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At least 127 records · Page 7Linked to original sources
PubMed1986

Cardiorespiratory patterns occurring in infants during and after recovery from respiratory tract infection.

During and after respiratory tract infections in 29 hospitalized infants, 12 cardiorespiratory measurements were performed on 24-hour recordings of ECG and respiratory activity. These measurements were compared with similar data obtained from 110 age-matched control infants without infection. Respiratory and heart rates during the state of regular breathing were increased during infection, as compared with recordings made after recovery. The numbers of short apneic pauses 3.6 to 6.0 seconds and greater than 6.0 to 12.0 seconds in duration, together with the duration of the overall longest apneic pause per recording, were reduced during infection compared with after recovery. The total durations of periodic breathing and of periodic apnea per recording were also reduced during infection compared with after recovery. These effects were consistent in 27 of the 29 cases, but in two, periodic breathing levels during infection exceeded the 90th percentile in age-matched controls and were reduced after recovery. Measurements made after recovery tended to conform more closely to values in the control infants. None of the 29 infants studied subsequently died or suffered chronic respiratory problems. This study suggests that prolonged apneic pauses or increased numbers of short pauses are not usually a consequence of respiratory tract infection in normal infants.

Apnea↗
PubMed2004

Atypical pathogens and respiratory tract infections.

The atypical respiratory pathogens Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila are now recognised as a significant cause of acute respiratory-tract infections, implicated in community-acquired pneumonia, acute exacerbations of chronic bronchitis, asthma, and less frequently, upper respiratory-tract infections. Chronic infection with C. pneumoniae is common among patients with chronic obstructive pulmonary disease and may also play a role in the natural history of asthma, including exacerbations. The lack of a gold standard for diagnosis of these pathogens still handicaps the current understanding of their true prevalence and role in the pathogenesis of acute and chronic respiratory infections. While molecular diagnostic techniques, such as polymerase chain reaction, offer improvements in sensitivity, specificity and rapidity over culture and serology, the need remains for a consistent and reproducible diagnostic technique, available to all microbiology laboratories. Current treatment guidelines for community-acquired pneumonia recognise the importance of atypical respiratory pathogens in its aetiology, for which macrolides are considered suitable first-line agents. The value of atypical coverage in antibiotic therapy for acute exacerbations of chronic bronchitis and exacerbations of asthma is less clear, while there is no evidence to suggest that atypical pathogens should be covered in antibiotic treatment of upper respiratory-tract infections.

Anti-Bacterial Agents↗
PubMed1995

The role of new quinolones in the treatment of respiratory tract infections.

Infections of the respiratory tract are the leading cause of antibacterial prescribing in both hospital and community practice. The microbial aetiology is diverse in both of these settings and differs in the distribution and virulence of the pathogens. Furthermore, in recent years the antibacterial susceptibility of many of the common pathogens has changed significantly. In particular, penicillin resistance has emerged among pneumococci, while beta-lactamase production among Haemophilus influenzae and many Gram-negative bacilli has led to alterations in first-line therapy options. The fluoroquinolone antibacterials have been used in selected respiratory tract infections, but concerns have remained with regard to their efficacy in infections caused by marginally susceptible organisms, and in particular pneumococcal infections. The availability of a number of quinolones with enhanced Gram-positive activity, which includes Streptococcus pneumoniae, is of considerable interest. In vitro data and preliminary clinical experience with sparfloxacin suggest that managing pneumococcal lung disease with this and future agents is a distinct possibility. One caveat must be considered, and that is the potential for more resistant strains of pneumococci emerging, against which even these new quinolones could prove less effective.

4-Quinolones↗
PubMed2006

Rapid detection and clinical features of infants and young children with acute lower respiratory tract infection due to respiratory syncytial virus.

During December to the end of February of 2003 and 2004, a total of 282 nasopharyngeal aspirates were obtained from infants and young children admitted to the Buraidah Maternity and Pediatric Hospital, Al-Qassim, Saudi Arabia, and clinically diagnosed as suffering from acute lower respiratory tract infections. The aspirates were tested for the presence of respiratory syncytial virus using direct fluorescein-labeled monoclonal antibody assay. Of the 282 specimens, 128 (45.4%) were found to be positive for respiratory syncytial virus. The most positive specimens came from patients less than one year old (51.3%), and were associated with bronchopneumonia (56.7%) or bronchiolits (55.4%). Coughing (100%) and tachpnea (98%) were significantly more frequent in infants with respiratory syncytial virus infection, followed by wheezing, crepitation and retraction, each representing 66%. Three deaths were reported. The availability of a rapid viral diagnostic assay will be an important tool for physicians to make more accurate treatment decisions and therefore reduce unnecessary antibiotic usage and hospital stay for the patients.

Age Factors↗
PubMed1978

Antibiotic treatment of common bacterial respiratory tract infection in general practice.

Respiratory tract infections, particularly in children, are some of the most common conditions seen in general practice. It would seem reasonable, therefore, that these conditions would be treated well. However, analysis of the figures taken from the Australian Morbidity Survey conducted by The Royal Australian College of General Practitioners shows that whilst most general practitioners use antibiotics satisfactorily, there are a few occasions in which it is fairly obvious that there is a lack of knowledge of the action of a particular antibiotic against a specific organism. This article is not intended to be a treatise on the microbiology of different respiratory tract infections and antibiotic use, but it is intended to be a guide to the treatment of common respiratory infections as seen in general practice.

Anti-Bacterial Agents↗
PubMed2000

[Treatment of upper respiratory tract infections].

Today most upper respiratory tract infections are mild and of short duration with minor risk of complications. Hence, the effects of antibiotic treatment are marginal. The only and most important reason for treatment is to stop dissemination. Penicillin V should be the first drug of choice. A review of the literature about antibiotic treatment of upper respiratory tract infections shows that most published studies exclude two categories of patients: children below the age of 6 months and patients who are severely ill. Therefore, there is an additional need for further studies focused on select groups of patients to investigate the benefit, if any, of antibiotic treatment as well as to study the effect of introducing near-patient-tests and the use of extended microbiological service in daily clinical practice.

Anti-Bacterial Agents↗
PubMed2006

Detection of Simkania negevensis by culture, PCR, and serology in respiratory tract infection in Cornwall, UK.

Respiratory tract infections are often treated empirically without investigation to detect the aetiological agent, which may be a virus or a bacterium, including atypical pathogens such as Chlamydophila pneumoniae or Mycoplasma pneumoniae. Recently, several types Chlamydia-like intracellular bacteria have been detected in environmental samples and clinical specimens. Little is known of their geographical distribution and potential pathogenicity. We describe the detection, by PCR and isolation in cell culture, of Simkania negevensis in nasopharyngeal aspirates of paediatric patients with bronchiolitis in Cornwall, UK. We also present serological evidence of exposure to the organism in 62% of adult patients and 46% of a sample of pregnant women. Empirical treatment of serious respiratory tract infection should consider the possible contribution of these organisms.

Adolescent↗
PubMed1991

[The study on bacterial infection in chronic lower respiratory tract infection--from the viewpoints of acute and chronic infection].

Using mainly changes in the amount of sputum as an index of the infectious course of chronic lower respiratory tract infection associated with purulent sputum over years, the disease was divided into stable and acute exacerbated phases and a bacteriological investigation using transtracheal aspiration (TTA) conducted. TTA was performed 107 and 45 episodes during stable phases and acute exacerbated phases respectively. Monomicrobial and polymicrobial infection were detected most frequently during the stable and acute exacerbated phases respectively (p less than 0.01). During the stable phases, the single organisms detected most frequently were H. influenzae (26 episodes) and P. aeruginosa (20 episodes), while in the cases in which multiple organisms were detected during stable phases, combination including H. influenzae were most common (19 episodes). H. influenzae was the most frequently detected organism in cases showing single organisms during acute exacerbated phases (7 episodes). In the cases in which multiple organisms were detected as well, H. influenzae was the most commonly detected organism assumed to predispose to exacerbation (7 episodes), while P. aeruginosa was not found. These results suggest that in chronic lower respiratory tract infection. H. influenzae and P. aeruginosa are important as persistent infective organisms, while H. influenzae are important in acute exacerbation.

Acute Disease↗
PubMed2003

[Are new antibiotics in therapy of respiratory tract infections necessary?].

Increasing worldwide antibacterial resistance among respiratory pathogens, especially S. pneumoniae, are an emerging problem in the treatment of respiratory tract infections. In some areas penicillin-resistant S. pneumoniae increased to 80% and macrolide-resistance and MLSb-resistance are an evolving problem. In addition, increasing resistance to quinolones has been documented in Hong Kong and in Spain. One way to combat increasing resistance is the development of new antimicrobial drugs. However, the practice of just changing one drug for another without also altering poor prescribing habits merely results in different resistance issues. In the long-term, to prevent increasing resistance, clinicians must be aware of restrictive antibiotic prescription and adequate dosages.

Anti-Bacterial Agents↗
PubMed1987

Treatment of respiratory tract infections with cephalosporin antibiotics.

Infections of the respiratory tract are among the most common causes for antibiotic prescribing. Their diagnosis within the community is generally limited to clinical criteria, and microbiological information is frequently lacking. Hospitalised patients with respiratory tract infections are more likely to undergo diagnostic sampling, but difficulties remain in reliably defining a microbial aetiology, thereby providing a confident basis for antibiotic selection. In considering the role of the cephalosporins in the treatment of respiratory tract infections, over 500 published articles have been reviewed. The pharmacokinetic considerations are discussed and the limitations of existing methodology are emphasised. Individual agents are reviewed by site of sepsis and conclusions are drawn from both comparative and non-comparative studies and in relation to currently recommended regimens. Although oral cephalosporins are widely used to treat upper respiratory tract infections, none is considered ideal, especially where Haemophilus influenzae is pathogenic. In the case of lower respiratory tract infections the beta-lactamase stable parenteral cephalosporins have become widely used to treat pneumonia in hospitalised patients, especially where Gram-negative enteric bacilli are of aetiological importance. However, the lack of activity of these drugs against Legionella spp., Mycoplasma pneumoniae and Coxiella burnetii must be emphasised. Another area of increasing use is in the treatment of infective exacerbations in patients suffering from cystic fibrosis of the lungs where Pseudomonas aeruginosa is pathogenic; ceftazidime in particular has proved a useful alternative to earlier antipseudomonal penicillin antibiotics.

Animals↗
PubMed1999

Parainfluenza virus infection among adults hospitalized for lower respiratory tract infection.

To better define the contribution of human parainfluenza viruses (HPIVs) to lower respiratory tract infection in adults, we tested acute- and convalescent-phase serum specimens from hospitalized adults participating in a population-based prospective study of lower respiratory tract infection during 1991-1992. We tested all available specimens from the epidemic seasons for each virus and approximately 300 randomly selected specimens from the corresponding off-seasons for antibodies to HPIV-1, HPIV-2, or HPIV-3. During the respective epidemic season, HPIV-1 infection was detected in 18 (2.5%) of 721 and HPIV-3 infection in 22 (3.1%) of 705 patients with lower respiratory tract infection. Only 2 (0.2%) of 1,057 patients tested positive for HPIV-2 infection. No HPIV-1 infections and only 2 (0.7% of 281 patients tested) HPIV-3 infections were detected during the off-seasons. HPIV-1 and HPIV-3 were among the four most frequently identified infections associated with lower respiratory tract infection during their respective outbreak seasons.

Adult↗
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↗
PubMed1999

The impact of antimicrobial resistance: changing epidemiology of community-acquired respiratory-tract infections.

Current surveillance data and mechanisms of resistance for the three most common bacteria infecting the respiratory tract are reviewed. Many pathogens, once susceptible to available antimicrobials, are now demonstrating high levels of resistance to commonly prescribed antimicrobial agents for the treatment of respiratory-tract infections. The three most common respiratory-tract pathogens, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, all exhibit high-level resistance to one or a number of agents, including penicillin, ampicillin, erythromycin, tetracycline, and first-generation cephalosporins. To determine the prevalence of resistance in these organisms, surveillance programs have begun tracking the emergence of antimicrobial resistance in the United States and worldwide. Data recovered from several national surveillance studies should help guide decisions about empirical therapeutic treatment.

Community-Acquired Infections↗