1
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Sagawe JS, Loake VIP, Openshaw PJM, Kemp P, Culley FJ. Aging enhances pro-atrogenic gene expression and skeletal muscle loss following respiratory syncytial virus infection. GeroScience 2024:10.1007/s11357-024-01370-2. [PMID: 39354240 DOI: 10.1007/s11357-024-01370-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 09/25/2024] [Indexed: 10/03/2024] Open
Abstract
Aging and many age-related health conditions are associated with skeletal muscle loss. Furthermore, older adults are more susceptible to severe respiratory infections, which can in turn lead to muscle wasting. The mechanisms by which respiratory viral infection can impact skeletal muscle in older adults are not well understood. We determined the effects of acute infection with respiratory syncytial virus (RSV) on the lung and skeletal muscle of aged mice. RSV infection caused more severe disease in aged mice with enhanced weight loss, reduced feeding, higher viral load, and greater airway inflammation. Aged but not young mice showed decreased leg muscle weight at the peak of illness and decreased size of leg muscle fibers. Aged mice increased muscle-specific expression of atrophy-promoting enzymes (Atrogin-1 and MuRF-1) and failed to increase the rate of muscle protein synthesis during RSV infection. In aged mice, the changes in Atrogin-1 and MuRF-1 gene expression in skeletal muscle correlated with IL-6 levels in the lungs. These findings indicate that RSV infection of aged mice provides a model for studying the diverse adverse systemic consequences of respiratory viral infections on health and wellbeing in older adults.
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Affiliation(s)
- J Sophie Sagawe
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Verity I P Loake
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Peter J M Openshaw
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Paul Kemp
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Fiona J Culley
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
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2
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Liao JY, Feng XY, Zhang JX, Yang TD, Zhan MX, Zeng YM, Huang WY, Lian HB, Ke L, Cai SS, Zhang NF, Fang JW, Cai XY, Chen JD, Lin GY, Lin LY, Chen WZ, Liu YY, Huang FF, Lin CX, Lin M. RT-RPA- PfAgo detection platform for one-tube simultaneous typing diagnosis of human respiratory syncytial virus. Front Cell Infect Microbiol 2024; 14:1419949. [PMID: 39119294 PMCID: PMC11306018 DOI: 10.3389/fcimb.2024.1419949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/17/2024] [Indexed: 08/10/2024] Open
Abstract
Human respiratory syncytial virus (HRSV) is the most prevalent pathogen contributing to acute respiratory tract infections (ARTI) in infants and young children and can lead to significant financial and medical costs. Here, we developed a simultaneous, dual-gene and ultrasensitive detection system for typing HRSV within 60 minutes that needs only minimum laboratory support. Briefly, multiplex integrating reverse transcription-recombinase polymerase amplification (RT-RPA) was performed with viral RNA extracted from nasopharyngeal swabs as a template for the amplification of the specific regions of subtypes A (HRSVA) and B (HRSVB) of HRSV. Next, the Pyrococcus furiosus Argonaute (PfAgo) protein utilizes small 5'-phosphorylated DNA guides to cleave target sequences and produce fluorophore signals (FAM and ROX). Compared with the traditional gold standard (RT-qPCR) and direct immunofluorescence assay (DFA), this method has the additional advantages of easy operation, efficiency and sensitivity, with a limit of detection (LOD) of 1 copy/μL. In terms of clinical sample validation, the diagnostic accuracy of the method for determining the HRSVA and HRSVB infection was greater than 95%. This technique provides a reliable point-of-care (POC) testing for the diagnosis of HRSV-induced ARTI in children and for outbreak management, especially in resource-limited settings.
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Affiliation(s)
- Jia-Yu Liao
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xue-Yong Feng
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jie-Xiu Zhang
- Shantou University Medical College, Shantou, Guangdong, China
| | - Tian-Dan Yang
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Min-Xuan Zhan
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yong-Mei Zeng
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Wei-Yi Huang
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, China
| | - Hao-Bin Lian
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Lin Ke
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Si-Si Cai
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Nan-Fei Zhang
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jin-Wen Fang
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiao-Ying Cai
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jun-Duo Chen
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Guang-Yu Lin
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Li-Yun Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, China
| | - Wei-Zhong Chen
- Department of Medical Laboratory, Chaozhou People’s Hospital Affiliated to Shantou University Medical College, Chaozhou, Guangdong, China
| | - Yu-Yan Liu
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, China
| | - Fei-Fei Huang
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, China
| | - Chuang-Xing Lin
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Min Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, China
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, China
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3
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Johnson NV, van Scherpenzeel RC, Bakkers MJG, Ramamohan AR, van Overveld D, Le L, Langedijk JPM, Kolkman JA, McLellan JS. Structural basis for potent neutralization of human respirovirus type 3 by protective single-domain camelid antibodies. Nat Commun 2024; 15:5458. [PMID: 38937429 PMCID: PMC11211449 DOI: 10.1038/s41467-024-49757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 06/18/2024] [Indexed: 06/29/2024] Open
Abstract
Respirovirus 3 is a leading cause of severe acute respiratory infections in vulnerable human populations. Entry into host cells is facilitated by the attachment glycoprotein and the fusion glycoprotein (F). Because of its crucial role, F represents an attractive therapeutic target. Here, we identify 13 F-directed heavy-chain-only antibody fragments that neutralize recombinant respirovirus 3. High-resolution cryo-EM structures of antibody fragments bound to the prefusion conformation of F reveal three distinct, previously uncharacterized epitopes. All three antibody fragments bind quaternary epitopes on F, suggesting mechanisms for neutralization that may include stabilization of the prefusion conformation. Studies in cotton rats demonstrate the prophylactic efficacy of these antibody fragments in reducing viral load in the lungs and nasal passages. These data highlight the potential of heavy-chain-only antibody fragments as effective interventions against respirovirus 3 infection and identify neutralizing epitopes that can be targeted for therapeutic development.
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Affiliation(s)
- Nicole V Johnson
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, 78712, USA
| | | | - Mark J G Bakkers
- Janssen Vaccines & Prevention BV, Leiden, The Netherlands
- ForgeBio B.V., Amsterdam, The Netherlands
| | - Ajit R Ramamohan
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, 78712, USA
| | | | - Lam Le
- Janssen Vaccines & Prevention BV, Leiden, The Netherlands
| | - Johannes P M Langedijk
- Janssen Vaccines & Prevention BV, Leiden, The Netherlands
- ForgeBio B.V., Amsterdam, The Netherlands
| | - Joost A Kolkman
- Janssen Infectious Diseases and Vaccines, 2340, Beerse, Belgium
| | - Jason S McLellan
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, 78712, USA.
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4
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Wang Y, Liu ZL, Yang H, Li R, Liao SJ, Huang Y, Peng MH, Liu X, Si GY, He QZ, Zhang Y. Prediction of viral pneumonia based on machine learning models analyzing pulmonary inflammation index scores. Comput Biol Med 2024; 169:107905. [PMID: 38159398 DOI: 10.1016/j.compbiomed.2023.107905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/04/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
OBJECT To obtain Pulmonary Inflammation Index scores from imaging chest CT and combine it with clinical correlates of viral pneumonia to predict the risk and severity of viral pneumonia using a computer learning model. METHODS All patients with suspected viral pneumonia on CT examination admitted to The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from December 2022 to March 2023 were retrospectively selected. The respiratory viruses were monitored by RT-PCR and categorized into patients with viral pneumonia and those with non-viral pneumonia. The extent of lung inflammation was quantified according to the Pulmonary Inflammation Index score (PII). Information on patient demographics, comorbidities, laboratory tests, pathogenetic testing, and radiological data were collected. Five machine learning models containing Random Forest(RF), Radial Basis Function Neural Network (RBFNN), Support Vector Machine (SVM), K Nearest Neighbour Algorithm (KNN), and Kernel Ridge Regression (KRR) were used to predict the risk of onset and severity of viral pneumonia based on the clinically relevant factors or PII. RESULTS Among the five models, the SVM model performed best in ACC (76.75 %), SN (73.99 %), and F1 (72.42 %) and achieved a better area under the receiver operating characteristic curve (ROC) (0.8409) when predicting the risk of developing viral pneumonia. RF had the best overall classification accuracy in predicting the severity of viral pneumonia, especially in predicting pneumonia with a PII classification of grade I, the RF model achieved an accuracy of 98.89%. CONCLUSION Machine learning models are valuable in assessing the risk of viral pneumonia. Meanwhile, machine learning models confirm the importance in predicting the severity of viral pneumonia through PII. The establishment of machine learning models for predicting the risk and severity of viral pneumonia promotes the further development of machine learning in the medical field.
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Affiliation(s)
- Yong Wang
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China; Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, Sichuan Province, 646000, China.
| | - Zong-Lin Liu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China; Department of Intervention Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, China.
| | - Hai Yang
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Run Li
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Si-Jing Liao
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Yao Huang
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Ming-Hui Peng
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Xiao Liu
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Guang-Yan Si
- Department of Intervention Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, China.
| | - Qi-Zhou He
- Department of Radiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Ying Zhang
- Department of Anesthesiology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
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5
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Akila SM, Imanov E, Almezhghwi K. Investigating Beta-Variational Convolutional Autoencoders for the Unsupervised Classification of Chest Pneumonia. Diagnostics (Basel) 2023; 13:2199. [PMID: 37443592 DOI: 10.3390/diagnostics13132199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
The world's population is increasing and so is the challenge on existing healthcare infrastructure to cope with the growing demand in medical diagnosis and evaluation. Although human experts are primarily tasked with the diagnosis of different medical conditions, artificial intelligence (AI)-assisted diagnoses have become considerably useful in recent times. One of the critical lung infections, which requires early diagnosis and subsequent treatment to reduce the mortality rate, is pneumonia. There are different methods for obtaining a pneumonia diagnosis; however, the adoption of chest X-rays is popular since it is non-invasive. The AI systems for a pneumonia diagnosis using chest X-rays are often built on supervised machine-learning (ML) models, which require labeled datasets for development. However, collecting labeled datasets is sometimes infeasible due to constraints such as human resources, cost, and time. As such, the problem that we address in this paper is the unsupervised classification of pneumonia using unsupervised ML models including the beta-variational convolutional autoencoder (β-VCAE) and other variants, such as convolutional autoencoders (CAE), denoising convolutional autoencoders (DCAE), and sparse convolutional autoencoders (SCAE). Namely, the pneumonia classification problem is cast into an anomaly detection to develop the aforementioned ML models. The experimental results show that pneumonia can be diagnosed with high recall, precision, f1-score, and f2-score using the proposed unsupervised models. In addition, we observe that the proposed models are competitive with the state-of-the-art models, which are trained on a labeled dataset.
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Affiliation(s)
- Serag Mohamed Akila
- Department of Biomedical Engineering, Near East University, Mersin 10, 99138 Nicosia, Turkey
| | - Elbrus Imanov
- Department of Computer Engineering, Near East University, Mersin 10, 99138 Nicosia, Turkey
| | - Khaled Almezhghwi
- Electrical and Electronics Engineering, College of Electronics Technology Tripoli, Tripoli 00000, Libya
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6
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García-García J, Gracián C, Baños A, Guillamón E, Gálvez J, Rodriguez-Nogales A, Fonollá J. Beneficial Effects of Daily Consumption of Garlic and Onion Extract Concentrate on Infectious Respiratory Diseases in Elderly Resident Volunteers. Nutrients 2023; 15:nu15102308. [PMID: 37242191 DOI: 10.3390/nu15102308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/17/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Aging is a biological process with high susceptibility to several infections. This risk increases in older patients in residential care facilities (RCF). Thus, there is a clear demand for developing preventive interventions with new therapeutic compounds that combine efficacy and safety. This could be the case of compounds derived from plants of the genus Allium spp. The purpose of this study was to evaluate the impact of a combination of a garlic and onion extract concentrate standardized in organosulfur compounds derived from propiin on the incidence of respiratory tract infections in elderly patients of RCF. Sixty-five volunteers were selected at random to receive a placebo or a single daily dose of the extract for thirty-six weeks. Different clinical visits were performed to evaluate the main respiratory diseases with an infectious origin, as well as the associated symptoms and their duration. The extract showed a clinical safety profile and significantly reduced the incidence of respiratory infections. Moreover, the treatment decreased the number and duration of the associated symptoms compared with the placebo group. For the first time, we demonstrated the protective effect of Alliaceae extract in respiratory infectious diseases in elderly healthy volunteers, which could be used prophylactically against the most common infectious respiratory diseases.
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Affiliation(s)
- Jorge García-García
- Department of Pharmacology, Center for Biomedical Research (CIBM), University of Granada, 18071 Granada, Spain
| | - Carlos Gracián
- Nursing Home "Residencia de Mayores Claret", 18011 Granada, Spain
| | | | | | - Julio Gálvez
- Department of Pharmacology, Center for Biomedical Research (CIBM), University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), 18012 Granada, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Hepáticas y Digestivas (CIBER-EHD), 28029 Madrid, Spain
| | - Alba Rodriguez-Nogales
- Department of Pharmacology, Center for Biomedical Research (CIBM), University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), 18012 Granada, Spain
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7
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In Vitro Antiviral and Anti-Inflammatory Activities of N-Acetylglucosamine: Development of an Alternative and Safe Approach to Fight Viral Respiratory Infections. Int J Mol Sci 2023; 24:ijms24065129. [PMID: 36982205 PMCID: PMC10049122 DOI: 10.3390/ijms24065129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Viral respiratory tract infections (RTIs) are responsible for significant morbidity and mortality worldwide. A prominent feature of severe respiratory infections, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is the cytokine release syndrome. Therefore, there is an urgent need to develop different approaches both against viral replication and against the consequent inflammation. N-acetylglucosamine (GlcNAc), a glucosamine (GlcN) derivative, has been developed as an immunomodulatory and anti-inflammatory inexpensive and non-toxic drug for non-communicable disease treatment and/or prevention. Recent studies have suggested that GlcN, due to its anti-inflammatory activity, could be potentially useful for the control of respiratory virus infections. Our present study aimed to evaluate in two different immortalized cell lines whether GlcNAc could inhibit or reduce both viral infectivity and the inflammatory response to viral infection. Two different viruses, frequent cause of upper and lower respiratory tract infections, were used: the H1N1 Influenza A virus (IAV) (as model of enveloped RNA virus) and the Human adenovirus type 2 (Adv) (as model of naked DNA virus). Two forms of GlcNAc have been considered, bulk GlcNAc and GlcNAc in nanoform to overcome the possible pharmacokinetic limitations of GlcNAc. Our study suggests that GlcNAc restricts IAV replication but not Adv infection, whereas nano-GlcNAc inhibits both viruses. Moreover, GlcNAc and mainly its nanoformulation were able to reduce the pro-inflammatory cytokine secretion stimulated by viral infection. The correlation between inflammatory and infection inhibition is discussed.
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8
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Turner MD. Possible Causes of Hypertrophic Osteoarthropathy in the La Ferrassie 1 Neanderthal. Cureus 2023; 15:e35721. [PMID: 37016656 PMCID: PMC10066876 DOI: 10.7759/cureus.35721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
For over a century, researchers have been perplexed by the unique osteological findings on La Ferrassie 1 (LF1), one of the most complete Neanderthal remains ever found. In 1997, Fennel and Trinkaus proposed that LF1 suffered from hypertrophic osteoarthropathy (HOA), likely secondary to chronic thoracic infection or pulmonary malignancy. This disease process can have many etiologies, and no study has fully explored the possible origin of LF1's HOA. Ultimately, it is most likely that LF1's HOA etiology arose from one of the many infectious diseases that prehistoric Neanderthals were exposed to, specifically a chronic pulmonary RNA virus.
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Narasimhan H, Wu Y, Goplen NP, Sun J. Immune determinants of chronic sequelae after respiratory viral infection. Sci Immunol 2022; 7:eabm7996. [DOI: 10.1126/sciimmunol.abm7996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The acute effects of various respiratory viral infections have been well studied, with extensive characterization of the clinical presentation as well as viral pathogenesis and host responses. However, over the course of the recent COVID-19 pandemic, the incidence and prevalence of chronic sequelae after acute viral infections have become increasingly appreciated as a serious health concern. Post-acute sequelae of COVID-19, alternatively described as “long COVID-19,” are characterized by symptoms that persist for longer than 28 days after recovery from acute illness. Although there exists substantial heterogeneity in the nature of the observed sequelae, this phenomenon has also been observed in the context of other respiratory viral infections including influenza virus, respiratory syncytial virus, rhinovirus, severe acute respiratory syndrome coronavirus, and Middle Eastern respiratory syndrome coronavirus. In this Review, we discuss the various sequelae observed following important human respiratory viral pathogens and our current understanding of the immunological mechanisms underlying the failure of restoration of homeostasis in the lung.
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Affiliation(s)
- Harish Narasimhan
- Carter Immunology Center, University of Virginia, Charlottesville, VA 22908, USA
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA 22908, USA
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
| | - Yue Wu
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA 22908, USA
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
| | - Nick P. Goplen
- Division of Pulmonary and Critical Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, MN 55905, USA
| | - Jie Sun
- Carter Immunology Center, University of Virginia, Charlottesville, VA 22908, USA
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA 22908, USA
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
- Division of Pulmonary and Critical Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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10
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Akpalu W, Amegashie JA, Karuaihe ST. COVID -19 Morbidity and mortality in tropical countries: The effects of economic, institutional, and climatic variables. SCIENTIFIC AFRICAN 2022; 16:e01257. [PMID: 35765587 PMCID: PMC9221631 DOI: 10.1016/j.sciaf.2022.e01257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/21/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the significant and rising human and economic costs of the novel coronavirus disease (COVID-19), our knowledge on its epidemiology remains limited necessitating expedited research to aid public policy. This study contributes to the knowledge gap by focusing on exploring the effects of potential covariates (economic, institutional, and climatic conditions) on COVID-19 in tropical countries. Using an Ordinary Least Square (OLS) regression, our results showed a non-linear relationship between temperature and infection-to-test ratio. Specifically, temperatures warmer than 18 °C can favor the spread of the disease. In addition, strikingly, countries with better democratic principles registered more positive cases than their counterparts at high levels of corruption.
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Affiliation(s)
- Wisdom Akpalu
- School of Research and Graduate Studies (SRGS, Ghana Institute of Management and Public Administration (GIMPA), P. O. Box AH 50, Achimota-Accra, Ghana
| | - J Atsu Amegashie
- Department of Economics and Finance, Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, ON, N1G 2W1
| | - Selma T Karuaihe
- Department of Agricultural Economics, Extension and Rural Development, Faculty of Natural and Agricultural Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, Pretoria, South Africa
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11
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Hindupur A, Menon T, Dhandapani P. Molecular investigation of human metapneumovirus in children with acute respiratory infections in Chennai, South India, from 2016-2018. Braz J Microbiol 2022; 53:655-661. [PMID: 35118597 PMCID: PMC9151977 DOI: 10.1007/s42770-022-00689-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
Human metapneumovirus (hMPV) has emerged as a frequent cause of acute respiratory infections (ARI) among young children. The prevalence and genetic diversity of hMPV circulating in Chennai, Southern India, has not been studied yet. Hence, this study was aimed to investigate the prevalence, co-infection with other respiratory viruses like HRSV A and B, influenza A and B, hRV and HPIV 1-4 viruses, socio-demographic associations, and genotypes of hMPV among children in Chennai. A total of 350 nasal swab specimens were collected from children with ARI during April 2016 to August 2018 and tested for hMPV by real time PCR method. In this study, hMPV was detected in 4% (14/350) of the samples. One hMPV positive sample was found to be co-infected with influenza B virus. The mean and median ages of the children with hMPV infection were 61.5 months (5.1 years) and 83 months (6.9 years), respectively. Phylogenetic analysis of the partial F gene revealed the presence of A2c subcluster among the study strains as well as with B1 and B2 lineages. The prevalence data obtained in this study is important in evaluating the role of hMPV in childhood ARI and emphasizes the importance of routine viral diagnosis in hospitals. To the best of our knowledge, this is the first study to report the prevalence, seasonality, and genetic diversity of hMPV in Chennai as well as the first study to report A2c subcluster of hMPV among children in India.
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Affiliation(s)
- Anusha Hindupur
- grid.413015.20000 0004 0505 215XDepartment of Microbiology, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Chennai, Tamil Nadu India
| | - Thangam Menon
- Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu India
| | - Prabu Dhandapani
- grid.413015.20000 0004 0505 215XDepartment of Microbiology, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Chennai, Tamil Nadu India
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12
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Schuliga M, Read J, Knight DA. Ageing mechanisms that contribute to tissue remodeling in lung disease. Ageing Res Rev 2021; 70:101405. [PMID: 34242806 DOI: 10.1016/j.arr.2021.101405] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022]
Abstract
Age is a major risk factor for chronic respiratory diseases such as idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD) and certain phenotypes of asthma. The recent COVID-19 pandemic also highlights the increased susceptibility of the elderly to acute respiratory distress syndrome (ARDS), a diffuse inflammatory lung injury with often long-term effects (ie parenchymal fibrosis). Collectively, these lung conditions are characterized by a pathogenic reparative process that, rather than restoring organ function, contributes to structural and functional tissue decline. In the ageing lung, the homeostatic control of wound healing following challenge or injury has an increased likelihood of being perturbed, increasing susceptibility to disease. This loss of fidelity is a consequence of a diverse range of underlying ageing mechanisms including senescence, mitochondrial dysfunction, proteostatic stress and diminished autophagy that occur within the lung, as well as in other tissues, organs and systems of the body. These ageing pathways are highly interconnected, involving localized and systemic increases in inflammatory mediators and damage associated molecular patterns (DAMPs); along with corresponding changes in immune cell function, metabolism and composition of the pulmonary and gut microbiomes. Here we comprehensively review the roles of ageing mechanisms in the tissue remodeling of lung disease.
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Affiliation(s)
- Michael Schuliga
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Jane Read
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Darryl A Knight
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Providence Health Care Research Institute, Vancouver, British Columbia, Canada
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13
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Role of Chest Imaging in Viral Lung Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126434. [PMID: 34198575 PMCID: PMC8296238 DOI: 10.3390/ijerph18126434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/24/2022]
Abstract
The infection caused by novel beta-coronavirus (SARS-CoV-2) was officially declared a pandemic by the World Health Organization in March 2020. However, in the last 20 years, this has not been the only viral infection to cause respiratory tract infections leading to hundreds of thousands of deaths worldwide, referring in particular to severe acute respiratory syndrome (SARS), influenza H1N1 and Middle East respiratory syndrome (MERS). Although in this pandemic period SARS-CoV-2 infection should be the first diagnosis to exclude, many other viruses can cause pulmonary manifestations and have to be recognized. Through the description of the main radiological patterns, radiologists can suggest the diagnosis of viral pneumonia, also combining information from clinical and laboratory data.
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14
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Braun MR, Noton SL, Blanchard EL, Shareef A, Santangelo PJ, Johnson WE, Fearns R. Respiratory syncytial virus M2-1 protein associates non-specifically with viral messenger RNA and with specific cellular messenger RNA transcripts. PLoS Pathog 2021; 17:e1009589. [PMID: 34003848 PMCID: PMC8162694 DOI: 10.1371/journal.ppat.1009589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 05/28/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a major cause of respiratory disease in infants and the elderly. RSV is a non-segmented negative strand RNA virus. The viral M2-1 protein plays a key role in viral transcription, serving as an elongation factor to enable synthesis of full-length mRNAs. M2-1 contains an unusual CCCH zinc-finger motif that is conserved in the related human metapneumovirus M2-1 protein and filovirus VP30 proteins. Previous biochemical studies have suggested that RSV M2-1 might bind to specific virus RNA sequences, such as the transcription gene end signals or poly A tails, but there was no clear consensus on what RSV sequences it binds. To determine if M2-1 binds to specific RSV RNA sequences during infection, we mapped points of M2-1:RNA interactions in RSV-infected cells at 8 and 18 hours post infection using crosslinking immunoprecipitation with RNA sequencing (CLIP-Seq). This analysis revealed that M2-1 interacts specifically with positive sense RSV RNA, but not negative sense genome RNA. It also showed that M2-1 makes contacts along the length of each viral mRNA, indicating that M2-1 functions as a component of the transcriptase complex, transiently associating with nascent mRNA being extruded from the polymerase. In addition, we found that M2-1 binds specific cellular mRNAs. In contrast to the situation with RSV mRNA, M2-1 binds discrete sites within cellular mRNAs, with a preference for A/U rich sequences. These results suggest that in addition to its previously described role in transcription elongation, M2-1 might have an additional role involving cellular RNA interactions.
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Affiliation(s)
- Molly R. Braun
- Department of Microbiology, Boston University School of Medicine; National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, United States of America
| | - Sarah L. Noton
- Department of Microbiology, Boston University School of Medicine; National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, United States of America
| | - Emmeline L. Blanchard
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States of America
| | - Afzaal Shareef
- Department of Microbiology, Boston University School of Medicine; National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, United States of America
| | - Philip J. Santangelo
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States of America
| | - W. Evan Johnson
- Division of Computational Biomedicine and Bioinformatics Program and Department of Biostatistics, Boston University, Boston, Massachusetts, United States of America
| | - Rachel Fearns
- Department of Microbiology, Boston University School of Medicine; National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, United States of America
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15
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Kumar R, Dar L, Amarchand R, Saha S, Lafond KE, Purakayastha DR, Kumar R, Choudekar A, Gopal G, Dhakad S, Narayan VV, Wahi A, Chhokar R, Lindstrom S, Whitaker B, Choudhary A, Dey AB, Krishnan A. Incidence, risk factors, and viral etiology of community-acquired acute lower respiratory tract infection among older adults in rural north India. J Glob Health 2021; 11:04027. [PMID: 33880179 PMCID: PMC8035979 DOI: 10.7189/jogh.11.04027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are limited data on incidence, risk factors and etiology of acute lower respiratory tract infection (LRTI) among older adults in low- and middle-income countries. METHODS We established a cohort of community dwelling older adults ≥60 years and conducted weekly follow-up for acute respiratory infections (ARI) during 2015-2017. Nurses assessed ARI cases for LRTI, collecting combined nasal/throat swabs from all LRTI cases and an equal number of age- and sex-matched asymptomatic neighbourhood controls. Swabs were tested for influenza viruses, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza viruses (PIV) using polymerase chain reaction. LRTI and virus-specific LRTI incidence was calculated per 1000 person-years. We estimated adjusted incidence rate ratios (IRR) for risk factors using Poisson regression and calculated etiologic fractions (EF) using adjusted odds ratios for detection of viral pathogens in LRTI cases vs controls. RESULTS We followed 1403 older adults for 2441 person-years. LRTI and LRTI-associated hospitalization incidences were 248.3 (95% confidence interval (CI) = 229.3-268.8) and 12.7 (95% CI = 8.9-18.1) per 1000 person-years. Persons with pre-existing chronic bronchitis as compared to those without (incidence rate ratio (IRR) = 4.7, 95% CI = 3.9-5.6); aged 65-74 years (IRR = 1.6, 95% CI = 1.3-2.0) and ≥75 years (IRR = 1.8, 95% CI = 1.4-2.4) as compared to 60-64 years; and persons in poorest wealth quintile (IRR = 1.4, 95% CI = 1.1-1.8); as compared to those in wealthiest quintile were at higher risk for LRTI. Virus was detected in 10.1% of LRTI cases, most commonly influenza (3.8%) and RSV (3.0%). EF for RSV and influenza virus was 83.9% and 83.6%, respectively. CONCLUSION In this rural cohort of older adults, the incidence of LRTI was substantial. Chronic bronchitis was an important risk factor; influenza virus and RSV were major viral pathogens.
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Affiliation(s)
- Rakesh Kumar
- All India Institute of Medical Sciences, New Delhi
| | - Lalit Dar
- All India Institute of Medical Sciences, New Delhi
| | | | - Siddhartha Saha
- Influenza Division, Centers for Disease Control and Prevention- India Country Office, New Delhi, India
| | - Kathryn E Lafond
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ramesh Kumar
- All India Institute of Medical Sciences, New Delhi
| | | | | | | | - Venkatesh Vinayak Narayan
- Influenza Division, Centers for Disease Control and Prevention- India Country Office, New Delhi, India
| | | | | | | | - Brett Whitaker
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - A B Dey
- All India Institute of Medical Sciences, New Delhi
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16
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Morimoto Y, Ishiguro T, Kasuga K, Takano K, Ozawa R, Isono T, Akiyama Y, Kobayashi Y, Kobayashi Y, Shimizu Y, Takayanagi N. Two Cases of Primary Rhinovirus Pneumonia with Multiple Pulmonary Nodules. Intern Med 2021; 60:435-439. [PMID: 32863361 PMCID: PMC7925285 DOI: 10.2169/internalmedicine.4586-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Two patients, a 60-year-old man and 43-year-old woman, presented to our hospital with symptoms of respiratory tract infection. These patients showed imaging findings of multiple small nodules, ground-glass opacities, and consolidations. In case 1, although antibiotics were started, bilateral shadows spread widely, which made us suspect interstitial pneumonia. The condition improved after steroid administration, and there has been no recurrence since completing this treatment. In case 2, the patient recovered rapidly with antibiotics only. In both cases, we performed bronchoalveolar lavage, in which only human rhinovirus infection was detected by multiplex polymerase chain reaction testing, and primary rhinovirus pneumonia was diagnosed.
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Affiliation(s)
- Yasuhiro Morimoto
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Keisuke Kasuga
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Kenji Takano
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Ryota Ozawa
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Taisuke Isono
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yuto Akiyama
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yasuhito Kobayashi
- Department of Pathology, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yoichi Kobayashi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yoshihiko Shimizu
- Department of Pathology, Saitama Cardiovascular and Respiratory Center, Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
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17
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Sharma A, Batra J, Stuchlik O, Reed MS, Pohl J, Chow VTK, Sambhara S, Lal SK. Influenza A Virus Nucleoprotein Activates the JNK Stress-Signaling Pathway for Viral Replication by Sequestering Host Filamin A Protein. Front Microbiol 2020; 11:581867. [PMID: 33101257 PMCID: PMC7546217 DOI: 10.3389/fmicb.2020.581867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/07/2020] [Indexed: 12/28/2022] Open
Abstract
Influenza A virus (IAV) poses a major threat to global public health and is known to employ various strategies to usurp the host machinery for survival. Due to its fast-evolving nature, IAVs tend to escape the effect of available drugs and vaccines thus, prompting the development of novel antiviral strategies. High-throughput mass spectrometric screen of host-IAV interacting partners revealed host Filamin A (FLNA), an actin-binding protein involved in regulating multiple signaling pathways, as an interaction partner of IAV nucleoprotein (NP). In this study, we found that the IAV NP interrupts host FLNA-TRAF2 interaction by interacting with FLNA thus, resulting in increased levels of free, displaced TRAF2 molecules available for TRAF2-ASK1 mediated JNK pathway activation, a pathway critical to maintaining efficient viral replication. In addition, siRNA-mediated FLNA silencing was found to promote IAV replication (87% increase) while FLNA-overexpression impaired IAV replication (65% decrease). IAV NP was observed to be a crucial viral factor required to attain FLNA mRNA and protein attenuation post-IAV infection for efficient viral replication. Our results reveal FLNA to be a host factor with antiviral potential hitherto unknown to be involved in the IAV replication cycle thus, opening new possibilities of FLNA-NP interaction as a candidate anti-influenza drug development target.
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Affiliation(s)
- Anshika Sharma
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
| | - Jyoti Batra
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
| | - Olga Stuchlik
- National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Matthew S Reed
- National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jan Pohl
- National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Vincent T K Chow
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Suryaprakash Sambhara
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sunil K Lal
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia.,Tropical Medicine and Biology Multidisciplinary Platform, Monash University Malaysia, Subang Jaya, Malaysia
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18
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Garcia LL. The Contagion of Pneumonia in Older Persons: An Application of the Bass Diffusion Model. Gerontol Geriatr Med 2020; 6:2333721420949308. [PMID: 32923521 PMCID: PMC7448265 DOI: 10.1177/2333721420949308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/07/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022] Open
Abstract
This aims to provide an understanding of the spread of pneumonia through analysis of the interaction between infected and potentially infected. Data from 2010 to 2018 on Pneumonia morbidity among older persons age 65 and above was extracted from the Department of Health Field Health Service Information System (FHSIS) annual reports. The data were used to represent the cumulative adopters by fitting them to the Bass diffusion model using the Bass Forecasting Spreadsheet. The number of new adopters was graphed to forecast the diffusion of Pneumonia. The number of cases is expected to increase. The adoption rate in 2024 will be around 45% of the current population. Morbidity of pneumonia is expected to peak in the year 2200, 190 years after the first data. The use of the model provided an insight into the cumulative nature of pneumonia infection due to the interaction between infected and the potentially infected.
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19
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Gilsenan-Reed C, Higgins G, Langlois N. Determining a sampling regime for PCR detection of respiratory tract viral infection at coronial post-mortem examinations. Forensic Sci Med Pathol 2020; 16:457-462. [PMID: 32578131 PMCID: PMC7308444 DOI: 10.1007/s12024-020-00273-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 02/08/2023]
Abstract
Death due to respiratory infection is commonly encountered at autopsy. With only one opportunity to obtain samples for identification of a causative agent, it is important to ensure that sampling regimes are optimized to provide the greatest detection, without the expense and redundancy that can arise from over-sampling. This study was performed retrospectively using data from Coronial autopsies over the period 2012–2019 from which swabs from the nasopharyngeal region, trachea and lung parenchyma, in addition to samples of lung tissue, had been submitted for multiplex PCR detection of respiratory pathogens. From 97 cases with all four samples, there were 24 with at least one positive result for viral infection. Some cases had multiple positive results and a total of 27 respiratory tract viruses were identified, of which rhinovirus, influenza A virus and respiratory syncytial virus were the most common. Seventeen of the 27 viral infections (63%) were identified in all four samples. However, in nearly all cases (96%) the nasopharyngeal swab detected the infective agent when the multiplex PCR panel had detected infection in any of the four sample types. A nasopharyngeal swab is considered to be an optimal sample for detection of respiratory tract viral infection. As the samples analyzed were acquired before the appearance of the COVID-19 virus, the applicability of this finding for COVID-19 screening is not established.
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Affiliation(s)
- Caitlin Gilsenan-Reed
- School of Medical and Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Geoff Higgins
- Microbiology and Infectious Diseases Directorate, SA Pathology, North Terrace, Adelaide, South Australia, Australia
| | - Neil Langlois
- School of Medical and Health Sciences, University of Adelaide, Adelaide, South Australia, Australia. .,Consultant Forensic Pathologist, Forensic Science SA, GPO Box 2790, Adelaide, South Australia, 5001, Australia.
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20
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Ishiguro T, Kobayashi Y, Takano K, Ozawa R, Shimizu Y, Takayanagi N. Two Cases of Primary Human Parainfluenza Virus 1 Pneumonia in Which Bronchoalveolar Lavage Fluid Yielded Human Parainfluenza Virus 1. Intern Med 2020; 59:101-105. [PMID: 31511487 PMCID: PMC6995725 DOI: 10.2169/internalmedicine.3435-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Two patients, a 76-year-old woman and 66-year-old woman, presented to our hospital with symptoms of lower respiratory tract infection. Both patients showed chest imaging findings of bilateral ground-glass opacities and consolidations. We initially suspected these patients of having influenza-associated pneumonia and cryptogenic organizing pneumonia, respectively, and performed bronchoalveolar lavage, but only human parainfluenza virus-1 infection was detected by multiplex polymerase chain reaction testing. These findings suggest that pneumonia due to human parainfluenza virus-1 should be included in the differential diagnosis of such cases.
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Affiliation(s)
- Takashi Ishiguro
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yasuhito Kobayashi
- Department of Pathology, Saitama Cardiovascular and Respiratory Center, Japan
| | - Kenji Takano
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Ryota Ozawa
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
| | - Yoshihiko Shimizu
- Department of Pathology, Saitama Cardiovascular and Respiratory Center, Japan
| | - Noboru Takayanagi
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan
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21
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Liu WK, Chen DH, Tan WP, Qiu SY, Xu D, Zhang L, Gu SJ, Zhou R, Liu Q. Paramyxoviruses respiratory syncytial virus, parainfluenza virus, and human metapneumovirus infection in pediatric hospitalized patients and climate correlation in a subtropical region of southern China: a 7-year survey. Eur J Clin Microbiol Infect Dis 2019; 38:2355-2364. [PMID: 31489496 PMCID: PMC6858468 DOI: 10.1007/s10096-019-03693-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/26/2019] [Indexed: 11/11/2022]
Abstract
To investigate the features of paramyxovirus respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (HMPV) infection and determine the effect of meteorological conditions in Guangzhou, a subtropical region of southern China. We collected 11,398 respiratory samples from hospitalized pediatric patients with acute respiratory illness between July 2009 and June 2016 in Guangzhou. The samples were tested simultaneously for 18 respiratory pathogens using real-time PCR. Local meteorological data were also collected for correlation analysis. Of 11,398 patients tested, 5606 (49.2%) patients tested positive for one or more pathogens; RSV, PIV, and HMPV were the first, sixth, and ninth most frequently detected pathogens, in 1690 (14.8%), 502 (4.4%), and 321 (2.8%) patients, respectively. A total 17.9% (4605/5606) of patients with positive results had coinfection with other pathogens. Significant differences were found in the prevalence of RSV, PIV, and HMPV among all age groups (p < 0.001). RSV and HMPV had similar seasonal patterns, with two prevalence peaks every year. PIV appeared alternatively with RSV and HMPV. Multiple linear regression models were established for RSV, PIV, and HMPV prevalence and meteorological factors (p < 0.05). RSV and PIV incidence was negatively correlated with monthly mean relative humidity; RSV and HMPV incidence was negatively correlated with sunshine duration; PIV incidence was positively correlated with mean temperature. We described the features of paramyxovirus infection in a subtropical region of China and highlighted the correlation with meteorological factors. These findings will assist public health authorities and clinicians in improving strategies for controlling paramyxovirus infection.
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Affiliation(s)
- Wen-Kuan Liu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | - De-Hui Chen
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Ping Tan
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shu-Yan Qiu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | - Duo Xu
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | - Li Zhang
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | - Shu-Jun Gu
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rong Zhou
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | - Qian Liu
- Scientific Research Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Pediatrics, Dongguan Eighth People’s Hospital, Dongguan, China
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22
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Qian Y, Ai J, Wu J, Yu S, Cui P, Gao Y, Jin J, Weng X, Zhang W. Rapid detection of respiratory organisms with FilmArray respiratory panel and its impact on clinical decisions in Shanghai, China, 2016-2018. Influenza Other Respir Viruses 2019; 14:142-149. [PMID: 31786832 PMCID: PMC7040966 DOI: 10.1111/irv.12701] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/15/2019] [Accepted: 10/18/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In this study, we evaluated the diagnostic potential and clinical impact of an automated multiplex PCR platform (the FilmArray Respiratory Panel; FA-RP), specially designed for pathogen detection in respiratory tract infections in adults with unexplained pneumonia (UP). METHODS A total of 112 UP patients in Shanghai, China, were enrolled prospectively and assessed using the FA-RP from October 2016 to March 2018. We examined the test results and their influence on clinical decisions. Furthermore, as a control group, we retrospectively obtained the clinical data of 70 UP patients between October 2014 and March 2016 (before the FA-RP was available). The two patient groups were compared with respect to factors, including general antimicrobial use and defined daily dose (DDD) numbers. RESULTS Between October 2016 and March 2018, the positive rate obtained using FA-RP for UP was 76.8%. The primary pathogens in adults with UP were Influenza A/B (47.3%, 53/112). Compared with the patients before FA-RP was available, patients who underwent FA-RP testing had higher rates of antiviral drug use and antibiotic de-escalation during clinical treatment. FA-RP significantly decreased the total DDDs of antibiotic or antifungal drugs DDDs by 7 days after admission (10.6 ± 2.5 vs 14.1 ± 8.8, P < .01). CONCLUSIONS The FA-RP is a rapid and sensitive nucleic acid amplification test method for UP diagnosis in adults. The application of FA-RP may lead to a more accurately targeted antimicrobial treatment and reduced use of antibiotic/antifungal drugs.
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Affiliation(s)
- Yiyi Qian
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingwen Ai
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Shenglei Yu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Peng Cui
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Gao
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jialin Jin
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinhua Weng
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,Key Laboratory of Medical Molecular Virology (MOE/MOH) and Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China
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23
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Civljak R, Kosutic-Gulija T, Slovic A, Huljev E, Turcic N, Mestrovic T, Vranes J, Ljubin-Sternak S. An Outbreak of Human Parainfluenza Virus 3 (Phylogenetic Subcluster C5) Infection among Adults at a Residential Care Facility for the Disabled in Croatia, 2018. Intervirology 2019; 62:174-181. [PMID: 31661701 DOI: 10.1159/000503630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/20/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Although highly pertinent for children, outbreaks of human parainfluenza virus (HPIV) may cause up to 15% of all respiratory illnesses in adults and predispose them to serious adverse outcomes, with HPIV serotype 3 (HPIV3) being the most common. This study represents the first report of an HPIV3 outbreak among adults at a long-term health-care facility in Croatia. METHODS A retrospective study was conducted to investigate an outbreak of acute respiratory infection (ARI) at a single residential care facility for the disabled in Croatia. Demographic, epidemiological, and clinical data were collected for all residents, while hospitalized patients were appraised in detail by laboratory/radiological methods. Multiplex PCR for respiratory viruses and sequencing was performed. Partial HPIV3 HN 581 nt sequences were aligned with HPIV3 sequences from the GenBank database to conduct a phylogenetic analysis, where different bioinformatic approaches were employed. RESULTS In late June 2018, 5 of the 10 units at the facility were affected by the outbreak. Among the 106 residents, 23 (21.7%) developed ARI, and 6 (26.1%) of them were hospitalized. HPIV3 was identified in 18 (73%) of the residents and 5 (83%) of the hospitalized individuals. Isolated HPIV3 strains were classified within the phylogenetic subcluster C5 but grouped on 2 separate branches of the phylogenetic tree. During the entire outbreak period, none of the institution's employees reported symptoms of ARI. CONCLUSIONS Our study has shown that this health care-associated outbreak of HPIV3 infection could have been linked to multiple importation events. Preventive measures in curbing such incidents should be enforced vigorously.
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Affiliation(s)
- Rok Civljak
- Department of Respiratory Tract Infections,Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Tanja Kosutic-Gulija
- Center of Excellence for Virus Immunology and Vaccines, Center for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Anamarija Slovic
- Center of Excellence for Virus Immunology and Vaccines, Center for Research and Knowledge Transfer in Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Eva Huljev
- Department of Respiratory Tract Infections,Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nikolina Turcic
- Department of Epidemiology, Zagreb County Institute of Public Health, Dugo Selo Branch, Dugo Selo, Croatia
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia.,University Centre Varaždin, University North, Varaždin, Croatia
| | - Jasmina Vranes
- Clinical Microbiology Department, Dr. Andrija Stampar Teaching Institute of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Suncanica Ljubin-Sternak
- Clinical Microbiology Department, Dr. Andrija Stampar Teaching Institute of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia,
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Dowson L, Marshall C, Buising K, Friedman ND, Kong DCM, Stuart RL. Optimizing treatment of respiratory tract infections in nursing homes: Nurse-initiated polymerase chain reaction testing. Am J Infect Control 2019; 47:911-915. [PMID: 30851997 PMCID: PMC7172091 DOI: 10.1016/j.ajic.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/03/2019] [Accepted: 02/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diagnostic testing using polymerase chain reaction (PCR) is infrequently initiated for diagnosis of respiratory tract infections (RTIs) in nursing homes. The objectives of this study were to determine the feasibility of implementing nurse-initiated PCR testing of respiratory specimens in nursing home settings and to compare antibiotic prescribing prior to and during the implementation. METHODS This was a pragmatic, historically controlled study in 3 nursing homes (181 total beds) in Melbourne, Australia. RESULTS The number of PCR tests of respiratory specimens (over 12 months) increased from 5 to 67 when nurses could initiate the tests. Residents with RTI symptoms had a virus identified by PCR in 50.7% of tests, including 14 positive for influenza. Six outbreaks were identified. When clustering was taken into consideration, incidence rates of antibiotic days of therapy did not change (incidence rate ratio = 0.94, 95% confidence interval, 0.25-3.35, P = .92) despite identification of more viral pathogens. CONCLUSIONS In nursing homes, nurse-initiated PCR testing of respiratory specimens is feasible and useful in terms of identifying the cause of many RTIs and outbreaks, and viruses are common in this context. However, the current study suggests the availability of these test results alone does not impact antibiotic prescribing.
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Affiliation(s)
- Leslie Dowson
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Caroline Marshall
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia; Victorian Infectious Diseases Service, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Infection Prevention and Surveillance Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Kirsty Buising
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia; Victorian Infectious Diseases Service, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia
| | - N Deborah Friedman
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia; Departments of General Medicine and Infectious Diseases, Barwon Health, Geelong, Victoria, Australia
| | - David C M Kong
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Pharmacy Department, Ballarat Health Services, Ballarat, Victoria, Australia
| | - Rhonda L Stuart
- National Centre for Antimicrobial Stewardship, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia; Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Monash Infectious Diseases and Infection Control and Epidemiology, Monash Health, Clayton, Victoria, Australia.
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Jinnouchi O, Ohnishi H, Kondo E, Kawata I, Bando H, Okamoto H, Azuma T, Sato G, Kitamura Y, Abe K, Takeda N. Aural stimulation with capsaicin prevented pneumonia in dementia patients. Auris Nasus Larynx 2019; 47:154-157. [PMID: 31280931 DOI: 10.1016/j.anl.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/11/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In the present study, we examined the effects of daily application of capsaicin ointment to the external auditory canal for 6 months on the development of pneumonia in elderly dementia patients at high risk of aspiration. METHODS Twenty-nine oldest-old bedridden dementia inpatients at high risk of aspiration were enrolled in the present study. Ointment containing 0.025% capsaicin was applied to each external auditory canal with a cotton swab alternatively once a day for 6 months. RESULTS The incidence of pneumonia during the 6 months before the intervention was 1.80±0.37 in these patients. However, this incidence significantly decreased to 0.40±0.29 (p<0.01) during the 6 months of the alternative application of capsaicin ointment to each auditory canal. No adverse effect such as otalgia was observed. CONCLUSION These findings suggest that daily long-term aural stimulation with capsaicin ointment enhanced the cough reflex via Arnold's ear-cough reflex as a glottis protective measure, resulting in the reduction of incidence of pneumonia in elderly dementia patients at high risk of aspiration. The daily aural stimulation with capsaicin ointment may be a safe and promising intervention to prevent aspiration pneumonia in elderly people, especially those who cannot undergo swallowing exercise.
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Affiliation(s)
- Osamu Jinnouchi
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan; Department of Otolaryngology, Anan Kyoei Hospital, Tokushima, Japan
| | - Hiroki Ohnishi
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Eiji Kondo
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ikuji Kawata
- Department of Otolaryngology, Anan Kyoei Hospital, Tokushima, Japan
| | - Hiroyasu Bando
- Department of Respiratory Medicine, Tokushima Prefectural Kaifu Hospital, Tokushima, Japan
| | - Hidehiko Okamoto
- Department of Physiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Takahiro Azuma
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Go Sato
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koji Abe
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
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Sinha A, Ponnusamy V, Gupta SS, Raheja H, Patti R, Soni P, Malhan N, Lin YS, Kupfer Y. An Intensive Care Unit Outbreak of Acute Respiratory Distress Syndrome due to Human Metapneumo Virus Infection. J Investig Med High Impact Case Rep 2019; 7:2324709619860549. [PMID: 31271048 PMCID: PMC6611009 DOI: 10.1177/2324709619860549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Human metapneumo virus is an emerging cause of upper and lower respiratory tract illness with increasing reports of a varied spectrum of disease over all age groups. We report an outbreak of 6 cases of human metapneumo virus infection in the intensive care unit of a metropolitan tertiary care center over 6 weeks, leading to severe acute respiratory distress syndrome. We report the subsequent favorable outcomes due to the institution of extracorporeal membrane oxygenation.
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Affiliation(s)
- Ankur Sinha
- 1 Maimonides Medical Center, Brooklyn, NY, USA
| | | | | | | | | | - Parita Soni
- 1 Maimonides Medical Center, Brooklyn, NY, USA
| | | | - Yu Shia Lin
- 1 Maimonides Medical Center, Brooklyn, NY, USA
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Badar N, Salman M, Aamir UB, Ansari J, Ranjha MA, Khan MA, Ikram A, Nisar N, Mushtaq N, Mirza HA. Evolutionary analysis of influenza A(H1N1)pdm09 during the pandemic and post-pandemic period in Pakistan. J Infect Public Health 2019; 13:407-413. [PMID: 31000492 DOI: 10.1016/j.jiph.2019.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/08/2019] [Accepted: 03/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The first case of influenza A(H1N1)pdm09 was detected in Pakistan in June 2009. Since then, it has continued to circulate causing considerable morbidity and mortality. The purpose of this study was to evaluate the evolutionary changes in influenza A(H1N1)pdm09 viruses from 2009 to 2016 and their relevance to the current vaccine viruses. METHODS Respiratory specimens (throat or nasopharyngeal swabs) were collected from patients with influenza-like illness and severe acute respiratory illness. Samples were processed following the protocol of the US Centers for Disease Control and Prevention. Sequencing and phylogenetic analysis of Haemagglutinin and neuraminidase genes were carried out on representative isolates of Pakistan viruses. RESULTS Between January 2009 and February 2016, out of 16,024 samples analysed, 1950 (12%) were positive for influenza A. During the pandemic period (2009-2010), influenza A(H1N1)pdm09 was the dominant strain with 366 out of 808 (45%) total influenza positive cases. In the post-pandemic period (2011-2016), a total of 1078 out of 1911 (56%) cases were positive for influenza A(H1N1)pdm09 with co-circulation of different influenza A subtypes. The Pakistan A(H1N1)pdm09 viruses belonged to two genetic clades: clade 7 in the pandemic period, and clade 7 (2011) and clade 6B (2015) in the post-pandemic period. Sequence analysis of genes coding for surface glycoprotein's of Haemagglutinin and neuraminidase had a high degree of sequence similarity with corresponding genes of regional viruses circulating in South-East Asia. CONCLUSION Influenza A(H1N1)pdm09 viruses from Pakistan clustered into two genetic clades, with co-circulation of some variants. Key substitutions in the receptor binding site and a few changes indicative of virulence were also detected in the post-pandemic strains. Continued monitoring of the viruses is essential for early identification of potential variants of high virulence and their relevance to current vaccine strains.
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Affiliation(s)
- Nazish Badar
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan.
| | - Muhammad Salman
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Uzma B Aamir
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Jamil Ansari
- Department of Field Epidemiology & Disease Surveillance Unit, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Muazam A Ranjha
- Department of Field Epidemiology & Disease Surveillance Unit, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Mumtaz A Khan
- Department of Field Epidemiology & Disease Surveillance Unit, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Aamer Ikram
- Executive Director, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Nadia Nisar
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Nighat Mushtaq
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Hamza A Mirza
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
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Prendki V, Huttner B, Marti C, Mamin A, Fubini PE, Meynet MP, Scheffler M, Montet X, Janssens JP, Reny JL, Kaiser L, Garin N, Stirnemann J. Accuracy of comprehensive PCR analysis of nasopharyngeal and oropharyngeal swabs for CT-scan-confirmed pneumonia in elderly patients: a prospective cohort study. Clin Microbiol Infect 2019; 25:1114-1119. [PMID: 30641227 PMCID: PMC7172172 DOI: 10.1016/j.cmi.2018.12.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 12/18/2018] [Accepted: 12/22/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES We aimed to assess the accuracy of PCR detection of viruses and bacteria on nasopharyngeal and oropharyngeal swabs (NPS) for the diagnosis of pneumonia in elderly individuals. METHODS We included consecutive hospitalized elderly individuals suspected of having pneumonia. At inclusion, NPS were collected from all participants and tested by PCR for the presence of viral and bacterial respiratory pathogens (index test, defined as comprehensive molecular testing). Routine diagnostic tests (blood and sputum culture, urine antigen detection) were also performed. The reference standard was the presence of pneumonia on a low-dose CT scan as assessed by two independent expert radiologists. RESULTS The diagnosis of pneumonia was confirmed in 127 of 199 (64%) included patients (mean age 83 years, community-acquired pneumonia in 105 (83%)). A pathogen was identified by comprehensive molecular testing in 114 patients (57%) and by routine methods in 22 (11%). Comprehensive molecular testing was positive for viruses in 62 patients (31%) and for bacteria in 73 (37%). The sensitivity and specificity were 61% (95% CI 53%-69%) and 50% (95% CI 39%-61%) for comprehensive molecular testing, and 14% (95% CI 82%-21%) and 94% (95% CI 86%-98%) for routine testing, respectively. Positive likelihood ratio was 2.55 for routine methods and 1.23 for comprehensive molecular testing. CONCLUSION Comprehensive molecular testing of NPS increases the number of pathogens detected compared with routine methods, but results are poorly predictive of the presence of pneumonia. Hence, comprehensive molecular testing is unlikely to impact clinical decision-making (NCT02467192). CLINICAL TRIALS REGISTRATION NCT02467192.
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Affiliation(s)
- V Prendki
- ) Division of Internal Medicine and Rehabilitation, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland; ) Faculty of Medicine, University of Geneva, Switzerland.
| | - B Huttner
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Division of Infectious Diseases, Geneva University Hospitals, Switzerland
| | - C Marti
- ) Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
| | - A Mamin
- ) Division of Infectious Diseases, Geneva University Hospitals, Switzerland
| | - P E Fubini
- ) Division of Internal Medicine and Rehabilitation, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland; ) Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
| | - M P Meynet
- ) Division of Internal Medicine and Rehabilitation, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
| | - M Scheffler
- ) Department of Radiology, Geneva University Hospitals, Switzerland
| | - X Montet
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Department of Radiology, Geneva University Hospitals, Switzerland
| | - J P Janssens
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Department of Pneumology, Geneva University Hospitals, Switzerland
| | - J L Reny
- ) Division of Internal Medicine and Rehabilitation, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland; ) Faculty of Medicine, University of Geneva, Switzerland; ) Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
| | - L Kaiser
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Division of Infectious Diseases, Geneva University Hospitals, Switzerland
| | - N Garin
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland; ) Department of General Internal Medicine, Riviera Chablais Hospitals,Monthey, Switzerland
| | - J Stirnemann
- ) Faculty of Medicine, University of Geneva, Switzerland; ) Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
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Tinsley A, Navabi S, Williams ED, Liu G, Kong L, Coates MD, Clarke K. Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2019; 25:369-376. [PMID: 30020478 DOI: 10.1093/ibd/izy243] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Diseases of immune dysregulation are associated with an increased risk of viral infections, some of which may be preventable. To date, there are very limited data on the incidence and risk of influenza and related complications in patients with inflammatory bowel disease (IBD). Furthermore, the impact of immunosuppressive medications on that risk is unclear. Therefore, the aim of this study was to estimate the incidence and severity of influenza infections in IBD patients. In addition, we looked specifically at the effect of medications on influenza risk. METHODS Using the MarketScan Database (January 2008 to December 2011), we conducted a retrospective cohort study to estimate the incidence of influenza and risk of related complications in IBD patients compared with those without IBD. We employed a nested case-control study design to evaluate the potential independent effect of IBD medications on influenza risk. RESULTS A total of 140,480 patients with IBD and non-IBD controls were studied. There were 2963 patients with influenza compared with 1941 non-IBD subjects. Inflammatory bowel disease patients had an increased influenza risk compared with those without IBD (incidence rate ratio, 1.54; 95% confidence interval [CI], 1.49-1.63). A higher rate of hospitalizations (162/2994 [5.4%] vs 36/1941 [1.85%]; P < 0.001) was noted. Systemic corticosteroids were found to be independently associated with influenza (odds ratio, 1.22; 95% CI, 1.08-1.38). CONCLUSIONS Inflammatory bowel disease patients had an increased risk of influenza compared with those without IBD and were more likely to require hospitalization. Steroids were the only medication class independently associated with flu risk.
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Affiliation(s)
- Andrew Tinsley
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Seyedehsan Navabi
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Emmanuelle D Williams
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Guodong Liu
- Department of Public Health, College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Lan Kong
- Department of Public Health, College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Matthew D Coates
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Kofi Clarke
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
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Etiology and epidemiology of community-acquired pneumonia in adults requiring hospital admission: A prospective study in rural Central Philippines. Int J Infect Dis 2018; 80:46-53. [PMID: 30550945 DOI: 10.1016/j.ijid.2018.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality among adults worldwide. However, the distribution of the etiology of CAP varies from one country to another, with limited data from rural areas. METHODS A prospective hospital-based study on adult CAP was conducted in Leyte, Central Philippines from May 2010 to May 2012. Blood, sputum, and nasopharyngeal samples obtained from patients were used to identify pathogens using standard microbiological culture methods and PCR. RESULTS Of the 535 patients enrolled, 38% were younger than 50 years old. More than half of the patients had an underlying disease, including pulmonary tuberculosis (22%). The detection rate was higher for bacteria (40%) than viruses (13%). Haemophilus influenzae (12%) was the most commonly detected bacterium and influenza virus (5%) was the most commonly detected virus. The proportion of CAP patients with Mycobacterium tuberculosis infection was higher in the younger age group than in the older age group. Among CAP patients, 14% died during hospitalization, and drowsiness on admission and SpO2 <90% were independent risk factors for mortality. CONCLUSIONS Bacterial infections contribute substantially to the number of hospitalizations among CAP patients in rural Philippines. This study also highlights the importance of treatment of tuberculosis in reducing the burden of adult CAP in the country.
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Wieruszewski PM, Linn DD. Contemporary management of severe influenza disease in the intensive care unit. J Crit Care 2018; 48:48-55. [PMID: 30172033 PMCID: PMC7127549 DOI: 10.1016/j.jcrc.2018.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 01/12/2023]
Abstract
Despite continued efforts to optimize vaccination composition, severe influenza disease requiring intensive care unit (ICU) admission remains a clinical issue. Influenza epidemics and pandemics worldwide continue to challenge clinicians with managing infected patients requiring ICU care. While routine use of antiviral therapy is deployed in ambulatory outpatients, their use in the ICU in patients with hypoxemic respiratory failure is less well established. Additionally, these therapies primarily target the neuraminidase protein, while contemporary research is increasingly demonstrating potential therapeutic benefits of targeting the hemagglutinin protein. These data have given rise to a growing interest in the use of immune modulating therapies for treatment of severe influenza. Additionally, pandemic outbreaks have revealed the growing need for salvage management, wherein lies the potential role for venovenous extracorporeal membrane oxygenation therapy in refractory respiratory failure. In this report, we review the contemporary ICU care of the severe influenza patient. Influenza remains a challenging disease in the intensive care unit. Early anti-viral therapy may be associated with reduced mortality in the critically ill. Evidence surrounding the use of immune modulating therapies is growing. Corticosteroids are harmful and should not be used during the treatment of influenza. Additional research and commercial optimization is needed for widespread application of immune therapies.
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Affiliation(s)
- Patrick M Wieruszewski
- Department of Pharmacy, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
| | - Dustin D Linn
- Department of Pharmacy, Parkview Regional Medical Center, 11109 Parkview Plaza Drive, Fort Wayne, IN 46845, United States; Manchester University College of Pharmacy, Natural, & Health Sciences, 10627 Diebold Road, Fort Wayne, IN 46845, United States.
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Wang B, Hylwka T, Smieja M, Surrette M, Bowdish DME, Loeb M. Probiotics to Prevent Respiratory Infections in Nursing Homes: A Pilot Randomized Controlled Trial. J Am Geriatr Soc 2018; 66:1346-1352. [PMID: 29741754 DOI: 10.1111/jgs.15396] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the feasibility of conducting a large clinical trial to evaluate the effectiveness of probiotics to reduce influenza and other respiratory virus infections in residents of long-term and chronic care facilities (LTCFs). DESIGN Randomized, double-blind, placebo-controlled pilot trial. SETTING Fourteen nursing homes in Hamilton and surrounding region, Ontario, Canada. PARTICIPANTS Nursing home residents aged 65 and older (N=209). Those who were taking immunosuppressives (steroids or other immunosuppressives) or had a hematological malignancy, structural heart disease, or gastroesophageal or intestinal injury and others at high risk of an endovascular infection were excluded. INTERVENTION Participants were randomized to receive study probiotics-2 capsules of Lactobacillus rhamnosus GG (estimated 10 billion colony forming units of L. rhamnosus GG per capsule) or placebo (calcium carbonate) daily for 6 months. MEASUREMENTS Laboratory-confirmed respiratory viral infections. RESULTS One hundred ninety-six individuals were included in the analysis: 100 in the probiotics group and 96 in the placebo group. Laboratory-confirmed respiratory viral infections were observed in 14 (15.0%) residents in the probiotic group and 21 (22.9%) in the placebo group (hazard ratio=0.65, 95% confidence interval=0.32-1.31). CONCLUSION A larger trial is warranted to determine whether probiotics reduce influenza and other respiratory virus infections in residents of LTCFs.
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Affiliation(s)
- Biao Wang
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tammy Hylwka
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marek Smieja
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael Surrette
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Dawn M E Bowdish
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Chasqueira MJ, Paixão P, Rodrigues ML, Piedade C, Caires I, Palmeiro T, Botelho MA, Santos M, Curran M, Guiomar R, Pechirra P, Costa I, Papoila A, Alves M, Neuparth N. Respiratory infections in elderly people: Viral role in a resident population of elderly care centers in Lisbon, winter 2013-2014. Int J Infect Dis 2018; 69:1-7. [PMID: 29391246 PMCID: PMC7110569 DOI: 10.1016/j.ijid.2018.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to analyze the etiology and clinical consequences of viral respiratory infections in 18 elderly care centers (ECC) in Lisbon, which housed a total of 1022 residents. METHODS Nasopharyngeal swabs were collected whenever an elderly had symptoms of acute respiratory infections (ARI). PCR and RT-PCR were performed for influenza A/B, human parainfluenza virus 1-4, adenovirus, human metapneumovirus (HMPV), respiratory syncytial virus (RSV), rhinovirus, enterovirus, human coronavirus and human Bocavirus (HBoV). Array cards for atypical bacteria were also used in severe cases. RESULTS In total, 188 episodes of ARI were reported, being rhinovirus the most frequently detected (n=53), followed by influenza A(H3) (n=19) and HBoV (n=14). Severe infections were reported in 19 patients, 11 of which were fatal, Legionela pneumophila, rhinovirus, HMPV and RSV associated with these fatalities. Nine influenza strains were analyzed, all antigenically dissimilar from vaccine strain 2013/14. "Age", "HMPV" and "Respiratory disease" showed an association with severe infection. CONCLUSIONS In this study an etiologic agent could be found in 60% of the acute respiratory episodes. These data provides information about the circulating viruses in ECC and highlights the importance of searching both viruses and atypical bacteria in severe ARI.
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Affiliation(s)
- Maria-Jesus Chasqueira
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Paulo Paixão
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Maria-Lúcia Rodrigues
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Cátia Piedade
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Iolanda Caires
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Teresa Palmeiro
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Maria-Amalia Botelho
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Madalena Santos
- Hospital Curry Cabral, Centro Hospitalar de Lisboa Central, Rua da Beneficência n.° 8, 1069-166 Lisboa, Portugal.
| | - Martin Curran
- Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0QQ, UK.
| | - Raquel Guiomar
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Pedro Pechirra
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Inês Costa
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Ana Papoila
- Epidemiology and Statistics, Research Unit, Centro Hospitalar de Lisboa Central, EPE, Rua José António Serrano, 1150-199 Lisboa, Portugal; CEAUL, Departamento de Bioestatística e Informática, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Marta Alves
- Epidemiology and Statistics, Research Unit, Centro Hospitalar de Lisboa Central, EPE, Rua José António Serrano, 1150-199 Lisboa, Portugal.
| | - Nuno Neuparth
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
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Zhang L, Liu W, Liu D, Chen D, Tan W, Qiu S, Xu D, Li X, Liu T, Zhou R. Epidemiological and clinical features of human metapneumovirus in hospitalised paediatric patients with acute respiratory illness: a cross-sectional study in Southern China, from 2013 to 2016. BMJ Open 2018; 8:e019308. [PMID: 29437754 PMCID: PMC5829904 DOI: 10.1136/bmjopen-2017-019308] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Human metapneumovirus (HMPV) is one of the most important respiratory viral pathogens affecting infants and children worldwide. Our study describes the epidemiological and clinical characteristics of HMPV present in patients hospitalised with acute respiratory illness (ARI) in Guangzhou, Southern China. STUDY DESIGN A cross-sectional study. SETTING Two tertiary hospitals in Guangzhou. PARTICIPANTS AND METHODS Throat swabs were collected over a 3-year period from 5133 paediatric patients (≤14 years) hospitalised with ARI. Patients who are HMPV positive with clinical presentations (101/103) were recorded for further analysis. RESULTS Of the 5133 patients included in the study, 103 (2.0%) were positive for HMPV. HMPV was more prevalent in children ≤5 years (2.2%, 98/4399) compared with older children (>5-14 years) (0.7%, 5/734) (P=0.004). Two seasonal HMPV peaks were observed each year and mainly occurred in spring and early summer. Overall, 18.4% (19/103) of patients who are HMPV positive were codetected with other pathogens, most frequently respiratory syncytial virus (36.8%, 7/19). Patients who are HMPV positive presented with a wide spectrum of clinical features, including cough (100.0%, 101/101), abnormal pulmonary breath sound (91.1%, 92/101), fever (88.1%, 89/101), expectoration (77.2%, 78/101), coryza (50.5%, 51/101) and wheezing (46.5%, 47/101). The main diagnosis of patients who are HMPV positive was bronchopneumonia (66.7%, 56/84). Fever (≥38˚C) (91.6%, 76/83) was detected more often in patients with only HMPV detected than in patients with HMPV plus other pathogen(s) detected (72.2%, 13/18) (P=0.037), whereas diarrhoea was more common in patients with HMPV plus other pathogen(s) detected (22.2%, 4/18), compared with patients with HMPV only (3.6%, 3/83) (P=0.018). CONCLUSIONS HMPV is an important respiratory pathogen in children with ARI in Guangzhou, particularly in children ≤5 years old. HMPV has a seasonal variation. Bronchopneumonia is a major diagnosis in patients who are HMPV positive.
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Affiliation(s)
- Ling Zhang
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Wenkuan Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Donglan Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Dehui Chen
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Weiping Tan
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Shuyan Qiu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Duo Xu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiao Li
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Tiantian Liu
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Rong Zhou
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
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Abstract
A review of pulmonary infections of all types with diagnostic and morphological features.
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Cowling BJ, Xu C, Tang F, Zhang J, Shen J, Havers F, Wendladt R, Leung NH, Greene C, Iuliano AD, Shifflett P, Song Y, Zhang R, Kim L, Chen Y, Chu DK, Zhu H, Shu Y, Yu H, Thompson MG. Cohort profile: the China Ageing REespiratory infections Study (CARES), a prospective cohort study in older adults in Eastern China. BMJ Open 2017; 7:e017503. [PMID: 29092901 PMCID: PMC5695487 DOI: 10.1136/bmjopen-2017-017503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 12/19/2022] Open
Abstract
PURPOSE This study was established to provide direct evidence on the incidence of laboratory-confirmed influenza virus and respiratory syncytial virus (RSV) infections in older adults in two cities in Jiangsu Province, China, and the potential impact of acute respiratory infections on frailty. PARTICIPANTS The cohort was enrolled in Suzhou and Yancheng, two cities in Jiangsu Province in Eastern China. Between November 2015 and March 2016, we enrolled 1532 adults who were 60-89 years of age, and collected blood samples along with baseline data on demographics, general health, chronic diseases, functional status and cognitive function through face-to-face interviews using a standardised questionnaire. Participants are being followed weekly throughout the year to identify acute respiratory illnesses. We schedule home visits to ill participants to collect mid-turbinate nasal and oropharyngeal swabs for laboratory testing and detailed symptom information for the acute illness. Regular follow-up including face-to-face interviews and further blood draws will take place every 6-12 months. FINDINGS TO DATE As of 3 September 2016, we had identified 339 qualifying acute respiratory illness events and 1463 (95%) participants remained in the study. Laboratory testing is ongoing. FUTURE PLANS We plan to conduct laboratory testing to estimate the incidence of influenza virus and RSV infections in older adults. We plan to investigate the impact of these infections on frailty and functional status to determine the association of pre-existing immune status with protection against influenza and RSV infection in unvaccinated older adults, and to assess the exposure to avian influenza viruses in this population.
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Affiliation(s)
- Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Cuiling Xu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Fenyang Tang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jinjin Shen
- Yancheng Center for Disease Prevention and Control, Yancheng, China
| | - Fiona Havers
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Nancy Hl Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Carolyn Greene
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ran Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay Kim
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yuyun Chen
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Daniel Kw Chu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Huachen Zhu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Yuelong Shu
- Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Cao B, Huang Y, She DY, Cheng QJ, Fan H, Tian XL, Xu JF, Zhang J, Chen Y, Shen N, Wang H, Jiang M, Zhang XY, Shi Y, He B, He LX, Liu YN, Qu JM. Diagnosis and treatment of community-acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association. CLINICAL RESPIRATORY JOURNAL 2017; 12:1320-1360. [PMID: 28756639 PMCID: PMC7162259 DOI: 10.1111/crj.12674] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/25/2017] [Indexed: 02/05/2023]
Abstract
Community‐acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence. Corresponding recommendations are provided appropriately based on the level of evidence. This updated guideline covers comprehensive topics on CAP, including aetiology, antimicrobial resistance profile, diagnosis, empirical and targeted treatments, adjunctive and supportive therapies, as well as prophylaxis. The recommendations may help clinicians manage CAP patients more effectively and efficiently. CAP in pediatric patients and immunocompromised adults is beyond the scope of this guideline. This guideline is only applicable for the immunocompetent CAP patients aged 18 years and older. The recommendations on selection of antimicrobial agents and the dosing regimens are not mandatory. The clinicians are recommended to prescribe and adjust antimicrobial therapies primarily based on their local etiological profile and results of susceptibility testing, with reference to this guideline.
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Affiliation(s)
- Bin Cao
- National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Capital Medical University, Beijing 100029, China
| | - Yi Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China
| | - Dan-Yang She
- Department of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Qi-Jian Cheng
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan 610041, China
| | - Xin-Lun Tian
- Department of Pulmonary Medicine, Peking Union Medical College Hospital, Beijing 100730, China
| | - Jin-Fu Xu
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yu Chen
- Department of Respiratory and Critical Care Medicine, Shengjing Hospital, China Medical University, Shenyang 110004, China
| | - Ning Shen
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Hui Wang
- Department of Laboratory Medicine, Peking University People's Hospital, Beijing 100044, China
| | - Mei Jiang
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xiang-Yan Zhang
- Department of Respiratory and Critical Care Medicine, Guizhou Provincial People's Hospital, Guizhou 550002, China
| | - Yi Shi
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing 210002, China
| | - Bei He
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Li-Xian He
- Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - You-Ning Liu
- Department of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Jie-Ming Qu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
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Walter JM, Wunderink RG. Severe Respiratory Viral Infections: New Evidence and Changing Paradigms. Infect Dis Clin North Am 2017; 31:455-474. [PMID: 28687214 PMCID: PMC7347414 DOI: 10.1016/j.idc.2017.05.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Lower respiratory tract infection is a leading cause of death in the United States. Advances in diagnostic testing have improved our ability to detect pathogens. Viral pathogens are important causal pathogens in immunocompetent patients. As the number of elderly adults and those with chronic medical conditions increases, the burden of viral respiratory infections will increase. Clinicians must be familiar with the characteristics of rhinovirus, human adenoviruses, respiratory syncytial virus, and human metapneumovirus. Major challenges include distinguishing true infection from asymptomatic carriage and characterizing patients admitted with severe lower respiratory tract infection who do not have a causative pathogen identified.
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Affiliation(s)
- James M Walter
- Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Arkes 14-000, Chicago, IL 60611, USA
| | - Richard G Wunderink
- Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Arkes 14-000, Chicago, IL 60611, USA.
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Abstract
Whenever the cardinal manifestations of a disorder occur in similar disorders, there is potential for a disease mimic. Legionnaire's disease has protean manifestations and has the potential to mimic or be mimicked by other community acquired pneumonias (CAPs). In CAPs caused by other than Legionella species, the more characteristic features in common with legionnaire's disease the more difficult the diagnostic conundrum. In hospitalized adults with CAP, legionnaire's disease may mimic influenza or other viral pneumonias. Of the bacterial causes of CAP, psittacosis and Q fever, but not tularemia, are frequent mimics of legionnaire's disease.
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Affiliation(s)
- Burke A Cunha
- Infectious Disease Division, Winthrop-University Hospital, 222 Station Plaza North, #432, Mineola, NY 11501, USA; School of Medicine, State University of New York, Stony Brook, NY, USA.
| | - Cheston B Cunha
- Division of Infectious Disease, Rhode Island Hospital, The Miriam Hospital, Brown University Alpert School of Medicine, Providence, RI, USA
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40
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Lim TK, Siow WT. Pneumonia in the tropics. Respirology 2017; 23:28-35. [PMID: 28763150 PMCID: PMC7169137 DOI: 10.1111/resp.13137] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/27/2017] [Accepted: 06/12/2017] [Indexed: 12/19/2022]
Abstract
Pneumonia in the tropics poses a heavy disease burden. The complex interplay of climate change, human migration influences and socio-economic factors lead to changing patterns of respiratory infections in tropical climate but also increasingly in temperate countries. Tropical and poorer countries, especially South East Asia, also bear the brunt of the global tuberculosis (TB) pandemic, accounting for almost one-third of the burden. But, as human migration patterns evolve, we expect to see more TB cases in higher income as well as temperate countries, and rise in infections like scrub typhus from ecotourism activities. Fuelled by the ease of air travel, novel zoonotic infections originating from the tropics have led to global respiratory pandemics. As such, clinicians worldwide should be aware of these new conditions as well as classical tropical bacterial pneumonias such as melioidosis. Rarer entities such as co-infections of leptospirosis and chikungunya or dengue will need careful consideration as well. In this review, we highlight aetiologies of pneumonia seen more commonly in the tropics compared with temperate regions, their disease burden, variable clinical presentations as well as impact on healthcare delivery.
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Affiliation(s)
- Tow Keang Lim
- Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore
| | - Wen Ting Siow
- Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore
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41
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Russell E, Ison MG. Parainfluenza Virus in the Hospitalized Adult. Clin Infect Dis 2017; 65:1570-1576. [DOI: 10.1093/cid/cix528] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/05/2017] [Indexed: 12/19/2022] Open
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Cheemarla NR, Baños-Lara MDR, Naidu S, Guerrero-Plata A. Neutrophils regulate the lung inflammatory response via γδ T cell infiltration in an experimental mouse model of human metapneumovirus infection. J Leukoc Biol 2017; 101:1383-1392. [PMID: 28336678 DOI: 10.1189/jlb.4a1216-519rr] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 12/28/2022] Open
Abstract
Neutrophils are the most abundant leukocytes in human circulation. They are the first immune cell population recruited to the sites of infection. However, the role of neutrophils to regulate host immune responses during respiratory viral infections is largely unknown. To elucidate the role of neutrophils in respiratory antiviral defense, we used an experimental mouse model of human metapneumovirus (HMPV) infection. HMPV, a member of the Paramyxoviridae family, is a leading respiratory pathogen causing severe symptoms, such as bronchiolitis and pneumonia, in young, elderly, and immunocompromised patients. We demonstrate that neutrophils are the predominant population of immune cells recruited into the lungs after HMPV infection. This led us to hypothesize that neutrophils represent a key player of the immune response during HMPV infection, thereby regulating HMPV-induced lung pathogenesis. Specific depletion of neutrophils in vivo using a mAb and simultaneous infection with HMPV exhibited higher levels of inflammatory cytokines, pulmonary inflammation, and severe clinical disease compared with HMPV-infected, competent mice. Interestingly, the lack of neutrophils altered γδ T cell accumulation in the lung. The absence of γδ T cells during HMPV infection led to reduced pulmonary inflammation. These novel findings demonstrate that neutrophils play a critical role in controlling HMPV-induced inflammatory responses by regulating γδ T cell infiltration to the site of infection.
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Affiliation(s)
- Nagarjuna R Cheemarla
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Ma Del Rocío Baños-Lara
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Shan Naidu
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and
| | - Antonieta Guerrero-Plata
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, Louisiana, USA; and .,Center for Experimental Infectious Disease Research, Louisiana State University, Baton Rouge, Louisiana, USA
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43
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Samuel S, Nanjappa S, Cooper CD, Greene JN. Human Metapneumovirus Infection in Immunocompromised Patients. Cancer Control 2017; 23:442-445. [PMID: 27842334 DOI: 10.1177/107327481602300416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Human metapneumovirus (HMPV) is a pathogen associated with respiratory tract infection and is related to avian pneumovirus. Typically, children, the elderly, and those who are immunocompromised are the most susceptible to HMPV infection; however, the virus can infect persons of all ages. In otherwise healthy individuals, HMPV infection is generally self-limiting, but immunocompromised individuals can develop fatal complications. We present a case series of 3 severely immunocompromised patients who were infected with HMPV and describe their clinical course. All 3 patients had acute myeloid leukemia, histories of neutropenic fever, and prolonged hospitalization stays. This case series highlights the severe sequelae observed in individuals infected with HMPV, particularly among those who are immunocompromised.
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Affiliation(s)
- Sharmeen Samuel
- Department of Infectious Diseases, Moffitt Cancer Center, Tampa, FL, USA.
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Rashid H, Shafi S, Booy R, Bashir HE, Ali K, Zambon MC, Memish ZA, Ellis J, Coen PG, Haworth E. Influenza and respiratory syncytial virus infections in British Hajj pilgrims. EMERGING HEALTH THREATS JOURNAL 2017. [DOI: 10.3402/ehtj.v1i0.7072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- H Rashid
- Academic Unit of Child Health, Queen Mary University of London, London, UK
| | - S Shafi
- HPA Collaborating Laboratory, Department of Microbiology, Northwick Park Hospital, Middlesex, UK
| | - R Booy
- Academic Unit of Child Health, Queen Mary University of London, London, UK
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Disease, The Children’s Hospital at Westmead, The University of Sydney, Sydney, New South Wales, Australia
| | - H El Bashir
- Academic Unit of Child Health, Queen Mary University of London, London, UK
| | - K Ali
- Academic Unit of Child Health, Queen Mary University of London, London, UK
| | - MC Zambon
- Respiratory Virus Unit, Centre for Infections, Health Protection Agency, London, UK
| | - ZA Memish
- Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Infection Prevention and Control, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh; Saudi Arabia
| | - J Ellis
- Respiratory Virus Unit, Centre for Infections, Health Protection Agency, London, UK
| | - PG Coen
- Infection Control Office, Windeyer Institute of Medical Sciences, University College. London Hospitals NHS Trust, London, UK; and
| | - E Haworth
- Thames Valley Health Protection Unit, Health Protection Agency South East, Oxford, UK
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Taylor G. Animal models of respiratory syncytial virus infection. Vaccine 2017; 35:469-480. [PMID: 27908639 PMCID: PMC5244256 DOI: 10.1016/j.vaccine.2016.11.054] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/12/2016] [Accepted: 11/16/2016] [Indexed: 11/26/2022]
Abstract
Human respiratory syncytial virus (hRSV) is a major cause of respiratory disease and hospitalisation of infants, worldwide, and is also responsible for significant morbidity in adults and excess deaths in the elderly. There is no licensed hRSV vaccine or effective therapeutic agent. However, there are a growing number of hRSV vaccine candidates that have been developed targeting different populations at risk of hRSV infection. Animal models of hRSV play an important role in the preclinical testing of hRSV vaccine candidates and although many have shown efficacy in preclinical studies, few have progressed to clinical trials or they have had only limited success. This is, at least in part, due to the lack of animal models that fully recapitulate the pathogenesis of hRSV infection in humans. This review summarises the strengths and limitations of animal models of hRSV, which include those in which hRSV is used to infect non-human mammalian hosts, and those in which non-human pneumoviruses, such as bovine (b)RSV and pneumonia virus of mice (PVM) are studied in their natural host. Apart from chimpanzees, other non-human primates (NHP) are only semi-permissive for hRSV replication and experimental infection with large doses of virus result in little or no clinical signs of disease, and generally only mild pulmonary pathology. Other animal models such as cotton rats, mice, ferrets, guinea pigs, hamsters, chinchillas, and neonatal lambs are also only semi-permissive for hRSV. Nevertheless, mice and cotton rats have been of value in the development of monoclonal antibody prophylaxis for infants at high risk of severe hRSV infection and have provided insights into mechanisms of immunity to and pathogenesis of hRSV. However, the extent to which they predict hRSV vaccine efficacy and safety is unclear and several hRSV vaccine candidates that are completely protective in rodent models are poorly effective in chimpanzees and other NHP, such as African Green monkeys. Furthermore, interpretation of findings from many rodent and NHP models of vaccine-enhanced hRSV disease has been confounded by sensitisation to non-viral antigens present in the vaccine and challenge virus. Studies of non-human pneumoviruses in their native hosts are more likely to reflect the pathogenesis of natural hRSV infection, and experimental infection of calves with bRSV and of mice with PVM result in clinical disease and extensive pulmonary pathology. These animal models have not only been of value in studies on mechanisms of immunity to and the pathogenesis of pneumovirus infections but have also been used to evaluate hRSV vaccine concepts. Furthermore, the similarities between the epidemiology of bRSV in calves and hRSV in infants and the high level of genetic and antigenic similarity between bRSV and hRSV, make the calf model of bRSV infection a relevant model for preclinical evaluation of hRSV vaccine candidates which contain proteins that are conserved between hRSV and bRSV.
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Affiliation(s)
- Geraldine Taylor
- The Pirbright Institute, Ash Road, Pirbright, Woking Surrey GU24 0NF, United Kingdom.
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Abstract
Pneumonia is of great global public health importance. Viral infections play both direct and indirect parts in its cause across the globe. Influenza is a leading cause of viral pneumonia in both children and adults, and respiratory syncytial virus is increasingly recognized as causing disease at both extremes of age. Vaccination offers the best prospect for prevention but current influenza vaccines do not provide universal and durable protection, and require yearly reformulation. In the future, it is hoped that influenza vaccines will give better and universal protection, and that new vaccines can be found for other causes of viral pneumonia.
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Affiliation(s)
- Clementine S Fraser
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Akhilesh Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK
| | - Peter J M Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London (St Mary's Campus), Norfolk Place, Paddington, London W2 1PG, UK.
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Uršič T, Miksić NG, Lusa L, Strle F, Petrovec M. Viral respiratory infections in a nursing home: a six-month prospective study. BMC Infect Dis 2016; 16:637. [PMID: 27814689 PMCID: PMC5097393 DOI: 10.1186/s12879-016-1962-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/25/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The knowledge on viral respiratory infections in nursing home (NH) residents and their caregivers is limited. The purpose of the present study was to assess and compare the incidence of acute respiratory infections (ARI) in nursing home (NH) residents and staff, to identify viruses involved in ARI and to correlate viral etiology with clinical manifestations of ARI. METHODS The prospective surveillance study was accomplished in a medium-sized NH in Slovenia (central Europe). Ninety NH residents and 42 NH staff were included. Nasopharyngeal swabs were collected from all participants at enrollment (December 5th, 2011) and at the end of the study (May 31st, 2012), and from each participant that developed ARI within this timeframe. Molecular detection of 15 respiratory viruses in nasopharyngeal swab samples was performed. RESULTS The weekly incidence rate of ARI in NH residents and NH staff correlated; however, it was higher in staff members than in residents (5.9 versus 3.8/1,000 person-days, P = 0.03), and was 2.5 (95 % CI: 1.36-4.72) times greater in residents without dementia than in residents with dementia. Staff members typically presented with upper respiratory tract involvement, whereas in residents lower respiratory tract infections predominated. Respiratory viruses were detected in 55/100 ARI episodes. In residents, influenza A virus, respiratory syncytial virus, and human metapneumovirus were detected most commonly, whereas in NH staff rhinovirus and influenza A virus prevailed. 38/100 ARI episodes (30/56 in residents, 8/44 in staff) belonged to one of three outbreaks (caused by human metapneumovirus, influenza A virus and respiratory syncytial virus, respectively). NH residents had higher chances for virus positivity within outbreak than HN staff (OR = 7.4, 95 % CI: 1.73-31.48, P < 0.01). CONCLUSIONS ARI are common among NH residents and staff, and viruses were detected in a majority of the episodes of ARI. Many ARI episodes among NH residents were outbreak cases and could be considered preventable. TRIAL REGISTRATION The study was registered on the 1th of December 2011 at ClinicalTrials ( NCT01486160 ).
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Affiliation(s)
- Tina Uršič
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
| | - Nina Gorišek Miksić
- Department of Infectious Diseases, Maribor University Medical Center, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Lara Lusa
- Faculty of Medicine, Institute for Biostatistics and Medical Informatics, Vrazov trg 2, 1104, Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Center Ljubljana, Japljeva 2, 1525, Ljubljana, Slovenia
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
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Abstract
Human parainfluenza viruses (HPIVs) are single-stranded, enveloped RNA viruses of the Paramyoviridaie family. There are four serotypes which cause respiratory illnesses in children and adults. HPIVs bind and replicate in the ciliated epithelial cells of the upper and lower respiratory tract and the extent of the infection correlates with the location involved. Seasonal HPIV epidemics result in a significant burden of disease in children and account for 40% of pediatric hospitalizations for lower respiratory tract illnesses (LRTIs) and 75% of croup cases. Parainfluenza viruses are associated with a wide spectrum of illnesses which include otitis media, pharyngitis, conjunctivitis, croup, tracheobronchitis, and pneumonia. Uncommon respiratory manifestations include apnea, bradycardia, parotitis, and respiratory distress syndrome and rarely disseminated infection. Immunity resulting from disease in childhood is incomplete and reinfection with HPIV accounts for 15% of respiratory illnesses in adults. Severe disease and fatal pneumonia may occur in elderly and immunocompromised adults. HPIV pneumonia in recipients of hematopoietic stem cell transplant (HSCT) is associated with 50% acute mortality and 75% mortality at 6 months. Though sensitive molecular diagnostics are available to rapidly diagnose HPIV infection, effective antiviral therapies are not available. Currently, treatment for HPIV infection is supportive with the exception of croup where the use of corticosteroids has been found to be beneficial. Several novel drugs including DAS181 appear promising in efforts to treat severe disease in immunocompromised patients, and vaccines to decrease the burden of disease in young children are in development.
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Affiliation(s)
- Angela R Branche
- Department of Medicine, University of Rochester, Rochester, New York
| | - Ann R Falsey
- Department of Medicine, University of Rochester, Rochester, New York
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Kabalak PA, Esenkaya A. Severe Pneumonia Treated Succesfully with Levofloxacin and Oseltamivir During Flu Epidemic. Turk Thorac J 2016; 17:84-87. [PMID: 29404131 DOI: 10.5578/ttj.17.2.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 08/03/2015] [Indexed: 11/15/2022]
Abstract
Viral pneumonia is an important cause of community acquired pneumonias (CAP). It's not only specific to childhood period. Although immunocompromised adults are susceptible; all young and healthy adults are at risk. Viral pneumonias are usually underestimated due to lack of diagnostic modalities so a clinician must be aware of. Co-infection of viruses and bacteria is not uncommon and can be mortal especially in a flu epidemic, therefore, in the absence of diagnostic tools initiating to anti-viral treatment without delay is important.
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Affiliation(s)
| | - Asım Esenkaya
- Clinic of Radiology, Düzce Atatürk State Hospital, Düzce, Turkey
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