Journal of Tropical Medicine最新文献

Cancer patients are at a high risk of Candida infections, and candidemia may aggravate the prognosis among patients with cancers. To investigate the incidence, mortality, risk factors, and antifungal resistance of candidemia among cancer patients, 100 inpatients with malignant solid tumors and candidemia in Fujian Province, southern China, during the period from January 2014 through December 2023 were recruited. Among the study subjects, Candida albicans was the predominant Candida species (50%), and the prevalence of candidemia showed an overall tendency towards a slight decline during the study period. Candida tropicalis showed 10.53% prevalence of resistance to fluconazole, voriconazole and itraconazole, while C. albicans, Candida glabrata and Candida parapsilosis were all totally susceptible to fluconazole, voriconazole, itraconazole and amphotericin B. The overall 30-day crude mortality of candidemia was 67% among cancer patients, and there was no significant difference between the mortality due to Candida catheter-related bloodstream infection (CRBSI) and bloodstream infection (BSI) (p = 0.59). Multivariate Cox regression analysis identified that the presence of cardiovascular diseases and use of two to three catheters (OR = 385.064, p = 0.005) increased the risk of candidemia among cancer patients. Our data demonstrate an overall tendency towards a slight decline in the prevalence of candidemia and a high mortality rate of candidemia among cancer patients in southeastern China from 2014 to 2023, and development of cardiovascular diseases and use of two to three catheters may increase the risk of candidemia among cancer patients.

Background: Mycetoma is a public health problem with a high prevalence in Africa. Materials and Methods: The study included 50 cases presenting at a tertiary care research hospital, retrospectively (cases we visited and followed up between November 2022 and March 2023) and prospectively between 1 August and 30 September 2024. Demographic characteristics, clinical features, physical examination findings, and diagnostic methods were reported. Results: Out of 50 patients, 76% were male and 24% were female. The mean age (mean ± SD) of all cases was 35.50 ± 15.14. The most affected occupational group was farmers (44%). All patients presented with complaints of swelling. Symptoms continued for > 1-5 years in about 30 percent of cases. The diagnosis was made by pathological biopsy in 62% of the cases. The lower extremities were most commonly affected (80%), and subcutaneous soft tissue and muscle involvement was also commonly encountered. Bone involvement was higher in eumycetoma cases as compared to actinomycetoma. Conclusion: The frequency of myçetoma cases, which can involve all parts of the lower extremities, was determined, especially in Somali farmers. Difficulties in diagnosis and follow-up were analyzed.

Background: Even in well-resourced settings, the case-fatality rate of melioidosis approaches 10%. This has prompted an interest in identifying adjunctive therapies that might improve survival. A prospective, multicentre study in Thailand suggested that statin therapy may reduce the incidence of pneumonia in patients with melioidosis; however, the impact of statins on the clinical course of patients with the infection is incompletely defined. Materials and Methods: We examined all cases of culture-confirmed melioidosis in Far North Queensland, tropical Australia, since October 2016 to determine if statin therapy influenced the clinical phenotype of melioidosis and the patients' clinical course. Results: Of 321 individuals with culture-confirmed melioidosis, 100 (31%) were prescribed a statin at the time of their diagnosis. There was no difference in the clinical phenotype of patients who were- and were not-taking statin therapy. Pulmonary involvement, specifically, was no less common in patients taking a statin (79/100 [79%] versus 175/221 [79%], p = 0.97). A smaller proportion of patients taking statin therapy died before hospital discharge, but this difference did not reach statistical significance (5/100 [5%] versus 26/221 [12%], p = 0.07). This finding was at least partially explained by the fact that fewer patients with an active malignancy were taking a statin (7/37 [19%] versus 93/284 [33%] patients without a malignancy, p = 0.09) and that, in multivariable analysis, patients with malignancy were more likely to die before hospital discharge (odds ratio [95% confidence interval]: 4.73 [1.62-13.87], p = 0.005). Among 290 individuals surviving to hospital discharge, there was no difference in 12-month mortality between those that were-and were not-prescribed a statin at presentation (11/95 [12%] versus 23/195 [12%], p = 0.96). Conclusion: Statin therapy does not appear to have any significant influence on the clinical phenotype of patients with melioidosis. There is also no appreciable impact of statin therapy on patients with melioidosis' short-term or 12-month survival.

Dengue is one of the major public health concerns in tropical and subtropical countries. In addition to neurological sequelae which are well documented, emerging evidence suggests that dengue may also lead to psychiatric sequelae including mood disorders, psychosis, anxiety, and body dysmorphic disorder. This narrative review aims to synthesize the existing literature to explore the psychiatric manifestations and postulated pathophysiological mechanisms and identify predictors and treatment of psychiatric sequelae in dengue. This review identified 30 studies including observational studies, case reports, and case series. The immune-inflammatory responses due to cytokine dysregulation, blood-brain barrier disruption, direct viral effects, and epigenetic mechanisms with histone deacetylase activation are possible contributors to psychiatric sequelae in dengue. The main predictors include severity of dengue, thrombocytopenia, central nervous system involvement, febrile and critical phase of illness, specific dengue virus serotypes (DENV-2 and DENV-3), and stress due to hospitalization. Psychiatric symptoms often persist beyond the acute phase, highlighting the importance of long-term follow-up to evaluate the impact of dengue on mental health. Additionally, comparisons with other Flaviviridae viruses, such as Zika, West Nile, and Japanese encephalitis viruses, reveal both shared and distinct psychiatric implications, suggesting potential virus-specific mechanisms. The current treatment approaches are largely extrapolated from general psychiatric practice, with limited research on targeted interventions. Future research should focus on standardized diagnostic assessment, longitudinal follow-up, diagnostic biomarkers, and developing targeted treatment strategies to improve clinical outcomes. With rising cases of dengue, integrating psychiatric screening into routine dengue management may enhance early recognition and intervention. Hence, a multidisciplinary research approach involving psychiatrists, neurologists, infectious disease specialists, immunologists, and policymakers is crucial for addressing psychiatric sequelae in dengue fever and mitigating the detrimental implications on public health.

The increase in antibiotic resistance has increased the demand for new and safe therapeutic options. Herbal beverages, whether used alone or combined with standard antibiotics, have shown promise in combating drug-resistant bacteria. This study investigated the antibacterial activity and combinatorial efficacy of common herbal beverages prepared from clove, cinnamon, and thyme. The inhibitory and cidal effects were examined using MIC and MBC on a panel of 14 multidrug-resistant strains and clinical isolates (resistant to ciprofloxacin (CIP), tetracycline (TET), and erythromycin (ERY)), including Staphylococcus aureus, Salmonella and Shigella species, Escherichia coli, and Pseudomonas aeruginosa. The combinatorial efficacy was further evaluated using a fractional inhibitory concentration index (FICi). Qualitative phytochemical screening of the plant extracts followed established protocols. The tested botanicals showed inhibitory effects against all 14 tested bacteria, with varying degrees of potency (MICs ranged from 13.33 ± 2.67 to 1024 ± 0.00 μg/mL). The aqueous and hydroethanolic extracts of clove demonstrated the highest activity, with most MIC values ranging from 13.33 ± 2.67 to 256 ± 0.00 μg/mL, indicating excellent to good efficacy. When combined with TET, CIP, and ERY, clove extracts exhibited significant synergistic and additive interactions, leading to more than a 100-fold reduction in the MICs of the antibiotics in some cases. The most notable synergistic interactions were observed with the combination of clove hydroethanol extract with TET (FICi = 0.078 ± 0.016) against P. aeruginosa. The findings indicate possible optimization of antibiotic treatment strategies using these combinations, which may help mitigate antibiotic resistance and improve patient outcomes. However, an antagonistic effect was observed with the clove aqueous extract and CIP on S. aureus, which may require further evaluation. Phytochemical analysis revealed the presence of several major bioactive secondary metabolites, including phenols, flavonoids, tannins, anthocyanins, saponins, and alkaloids. Overall, the tested botanicals, particularly clove, demonstrate considerable potential in fighting drug-resistant bacteria, either through direct action or by enhancing the effectiveness of existing antibiotics. Further, in vivo testing and investigation of the mechanisms behind the active combinations are recommended to assess their overall efficacy.

Background: Juglans regia L. is renowned for its traditional use as a cure for respiratory diseases such as asthma and sinusitis. Objectives: This study was intended to assess the protective mechanism of the effects of hydroalcoholic extract of the leaf of Juglans regia L. against airway inflammation and pulmonary edema by measuring the expression levels of heme oxygenase-1 (HO-1), occludin, and Zonula occludens-1 (ZO-1) in the lung tissues. Methods: Ovalbumin (OVA) was used intraperitoneally to sensitize mice on Days 0 and 14 to induce allergic asthma by the intraperitoneal route. Animals were divided into 5 groups, consisting of normal control (NC), disease group (OVA, i.p), low-dose J. regia (LDJR) and high-dose J. regia (HDJR), methylprednisolone (MP), and reference control (RC) drug. On the 28^th day, blood and bronchial alveolar lavage fluid (BALF) were collected for total leukocyte (TLC) and differential leukocyte (DLC) analysis. Hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining of the lungs were performed for the architectural changes caused by OVA-induced bronchial asthma. Tight junction proteins were assessed by measuring the expression levels of HO-1, occludin, and ZO-1 in the lung tissues by using real-time polymerase chain reaction. Results: Scores of inflammations, edema, and goblet cell hyperplasia were significantly increased (all p ≤ 0.05) in the DC group compared to the NC group, while treatment with LDJR and HDJR significantly reduced (all p ≤ 0.05) the scores of inflammations, edema, and goblet cell hyperplasia compared to the DC group. Real-time polymerase chain reaction data showed that expression levels of HO-1, occludin, and ZO-1 in lung tissues of the DC group were significantly reduced (all p ≤ 0.05), when the same was compared to the NC group, while treatment with LDJR and HDJR significantly increased (p ≤ 0.05) their expression level when compared to the DC group. Conclusion: Juglans regia L.'s hydroalcoholic extract possesses antiasthmatic activity by normalizing the TLC cells and DLC cells. Juglans regia L.'s hydroalcoholic extract resulted in the amelioration of pulmonary edema which is attributed to the upregulation of HO-1, occludin, and ZO-1 in the lung tissues of the Juglans regia L. treated groups when compared to the diseased control group. Administration of Juglans regia L.'s extract also reduces the scores of inflammation and vascular congestion by evaluation of the lungs' histopathology in the disease control group when compared to the NC group.

Battling female infertility has posed a global challenge, where neglected tropical diseases (NTDs) are nonetheless a notable contributing factor. NTDs affect a variety of diseases, often of a chronic nature, which are often cited as some of the most lethal diseases operating against the most economically disadvantaged populations across the globe. The various causative agents for NTDs have been documented and could originate from a myriad of sources-from bacteria, fungi and viruses to ecto- and endoparasitic species-including but not limited to helminths and protozoa. This paper will seek to describe how NTDs influence female reproductive health, together with likely mediators. While these diseases have curable forms, their effects have gone well beyond female infertility, to major pain, disability and even mortality, particularly in poorer countries, thus causing economic hardship, reduced productivity and a pool of social stigma. NTDs adversely affect female reproductive functions through multiple mechanisms, including ROS-sensitive signalling, depression of steroidogenic markers and promotion of apoptosis. The effects also may reflect their influence on ovarian histomorphology, consequently resulting in female infertility. Current-directed studies, however, suggest a potential benefit in combining drugs for the most common NTDs as a deterrent to possible female infertility endowed by NTD infection. Nonetheless, further clinical investigations will be instrumental in elucidating the probable preventive value of combination drugs as adjuvant therapy to NTDs infections. This will provide comprehensive insight into the pathophysiological and molecular basis for the impairment of female fertility brought about by NTDs, leading to the development of preventive models to curb the adverse effects of NTDs on female reproductive health. Therefore, attention should be given to providing the right, timely and effective mode of treatment for NTDs-related female infertility.

Molecular docking and molecular dynamics simulations were conducted to assess propolis compounds of sulabiroin-A, sulabiroin-B, and broussoflavonol F as tuberculosis (TB) inhibitors with rifampicin as the control ligand. TB remains a significant world health concern, requiring the development of new drug candidates to address more drug-resistant variants. The target protein chosen was 3PTY. The molecular docking simulation showed that sulabiroin-A, sulabiroin-B, and broussoflavonol F docking scores are comparable to rifampicin, with the order of docking score from least favorable to more favorable is sulabiroin-B< sulabiroin-A< rifampicin< broussoflavonol F (-3.397, -3.449, -5.256, -5.961). Molecular dynamics simulations also demonstrated that sulabiroin-B exhibited stable interactions with the target protein, comparable to rifampicin, while sulabiroin-A and broussoflavonol F demonstrated increased fluctuation, suggesting possible instability. Absorption, distribution, metabolism, excretion, and toxicity (ADMET) study verified that all three drugs possess advantageous pharmacokinetic characteristics, with broussoflavonol F exhibiting the most favorable safety and tolerability profile. According to these findings, sulabiroin-B is recognized as the most promising candidate for TB treatment owing to its enhanced stability in molecular dynamics simulations, although broussoflavonol F and sulabiroin-A exhibit intermediate promise. Additional experimental validation is advised to verify their therapeutic efficacy.

Objective: To investigate the infection status, species composition, and genetic diversity of Bartonella in local rodent populations in coastal mudflat wetland habitats in eastern Jiangsu Province of China. Methods: From March to June 2023, rodents were captured in mudflat wetlands of Dongtai and Tinghu Counties, Eastern China. Rodent species were identified, and nucleic acids were extracted from liver and spleen tissues. The mitochondrial cytochrome b (mt-cytb) gene was amplified by PCR, while Bartonella-specific citrate synthase (gltA) and 16S rRNA genes were amplified by semi-nested PCR. Phylogenetic and homology analyses were conducted to identify rodent and Bartonella species. Results: Among 29 captured rodents, 26 were Apodemus agrarius and 3 were Mus musculus. Phylogenetic analysis of the mt-cytb gene divided A. agrarius into 7 lineages, each linked to geographically diverse Bartonella populations. Six A. agrarius rodents tested positive for Bartonella, with a positivity rate of 20.69%. Phylogenetic analyses revealed three Bartonella species: B. fuyuanensis, B. taylorii, and one undetermined species. The infected Bartonella strains clustered into three evolutionary branches based on gltA and 16S rRNA genes. Conclusions: This study provides the first evidence of Bartonella infection among rodent populations in wetland habitats along China's eastern coast. The region harbors diverse rodent species, with a high Bartonella infection rate, and at least three species were identified, including a potential novel species.

Currently, carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains, particularly those producing New Delhi metallo-beta-lactamase (NDM), are increasingly recognized as a significant threat to global health. The present study aimed to conduct a genomic analysis of an NDM-1-producing CR-KP strain isolated from patients with coronavirus disease of 2019 (COVID-19) admitted to the intensive care unit (ICU). The K. pneumoniae isolate was obtained from the bronchoalveolar lavage fluid of a 68 year-old male patient hospitalized in the ICU with COVID-19 at Besat Hospital in Sanandaj, Iran. The minimum inhibitory concentrations (MICs) for 15 antibiotics were determined using the VITEK 2 system. Genomic analysis of the isolate was performed using whole genome sequencing. The CRKP-51 strain was identified as an extensively drug-resistant (XDR) strain, exhibiting resistance to all tested antibiotics except tigecycline (MIC = 2 μg/mL). The highest resistance values were recorded against sulfamethoxazole-trimethoprim (SXT), nitrofurantoin (NIT), and piperacillin-tazobactam (TZP), with MICs of ≥ 320, 256 μg/mL, and ≥ 128 μg/mL, respectively. Multilocus sequence typing revealed that CRKP-51 belonged to sequence type 15 (ST15). The IncHI1B replicon type associated with this strain harbored several resistance genes, including bla _NDM-1 , armA, msrE, mphE, BRP (MBL), bla _OXA-1, aadA2, dfrA12, qnrB1, bla _CTX-M-15, and cat1. High-risk K. pneumoniae clones, such as ST15, are increasingly associated with antimicrobial resistance and the emergence of XDR strains in ICUs. Additionally, the global dissemination of the NDM enzyme occurs through various plasmid replicon types. Therefore, monitoring local epidemiology is essential for the effectiveness of antimicrobial stewardship programs.