Klebsiella pneumoniae Lower Respiratory Tract Infection in a South African Birth Cohort: a Longitudinal Study.
Klebsiella pneumoniae Lower Respiratory Tract Infection in a South African Birth Cohort: a Longitudinal Study.
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南非出生队列中肺炎克雷伯菌下呼吸道感染的纵向研究。
DOI：
10.1016/j.ijid.2022.04.043
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发表时间：
2022-08
影响因子：
8.4
通讯作者：
Nicol, Mark P.
中科院分区：
文献类型：
--
作者：
Zar, Heather J.;MacGinty, Rae;Workman, Lesley;Burd, Tiffany;Smith, Gerald;Myer, Landon;Haggstrom, Jonas;Nicol, Mark P.
肺炎克雷伯氏菌（Klebsiella pneumoniae，KP）可引起相当比例的婴儿下呼吸道感染（LRTI）。肺炎克雷伯氏菌（Klebsiella pneumoniae，KP）与早产、HIV暴露或母乳喂养时间短有关。我们纵向调查KP殖民和它的关联与LRTI在南非出生队列。我们对发生LRTI的婴儿和年龄匹配的对照进行了病例对照研究，每周两次随访。每两周和在LRTI采集鼻咽拭子进行33倍定量多重实时聚合酶链反应，在LRTI和LRTI前90天每周两次进行检测。在相同时间段内对对照品进行检测。多变量模型研究了与LRTI或KP相关LRTI（KP-LRTI）相关的因素。在885名婴儿中，有439例下呼吸道感染发作，其中68例（15.5%）为KP-LRTI（OR 1.93; 95%CI 1.25-3.03）。患有KP-LRTI的婴儿比没有KP-LRTI的婴儿更年轻（中位数[IQR] 3.7 [2.1-5.9] vs 4.7 [2.8-7.9]个月，P值=0.009）。KP和非KP-LRTI的临床特征相似，114例（26%）婴儿住院。早产（校正比值比[aOR] 11.86; 95%CI 5.22-26.93）、HIV暴露（aOR 3.32; 95%CI 1.69-6.53）、出生体重较低（aOR 0.68; 95%CI 0.51-0.91）和母乳喂养时间较短（aOR 0.79; 95%CI 0.65-0.96）与KP-LRTI相比与非LRTI相关。与非KP-LRTI相比，这些因素和年轻年龄与KP-LRTI相关。KP与相当大比例的LRTI相关，特别是在早产儿或暴露于艾滋病毒的婴儿中，应加强治疗和预防策略。
Klebsiella pneumoniae (KP) caused a substantial proportion of lower respiratory tract infection (LRTI) in infants KP-LRTI was associated with prematurity, HIV exposure, or short breastfeeding time Preceding colonization with KP was associated with LRTI Premature or HIV-exposed infants with severe LRTI may require therapy for KP The role of Klebsiella pneumoniae (KP) in lower respiratory tract infection (LRTI) is not well studied. We longitudinally investigated KP colonization and its association with LRTI in a South African birth cohort. We conducted a case-control study of infants who developed LRTI and age-matched controls, followed twice weekly through infancy. Nasopharyngeal swabs taken fortnightly and at LRTI for 33-multipex Quantitative multiplex real-time polymerase chain reaction were tested at LRTI and twice weekly from 90 days preceding LRTI. Controls were tested over the equivalent period. Multivariate models investigated the factors associated with LRTI or with KP-associated LRTI (KP-LRTI). Among 885 infants, there were 439 LRTI episodes, of which 68 (15.5%) were KP-LRTI (OR 1.93; 95% CI 1.25–3.03). Infants with KP-LRTI were younger than those without KP-LRTI (median [IQR] 3.7 [2.1–5.9] vs 4.7 [2.8–7.9] months, P-value=0.009). Clinical features of KP and non-KP-LRTI were similar with 114 (26%) infants hospitalized. Prematurity (adjusted odds ratio [aOR] 11.86; 95% CI 5.22–26.93), HIV exposure (aOR 3.32; 95% CI 1.69–6.53), lower birthweight (aOR 0.68; 95% CI 0.51–0.91), and shorter breastfeeding time (aOR 0.79; 95% CI 0.65–0.96) were associated with KP-LRTI versus non-LRTI. These factors and younger age were associated with KP-LRTI versus non-KP-LRTI. KP was associated with a substantial proportion of LRTI, particularly in premature or HIV-exposed infants in whom strategies for treatment and prevention should be strengthened.
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影响因子：
3.7
作者：
Zar, Heather J.;Pellowski, Jennifer A.;Stein, Dan J.
通讯作者：
Stein, Dan J.
在幼儿进行上呼吸道和下呼吸道感染的细菌之间的关联：系统评价和荟萃分析。
DOI：
10.1016/j.cmi.2021.05.034
发表时间：
2021-09
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Claassen-Weitz S;Lim KYL;Mullally C;Zar HJ;Nicol MP
通讯作者：
Nicol MP
DOI：
10.1016/s2213-2600(16)00096-5
发表时间：
2016-06
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Zar HJ;Barnett W;Stadler A;Gardner-Lubbe S;Myer L;Nicol MP
通讯作者：
Nicol MP
调查非洲疾病的早期决定因素：Drakenstein儿童健康研究。
影响因子：
10
作者：
Zar HJ;Barnett W;Myer L;Stein DJ;Nicol MP
通讯作者：
Nicol MP
影响因子：
2.4
作者：
Fenton TR;Kim JH
通讯作者：
Kim JH