Role of Complementary and Alternative Therapies in Infectious Disease

Enhancing prognostic prediction of invasive candidiasis among cancer patients with a serum C5a-based scoring model

PURPOSE

Invasive candidiasis poses a life-threatening risk, and early prognosis assessment is vital for timely interventions to reduce mortality. Serum C5a levels have recently been linked to prognosis, but confirmation in cancer patients is pending.

METHODS

We detected the concentrations of serum C5a in hospitalized cancer patients with invasive candidiasis from 2020 to 2023, and retrospectively analyzed the clinical data.

RESULTS

372 cases were included in this study, with a 90-day mortality rate of 21.8%. Candida albicans (48.7%) remained the predominant pathogen, followed by Candida glabrata (25.5%), Candida tropicalis (12.4%), and Candida parapsilosis (8.3%). Gastrointestinal cancer was the most diagnosed pathology type (37.6%). Serum C5a demonstrated a noteworthy correlation with 90-day mortality, and employing a cutoff value of 36.7 ng/ml revealed significantly higher 90-day mortality in low-C5a patients (41.2%) compared to high-C5a patients (6.3%) (p < 0.001). We also identified no source control, no surgery, metastasis, or chronic renal failure independently correlated with the 90-day mortality. Based on this, a prognostic model combining C5a and clinical parameters was constructed, which performed better than models built solely on C5a or clinical parameters. Furthermore, we weighted scores to each parameter in the model and presented diagnostic sensitivity and specificity corresponding to different score points calculated by the model.

CONCLUSION

We constructed a prognostic scoring model including serum C5a and clinical parameters, which would contribute to precise prognosis assessment and benefit the outcome among cancer patients.

Deep insights into urinary tract infections and effective natural remedies

Background

Urinary tract infection (UTI) is a common occurrence in females, during pregnancy, and in peri- and postmenopausal women. UTIs are associated with significant morbidity and mortality, and they affect the quality of life of the affected patients. Antibiotic therapy is an effective approach and reduces the duration of symptoms. Development of resistance, adverse effects of antibiotics, and other associated problems lead to establishing the research framework to find out the alternative approaches in controlling UTIs. Natural approaches have been extensively used for the management of various diseases to improve symptoms and also improve general health.

Main body

Different databases were employed to identify studies reporting on natural options including herbal medicines, vitamins, trace elementals, sugars, and probiotics without time limitations.

Conclusion

Herbal medicines can be effective at the first sign of the infection and also for short-term prophylaxis. Using vitamins, trace elementals, and/or sugars is an effective approach in preventing UTIs, and a combination of them with other antibacterial agents shows positive results. Probiotics have great potential for the threat of antibiotic over-usage and the prevalence of antibiotic-resistant microorganisms. This study may be of use in developing the efficient formulation of treatment of UTI.

Dosage Determination of Ethnopharmacologically Used Fermented Zea mays subsp. mays Liquor Extract of Bambusa vulgaris Schrad. Ex. J.C. Wendel Leaf Against Salmonella typhi

Background: Bambusa vulgaris (bamboo) is a common plant in tropical regions of the world, with multiple biological activities. Cereal steep liquors have been identified to act against some fecal bacteria. Given the increasing prevalence of antimicrobial resistance coupled with the cost of antibiotics, there is a need for mitigation efforts and the shift by locals to herbal products. Methods: The factorial study design was employed. Bamboo leaves were washed, dried, milled, and soxhlet extracted for 16 h using the steep fermented liquor from Zea mays subsp. mays as the solvent. Rotary evaporated extracts of various weights were used to carry out sensitivity and minimum inhibitory concentration (MIC) tests. Oral acute toxicity was determined. The in vivo assay was used to determine the effective dosage for the treatment of infected mice while distilled water and ciprofloxacin served as negative and positive controls, respectively. Results: The average inhibition zone diameters in the sensitivity test at 25, 50, and 100 mg/mL concentrations were 16.20 ± 0.06 mm, 19.10 ± 0.02 mm, and 22.10 ± 0.05 mm, respectively, while the MIC against Salmonella typhi was 25 mg/mL. The extract was found to be safe at up to 5000 mg/kg dose, which means that the LD50 was ≥ 3808 mg/kg. The Widal test revealed that mice responded to treatment with the extract at different concentrations (50, 100, and 200 mg/mL) as the number of days increased. The in vivo assay on day 14 showed the bactericidal property at a dosage of 200 mg/mL. Conclusions: Bamboo leaves extract in steep liquor from fermented yellow maize displayed excellent pharmacological activity against the pathogenic organism of typhoid fever with a potential source of active agents.

Fruit extracts to control pathogenic Escherichia coli: A sweet solution

Escherichia coli is a major cause of diarrhea and is as well responsible for extraintestinal infections in humans and animals. Many pathotypes have been defined for this ubiquitous microorganism on the basis of the virulence attributes. For the last 70 years, antibiotics have been used to control infections caused by E. coli. However, with the resistance observed with many strains these drugs are less recommended. Plant extracts, in particular fruit, represent a source of bioactive compounds that could be beneficial in the control of infectious diseases caused by E. coli. These could have bacteriostatic or bactericidal potential or could be used as synergic agents to amplify the activity of antibiotics for which the germs present some level of resistance. Certain studies also revealed that fruit extracts could act directly on virulence characters to attenuate the pathogenic capacity of microorganisms. This review intent to expose the scant but rapidly growing information available that shows that fruit, used as crude extracts or purified molecules, should be considered to manage diverse types of infections caused by E. coli.