María Azul de Hernández, Silvina Raquel Villar, Pamela Cribb
Chagas disease, caused by <i>Trypanosoma cruzi</i>, presents a variety of clinical outcomes ranging from mild symptoms to Chagas cardiomyopathy, the most severe and life-threatening manifestation of the disease. The degree of virulence is influenced by both parasite and host factors. In this study, we characterized a murine infection model using the <i>T. cruzi</i> Dm28c strain in BALB/c mice to assess disease progression. Infected mice showed a peak of parasitemia at 14 dpi, followed by a progressive decrease. Spleen weight increased up to sixfold compared to uninfected controls at 14 and 21 dpi, correlating with parasitemia levels. Histological analysis revealed focal inflammatory infiltrates in the heart starting at 7 dpi, with maximal intensity at 14 and 21 dpi. The expression of inflammatory cytokines (IFN-γ, IL-1β, TNF-α) and anti-inflammatory cytokines (IL-10, TGF-β) in the spleen showed a dynamic profile, with an early increase during the acute phase. Dm28c infection of BALB/c mice can be considered as a non-lethal Chagas disease experimental model, with detectable parasitemia during the acute phase and a controlled inflammatory response.
Infectious and parasitic diseases, Biology (General)
Hiroto Mizushima, Miwa Komori, Carolina Andrea Yoshida
et al.
Prophylaxis for ophthalmia neonatorum remains in use despite decreased incidence of the condition. We report a breakthrough case of neonatal conjunctivitis in Japan caused by a levofloxacin-resistant Neisseria gonorrhoeae bacteria strain, co-infected with Chlamydia trachomatis bacteria. This case highlights failures in screening, prophylaxis, and treatment, underscoring the need to reassess prevention strategies.
Devaki Nambiar, Jaison Joseph, Hari Sankar D
et al.
Background: Multi‑Sectoral Action (MSA) for health involves the collaboration of various stakeholder groups within and beyond the health sector and is seen to be critical for the attainment of the Sustainable Development Goals. In Kerala, India, decentralisation reforms have been in place for some time, and we sought to characterise the roles specifically played by locally elected representatives or Local Self‑Government (LSG) members, in relation to MSA. Methods: Between July and October 2021, we conducted in‑depth interviews with 80 participants from four districts in the southern Indian state of Kerala. Participants were community leaders, healthcare professionals, public health officials and elected members of LSG bodies. After obtaining written informed consent, participants were interviewed about the roles of various stakeholders in implementing primary care reforms with a particular focus on MSA at the grassroots level. The interviews were recorded, translated into English, and thematically analysed by the research team using ATLAS.ti 9.1 software. Results: Participants ranged in age from 35 to 60 years. LSGs played a number of critical MSA roles, including being a gatekeeper for local action; coordinator of departments, sectors and actors (departments of health, revenue, labour, and education departments as well as volunteers); custodian of community, particularly those ‘left behind,’ crisis manager, team builder and advocate even for communities for which they did not have direct responsibility. Conclusion: LSGs were widely seen by implementers as central figures in coordinating MSA for health in Kerala, before and during the COVID‑19 pandemic, and in relation to ‘left behind’ groups. The multiplicity of roles played by LSGs suggests the need for flexibility on the one hand as well as the plurality of roles on the other hand, which may be necessary to enable convergence and MSA, particularly at local levels.
Infectious and parasitic diseases, Public aspects of medicine
Giardiasis is the most common waterborne parasitic infection of the human intestine worldwide. The etiological agent, Giardia duodenalis (syn. G. intestinalis, G. lamblia), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts. Human giardiasis is a true cosmopolitan pathogen, with highest prevalence in developing countries. Giardiasis can present with a broad range of clinical manifestations from asymptomatic, to acute or chronic diarrheal disease associated with abdominal pain and nausea. Most infections are self-limiting, although re-infection and chronic infection can occur. Recent evidence indicating that Giardia may cause chronic post-infectious gastrointestinal complications have made it a topic of intense research. The causes of the post-infectious clinical manifestations due to Giardia, even after complete elimination of the parasite, remain obscure. This review offers a state-of-the-art discussion on the long-term consequences of Giardia infections, from extra-intestinal manifestations, growth and cognitive deficiencies, to post-infectious irritable bowel syndrome. The discussion also sheds light on some of the novel mechanisms recently implicated in the production of these post-infectious manifestations.
Brianna Wright, Daniel Kang, Allison Schuette
et al.
Abstract
Objectives:
We evaluated SARS-CoV-2 anti-nucleocapsid (anti-N) seroconversion and seroreversion rates, risk factors associated with SARS-CoV-2 seroconversion, and COVID-19 risk perceptions among academic healthcare center employees in a rural state.
Methods:
Among employees aged ≥18 years who completed a screening survey (n = 1,377), we invited all respondents reporting previous COVID-19 (n = 85; 82 accepted) and a random selection of respondents not reporting previous COVID-19 (n = 370; 220 accepted) to participate. Participants completed surveys and provided blood samples at 3-month intervals (T0, T3, T6, T9). We used logistic regression to identify risk factors for seropositivity at T0.
Results:
The cohort was primarily direct patient caregivers (205/302; 67.9%), white (278/302; 92.1%), and female (212/302; 70.2%). At T0, 86/302 (28.4%) participants were seropositive. Of the seronegative participants, 6/198 (3.0%), 6/183 (3.3%), and 14/180 (7.8%) had seroconverted at T3, T6, and T9, respectively. The overall seroreversion rate was 6.98% at T9. At T0, nursing staff (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.08, 5.19) and being within six feet of a non-household member outside of work (OR, 2.91; 95% CI, 1.02, 8.33) had significantly higher odds of seropositivity. Vaccination (OR, 0.05; 95% CI, 0.02, 0.12) and face mask use (OR, 0.36; 95% CI, 0.17, 0.78) were protective.
Conclusions:
The seroconversion and seroreversion rates were low among participants. Public health and infection prevention measures implemented early in the COVID-19 pandemic – vaccination, face mask use, and social distancing – were associated with significantly lower odds of SARS-CoV-2 seropositivity among participants.
Infectious and parasitic diseases, Public aspects of medicine
Lili Dobreva, Nikoleta Atanasova, Petar Donchev
et al.
<i>Lactobacillus</i> species are widely recognized for their probiotic potential, focusing on their mechanisms of health benefits and protection. Here we conducted an in vitro investigation of the probiotic potential with a role in microbiome homeostasis of four strains: <i>Lactiplantibacillus plantarum</i> L6 and F53, <i>Ligilactobacillus salivarius</i> 1, and <i>Lactobacillus helveticus</i> 611. A broad spectrum of antibacterial and antifungal activity was determined. The strain-specific inhibition of <i>Staphylococcus aureus</i>, <i>Streptococcus mutans</i>, <i>Escherichia coli</i>, <i>Pseudomonas aeruginosa</i>, and saprophytic/toxigenic fungi makes them promising as protective cultures. DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (2,2′-azino-bis-(3-ethylbenzothiazoline-6-sulfonic) acid) measurements showed that tested samples had strain-specific capacity for scavenging of radicals. The molecular base for the antioxidant potential of two lyophilized forms of active strains was investigated by electron paramagnetic resonance spectroscopy. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, with fractions of the most active postbiotics obtained by SEC-FPLC (fast protein liquid chromatography) analysis, showed a wide variety of effects on the growth of a K562 myeloid leukemia cell line. The IC<sub>50</sub> (half-maximal inhibitory concentration) of <i>L. salivarius</i> 1 was determined to be 46.15 mg/mL. The proven in vitro functionality of the selected lactobacilli make them suitable for development of target probiotics with specific beneficial effects expected in vivo. Further investigations on produced postbiotics and safety have to be completed before they can be considered as scientifically proven probiotic strains.
Michalina A. Montaño, Takudzwa Mtisi, Ntokozo Ndlovu
et al.
Abstract Introduction In East and Southern Africa, people with HIV (PWH) experience worse cancer-related outcomes and are at higher risk of developing certain cancers. Siloed care delivery pathways pose a substantial barrier to co-management of HIV and cancer care delivery. Methods We conducted cross-sectional studies of adult cancer patients at public radiotherapy and oncology units in Malawi (Kamuzu Central Hospital), Zimbabwe (Parirenyatwa Group of Hospitals), and South Africa (Charlotte Maxeke Hospital) between 2018 and 2019. We abstracted cancer- and HIV-related data from new cancer patient records and used Poisson regression with robust variance to identify patient characteristics associated with HIV documentation. Results We included 1,648 records from Malawi (median age 46 years), 1,044 records from South Africa (median age 55 years), and 1,135 records from Zimbabwe (median age 52 years). Records from all three sites were predominately from female patients; the most common cancers were cervical (Malawi [29%] and Zimbabwe [43%]) and breast (South Africa [87%]). HIV status was documented in 22% of cancer records from Malawi, 92% from South Africa, and 86% from Zimbabwe. Patients with infection-related cancers were more likely to have HIV status documented in Malawi (adjusted prevalence ratio [aPR]: 1.92, 95% confidence interval [CI]: 1.56–2.38) and Zimbabwe (aPR: 1.16, 95%CI: 1.10–1.22). Patients aged ≥ 60 years were less likely to have HIV status documented (Malawi: aPR: 0.66, 95% CI: 0.50–0.87; Zimbabwe: aPR: 0.76, 95%CI: 0.72–0.81) than patients under age 40 years. Patient age and cancer type were not associated with HIV status documentation in South Africa. Conclusion Different cancer centers have different gaps in HIV status documentation and will require tailored strategies to improve processes for ascertaining and recording HIV-related information in cancer records. Further research by our consortium to identify opportunities for integrating HIV and cancer care delivery is underway.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Infectious and parasitic diseases
Zoya Ivanova, Ivva Philipova, Lyubomira Boyanova
et al.
The yeast C. auris was first described as a new species in 2009. Since then, this species was recognized as an emerging multi-drug-resistant (MDR) yeast that can cause a wide spectrum of infections, ranging from fungemia to deep-seated infections, especially in intensive care settings. It can be not- or misidentified by commercial identification systems. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has recently been considered as a convenient, rapid and accurate technology in the identification of yeast isolates to species level. A total of 132 clinical isolates, collected from 2015 to 2021 in the National Reference Laboratory of Mycology and Sexually Transmitted Infections were included in the study. The isolates were mainly from patients with candidemia and other specimens from invasive Candida infections. The isolates were identified by standard mycological procedures, the assimilation profile was done by commercially available strips and with the automated VITEK2 Compact system. All the strains were identified with MALDI-TOF MS. Antifungal susceptibility testing was conducted to some of the strains by agar disk-diffusion (according to CLSI M44-A2), E-test and VITEK2. Some of the strains which could not be identified or were misidentified by standard mycological procedures were correctly determined by MALDI-TOF MS. None of them was identified as C. auris. There were no large deviations in the antifungal susceptibility profiles of the tested strains. We assess MALDI-TOF MS as convenient, rapid, cost- effective and accurate technology in the identification of fungal strains which are difficult to determine with the traditional procedures. Up to now, isolation of C. auris has not been reported in Bulgaria.
Luiza F O Gervazoni, Gabrielle Barcellos, Taiana Ferreira-Paes
et al.
Leishmaniasis is an infectious parasitic disease that is caused by protozoa of the genus Leishmania, a member of the Trypanosomatidae family. Leishmaniasis is classified by the World Health Organization as a neglected tropical disease that is responsible for millions of deaths worldwide. Although there are many possible treatments for leishmaniasis, these treatments remain mostly ineffective, expensive, and long treatment, as well as causing side effects and leading to the development of resistance. For novel and effective treatments to combat leishmaniasis, many research groups have sought to utilize natural products. In addition to exhibiting potential as therapeutic compounds, natural products may also contribute to the development of new drugs based on their chemical structures. This review presents the most promising natural products, including crude extracts and isolated compounds, employed against Leishmania spp.
Johannes Leiner, Vincent Pellissier, Sven Hohenstein
et al.
Abstract Background The SARS-CoV-2 variant B.1.1.529 (Omicron) was first described in November 2021 and became the dominant variant worldwide. Existing data suggests a reduced disease severity with Omicron infections in comparison to B.1.617.2 (Delta). Differences in characteristics and in-hospital outcomes of COVID-19 patients in Germany during the Omicron period compared to Delta are not thoroughly studied. ICD-10-code-based severe acute respiratory infections (SARI) surveillance represents an integral part of infectious disease control in Germany. Methods Administrative data from 89 German Helios hospitals was retrospectively analysed. Laboratory-confirmed SARS-CoV-2 infections were identified by ICD-10-code U07.1 and SARI cases by ICD-10-codes J09-J22. COVID-19 cases were stratified by concomitant SARI. A nine-week observational period between December 6, 2021 and February 6, 2022 was defined and divided into three phases with respect to the dominating virus variant (Delta, Delta to Omicron transition, Omicron). Regression analyses adjusted for age, gender and Elixhauser comorbidities were applied to assess in-hospital patient outcomes. Results A total cohort of 4,494 inpatients was analysed. Patients in the Omicron dominance period were younger (mean age 47.8 vs. 61.6; p < 0.01), more likely to be female (54.7% vs. 47.5%; p < 0.01) and characterized by a lower comorbidity burden (mean Elixhauser comorbidity index 5.4 vs. 8.2; p < 0.01). Comparing Delta and Omicron periods, patients were at significantly lower risk for intensive care treatment (adjusted odds ratio 0.72 [0.57–0.91]; p = 0.005), mechanical ventilation (adjusted odds ratio 0.42 [0.31–0.57]; p < 0.001), and in-hospital mortality (adjusted odds ratio 0.42 [0.32–0.56]; p < 0.001). This also applied mostly to the separate COVID-SARI group. During the Delta to Omicron transition, case numbers of COVID-19 without SARI exceeded COVID-SARI for the first time in the pandemic’s course. Conclusion Patient characteristics and outcomes differ during the Omicron dominance period as compared to Delta suggesting a reduced disease severity with Omicron infections. SARI surveillance might play a crucial role in assessing disease severity of future SARS-CoV-2 variants.
Tsuyoshi Sekizuka, Chihiro Katsukawa, Makoto Kuroda
et al.
We conducted molecular typing of a Corynebacterium ulcerans isolate from a woman who died in Japan in 2016. Genomic DNA modification might have affected the isolate’s ribotyping profile. Multilocus sequence typing results (sequence type 337) were more accurate. Whole-genome sequencing had greater ability to discriminate lineages at high resolution.
Daniel W. Awari, Aditya S. Shah, Amber M. Sexton
et al.
Management of infections in the immunocompromised patient requires unique considerations that are not typically seen in the immunocompetent. Immunocompromised hosts require a broad set of differential diagnoses when presenting with febrile illness involving a wide variety of microbiology. Moreover, fungal infections are common, and cotreatment of fungal and bacterial infections occurs with regularity. Fungal coinfection, however, is rare. Here, we describe a patient with Aspergillus and recurrent Cryptococcus neoformans coinfection following completion of treatment for pulmonary cryptococcosis.