Rhinosinusitis is an inflammation of the nasal mucosa and paranasal sinuses, of infectious or noninfectious origin, and may be acute or chronic. Fungal forms are more frequent in immunosuppressed individuals but can also affect immunocompetent patients. Chronic disease caused by Candida pelliculosa and Cladosporium sp. may result from inhalation of environmental spores, followed by mucosal colonization and activation of an inflammatory response. Candida pelliculosa is an opportunistic yeast rarely associated with human infections, while Cladosporium sp. are saprophytic fungi that may act as pathogens in susceptible hosts. We report the case of a 47-year-old immunocompetent woman, overweight, with a history of bilateral hearing loss and decreased visual acuity related to an undiagnosed polyneuropathy, who presented with recurrent rhinosinusitis for approximately two years, unresponsive to prolonged antibiotic and corticosteroid therapy. She developed nasal deformity (saddle nose), progressive obstruction, dark crusts, rhinorrhea, and recurrent fever. Rheumatologic investigation ruled out autoimmune disease. CT imaging showed chronic pansinusitis, probable polyps, obstruction of drainage pathways, and bone osteopenia. She underwent nasal debridement surgery, and cultures grew Candida pelliculosa sensitive to fluconazole. She was treated with fluconazole 300 mg/day for six months, with partial improvement. A second surgery and culture revealed Cladosporium sp., and itraconazole 200 mg/day was initiated for six weeks, with good response. Three months after completing antifungal therapy, reevaluation showed absence of secretion and complete resolution of inflammatory signs, with negative cultures, indicating infection resolution. In prolonged or recurrent rhinosinusitis, even in the absence of defined immunosuppression, fungal etiology should be suspected to guide appropriate diagnostic and therapeutic strategies, prevent sequelae, and improve quality of life.
Kateřina Bruštíková, Jitka Forstová, Barbora Holajová
et al.
Abstract BK polyomavirus (BKPyV) is a human pathogen that causes severe disease in immunocompromised individuals. Although discovered in the 1970s, important gaps in our understanding of BKPyV biology persist. Key unresolved areas include the precise molecular mechanisms governing viral latency and reactivation, the specific host and viral factors determining the virus tropism towards the urinary tract, and the intricate virus-host interactions that drive clinical pathogenesis. These unresolved biological questions have stalled the development of targeted therapeutics; as a result, no specific antiviral therapy is currently available for BKPyV-related diseases. In this review, we examine findings from both experimental models and clinical samples that investigate how BKPyV remodels host organelles and the molecular pathways underlying these alterations. We focus on BKPyV-driven changes in cellular membranes, including endoplasmic reticulum remodeling, mitochondrial disruption, the formation of endoplasmic reticulum-derived tubuloreticular structures, vacuoles, and autophagosomes, as well as the accumulation of lipid droplets. Collectively, these organelle-specific modifications highlight membrane remodeling as a central feature of BKPyV replication and pathogenesis. Addressing the key knowledge gaps in the molecular basis of virus-induced membrane remodeling will be critical for guiding the development of effective antiviral strategies.
Alpha Umaru Bai-Sesay, Daniel Karim Dauda Sesay, Alieu Tommy
Abstract Background: Infectious and parasitic diseases, including malaria, HIV/AIDS, and tuberculosis, are leading causes of mortality in low-income countries like Sierra Leone. Despite progress in reducing mortality, sex-based disparities persist. This study examines trends in sex-based inequalities in mortality from infectious and parasitic diseases in Sierra Leone from 2001 to 2021. Methods: Using the World Health Organization’s Global Health Estimates from the WHO equity standardized data set, 2024 update, we analyzed mortality rates (deaths per 100,000 population) for infectious and parasitic diseases by sex (male and female) in 2001, 2006, 2011, 2016, and 2021. The Health Equity Assessment Toolkit (HEAT, Version 6.1) was used to compute four inequality metrics: Difference, Ratio, Population Attributable Fraction, and Population Attributable Risk, following WHO methodology. Results: Mortality rates declined substantially from 2001 to 2021, with female mortality decreasing from 792.3 to 258.5 per 100,000 and male mortality from 862.6 to 289.0 per 100,000. The absolute difference narrowed from −70.4 to −30.6, with males consistently showing higher mortality. The relative ratio remained stable at 0.9. PAF and PAR were consistently 0 (95% CIs crossing zero), indicating no significant population-level burden attributable to sex inequality. Conclusion: Despite notable declines in overall mortality from infectious and parasitic diseases in Sierra Leone, sex-based inequalities persist, with males experiencing a disproportionately higher burden. These findings highlight the need for targeted, gender-sensitive public health interventions to address persistent disparities and promote health equity.
Tagreed Al-Subhi, Muhammad Yasir, Samar A. Badreddine
et al.
Background: The microbiome of the respiratory system functions as a gatekeeper of respiratory health and is influenced by respiratory diseases. The aim of this study was to identify changes in the respiratory bacterial community composition associated with respiratory infections and to explore their relationship with specific bacterial pathogens in the Saudi Arabian population. Methods: Nasopharyngeal samples were screened from 73 individuals, including 34 symptomatic respiratory tract infection patients, 10 asymptomatic participants, and 29 healthy controls. Respiratory pathogens were detected using real-time PCR, and the microbiota were characterized through 16S rRNA gene amplicon sequencing. Results: Alpha diversity analysis revealed a slight decrease in bacterial richness in patients and asymptomatic individuals compared to healthy controls. In beta diversity analysis, healthy controls clustered together, while most symptomatic patients clustered separately. Actinobacteria, known for maintaining microbial homeostasis and preventing pathogenic colonization, were abundant in asymptomatic and healthy controls (> 30 %) but were substantially reduced to < 20 % relative abundance in symptomatic patients. Several bacterial genera, including Abiotrophia, Capnocytophaga, Megasphaera, Campylobacter, Peptostreptococcus, Veillonella, Streptococcus, and Bulleidia, were positively correlated with respiratory infections. Corynebacterium, Dolosigranulum, and Lawsonella were more abundantly found in healthy and asymptomatic individuals. Patients harboring Streptococcus pneumoniae or methicillin-resistant Staphylococcus aureus (MRSA) exhibited distinct bacterial profiles. Genera such as Staphylococcus, Pseudomonas, and Peptoniphilus were correlated with MRSA infection, while samples positive for S. pneumoniae exhibited a relatively higher abundance of Neisseria and Prevotella. Notably, a substantial number of symptomatic patients tested negative for any of the screened pathogens by real-time PCR but still showed alterations in bacterial community composition. Conclusions: Specific bacterial taxa showed significant differences between healthy controls and symptomatically infected patients, suggesting that bacterial community structures and groups of taxa, rather than individual bacterial taxa, may play a role in regulating respiratory infections.
Infectious and parasitic diseases, Public aspects of medicine
Fenny Ong, Geert Molenberghs, Andrea Callegaro
et al.
Introduction:
Identifying hemagglutination inhibition (HI) antibody titers as a key immune correlate of protection (CoP) is crucial for developing, licensing, and monitoring the ongoing effectiveness of new influenza vaccines. Using a new statistical methodology, we explored the link between an inactivated quadrivalent influenza vaccine’s impact on HI antibody titers and its effectiveness against A/H1N1-associated influenza illness.
Methods:
We utilized data from a phase 3, observer-blind, randomized, controlled trial in children aged 6–35 months to assess HI antibody titers as an immune CoP. The assessment used a statistical method developed within a causal inference framework and a new information-theoretic metric of surrogacy, the so-called individual causal association (ICA).
Results:
The 75% and 85% uncertainty intervals of the ICA are 0.5511–0.8282 and 0.3632–0.8684, respectively, indicating a substantial reduction in the uncertainty about the vaccine’s effect on the absence of infection when its impact on the HI antibody titers is known.
Conclusions:
The evaluation yielded evidence supporting the validity of HI antibody titers as a CoP for influenza infection.
Abstract Aim Palivizumab has proven effective in reducing hospitalizations, preventing severe illness, improving health outcomes, and reducing healthcare costs for infants at risk of respiratory syncytial virus (RSV) infection. We aim to assess the value of palivizumab in preventing RSV infection in high-risk infants in Colombia, where RSV poses a significant threat, causing severe respiratory illness and hospitalizations. Methods We conducted a decision tree analysis to compare five doses of palivizumab with no palivizumab. The study considered three population groups: preterm neonates (≤ 35 weeks gestational age), infants with bronchopulmonary dysplasia (BPD), and infants with hemodynamically significant congenital heart disease (CHD). We obtained clinical efficacy data from IMpact-RSV and Cardiac Synagis trials, while we derived neonatal hospitalization risks from the SENTINEL-1 study. We based hospitalization and recurrent wheezing management costs on Colombian analyses and validated them by experts. We estimated incremental cost-effectiveness ratios and performed 1,000 Monte Carlo simulations for probabilistic sensitivity analyses. Results Palivizumab is a dominant strategy for preventing RSV infection in preterm neonates and infants with BPD and CHD. Its high efficacy (78% in preventing RSV in preterm infants), the substantial risk of illness and hospitalization, and the high costs associated with hospitalization, particularly in neonatal intensive care settings, support this finding. The scatter plots and willingness-to-pay curves align with these results. Conclusion Palivizumab is a cost-saving strategy in Colombia, effectively preventing RSV infection in preterm neonates and infants with BPD and CHD by reducing hospitalizations and lowering healthcare costs.
Yuliana Atanasova, Stanislava Yordanova, Ana Baykova
et al.
Background: Nontuberculous mycobacteria (NTM) are generally free-living and have a potential to cause opportunistic infection. More than 190 species of NTM have been identified (http://www.bacterio.net/mycobacterium.html), up to 60 species of them are pathogenic. The distribution is geographically specific for some species and others are cosmopolitan. Understanding their diversity has practical value for the treatment and management of NTM disease. Except for isolated reports, there is no accurate information about NTM spread among Bulgarian patients. Material and Methods: We retrospectively analysed the data on the NTM isolated from patients throughout the country for the period from January 2010 to December 2017. Identification to the species level was done by Line Probe Assay (LPA). Results: 586 NTM strains were identified. We calculated the rate of NTM isolation in Bulgaria and NTM disease incidence by applying microbiological criteria defined by the American Thoracic Society (ATS). As a result, the laboratory isolation rate amounted to 1/100 000 people for the period, and when applying only the ATS criteria, the prevalence of NTM disease was 0,23 per 100 000 people. In both cases, we reported that NTM disease incidence remains low as compared to tuberculosis, though with an increasing trend. The prevalence of NTM varied significantly between northern and southern Bulgaria, as well as between the capital and the rest of the country's regions. Conclusions: Slow growing NTM species predominate in Bulgaria but rapidly growing ones have isolation levels higher than the average for Europe and closer to that of Asian countries. Given the demographic situation in Bulgaria and the changing climatic factors, NTM infections need special attention.
Nadin Younes, Jerzy M. Behnke, Ahmed Ismail
et al.
Abstract Background The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service, and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common. In this study, we explored the environmental and socio-demographic characteristics of immigrant workers in Doha Qatar, which might explain the persistence of the parasites that they harbor. Methodology This cross-sectional survey was conducted among 2486 newly arrived immigrant workers and those who visited Qatar previously during the period 2012–2014. Through questionnaires and census data, we characterized the socio-demographic conditions at an individual, family, and neighborhood levels. Results Overall, the prevalence of combined protozoan infection was 11.7% and that of helminth was 7.0%. Combined protozoan infections were significantly associated with immigrant workers arriving in Doha for the first time. In univariate log-linear statistical models fitted in phase 1 of the analysis, significant associations were observed between the prevalence of combined protozoan infections and personal and familial factors that included religion, the level of education of subjects, both parents’ educational levels and their jobs, and the number of siblings. Furthermore, environmental effects on the prevalence of protozoan infections including the country of origin, the floor of the house, toilet type, household content index, provision of household water, farming background showed strong associations with protozoan infections. However, in phase 2, multifactorial binary logistic generalized linear models focusing only on the significant effects identified in phase 1, showed that only five factors retained significance (age class, floor of the house, household contents index, father’s education, and the number of siblings). The only factors that had a significant effect on the prevalence of helminth infections were the subjects’ age class and the mother’s educational level. Conclusions The prevalence of intestinal protozoan parasites among immigrant workers in Qatar is clearly multifactorial in origin determined by key familial relationships of subjects and also the environment, in which the subjects lived prior to their arrival in Qatar. Moreover, our results suggest that screening protocols for applicants for visas/work permits need to be revised giving more careful attention to the intestinal protozoan infections that potential immigrant workers may harbor.
The incidence of infections caused by Cryptococcus neoformans has increased significantly in recent years, especially in the settings of immune deficiency (HIV infection transplantation, etc.). Most often after inhalation of spores dissemination of yeast to the brain parenchyma occurs, leading to meningitis (meningo-encephalitis). Our clinical case, is a patient with cryptococcal meningitis after liver transplantation , who died despite the onset of antifungal therapy. This is further evidence of the severe prognosis of CNS cryptococcosis, especially in immunocompromised patients.
A comprehensive understanding of common diseases of backyard poultry flocks is important to providing poultry health information to flock owners, veterinarians, and animal health officials. We collected autopsy reports over a 3-y period (2015–2017) from diagnostic laboratories in 8 states in the United States; 2,509 reports were collected, involving autopsies of 2,687 birds. The primary cause of mortality was categorized as infectious, noninfectious, neoplasia or lymphoproliferative disease, or undetermined. Neoplasia or lymphoproliferative disease was the most common primary diagnosis and involved 42% of the total birds autopsied; 63% of these cases were diagnosed as Marek’s disease or leukosis/sarcoma. Bacterial, parasitic, and viral organisms were commonly detected, involving 42%, 28%, and 7% of the birds autopsied, respectively, with 2 or more organisms detected in 69% of birds. Our findings demonstrate the importance of educating flock owners about disease prevention and biosecurity practices. The detection of zoonotic bacteria including paratyphoid salmonellae, Campylobacter spp., Listeria monocytogenes, and Mycobacterium avium, and the detection of lead and other heavy metals, indicate public health risks to flock owners and consumers of backyard flock egg and meat products.
Cedecea lapagei is rarely known to cause infections in humans. We report the first case of pneumonia and septic shock caused by Cedecea lapagei in a 38-year-old man in Vietnam. Cedecea lapagei may be an emerging infectious agent in humans.
Charoenpak R, Santimaleeworagun W, Suwanpimolkul G
et al.
Ratchanu Charoenpak, 1 Wichai Santimaleeworagun, 2 Gompol Suwanpimolkul, 3–5 Weerawat Manosuthi, 6 Paweena Kongsanan, 6 Suthidee Petsong, 7 Chankit Puttilerpong 8 1College of Pharmacotherapy Thailand, Nonthaburi, Thailand; 2Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand; 3Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 4Tuberculosis Research Unit, Chulalongkorn University, Bangkok, Thailand; 5Emerging Infectious Diseases Clinical Center, Thai Red Cross, Bangkok, Thailand; 6Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand; 7Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 8Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, ThailandCorrespondence: Chankit PuttilerpongDepartment of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phayathai Road, Patumwan, Bangkok, ThailandTel|Fax +66 2 218 8403Email Chankit.P@chula.ac.thPurpose: The emergence of isoniazid-resistant tuberculosis (HR-TB) is a global public health problem, causing treatment failure and high mortality rates. This study aimed to determine the minimal inhibitory concentration (MIC) of isoniazid and detect the gene mutation in HR-TB and any association between the level of isoniazid resistance and gene mutation.Methods: We collected 74 clinical HR-TB isolates from two tertiary-care centers in Thailand. MICs were established using broth macrodilution. A line probe assay (LPA) was used to detect gene mutations that confer resistance to isoniazid, rifampicin, aminoglycosides, and fluoroquinolones.Results: Sixty-one (82.4%) isolates were monoresistant to isoniazid and 44 (72.1%) were highly resistant to isoniazid. From the clinical isolates, the range of isoniazid MICs was 0.4– 16 μg/mL. The katG S315T gene mutation was the prominent mutation in both isoniazid-monoresistant TB (70.5%) and multidrug-resistant TB (72.7%) isolates. The positive predictive value (PPV) of katG was 100% in detecting high levels of isoniazid resistance. The PPV of the inhA mutation was 93.8% in detecting low levels of isoniazid resistance. Five isolates (6.8%) exhibited low-level phenotypic resistance, whereas an LPA failed to detect an isoniazid gene mutation. Our study found one HR-TB isolate with a gyrA fluoroquinolone-resistant gene mutation.Conclusion: Most HR-TB isolates had high isoniazid-resistance levels associated with the katG gene mutation. High-dose isoniazid should be used with caution in patients with HR-TB. Early detection of drug resistance by genotypic assay can help determine an appropriate regimen.Keywords: tuberculosis, isoniazid, minimal inhibitory concentration, line probe assay, gene mutation
SUMMARY Transcriptomics, the analysis of genome-wide RNA expression, is a common approach to investigate host and pathogen processes in infectious diseases. Technical and bioinformatic advances have permitted increasingly thorough analyses of the association of RNA expression with fundamental biology, immunity, pathogenesis, diagnosis, and prognosis. Transcriptomic approaches can now be used to realize a previously unattainable goal, the simultaneous study of RNA expression in host and pathogen, in order to better understand their interactions. This exciting prospect is not without challenges, especially as focus moves from interactions in vitro under tightly controlled conditions to tissue- and systems-level interactions in animal models and natural and experimental infections in humans. Here we review the contribution of transcriptomic studies to the understanding of malaria, a parasitic disease which has exerted a major influence on human evolution and continues to cause a huge global burden of disease. We consider malaria a paradigm for the transcriptomic assessment of systemic host-pathogen interactions in humans, because much of the direct host-pathogen interaction occurs within the blood, a readily sampled compartment of the body. We illustrate lessons learned from transcriptomic studies of malaria and how these lessons may guide studies of host-pathogen interactions in other infectious diseases. We propose that the potential of transcriptomic studies to improve the understanding of malaria as a disease remains partly untapped because of limitations in study design rather than as a consequence of technological constraints. Further advances will require the integration of transcriptomic data with analytical approaches from other scientific disciplines, including epidemiology and mathematical modeling.