Mediterranean Journal of Hematology and Infectious Diseases最新文献

Background: To investigate the differences in clinical characteristics between Gram-positive and Gram-negative neonatal sepsis (NS).

Methods: A retrospective analysis was conducted on a total of 151 neonates admitted between March 2019 and March 2024. The 91 NS patients were divided into the Gram-negative bacteria group (n=31) and the Gram-positive bacteria group (n=60). Sixty (n=60) non-septic neonates served as controls, and general information was collected from all participants. C-reactive protein (CRP), procalcitonin (PCT) and platelets (PLT) were independent factors that influenced the differentiating infections caused by the two pathogens. The onset symptoms, strain distribution, and various biochemical parameters were compared before the treatment among the three groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy.

Results: The proportions of patients with amniotic fluid contamination and fever (body temperature ≥ 38.0 °C) were higher in the Gram-negative group than in the Gram-positive group (P=0.023, 0.049). The concentrations for CRP, PCT and PLT were P=0.019, 0.023, 0.030 respectively. ROC curve analysis revealed that the specificity of the combination of CRP, PCT and PLT in diagnosing Gram-negative bacterial infection was 100.00%, and the area under the curve (AUC) was 0.904, which was higher than those of single indicators (P=0.05).

Conclusion: There are differences in the expression of CRP, PCT and PLT between Gram-positive and Gram-negative NS. The simultaneous detection of the three has a high diagnostic value in differentiating infections caused by the two pathogens.

Background: Worldwide, glucose dysregulation (GD) and diabetes mellitus are common complications in transfusion-dependent β-thalassemia (β-TDT) patients. Impaired insulin sensitivity and insulin secretion are both involved in the deterioration of glucose tolerance from a normal to a glucose-intolerant state.

Objective: The main aim of the present study was to evaluate the plasma glucose (PG) increment (PG %) retrospectively at two h during oral glucose tolerance test (OGTT) over fasting plasma (FPG) concentration as a simple parameter to recognize early β-cell dysfunction in normoglycemic β-TDT patients with NGT and different severities of iron overload (IOL).

Patients and methods: A total of 19 β-TDT young adult patients with normal OGTT were re-evaluated according to the American Diabetes Association (ADA) guidelines. Venous blood samples were collected at baseline and at 30, 60, and 120 minutes to determine PG (mg/dL) and insulin concentrations (μIU/mL). The time required for the PG concentration to return to the fasting level was calculated by computing the percentage increment of 2-h PG with respect to FPG (PG%), using the formula [(2-h PG-FPG)/FPG]x 100. The early phase of insulin secretion (IGI) and sensitivity were assessed by validated surrogate indices calculated from parameters obtained during the four-point OGTT.

Results: The mean age of patients was 30.3 ± 5.7 (range: 23.10-44.3). The mean ± SD, median, and range of PG% increment between 2 h-PG and FPG were 35.5 ± 20.2, 38.7, and 0 - 68.2 mg/dL, respectively. The PG% increment was negatively correlated to the patient's age, FPG, and IGI, and positively correlated with 2-h PG post-glucose load. IGI was negatively correlated with 1-h and 2-h PG after post-glucose load and positively correlated with oral disposition index (oDI).

Conclusions: The PG% increment is a simple, useful screening parameter that can expand the clinical weight of OGTT and can provide valuable metabolic information on β-cell dysfunction.

Background: Emerging treatment strategies have enhanced life expectancy for cancer patients, but late complications, including vaccine-preventable infections from diminished antibody titers, are common. This study evaluates viral vaccine immunity in children post-leukemia treatment and examines the need for additional vaccine doses and their effectiveness.

Methods: Our cohort included 62 children diagnosed with acute leukemia. We recorded patients' sex, age at diagnosis, type of leukemia, risk groups, vaccination status prior to chemotherapy, and serology results for hepatitis A, hepatitis B, varicella, measles, rubella, and mumps (MMR) both at the end of chemotherapy and after vaccination following chemotherapy.

Results: Post-treatment, patients exhibited a loss of protective antibody responses: hepatitis A (44.4%), hepatitis B (67.7%), varicella (62.5%), measles (46.9%), rubella (43.5%), and mumps (50%). Notably, high-risk group acute lymphoblastic leukemia (HRG ALL) patients had a marked decrease in protective antibodies for hepatitis B, measles, rubella, and mumps compared to standard/intermediate risk group (SRG/IRG) ALL patients (p<0.05). Among the seronegative patients, following vaccination, five (15.2%) remained seronegative for varicella, one (2.2%) for hepatitis A, one (3.5%) for measles, one (3.8%) for rubella, and two (6.5%) for mumps.

Conclusion: Our study highlights a significant loss of vaccine-protective antibody responses after acute leukemia treatment, particularly among HRG. The increased vulnerability to vaccine-preventable infections, particularly hepatitis B, measles, rubella, mumps, and varicella, in HRG ALL patients highlights the importance of ongoing monitoring of immunization status and potential revaccination strategies to ensure adequate protection against infectious diseases.

Background: Rickettsioses are considered emerging or re-emerging hematophagous arthropod-borne zoonosis. In addition, Meningeal syndromes are among the most common reasons for consultation in infectious disease emergencies.

Objectives: Our study aimed to identify Rickettsia spp using IFA and qPCR for serological and molecular tests, respectively, in patients presenting with Meningeal Syndrome at the National Centre of Infectious Diseases El-HADI FLICI Hospital, Nicolle-Laveran department in Algiers.

Methods: We collected 55 whole blood and 55 sera from patients with meningeal syndrome of various ages and genders, with a mean age of 24.03 (ranging from 2 to 50 years old).

Results: The indirect immunofluorescence assay (IFA) for Rickettsia spp returned positive results in seven sera (7/55, 12.72%). We diagnosed four cases of Spotted Mediterranean Fever (MSF) caused by R. conorii, two cases of Murine Typhus caused by R. typhi, and one case of Flea-borne Spotted Fever caused by R. felis. Concerning the spinal tap, we reported that three patients were positive for R. conorii, where cerebrospinal fluid was opalescent, and there was a mixed cellular profile on cytology. These findings suggest a possible co-infection with R. conorii in patients with meningeal syndrome. Thus, the serological findings coupled with the Meningeal syndrome and the diverse clinical manifestations of both pathogens observed among these patients suggest a possible overlap in clinical expression.

Conclusion: These results highlight the importance of heightened awareness among infectious disease specialists, particularly when faced with confirmed cases of Meningeal Syndrome that may exhibit clinical similarities with Rickettsial diseases, especially in regions where hematophagous arthropod-borne zoonoses are prevalent.