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Morrison JM, Hassan A, Kysh L, Dudas RA, Russell CJ. Diagnosis, management, and outcomes of pediatric tracheostomy-associated infections: A scoping review. Pediatr Pulmonol 2022; 57:1145-1156. [PMID: 35229491 PMCID: PMC9313552 DOI: 10.1002/ppul.25873] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Children with tracheostomy are frequently admitted to the hospital for tracheostomy-associated respiratory infections (TRAINs). However, there remains a paucity of evidence to direct the diagnosis, treatment, and prevention of TRAINs. An important first step to addressing this knowledge gap is to synthesize existing data regarding TRAINs to inform current practice and facilitate innovation. DATA SOURCES We searched PubMed, Embase, Cochrane Library, CINAHL, and Web of Science from inception to October 2020. Original research articles and published abstracts including children and young adults 0-21 years of age with tracheostomy were included. Included studies assessed the clinical definitions of and risk factors for TRAINs, microbiologic epidemiology and colonization of tracheostomies, and treatment and outcomes of TRAINs. DATA SYNTHESIS Out of 5755 studies identified in the search, 78 full-text studies were included in the final review. A substantial number of studies focused on the detection of specific pathogens in respiratory cultures including Pseudomonas aeruginosa. Several different definitions of TRAIN including clinical, microbiologic, and laboratory testing results were utilized; however, no uniform set of criteria were identified. The few studies focused on treatment and prevention of TRAIN emphasized the role of empiric antimicrobial therapy and the use of inhaled antibiotics. CONCLUSIONS Despite a growing number of research articles studying TRAINs, there is a paucity of prospective interventional trials to guide the diagnosis, treatment, and prevention of respiratory disease in this vulnerable population. Future research should include studies of interventions designed to improve short- and long-term respiratory-related outcomes of children with tracheostomy.
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Affiliation(s)
- John M Morrison
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Division of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Amir Hassan
- Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Lynn Kysh
- The Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Robert A Dudas
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Division of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA
| | - Christopher J Russell
- Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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2
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Wilmont S, Hessels AJ, Kelly AM, Larson EL. Family Experiences and Perspectives on Infection Prevention in Pediatric Long-Term Care. Rehabil Nurs 2019; 43:307-314. [PMID: 30395556 PMCID: PMC6221461 DOI: 10.1097/rnj.0000000000000013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Residents of pediatric long-term care facilities (pLTCF) are particularly vulnerable to healthcare-associated infections. The aims of this qualitative study were to (a) explore perspectives on infection prevention among families visiting children in pLTCF and (b) identify facilitators of and barriers to optimal hand hygiene. DESIGN AND METHODS Semistructured, in-depth interviews with 10 family members visiting two New York City metropolitan area facilities were analyzed to identify themes. FINDINGS "Everyone follows the rules" and "infections are inevitable" were primary themes. Participants reported "common sense" as a facilitator and "distraction" as a major barrier to prevention practices. CONCLUSION Current education for visitors may be inadequate to improve infection prevention behaviors. CLINICAL RELEVANCE Nurse-led education strategies for infection prevention should be tested and modified for families visiting pLTCF.
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Affiliation(s)
- Sibyl Wilmont
- The Center for Interdisciplinary Research to Prevent Infections, Columbia University School of Nursing, New York
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3
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Miyakawa R, Barreto NB, Kato RM, Neely MN, Russell CJ. Early Use of Anti-influenza Medications in Hospitalized Children With Tracheostomy. Pediatrics 2019; 143:e20182608. [PMID: 30814271 PMCID: PMC6398370 DOI: 10.1542/peds.2018-2608] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early administration of anti-influenza medications is recommended for all children hospitalized with influenza. We investigated whether early use of anti-influenza medications is associated with improved outcomes in children with tracheostomy hospitalized with influenza. METHODS We performed a multicenter retrospective cohort study through the Pediatric Health Information System database for patients aged 30 days to 19 years who were discharged between October 1, 2007, and September 30, 2015 with diagnostic codes for both influenza and tracheostomy. Our primary predictor was receipt of anti-influenza medications on hospital day 0 or 1. We used propensity score matching to adjust for confounding by indication. Primary outcomes were length of stay (LOS) and 30-day all-cause revisit rate (emergency department visit or hospital admission). RESULTS Of 1436 discharges screened, 899 met inclusion criteria. The median admission age was 5 years (interquartile range: 2-10). The majority had multiple complex chronic conditions (median 3; interquartile range: 3-4) and technology dependence, such as gastrostomy tube (73.6%). After matching 772 unique admissions by propensity score, LOS was shorter for the cohort receiving early anti-influenza medications (6.4 vs 7.5 days; P = .01) without increase in revisit rate (27.5% vs 24.1%; P = .28). More than 80% in both cohorts received empirical antibiotics, and the duration of antibiotic therapy was similar (5.0 vs 5.6 days; P = .11). CONCLUSIONS Early use of anti-influenza medications in children with tracheostomy hospitalized with influenza is associated with shorter LOS, but these children continue to receive antibiotics despite identification and treatment of their viral infections.
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Affiliation(s)
- Ryo Miyakawa
- Divisions of Pediatric Pulmonology and Sleep Medicine
| | - Nicolas B Barreto
- Department of Psychology, Claremont Graduate University, Claremont, California; and
| | - Roberta M Kato
- Divisions of Pediatric Pulmonology and Sleep Medicine
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Michael N Neely
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Infectious Diseases, and
| | - Christopher J Russell
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California
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4
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Saiman L, Maykowski P, Murray M, Cohen B, Neu N, Jia H, Hutcheon G, Simpser E, Mosiello L, Alba L, Larson E. Incidence, Risks, and Types of Infections in Pediatric Long-term Care Facilities. JAMA Pediatr 2017; 171:872-878. [PMID: 28738121 PMCID: PMC5710407 DOI: 10.1001/jamapediatrics.2017.1482] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
IMPORTANCE The population of infants, children, and adolescents cared for at pediatric long-term care facilities is increasing in complexity and size and thus consumes substantial health care resources. Infections are a significant cause of morbidity and mortality in this population, but few recent data describe their incidence and effects. OBJECTIVES To describe the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identify risk factors for respiratory tract infections (RTIs). DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study, which was part of a larger trial called Keep It Clean for Kids, was conducted from September 1, 2012, to December 31, 2015, at 3 pediatric long-term care facilities in New York. Residents of the facilities who were 21 years or younger and either residents or admitted during the study period (n = 717) were enrolled in the study. Medical records were reviewed to identify infections diagnosed by site clinicians. MAIN OUTCOMES AND MEASURES Incidence of infections, such as RTIs; skin and soft-tissue infections; chronic comorbid conditions, including neurologic and respiratory disorders; and device use, including gastrostomy tubes and tracheostomies, was determined. Risk factors for RTIs were assessed by generalized linear mixed method regression modeling. RESULTS The 717 residents had a median (interquartile range) age at enrollment of 2.6 (0.4-9.1) years; 358 (49.9%) were male. Four hundred twenty-eight residents (59.7%) had feeding tubes and 215 (30.0%) had tracheostomies. Most chronic comorbid conditions were musculoskeletal or ambulation (532 residents [74.2%]), neurologic (505 [70.4%]), respiratory (361 [50.3%]), and gastrointestinal (230 [32.1%]) disorders, and 460 residents (64.2%) had 4 or more chronic comorbid conditions. Site clinicians diagnosed 2052 infections during the 3-year study period. Respiratory tract infections were most common and were diagnosed in 1291 residents (62.9%). The overall infection rate was 5.3 infections per 1000 resident-days, and RTI rates were 3.3 infections per 1000 resident-days. Overall infection rates and rates of RTI, skin and soft-tissue infection, urinary tract infection, and bloodstream infection varied among the 3 sites. In the multivariable model, younger age (incidence rate ratio [IRR], 1.05; 95% CI, 1.03-1.06), increased number of chronic comorbid conditions (IRR, 1.12; 95% CI, 1.06-1.19), and the use of feeding tubes (IRR, 1.34; 95% CI, 1.03-1.64) and tracheostomies (IRR, 1.40; 95% CI, 1.17-1.69) were associated with RTIs. CONCLUSIONS AND RELEVANCE In this study, RTIs were the most common infections diagnosed, but modifiable risk factors for RTIs were not identified. Future work should focus on optimizing infection prevention and control strategies to reduce infections, particularly RTIs, in the pediatric long-term care population.
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Affiliation(s)
- Lisa Saiman
- Department of Pediatrics, Columbia University Medical Center, New York, New York,Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York
| | - Philip Maykowski
- Department of Pediatrics, Columbia University Medical Center, New York, New York,Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Meghan Murray
- School of Nursing, Columbia University Medical Center, New York, New York
| | - Bevin Cohen
- School of Nursing, Columbia University Medical Center, New York, New York
| | - Natalie Neu
- Department of Pediatrics, Columbia University Medical Center, New York, New York,Elizabeth Seton Pediatric Center, Yonkers, New York
| | - Haomioa Jia
- Mailman School of Public Health, Columbia University Medical Center, New York, New York,School of Nursing, Columbia University Medical Center, New York, New York
| | - Gordon Hutcheon
- Elizabeth Seton Pediatric Center, Yonkers, New York,Department of Pediatrics, New York Medical College, Valhalla
| | | | - Linda Mosiello
- Sunshine Children’s Home and Rehab Center, Ossining, New York
| | - Luis Alba
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Elaine Larson
- Mailman School of Public Health, Columbia University Medical Center, New York, New York,School of Nursing, Columbia University Medical Center, New York, New York
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Paramyxovirus Outbreak in a Long-Term Care Facility: The Challenges of Implementing Infection Control Practices in a Congregate Setting. Infect Control Hosp Epidemiol 2017; 38:399-404. [PMID: 28065183 DOI: 10.1017/ice.2016.316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We report an outbreak of respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) infections in a dementia care ward containing 2 separately locked units (A and B) to heighten awareness of these pathogens in the older adult population and highlight some of the infection prevention challenges faced during a noninfluenza respiratory viral outbreak in a congregate setting. METHODS Cases were defined by the presence of new signs or symptoms that included (1) a single oral temperature ≥ 37.8°C (100.0°F) and (2) the presence of at least 2 of the following symptoms: cough, dyspnea, rhinorrhea, hoarseness, congestion, fatigue, and malaise. Attempted infection-control measures included cohorting patients and staff, empiric isolation precautions, and cessation of group activities. Available nasopharyngeal swab specimens were sent to the Tennessee Department of Health for identification by rT-PCR testing. RESULTS We identified 30 of the 41 (73%) residents as cases over this 16-day outbreak. Due to high numbers of sick personnel, we were unable to cohort staff to 1 unit. Unit B developed its first case 8 days after infection control measures were implemented. Of the 14 cases with available specimens, 6 patients tested positive for RSV-B, 7 for HMPV and 1 patient test positive for influenza A. Overall, 15 cases (50%) required transfer to acute care facilities; 10 of these patients (34%) had chest x-ray confirmed pulmonary infiltrates; and 5 residents (17%) died. CONCLUSIONS This case report highlights the importance of RSV and HMPV in causing substantial disease in the older adult population and highlights the challenges in preventing transmission of these viruses. Infect Control Hosp Epidemiol 2017;38:399-404.
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6
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Maitre NL, Williams JV. Human metapneumovirus in the preterm neonate: current perspectives. RESEARCH AND REPORTS IN NEONATOLOGY 2016; 6:41-49. [PMID: 27891060 PMCID: PMC5120728 DOI: 10.2147/rrn.s76270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Premature birth (<37 weeks gestation) occurs in ~11% of all births in the US. These infants are at risk of chronic lung disease and respiratory conditions, including bronchopulmonary dysplasia. Respiratory viruses are important causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased health care burden, and long-term morbidity. Human metapneumovirus (HMPV) is a paramyxovirus discovered in 2001 that is related to respiratory syncytial virus. Epidemiologic studies show that HMPV is a leading cause of ARI in children and adults worldwide. Prematurity is a major risk factor for severe HMPV disease, requiring hospitalization. Moreover, limited data suggest that HMPV infection during infancy is associated with asthma and recurrent wheezing, which are common long-term pulmonary complication of prematurity. HMPV causes nosocomial outbreaks of ARI in hospitals and long-term care facilities, although there are few studies of the prevalence of HMPV in neonatal intensive care unit populations. HMPV is a common and important virus in premature infants, and caregivers for preterm infants should consider this virus in patients with acute respiratory symptoms.
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Affiliation(s)
- Nathalie L Maitre
- Center for Perinatal Research, Department of Pediatrics, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - John V Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility. Infect Control Hosp Epidemiol 2016; 37:859-62. [PMID: 27053088 DOI: 10.1017/ice.2016.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.
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8
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Løyland B, Wilmont S, Hessels AJ, Larson E. Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities. Nurs Res 2016; 65:132-41. [PMID: 26938362 PMCID: PMC4822544 DOI: 10.1097/nnr.0000000000000136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. OBJECTIVES The aims of this study were to explore direct care providers' knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others' hand hygiene practices, and their ideas and advice for improving infection prevention efforts. METHODS This exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. RESULTS From 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust "us" and "them" mentality between professionals. DISCUSSION One essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities.
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Affiliation(s)
- Borghild Løyland
- Borghild Løyland, PhD, RN, is Associate Professor, Department of Nursing and Health Promotion, Oslo and Akershus University College, Norway. Sibyl Wilmont, BSN, RN, is Research Assistant; and Amanda J. Hessels, PhD, RN, is Postdoctoral Research Fellow, School of Nursing, Columbia University, New York. Elaine Larson, PhD, RN, FAAN, CIC, is Anna C. Maxwell Professor of Nursing Research, Associate Dean for Nursing Research, School of Nursing, and Professor of Epidemiology, the Mailman School of Public Health, Columbia University, New York, and Editor, American Journal of Infection Control
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9
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Murray MT, Neu N, Cohen B, Hutcheon G, Simpser E, Larson E, Saiman L. Developing Case Definitions for Health Care-Associated Infections for Pediatric Long-Term Care Facilities. Clin Pediatr (Phila) 2015; 54:1380-2. [PMID: 26239921 DOI: 10.1177/0009922815599379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Natalie Neu
- Columbia University Medical Center, New York, NY, USA Elizabeth Seton Pediatric Center, Yonkers, NY, USA
| | - Bevin Cohen
- Columbia University Medical Center, New York, NY, USA
| | | | | | - Elaine Larson
- Columbia University Medical Center, New York, NY, USA
| | - Lisa Saiman
- Columbia University Medical Center, New York, NY, USA NewYork-Presbyterian Hospital, New York, NY, USA
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10
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Løyland B, Wilmont S, Cohen B, Larson E. Hand-hygiene practices and observed barriers in pediatric long-term care facilities in the New York metropolitan area. Int J Qual Health Care 2015; 28:74-80. [DOI: 10.1093/intqhc/mzv097] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 12/13/2022] Open
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11
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Murray MT, Pavia M, Jackson O, Keenan M, Neu NM, Cohen B, Saiman L, Larson EL. Health care-associated infection outbreaks in pediatric long-term care facilities. Am J Infect Control 2015; 43:756-8. [PMID: 25934066 PMCID: PMC7132675 DOI: 10.1016/j.ajic.2015.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/27/2015] [Accepted: 03/11/2015] [Indexed: 12/31/2022]
Abstract
Children in pediatric long-term care facilities (pLTCFs) have complex medical conditions and increased risk for health care-associated infections (HAIs). We performed a retrospective study from January 2010-December 2013 at 3 pLTCFs to describe HAI outbreaks and associated infection control interventions. There were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services. Further research should examine interventions to limit transmission of infections in pLTCFs.
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12
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Infection prevention and control practices in pediatric long-term care facilities. Am J Infect Control 2014; 42:1233-4. [PMID: 25444271 DOI: 10.1016/j.ajic.2014.07.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/18/2014] [Accepted: 07/21/2014] [Indexed: 11/23/2022]
Abstract
Pediatric long-term care facilities (pLTCFs) provide for children with chronic, complex medical needs and therefore face unique challenges for infection prevention and control (IP&C). At a conference in 2012, pLTCF providers reported IP&C issues of greatest concern in a survey. Major concerns included the lack of IP&C best practice guidelines, multidrug-resistant bacteria, and viral respiratory infections. Best practice guidelines for IP&C specific to pLTCF populations should be developed and evaluated.
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14
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Liu X, Qin X, Xiang Y, Liu H, Gao G, Qin L, Liu C, Qu X. Progressive changes in inflammatory and matrix adherence of bronchial epithelial cells with persistent respiratory syncytial virus (RSV) infection (progressive changes in RSV infection). Int J Mol Sci 2013; 14:18024-40. [PMID: 24005865 PMCID: PMC3794767 DOI: 10.3390/ijms140918024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 08/16/2013] [Accepted: 08/21/2013] [Indexed: 12/11/2022] Open
Abstract
In addition to the acute manifestations of respiratory syncytial virus (RSV), persistent infection may be associated with long-term complications in the development of chronic respiratory diseases. To understand the mechanisms underlying RSV-induced long-term consequences, we established an in vitro RSV (strain A2) infection model using human bronchial epithelial (16HBE) cells that persists over four generations and analyzed cell inflammation and matrix adherence. Cells infected with RSV at multiplicity of infection (MOI) 0.0067 experienced cytolytic or abortive infections in the second generation (G2) or G3 but mostly survived up to G4. Cell morphology, leukocyte and matrix adherence of the cells did not change in G1 or G2, but subsequently, leukocyte adherence and cytokine/chemokine secretion, partially mediated by intercellular adhesion molecule-1 (ICAM-1), increased drastically, and matrix adherence, partially mediated by E-cadherin, decreased until the cells died. Tumor necrosis factor-α (TNF-α) secretion was inhibited by ICAM-1 antibody in infected-16HBE cells, suggesting that positive feedback between TNF-α secretion and ICAM-1 expression may be significant in exacerbated inflammation. These data demonstrate the susceptibility of 16HBE cells to RSV and their capacity to produce long-term progressive RSV infection, which may contribute to inflammation mobilization and epithelial shedding.
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Affiliation(s)
- Xiaoai Liu
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
- Department of Physiology, Guangzhou Medical University, Guangzhou 510182, China
| | - Xiaoqun Qin
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +86-731-8235-5051; Fax: +86-731-8235-5056
| | - Yang Xiang
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
| | - Huijun Liu
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
| | - Ge Gao
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
| | - Ling Qin
- Respiratory Department, Xiangya Hospital, Central South University, Changsha 410078, China; E-Mail:
| | - Chi Liu
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
| | - Xiangping Qu
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha 410078, China; E-Mails: (X.L.); (Y.X.); (H.L.); (G.G.); (C.L.); (X.Q.)
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