Predominance of lower respiratory tract infections caused by B. catarrhalis with high adherence rate was observed in winter. Adherence activity was moderate in spring and autumn and low in summer and accompanied by a similar incidence of lower respiratory tract infections with this bacteria. In addition, similar results were found in patients in whom investigations were done successively in the above four seasons. Bacterial adherence activity to cells however, was weak in winter in the control group. These results indicate that seasonal variation plays a significant role in the ability of B. catarrhalis to adhere to oropharyngeal cells. This is an important pathogenic factor correlated with the incidence of lower-respiratory tract infections in these patients.

Adult↗
PubMed2005

[Q fever in acute exacerbation of chronic lower respiratory tract infection].

We studied the effect of Q fever in acute exacerbation of chronic lower respiratory tract infection. The subjects consisted of 80 cases with acute exacerbation of chronic lower respiratory tract infection treated during the period from March 2002 till October 2004. Q fever was diagnosed using a PanBio Coxiella burnetii ELISA test kit. Two cases (2.5%) were positive for IgM in the acute stage, and were diagnosed as having acute infection by C. burnetii. They were elderly women with bronchiectasis, aged 76 and 82. They had no history of keeping cats or dogs, but the onset of acute exacerbation of chronic lower respiratory tract infection was June and March which is the breeding seasons for cats and dogs. Acute exacerbation of chronic lower respiratory tract infection were considerd to be a mixed infection with Pseudomonas aeruginosa (the 76-year-case) and Haemophilus influenzae (the 82-year-case). It is concluded that C. burnetii can induce exacerbation of chronic lower respiratory tract infection, their cases were considerd to be mixed infection with C. burnetii and other bacteria.

Acute Disease↗
PubMed2005

[Metapneumoviruses--the "youngest" pathogens of respiratory tract infections in human].

Acute respiratory infections are the most common diseases in all age groups in the world. Lower respiratory infections are the main reason of death, hospitalization and antibiotic use in immunocomprised patients and/or patients with respiratory system chronic diseases. The leading role plays viruses: rhinoviruses, influenza and parainfluenza viruses, respiratory syncytial viruses (RSV), adnenoviruses and coronaviruses. The "youngest" pathogen in this group are human metapneumowiruses (hMPV), identified in 2001. They are the reason of infections in infants, older adults and immunocomprised patients. Manifestation of the infection can have a form from a self-limiting upper respiratory tract inflammation, through bronchitis (in adults), bronchiolitis (in infants) and pneumonitis (in infants and adults), and extremely of severe acute respiratory failure with a need of mechanical ventilation. The authores describe microbiological, epidemiological and clinical features on infection with hMPVs.

Aged↗
PubMedDate not supplied

Cefoperazone sodium in the treatment of serious bacterial infections in 2,100 adults and children: multicentered trials in Europe, Latin America, and Australasia.

Data from noncomparative multicenter trials of cefoperazone sodium in 17 countries throughout Australasia, Europe, and Latin America were analyzed. The study populations included 1,659 adults and 438 children with a wide variety of serious urinary tract infections, respiratory tract infections, and miscellaneous infections. Most adult patients received either 1 g (42%) or 2 g (53%) of cefoperazone iv twice daily for 8-10 days. Satisfactory clinical responses were achieved in 91% of 586 assessable patients with respiratory tract infections, 94% of 571 with urinary tract infections, and 93% of 301 with miscellaneous infections. Organisms resistant to most cephalosporins, including Pseudomonas aeruginosa, other Pseudomonas species, Enterobacter, indole-positive Proteus, Serratia, Bacteroides fragilis, and Streptococcus faecalis (nonendocarditis infections) responded to cefoperazone treatment. Ten percent of patients reported one or more adverse effects directly attributable to cefoperazone, most of which were mild or moderate in severity. In a global evaluation that took into account baseline disease severity, clinical and bacteriological outcome, and toleration, investigators judged cefoperazone as excellent or good in 83% of patients, fair in 10%, and poor in 7%. The usual dosage for pediatric patients was 25-50 mg/kg two or three times daily for about seven days. Overall clinical effectiveness in 417 assessable patients was 89% for a wide variety of infections. Ten of 11 cases of meningitis were cured. Mild adverse reactions were reported for 14 patients. The results indicate that cefoperazone sodium is a safe and effective antibiotic for use in adults and children with serious bacterial infections.

Adolescent↗
PubMed2006

[Resistance of infectious agents involved in low respiratory tract infections in France].

This review concerning the major lower respiratory tract pathogens in France has for aim to describe the epidemiology of resistance to beta-lactams, macrolides, ketolides, and fluoroquinolones especially in Streptococcus pneumoniae and Haemophilus influenzae. It should also provide new insights on the mechanisms of acquired resistance and the level of resistance conferred, highlighting the related ecological impact. In the context of this XVth consensus conference, this review should contribute to the elaboration of guidelines for the treatment of lower respiratory tract infections in adults.

Anti-Bacterial Agents↗
PubMed2003

Desire for antibiotics and antibiotic prescribing for adults with upper respiratory tract infections.

OBJECTIVE: Prior studies have shown that 60% to 75% of adults with upper respiratory tract infections want antibiotics. More recent research indicates declines in antibiotic prescribing for upper respiratory tract infections. To investigate whether there has been a comparable decrease in patients' desire for antibiotics, we measured the proportion of adults with upper respiratory tract infections who wanted antibiotics in the winter of 2001-2002. We also sought to identify factors independently associated with wanting antibiotics and antibiotic prescribing. DESIGN: Prospective survey of adults with upper respiratory tract infections prior to visiting an acute care clinic from November 2001 to February 2002. MEASUREMENTS AND MAIN RESULTS: Thirty-nine percent of 310 patients wanted antibiotics. Many patients wanted relief from symptoms (43%) or pain (24%) and many patients expected to receive a diagnosis (49%) or reassurance during the visit (13%). In multivariable modeling, independent predictors of wanting antibiotics were prior antibiotic use (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.7) and current smoking (OR, 3.1; 95% CI, 1.3 to 7.3). Physicians prescribed antibiotics to 46% of patients who wanted antibiotics and 29% of patients who did not want antibiotics (P=.01). In multivariable modeling, wanting antibiotics was an independent predictor of antibiotic prescribing (OR, 2.1; 95% CI, 1.1 to 4.4). CONCLUSIONS: Only 39% of adults seeking care for upper respiratory tract infections wanted antibiotics, less than in previous studies. In continuing efforts to break the cycle of inappropriate antibiotic use, physicians should not assume that most patients with upper respiratory tract infections want antibiotics.

Acute Disease↗
PubMed1986

Clinical evaluation of ofloxacin in lower respiratory tract infections.

The clinical efficacy and the safety of ofloxacin in lower respiratory tract infections were evaluated by 42 research groups in Japan. 127 patients with bacterial pneumonia and 399 patients with chronic lower respiratory tract infection were analyzed for clinical efficacy. The drug was orally administered, mostly in daily doses of 300 mg to 600 mg for an average of 15 days. The therapeutic success rate was 80% in bacterial pneumonias and 78% in chronic lower respiratory tract infections. As for bacteriological response, eradication rates of 93% and 72%, respectively, were observed against isolates from bacterial pneumonias and chronic lower respiratory tract infections. Side effects mainly in the gastrointestinal tract and central nervous system were noted in 7.6% of 540 patients, but none of them was severe.

Adolescent↗
PubMed1998

Seasonal trends of viral respiratory tract infections in the tropics.

To evaluate the seasonal trends of viral respiratory tract infections in a tropical environment, a retrospective survey of laboratory virus isolation, serology and immunofluorescence microscopy in two large general hospitals in Singapore between September 1990 and September 1994 was carried out. Respiratory tract viral outbreaks, particularly among infants who required hospitalization, were found to be associated mainly with respiratory syncytial (RSV) infections (72%), influenza (11%) and parainfluenza viruses (11%). Consistent seasonal variations in viral infections were observed only with RSV (March-August) and influenza A virus (peaks in June, December-January). The RSV trends were associated with higher environmental temperature, lower relative humidity and higher maximal day-to-day temperature variation. Although the influenza A outbreaks were not associated with meteorological factors, influenza B isolates were positively associated with rainfall. These data support the existence of seasonal trends of viral respiratory tract infections in the tropics.

Adolescent↗
PubMed1992

Cilia in children with recurrent upper respiratory tract infections: ultrastructural observations.

We investigated the ultrastructure of nasal cilia in 27 children suffering from recurrent infections of the upper respiratory tract, during and after the onset of an acute respiratory infection, and after a convalescent period of 12 weeks. Our results demonstrated that in seven subjects after resolution of infection, the morphology of a large proportion of the cilia (32%) was not back to normal. These findings suggest a long-term residual effect of infection, or the inability to reestablish normal ciliary structure during the convalescent period in some subjects with recurrent upper respiratory tract infection.

Acute Disease↗
PubMed2001

Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults: background.

The following principles of appropriate antibiotic use for adults with nonspecific upper respiratory tract infections apply to immunocompetent adults without complicating comorbid conditions, such as chronic lung or heart disease.1. The diagnosis of nonspecific upper respiratory tract infection or acute rhinopharyngitis should be used to denote an acute infection that is typically viral in origin and in which sinus, pharyngeal, and lower airway symptoms, although frequently present, are not prominent. 2. Antibiotic treatment of adults with nonspecific upper respiratory tract infection does not enhance illness resolution and is not recommended. Studies specifically testing the impact of antibiotic treatment on complications of nonspecific upper respiratory tract infections have not been performed in adults. Life-threatening complications of upper respiratory tract infection are rare.3. Purulent secretions from the nares or throat (commonly observed in patients with uncomplicated upper respiratory tract infection) predict neither bacterial infection nor benefit from antibiotic treatment.

Adult↗
PubMed2001

Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults: background.

The following principles of appropriate antibiotic use for adults with nonspecific upper respiratory tract infections apply to immunocompetent adults without complicating comorbid conditions, such as chronic lung or heart disease. 1. The diagnosis of nonspecific upper respiratory tract infection or acute rhinopharyngitis should be used to denote an acute infection that is typically viral in origin and in which sinus, pharyngeal, and lower airway symptoms, although frequently present, are not prominent. 2. Antibiotic treatment of adults with nonspecific upper respiratory tract infection does not enhance illness resolution and is not recommended. Studies specifically testing the impact of antibiotic treatment on complications of nonspecific upper respiratory tract infections have not been performed in adults. Life-threatening complications of upper respiratory tract infection are rare. 3. Purulent secretions from the nares or throat (commonly observed in patients with uncomplicated upper respiratory tract infection) predict neither bacterial infection nor benefit from antibiotic treatment.

Acute Disease↗
PubMed1991

Ceftriaxone in treatment of serious infections. Pneumonia and lower respiratory tract infections.

One gram once daily of ceftriaxone is as effective as 2 gm for the common causative organisms of community-acquired and nosocomial pneumonias. It should not be used alone against L. pneumophila, the TWAR pneumoniae, and possibly anaerobic pathogens. Preliminary study suggests that a regimen of 500 mg a day may be effective in selected patients with simple pneumonias caused by sensitive pathogens. Ceftriaxone is safe, well tolerated, and cost-effective, which means it can play a significant therapeutic role in nursing homes and other long-term care facilities as well as in outpatient therapy.

Bacterial Infections↗
PubMed2003

Respiratory tract infections in travelers: a review of the GeoSentinel surveillance network.

Respiratory tract infections are common in travelers, and improving our knowledge of risk factors associated with specific types of respiratory infections should enable implementation of better preventive strategies. Data collected by the GeoSentinel surveillance network were analyzed, and the most significant predictors for developing specific categories of respiratory infections while abroad were age, sex, season of travel, trip duration, and reason for travel. In particular, influenza was associated with travel to the Northern Hemisphere during the period of December through February, travel involving visits to friends or relatives, and trip duration of >30 days. Lower respiratory tract infections were associated with male sex and increasing age. Knowledge of the respiratory tract infections that occur in specific groups of travelers allows for the development of targeted pretravel preventive strategies to high-risk groups.

Adolescent↗