Pathology of Pulmonary Infection

Kradin, Richard L.; Mark, Eugene J.

doi:10.1016/b978-0-323-44585-6.00008-4

Cited by 10 publications

(4 citation statements)

References 95 publications

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“…In the diagnosis of localized infections, noninvasive approaches are less sensitive than biopsy and cannot distinguish between colonizing commensals and invasive pathogens [9]. Additionally, lung biopsy provides a more accurate assessment of immune competence than noninvasive methods and is necessary to rule out infection and diagnose noninfective conditions, such as chemotherapy-induced acute lung injury [10]. However, the performance of mNGS can vary depending on sample types, sample sizes, and populations, and the accuracy of sampling may impact the results of mNGS.…”

Section: Introductionmentioning

confidence: 99%

A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients

Gao,

Li,

et al. 2024

Respir Res

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Introduction Lower respiratory tract infections(LRTIs) in adults are complicated by diverse pathogens that challenge traditional detection methods, which are often slow and insensitive. Metagenomic next-generation sequencing (mNGS) offers a comprehensive, high-throughput, and unbiased approach to pathogen identification. This retrospective study evaluates the diagnostic efficacy of mNGS compared to conventional microbiological testing (CMT) in LRTIs, aiming to enhance detection accuracy and enable early clinical prediction. Methods In our retrospective single-center analysis, 451 patients with suspected LRTIs underwent mNGS testing from July 2020 to July 2023. We assessed the pathogen spectrum and compared the diagnostic efficacy of mNGS to CMT, with clinical comprehensive diagnosis serving as the reference standard. The study analyzed mNGS performance in lung tissue biopsies and bronchoalveolar lavage fluid (BALF) from cases suspected of lung infection. Patients were stratified into two groups based on clinical outcomes (improvement or mortality), and we compared clinical data and conventional laboratory indices between groups. A predictive model and nomogram for the prognosis of LRTIs were constructed using univariate followed by multivariate logistic regression, with model predictive accuracy evaluated by the area under the ROC curve (AUC). Results (1) Comparative Analysis of mNGS versus CMT: In a comprehensive analysis of 510 specimens, where 59 cases were concurrently collected from lung tissue biopsies and BALF, the study highlights the diagnostic superiority of mNGS over CMT. Specifically, mNGS demonstrated significantly higher sensitivity and specificity in BALF samples (82.86% vs. 44.42% and 52.00% vs. 21.05%, respectively, p < 0.001) alongside greater positive and negative predictive values (96.71% vs. 79.55% and 15.12% vs. 5.19%, respectively, p < 0.01). Additionally, when comparing simultaneous testing of lung tissue biopsies and BALF, mNGS showed enhanced sensitivity in BALF (84.21% vs. 57.41%), whereas lung tissues offered higher specificity (80.00% vs. 50.00%). (2) Analysis of Infectious Species in Patients from This Study: The study also notes a concerning incidence of lung abscesses and identifies Epstein-Barr virus (EBV), Fusobacterium nucleatum, Mycoplasma pneumoniae, Chlamydia psittaci, and Haemophilus influenzae as the most common pathogens, with Klebsiella pneumoniae emerging as the predominant bacterial culprit. Among herpes viruses, EBV and herpes virus 7 (HHV-7) were most frequently detected, with HHV-7 more prevalent in immunocompromised individuals. (3) Risk Factors for Adverse Prognosis and a Mortality Risk Prediction Model in Patients with LRTIs: We identified key risk factors for poor prognosis in lower respiratory tract infection patients, with significant findings including delayed time to mNGS testing, low lymphocyte percentage, presence of chronic lung disease, multiple comorbidities, false-negative CMT results, and positive herpesvirus affecting patient outcomes. We also developed a nomogram model with good consistency and high accuracy (AUC of 0.825) for predicting mortality risk in these patients, offering a valuable clinical tool for assessing prognosis. Conclusion The study underscores mNGS as a superior tool for lower respiratory tract infection diagnosis, exhibiting higher sensitivity and specificity than traditional methods.

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Section: Introductionmentioning

confidence: 99%

A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients

Gao,

Li,

et al. 2024

Respir Res

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“…паление, в том числе и его вариант -эпителиоидноклеточный гранулематоз[71,88]. Этиология гранулематоза может быть инфекционной, аутоиммунной, токсической, аллергической и неопластической[32,51,62,71,75,84,88,101]. В зависимости от этиологического фактора гранулемы могут иметь те или иные особенности строения и инволюции.…”

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The Use of Rilpivirine/Tenofovir/Emtricitabine in Hiv-Infected Pregnant Women, Its Effect on Fetal Development, Perinatal Transmission of Hiv. Analysis of Physical and Psychomotor Development of Children 0-2 Years Old

Nabiullina,

Vlatzkaya,

Mazus

2023

TSZZ

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The data of medical records of 43 HIV-infected pregnant women and 46 children analyzed for the period from 2017 to 2022. The average age of the women was 33 years (33.6 ± 0.89). Many women (86.0%) had sexual transmission of HIV. The duration of HIV infection in more than half cases (51.1%) was more than 6 years. HIV/HCV co-infection diagnosed in 27.9% of women. 29 HIV-infected women received rilpivirine/ tenofovir/emtricitabine before pregnancy. 14 patients received ART regimens, including 2NRTIs and NNRTIs or Pis, and were switched to rilpivirine/tenofovir/emtricitabine during pregnancy. During pregnancy, CD4+ cells increased from 632.2 ± 42.6) cells/mm³ before pregnancy to 702.1 ± 39.7 cells/mm³ after delivery. HIV RNA levels before pregnancy averaged 795.3 ± 468.1 copies/mL and decreased to undetectable during pregnancy and after delivery. There were no cases of the mother-to-child transmission of HIV. The average birth weight of newborns was 3.350 grams (1.300–4.200), and the average height was 53 cm (45–56). During the observation period, the physical and psychomotor development of children corresponded to age norms.

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The Relationship of Long-Term Reactivation of Post-Vaccination Scar After Immunization With BCG Vaccine With Nonspecific Affects

Tarasova,

Streltzova

2023

TSZZ

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BCG is a unique vaccine. It was created and successfully used for specific prevention of tuberculosis. Reactivation of the BCG scar is a transient condition that occurs against the background of various diseases, capable of resolving itself, does not involve surgical intervention, but due to the low frequency of detected cases and the lack of pathogenetic justification for its occurrence requires dynamic observation.

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Pathology of Pulmonary Infection

Cited by 10 publications

References 95 publications

A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients

A single-center, retrospective study of hospitalized patients with lower respiratory tract infections: clinical assessment of metagenomic next-generation sequencing and identification of risk factors in patients

The Use of Rilpivirine/Tenofovir/Emtricitabine in Hiv-Infected Pregnant Women, Its Effect on Fetal Development, Perinatal Transmission of Hiv. Analysis of Physical and Psychomotor Development of Children 0-2 Years Old

The Relationship of Long-Term Reactivation of Post-Vaccination Scar After Immunization With BCG Vaccine With Nonspecific Affects

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