BACKGROUNDThe accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children.

METHODSThe prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection: bacterial detection by culture, Mycoplasma pneumoniae (Mp) detection by polymerase chain reaction assay and virus (influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus) detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years (n = 194) and >3 years (n = 294).

RESULTSWe collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age >3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children >3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age >3 years.

CONCLUSIONSNPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in "rule out" lower airway infection; however, a positive result does not reliably "rule in" the presence of pathogens.

Acinetobacter baumannii ; isolation & purification ; pathogenicity ; Adolescent ; Child ; Child, Preschool ; Clinical Laboratory Techniques ; methods ; Enterobacter aerogenes ; isolation & purification ; pathogenicity ; Escherichia coli ; isolation & purification ; pathogenicity ; Female ; Haemophilus influenzae ; isolation & purification ; pathogenicity ; Humans ; Infant ; Male ; Nasopharynx ; microbiology ; Prospective Studies ; Pseudomonas aeruginosa ; isolation & purification ; pathogenicity ; Respiratory Tract Infections ; diagnosis ; microbiology ; Sensitivity and Specificity ; Staphylococcus aureus ; isolation & purification ; pathogenicity ; Streptococcus pneumoniae ; isolation & purification ; pathogenicity

No abstract available.
Acinetobacter baumannii/isolation & purification ; Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; C-Reactive Protein/analysis ; Community-Acquired Infections/*diagnosis/microbiology/pathology ; Female ; Humans ; Klebsiella pneumoniae/isolation & purification ; Leukocyte Count ; Male ; Middle Aged ; Neutrophils/*cytology ; Pneumonia/*diagnosis/microbiology/pathology ; ROC Curve ; Respiratory Tract Infections/*diagnosis/microbiology/pathology ; Severity of Illness Index ; Staphylococcus aureus/isolation & purification ; Streptococcus pneumoniae/isolation & purification

A young female complained repeated nasal discharge for over three months with discomfort of right cheek, and oral antibiotics had less effect. She has a history of "root canal therapy" five years before. Physical examination found purulent secretion in the right middle nasal meatus, and light tenderness in the right side of the maxillary sinus area. The CT scan of paranasal sinus shown possible fungal infection of right maxillary sinus. Finally the nasal endoscopic surgery confirmed the fungus ball of right maxillary sinus with foreign body (the root canal filling material).
Endoscopy ; Female ; Foreign Bodies ; diagnosis ; Humans ; Maxillary Sinus ; microbiology ; Maxillary Sinusitis ; microbiology ; Mycoses ; diagnosis ; Respiratory Tract Infections ; microbiology ; Tomography, X-Ray Computed

No abstract available.
Aged ; Ampicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Antimetabolites, Antineoplastic/therapeutic use ; Asian Continental Ancestry Group ; Cytarabine/therapeutic use ; Drug Therapy, Combination ; Humans ; Idarubicin/therapeutic use ; Leukemia, Myeloid, Acute/complications/*diagnosis/drug therapy ; Male ; Moraxella/genetics/*isolation & purification ; Moraxellaceae Infections/*diagnosis/drug therapy/microbiology ; RNA, Ribosomal, 16S/chemistry/genetics ; Republic of Korea ; Respiratory Tract Infections/diagnosis/microbiology ; Sequence Analysis, RNA ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Sulbactam/therapeutic use

We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Bronchogenic Cyst/*complications/diagnosis/immunology/surgery ; Humans ; *Immunocompetence ; Male ; Mycobacterium avium Complex/*isolation & purification ; Mycobacterium avium-intracellulare Infection/*complications/diagnosis/drug therapy/immunology/microbiology ; Pneumonectomy ; Respiratory Tract Infections/*complications/diagnosis/drug therapy/immunology/microbiology ; Sputum/microbiology ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

No abstract available.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Asian Continental Ancestry Group ; Bacterial Proteins/genetics/*metabolism ; China ; Cilastatin/therapeutic use ; Citrobacter freundii/drug effects/*enzymology/isolation & purification ; Drug Combinations ; Drug Resistance, Multiple, Bacterial ; Humans ; Imipenem/therapeutic use ; Male ; Microbial Sensitivity Tests ; Plasmids/*metabolism ; Respiratory Tract Infections/*diagnosis/drug therapy/microbiology ; beta-Lactamases/genetics/*metabolism

No abstract available.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Cefotaxime/therapeutic use ; China ; Ciprofloxacin/therapeutic use ; Citrobacter freundii/drug effects/*enzymology/isolation & purification ; Drug Resistance, Multiple, Bacterial ; Humans ; Imipenem/pharmacology ; Male ; Microbial Sensitivity Tests ; Respiratory Tract Infections/*diagnosis/drug therapy/microbiology ; Thienamycins/pharmacology ; beta-Lactamases/*metabolism

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Diagnosis, Differential ; Humans ; Lung Neoplasms/diagnosis ; Male ; Middle Aged ; Multimodal Imaging ; Multiple Pulmonary Nodules/diagnosis/drug therapy/*microbiology ; Penicillin G Benzathine/therapeutic use ; Predictive Value of Tests ; Prostitution ; Respiratory Tract Infections/diagnosis/drug therapy/*microbiology/transmission ; Sex Workers ; Syphilis/*diagnosis/drug therapy/*microbiology/transmission ; Syphilis Serodiagnosis ; Tomography, X-Ray Computed ; Treatment Outcome ; Unsafe Sex

Acute Disease ; Humans ; Respiratory Tract Infections ; diagnosis ; etiology ; microbiology ; virology

INTRODUCTIONThe addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.

METHODSThis was a double-blinded randomised controlled trial. Babies who were admitted to the neonatal intensive care unit (NICU) and who required PN were eligible for inclusion in the study. The subjects were randomised to receive either glutamine-added PN (intervention) or standard PN (control). The most important outcomes included time to full enteral nutrition, incidence of sepsis and necrotising enterocolitis (NEC), clinical or culture-proven sepsis.

RESULTSOut of 270 subjects, 132 were randomised to the intervention group and 138, to the control group. Baseline data were comparable in both groups. The median time taken to reach full enteral nutrition was similar for both intervention and control groups (six days in each group, p-value is 0.52). The incidences of NEC, clinical sepsis and culture-proven sepsis did not differ significantly in the intervention and control groups (5.8 vs. 7.1 percent, p-value is 0.68; 15.7 percent vs. 10.2 percent, p-value is 0.21 and 16.5 percent vs. 15.7 percent, p-value is 0.38, respectively). Other outcomes such as duration of ventilation, duration of NICU stay and a subgroup analysis for preterm and term babies also showed no statistically significant differences.

CONCLUSIONAddition of glutamine to neonatal PN was not shown to improve outcome.

Double-Blind Method ; Enteral Nutrition ; Female ; Glutamine ; therapeutic use ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Intensive Care, Neonatal ; Malaysia ; Male ; Parenteral Nutrition ; Respiratory Tract Infections ; diagnosis ; Sepsis ; microbiology ; prevention & control ; Treatment Outcome