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Søgeord (pneumoni) valgt.
19 emner vises.
Zhongxiang Tang, Yu Mao, Pinglang Ruan, Jiani Li, Xiangjie Qiu, Yuting Meng, Mengyu Wang, Guojun Wu, Lili Wang, Yurong Tan
Journal of Medical Virology, 3.05.2024
Tilføjet 3.05.2024
Jiankang ZhaoDanni PuZiyao LiYulin ZhangXinmeng LiuXianxia ZhuoBinghuai LuBin Caoa National Center for Respiratory Medicine, Beijing, Chinab State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, Chinac National Clinical Research Center for Respiratory Diseases, Beijing, Chinad Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, Chinae Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, Chinaf Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, Chinag Department of Respiratory Medicine, Capital Medical University, Beijing, Chinah Tsinghua University-Peaking University Joint Center for Life Sciences, Beijing, China
Virulence, 3.05.2024
Tilføjet 3.05.2024
Journal of Infectious Diseases, 2.05.2024
Tilføjet 2.05.2024
Abstract Streptococcus pneumoniae is a leading cause of morbidity and mortality in children and older adults. Yet knowledge on the development of pneumococcal protein-specific antibody responses throughout life is limited. To investigate this, we measured serum IgG levels to 55 pneumococcal proteins in 11-month old infants (n=73), 24-month old children (n=101), parents (n=99), adults without children 60 years (n=100). Our findings revealed low IgG levels in infancy, with distinct development patterns peaking in adults. A decrease in levels was observed for 27 antigens towards older age. Adults and older adults had increased IgG levels during pneumococcal carriage and at increased exposure risk to S. pneumoniae. Carriage was a stronger predictor than exposure or age for antibody responses. These findings highlight the dynamic nature of naturally acquired humoral immunity to pneumococcal proteins throughout life, offering insights for age-targeted interventions.
Læs mere Tjek på PubMedStephen M. Humphries, Devlin Thieke, David Baraghoshi, Matthew J. Strand, Jeffrey J. Swigris, Kum Ju Chae, Hye Jeon Hwang, Andrea S. Oh, Kevin R. Flaherty, Ayodeji Adegunsoye, Renea Jablonski, Cathryn T. Lee, Aliya N. Husain, Jonathan H. Chung, Mary E. Strek, David A. Lynch
American Journal of Respiratory and Critical Care Medicine , 2.05.2024
Tilføjet 2.05.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 9, Page 1121-1131, May 1, 2024.
Læs mere Tjek på PubMedEileen M. Harder, Fereidoun Abtin, Pietro Nardelli, Adam Brownstein, Richard N. Channick, George R. Washko, Jonathan Goldin, Raúl San José Estépar, Farbod N. Rahaghi, Rajan Saggar
American Journal of Respiratory and Critical Care Medicine , 2.05.2024
Tilføjet 2.05.2024
American Journal of Respiratory and Critical Care Medicine, Volume 209, Issue 9, Page 1170-1173, May 1, 2024.
Læs mere Tjek på PubMedNicholas Heming, Alain Renault, Emmanuelle Kuperminc, Christian Brun-Buisson, Bruno Megarbane, Jean-Pierre Quenot, Shidasp Siami, Alain Cariou, Xavier Forceville, Carole Schwebel, Marc Leone, Jean-Francois Timsit, Benoît Misset, Mohamed Ali Benali, Gwenhael Colin, Bertrand Souweine, Karim Asehnoune, Emmanuelle Mercier, Loïc Chimot, Claire Charpentier, Bruno François, Thierry Boulain, Frank Petitpas, Jean Michel Constantin, Gilles Dhonneur, François Baudin, Alain Combes, Julien Bohé, Jean-François Loriferne, Fabrice Cook, Michel Slama, Olivier Leroy, Gilles Capellier, Auguste Dargent, Tarik Hissem, Rania Bounab, Virginie Maxime, Pierre Moine, Eric Bellissant, Djillali Annane, APROCCHSS investigators, CRICS-TRIGGERSEP network
Lancet Respiratory Medicine, 1.05.2024
Tilføjet 1.05.2024
In a pre-specified subgroup analysis of the APROCCHSS trial of patients with CAP and septic shock, hydrocortisone plus fludrocortisone reduced mortality as compared with placebo. Although a large proportion of patients with CAP also met criteria for ARDS, the subgroup analysis was underpowered to fully discriminate between ARDS and CAP modifying effects on mortality reduction with corticosteroids. There was no evidence of a significant treatment effect of corticosteroids in the non-CAP subgroup.
Læs mere Tjek på PubMedClaire Dahyot-Fizelier, Sigismond Lasocki, Thomas Kerforne, Pierre-Francois Perrigault, Thomas Geeraerts, Karim Asehnoune, Raphaël Cinotti, Yoann Launey, Vincent Cottenceau, Marc Laffon, Thomas Gaillard, Matthieu Boisson, Camille Aleyrat, Denis Frasca, Olivier Mimoz, PROPHY-VAP Study Group and the ATLANREA Study Group
Lancet Respiratory Medicine, 1.05.2024
Tilføjet 1.05.2024
In patients with acute brain injury, a single ceftriaxone dose decreased the risk of early VAP. On the basis of our findings, we recommend that an early, single dose of ceftriaxone be included in all bundles for the prevention of VAP in patients with brain injury who require mechanical ventilation.
Læs mere Tjek på PubMedYin Mo, Suchart Booraphun, Andrew Yunkai Li, Pornanan Domthong, Gyan Kayastha, Yie Hui Lau, Ploenchan Chetchotisakd, Direk Limmathurotsakul, Paul Anantharajah Tambyah, Ben S Cooper, REGARD-VAP investigators
Lancet Respiratory Medicine, 1.05.2024
Tilføjet 1.05.2024
In this study of adults with VAP, individualised shortened antibiotic duration guided by clinical response was non-inferior to longer treatment durations in terms of 60-day mortality and pneumonia recurrence, and associated with substantially reduced antibiotic use and side-effects. Individualised, short-course antibiotic treatment for VAP could help to reduce the burden of side-effects and the risk of antibiotic resistance in high-resource and resource-limited settings.
Læs mere Tjek på PubMedVidmantas PetraitisRuta PetraitienePovilas KavaliauskasEthan NaingAndrew GarciaVilma ZigmantaiteRamune GrigaleviciuteAudrius KucinskasAlius PockeviciusRimantas StakauskasThomas J. Walsh1Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, New York, New York, USA2The Biological Research Center, Lithuanian University of Health Sciences, Kaunas, Lithuania3Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania4Department of Veterinary Pathobiology, Veterinary Academy, Pathology Center, Lithuanian University of Health Sciences, Kaunas, Lithuania5Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA, Anne-Catrin Uhlemann
Antimicrobial Agents And Chemotherapy, 30.04.2024
Tilføjet 30.04.2024
Li, W., Chung, S. L., Lei, M., Yang, X., Jin, Z.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
BackgroundSevere pneumonia (SP) stands as one of the most prevalent critical illnesses encountered in clinical practice, characterised by its rapid onset and progression, numerous complications and elevated mortality rates. While modern medical interventions primarily focus on symptomatic management such as anti-infective therapy and mechanical ventilation, challenges including high drug resistance and suboptimal therapeutic outcomes for certain patients persist. Dry cupping as an ancient practice with over a millennium of clinical use in China is renowned for its convenience and perceived clinical efficacy in various illnesses. Nevertheless, the lack of well-designed studies assessing its effects remains a notable gap in the literature. This protocol describes a placebo-controlled, randomised, single-blind study to evaluate the efficacy and safety of dry cupping as an adjuvant treatment for SP. Methods and analysis66 patients diagnosed with SP, aged 18–80 years, will be randomly divided into two groups: intervention group, receiving 10 times of dry cupping treatment; control group, receiving placebo dry cupping therapy. Both applications are used in bilateral Fei Shu (BL13), Pi Shu (BL21) and Shen Shu (BL22) cupping. The application will be conducted once a day for 10 days. Participants will be assessed before treatment (D0), after the first intervention (D1), after the fifth intervention (D5) and after treatment ended (D10). The assessments include blood oxygen saturation, respiratory rate, traditional Chinese medicine symptom score, inflammatory response, mechanical ventilation time and oxygen condition. Ethics and disseminationThis protocol has been approved by the Ethics Committee of Shanghai Seventh People’s Hospital (2023-7th-HIBR-070). The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings. Trial registration numberChiCTR2300076958.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Ying Kong, Liang Hong, Xiao-cheng Xu, Yun-feng Chen, Jia Xu
PLoS One Infectious Diseases, 29.04.2024
Tilføjet 29.04.2024
by Ying Kong, Liang Hong, Xiao-cheng Xu, Yun-feng Chen, Jia Xu Objective Immune checkpoint inhibitor pneumonitis (CIP) is a prevalent form of immunotherapy-induced pulmonary toxicity, ranking among the leading causes of mortality associated with immune checkpoint inhibitors (ICIs). Despite its significance, the risk stratification of CIP in advanced non-small cell lung cancer (NSCLC) remains uncertain. In this study, we conducted a comprehensive analysis, comparing various factors such as histological types, treatment regimens, PD-L1 expression levels, and EGFR/ALK negativity in advanced NSCLC. Our investigation extends to evaluating the relative risk of developing CIP based on previous treatment history. This analysis aims to provide valuable insights for the identification of specific patient subgroups at higher risk, facilitating more effective risk management and precision therapy approaches. Methods PubMed, Embase, and Cochrane databases were systematically searched up to February 16, 2023. We conducted a screening of randomized controlled trials (RCTs) that compared ICI monotherapy or its combination with chemotherapy in advanced NSCLC. The trials were categorized based on histological type, treatment regimen, PD-L1 expression level, EGFR/ALK-negative status, and prior treatment history. Subsequently, the data were stratified into five subgroups, and the occurrences of all-grades (1–5) and high-grades (3–5) pneumonia events were extracted. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were then calculated for further analysis. Results Twenty-two RCTs, encompassing 13,725 patients with advanced NSCLC, were included in this analysis. Regardless of histology (OR = 2.47, 95% CI 1.41–4.33, P = 0.002; OR = 1.84, 95% CI 1.10–3.09, P = 0.02), treatment regimen (OR = 3.27, 95% CI 2.00–5.35, P < 0.00001; OR = 2.91, 95% CI 1.98–4.27, P < 0.00001), PD-L1 expression level (OR = 5.11, 95% CI 2.58–10.12, P < 0.00001; OR = 5.15, 95% CI 2.48–10.70, P < 0.0001), negative EGFR/ALK expression (OR = 4.32, 95% CI 2.22–8.41, P < 0.0001; OR = 3.6, 95% CI 1.56–8.28, P = 0.003), whether there is a history of treatment (OR = 3.27, 95% CI 2.00–5.35, P < 0.00001; OR = 2.74, 95% CI 1.75–4.29, P < 0.0001), ICI use was associated with a higher risk of all-grade (1–5) and high-grade (3–5) pneumonia compared to chemotherapy. Subgroup analysis revealed that the squamous group, the ICI vs. combination chemotherapy (CT) group, the PD-L1 > 50% group, and the previously untreated group had a higher risk of developing all-grade and grade 3–5 CIP (P < 0.05). Conclusions In advanced NSCLC, ICI treatment was linked to an elevated risk of pneumonitis across all grades (1–5) as well as high-grade occurrences (3–5) compared to chemotherapy. Notably, individuals with squamous histology and high PD-L1 expression, along with those lacking a history of prior treatment, demonstrated a heightened susceptibility to developing immune-related pneumonitis of all grades (1–5) and high grades (3–5). These observations provide valuable insights for clinicians seeking to enhance the management of pulmonary toxicity associated with immunotherapy.
Læs mere Tjek på PubMedFEMS Microbiology Reviews, 28.04.2024
Tilføjet 28.04.2024
Abstract Group B Streptococcus (GBS; also known as Streptococcus agalactiae) is an opportunistic bacterial pathogen that causes sepsis, meningitis, pneumonia and skin and soft tissue infections in neonates and healthy or immunocompromised adults. GBS is well-adapted to survive in humans due to a plethora of virulence mechanisms that afford responses to support bacterial survival in dynamic host environments. These mechanisms and responses include counteraction of cell death from exposure to excess metal ions that can cause mismetallation and cytotoxicity, and strategies to combat molecules such as reactive oxygen and nitrogen species that are generated as part of innate host defence. Cytotoxicity from reactive molecules can stem from damage to proteins, DNA, and membrane lipids, potentially leading to bacterial cell death inside phagocytic cells or within extracellular spaces within the host. Deciphering the ways in which GBS responds to the stress of cytotoxic reactive molecules within the host will benefit the development of novel therapeutic and preventative strategies to manage the burden of GBS disease. This review summarises knowledge of GBS carriage in humans and the mechanisms used by the bacteria to circumvent killing by these important elements of host immune defence: oxidative stress, nitrosative stress, and stress from metal ion intoxication/mismetallation.
Læs mere Tjek på PubMedBMC Infectious Diseases, 27.04.2024
Tilføjet 27.04.2024
Abstract Background Patients infected with Acinetobacter baumannii (AB) bacteremia in hospital have high morbidity and mortality. We analyzed the clinical characteristics of pneumonia and nonpneumonia-related AB bloodstream infections (AB BSIs) and explored the possible independent risk factors for the incidence and prognosis of pneumonia-related AB BSIs. Methods A retrospective monocentric observational study was performed. All 117 episodes of hospital-acquired AB bacteremia sorted into groups of pneumonia-related AB BSIs (n = 45) and nonpneumonia-related AB BSIs (n = 72) were eligible. Univariate/multivariate logistic regression analysis was used to explore the independent risk factors. The primary outcome was the antibiotic susceptibility in vitro of pneumonia-related AB BSIs group. The secondary outcome was the independent risk factor for the pneumonia-related AB BSIs group. Results Among 117 patients with AB BSIs, the pneumonia-related group had a greater risk of multidrug resistant A. baumannii (MDRAB) infection (84.44%) and carbapenem-resistant A. baumannii (CRAB) infection (80%). Polymyxin, minocycline and amikacin had relatively high susceptibility rates (> 80%) in the nonpneumonia-related group. However, in the pneumonia-related group, only polymyxin had a drug susceptibility rate of over 80%. Univariate analysis showed that survival time (day), CRAB, MDRAB, length of hospital stay prior to culture, length of ICU stay prior to culture, immunocompromised status, antibiotics used prior to culture (n > = 3 types), endotracheal tube, fiberoptic bronchoscopy, PITT, SOFA and invasive interventions (n > = 3 types) were associated with pneumonia-related AB bacteremia. The multivariate logistic regression analysis revealed that recent surgery (within 1 mo) [P = 0.043; 0.306 (0.098–0.962)] and invasive interventions (n > = 3 types) [P = 0.021; 0.072 (0.008–0.671)] were independent risk factors related to pneumonia-related AB bacteremia. Multivariate logistic regression analysis revealed that length of ICU stay prior to culture [P = 0.009; 0.959 (0.930–0.990)] and recent surgery (within 1 mo) [P = 0.004; 0.260 (0.105–0.646)] were independent risk factors for mortality in patients with pneumonia-related AB bacteremia. The Kaplan‒Meier curve and the timing test showed that patients with pneumonia-related AB bacteremia had shorter survival time compared to those with nonpneumonia-related AB bacteremia. Conclusions Our study found that A. baumannii had a high rate of antibiotic resistance in vitro in the pneumonia-related bacteremia group, and was only sensitive to polymyxin. Recent surgery was a significantly independent predictor in patients with pneumonia-related AB bacteremia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 27.04.2024
Tilføjet 27.04.2024
Abstract Objectives The increasing prevalence of severe Mycoplasma pneumoniae pneumonia (SMPP) poses a significant threat to the health of children. This study aimed to characterise and assess the outcomes in children with SMPP. Methods We retrospectively analysed children hospitalised for M. pneumoniae pneumonia (MPP) between January and December 2022. Retrospectively, demographic, clinical, underlying diseases, laboratory and radiological findings, and treatment outcomes were collected and analysed. Disease severity was defined as severe or general according to the Guideline for diagnosis and treatment of community-acquired pneumonia in children (2019 version). Results Over a 12-month observation period, 417 children with MPP were enrolled, 50.6% (211/417) of whom had SMPP, with the peak incidence observed in winter. Of the 211 children with SMPP, 210 were treated and discharged with improvement, while one child with congenital heart disease died of cardioembolic stroke. A significantly higher proportion of patients with SMPP had underlying diseases, extrapulmonary complications (myocardial and digestive system involvement), and bacterial co-infection. A total of 25 (12%) children with SMPP received mechanical ventilation. The median duration of mechanical ventilation was 3 days. All children were treated with macrolide antibiotic. A significantly higher proportion of patients with SMPP received antibiotic other than macrolides, methylprednisolone sodium succinate, intravenous immunoglobulin and anticoagulation, compared with patients with general MPP (GMPP). Children with SMPP had significantly higher levels of white blood cells, neutrophil percentage, C-reactive protein, procalcitonin, interferon-γ, interleukin (IL)-2, IL-5, IL-6, IL-8, IL-10 and significantly lower percentages of lymphocytes, monocytes, and natural killer cells, compared with GMPP group. Conclusion Our findings suggest that severely ill children have more pronounced inflammatory reaction and extrapulmonary complications. For effective management of children with SMPP, hormonal, prophylactic, anticoagulant therapy, as well as the use of antibiotics other than macrolides for bacterial co-infections, could be incorporated into treatment regimens.
Læs mere Tjek på PubMedMarx, T., Moore, L., Talbot, D., Guertin, J. R., Lachapelle, P., Blais, S., Singbo, N., Simonyan, D., Lavallee, J., Zada, N., Shahrigharahkoshan, S., Huard, B., Olivier, P., Mallet, M., Letourneau, M., Lafreniere, M., Archambault, P., Berthelot, S., For the Network of Canadian Emergency Researchers
BMJ Open, 26.04.2024
Tilføjet 26.04.2024
ObjectiveTo compare health outcomes and costs given in the emergency department (ED) and walk-in clinics for ambulatory children presenting with acute respiratory diseases. DesignA retrospective cohort study. SettingThis study was conducted from April 2016 to March 2017 in one ED and one walk-in clinic. The ED is a paediatric tertiary care centre, and the clinic has access to lab tests and X-rays. ParticipantsInclusion criteria were children: (1) aged from 2 to 17 years old and (2) discharged home with a diagnosis of upper respiratory tract infection (URTI), pneumonia or acute asthma. Main outcome measuresThe primary outcome measure was the proportion of patients returning to any ED or clinic within 3 and 7 days of the index visit. The secondary outcome measures were the mean cost of care estimated using time-driven activity-based costing and the incidence of antibiotic prescription for URTI patients. ResultsWe included 532 children seen in the ED and 201 seen in the walk-in clinic. The incidence of return visits at 3 and 7 days was 20.7% and 27.3% in the ED vs 6.5% and 11.4% in the clinic (adjusted relative risk at 3 days (aRR) (95% CI) 3.17 (1.77 to 5.66) and aRR at 7 days 2.24 (1.46 to 3.44)). The mean cost (95% CI) of care (CAD) at the index visit was $C96.68 (92.62 to 100.74) in the ED vs $C48.82 (45.47 to 52.16) in the clinic (mean difference (95% CI): 46.15 (41.29 to 51.02)). Antibiotic prescription for URTI was less common in the ED than in the clinic (1.5% vs 16.4%; aRR 0.10 (95% CI 0.03 to 0.32)). ConclusionsThe incidence of return visits and cost of care were significantly higher in the ED, while antibiotic use for URTI was more frequent in the walk-in clinic. These data may help determine which setting offers the highest value to ambulatory children with acute respiratory conditions.
Læs mere Tjek på PubMedHagel, S., Brillinger, N., Decker, S., Deja, M., Ertmer, C., Fiedler, S., Franken, P., Heim, M., Weigand, M. A., Zarbock, A., Pletz, M. W., SepNet Critical Care Trials Group, Ehler, Bloos, Bauer, Brenner, Meybohm, Kluge, Vogt, Lahmer, Fortenbach, John, Berger, Ling, Dutzmann, Nierhaus, Güldner, Bach, Nierhaus, Jung, Bruno, Zoller, Frank, Müller, Bercker, Feussner, Groesdonk, Putensen, Münster, Rosenberger, Häberle, Frey, Wischermann, Otto, Lindner, Heyckendorf, Reuchsel, Reichmann, Weis
BMJ Open, 26.04.2024
Tilføjet 26.04.2024
IntroductionHerpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients and is associated with a worse outcome. The aim of this study is to determine whether antiviral therapy in HSV-positive patients improves outcome. Methods and analysisProspective, multicentre, open-label, randomised, controlled trial in parallel-group design. Adult, mechanically ventilated patients with pneumonia and HSV type 1 detected in bronchoalveolar lavage (≥105 copies/mL) are eligible for participation and will be randomly allocated (1:1) to receive acyclovir (10 mg/kg body weight every 8 hours) for 10 days (or until discharge from the intensive care unit if earlier) or no intervention (control group). The primary outcome is mortality measured at day 30 after randomisation (primary endpoint) and will be analysed with Cox mixed-effects model. Secondary endpoints include ventilator-free and vasopressor-free days up to day 30. A total of 710 patients will be included in the trial. Ethics and disseminationThe trial was approved by the responsible ethics committee and by Germany’s Federal Institute for Drugs and Medical Devices. The clinical trial application was submitted under the new Clinical Trials Regulation through CTIS (The Clinical Trials Information System). In this process, only one ethics committee, whose name is unknown to the applicant, and Germany’s Federal Institute for Drugs and Medical Devices are involved throughout the entire approval process. Results will be published in a journal indexed in MEDLINE and CTIS. With publication, de-identified, individual participant data will be made available to researchers. Trial registration number NCT06134492.
Læs mere Tjek på PubMedInfection, 26.04.2024
Tilføjet 26.04.2024
Abstract Purpose Antibodies against SARS-CoV-2 spike (anti-S) may confer protection against symptomatic COVID-19. Whether their level predicts progression among those with COVID-19 pneumonia remains unclear. Methods We conducted a retrospective cohort study to assess predictors of anti-S levels and whether anti-S titer is associated with death or mechanical ventilation (MV). Adults hospitalized for COVID-19 pneumonia between July 2021 and July 2022 were enrolled if anti-S had been measured within 72 h of admission. Predictors of anti-S level were explored using multivariable quantile regression. The association between anti-S levels and 30-day death/MV was investigated via multivariable logistic regression. Analyses were stratified by vaccine status. Results The median anti-S level was 1370 BAU/ml in 328 vaccinated and 15.5 BAU/ml in 206 unvaccinated individuals. Among the vaccinated, shorter symptom duration (p = 0.001), hematological malignancies (p = 0.002), and immunosuppressive therapy (p = 0.004) were associated with lower anti-S levels. In the unvaccinated group, symptom duration was the only predictor of anti-S levels (p
Læs mere Tjek på PubMedZheng LvXuan ZhangKelei ZhaoLianming DuXinrong WangYiwen ChuTing Huanga Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of pharmacy, Chengdu University, Chengdu, Chinab Institute for Advanced Study, Chengdu University, Chengdu, Chinac Antiinfective Agent Creation Engineering Research Centre of Sichuan Province, Sichuan Industrial Institute of Antibiotics, School of pharmacy, Chengdu University, Chengdu, China
Virulence, 25.04.2024
Tilføjet 25.04.2024