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Stefan M T Vestjens, Esther Wittermans, Simone M C Spoorenberg, Jan C Grutters, Charlotte A van Ruitenbeek, G Paul Voorn, Willem Jan W Bos, Ewoudt M W van de Garde
Background: Utilization of diagnostics and biomarkers are the second largest cost drivers in the management of patients hospitalized with community-acquired pneumonia (CAP). The present study aimed to systematically assess the inter-hospital variation in these cost drivers in relation to antibiotic use in CAP. Methods: Detailed resource utilization data from 300 patients who participated in a multicenter placebo-controlled trial investigating dexamethasone as adjunctive treatment for community-acquired pneumonia was grouped into 3 categories: clinical chemistry testing, radiological exams, and microbiological testing...
2018: Pneumonia
Eddy Fadlyana, Eileen M Dunne, Kusnandi Rusmil, Rodman Tarigan, Sunaryati Sudigdoadi, Chrysanti Murad, Emma Watts, Cattram Nguyen, Catherine Satzke, Nurhandini Eka Dewi, Sang Ayu Kompiyang Indriyani, Finny Fitry Yani, Kim Mulholland, Cissy Kartasasmita
Background: Potentially pathogenic bacteria Streptococcus pneumoniae , Haemophilus influenzae , Moraxella catarrhalis , and Staphylococcus aureus are commonly carried in the nasopharynx of young children. Host and environmental factors have been linked with pathogen carriage, and in many studies rural children have higher carriage rates than their urban counterparts. There are few published data on what factors contribute to increased pathogen density. The objectives of this study were to identify risk factors for nasopharyngeal carriage and density of S...
2018: Pneumonia
Michael J Binks, Sarah A Moberley, Anne Balloch, Amanda J Leach, Sandra Nelson, Kim M Hare, Cate Wilson, Jane Nelson, Peter S Morris, Robert S Ware, Mimi L K Tang, Paul J Torzillo, Jonathan R Carapetis, Kim Mulholland, Ross M Andrews
Background: Indigenous children in Australia's Northern Territory are densely colonised with the pneumococcus within weeks of birth antecedent to a high prevalence of acute lower respiratory infection (ALRI). We assessed the impact of the 23-valent pneumococcal polysaccharide vaccine (23vPPV) in pregnancy against infant ALRI in this setting. Methods: In an open label, allocation concealed, outcome-assessor blinded, randomised controlled trial conducted in the Northern Territory of Australia, healthy Indigenous women aged 17-39 years were randomised to receive the 23vPPV during pregnancy ( n  = 75; 30-36 weeks gestation), at birth ( n  = 75), or at 7 months post-partum ( n  = 77)...
2018: Pneumonia
Ilektra Voulgareli, Alexandra Chronaiou, Dionisios Tsoukalas, George Tsoukalas
We report a case of endogenous lipoid pneumonia secondary to long-term use of amiodarone (> 30 years) for atrial fibrillation in a 76-year-old Caucasian woman, presenting with cough and dyspnea. Endogenous Lipoid pneumonia is a rare underdiagnosed condition more prevalent in adults. It is usually asymptomatic and a diagnosis is generally made in patients who have become clinically unstable or when an abnormal lung shadow is found on a chest X-ray. In the case here described it was diagnosed by fiberoptic bronchoscopy with bronchoalveolar lavage (BALF) where fat-laden macrophages (oil red O stain) were identified...
2018: Pneumonia
Paul N Zivich, John D Grabenstein, Sylvia I Becker-Dreps, David J Weber
Background: Streptococcus pneumoniae is capable of causing multiple infectious syndromes and occasionally causes outbreaks. The objective of this review is to update prior outbreak reviews, identify control measures, and comment on transmission. Methods: We conducted a review of published S. pneumoniae outbreaks, defined as at least two linked cases of S. pneumoniae . Results: A total of 98 articles (86 respiratory; 8 conjunctivitis; 2 otitis media; 1 surgical site; 1 multiple), detailing 94 unique outbreaks occurring between 1916 to 2017 were identified...
2018: Pneumonia
Katharine Yang, Robert L Kruse, Weijie V Lin, Daniel M Musher
Background: In most cases of community-acquired pneumonia (CAP), an etiologic agent is not determined; the most common report from the microbiological evaluation of sputum cites "normal respiratory flora." Non-diphtheria Corynebacterium spp. , a component of this flora, is commonly viewed as a contaminant, but it may be the cause of pneumonia and the frequency with which it causes CAP may be underestimated. Case presentations: This report present 3 cases of CAP in which Corynebacterium spp...
2018: Pneumonia
Carlos M Luna, Laura Pulido, Michael S Niederman, Alberto Casey, Diego Burgos, Sebastián D Leiva Agüero, Alejandra Grosso, Evangelina Membriani, Andrea C Entrocassi, Marcelo Rodríquez Fermepin, Carlos A Vay, Susana Garcia, Angela Famiglietti
Background: Streptococcus pneumoniae (SP) is one of the most common pathogens of Community-Acquired Pneumonia (CAP), but recent reports suggest that its incidence may be declining in relation to the use of the conjugate 13-valent pneumococcal vaccine in children. We compared the result of the immunochromatographic SP urinary antigen test (SPUAT) and clinical outcomes in patients with CAP admitted in two periods of time: 2001-2002(CAP1) and 2015-2016(CAP2). Methods: This was a matched nested case-control study of two prospectively recorded cohorts of patients admitted with CAP, with SPUAT and blood culture performed in all patients...
2018: Pneumonia
Ger T Rijkers, Stephen I Pelton
No abstract text is available yet for this article.
2018: Pneumonia
Robyn L Marsh, Maria T Nelson, Chris E Pope, Amanda J Leach, Lucas R Hoffman, Anne B Chang, Heidi C Smith-Vaughan
Background: Culture-independent sequencing methods are increasingly used to investigate the microbiota associated with human mucosal surfaces, including sites that have low bacterial load in healthy individuals (e.g. the lungs). Standard microbiota methods developed for analysis of high bacterial load specimens (e.g. stool) may require modification when bacterial load is low, as background contamination derived from sterile laboratory reagents and kits can dominate sequence data when few bacteria are present...
2018: Pneumonia
Esther L German, Bahij Al-Hakim, Elena Mitsi, Shaun H Pennington, Jenna F Gritzfeld, Angie D Hyder-Wright, Antonia Banyard, Stephen B Gordon, Andrea M Collins, Daniela M Ferreira
Background: The incidence of community-acquired pneumonia and lower respiratory tract infection rises considerably in later life. Immunoglobulin M (IgM) antibody levels to pneumococcal capsular polysaccharide are known to decrease with age; however, whether levels of IgM antibody to pneumococcal proteins are subject to the same decline has not yet been investigated. Methods: This study measured serum levels and binding capacity of IgM antibody specific to the pneumococcal surface protein A (PspA) and an unencapsulated pneumococcal strain in serum isolated from hospital patients aged < 60 and ≥ 60, with and without lower respiratory tract infection...
2018: Pneumonia
Leah N Githinji, Diane M Gray, Heather J Zar
Background: The advent of antiretroviral therapy has led to the improved survival of human immunodeficiency virus (HIV)-infected children to adulthood and to HIV becoming a chronic disease in older children and adolescents. Chronic lung disease is common among HIV-infected adolescents. Lung function measurement may help to delineate the spectrum, pathophysiology and guide therapy for HIV-related chronic lung disease. Aim: The aim of this study was to review the available data on the spectrum and determinants of lung function abnormalities and the impact of antiretroviral therapy on lung function in perinatally HIV-infected children and adolescents...
2018: Pneumonia
Rkia Eddabra, Hassan Ait Benhassou
Tuberculosis (TB) is an infectious disease that remains an important public health problem at the global level. It is one of the main causes of morbidity and mortality, due to the emergence of antibiotic resistant Mycobacterium strains and HIV co-infection. Over the past decade, important progress has been made for better control of the disease. While microscopy and culture continue to be indispensible for laboratory diagnosis of tuberculosis, the range of several molecular diagnostic tests, including the nucleic acid amplification test (NAAT) and whole-genome sequencing (WGS), have expanded tremendously...
2018: Pneumonia
Hirotaka Nakashima, Kazuhisa Watanabe, Hiroyuki Umegaki, Yusuke Suzuki, Masafumi Kuzuya
Background: Pneumonia is a very common disease, especially among the elderly. Various drugs' preventive effects against pneumonia have been reported. The antiplatelet drug cilostazol is used to prevent pneumonia, but the robustness of its efficacy is unclear. This review estimates the effectiveness of cilostazol for preventing pneumonia in elderly individuals. Methods: The following databases were searched from the earliest record to January 2016, without language restriction (the secondary search was conducted on February 2017): MEDLINE, Cochrane Library, CINAHL, and Ichushi-Web...
2018: Pneumonia
Biswajit Chakrabarti, Dan Wootton, Steven Lane, Elizabeth Kanwar, Joseph Somers, Jacyln Proctor, Nancy Prospero, Mark Woodhead
Background: The majority of patients with community acquired-pneumonia (CAP) are treated in primary care and the mortality in this group is very low. However, a small but significant proportion of patients who begin treatment in the community subsequently require admission due to symptomatic deterioration. This study compared patients who received community antibiotics prior to admission to those who had not, and looked for associations with clinical outcomes. Methods: This study analysed the Advancing Quality (AQ) Pneumonia database of patients admitted with CAP to 9 acute hospitals in the northwest of England over a 12-month period...
2018: Pneumonia
Paul Van Buynder, Robert Booy
Disease due to Streptococcus pneumoniae , the pneumococcus, remains a major source of illness in older persons. Globally, it remains the most important pathogen in respiratory infection deaths. Conjugated pneumococcal vaccines are used extensively in national pediatric programs, whereas a polysaccharide vaccine is used in all age groups, but mainly in the elderly and for high-risk groups. Recent data from the Netherlands led to the licensing in many countries of conjugated pneumococcal vaccines for older persons...
2018: Pneumonia
Deborah Lehmann, Wendy Kirarock, Anita H J van den Biggelaar, Megan Passey, Peter Jacoby, Gerard Saleu, Geraldine Masiria, Birunu Nivio, Andrew Greenhill, Tilda Orami, Jacinta Francis, Rebecca Ford, Lea-Ann Kirkham, Vela Solomon, Peter C Richmond, William S Pomat
Background: Children in third-world settings including Papua New Guinea (PNG) experience early onset of carriage with a broad range of pneumococcal serotypes, resulting in a high incidence of severe pneumococcal disease and deaths in the first 2 years of life. Vaccination trials in high endemicity settings are needed to provide evidence and guidance on optimal strategies to protect children in these settings against pneumococcal infections. Methods: This report describes the rationale, objectives, methods, study population, follow-up and specimen collection for a vaccination trial conducted in an endemic and logistically challenging setting in PNG...
2017: Pneumonia
Ger T Rijkers, Maria Rodriguez Gomez
Ever since Chuck Berry coined the term "rocking pneumonia" in his 1956 song "Roll over Beethoven", pneumonia has been mentioned frequently in modern blues and rock songs. We analyzed the lyrics of these songs to examine how various elements of pneumonia have been represented in popular music, specifically the cause of pneumonia, the risk groups, comorbidity (such as the boogie woogie flu), the clinical symptoms, and treatment and outcome. Up to this day, songwriters suggest that pneumonia is caused mainly by the cold and rain and that treatment is hardly possible, aside from a shot of rhythm and blues...
2017: Pneumonia
Keiko Konomura, Hideaki Nagai, Manabu Akazawa
Background: This study aimed to estimate the economic burden of community-acquired pneumonia (CAP) among elderly patients in Japan. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors. Methods: An administrative database was searched for elderly patients (≥ 65 years old) who had pneumonia (ICD-10 code: J12-J18) and an antibiotic prescription between 1 June 2014 and 31 May 2015. The all-cause total healthcare costs of outpatient and inpatient CAP episodes were calculated...
2017: Pneumonia
Esther Muthumbi, Brett S Lowe, Cyprian Muyodi, Esther Getambu, Fergus Gleeson, J Anthony G Scott
Background: Pneumonia is a leading cause of morbidity and mortality among adults worldwide; however, the risk factors for community-acquired pneumonia in Africa are not well characterized. Methods: The authors recruited 281 cases of community-acquired pneumonia and 1202 hospital controls among patients aged ≥15 years who attended Kilifi District Hospital/Coast Provincial General Hospital in Kenya between 1994 and 6. Cases were admissions with an acute illness with ≥2 respiratory signs and evidence of consolidation on a chest radiograph...
2017: Pneumonia
Diana van Kessel, Thijs Hoffman, Heleen van Velzen-Blad, Bob Meek, Suzan van Mens, Jan Grutters, Ger Rijkers
Background: Patients with recurrent respiratory tract infections and an impaired response to pneumococcal polysaccharide vaccination are diagnosed with a specific antibody deficiency. In adult patients with pneumococcal pneumonia an impaired antibody response to the infecting pneumococcal serotype can sometimes be found. It is unknown whether these patients are unable to produce an adequate anti-polysaccharide antibody response to pneumococcal vaccination after recovery. Case presentation: The authors describe a case of invasive pneumonia caused by Streptococcus pneumoniae serotype 9V in a previously healthy 35-year-old female...
2017: Pneumonia
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