Journal of Global Infectious Diseases最新文献

Introduction: Enterococcus faecalis is a Gram-positive facultative anaerobe bacteria now known to be implicated in periodontitis, tooth root infections, adimplantitis which are oral biofilm-mediated diseases. The ability of E. faecalis to form a biofilm even as a mono-infection makes it more resistant to antibiotics. Bacteriophages are known to cure antibiotic-resistant bacterial infections. However, the main concern in phage formulations is the bacteriophage stability and loss of "antibacterial" activity.

Methods: In this study, a novel E. faecalis phage was isolated against E. faecalis 29212 from the sewage sample. The phage was propagated and identified using transmission electron microscope. Encapsulated phages were prepared using a biodegradable food grade chitosan-alginate coating shell suspended in honey-gelatin. The morphology of the chitosan-alginate microsphere was examined using scanning electron microscope (SEM) and pore size was determined by field emission gun-SEM. The encapsulated phages were checked for their lytic activity against host bacteria. The encapsulated bacteriophage was assayed for acid stability and thermal stability in simulated saliva.

Results: The phage isolated was lytic belonging to Siphoviridae family. The mean diameter of the chitosan-alginate microspheres was 1.7 ± 0.13 mm. The pore size of the phage-loaded chitosan-alginate shell was less than 100 nm, resulting in sustained release of the phages. The chitosan-alginate encapsulated phage was stable for a long time (6 h) in simulated saliva. The encapsulated phage could withstand exposure to different pH (pH 2, pH 4, and pH 7) in simulated saliva. It was also stable at different temperatures (4°C, 37°C, and 60°C).

Conclusion: The encapsulated phage has the potential to be used as phage therapy in oral diseases. Further, the chitosan-alginate encapsulated phage microsphere can be incorporated in a patch/membrane/gel in combination with antibiotics/nutritional components/anti-inflammatory agents as treatment for oral diseases induced by E. faecalis.

Introduction: Electrophoresis of serum proteins (ESP) reveals the proteins present during the acute phase of a disease and enables the detection and monitoring of inflammatory syndrome. The aim of this study was to explore whether ESP could help to identify patients at risk of COVID-19 aggravation.

Methods: This was a two-center, observational, prospective study carried out between March 2021 and February 2022. Patients hospitalized in a COVID-19 unit, with an oxygen requirement of <6 L/min, were included. ESP was carried out every 4 days until clinical aggravation or discharge. Aggravation was defined by the requirement for >6 L/min oxygen, intensive care unit admission, or death. Risk factors for aggravation evaluated included age, comorbidities, serum proteins (albumin, globulins), % pulmonary damage (%PD) on computed tomography scans, D-dimers, C-reactive protein (CRP), ferritin, lymphocytes, and PO₂. Student's t-test or Wilcoxon-Mann-Whitney test (quantitative variables) and Chi-square or Fisher's test (qualitative variables) were used for univariate analysis. Risk factors for COVID-19 aggravation were analyzed by logistic regression. The threshold of significance was 5%.

Results: A total of 161 patients were analyzed (mean [±standard deviation (SD)] age: 67.3 ± 16.6 years; 50.9% female). COVID-19 aggravated in 37 patients, within a mean (±SD) of 4.1 ± 2.6 days. In univariate analysis, α-1 globulins (P = 0.04), %PD (P = 0.02), and CRP (P = 0.02) at inclusion were significantly higher in patients whose disease aggravated. In multivariate analysis, %PD at inclusion was the only factor significantly linked to aggravation (OR = 2.3 [95% CI: 1.3‒4.7]; P = 0.01).

Conclusions: ESP was not predictive of clinical aggravation in hospitalized COVID-19 patients.

Introduction: Neurological complications associated with the COVID-19 vaccine can include different neurological diseases. Although these cases are rare, it is crucial for healthcare professionals to recognize them for timely diagnosis and treatment. The aim of this study was to analyze the impact, trend, and visibility of scientific publications on the neurological effects of the COVID-19 vaccine during 2020-2023 in Scopus.

Methods: A bibliometric, descriptive, and retrospective study was conducted. Through Scopus (SciVal), variables were measured objectively. Data were sought from December 2018 to August 2023. All papers on neurological effects associated with the COVID-19 vaccine were published between January 2020 and August 2023 in the Scopus database. On August 18, 2023, 65 articles were identified, of which 59 met the inclusion criteria. They were downloaded and exported in.csv format and subsequently analyzed in Microsoft Excel® 2019 using tables.

Results: The United States was the country with the highest number of authors (six) publishing on the subject in Scopus, followed by India with two authors. In addition, it was observed that the United States was the country with the highest production, with 30 publications and 411 countable citations. However, India, being the second in scientific production, was the country with the highest impact. Of the most productive institutions, six were from the United States, with Harvard University being the institution with the highest scientific production. With respect to the journals, six obtained two publications on the subject under study, where "Journal of Neurology" and "Journal of Clinical Medicine" stand out with 100 and 80 publications, respectively.

Conclusions: The bibliometric analysis reveals that the USA leads in publications on adverse neurological effects of COVID-19 vaccine. India stands out for its impact, especially through institutions such as Ahmedabad Civil Hospital and B. J. Medical College. It is suggested to expand the research to other databases.

Introduction: The prevalence of nontuberculous mycobacteria (NTM) is on the rise worldwide. The diagnosis of NTM lung disease (NTM-LD) is a dilemma. The 2020 guidelines jointly established by the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) outline the criteria for diagnosing pulmonary NTM disease. Herein, we report a series of cases with an analysis of relevant literature to gain insight into the pathogenicity of NTM species, the risk factors involved, and treatment strategies.

Methods: This is a prospective observational study starting from April 2023 to December 2023. A total of 370 suspected pulmonary tuberculosis (TB) patients were included. Clinical specimens were processed for Ziehl-Neelsen staining, GeneXpert Mycobacterium tuberculosis (MTB)/RIF assay, and culture. Culture-positive mycobacteria were classified as MTB complex or NTM based on detection of MPT64 antigen. The NTM isolates were speciated by line probe assay using GenoType^® Mycobacterium common mycobacteria (Hain Lifescience, Nehren, Germany). The criteria of ATS/IDSA were applied to confirm NTM-LD.

Results: Nine (n = 9) patients were diagnosed as cases of NTM-LD. Bronchiectasis and previous TB were the most common comorbidities. Mycobacterium scrofulaceum (n = 2), Mycobacterium szulgai (n = 2), Mycobacterium intracellulare (n = 1), Mycobacterium kansasii (n = 1), Mycobacterium abscessus (n = 1), Mycobacterium fortuitum (n = 1), and Mycobacterium interjectum (n = 1) were the species involved. Specific therapeutic drug regimens were administered in four cases, which resulted in clinical improvement.

Conclusion: People with comorbid (LDs) are at risk of NTM-LD. The severity of NTM-LD and mortality also depend on the species involved. New guidelines with evidence-based recommendations should be formulated to simplify the diagnosis and treatment of NTM-LD caused by an array of more than 190 species.

Introduction: Scrub typhus is a vector-borne infection caused by the bacterium Orientia tsutsugamushi, transmitted to humans through the bite of larval forms of Leptotrombidium mites and hence called tsutsugamushi disease or rickettsial disease. The objective of the study is to assess the disease severity, laboratory investigations, and complications of scrub typhus with the association of liver diseases and mortality rate of scrub typhus.

Methods: Data sources PubMed, Cochrane, and Google Scholar were systematically searched for data published up to May 2024. The studies selected were all scrub typhus patients associated with liver diseases. The data extraction was done as per the preestablished checklist. The mean difference for liver function test (LFT)'s aspartate aminotransferease and alanine aminotransferase level was analyzed, and risk difference was evaluated with liver disease and mortality rate using RevMan 5.4 software. Data analyses were performed from 2019 to 2024 (PROSPERO Registration: ID CRD42024515922).

Results: The analysis included a total of 901 scrub typhus cases with 554 cases associated with liver diseases. The study further investigated the LFT parameters, clinical symptoms, and 129 case mortality of scrub typhus. The meta-analyses showed that AST and ALT levels of scrub typhus patients had an overall significant effect in scrub typhus with liver disease (95% confidence interval [CI]: 135.81-153.15) with P < 0.00001 and scrub typhus with liver disease and mortality rate (risk ratio: 4.29 [95% CI: 3.64-5.07], P < 0.0001). A significant Q statistic P-value indicates the presence of heterogeneity, as reflected by high I2 values (I2 = 96% and I2= 78%).

Conclusion: 61.50% scrub typhus with liver disease patients and 14.32% mortality rate in scrub typhus were evaluated. This study demonstrated an association betweeen scrub typhus and liver disease, highlighting its severity and the mortality rate among hospitalized patients.

Miliary tuberculosis (MTB) is a disseminated form of tuberculosis (TB) arising from the lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli followed by millet seed-sized tuberculous foci. It mainly affects immunocompromised patients and can lead to severe complications or even death. The clinical manifestation is diverse and depends on the organ affected, the patient's immune status, and the possible involvement of the central nervous system (CNS). Hence, this case report presents a case of an immunocompetent male with a decreased level of consciousness and convulsions requiring admission to the intensive care unit. The patient was diagnosed with MTB, meningoencephalitis, hydrocephalus, and severe hyponatremia. He subsequently improved after a short period of initiation of anti-TB medications. This report also highlights the clinical features of MTB and reviews the literature on associated CNS complications of MTB.

Psittacosis is a zoonotic disease caused by the bacteria Chlamydia psittaci. It commonly presents with flu-like symptoms and community-acquired pneumonia (CAP). The bacteria is transmitted from birds to humans. The most common bird is parrots. Here, we present a cluster of cases of psittacosis in a family which led to the hospitalization of all the five members of the family. All the five patients presented with fever, weakness, dry cough, and dyspnea on exertion. Chlamydia psittaci immunoglobulin M was detected by indirect immunofluorescence assay. The family had a history of contact with parrots. The patients were treated with doxycycline and recovered without any complications. Psittacosis is an uncommon cause of CAP which can have a wide range of presentations, from being asymptomatic, to flu-like symptoms or to fulminant disease. Elaborate history and a high degree of suspicion are very important to come to the diagnosis. The infection is easily treatable with appropriate antibiotics. Public awareness and education regarding the zoonotic transmission of disease can reduce disease incidence.

Introduction: The study aimed to evaluate the risk factors linked to poor outcomes in pediatric patients diagnosed with tubercular bacterial meningitis (TBM).

Methods: A retrospective cohort study was conducted at King George's Medical University in India, focusing on children diagnosed with TBM (n = 514) over a 5-year period from 2019 to 2023. The study evaluates various aspects of TBM in this population, including clinical presentation, diagnostic methods, and outcomes. Statistical analyses for the study were conducted using SPSS version 16.0 (SPSS, Chicago, IL, USA).

Results: Out of a total of 514 patients with TBM, 98 (19.1%) patients experienced a poor outcome. Multivariate analysis identified several factors associated with a poor outcome: age over 5 years (B = 0.829, P = 0.002, odds ratio [OR] = 2.291, 95% confidence interval [CI]: 1.344-3.904), altered consciousness (B = 1.040, P < 0.001, OR = 2.829, 95% CI: 1.686-4.747), a cerebrospinal fluid (CSF)-to-plasma glucose ratio <50% (B = -0.892, P = 0.001, OR = 0.410, 95% CI: 0.244-0.688), hydrocephalus (B = 1.050, P = 0.003, OR = 2.857, 95% CI: 1.417-5.760), and lack of Bacille Calmette-Guerin (BCG) immunization (B = 1.291, P < 0.001, OR = 3.638, 95% CI: 2.150-6.156).

Conclusion: The study identified key risk factors for poor outcomes in childhood TBM, including age over 5 years, high CSF protein levels, coma, hydrocephalus, and inadequate BCG immunization. These factors underline the severity of childhood TBM as a public health issue and emphasize the need for timely initiation of antituberculosis therapy.