Pneumonia最新文献

{"title":"Measuring accuracy of plethysmography based respiratory rate measurement using pulse oximeter at a tertiary hospital in India.","authors":"Varun Alwadhi,&nbsp;Enisha Sarin,&nbsp;Praveen Kumar,&nbsp;Prasant Saboth,&nbsp;Ajay Khera,&nbsp;Sachin Gupta,&nbsp;Harish Kumar","doi":"10.1186/s41479-020-00067-2","DOIUrl":"https://doi.org/10.1186/s41479-020-00067-2","url":null,"abstract":"<p><strong>Background: </strong>Childhood pneumonia continues to be a major infectious killer in India. WHO recommended respiratory rate and oxygen saturation (SpO₂) measurements are not well implemented in Indian public health outpatient facilities with the result that treatment decision-making rely on subjective assessments from variably trained and supervised healthcare providers. The introduction of a multi-modal pulse oximeter (POx) that gives reliable measurements would mitigate incorrect diagnosis. In light of future potential use of pulse oximeter in peripheral health centres, it becomes important to measure accuracy of respiratory rate and oxygen saturation of such an instrument. The current study measures accuracy of plethysmography based respiratory rate (RR) using a pulse oximeter (Masimo Rad-G) by comparing it with a gold standard (pediatrician) measurement.</p><p><strong>Study design: </strong>A cross sectional study was conducted in the OPD and emergency ward of Kalawati Saran Children's Hospital over a 2 week period wherein a convenience sample of 97 children (2 to 59 months) were assessed by a pediatrician as part of routine assessment alongside independent measure by a consultant using pulse oximeter. The level of agreement between plethymography based RR and pediatrician measure was analyzed along with sensitivity and specificity of fast breathing of plethymography based RR measure.</p><p><strong>Results: </strong>Both methods of measurement show strong association (97%, <i>p</i> < 0.001) and observed values, falling on line of unity, obtained either from pulse oximeter or by pediatrician are very close to each other. Fast breathing measured by POx has a sensitivity of 95% and specificity of nearly 94%.</p><p><strong>Conclusion: </strong>The current study provides evidence of the accuracy of a plethysmography based RR using a pulse oximeter which can potentially be of use in planning of pneumonia management in public health facilities.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":" ","pages":"4"},"PeriodicalIF":6.8,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-020-00067-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of certain underlying comorbidities on the risk of developing hospitalised pneumonia in England","authors":"J. Campling, D. Jones, J. Chalmers, Q. Jiang, A. Vyse, H. Madhava, G. Ellsbury, M. Slack","doi":"10.1186/s41479-019-0063-z","DOIUrl":"https://doi.org/10.1186/s41479-019-0063-z","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"11 1","pages":""},"PeriodicalIF":6.8,"publicationDate":"2019-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-019-0063-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47746253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningococcal pneumonia: a review","authors":"C. Feldman, R. Anderson","doi":"10.1186/s41479-019-0062-0","DOIUrl":"https://doi.org/10.1186/s41479-019-0062-0","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-019-0062-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49444171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of community-onset pneumonia in neutropenic cancer patients: β-lactam monotherapy versus combination antibiotic regimens.","authors":"Hyeri Seok,&nbsp;Jae-Hoon Ko,&nbsp;Kyong Ran Peck,&nbsp;Ji-Yeon Kim,&nbsp;Ji Hye Lee,&nbsp;Ga Eun Park,&nbsp;Sun Young Cho,&nbsp;Cheol-In Kang,&nbsp;Nam Yong Lee,&nbsp;Doo Ryeon Chung","doi":"10.1186/s41479-019-0061-1","DOIUrl":"https://doi.org/10.1186/s41479-019-0061-1","url":null,"abstract":"<p><strong>Background: </strong>Although β-lactam monotherapy may be sufficient in non-critically ill patients with community-acquired pneumonia, the value of combination antibiotic regimens in community-onset neutropenic pneumonia remains unclear.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted to compare the effects of combination antibiotic regimens to those of β-lactam monotherapy in cancer patients with community-onset neutropenic pneumonia. Electronic medical records of patients diagnosed with community-onset neutropenic pneumonia between March 1995 and February 2015 at a tertiary care center were reviewed.</p><p><strong>Results: </strong>During the study period, 165 cancer patients with community-onset neutropenic pneumonia were identified. Seventy-two patients received β-lactam monotherapy and 93 received combination therapy (β-lactam plus either a macrolide or fluoroquinolone). Causative pathogens were identified in 27.9% of the patients, and only two were positive for atypical pathogens. Although 30-day mortality was higher in the β-lactam group (15.3% versus 4.3%; <i>P</i> = 0.015), combination therapy was not associated with a statistically significant survival benefit in the multivariate analysis (hazard ratio 0.85, 95% confidence interval 0.20-3.67; <i>P</i> = 0.827). Duration of neutropenia, C-reactive protein level, and Multinational Association for Supportive Care in Cancer risk index were significant factors for 30-day mortality. In a subgroup analysis of patients treated with cefepime, the most frequently used β-lactam (63.0%), combination therapy also showed no significant survival benefit.</p><p><strong>Conclusions: </strong>Combination antibiotic regimens were not associated with a survival benefit over β-lactam monotherapy in the treatment of community-onset neutropenic pneumonia. Unnecessary combination therapy should be reconsidered in cancer patients who are at high risk for adverse drug reactions and colonization with multi-drug resistant organisms.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":" ","pages":"2"},"PeriodicalIF":6.8,"publicationDate":"2019-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-019-0061-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40225315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Mycobacterium tuberculosis</i>: escape room world champion.","authors":"Thuc Anh Nguyen,&nbsp;Sophie Croon,&nbsp;Ger Rijkers","doi":"10.1186/s41479-019-0060-2","DOIUrl":"https://doi.org/10.1186/s41479-019-0060-2","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"11 ","pages":"1"},"PeriodicalIF":6.8,"publicationDate":"2019-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-019-0060-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37285177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with nasopharyngeal carriage and density of <i>Streptococcus pneumoniae</i>, <i>Haemophilus influenzae</i>, <i>Moraxella catarrhalis</i>, and <i>Staphylococcus aureus</i> in young children living in Indonesia.","authors":"Eddy Fadlyana,&nbsp;Eileen M Dunne,&nbsp;Kusnandi Rusmil,&nbsp;Rodman Tarigan,&nbsp;Sunaryati Sudigdoadi,&nbsp;Chrysanti Murad,&nbsp;Emma Watts,&nbsp;Cattram Nguyen,&nbsp;Catherine Satzke,&nbsp;Nurhandini Eka Dewi,&nbsp;Sang Ayu Kompiyang Indriyani,&nbsp;Finny Fitry Yani,&nbsp;Kim Mulholland,&nbsp;Cissy Kartasasmita","doi":"10.1186/s41479-018-0058-1","DOIUrl":"https://doi.org/10.1186/s41479-018-0058-1","url":null,"abstract":"<p><strong>Background: </strong>Potentially pathogenic bacteria <i>Streptococcus pneumoniae</i>, <i>Haemophilus influenzae</i>, <i>Moraxella catarrhalis</i>, and <i>Staphylococcus aureus</i> are commonly carried in the nasopharynx of young children. Host and environmental factors have been linked with pathogen carriage, and in many studies rural children have higher carriage rates than their urban counterparts. There are few published data on what factors contribute to increased pathogen density. The objectives of this study were to identify risk factors for nasopharyngeal carriage and density of <i>S. pneumoniae</i>, <i>H. influenzae</i>, <i>M. catarrhalis</i>, and <i>S. aureus</i> in young children in Indonesia.</p><p><strong>Methods: </strong>Risk factor analysis was done using data on bacterial carriage and participant characteristics from a cross-sectional study that enrolled 302 children aged 12-24 months living in urban or semi-rural areas of Indonesia. Associations between host factors and odds of pathogen carriage were explored using logistic regression. Characteristics identified to be independent predictors of carriage by univariable analysis, as well as those that differed between urban and semi-rural participants, were included in multivariable models. Risk factors for increased pathogen density were identified using linear regression analysis.</p><p><strong>Results: </strong>No differences in carriage prevalence between urban and semi-rural children were observed. Multiple children under the age of 5 years in the household (< 5y) and upper respiratory tract infection (URTI) symptoms were associated with <i>S. pneumoniae</i> carriage, with adjusted odds ratios (aOR) of 2.17 (95% CI 1.13, 4.12) and 2.28 (95% CI 1.15, 4.50), respectively. There was some evidence that URTI symptoms (aOR 1.94 [95% CI 1.00, 3.75]) were associated with carriage of <i>M. catarrhalis</i>. Children with URTI symptoms (<i>p</i> = 0.002), and low parental income (<i>p</i> = 0.011) had higher <i>S. pneumoniae</i> density, whereas older age was associated with lower <i>S. pneumoniae</i> density (<i>p</i> = 0.009). URTI symptoms were also associated with higher <i>M. catarrahlis</i> density (<i>p</i> = 0.035). Low maternal education (<i>p</i> = 0.039) and multiple children < 5y (<i>p</i> = 0.021) were positively associated with <i>H. influenzae</i> density, and semi-rural residence was associated with higher <i>S. aureus</i> density (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study provides a detailed assessment of risk factors associated with carriage of clinically-relevant bacteria in Indonesian children, and new data on host factors associated with pathogen density.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"14"},"PeriodicalIF":6.8,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0058-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36828700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of lipoid pneumonia attributed to amiodarone.","authors":"Ilektra Voulgareli,&nbsp;Alexandra Chronaiou,&nbsp;Dionisios Tsoukalas,&nbsp;George Tsoukalas","doi":"10.1186/s41479-018-0056-3","DOIUrl":"https://doi.org/10.1186/s41479-018-0056-3","url":null,"abstract":"<p><p>We report a case of endogenous lipoid pneumonia secondary to long-term use of amiodarone (> 30 years) for atrial fibrillation in a 76-year-old Caucasian woman, presenting with cough and dyspnea. Endogenous Lipoid pneumonia is a rare underdiagnosed condition more prevalent in adults. It is usually asymptomatic and a diagnosis is generally made in patients who have become clinically unstable or when an abnormal lung shadow is found on a chest X-ray. In the case here described it was diagnosed by fiberoptic bronchoscopy with bronchoalveolar lavage (BALF) where fat-laden macrophages (oil red O stain) were identified. Since a history of use of oil-based products had been ruled out, amiodarone was deemed to be the most likely cause of lipoid pneumonia. The patient was managed with the replacement of amiodarone with digoxin and treated with oral prednisolone. The patient has remained clinically stable with radiological improvement during a follow-up of two years.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"12"},"PeriodicalIF":6.8,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0056-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36769017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corynebacteria as a cause of pulmonary infection: a case series and literature review.","authors":"Katharine Yang,&nbsp;Robert L Kruse,&nbsp;Weijie V Lin,&nbsp;Daniel M Musher","doi":"10.1186/s41479-018-0054-5","DOIUrl":"https://doi.org/10.1186/s41479-018-0054-5","url":null,"abstract":"<p><strong>Background: </strong>In most cases of community-acquired pneumonia (CAP), an etiologic agent is not determined; the most common report from the microbiological evaluation of sputum cites \"normal respiratory flora.\" Non-diphtheria <i>Corynebacterium</i> spp.<i>,</i> a component of this flora, is commonly viewed as a contaminant, but it may be the cause of pneumonia and the frequency with which it causes CAP may be underestimated.</p><p><strong>Case presentations: </strong>This report present 3 cases of CAP in which <i>Corynebacterium</i> spp. was clearly the predominant isolate; identification was confirmed by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry. Two cases were caused by <i>C. propinquum</i> and one by <i>C. striatum.</i> Two patients had a tracheostomy and one was on hemodialysis. Patients who received an appropriate antibiotic responded well.</p><p><strong>Conclusion: </strong>When identified as the predominant isolate in sputum from a patient with CAP, <i>Corynebacterium</i> spp. should be considered as a potential cause of the infection. In cases with patients who have compromised airway clearance or who are immunocompromised, microaspiration may be responsible. While some <i>Corynebacterium</i> spp. are suspectible to antibiotics usually prescribed for CAP, others are susceptible only to vancomycin or aminoglycosides. Vancomycin is thus the appropriate empiric antibiotic, pending speciation and susceptibility test results. The number of reported cases with result of antibiotic susceptibility testing, however, remains limited, and further investigation is needed. Non-diphtheria <i>Corynebacterium</i> spp. represent a noteworthy clinical cause of pneumonia. Identification by Gram stain and as a predominant organism on culture demands careful consideration for management.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"10"},"PeriodicalIF":6.8,"publicationDate":"2018-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0054-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36588158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased relative risk of pneumococcal pneumonia during the last decade, a nested case-control study.","authors":"Carlos M Luna,&nbsp;Laura Pulido,&nbsp;Michael S Niederman,&nbsp;Alberto Casey,&nbsp;Diego Burgos,&nbsp;Sebastián D Leiva Agüero,&nbsp;Alejandra Grosso,&nbsp;Evangelina Membriani,&nbsp;Andrea C Entrocassi,&nbsp;Marcelo Rodríquez Fermepin,&nbsp;Carlos A Vay,&nbsp;Susana Garcia,&nbsp;Angela Famiglietti","doi":"10.1186/s41479-018-0053-6","DOIUrl":"https://doi.org/10.1186/s41479-018-0053-6","url":null,"abstract":"<p><strong>Background: </strong><i>Streptococcus pneumoniae</i> (SP) is one of the most common pathogens of Community-Acquired Pneumonia (CAP), but recent reports suggest that its incidence may be declining in relation to the use of the conjugate 13-valent pneumococcal vaccine in children. We compared the result of the immunochromatographic SP urinary antigen test (SPUAT) and clinical outcomes in patients with CAP admitted in two periods of time: 2001-2002(CAP1) and 2015-2016(CAP2).</p><p><strong>Methods: </strong>This was a matched nested case-control study of two prospectively recorded cohorts of patients admitted with CAP, with SPUAT and blood culture performed in all patients. CAP2 cases and CAP1 controls were matched for age ± 4 years, sex, and Pneumonia Severity Index (PSI) score ± 10 points. Odds ratios (OR) for having SPUAT positive was estimated by conditional logistic regression. A multivariate model assessed the contribution of individual variables.</p><p><strong>Results: </strong>Four hundred ninety-eight patients were recruited; 307 during the CAP1 and 191 during the CAP2 periods. Comparing both periods we observed differences, in age, PSI score, and the percentage of smokers, outpatients, previously immunized with pneumococcal vaccine, and positive SPUAT. On the other hand, mortality, admission from nursing homes, pneumococcal bacteremia and hospital admission were not different. After matching, pneumonia due to SP per the SPUAT was observed in 34(23.4%) of CAP1 and in 12(8.3%) of CAP2 patients (<i>p</i> < 0.001), and 6/145 CAP1 vs 33/145 CAP2 patients had received pneumococcal immunization before their admission (<i>p</i> < 0.001). A multivariate analysis confirmed that, independent of falling into PSI class 5, having not received the pneumococcal vaccine and having not survived the episode of pneumonia, there were two factors that increased the probability of having SPUAT positive: developing pneumonia during the CAP1 period (OR = 1.23) and having pneumococcal bacteremia (OR = 2.66).</p><p><strong>Conclusion: </strong>We observed a reduction of the role of SP as pathogen, along with an increase in the number of patients who received pneumococcal immunization before admission, in 2015-2016 compared to 2001-2002. In addition, the use of conjugate 13-valent vaccine, starting in 2012 for childhood immunization, could be an additional factor contributing to these changes, as a result of early herd immunity in adults pneumonia.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"9"},"PeriodicalIF":6.8,"publicationDate":"2018-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0053-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36529842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The old man's friend.","authors":"Ger T Rijkers,&nbsp;Stephen I Pelton","doi":"10.1186/s41479-018-0052-7","DOIUrl":"https://doi.org/10.1186/s41479-018-0052-7","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"10 ","pages":"8"},"PeriodicalIF":6.8,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41479-018-0052-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36358750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}