Prevention Of Severe Infection Research Articles

Positive impact of sulfamethoxazole-trimethoprim prophylaxis on prevention of severe infections in a patient with glycogen storage disease type Ib

ObjectiveGlycogen storage disease type Ib (GSD-Ib) is a very rare disease complicated by neutropenia with consequent recurrent bacterial infections. Treatment with Filgrastim is not always effective.The low CD4 count observed in our patient is likely the underlying cause of this treatment failure. This low value was previously examined in a small-scale study. Therefore, adding sulfamethoxazole-trimethoprim (SMX-TMP) might be a good strategy.MethodsWe present the case of a male patient with GSD-Ib. He has severe neutropenia (380/mm3) with recurrent infections. Despite neutrophil improvement with Filgrastim, he developed three severe infections requiring hospitalization. Lymphocyte phenotyping showed a deficit in T CD4 + cells (280/mm3) which led us to HIV testing returning negative. Based on this finding we initiated prophylaxis with SMX-TMP.ResultsSince the start of SMX-TMP along with Filgrastim, the patient was not admitted to the hospital for any bacterial infection.ConclusionTo date, no study has examined the significance of incorporating antibiotic prophylaxis for neutropenic patients with GSD-Ib based on CD4 count, akin to the approach of adding SMX-TMP to antiretroviral therapy for HIV patients. Cotrimoxazole is empirically prescribed without assessing the CD4 count or conducting a comparative analysis of the advantages of its addition to Filgrastim. Such practices could potentially exert a significant influence on the disease’s presentation and severity.

Significance of Anti-COVID-IgA antibody response in COVID-19 breakthrough infection in vaccinated patients - a single-centered study from Pakistan.

An increasing number of breakthrough-COVID-19-vaccinated individuals are being reported across the world. Humoral immunity has a crucial role in combating infection. In this study, we aimed to assess the importance of anti-COVID-S1-IgA and anti-COVID-NP-IgA in confirmed COVID-19 after vaccination (breakthrough infection group). Blood samples were collected from the breakthrough infection group within one week of breakthrough infections (n = 34). A second sample was also collected after 4 to 8 weeks (n = 27). Blood samples of healthy individuals (n = 29) were collected 4-8 weeks after the completion of vaccination. Anti-COVID-S1-IgA and anti-COVID-NP-IgA were detected by ELISA. Statistical analysis was performed using IBM SPSS version 24. In this study, we found a higher positivity rate for anti-COVID-S1-IgA in the breakthrough infection group (70% vs. 28% in healthy individuals). Anti-COVID-NP-IgA was not found in the control group (11% in the breakthrough infection group vs. 0 in healthy individuals). In the breakthrough-infected group, the positivity rate of anti-COVID-NP-IgA decreased significantly (median titers 16.9 IU/ml decreased to 4.2 IU/ml) p = 0.001), while anti-COVID-S1-IgA increased over a period of 4-8 weeks (9.35-16.35 IU/ml). Importantly, IgA response to both COVID-19 NP and S1 antigens was not found in 13 patients at initial testing. The findings of this study show that serum IgA may have a role both in breakthrough infections and also in the prevention of severe infection. Sluggish anti-COVID-19-IgA antibody response may be responsible for the occurrence of COVID-19 infection in breakthrough infection. On the other hand, more sustained anti-COVID-19-S1-IgA over a longer period of time may have a role in preventing these patients from severe infections and hospitalization. However, a study on a larger sample size including patients with severe disease after vaccination is required to prove this hypothesis. To the best of our knowledge, this is the first study reporting the importance of serum IgA in breakthrough-infected patients from our region.

Advances in intranasal vaccine delivery: A promising non-invasive route of immunization.

The importance of vaccination has been proven particularly significant the last three years, as it is revealed to be the most efficient weapon for the prevention of several infections including SARS-COV-2. Parenteral vaccination is the most applicable method of immunization, for the prevention of systematic and respiratory infections, or central nervous system disorders, involving T and B cells to a whole-body immune response. However, the mucosal vaccines, such as nasal vaccines, can additionally activate the immune cells localized on the mucosal tissue of the upper and lower respiratory tract. This dual stimulation of the immune system, along with their needle-free administration favors the development of novel nasal vaccines to produce long-lasting immunity. In recent years, the nanoparticulate systems have been extensively involved in the formulation of nasal vaccines as polymeric, polysaccharide and lipid ones, as well as in the form of proteosomes, lipopeptides and virosomes. Advanced delivery nanosystems have been designed and evaluated as carriers or adjuvants for nasal vaccination. To this end, several nanoparticulate vaccines are undergone clinical trials as promising candidates for nasal immunization, while nasal vaccines against influenza type A and B and hepatitis B have been approved by health authorities. This comprehensive literature review aims to summarize the critical aspects of these formulations and highlight their potential for the future establishment of nasal vaccination. Both preclinical (in vitro and in vivo) and clinical studies are incorporated, summarized, and critically discussed, as well as the limitations of nasal immunization.

The association of travel distance and severity of odontogenic infections.

Odontogenic infections (OI) are a preventable disease commonly managed in a tertiary hospital setting. Prevention of severe infections and hospitalisation relies on timely access to primary dental care. This study outlines the pre-hospital treatment of patients presenting to hospital with OIs and the association between travel distance from thepatients' residence to a tertiary hospital oral and maxillofacial surgical (OMS) unit. This study analysed patients who initially presented hospital with an OI. Patient demographics, pre-hospital treatment, and clinical markers of severity were recorded. The travel distance from the patient's residence to the hospital was recorded in kilometers, along with any inter-hospital transfer via road/air ambulance. Two hundred twenty-seven patients were included in this study, 17.2% required an inter-hospital transfer. Of these patients, 70.3% had prior treatment before hospitalisation, and antibiotics without source control was the most frequent treatment (83.1%). The mean travel distance for patients with more severe markers of infection significantly greater than patients with minor infections (p = < .001). Patients who required an inter-hospital transfer accounted for most cases with airway compromise requiring ICU admission. This study found that most patients presenting to hospital with an OI had received antibiotics alone as treatment before hospitalisation. The travel distance from a tertiary hospital with OMS services had a significant correlation to more severe infections. This has important public health implications for the allocation of preventative dental services, and patient access to OMS services.

The Relationship Between Vitamin D and Infections Including COVID-19: Any Hopes?

Vitamin D is proposed to have a potential role in the pathogenicity, clinical presentation, prognosis, complications, and treatment of several diseases. In addition to its well-known role in calcium metabolism, vitamin D regulates both innate and adaptive immunity, and subsequently modulates the antiviral and antibacterial inflammatory immune responses. In view of the emerging coronavirus disease 2019 (COVID-19) pandemic, searching for potential therapeutic and protective strategies is of urgent interest, and vitamin D is one of the promising agents in this field. In this review, we present data from literature that supports the promising role of vitamin D in treatment and/or prevention of several infections including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review summarizes vitamin D metabolism and its role in inflammation, thrombosis and immune regulation. It also reviews, in short, the role of vitamin D and the impact of its deficiency in several infections namely tuberculosis, influenza, human immunodeficiency virus (HIV), and SARS-CoV-2. Considering the roles of vitamin D on immune modulation, controlling of thrombosis, and attacking several microorganisms, the current review will elaborate on the association between these salient roles of vitamin D and the pathogenicity of various infectious agents including COVID-19. Consequently, the comprehensive finding of the current review shows a possible significant impact of vitamin D supplement as a hope in preventing, treating, and/or improving the progression of certain infections, specifically during the worldwide attempts to fight against the COVID-19 pandemic and minimize the severity of health complications encountered accordingly. In addition, avoiding a status of vitamin D deficiency to obtain its positive effects on the immune system and its protective mechanism during infections will be a general benefit overall.

NEONATAL SCREENING IN UKRAINE: THE NEW CHALLENGES

Introduction. The priority of modern pediatrics and neonatology is to improve the organizational forms and methods of providing medical care to children, reducing morbidity, mortality and disability prevention. Severe Combined Immunodeficiency (SCID) is a group of primary immunodeficiency conditions with particularly severe dysfunction or absence of T and B cells, and sometimes NK lymphocytes. Late diagnosis of primary immunodeficiency, namely SCID, leads to the development of severe infectious complications, significantly complicates the further treatment and survival of patients, often leading to death from infancy. Today there are results of SCID treatment, with early diagnosis the effectiveness of therapy and survival of children is more than 90% in the world. A number of countries around the world conduct neonatal screening at the state level for early diagnosis of SCID. Modern neonatal screening in Ukraine is provided for 4 nosologies, while in other countries it covers from 8 to 60 genetic pathologies. The aim of our study is the early detection and diagnosis of severe primary immunodeficiency by neonatal screening, prevention of severe infections and complications in this group of patients, timely radical treatment, improving survival and quality of life of children with severe primary immunodeficiency. Materials and methods. For the first time in Ukraine, it is planned to conduct a pilot study of screening of newborns to detect severe primary immunodeficiencies, which will be based on the determination of T- and B-lymphopenia by TRECs and KRECs. The prevalence of T- and B-lymphopenias among 19 newborns, their importance in the diagnosis of severe combined immunodeficiencies and severe antibody disorders will be determined. Based on the results of the study, a protocol for the detection of primary immunodeficiencies by TRECs and KRECs and further tactics for infection prevention, treatment and surveillance of such children will be developed. For the first time, the clinical and economic feasibility of introducing neonatal screening for severe immunodeficiencies in Ukraine will be substantiated. Expected results. After studying the prevalence of T- and B-lymphopenia in infants, their importance in the diagnosis of SCID and severe antibody disorders will be formulated. Conclusions. Early diagnosis of primary immunodeficiency is extremely important to improve the patient's quality of life, as delayed diagnosis leads to a lack of adequate therapy and, consequently, to further serious infections that interfere with daily life, increasing the risk of various non-infectious complications. It is known that these disorders negatively affect the health of the patient, the quality of life of his family and people caring for him. In addition, existing research in the world proves that early diagnosis and bone marrow transplantation is an effective way to reduce the incidence and mortality of patients with SCID and lymphopenia

Promotive and preventive programs of heavy infection knowledge in Medan Barat district

Sepsis is still an important health problem in the world today. The incidence of sepsis can reach 750,000 cases per year. When mothers have a vital role in family health, their lack of knowledge and concern about sepsis remains an obstacle. Therefore, we need a program to promote and prevent sepsis among mothers in West Medan District as an effort to reduce the number of sepsis in Indonesia. Coaching, training, and counseling are given to PKK mothers and Posyandu cadres regarding the prevention of severe infections that can cause sepsis. This activity began by collecting basic data using the Sepsis Knowledge Scale questionnaire and then provided counseling and training on sepsis. Then, the final results were assessed with a behavioral questionnaire and sepsis knowledge questionnaire. The activity was attended by 29 people, 20 women (72.4%) and 9 men (27.6%). No significant changes were found in the level of knowledge and behavior before and after the activity (Z-score: 0.001; p = 1,000).

Prevention of severe infection with the help of nosocomial infection control in intensive care units

Prevention of severe infection with the help of nosocomial infection control in intensive care units

Emerging biopharmaceuticals from bioactive peptides derived from marine organisms.

Biologically active natural products are spontaneous medicinal entrants, which encourage synthetic access for enhancing and supporting drug discovery and development. Marine bioactive peptides are considered as a rich source of natural products that may provide long-term health, in addition to many prophylactic and curative medicinal drug treatments. The large literature concerning marine peptides has been collected, which shows high potential of nutraceutical and therapeutic efficacy encompassing wide spectra of bioactivities against a number of infection-causing agents. Their antimicrobial, antimalarial, antitumor, antiviral, and cardioprotective actions have achieved the attention of the pharmaceutical industry toward new design of drug formulations, for treatment and prevention of several infections. However, the mechanism of action of many peptide molecules has been still untapped. So in this regard, this paper reviews several peptide compounds by which they interfere with human pathogenesis. This knowledge is one of the key tools to be understood especially for the biotransformation of biomolecules into targeted medicines. The fact that different diseases have the capability to fight at different sites inside the body can lead to a new wave of increasing the chances to produce targeted medicines.

The role of probiotics in the prevention of severe infections following abdominal surgery

Administration of probiotics has been proposed for various medical and surgical conditions. Their effect has been largely attributed to their ability to maintain the integrity of the intestinal mucosal barrier as well as to modulate the innate immune response. Multiple studies have demonstrated their effect in reducing infectious complications in critically ill patients, minimising bacterial translocation and increasing the secretion of anti-inflammatory cytokines. Furthermore, they have been shown to be effective in reducing infections following colorectal surgery, while at the same time preventing overgrowth of bacterial species such as Pseudomonas aeruginosa that has been implicated in the pathogenesis of anastomotic leak. Recent experimental studies have demonstrated that probiotics may decrease expression of the SOCS3 gene, which encodes the protein SOCS3 that suppresses cytokine production, implying a direct interaction of probiotics with the innate immune system. These results hold high promises for the development of new therapeutic strategies.

Commensal Streptococcus mitis is a unique vector for oral mucosal vaccination

The development of vaccine approaches that induce mucosal and systemic immune responses is critical for the effective prevention of several infections. Here, we report on the use of the abundant human oral commensal bacterium Streptococcus mitis as a delivery vehicle for mucosal immunization. Using homologous recombination we generated a stable rS. mitis expressing a Mycobacterium tuberculosis protein (Ag85b). Oral administration of rS. mitis in gnotobiotic piglets resulted in efficient oral colonization and production of oral and systemic anti-Ag85b specific IgA and IgG antibodies. These results support that the commensal S. mitis is potentially a useful vector for mucosal vaccination.

Antibody against Haemophilus influenzae protein D in patients with chronic conditions causing secondary immunodeficiency

Prevalence of non-typeable Haemophilus influenzae (NTHi) in the etiology of invasive infections in immunocompromised individuals is increasing. Serum IgG antibody levels to H. influenzae protein D (PD) were significantly lower in adults suffering from chronic conditions causing secondary immunodeficiency (COPD, cancer, chronic renal failure, and diabetes) compared to age-matched healthy controls. A lack of naturally acquired antibody against this highly conserved antigen may contribute to an increased susceptibility to invasive NTHi disease. As COPD patients frequently infected with NTHi during disease exacerbations were unable to develop antibody response to PD, such defect could potentially contribute to the pathogenesis. Considering that pediatric PD-containing vaccines show protective effect against NTHi-caused otitis media, our data suggest the possibility of improving the defense against NTHi in COPD patients using immunization against PD. Although more research on the role of anti-PD antibody in protection against invasive NTHi disease is warranted, development of adult formulations of PD-based vaccines may be advantageous for prevention of severe infections in immunocompromised individuals.

Clinical analysis for iatrogenic injuries in the distal part of common bile duct

To investigate the early diagnosis on iatrogenic injuries in distal part of common bile duct and the prevention of severe retroperitoneal infection. From 1990 to 2004, 17 patients with bile duct injures in the distal part of common biliary tract were admitted. And the clinical data of the 17 cases were retrospectively analyzed. Of the 17 cases, the injuries of 15 cases were caused by the operation, and the injuries of the other 2 cases were caused in the process of removing the stone by endoscopic retrograde cholangiopancreatography (ERCP). The injuries of 14 cases were found during the operation, but the other one was not found in time. Before the operation, 16 cases were examined by B-type ultrasonography, 2 by MRCP and 6 by intraoperative choledocho-endoscope after the biliary tract exploration. Ten cases underwent perforating suture repair and T-tube drainage; 2 with Odd's sphincter incision and shaping; 2 with choledochojejunostomy; 1 with duodenum wall and bile duct repair and drainage. When the bile duct injured, the major findings during operation were bile duct explorer located out of the duodenum wall and bile duct, two or more than cleft in the distal part of common biliary tract found by choledocho-endoscopic examination, retroperitoneal edema and liquid accumulation found by irrigating water through T-tube, and/or retroperitoneal tissues stained blue by irrigating methylthioninium chloride through T-tube. The clinical manifestations after injuries were abdominal distention, abdominal pain, pain in the waist and back, fever and shock, et al. Thirteen cases were cured. And the syndromes included 1 case with intestinal fistula, 1 with incisional infection, 4 dead (3 died from infectious shock; 1 from bleeding in gastrectomy). The postoperative clinical manifestations for iatrogenic injuries in the distal part of common biliary tract lack specificity, CT examinations are necessary to doubtful patients. Early diagnosis and timely management can obtain better results, and can effectively lower severe retroperitoneal infection. The perfect preoperative imaging examinations and intraoperative choledocho-endoscopic examinations before the biliary tract exploration maybe reduce iatrogenic injuries in the distal part of common biliary tract.

Current approaches to the management of ovine footrot

Ovine footrot remains the most important cause of lameness in sheep flocks in the UK, despite the existence of proven methods for the control of the disease. Recent research suggests that sheep farmers may be unaware of these methods and may allocate greater resources to treatment of footrot rather than to its prevention. Foot paring, topical treatments, vaccination and parenteral antibiotic therapy all have a role in treating sheep with advanced footrot infections, but prevention of severe infections is best achieved by the timely implementation of control programmes. These are usually based on footbathing and vaccination. For control programmes to be effective it is essential that the pathogenesis and epidemiology of footrot is understood and that control methods are implemented at appropriate times in the season, depending on climatic and pasture conditions. This article reviews these strategies and makes recommendations for steps to reduce the spread of footrot between flocks and to reduce the incidence of footrot within UK flocks.

Évaluation d' une neutropénie chez l'enfant

Many circumstances lead to discover a neutropenia in paediatric practice. In most of the cases, it is an acquired, transient neutropenia, related to a viral or a bacterial infection, a malignant haemopathy, or an acquired auto-immune neutropenia, also called benign chronic neutropenia. Constitutional disorder with neutropenia is more exceptional. Many complex genetic diseases include a neutropenia, among which several immunologic disorders that could be easily diagnosed by immunological tests. Other complex genetic diseases include Shwachman-Diamond syndrome, associating an external pancreatic insufficiency with bone and skin abnormalities ; Glycogen storage disease type Ib, with metabolic disorder. Primary constitutional neutropenias are limited to very few entities. Kostmann's disease is a permanent isolated neutropenia, usually associated with a bone marrow granulopoeisis blockage ; cyclic neutropenia is characterised by recurrent oscillations (every 21 days) of neutrophil count. Elastase 2 gene mutations have been observed in both diseases. Treatment and prevention of severe infections are a major concern in the management of chronic neutropenia and could be achieved by prophylactic antibiotics (like sulfamethoxazole-trimethoprime) and also G-CSF, which is regularly effective, but could facilitate various side-effects. Constitutional neutropenias, especially Kostmann's disease and Shwachman-Diamond syndrome, are associated with an increased leukemic risk.

Risk factors for severe respiratory syncytial virus infection leading to hospital admission in children in the Western Region of The Gambia.

Acute lower respiratory tract infections (ALRI) are the major cause of mortality and morbidity in young children worldwide. Respiratory syncytial virus (RSV) infection is the most important viral cause of severe ALRI but only a small proportion of children infected with this virus develop severe disease. To identify possible risk factors for severe RSV infection leading to hospital admission we have carried out a case-control study of Gambian children with RSV infection admitted to hospital. In all, 277 children admitted to three hospitals in the Western Region of The Gambia with lower respiratory tract infection due to RSV were compared with 364 control children matched for age and location of residence who had not been admitted to hospital with an ALRI during the RSV season. A detailed questionnaire covering a wide range of potential social, environmental and nutritional risk factors was administered to the child's guardian. Cases came from larger or more crowded compounds than controls; increased risk was particularly associated with greater numbers of children in the age group 3-5 years living in the compound (odds ratio [OR] for > or =2 children in the age group 3-5 years = 9.1, 95% CI: 3.7-28). Cases were more likely to have a sibling who had died (OR = 3.4, 95% CI: 1.7-7). Controls were more likely to have been exposed to smoke from cooking fires (OR for the mother of cases cooking at least once daily = 0.31, 95% CI: 0.14-0.7). Other protective factors were father's nationality and some professions. Vegetables were included in the diet of controls more frequently than in that of cases (OR = 0.16, 95% CI: 0.06-0.46). Mothers of cases complained of asthma more frequently than mothers of controls, but the number of asthmatic mothers was small (4.2 versus 0.5%, P = 0.05). Risk factors for severe RSV infection identified in this study are not amenable to public health interventions. Prevention of severe infection is likely to require the development of an effective vaccine.

Znaczenie selektywnej dekontaminacji w zapobieganiu ciężkim zakażeniom u chorych na ostre białaczki i chłoniaki złośliwe

Znaczenie selektywnej dekontaminacji w zapobieganiu ciężkim zakażeniom u chorych na ostre białaczki i chłoniaki złośliwe