Prevalence of Human Bocavirus in Children Under 5 Years with Upper and Lower Respiratory Infections in Southeastern Iran

Background: Human Bocavirus (HBoV) is a parvovirus associated with mild to severe upper and lower respiratory tract infections in children. Objectives: This study aimed to detect the virus in the nasopharynx of children under 5-year-old with respiratory infection by polymerase chain reaction (PCR). Methods: Two hundred samples were taken from children referred to pediatric clinics in Kerman, southeastern Iran, with respiratory infections and were positive for virus by PCR. Next, the positive samples were genotyped by real-time PCR. Results: Out of 200 samples, 13 (6.5%) were positive for the Bocavirus gene, and all positive samples were infected by HBoV-1. We observed that 116 patients were male, and there was no difference in the prevalence of the virus based on gender (P = 0.345). The prevalence was significantly higher in infants under 10 months old (P = 0.049). Infection by Bucavirus virus was significantly correlated with symptoms, such as fever (P = 0.035, r = 0.7), otitis media (P = 0.013, r = 0.8), diarrhea, nausea, and vomiting (P = 0.001, r = 0.4). Conclusions: According to our findings, HBoV could be one of the causes of infections in the respiratory system of children, and the only type in the studied region is HBoV-1.

An Overview of Antivirals for Treating Lower Respiratory Tract Infections

Covid-19 has resulted in a worldwide epidemic (pandemic) with high morbidity and mortality, which has generated efforts in various areas of research looking for safe and effective treatments to combat the virus that generates this disease: SARS-CoV-2. However, several viruses have been emerged/adapted in the last few decades, also affecting the respiratory system. According to the world health organization (WHO), lower respiratory tract infections (LRTIs) are one of the leading causes of death worldwide, and viruses are playing important roles as the cause of these infections. In contrast to the vast repertoire of antibiotics that exist to treat bacteria-caused LRTIs, there are a very few antivirals approved for the treatment of virus-caused LRTIs, whose approach consists mainly of drug reuse. This minireview deals on the main viral pathogens that cause LRTIs and some of the most relevant antivirals to counter them (available drugs and molecules in research/clinical trials), with concise comments of their mechanism of action. Resumen. Covid-19 ha resultado en una epidemia mundial (pandemia) con alta morbilidad y mortalidad, lo que ha generado esfuerzos en diversas áreas de investigación en la búsqueda de tratamientos seguros y eficaces para combatir el virus que genera esta enfermedad: el SARS-CoV-2. Sin embargo, un número de virus han surgido o se han adaptado en las últimas décadas, que también afectan el sistema respiratorio. Según la Organización Mundial de la Salud (OMS), las infecciones en vías respiratorias inferiores (LRTIs, por sus siglas en inglés) son una de las principales causas de muerte a nivel mundial, siendo los virus de los principales patógenos causantes de estas infecciones. En contraste con el repertorio amplio de antibióticos que existen para tratar LRTIs causadas por bacterias, existen muy pocos antivirales aprobados para su tratamiento, cuyo enfoque consiste principalmente en la reutilización de fármacos. Este ensayo consiste en una breve revisión de los principales agentes virales que causan LRTIs y de los antivirales más relevantes para combatir los virus que las causan (tanto fármacos disponibles como moléculas en fases de investigación o clínicas), con comentarios concisos sobre su mecanismo de acción.

Inhaled ciprofloxacin-loaded poly(2-ethyl-2-oxazoline) nanoparticles from dry powder inhaler formulation for the potential treatment of lower respiratory tract infections

Lower respiratory tract infections (LRTIs) are one of the fatal diseases of the lungs that have severe impacts on public health and the global economy. The currently available antibiotics administered orally for the treatment of LRTIs need high doses with frequent administration and cause dose-related adverse effects. To overcome this problem, we investigated the development of ciprofloxacin (CIP) loaded poly(2-ethyl-2-oxazoline) (PEtOx) nanoparticles (NPs) for potential pulmonary delivery from dry powder inhaler (DPI) formulations against LRTIs. NPs were prepared using a straightforward co-assembly reaction carried out by the intermolecular hydrogen bonding among PEtOx, tannic acid (TA), and CIP. The prepared NPs were characterized by scanning electron microscopy (SEM), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), powder X-ray diffraction analysis (PXRD), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). The CIP was determined by validated HPLC and UV spectrophotometry methods. The CIP loading into the PEtOx was between 21–67% and increased loading was observed with the increasing concentration of CIP. The NP sizes of PEtOx with or without drug loading were between 196–350 nm and increased with increasing drug loading. The in vitro CIP release showed the maximum cumulative release of about 78% in 168 h with a burst release of 50% in the first 12 h. The kinetics of CIP release from NPs followed non-Fickian or anomalous transport thus suggesting the drug release was regulated by both diffusion and polymer degradation. The in vitro aerosolization study carried out using a Twin Stage Impinger (TSI) at 60 L/min air flow showed the fine particle fraction (FPF) between 34.4% and 40.8%. The FPF was increased with increased drug loading. The outcome of this study revealed the potential of the polymer PEtOx as a carrier for developing CIP-loaded PEtOx NPs as DPI formulation for pulmonary delivery against LRTIs.

The spectrum of Cefditoren for Lower Respiratory Tract Infections (LRTIs) in Surabaya

Background: Empirical antibiotics among outpatients with Lower Respiratory Tract Infections (LRTIs) are scarcely allocated in Indonesia. The study aims to evaluate the pathogens causing LRTIs, drug sensitivity test and the minimum inhibitory concentrations of 90% (MIC90) of Cefditoren, Azithromycin, Amoxicillin-Clavulanic Acid, and Cefixime Methods: The study was performed in adult outpatients with LRTI that can be expectorated. Patients with diabetes mellitus, HIV, lung tuberculosis, renal or hepatic failure, and hemoptysis were excluded. We performed bacterial culture, antibiotic sensitivity, and MIC measurement of four antibiotics. Results: There were 126 patients with LRTIs, and 61 patients were eligible for the study. We identified 69 bacteria. We found Klebsiella pneumonia (n=16; 26.23%), Staphylococcus aureus (n=11; 18%), Pseudomonas aeruginosa (n=8; 13.11%), Acinetobacter baumanii complex (n= 4; 6.55%), Streptococcus pneumonia (n=3; 4.9%) and others bacteria as causa of LRTI. Testing MIC90 of Cefditoren and three empiric antibiotics on LRTI found that Cefditoren has a lower MIC of 90 for K. pneumonia (0.97(2.04) µg.mL-1) and S. pneumonia (0.06(0.00)µg.mL-1) than other antibiotics, but almost the same as Cefixime ((0.05(0.16)µg.mL-1) and (0.38(0.17)µg.mL-1). MIC90 Cefditoren for S.aureus (3.18(3.54)µg.mL-1) and P.aeruginosa (9.2(3.53)µg.mL-1) is lower than Cefixime but higher than Azithromycin and Amoxicillin-Clavulanic acid. Reference data MIC90 of Cefditoren for LRTI bacteria is lower than the other three oral empirical antibiotics. Conclusions: In vitro studies of an outpatient LRTI in Surabaya found gram-negative bacteria dominant. Cefditoren can inhibit K.pneumonia and S.pneumonia has lower MIC90 compared to other antibiotics. Cefditoren can inhibit gram-negative and positive bacteria causing LRTI.

Lower Respiratory Tract Infections in Primary Care, Review Article

Any infectious illness of the upper or lower respiratory tract is classified as a respiratory tract infection (RTI). Acute bronchitis, bronchiolitis, pneumonia, and tracheitis are examples of lower respiratory tract infections (LRTIs). The most prevalent cause of death from lower respiratory infections is pneumococcal pneumonia. Pneumonia is a major cause of death globally. new advances in pneumonia diagnosis and treatment have been made, identification of new pathogens as well as the development of newer therapeutic agents like fluoroquinolones, macrolides, streptogramins, oxazolidinones, and –actam antibiotics. Despite these advancements, respiratory tract infections continue to be a challenge in both the diagnostic and therapeutic domains. Because detecting and treating pneumonia may be difficult, a number of professional organizations have created treatment recommendations. In this review we’ll be looking at LRTIs and pneumonia epidemiology, etiology, diagnosis and treatment.