Existence Of Co-infection Research Articles

A case report of fatal feline babesiosis caused by Babesia canis in north western Spain

BackgroundIn Europe, Babesia infections in cats are sporadic and only partial knowledge is currently available since the number of described cases including both the clinical presentation and the molecular identification of the Babesia species involved is limited. In the present case report, the clinical signs, the epidemiological data and the molecular results suggest that this is the first reported fatal case of feline babesiosis caused by Babesia canis.Case presentationA six month old female European shorthair cat from north-western Spain died after being hospitalized for two days. This animal was pregnant and showed anorexia, lethargy, weakness, jaundice and fever with increased respiratory and heart rates. Haematological analysis revealed haemolytic regenerative anaemia, thrombocytopenia and leukocytosis. The presence of piroplasms was assessed using a PCR targeting the 18S rRNA gene of Babesia spp. and Theileria spp.; the sample resulted positive and B. canis was identified by DNA sequence analysis. The possible existence of co-infections with other vector-borne pathogens such as Anaplasma spp., Bartonella spp., Borrelia burgdorferi s.l., Cytauxzoon spp., Ehrlichia spp., Hepatozoon canis, Mycoplasma spp. or Rickettsia spp. was excluded by qPCR.ConclusionsOur results together with previous reports on Babesia infections in cats from Europe suggest that feline babesiosis should be included in the differential diagnosis of animals with anaemia, thrombocytopenia, anorexia and lethargy, especially in young or immunocompromised animals from endemic areas for canine babesiosis.

Two trichinellosis outbreaks in Serbia - challenging diagnosis due to a potential co-infection with Toxocara spp.

In Serbia, in most cases, small family outbreaks of trichinellosis occur due to the consumption of untested infected meat from domestic pigs that are raised and slaughtered in the backyards of small individual farms. The aim of this study is to present data regarding 24 patients involved in two outbreaks that occurred in two neighbouring districts in Serbia during a closely related period of time in August 2014. The source of infection in the first outbreak was undercooked pork, while raw pork sausages caused the second outbreak. Meat samples and sausages were Trichinella spp. positive by artificial digestion. With the aim to obtain a second opinion and validate the serological findings discovered at the Public Health Institute Nis, all samples were sent to the National Reference Laboratory for Trichinellosis, INEP. Serodiagnosis showed that 21 persons were positive (87.5%) and three (12.5%) were negative for anti-Trichinella antibodies, while 15 patients fulfilled the trichinellosis case definition. Western blot analysis (using an epitope unique for the muscle larvae stage of the Trichinella genus) confirmed the diagnosis of trichinellosis in five patients. Six patients also had specific antibodies against Toxocara canis (T. canis). Due to the fact that in endemic foci in Serbia there is the presence of Trichinella spiralis and T. canis and that these two infections could be asymptomatic, we consider that trichinellosis cases were irrefutably proven. The dilemma about the existence of co-infection with T. canis remained open due to the lack of clinical findings.

The Effect of cART on Platelets/Lymphocytes Ratio and Viral Load Indices in HIV+ Subjects Initiating Therapy in a Tertiary Hospital in Port Harcourt, Nigeria

<i>Background:</i> In other to enhance immune response and remove completely the danger of disease associated with AIDS, commencement of combination Antiretroviral Therapy (cART) is advocated. Common among HIV positive subjects are diseases such as cardiovascular conditions among others which happen when there is distortion in the gut mucosa, existence of co-infections, and long-term cART effect which gives room to vicious cycle that impairs on immune activities and inflammation. Inflammatory predictors which reveal the danger of morbidity and mortality are raised in HIV disease. A novel marker for inflammation – Platelet/Lymphocyte ratio (PLR), is a prognostic tool for assessing inflammation, atherosclerosis and platelet activation. <i>Aim:</i> This study was aimed at assessing prospectively, cART effect on the PLR and coagulation indices in HIV positive subjects presenting to commence cART in Rivers State University Teaching Hospital. <i>Methods</i>: Six milliliters of venous blood was collected from each participants into EDTA bottles at entry into the study, after 3 months and 6 months on cART respectively for Full Blood Count using a 3-part Sysmex XP300 and HIV Viral Load using RT-PCR Cobas TaqMan version 1.5 <i>Results</i>: A total of 40 subjects were recruited, with a mean age of 36.20 years, 14 (35%) of them were males. Mean PCV, Platelet: Lymphocyte ratio and HIV VL at Month 0 were 31.65±7.30%, 7.82±2.90 and 215767.85 ± 360338.04cp/ml respectively. There was a statistically significant increase (p <0.001) in the haematocrit by the 6^th month on cART, the reduction in Platelet: Lymphocyte count and of HIV VL by the 6^th month was also significant (P<0.001). Interestingly, PLR positively correlated with the VL at baseline (0.3676), however, there was a negative correlation at 3 months (-0125) and 6 months (-0.028). <i>Conclusion</i>: From this work it is clear that all the cases in this regard, confirm the fact that cART remarkably drops the viral load and inflammation in HIV positive subjects; nevertheless, it also shows that a low-level inflammation continues which probably leads to chronic inflammatory state, morbidity and mortality in this group of subjects.

Investigation of Mycobacterium bovis and Metastrongylus sp. co-infection and its relationship to tuberculosis lesions’ occurrence in wild boars

Animal tuberculosis (aTB) is a zoonotic disease characterized by granulomatous lesions on affected tissues, occurring as a consequence of immunological response to infection. Mycobacterium bovis, the main causative agent of aTB, was investigated in Brazilian wild boars with 37.7 % (29/77) positivity. Among these animals, most had no macroscopic tuberculosis-like lesions (89.6 %; 26/29). The existence of co-infections, which may alter an individual's immune response to an immunological challenge, could influence the formation of tuberculosis lesions. Therefore, we investigated Metastrongylus sp. and aTB co-infection to seek an explanation for the absence of macroscopic lesions in aTB. Of the tested animals, 77.9 % (60/77) had Metastrongylus sp., however, there was no association between its occurrence and the pattern of aTB lesions. The absence of tuberculous lesions in infected animals is worrisome, especially to hunters who handle their carcasses, potentially assuming that the animal is healthy. Studies evaluating other possibilities that can explain the absence of lesions in infected animals should be carried out to better understand these findings.

Socioeconomic factors associated with infection by Toxoplasma gondii and Toxocara canis in children.

The intense contact of children with domestic animals or environments contaminated with faeces of these animals, together with habits related to lack of hygiene, can facilitate infection by zoonoses. The study evaluated the seroprevalence and risk factors associated with toxoplasmosis and toxocariasis in schoolchildren in the city of Jataizinho, Paraná. Of the 412 children aged 4-15years, 56.8% (234/412) presented antibodies reactive to Toxoplasma gondii, 42.5% (175/412) presented antibodies reactive to Toxocara canis, and 27.4% (113/412) were reactive for the two species. The analysis of risk factors showed that prevalence of toxoplasmosis and toxocariasis was associated with the level of education of the child's mother (less than eight years of schooling), age range (10-15years) and the presence of cats in the residence. In addition, family income (up to a minimum wage), presence of a dog, the habit of playing in soil/sand and eosinophilia were associated with Toxocara canis infection. There was an association between the two zoonoses (p<.01), indicating the existence of coinfection. The results show high prevalence of these two important zoonoses, alerting to the need of implementing control measures in order to reduce the incidence and risks of sequelae in children.

Does Pulmonary Aspergillosis Complicate Coronavirus Disease 2019?

Objectives:Aspergillus coinfection in coronavirus disease 2019 patients has rarely been described but may be occurring among coronavirus disease 2019 patients admitted to ICUs. Previous reports of viral coinfections with Aspergillus, including influenza-associated pulmonary aspergillosis, suggest that coronavirus disease 2019–associated aspergillosis is plausible. This report aims to summarize what is known about coronavirus disease 2019 complicated by Aspergillus, introduces coronavirus disease 2019–associated pulmonary aspergillosis as a possible clinical entity, and describes reasons clinical suspicion of Aspergillus is warranted in the critical care setting.Data Sources:We summarize the available evidence suggesting the existence of Aspergillus coinfection among severe coronavirus disease 2019 patients. This includes published coronavirus disease 2019 patient case series, a case description, and a review of potential biologic mechanisms.Study Selection:Reports of coronavirus disease 2019 patient attributes were selected if they included clinical, microbiologic, or radiologic signs of invasive fungal infection.Data Extraction:Data included in summary tables were identified through a literature search for coronavirus disease 2019–associated pulmonary aspergillosis.Data Synthesis:We present descriptive data extracted from coronavirus disease 2019–associated pulmonary aspergillosis case series current at the time of article submission.Discussion:Pulmonary aspergillosis is known to occur among influenza patients requiring intensive care and is associated with increased mortality. If Aspergillus coinfections are occurring among coronavirus disease 2019 patients, early clinical suspicion and testing are needed to understand the epidemiology of these infections and prevent associated mortality. As the coronavirus disease 2019 pandemic unfolds, reports on the existence of this coinfection are needed, and opportunities to contribute cases of Aspergillus coinfection among coronavirus disease 2019 patients to an ongoing registry are described.

A51 Genetic variability of small ruminant lentiviruses in sheep and goats from single-species flocks from Poland

Previous phylogenetic analyses of small ruminant lentivirus (SRLV) sequences found in Poland revealed the circulation of subtype A1 in both sheep and goats, subtypes B1 in goats, and subtypes B2, A12, and A13 in sheep only. This study aimed to analyze the genetic nature of SRLV circulating in sheep and goats from single-species flocks. In order to analyze the degree of genetic variability, the fragments of gag and env genes of 24 SRLV strains were amplified by PCR, cloned into plasmid vectors, sequenced, and consensus sequences were aligned to each other and to reference sequences available from GenBank. Phylogenetic analysis was performed using the Geneious tree-builder tool, and phylogenetic trees were constructed using Mr Bayes (using the general time reversible substitution model) within Geneious Pro 5.3. Pairwise genetic distances were calculated in MEGA 6. Phylogenetic analysis revealed that the strains were highly heterogeneous and represented ovine strains belonging to subtypes A12 and B2 and caprine strains grouped in subtypes B1, B2, A1, and A12. In addition, two novel subtypes, A16 and A17, were found in goats. The mean pairwise genetic distances of gag and env sequences of both clusters were above 15 per cent nucleotide divergence when compared to all other subtypes within group A, which is a criterion required to distinguish a new subtype. Additionally, the existence of two separated clusters was confirmed by high bootstrap values. Co-infections with strains belonging to different subtypes within A and B groups were detected in one sheep and four goats originating from four flocks. Since the co-infection with more than one lentivirus genotype offers an opportunity for viral recombination, the possible recombination events were tested based on RDP analysis. For all co-infected animals, no evidence of recombination was found within the gag gene; however, env sequences showed some recombination patterns in three samples. In conclusion, we have demonstrated extended genetic variability of SRLV in sheep and goats from Poland with the existence of co-infection and recombination events.

Molecular and pathological characterization of duck enteritis virus in Egypt.

In winter 2016, a fatal disease outbreak suspected to be duck virus enteritis (DVE) stroke over a million ducklings in 10 white Pekin and Muscovy ducks flocks in Dakahlia and Gharbia Governorates, Egypt, causing heavy economic losses. The disease quickly killed 20%-60% of affected farms. The clinical signs were inappetence, ataxia, crowding in corners, partially closed eye lids and blue beaks. Post mortem examination revealed white necrotic foci in liver, mottled spleen and sometimes cecal core. A total of 10 intestines, livers and spleens samples were collected from diseased flocks. Each sample was pooled randomly from eight to ten ducklings. Polymerase chain reaction (PCR) and histopathological examination were utilized for DEV identification in collected samples. Nucleotides sequences of the amplified DNA polymerase gene were compared with the other DEVs available on GeneBank. Also, existence of co-infection with Salmonella spp. was verified via PCR. DEV nucleic acid was detected by PCR in 8 of 10 collected samples (80%) with positive amplification of polymerase gene. Histopathological examination revealed eosinophilic and basophilic intranuclear inclusion bodies in enterocytes. In some infected enterocytes, intranuclear and intracytoplasmic inclusions were observed in the same cell. Respectively, eosinophilic intranuclear inclusion bodies found in hepatocytes and reticular cells of liver and spleen of diseased ducklings. Four of the 10 collected samples showed positive results for Salmonella spp. infection that may be involved in enhancing infection with DEV. The identified DEVs revealed close genetic relationship with DEVs detected previously in India and China indicating potential transmission of the virus from there that crucially needs further work for better understanding of virus origin. In conclusion, our study revealed infection of duckling farms with DEV and Salmonella that necessitate the implementation of restricted early preventive and control measures for both diseases to decrease the expected economic losses.

Universal Health Coverage in Africa: Coinfections and Comorbidities

At the 67th session of the World Health Organization (WHO) Regional Committee meeting in August 2017, African health ministers adopted a range of transformational actions intended to strengthen health systems in countries, leading to Universal Health Coverage (UHC). A critical challenge for UHC is the existence of coinfections and noncommunicable diseases (NCDs), characterised by comorbidities.

Molecular Evidence of Rickettsia spp., Anaplasma phagocytophilum, and "Candidatus Neoehrlichia mikurensis" in Ticks from Natural and Urban Habitats in Eastern Romania.

Ixodid ticks are competent vectors for multiple pathogens, several of which cause infections in human. The medical importance of tick-borne pathogens is well known, yet unanswered questions remain regarding the occurrence of pathogens such as Rickettsia spp., Anaplasma phagocytophilum, and "Candidatus Neoehrlichia mikurensis" in questing ticks in Romania. Our objectives were to identify three emerging tick-borne zoonotic pathogens in eastern Romania, to assess their prevalence, establish co-infection rates, and to compare infection levels of selected pathogens in questing ticks collected from one suburban area in the city of Iaşi and one forested area located in the Danube Delta Biosphere Reserve. We collected 490 questing nymphs or adult ticks (467 Ixodes ricinus, 4 Dermacentor reticulatus, and 19 Haemaphysalis punctata). We individually analyzed ticks for the presence of Rickettsia spp., A. phagocytophilum, and "C. N. mikurensis." Rickettsia spp. was detected in 9.4% of ticks from both sampling areas. Rickettsia spp. included R. helvetica (n = 17 I. ricinus ticks), R. monacensis (n = 28 I. ricinus ticks), and R. raoultii (n = 1 D. reticulatus). "C. N. mikurensis" had an infection rate of 4.9% while A. phagocytophilum was detected only in the forested area with a global prevalence of 1.2%. The overall prevalence of ticks infected with at least one pathogen was 15.5%, and 5.3% of infected ticks were tested positives for dual pathogen association. Our study documents the presence of pathogens in questing ticks in the urban recreational areas of Iaşi and forested areas located in the Danube Delta Biosphere Reserve. Worth mentioning, is the presence of "C. N. mikurensis" in ticks from eastern Romania, an agent just recently described in Romania, and the existence of co-infections in ticks at a similar prevalence to other European countries.

The Level of CD4&amp;lt;sup&amp;gt;+&amp;lt;/sup&amp;gt; T Cell Count among Reproductive Age Women Coinfected with Human Immune Virus, Hepatitis Surface Antigen and Herpes Simplex Virus in Kogi State, Nigeria

Background: There are pockets of evidence to show the existence of co-infections of viral particles in humans. Aim: The study aimed at evaluating the CD4+ T cell count among women of reproductive age co-infected with human immune virus, hepatitis surface antigen and herpes simplex virusin Kogi state, Nigeria. Methodology: 342 females of reproductive age within the ages of 15 - 49 years participated in this study. They were recruited from various local government areas of three Senatorial districts of Kogi state. Blood samples were collected from participants and analyzed for HSV1/HSV2, HIV, HBsAg and CD4 using different scientific methods and procedures. Results: There was no significant differences in mean CD4+ T cell counts between subjects who tested positive and those who tested negative for only HSV1 (p = 0.61), HSV2 (p = 0.95), HIV (p = 0.48) and co-infection for HSV1, HSV2, HIV (0.68). In contrast, mean CD4+ T cell count was significantly higher in those who tested positive compared with those who tested negative for HBsAg alone (p = 0.03) and those co-infected with HSV1, HSV2, HBsAg (p = 0.01). Analysis of variance (ANOVA) indicated no significant differences in CD4+ T cell counts among the different classes of infections. Conclusion: This study shows no decline in the count of CD4+ T cell on the co-infections of HSV1, HSV2 and HIV, but higher significant difference in those co-infected with HSV1, HSV2 and HBsAg was recorded among the women of child bearing age in Kogi state.

A Review on Therapeutic Management of Chronic Hepatitis B Infection

The current therapeutic goal in the management of chronic hepatitis B (CHB) infection is to persistently suppress hepatitis B virus (HBV) replication and prevent its progression to liver failure and the development of hepatocellular carcinoma (HCC). At present, the therapeutic strategies for CHB includes either a short course of pegylated-interferon-alfa (PEG-IFNa) and/or a long term course of nucleos(t)ide analogues (NA’s). NA’s are more preferable to PEG-IFNa, majorly for its easier route of administration and excellent tolerance and safety profiles. Entecavir (ETV) and tenofovir (TDF) are the current first line options for its potency to maintain sustained virological response (SVR) in almost 100% of the adherent individuals along with minimal to no long-term resistance. These sustained inhibitions of HBV replication have been shown to be associated with histological improvement, modifying the long-term outcomes. However, HBsAg seroconversion, the best surrogate marker for viral clearance is still unachievable with the current first line agents and hence the risk for hepatocellular carcinoma (HCC) still exists among them. This makes us to still consider, a finite duration of PEG-IFN a that has shown considerable results with regards to HBsAg loss, as an attractive add-on or monotherapy option despite its adverse events profile. Existing evidences do not recommends its usage. However, numerous studies are ongoing and also further studies to evaluate the reliable baseline predictors of response to PEG-IFNa and early on-treatment stopping rules based on age, alanine aminotransferase levels (ALT), HBV DNA levels and HBsAg kinetics would be ideal. existing practice guidelines such as that of American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), and Asian Pacific Association for the Study of the Liver (APASL) assist physicians in the diagnosis and optimal management of CHB; they are still expected to individualize the management considering various factors like cost-effectiveness, compliance, efficacy and duration of anti-viral agents, existence of coinfections etc. [1,3,4]. This article reviews the basis for those guideline recommendations, the natural history of the disease, treatment options and what we do in our practice to illustrate factors that may influence the management of CHB. Natural history of chronic hepatitis B infection

Oral Cavity as an Extragastric Reservoir of Helicobacter pylori

Background. Several studies were reported on the prevalence, and relationship between the existence of Helicobacter pylori (H. pylori) in oral cavity and in stomach of patients. The purpose of this study was to systematically review the existing literature on the presence of H. pylori in the oral cavity and its link to gastric infection, the existence of coinfection, and the impact of anti-H. pylori therapy on the dental plaque and vice versa. Method. Two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. The articles were analyzed critically and all qualified studies were included. The search was carried out by using a combined text and the MeSH search strategies: using the key words Helicobacter, Helicobacter pylori, and H. pylori in combination with dental plaque, periodontitis, and oral hygiene. Results. The data was presented in 8 tables and each topic separately discussed. Conclusion. Based on the systematic review of the available literature on H. pylori infection and its presence in the oral cavity, it can be concluded that dental plaque can act as a reservoir, and proper oral hygiene maintenance is essential to prevent reinfection. Due to the diversified methods and population groups involved in the available literature, no concrete evidence can be laid down. Further studies are necessary to establish the role of H. pylori in the oral cavity and its eradication on preventing the gastroduodenal infection.

Coinfection Of HIV With HBV And HVC In A Low Resources Setting

Background Co-infection of HIV with HVB and C is well described in medical literature from all over the world. The coexistence of these infections can worsen the evolution of anyone of them, therefore a fast diagnosis and treatment can help to achieve a better prognosis. Malvinas Argentinas County is a low resources seting located in NW of Buenos Aires Province. Objective: Determining the existence of coinfection with HIV and HVB and/or HVC in patients (p) included in the Municipal Program Against HIV and establishing the characteristics of the infected population.

Approche moléculaire de la pneumocystose

Pneumocystis carinii (Pc) is an eukaryotic ubiquitous micro-orgaminsm which cause fatal pneumonia in immunocompromised individuals especially in AIDS patients. Despite major improvements in diagnosis and therapy, epidemiological data are fragmentary. The mode of transmission is poorly understood, in large part due to a lack of a continuous in vitro culture system for its isolation, but contamination probably occurs through inhalation of unknown forms present in air. Molecular techniques, such as DNA amplification and sequence analysis of Pc genes, have played an important role in demonstrating a large degree of specificity and heterogeneity among the different Pc organisms and in studying Pneumocystis carinii pneumonia (PCP) epidemiology. The genes analysis allowed to show that recurrence may be due to de novo infection rather than reactivation of organisms not eliminated by treatment during the first episode, the existence of coinfection with two different strains of Pc and to detect Pc DNA in ambient air. Studies of suspected person-to-person transmission, typing different DNA regions, most of the time rule out transmission within couple or hospitalized patients and therefore suggest that the most probable mode of transmission is environmental. Typing gene methods have also permit studies on drug-resistant markers such as mutation on dihydroptéroate synthethase gene of Pc. Pc typing may be simultaneously use with in vitro cultivation to improve our knowledge on PCP epidemiology such as environmental reservoirs, life cycle of this atypic fungus.