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Severe Community-Acquired Pneumonia in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Community-acquired pneumonia (CAP) may present as mild, moderate, or severe pneumonia. Patients with severe CAP require hospital admission and usually are admitted to the critical care unit (CCU). Patients with severe CAP in the CCU are those requiring ventilatory support. Clinically in immunocompetent patients, CAP is severe, primarily because of the underlying cardiopulmonary status. While some pathogens are inherently more virulent than others, e.g., Legionella is more virulent than Moraxella catarrhalis, clinical severity is primarily determined by host rather than by microbial factors. A patient with Legionnaire’s disease and good cardiopulmonary function may present with severe CAP, as may a patient with severe chronic obstructive pulmonary disease with M. catarrhalis CAP. Patients with bacterial CAP and various degrees of hyposplenism often present with severe CAP [1–7].
Respiratory Pathogens
Published in Victor A. Bernstam, Pocket Guide to GENE LEVEL DIAGNOSTICS in Clinical Practice, 2019
Moraxella (Branhamella) catarrhalis is a respiratory pathogen identified in patients with underlying pulmonary disease, in immuno-eompromised patients, as well as in children with otitis media and sinusitis.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Of those organisms mentioned, Pseudomonas is the only Gram-negative bacillus and is typically seen in immunocompromised patients and hospital-acquired infections and is associated with respirators and drainage tubes. Listeria is a Gram-positive bacillus as is actinomyces. Moraxella is a Gram-negative coccus that is seen in atypical pneumonia. Staphylococcus aureus is a Gram-positive coccus.
Current and emerging treatment modalities for bacterial rhinosinusitis in adults: a comprehensive review
Published in Expert Opinion on Pharmacotherapy, 2022
Maria Gabriella Matera, Barbara Rinaldi, Vito de Novellis, Paola Rogliani, Mario Cazzola
Acute bacterial rhinosinusitis (ABRS) is frequently associated with a predisposing disease, such as allergies, immunological dysfunction, decreased ciliary function, anatomic sinus constriction, or poor dentition, which causes an inflammatory process in the nasal mucosa and sinuses [1,4]. Streptococcus pneumoniae and Haemophilus influenzae have been identified as the two primary pathogens in acute rhinosinusitis (ARS), accounting for more than half of cases in many investigations [4]. Moraxella catarrhalis is a less prevalent pathogen in adults but accounts for one-quarter of infections in children [5]. Less frequent pathogens in ARS include Streptococcus pyogenes, Staphylococcus aureus, Gram-negative bacilli, and oral anaerobes [6]. Anaerobic organisms often linked with ARS of odontogenic origin include Peptostreptococcus spp., Fusobacterium spp., and Prevotella spp., as well as mixed anaerobic and facultative anaerobic bacteria (a-hemolytic streptococci, microaerophilic streptococci, and S aureus) [7].
Clinical Characteristics of 17 Patients with Moraxella Keratitis
Published in Seminars in Ophthalmology, 2018
Yui Tobimatsu, Noriko Inada, Jun Shoji, Satoru Yamagami
The isolated causative Moraxella spp. in the present study included 12 cases of Moraxella spp., four cases of M. catarrhalis, and one case of M. osloensis. In our culture results, M. lacunata, which is thought to be the most frequent causative species of Moraxella keratitis, may have been one of the strains recorded as Moraxella spp. Furthermore, M. osloensis, which is a rarely isolated causative bacterium in ocular infections, was detected in a female 18-year-old soft contact lens wearer without systemic predisposing factors. Moraxella osloensis is a resident bacterium of the upper respiratory tract and oral cavity, and is sometimes reported as the causative agent of sepsis and meningitis.21,22 In ocular infections, there have been some reports of endophthalmitis caused by M. osloensis, but there are no reports of M. osloensis keratitis. These results show that due to the wide variety of strains isolated from Moraxella keratitis, antimicrobial susceptibility to isolated Moraxella spp. warrants specific attention.
Relationship between nasopharyngeal microbiota and patient’s susceptibility to viral infection
Published in Expert Review of Anti-infective Therapy, 2019
Grégory Dubourg, Sophie Edouard, Didier Raoult
All these elements explain why we have not yet elucidated how the nasopharyngeal microbiota promotes or affects viral respiratory infections. There are however several findings of importance that open the way to further works. First, the early nasopharyngeal microbiota is affected by the mode of delivery and the infant’s feeding pattern. Second, its composition during the first few weeks of life seems to predispose to acute respiratory diseases [15,34,47]. In particular, microbiota dominated by Streptococcus spp., Moraxella spp. or Haemophilus spp.are associated with a higher likehood of acute respiratory infections when compared to patterns dominated by other genera. In general, Staphylococcus abundance, and in particular S. aureus, is negatively associated with the occurrence of ARI in children or their severity. This finding is counter-intuitive as S. aureus is frequently involved in respiratory viral superinfections [18,20], but immunological studies have added substance to its potential protective role. Data concerning Moraxella spp. are however conflicting, possibly due to a carriage rate that possibly reaches 75% in children when the species M. catarrhalis is considered [93]. There are however few doubts about the negative impact of high abundance of Haemophilus in children nasopharyngeal microbiota considering both incidence and symptom severity. Finally, children appear to be more susceptible to influenza infection, apparently due to a less stable microbiota rather than the presence of specific pathobionts [62]. As for adults, no specific microbiota has been identified, to the best of our knowledge, as predisposing to susceptibility to respiratory viral infections. This is probably due to the difficulty to obtain consecutive respiratory specimen in such populations during long periods, thereby explaining the scarcity of robust data. However, only the presence of H. influenzae is frequently increased in infected subjects, while the presence of Moraxella spp. may be more relevant because the rate of carrying in adults is low. In addition, changes in the nasopharyngeal microbiota has been associated with severity of the symptoms rather than virus acquisition, as shown for HRV infection [65,66]. Also, even if based on a single observation, the fact that the asymptomatic influenza patient included in the study conducted by Edouard et al. clustered with asymptomatic controls is in line with this hypothesis. While data concerning the diversity are discrepant, these elements point out the need for further studies.