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PubMed1993

Acute lower respiratory tract infection associated with Chlamydia pneumoniae in Germany.

Serum specimens from 223 patients with acute lower respiratory tract infection were examined for antibodies to Chlamydia pneumoniae using the microimmunofluorescence test. Antibodies to Chlamydia pneumoniae were detected in 18 (20%) of 91 children and 64 (48%) of 132 adults. Among those individuals, 4 (4%) children and 15 (11%) adults had elevated IgG antibody titres indicating acute or recent infection. Specific IgM antibodies were observed in two patients. These results suggest that a significant proportion of lower respiratory tract infections in Germany is caused by Chlamydia pneumoniae.

Acute Disease↗

PubMed1984

Respiratory tract immunity in the aged.

In the elderly, respiratory infections are frequent and constitute the leading cause of death. Presumably this is the consequence of reduced local immunity in the respiratory tract. The present knowledge based on investigations in man and laboratory animals, including results of own research, is reviewed. Further research is needed to give a definite answer and to improve immunoprophylaxis in the elderly.

Age Factors↗

PubMed1989

Specific antibody response in porcine respiratory tract secretion following intraperitoneal immunization.

Experiments were conducted to determine whether intraperitoneal (IP) immunization and subsequent intratracheal (IT) challenge were able to augment the specific antibody response in secretions of the porcine respiratory tract. Following IP immunization and two IT challenges within a period of 18 days the specific IgG and IgA antibody response was elevated in respiratory tract secretions and serum. While a portion of the anti-ovalbumin (OVA) IgG in respiratory tract secretions was generated locally, it would appear that the bulk of anti-OVA IgA was derived from serum.

Administration, Inhalation↗

PubMed1987

[Clinical evaluations of flomoxef in respiratory tract infections].

Flomoxef (FMOX, 6315-S), a new antibacterial drug, was administered to 9 cases with respiratory tract infections for a duration of 8 approximately 16 days at a daily dose of 2 g. Diagnosis of these patients were bronchopneumonia 5 cases, chronic bronchitis 3 cases and acute bronchitis 1 case. From transtracheal aspiration several organisms were isolated; Haemophilus influenzae was isolated in 3 cases, Streptococcus pneumoniae in 3 cases, H. influenzae plus Branhamella catarrhalis in 1 case, Streptococcus dysgalactiae plus Neisseria meningitidis in 1 case and Corynebacterium pseudodiphtheriticum in 1 case. The clinical efficacy was good in all 9 cases, the efficacy rate was 100%. All the bacteria were eliminated. Side effects were not observed. From these results, it appears that FMOX is a valuable drug in the treatment of respiratory tract infections.

Adult↗

PubMed1975

Primary amyloidosis of the respiratory tract.

Two patients with solitary amyloidosis of the respiratory tract are discussed. Bronchial obstruction caused by amyloid deposits led to the death of our first patient. Diagnosis in the second patient was made after removal of a localized amyloid deposit within the lung parenchyma.

Adult↗

PubMed1975

Mycoplasmas isolated from the respiratory tract of horses.

Ten mycoplasmas were isolated from 130 nasopharyngeal swabs from thoroughbred horses with acute respiratory disease and three from 198 apparently normal horses. Two mycoplasmas were isolated from 21 tracheal swabs taken at necropsy. These mycoplasmas, together with six isolated from the equine respiratory tract by other workers, were subjected to biochemical and serological tests. Other properties examined in certain representative strains were appearance under the electron microscope, ability to adsorb or agglutinate the erythrocytes of various animal species and the electrophoretic pattern of the cell proteins. On the basis of these test, mycoplasmas from the equine respiratory tract were divided into seven species. Three species belonged to the genus Acholeplasma, members of which do not require sterol for growth, and were identified as A. laidlawii, A. oculi (formerly A. oculusi) originally isolated from the eyes of goats, and a recently named species A. equifoetale, previously isolated from aborted equine fetuses. Of the four sterol-dependent Mycoplasma species, one was indentified as M. pulmonis, a common rodent pathogen. Another cross-reacted serologically with M. felis and should probably be classified as that species. The other two species probably represent new species peculiar to the horse. One of these, represented by the strains N3 and N11, ferments glucose and is serologically distinct from 19 recognized species of glucose-utilizing mycoplasmas and from two species which do not metabolize either glucose or arginine. The other species, represented by four strains, hydrolyses arginine and, because it is serologically distinct from all the named arginine-hydrolysing Mycoplasma species, the name M. equirhinis sp.nov. is proposed for it. Of the seven species, only M. pulmonis and the glucose-utilizing species represented by N3 and N11 were found exclusively in horses with acute respiratory disease. A. oculi was isolated from an apparently normal horse. The other four species were found in normal horses as well as those with respiratory disease, although three out of the four strains of M. equirhinis were from sick horses.

Acute Disease↗

PubMed2003

Antimicrobial resistance among isolates of respiratory tract infection pathogens from the southern United States: data from the PROTEKT US surveillance program 2000/2001.

BACKGROUND: PROTEKT US (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin in the United States) was established in 2000 to monitor antimicrobial resistance among respiratory tract pathogens across the United States. METHODS: During 2000 to 2001, 75 southern US centers collected 3,867 Streptococcus pneumoniae, 1,455 Streptococccus pyogenes and 1,042 Haemophilus influenzae. RESULTS: Overall, 46.1% of S. pneumoniae isolates were nonsusceptible to penicillin, 35.8% were resistant to erythromycin, and 0.5% were resistant to fluoroquinolones. Against S. pneumoniae the most active agents were telithromycin (99.7% susceptible), linezolid (99.8%) and the fluoroquinolones (levofloxacin 99.4%, gatifloxacin 99.5%). The prevalence of erythromycin-resistant S. pyogenes isolates was 4.5%. Telithromycin, at concentration of < or = 1 mg/L, inhibited 99.9% of S. pyogenes. The prevalence of beta-lactamase positive H. influenzae was 26.2%. Telithromycin was active (MIC90 4 mg/L) against H. influenzae, irrespective of beta-lactamase production. CONCLUSION: The prevalence of penicillin and macrolide resistance among respiratory tract pathogens from the southern United States is high. Fluoroquinolone resistance is low. Telithromycin is highly active against respiratory tract pathogens with reduced susceptibility to beta-lactams, macrolides, and fluoroquinolones.

Anti-Bacterial Agents↗

PubMed1983

Pathogenesis of change in the upper respiratory tracts of turkeys experimentally infected with an Alcaligenes faecalis isolate.

The course of changes within the upper respiratory tracts of turkey poults experimentally infected with Alcaligenes faecalis was studied. The initial change observed (5 days post-inoculation) was colonization of the upper respiratory tract by the bacterium. Changes in the nasal turbinates and trachea were first apparent as a focal loss of cilia but subsequently developed into a general loss of cilia (11 days post-inoculation). Eventually, the entire ciliated epithelial layer in the cranial region of the trachea was lost (13 days post-inoculation). With the loss of cilia and ciliated cells, a highly viscous mucus was able to accumulate in the anterior one-half to two-thirds of the trachea. In addition, changes in the gross structure of the trachea (flaccid trachea) were observed in all poults inoculated with A. faecalis. There was an apparent gradation in the severity of these changes from severe in the cranial region of the trachea to mild in the region just anterior to the bronchial bifurcation. The observations resulting from A. faecalis infection indicated two major tracheal changes responsible for the chronic and sometimes severe nature of this disease. These changes included a loss of ciliary activity and a flaccid trachea which together resulted in the accumulation and stasis of mucus and tracheal collapse.

Alcaligenes↗

PubMed2005

Aetiological role of viral and bacterial infections in acute adult lower respiratory tract infection (LRTI) in primary care.

BACKGROUND: Lower respiratory tract infections (LRTI) are a common reason for consulting general practitioners (GPs). In most cases the aetiology is unknown, yet most result in an antibiotic prescription. The aetiology of LRTI was investigated in a prospective controlled study. METHODS: Eighty adults presenting to GPs with acute LRTI were recruited together with 49 controls over 12 months. Throat swabs, nasal aspirates (patients and controls), and sputum (patients) were obtained and polymerase chain reaction (PCR) and reverse transcriptase polymerase chain reaction (RT-PCR) assays were used to detect Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, influenza viruses (AH1, AH3 and B), parainfluenza viruses 1-3, coronaviruses, respiratory syncytial virus, adenoviruses, rhinoviruses, and enteroviruses. Standard sputum bacteriology was also performed. Outcome was recorded at a follow up visit. RESULTS: Potential pathogens were identified in 55 patients with LRTI (69%) and seven controls (14%; p<0.0001). The identification rate was 63% (viruses) and 26% (bacteria) for patients and 12% (p<0.0001) and 6% (p = 0.013), respectively, for controls. The most common organisms identified in the patients were rhinoviruses (33%), influenza viruses (24%), and Streptococcus pneumoniae (19%) compared with 2% (p<0.001), 6% (p = 0.013), and 4% (p = 0.034), respectively, in controls. Multiple pathogens were identified in 18 of the 80 LRTI patients (22.5%) and in two of the 49 controls (4%; p = 0.011). Atypical organisms were rarely identified. Cases with bacterial aetiology were clinically indistinguishable from those with viral aetiology. CONCLUSION: Patients presenting to GPs with acute adult LRTI predominantly have a viral illness which is most commonly caused by rhinoviruses and influenza viruses.

Acute Disease↗

PubMed1985

A comparison of oral cefuroxime axetil and oral amoxycillin in lower respiratory tract infections.

We assessed oral cefuroxime axetil in an open study of 30 patients with lower respiratory tract infection and then compared oral cefuroxime with oral amoxycillin in a randomized double blind study in a further 40 patients. Satisfactory clinical responses were obtained in 73% of patients receiving cefuroxime axetil 500 mg tid in the open study, and in the comparative study in 71% of patients receiving cefuroxime axetil 500 mg bd, in 60% of patients receiving cefuroxime axetil 500 mg tid and in 63% of patients receiving amoxycillin 500 mg tid. There were no significant differences in response rates between the three regimens in the comparative study. There were no important adverse effects in any of the patients. Oral cefuroxime axetil is safe and effective in the therapy of lower respiratory tract infections.

Administration, Oral↗

PubMed1998

High resolution imaging of the upper respiratory tract with optical coherence tomography: a feasibility study.

A need exists in respiratory medicine for a technology capable of identifying airway pathology on a micron scale. This study has demonstrated the feasibility of optical coherence tomography (OCT) for ultrahigh resolution imaging of the upper respiratory tract by in vitro studies of human tissue. OCT is a relatively new technique that can be used to noninvasively collect tomographic images of tissue microstructure with micron-scale resolution. OCT is analogous to ultrasound, measuring the intensity of infrared light rather than acoustical waves. Samples throughout the upper respiratory tract, from the epiglottis to the secondary bronchi, were imaged. The resulting images were compared with histopathology and verified the ability of OCT to delineate relevant structures such as the epithelium, mucosa, cartilage and its sublayers, and glands at a resolution higher than any clinical imaging technology. The ability of OCT to generate image resolution in the range close to that of histopathology in real time, as well as easy integration with small, relatively inexpensive endoscopes, low cost, and lack of a need for a transducing medium, supports the hypothesis that this optical technology could become a powerful modality in the diagnosis and management of a wide range of clinical respiratory pathology.

Feasibility Studies↗

PubMed1978

The coating of respiratory syncytial (RS) virus-infected cells in the respiratory tract by immunoglobulins.

During the course of 26 respiratory syncytial (RS) virus infections, infected cells in the respiratory tract become coated with immunoglobulins (IgA, IgG, and IgM), IgA being predominant. Methods are described for detecting both intracellular virus and coating immunoglobulin using a double staining technique and immunofluorescence. IgA coating antibody appears in small amounts very early in the illness. The relationship of coating antibody to pathogenesis, prevention, and recovery from RS virus infection is discussed.

Antigen-Antibody Complex↗

PubMed1997

[Occurrence of Moraxella catarrhalis in patients with respiratory tract infections].

The study was undertaken to evaluate the incidence of Moraxella catarrhalis in patients with respiratory tract infections. Overall 514 specimens including 370 throat swabs and 114 sputum specimens were examined. The 78 strains isolated basing on morphological and biochemical characteristics were classified as Moraxella catarrhalis. The sensitivity of the strains to antibiotics was also estimated. The frequency of M. catarrhalis isolation from the throat swabs (15.9%) was higher than from the sputum (13.2%). Selected 25 specimens of sputum were tested simultaneously by quantitative and qualitative methods. Quantitative method was more sensitive (84% positive findings) than qualitative method (60% positive findings). Resistance to ampicillin was found in 52 (66.7%) strains of M. catarrhalis determined mainly by beta-lactamase production (over 70% strains were producers of beta-lactamase). All strains were sensitive to ofloxacin and amoxycillin/clavulanic acid combination. The frequency of M. catarrhalis isolation was higher in autumn-winter period than in summer (May-September). We conclude that M. catarrhalis, beside Streptococcus pyogenes (20.2%) and Streptococcus pneumoniae (17.1%), are the most frequently isolated bacteria in patients with respiratory tract infections.

Amoxicillin-Potassium Clavulanate Combination↗

PubMed2005

Inflammatory and bronchospastic factors in asthma exacerbations caused by upper respiratory tract infections.

It is still uncertain how viral respiratory infections cause acute exacerbations of bronchial asthma, although several mechanisms have been proposed. We studied the relationship between the airway narrowing and the inflammatory and bronchospastic factors in peripheral venous blood and urine, in 30 patients with asthma at the exacerbations caused by upper respiratory tract infections (URTIs). Acute exacerbations caused decreases in peak expiratory flow rate (PEFR) in all 30 patients with asthma. Asthma exacerbations caused the rises in serum levels of interleukin-6, soluble intercellular adhesion molecule-1 and eosinophil cationic protein, concentrations of urinary leukotriene E4 and plasma histamine, compared with those in patients with asthma at a stable condition and those in 30 control subjects (p < 0.05). The values of PEFR at the exacerbations correlated with the levels of these factors. Treatment with oral glucocorticoids reversed the decreases in PEFR and the increases in these factors. At the onset of URTIs, rhinovirus and influenza type A virus were identified in 13 and 7 patients, respectively. Each of parainfluenza virus, adenovirus, and enterovirus was identified in one patient. These findings suggest that respiratory viral infections may cause acute asthma exacerbations via the production of mediators that induce inflammation and bronchospasm.

Acute Disease↗

PubMed2000

Intratracheal instillation as an exposure technique for the evaluation of respiratory tract toxicity: uses and limitations.

The evaluation of respiratory tract toxicity from airborne materials frequently involves exposure of animals via inhalation. This provides a natural route of entry into the host and, as such, is the preferred method for the introduction of toxicants into the lungs. However, for various reasons, this technique cannot always be used, and the direct instillation of a test material into the lungs via the trachea has been employed in many studies as an alternative exposure procedure. Intratracheal instillation has become sufficiently widely used that the Inhalation Specialty Section of the Society of Toxicology elected to develop this document to summarize some key issues concerning the use of this exposure procedure. Although there are distinct differences in the distribution, clearance, and retention of materials when administered by instillation compared to inhalation, the former can be a useful and cost-effective procedure for addressing specific questions regarding the respiratory toxicity of chemicals, as long as certain caveats are clearly understood and certain guidelines are carefully followed.

Aerosols↗

PubMed1980

The therapeutic efficacy of human immunoglobulins as a function of their in vitro antibody activity toward circulating antigens in children with recurrent infections of the upper respiratory tract.

Children with recurrent infections of the upper respiratory tract were treated by injections of human immunoglobulins. Of the 58 children who were followed after treatment, the clinical outcome and the results of laboratory tests, i.e. serum protein profile and level of circulating immune complexes, were improved in 33. The improvement was significantly related to the in vitro antibody reaction of the immunoglobulin batch that was used for injections with unidentified antigens present, before treatment, in the patient's serum.

Antigen-Antibody Complex↗

PubMed1999

[The detection of virus antigen in the lower respiratory tract of the patients with lung cancer].

OBJECTIVE: To find out about the viral infection situation of lower respiratory tract of the patients with lung cancer. METHODS: The excretion from the surface of bronchiogenic carcinoma was brushed under fibrobronchoscopy. The respiratory virus antigen was detected and analysed by reagent kit produced by the 262nd Hospital of Beijing Military Region. RESULTS: The respiratory virus antigen was positive in eight cases of lung cancer group, the positive rate was 17.4%(8/46), it was significantly higher than that in non-lung cancer group (P < 0.05). Among them, there were one case of influenza virus A, two cases of influenza virus B, two cases of para-influenza 1,3, two cases of adenovirus and one case of respiratory syncytial virus. The carcinoma accompanied with viral infection were 4,3,1, cases in order of squamous carcinoma, small cell lung carcinoma and adenocarcinoma. CONCLUSION: The results showed that a relationship existed between lung cancer and viral infection of respiratory tract statistically. The viral infection increased in patients with lung cancer, this is worthy to pay attention to.

Adult↗

PubMed2004

Antibiotics for acute respiratory tract symptoms: patients' expectations, GPs' management and patient satisfaction.

BACKGROUND: GPs often assume that prescribing antibiotics increases patient satisfaction. OBJECTIVE: The purpose of this study was to determine the associations between receiving antibiotics and information/reassurance on the one hand and patients' satisfaction on the other in patients with acute respiratory tract symptoms, and to assess whether this relationship is influenced by patients' expectations. METHODS: Questionnaires were distributed among patients presenting with acute respiratory tract symptoms in 51 general practices (122 GPs) in the region of Utrecht, The Netherlands. Outcome measures were patients' expectations, GPs' management regarding antibiotic prescribing and information/reassurance, and patient satisfaction. RESULTS: Information/reassurance was expected by 90% of the respondents (916/1014); 97% of those actually received it (888/916). Fifty percent expected antibiotics (467/926), while 73% of them received antibiotics (343/467). Receiving information/reassurance was more strongly associated with satisfaction than an antibiotic prescription [adjusted odds ratio (OR) 10.6; 95% confidence interval (CI) 5.6-20.1, and adjusted OR 2.2; 95% CI 1.3-3.8, respectively]. Patients' expectations towards antibiotics modified these associations; in patients not expecting antibiotics, receiving information/reassurance was the only independent determinant of satisfaction (adjusted OR 21.6; 95% CI 7.4-62.7) and in patients who expected antibiotics, actually receiving antibiotics and receiving information/reassurance were equally important determinants of satisfaction (adjusted OR 3.8; 95% CI 1.9-7.5, and adjusted OR 4.7; 95% CI 1.9-11.9, respectively). CONCLUSION: GPs should first explore patients' expectations about antibiotic treatment before giving information about the self-limitedness of respiratory tract symptoms and (in)effectiveness of antibiotics in order to enhance shared decision making and rationalize antibiotic prescribing.

Adolescent↗