Outcome Of Infection Research Articles

Incidence and Outcomes of Nontuberculous Mycobacterium Infections in Patients Undergoing Peritoneal Dialysis

Incidence and Outcomes of Nontuberculous Mycobacterium Infections in Patients Undergoing Peritoneal Dialysis

Pre- and Post-transplant BK Virus-Specific Enzyme-Linked Immunospot (ELISPot) Assay for Predicting the Outcome of BK Virus Infection in Kidney Transplant Recipients

Pre- and Post-transplant BK Virus-Specific Enzyme-Linked Immunospot (ELISPot) Assay for Predicting the Outcome of BK Virus Infection in Kidney Transplant Recipients

Hyperfunctional T cell responses unchecked by regulatory T cells are unable to resolve hepaciviral infection without humoral contribution

Background & AimsThe most recent T cell-based vaccine against hepatitis C virus (HCV) in human subjects failed to swing the pendulum from chronicity to resolution despite eliciting cellular responses in the majority of individuals. These results naturally evoke the question of whether hyperactivated responses of a single adaptive immune arm are capable of inducing HCV clearance or if coordinated efforts between antibodies and T cells are indeed necessary. Here, we sought to address this point in determining whether the suppression of antiviral T cell and IgG responses by regulatory T cells (Tregs) is a critical prerequisite of delayed viral clearance or overt chronicity. MethodsUsing a surrogate model of HCV infection, rodent hepacivirus (RHV) infection in mice, we utilized Foxp3-DTR mice to assess how Tregs modulate the generation of acute antiviral adaptive immune responses and indirectly dictate infection fate via intracellular flow cytometry staining, ELISA, RNA sequencing, and qPCR. ResultsTransient depletion of Tregs prior to infection decreased viral-specific CD4+ T cell function, IgG production, and delayed viral clearance. In contrast, transient Treg depletion after infection increased both T cell functionality and IgG production, thereby facilitating accelerated viral clearance. Hyperactivated T cells, achieved via transient Treg depletion, were unable to clear the virus as an isolated effector arm without the help of viral-specific IgG production. ConclusionsTregs control the outcome of RHV infection via direct modulation of CD4+ T cells and IgG production. Hyperactivated T cell responses are incapable of compensating for experimentally induced lack of antibodies, further reinforcing the notion of cooperative interplay between adaptive immune arms in facilitating hepaciviral clearance. Impact and implicationsWe demonstrate herein how timing of Treg depletion determines the fate of effector T cells, humoral responses, and the kinetics of viral clearance. Our observations provide direct evidence that functional T cell responses are incapable of compensating for suboptimal humoral responses in facilitating viral resolution. Our results imply that future HCV vaccine regimens should not solely rely on eliciting focused responses of a single effector arm, but rather incorporate immunogens capable of inducing durable features of both humoral and cellular memory.

Prescribing Pattern and Treatment Outcomes in Upper Respiratory Tract Infection: A Comparative Study of Allopathic and Unani Medicine

Background and objectiveUpper respiratory tract infections (URTIs) rank among the top three diagnoses in outpatient settings. URTIs patients currently have access to treatment choices encompassing traditional and allopathic medications. The study aimed to elucidate the prevailing treatment practices in Unani and allopathic systems for URTIs, while concurrently assessing their efficacy in alleviating its symptoms. Materials and methodsA cross-sectional study was conducted at NIUM Hospital and a primary health centre in Bengaluru between June to December 2022. 200 eligible patients (100 per facility) were selected through purposive sampling. Prescriptions were analysed using established WHO and customized Unani indicators. Treatment efficacy was assessed using the WURSS-21 and Jackson scales. Information from the patients was gathered through interviews after obtaining written informed consent. ResultsThe average number of drugs per prescription was 2.68 in allopathy and 3.87 in Unani medicine. Antihistamines and antibiotics were the most prescribed drugs in allopathy, with cetirizine and amoxicillin dominating the list. In Unani Medicine, Arq Ajeeb and Nuqoo-e-Nazla were commonly prescribed. Only 10.8% of prescribed drugs in allopathy were from WHO list of essential medicines. Statistically significant improvement (p<0.001) in URTIs symptoms was observed with both Unani and allopathic treatments. ConclusionThe findings indicates that average number of drugs per prescription in both facilities were above the recommendations. In allopathy, overprescribing of antibiotics and antihistamines, and deviation from EDL, was observed, while polypharmacy was noted in Unani prescriptions. Findings indicate that both Unani and allopathic treatments are effective in alleviating the URTIs symptoms, as reported by patients.

Oral Cavity Microbiome Impact on Respiratory Infections Among Children.

The respiratory system, traditionally considered antiseptic, harbors a diverse and dynamic bacterial microbiome. Recent advancements in microbiome research have revealed its significant influence on both innate and adaptive immunity, particularly in the context of respiratory infections in children. This article also provides an overview of the types of bacteria that commonly affect the respiratory system, including Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. These bacteria are prevalent in pediatric populations and significantly contribute to the development and severity of respiratory tract infections (RTIs). This review aims to evaluate the impact of the oral cavity and upper respiratory microbiome on the susceptibility and severity of respiratory infections in pediatric populations. We specifically focus on how early colonization patterns of bacteria such as Moraxella and Streptococcus contribute to the development of respiratory tract infections in children from birth through adolescence. A thorough literature review was performed, focusing on studies publishing between 2004 and 2023. The review included research exploring the role of the upper respiratory microbiome in pediatric populations, with a specific focus on children aged birth to 18 years. Emphasis was placed on microbial characterization, the modulation of immune responses in respiratory tract infections, and the potential therapeutic applications of microbiome-targeted interventions. The findings suggest that the composition and disruption of the upper respiratory microbiome significantly influence clinical outcomes in children with respiratory infections. Notably, dysbiosis in the microbiome has been linked to increased susceptibility to repeated infections, highlighting the importance of maintaining microbial balance for optimal respiratory health. Understanding the impact of oral cavity and upper respiratory microbiome could lead to improved management and prevention strategies for respiratory infections in children. This review underscores the potential of microbiome modulation, including the use of probiotics as a therapeutic approach to enhance clinical outcomes in pediatric respiratory infections.

Risks and outcomes among coronavirus disease 2019 patients admitted to Assiut University Hospital

Introduction The clinical characteristics present with coronavirus disease 2019 (COVID-19) encompasses asymptomatic to severe disease and mortality. Clinicians need to detect patients whose risk of illness progression and unfavorable outcomes is high. Aim To evaluate potential risk factors affecting the severity and outcome of coronavirus infection in patients admitted to Assiut University. Patients and methods From October 2021 to October 2022, Assiut University Hospital served as the site of this observational analytical cross-sectional single-centered study. A full medical history, examination, radiographic, and laboratory investigations were performed on patients. Results The primary risk variables for mortality of COVID-19 patients include a greater mean age (73.61 ± 10.51) (P value&lt;0.001). Individuals with chronic kidney disease (P value=0.005), and liver cirrhosis (P value&lt;0.001). Those unvaccinated against COVID-19 the (P value = 0.004). Laboratory findings can be used as a predictor of infection severity as higher median white blood cell count (P value=0.044), lower median lymphocytic count (P value=0.028), higher serum ferritin (P value=0.02). Radiologically, a significant higher mean computed tomography severity score percentage is noticed among died patients (16.61 ± 4.55%) (P value&lt;0.001). Conclusion Advanced age, patients with renal or hepatic impairment, patients with lower lymphocytic counts or with higher computed tomography severity score are linked to a worse clinical course and outcome among COVID-19 patients who were admitted to Assiut University Hospital. Trial registration ClinicalTrials.gov. NCT04860232.

CARD8 polymorphisms among bacterial meningitis patients in North-West Ethiopia

BackgroundThe severity of infectious disease outcomes is dependent on the virulence factors of the pathogen and the host immune response. CARD8 is a major regulator of the innate immune proinflammatory response and has been suggested to modulate the host response to common inflammatory diseases. In the present study, the C10X genetic polymorphism in the CARD8 gene was investigated in relation to bacterial meningitis.MethodsA total of 400 clinically suspected meningitis patients hospitalized at the University of Gondar Hospital were enrolled in the study. Cerebrospinal fluid (CSF) and blood samples were collected for laboratory investigations. The collected CSF was cultured, and all the results obtained from the culture were confirmed using direct RT‒PCR. Genotyping of whole-blood samples was performed using a TaqMan assay. The results were compared with apparently healthy controls and with PCR-negative meningitis suspected patients.ResultsOf the included patients, 57% were men and the most common clinical signs and symptoms were fever (81%), headache (80%), neck stiffness (76%), nausea (68%), and vomiting (67%). Microbiology culture identified 7 patients with bacterial meningitis caused by Neisseria meningitidis (n = 4) and Streptococcus pneumoniae (n = 3). The RT-PCR revealed 39 positive samples for N. meningitidis (n = 10) and S. pneumoniae (n = 29). A total of 332 whole-blood samples were genotyped with the following results: 151 (45.5%) C10X heterozygotes, 59 (17.7%) C10X homozygotes and 122 (36.7%) wild genotypes. The polymorphic gene carriers among laboratory confirmed, clinically diagnosed meningitis and healthy controls were 23(46%), 246(40%), and 1526(39%), respectively with OR = 1.27 (0.7–2.3) and OR = 1.34 (0.76–2.4). The presence of the C10X polymorphism in the CARD8 gene was more prevalent in suspected meningitis patients than in healthy controls (OR 1.2; 1.00-1.5). Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease. The presence of viable or active bacterial infection was found to be associated with the presence of heterozygous C10X carriers.ConclusionsA greater proportion of C10X in the CARD8 gene in confirmed bacterial meningitis patients and clinically diagnosed meningitis patients than in healthy controls. Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease than heterozygote gene carriers and healthy controls.

Associations between infectious diseases and clinical outcomes among children aged 6-59 months admitted for severe acute malnutrition: The SAMAC study

Associations between infectious diseases and clinical outcomes among children aged 6-59 months admitted for severe acute malnutrition: The SAMAC study

Association between helicobacter pylori infection and post operative outcomes after bariatric surgery

Association between helicobacter pylori infection and post operative outcomes after bariatric surgery

Risk of infections among persons treated with opioids for chronic pain: a systematic review and meta-analysis protocol

IntroductionMillions of persons with chronic pain across North America and Europe use opioids. While the immunosuppressive properties of opioids are associated with risks of infections, these outcomes could be mitigated...

Role of interleukin 6 polymorphism and inflammatory markers in outcome of pediatric Covid- 19 patients

BackgroundIL-6 polymorphisms were associated to viral infection outcomes through affection of IL-6 production and it is an early indicator of tissue injury and systemic inflammatory response. The study aimed to determine whether genetic IL-6 polymorphisms, serum interleukin-6 level and inflammatory markers (Presepsin, CXCL-10, C3, and C4) are associated with the prediction of disease severity in pediatric COVID-19 patients and its possible use as a prognostic tool in pediatric patients admitted to hospital.MethodsThis prospective cohort study was conducted on 150 children with COVID-19. Patients were divided according to the severity of infection into four groups: group I (mild) 67 cases; group II (moderate) 53 cases, group III (severe) 17 cases and group IV (critical) 14 cases. Serum Interleukin 6, CXCL-10, Presepsin, renal and liver functions, electrolytes, C3, C4, ferritin, and D dimer serum levels were assessed in all patients. The Kruskal Wallis test used to compare parametric quantitative data between studied groups and Mann Whitney test for each pair of groups. Non-parametric quantitative data was compared between studied groups using a one-way ANOVA test and post-hoc Bonferroni analysis for each pair of groups.ResultsGroup I: 35 males and 32 females with a median age of 16 months. Group II: 17 males and 35 females with a median age of 13 months. Group III: 6 males and 11 females with a median age of 12 months and group IV: 3 males and 11 females with a median age of 12 months. There was no statistical difference between the studied groups regarding gender and age. Serum levels of IL- 6, serum ferritin; D-dimer, Presepsin and CXCL 10 were significantly higher in both severe and critical groups than the other 2 groups (mild and moderate). ROC curve analysis showed that interleukin-6 and Presepsin were good markers for prediction of severity of COVID-19 among the diseased children. For severe cases, the sensitivity of interleukin-6 was 76.47% and specificity was 92.31%. For critical cases, the sensitivity of interleukin-6 was 71.43% and specificity was 82.35%. The sensitivity of Presepsin was 76.47% and specificity was 88.46% in severe cases. For critical cases, the sensitivity of Presepsin was 78.57% and specificity of 91.2%. There was significant difference in IL-6 572 allelic among moderate cases with the most frequent 42.3% for genotype (GC) and allelic among severe cases with the most frequent 47.1% for genotype (GC). Significant difference in IL-6 174 allelic among critical cases with the most frequent 78.6% for genotype (CC).ConclusionsChildren whom expressed GC genotypes of IL6 (-572G > C) polymorphism are at a considerably higher risk of developing a severe disease. This risk is significantly larger in the severe group of children than in children in critical condition who have GC genotypes of IL6 (-174 G > C) polymorphism. While IL6 (-597G > A) polymorphism has no role in COVID 19 severity in children.

Spine surgical site infection outcome with preoperative application of a presaturated 10% povidone-iodine nasal decolonization product in a 32-bed surgical hospital

Spine surgical site infection outcome with preoperative application of a presaturated 10% povidone-iodine nasal decolonization product in a 32-bed surgical hospital

Different classes of crystal methamphetamine use are associated with psychological and sexually transmitted infection outcomes among gay, bisexual, and other men who have sex with men

Different classes of crystal methamphetamine use are associated with psychological and sexually transmitted infection outcomes among gay, bisexual, and other men who have sex with men

Predictors of interferon-gamma release assay results and their association with COVID-19 infection outcomes.

An 'indeterminate' interferon-gamma release assay (IGRA) result used in the diagnosis of latent TB infection (LTBI) is most commonly due to an inadequate control (or 'mitogen') response, which may reflect underlying T-cell dysfunction. We performed a single-centre, retrospective study on COVID-19 patients admitted to a tertiary referral hospital who had IGRA testing conducted over a 5-month period. The primary outcomes included predictors of indeterminate IGRA results and associations with COVID-19 outcomes. A total of 181 patients were included for analysis. Approximately one-third of patients hospitalised with COVID-19 with IGRA testing performed (60/181) had an indeterminate result. The likelihood of an indeterminate IGRA was increased in patients with a history of solid organ transplant and a higher severity of COVID-19 at the time of testing. An indeterminate IGRA was associated with a higher risk of severe COVID-19 and a higher risk of admission to the ICU during admission to the hospital. No difference in mortality between the two subgroups was found. Our study demonstrated that COVID-19 patients on immunosuppression had a high likelihood of an indeterminate IGRA result, which was associated with markers of disease severity and immunosuppression. In this cohort, an indeterminate result was associated with worse COVID-19 outcomes.

Association of Intravenous vs. Oral Iron Therapy with Risk of Infectious Outcomes in Patients with CKD

Association of Intravenous vs. Oral Iron Therapy with Risk of Infectious Outcomes in Patients with CKD

Asymptomatic Group B Streptococcal infection, Antibiotic Sensitivity, Risk Factors and Pregnancy Outcome among Pregnant Women at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Background Streptococcus agalactiae or group B streptococcus (GBS), although a normal commensal, it is a leading cause of both maternal and neonatal sepsis. Objectives The study assessed the prevalence and sensitivity pattern of Group B Streptococcus, as well as the risk factors for infection and pregnancy outcome among pregnant women at the department of Obstetrics and Gynaecology of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Methods A prospective study among 152 pregnant women at the antenatal care clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, selected by simple random sampling technique and relevant information was obtained using semi structured interviewer questionnaire. Swab samples were collected from the vagina and rectum for culture and further evaluation. The data was managed using SPSS software version 26 and the variables were analysed using descriptive and inferential statistics, and P- value &lt; 0.05 was considered statistically significant. Result The prevalence of Group B Streptococcal infection among respondents was 4.6%. The mean age was 26.97± 5.6 with a range of 16 to 39 years. The organism was 100 % sensitive to Levofloxacin, Gentamycin and Clindamycin, but 57.1 %, 28.6 % and 14.3 % sensitive to Erythromycin, Augmentin and Penicillin respectively. The spousal educational status was statistically associated with GBS infection at a P- Value 0.04. There was 1(0.7%) each of spontaneous miscarriage and a preterm birth at 36 weeks’ gestation. Conclusion Group B Streptococcal infection is relatively common in our environment, with a contrary susceptibility pattern. It is association with spousal educational status.

Evaluation of prevalence, predisposing factors, inter-species differences in clinical profile and outcome of Campylobacter blood-stream infections: A 7-year experience from north India

Purpose: A comprehensive study evaluating prevalence, risk factors and outcome of Campylobacter bloodstream infection (CBSI) in Indian population is lacking. Methods: A retrospective analysis of blood culture specimens positive for Campylobacter species over a 7-year period (September 2013 to August 2020) was conducted. Campylobacter species were identified using MALDI-TOF MS and patients’ details were retrieved from hospital records. Results: 39 episodes from 38 patients were reported (0.15% of all BSI), with one case of recurrence. The median age was 10 years. 54.5% patients presented with gastrointestinal symptoms. Steroid-dependent nephrotic syndrome predisposed paediatric patients (27.3%) and liver cirrhosis predisposed adult patients (81.8%) to CBSI. Conclusion: C. jejuni was the most prevalent species (59%) followed by C. coli (25.6%) and C. fetus (15.4%). C. fetus infection was seen in immunocompetent patients (p=0.01) and was associated with longer hospital stay (p=0.01). Overall outcome of CBSI was good.

Profile of women with retained placenta at a tertiary care hospital

Abstract The placenta is said to be retained when it is not expelled from the uterus even 30 min after the delivery of the baby. The occurrence of retained placenta following vaginal birth is estimated to be 1%–3% of deliveries. It can lead to severe bleeding, infection, and other adverse outcomes, making it a significant concern in obstetric care. Hence, the present study was carried out to study the profile of women with retained placenta. This was a descriptive study among 97 women with retained placenta. The incidence of retained placenta was 97 (1.8%). The most common characteristic feature was postdated pregnancy in 29.8%. Eighty women responded to medical management alone, whereas 17 women required manual removal. The most common complication was postpartum hemorrhage in 33.3%. We conclude that a retained placenta can be a source of significant hemorrhagic and surgical morbidity to the mother. In considering ways to lessen morbidity, the clinician should have a knowledge of the clinical profile of retained placenta.

Serological study of Crimean – Congo haemorrhagic fever in Sheep in Thi – Qar province

Crimean Congo hemorrhagic fever virus (CCHFV) causes a lethal tick – borne zoonotic disease with severe clinical manifestation in humans but does not produce symptomatic disease in wild or domestic animals. It is endemic in a large region of the word. One of the main indicators that the disease is endemic in a region is the presence of antibodies specific to CCHFV in animal populations. The factors contributing to differential outcomes of infection between species are not understood. Serological studies have shown sheep are important to the survival of CCHFV in nature. Nevertheless, need for more studies on this subject in Iraq. Blood samples were taken from 200 sheep of different sex, variable age and physiological status. Only 100 samples used for physiological testes while 186 used for Microbiological test (ELISA) test. The present study was appeared a high level about (144)78.53% of positive carrier sheep while negative samples (42)21.46% in Thi – Qar province which include different regions such as Al-eakihah , Al- rifai and Al- garma region which recorded about 92.85% , 90% and 90 % respectively comparative with another region of thi qar province that appear low level of infected such as Al-fadhliya , Al-tar and Al- manar which recorded about 75%, 50% and 60.71% respectively. The current study focused on and attempted to connect the different physiological states, sex and age with infected animals. The male sex appears ahigh level of infected about 83.92% comparative with female was appeared low level of infected by CCHF virus about 74.61%, while recorded high infected in non – pregnant about 75% comparative with pregnant about 73,80 . Also, the present study was showed ahigh level of infected in age from 5 to nine years about 82.4% comparative with another age ranges which appeared about 71.11, 78.50 %.

Antimicrobial Sub-MIC induces Staphylococcus aureus biofilm formation without affecting the bacterial count

BackgroundBiofilm formation is an essential virulence factor that creates a highly protected growth mode for Staphylococcus aureus (S. aureus) to survive in any hostile environment. Antibiotic sub-minimal inhibitory concentration (sub-MIC) may modulate the biofilm formation ability of bacterial pathogens, thereby affecting bacterial pathogenesis and infection outcomes. Intense antimicrobial therapy to treat biofilm-associated infections can control the pathogenic infection aggravation but cannot guarantee its complete eradication.ObjectiveThis study aimed to assess the sub-MICs effect of 5 different antimicrobial classes on biofilm-forming capacity among Staphylococcus aureus clinical isolates using three different biofilm quantitation techniques.MethodsIn this study, the effects of 5 different antimicrobial agents, namely, azithromycin, gentamicin, ciprofloxacin, doxycycline, and imipenem, at sub-MICs of 12.5%, 25%, and 50% were tested on 5 different clinical isolates of S. aureus. The biofilms formed in the absence and presence of different antimicrobial sub-MICs were then assessed using the following three different techniques: the crystal violet (CV) staining method, the quantitative PCR (qPCR) method, and the spread plate method (SPM).ResultsBiofilm formation was significantly induced in 64% of the tested conditions using the CV technique. On the other hand, the qPCR quantifying the total bacterial count and the SPM quantifying the viable bacterial count showed significant induction only in 24% and 17.3%, respectively (Fig. 1). The difference between CV and the other techniques indicates an increase in biofilm biomass without an increase in bacterial growth. As expected, sub-MICs did not reduce the viable cell count, as shown by the SPM. The CV staining method revealed that sub-MICs of imipenem and ciprofloxacin had the highest significance rate (80%) showing an inductive effect on the biofilm development. On the other hand, doxycycline, azithromycin, and gentamicin displayed lower significance rates of 73%, 53%, and 47%, respectively.ConclusionExposure to sub-MIC doses of antimicrobial agents induces the biofilm-forming capacity of S. aureus via increasing the total biomass without significantly affecting the bacterial growth of viable count.