High Rates Of Co-infection Research Articles

Coinfection of HCV among HIV-infected patients: Across-sectional study in rivers State, Nigeria

Background: Hepatitis C virus (HCV) has emerged as the cause of the second major epidemic of viral infection after human immunodeficiency virus (HIV) within the past two decades. HCV is the cause of more than three-quarters of liver-relate deaths in HIV-seropositive individuals and it is remarkable that today approximately one-quarter of HIV-infected individuals Aim: this study aimed at determining the prevalence of coinfection patterns of HCV among HIV infected individual in Rivers State, Nigeria. Materials and methods: A retrospective survey conducted on 350 HIV infected individual attending ART clinic at Rivers State University Teaching Hospital, Port Harcourt, Nigeria. Sociodemographic data were collected based on interviewer-based questionnaire, and clinical history was obtained from participants' medical records. Antibody analyses for HCV were done using ELISA method. Results: The prevalence of hepatitis C virus coinfection among HIV positive individual was 6(4.0%), The prevalence of HCV and HIV positive individual with regards to age was high within the age of 21 -40 5(2.4%). Prevalence based on gender was females 4(1.1%) and males 2(1.4%), prevalence of HIV/HCV co-infection with respect to marital status was high among the single 6(4.9%), prevalence of HIV/HCV co-infection with respect educational status was high with tertiary 3(3.5%) than the secondary 3(1.6%). The prevalence among the different occupational groups, business had the highest co-infection rate (1.1%) followed closely by Working class (0.8%). Higher HIV/HCV co-infection was observed among those with CD4 cell count 350-499 cells/μl (4.6%). Conclusion: However, the low burden of this hepatotropic virus coinfection calls for continued need to screen for HCV among individual infected with HIV before the start of ART.

The prevalence, genetic diversity and evolutionary analysis of cachavirus firstly detected in northeastern China.

Canine cachavirus is a novel parvovirus belonging to the genus Chaphamaparvovirus that was first detected in dogs in the United States. However, our knowledge of the prevalence and genetic characteristics of cachavirus is relatively limited. In this study, 325 canine fecal specimens collected from healthy and diarrheic dogs in northeastern China were screened with PCR. Twenty-two of the 325 (6.8%) samples were positive for cachavirus. The diarrhea samples showed high viral coinfection rates, and we detected coinfections with canine astrovirus (CaAstV) and cachavirus for the first time. A sequence analysis revealed that the Chinese cachavirus strains have point mutations in four consecutive amino acid codons relative to the original American strain. A codon usage analysis of the VP1 gene showed that most preferred codons in cachavirus were A- or T-ending codons, as in traditional canine parvovirus 2. A co-evolutionary analysis showed that cachavirus has undergone cospeciation with its hosts and has been transmitted among different host species. Our findings extend the limited cachavirus sequences available, and provide detailed molecular characterization of the strains in northeastern China. Further epidemiological surveillance is required to determine the significance and evolution of cachavirus.

Correlation of endemicity between monogenean trematode, Microcotyle sebastis, and parasitic copepods in Korean rockfish, Sebastes schlegelii, from a fish farm in Tongyeong-si, Gyeongsangnam-do, Korea.

Infestations of parasites, particularly those caused by copepods and monogeneans, are a major hindrance to aquaculture and have a big negative economic impact. Sebastes schlegelii, a farmed Korean rockfish, is particularly prone to copepods and monogeneans. This study comprehended how parasitic copepods and rockfish from a farm in Tongyeong-si, Gyeongsangnam-do, Korea, are related to the monogenean trematode Microcotyle sebastis. Our research revealed that monogeneans predominated, with a rate of 98.4% and an average infection intensity of 7 per infected fish. With an average infection intensity of 4 per sick fish, the infection rate for parasitic copepods was equally considerable, coming in at 91.7%. The high co-infection rate of both parasite families, at 90.8%, is noteworthy. Furthermore, Lepeophtheirus elegans and Peniculus truncatus, 2 parasitic copepod species, were discovered to have M. sebastis eggs attached to their bodies. This demonstrates a connection between parasitic copepod infestations in farmed Korean rockfish and the monogenean trematode M. sebastis. These discoveries highlight the necessity for creating more potent parasite control methods for the aquaculture sector and shed light on the intricate relationships between various parasite species.

Co-infecting Haemoproteus species (Haemosporida, Apicomplexa) show different host tissue tropism during exo-erythrocytic development in Fringilla coelebs (Fringillidae)

Avian haemosporidians of the genera Plasmodium, Haemoproteus, and Leucocytozoon are common blood parasites in wild birds all over the world. Despite their importance as pathogens potentially compromising host fitness and health, little is known about the exo-erythrocytic development of these parasites, particularly during co-infections which predominate in wildlife. This study aimed to address this issue using Haemoproteus parasites of Fringilla coelebs, a common bird species of the Western Palearctic and host to a variety of haemosporidian parasite lineages. Blood and tissue samples of 20 F. coelebs, positive for haemosporidians by blood film microscopy, were analysed by PCR and sequencing to determine cytochrome b lineages of the parasites. Tissue sections were examined for exo-erythrocytic stages by histology and in situ hybridization applying genus-, species-, and lineage-specific probes which target the 18S rRNA of the parasites. In addition, laser microdissection of tissue stages was performed to identify parasite lineages. Combined molecular results of PCR, laser microdissection, and in situ hybridization showed a high rate of co-infections, with Haemoproteus lineages dominating. Exo-erythrocytic meronts of five Haemoproteus spp. were described for the first known time, including Haemoproteus magnus hCCF6, Haemoproteus fringillae hCCF3, Haemoproteus majoris hCCF5, Haemoproteus sp. hROFI1, and Haemoproteus sp. hCCF2. Merogonic stages were observed in the vascular system, presenting a formerly unknown mode of exo-erythrocytic development in Haemoproteus parasites. Meronts and megalomeronts of these species were distinct regarding their morphology and organ distribution, indicating species-specific patterns of merogony and different host tissue tropism. New pathological aspects of haemoproteosis were reported. Furthermore, phylogenetic analysis of Haemoproteus spp. with regard to their exo-erythrocytic stages points towards separation of non-megalomeront-forming species from megalomeront-forming species, calling for further studies on exo-erythrocytic development of haemosporidian parasites to explore the phylogenetic character of this trait.

Demographic and clinical characteristics of human bocavirus-1 infection in patients with acute respiratory tract infections during the COVID-19 pandemic in the Central Province of Sri Lanka

BackgroundHuman bocavirus-1 (hBoV-1) was first detected in respiratory specimens in 2005. Due to high co-infection rates and prolonged shedding of the virus, the pathogenic role of hBoV-1 as a primary causative agent of respiratory infections is still under discussion. This study aimed to determine the prevalence of hBoV-1 infection in patients with acute respiratory tract infections (ARTIs) during the COVID-19 pandemic in the Central Province of Sri Lanka.MethodsA total of 1021 patients (Age 12 days to ≤ 85 years) with ARTI symptoms including fever, cough, cold, sore throat and shortness of breath within first 7 days of the illness were included. The study was carried out at the National Hospital, Kandy, Sri Lanka from January 2021 to October 2022. Respiratory specimens were tested to detect 23 pathogens including hBoV-1 using a real time PCR. Prevalence of hBoV-1 co-infections with other respiratory pathogens and distribution of hBoV-1 infection among different age groups were determined. Moreover, clinical and demographic characteristics of hBoV-1 mono-infection associated ARTI were compared with that of the hBoV-1 co-infections.ResultsRespiratory infections were detected in 51.5% (526/1021) of the patients and of these 82.5% were mono- and 17.1% were co-infections. hBoV-1 was detected in 66 patients and this was the most prevalent respiratory virus associated with 40% co-infections. Of the 66 hBoV-1 positive patients, 36 had co-infections and of these 33 had dual and 3 had triple infections. Most of the hBoV-1 co-infections were identified in children aged 2-<5 years. hBoV-1 co-infections were most frequently detected with respiratory syncytial virus (RSV) and Rhino/ Entero viruses (Rh/EnV). No differences were observed in age, gender and clinical presentations in those with hBoV-1 mono- compared to co-infections. Intensive care admissions were less among hBoV-1 mono-infected than hBoV-1 co-infected patients.ConclusionThis study shows a prevalence of 12.5% for hBoV-1 infections in patients with ARTI. RSV and Rh/EnV were the most common co-infecting pathogens with hBoV-1. Clinical features of hBoV-1 mono-infections were not different to that of the hBoV-1 co-infections. Interactions between hBoV-1 and other respiratory pathogens need investigation to identify the role of hBoV-1 in clinical severity of co-infections.

WS03.02 Keep your enemies close: natural foes, Pseudomonas aeruginosa and Staphylococcus aureus are associated with fewer adverse clinical consequences when present in patients with chronic co-infection

Objectives: Pseudomonas aeruginosa (PA) has a reputation for predatory competition against neighbouring organisms like Staphylococcus aureus (SA) using toxins such as ExoS and cyanide. Despite this, we and others have reported high rates of chronic co-infection. We hypothesize that sustained co-existence occurs with less virulent strains which may limit collateral damage to the host. We explored a large, 20-year dataset to determine the impacts of PA and SA chronic mono- and co-infection on patient FEV1% and number of hospital IV days.

Bacterial Periodontitis in Horses: An Epidemiological Study in Southern Italy.

Equine periodontal disease (EPD) is a painful oral inflammatory syndrome characterized by multifactorial pathogenesis. Although it is well known that bacterial proliferation and consequent gingivitis are caused by the decomposition process of food residues, in hypsodont species, the pathogenetic role and the different bacterial species involved in the progression of EPD must be fully clarified. This study aimed to investigate the association of bacteria, including the complex red bacteria (RCB), with EPD, and to evaluate possible EPD risk factors. Bacterial species, including Treponema denticola, Tannerella forsythia, Porphyromonas gingivalis (belonging to the RCB), Fusobacterium nucleatum, Veilonella parvula, and Prevotella intermedia, were investigated in 125 oral swabs from healthy and EPD-affected horses using real-time multiplex PCR. Subsequently, possible risk factors (i.e., age, gender, and breed of the animals and type of feed used) were evaluated using univariate and multivariate analyses. Tannerella spp. and Treponema spp. were detected in a significantly higher proportion of horses affected by EPD than in healthy animals, although pathogens belonging to RCB were detected in low number of horses. At the same time, none of the investigated pathogens was significantly associated with a particular stage of disease severity. Horses aged older than 20 years were at higher risk of EPD. The high rate of coinfection, statistically associated with EPD, supports the hypothesis that EPD is a complex syndrome characterized by the possible simultaneous involvement of several pathogens and an increased risk depending on the animal's age. Constant oral hygiene is the best prevention to prevent and treat the disease, especially in old animals.

Kinetic and structural studies of Mycobacterium tuberculosis dihydroorotate dehydrogenase reveal new insights into class 2 DHODH inhibition

Tuberculosis (TB) is a leading cause of death worldwide. TB represents a serious public health threat, and it is characterized by high transmission rates, prevalence in impoverished regions, and high co-infection rates with HIV. Moreover, the serious side effects of long-term treatment that decrease patient adherence, and the emergence of multi-resistant strains of Mycobacterium tuberculosis, the causing agent of TBs, pose several challenges for its eradication. The search for a new TB treatment is necessary and urgent. Dihydroorotate dehydrogenase (DHODH) is responsible for the stereospecific oxidation of (S)-dihydroorotate (DHO) to orotate during the fourth and only redox step of the de novo pyrimidine nucleotide biosynthetic pathway. DHODH has been considered an attractive target against infectious diseases. As a first step towards exploiting DHODH as a drug target against TB, we performed a full kinetic characterization of both bacterial MtDHODH and its human ortholog (HsDHDOH) using both substrates coenzyme Q0 (Q0) and vitamin K3 (K3). MtDHODH follows a ping-pong mechanism of catalysis and shares similar catalytic parameters with the human enzyme. Serendipitously, Q0 was found to inhibit MtDHODH (KI (Q0) = 138 ± 31 μM). To the best of our knowledge, Q0 is the first non-orotate like dihydroorotate-competitive inhibitor for class 2 DHODHs ever described. Molecular dynamics simulations along with in silico solvent mapping allowed us to successfully probe protein flexibility and correlate it with the druggability of binding sites. Together, our results provide the starting point for the design of a new generation of potent and selective inhibitors against MtDHODH.

Cheating leads to the evolution of multipartite viruses.

In multipartite viruses, the genome is split into multiple segments, each of which is transmitted via a separate capsid. The existence of multipartite viruses poses a problem, because replication is only possible when all segments are present within the same host. Given this clear cost, why is multipartitism so common in viruses? Most previous hypotheses try to explain how multipartitism could provide an advantage. In so doing, they require scenarios that are unrealistic and that cannot explain viruses with more than 2 multipartite segments. We show theoretically that selection for cheats, which avoid producing a shared gene product, but still benefit from gene products produced by other genomes, can drive the evolution of both multipartite and segmented viruses. We find that multipartitism can evolve via cheating under realistic conditions and does not require unreasonably high coinfection rates or any group-level benefit. Furthermore, the cheating hypothesis is consistent with empirical patterns of cheating and multipartitism across viruses. More broadly, our results show how evolutionary conflict can drive new patterns of genome organisation in viruses and elsewhere.

Utility of Extended HPV Genotyping as Primary Cervical Screen in an Unscreened Population With High HIV Co-Infection Rate.

Screening with primary human papillomavirus (HPV) testing has been evaluated in highly prescreened populations with lower HPV and HIV prevalence than what is the case in South Africa. High prevalence of HPV and underlying precancer in women living with HIV (WLWH) affect the clinical performance of screening tests significantly. This study investigates the utility and performance of an extended genotyping HPV test in detection of precancer in a population with a high coinfection rate with HIV. A total of 1,001 women aged 25 to 65 years with no cervical cancer screening in the preceding 5 years were tested with cytology and primary extended genotyping HPV testing. The cohort of 1,001 women included 430 WLWH (43.0%) and 564 HIV-negative (56.3%) women. Abnormal cytology (atypical squamous cells of undetermined significance or higher) was significantly higher in WLWH (37.2% vs 15.9%) and high-grade squamous intraepithelial lesion or above (23.5% vs 5.2%). The WLWH also tested positive more often for any HPV type (44.3% vs 19.6%; p < .0001) The specificity for cervical intraepithelial neoplasia 2+ at 91.2% of a combination of HPV types, 16/18/45 (very high risk) and 31/33/58/52 (moderate risk), performed better than cytology or any HPV-positive result to predict cervical intraepithelial neoplasia 3+ on histology. The additional genotype information supports direct referral to treatment or colposcopy in a larger proportion of the screen-positive population. The potential contribution of extended genotyping is demonstrated. The ideal choice of sensitivity and specificity ultimately depends on the health budget. More information will allow a screening algorithm, guiding management according to risk.

Prevalence of coinfections in a cross-sectional cohort of women screened for multiple pathogens in Peru

ObjectiveTo determine the prevalence and risk factors of sexually transmitted infections (STIs) including Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium among asymptomatic women with human papillomavirus (HPV) infection. MethodsA cross-sectional study was performed in 842 asymptomatic women from Cajamarca, Peru. The pathogens were detected using polymerase chain reaction (PCR) and the results were analyzed according to the HPV status: high-risk HPV, low-risk HPV and negative for HPV. Demographical and gyneco-obstetric data was analyzed to identify risk factors. ResultsWe found that 23.99% (202/842) women were positive for HPV, of whom 79.21% (160/202) were infected with a high-risk genotype. Co-infections were evaluated and 14.38% (23/160) were positive for Ureaplasma urealyticum, 9.38% (15/160) for Chlamydia trachomatis and 1.25% (2/160) for Mycoplasma genitalium. We found a significant association between HPV genotype and the number of children, partners, and history of sexual abuse. The co-infection between high-risk HPV and Chlamydia trachomatis was associated with number of abortions, number of sexual partners and no use of condom. Finally, co-infection between high-risk HPV and Ureaplasma urealyticum was associated with no use of condom and history of STIs. ConclusionHPV infection continues to be a highly relevant problem in Peru, particularly due to the high prevalence of high-risk genotypes. In addition, we report high rates of co-infections with other STIs, such as U. urealyticum and C. trachomatis. We highlight the importance of active surveillance to promptly diagnose these infections, since they may lead to persistent HPV infections.

Coinfection rates of avian blood parasites increase with latitude in parapatric host species.

Animals are frequently coinfected with multiple parasites concurrently, and advances in our sampling of these complex intra-host parasite communities have revealed important ecological impacts on their hosts. However, the spatial distributions and environmental determinants of parasite coinfection remain infrequently studied. Here, we investigated the drivers of haemosporidian blood parasite coinfection in the Bicknell's thrush (Catharus bicknelli) and grey-cheeked thrush (Catharus minimus), parapatric sister species that occur across a broad latitudinal range in northern North America. Using 298 samples from across the distributions of these species, we found high overall infection (86%) and coinfection (41%) rates within host populations. Coinfection rates within populations were highly variable across sampling sites, ranging from 7 to 75%. Latitude was a more important predictor of coinfection frequency than host species identity, with coinfections becoming more abundant at higher latitudes. The 2 host species exhibited similar parasite faunas, and an analysis of the co-occurrence patterns among haemosporidians showed that host species identity was largely not a factor in structuring which parasites were found within coinfections. To our knowledge, this is the first study to illustrate a reverse latitudinal gradient in coinfection frequency in a eukaryotic parasite system. Further work is necessary to determine whether vector ecology or some other factor is the primary proximate driver of this pattern.

Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil.

By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p<0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p<0.0001) and using PrEP (31.6% vs. 10.1%; p<0.0001). HIV (53.2% vs. 20.2%; p<0.0001), HCV (9.8% vs. 1.1%; p=0.0046), syphilis (21.2% vs. 16.3%; p=0.43) and other STIs (33.0% vs. 21.6%; p=0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p<0.0001) and anal lesions (33.1% vs. 11.5%; p<0.0001), proctitis (37.1% vs. 13.3%; p<0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p=0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p=0.011), anal lesions (45.7% vs. 20.5%; p<0.001) and clinical features of proctitis (45.2% vs. 29.3%; p=0.058). Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

PS-C16-11: PREVALENCE AND HOSPITAL OUTCOME OF BACTERIAL CO-INFECTION IN RESPIRATORY TRACT SPECIMEN AMONG COVID 19 PATIENTS WITH SARS-COV-2 PNEUMONIA

Introduction: COVID-19, a zoonotic disease caused by the novel coronavirus SARS-CoV-2, is a highly transmittable pathogenic viral infection, infecting millions of people globally. Guidelines recommendthe use of empiric antimicrobials based on clinical judgment, patient host factors and local epidemiology in patients suspected or confirmed severe COVID-19. However, current evidence does not support a high rate of bacterial respiratory co-infections in patients with SARS-COV-2 infection. At present, there is no known study regarding the prevalence of bacterial co-infection in COVID-19 patients in the Philippines Methods: This research is a cross-sectional hospital-based study that utilized hospital electronic and printed medical records, chest radiograph and microbiologic results. All respiratory specimen bacteriologic results for the year 2020 and 2021 were collected from the hospital laboratory unit followed by review of the hospital electronic records, printed medical records and chest radiograph results. Data were analyzed using Two-tailed Z-test for significance test for proportions and Chi-square test. Results: Among 100 subjects, only 22% (n = 22) of the subjects were found to have bacterial isolates. the only demographic that is dependent with presence of bacterial infection is gender. The three most common bacterial isolate among COVID confirmed patients are Klebsiella pneumoniae (n = 9), Pseudomonas aeruginosa (n = 5), and Acinetobacter baumannii (n = 3). Although the most common bacterial isolate is Klebsiella pneumoniae, the most common bacterial co-infection in patients who died are Acinetobacter baumannii (n = 2, 29%)and Pseudomonas aeruginosa (n = 2, 29%). Conclusion: The prevalence of bacterial co-infection among COVID confirmed patients is relatively low, hence appropriate guidelines regarding antibiotic use should be formed taking into consideration local data on antimicrobial resistance.

Association of HPV and sexually transmitted infections among patients with genital warts and asymptomatic individuals: a cross-sectional study

STIs can impact HPV infection and persistence, potentially predisposing HPV-related cervical cancer development. This study examines HPV genotype prevalence and co-occurrence with other STIs to inform targeted prevention and treatment strategies for reducing cervical cancer incidence. 129 female patients aged 18–57 were enrolled based on the presence of anogenital warts, individuals with a history of risky sexual behaviors, having a partner with HPV infection, or voluntarily seeking HPV screening. Patients with a history of any STIs, prior HPV vaccination, systemic illnesses, or undergoing cancer treatment were excluded. Patients were divided into two groups: Genital warts group (31.8%) and asymptomatic group (68.2%). Among patients with genital warts, HPV types 6, 11, and 61 were prevalent, whereas in asymptomatic patients, HPV types 53, 31, and 16 were more common. The STI positivity rate among HPV-positive patients was 63.9%, significantly higher than HPV-negative cases. In the genital warts group at admission, Ureaplasma Parvum (UP) was the most common STI (40.0%), followed by Uraeplasma Urealyticum (UU) (28.5%), Mycoplasma Hominis (MH) (17.2%), and Chlamidia Trachomatis (CT) (11.4%). In the asymptomatic group, UP was also the most common STI (41.2%), followed by UU (17.6%), MH (15.8%), CT (9.7%), TV (6.2%), MG (5.3%), HSV-2 (2.6%), TP (0.8%), and NG (0.8%). The prevalence of UP was significantly higher (53.7%) in the HPV-positive group, suggesting a 6.96-fold greater risk of UP infection in individuals with HPV. This study demonstrates a high co-infection rate between HPV and UP, emphasizing the importance of genital infection screening for high-risk HPV-positive women. Further longitudinal research is needed to investigate the role of STIs as contributing factors in HPV-related cervical cancer development.

Assessment of Risk Factors and Clinical Outcomes in Hospitalized COVID-19 Patients with Candida spp. Co-infections: Species Distribution and Antifungal Susceptibility Patterns of Isolates.

Fungal co-infections are considered an important complication in hospitalized patients with SARS-CoV-2 that can be attributed to disease aggravation, increased mortality, and poor outcomes. This study was conducted to determine the species distribution and antifungal susceptibility patterns of Candida isolates from hospitalized COVID-19 patients in Shiraz, Iran, in addition to associated risk factors and outcomes of co-infections with Candida species. In this single-center study, a total of 106 hospitalized COVID-19 patients were evaluated for clinical characteristics and outcomes. Species identification was performed by ITS1-5.8S-ITS2 gene sequencing. Antifungal susceptibility testing to fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, amphotericin B, and nystatin was determined according to the M27-A3/S4 CLSI protocol. Candida species were recovered from 48% (51/106) of hospitalized COVID-19 patients. Statistical analysis showed that patients who had heart failure, bacterial co-infection, and were receiving empirical antifungal therapy had a higher risk of developing Candida co-infection. In total, 71 Candida isolates were recovered, of which C. albicans (69%) was the most prevalent isolate. The majority of the Candida isolates were susceptible to all classes of tested antifungal drugs. Our results elucidate a high rate of Candida co-infections among hospitalized COVID-19 patients. Comorbidities such as heart failure, HTN, COPD, bacterial infections as well as therapeutic interventions including catheterization, mechanical ventilation, and ICU admission increased the risk of Candida spp. isolation from the bloodstream, respiratory tract and urine samples, which led to a higher in-hospital mortality rate. Additionally, obtained data clarified that empirical antifungal therapy was not as successful as anticipated.

Detection of FeChPV in a cat shelter outbreak of upper respiratory tract disease in China.

Feline parvovirus often causes a fatal infectious disease and has a serious impact on domestic cats and wild felines. Feline chaphamaparvovirus (FeChPV) is a novel type of feline parvovirus that has been successively identified in Canada, Italy, and Turkey. The prevalence and pathogenicity of FeChPV in other regions is still unknown. In this study, we recorded the detection of FeChPV in a cat shelter in China. A high prevalence (81.08%, 30/37) of FeChPV was detected in cats with symptoms of upper respiratory tract disease (URTD) in this cat shelter. Multiple pathogen testing indicated high coinfection rates of 80% (24/30) with other common viruses in FeChPV-positive cats. Analyses of the necropsy and histopathological findings revealed severe lymphadenitis, encephalitis, and viral DNA in several tissues (including brain) of the deceased cat. Finally, we obtained nearly full-length genomes of four strains with 98.4%~98.6% homology with previously reported genomes. Notably, VP1 proteins showed seven unique amino acid mutations, while NS1 proteins carried eight mutations. In the evolutionary tree based on VP1 and NS1, the sequences clustered in a large branch with Italian and Canadian FeChPV strains. Given the possible association of FeChPV with URTD, further studies are necessary to evaluate the pathogenicity and epidemiological characteristics of this novel feline pathogen.

Malaria And Typhoid Co – Infection Among Patients Attending Some Selected Healthcare Facilities In Kawo Metropolis, Kaduna State, Nigeria

Malaria and typhoid fever are two leading infections of poverty with serious health and socioeconomic impacts, and due to their geographical overlap, co-infections are very common. Their mimicking symptomatology often present with gross misdiagnosis and mistreatment. This study was carried out to determine the incidence of malaria and typhoid co-infections among adult population attending some selected healthcare facilities in Kawo Metropolis, Kaduna, Kaduna State. A cross-sectional study was conducted on Two hundred and seventy six (276) patients. Venous blood samples were collected for Widal and Malaria tests, respectively. The Widal agglutination test was performed by the rapid slide titration method using commercial antigen suspension while the Malaria diagnosis was carried out using antigen based- Rapid Diagnostic Test (RDT). Out of the 276 blood samples analyzed, 184 (66.67%) were positive for malaria, 143 (51.81%) were positive for Salmonella typhi, while 132 (47.83%) were positive for both typhoid and malaria co – infection. However, the prevalence of malaria parasite was statistically significant in relation to sex (p&lt;0.05), as males had 75 (40.76%) prevalence and females, 109 (59.24%). The highest prevalence of typhoid fever was recorded in males 87 (60.84%) while females had the lowest prevalence of typhoid fever 56 (39.16%). Both malaria and typhoid were prevalent among the studied population with high rate of co-infection. Co-infection was higher in females than males and use of herbal medicine for treatment was common. Efforts should be made to improve on the living conditions of the people of Kawo and also, there should be public enlightenment on the preventive and control measures of the two diseases. Since both diseases have similar symptomatology, treatment should be based on adequate laboratory diagnosis. Also, personal hygiene is hereby encouraged among the populace.

Severe pneumonia caused by human adenovirus type 55 in children.

BackgroundEmerging human adenovirus type 55 (HAdV-55) causes fatal pneumonia in adults. There is a lack of studies on severe pneumonia caused by HAdV-55 in children.MethodsWe conducted a retrospective review of pediatric patients hospitalized at Guangzhou Women and Children’s Medical Center with severe pneumonia from 2013 to 2020 who had human adenovirus (HAdV) detected in throat samples or bronchoalveolar lavage fluid using RT-PCR. The presence of HAdV-55 was determined by PCR amplification of the hypervariable regions of the hexon gene. Demographic, clinical, etiological, and outcome data were collected and analyzed.ResultsOver the eight-year period, HAdV-55 was detected in three severe and six critical pediatric pneumonia patients. None of the patients had any underlying diseases, and had a median age of 18 months (range, 6–108 months). The male to female ratio was 2:1. All patients presented with fever and cough, and three patients presented with wheezing and diarrhea. Six patients had coinfections with other respiratory pathogens, such as bacteria, Mycoplasma pneumoniae and fungi. Three critical patients developed plastic bronchitis (PB). The median lengths of invasive mechanical ventilation and hospital stay of the critical patients were 10 (8, 28.75) days and 25 (13, 32.25) days, respectively. Three critical patients died, although two of them received extracorporeal membrane oxygenation (ECMO) and blood purification. Three surviving patients developed post-infectious bronchiolitis obliterans (PIBO) at the follow-up.ConclusionsHAdV-55 can cause fatal pneumonia in children, and shows a high rate of co-infection with other respiratory pathogens and a poorer prognosis combined with PB. Thus, HAdV-55 may be an important subtype in patients with HAdV-induced pneumonia who develop PIBO.

Bloodstream and respiratory coinfections in patients with COVID-19 on ECMO.

BackgroundAlthough several studies have characterized the risk of coinfection in COVID pneumonia, the risk of the bloodstream and respiratory coinfection in patients with COVID‐19 pneumonia on extracorporeal membrane oxygenation (ECMO) supports severe acute respiratory distress syndrome (ARDS) is poorly understood.MethodsThis is a retrospective analysis of patients with COVID‐19 ARDS on ECMO at a single center between January 2020 and December 2021. Patient characteristics and clinical outcomes were compared.ResultsOf 44 patients placed on ECMO support for COVID‐19 ARDS, 30 (68.2%) patients developed a coinfection, and 14 (31.8%) patients did not. Most patients underwent venovenous ECMO (98%; 43/44) cannulation in the right internal jugular vein (98%; 43/44). Patients with coinfection had a longer duration of ECMO (34 [interquartile range, IQR: 19.5, 65] vs. 15.5 [IQR 11, 27.3] days; p = .02), intensive care unit (ICU; 44 [IQR: 27,75.5] vs 31 [IQR 20–39.5] days; p = .03), and hospital (56.5 [IQR 27,75.5] vs 37.5 [IQR: 20.5–43.3]; p = .02) length of stay. When stratified by the presence of a coinfection, there was no difference in hospital mortality (37% vs. 29%; p = .46) or Kaplan–Meier survival (logrank p = .82). Time from ECMO to first positive blood and respiratory culture were 12 [IQR: 3, 28] and 10 [IQR: 1, 15] days, respectively. Freedom from any coinfection was 50 (95% confidence interval: 37.2–67.2)% at 15 days from ECMO initiation.ConclusionsThere is a high rate of co‐infections in patients placed on ECMO for COVID‐19 ARDS. Although patients with coinfections had a longer duration of extracorporeal life support, and longer length of stays in the ICU and hospital, survival was not inferior.