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Associated effects of clinical characteristics, risk factors, and comorbidity on disease severity and mortality among patients with COVID-19 in Sulaimani City/ Kurdistan Region of Iraq. 伊拉克苏莱曼尼市/库尔德斯坦地区临床特征、危险因素和合并症对COVID-19患者疾病严重程度和死亡率的相关影响
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Shakhawan Aziz-Mawlood, Salar Ibrahim Ali, Muhammed Babakir-Mina, Silvia Angeletti, Salvatore Dimonte, Michele Pellegrino, Massimo Ciccozzi, Stefano Aquaro

The effects of clinical symptoms, laboratory indicators, and comorbidity status of SARS-CoV-2-infected patients on the severity of disease and the risk of death were investigated. Questionnaires and electronic medical records of 371 hospitalized COVID-19 patients were used for data collection (demographics, clinical manifestation, comorbidities, laboratory data). Association among categorical variables was determined using Kolmogorov-Smirnov test (P-value ≤0.05). Median age of study population (249 males, 122 females) was 65 years. Roc curves analysis found that age ≥64 years and age ≥67 years are significant cut-offs identifying patients with more severe disease and mortality at 30 days. CRP values at cut-off ≥80.7 and ≥95.8 significantly identify patients with more severe disease and mortality. Patients with more severe disease and risk of death were significantly identified with platelet value at the cut-off ≤160,000, hemoglobin value at the cut-off ≤11.7, D-Dimer values ≥1383 and ≥1270, and with values of neutrophil granulocytes (≥8.2 and ≤2) and lymphocytes (≤2 and ≤2.4). Detailed clinical investigation suggests granulocytes together with lymphopenia may be a potential indicator for diagnosis. Older age, several comorbidities (cancer, cardiovascular diseases, hypertension) and more laboratory abnormalities (CRP, D-Dimer, platelets, hemoglobin) were associated with development of more severity and mortality among COVID-19 patients.

探讨sars - cov -2感染患者的临床症状、实验室指标、合并症情况对病情严重程度和死亡风险的影响。采用调查问卷和电子病历收集371例新冠肺炎住院患者的数据(人口统计学、临床表现、合并症、实验室数据)。分类变量间的相关性采用Kolmogorov-Smirnov检验(p值≤0.05)。研究人群的中位年龄(249名男性,122名女性)为65岁。Roc曲线分析发现,年龄≥64岁和年龄≥67岁是识别30天内疾病和死亡率更严重患者的显著截断点。CRP值在临界值≥80.7和≥95.8时,可以明显识别出病情和死亡率更严重的患者。血小板值在临界值≤160,000,血红蛋白值在临界值≤11.7,d -二聚体值≥1383和≥1270,中性粒细胞值(≥8.2和≤2)和淋巴细胞值(≤2和≤2.4)显著鉴别病情较重和有死亡风险的患者。详细的临床调查表明,粒细胞伴淋巴细胞减少可能是诊断的潜在指标。年龄较大、一些合并症(癌症、心血管疾病、高血压)和更多的实验室异常(CRP、d -二聚体、血小板、血红蛋白)与COVID-19患者的严重程度和死亡率增加有关。
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引用次数: 0
Aggregatibacter aphrophilus and Eikenella corrodens: a case of brain abscess. 嗜艾肯氏菌与嗜艾肯氏菌联合腐蚀脑脓肿1例。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Concetta Lo Biundo, Annalisa Bongiovanni, Silvana Tumbiolo, Arianna Sucato, Teresa Fasciana, Anna Giammanco, Orazia Diquattro

We report a case of a 26-year-old female who developed a brain abscess that was strongly suspected to be caused by Staphylococcus epidermidis, A. aphrophilus, and E. corrodens species. In general, A. aphrophilus and E. corrodens, members of the HACEK group (Haemophilus spp., Aggregatibacter spp., C. hominis, E. corrodens, and K. kingae), have been associated with the development of endocarditis, meningitis, sinusitis, otitis media, pneumonia, osteomyelitis, peritonitis, and wound infections. Cerebral abscesses are a rare manifestation of these bacteria; only a few cases are described in the literature, generally related to the diffusion of these organisms through the bloodstream after a dental procedure or a heart disease. Our case is unique because the rarity of the infection site appeared apparently in absence of risk factors. The patient underwent surgery to drain the abscess and was subsequently put on intravenous antibiotic treatment with ceftriaxone, vancomycin, and metronidazole. After 6 months, brain imaging revealed that the lesion had disappeared. The patient achieved excellent results with this approach.

我们报告一例26岁的女性发生脑脓肿,强烈怀疑是由表皮葡萄球菌、嗜蚜葡萄球菌和腐蚀葡萄球菌引起的。一般来说,HACEK组的成员(嗜血杆菌、聚集杆菌、人原杆菌、腐蚀杆菌和金氏杆菌)与心内膜炎、脑膜炎、鼻窦炎、中耳炎、肺炎、骨髓炎、腹膜炎和伤口感染有关。脑脓肿是这些细菌的罕见表现;文献中只描述了少数病例,通常与牙科手术或心脏病后这些生物体通过血液扩散有关。我们的病例是独特的,因为感染部位的罕见性明显出现在没有危险因素的情况下。患者行手术引流脓肿,随后静脉给予头孢曲松、万古霉素、甲硝唑等抗生素治疗。6个月后,脑成像显示病变消失。患者采用这种方法取得了很好的效果。
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引用次数: 0
Lactococcus lactis blood products contamination resulting in fatal human case: insights from a forensic case. 乳酸乳球菌血液制品污染导致人类死亡的案例:来自法医案例的见解。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Simone Giuliano, Andrea Scatena, Francesco Sbrana, Luca Martini, Alice Chiara Manetti, Carlo Tascini, Marco Di Paolo

Lactococcus species are micro-aerophilic Gram positive bacteria characterized by low virulence features and other biotechnological properties of industrial interest. They are thus widely employed in food fermentation processes. Despite its low pathogenic potential and food grade safety, L. lactis may, however, rarely cause infections, especially among immunocompromised hosts. Moreover, the growing complexity of patients implies increased detections of such infections. This said, there is a paucity of data concerning L. lactis infections from infusion of blood transfusion products. To our knowledge, this is the first case of L. lactis infection from transfusion of blood products, as observed in an 82-year-old Caucasian male undergoing weekly platelet and blood transfusion due to sustained severe thrombocytopenia. Albeit minimally pathogenic, L. lactis should be considered for thorough testing, especially in the case of human-derived infusion products such as platelets due to their storage requirements for extended times at room temperature and their use in immunocompromised and critically ill subjects.

乳球菌是一种微嗜气的革兰氏阳性菌,具有低毒力和其他具有工业价值的生物技术特性。因此,它们被广泛应用于食品发酵过程中。尽管乳酸菌具有低致病性和食品级安全性,但它很少引起感染,特别是在免疫功能低下的宿主中。此外,患者日益复杂意味着这类感染的检测也在增加。这就是说,关于输血产品输注乳酸乳杆菌感染的数据缺乏。据我们所知,这是首例因输血引起乳杆菌感染的病例,该病例发生在一名82岁的白人男性中,由于持续严重的血小板减少症,他每周接受血小板和输血。尽管致病性极低,但乳酸乳杆菌应考虑进行彻底检测,特别是在血小板等人源输注产品的情况下,因为它们需要在室温下长时间储存,并且用于免疫功能低下和危重患者。
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引用次数: 0
Pragmatic overview on acute bacterial and fungal infections of the central nervous system: a holistic update from diagnosis to treatment. 对中枢神经系统的急性细菌和真菌感染的实用概述:从诊断到治疗的整体更新。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Simone Giuliano, Sarah Flammini, Agnese Zanus-Fortes, Luca Montanari, Gabriele Maria Leanza, Vittorio Attanasio, Davide Pecori, Francesco Sbrana, Carlo Tascini

Although progress has led to a drop in infections, meningitis still represents a threat worldwide, affecting some areas more than others. As a medical emergency, it requires prompt recognition and treatment. Moreover, diagnosis relies on invasive methods, while representing a tug-of-war with timely therapeutic interventions, since delays are burdened by mortality and life-long sequalae. While counterbalancing the overuse of antimicrobials, it is imperative to assess correct interventions in order to optimize treatments and reduce negative outcomes. Because the drop in mortality and consequences has been consistent, although not as impactful as with other vaccine-preventable diseases, the WHO has traced a roadmap detailing actions to reduce the meningitis burden by 2030. There are currently no updated guidelines, whereas novel diagnostic methods as well as pharmacological interventions are increasing, along with the shifting epidemiology. In light of the above, this paper wishes to summarize existing data and evidences and suggest potential novel solutions to a complex problem.

尽管取得的进展导致感染率下降,但脑膜炎仍然是世界范围内的一个威胁,对一些地区的影响大于其他地区。作为医疗紧急情况,需要及时识别和治疗。此外,诊断依赖于侵入性方法,同时代表着与及时治疗干预的拉锯战,因为延误会受到死亡率和终身后遗症的影响。在平衡过度使用抗微生物药物的同时,必须评估正确的干预措施,以优化治疗并减少不良后果。由于死亡率及其后果的下降一直是一致的,尽管不如其他疫苗可预防疾病那样有影响力,因此世卫组织制定了一份路线图,详细说明到2030年减少脑膜炎负担的行动。目前尚无更新的指南,而随着流行病学的变化,新的诊断方法和药理学干预措施正在增加。鉴于此,本文希望总结现有的数据和证据,并为一个复杂问题提出潜在的新解决方案。
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引用次数: 0
Drug resistant tuberculosis in Italy through a global health lens. 从全球健康角度看意大利的耐药结核病。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Federico Fama, Camilla Genovese, Mario Raviglione, Andrea Gori

Drug-resistant tuberculosis (DR-TB) is a major global health challenge. In 2021, about one third of DR-TB patients worldwide were enrolled in treatment. In order to reach the targets set during by the 2018 UN General Assembly (UNGA) Political Declaration on Tuberculosis, a global effort must be made by both high- and low-incidence countries. Data concerning high-incidence countries are vast in the literature, but insufficient political attention has been paid in low-incidence countries to face this infectious threat. This review aims at providing an overview of DR-TB focused on different facets of DR-TB management. First, global and Italian data on the main at-risk populations for TB and DR-TB were gathered, together with the latest studies on the correlation between TB risk factors and the onset of drug resistance. Second, this review provides an analysis of obsolete Italian guidelines on the diagnosis and management of TB and DR-TB, highlighting the challenges that our country is currently facing to properly implement the latest international recommendations. Finally, some key suggestions are provided to design public health (PH) policies that can effectively tackle the DR-TB issue from a "global health" perspective.

耐药结核病(DR-TB)是一项重大的全球卫生挑战。2021年,全世界约有三分之一的耐药结核病患者接受了治疗。为了实现2018年联合国大会《关于结核病问题的政治宣言》中确定的目标,高发病率国家和低发病率国家都必须作出全球努力。文献中有大量关于高发病率国家的数据,但在低发病率国家,对这一传染性威胁的政治关注不够。这篇综述的目的是提供耐药结核病的概述,重点是耐药结核病管理的不同方面。首先,收集了关于结核病和耐药结核病主要危险人群的全球和意大利数据,以及关于结核病危险因素与耐药性发生之间相关性的最新研究。其次,本综述对过时的意大利结核病和耐药结核病诊断和管理指南进行了分析,突出了我国目前在正确实施最新国际建议方面面临的挑战。最后,从“全球卫生”的角度出发,为制定有效应对耐药结核病问题的公共卫生政策提供了一些关键建议。
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引用次数: 0
An unusual case of native aortic endocarditis due to Corynebacterium pseudodiphtheriticum. 假性白喉杆状杆菌引起的原发性主动脉心内膜炎1例。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Frédéric Wallet, Stéphanie Vanagt, Moulay Alaoui, Guillaume Gantois, Francis Juthier, Claire Duployez, Caroline Loïez

Corynebacterium pseudodiphtheriticum, a Gram-positive rod belonging the oropharynx microbiota, is usually described in pulmonary infections, especially in immunocompromised patients. This paper describes a rare case of native aortic infectious endocarditis (IE) and reviews the literature on similar cases. A 62-year-old man with rheumatic fever since childhood was hospitalized for surgical treatment of a febrile IE due to C. diphtheriticum with a large vegetation (15.8 X 8.3 mm). MALDI-TOF-MS from strain isolated in positive blood cultures identified C. pseudodiphtheriticum (2.34), and 16S rRNA sequencing from the valve sample confirmed the identification. The summary of 25 cases shows that the outcome of an IE due to C. pseudodiphtheriticum is bad. The review of the literature shows that this agent found in blood cultures in a cardiovascular context deserves to be explored meticulously because an unfavorable prognosis is frequent.

假性白喉棒状杆菌是一种属于口咽部微生物群的革兰氏阳性棒状菌,通常见于肺部感染,特别是免疫功能低下的患者。本文报告一例罕见的先天性主动脉感染性心内膜炎(IE),并回顾了类似病例的文献。一名62岁男性,从小患有风湿热,因白喉支原体大(15.8 X 8.3 mm)感染发热性IE住院接受手术治疗。阳性血培养株MALDI-TOF-MS鉴定为假白喉双歧杆菌(2.34),阀样16S rRNA测序证实了该鉴定。本文总结了25例假白喉C.所致IE的预后较差。回顾文献表明,这种药物在血液培养中发现在心血管背景值得仔细探索,因为不良预后是常见的。
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引用次数: 0
In Vitro Virucidal Effects of Ultraviolet Light Prototypes on RNA viruses. 紫外光原型对RNA病毒的体外杀病毒作用。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Matteo Fracella, Mirko Scordio, Leonardo Sorrentino, Alessandra D'Auria, Raffaele Ingenito, Massimo Gentile, Alessandra Pierangeli, Guido Antonelli, Carolina Scagnolari, Federica Frasca

Ultraviolet-C (UVC) has been used to cause virus inactivation. The virucidal activity of three UV light lamps [UVC high frequencies (HF), UVC+B LED and UVC+A LED] was evaluated against the enveloped feline coronavirus (FCoVII), a surrogate model of SARS-CoV-2, the enveloped vesicular stomatitis virus (VSV), and the naked encephalomyocarditis virus (EMCV). Virucidal assays were performed at different time points of UV-light exposure (i.e., 5, 30 minutes and 1, 6, and 8 hours), placing each virus 180 cm below the perpendicular irradiation of the lamp and 1 and 2 meters from the perpendicular axis. We found that the UVC HF lamp had virucidal effects (≥96.8% of virus inactivation) against FCoVII, VSV and EMCV after 5 minutes of irradiation at each distance analyzed. Moreover, the UVC+B LED lamp had the highest inhibitory effects on FCoVII and VSV infectivity (≥99% of virus inactivation) when these viruses were settled below the perpendicular axis of the lamp for 5 minutes. Conversely, the UVC+A LED lamp was the least effective, achieving ≥85.9% inactivation of enveloped RNA viruses after 8 hours of UV exposure. Overall, UV light lamps, and in particular UVC HF and UVC+B LED ones, had a rapid and strong virucidal activity against distinct RNA viruses, including coronaviruses.

紫外线c (UVC)已被用于灭活病毒。研究了三种紫外线灯[UVC高频(HF)、UVC+B LED和UVC+A LED]对包膜性猫冠状病毒(FCoVII)、SARS-CoV-2替代模型、包膜性水泡性口炎病毒(VSV)和裸脑心肌炎病毒(EMCV)的抗病毒活性。在紫外线照射的不同时间点(即5分钟、30分钟、1小时、6小时和8小时)进行毒力测定,将每个病毒置于灯垂直照射下180厘米处,距离垂直轴1米和2米处。结果表明,UVC高频灯对FCoVII、VSV和EMCV的病毒灭活率≥96.8%,照射时间为5 min。UVC+B LED灯对FCoVII和VSV的抑制效果最好,当病毒在灯的垂直轴下沉淀5分钟时,病毒灭活率≥99%。相反,UVC+A LED灯的灭活效果最差,在紫外线照射8小时后,包膜RNA病毒的灭活率≥85.9%。总的来说,紫外线灯,特别是UVC HF和UVC+B LED灯,对包括冠状病毒在内的多种RNA病毒具有快速而强的杀病毒活性。
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引用次数: 0
BK Virus Infections and Hemorrhagic Cystitis in Allogeneic Hematopoietic Stem Cell Transplant Recipients. 异基因造血干细胞移植受者的BK病毒感染和出血性膀胱炎。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-05-01
Huri Sökmen, Gökhan Öztürk, Mehmet Çimentepe, Serap Özen, Hasan Alaa Wahhab Alantake, İbrahim Bayram, Fügen Yarkın

BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. This study aims to investigate BKV infections and HC in pediatric patients after allogeneic hematopoietic stem cell transplantation. Between November 2018 and November 2019, a total of 51 patients between the ages of 11 months and 17 years were included in the study. BKV Bosphore ® v1 quantification kit (Geneworks Anatolia, Turkey) was used for the detection of BKV DNA in urine and blood samples. Among the total of 51 patients, the incidence of BKV infection was found to be 86.3%. Allogeneic HSCT was performed in 40 patients and autologous HSCT in 11 patients. BK viruria and/or viremia were detected in 85% (44) of patients who underwent allogeneic HSCT and in 90% in the autologous group. High-level BK viruria (>107 copies/mL) was found in 41% (9) of 22 patients who were BKV positive before transplantation, while in 27.5% (8) of 29 patients who were BKV negative before transplantation; thus, BKV positivity before transplantation was considered a risk factor for high-level BK viruria. Acute GVHD developed in 6 of 40 patients in the allogeneic group. HC was prevented in 12 (67%) of 18 patients who received preemptive treatment, while HC developed in 6 (33%). HC occurred at a median of 35 days (17-49 days) post-transplant. Despite preemptive treatment, 6 (15%) patients who developed HC associated with BKV were in the allogeneic group but not in the autologous group. Of these patients with HC, 5 received a myeloablative treatment regimen, and 1 patient was given a reduced-intensity treatment regimen. The viral load in urine was found to be 107-9 copies/mL within 2 weeks before the development of HC and has been identified as a prognostic indicator. In conclusion, early diagnosis of viral infections by monitoring BKV viral load in HSCT patients will be effective in preventing the progression of complications such as BKV-associated HC by providing timely initiation of preemptive treatment.

BK病毒(BKV)与出血性膀胱炎(HC)相关是血液系统恶性肿瘤患者造血干细胞移植(HSCT)后发生的最重要并发症。本研究旨在探讨小儿异体造血干细胞移植后BKV感染与HC的关系。在2018年11月至2019年11月期间,共有51名年龄在11个月至17岁之间的患者被纳入该研究。BKV Bosphore®v1定量试剂盒(Geneworks Anatolia,土耳其)用于检测尿液和血液样本中的BKV DNA。51例患者中,BKV感染率为86.3%。40例患者接受同种异体移植,11例患者接受自体移植。在接受同种异体造血干细胞移植的患者中,85%(44)检测到BK病毒和/或病毒血症,而在自体组中,这一比例为90%。移植前BKV阳性的22例患者中有41%(9例)存在高水平BK病毒(>107拷贝/mL),移植前BKV阴性的29例患者中有27.5%(8例)存在高水平BK病毒;因此,移植前BKV阳性被认为是高水平BK病毒的危险因素。同种异体组40例患者中有6例出现急性GVHD。在接受预防性治疗的18例患者中,12例(67%)未发生丙型肝炎,6例(33%)发生丙型肝炎。HC发生在移植后平均35天(17-49天)。尽管采取了先发制人的治疗,6例(15%)与BKV相关的HC患者属于同种异体组,而不是自体组。在这些HC患者中,5名患者接受了清髓治疗方案,1名患者接受了低强度治疗方案。在HC发生前2周内发现尿病毒载量为107-9拷贝/mL,已被确定为预后指标。总之,通过监测HSCT患者的BKV病毒载量来早期诊断病毒感染将有效地预防并发症的进展,如BKV相关的HC,及时提供先发制人的治疗。
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引用次数: 0
Virucidal efficacy of a novel silver-based disinfectant against SARS-CoV-2 Omicron BA.5. 新型银基消毒剂对SARS-CoV-2 Omicron BA.5的杀病毒效果
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-02-01
Alberto Zani, Serena Messali, Francesca Caccuri

In this study we evaluated the antiviral activity of the Silver Barrier® disinfectant against SARSCoV-2. Silver Barrier® showed time- and concentration-dependent antiviral activity against SARSCoV-2. After 5 min contact time, Silver Barrier® at 0.002% showed a strong inhibitory effect (p<0.001), with a 2-fold reduction of viral genome copy numbers, and a robust suppression (94%) of SARS-CoV-2 infectivity. Considering the effects obtained in solution and within a very short time, Silver Barrier® stands as an excellent new candidate for the disinfection of work environments, especially at the healthcare level, where there are people at high risk of serious illnesses.

在这项研究中,我们评估了银屏障®消毒剂对SARSCoV-2的抗病毒活性。Silver Barrier®对SARSCoV-2的抗病毒活性具有时间和浓度依赖性。接触时间5 min后,0.002%的银屏障显示出较强的抑制作用(p
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引用次数: 0
Progesterone and Estradiol alter the growth, virulence and antibiotic susceptibilities of Staphylococcus aureus. 黄体酮和雌二醇改变金黄色葡萄球菌的生长、毒力和对抗生素的敏感性。
IF 1.8 4区 医学 Q4 MICROBIOLOGY Pub Date : 2023-02-01
Fatma Kalaycı-Yüksek, Defne Gümüş, Varol Güler, Aysun Uyanık-Öcal, Mine Anğ-Küçüker

In the present study, the effects of progesterone (PRO) and estradiol (EST) on the growth, adhesion, invasion, biofilm and antibiotic susceptibilities of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) were examined. We also investigated effects of S. aureus infections on the viability of human breast adenocarcinoma (MCF-7) cells in the presence/ absence of hormones. The effects of hormones on the growth, adhesion and invasion of S. aureus were investigated in MCF-7 cells. Growths were assessed spectrophotometrically. Adhesive/invasive bacterial counts were examined by colony counting method. Biofilm was determined using microtiter plate assay. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of ciprofloxacin (CIP) and gentamicin (GN) were examined by the microdilution method. Cell viabilities were detected via methylthiazolyldiphenyl-tetrazolium bromide assay. Growths of bacteria were decreased by hormones (p<0.0001). Adhesion was affected differently depending on hormones and strains tested. Hormones reduced the invasion (p≤0.0001) and biofilm (p<0.0001) of both strains. Progesterone increased and estradiol decreased MIC and MBC of CIP for MRSA; however, MICs of MSSA were not affected. S. aureus infected-MCF-7 viabilities were decreased in the presence of hormones except for high-level PRO (p<0.05). Our results showed that these two hormones have different effects on behaviors of S. aureus strains.

本研究探讨了黄体酮(PRO)和雌二醇(EST)对耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林金黄色葡萄球菌(MSSA)生长、粘附、侵袭、生物膜及抗生素敏感性的影响。我们还研究了金黄色葡萄球菌感染在存在或不存在激素的情况下对人乳腺腺癌(MCF-7)细胞活力的影响。在MCF-7细胞中研究了激素对金黄色葡萄球菌生长、粘附和侵袭的影响。用分光光度法测定生长情况。采用菌落计数法检测粘附/侵袭性细菌计数。采用微滴板法测定生物膜。采用微量稀释法测定环丙沙星(CIP)和庆大霉素(GN)的最小抑菌浓度(MIC)和最小杀菌浓度(MBC)。采用甲基噻唑基二苯四唑溴化法检测细胞活力。激素抑制了细菌的生长(p
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