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Improved access to healthcare, vaccines and treatment with antibiotics has reduced global mortality from childhood community-acquired pneumonia. However, as respiratory viruses are responsible for most episodes of pneumonia, important questions remain over who should receive these agents and the length of each treatment course. Worldwide concerns with increasing antibiotic resistance in respiratory...
Neonatal pneumonia is a devastating condition. Most deaths in sub-Saharan Africa can be attributed to preventable diseases, including pneumonia, diarrhoea and malaria, which together killed an estimated 2.2 million children under the age of 5 years in 2012, accounting for a third of all under-five deaths in this region. Some countries are making progress in reducing mortality through community-based...
Pediatric tuberculosis (TB) is an underappreciated problem and accounts for 10 % of all TB deaths worldwide. Children are highly susceptible to infection with Mycobacterium tuberculosis and interrupting TB spread would require the development of effective strategies to control TB transmission in pediatric populations. The current vaccine for TB, M. bovis Bacille Calmette-Guérin (BCG), can afford some...
The accurate diagnosis of tuberculosis (TB) in children remains challenging. A myriad of common childhood diseases can present with similar symptoms and signs, and differentiating between exposure and infection, as well as infection and disease can be problematic. The paucibacillary nature of childhood TB complicates bacteriological confirmation and specimen collection is difficult. In most instances...
Non-typeable Haemophilus influenzae (NTHi)-associated ear and respiratory diseases (including pneumonia) represent a major health burden in many parts of the world. NTHi strains retrieved from the upper airways commonly reflect those found in the lower airways. Despite growing genomic and genotyping data on NTHi, there remains a limited understanding of global and regional NTHi population structures...
Pneumococcal conjugate vaccine (PCV) has the potential to interact with other vaccines containing diphtheria toxin-like antigens (such as those found in the DTP vaccine) upon sequential administration. This is attributed to the similarity of the diphtheria toxoid antigen to the carrier protein used to make PCV, (known as cross reactive material [CRM]) to diphtheria toxin 197 or CRM197. The interaction...
Macrolide antibiotics are widely used for a range of indications, including pneumonia. Both high-level and low-level resistance to macrolides is increasing in pneumococci globally. Macrolide resistance in pneumococci is of limited clinical relevance where ß-lactams remain the mainstay of treatment, such as for moderate/severe pneumonia; however, data suggest that macrolides may not be able to be relied...
Background The role and relationship between pro- and anti-inflammatory cytokines represents one of the least studied aspects of the pathogenesis of community-acquired pneumonia (CAP). The aim of the present study was to evaluate pro- and anti-inflammatory cytokines at both local (lung) and systemic (blood) levels and their relationship with the severity of the disease on admission and time for a...
It is now well recognised that cardiac events occur relatively commonly in patients with acute community-acquired pneumonia. While these events are more frequent in patients with underlying risk factors—such as those with underlying chronic cardiovascular and respiratory comorbidities, the elderly, and in nursing home residents—they also occur in patients with no underlying risks other than severe...
Background The burden of pneumococcal disease in adults aged 65 years and older in Australia is not well defined. This retrospective cross-sectional study calculated rates for pneumococcal pneumonia using data from the Australian Institute of Health and Welfare and from the Bettering Evaluation and Care of Health program. Methods Invasive pneumococcal disease (IPD) incidence was calculated using...
Streptococcus pneumoniae is an opportunistic pathogen globally associated with significant morbidity and mortality. It is capable of causing a wide range of diseases including sinusitis, conjunctivitis, otitis media, pneumonia, bacteraemia, sepsis, and meningitis. While its capsular polysaccharide is indispensible for invasive disease, and opsonising antibodies against the capsule are the basis for...
Community-acquired pneumonia (CAP) is a common cause of presentation to healthcare facilities. The diagnosis of CAP is usually made in patients with suggestive symptoms, signs, and radiological features. A number of non-infectious conditions, including neoplastic lesions, pulmonary oedema, pulmonary embolism, drug-induced pneumonitis, diffuse alveolar haemorrhage syndromes, cryptogenic organising...
Community-acquired pneumonia (CAP) is a leading cause of death in both the developed and developing world. The very young and elderly are especially vulnerable. Even with appropriate early antibiotics we still have not improved the outcomes in these patients since the 1950s, with 30-day case fatality rates of between 10–12%. Interventions to improve outcomes include immunomodulatory agents such as...
Background Despite significant progress, pneumonia is still the leading cause of infectious deaths in children under five years of age. Poor adherence to antibiotics has been associated with treatment failure in World Health Organisation (WHO) defined clinical pneumonia; therefore, improving adherence could improve outcomes in children with fast-breathing pneumonia. We examined clinical factors that...
Pneumonia remains the most common cause of hospitalization and the most important cause of death in young children. In high human immunodeficiency virus (HIV)-burden settings, HIV-infected children carry a high burden of lower respiratory tract infection from common respiratory viruses, bacteria and Mycobacterium tuberculosis. In addition, Pneumocystis jirovecii and cytomegalovirus are important opportunistic...
Over the last 10 years, interest in pediatric tuberculosis (TB) has increased dramatically, together with increased funding and research. We have a better understanding of the burden of childhood TB as well as a better idea of how to diagnose it. Our appreciation of pathophysiology is improved and with it investigators are beginning to consider pediatric TB as a heterogeneous entity, with different...
Abstaining from tobacco smoking is likely to lower the risk of respiratory infections and pneumonia. Unfortunately, quitting smoking is not easy. Electronic cigarettes (ECs) are emerging as an attractive long-term alternative nicotine source to conventional cigarettes and are being adopted by smokers who wish to reduce or quit cigarette consumption. Also, given that the propylene glycol in EC aerosols...
The biggest recent development in pneumonia diagnostics has been the increased availability and use of nucleic acid detection assays, although this change has brought with it new challenges about the interpretation of positive results. Recognition of the existence of the lung microbiome has challenged the traditional views of pneumonia pathogenesis and may provide the opportunity for new diagnostic...
Background The aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO). Methods A questionnaire was developed and distributed by the Community-Acquired Pneumonia...
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