Paediatric respiratory infections

Everard, Mark L.

doi:10.1183/16000617.0084-2015

Cited by 30 publications

(30 citation statements)

References 32 publications

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“…Environmental factors and highly contagious, air-borne pathogens cause airway infections. 14 All subjects who died were treated in the PICU with mean LOS of 8.7 days, which was shorter than that of the survived group (11.94 days). This finding was likely due to the fact that PICU patients tend to have more severe clinical conditions than those treated in HCU.…”

Section: Discussionmentioning

confidence: 93%

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Wulandari¹,

Pudjiastuti²,

Martuti³

2019

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Background Sepsis is one of the main causes of death in infants and children. Currently, it is defined as a life-threatening organ dysfunction, caused by an inflammatory response of infection. Several organ dysfunction assessment methods are available, but they are not uniformly used. Objective To compare the accuracy of three mortality predictor tools: severe sepsis criteria, pediatric logistic organ dysfunction (PELOD)-2, and pediatric sequential organ failure assessment (pSOFA), in critically ill children with sepsis. Methods This prospective cohort study was conducted in the pediatric intensive care unit (PICU) and pediatric high care unit (HCU) of dr. Moewardi Hospital, Surakarta, Central of Java. All patients who met the systemic inflammatory response syndrome (SIRS) criteria were included in our study. The exclusion criteria were congenital anomalies of heart or kidney, malignancy, or hematological abnormalities. The data were taken from laboratory and physical examinations by the physicians on duty. The outcome assessed was mortality. Results Of 30 subjects, the mean age was 22.22 (SD 29.36) months; the most common infection source was the respiratory tract, followed by gastrointestinal tract and central nervous system. Most subjects were treated in the PICU and had a mean length of stay of 8.70 (SD 11.91) days. Severe sepsis and PELOD-2 were not significant predictors of death. However, pSOFA score was a statistically significant predictor of mortality, with odds ratio 10.11 (95%CI 1.054 to 97.002; P=0.039). Conclusion Pediatric SOFA (pSOFA) is a better predictor of mortality compared to PELOD-2 and SIRS-severe sepsis. A pSOFA score ≥ 2 increases the risk of mortality by 10.11-fold.

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Section: Discussionmentioning

confidence: 93%

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Wulandari¹,

Pudjiastuti²,

Martuti³

2019

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“…The paradigmatic example is pneumococcal pneumonia complicating influenza, a condition characterized by an elevated morbidity and mortality in the most susceptible age groups; young children and elderly subjects 6,7 . Detrimental interactions can also occur in otherwise healthy individuals and between other viruses and bacteria species 2,5,8 . Such respiratory coinfections are exemplified by nontypeable Haemophilus influenzae (NTHi), Moraxella catarrhalis, Klebsiella pneumoniae , and Streptococcus pneumoniae with parainfluenza viruses, human rhinovirus (HRV), and human bocavirus that affect the upper and lower airways and contribute to disease severity, predominantly in children 9 .…”

Section: Introductionmentioning

confidence: 99%

Viral strategies predisposing to respiratory bacterial superinfections

Rossi

Fanous

Colin

2020

Pediatric Pulmonology

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Acute respiratory infections are amongst the leading causes of childhood morbidity and mortality globally. Viruses are the predominant cause of such infections, but mixed etiologies with bacteria has for decades raised the question of the interplay between them in causality and determination of the outcome of such infections. In this review, we examine recent microbiological, biochemical, and immunological advances that contribute to elucidating the mechanisms by which infections by specific viruses enable bacterial infections in the airway, and exacerbate them. We analyze specific domains in which viruses play such facilitating role including enhancement of bacterial adhesion by unmasking cryptic receptors and upregulation of adhesion proteins, disruption of tight junction integrity favoring paracellular transmigration of bacteria and loss of epithelial barrier integrity, increased availability of nutrient, such as mucins and iron, alteration of innate and adaptive immune responses, and disabling defense against bacteria, and lastly, changes in airway microbiome that render the lung more vulnerable to pathogens. Separate exhaustive analysis of each domain focuses on individuals with cystic fibrosis (CF), in whom viruses may play a key role in paving the way for the primary injury that leads to permanence of bacterial pathogens, viruses may then serve as triggers for “CF exacerbations”; these constituting the signature and ultimately the outcome determinants of these patients.

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“…R espiratory tract infections include both upper tract infections, such as the common cold, and lower tract infections, such as pneumonia, bronchitis, bronchiolitis, and exacerbation of asthma. Lower respiratory tract infections cause substantial morbidity and mortality and are a leading cause of hospitalization, especially for infants, the elderly, and immunocompromised individuals (1)(2)(3)(4). Respiratory tract infections are caused by a wide variety of pathogens, which include several viral and bacterial agents.…”

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confidence: 99%

Impact of Rapid Molecular Detection of Respiratory Viruses on Clinical Outcomes and Patient Management

Kuypers

2019

J Clin Microbiol

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To determine if rapid molecular testing for respiratory viruses in patients with respiratory illnesses can provide advantages to patients and hospitals, rigorous investigations on the impacts of using these assays are required. Well-conducted studies are needed to inform decisions about implementation of new rapid assays to replace standard molecular testing or to initiate testing in laboratories that are currently not doing molecular tests for respiratory viruses due to the complex nature of standard panels. In this issue of the Journal of Clinical Microbiology, N. Wabe et al. (J Clin Microbiol 57:e01727-18, 2019, https://doi.org/10.1128/JCM.01727-18) report the results of their evaluation of the impact of using a rapid molecular test for influenza A/influenza B and RSV on outcomes for adults hospitalized with respiratory illness. The median time from admission to test result of the rapid test was 7.5 h compared to 40.3 h for the standard PCR assay. Compared to the use of the standard molecular assay, use of a rapid test significantly shortened time in the hospital and reduced the number of other microbiology tests performed. The authors concluded that rapid PCR testing of adults hospitalized with respiratory illnesses could provide benefits to both the patients and the hospital. Patients were able to leave the hospital earlier and a greater proportion of them had received their test results before discharge, which would allow appropriate treatment to be provided more quickly.

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Paediatric respiratory infections

Cited by 30 publications

References 32 publications

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Viral strategies predisposing to respiratory bacterial superinfections

Impact of Rapid Molecular Detection of Respiratory Viruses on Clinical Outcomes and Patient Management

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