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Hu X, Jiang L, Liu X, Chang H, Dong H, Yan J, Zhou X, Kong M. The diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in critically ill patients with respiratory tract infections. Microbiol Spectr 2024:e0045824. [PMID: 38916357 DOI: 10.1128/spectrum.00458-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/18/2024] [Indexed: 06/26/2024] Open
Abstract
Metagenomic next-generation sequencing (mNGS) is an unbiased and rapid method for detecting pathogens. This study enrolled 145 suspected severe pneumonia patients who were admitted to the Affiliated Hospital of Jining Medical University. This study primarily aimed to determine the diagnostic performance of mNGS and conventional microbiological tests (CMTs) using bronchoalveolar lavage fluid samples for detecting pathogens. Our findings indicated that mNGS performed significantly higher sensitivity (97.54% vs 28.68%, P < 0.001), coincidence (90.34% vs 35.17%, P < 0.001), and negative predictive value (80.00% vs 13.21%, P < 0.001) but performed lower specificity than CMTs (52.17% vs 87.5%, P < 0.001). Streptococcus pneumoniae as the most common bacterial pathogen had the largest proportion (22.90%, 30/131) in this study. In addition to bacteria, fungi, and virus, mNGS can detect a variety of atypical pathogens such as Mycobacterium tuberculosis and non-tuberculous. Mixed infections were common in patients with severe pneumonia, and bacterial-fungal-viral-atypical pathogens were the most complicated infection. After adjustments of antibiotics based on mNGS and CMTs, the clinical manifestation improved in 139 (95.86%, 139/145) patients. Our data demonstrated that mNGS had significant advantage in diagnosing respiratory tract infections, especially atypical pathogens and fungal infections. Pathogens were detected timely and comprehensively, contributing to the adjustments of antibiotic treatments timely and accurately, improving patient prognosis and decreasing mortality potentially.IMPORTANCEMetagenomic next-generation sequencing using bronchoalveolar lavage fluid can provide more comprehensive and accurate pathogens for respiratory tract infections, especially when considering the previous usage of empirical antibiotics before admission or complicated clinical presentation. This technology is expected to play an important role in the precise application of antimicrobial drugs in the future.
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Affiliation(s)
- Xiaohang Hu
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Liqing Jiang
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Xiaowei Liu
- Department of Intensive Care Unit, Affiliated Hospital of Jining Medical University,Jining Medical University, Shandong Jining, China
| | - Hong Chang
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Haixin Dong
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Jinyan Yan
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Xiaoya Zhou
- Medical Laboratory of Jining Medical University, Lin He's Academician Workstation of New Medicine and Clinical Translation in Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Min Kong
- Medical Laboratory of Jining Medical University, Lin He's Academician Workstation of New Medicine and Clinical Translation in Jining Medical University, Jining Medical University, Shandong Jining, China
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Chen S, Wen L, Ou J, Lai Y, Shen Y. Exploring the Application of Metagenomic Next-Generation Sequencing in the Diagnosis of Unexplained Pulmonary Infection. Int J Gen Med 2024; 17:2465-2474. [PMID: 38826507 PMCID: PMC11141768 DOI: 10.2147/ijgm.s459373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024] Open
Abstract
Background Pulmonary infections are significant global health burdens, and conventional diagnostic methods (culture and polymerase chain reaction), are often limited by slow results and low sensitivity. Metagenomic next-generation sequencing (mNGS) offers a rapid, comprehensive alternative for identifying diverse pathogens, including rare and mixed infections. Thus, we assessed the diagnostic performance of mNGS in pulmonary infections, compared the findings with those of traditional pathogen detection methods, and explored its potential to enhance clinical diagnostics and patient care. Methods We collected samples from 125 immunocompromised patients diagnosed with pulmonary infection at the Department of Respiratory Medicine of Shenzhen Longgang Central Hospital from March 2020 to July 2022. We compared the rate of pathogen positivity and pathogen distribution between conventional pathogen detection methods and mNGS using samples including sputum, blood, and bronchoalveolar lavage fluid. Results Among the 125 cases of unexplained pulmonary infection, 82 (65.6%) and 40 (32.0%) tested positive for pathogens using mNGS and routine culture, respectively (P < 0.05). Both methods of pathogen detection were positive in 28 (22.4%) cases (complete match, 9; complete mismatch, 13; partial match, 6). However, 43.2% of cases only tested positive using mNGS, 9.4% only tested positive using routine tests, and 24.8% tested negative using both methods. A viral infection was present in 55.2% of cases. The detection rate of mycobacteria using mNGS (12.8%) was higher than that using conventional pathogen detection methods (5.6%). Conclusion mNGS technology enhances pathogen detection in unexplained pulmonary infections, enabling targeted antimicrobial therapy and consequently helping to reduce broad-spectrum antibiotic use, aligning treatments more closely with the causative pathogens. Thus, mNGS offers significant clinical value by improving treatment efficacy and potentially reducing antibiotic resistance in pulmonary infection cases.
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Affiliation(s)
- Sida Chen
- Department of Respiratory, Shenzhen Longgang Central Hospital, Shenzhen, Guangdong, 518000, People’s Republic of China
| | - Ling Wen
- Department of Respiratory, Shenzhen Longgang Central Hospital, Shenzhen, Guangdong, 518000, People’s Republic of China
| | - Jintao Ou
- Department of Respiratory, Shenzhen Longgang Central Hospital, Shenzhen, Guangdong, 518000, People’s Republic of China
| | - Yuting Lai
- Department of Respiratory, Shenzhen Longgang Central Hospital, Shenzhen, Guangdong, 518000, People’s Republic of China
| | - Yan Shen
- Department of Respiratory, Shenzhen Longgang Central Hospital, Shenzhen, Guangdong, 518000, People’s Republic of China
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Shen D, Lv X, Zhang H, Fei C, Feng J, Zhou J, Cao L, Ying Y, Li N, Ma X. Association between Clinical Characteristics and Microbiota in Bronchiectasis Patients Based on Metagenomic Next-Generation Sequencing Technology. Pol J Microbiol 2024; 73:59-68. [PMID: 38437464 PMCID: PMC10911701 DOI: 10.33073/pjm-2024-007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 03/06/2024] Open
Abstract
This study aimed to investigate the disparities between metagenomic next-generation sequencing (mNGS) and conventional culture results in patients with bronchiectasis. Additionally, we sought to investigate the correlation between the clinical characteristics of patients and their microbiome profiles. The overarching goal was to enhance the effective management and treatment of bronchiectasis patients, providing a theoretical foundation for healthcare professionals. A retrospective survey was conducted on 67 bronchiectasis patients admitted to The First Hospital of Jiaxing from October 2019 to March 2023. Clinical baseline information, inflammatory indicators, and pathogen detection reports, including mNGS, conventional blood culture, bronchoalveolar lavage fluid (BALF) culture, and sputum culture results, were collected. By comparing the results of mNGS and conventional culture, the differences in pathogen detection rate and pathogen types were explored, and the diagnostic performance of mNGS compared to conventional culture was evaluated. Based on the various pathogens detected by mNGS, the association between clinical characteristics of bronchiectasis patients and mNGS microbiota results was analyzed. The number and types of pathogens detected by mNGS were significantly larger than those detected by conventional culture. The diagnostic efficacy of mNGS was significantly superior to conventional culture for all types of pathogens, particularly in viral detection (p < 0.01). Regarding pathogen detection rate, the bacteria with the highest detection rate were Pseudomonas aeruginosa (17/58) and Haemophilus influenzae (11/58); the fungus with the highest detection rate was Aspergillus fumigatus (10/21), and the virus with the highest detection rate was human herpes virus 4 (4/11). Differences were observed between the positive and negative groups for P. aeruginosa in terms of common scoring systems for bronchiectasis and whether the main symptom of bronchiectasis manifested as thick sputum (p < 0.05). Significant distinctions were also noted between the positive and negative groups for A. fumigatus regarding Reiff score, neutrophil percentage, bronchiectasis etiology, and alterations in treatment plans following mNGS results reporting (p < 0.05). Notably, 70% of patients with positive A. fumigatus infection opted to change their treatment plans. The correlation study between clinical characteristics of bronchiectasis patients and mNGS microbiological results revealed that bacteria, such as P. aeruginosa, and fungi, such as A. fumigatus, were associated with specific clinical features of patients. This underscored the significance of mNGS in guiding personalized treatment approaches. mNGS could identify multiple pathogens in different types of bronchiectasis samples and was a rapid and effective diagnostic tool for pathogen identification. Its use was recommended for diagnosing the causes of infections in bronchiectasis patients.
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Affiliation(s)
- Dongfeng Shen
- The Intensive Care of Unit, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Xiaodong Lv
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Hui Zhang
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Chunyuan Fei
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Jing Feng
- Department of Respiratory, Zhengzhou YIHE Hospital, Zhengzhou, China
| | - Jiaqi Zhou
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Linfeng Cao
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Ying Ying
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Na Li
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
| | - Xiaolong Ma
- Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China
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Rodríguez-Sabogal IA, Cabrera R, Marin D, Lopez L, Aguilar Y, Gomez G, Peña-Valencia K, Riaño W, Vélez L, Keynan Y, Rueda ZV. Does the Recovery of Respiratory Viruses Impact Pulmonary Function at Baseline and 1-, 6-, and 12-Month Follow-Up in People Living with HIV and Pneumonia? Viruses 2024; 16:344. [PMID: 38543710 PMCID: PMC10974101 DOI: 10.3390/v16030344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/10/2024] [Accepted: 02/21/2024] [Indexed: 05/23/2024] Open
Abstract
The frequency of respiratory viruses in people living with HIV (PLHIV) and their impact on lung function remain unclear. We aimed to determine the frequency of respiratory viruses in bronchoalveolar lavage and induced sputum samples in PLHIV and correlate their presence with lung function. A prospective cohort of adults hospitalized in Medellín between September 2016 and December 2018 included three groups: group 1 = people diagnosed with HIV and a diagnosis of community-acquired pneumonia (CAP), group 2 = HIV, and group 3 = CAP. People were followed up with at months 1, 6, and 12. Clinical, microbiological, and spirometric data were collected. Respiratory viruses were detected by multiplex RT-PCR. Sixty-five patients were included. At least 1 respiratory virus was identified in 51.9%, 45.1%, and 57.1% of groups 1, 2 and 3, respectively. Among these, 89% of respiratory viruses were detected with another pathogen, mainly Mycobacterium tuberculosis (40.7%) and Pneumocystis jirovecii (22.2%). The most frequent respiratory virus was rhinovirus (24/65, 37%). On admission, 30.4% of group 1, 16.6% of group 2, and 50% of group 3 had airflow limitation, with alteration in forced expiratory volume at first second in both groups with pneumonia compared to HIV. Respiratory viruses are frequent in people diagnosed with HIV, generally coexisting with other pathogens. Pulmonary function on admission was affected in patients with pneumonia, improving significantly in the 1st, 6th, and 12th months after CAP onset.
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Affiliation(s)
- Iván Arturo Rodríguez-Sabogal
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
| | - Ruth Cabrera
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo Biología de Sistemas, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia
| | - Diana Marin
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Lucelly Lopez
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Yudy Aguilar
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo Investigador de Problemas en Enfermedades Infecciosas—GRIPE, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia
| | - Gustavo Gomez
- Pulmonologist Section, Hospital Universitario San Vicente Fundacion, Medellin 050010, Colombia;
| | - Katherine Peña-Valencia
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
- Escuela de Microbiología, Universidad de Antioquia, Medellín 050010, Colombia
- Grupo Bacterias & Cancer, School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia
| | - Will Riaño
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Lázaro Vélez
- School of Medicine, Universidad de Antioquia, Medellin 050010, Colombia; (I.A.R.-S.); (W.R.); (L.V.)
- Infectious Diseases Section, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
- Grupo Investigador de Problemas en Enfermedades Infecciosas—GRIPE, Facultad de Medicina, Universidad de Antioquia, Medellin 050010, Colombia
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | - Zulma Vanessa Rueda
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia; (R.C.); (D.M.); (L.L.); (Y.A.)
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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Rucar A, Totet A, Le Govic Y, Demey B, Damiani C. Pulmonary co-infections by Pneumocystis jirovecii and Herpesviridae: a seven-year retrospective study. Ann Clin Microbiol Antimicrob 2024; 23:8. [PMID: 38245721 PMCID: PMC10800065 DOI: 10.1186/s12941-023-00663-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Pneumocystis jirovecii (P. jirovecii) is an opportunistic fungus responsible for Pneumocystis pneumonia (PCP) in deeply immunocompromised patients and for pulmonary colonization in individuals with mild immunosuppression or impaired respiratory function. PCP and Cytomegalovirus (CMV) co-infections have been widely described whereas those involving other Herpesviruses (HVs) such as Epstein-Barr virus (EBV), Herpes simplex virus type 1 and type 2 (HSV-1 and -2), and Varicella zoster virus (VZV) remain scarce. To date, no data are available concerning HVs co-infections in P. jirovecii colonization. METHODS Our main objective was to evaluate the frequency of HVs in bronchoalveolar lavage fluid (BALF) samples from patients with PCP or with pulmonary colonization. The secondary objective was to assess the relationship between HVs and the mortality rate in PCP patients. A retrospective single-center study over a seven-year period was conducted. All patients with P. jirovecii detected using PCR in a BALF sample and for whom a PCR assay for HVs detection was performed were included in the study. RESULTS One hundred and twenty-five patients were included, corresponding to 77 patients with PCP and 48 colonized patients. At least one HV was detected in 54/77 (70.1%) PCP patients and in 28/48 (58.3%) colonized patients. EBV was the most frequent in both groups. Furthermore, the 30-day survival rate in PCP patients was significantly lower with [EBV + CMV] co-infection than that with EBV co-infection, [EBV + HSV-1] co-infection and without HV co-infection. CONCLUSION Our results show that the frequency of HV, alone or in combination is similar in PCP and colonization. They also suggest that [EBV + CMV] detection in BALF samples from PCP patients is associated with an increased mortality rate, underlying the significance to detect HVs in the course of PCP.
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Affiliation(s)
- Alan Rucar
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens-Picardie, 1 rond-point du Pr Cabrol, 80054, Amiens Cedex 1, France
| | - Anne Totet
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens-Picardie, 1 rond-point du Pr Cabrol, 80054, Amiens Cedex 1, France
- Agents Infectieux, Résistance et Chimiothérapie (AGIR), UR 4294, Université de Picardie Jules Verne, 1 rue des Louvels, 80037, Amiens Cedex 1, France
| | - Yohann Le Govic
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens-Picardie, 1 rond-point du Pr Cabrol, 80054, Amiens Cedex 1, France
- Agents Infectieux, Résistance et Chimiothérapie (AGIR), UR 4294, Université de Picardie Jules Verne, 1 rue des Louvels, 80037, Amiens Cedex 1, France
| | - Baptiste Demey
- Agents Infectieux, Résistance et Chimiothérapie (AGIR), UR 4294, Université de Picardie Jules Verne, 1 rue des Louvels, 80037, Amiens Cedex 1, France
- Laboratoire de Virologie, Centre de Biologie Humaine, CHU Amiens-Picardie, 1 rond-point du Pr Cabrol, 80054, Amiens Cedex 1, France
| | - Céline Damiani
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens-Picardie, 1 rond-point du Pr Cabrol, 80054, Amiens Cedex 1, France.
- Agents Infectieux, Résistance et Chimiothérapie (AGIR), UR 4294, Université de Picardie Jules Verne, 1 rue des Louvels, 80037, Amiens Cedex 1, France.
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Tancharoen L, Muangsomboon S, Sarasombath PT, Angkasekwinai N. Extrapulmonary Pneumocystis jirovecii infection in an advanced HIV-infected patient: A case report and literature review. BMC Infect Dis 2023; 23:185. [PMID: 36991362 PMCID: PMC10053109 DOI: 10.1186/s12879-023-08143-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
Background Pneumocystis jirovecii infection is the most common opportunistic infection that causes pneumonia in human immunodeficiency virus (HIV)-infected patients; however, extrapulmonary P. jirovecii infection is extremely rare after the use of antiretroviral therapy. Here, we present the second reported case of paraspinal mass caused by P. jirovecii infection in an advanced HIV-infected patient. Case presentation A 45-year-old woman presented with dyspnea on exertion, and significant weight loss within the preceding 4 months. Initial complete blood count (CBC) findings revealed pancytopenia with a hemoglobin (Hb) level of 8.9 g/dL, a white blood cell (WBC) count of 2180 cells/mm3 with 68% neutrophils, and a platelet count of 106,000 cells/mm3. Anti-HIV was positive with an absolute cluster of differentiation 4 (CD4) count of 16 cells/ mm3. A computed tomography scan of the chest revealed an enhancing soft tissue mass-like lesion at the right paravertebral region (T5-T10 level) and a thick-walled cavity lesion at the left lower lung. A CT-guided biopsy of the paravertebral mass was performed and histopathology revealed granulomatous inflammation consisting of dense aggregates of epithelioid cells and macrophages, and scattered foci of pink foamy to granular materials amidst the granulomatous inflammation. Gomori methenamine silver (GMS) staining revealed thin cystic-like structures (ascus) that were observed to be morphologically consistent with P. jirovecii. Molecular identification and DNA sequencing from the paraspinal mass was 100% identical to P. Jirovecii. The patient was successfully treated with oral trimethoprim-sulfamethoxazole for 3 weeks and antiretroviral therapy (ART) with tenofovir (TDF), lamivudine (3TC), and dolutegravir (DTG). A follow-up CT scan of the chest at 2 months after treatment showed a decrease in sizes of both the paravertebral mass and the cavitary lung lesion. Conclusions Extrapulmonary pneumocystosis (EPCP) has become an extremely rare condition in HIV-infected patients after the widespread use of ART. EPCP should be considered in ART-naive HIV-infected patients suspected of having or diagnosed with Pneumocystis jirovecii pneumonia who present with atypical symptoms and/or signs. Histopathologic examination with GMS staining of affected tissue is necessary for the diagnosis of EPCP.
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Affiliation(s)
- Lalita Tancharoen
- grid.10223.320000 0004 1937 0490Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
| | - Soranart Muangsomboon
- grid.10223.320000 0004 1937 0490Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patsharaporn T. Sarasombath
- grid.10223.320000 0004 1937 0490Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nasikarn Angkasekwinai
- grid.10223.320000 0004 1937 0490Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700 Thailand
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Zhao X, Duan MX, Lu YY, Bai LP, Zhao XY. Short-term prognostic analysis of patients with systemic lupus erythematosus co-infection and comparison of mNGS and conventional microbiological test results. Front Cell Infect Microbiol 2023; 13:1131258. [PMID: 37051301 PMCID: PMC10083406 DOI: 10.3389/fcimb.2023.1131258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023] Open
Abstract
ObjectivesInfection is one of the major causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE), and as a new diagnostic technique, metagenomic next-generation sequencing (mNGS) is increasingly used for the pathogenetic detection of co-infected SLE patients. However, conventional microbiological testing (CMT) is still the gold standard for pathogenic diagnosis, and the specific diagnostic efficacy of mNGS versus CMT in such patients is not known. In addition, there are few studies on the short-term prognosis of co-infected SLE patients.MethodsThis study retrospectively included 58 SLE patients with co-infection admitted to the First Affiliated Hospital of Zhengzhou University from October 2020 to August 2022. Patients were divided into a survivors (n=27) and a non-survivors (n=31) according to their discharge status. Baseline characteristics and etiological data were collected and statistically analyzed for all patients during their hospitalization. The sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE) II and systemic lupus erythematosus disease activity index (SLEDAI) were calculated for each patient to assess the predictive ability of the 3 scores on the short-term prognosis of SLE patients. The mNGS and CMT culture results were also compared to clarify the flora characteristics of patients with SLE infection.ResultsMore patients in the non-survivors had renal impairment, neurological manifestations, multiplasmatic cavity effusion and gastrointestinal manifestations compared to the survivors (p < 0.05). The SOFA score, APACHE II and SLEDAI were significantly higher in the non-survivors than in the survivors (p < 0.01). There were also significant differences between the two groups in several tests such as hemoglobin, platelets, albumin, total bilirubin, C-reactive protein (CRP), procalcitonin (PCT), and complement C3 (p < 0.05). In addition, the absolute values of T lymphocytes, CD4+ T cells and CD8+ T cells were smaller in the non-survivors than in the survivors (p < 0.05). The most common type of infection in this study was pulmonary infection, followed by bloodstream infection. mNGS and CMT positivity rates were not significantly different among patients in the non-survivors, but were significantly different among patients in the survivors (p=0.029). In-hospital survival of patients with SLE infection could be predicted based on the SOFA score in relation to 6. For patients with SOFA <6, we recommend earlier mNGS testing to identify the pathogen and improve patient prognosis.ConclusionsFor SLE patients with co-infection, in-hospital survival can be predicted based on SOFA score. For patients with SOFA <6, advising them to complete mNGS testing as early as possible may improve the prognosis to some extent.
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Xie Y, Dai B, Zhou X, Liu H, Wu W, Yu F, Zhu B. Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients. Infect Drug Resist 2023; 16:607-618. [PMID: 36733920 PMCID: PMC9888013 DOI: 10.2147/idr.s394265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Background To evaluate the value and challenges of real-world clinical application of metagenomic next-generation sequencing (mNGS) for bronchoalveolar lavage fluid (BALF) in HIV-infected patients with suspected multi-pathogenic pneumonia. Methods Fifty-seven HIV-infected patients with suspected mixed pneumonia who were agreed to undergo the bronchoscopy were recruited and retrospectively reviewed the results of mNGS and conventional microbiological tests (CMTs) of BALF from July 2020 to June 2022. Results 54 patients were diagnosed with pneumonia including 49 patients with definite pathogens and five patients with probable pathogens. mNGS exhibited a higher diagnostic accuracy for fungal detection than CMTs in HIV-infected patients with suspected pulmonary infection. The sensitivity of mNGS in diagnosis of pneumonia in HIV-infected patients was much higher than that of CMTs (79.6% vs 61.1%; P < 0.05). Patients with mixed infection had lower CD4 T-cell count and higher symptom duration before admitting to the hospital than those with single infection. The detection rate of mNGS for mixed infection was significantly higher than that of CMTs and more co-pathogens could be identified by mNGS. The most common pattern of mixed infection observed was fungi-virus (11/29, 37.9%), followed by fungi-virus-bacteria (6/29, 20.7%) coinfection in HIV-infected patients with multi-pathogenic pneumonia. Conclusion mNGS improved the pathogens detection rate and exhibited advantages in identifying multi-pathogenic pneumonia in HIV-infected patients. Early performance of bronchoscopy and mNGS are recommended in HIV-infected patients with low CD4 T cell counts and long duration of symptoms. The most common pattern of mixed infection observed was fungi-virus, followed by fungi-virus-bacteria coinfection in HIV infected patients with multi-pathogenic pneumonia.
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Affiliation(s)
- Yirui Xie
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China,Correspondence: Yirui Xie; Biao Zhu, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79, QingChun Road, Hangzhou, 310003, People’s Republic of China, Tel/Fax +86-571-87236416, Email ;
| | - Bohao Dai
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China
| | - Xiaotang Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China
| | - Huiting Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China
| | - Wei Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China
| | - Fei Yu
- Key Laboratory of Clinical in vitro Diagnostic Techniques of Zhejiang Province, Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Biao Zhu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People’s Republic of China
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9
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Ali MR, Bacchu MS, Al-Mamun MR, Hossain MI, Khaleque A, Khatun A, Ridoy DD, Aly MAS, Khan MZH. Recent Advanced in MXene Research toward Biosensor Development. Crit Rev Anal Chem 2022:1-18. [PMID: 36068703 DOI: 10.1080/10408347.2022.2115286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
MXene is a rapidly emerging group of two-dimensional (2D) multifunctional nanomaterials, drawing huge attention from researchers of a broad scientific field. Reporting the synthesis of MXene was the following breakthrough in 2D materials following the discovery of graphene. MXene is considered the most recent developments of materials, including transition metal carbonitrides, nitrides, and carbides synthesized by etching or mechanical-based exfoliation of selective MAX phases. MXene has a plethora of prodigious properties such as unique interlayer spacing, high ion and electron transport, large surface area, excellent thermal and electrical conductivity, exceptional volumetric capacitance, thermal shock, and oxidation resistance, easily machinable and inherently hydrophilic, and biocompatibility. Owing to the abundance of tailorable surface function groups, these properties can be further enhanced by surface functionalization with covalent and non-covalent modifications via numerous surface functionalization methods. Therefore, MXene finds their way to a plethora of applications in numerous fields including catalysis, membrane separation, energy storage, sensing, and biomedicine. Here, the focus is on reviewing the structure, synthesis techniques, and functionalization methods of MXene. Furthermore, MXene-based detection platforms in different sensing applications are survived. Great attention is given to reviewing the applications of MXene in the detection of biomolecules, pathogenic bacteria and viruses, cancer biomarkers food contaminants and mycotoxins, and hazardous pollutants. Lastly, the future perspective of MXene-based biosensors as a next-generation diagnostics tool is discussed. Crucial visions are introduced for materials science and sensing communities to better route while investigating the potential of MXene for creating innovative detection mechanisms.
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Affiliation(s)
- Md Romzan Ali
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Md Sadek Bacchu
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Md Rashid Al-Mamun
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Md Ikram Hossain
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Abdul Khaleque
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Anowara Khatun
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Dipto Debnath Ridoy
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
| | - Mohamed Aly Saad Aly
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, South Korea
| | - Md Zaved Hossain Khan
- Department of Chemical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
- Laboratory of Nano-bio and Advanced Materials Engineering (NAME), Jashore University of Science and technology, Jashore, Bangladesh
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10
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Application of mNGS in the Etiological Analysis of Lower Respiratory Tract Infections and the Prediction of Drug Resistance. Microbiol Spectr 2022; 10:e0250221. [PMID: 35171007 PMCID: PMC8849087 DOI: 10.1128/spectrum.02502-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Lower respiratory tract infections (LRTIs) have high morbidity and mortality rates. However, traditional etiological detection methods have not been able to meet the needs for the clinical diagnosis and prognosis of LRTIs. The rapid development of metagenomic next-generation sequencing (mNGS) provides new insights for the diagnosis and treatment of LRTIs; however, little is known about how to interpret the application of mNGS results in LRTIs. In this study, lower respiratory tract specimens from 46 patients with suspected LRTIs were tested simultaneously using conventional microbiological detection methods and mNGS. Receiver operating characteristic (ROC) curves were used to evaluate the performance of the logarithm of reads per kilobase per million mapped reads [lg(RPKM)], genomic coverage, and relative abundance of the organism in predicting the true-positive pathogenic bacteria. True-positive viruses were identified according to the lg(RPKM) threshold of bacteria. We also evaluated the ability to predict drug resistance genes using mNGS. Compared to that using conventional detection methods, the false-positive detection rate of pathogenic bacteria was significantly higher using mNGS. It was concluded from the ROC curves that the lg(RPKM) and genomic coverage contributed to the identification of pathogenic bacteria, with the performance of lg(RPKM) being the best (area under the curve [AUC] = 0.99). The corresponding lg(RPKM) threshold for identifying the pathogenic bacteria was −1.35. Thirty-five strains of true-positive virus were identified based on the lg(RPKM) threshold of bacteria, with the detection of human gammaherpesvirus 4 being the highest and prone to coinfection with Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. Antimicrobial susceptibility tests (AST) revealed the resistance of bacteria containing drug resistance genes (detected by mNGS). However, the drug resistance genes of some multidrug-resistant bacteria were not detected. As an emerging technology, mNGS has shown many advantages for the unbiased etiological detection and the prediction of antibiotic resistance. However, a correct understanding of mNGS results is a prerequisite for its clinical application, especially for LRTIs. IMPORTANCE LRTIs are caused by hundreds of pathogens, and they have become a great threat to human health due to the limitations of traditional etiological detection methods. As an unbiased approach to detect pathogens, mNGS overcomes such etiological diagnostic challenges. However, there is no unified standard on how to use mNGS indicators (the sequencing reads, genomic coverage, and relative abundance of each organism) to distinguish between pathogens and colonizing microorganisms or contaminant microorganisms. Here, we selected the mNGS indicator with the best identification performance and established a cutoff value for the identification of pathogens in LRTIs using ROC curves. In addition, we also evaluated the accuracy of antibiotic resistance prediction using mNGS.
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11
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de Armas Y, Capó V, Bornay-Linares FJ, Del Águila C, Matos O, Calderón EJ. Pneumocystis jirovecii and microsporidia: An unusual coinfection in HIV patients? Med Mycol 2021; 58:1191-1194. [PMID: 32497173 DOI: 10.1093/mmy/myaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/03/2020] [Accepted: 05/19/2020] [Indexed: 12/30/2022] Open
Abstract
Pneumocystis jirovecii and microsporidia species are recognized as opportunistic infectious pathogens in AIDS patients. Coinfection of both in one patient has been rarely reported. The aim of the present study was to investigate the coinfection of P. jirovecii and microsporidia in different tissues from AIDS deceased patients. Post mortem histological finding of P. jirovecii and microsporidia was demonstrated by means of the Grocott's methenamine silver and Brown Brenn staining, respectively. Molecular technique was used for identification and characterization of both fungi. Out of the 514 autopsied cases P. jirovecii and microsporidia species were identified in 53 (10.3%) and 62 (12.1%) cases respectively. A total of five cases (0.97%) coinfected with Pneumocystis and microsporidia were recovered from all analyzed autopsies. Coinfection of Pneumocystis and microsporidia is very challenging and raises interesting issues about host-parasite relationship. The early diagnosis of both pathogens must be crucial to establish correct and early treatments, improve the patient's evolution, reducing the risk of death.
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Affiliation(s)
- Yaxsier de Armas
- Pathology Department, Institute of Tropical Medicine "Pedro Kourí," Havana, Cuba
| | - Virginia Capó
- Pathology Department, Institute of Tropical Medicine "Pedro Kourí," Havana, Cuba
| | | | | | - Olga Matos
- Medical Parasitology Unit, Group of Opportunistic Protozoa/HIV and Other Protozoa, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Enrique J Calderón
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Seville, Spain
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12
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Elabbadi A, Pichon J, Visseaux B, Schnuriger A, Bouadma L, Philippot Q, Patrier J, Labbé V, Ruckly S, Fartoukh M, Timsit JF, Voiriot G. Respiratory virus-associated infections in HIV-infected adults admitted to the intensive care unit for acute respiratory failure: a 6-year bicenter retrospective study ( HIV- VIR study). Ann Intensive Care 2020; 10:123. [PMID: 32953200 PMCID: PMC7488215 DOI: 10.1186/s13613-020-00738-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/06/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. Methods HIV-infected adults admitted to two intensive care units over a 6-year period for an acute respiratory failure and explored for respiratory viruses with multiplex polymerase chain reaction (mPCR) were retrospectively selected. Objectives were to describe the prevalence of respiratory viruses, coinfections with non-viral pathogens, and hospital outcome. Results A total of 123 episodes were included. An HIV infection was newly diagnosed in 9% of cases and 72% of the population were on antiretroviral therapy. Real-time mPCR tests identified at least one respiratory virus in the respiratory tract of 33 (27%) patients, but with a non-viral copathogen in two-thirds of cases. Rhinovirus was predominant, documented in 15 patients, followed by Influenza and Respiratory Syncytial Viruses (both n = 6). The prevalence of respiratory virus-associated infection did not vary along with the level of the CD4 T-cell deficiency, except for Rhinovirus which was more prevalent in patients with a CD4 lymphocyte count below 200 cells/µL (n = 13 (20%) vs. n = 2 (4%), p < 0.01). In multivariate analysis, respiratory virus-associated infection was not associated with a worse prognosis. Conclusions Viruses are frequently identified in the respiratory tract of HIV-infected patients with acute respiratory failure that requires ICU admission, but with a non-viral copathogen in two-thirds of cases. Rhinovirus is the predominant viral specie; its prevalence is highest in patients with a CD4 lymphocyte count below 200 cells/µL.
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Affiliation(s)
- Alexandre Elabbadi
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jérémie Pichon
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Benoit Visseaux
- Assistance Publique - Hôpitaux de Paris, Service de virologie, Hôpital Bichat, Université de Paris, Paris, France.,UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Université de Paris, Paris, France
| | - Aurélie Schnuriger
- INSERM, Saint-Antoine Research Center (CRSA), Assistance Publique - Hôpitaux de Paris, Département de virologie site Trousseau, Sorbonne Université, Paris, France
| | - Lila Bouadma
- UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Université de Paris, Paris, France.,Assistance Publique - Hôpitaux de Paris, Service de réanimation médicale et infectieuse, Hôpital Bichat, Université de Paris, Paris, France
| | - Quentin Philippot
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Juliette Patrier
- Assistance Publique - Hôpitaux de Paris, Service de réanimation médicale et infectieuse, Hôpital Bichat, Université de Paris, Paris, France
| | - Vincent Labbé
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France.,Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomédicale, INSERM, Université Paris Est, Créteil, France
| | - Stéphane Ruckly
- UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Université de Paris, Paris, France
| | - Muriel Fartoukh
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France.,Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomédicale, INSERM, Université Paris Est, Créteil, France
| | - Jean-François Timsit
- UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Université de Paris, Paris, France.,Assistance Publique - Hôpitaux de Paris, Service de réanimation médicale et infectieuse, Hôpital Bichat, Université de Paris, Paris, France
| | - Guillaume Voiriot
- Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, Paris, France.,Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomédicale, INSERM, Université Paris Est, Créteil, France
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13
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Grant JK, Vincent L, Ebner B, Hurwitz BE, Alcaide ML, Martinez C. Early Insights into COVID-19 in Persons Living with HIV and Cardiovascular Manifestations. JOURNAL OF AIDS AND HIV TREATMENT 2020; 2:68-74. [PMID: 33748827 PMCID: PMC7971556 DOI: 10.33696/aids.2.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Persons living with HIV-1 (PLHIV) are at increased risk of cardiovascular complications in part due to the persistent inflammatory state despite viral suppression. SARS-CoV-2, the virus causing COVID-19, was declared a pandemic virus in March 2020, and caused over 30 million cases and 900,000 deaths worldwide to date. Individuals with COVID-19 are manifesting acute cardiovascular complications because of the inflammatory response associated with SARS-CoV-2 infection. It is not yet known whether having COVID-19 in the context of ongoing HIV-1 infection results in worse cardiovascular complications than in PLHIV who have not had COVID-19 infection. In this review, the potential for exacerbated cardiovascular manifestations in persons coinfected with HIV-1 and COVID-19 is considered.
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Affiliation(s)
- Jelani K. Grant
- Department of Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida, USA
| | - Louis Vincent
- Department of Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida, USA
| | - Bertrand Ebner
- Department of Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida, USA
| | - Barry E. Hurwitz
- Behavioral Medicine Research Center, University of Miami, Miami, Florida, USA
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
- Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Maria L. Alcaide
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Claudia Martinez
- Department of Medicine, Division of Cardiovascular Disease, University of Miami Miller School of Medicine, Miami, Florida, USA
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