Diagnosis Of Infection Research Articles

Temperature-Enhanced Purine Metabolism-Based Versatile SERS Platform for Rapid Clinical Pathogens Diagnosis and Drug-Resistant Assessment.

Label-free surface-enhanced Raman spectroscopy (SERS) combined with machine learning (ML) techniques presents a promising approach for rapid pathogen identification. Previous studies have demonstrated that purine degradation metabolites are the primary contributors to SERS spectra; however, generating these distinguishable spectra typically requires a long incubation time (>10 h) at room temperature. Moreover, the lack of attention to spectral variations between strains of the same bacterial species has limited the generalizability of ML models in real-world applications. To address these issues, we investigated temperature-induced alterations in bacterial purine metabolism and found that robust SERS spectra could be obtained within just 1 h by heating samples to 60 °C. Our study further revealed that pathogens exhibit multiple fingerprint patterns across strains, rather than a uniform spectral signature. To enhance practicality, we optimized ML models by training them on data sets capturing all relevant SERS fingerprints and validated them on separate bacterial strains. The SoftMax classifier achieved 100% accuracy in identifying both laboratory and clinical specimens within 17 h. Additionally, the platform demonstrated over 91% accuracy in distinguishing drug-resistant strains, such as methicillin-resistant Staphylococcus aureus and carbapenem-resistant Klebsiella pneumoniae, and achieved 99.66% accuracy in differentiating specific strains within a species, such as enterohemorrhagic Escherichia coli. This accelerated, purine metabolism-based SERS platform offers a highly promising alternative for the rapid diagnosis of bacterial infections.

Refractory and Resistant Herpes Simplex Virus Mucocutaneous Infections in Immunocompromised Patients: Literature Review and Proposed Definitions for Use in Clinical Trials.

Herpes simplex virus (HSV) infection is one of the most prevalent viral infections worldwide. In general, host immunity is sufficient to clear viral shedding and recurrences, although it is insufficient to prevent subsequent virologic reactivations. In immunocompromised patients, prolonged and difficult-to-treat HSV infections may develop. The diagnosis of refractory HSV infection is based on the lack of clinical response to nucleoside analogs. Antiviral resistance is confirmed via genotypic and/or phenotypic testing. To provide consensus definitions of refractory and/or resistant (R/R) HSV mucocutaneous infections for clinical trial use, the HSV Resistance Working Group of the Transplant Associated Viral Infections Forum, which includes international clinicians, scientists, industry representatives, and regulatory officials, conducted a literature review of previously published data related to R/R HSV infections in immunocompromised patients. We propose definitions of R/R HSV mucocutaneous infections, which will be subject to re-evaluation and revision based on forthcoming data and future studies.

Comparison of the epidemiological characteristics of mycoplasma pneumoniae infections among children during two epidemics in Wuhan from 2018 to 2024

BackgroundMycoplasma pneumoniae (M pneumoniae, MP) is a common pathogen causing respiratory tract infections, particularly in children. In 2023, a resurgence of MP epidemics was observed in Wuhan, Hubei Province, China. This study aims to examine the epidemiological trends and clinical characteristics of MP infections among children in Wuhan from 2018 to 2024, providing valuable scientific evidence to guide local prevention strategies.MethodsFrom January 1, 2018, to June 30, 2024, samples were collected from children under 14 years with Acute Respiratory Tract Infections (ARTI) at Renmin Hospital of Wuhan University. MP infections were diagnosed through MP-IgM antibody detection and MP-DNA detection. Results were analyzed and compared across distinct epidemic periods.ResultsOf the 183 626 ARTI children, 57 393 (31.26%) tested positive for MP, with an average age of 4.87 ± 2.99 years and a male-to-female ratio of 1.12:1. The annual positive rates from 2018 to 2024 were 45.92%, 32.23%, 22.84%, 16.22%, 16.26%, and 42.93%, respectively. Across the study period, the highest positive rate was recored in autumn (35.13%, P < 0.05). Two distinct MP outbreaks were identified, in 2018–2019 and 2023. Significant differences were observed between the two outbreaks. The 2018–2019 epidemic peaked in summer, while the 2023 epidemic peaked in November and persisted into February 2024. By age, the 2018–2019 outbreaks predominantly affected pre-school children, whereas the 2023 outbreaks mainly involved school-aged children. In boths outbreaks, girls had higher positive rates. Antibody and DNA testing results followed similar trends.ConclusionThis study highlights the epidemiological trends and clinical characteristics of MP infections in Wuhan from 2018 to 2024, including two distinct outbreaks with differing seasonal patterns. The MP strain in 2023 appeared to predominantly affect older children.The trends observed suggest that MP infections may persist into the winter of 2024. Enhanced surveillance of respiratory pathogens and early diagnosis and prevention of MP infections in children remain critical in this region.

Using Pharmacoepidemiology to Examine the Interplay of Sulfonylureas and Infection Risk in Patients With Diabetes Mellitus.

Sulfonylureas (SU) are commonly prescribed as oral hypoglycemic agents for the management of diabetes mellitus (DM). We postulated that SU possess antimicrobial properties due to their structural resemblance to the antimicrobial agent sulfamethoxazole. Using data from Taiwan's National Health Insurance Research Database, we enrolled patients diagnosed with DM between 2000 and 2013 and followed them for a three-year period. Patients who consistently used SU were categorized into the SU cohort, while those who had never used SU formed the non-sulfonylurea (non-SU) cohort. The primary study endpoints were diagnoses of pneumonia and urinary tract infections (UTIs). Within the database, we identified a total of 15,458,554 patients with DM, with 754,601 (4.88%) in the SU cohort and 2,244,436 (14.52%) in the non-SU cohort. After individual matching based on age, gender, index day, and propensity score of comorbidities, we included 663,056 patients in each cohort. The cumulative incidence of pneumonia and UTI was 29,239 (4.41%) and 60,733 (9.16%) in the SU cohort, respectively, and 24,599 (3.71%) and 56,554 (8.53%) in the non-SU cohort, respectively. Our findings indicated that the use of SU increased the risk of pneumonia (1.26-1.60 times) and UTI (1.13-1.22 times), while also potentially offsetting the protective effects of metformin. This pharmacoepidemiological study represents a concerted effort to assess latent drug properties that may have a significant impact on the clinical management of patients with DM.

Early antibiotics administration reduces mortality in sepsis patients in tertiary care hospital

IntroductionEarly antibiotic administration is one of the core treatments of sepsis which associated with reduced mortality rate. However, the appropriate timing of antibiotics remains a controversial issue, especially in patients without septic shock. Here, we reported the outcomes of early antibiotic administration within one hour from the time of infection suspicion in a tertiary care hospital.MethodsWe reviewed the medical records and sepsis protocols in Chulabhorn Hospital, Bangkok, Thailand, from January 2021 to December 2023 for patients presenting with sepsis. We had our own sepsis protocol which we used for early detection and treatment of sepsis patients. We compared the 28-day mortality, 90-day mortality, and the length of stay between patients with time-to-antibiotics (TTA) within one hour and patients with TTA more than one hour.ResultsWe recruited 1,506 patients into our study. The mean age is 68 years and 49.40% of patients is female. 90.97% of the patients have comorbidities. The most common comorbidities were cancer (68.66%), and hypertension (33.40%). The 28-day mortality rate and the 90-day mortality rate were significantly lower in the patients with TTA within one hour compared to those with TTA more than one hour (P = 0.009 and P = 0.042, respectively). Nonetheless, adjusted mortality rate was significantly lower in only 28-day mortality rate but not 90-day mortality rate. Subgroup analysis showed that the mortality rate was significantly lower in patients with ICD-10 diagnosis of infections (15.35% vs. 21.51%, P = 0.029), patients with cancer (17.29% vs. 24.11%, P = 0.016), and patients with solid cancer (20.86% vs. 28.18%, P = 0.036). However, subgroup analysis for the mortality rate at 90 days were not statistically significant.ConclusionAntibiotic administration within one hour from the time of infection suspicion is associated with lower mortality rates at 28 days but not at 90 days after adjusted analysis. Cancer patients, especially patients with solid cancer, will benefit more with time-to-antibiotics less than one hour.

Macrophage Membrane-Encapsulated Carbon Dots for Precise Targeting Diagnosis and Treatment of Bacterial Infections.

How to accurately diagnose and treat bacterial infections in vivo remains a huge challenge. Therefore, we have developed a targeted delivery nanosystem by coextruding the pretreated macrophage membrane of S. aureus with carbon dots (M@CD). The M@CD nanosystem demonstrates potent antibacterial effects both in vivo and in vitro through the generation of reactive oxygen species (ROS). Furthermore, M@CD exhibits enhanced targeting ability and stable fluorescence properties, addressing issues such as poor targeting efficiency and high immunogenicity in vivo. This innovative approach enables infection site specific aggregation and elimination of bacterial infections, thereby providing a promising strategy for the integrated diagnosis, treatment, and monitoring of bacterial infections.

Draft Genome of Naganishia uzbekistanensis from a Clinical Pulmonary Infection.

This study presents the first high-quality assembled genome of Naganishia uzbekistanensis, derived from a clinical isolate CY11558 obtained from a patient with a postoperative pulmonary infection. This work provides an improved reference assembly for downstream research and diagnosis of infections caused by this species.

ILC3 Function as a Double-Edged Sword in EV71 Infection

Enterovirus 71 (EV71) is a common pathogen responsible for hand, foot, and mouth disease (HFMD), leading to severe neurological complications and even death. However, the mechanisms underlying severe EV71-induced disease remain unclear, and no effective specific treatments are available. In this study, we successfully infected mice of different ages using a mouse-adapted EV71 strain, resulting in disease and mortality. We compared immune system responses between infected and uninfected mice of different ages to identify key pathogenic targets during EV71 infection. Our findings revealed that the level of Group 3 Innate Lymphoid Cells (ILC3s) in mice negatively correlated with the severity of disease induced by EV71 infection. We conducted anti-ILC3 cytokine injections and cytokine neutralizing antibody experiments on 14-day-old EV71-infected mice. The results showed that the cytokine IL-17 secreted by ILC3 cells had a mild protective effect, while IL-22 promoted inflammatory responses. Our research demonstrates that ILC3 cells play a dual role in EV71 infection. These findings not only clarify key immune factors in the progression of EV71-induced disease but also provide a promising approach for the early diagnosis and treatment of severe EV71 infections.

ЗНАЧЕНИЕ ПОЛИМЕРАЗНОЙ ЦЕПНОЙ РЕАКЦИИ В ВЫЯВЛЕНИИ ИНФЕКЦИОННЫХ АГЕНТОВ У КРУПНОГО РОГАТОГО СКОТА

The aim of our work was to identify bacterial and viral infectious agents in biological material from cows and calves with different clinical manifestations of diseases by PCR. Biological materials from animals were sent to the PCR laboratory from 23 agricultural organizations in the Ural Region. A total of 808 samples were studied, of which genomes of pathogens were found in 11.9 % of cases: Mycoplasma bovis DNA in 2.4 % of samples, Bovine virus diarrhoea RNA in 2.3 % of samples, Mycoplasma spp. and Chlamydia spp DNA in 2 % of samples, Mycoplasma bovigenitalium, Bovine herpesvirus (type 1), Chlamydophila abortus, Chlamydophila pecorum were found singly. Out of 80 samples in 36.2 % of biomaterials, specific DNA sites of Cl. difficile were found – 31.2 % of samples, Cl. perfringens – 20.0 % of samples, Cl. difficile + Cl. perfringens – 25.0 % of biosamples. Toxins were found in Cl. difficile: CDT toxin in 41.0 % of clostridia, toxin B in 6.0 % of pathogens, less often toxin A. In some cases, clostridia (Cl. perfringens, Cl. difficile B) were found in the biomaterial from dead calves, which confirmed the diagnosis – infectious anaerobic enterotoxemia of calves. Bacteria (E. coli, Salmonella enterica spp. entericaserogroup C (0:9, 2), Cl. perfringens and Cl. difficile CDT DNA) were detected in the biomaterial from dead cows, which confirmed the diagnosis of acute intestinal infection. All detected pathogens were presented in the form of monoinfection and singly in the form of mixed infections. Using PCR, it was possible to detect DNA and RNA of infectious agents in various clinical manifestations of diseases of bacterial and viral etiology in cattle herds in the Ural Region.

Microbiological spectrum of pathogens in cardiac surgery patients in the intensive care unit

Background. Intensive care unit (ICU) patients are at high risk of hospital-acquired infections, which is a significant problem in modern medicine. Every year, 140,000 deaths from hospital-acquired infections are reported. For example, studies in the United States show that 30 % of infections occur in the ICUs. The presence of hospital-acquired flora in patients prolongs their stay in the ICU, increases the duration of antibiotic therapy, and treatment costs. The occurrence of such an infection is the result of a complex interaction of pathogenic (virulence, antibiotic resistance), patients’ (comorbidities, acute illnesses, emergency surgery), and treatment factors (invasive devices), and the work of the health care system (staffing, preventive measures). Mortality among individuals with a positive bacteriological blood test reaches 25 % among all patients in the intensive care unit, which emphasizes the importance of timely diagnosis and control of such infection. The analysis of the microbiological spectrum of pathogens in cardiac surgery patients is a complex process, but it is quite possible and necessary to improve the effectiveness of treatment of cardiac surgery patients. Objective: to analyze the microbiological spectrum of pathogens in cardiac surgery patients in the ICU. Materials and methods. The study included retrospective clinical data of 323 patients who were treated in the preoperative or postoperative period at the intensive care unit of the State Institution “Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine” from January 1, 2021, to December 31, 2023. The entire cohort had a positive bacteriological blood test. The microbiological analysis was performed using a Vitek 2 Compact analyzer with a BACT/ALERT 3D60 colometric system for detecting bacterial growth (No. VK2C8748). The microbiological spectrum of pathogens in cardiac surgery patients in the intensive care unit was analyzed. Results. In 2021, 81 patients had a positive microbiological blood test. The incidence of pathogens was as follows: gram-positive infection — 69 (85.1 %), gram-negative infection — 11 (14.6 %), fungi of the genus Candida — 1 (0.3 %) case, respectively. In 2022, 95 patients had a positive microbiological blood test. The frequency of pathogens was as follows: gram-positive infection — 75 (78.9 %) cases, gram-negative infection — 20 (21.1 %). In 2023, 147 patients had a positive microbiological blood test. The incidence of pathogens was as follows: gram-positive infection — 97 (66.0 %) cases, gram-negative infection — 46 (31.3 %) cases, Candida fungi — 4 (2.7 %) cases, respectively. Conclusions. An increase was found in the frequency of Klebsiella spp. microorga-nisms from 60 to 84 % of cases from the total spectrum of gram-negative pathogens in the ICU in 2023. There was a decrease in the frequency of Enterobacter spp. from 22 % of cases in 2021 to 13 % in 2023. The proportion of identified Acinetobacter spp. pathogens decreased from 11 % of cases in 2021 to 3 % in 2023.

Early identification of macrophage activation syndrome in adult-onset Still’s disease: a case report and literature review

BackgroundAdult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder characterized by high spiking fevers, evanescent rash, and polyarthritis. A serious complication of AOSD is macrophage activation syndrome (MAS), a life-threatening hyperinflammatory condition that can lead to multiorgan failure if not promptly diagnosed and treated.ObjectiveThis case report and literature review focus on the early identification of MAS in patients with AOSD, highlighting diagnostic challenges, differential diagnoses, and the utility of scoring systems like the HScore and MS score in clinical practice.Case presentationWe report the case of an 80-year-old woman who presented with a complex diagnostic challenge involving AOSD complicated by MAS and concurrent cytomegalovirus (CMV) infection. Her clinical course was marked by recurrent high fevers, cytopenias, hyperferritinemia, and liver dysfunction. Despite extensive workup, initial diagnoses of infections and autoimmune conditions were considered and ruled out. The HScore and MS score were calculated to be 210 and 1.607, respectively, both indicative of MAS. The patient was treated according to the HLH-94 protocol, with high-dose dexamethasone and etoposide, alongside broad-spectrum antimicrobial and antiviral therapy. She responded well to treatment, with resolution of fever and improvement in clinical symptoms.DiscussionThe overlap between AOSD and MAS symptoms complicates early diagnosis, making scoring systems critical in differentiating MAS from other conditions. The HScore and MS score provided a structured approach to diagnosis, guiding timely intervention and improving the patient’s prognosis. Our literature review emphasizes the importance of early recognition and integration of these scoring systems into routine clinical practice to enhance outcomes.ConclusionThis case underscores the necessity of early identification and intervention in MAS associated with AOSD. The application of diagnostic scoring systems like the HScore and MS score is essential for prompt diagnosis and effective treatment, ultimately improving patient survival rates.

Editorial: Nanomaterial and nanostructures for cancer and pathogenic infection diagnosis and therapy

Editorial: Nanomaterial and nanostructures for cancer and pathogenic infection diagnosis and therapy

Preoperative diagnostic efficacy of novel blood markers white blood cell ratio and fibrinogen levels in periprosthetic joint infection

To investigate the clinical utility of novel of new hematological markers in the preoperative diagnosis of periprosthetic joint infection (PJI). A retrospective analysis was conducted on a total of 149 patients who underwent revision of total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single center between January 2016 and June 2022, including 63 males and 86 females, aged from 47 to 93 years old with an average of (69.5±11.8) years old. Of them, 46 were diagnosed as PJI(PJI group), including 22 males and 24 females. The mean age was (71.3±12.5) years old. The body mass index (BMI) was (26.4±3.1) kg·m-2. And 103 patients were diagnosed as aseptic prosthesis loosening (aseptic group), including 41 males and 62 females. The mean age was (68.7±11.4) years old. The BMI was (25.8±3.5) kg·m-2. Preoperatively analyzed clinical parameters included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, and plasma fibrinogen. The receiver operating characteristic curve (ROC), sensitivity, and specificity analysis were employed to compare the diagnostic value of each blood marker in preoperative PJI diagnosis. In the PJI group, the levels of CRP were 16.6 (7.6, 4.5) mg·L-1, ESR was 17.0 (12.8, 35.5) mm·h-1, plasma D-dimer was 1.0 (0.5, 3.1) μg·L-1, and plasma fibrinogen was 4.2 (3.2, 3.1) mg·L-1;all of which were higher compared to the aseptic group with CRP at 4.2 (2.6, 7.8) mg·L-1, ESR at 12.0(8.0, 20.0 )mm·h-l, D-dimer at 0.4(0.2, 0.7)μg·L-1, and fibrinogen at 2.8(2.4, 3.3 ) g·L-1(P<0.05). However, the albumin level of 35.3 (32.3, 37.5) g·L-1 and the WBC ratio of 1.0(0.9, 1.1) in the PJI group were significantly lower compared to the aseptic group with levels of 39.8 (36.1, 41.8) g·L-1 and 1.4 (1.3, 1.5), respectively (P<0.05). Only the area under the curve (AUC) of AGR and plasma fibrinogen were greater than 0.8. The optimal predictive cut-1off, AUC, sensitivity and specificity were 3.4 g·L-1, 0.820, 69.57% and 84.47% for plasma fibrinogen; 1.18, 0.813, 82.61% and 78.64% for AGR, respectively. AGR and plasma fibrinogen are promising blood markers for improving the diagnosis of PJI.

Point-of-care nucleic acid testing - a step forward in controlling the HIV epidemic: A review.

The HIV/AIDS epidemic, with 85.6 million infections and 40.4 million AIDS-related deaths globally, remains a critical public health challenge. Current diagnostic methods, primarily fourth-generation immunoassays, have limitations due to their long window periods, and most viral load assays require centralized testing protocols that result in delays, especially in remote regions. Point-of-care (POC) nucleic acid amplification testing (NAAT) presents a transformative approach by reducing the window period for detection to one week and significantly shortening turnaround times for viral load monitoring. This review highlights the clinical utility of POC NAAT for acute HIV infection diagnosis, its role in timely combination antiretroviral therapy adjustments, and its potential to reduce the basic reproduction number (R0), a critical threshold for suppressing the epidemic. By improving early detection and facilitating faster clinical decisions, POC NAAT enhances the effectiveness of HIV prevention and treatment programmes, particularly in high-risk and remote communities, and supports the global effort to achieve the ambitious UNAIDS 95-95-95 targets.

Exploring the clinical value of procalcitonin, c-reactive protein, white blood cell count, and neutrophil-to-lymphocyte ratio in the early diagnosis of bloodstream infections in children

BackgroudIn the diagnosis of bloodstream infections (BSI) in children, compared to the gold standard of blood culture, markers in the blood offer advantages such as rapid results and cost-effectiveness. Therefore, we investigated the clinical value of procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in the early diagnosis of BSI in children.MethodsThis study included a retrospective analysis of 309 suspected BSI cases and patients were categorized into 2 groups based on blood culture results: blood culture-positive group, and blood culture-negative group. The blood culture-positive group was further partitioned into 3 sub-groups based on the type of pathogen: Gram-positive (G +) bacteria, Gram-negative (G-) bacteria, and fungi. Changes in PCT, CRP, WBC, and NLR were evaluated, and pathogen infections among these aforementioned groups were further determined. Moreover, the study employed the receiver operating characteristic (ROC) curve to evaluate the diagnostic value of these indicators in identifying BSI in pediatric patients at an early stage.ResultsAmong the 98 strains of pathogens detected in blood culture, 58 (58.2%) strains were G- bacteria, 33 (33.7%) strains were G + bacteria, and 7 (7.1%) strains were fungi. The levels of PCT, CRP, WBC, and NLR were found to be significantly higher in the blood culture-positive group than the blood culture-negative group (p < 0.01). Upon comparing the levels of PCT and CRP in the three pathogen infections, it was found that the fungi group exhibited higher levels than the G- and G + bacteria groups (p < 0.01). The G- bacteria group exhibited higher levels of PCT, CRP, and WBC than the blood culture-negative group (p < 0.05). Similarly, the G + bacteria group exhibited higher levels of PCT, WBC, and NLR than the blood culture-negative group (p < 0.01). Besides, PCT presented the highest diagnostic efficiency among the single-item detections, with an AUC of 0.862 (95% CI: 0.819–0.906). The simultaneous detection of multiple parameters does not necessarily improve diagnostic performance but can enhance detection sensitivity.ConclusionsPCT and CRP can provide important complementary information for the etiological diagnosis of BSI in children. Elevated levels of PCT and CRP were often associated with fungal or G- bacterial infections, with PCT showing particularly significant effects. Combined use of serum PCT, CRP, WBC, and NLR testing can improve the diagnostic sensitivity of pediatric BSI, reducing the risk of missed diagnoses, thereby enhancing the early diagnostic value of pediatric BSI.

Knowledge, attitudes and practices of Australian dairy goat farmers towards the control of gastrointestinal parasites

BackgroundGastrointestinal parasites such as nematodes and coccidia are responsible for significant economic losses in the goat industry globally. An indiscriminate use of antiparasitic drugs, primarily registered for use in sheep and cattle, in goats has resulted in drug-resistant gastrointestinal parasites. Very little is known about the gastrointestinal parasite control practices used by Australian dairy goat farmers that are pivotal for achieving sustainable control of economically important parasites. The study reported here provides insights into gastrointestinal parasite control practices of Australian dairy goat farmers based on responses to an online survey.MethodsThe questionnaire comprised 58 questions on farm demography, husbandry and grazing management, knowledge of gastrointestinal parasites and their importance in dairy goats, diagnosis of infections, antiparasitic drugs and alternate control options. After a pilot survey (n = 15 respondents), a link to the questionnaire was available to all (n = 456) registered members of the Dairy Goat Society of Australia Ltd from 17 April to 16 June 2023. Multiple correspondence analyses (MCA) were performed to explore the association between selected parasite control practices.ResultsA total of 66 (14%) respondents completed the questionnaire. Of these, 74% (49/66) observed parasite-related illnesses in their goats; two-thirds of them assessed worms burden using faecal egg counts (FECs), with 26% (39/149) deworming their goats based on the results of the FECs. Most respondents (97%; 183/188) perceived that gastrointestinal parasites caused production losses and ranked Haemonchus contortus as the most important parasite. Anitparasitic drugs were used by 94% (62/66) of respondents, with the most frequently used anthelmintics being a commercial combination of four anthelmintics (levamisole, closantel, albendazole and abamectin), benzimidazoles and macrocyclic lactones. Most respondents (77%; 51/66) were unaware of anthelmintic resistance on their property. MCA results delineated two clusters of gastrointestinal parasites management.ConclusionsThis study provides insights into the demography of Australian dairy goat farms, the husbandry and grazing practices used by dairy goat farmers, their knowledge regarding gastrointestinal parasites and their practices for internal parasite control, thereby paving the way for tackling drug resistance in gastrointestinal parasites in dairy goats.Graphical

DNA-Based Nanobiosensor for the Colorimetric Detection of Dengue Virus Serotype 2 Synthetic Target Oligonucleotide

Annually, the Philippines is burdened by a high number of infections and deaths due to Dengue. This disease is caused by the Dengue virus (DENV) and is transmitted from one human host to another by the female Aedes aegypti mosquito. Being a developing country, most of the high-risk areas in the Philippines are resource-limited and cannot afford equipment for detection and monitoring. Moreover, traditional clinical diagnoses of DENV infection are costly and time-consuming and require expertise. Hence, it is important to establish effective vector control and surveillance measures. In this study, we developed a DNA-based nanobiosensor for the colorimetric detection of Dengue virus serotype 2 (DENV-2) synthetic target DNA (stDNA S2) using gold nanoparticles (AuNPs). We successfully functionalized dextrin-capped gold nanoparticles with the designed DENV-2 oligonucleotide probes. The detection of the complementary stDNA S2, indicated by the pink-colored solution, was successfully performed within 15 min using 0.40 M NaCl solution. We were able to detect up to 36.14 ng/μL of stDNA S2 with some cross-reactivity observed with one non-complementary target. We believe that our study offers a basis for developing nanobiosensors for other DENV serotypes.

Evaluation and Management of Congenital Cytomegalovirus Infection.

The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary. Although the risk of congenital CMV infection is lower with infection at earlier gestational ages, clinical sequelae are more severe with maternal infections earlier in gestation. At present, routine screening for maternal CMV infection is not recommended by U.S. guidelines. When maternal primary infection is confirmed in early pregnancy, emerging data support consideration of maternal antiviral therapy to prevent congenital CMV infection. When congenital CMV infection is confirmed, typically after an abnormal prenatal ultrasound result, there are more limited data on the utility of maternal antiviral therapy. Universal newborn screening for congenital CMV infection is not mandatory in most U.S. states at present. Newborns diagnosed with congenital CMV infection undergo an extensive evaluation to determine whether neurologic symptoms are present, which guides postnatal evaluation and management. In this review, we discuss the diagnosis and management of maternal CMV infection, the risk and diagnosis of congenital CMV infection, prevention and potential treatment of congenital CMV infection in utero, and neonatal congenital CMV infection diagnosis and management.

Molecular-genetic studies in the diagnosis of Helicobacter pylori infection

The issues of optimizing the management of patients infected with Helicobacter pylori have remained relevant in clinical therapy and gastroenterology for many years. This is due both to the high prevalence of H. pylori infection in Russia: depending on the region, it is 35–60 %, and to the potential carcinogenicity of the microorganism in relation to the development of stomach cancer. According to clinical recommendations, when conducting an endoscopic examination of the upper gastrointestinal tract, a rapid urease test with a biopsy from the antrum and the body of the stomach or polymerase chain reaction (PCR) with a biopsy of the stomach may be recommended as a method of primary diagnosis of infection. Enhanced molecular genetic typing of the microbe can increase the effectiveness of diagnosis, with the identification of several genes encoding the synthesis of pathogenicity factors H. pylori, as well as the analysis of microbial resistance to antibiotics (detection of genes encoding mutations associated with microbial resistance). Thanks to a set of studies that include not only verification of the pathogen, but also molecular genetic typing of infection by PCR, it is possible to significantly optimize the management tactics of patients infected with H. pylori and provide a personalized approach to antihelicobacter therapy depending on the virulence and resistance of the strain of the pathogen with which a person is infected. The relevance and breadth of the use of full-genome H. pylori sequencing is increasing, however, this study is not used in routine medical practice, including due to the high cost.

Impact of an institutional antifungal stewardship program on antifungal usage and outcomes in patients with invasive fungal infections.

Therapeutic and prophylactic use of antifungals is rising continuously. However, lack of awareness of diagnostic and treatment guidelines and limited laboratory modalities are leading to inappropriate use. This study assessed the impact of an institutional antifungal stewardship program on antifungal use practices and patient outcome. In the pre-intervention phase, data was collected regarding antifungal therapy among patients with invasive fungal infections. Appropriateness of antifungal prescription was assessed. In the intervention phase, simple algorithms for diagnosis and management of fungal infections were prepared from international guidelines; and incorporated into a booklet for distribution. Monthly training sessions were conducted. New serological and molecular tests and therapeutic drug monitoring were introduced. In the post-intervention phase, an antifungal stewardship team was constituted which was available for clinical advisory on demand and participated in ongoing training. Data regarding antifungal therapy was collected and compared with pre-intervention data. Proportion of untreated patients decreased from 25% to 18.9% post-intervention (P=0.28). Among patients with single fungal infection, appropriate antifungal use increased from 72.6% to 77.9% (P=0.4). Among those with dual fungal infections, appropriate antifungal use for at least one infection increased from 57.1% to 88.5% (P=0.04). 49 incidents of inappropriate use in various categories was seen among 75 patients who received antifungals pre-intervention, which decreased to 42 incidents among 94 patients post-intervention (P=0.06); particularly evident among patients with dual infections (P=0.002). Mortality increased from 51% to 75.86% post-intervention (P=0.0001). Overall, the small improvement noticed in antifungal usage pattern can still be considered significant, given the limited study period.