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At least 19 recordsLinked to original sources
PubMed2001

Epidemiology of sinusitis in the primary care setting: results from the 1999-2000 respiratory surveillance program.

The Respiratory Surveillance Program (RESP) was undertaken over a 10-month period (July to April) during the 1999-2000 respiratory infection season. A total of 16,213 nasal swab samples were taken by primary care physicians in outpatient settings from patients diagnosed as having acute bacterial rhinosinusitis. The samples were sent to a central laboratory where a pathogen was identified and antibiotic susceptibilities were determined. A pathogen could be isolated from 34% of the samples submitted. Four pathogens accounted for 79.7% of all identifiable isolates: Streptococcus pneumoniae (11.3%), Haemophilus influenzae (21.7%), Moraxella catarrhalis (28.9%), and Staphylococcus aureus (17.9%). Resistance to penicillin was found for S pneumoniae (16% fully resistant, 20% intermediate resistance). S pneumoniae had a 32% to 35% rate of resistance to erythromycin, azithromycin, and clarithromycin. H influenzae showed a high rate of resistance to clarithromycin (36%). M catarrhalis had a 15% rate of resistance to erythromycin and a 91.5% rate of resistance to penicillin. Low levels of resistance were seen to the newer fluoroquinolones levofloxacin (minimum inhibitory concentration [MIC](90) = 2 microg/mL) and gatifloxacin (MIC(90) = 0.5 microg/mL), with the 4 major bacterial isolates having a 95% to 100% rate of susceptibility to these medications. The results from the RESP study can give practicing physicians vital information about pathogen profiles and susceptibilities within their communities and help them in making appropriate treatment choices for their patients with acute rhinosinusitis. Patients with previous antibiotic exposure had a higher incidence of nonsusceptible strains than patients who did not receive prior therapy.

Adolescent↗
PubMed2001

Clinical resistance encountered in the respiratory surveillance program (RESP) study: a review of the implications for the treatment of community-acquired respiratory tract infections.

The Respiratory Surveillance Program (RESP) is a large-scale surveillance study of potential bacterial pathogens from respiratory tract infections that was performed over a 10-month period (July to April) during the 1999-2000 respiratory infection season. It is also the first study of its kind to derive its information entirely from community-based medical practices. This study, therefore, provides insight into the identity, frequency, and susceptibility of the possible pathogens isolated from patients encountered by primary care physicians. Reduction of antibiotic susceptibility in various bacterial pathogens may be of academic interest. However, it is only the emergence of clinical resistance (strains exhibiting minimum inhibitory concentrations above the resistance breakpoint) to commonly used antibacterial agents in the most prevalent species that has significant impact on empiric therapy choices. A review of data from RESP indicated that the most prevalent species were Moraxella catarrhalis, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. As expected, the prevalence of these bacterial isolates varied by disease state. The prevalence of clinical resistance to various antibiotics ranged, within these 4 species, between 0% and 92%. Resistance to the greatest number of drugs was expressed by S pneumoniae, followed by S aureus, H influenzae, and M catarrhalis. The prevalence of antibiotic resistance found among these community-isolated pathogens was surprisingly similar to that reported in hospital-based studies, suggesting that resistance is as important an issue in the community as it is in hospitals. With few exceptions, the prevalence of resistance was fairly uniform across disease states. The antibiotics most likely to encounter clinically resistant isolates during the treatment of community-acquired respiratory tract infections were penicillins, macrolides, and trimethoprim/sulfamethoxazole. The antibiotics least likely to encounter resistance were quinolones, followed by ceftriaxone and amoxicillin/clavulanate.

Anti-Bacterial Agents↗
PubMed2001

Frequency of pathogen occurrence and antimicrobial susceptibility among community-acquired respiratory tract infections in the respiratory surveillance program study: microbiology from the medical office practice environment.

Continuing problems of antimicrobial resistance have prompted the initiation of several surveillance programs. Few, if any, of these programs focus on community-acquired respiratory tract infections seen in routine office-based practices. The Respiratory Surveillance Program (RESP; 1999-2000) in 674 community-based physician office practices in the United States determined the frequency of potential bacterial pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in patients diagnosed clinically with community-acquired pneumonia, acute exacerbations of chronic bronchitis, and sinusitis throughout all 9 US census/geographic regions. Susceptibility to the penicillins (ampicillin, penicillin), oral cephalosporins, fluoroquinolones (gatifloxacin, levofloxacin, ciprofloxacin), macrolides (erythromycin, azithromycin, clarithromycin), tetracycline, and trimethoprim/sulfamethoxazole was determined by reference methods. Patients were required to have a culturable focus of infection, and specimens were immediately sent to a reference laboratory. Among 22,689 total specimens (610 community-acquired pneumonia, 4,779 acute exacerbation of chronic bronchitis, 16,213 sinusitis, 1,087 other), H influenzae was the most commonly isolated organism from patients with community-acquired pneumonia (38%) and acute exacerbation of chronic bronchitis (35%) in all nine geographic regions. S pneumoniae was isolated in 18% of community-acquired pneumonia cases, 13% of acute exacerbation of chronic bronchitis cases, and 11% of sinusitis cases. M catarrhalis was most commonly isolated from the nasopharynx of patients with sinusitis (29%). High-level resistance to penicillin (2 microg/mL or greater; 16% overall) and the macrolides (32% to 35%) among S pneumoniae varied both with site of infection and with geographic region. The greatest resistance was observed among isolates from the nasopharynx of patients with sinusitis and from patients from the East South Central or South Atlantic regions of the United States. Although the susceptibility of H influenzae and M catarrhalis to the tested antimicrobials did not vary with the type of infection, beta-lactamase-mediated resistance to ampicillin among H influenzae ranged from 15% in New England to 32% in the East South Central region. The fluoroquinolones were highly active against these cultured isolates from community-acquired respiratory tract infection patients, with >99% of all S pneumoniae, H influenzae, and M catarrhalis strains susceptible to gatifloxacin (MIC(90), 0.5 microg/mL) and levofloxacin (MIC(90), 2 microg/mL). The extended-spectrum fluoroquinolones appear well suited for community-acquired respiratory tract infection therapy, including pathogens other than pneumococcus, H influenzae, and M catarrhalis.

Adolescent↗
PubMed2026

Clinical and genomic characterization of Influenza A co-infection with SARS-CoV-2 and Influenza B: a respiratory surveillance study in Assam, India.

Influenza and SARS-CoV-2 are the primary contributors to seasonal respiratory infections and frequently co-circulate, creating significant health challenges. The present respiratory surveillance study was conducted in Dibrugarh, Assam, India from January 2025 to August 2025 to investigate the genomic characteristics of circulating viruses and identify potential co-infections. Overall, 4,948 respiratory samples were screened using multiplex real-time PCR, followed by subtyping of Influenza A and Influenza B. Next-generation sequencing (NGS) was performed in selected positives of SARS-CoV-2 and Influenza A. Genomic analysis included mutational profiling, phylogenetic analysis and N-glycosylation site prediction using bioinformatics tools. Two co-infection cases were detected: one involving Influenza A (H3N2) with SARS-CoV-2 (Omicron XFG lineage) and another involving Influenza A (H3N2) with Influenza B (Victoria lineage). Both patients experienced mild illness without hospitalisation. NGS revealed that the Influenza A (H3N2) viruses belonged to clade 3C.2a1b.2a.2a.3a.1 while SARS-CoV-2 sequence was classified under the Omicron XFG lineage. Mutational analysis of the HA gene showed several amino acid differences compared to the reference vaccine strain A/Darwin/6/2021. N-glycosylation analysis predicted conserved sites at positions 79, 181, 262, and 301 in all strains along with an additional predicted site at position 110 in both co-infection cases. Although the co-infection cases presented with mild clinical manifestations, the observed genomic variations indicate a potential role of co-infecting viruses in shaping viral evolution. Given the limited genomic data available from Northeast India, the study underscores the need for sustained large scale follow up and genomic surveillance to monitor emerging mutations and target future vaccine strategies.

Humans↗
PubMed1999

Isocyanate medical surveillance: respiratory referrals from a foam manufacturing plant over a five-year period.

This study assesses the causes of medical surveillance changes leading to specialist referral from one isocyanate-using company where 39 workers (about 20% of all employees) were referred to a hospital occupational clinic during a 5-year period for concerns regarding their surveillance respiratory questionnaire or spirometry results. The respiratory assessment determined that the questionnaire had detected 5 workers with non-occupational asthma, 2 with possible occupational asthma (OA), and 1 with subsequently confirmed OA, while no additional asthmatics were detected by spirometry without questionnaire findings. The surveillance questionnaire in this study was sensitive but not specific (no additional compensation claims for OA were made during this time period): workplace spirometry, however, did not add to the detection rate of asthma.

Adult↗
PubMed2001

Epidemiology of clinically diagnosed community-acquired pneumonia in the primary care setting: results from the 1999-2000 respiratory surveillance program.

To evaluate the prevalence of typical pathogens, level of resistance, and risk factors associated with community-acquired pneumonia (CAP) in the outpatient primary care setting and define current antibiotic treatment for office-based CAP, the Respiratory Surveillance Program (RESP) recruited 1,200 primary care clinics during the 1999-2000 respiratory infection season. Participating community-based physicians submitted sputum samples from patients presenting with a community-acquired respiratory infection including community-acquired pneumonia (CAP). All patients were aged > or =18 years. Patient demographics and risk factors were collected. Physicians express-mailed the specimens to a central laboratory for identification and susceptibility testing. All isolates were tested against a select panel of antimicrobial agents that are used to treat CAP. Patients with CAP were diagnosed by the treating physicians. Chest radiographs were not required as part of the study. A total of 610 specimens were submitted from patients with CAP. A smoking history or reported history of chronic obstructive pulmonary disease were present in >50% of those diagnosed with CAP. The most common pathogens were, in order of prevalence, Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. During the study period, a variety of antibiotics were prescribed for the treatment of outpatient CAP. The top 3 prescribed antibiotics include levofloxacin (23%), clarithromycin (19%), and azithromycin (10%). Gatifloxacin, which was approved in December 1999 and therefore available for only part of the study, accounted for 4% of the prescriptions. Of S pneumoniae isolates, 8% demonstrated high-level resistance to penicillin (> or =2 microg/mL) and 33% were found resistant to macrolides and trimethoprim/sulfamethoxazole. All S pneumoniae isolates were sensitive to gatifloxacin, vancomycin, and levofloxacin. Other less common organisms isolated were staphylococci, streptococci, Enterobacteriaceae, Pseudomonas spp, and Acinetobacter spp. The choice of antibiotic to treat outpatient CAP varies from practice to practice and does not appear to be influenced by the patient's age, the patient's history of smoking, or comorbidity.

Adolescent↗
PubMed1999

Longitudinal decline in measured firefighter single-breath diffusing capacity of carbon monoxide values. A respiratory surveillance dilemma.

Seattle firefighters participate in a voluntary annual medical surveillance program including measurements of ventilatory capacity (FVC and FEV1) and single-breath diffusing capacity of carbon monoxide (DLCO). From 1989 to 1996, average % predicted DLCO (Crapo) for all participating firefighters declined from 94.4% (95% confidence interval [CI]: 93.4% to 95.5%) to 87.3% (95% CI: 86.2% to 88.3%), with no significant change in average FVC or FEV1. A random-effects regression model based on data from 812 firefighters with at least two annual sets of DLCO measurements showed the expected associations between DLCO and age, height, gender, race, ventilatory capacity, and smoking. In addition, two important temporal changes were observed, including, for an average firefighter, a large mean decline in DLCO of -1.02 ml/min/mm Hg associated with year of measurement, and a relatively smaller decline of -0.006 ml/min/mm Hg associated with number of fires fought. Although the stability of ventilatory capacity over time is reassuring, the marked temporal decline in diffusing capacity among this population of firefighters raises issues of concern. Interpretation of the observed decline poses a dilemma in terms of the reliability and efficacy of diffusing capacity as a screening tool, in whether DLCO is subject to unacceptable technical variability or whether it might provide more sensitive detection of early adverse respiratory effects of smoke inhalation.

Adult↗
PubMed1985

Surveillance of respiratory viral infections by rapid immunofluorescence diagnosis, with emphasis on the epidemiological development of respiratory syncytial virus infections.

Surveillance of certain respiratory viral infections by applying immunofluorescence (IF) examinations to samples of nasopharyngeal secretions has been evaluated using a simplified procedure for the preparation of cell smears. Samples from 711 children living in different parts of Norway were examined during the winter 1982/83 and a positive diagnosis was made for 290 children (41%). Temporal epidemic peaks were observed for respiratory syncytial virus (RSV), parainfluenza virus type 3 and influenza virus. On the other hand, the monthly number of negative samples was almost constant throughout the period. Differences in timing of RSV outbreaks were observed between two regions in Norway. Compared to rapid IF diagnosis, RSV notifications obtained by serological examinations were delayed by several weeks. Rapid virus diagnosis by IF examinations with our simplified procedure for preparation of nasopharyngeal samples seems to be suitable for the epidemiological surveillance of respiratory viral infections, both for its simplicity of preparation of the samples and for its accuracy in defining the time of the actual virus infection. Nevertheless, the method is not without pitfalls; a close cooperation between those who take the specimens and the laboratory is essential, and the IF examinations should be performed by an experienced microscopist.

Antibodies, Viral↗
PubMed2006

Validation of syndromic surveillance for respiratory infections.

STUDY OBJECTIVE: A key public health question is whether syndromic surveillance data provide early warning of infectious outbreaks. One cause for skepticism is that biological correlates of the administrative and clinical data used in these systems have not been rigorously assessed. This study measures the value of respiratory data currently used in syndromic surveillance systems to detect respiratory infections by comparing it against criterion standard viral testing within a pediatric population. METHODS: We conducted a longitudinal study with prospective validation in the emergency department (ED) of a tertiary care children's hospital. Children aged 7 years or younger who presented with a respiratory syndrome or who were tested for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus, adenovirus, or enterovirus between January 1993 and June 2004 were included. We assessed the predictive ability of the viral tests by fitting generalized linear models to respiratory syndrome counts. RESULTS: Of 582,635 patient visits, 89,432 (15.4%) were for respiratory syndromes, and of these, 7,206 (8.1%) patients were tested for the viruses of interest. RSV was significantly related to respiratory syndrome counts (adjusted rate ratio [RR] 1.33; 95% confidence interval [CI] 1.04 to 1.71). In multivariate models including all viruses tested, influenza virus was also a significant predictor of respiratory syndrome counts (RR 1.47; 95% CI 1.03 to 2.10). This model accounted for 81.6% of the observed variability in respiratory syndrome counts. CONCLUSION: Respiratory syndromic surveillance data strongly correlate with virologic test results in a pediatric population, providing evidence of the biologic validity of such surveillance systems. Real-time outbreak detection systems relying on syndromic data may be an important adjunct to the current set of public health systems for the detection and surveillance of respiratory infections.

Boston↗
PubMed2004

Severe acute respiratory syndrome surveillance in Australia.

In March 2003, the World Health Organization (WHO) issued a global alert recommending active worldwide surveillance for severe acute respiratory syndrome (SARS). This paper describes the epidemiological features of cases reported by Australian states and territories to the Australian Government Department of Health and Ageing between 17 March and 31 July 2003. There were 138 people investigated for SARS: 111 as suspect and 27 as probable. Five probable cases were reported to WHO after review of other possible diagnoses and Australia-specific exclusion criteria had been applied. An additional probable case identified by laboratory testing overseas, but who was not under investigation when in Australia, was also reported to WHO. The method by which surveillance for SARS was rapidly established provided an opportunity to examine Australia's planning and preparedness for future respiratory disease epidemics such as influenza.

Adolescent↗
PubMed2002

Implementation of statutory occupational respiratory health surveillance.

Health surveillance is required by UK regulations in certain circumstances, and is usually provided through an occupational health organization. Although there are studies assessing the provision of health surveillance across the country, there are no published studies addressing the practical application of legislation, guidelines and medical research to respiratory health surveillance programmes. An audit of a multidisciplinary health surveillance programme was carried out, using review of occupational health records, occupational hygiene reports and managers' risk assessments, to compare the implementation of health surveillance in different organizations and under different contractual relationships. Sixty-six per cent of National Health Service (NHS) and 56% of industrial workplaces were able to provide risk assessments but were unable to link these with appropriate health surveillance. Twenty-seven per cent of NHS employees potentially exposed to respiratory sensitizers had baseline surveillance, compared with 87% in industry. Fifty-five per cent of Medical Research Council questionnaires were inappropriately administered by the employee themselves, rather than an interviewer as recommended. Other follow-up questionnaires in use had not been formally validated. Non-regular lung function assessment using spirometry was the predominant tool used for follow-up surveillance. There was no overall strategic approach to respiratory health surveillance in the organization studied. Health surveillance programmes should focus on disease prevention without becoming a repetitious application of unvalidated tools. Clinical governance demands quality assurance standards that will effectively implement a coordinated approach to health surveillance.

Asthma↗
PubMed1994

Benefits and limitations of the Witwatersrand influenza and acute respiratory infections surveillance programme.

OBJECTIVE: To establish an ongoing active surveillance programme for acute respiratory infections in general, and influenza in particular. DESIGN: A network of 16 sentinel primary health care providers furnished morbidity information and clinical specimens for virus characterisation supplemented by school absenteeism and regional mortality data. SETTING: General practices, hospital outpatient departments and staff clinics in the Witwatersrand area. PARTICIPANTS: Subjects treated for acute respiratory infections by 7 general practitioners, 1 specialist pulmonologist, 4 paediatric outpatient departments, 1 mine hospital and university, factory and institutional staff clinics. Absenteeism data were obtained from 8 primary and 6 high schools in the region (representing 9,000 pupils). OUTCOME MEASURES: Morbidity information and strain characterisation of influenza isolates as well as other viral respiratory pathogens, school absenteeism, seasonal excess mortality. RESULTS: The most sensitive indicator of influenza activity was virus isolation, which gives an earlier warning signal of an impending epidemic than morbidity or absenteeism parameters. Both morbidity and school absenteeism provided quantitative indicators of the severity of the epidemic. Mortality from all causes showed characteristic winter increases in the 65-year-old and older population which were not seen in younger individuals. Circulating influenza viral strains matched the strains recommended for the vaccine in 1991 and 1992, but not in 1993. CONCLUSIONS: The course and extent of the annual winter influenza epidemic can be charted by means of an active surveillance programme, with sentinel primary health care providers furnishing morbidity data and clinical material from which virus isolations can be made. Antigenic characterisation of the isolates demonstrated that circulating strains may not match recommended strains in northern hemisphere-formulated vaccines and stresses the need for a southern hemisphere vaccine formulation for South Africa. Absenteeism information provides an indicator of the impact of influenza on the economy and excess mortality data emphasise the need for routine immunisation of the elderly.

Absenteeism↗
PubMed1992

Respiratory disease surveillance in Hungary.

In October 1989, the Hungarian National Institute of Hygiene initiated the Children's Acute Respiratory Morbidity (CHARM) Surveillance System to assess the association between nine reportable respiratory diseases and air pollution. The weekly number of physician-diagnosed, reportable respiratory diseases among four age groups of children (less than 1, 1-2, 3-5, and 6-14 years) was tabulated for Sopron, a city with 60,000 residents. We calculated the proportion of diseases occurring during weeks with low, moderate, and high sulfur dioxide (SO2) and nitrogen dioxide (NO2) concentrations. The weekly averages of the 24-hour median SO2 concentrations were divided into thirds at less than or equal to 17.6, greater than 17.6 to less than or equal to 26.3, and greater than 26.3 micrograms/m3 (range: 0.9-79.6 micrograms/m3), and the NO2 concentrations at less than or equal to 29.8, greater than 29.8 to less than or equal to 44.1, and greater than 44.1 micrograms/m3 (range: 4.2-90.1 micrograms/m3). During 1990, 11,474 respiratory disease cases occurred among the 4,020 children less than 15 years of age living in Sopron and monitored by the CHARM system. The two most frequently reported disease categories were rhinitis/tonsillitis/pharyngitis (71.5%) and acute bronchitis (8.5%). Sixty-seven percent of pneumonia cases occurred when SO2 concentrations were highest. We found no association between levels of NO2 and respiratory diseases. The CHARM Surveillance System may characterize more fully which groups of children develop particular respiratory diseases following exposure to air pollution.

Acute Disease↗
PubMedDate not supplied

Surveillance for respiratory illness in long-term care settings: detection of illness using a prospective research technique.

BACKGROUND: The overall frequency and severity of viral respiratory infections affecting residents of long-term care facilities (LTCFs) is not well described. This is due primarily to the cumbersome and expensive techniques required for adequate surveillance of respiratory illnesses and the associated costs and availability of a laboratory capable of the relevant and timely report of diagnostic tests. Here we describe our technique for surveillance of respiratory illness in the LTCF. Elements of it may serve as strategies for routine care. METHODS: Nurses were trained to record respiratory complaints and to track them using a histogram-based calendar charting system. For the research technique, all new illnesses during the winter months, no matter how minor, were sampled for viral culture. RESULTS: Influenza A and B, parainfluenza types 1 through 4, herpes simplex virus types 1 and 2, rhinovirus, and respiratory syncytial virus (RSV) were detected in the nursing homes studied. Outbreaks of influenza were documented annually by prospective surveillance. Outbreaks of parainfluenza type 1 and RSV indistinguishable clinically from influenza were detected. CONCLUSIONS: Intense surveillance for respiratory illness and viral pathogens using the described research technique identified viral activity reliably on an annual basis in several large LTCFs. Elements of the research protocol may be adapted for general use to create a cost-effective surveillance program for LTCFs that have limited resources. Such a technique is essential for implementing effective measures for outbreak prevention and control.

Journal Article↗
PubMed2003

Antimicrobial susceptibility of lower respiratory tract pathogens in Great Britain and Ireland 1999-2001 related to demographic and geographical factors: the BSAC Respiratory Resistance Surveillance Programme.

OBJECTIVE: The aim of this study was to assess the antimicrobial susceptibility of community-acquired lower respiratory pathogens in Great Britain and Ireland, and investigate its relationship with demographic and geographical factors using multiple logistic regression analysis. METHODS: A total of 1328 isolates of Streptococcus pneumoniae, 1894 Haemophilus influenzae and 845 Moraxella catarrhalis were collected from lower respiratory clinical specimens (primarily sputum) by 20 laboratories in Great Britain (England, Wales and Scotland) and Ireland (Northern Ireland and Eire) between 1999 and 2001. RESULTS: Of 1154 S. pneumoniae from Great Britain, 92-100% were susceptible to beta-lactams (only 0.2% having penicillin MICs > or =2 mg/L), 89% were susceptible to erythromycin, 93% susceptible to tetracycline, and 94-100% intermediate or susceptible to fluoroquinolones. Susceptibility to agents other than fluoroquinolones was less frequent in the 174 isolates from Ireland: beta-lactam susceptibility was 68-99% (3.4% having penicillin MICs > or =2 mg/L), erythromycin susceptibility was 78% and tetracycline susceptibility was 82%. In multivariate analysis, susceptibility in S. pneumoniae was associated with country and patient age, being most common overall in the 20-49 years age group. Of 1894 H. influenzae, 15% produced beta-lactamase and 79-100% were susceptible to beta-lactams other than cefaclor. Ninety-six per cent were intermediate and 1% susceptible to erythromycin, 97% susceptible to tetracycline, and 89% susceptible to trimethoprim. Only one isolate showed resistance to ciprofloxacin. H. influenzae from sputum were more likely to be susceptible than isolates from other sources. Of 845 M. catarrhalis, 92% produced beta-lactamase and 9% were susceptible to ampicillin, >99% were susceptible to co-amoxiclav, cefotaxime, erythromycin and fluoroquinolones. CONCLUSIONS: Clinically relevant demographic factors predictive of susceptibility were country and patient age in S. pneumoniae, and specimen type (sputum/non-sputum) in H. influenzae. Susceptibility to most antimicrobials remains high in Ireland and very high in Great Britain.

Adult↗