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Journal of Infection in Developing Countries
Journal Prestige (SJR): 0.704
Citation Impact (citeScore): 2
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2036-6590 - ISSN (Online) 1972-2680
Published by The Journal of Infection in Developing Countries Homepage  [1 journal]
  • Genotyping methods and their contributions to the study of tuberculosis
           dynamic in Latin America

    • Authors: Yasmin Castillos de Ibrahim das Neves; Ana Julia Reis, Nathália Xavier Maio, Júlia Vianna, João Perdigão, Ivy Bastos Ramis, Pedro Eduardo Almeida da Silva, Andrea von Groll
      Abstract: Introduction: Mycobacterium tuberculosis genotyping has impacted evolutionary studies worldwide. Nonetheless, its application and the knowledge generated depend on the genetic marker evaluated and the detection technologies that have evolved over the years. Here we describe the timeline of main genotypic methods related to M. tuberculosis in Latin America and the main findings obtained. Methodology: Systematic searches through the PubMed database were performed from 1993 to May 2021. A total of 345 articles met the inclusion criteria and were selected. Results: Spacer oligonucleotide typing (spoligotyping) was the most widely used method in Latin America, with decreasing use in parallel with increasing use of mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) and whole genome sequencing (WGS). Among the countries, Brazil, Mexico, and Argentina had the most publications, and a considerable part of the articles were in collaboration with Latin American or non-Latin American institutions; a small proportion of studies needed partnerships to perform the genotypic methods. The genotypic methods allowed the identification of M. tuberculosis genotypes with greater capacity for clonal expansion and revealed the predominance of the Euro-American lineage in Latin America. There was a notable presence of the Beijing family in Peru and Colombia. Conclusions: The data obtained demonstrated the importance of expanding collaborative networks of tuberculosis (TB) research groups to countries with low productivity in this area, the commitment of the few Latin American countries to advance TB research, as well as the inestimable value of building a Latin America database, considering ease of population mobility between countries.
      PubDate: Sun, 12 Nov 2023 00:00:00 +000
       
  • Serum vitamin D concentration in children with pneumonia and acute
           respiratory infections, risk factors for its low level

    • Authors: Gohar Ayvazyan; Nune Baghdasaryan, Lilit Avetisyan, Nane Mnatsakanyan, Lilit Aleksanyan
      Abstract: Introduction: While there is extensive literature discussing the link between various respiratory infections and risk factors that contribute to low vitamin D levels, there is still no consensus on this relationship. The aim of this study was to test whether low vitamin D levels are associated with pneumonia and acute respiratory infections (ARI) and to identify risk factors for low vitamin D levels in children with these conditions. Methodology: The study was conducted at the Muratsan Hospital in Yerevan from February to December 2017. It included 140 randomly selected children aged 1 to 5 years, half of whom had pneumonia and the other half had ARI. Based on serum vitamin D levels, the children were further divided into groups with low (52 patients with pneumonia and 38 patients with ARI) and normal vitamin D levels (18 patients with pneumonia and 32 patients with ARI). Factors such as feeding, age, gender, and mother’s education were included as indicators of risk for low vitamin D. Results: The difference between the mean values of vitamin D in groups of children with pneumonia and ARI was statistically significant (p < 0.05). Feeding was positively, and age was negatively associated with the level of vitamin D (p < 0.05). Conclusions: We found that children with pneumonia had a lower vitamin D level. We also found that poor nutrition and the age of the child (1 to 5 years) were risk factors for low vitamin D levels with respiratory infections.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Prevalence and molecular determinants of carbapenemase-producing
           Klebsiella pneumoniae isolated from Jazan, Saudi Arabia

    • Authors: Thamer Brek; Ahmed K Alghamdi, Turki S Abujamel, Muhammad Yasir, Elaf M Alattas, Maryam S Hazazi, Ibrahim A Al-Zahrani
      Abstract: Introduction: The World Health Organization (WHO) designated Carbapenem-resistant Enterobacterales (CRE), formerly Enterobacteriaceae, among the global priority list of antibiotic-resistant bacteria. The rate of CRE in Arabian countries, including Saudi Arabia has increased. Here, we report the prevalence of carbapenemase-producing Klebsiella pneumoniae (CPKP) in the Jazan region, a southern coastal province of Saudi Arabia. Methodology: Eighty-six non-repetitive clinical isolates of K. pneumoniae that showed resistance to at least one of the carbapenem drugs were collected from three tertiary hospitals in the Jazan region from March 2020 to April 2021. The identification and antimicrobial susceptibility testing (AST) of isolates were performed using various automated systems. Molecular detection of carbapenemase genes was conducted using a multiplex PCR. Results: Out of the 86 tested CRKP isolates, 64 (74.4%) were carbapenemase-producing isolates. The blaOXA-48 gene was the most predominant carbapenemase gene, detected in 65.1% (n = 56) of isolates. The blaNDM gene was detected in only 9.3% (n = 8) of isolates; three were found to be co-harbored with blaVIM. Interestingly, one isolate of CRKP was found to have carbapenemase genes (blaNDM, blaVIM and blaKPC), which was associated with COVID-19 patient. Conclusions: The incidence of carbapenemase-producing K. pneumoniae in Jazan hospitals seemed to be high, confirming the continued prevalence of carbapenem resistance in Saudi Hospitals. We report K. pneumoniae strain with triple carbapenemase genes in southern Saudi Arabia. The emergence of such an isolate could threaten patients and healthcare workers and requires great attention to rapid interventions to avoid further dissemination, particularly during the COVID-19 pandemic.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Antibiotic resistance patterns of pediatric community-acquired urinary
           tract infections in a tertiary care center in Jeddah, Saudi Arabia

    • Authors: Mohammed A Alsubaie; Abdullah Z Alsuheili, Mohammed N Aljehani, Abdulrahman A Alothman, Abdulaziz S Alzahrani, Hamza A Mohammedfadel, Mazin A Alshehry, Abeer A Alnajjar
      Abstract: Introduction: Urinary tract infections (UTIs) are common in children. UTIs can lead to serious and permanent damage to the urinary tract if treatment is delayed or insufficient, particularly in repeated infections. Knowledge of antibiotic resistance trends aids in the selection of appropriate empiric antibiotics. There is limited data regarding this in Saudi Arabia. This study aimed to investigate uropathogens and their antibiotic resistance patterns in the pediatric community in a tertiary care center. Methodology: The study population included children aged 0 to 14 years old who had culture-proven UTIs evaluated in the Department of Pediatrics, King Abdulaziz University Hospital in Jeddah, Saudi Arabia from February 2019 to September 2021. Results: Out of 510 UTI episodes, Escherichia coli (54.5%) was the predominant causative pathogen. Of the total episodes, 137 (26.8%) were caused by extended spectrum beta-lactamase (ESBL) producers. In general, the highest resistance was observed against ampicillin (73.2%), cefazolin (54.6%), co-trimoxazole (46%), and cefuroxime (40.6%), whereas amikacin (0.4%), imipenem (0.8%), and meropenem (0.8%) showed the lowest rates of resistance. Conclusions: Antibiotic resistance is a major concern worldwide due to misuse of antibiotics and subsequent rise of multidrug resistant organisms. Our findings highlight the rise in antibiotic resistance, particularly in E. coli strains. Furthermore, ESBL-producing bacteria were responsible for approximately one-third of UTIs. Our study emphasizes the importance of local antibiograms for pediatric community-acquired infections, as it guides clinicians in every center in the choice of appropriate empiric antibiotic treatment.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Prevalence and antibacterial resistance patterns of uropathogenic
           staphylococci in Casablanca, Morocco

    • Authors: Rafik Aniba; Abouddihaj Barguigua, Asmaa Dihmane, Ghizlane Momen, Kaotar Nayme, Mohammed Timinouni
      Abstract: Introduction: The purpose of this research is to evaluate the resistance profile of uropathogenic staphylococci bacteria in Casablanca, Morocco. Methodology: In this retrospective cross-sectional research carried out from January 2017 to December 2020, isolation and identification were carried out according to the usual techniques in medical microbiology. Staphylococcus aureus isolates were confirmed by polymerase chain reaction (PCR) amplification of the nuc gene, and the antibiogram was performed according to the guidelines of the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2021). The susceptibility of uropathogenic staphylococci to vancomycin was determined with broth microdilution following the recommendations of the Clinical and Laboratory Standards Institute. The mecA gene was tested on phenotypically cefoxitin-resistant S. aureus isolates by PCR. Results: The prevalence of urinary tract infections (UTIs) was 18% (772/4374). UTIs were more common in females (n = 483, 63%) than males (n = 289, 37%). Among the Gram-positive bacteria isolated (198, 25.65%), the prevalence of staphylococci was (130/198, 65.66%). Among staphylococcal species identified, coagulase-negative staphylococci (CoNS) were more prevalent (112/130, 86.15%), and Staphylococcus saprophyticus was the most frequently isolated CoNS (46/112, 41.07%). Additionally, there were several S. aureus strains (18/130, 13.85%). Forty-four percent of S. aureus isolates (n = 8) were resistant to cefoxitin and also harboured the mecA gene. All S. aureus isolates were susceptible to linezolid, cotrimoxazole and vancomycin. Conclusions: The prevalence and antibacterial resistance patterns of uropathogenic staphylococci in this study, with a high percentage of methicillin resistance, require careful consideration of antimicrobial therapy for staphylococcal UTIs.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Molecular epidemiological investigation of carbapenem resistant Klebsiella
           pneumoniae isolated from intensive care unit patients of six geographical
           regions of Turkey

    • Authors: Şükran Köse; Tuba Dal, Rıza Aytaç Çetinkaya, Oğuz Arı, Ercan Yenilmez, Esra Nurlu Temel, Emel Sesli Çetin, Çiğdem Arabacı, Seyit Ali Büyüktuna, Mürşit Hasbek, Neslihan Külahlıoğlu, Tuba Müderris, Teoman Kaynar, Tuğba Sarı, Ata Nevzat Yalçın, Kenan Ak, Berivan Tunca Yıldırım, Merve Şahin, Rıza Durmaz
      Abstract: Introduction: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study. Methodology: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing). Results: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST. ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In İstanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7). Conclusions: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Detection of Clostridium difficile among diarrheic children using cultural
           and polymerase chain reaction technique

    • Authors: Bakhtyar Nader Ali; Ali Yahya Saeed, Amir Abdulmawjood
      Abstract: Introduction: Clostridium difficile is the most common cause of antibiotic-associated diarrhea and colitis. Several methods are available for the detection of C. difficile in stool samples. This study aimed to use glutamate dehydrogenase (GDH), toxin detection, culture and polymerase chain reaction (PCR) techniques for the diagnosis of this pathogen. Methodology: A total of 300 stool samples were collected from children with hospital acquired diarrhea (HA-D), community acquired diarrhea (CA-D), and hospitalized non-diarrheic children as control with ages ranging from 6 months to 6 years (mean 3.7 ± 1.7). Each stool sample was divided into two parts; one part was tested for the enzyme GDH, toxin A and B and then cultured on selective media; and the other part for direct DNA extraction. Results: From a total of 300 stool samples, 9 (3.0%) were positive for C. difficile by the PCR technique, 7 (7%) samples of which were from HA-D cases and 2 (2.0%) from CA-D cases; the control group samples were negative. The enzyme GDH was detected in 12 (12%) samples and toxins A and B in 8 (8%) samples from HA-D cases compared to 5 (5%) and 2 (2%), respectively from CA-D cases. Both GDH and the toxins were negative in control samples. Only 19 (19.0%) samples from HA-D cases gave suspected growth and all of these were negative by PCR. Conclusions: Based on the results of this study, we conclude that the PCR technique is the only reliable method for the diagnosis of this pathogen.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • The role of TNF receptors as mediators of chronic vasculitis in possible
           milder forms of the CNS tuberculosis

    • Authors: Alejandro Rivas-Castro; Citlaltepetl Salinas-Lara, Carlos Sánchez Garibay, Edgar Abarca-Rojano, Rogelio Hernández-Pando, Brenda Marquina-Castillo, Manuel Alejandro Flores Barrada, Yazmín Peralta-Díaz, Elsa Yazmín León-Marroquín, Martha Lilia Tena Suck, Jessica Medina Mendoza, Yaser Sánchez Gama, Luis O Soto Rojas, José Alberto Choreño Parra, José Pablo Romero-López
      Abstract: Introduction: Central nervous system (CNS) tuberculosis (TB) is the most severe form of TB due to its high mortality and functional sequelae. There are several differential diagnoses for TB; and, it can also cause secondary conditions, such as vasculitis. Methodology: 155 biopsies, corresponding to 155 different patients out of 5,386 registered biopsies from 2008-2013, met the criteria of unknown etiology vasculitis and evidence of cerebral vascular disease. These were analyzed to assess the presence of central nervous system TB. The selected cases were assessed with Suzaan Marais (SM) criteria for clinical tuberculosis. After that, Ziehl-Neelsen (ZN) staining and polymerase chain reaction (PCR) were performed to amplify a fragment of the insertion sequence IS6110 of M. tuberculosis. 21 patients met the criteria for definitive tuberculosis by ZN staining and PCR, and 2 met the criteria for possible tuberculosis. Tumor necrosis factor (TNF)-α, TNF-R1, and TNF-R2 were determined by immunohistochemistry in histological sections from formalin-fixed paraffin-embedded (FF-PE) tissues in the 23 selected patients. Results: Granulomatous TB was present in almost half of the cases. TNF-R1 and TNF-R2 were expressed mainly in blood vessels, histiocytes, and macrophages. TNF-R2 expression was higher than the other markers, which suggests an anti-inflammatory response against M. tuberculosis Conclusions: The histopathological presentation of TB is not always limited to granulomas, abscesses, or meningitis; there are also clinical presentations characterized only with chronic inflammation of nervous and vascular tissue.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Vaccination compliance of selected childhood immunization programs and the
           socio-determinant factors in Nigeria

    • Authors: Oluyemi A Okunlola; Olawunmi R Oyerinde, Imisioluwa D Fashina, Oyetunde T Oyeyemi
      Abstract: Introduction: Adherence to full vaccination is important in preventing childhood diseases. The aim of this study was to evaluate the level of compliance to full vaccination and identify the socio-cultural factors associated with full vaccination compliance in children. Methodology: The socioeconomic variables associated with each of the four binary dependent variables of whether or not a child is fully vaccinated against tetanus, BCG, measles, and pentavalent were determined using logistic regression. Results: While compliance to full tetanus and BCG vaccinations was > 60% at the national level, less than 50% and 10% full vaccination compliance were recorded for pentavalent and measles vaccinations, respectively. The South East region of Nigeria recorded the overall highest full vaccination compliance while the least performing region was the North West zone. The mother or guardian literacy level, employment status, antenatal care attendance, and internet usage were strong predictors of full vaccination compliance (p < 0.05). Conclusions: The socio-cultural factors associated with achieving full vaccination coverage in Nigeria in this study should drive the implementation of policies that will be best suited to each geopolitical zone of Nigeria.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Comparison of two multiplex PCR tests for common pathogen detection in
           hospitalized children with acute respiratory infection

    • Authors: Le Wang; Suzhen Sun, Dianping You, Fang Chen, Yinghui Guo, Xianping Zeng, Weijian Wang, Shuo Yang
      Abstract: Introduction: Multiplex PCR methods have significantly improved the diagnosis of acute respiratory tract infections (ARTIs) in children. The ResP-CE System coupled with capillary electrophoresis is a highly specialized, automated, and expensive technology for detecting common pathogens in ARTIs. The XYRes-MCA System, a remarkably less expensive multiplex PCR instrument, employs hybridization for the detection of ARTI pathogens. Both methods detect 9 common microorganisms in ARTIs, i.e., RSV, FLUAV, FLUBV, ADV, PIV, HMPV, HBOV, HCOV, and MP. In this study, we aimed to compare the performance of these two methods in the detection of pathogens from sputum specimens collected from children with ARTIs. Methodology: Sputum specimens were collected from 237 hospitalized children with ARTIs. Nucleic acid was extracted on an automated workstation. The ResP-CE and XYres-MCA systems were applied to detect pathogens from the samples, and the test result agreement between the two methods was evaluated using Kappa statistics. Results: The ResP-CE and XYres-MCA identified pathogens, single or in combination, in 151 (63.7%) and 171 (72.1%) of 237 samples, respectively. Approximately 85% of positive samples identified by either method contained a single pathogen. Moderate to almost perfect concordance between the two methods was found in detecting the following 7 pathogens: RSV, FLUAV, FLUBV, PIV, HMPV, HBOV, and MP. Conclusions: These two methods are comparable in detecting common pathogens of ARTIs in children. As XYres-MCA analysis is more cost-effective, it could play an important role in diagnosing ARTIs in children in less economically developed regions.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Angiogenesis and eosinophilia in the nasal mucosa of patients with
           different clinical phenotypes of chronic rhinosinusitis

    • Authors: Tijana Vukadinović; Aleksandra Vuksanović Božarić, Biserka Vukomanović Đurđević, Miroslav Radunović, Aleksandar Perić
      Abstract: Introduction: Dense inflammatory cell infiltration and vascularization of the nasal mucosa are histological characteristics of chronic rhinosinusitis (CRS). We aimed to evaluate the association between eosinophilia and vascularization in the stroma of mucosal layer/nasal polyps (NP) and clinical parameters in patients with different phenotypes of CRS. Methodology: This cross-sectional study involved 33 patients who had CRS with NP without aspirin sensitivity (CRSwNP), 20 NP patients as a part of aspirin-exacerbated respiratory disease (AERD), and 10 patients who had CRS without NP (CRSsNP), selected for surgery. Control group consisted of 31 subjects without nasal/sinus inflammation, selected for surgery of pneumatized middle turbinate. All patients were clinically scored before surgery for nasal symptoms, quality of life (QoL) outcome and findings from computed tomography scans. NP/nasal mucosa samples of participants were immunohistochemically stained for eosinophil infiltration marker BMK13 and angiogenesis markers CD31 and CD34. Results: AERD patients had the highest level of immunoexpression for BMK13. The strongest staining pattern of CD34 was found in AERD group and the highest expression level for CD31 in CRSwNP group. We found a positive correlation between BMK13, impaired QoL and radiologically evaluated disease extent in patients with CRSwNP. Excepting CRSsNP patients, no correlation was found between the marker of tissue eosinophilia and markers of vascular proliferation. Conclusions: Patients from AERD phenotype have the highest degree of stromal eosinophilic infiltration and endothelial proliferation in comparison to other CRS phenotypes. Eosininophil infiltration marker BMK13 correlates better with the clinical parameters of CRS in comparison to the vascular proliferation markers.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • HBeAg testing is better than quantitative HBsAg assay as an alternative to
           HBV DNA assay among HBV-infected pregnant women

    • Authors: Minh Ngoc Nguyen; Thi Thu Huong Nguyen, Tran Dieu Hien Pham, Van Nghia Khuu, Quoc Cuong Hoang, Vu Thuong Nguyen, Ngoc Huu Tran
      Abstract: Introduction: Using tenofovir disoproxil fumarate (TDF) is recommended in the 3rd trimester for pregnant women with HBV DNA ≥ 200,000 IU/mL to prevent mother-to-child transmission (MTCT) of hepatitis B virus (HBV). However, HBV DNA quantification is unavailable in many resource-limited areas worldwide, hence prophylaxis is often missed. The aim of this study was to determine whether HBeAg or qHBsAg is a better alternative to HBV DNA testing in HBV-infected pregnant women. Methodology: In this prospective cohort study, pregnant women with HBV infection were recruited in 3 hospitals from October 2019 to November 2020. Socio-demographic and clinical data were collected. Blood samples were taken for qHBsAg and HBV DNA testing. HBeAg results were collected from the medical records of the participants who visited a doctor during the study. Results: 465 pregnant women met the study criteria. 41.9% were HBeAg positive, 33.3% had high qHBsAg levels (> 104 IU/mL), 38.3% had high HBV DNA levels (≥ 200,000 IU/mL). Pregnant women with high qHBsAg levels were 27 times more likely to have high HBV DNA levels (aOR = 27.0, 95% CI: 11.1-65.5, p < 0.001). Participants who were HBeAg positive were 57.5 times more likely to have high HBV DNA levels (aOR = 57.5, 95% CI: 23.0-140.0, p < 0.001). The sensitivity of qHBsAg and HBeAg was 80% and 94%, respectively; and specificity was 95% and 90%, respectively. Conclusions: HBeAg testing should be considered over qHBsAg assay as an alternative to HBV DNA assay because of its technical simplicity, lower cost, and fewer missed treatments.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Clinical characteristics and risk factors associated with secondary
           bacterial pneumonia among COVID-19 patients in ICU

    • Authors: Insa Gül Ekiz Iscanli; Mehtap Aydin, Bengü Şaylan
      Abstract: Introduction: COVID-19 and secondary infections developing during COVID-19 follow-up are one of the most important causes of morbidity and mortality in intensive care units (ICU). In this study, we aimed to determine the frequency, microbiology, risk factors, and outcomes of secondary bacterial pneumonia in hospitalized patients due to COVID-19. Methodology: We studied all patients with bacterial pneumonia developed in patients with severe COVID-19 infection in the COVID-19 intensive care unit in a single-center hospital between March 16, 2020 and June 17, 2020. Patients hospitalized and followed up in the ICU for respiratory failure were examined in terms of secondary infection affecting morbidity and mortality. Results: Ninety-six (20%) of 471 patients had secondary bacterial pneumonia, respectively; of the leading pathogens were Acinetobacter baumannii (44.8%) and Klebsiella pneumoniae (39.6%), followed by Pseudomonas aeruginosa (4.2%), Escherichia coli (3.1%), methicillin-resistant Staphylococcus aureus (MRSA) (3.1%), Streptococcus pneumoniae (3.1%), and Methicillin-susceptible Staphylococcus aureus (MSSA) (1%). The mortality rate among infected (75% / 47.5%) was significantly higher than in uninfected patients. Associated with the development of secondary bacterial pneumonia in COVID-19 patients; corticosteroid therapy [odds ratio (OR) 6250, 95% confidence interval (CI) 1.383-28.571, p = 0.017), corticosteroid dose (OR 8.862 CI 2.299-70.258, p= 0.006), duration of mechanical ventilation (OR 1.199 CI) 1.088-1.322, p< 0.001). Conclusions: Secondary bacterial pneumonia was found to be associated with the severity and survival of the disease in patients admitted to ICU due to COVID-19. Duration of mechanical ventilation and use of corticosteroids and high-dose corticosteroids are risk factors for secondary bacterial pneumonia.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Relationship of angiopoietin-2 level with the prognosis of the COVID-19
           disease

    • Authors: Olgun Keskin; Işılay Kalan Sari, Aysegul Seremet Keskin, Hamit Yaşar Ellidağ, Orbay Harmandar
      Abstract: Introduction: COVID-19 infection is associated with coagulopathy. There is increased expression of markers such as E-selectin or angiopoietin-2 upon the activation of endothelin. The aim of this study was to determine whether there was a difference in angiopoietin-2 levels among patients with a diagnosis of COVID-19 who need to be hospitalized in the intensive care units (ICUs) or service. Methodology: COVID-19 infected patients admitted in the hospital were included in this study. In addition to the routine biochemical parameters of patients in ICUs and services, 5 cc blood samples were collected and angiopoietin-2 was analyzed. Demographic data of the patients, biochemical parameters at the time of hospitalization, places and durations of hospitalization as well as their ways of being discharged from hospital were recorded. Results: 180 patients who presented to our hospital’s emergency service and were hospitalized with a diagnosis of COVID-19 were included in our study. 137 patients (76.1%) were hospitalized in the service and 43 (23.9%) were hospitalized in ICU. The angiopoietin-2 level was determined to be significantly high in the patients hospitalized in ICUs (p = 0.018). When the cut-off value of angiopoetin-2 in predicting the ICU hospitalization was assumed as 64.5 ng/L, its sensitivity was determined to be 59% and its specificity was found to be 42%. Conclusions: We concluded that angiopoietin-2 level in COVID-19 patients upon their presentation to the hospital might be an important parameter in predicting and ascertaining their place of hospitalization.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Apnea or cyanosis as COVID-19 initial presentation in newborns

    • Authors: Carolina Tamayo-Múnera; Zoila Margarita Insignares Vizcaino, Ana Lucia Torres Millán, Laura Niño-Serna, Carolina Giraldo Alzate, Cesar Augusto Vanegas Diaz, Hernan Dario Herrera Salazar, Sandra Liliana Gómez Tovar, Maria Carolina Caicedo Baez, Eliana López-Barón
      Abstract: Introduction: The clinical manifestation of coronavirus disease 2019 (COVID-19) infection in newborns varies from asymptomatic infection to severe illness. Apnea or cyanosis as the earliest symptoms is rarely mentioned. The aim of this study is to describe the characteristics of newborns with COVID-19 infection admitted to the neonatal intensive care unit considering cyanosis or apnea as a form of presentation. Methodology: This is a descriptive observational study with retrospectively collected data. All neonates under 30 days old and preterm infants with corrected gestational age of 44 weeks who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with a positive antigen or reverse transcriptase polymerase chain reaction (RT-PCR) test and who were attended to between March 2020 and March 2022 were included. Results: During the two years of the study, 410 patients were admitted to the neonatal unit. Twenty-six patients (6.3%) presented with confirmed SARS-CoV-2 infection. The main clinical characteristic at admission was apnea in 55% and cyanosis in 45%. Of the 11 patients admitted with this presentation, eight were diagnosed with COVID-19 acute upper respiratory disease, and three met the definition of COVID-19 bronchiolitis. A large proportion of the patients had a mild infection (65%, n = 17), 31% (n = 8) had a severe infection and only one patient had a critical infection, accounting for 4%. Conclusions: Apnea and cyanosis can be a manifestation of SARS-CoV-2 infection in newborns, which suggests the need to include it in the diagnostic workup as other viral respiratory infections.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Neutralizing antibodies from naturally infected individuals against
           SARS-CoV-2 Gamma and Delta variants in the Paraguayan population

    • Authors: Angélica Samudio; Pablo H Sotelo, Pamela González-Maldonado, Laura Alfonso, Fernando Valiente-Echeverría, Ricardo Soto-Rifo, Patricia Langjahr
      Abstract: Introduction: Severe Acute Respiratory Syndrome-Coronavirus-2 Virus (SARS-CoV-2) is responsible for Coronavirus Disease 2019 (COVID-19). A substantial number of SARS-CoV-2 infection cases have been reported during the pandemic, and vaccination coverage in some regions, particularly in developing countries, remains very low. SARS-CoV-2 variants of concern (VOCs) have also emerged as some of the most pressing public health issues. In this scenario, it is crucial to know whether COVID-19 convalescent antibodies have cross-neutralizing action against VOCs to contribute to the analysis of the future progress of the pandemic. Methodology: The plasma of individuals infected with SARS-CoV-2 from June to November 2020 in Paraguay (before the first recorded infections associated with VOCs in the country) was selected. Anti-spike antibodies were determined in plasma samples (n = 626) obtained from this convalescent and unvaccinated group. Using a pseudotyped virus neutralization assay, we then investigated the neutralizing response against D614G variant and Gamma, and Delta VOCs. Results: IgG antibodies against spike were detected in 85.6% of convalescent individuals. Samples from individuals previously infected by a non-VOC showed a 6.6- and 8.1-fold reduction in neutralizing capacity to the Gamma and Delta variants, respectively, when compared to the D614G variant. Conclusions: Our findings show that antibodies generated by non-VOC infection have reduced neutralizing capabilities against Gamma and Delta variants that appeared subsequently and might have implications for immunity strategies.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • PNI, NLR and PLR combined detection prognosis of patients with chronic
           hepatitis C-associated cirrhosis complicated by T2DM

    • Authors: Dong Wu; Xiaowu Wang; Yunyun Ding, Yan Liu, Tuantuan Li, Yi lang Zhu, Yong Gao, Xiaojuan Wang
      Abstract: Introduction: The prognostic nutrition index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) have been studied widely in the context of cancer; however, their correlation with chronic hepatitis C-associated cirrhosis complicated by type 2 diabetes mellitus (T2DM) is unknown. Aim: To investigate the correlation of the PNI, NLR, and PLR with chronic hepatitis C-associated cirrhosis complicated by T2DM. Methodology: We investigated 226 patients, comprising 56 patients with chronic hepatitis C-associated cirrhosis complicated by T2DM mellitus (group A), 85 patients with chronic hepatitis C-associated cirrhosis (group B), and 85 patients with T2DM (group C). The baseline data of all patients were analyzed. Results: A comparison of baseline data among the three groups showed significant differences in age (p = 0.008). The levels of PNI were different among the three groups (p < 0.01). The NLR, PNI, and PLR were significantly different between the good and poor prognosis groups (p < 0.05). The AUC for the combined determination of PNI, NLR, and PLR, showed excellent diagnostic performance (AUC = 0.911, 95% CI 0.741—0.985, sensitivity = 80.00 %, and specificity = 88.89%). Conclusions: The PNI, NLR, and PLR were closely related to the prognosis of chronic hepatitis C-associated cirrhosis complicated by T2DM, and their combined detection had the highest specificity and sensitivity for the early prediction of the poor prognosis of chronic hepatitis C-associated cirrhosis complicated by T2DM, which has important clinical value.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Diagnostic and prognostic values of immunocyte ratios in patients with
           sepsis in the intensive care unit

    • Authors: Dan Wu; Haidong Qin
      Abstract: Introduction: The aim of this study was to evaluate the diagnostic and prognostic values of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), monocyte-to-lymphocyte ratio (MLR), neutrophils-to-lymphocytes and platelets ratio (N/LPR), mean platelet volume-to-platelet count ratio (MPV/PC), red blood cell distribution width-to-platelet count ratio (RDW/PC), and platelet volume distribution width-to-platelet count ratio (PDW/PC) in patients with sepsis. Methodology: A total of 203 patients with sepsis admitted to an emergent intensive care unit (EICU) were enrolled in this retrospective study. Basic data, inflammatory factors, NLR, PLR, PNR, MLR, N/LPR, MPV/PC, RDW/PC, PDW/PC were compared between survival and non-survival groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic values. The univariate and multivariate regression analyses were used for constructing a prognostic model for sepsis. Results: There were significant differences in acute physiology and chronic health evaluation (APACHEII) score, mechanical ventilation, use of vasopressors, acute kidney injury (AKI), continuous renal replacement therapy (CRRT), long-term antiplatelet drug use, lymphocyte, monocyte, hemoglobin, procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP)*PCT, and N/LPR. APACHE II had the highest diagnostic value [Area Under Curve (AUC) = 0.999], followed by CRP*PCT (AUC = 0.718). The prognoses were different between patients stratified according to CRP, IL-6, lactic acid (Lac), PNR, PLR, PDW/PC, and APACHEII. Lac, CRP*PCT, PDW/PC, MPV/PC and APACHE II were independent prognostic factors of sepsis. Conclusions: Both N/LPR and CRP*PCT had high values to predict mortality in sepsis patients. CRP*PCT, PDW/PC and MPV/PC were independent factors to predict the prognosis of sepsis.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Stevens-Johnson syndrome: a case report of possible cephalosporin-induced
           cutaneous adverse reaction

    • Authors: Anna Mkhoyan; Md. Foorquan Hashmi, Fiza Khan, Naira Gyulazyan, Vigen Asoyan, Varsen Nersisyan
      Abstract: A severe medical condition known as Stevens-Johnson syndrome (SJS) is marked by a cutaneous and mucosal reaction from the use of specific medications. The prodromal illness is followed by severe mucocutaneous symptoms in this immune-mediated disease. We describe the clinical history of a 55-year-old Caucasian woman who was exposed to cephalosporins. In resource-constrained countries and hospitals where cutaneous biopsy is not readily available, it is not easy to diagnose Steven Johnson Syndrome. This is particularly true in countries where the incidence of infectious diseases such as scarlet fever and measles is high and the early symptoms of SJS can be mistaken for these conditions. We used the Naronjo scale to confirm the probable association of the drug with the syndrome. Physicians while writing prescriptions for their patients need to warn them of potential side effects and they should keep in mind conditions like Stevens-Johnson syndrome. This case report highlights the need for improved knowledge and understanding of SJS among healthcare practitioners in resource-limited communities where the prevalence of infectious diseases is high.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
  • Myositis-specific autoantibodies in a non-traveler, patient from a
           non-endemic country, with Plasmodium vivax malaria

    • Authors: Maja Stojanovic; Aleksandra Barac, Rada Miskovic, Dragana Jovanovic, Jasna Bolpacic, Jelena Ljubicic, Goran Stevanovic, Snezana Jovanovic, Andrija Bogdanovic
      Abstract: Introduction: Autoantibodies (AAb) are a hallmark of immune-mediated inflammatory diseases. Malaria is a parasitic disease caused by Plasmodium protozoa. Individuals with malaria may present with a wide range of symptoms. It is frequently linked to the development of different AAb. Case description: A 35-year-old male presented with repeated episodes of fever, malaise, myalgia, dark urine, and yellowish sclera. Initial diagnostic workup revealed severe Coombs-positive anemia, increased C-reactive protein, and procalcitonin, pathological liver tests, high concentration of serum IgE, IgG, IgM, IgA, positive antinuclear antibodies (ANA), and positive antineutrophil cytoplasmatic antibodies (ANCA). In addition, myositis-specific antibodies directed to polymiositis-scleroderma 75 protein (PmScl75), threonyl-tRNA synthetase (PL-7), alanyl-tRNA synthetase (PL-12), Mi-2 antigen (Mi-2), Ku DNA helicase complex (Ku), signal recognition particle (SRP), and antiaminoacyl tRNA synthetase (EJ) were detected. The patient was suspected of having systemic lupus erythematosus and sent to the Clinic of Allergy and Immunology for further evaluation and treatment. A peripheral blood film examined by the hematologist during an episode of fever revealed intra-erythrocytic parasitic forms of Plasmodium vivax (P. vivax). After being diagnosed with P. vivax malaria, he was transferred to the Clinic for Infective and Tropical Diseases. The therapy consisted of artesunate/mefloquine and prednisone led to a complete clinical recovery and autoantibodies gradually disappeared. Conclusions: Malaria would not normally be considered during the initial diagnostic workup in a non-traveler and a patient from a non-endemic country. However, a thorough parasitic evaluation in patients presenting with a broad range of autoantibodies might be of particular importance.
      PubDate: Tue, 31 Oct 2023 00:00:00 +000
       
 
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JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


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