Evidence Of Secondary Infection Research Articles

A Metabolomics approach for the diagnosis Of SecondAry InfeCtions in COVID-19 (MOSAIC): a study protocol

BackgroundCritically ill patients with COVID-19 are at an increased risk of developing secondary bacterial infections. These are both difficult to diagnose and are associated with an increased mortality. Metabolomics may aid clinicians in diagnosing secondary bacterial infections in COVID-19 through identification and quantification of disease specific biomarkers, with the aim of identifying underlying causative microorganisms and directing antimicrobial therapy.MethodsThis is a multi-centre prospective diagnostic observational study. Patients with COVID-19 will be recruited from critical care units in three Scottish hospitals. Three serial blood samples will be taken from patients, and an additional sample taken if a patient shows clinical or microbiological evidence of secondary infection. Samples will be analysed using LC–MS and subjected to bioinformatic processing and statistical analysis to explore the metabolite changes associated with bacterial infections in COVID-19 patients. Comparisons of the data sets will be made with standard microbiological and biochemical methods of diagnosing infection.DiscussionMetabolomics analyses may provide additional strategies for identifying secondary infections, which might permit faster initiation of specific tailored antimicrobial therapy to critically ill patients with COVID-19.

Tofacitinib as a novel therapy in COVID-19 acute respiratory distress syndrome.

Tofacitinib as a novel therapy in COVID-19 acute respiratory distress syndrome.

COVID-19 herd immunity by immunisation: are children in the herd?

COVID-19 herd immunity by immunisation: are children in the herd?

Clinico-epidemiological and Outcome Analysis of Anogenital Injuries in Children: Retrospective Study from a Tertiary Care Centre, Central India

Introduction: Paediatric perineal trauma or Anogenital Injury (AGI) in the paediatric age group remains lesser reported in under-developed areas or rural areas of India. Most of these injuries remain under reported to tertiary care centres because of a social stigma or poor access to a health facility. Aim: To present the clinico-epidemiological parameters of AGI in children and to assess the outcome of staged and definitive management in these children, comparing the results with other similar studies. Materials and Methods: This was a retrospective study on data of 11 cases (age range 1-14 years, seven cases were boys and 4 cases were girls) of paediatric anogenital injuries, admitted at the tertiary care centre from 1st July 2018 to 30th June 2020 were analysed. Data of all the patients, demographic details, relevant clinical history such as time of presentation, mode of injury and type of management, outcomes and complications was collected and studied. All the collected data was analysed by calculating mean±SD, frequency (n) and percentages (%). Results: Road traffic accident was the most common cause of AGI (n=5, 45.5%), followed by sexual assault (n=3, 27.3%). Wound infection in late presenters (n=5, 45.5%) was the most common complication affecting the outcome. Children with a primary diversion of the faecal stream or diversion colostomy (n=5, 45.5%) as an associated procedure had a better outcome. Primary repair without diversion (n=3, 27.3%) was noticed to have a high incidence of wound infection and anovaginal scaring. Conclusion: A high incidence of poor wound healing related to late presentation and malnutrition noted among these AGI cases belonging to rural or semi-urban settings. Management of these injuries, therefore, needs to be individualised on case-to-case basis. The diversion stoma formation seems to be considered in all high grade anogenital injuries and selected lower grade injuries with evidence of secondary infection or poor healing of the primary repair.

Porcine circovirus 2 immunology and viral evolution.

Porcine circovirus 2 (PCV2) has and is still causing important economic losses to pig industry. This is due to PCV2-systemic disease (PCV2-SD), formerly known as postweaning multi-systemic wasting syndrome (PMWS), which increases mortality rates and slows down the growth of the animals, as well as other conditions collectively included within the so-called porcine circovirus diseases (PCVD). PCV2-SD affected pigs are considered to be immunosuppressed, with severe lymphocyte depletion and evidence of secondary infections. However, PCV2-infected pigs not developing the disease are able to mount humoral and cellular immune responses and clear the virus or limit the infection. On the contrary, insufficient amounts of neutralizing antibodies have been linked to increased PCV2 replication, severe lymphoid lesions and development of PCV2-SD. Central role in controlling PCV2 infection are played by the antigen specific memory T cells. These cells persist long term post-infection or vaccination and are able to expand rapidly after recall antigen recognition. Most farms in the main pig producing countries are applying vaccination against PCV2 to prevent the disease and improve the farm performance. Vaccines do not induce sterilizing immunity and PCV2 keeps on circulating even in farms applying vaccination. This, together with the high mutation rate of PCV2, world-wide fluctuations in the genotype dominance and emergence of novel genetic variants, warrant close molecular survey of the virus in the field.

Biology and natural history of Caladenia

The genus Caladenia comprises species that exhibit remarkable consistency in terms of growth form and phenological patterns. All taxa are herbaceous perennials, with the shoot arising annually from a single, usually spheroid, tuber and producing a single, hairy leaf. The tuber is annually replaced either side-by-side with the parent tuber or terminating a descending structure known as a dropper. The dropper is a depth-seeking mechanism that enables placement of the tuber at depth in the soil as a means to avoid predation by surface-foraging native mammals or away from the high temperatures and desiccating conditions during summer dormancy. The 3--5 attenuated roots produced at the junction between the tuber and shoot and produced late in the growing cycle and devoid of mycorrhiza suggest their functional significance may relate to water uptake. Mycorrhizal endophytes are confined to a hypertrophic stem region at the soil surface (collar) subtending the leaf that positions the collar directly in the organically rich zone at the soil surface. This morphology is a unique characteristic of several Australasian orchids in the tribe Diuridae. Mycorrhizal infection occurs rapidly, with maximum colonisation in concert with the onset of breaking rains. Pelotons are restricted to cortical cells, with fully developed pelotons throughout infected tissues within a week or so of soil wetting. Infection occurs as a ‘once-off’ event, with little evidence of secondary infection later in the growth cycle and no evidence of peloton digestion. Some taxa utilise vegetative propagation, often leading to localised clustering as for taxa in the ‘filamentosa’ complex or, extensive clonal mats as found in Caladenia flava and C. latifolia where daughter tubers are produced at the end of extending horizontal outgrowths. For the majority of taxa, plants remain dry-season (summer) dormant from a few months up to 7 months for arid-zone taxa, with shoot emergence from the tuber of temperate species thought to occur in response to a drop in the mean minimum temperature. Pollination biology of Caladenia is apparently through a process of deception, either as food or sexual mimics, with some taxa engaging in self-pollination. Here we review the natural history of Caladenia and acknowledge that much of our understanding is based on assumptions of the biology of terrestrial orchids in general and emphasise areas of research and biological enquiry that will be critical in the development of an effective conservation program for the genus.

STINGING INSECT HYPERSENSITIVITY: A PRACTICE PARAMETER

STINGING INSECT HYPERSENSITIVITY: A PRACTICE PARAMETER

Tumor necrosis factor-α responses are depressed and interleukin-6 responses unaltered in feline immunodeficiency virus infected cats

Feline immunodeficiency virus (FIV), a lentivirus similar to HIV, causes an acquired immunodeficiency syndrome in cats. Similar to human immunodeficiency virus (HIV), the pathogenesis of FIV is associated with dysregulation of the cytokine network. While alterations in tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expression have been reported in HIV-infected patients, changes attributable to HIV and those caused by cofactors such as secondary infections cannot always be readily distinguished. This study evaluated the effect of FIV infection on TNF-α and IL-6 production in cats not exposed to other potential cofactors such as secondary infections. TNF-α and IL-6 activities were evaluated in bronchoalveolar lavage (BAL) cells from FIV-infected and uninfected specific pathogen free (SPF) cats. Supernatants from lipopolysaccharide (LPS)-stimulated BAL cells from uninfected SPF cats had high levels of TNF-α and IL-6 activity, while stimulated BAL cell supernatants from FIV-infected SPF cats had significantly lower levels of TNF-α but unaltered IL-6 activity. Similarly, Con A/phorbol myristate acetate (PMA) stimulated non-adherent (NA-) peripheral blood mononuclear cells (PBMC) from FIV infected cats synthesized less TNF-α than similarly treated NA-PBMC from uninfected cats. Feline immunodeficiency virus could be recovered from the culture supernatants of BAL cells from infected cats by co-cultivation with susceptible lymphocytes. In situ hybridization identified FIV mRNA in a small fraction of alveolar macrophages in the BAL cell cultures. Considering that these SPF cats have been infected with FIV for up to 3 years, yet remain asymptomatic and have no evidence of secondary infections, the present data suggest that the deficiency in TNF-α production by BAL cells and NA-PBMC is an intrinsic characteristic of the FIV infection.

Cytomegalovirus infections and toxoplasmosis in heart transplant recipients in Sweden.

The morbidity of cytomegalovirus (CMV) infection and toxoplasmosis was evaluated in 75 heart transplant recipients. Among the 73 patients who survived more than one week after transplantation, 16 (22%) acquired primary CMV infection and 30 (41%) had evidence of secondary infection. All CMV seronegative recipients receiving hearts from seropositive donors developed CMV infection. The majority of infections (42/46) occurred during the first 4 months after transplantation. Overall, the incidence of symptomatic CMV disease was 44%. The infections were generally mild and only 1 death was attributed to primary CMV disease complicated by bacterial septicaemia and multiple organ failure. The severity of CMV disease was greatest among those with primary infection. There were 3 cases of toxoplasmosis. Two patients were toxoplasma seronegative before transplantation and developed clinical and serological signs of infection 2-3 months after transplantation despite receiving organs from seronegative donors. Of toxoplasma seronegative recipients receiving allografts from seropositive donors 3/4 were prophylactically treated with pyrimethamine for 6 weeks. None developed clinical or serological signs of toxoplasmosis while one patient who received trimethoprim-sulfamethoxazole had a subclinical infection.