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Chen J, Wang Q, Zhong B, Zheng H, Wang D, Huang X, Liu L, Liu T. Activation of the RIG-I/MAVS Signaling Pathway during Human Adenovirus Type 3 Infection Impairs the Pro-Inflammatory Response Induced by Secondary Infection with Staphylococcus aureus. Int J Mol Sci 2024; 25:4178. [PMID: 38673764 PMCID: PMC11049948 DOI: 10.3390/ijms25084178] [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: 12/26/2023] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
The exacerbation of pneumonia in children with human adenovirus type 3 (HAdV-3E) is secondary to a Staphylococcus aureus (S. aureus) infection. The influence of host-pathogen interactions on disease progression remains unclear. It is important to note that S. aureus infections following an HAdV-3E infection are frequently observed in clinical settings, yet the underlying susceptibility mechanisms are not fully understood. This study utilized an A549 cell model to investigate secondary infection with S. aureus following an HAdV-3E infection. The findings suggest that HAdV-3E exacerbates the S. aureus infection by intensifying lung epithelial cell damage. The results highlight the role of HAdV-3E in enhancing the interferon signaling pathway through RIG-I (DDX58), resulting in the increased expression of interferon-stimulating factors like MX1, RSAD2, and USP18. The increase in interferon-stimulating factors inhibits the NF-κB and MAPK/P38 pro-inflammatory signaling pathways. These findings reveal new mechanisms of action for HAdV-3E and S. aureus in secondary infections, enhancing our comprehension of pathogenesis.
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Affiliation(s)
| | | | | | | | | | | | - Li Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China; (J.C.); (Q.W.); (B.Z.); (H.Z.); (D.W.); (X.H.)
| | - Tiantian Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China; (J.C.); (Q.W.); (B.Z.); (H.Z.); (D.W.); (X.H.)
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Influence of Sex on Respiratory Syncytial Virus Genotype Infection Frequency and Nasopharyngeal Microbiome. J Virol 2023; 97:e0147222. [PMID: 36815771 PMCID: PMC10062153 DOI: 10.1128/jvi.01472-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Respiratory syncytial virus (RSV) has a significant health burden in children, older adults, and the immunocompromised. However, limited effort has been made to identify emergence of new RSV genotypes' frequency of infection and how the combination of nasopharyngeal microbiome and viral genotypes impact RSV disease outcomes. In an observational cohort designed to capture the first infant RSV infection, we employed multi-omics approaches to sequence 349 RSV complete genomes and matched nasopharyngeal microbiomes, during which the 2012/2013 season was dominated by RSV-A, whereas 2013 and 2014 was dominated by RSV-B. We found non-G-72nt-duplicated RSV-A strains were more frequent in male infants (P = 0.02), whereas G-72nt-duplicated genotypes (which is ON1 lineage) were seen equally in both males and females. DESeq2 testing of the nasal microbiome showed Haemophilus was significantly more abundant in infants with RSV-A infection compared to infants with RSV-B infection (adjusted P = 0.002). In addition, the broad microbial clustering of the abundant genera was significantly associated with infant sex (P = 0.03). Overall, we show sex differences in infection by RSV genotype and host nasopharyngeal microbiome, suggesting an interaction between host genetics, virus genotype, and associated nasopharyngeal microbiome. IMPORTANCE Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children and is responsible for high hospitalization rates and morbidity in infants and the elderly. To understand how the emergence of RSV viral genotypes and viral-respiratory microbiome interactions contribute to infection frequency and severity, we utilized an observational cohort designed to capture the first infant RSV infection we employed multi-omics approaches to sequence 349 RSV complete genomes and matched nasopharyngeal microbiomes. We found non-G-72nt-duplicated RSV-A genotypes were more frequent in male infants, whereas G-72nt-duplicated RSV-A strains (ON1 lineage) were seen equally in both males and females. Microbiome analysis show Haemophilus was significantly more abundant in infants with RSV-A compared to infants with RSV-B infection and the microbial clustering of the abundant genera was associated with infant sex. Overall, we show sex differences in RSV genotype-nasopharyngeal microbiome, suggesting an interaction host genetics-virus-microbiome interaction.
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Zhang X, Yang Y, Chen S, Li W, Li Y, Akerley BJ, Shao L, Zhang W, Shen H, Abt MC. Antigen-specific memory Th17 cells promote cross-protection against nontypeable Haemophilus influenzae after mild influenza A virus infection. Mucosal Immunol 2023; 16:153-166. [PMID: 36736665 DOI: 10.1016/j.mucimm.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
Secondary bacterial pneumonia after influenza A virus (IAV) infection is the leading cause of hospitalization and death associated with IAV infection worldwide. Nontypeable Haemophilus influenzae (NTHi) is one of the most common causes of secondary bacterial pneumonia. Current efforts to develop vaccines against NTHi infection focus on inducing antibodies but are hindered by antigenic diversity among NTHi strains. Therefore, we investigated the contribution of the memory T helper type 17 (Th17) response in protective immunity against IAV/NTHi coinfection. We observed that even a mild IAV infection impaired the NTHi-specific Th17 response and increased morbidity and mortality compared with NTHi monoinfected mice. However, pre-existing memory NTHi-specific Th17 cells induced by a previous NTHi infection overcame IAV-driven Th17 inhibition and were cross-protective against different NTHi strains. Last, mice immunized with a NTHi protein that induced a strong Th17 memory response were broadly protected against diverse NTHi strains after challenge with coinfection. These results indicate that vaccination that limits IAV infection to mild disease may be insufficient to eliminate the risk of a lethal secondary bacterial pneumonia. However, NTHi-specific memory Th17 cells provide serotype-independent protection despite an ongoing IAV infection and demonstrate the advantage of developing broadly protective Th17-inducing vaccines against secondary bacterial pneumonia.
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Affiliation(s)
- Xinyun Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China; Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Ying Yang
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - ShengSen Chen
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China; Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA; Department of Endoscopy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Wenchao Li
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA; Shanghai Institute of Immunology, Shanghai Jiaotong University, Shanghai, China; Department of Immunology and Rheumatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yong Li
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA; Shanghai Institute of Immunology, Shanghai Jiaotong University, Shanghai, China
| | - Brian J Akerley
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Linyun Shao
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, 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), Shanghai Medical College, Fudan University, Shanghai, China
| | - Hao Shen
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
| | - Michael C Abt
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
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Guan X, Gao S, Zhao H, Zhou H, Yang Y, Yu S, Wang J. Clinical characteristics of hospitalized term and preterm infants with community-acquired viral pneumonia. BMC Pediatr 2022; 22:452. [PMID: 35897053 PMCID: PMC9325944 DOI: 10.1186/s12887-022-03508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pneumonia is a serious problem that threatens the health of newborns. This study aimed to investigate the clinical characteristics of hospitalized term and preterm infants with community-acquired viral pneumonia. METHODS This was a retrospective analysis of cases of community-acquired viral pneumonia in the Neonatal Department. Nasopharyngeal aspirate (NPA) samples were collected for pathogen detection, and clinical data were collected. We analysed pathogenic species and clinical characteristics among these infants. RESULTS RSV is the main virus in term infants, and parainfluenza virus (PIV) 3 is the main virus in preterm infants. Patients infected with PIV3 were more susceptible to coinfection with bacteria than those with respiratory syncytial virus (RSV) infection (p < 0.05). Preterm infants infected with PIV3 were more likely to be coinfected with bacteria than term infants (p < 0.05), mainly gram-negative bacteria (especially Klebsiella pneumonia). Term infants with bacterial infection were more prone to fever, cyanosis, moist rales, three concave signs, elevated C-reactive protein (CRP) levels, respiratory failure and the need for higher level of oxygen support and mechanical ventilation than those with simple viral infection (p < 0.05). The incidence of hyponatremia in neonatal community-acquired pneumonia (CAP) was high. CONCLUSIONS RSV and PIV3 were the leading causes of neonatal viral CAP. PIV3 infection is the main cause of viral CAP in preterm infants, and these individuals are more likely to be coinfected with bacteria than term infants, mainly gram-negative bacteria. Term infants with CAP coinfected with bacteria were more likely to have greater disease severity than those with single viral infections.
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Affiliation(s)
- Xinxian Guan
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China
| | - Shasha Gao
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China
| | - He Zhao
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China
| | - Huiting Zhou
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China
| | - Yan Yang
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China
| | - Shenglin Yu
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
| | - Jian Wang
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China.
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Sanz I, Perez D, Rojo S, Domínguez-Gil M, de Lejarazu RO, Eiros JM. Coinfections of influenza and other respiratory viruses are associated to children. An Pediatr (Barc) 2022; 96:334-341. [DOI: 10.1016/j.anpede.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022] Open
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Bendala Estrada AD, Calderón Parra J, Fernández Carracedo E, Muiño Míguez A, Ramos Martínez A, Muñez Rubio E, Rubio-Rivas M, Agudo P, Arnalich Fernández F, Estrada Perez V, Taboada Martínez ML, Crestelo Vieitez A, Pesqueira Fontan PM, Bustamante M, Freire SJ, Oriol-Bermúdez I, Artero A, Olalla Sierra J, Areses Manrique M, Carrasco-Sánchez HFJ, Vento VC, García García GM, Cubero-Morais P, Casas-Rojo JM, Núñez-Cortés JM. Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy. BMC Infect Dis 2021; 21:1144. [PMID: 34749645 PMCID: PMC8575150 DOI: 10.1186/s12879-021-06821-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023] Open
Abstract
Background Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection.
Methods This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality.
Results Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often. Conclusions Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06821-1.
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Affiliation(s)
| | - Jorge Calderón Parra
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | | | - Antonio Muiño Míguez
- Internal Medicine Department, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Antonio Ramos Martínez
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | - Elena Muñez Rubio
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | - Manuel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paloma Agudo
- Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Marta Bustamante
- Internal Medicine Department, La Princesa University Hospital, Madrid, Spain
| | - Santiago J Freire
- Internal Medicine Department, A Coruña University Hospital, A Coruña, Spain
| | - Isabel Oriol-Bermúdez
- Infectious Diseases, Internal Medicine Department, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
| | - Arturo Artero
- Internal Medicine Department, Dr. Peset University Hospital, Valencia, Spain
| | | | | | | | | | | | - Pablo Cubero-Morais
- Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), Valladolid, Spain
| | - José-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain
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Sanz I, Perez D, Rojo S, Domínguez-Gil M, Lejarazu ROD, Eiros JM. [Coinfections of influenza and other respiratory viruses are associated to children]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00143-0. [PMID: 33745837 DOI: 10.1016/j.anpedi.2020.12.024] [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: 11/12/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Coinfections of influenza and other respiratory viruses (ORVs) are frequent in the epidemic season. The aim of this study was to examine the demographic and virological variables associated with coinfections by influenza and ORVs. MATERIALS AND METHODS We analysed respiratory samples of patients with laboratory-confirmed influenza using molecular diagnostic methods obtained in 8 consecutive influenza seasons (2011-2012 to 2018-2019). We analysed data focusing on different variables: age, sex, type of patient (hospitalized/sentinel) and detected type/subtype of influenza. RESULTS Coinfections of influenza and ORVs were detected in 17.8% of influenza-positive samples. The probability of detecting coinfection was significantly higher in young children (0-4 years; OR: 2.7; 95% CI: 2.2-3.4), children (5-14 years; OR: 1.6; 95% CI: 1.2-2.1) and patients infected with the A(H3N2) subtype (OR: 1.4; 95% CI: 1.14-1.79). Also, we found a significantly higher frequency of coinfections involving influenza and 2 or more other respiratory viruses in young children (0-4 years; OR: 0.5; 95% CI: 0.32-0.8), adults (40-64 years; OR: 0.5; 95% CI: 0.3-0.9) and women (OR: 0.7; 95% CI: 0.5-0.9). DISCUSSION These results show that coinfections of influenza and ORVs are more frequent in young children and children, and in cases involving the A(H3N2) influenza subtype. Our findings can be useful to guide the use of multiplex diagnostic methods in laboratories with limited resources.
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Affiliation(s)
- Ivan Sanz
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España.
| | - Diana Perez
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - Silvia Rojo
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España; Unidad de Virología, Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - Marta Domínguez-Gil
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España; Servicio de Microbiología, Hospital Universitario Río Hortega, Valladolid, España
| | - Raúl Ortiz de Lejarazu
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - José María Eiros
- Centro Nacional de Gripe de Valladolid, Edifico Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, España; Unidad de Virología, Servicio de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Servicio de Microbiología, Hospital Universitario Río Hortega, Valladolid, España
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Karwelat D, Schmeck B, Ringel M, Benedikter BJ, Hübner K, Beinborn I, Maisner A, Schulte LN, Vollmeister E. Influenza virus-mediated suppression of bronchial Chitinase-3-like 1 secretion promotes secondary pneumococcal infection. FASEB J 2020; 34:16432-16448. [PMID: 33095949 DOI: 10.1096/fj.201902988rr] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Abstract
Infections of the lung are among the leading causes of death worldwide. Despite the preactivation of innate defense programs during viral infection, secondary bacterial infection substantially elevates morbidity and mortality rates. Particularly problematic are co-infections with influenza A virus (IAV) and the major bacterial pathogen Streptococcus pneumoniae. However, the molecular processes underlying the severe course of such co-infections are not fully understood. Previously, the absence of secreted glycoprotein Chitinase-3-like 1 (CHI3L1) was shown to increase pneumococcal replication in mice. We therefore hypothesized that an IAV preinfection decreases CHI3L1 levels to promote pneumococcal infection. Indeed, in an air-liquid interface model of primary human bronchial epithelial cells (hBECs), IAV preinfection interfered with apical but not basolateral CHI3L1 release. Confocal time-lapse microscopy revealed that the gradual loss of apical CHI3L1 localization during co-infection with influenza and S. pneumoniae coincided with the disappearance of goblet as well as ciliated cells and increased S. pneumoniae replication. Importantly, extracellular restoration of CHI3L1 levels using recombinant protein significantly reduced bacterial load in influenza preinfected bronchial models. Thus, recombinant CHI3L1 may provide a novel therapeutic means to lower morbidity and mortality associated with post-influenza pneumococcal infections.
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Affiliation(s)
- Diana Karwelat
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Bernd Schmeck
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany.,Department of Pulmonary and Critical Care Medicine, University Medical Center Marburg, Universities of Giessen and Marburg Lung Center, Philipps University Marburg, Hesse, Germany.,German Center for Lung Research (DZL), Marburg, Hesse, Germany.,Center for Synthetic Microbiology (SYNMIKRO), Philipps University Marburg, Marburg, Hesse, Germany
| | - Marc Ringel
- Institute of Virology, Philipps University Marburg, Marburg, Hesse, Germany
| | - Birke J Benedikter
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Kathleen Hübner
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Isabell Beinborn
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
| | - Andrea Maisner
- Institute of Virology, Philipps University Marburg, Marburg, Hesse, Germany
| | - Leon N Schulte
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany.,German Center for Lung Research (DZL), Marburg, Hesse, Germany
| | - Evelyn Vollmeister
- Institute for Lung Research, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), Marburg, Philipps University Marburg, Hesse, Germany
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McElhaney JE, Verschoor CP, Andrew MK, Haynes L, Kuchel GA, Pawelec G. The immune response to influenza in older humans: beyond immune senescence. Immun Ageing 2020; 17:10. [PMID: 32399058 PMCID: PMC7204009 DOI: 10.1186/s12979-020-00181-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 04/13/2020] [Indexed: 01/18/2023]
Abstract
Despite widespread influenza vaccination programs, influenza remains a major cause of morbidity and mortality in older adults. Age-related changes in multiple aspects of the adaptive immune response to influenza have been well-documented including a decline in antibody responses to influenza vaccination and changes in the cell-mediated response associated with immune senescence. This review will focus on T cell responses to influenza and influenza vaccination in older adults, and how increasing frailty or coexistence of multiple (≥2) chronic conditions contributes to the loss of vaccine effectiveness for the prevention of hospitalization. Further, dysregulation of the production of pro- and anti-inflammatory mediators contributes to a decline in the generation of an effective CD8 T cell response needed to clear influenza virus from the lungs. Current influenza vaccines provide only a weak stimulus to this arm of the adaptive immune response and rely on re-stimulation of CD8 T cell memory related to prior exposure to influenza virus. Efforts to improve vaccine effectiveness in older adults will be fruitless until CD8 responses take center stage.
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Affiliation(s)
- Janet E. McElhaney
- Health Sciences North Research Institute, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1 Canada
| | - Chris P. Verschoor
- Health Sciences North Research Institute, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1 Canada
| | - Melissa K. Andrew
- Department of Medicine and Canadian Centre for Vaccinology, Dalhousie University, Halifax, NS Canada
| | - Laura Haynes
- University of Connecticut Center on Aging, UConn Health Center, Farmington, CT USA
| | - George A. Kuchel
- University of Connecticut Center on Aging, UConn Health Center, Farmington, CT USA
| | - Graham Pawelec
- Health Sciences North Research Institute, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1 Canada
- Department of Immunology, University of Tübingen, Tübingen, Germany
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10
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[Bacteriologic profile and drug resistance in children with respiratory infection from 2016 to 2018]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019. [PMID: 31874656 PMCID: PMC7389001 DOI: 10.7499/j.issn.1008-8830.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To study the bacteriologic profile and drug resistance of respiratory infection in children, and to provide a basis for etiological diagnosis and rational use of antimicrobial agents. METHODS A retrospective analysis was performed for 15 047 children who attended the hospital due to respiratory infection from January 2016 to December 2018. Their sputum samples were collected, and the Phoenix-100 automatic microbial identification system was used for the identification and drug sensitivity analysis of the isolated pathogenic bacteria. RESULTS Of all 17 174 sputum samples detected, there were 2 395 positive samples, with a positive rate of 13.95%; a total of 2 584 strains of pathogenic bacteria were isolated, among which there were 1 577 (61.03%) Gram-negative strains, 967 (37.42%) Gram-positive strains, and 40 (1.55%) fungal strains. The most common pathogen was Haemophilus influenzae (33.90%), followed by Streptococcus pneumoniae (33.55%), Moraxella catarrhalis (19.20%), and Staphylococcus aureus (3.64%). Among the 2 331 children with positive infection, 251 had mixed infection, most commonly with Haemophilus influenzae and Streptococcus pneumoniae. The detection rate of pathogenic bacteria was higher in winter and spring and lower in summer and autumn. There was a significant difference in the detection rate of pathogenic bacteria between different age groups (P<0.05), with the highest detection rate in infants aged 1 month to <1 year. Streptococcus pneumoniae and Staphylococcus aureus had a sensitivity rate of 100% to vancomycin, linezolid, and teicoplanin, and Haemophilus influenzae had a lower sensitivity rate to ampicillin, compound sulfamethoxazole and cefuroxime and a higher sensitivity rate to other drugs. CONCLUSIONS Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis are the main pathogenic bacteria of respiratory infection in children, and mixed infection is the most common type of infection. The detection rate of pathogenic bacteria varies across seasons and ages. Different pathogenic bacteria have different features of drug resistance, and antibiotics should be selected based on drug sensitivity results.
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Wang QY, Li CR, Guo J, Tang KW. [Bacteriologic profile and drug resistance in children with respiratory infection from 2016 to 2018]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:1182-1187. [PMID: 31874656 PMCID: PMC7389001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/31/2019] [Indexed: 08/01/2024]
Abstract
OBJECTIVE To study the bacteriologic profile and drug resistance of respiratory infection in children, and to provide a basis for etiological diagnosis and rational use of antimicrobial agents. METHODS A retrospective analysis was performed for 15 047 children who attended the hospital due to respiratory infection from January 2016 to December 2018. Their sputum samples were collected, and the Phoenix-100 automatic microbial identification system was used for the identification and drug sensitivity analysis of the isolated pathogenic bacteria. RESULTS Of all 17 174 sputum samples detected, there were 2 395 positive samples, with a positive rate of 13.95%; a total of 2 584 strains of pathogenic bacteria were isolated, among which there were 1 577 (61.03%) Gram-negative strains, 967 (37.42%) Gram-positive strains, and 40 (1.55%) fungal strains. The most common pathogen was Haemophilus influenzae (33.90%), followed by Streptococcus pneumoniae (33.55%), Moraxella catarrhalis (19.20%), and Staphylococcus aureus (3.64%). Among the 2 331 children with positive infection, 251 had mixed infection, most commonly with Haemophilus influenzae and Streptococcus pneumoniae. The detection rate of pathogenic bacteria was higher in winter and spring and lower in summer and autumn. There was a significant difference in the detection rate of pathogenic bacteria between different age groups (P<0.05), with the highest detection rate in infants aged 1 month to <1 year. Streptococcus pneumoniae and Staphylococcus aureus had a sensitivity rate of 100% to vancomycin, linezolid, and teicoplanin, and Haemophilus influenzae had a lower sensitivity rate to ampicillin, compound sulfamethoxazole and cefuroxime and a higher sensitivity rate to other drugs. CONCLUSIONS Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis are the main pathogenic bacteria of respiratory infection in children, and mixed infection is the most common type of infection. The detection rate of pathogenic bacteria varies across seasons and ages. Different pathogenic bacteria have different features of drug resistance, and antibiotics should be selected based on drug sensitivity results.
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Affiliation(s)
- Qian-Yu Wang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China.
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12
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Zhou F, Wang Y, Liu Y, Liu X, Gu L, Zhang X, Pu Z, Yang G, Liu B, Nie Q, Xue B, Feng J, Guo Q, Liu J, Fan H, Chen J, Zhang Y, Xu Z, Pang M, Chen Y, Nie X, Cai Z, Xu J, Peng K, Li X, Xiang P, Zhang Z, Jiang S, Su X, Zhang J, Li Y, Jin X, Jiang R, Dong J, Song Y, Zhou H, Wang C, Cao B. Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network. Eur Respir J 2019; 54:13993003.02406-2018. [PMID: 31164430 DOI: 10.1183/13993003.02406-2018] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/02/2019] [Indexed: 02/05/2023]
Abstract
Although broad knowledge of influenza viral pneumonia has been established, the significance of non-influenza respiratory viruses in community-acquired pneumonia (CAP) and their impact on clinical outcomes remains unclear, especially in the non-immunocompromised adult population.Hospitalised immunocompetent patients with CAP were prospectively recruited from 34 hospitals in mainland China. Respiratory viruses were detected by molecular methods. Comparisons were conducted between influenza and non-influenza viral infection groups.In total, 915 out of 2336 adult patients with viral infection were enrolled in the analysis, with influenza virus (28.4%) the most frequently detected virus, followed by respiratory syncytial virus (3.6%), adenovirus (3.3%), human coronavirus (3.0%), parainfluenza virus (2.2%), human rhinovirus (1.8%) and human metapneumovirus (1.5%). Non-influenza viral infections accounted for 27.4% of viral pneumonia. Consolidation was more frequently observed in patients with adenovirus infection. The occurrence of complications such as sepsis (40.1% versus 39.6%; p=0.890) and hypoxaemia (40.1% versus 37.2%; p=0.449) during hospitalisation in the influenza viral infection group did not differ from that of the non-influenza viral infection group. Compared with influenza virus infection, the multivariable adjusted odds ratios of CURB-65 (confusion, urea >7 mmol·L-1, respiratory rate ≥30 breaths·min-1, blood pressure <90 mmHg (systolic) or ≤60 mmHg (diastolic), age ≥65 years) ≥3, arterial oxygen tension/inspiratory oxygen fraction <200 mmHg, and occurrence of sepsis and hypoxaemia for non-influenza respiratory virus infection were 0.87 (95% CI 0.26-2.84), 0.72 (95% CI 0.26-1.98), 1.00 (95% CI 0.63-1.58) and 1.05 (95% CI 0.66-1.65), respectively. The hazard ratio of 90-day mortality was 0.51 (95% CI 0.13-1.91).The high incidence of complications in non-influenza viral pneumonia and similar impact of non-influenza respiratory viruses relative to influenza virus on disease severity and outcomes suggest more attention should be given to CAP caused by non-influenza respiratory viruses.
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Affiliation(s)
- Fei Zhou
- Dept of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine Chinese Academy of Medical Science, National Clinical Research Center of Respiratory Diseases, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,These authors contributed equally to this work
| | - Yimin Wang
- Dept of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine Chinese Academy of Medical Science, National Clinical Research Center of Respiratory Diseases, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,These authors contributed equally to this work
| | - Yingmei Liu
- Dept of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine Chinese Academy of Medical Science, National Clinical Research Center of Respiratory Diseases, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,These authors contributed equally to this work
| | - Xuedong Liu
- Dept of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao, China.,These authors contributed equally to this work
| | - Li Gu
- Dept of Infectious Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,These authors contributed equally to this work
| | - Xiaoju Zhang
- Dept of Respiratory Medicine, Henan Provincial People's Hospital, Zhengzhou, China.,These authors contributed equally to this work
| | - Zenghui Pu
- Dept of Infectious Diseases, Yantai Yu Huang-Ding Hospital, Yantai, China.,These authors contributed equally to this work
| | - Guoru Yang
- Dept of Pulmonary and Critical Care Medicine, Weifang No. 2 People's Hospital, Weifang, China.,These authors contributed equally to this work
| | - Bo Liu
- Dept of Respiratory and Critical Care Medicine, Linzi District People's Hospital, Zibo, China.,These authors contributed equally to this work
| | - Qingrong Nie
- Dept of Respiratory and Critical Care Medicine, Liangxiang Hospital, Beijing, China
| | - Bing Xue
- Dept of Respiratory Medicine, Chuiyangliu Hospital Affiliated to Tshinghua University, Beijing, China
| | - Jing Feng
- Dept of Respiratory Medicine, General Hospital of Tianjin Medical University, Tianjin, China
| | - Qiang Guo
- Dept of Respiratory, Emergency and Critical Care Medicine, First Affiliated Hospital of Soochow University, Jiangsu, China
| | - Jianhua Liu
- Dept of Respiratory Medicine, Beijing Huairou Hospital of University of Chinese Academy of Science, Beijing, China
| | - Hong Fan
- Dept of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Chen
- Dept of Respiratory Medicine, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Zhang
- Dept of Respiratory Medicine, Daxing Teaching Hospital, Capital Medical University, Beijing, China
| | - Zhenyang Xu
- Dept of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Min Pang
- Dept of Respiratory Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yu Chen
- Dept of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Beijing China
| | - Xiuhong Nie
- Dept of Respiratory Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhigang Cai
- Dept of Pulmonary and Critical Care Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jinfu Xu
- Dept of Pulmonary and Critical Care Medicine, Shanghai Pulmonary Hospital, Shanghai, China
| | - Kun Peng
- Dept of Respiratory Medicine, Beijing No. 6 Hospital, Beijing, China
| | - Xiangxin Li
- Dept of Pulmonary and Critical Care Medicine, Beijing Changping Hospital, Beijing, China
| | - Pingchao Xiang
- Dept of Pulmonary and Critical Care Medicine, Peking University Shougang Hospital, Beijing, China
| | - Zuoqing Zhang
- Dept of Respiratory Medicine, Beijing Shijingshan Hospital, Beijing, China
| | - Shujuan Jiang
- Dept of Pulmonary and Critical Care Medicine, Shandong Province Hospital, Jinan, China
| | - Xin Su
- Dept of Respiratory Medicine, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing, China
| | - Jie Zhang
- Dept of Respiratory Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanming Li
- Dept of Pulmonary and Critical Care Medicine, Beijing Hospital, Beijing, China
| | - Xiuhong Jin
- Dept of Respiratory Medicine, Beijing Pinggu Hospital, Beijing, China
| | - Rongmeng Jiang
- Infectious Disease Diagnosis and Treatment Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jianping Dong
- Dept of Infectious Diseases, Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing, China
| | - Yuanlin Song
- Dept of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hong Zhou
- Dept of Respiratory Medicine, Beijing Electric Power Hospital, Beijing, China
| | - Chen Wang
- Dept of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine Chinese Academy of Medical Science, National Clinical Research Center of Respiratory Diseases, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,These authors contributed equally to this work
| | - Bin Cao
- Dept of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, Institute of Respiratory Medicine Chinese Academy of Medical Science, National Clinical Research Center of Respiratory Diseases, Beijing, China .,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,These authors contributed equally to this work
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13
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Abstract
Pneumonia is a type of acute lower respiratory infection that is common and severe. The outcome of lower respiratory infection is determined by the degrees to which immunity is protective and inflammation is damaging. Intercellular and interorgan signaling networks coordinate these actions to fight infection and protect the tissue. Cells residing in the lung initiate and steer these responses, with additional immunity effectors recruited from the bloodstream. Responses of extrapulmonary tissues, including the liver, bone marrow, and others, are essential to resistance and resilience. Responses in the lung and extrapulmonary organs can also be counterproductive and drive acute and chronic comorbidities after respiratory infection. This review discusses cell-specific and organ-specific roles in the integrated physiological response to acute lung infection, and the mechanisms by which intercellular and interorgan signaling contribute to host defense and healthy respiratory physiology or to acute lung injury, chronic pulmonary disease, and adverse extrapulmonary sequelae. Pneumonia should no longer be perceived as simply an acute infection of the lung. Pneumonia susceptibility reflects ongoing and poorly understood chronic conditions, and pneumonia results in diverse and often persistent deleterious consequences for multiple physiological systems.
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Affiliation(s)
- Lee J Quinton
- Pulmonary Center, Boston University School of Medicine , Boston, Massachusetts
| | - Allan J Walkey
- Pulmonary Center, Boston University School of Medicine , Boston, Massachusetts
| | - Joseph P Mizgerd
- Pulmonary Center, Boston University School of Medicine , Boston, Massachusetts
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14
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Drăgănescu A, Săndulescu O, Florea D, Vlaicu O, Streinu-Cercel A, Oţelea D, Aramă V, Luminos ML, Streinu-Cercel A, Niţescu M, Ivanciuc A, Bacruban R, Piţigoi D. The influenza season 2016/17 in Bucharest, Romania - surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital. Braz J Infect Dis 2018; 22:377-386. [PMID: 30391275 PMCID: PMC9427989 DOI: 10.1016/j.bjid.2018.10.275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/18/2018] [Accepted: 10/18/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Influenza continues to drive seasonal morbidity, particularly in settings with low vaccine coverage. OBJECTIVES To describe the influenza cases and viral circulation among hospitalized patients. METHODS A prospective study based on active surveillance of inpatients with influenza-like illness from a tertiary hospital in Bucharest, Romania, in the season 2016/17. RESULTS A total of 446 patients were tested, with a balanced gender distribution. Overall, 192 (43%) patients tested positive for influenza, with the highest positivity rate in the age groups 3-13 years and >65 years. Peak activity occurred between weeks 1 and 16/2017, with biphasic distribution: A viruses were replaced by B viruses from week 9/2017; B viruses predominated (66.1%). Among the 133 (69.3%) subtyped samples, all influenza A were subtype H3 (n=57) and all influenza B were B/Victoria (n=76). Patients who tested positive for influenza presented fewer comorbidities (p=0.012), except for the elderly, in whom influenza was more common in patients with comorbidities (p=0.050). Disease evolution was generally favorable under antiviral treatment. The length of hospital stay was slightly longer in patients with influenza-like illness who tested patients negative for influenza (p=0.031). CONCLUSIONS Distinctive co-circulation of A/H3 and B/Victoria in Bucharest, Romania in the 2016/17 influenza season was found. While the A/H3 subtype was predominant throughout Europe that season, B/Victoria appears to have circulated specifically in Romania and the Eastern European region, predominantly affecting preschoolers and school children.
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Affiliation(s)
- Anca Drăgănescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Oana Săndulescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Dragoş Florea
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ovidiu Vlaicu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Anca Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dan Oţelea
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Victoria Aramă
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Monica Luminiţa Luminos
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adrian Streinu-Cercel
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Maria Niţescu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alina Ivanciuc
- Cantacuzino Military-Medical Research-Development National Institute, Bucharest, Romania; Bucharest University, Faculty of Biology, Bucharest, Romania
| | - Rodica Bacruban
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Daniela Piţigoi
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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15
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Abstract
PURPOSE OF REVIEW We aim to review the epidemiology of pneumonia with bacterial and viral coinfection, the pathogenesis and clinical impact of coinfection along with the current state of treatment and outcomes. RECENT FINDINGS Emphasis is given to the pathogenesis of bacterial and viral co-infection including specific highlighting on influenza, rhinovirus, respiratory syncytial virus and cytomegalovirus. Updates on the current state of diagnosis and management are included, as well as on areas where future research can be directed to improve patient clinical outcomes regarding viral and bacterial coinfection. SUMMARY Bacterial and viral coinfection is increasingly recognized as an underlying etiology for community- and hospital-acquired infections. Coinfections may be a risk factor for ICU admission, severity of disease, and mortality. Clinicians must be aware of these coinfections for appropriate management and prognostication, as well as for the prevention of nosocomial spread of viral illness.
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16
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Boucontet L, Passoni G, Thiry V, Maggi L, Herbomel P, Levraud JP, Colucci-Guyon E. A Model of Superinfection of Virus-Infected Zebrafish Larvae: Increased Susceptibility to Bacteria Associated With Neutrophil Death. Front Immunol 2018; 9:1084. [PMID: 29881380 PMCID: PMC5976802 DOI: 10.3389/fimmu.2018.01084] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/01/2018] [Indexed: 12/17/2022] Open
Abstract
Enhanced susceptibility to bacterial infection in the days following an acute virus infection such as flu is a major clinical problem. Mouse models have provided major advances in understanding viral-bacterial superinfections, yet interactions of the anti-viral and anti-bacterial responses remain elusive. Here, we have exploited the transparency of zebrafish to study how viral infections can pave the way for bacterial co-infections. We have set up a zebrafish model of sequential viral and bacterial infection, using sublethal doses of Sindbis virus and Shigella flexneri bacteria. This virus induces a strong type I interferons (IFN) response, while the bacterium induces a strong IL1β and TNFα-mediated inflammatory response. We found that virus-infected zebrafish larvae showed an increased susceptibility to bacterial infection. This resulted in the death with concomitant higher bacterial burden of the co-infected fish compared to the ones infected with bacteria only. By contrast, infecting with bacteria first and virus second did not lead to increased mortality or microbial burden. By high-resolution live imaging, we showed that neutrophil survival was impaired in Sindbis-then-Shigella co-infected fish. The two types of cytokine responses were strongly induced in co-infected fish. In addition to type I IFN, expression of the anti-inflammatory cytokine IL10 was induced by viral infection before bacterial superinfection. Collectively, these observations suggest the zebrafish larva as a useful animal model to address mechanisms underlying increased bacterial susceptibility upon viral infection.
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Affiliation(s)
- Laurent Boucontet
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Gabriella Passoni
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Valéry Thiry
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Ludovico Maggi
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Philippe Herbomel
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Jean-Pierre Levraud
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
| | - Emma Colucci-Guyon
- Institut Pasteur, Unité Macrophages et Développement de l'Immunité, Paris, France.,CNRS UMR 3738, Paris, France
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17
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Villa TG, Feijoo-Siota L, Rama JLR, Ageitos JM. Antivirals against animal viruses. Biochem Pharmacol 2017; 133:97-116. [PMID: 27697545 PMCID: PMC7092833 DOI: 10.1016/j.bcp.2016.09.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/29/2016] [Indexed: 01/19/2023]
Abstract
Antivirals are compounds used since the 1960s that can interfere with viral development. Some of these antivirals can be isolated from a variety of sources, such as animals, plants, bacteria or fungi, while others must be obtained by chemical synthesis, either designed or random. Antivirals display a variety of mechanisms of action, and while some of them enhance the animal immune system, others block a specific enzyme or a particular step in the viral replication cycle. As viruses are mandatory intracellular parasites that use the host's cellular machinery to survive and multiply, it is essential that antivirals do not harm the host. In addition, viruses are continually developing new antiviral resistant strains, due to their high mutation rate, which makes it mandatory to continually search for, or develop, new antiviral compounds. This review describes natural and synthetic antivirals in chronological order, with an emphasis on natural compounds, even when their mechanisms of action are not completely understood, that could serve as the basis for future development of novel and/or complementary antiviral treatments.
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Affiliation(s)
- T G Villa
- Department of Microbiology, Biotechnology Unit, Faculty of Pharmacy, University of Santiago de Compostela 15706, Spain
| | - L Feijoo-Siota
- Department of Microbiology, Biotechnology Unit, Faculty of Pharmacy, University of Santiago de Compostela 15706, Spain
| | - J L R Rama
- Department of Microbiology, Biotechnology Unit, Faculty of Pharmacy, University of Santiago de Compostela 15706, Spain
| | - J M Ageitos
- Department of Microbiology, Biotechnology Unit, Faculty of Pharmacy, University of Santiago de Compostela 15706, Spain.
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18
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Maciejewski BA, Jamieson KC, Arnason JW, Kooi C, Wiehler S, Traves SL, Leigh R, Proud D. Rhinovirus-bacteria coexposure synergistically induces CCL20 production from human bronchial epithelial cells. Am J Physiol Lung Cell Mol Physiol 2017; 312:L731-L740. [PMID: 28283475 DOI: 10.1152/ajplung.00362.2016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/17/2017] [Accepted: 03/02/2017] [Indexed: 01/23/2023] Open
Abstract
Exacerbations of chronic obstructive pulmonary disease are triggered by viral or bacterial pathogens, with human rhinovirus (HRV) and nontypeable Hemophilus influenzae (NTHI) among the most commonly detected pathogens. Patients who suffer from concomitant viral and bacterial infection have more severe exacerbations. The airway epithelial cell is the initial site of viral and bacterial interactions, and CCL20 is an epithelial chemokine that attracts immature dendritic cells to the airways and can act as an antimicrobial. As such, it contributes to innate and adaptive immune responses to infection. We used primary cultures of human bronchial epithelial cells and the BEAS-2B cell line to examine the effects of bacterial-viral coexposure, as well as each stimulus alone, on epithelial expression of CXCL8 and, in particular, CCL20. HRV-bacterial coexposure induced synergistic production of CXCL8 and CCL20 compared with the sum of each stimulus alone. Synergistic induction of CCL20 did not require viral replication and occurred with two different HRV serotypes that use different viral receptors. Synergy was also seen with either NTHI or Pseudomonas aeruginosa Synergistic induction of CCL20 was transcriptionally regulated. Although NF-κB was required for transcription, it did not regulate synergy, but NF-IL-6 did appear to contribute. Among MAPK inhibitors studied, neither SB203580 nor PD98059 had any effect on synergy, whereas U0126 prevented synergistic induction of CCL20 by HRV and bacteria, apparently via "off-target" effects. Thus bacterial-viral coexposure synergistically increases innate immune responses compared with individual infections. We speculate that this increased inflammatory response leads to worse clinical outcomes.
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Affiliation(s)
- Barbara A Maciejewski
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Kyla C Jamieson
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Jason W Arnason
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Cora Kooi
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Shahina Wiehler
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Suzanne L Traves
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Richard Leigh
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and.,Department of Medicine, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David Proud
- Department of Physiology & Pharmacology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
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19
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Abstract
Secondary bacterial pneumonia after viral respiratory infection remains a significant source of morbidity and mortality. Susceptibility is mediated by a variety of viral and bacterial factors, and complex interactions with the host immune system. Prevention and treatment strategies are limited to influenza vaccination and antibiotics/antivirals respectively. Novel approaches to identifying the individuals with influenza who are at increased risk for secondary bacterial pneumonias are urgently needed. Given the threat of further pandemics and the heightened prevalence of these viruses, more research into the immunologic mechanisms of this disease is warranted with the hope of discovering new potential therapies.
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Affiliation(s)
- Jason E Prasso
- Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, CHS 37-131, Los Angeles, CA 90095, USA
| | - Jane C Deng
- Division of Pulmonary and Critical Care Medicine, Veterans Affairs Healthcare System, University of Michigan, 2215 Fuller Road, 111G Pulmonary, Ann Arbor, MI 48105, USA.
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20
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Abstract
The transcriptome is a powerful proxy for the physiological state of a cell, healthy or diseased. As a result, transcriptome analysis has become a key tool in understanding the molecular changes that accompany bacterial infections of eukaryotic cells. Until recently, such transcriptomic studies have been technically limited to analyzing mRNA expression changes in either the bacterial pathogen or the infected eukaryotic host cell. However, the increasing sensitivity of high-throughput RNA sequencing now enables "dual RNA-seq" studies, simultaneously capturing all classes of coding and noncoding transcripts in both the pathogen and the host. In the five years since the concept of dual RNA-seq was introduced, the technique has been applied to a range of infection models. This has not only led to a better understanding of the physiological changes in pathogen and host during the course of an infection but has also revealed hidden molecular phenotypes of virulence-associated small noncoding RNAs that were not visible in standard infection assays. Here, we use the knowledge gained from these recent studies to suggest experimental and computational guidelines for the design of future dual RNA-seq studies. We conclude this review by discussing prospective applications of the technique.
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Affiliation(s)
- Alexander J. Westermann
- RNA Biology Group, Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Lars Barquist
- RNA Biology Group, Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Jörg Vogel
- RNA Biology Group, Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
- Helmholtz Institute for RNA-based Infection Research (HIRI), Würzburg, Germany
- * E-mail:
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21
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Jeon YH, Kim JH. Treatment of community-acquired pneumonia in Korean children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.4.177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- You Hoon Jeon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwasung, Korea
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
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Viral-bacterial co-infections in the respiratory tract. Curr Opin Microbiol 2016; 35:30-35. [PMID: 27940028 PMCID: PMC7108227 DOI: 10.1016/j.mib.2016.11.003] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 01/02/2023]
Abstract
Viruses predispose to secondary bacterial infection throughout the respiratory tract. Viral damage to airway epithelium and aberrant inflammatory responses play key roles. Dysregulation of both innate and acquired immune effectors contribute to co-infection. Viral co-infection promotes bacterial invasion of sterile sites within the airway. Optimal treatment likely requires control of both bacterial growth and host responses.
Preceding or concurrent viral respiratory tract infection can predispose to secondary bacterial co-infection throughout the airway. The mechanisms by which viruses promote these superinfections are diverse and replete. Whereas we understand much as to how viruses damage the airway and dysregulate both innate and acquired immune responses which, in turn, supports bacterial growth, adherence and invasion into normally sterile sites within the respiratory tract, new information regarding these co-infections is being gained from recent advances in microbiome research and our enhanced appreciation of the contribution of bacterial biofilms, among others. The advanced understanding obtained by continued research efforts in all aspects of viral–bacterial co-infections of the respiratory tract will allow us to devise novel approaches for disease prevention as well as to develop more effective therapeutics.
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Influenza A and B co-infection: a case-control study and review of the literature. Eur J Clin Microbiol Infect Dis 2016; 35:941-6. [PMID: 26980094 DOI: 10.1007/s10096-016-2620-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/29/2016] [Indexed: 01/13/2023]
Abstract
Influenza virus infection remains a major cause of morbidity and mortality during winter seasons. Bacterial and virus co-infection is a commonly described situation in these patients. However, data on co-infection by influenza A and B viruses are lacking. In this study, we present the cases of co-infection by influenza A and B viruses during the winter season of 2014-2015 in our institution. We analyzed 2759 samples from 2111 patients and found that 625 samples corresponding to 609 patients were positive for influenza A or B virus. A total of 371 patients had influenza A, 228 had influenza B, and 10 (1.6 %) had influenza A and B virus detection in the same sample. The median age of co-infected patients was 78.6 years, and only one of the co-infected patients died because of the infection. Comparison with a control group of mono-infected patients revealed that co-infection was significantly associated with nosocomial acquisition [odds ratio (OR) = 4.5, 95 % confidence interval (CI) = 1.05-19.25, p = 0.042]. However, co-infection was not associated with worse outcome, previous underlying condition, or vaccination status. Multivariate analysis revealed that co-infection was not an independent risk factor for death and that no single risk factor could predict co-infection.
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Arriaga-Pizano L, Ferat-Osorio E, Rodríguez-Abrego G, Mancilla-Herrera I, Domínguez-Cerezo E, Valero-Pacheco N, Pérez-Toledo M, Lozano-Patiño F, Laredo-Sánchez F, Malagón-Rangel J, Nellen-Hummel H, González-Bonilla C, Arteaga-Troncoso G, Cérbulo-Vázquez A, Pastelin-Palacios R, Klenerman P, Isibasi A, López-Macías C. Differential Immune Profiles in Two Pandemic Influenza A(H1N1)pdm09 Virus Waves at Pandemic Epicenter. Arch Med Res 2015; 46:651-8. [PMID: 26696552 PMCID: PMC4914610 DOI: 10.1016/j.arcmed.2015.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 12/01/2015] [Indexed: 11/26/2022]
Abstract
Background and Aims Severe influenza A(H1N1)pdm2009 virus infection cases are characterized by sustained immune activation during influenza pandemics. Seasonal flu data suggest that immune mediators could be modified by wave-related changes. Our aim was to determine the behavior of soluble and cell-related mediators in two waves at the epicenter of the 2009 influenza pandemic. Methods Leukocyte surface activation markers were studied in serum from peripheral blood samples, collected from the 1st (April–May, 2009) and 2nd (October 2009–February 2010) pandemic waves. Patients with confirmed influenza A(H1N1)pdm2009 virus infection (H1N1), influenza-like illness (ILI) or healthy donors (H) were analyzed. Results Serum IL-6, IL-4 and IL-10 levels were elevated in H1N1 patients from the 2nd pandemic wave. Additionally, the frequency of helper and cytotoxic T cells was reduced during the 1st wave, whereas CD69 expression in helper T cells was increased in the 2nd wave for both H1N1 and ILI patients. In contrast, CD62L expression in granulocytes from the ILI group was increased in both waves but in monocytes only in the 2nd wave. Triggering Receptor Expressed on Myeloid cells (TREM)-1 expression was elevated only in H1N1 patients at the 1st wave. Conclusions Our results show that during the 2009 influenza pandemic a T cell activation phenotype is observed in a wave-dependent fashion, with an expanded activation in the 2nd wave, compared to the 1st wave. Conversely, granulocyte and monocyte activation is infection-dependent. This evidence collected at the pandemic epicenter in 2009 could help us understand the differences in the underlying cellular mechanisms that drive the wave-related immune profile behaviors that occur against influenza viruses during pandemics.
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Affiliation(s)
- Lourdes Arriaga-Pizano
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - Eduardo Ferat-Osorio
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico; Gastrointestinal Surgery Service, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | | | - Ismael Mancilla-Herrera
- Infectology and Immunology department, National Institute of Perinatology, SSA, Mexico City, Mexico
| | - Esteban Domínguez-Cerezo
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico; Graduate Program on Immunology, ENCB-IPN, Mexico City, Mexico
| | - Nuriban Valero-Pacheco
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico; Graduate Program on Immunology, ENCB-IPN, Mexico City, Mexico
| | - Marisol Pérez-Toledo
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico; Graduate Program on Immunology, ENCB-IPN, Mexico City, Mexico
| | - Fernando Lozano-Patiño
- Internal Medicine Service, Specialties Hospital of the National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - Fernando Laredo-Sánchez
- Internal Medicine Service, Specialties Hospital of the National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - José Malagón-Rangel
- Internal Medicine Service, Specialties Hospital of the National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - Haiko Nellen-Hummel
- Internal Medicine Service, Specialties Hospital of the National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - César González-Bonilla
- Unit for Epidemiological Surveillance, National Medical Center La Raza, IMSS, Mexico City, Mexico
| | | | | | | | - Paul Klenerman
- Oxford Biomedical Research Centre and Oxford Martin School, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Armando Isibasi
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico
| | - Constantino López-Macías
- Medical Research Unit in Immunochemistry, Specialties Hospital, National Medical Center Siglo XXI, IMSS, Mexico City, Mexico; Visiting Professor of Immunology, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Crotty MP, Meyers S, Hampton N, Bledsoe S, Ritchie DJ, Buller RS, Storch GA, Micek ST, Kollef MH. Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study. Medicine (Baltimore) 2015; 94:e2332. [PMID: 26683973 PMCID: PMC5058945 DOI: 10.1097/md.0000000000002332] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Advanced technologies using polymerase-chain reaction have allowed for increased recognition of viral respiratory infections including pneumonia. Co-infections have been described for several respiratory viruses, especially with influenza. Outcomes of viral pneumonia, including cases with co-infections, have not been well described. This was observational cohort study conducted to describe hospitalized patients with viral pneumonia including co-infections, clinical outcomes, and predictors of mortality. Patients admitted from March 2013 to November 2014 with a positive respiratory virus panel (RVP) and radiographic findings of pneumonia within 48 h of the index RVP were included. Co-respiratory infection (CRI) was defined as any organism identification from a respiratory specimen within 3 days of the index RVP. Predictors of in-hospital mortality on univariate analysis were evaluated in a multivariate model. Of 284 patients with viral pneumonia, a majority (51.8%) were immunocompromised. A total of 84 patients (29.6%) were found to have a CRI with 48 (57.6%) having a bacterial CRI. Viral CRI with HSV, CMV, or both occurred in 28 patients (33.3%). Fungal (16.7%) and other CRIs (7.1%) were less common. Many patients required mechanical ventilation (54%) and vasopressor support (36%). Overall in-hospital mortality was high (23.2%) and readmissions were common with several patients re-hospitalized within 30 (21.1%) and 90 days (36.7%) of discharge. Predictors of in-hospital mortality on multivariate regression included severity of illness factors, stem-cell transplant, and identification of multiple respiratory viruses. In conclusion, hospital mortality is high among adult patients with viral pneumonia and patients with multiple respiratory viruses identified may be at a higher risk.
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Affiliation(s)
- Matthew P Crotty
- From the Pharmacy St. Louis College of Pharmacy (STLCOP) (MPC); STLCOP and Dept of Pharmacy, Barnes-Jewish Hospital (DJR); STLCOP (SM); STLCOP and Dept of Pharmacy, Barnes-Jewish Hospital (STM); Center for Clinical Excellence, BJC Healthcare (NH); Department of Pediatrics, Washington University School of Medicine (RSB, GAS); and Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine (MHK)
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Cillóniz C, Civljak R, Nicolini A, Torres A. Polymicrobial community-acquired pneumonia: An emerging entity. Respirology 2015; 21:65-75. [PMID: 26494527 DOI: 10.1111/resp.12663] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/21/2015] [Accepted: 07/28/2015] [Indexed: 12/13/2022]
Abstract
Polymicrobial aetiology in community-acquired pneumonia (CAP) is more common than previously recognized. This growing new entity can influence inflammation, host immunity and disease outcomes in CAP patients. However, the true incidence is complicated to determine and probably underestimated due mainly to many cases going undetected, particularly in the outpatient setting, as the diagnostic yield is restricted by the sensitivity of currently available microbiologic tests and the ability to get certain types of clinical specimens. The observed rate of polymicrobial cases may also lead to new antibiotic therapy considerations. In this review, we discuss the pathogenesis, microbial interactions in pneumonia, epidemiology, biomarkers and antibiotic therapy for polymicrobial CAP.
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Affiliation(s)
- Catia Cillóniz
- Department of Pneumology, Thorax Institute, Hospital Clinic of Barcelona-August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona (UB)-SGR 911-, Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain
| | - Rok Civljak
- University of Zagreb School of Medicine, 'Dr. Fran Mihaljevic' University Hospital for Infectious Diseases, Zagreb, Croatia
| | | | - Antoni Torres
- Department of Pneumology, Thorax Institute, Hospital Clinic of Barcelona-August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona (UB)-SGR 911-, Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain
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27
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Damasio GAC, Pereira LA, Moreira SDR, Duarte dos Santos CN, Dalla-Costa LM, Raboni SM. Does virus-bacteria coinfection increase the clinical severity of acute respiratory infection? J Med Virol 2015; 87:1456-61. [PMID: 25976175 PMCID: PMC7166438 DOI: 10.1002/jmv.24210] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 02/05/2023]
Abstract
This retrospective cohort study investigated the presence of bacteria in respiratory secretions of patients hospitalized with acute respiratory infections and analyzed the impact of viral and bacterial coinfection on severity and the mortality rate. A total of 169 patients with acute respiratory infections were included, viruses and bacteria in respiratory samples were detected using molecular methods. Among all samples, 73.3% and 59.7% were positive for viruses and bacteria, respectively; 45% contained both virus and bacteria. Bacterial coinfection was more frequent in patients infected by community respiratory viruses than influenza A H1N1pdm (83.3% vs. 40.6%). The most frequently bacteria detected were Streptococcus pneumoniae and Haemophilus influenzae. Both species were co‐detected in 54 patients and identified alone in 22 and 21 patients, respectively. Overall, there were no significant differences in the period of hospitalization, severity, or mortality rate between patients infected with respiratory viruses alone and those coinfected by viruses and bacteria. The detection of mixed respiratory pathogens is frequent in hospitalized patients with acute respiratory infections, but its impact on the clinical outcome does not appear substantial. However, it should be noted that most of the patients received broad‐spectrum antibiotic therapy, which may have contributed to this favorable outcome. J. Med. Virol. 87:1456–1461, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Guilherme A C Damasio
- Postgraduate Program in Microbiology, Parasitology and Pathology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Luciane A Pereira
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Suzana D R Moreira
- Hospital Epidemiology Division, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - Libera M Dalla-Costa
- Bacteriology Laboratory, Universidade Federal do Paraná, Curitiba, PR, Brazil.,Faculdades e Instituto de Pesquisa Pel, é, Pequeno Pr, í, ncipe, Curitiba, Paraná, Brazil
| | - Sonia M Raboni
- Postgraduate Program in Microbiology, Parasitology and Pathology, Universidade Federal do Paraná, Curitiba, Brazil.,Virology Laboratory, Universidade Federal do Paraná, Curitiba, PR, Brazil
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28
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Campigotto A, Mubareka S. Influenza-associated bacterial pneumonia; managing and controlling infection on two fronts. Expert Rev Anti Infect Ther 2014; 13:55-68. [DOI: 10.1586/14787210.2015.981156] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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29
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Deng JC. Viral-bacterial interactions-therapeutic implications. Influenza Other Respir Viruses 2014; 7 Suppl 3:24-35. [PMID: 24215379 PMCID: PMC3831167 DOI: 10.1111/irv.12174] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2013] [Indexed: 01/09/2023] Open
Abstract
Viral and bacterial respiratory tract infections are a leading cause of morbidity and mortality worldwide, despite the development of vaccines and potent antibiotics. Frequently, viruses and bacteria can co‐infect the same host, resulting in heightened pathology and severity of illness compared to single infections. Bacterial superinfections have been a significant cause of death during every influenza pandemic, including the 2009 H1N1 pandemic. This review will analyze the epidemiology and global impact of viral and bacterial co‐infections of the respiratory tract, with an emphasis on bacterial infections following influenza. We will next examine the mechanisms by which viral infections enhance the acquisition and severity of bacterial infections. Finally, we will discuss current management strategies for diagnosing and treating patients with suspected or confirmed viral‐bacterial infections of the respiratory tract. Further investigation into the interactions between viral and bacterial infections is necessary for developing new therapeutic approaches aimed at mitigating the severity of co‐infections.
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Affiliation(s)
- Jane C Deng
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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