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Outcome and Risk Factors for Acquisition of Multi-Drug Resistant Organisms among COVID-19 Patients, A Single Center Case Control Study COVID-19患者获得多重耐药菌的结局和危险因素:一项单中心病例对照研究
Pub Date : 2023-01-30 DOI: 10.26420/austinjinfectdis.2023.1079
Z. A. Maskari, S. Panchatcharam, Amal AL Tai, Warda AL Habsi, Khadija AL Zadjali
Introduction: Several recent reports have described an increase in multidrug-resistant organisms (MDROs) during the COVID- 19 pandemic, and multiple factors identified. Objectives: The primary objectives of the study are to determine the incidence of MDROs among hospitalized COVID-19 patients, the risk factors leading to infection or colonization with MDROs among these patients and the determinants of mortality among infected patients. The secondary objective is to study risk factors for mortality among the study cohort. Method: A retrospective case-control study included all patients screened for MDROs on admission or detected later to have a positive sample for MDROs during their hospital stay (April-September 2020). Associations were tested using chi-square and independent t-tests. For the adjusted analysis, Multivariate logistic regression applied. P<0.05 was considered as statistical significance. Result: The total number of patients included was 313. 33.2% (n=104) were MDRO-infected or colonized patients, and 66.8% (n=209) were controls. The incidence density during the study period of MDROs was 16.7 per 1000 patient days, and the incidence was 17. 9 per 100 admissions. The monthly incidence density of MDROs ranged from 7.0 per 1000 patient days to 30.6 per 1000 patient days and steadily increased. In univariate analysis, the length of ICU stays P <0.001, length of hospital stay P <0.001, receiving ventilation P0.001, having urinary catheter P0.004, tracheostomy P<0.001, NGT in situ P 0.001, receiving more than four antibiotics P<0.001 and having comorbidities P 0.001 were risk factors for acquiring MDROs. Comorbidities were independent factors for MDRO acquisition (OR 3.61, CI 1.37-9.61, P0.010). Mortality was higher among those with MDRO infection (50%, n=30) than those with colonization (31.8%, n=14). Only receiving a few antibiotics was related to worse outcomes (OR 3.09, CI; 1.13-8.44, P0.028). The independent risk factors for mortality among the study cohort were age (OR 1.087 CI 1.06 to 1.1, P <0.001), and acute dialysis (OR 4.392, CI 1.82-10.61, P 0.001). Conclusion: The acquisition of MDROs was not associated with worse outcomes among COVID-19 patients, although mortality was significantly higher among infected patients than colonized patients. Implementing strict infection prevention and control strategies is vital to prevent colonization and progression to infection among colonized patients.
导言:最近的几份报告描述了在COVID- 19大流行期间多重耐药生物(mdro)的增加,并确定了多种因素。目的:本研究的主要目的是确定住院COVID-19患者中MDROs的发生率,导致这些患者感染或定植MDROs的危险因素以及感染患者死亡的决定因素。次要目的是研究队列中死亡率的危险因素。方法:一项回顾性病例对照研究纳入了入院时进行MDROs筛查或随后在住院期间(2020年4月至9月)检测出MDROs阳性样本的所有患者。使用卡方检验和独立t检验检验相关性。校正分析采用多元逻辑回归。P<0.05为差异有统计学意义。结果:共纳入313例患者。33.2% (n=104)为mdro感染或定植患者,66.8% (n=209)为对照组。研究期间mdro的发病密度为16.7例/ 1000患者日,发病率为17例。每100人中有9人。mdro的月发病率密度从7.0 / 1000患者日到30.6 / 1000患者日不等,并稳步增加。在单因素分析中,ICU住院时间P<0.001、住院时间P<0.001、接受通气P0.001、有导尿管P0.004、气管造口P<0.001、原位NGT P0.001、接受4种以上抗生素P<0.001、有合并症P0.001是发生MDROs的危险因素。合并症是MDRO获得的独立因素(OR 3.61, CI 1.37-9.61, P0.010)。MDRO感染组的死亡率(50%,n=30)高于定植组(31.8%,n=14)。仅使用少量抗生素与较差的结果相关(OR 3.09, CI;1.13 - -8.44, P0.028)。研究队列中死亡率的独立危险因素是年龄(OR 1.087 CI 1.06 ~ 1.1, P <0.001)和急性透析(OR 4.392, CI 1.82 ~ 10.61, P <0.001)。结论:获得MDROs与COVID-19患者预后较差无关,尽管感染患者的死亡率明显高于定植患者。实施严格的感染预防和控制策略对防止定植和感染在定植患者中发展至关重要。
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引用次数: 0
A Mouse Model of Yellow Fever Virus Infection for Study of Pathogenesis and Development of Vaccines and Therapeutics 黄热病病毒感染小鼠模型的发病机制研究及疫苗和治疗方法的开发
Pub Date : 2023-01-10 DOI: 10.26420/austinjinfectdis.2023.1076
D. M., Dieye Y, Nguer Cm, Bédékélabou Ap, Boye Csb, Faye O, Fall C
Yellow Fever (YF) is a mosquito-borne viral disease that is endemic in several African and South American countries. YF Virus (YFV) causes subclinical infections with mild and non-specific symptoms, to severe, potentially lethal illness. Despite the existence of efficient vaccines, epidemics continue to occur, mostly in Africa. One major drawback of the available YF vaccines is their method of preparation that is fastidious and have limits to produce high volumes of doses needed to respond to recurring epidemics. The best available animal models for YFV are Non-Human Primates (NHP) in which it causes a disease similar to human infection. However, the cost of NHP studies is a limit to preclinical studies. There are a few mouse models of YF. However, these models consist of genetically deficient rodents that are not the best for evaluating new vaccines or therapies. We have developed a mouse model of YFV infection based on the Swiss Webster out bred strain. We have tested several epidemic isolates and identified two strains that, when administrated by the intraperitoneal route, caused an acute infection leading to death. Interestingly, these YFV strains are lethal only when prepared from mouse brain and not when cultured on cell lines. We used this model to test the efficacy of the 17D YFV vaccine strain in protecting mice against lethal challenge showing that the model can be used to evaluate new YF vaccines and therapies.
黄热病是一种蚊媒病毒性疾病,在若干非洲和南美洲国家流行。YF病毒(YFV)引起亚临床感染,具有轻微和非特异性症状,严重的,可能致命的疾病。尽管存在有效的疫苗,但流行病继续发生,主要是在非洲。现有的YF疫苗的一个主要缺点是其制备方法过于繁琐,难以生产应对反复出现的流行病所需的大剂量疫苗。可获得的最佳YFV动物模型是非人类灵长类动物(NHP),其引起的疾病与人类感染类似。然而,NHP研究的成本限制了临床前研究。这里有几种YF小鼠模型。然而,这些模型由基因缺陷的啮齿动物组成,并不是评估新疫苗或疗法的最佳方法。我们建立了一种基于瑞士韦伯斯特杂交株的YFV感染小鼠模型。我们已经测试了几种流行分离株,并确定了两种菌株,当通过腹腔注射途径给药时,会引起导致死亡的急性感染。有趣的是,这些YFV菌株只有在从小鼠大脑中制备时才具有致命性,而在细胞系上培养时则没有致命性。我们使用该模型测试了17D YFV疫苗株对小鼠致命攻击的保护作用,表明该模型可用于评估新的YF疫苗和治疗方法。
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引用次数: 0
How does the Geocosmos Control the Viruses in Biosphere: DNA, Ionospheric Microwaves and Water 地球宇宙如何控制生物圈中的病毒:DNA、电离层微波和水
Pub Date : 2023-01-10 DOI: 10.26420/austinjinfectdis.2023.1077
Avakyan Sv, Baranova La
The goal of the paper was to show that the phenomena observed in the works of L. Montagnier, the Nobel laureate on physiology, 2008, with the behavior of some bacteria and viruses (including the Human Imunodeficiency Virus), may be related to the effect of microwave fluxes primarily of ionospheric origin, to formation of water-containing complexes. A well-known mechanism of associative formation is taken into account, taking into account the high affinity for the proton in water molecules. The approach developed in our recent papers is used within the framework of supramolecular physics of complex molecular structures. Supramolecular physics describes a processes developing outside the molecules (atomic-molecular cores) in whose evolution to the complex forms (clusters, associates) electromagnetic radiation of external origin absorbed by exited Rydberg components of molecular complex takes part. Due to increasing value of orbital momentum of Rydberg electrons the stability of the complex grows because probability for forming a stable neutral cluster becomes higher as the electron more seldom penetrates into the ion core. We use the analogy with well known supramolecular chemistry proposed by J.-M. Lehn, the Nobel laureate on chemistry, 1987. He also discussed a possibility of contribution of cosmic influence both to information exchange in living organism and reaction to the environmental stimuli.
这篇论文的目的是表明,在2008年诺贝尔生理学奖得主L. Montagnier的著作中观察到的现象,以及一些细菌和病毒(包括人类免疫缺陷病毒)的行为,可能与主要来自电离层的微波通量对含水复合物形成的影响有关。考虑到水分子中质子的高亲和力,考虑到一个众所周知的结合形成机制。在我们最近的论文中开发的方法是在复杂分子结构的超分子物理学框架内使用的。超分子物理学描述了一个在分子(原子-分子核心)之外发展的过程,在这个过程中,分子复合体的出射里德伯成分吸收了外部来源的电磁辐射,从而演变成复杂的形式(簇,缔合)。由于Rydberg电子轨道动量值的增加,配合物的稳定性增加,因为形成稳定中性团簇的概率增加,电子很少穿透到离子核。我们用j.m.提出的著名的超分子化学来类比。1987年诺贝尔化学奖得主莱恩。他还讨论了宇宙影响对生物体的信息交换和对环境刺激的反应的可能性。
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引用次数: 0
The Pathological Changes in Osteoarthritis and Rheumatoid Arthritis Joint Diseases 骨关节炎和类风湿关节炎关节病的病理变化
Pub Date : 2022-11-29 DOI: 10.26420/austinjinfectdis.2022.1075
Pawlak Z, Yusuf Kq
The pathological changes observed in Osteoarthritis (OA) and Rheumatoid Arthritis (RA) affects the entire joint structure resulting in pain, surface change, molecules modification and dysfunction. In our study, we report molecular deactivation mechanism surface active phospholipids and cartilage matrix in (OA) and (RA). Deactivated PLs can be related to high friction leading to articular cartilage damage. The interaction occurs between antibodies β2-Glycoprotein I (β2-GPI) protonated amino acid functional group (-NH3+) and the phospholipid functional group (-PO4-): (β2-GPI) (-NH3+) + PL(-PO4-) → (-NH3+-PO4-) In a proposed articular cartilage damage of OA and RA, a substantial progress has been made towards understanding the mechanisms of PLs deactivation that lead to the degradation of the cartilage surface.
骨关节炎(OA)和类风湿关节炎(RA)的病理改变影响整个关节结构,导致疼痛、表面改变、分子修饰和功能障碍。在我们的研究中,我们报道了(OA)和(RA)中表面活性磷脂和软骨基质的分子失活机制。失活的PLs可能与高摩擦导致关节软骨损伤有关。抗体β2-糖蛋白I (β2-GPI)质子化氨基酸官能团(- nh3 +)和磷脂官能团(- po4 -)之间发生相互作用:(β2-GPI) (- nh3 +) + PL(- po4 -)→(- nh3 +- po4 -)在OA和RA的关节软骨损伤中,PLs失活性导致软骨表面降解的机制已经取得了实质性进展。
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引用次数: 0
The Role of the NETosis Phenomena as a Function of Neutrophils in the Pathogenesis of Infection and Cancer NETosis现象作为中性粒细胞在感染和癌症发病机制中的作用
Pub Date : 2022-11-03 DOI: 10.26420/austinjinfectdis.2022.1074
Glukhareva Ae, Afonin Gv, Mel'nikova Aa, Grivtsova Ly, Kolobaev Iv, Ivanov Sa, Kaprin Ad
Neutrophils are one of the key barriers to anti-infective protection, an important mechanism of which is NETosis - the formation of neutrophil extracellular traps (NET). In recent years, this ambiguous biological phenomenon has been considered as a factor of unfavorable prognosis in some types of cancer. This review is devoted to the analysis of the role of NETosis in the pathogenesis of autoimmune diseases and other non-communicable diseases. The role of NET in malignant tumors, in particular in metastasis and progression of the tumor process, has been studied and data on the subpopulations of neutrophils – low-density neutrophils (LDN) and high-density neutrophils (HDN) in tumor processes have been analyzed. Further study of the phenomenon of netosis and the characteristics of peripheral blood neutrophils in cancer patients will be useful both for detailing the mechanisms of the metastatic cascade and for identifying their role as a biomarker and a possible therapeutic target.
中性粒细胞是抗感染保护的关键屏障之一,其重要机制是NETosis -中性粒细胞胞外陷阱(NET)的形成。近年来,这种模糊的生物学现象被认为是某些类型癌症预后不良的因素。这篇综述致力于分析NETosis在自身免疫性疾病和其他非传染性疾病发病机制中的作用。NET在恶性肿瘤中的作用,特别是在肿瘤过程的转移和进展中,已被研究,并分析了中性粒细胞亚群-低密度中性粒细胞(LDN)和高密度中性粒细胞(HDN)在肿瘤过程中的数据。进一步研究肿瘤患者的netosis现象和外周血中性粒细胞的特征将有助于详细描述转移级联的机制,并确定它们作为生物标志物和可能的治疗靶点的作用。
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引用次数: 0
Opportunistic Infections in People Living with Human Immunodeficiency Virus Initiating Antiretroviral Therapy in Kinshasa, Democratic Republic of Congo 在刚果民主共和国金沙萨开始抗逆转录病毒治疗的人类免疫缺陷病毒感染者的机会性感染
Pub Date : 2022-10-28 DOI: 10.26420/austinjinfectdis.2022.1073
T. K. Ntumba, B. Bongenya, L. O. Losenga, G. I. Booto, N. M. Dikati, Rosalie Djamba Dembo, S. M. Selenge, Jocelyn Ewuti Nonga, Candide About Kabamba, B. Kabengele, M. Sombo, G. Bumoko, E. Kamangu
Background: Opportunistic infections, which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. Objective: The objective of this study was to determine the profile of Opportunistic Infections in People Living with HIV starting Antiretroviral Treatment (ART) in Kinshasa during the Dolutegravir era. Methods: The present study is a descriptive cross-sectional study to determine the profile of OIs among PLHIV starting ART in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included in the study. The patient inclusion period in the study was from October 04, 2021 to February 15, 2022. The population of the present study was patients over the age of 18 at inclusion, infected with HIV-1 and starting ART in a selected OTC. Results: 119 patients were included in this study respecting the inclusion criteria. 56.3% of patients included are women. The mean age on D0 is 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). The Opportunistic Infections most found in these PLHIV are: Malaria with 54 cases (45.4%), Tuberculosis (29.4%) and Cutaneous pruritus (23.5%). Conclusion: In this cohort of patients starting ARV treatment in Kinshasa, the most common opportunistic infections are Malaria, Tuberculosis and Cutaneous Pruritus.
背景:机会性感染是艾滋病毒感染者(PLHIV)护理中的一个主要问题,发生在免疫抑制的情况下。目的:本研究的目的是确定在Dolutegravir时代在金沙萨开始抗逆转录病毒治疗(ART)的艾滋病毒感染者的机会性感染概况。方法:本研究是一项描述性横断面研究,旨在确定在金沙萨门诊治疗中心(OTC)开始抗逆转录病毒治疗的PLHIV患者中OIs的概况。这项研究包括了16个非处方药。患者入组期为2021年10月4日至2022年2月15日。本研究的人群是纳入时年龄超过18岁、感染HIV-1并在选定的非处方药中开始抗逆转录病毒治疗的患者。结果:119例患者符合纳入标准。56.3%的患者为女性。D0患者平均年龄39.87±12.36岁。最具代表性的年龄组是36至45岁,有37例患者(31.9%)。机会性感染以疟疾54例(45.4%)、肺结核(29.4%)和皮肤瘙痒(23.5%)为主。结论:在金沙萨开始抗逆转录病毒治疗的患者队列中,最常见的机会性感染是疟疾、结核病和皮肤瘙痒症。
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引用次数: 0
Effects of Caspase-3 on HIV-1 Latency in a 3.01 Cells Caspase-3对3.01细胞中HIV-1潜伏期的影响
Pub Date : 2022-09-27 DOI: 10.26420/austinjinfectdis.2022.1072
W. X, Huang H, B. S, Zhao J, Devadas K, Hewlett I
Latent infection is a major barrier for cure of HIV-1/AIDS. HIV-1 is capable of establishing latency and the components of the apoptotic pathways may affect viral latency. However, it is not well-known how anti/pro-apoptotic components modulate HIV-1 replication and latency. Using the susceptible A3.01 cell line, we investigated some long-term effects of caspase-3 activities on HIV-1 DNA levels using a sensitive real-time PCR assay. Here we report that viral DNA levels increased upon treatment with caspase-3 inhibitor, Z-DEVD and decreased with caspase-3 activator, PAC1. We also simultaneously measured viral RNA from supernatants of these cell cultures and found that the degree of HIV-1 latency is inversely proportional to levels of viral replication. Furthermore, we demonstrated that inhibition of caspase-3 activities promoted viral latency and inhibited viral replication in several ways, which may include: 1) inhibition of viral RNA un coating with increased Trim5a expression; 2) deleterious mutations in the viral genome with increased APOBEC3G; 3) transcriptional interference with decreased levels of the host factors, NF-κB p65, Ap-1, Sp-1, NFAT, STAT1/3/5, IRF3/7, inactivated YB-1 and MAPK, Erk1/2 and p38, and inhibition of full-length of HIV-1 mRNA and P-TEF b signaling; 4) epigenetic silencing with decreased PCAF; 5) blocking trafficking of the components of viral particle and budding with decreased Tag101 and Alix. These data suggest that HIV-1 infection can employ or even manipulate the cellular apoptotic status to favor viral survival and escape monitoring and destruction by the host immune system.
潜伏感染是治愈HIV-1/艾滋病的主要障碍。HIV-1能够建立潜伏期,凋亡通路的组成部分可能影响病毒潜伏期。然而,抗/促凋亡成分如何调节HIV-1复制和潜伏期尚不清楚。使用易感的A3.01细胞系,我们使用灵敏的实时PCR检测caspase-3活性对HIV-1 DNA水平的长期影响。在这里,我们报告了caspase-3抑制剂Z-DEVD治疗后病毒DNA水平升高,而caspase-3激活剂PAC1治疗后病毒DNA水平降低。我们还同时测量了这些细胞培养的上清液中的病毒RNA,发现HIV-1潜伏期的程度与病毒复制水平成反比。此外,我们证明了抑制caspase-3活性可以通过几种方式促进病毒潜伏期和抑制病毒复制,其中可能包括:1)抑制病毒RNA包被,增加Trim5a表达;2) APOBEC3G增加的病毒基因组有害突变;3)转录干扰,降低宿主因子、NF-κB p65、Ap-1、Sp-1、NFAT、STAT1/3/5、IRF3/7水平,使YB-1、MAPK、Erk1/2、p38失活,抑制HIV-1 mRNA全长和P-TEF b信号通路;4)表观遗传沉默与PCAF降低;5)通过降低Tag101和Alix来阻断病毒颗粒组分的运输和出芽。这些数据表明,HIV-1感染可以利用甚至操纵细胞凋亡状态,以有利于病毒存活,逃避宿主免疫系统的监测和破坏。
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引用次数: 0
Do OTC Microbiome Enhancing Products Offer Preventative Care for Skin Health? 非处方微生物组增强产品能为皮肤健康提供预防性护理吗?
Pub Date : 2022-09-19 DOI: 10.26420/austinjinfectdis.2022.1071
Yadav E
There has been recent surge of pro and prebiotic based skincare products being available OTC. For example, there have been a lot of “yogurt masks” or even skin specific probiotic supplements that have flooded retail stores with the promise of improving what they claim to be their understanding of “the skin microbiome”. At first glance, there is psychological appeal towards believing in their use due to the increasing awareness around pathologies related to the skin (e.g. acne, rosacea, and hypersensitivity reactions). However, with all the research out there now about the gut microbiome, skin microbiome, and any part of the human microbiome basically, we figured these claims warranted a deeper dive.
最近市面上出现了大量基于益生元和益生元的非处方护肤品。例如,有很多“酸奶面膜”,甚至是专门针对皮肤的益生菌补充剂充斥着零售商店,它们承诺提高他们对“皮肤微生物群”的理解。乍一看,由于人们越来越意识到与皮肤有关的疾病(如痤疮、酒渣鼻和过敏反应),人们相信使用它们有心理上的吸引力。然而,现在有了所有关于肠道微生物群、皮肤微生物群和人类微生物群的研究,我们认为这些说法有必要进行更深入的研究。
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引用次数: 0
Historical Overview of the Maastricht Consensus Reports for the Management of Helicobacter Pylori Infection. Where are we Today? 关于幽门螺杆菌感染管理的马斯特里赫特共识报告的历史概述。我们今天在哪里?
Pub Date : 2022-09-09 DOI: 10.26420/austinjinfectdis.2022.1069
Jukic I, Vukovic J, Modun D, S. Z, Tonkic A
This letter summarizes historical overview of the European guidelines for management of Helicobacter pylori (H. pylori) infection, from Maastricht I consensus report through to Maastricht V/Florence consensus report. The inadequate application of Maastricht V/Florence consensus report in clinical practice has urged us to send an appeal to all national gastroenterological societies to emphasize the importance of these guidelines.
这封信总结了欧洲幽门螺杆菌感染管理指南的历史概况,从马斯特里赫特一号共识报告到马斯特里赫特五号/佛罗伦萨共识报告。马斯特里赫特V/佛罗伦萨共识报告在临床实践中的应用不足,促使我们向所有国家胃肠病学学会发出呼吁,强调这些指南的重要性。
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引用次数: 0
The Epidemiology of Viruses Causing Acute and Severe Respiratory Diseases in Children, Before and During the COVID-19 Pandemic 在COVID-19大流行之前和期间引起儿童急性和严重呼吸道疾病的病毒流行病学
Pub Date : 2022-09-09 DOI: 10.26420/austinjinfectdis.2022.1070
Ito Crm, S. Jas, Gonçalves Lc, Silva Pan, S. Mo, Moreira Ale, Pereira As, Peixoto Fao, Fonseca Jg, Wastowski Ij, Carneiro Lc, Avelino Mag
Viruses are the main pathogens that cause SARI, and children are much affected around the world. Therefore, the aim of this study is to assess the frequency of SARI and SARS cases caused by seasonal viruses in children before and during the COVID-19 pandemic.
病毒是导致严重急性呼吸道感染的主要病原体,世界各地的儿童都受到严重影响。因此,本研究的目的是评估在COVID-19大流行之前和期间儿童中由季节性病毒引起的SARI和SARS病例的频率。
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引用次数: 1
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Austin Journal of Infectious Diseases
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