Journal of Infection and Public Health最新文献

Background

Tissue-invasive end-organ disease (EOD) caused by cytomegalovirus (CMV) is less frequently reported in immunocompetent patients compared to immunocompromised patients. In this study, we investigated the association between CMV viremia and CMV end-organ disease in immunocompetent patients.

Methods

Adult patients (≥18 years old) with CMV viremia were screened from January 2010 to June 2022. The primary outcome was the presence of CMV EOD. Risk factors associated with CMV EOD were analyzed, and a receiver operating characteristic curve was plotted to determine the most accurate cutoff value of the CMV titer for the prediction of CMV EOD.

Results

Among the 106 immunocompetent patients with CMV viremia, 31 exhibited CMV EOD. Gastrointestinal tract disease was the most common. The log10 value of the CMV titer was significantly associated with the occurrence of CMV EOD in immunocompetent patients with CMV viremia. The optimal cut-off CMV titer for the prediction of CMV EOD was 749 IU/mL.

Conclusions

Our study suggests the potential association between high CMV titers and the development of CMV end-organ diseases and describes the diagnostic performance and utility of quantitative PCR as a surrogate marker for predicting the occurrence of CMV EOD in immunocompetent patients.

Background

In Brazil, despite the increase in coverage and access to rapid testing for syphilis in primary health care, no reduction in cases of syphilis and congenital syphilis was observed. Poor and low-educated populations are disproportionately affected by infection caused by T. pallidum. This study aims to estimate the prevalence of syphilis and associated factors among people aged 18 to 49 years old in the city of Belém, brazilian amazon.

Methods

Observational, cross-sectional study carried out in a sanitary administrative district of a capital of the Brazilian Amazon, Belém, state of Pará, Brazil. Data collection was conducted from August 2021 to February 2022. The participantes consisted of residents of the Montese, Guamá and Condor neighborhoods. People aged 18 to 49 years were included. This variable was treated as dichotomous (reagent and non-reagent). The selected response event was ‘reagent result’. The independent variables were the social factors and access to health services. To identify associated factors with the presence of markers of the bacteria studied, multiple logistic rules were performed.

Results

178 people participated in the study; the median age was 35.0 years. The prevalence of IgG and/or IgM antibodies against T. pallidum was 7 % (13). In the final regression model, it was observed that participants who had sexual intercourse after using alcohol and drugs and those who did not know about the prevention of sexually transmitted infections were five times more likely to have tested positive for T. pallidum.

Conclusions

Aspects of individual vulnerability and access to health services must be managed to reduce the exposure of poor urban populations to T. pallidum.

Background

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Vital organs like the heart are affected by the occlusion of blood vessels due to atherosclerotic plaque formation. However, the role of infectious agents has always been an essential subject of investigation. This study investigated the presence of microorganisms, including nanobacteria, in atherosclerotic plaques removed from human carotid arteries by microbiological and metagenomic examination.

Methods

Atheroma plaque samples were obtained from 20 patients with carotid artery stenosis who had atherectomy by surgery or percutaneous intervention. Nanobacteria were grown by culturing homogenates of the atheroma plaques. Whole genome sequencing was done for samples. Because of the high percentage of Toxoplasma gondii (T. gondii) DNA, PCR investigation was applied to detect T. gondii DNA in the samples.

Results

A molecular analysis of nanobacteria revealed them to be made of human proteins, supporting the theory that they are not living organisms. According to sequencing results, samples showed that more than 50 % of the metagenomic sequences belonged to Toxoplasma gondii. PCR investigation indicated that T. gondii DNA was positive in 8 (40 %) of 20 plaques.

Conclusions

Further evidence regarding the role of T. gondii in the etiology of plaque formation may help determine the strategy for prevention and treatment of infections in preventing atheroma plaque formation in the future.

Background

Effective and rapid diagnostic strategies are required to manage antibiotic resistance in Klebsiella pneumonia (KP). This study aimed to design an artificial intelligence-clinical decision support system (AI-CDSS) using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and machine learning for the rapid detection of ceftazidime-avibactam (CZA) resistance in KP to improve clinical decision-making processes.

Methods

Out of 107,721 bacterial samples, 675 specimens of KP with suspected multi-drug resistance were selected. These specimens were collected from a tertiary hospital and four secondary hospitals between 2022 and 2023 to evaluate CZA resistance. We used MALDI-TOF MS and machine learning to develop an AI-CDSS with enhanced speed of resistance detection.

Results

Machine learning models, especially light gradient boosting machines (LGBM), exhibited an area under the curve (AUC) of 0.95, indicating high accuracy. The predictive models formed the core of our newly developed AI-CDSS, enabling clinical decisions quicker than traditional methods using culture and antibiotic susceptibility testing by a day.

Conclusions

The study confirms that MALDI-TOF MS, integrated with machine learning, can swiftly detect CZA resistance. Incorporating this insight into an AI-CDSS could transform clinical workflows, giving healthcare professionals immediate, crucial insights for shaping treatment plans. This approach promises to be a template for future anti-resistance strategies, emphasizing the vital importance of advanced diagnostics in enhancing public health outcomes.

Background

With double pressures of endemic and imported emerging infectious diseases (EIDs), China’s ability to detect, prevent and control the unknown virus is of regional and global interest. This study aimed to establish an R&D Blueprint for EIDs in China by identifying the list of prioritized diseases and medical countermeasures (MCMs) that need proactive actions for the next pandemic.

Methods

The process mainly referred to the World Health Organization’s prioritization methodology, supplemented by pipeline landscape, rapid risk assessment and multi-dimensional analysis. The study included five steps: 1) identifying potential pathogens, 2) screening into the long list, 3) prioritizing the long list, 4) identifying the final list and 5) generating an R&D Blueprint.

Results

China’s R&D Blueprint identified 14 viral pathogens and two virus groups (i.e., Influenza HxNy and Coronavirus X) for proactive and representative MCM development. At least one diagnostic candidate in preclinical study, and one therapeutic and one vaccine candidate in Phase I/II clinical trials for each prioritized pathogen were suggested to be developed as strategic national stockpiles. Various generalized and innovative platform technologies were also highlighted for enhancing overall capacities of EID preparedness and response, covering basic research, experiment, detection, prevention and control, surveillance and information sharing.

Conclusions

This is the first study in developing countries that established an R&D Blueprint of prioritized diseases, countermeasures and technologies. Our findings could help to drive pre-emptive scientific and technological actions toward emerging pathogens that may cause the next epidemic and could provide evidence-based strategies for developing countries to establish their national health research agenda tailored to health and research context under resource-limited settings.

Objective

Tuberculosis is a major health problem in many countries, including Kazakhstan. Host genetics can affect TB risk, and epidemiological and social factors may contribute to disease progression. Due to the high incidence of pulmonary tuberculosis in the country, our research aimed to study the epidemiological and genetic aspects of pulmonary tuberculosis in Kazakhstan.

Material and methods

1026 participants of Central Asian origin were recruited in the study: 342 individuals diagnosed with active PTB, 342 household contacts, and 342 controls without a family history of TB. Genetic polymorphisms of selected genes were determined by real-time polymerase chain reaction. The association between the risk of pulmonary TB and polymorphisms was evaluated using logistic regression and assessed with the ORs and their corresponding 95 % CIs, and the significance level was determined as p < 0.05.

Results

Epidemiological data revealed that underweight BMI (χ² = 89.97, p < 0.001), employment (χ² = 39.28, p < 0.001), and diabetes (χ² = 12.38, p < 0.001) showed a significant association with PTB. A/T polymorphism of the IFG gene showed a lower risk, and A/A polymorphism showed an increased risk of susceptibility to TB. A/A polymorphism of the IFG gene was associated with an almost 3-fold increased risk of PTB, and A/T polymorphism of the IFG gene was associated with a decreased risk of PTB (OR = 0.67, 95 % CI = 0.49–0.92, p = 0.01). The analysis revealed a decreased risk of PTB for A/A polymorphism of the VDR ApaI (OR = 0.67, 95 % CI = 0.46–0.97, p < 0.05). A/A polymorphism of the TLR8 gene was associated with a 1.5-fold increased risk of PTB (OR = 1.53, 95 % CI = 1.00–2.33, p < 0.05).

Conclusion

Results showed that gender, employment, underweight BMI and diabetes are associated with PTB incidence in our study cohort. The A/A genotype of the IFG (rs2430561) and an A/A genotype of the TLR8 (rs3764880) genes were associated with an increased risk of PTB. A/T polymorphism of the IFG (rs2430561) and A/A polymorphism of the VDR ApaI were associated with a decreased risk of PTB.

Background

Serodiagnosis of TORCH infections should be performed in pre-pregnancy and reproductive-age women to prevent vertical transmission. Herein, we conducted a 5-year cross-sectional retrospective study in childbearing age women to provide prevalence data. Also, stratifying the cohort into three age groups, we identified those most susceptible to acute TORCH infections.

Methods

Between 2019 and 2023, serum samples from 2286 childbearing age women attending the “R. Dulbecco” University Hospital of Catanzaro were collected. Screening for TORCH pathogens, such as: Toxoplasma gondii (TOX), Cytomegalovirus (CMV), Rubella Virus (RUB), Parvovirus B19 (ParvoB19), Herpes Simplex Virus types 1 and 2 (HSV1, HSV2) and Treponema pallidum was carried out using serological tests. Chemiluminescent immunoassay was performed to detect TOX, CMV and ParvoB19 Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies, while Enzyme Linked Fluorescent Assay was performed to detect RUB IgM and IgG antibodies and CMV and TOX IgG Avidity. Enzyme Linked Immunosorbent Assay was performed to detect HSV1 IgG, HSV2 IgG, HSV1/2 IgM, T. pallidum total antibodies and RUB IgG Avidity. Binomial logistic regression models were developed to compare seroprevalence rates among different age groups.

Results

The highest immunological protection was observed for RUB infection (87 %), probably associated with vaccination practice, followed by HSV1 and CMV (82 % and 63 %). The 16–25 year age group results as the most susceptible to acute infections as demonstrated by odds of CMV IgM positivity (primary infection) which decreased with age.

Conclusions

The TORCH serological screening program should be implemented in women before pregnancy to formulate strategies for serological screening of childbearing age women and guiding clinicians in making decisions.

The advancement of safe, eco-friendly, and cost-efficient techniques for nanoparticle production is a crucial objective in nanotechnology. Among the various sustainable methods, the biological synthesis of nanoparticles utilizing fungi, bacteria, yeasts, and plants stands out. Fungi, in particular, are well suited for this task because of their capacity to secrete numerous enzymes and streamline subsequent processes. Using fungal strains for nanoparticle biosynthesis is both technologically appealing and economically viable. The utilization of fungal strains for nanoparticle biosynthesis is both technologically appealing and economically viable. Fungi have long been acknowledged as adept natural engineers capable of creating a wide array of nanoparticles with distinct properties and applications. This article provides an overview of fungus-mediated nanoparticle development, shedding light on the underlying mechanisms of their synthesis and the factors influencing their characteristics. Furthermore, the potential of fungus-mediated nanoparticles in the industrial domain has been explored. These findings emphasize the importance of different fungal species in nanoparticle synthesis, as well as the biocompatibility and environmental friendliness of fungus-mediated nanoparticles. By underscoring the essential role of fungi in connecting natural knowledge with innovative industrial applications, recent progress in enhancing nanoparticle production and optimizing synthesis conditions through fungi has been examined to underscore the feasibility of extensive industrial nanoparticle utilization via fungi.

Background

The gut microbiome is made up of a diverse range of bacteria, especially gram-negative bacteria, and is crucial for human health and illness. There is a great deal of interest in the dynamic interactions between gram-negative bacteria and their host environment, especially considering antibiotic resistance. This work aims to isolate gram-negative bacteria that exist in the gut, identify their species, and use resistance-associated gene analysis to define their resistance mechanisms.

Methods

Samples were collected from all patients who had a stool culture at a tertiary care center in Lebanon. Each type of bacteria that was identified from the stool samples was subjected to critical evaluations, and all discovered strains underwent antimicrobial susceptibility testing. Polymerase chain reaction was used to profile the genes for Carbapenem-resistant Enterobacteriaceae (CRE), Extended-spectrum beta-lactamase (ESBL), and that of Pseudomonas aeruginosa strains.

Results

Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa turned out to be the predominant microbiota members. Escherichia coli strains had a high frequency of extended-spectrum beta-lactamase genes, with the most discovered gene being bla CTX-M. Additionally, a considerable percentage of isolates had carbapenemase-resistant Enterobacteriaceae genes, suggesting the rise of multidrug-resistant strains. Multidrug resistance genes, such as bla mexR, bla mexB, and bla mexA, were found in strains of Pseudomonas aeruginosa, highlighting the possible difficulties in treating infections brought on by these bacteria.

Conclusion

The findings highlight the critical importance of effective surveillance and response measures to maintain the effectiveness of antibiotics considering the introduction of multidrug resistance genes in Pseudomonas aeruginosa and ESBL and CRE genes in Escherichia coli.

Background

The COVID-19 pandemic has caused 14.83 million deaths globally. This systematic review and meta-analysis aimed to provide a pooled estimate of the overall mortality and morbidity of critically ill COVID-19 patients.

Method

Four electronic databases, Medline/PubMed, the Cochrane Library, the WHO COVID-19 database, and the Web of Science, were used to identify relevant studies. Two authors independently screened the studies, evaluated the eligibility criteria and resolved discrepancies through discussion with the third author. The pooled effect size was computed using STATA software version 14. The Cochran Q test and I² test were utilized to assess heterogeneity across the studies. Additionally, subgroup analysis, sensitivity analysis, and publication bias were evaluated. It is registered in Prospero with Prospero ID CRD42020212146.

Results

A total of 1003 published articles were screened from various databases, and 24 studies involving a total of 142,291 critically ill COVID-19 participants were selected for inclusion in the review. Among the participants, 67 % were male, and the mean age was 63.43 + SD3.33 years. The mortality rate reported in the individual studies ranged from 4.5 % to 69.5 %. The findings from the analysis revealed that the overall pooled mortality rate was 34 % (95 % confidence interval: 31 %−37 %). Additionally, the findings showed that 62 % of critically ill COVID-19 patients required mechanical ventilation, while 68.7 % of these patients had chronic disease comorbidities.

Conclusion

Critically ill COVID-19 patients face a high-risk risk of death, with an estimate of about one in three patients dying from the virus. Notably, a substantial portion of critically ill COVID-19 patients (62 %) require mechanical ventilation; surprisingly, more than two-thirds of patients with COVID-19 have chronic disease comorbidities, highlighting the importance of managing comorbidities in this population.