Respiratory System Infections Research Articles

Talaromyces marneffei infection and complicate manifestation of respiratory system in HIV-negative children

BackgroundRespiratory symptoms are the earliest clinical manifestation of Talaromyces marneffei (TM) infection. In this study, we aimed to improve the early identification of TM infection in human immunodeficiency virus (HIV)-negative children with respiratory symptoms as the first manifestation, analyze the risk factors, and provide evidence for diagnosis and treatment.MethodsWe retrospectively analyzed six cases of HIV-negative children with respiratory system infection symptoms as the first presentation.ResultsAll subjects (100%) had cough and hepatosplenomegaly, and five subjects (83.3%) had a fever; other symptoms and signs included lymph node enlargement, rash, rales, wheezing, hoarseness, hemoptysis, anemia, and thrush. Additionally, 66.7% of the cases had underlying diseases (three had malnutrition, one had severe combined immune deficiency [SCID]). The most common coinfecting pathogen was Pneumocystis jirovecii, which occurred in two cases (33.3%), followed by one case of Aspergillus sp. (16.6%). Furthermore, the value of β-D-glucan detection (G test) increased in 50% of the cases, while the proportion of NK decreased in six cases (100%). Five children (83.3%) were confirmed to have the pathogenic genetic mutations. Three children (50%) were treated with amphotericin B, voriconazole, and itraconazole, respectively; three children (50%) were treated with voriconazole and itraconazole. All children were tested for itraconazole and voriconazole plasma concentrations throughout antifungal therapy. Two cases (33.3%) relapsed after drug withdrawal within 1 year, and the average duration of antifungal treatment for all children was 17.7 months.ConclusionThe first manifestation of TM infection in children is respiratory symptoms, which are nonspecific and easily misdiagnosed. When the effectiveness of anti-infection treatment is poor for recurrent respiratory tract infections, we must consider the condition with an opportunistic pathogen and attempt to identify the pathogen using various samples and detection methods to confirm the diagnosis. It is recommended the course for anti-TM disease be longer than one year for children with immune deficiency. Monitoring the blood concentration of antifungal drugs is important.

Molecular Study of ACE2 Gene Polymorphism of COVID-19 Infection among the Kurdish Population in Kurdistan Region- Iraq.

Coronavirus Disease 2019 (COVID-19) is a current pandemic infection of the human respiratory system, which is caused by which caused by Sever Acute respiratory syndrome virus 2 (SARS-CoV-2). The infection was classified by World Health Organization (WHO) as a universal pandemic in February 2020; there have been 494.587.638 confirmed cases and 6.170.283 deaths. The present study investigated the molecular genetics of the Angiotensin Converting Enzyme 2 (ACE2) gene in correlation to COVID-19 patients in the Kurdish population. Eighty-six individuals were clinically diagnosed with COVID-19 and control groups. After the genomic DNA extraction these participants the target 1, 2 and 8 exons of the ACE2 gene were amplified using the PCR technique, and then the Sanger sequencing technique was performed to analyze genetic variants of the ACE2 gene in 70 DNA samples of COVID-19 hospital patients at Emergency Hospital in Erbil city, Sarchnar Hospital in Sulaymaniyah city, Lalav Hospital in Duhok city and Wafa Hospital in Halabja city from Kurdistan Region of Iraq. The current study was designed into two groups control group and a patient group. The patient group was divided into two subgroups, severe and mild patients of different ages and genders. As a result, there were no mutations at the positions 1, 2 and 8 exons sequences, while single nucleotide polymorphisms (SNPs) were detected and identified three different types of mutation at intron position: twenty-six of c.12405 del T, two of c.12407 T>G, and two of c.12406 G>A in a total 86 participants. This result shows that genetic difference does not impact the COVID-19 infection severity among the Kurdish population regarding ACE2 gene polymorphism.

Peptide-based inhibitors hold great promise as the broad-spectrum agents against coronavirus.

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome (MERS), and the recent SARS-CoV-2 are lethal coronaviruses (CoVs) that have caused dreadful epidemic or pandemic in a large region or globally. Infections of human respiratory systems and other important organs by these pathogenic viruses often results in high rates of morbidity and mortality. Efficient anti-viral drugs are needed. Herein, we firstly take SARS-CoV-2 as an example to present the molecular mechanism of CoV infection cycle, including the receptor binding, viral entry, intracellular replication, virion assembly, and release. Then according to their mode of action, we provide a summary of anti-viral peptides that have been reported in peer-reviewed publications. Even though CoVs can rapidly evolve to gain resistance to the conventional small molecule drugs, peptide-based inhibitors targeting various steps of CoV lifecycle remain a promising approach. Peptides can be continuously modified to improve their antiviral efficacy and spectrum along with the emergence of new viral variants.

The dynamic and structure of mortality from respiratory diseases and COVID-19 in the Russian Federation for 2019–2021

The aim of the study is to analyze the nosological structure and dynamics of mortality from respiratory diseases and COVID-19 in 82 regions of the Russian Federation for the period of 2019–21. Material and methods. The data provided by Russian Statistics Committee for 2019–2021 on the average annual population and the number of deaths due to causes related to the diseases of the respiratory system (DRS (class J00–J99) and new coronavirus infection (U07.1–U07.2 )is used. Standardized death rate (SDR) has been calculated, regional averages for 82 regions of Russia have been determined. Results. For the period of 2019–2021, the increase in the average regional values of SDR from DRS was +34.4 ± 23.4 per 100 thousand people (from 36.6 ± 17.9 to 71.0 ± 39.3 per 100 thousand people). A significant regional variability of SDR was revealed (the maximum SDR differed from the minimum by 17 times in 2019 and 20 times in 2020). The contribution of DRS to all-cause mortality ranged from low of 1.2% in 2019 to high of 13.4% in 2021. The greatest contribution to the structure of DRS is made by other chronic obstructive pulmonary diseases (ICD-10 codes J42, J41, J44, taken into account in one line in the BNMC), pneumonia without specifying the pathogen, bacterial and viral pneumonia. In 2021, compared to 2019, the largest increase in SDR was recorded for the following nosologies: pneumonia without pathogen specification (+17.9 ± 8.47), viral pneumonia (+11.71 ± 1.74), bacterial pneumonia (+2, 2 ± 2.73). In 2021, compared to 2020, the increase in SDR from COVID-19 was 238.1% (222.41 ± 6.38 vs 65.79 ± 3.22). In 2020, SDR from COVID-19 was higher than SDR from DRS in 49 regions, in 2021 — in 77 regions. A negative correlation was detected between SDR from DRS and SDR from COVID-19 (−0.47; p < 0.0001). Conclusions. Increase in DRS deaths in 2020 and 2021 compared to 2019, mainly due to pneumonia, is caused by the COVID-19 pandemic, and significant variability in regional SDRs is probably due not only to the severity of the pathology, but also to the characteristic features of causes of death coding.

Prevalence, mortality, and treatment of patients with rheumatoid arthritis: A cohort study of the French National Health Data System, 2010-2019.

Rheumatoid arthritis (RA) is a chronic inflammatory disease mostly affecting the joints. Data on the prevalence of RA differ widely, depending on the study and country. Our objectives were to estimate the prevalence of RA in France and the mortality rate, characterise the causes of death, and identify prescribed treatments. This nationwide cohort study was based on data of the French National Health Data System (SNDS) which covers 99% of the French population. All patients identified with RA based on specific ICD-10 codes (M05 and M06, except M06.1) between 2010 and 2019 were included. We identified 385,919 RA cases between 2010 and 2019, 318,243 of which were followed in 2019 (65.8±16.8 years, 72% women). The overall crude prevalence rate in 2019 was 0.47%: 0.66% for women and 0.28% for men. The crude annual mortality rate was 3.1%. The overall standardised mortality ratio (SMR) of RA patients relative to the French general population decreased over time, reaching 1.21 in 2019. Cause-specific mortality was increased in RA patients for cardiovascular (SMR 1.40, 95% confidence interval 1.36-1.43), respiratory system (1.80, 1.73-1.87), digestive system (1.73, 1.59-1.88), and urogenital system (1.73, 1.59-1.88) diseases and infections (1.91, 1.76-2.06). We found no excess mortality due to tumours. The prevalence of treatment with conventional synthetic and biological/targeted synthetic disease-modifying antirheumatic drugs for RA in 2019 was 41.9% (n=133,477) and 18.7% (n=59,409), respectively. Our results may provide a better understanding of RA and its care in France.

The rapid diagnosis of Mycoplasma pneumonia using in situ hybridization on clinical samples

The microbiological etiology of seasonal upper respiratory illnesses in the United States is dominated by viruses, including influenza A, B, respiratory syncytial virus, and SARS-CoV2. Mycoplasma pneumonia, treatable with antibiotics, can also cause upper respiratory symptoms and is typically associated with about 15 % of cases. There is no clinical or radiologic finding diagnostic of Mycoplasma pneumonia infection and PCR-based testing is not routinely used in the clinical setting. Further, the bacteria grows slowly in culture and the diagnostic IgM response will take days after the onset of infection. Thus, a rapid diagnostic test for Mycobacterium pneumonia infection is needed. This study documented two cases of Mycoplasma pneumonia infection of the upper respiratory system using in situ hybridization in a series of over 20 patients who were being tested for SARS-CoV2 infection. The respiratory secretions were placed on a glass slide, fixed in 10 % buffered formalin, and then tested using a Mycoplasma pneumonia probe. The high bacterial number associated with acute infection allowed for straightforward detection by in situ hybridization in a few hours. Antibiotic therapy led to rapid resolution of the symptoms. This highlights the ability of standard in situ hybridization as a rapid diagnostic test for Mycoplasma pneumonia in the clinical setting.

Isolation and Diagnosis of Most Frequent Respiratory bacterial Infection from aged cases with and without Kidney Failure in Al-Diwaniya City

Several types of bacteria (most frequent) were isolated and its responsible on respiratory system infection , 150 sputum specimens were collected from older patients (infected and non-infected kidney failure) coming to Al-Diwaniya Teaching Hospital; they were distributed among 75 samples from patients with respiratory system infection (group control) and 75 other samples from patients with respiratory system infection and kidney failure. Under study bacterial species were diagnosed by conducting a series of biochemical tests on it, as well as to confirm the diagnosis by Vitek compact 2 system. Results of isolation showed that two types appear of single and mixed infections, which made both of higher isolation by S. pneumoniae by rate of 16.00% and 13.33% in the two groups of control and kidney failure, respectively and followed by S. pyogens in second place by (12.00 and 9.33)%, then S. viridans in third place and recorded equal proportion isolate (9.33%) for both groups as well as it recorded a mixed infections - bilateral (S. pneumoniae + S. pyogens) the highest percentage isolated in the control group (22.67%) compared to kidney failure group (20.00%), while the mixed infections - tripartite had all isolates were higher in kidney failure group than in the control group. Pharmacological sensitivity tested to under study bacterial isolates to ten antibiotics had commonly used to find out how to resist it; S. pneumoniae had shown full and intermediate resistance to the majority of antibiotics under study except Penicillin G, Ciprofloxacin, Amikacin and Tetracycline that had shown sensitivity reached (55.22, 82.55, 80.00 and 60.00)%, respectively, and the same thing applies to S. pyogens except to Tetracycline resistance by 60.00% and equal to resistance and sensitivity (50%) of Cephalothin. S. viridans was sensitive to Penicillin G, Ceftazidime, Ciprofloxacin and Amikacin by (81.55, 81.10, 83.67 and 66.34)%, respectively, while it was given equal resistance and sensitivity (50%) to Ampicillin and Cephalothin, and resisted to other antibiotics. Staph. aureus givensensitivity only to Ciprofloxacin and Amikacin by (88.00 and 54.50)%, respectively, compared to their resistance to other antibiotics. Haemophillus influnza showed that complete resistance to Cephalothin, Tobramycin and Tetracycline, and given semi-complete resistant for Penicillin G and Piperacillin by (85.10 and 75.30) % respectively, while the sensitivity and resistance by Haemophillus influnza were equal to Ciprofloxacin and Amikacin along with intermediate sensitivity to Cefotaxime and Ceftazidime by (55.00 and 59.79)%, respectively. Ps. aeruginosa were fully resistant to under study antibiotics majority except for intermediate sensitivity to Cefotaxime and Ceftazidime by (60.00 and 64.36)%, respectively, along with equal resistance and sensitivity to Ciprofloxacin and Amikacin.

Clinic and diagnosis and comorbidity of respiratory tuberculosis and viral pneumonia caused by <i>Herpes simplex virus, Cytomegalovirus Human</i> and SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency

Aim. To study the features of the social status, clinic and diagnosis of respiratory tuberculosis comorbidity and viral pneumonia caused by Herpes simplex virus type 1, Cytomegalovirus Human and SARS-CoV-2 in patients with late-stage HIV infection with immunodeficiency.
 Materials and methods. The prospective study included 25 patients with respiratory tuberculosis comorbidity with Mycobacterium tuberculosis, herpesvirus and coronavirus pneumonia, and 21 patients with respiratory tuberculosis with cytomegalovirus and coronavirus pneumonia (1a and 2a main groups) and, respectively, 25 and 21 similar patients, but without coronavirus pneumonia (1b and 2b comparison group), in the late stages of HIV infection with immunodeficiency. For the etiological diagnosis of herpesvirus- and cytomegalovirus pneumonia, PCR was used to detect the DNA of Herpes simplex virus type 1 and Cytomegalovirus Human in the diagnostic material of the respiratory tract, and for the etiological diagnosis of coronavirus pneumonia, PCR was used to detect SARS-CoV-2 RNA. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval.
 Results. The comorbidity of respiratory tuberculosis, herpes-, cytomegalo- and coronavirus pneumonia in patients with late-stage HIV infection, in the phase of progression and in the absence of ART was characterized by severe immunodeficiency and generalization of tuberculosis with multiple extrapulmonary lesions. This determines the similarity of clinical manifestations and visualization of CT changes in this comorbidity, which makes it difficult to distinguish them due to the simultaneous layering of several pathologies with the same type of clinical manifestations at once and requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients.
 Conclusion. Patients with tuberculosis of the respiratory system and HIV infection registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of infection with COVID-19 and CVP disease, and with severe immunodeficiency and GWP and CMVP, should be regularly subjected to preventive studies for timely detection of COVID-19 for the purpose of their emergency isolation and treatment.

Relationship between nosocomial infections and coronavirus disease 2019 in the neurosurgery unit: clinical characteristics and outcomes from a Chinese Tertiary-Care Hospital

BackgroundThe COVID-19 pandemic has raised awareness of infection prevention and control. We found that the incidence of nosocomial infection in neurosurgery has changed. This study aimed to evaluate the impact of “coronavirus disease 2019 (COVID-19) prevention and control measures” on nosocomial infections in neurosurgery.MethodsTo explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients undergoing neurosurgery at Taizhou Hospital of Zhejiang Province between January 1 and April 30, 2020 (COVID-19 era) were first analyzed and then compared with those from same period in 2019 (first pre-COVID-19 era). We also analyzed data between May 1 and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era).ResultsThe nosocomial infection rate was 7.85% (54/688) in the first pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.01). The respiratory system infection rate between the first pre-COVID-19 and COVID-19 eras was 6.1% vs. 2.0% (P < 0.01), while the urinary system infection rate was 1.7% vs. 2.0% (P = 0.84). Between the first pre-COVID-19 and COVID-19 eras, respiratory system and urinary infections accounted for 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26) of the total nosocomial infections, respectively (P < 0.01). Between the second pre-COVID-19 and post-COVID-19 eras, respiratory system and urinary accounted for 53.66% (44/82) vs. 40.63% (39/96) and 24.39% (20/82) vs. 40.63% (39/96) of the total nosocomial infections, respectively (P = 0.02).ConclusionsThe incidence of nosocomial infections in neurosurgery reduced during the COVID-19 pandemic. The reduction was primarily observed in respiratory infections, while the proportion of urinary infections increased significantly.

ODP516 Subacute Thyroiditis due to SARS-CoV-2 Vaccine

Abstract Background Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that resulted in a pandemic in 2019, causing systemic complications including endocrine system diseases. Subacute thyroiditis (SAT) of COVID-19 infection is believed to be due to direct virus entry into cells and cell destruction, cellular dysfunction due to inflammation and immune/antibody-mediated hormonal dysfunction. Here we present a case of SAT after the SARS-CoV-2 vaccine (Pfizer-BioNTech). Clinical Case A 39-year-old male healthcare worker presented with four weeks history of symptoms: fullness of the anterior neck, odynophagia, enlarged cervical lymph nodes, palpitations, anxiety and weight loss. Onset of symptoms was two days the second dose of Pfizer-BioNTech vaccine. There was no recent history of upper respiratory system infection or COVID-19 infection. Vital signs and physical exam findings were unavailable, as it was a telephone encounter. Initial workup was significant for a TSH of 0. 020 uIU/mL (n 0.45-5.330 uIU/mL), free T4 of 2.42 ng/mL (n 0.45-1.80 ng/mL) and total T3 225.4 pg/mL (n 87-179 pg/mL). There was no evidence of leukocytosis. Ultrasound of the thyroid gland was unremarkable for nodules or hyperemia. Autoimmune thyroid disease was ruled out with negative levels of thyroid stimulating immunoglobulin, thyroid receptor antibody and anti-microsomal antibody. Thyroid scintigraphy was significant for abnormally low uptake, consistent with SAT. Clinical and biochemical improvements (TSH 4.193 uIU/mL; free T4 0.98 ng/dL) were seen after 5 months. Conclusion Subacute thyroiditis (SAT) is an acute inflammatory disorder of the thyroid usually related to a viral infection. It was described in total of 27 patients of COVID-19 infection (3) . There are only a handful of cases related to COVID-19 vaccine and most of them are due to the inactivated vaccine (1,2) . To our knowledge, there are only three documented cases of subacute thyroiditis after receiving the Pfizer mRNA vaccine (1) . The pathophysiology in generating an autoimmune response is believed to be due to molecular mimicry and cross recognition between the coronavirus spike protein targeted with the mRNA vaccine and healthy thyroid cell antigens (1,2) . Clinicians should be alert and consider the possibility of SARS-CoV-2 vaccine as an etiology when evaluating patients for subacute thyroiditis.

Dynamic changes of platelet count in first week and their predictive value for prognosis in septic shock patients

To observe the dynamic changes of platelet counts in septic shock patients within first week, and to explore their predictive value for prognosis. Retrospective analysis of clinical data of patients with septic shock admitted to the department of intensive care unit (ICU) of the First Affiliated Hospital of University of Science and Technology of China from January 2020 to December 2021 was conducted. The baseline data on gender, age and primary diseases, clinical indicators on infection site, pathogenic microbial type, acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA), laboratory indicators and the trend of platelet count (PLT) on day 1, 3, 5 and 7 admitting ICU and patients prognosis of in-hospital were collected. Binary Logistic regression was used to assess the independent risk factors of in-hospital death in septic shock patients. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive power of each index for in-hospital mortality. A total of 193 patients with sepsis were enrolled. Among them, 73 patients died and 120 patients survived. Univariate analysis showed that the age, proportion of hypertension and respiratory system infection, APACHE II score, SOFA score and blood lactic acid (Lac) in the death group were significantly higher than those in the survival group, while the proportion of urinary system infection, white blood cell (WBC) and neutrophil (NEU) were significantly lower in the death group. Within 7 days after admitting ICU, the platelet (PLT) firstly decreased and then rebounded in the survival group, whereas it's showed a continuous downward trend in the death group. And the PLT count in both day 5 and 7 were significantly higher in the survival group compared with the dead group [×109/L: 94.5 (54.0, 182.0) vs. 50.0 (30.5, 87.5), 135.0 (86.8, 205.8) vs. 46.0 (23.5, 71.5), all P < 0.05]. Multivariate binary Logistic regression analysis showed that age [odds ratio (OR) = 1.059, 95% confidence interval (95%CI) was 1.002-1.118], hypertension (OR = 6.108, 95%CI was 1.340-27.851), respiratory system infection (OR = 5.300, 95%CI was 1.116-25.118), APACHE II score (OR = 1.158, 95%CI was 1.054-1.273), SOFA score (OR = 1.494, 95%CI was 1.060-2.107) and PLT on day 7 after admitting ICU (OR = 0.926, 95%CI was 0.894-0.958) were independent risk factors for in-hospital prognosis in septic shock patients (all P < 0.05). ROC analysis showed that APACHE II score, SOFA score and PLT on day 7 after admitting ICU all had good predictive value for in-hospital prognosis in septic shock patients, and the area under the ROC curve (AUC) of PLT on day 7 (AUC = 0.899, 95%CI was 0.857-0.941) was significantly higher than that of APACHE II score (AUC = 0.748, 95%CI was 0.680-0.816), SOFA score (AUC = 0.767, 95%CI was 0.702-0.833). Clinicians should pay close attention to the dynamic changes of platelet counts in septic shock patients, especially the platelet counts on day 7 after admitting ICU. And active intervention should be provided to improve the prognosis.

ANTIBIOTIC RESISTANCE RATES OF BACTERIA ISOLATED FROM ENDOTRACHEAL ASPIRATE SAMPLES OF INTENSIVE CARE UNIT PATIENTS

Amaç&#x0D; Nozokomiyal enfeksiyonlar hastanede yatan hastaların&#x0D; önemli mortalite ve morbidite nedenleri arasında&#x0D; yer almaktadır. Yoğun bakım ünite (YBÜ)’lerinde&#x0D; görülen enfeksiyonlar nozokomiyal enfeksiyonların&#x0D; %25’ini oluşturmakta, bunların içerisinde en sık solunum&#x0D; sistemi enfeksiyonları bildirilmektedir. Bu enfeksiyonlardan&#x0D; izole edilen etkenler ve antibiyotik direnç&#x0D; durumları hastaneler arasında farklılıklar gösterebileceği&#x0D; gibi aynı ünite içinde de zamanla değişiklikler&#x0D; görülebilmektedir. Endotrakeal aspirat (ETA) kültürleri,&#x0D; tüm dünyada solunum yolu örneklemesinde en&#x0D; yaygın kullanılan mikrobiyolojik tanı yöntemi olarak&#x0D; karşımıza çıkmaktadır. Bu çalışmada Süleyman Demirel&#x0D; Üniversitesi YBÜ’sindeki hastaların ETA örneklerinden&#x0D; izole edilen bakteriyel etkenler ve antibiyotik&#x0D; direnç oranlarının retrospektif olarak araştırılması&#x0D; amaçlanmıştır.&#x0D; Gereç ve Yöntem&#x0D; Ocak 2018- Ocak 2021 tarihleri arasında YBÜ’deki&#x0D; hastaların ETA örneklerinden izole edilen bakteriyel&#x0D; etkenler ve bu etkenlerin antibiyotik duyarlılık testleri&#x0D; (ADT) hastane veri tabanından retrospektrif olarak&#x0D; elde edildi. Duyarlılık sonuçları European Committee&#x0D; on Antimicrobial Susceptibility Testing (EUCAST) ve&#x0D; gerektiğinde Clinical &amp; Laboratory Standards Institute&#x0D; (CLSI) önerileri doğrultusunda değerlendirildi. Aynı&#x0D; hastaya ait tekrarlayan üremeler değerlendirme dışı&#x0D; bırakıldı.&#x0D; Bulgular&#x0D; Değerlendirilen süre zarfında 1031 adet ETA örneğinden&#x0D; 413’ü (%90,2) gram negatif, 45’i (%9,8) gram&#x0D; pozitif olmak üzere toplam 458 (%44,4) bakteri izole&#x0D; edildi. Gram negatif bakterilerden en sık Acinetobacter&#x0D; baumannii (%43,9), gram pozitif etkenlerden en&#x0D; sık Staphylococcus aureus (%5,9) tespit edildi. İzole&#x0D; edilen A. baumannii suşlarınının tüm yıllarda birçok&#x0D; antibiyotiğe yüksek direnç gösterdiği tespit edilmiş&#x0D; olup, en yüksek direnç %96,6 oranıyla karbapenem&#x0D; grubuna karşı saptandı. Genişlemiş spektrumlu beta&#x0D; laktamaz (GSBL) pozitifliği Escherichia coli suşlarında&#x0D; %48,1; Klebsiella pneumoniae suşlarındaysa&#x0D; %70,8 oranlarında tespit edildi. Çalışmamızda Metisiline&#x0D; dirençli Staphylococcus aureus (MRSA) %20,7,&#x0D; metisiline dirençli Koagülaz negatif Stafilokok (KNS),&#x0D; %76,9 oranında tespit edildi.&#x0D; Sonuç&#x0D; YBÜ’sinde yatan hastalarda gelişen enfeksiyonların&#x0D; belirgin özelliği sıklıkla antibiyotiklere dirençli patojenlerin&#x0D; etken olmasıdır. Enfeksiyona neden olan etkenin&#x0D; tanımlanması, antibiyotik direnç profilinin belirlenmesi&#x0D; antibiyotik seçimine yön verecek ve YBÜ’deki uygunsuz&#x0D; antibiyotik kullanımının önüne geçilmesine ve direnç&#x0D; oranlarını azaltmaya katkı sağlayacaktır.

Alt solunum yolu enfeksiyonu olan köpeklerde canine coronavirusun tespiti ve moleküler karakterizasyonu

Coronaviridae familyasında yer alan coronaviruslar insan ve hayvanlarda sindirim ve solunum sistemi enfeksiyonlarına neden olmaktadır. Alfacoronavirus içerisinde yer alan canine coronaviruslar (CCoV)’ın CCoV I ve CCoV II olmak üzere iki alt tipi bulunmaktadır. CCoV-II ise CCoV- IIa ve IIb olmak üzere iki genotipe ayrılmaktadır. CCoV her yaştaki ve her türlü beslenme şekline sahip köpekleri etkilemesine rağmen özellikle yeni doğan yavrular daha duyarlı ve ciddi şekilde etkilenebilmektedir. Yapılan literatür araştırmalarına göre ülkemizde özellikle alt solunum yolu enfeksiyonlarındaki canine coronavirus varlığının tespitine yönelik moleküler çalışmalara rastlanılmamıştır. Bu çalışmada alt solunum yolu enfeksiyonu tanımlanan barınak köpeklerinde CCoV’un tespiti ve moleküler karakterizasyonunun yapılması amaçlandı. Bu amaçla alt solunum yolu enfeksiyonu tespit edilen 40 adet barınak köpeğinden alınan Bronkoalveolar Lavaj (BAL) sıvıları incelendi. Test edilen 40 köpeğe ait BAL sıvılarından 3 tanesinde CCoV tespit edildi. Yapılan dizin analizi sonrasında elde edilen dizinler ile filogenetik ağaç yapıldı. Filogenetik ağaçta pozitif bulunan 3 örnekten 2 sinin CCoV-I, bir örneğin ise CCoV-II olduğu tespit edildi. Sonuç olarak bu çalışma ile barınak köpeklerinin alt solunum yolu rahatsızlıklarında CCoV-I ve CCoV-II’ nin rol oynayabileceği ortaya konulmuştur. Ayrıca aynı barınakta farklı hayvanlarda iki farklı CCoV’nun tespiti önemli bir veri olarak değerlendirilmiş olup özellikle barınak koşulları gibi kalabalık ortamda barındırılan köpeklerdeki her iki tipin tespiti gelecekte oluşabilecek yeni varyantların ya da alt tiplerin oluşabilme ihtimalinin de göz ardı edilmemesi gerektiğini göstermektedir.

MO696: Characteristics and Survival Results of Peritoneal Dialysis Patients Suffering from Covid-19 in Turkey: A Multicenter National Study

Abstract BACKGROUND AND AIMS Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short- and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHOD This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase–polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded. RESULTS We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102; 95% CI: 1.032–1.117; P:0.004), moderate–severe clinical disease at presentation (OR:26.825; 95% CI: 4.578–157.172; P &amp;lt; 0.001) and CRP levels (OR:1.008; 95% CI; 1.000–1.016; P:0.040) were associated with increased first-month mortality in multivariate analysis. CONCLUSION Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.

Sosialisasi Pencegahan Covid Melalui Penerimaan Vaksin Covid-19 Di Kecamatan Tebet Jakarta Selatan

Corona Virus Disease that has come to Indonesia cause respiratory system infections and death. COVID-19 is a new variant of disease that has never been identifies before in human body. Most of the cases that reported by the Ministry of Health in 2020 shows symptoms and clinical indication so that people are encouraged to follow the health protocols. Currently, the government is trying to develop vaccines to be more effective for preventing the infection of corona virus. COVID-19 vaccine is a good news for everyone, but there are some Indonesian people that still not willing to be vaccinated. The method of activity is involving stakeholders through the implementation of meeting activities consisting of community leaders and cadres. This action has the aim of persuading the community to implement the health protocols properly. Public needs to get the knowledge and information through education indirectly. The information that will be delivered are about the results of socialization and the explanations of educational material. The socialization that will be doing by the team is by implementing the identification of the survey results. The participants were attending by association, the representative of district, and the head of youth organization in some regions in South Jakarta. This service activity gave a conclusion that Community service activities are well-implemented where the target is to provide the understanding about the Covid-19 prevention behavior and public acceptance of vaccines. Furthermore, publics has given a good response regarding the socialization of providing knowledge to the community

Infecciones por estreptococo

Microorganisms of the Streptococcus spp. genus form a group of gram-positive cocci that includes notable human pathogens, such as Streptococcus pneumoniae, Streptococcus pyogenes, and Streptococcus agalactiae. Streptococci form part of the human microbiota of the nasopharynx, digestive system, skin, and mucosa and are the etiological agents of a large number of infectious diseases such as various respiratory system infections, skin and soft tissue infections, bacteremia, endocarditis, meningitis, severe sepsis, necrotizing fasciitis, and toxic shock syndrome. The diagnosis of infections caused by streptococci is based on the combination of signs and symptoms and the results of a microbiological study. The identification of streptococci as etiological agents requires a bacteria culture of the samples of interest combined with rapid antigen tests or molecular biology techniques. Streptococci are sensitive to beta-lactam antibiotics. Third- generation cephalosporins are the antibiotics of choice for invasive infections such as bacteremia or meningitis and clindamycin is of great use in necrotizing fasciitis due to its immunomodulating effects and its inhibition of exotoxins and other virulence factors. Given the current rates of macrolide resistance, their use is advised against. Prevention is fundamental.

Vitamin D Supplementation and COVID-19

Coronavirus Disease 2019 (COVID-19) happened due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. It is the third coronavirus causing a pandemic. Cases of COVID-19 have increased rapidly. Epidemiological studies show droplets as a medium of transmission of this virus. The high rate of transmission and the death rate create urgency on the management of COVID-19. Unfortunately, until now there is no definitive therapy for the SARS-CoV-2 virus. Several potential therapies, including antivirals, immunomodulatory agents, convalescent plasma transfusions, and supportive therapies such as vitamin D supplementation, have been applied in the management of COVID-19. As a hormone, vitamin D has an immunomodulatory effect used in supportive therapy for various immune-related diseases and respiratory system infections. The immunomodulatory effects of vitamin D are strengthening the physical barrier (cell junction), the specific immune system (adaptive immunity), and the non-specific immune system (innate immunity). Vitamin D is known to suppress pro-inflammatory cytokines and increase the production of anti-inflammatory cytokines. In addition, vitamin D also performs as a substantial part in the induction of ACE2 receptors which gives a weighty influence on pathogenesis of COVID-19. Vitamin D deficiency can amplify the risk of infections including COVID-19. Presently, clinical trials of vitamin D supplementation and COVID-19 are limited. This literature review further examined the role of vitamin D supplementation in COVID-19.

Comparative pathology of the nasal epithelium in K18-hACE2 Tg mice, hACE2 Tg mice, and hamsters infected with SARS-CoV-2.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes severe viral pneumonia and is associated with a high fatality rate. A substantial proportion of patients infected by SARS-CoV-2 suffer from mild hyposmia to complete loss of olfactory function, resulting in anosmia. However, the pathogenesis of the olfactory dysfunction and comparative pathology of upper respiratory infections with SARS-CoV-2 are unknown. We describe the histopathological, immunohistochemical, and in situ hybridization findings from rodent models of SARS-CoV-2 infection. The main histopathological findings in the olfactory epithelia of K8-hACE2 Tg mice, hACE2 Tg mice, and hamsters were varying degrees of inflammatory lesions, including disordered arrangement, necrosis, exfoliation, and macrophage infiltration of the olfactory epithelia, and inflammatory exudation. On the basis of these observations, the nasal epithelia of these rodent models appeared to develop moderate, mild, and severe rhinitis, respectively. Correspondingly, SARS-CoV-2 viral RNA and antigen were mainly identified in the olfactory epithelia and lamina propria. Moreover, viral RNA was abundant in the cerebrum of K18-hACE2 Tg mice, including the olfactory bulb. The K8-hACE2 Tg mouse, hACE2 Tg mouse, and hamster models could be used to investigate the pathology of SARS-CoV-2 infection in the upper respiratory tract and central nervous system. These models could help to provide a better understanding of the pathogenic process of this virus and to develop effective medications and prophylactic treatments.

Vascular inflammation in the central nervous system.

Vascular inflammation in the central nervous system.

Characterization and Structural Prediction of Proteins in SARS-CoV-2 Bangladeshi Variant Through Bioinformatics.

The renowned respiratory disease induced by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has become a global epidemic in just less than a year by the first half of 2020. The subsequent efficient human-to-human transmission of this virus eventually affected millions of people worldwide. The most devastating thing is that the infection rate is continuously uprising and resulting in significant mortality especially among the older age population and those with health co-morbidities. This enveloped, positive-sense RNA virus is chiefly responsible for the infection of the upper respiratory system. The virulence of the SARS-CoV-2 is mostly regulated by its proteins such as entry to the host cell through fusion mechanism, fusion of infected cells with neighboring uninfected cells to spread virus, inhibition of host gene expression, cellular differentiation, apoptosis, mitochondrial biogenesis, etc. But very little is known about the protein structures and functionalities. Therefore, the main purpose of this study is to learn more about these proteins through bioinformatics approaches. In this study, ORF10, ORF7b, ORF7a, ORF6, membrane glycoprotein, and envelope protein have been selected from a Bangladeshi Corona-virus strain G039392 and a number of bioinformatics tools (MEGA-X-V10.1.7, PONDR, ProtScale, ProtParam, SCRIBER, NetSurfP v2.0, IntFOLD, UCSF Chimera, and PyMol) and strategies were implemented for multiple sequence alignment and phylogeny analysis with 9 different variants, predicting hydropathicity, amino acid compositions, protein-binding propensity, protein disorders, and 2D and 3D protein modeling. Selected proteins were characterized as highly flexible, structurally and electrostatically extremely stable, ordered, biologically active, hydrophobic, and closely related to proteins of different variants. This detailed information regarding the characterization and structure of proteins of SARS-CoV-2 Bangladeshi variant was performed for the first time ever to unveil the deep mechanism behind the virulence features. And this robust appraisal also paves the future way for molecular docking, vaccine development targeting these characterized proteins.