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Taha S, Hong E, Denizon M, Falguières M, Terrade A, Deghmane AE, Taha MK. The rapid rebound of invasive meningococcal disease in France at the end of 2022. J Infect Public Health 2023; 16:1954-1960. [PMID: 37875044 DOI: 10.1016/j.jiph.2023.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/26/2023] [Accepted: 10/01/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Invasive meningococcal disease (IMD) cases declined upon the implementation of non-pharmaceutical measures to control the COVID-19 pandemic. A rebound in IMD cases was feared upon easing these measures. METHODS We conducted a retrospective descriptive study using the French National Reference Center Database for meningococci between 2015 and 2022. We scored serogroups, sex, age groups, and clonal complexes of the corresponding isolates. FINDINGS Our data clearly show a decline in the number of IMD cases for all serogroups and age groups until 2021. This decline was mainly due to a decrease in IMD cases provoked by the hyperinvasive ST-11 clonal complex. However, since the fall of 2021, there has been an increase in IMD cases, which accelerated in the second half of 2022. This rebound concerned all age groups, in particular 16-24 years. The increase in cases due to serogroups B, W, and Y were mainly due to the expansion of isolates of the ST-7460, the clonal complex ST-9316 and the clonal complex ST-23, respectively. INTERPRETATION IMD epidemiology changes constantly and profound epidemiological changes have been recently observed. The surveillance of IMD needs to be enhanced using molecular tools. Additionally, vaccination strategies need to be updated to acknowledge recent epidemiological changes of these vaccine-preventable serogroups.
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Affiliation(s)
- Samy Taha
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Eva Hong
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Mélanie Denizon
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Michael Falguières
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Aude Terrade
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Ala-Eddine Deghmane
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France.
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Biondo C, Ponzo E, Midiri A, Ostone GB, Mancuso G. The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients. Life (Basel) 2023; 13:1408. [PMID: 37374189 DOI: 10.3390/life13061408] [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: 05/18/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the World Health Organization (WHO) declared COVID-19 a global pandemic, the virus has spread to more than 200 countries with more than 500 million cases and more than 6 million deaths reported globally. It has long been known that viral respiratory tract infections predispose patients to bacterial infections and that these co-infections often have an unfavourable clinical outcome. Moreover, nosocomial infections, also known as healthcare-associated infections (HAIs), are those infections that are absent at the time of admission and acquired after hospitalization. However, the impact of coinfections or secondary infections on the progression of COVID-19 disease and its lethal outcome is still debated. The aim of this review was to assess the literature on the incidence of bacterial co-infections and superinfections in patients with COVID-19. The review also highlights the importance of the rational use of antibiotics in patients with COVID-19 and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, alternative antimicrobial agents to counter the emergence of multidrug-resistant bacteria causing healthcare-associated infections in COVID-19 patients will also be discussed.
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Affiliation(s)
- Carmelo Biondo
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | - Elena Ponzo
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | - Angelina Midiri
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
| | | | - Giuseppe Mancuso
- Department of Human Pathology, University of Messina, 98125 Messina, Italy
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Zhao J, Wang Y, Huang X, Ma Q, Song J, Wu X, Zhou H, Weng Y, Yang Z, Wang X. Liu Shen Wan inhibits influenza virus-induced secondary Staphylococcus aureus infection in vivo and in vitro. JOURNAL OF ETHNOPHARMACOLOGY 2021; 277:114066. [PMID: 33766755 DOI: 10.1016/j.jep.2021.114066] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/24/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Liu Shen Wan (LSW) is a traditional Chinese medicine (TCM) with detoxification and antiphlogistic activity; it is composed of bezoar, toad venom, musk, pearl powder, borneol and realgar. In recent years, LSW has been widely used in traditional medicine for the treatment of influenza, tonsillitis, pharyngitis, mumps, cancer and leukaemia. AIM OF STUDY The anti-influenza virus properties of LSW and its inhibition of the inflammatory response was demonstrated in our previous research; however, the effect and potential mechanism of LSW against influenza induced secondary bacteria have remained obscure. Therefore, in the present study, a model of influenza virus PR8 with secondary infection by Staphylococcus aureus (S. aureus) in vitro and in mice was established to examine the effect and potential mechanism by which LSW inhibits bacterial adhesion and subsequent severe pneumonia after viral infection. MATERIALS AND METHODS We investigated the effect of LSW on the PR8-induced adhesion of live S. aureus in A549 cells. RT-qPCR was used to detect the expression of adhesion molecules. Western blotting was used to determine the expression of CEACAM1, RIG-1, MDA5, p-NF-κB, and NF-κB in A549 cells. Inflammatory cytokines were detected using a Bio-Plex Pro Human Cytokine Screening Panel (R&D) in A549 cells and Mouse Magnetic Luminex Assays (R&D) in mice infected with PR8 virus and secondarily with S. aureus, respectively. Moreover, the survival rate, lung index, viral titre, bacterial loads and pathological changes in the lung tissue of mice infected with PR8 and S. aureus were investigated to estimate the effect of LSW in inhibiting severe pneumonia. RESULTS LSW significantly decreased S. aureus adhesion following influenza virus infection in A549 cells, which may have occurred by suppressing expression of the adhesion molecule CEACAM1. In addition, treatment with LSW dramatically suppressed the induction of proinflammatory cytokines (CCL2/MCP-1 and CXCL-9/MIG) and chemokines (IL-6 and TNF-α) by PR8 infection following secondary LPS stimulation in A549 cells. Upregulation of related signalling proteins (RIG-I, MDA5 and NF-κB) induced by viruses and bacteria was suppressed by LSW in A549 cells. LSW significantly decreased the viral titres and bacterial load, prolonged survival time, and ameliorated lung inflammation and injury in mice with S. aureus infection secondary to PR8 infection. CONCLUSIONS We demonstrated that LSW prevents S. aureus adherence to influenza virus-infected A549 cells, perhaps by inhibiting the expression of the adhesion molecule CEACAM1. The upregulation of proinflammatory cytokines and related signalling proteins induced by viruses and bacteria was suppressed by LSW in A549 cells. LSW significantly ameliorated lung injury caused by viral and secondary bacterial infection. These findings provide a further evaluation of LSW and suggest a beneficial effect of LSW for the prevention of secondary bacterial infection and related complications.
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Affiliation(s)
- Jin Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yutao Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaodong Huang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qinhai Ma
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Song
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiao Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hongxia Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yunceng Weng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zifeng Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China; State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau.
| | - Xinhua Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, China; Institute of Integration of Traditional and Western Medicine, Guangzhou Medical University, Guangzhou, China.
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Shi Y, Shi X, Liang J, Luo J, Ba J, Chen J, Wu B. Aggravated MRSA pneumonia secondary to influenza A virus infection is derived from decreased expression of IL-1β. J Med Virol 2020; 92:3047-3056. [PMID: 32697385 PMCID: PMC7692898 DOI: 10.1002/jmv.26329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022]
Abstract
Secondary methicillin-resistant Staphylococcus aureus (MRSA) infection is a cause of severe pneumonia with high mortality during influenza A virus (IAV) pandemics. Alveolar macrophages (AMs) mount cellular defenses against IAV and MRSA infection, which occurs via the nucleotide-binding domain-like receptor protein 3 (NLRP3) inflammasome. However, the activity and function of the NLRP3 inflammasome in MRSA pneumonia secondary to IAV infection remain unclear. To clarify this, we studied MRSA infection secondary to IAV both in vitro and in mouse model. The expression of the NLRP3 inflammasome was evaluated by quantitative reverse transcription polymerase chain reaction, immunofluorescence, Western blot, and enzyme-linked immunosorbent assay. The lung pathology and the rate of weight change were observed. We found that IAV infection for 1 week activated NLRP3 inflammasome. The enhanced expression of NLRP3, caspase-1, and cleaved caspase-1 was associated with MRSA infection secondary to IAV, but the expression of interleukin (IL)-1β decreased in superinfection with MRSA both in vitro and in vivo. The aggravated inflammatory pathology in MRSA pneumonia secondary to IAV infection was associated with decreased expression of IL-1β. And increased weight loss in MRSA pneumonia secondary to IAV infection was related to decreased concentration of IL-1β in serum. It infers that superinfection with MRSA reduces expression of IL-1β someway, and decreased expression of IL-1β impairs the host immunity and leads to aggravated pneumonia. These results contributed to our understanding of the detailed activity of the NLRP3 inflammasome, IL-1β, and their relationship with aggravation of MRSA pneumonia secondary to IAV infection. Immunotherapy targeting the IL-1β signaling pathway could be possible therapeutic strategy for secondary MRSA pneumonia.
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Affiliation(s)
- Yunfeng Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Xiaohan Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jingjing Liang
- Department of EmergencyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jinmei Luo
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Junhui Ba
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
| | - Jianning Chen
- Department of PathologyThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Benquan Wu
- Medical Intensive Care Unit, Department of Respiratory and Critical Care MedicineThe Third Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
- Department of Respiratory and Critical Care MedicineInstitute of Respiratory Diseases of Sun Yat‐Sen UniversityGuangzhouChina
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Martínez-Colón GJ, Warheit-Niemi H, Gurczynski SJ, Taylor QM, Wilke CA, Podsiad AB, Crespo J, Bhan U, Moore BB. Influenza-induced immune suppression to methicillin-resistant Staphylococcus aureus is mediated by TLR9. PLoS Pathog 2019; 15:e1007560. [PMID: 30682165 PMCID: PMC6364947 DOI: 10.1371/journal.ppat.1007560] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 02/06/2019] [Accepted: 01/03/2019] [Indexed: 12/15/2022] Open
Abstract
Bacterial lung infections, particularly with methicillin-resistant Staphylococcus aureus (MRSA), increase mortality following influenza infection, but the mechanisms remain unclear. Here we show that expression of TLR9, a microbial DNA sensor, is increased in murine lung macrophages, dendritic cells, CD8+ T cells and epithelial cells post-influenza infection. TLR9-/- mice did not show differences in handling influenza nor MRSA infection alone. However, TLR9-/- mice have improved survival and bacterial clearance in the lung post-influenza and MRSA dual infection, with no difference in viral load during dual infection. We demonstrate that TLR9 is upregulated on macrophages even when they are not themselves infected, suggesting that TLR9 upregulation is related to soluble mediators. We rule out a role for elevations in interferon-γ (IFNγ) in mediating the beneficial MRSA clearance in TLR9-/- mice. While macrophages from WT and TLR9-/- mice show similar phagocytosis and bacterial killing to MRSA alone, following influenza infection, there is a marked upregulation of scavenger receptor A and MRSA phagocytosis as well as inducible nitric oxide synthase (Inos) and improved bacterial killing that is specific to TLR9-deficient cells. Bone marrow transplant chimera experiments and in vitro experiments using TLR9 antagonists suggest TLR9 expression on non-hematopoietic cells, rather than the macrophages themselves, is important for regulating myeloid cell function. Interestingly, improved bacterial clearance post-dual infection was restricted to MRSA, as there was no difference in the clearance of Streptococcus pneumoniae. Taken together these data show a surprising inhibitory role for TLR9 signaling in mediating clearance of MRSA that manifests following influenza infection. Influenza-associated secondary bacterial infections, particularly with methicillin-resistant Staphylococcus aureus (MRSA), are a major cause of morbidity and mortality, and better therapeutic strategies are needed. Stimulation of TLR2 has shown promise for improving health in influenza-bacteria dual-infected animals. However, nothing is known about the role of other TLRs, including TLR9, in influenza-bacteria dual infection pathology. This is the first study of TLR9 regulation of influenza-bacterial superinfection and it highlights an unexpected pathologic role for TLR9 in regulating clearance of MRSA post-H1N1. It also highlights the important observation that TLR9 signaling has very different outcomes in the setting of influenza infection than in naïve mice and shows important distinctions in the mechanisms for susceptibility to MRSA vs. S. pneumoniae post-influenza. Our results also suggest that TLR9 expression on non-hematopoietic cells regulates macrophage function in vivo.
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Affiliation(s)
| | - Helen Warheit-Niemi
- Microbiology and Immunology Graduate Program, University of Michigan, Ann Arbor, MI United States of America
| | - Stephen J. Gurczynski
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Quincy M. Taylor
- Literature, Sciences and the Arts, Microbiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Carol A. Wilke
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Amy B. Podsiad
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Joel Crespo
- Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, United States of America
| | - Urvashi Bhan
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Bethany B. Moore
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States of America
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, United States of America
- * E-mail:
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Marked Improvement of Severe Lung Immunopathology by Influenza-Associated Pneumococcal Superinfection Requires the Control of Both Bacterial Replication and Host Immune Responses. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 183:868-80. [DOI: 10.1016/j.ajpath.2013.05.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 04/21/2013] [Accepted: 05/13/2013] [Indexed: 12/19/2022]
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Novel bacteriophage lysin with broad lytic activity protects against mixed infection by Streptococcus pyogenes and methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2013; 57:2743-50. [PMID: 23571534 DOI: 10.1128/aac.02526-12] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcus pyogenes (group A streptococcus [GrAS]) cause serious and sometimes fatal human diseases. They are among the many Gram-positive pathogens for which resistance to leading antibiotics has emerged. As a result, alternative therapies need to be developed to combat these pathogens. We have identified a novel bacteriophage lysin (PlySs2), derived from a Streptococcus suis phage, with broad lytic activity against MRSA, vancomycin-intermediate S. aureus (VISA), Streptococcus suis, Listeria, Staphylococcus simulans, Staphylococcus epidermidis, Streptococcus equi, Streptococcus agalactiae (group B streptococcus [GBS]), S. pyogenes, Streptococcus sanguinis, group G streptococci (GGS), group E streptococci (GES), and Streptococcus pneumoniae. PlySs2 has an N-terminal cysteine-histidine aminopeptidase (CHAP) catalytic domain and a C-terminal SH3b binding domain. It is stable at 50 °C for 30 min, 37 °C for >24 h, 4°C for 15 days, and -80 °C for >7 months; it maintained full activity after 10 freeze-thaw cycles. PlySs2 at 128 μg/ml in vitro reduced MRSA and S. pyogenes growth by 5 logs and 3 logs within 1 h, respectively, and exhibited a MIC of 16 μg/ml for MRSA. A single, 2-mg dose of PlySs2 protected 92% (22/24) of the mice in a bacteremia model of mixed MRSA and S. pyogenes infection. Serially increasing exposure of MRSA and S. pyogenes to PlySs2 or mupirocin resulted in no observed resistance to PlySs2 and resistance to mupirocin. To date, no other lysin has shown such notable broad lytic activity, stability, and efficacy against multiple, leading, human bacterial pathogens; as such, PlySs2 has all the characteristics to be an effective therapeutic.
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Damjanovic D, Small CL, Jeyananthan M, McCormick S, Xing Z. Immunopathology in influenza virus infection: Uncoupling the friend from foe. Clin Immunol 2012; 144:57-69. [DOI: 10.1016/j.clim.2012.05.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 04/30/2012] [Accepted: 05/08/2012] [Indexed: 12/23/2022]
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A possible relationship of natural killer T cells with humoral immune response to 23-valent pneumococcal polysaccharide vaccine in clinical settings. Vaccine 2012; 30:3304-10. [DOI: 10.1016/j.vaccine.2012.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 02/28/2012] [Accepted: 03/04/2012] [Indexed: 11/22/2022]
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Figueiró-Filho EA, Oliveira MLG, Pompilio MA, Uehara SNO, Coelho LR, De Souza BA, Breda I. Obstetric, clinical, and perinatal implications of H1N1 viral infection during pregnancy. Int J Gynaecol Obstet 2011; 116:214-8. [PMID: 22196994 DOI: 10.1016/j.ijgo.2011.10.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 10/07/2011] [Accepted: 11/24/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine perinatal outcome and epidemiologic, clinical, and obstetric characteristics among pregnant women infected with the H1N1 virus admitted to a Brazilian university hospital. METHODS A cross-sectional study was conducted of pregnant women infected with H1N1 who were admitted to the University Hospital at the School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil, during the 2009 pandemic. Data were obtained via a questionnaire, which was administered during the hospital evaluation of patients' medical records. RESULTS Thirty-one patients were included in the study. Antiviral therapy was initiated within 48 hours of the onset of symptoms in 64.5% of cases. Infection with the H1N1 virus was associated with severe clinical complications in 22.6% of patients and adverse perinatal outcomes in 41.9% of cases. The rate of maternal and perinatal mortality was 9.7%. There was a statistically significant association between late treatment with oseltamivir and increase in systemic complications in pregnancy (odds ratio 22.80 [95% confidence interval, 2.20-235.65]; P=0.007). CONCLUSION Early treatment with oseltamivir may prevent serious complications associated with H1N1 infection in pregnant women but it does not affect perinatal outcome.
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Affiliation(s)
- Ernesto A Figueiró-Filho
- Department of Gynecology and Obstetrics, School of Medicine-Federal University of Mato Grosso do Sul (FAMED-UFMS), Campo Grande, Brazil.
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Juzeniene A, Ma LW, Kwitniewski M, Polev GA, Lagunova Z, Dahlback A, Moan J. The seasonality of pandemic and non-pandemic influenzas: the roles of solar radiation and vitamin D. Int J Infect Dis 2010; 14:e1099-105. [PMID: 21036090 DOI: 10.1016/j.ijid.2010.09.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 08/08/2010] [Accepted: 09/01/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Seasonal variations in ultraviolet B (UVB) radiation cause seasonal variations in vitamin D status. This may influence immune responses and play a role in the seasonality of influenza. METHODS Pandemic and non-pandemic influenzas in Sweden, Norway, the USA, Singapore, and Japan were studied. Weekly/monthly influenza incidence and death rates were evaluated in view of monthly UVB fluences. RESULTS Non-pandemic influenzas mostly occur in the winter season in temperate regions. UVB calculations show that at high latitudes very little, if any, vitamin D is produced in the skin during the winter. Even at 26°N (Okinawa) there is about four times more UVB during the summer than during the winter. In tropical regions there are two minor peaks in vitamin D photosynthesis, and practically no seasonality of influenza. Pandemics may start with a wave in an arbitrary season, while secondary waves often occur the following winter. Thus, it appears that a low vitamin D status may play a significant role in most influenzas. CONCLUSIONS In temperate latitudes even pandemic influenzas often show a clear seasonality. The data support the hypothesis that high fluences of UVB radiation (vitamin D level), as occur in the summer, act in a protective manner with respect to influenza.
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Affiliation(s)
- Asta Juzeniene
- Department of Radiation Biology, Institute for Cancer Research, the Norwegian Radium Hospital, Oslo University Hospital, Montebello, N-0310 Oslo, Norway.
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Hilty M, Burke C, Pedro H, Cardenas P, Bush A, Bossley C, Davies J, Ervine A, Poulter L, Pachter L, Moffatt MF, Cookson WOC. Disordered microbial communities in asthmatic airways. PLoS One 2010; 5:e8578. [PMID: 20052417 PMCID: PMC2798952 DOI: 10.1371/journal.pone.0008578] [Citation(s) in RCA: 1208] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Accepted: 12/12/2009] [Indexed: 12/16/2022] Open
Abstract
Background A rich microbial environment in infancy protects against asthma [1], [2] and infections precipitate asthma exacerbations [3]. We compared the airway microbiota at three levels in adult patients with asthma, the related condition of COPD, and controls. We also studied bronchial lavage from asthmatic children and controls. Principal Findings We identified 5,054 16S rRNA bacterial sequences from 43 subjects, detecting >70% of species present. The bronchial tree was not sterile, and contained a mean of 2,000 bacterial genomes per cm2 surface sampled. Pathogenic Proteobacteria, particularly Haemophilus spp., were much more frequent in bronchi of adult asthmatics or patients with COPD than controls. We found similar highly significant increases in Proteobacteria in asthmatic children. Conversely, Bacteroidetes, particularly Prevotella spp., were more frequent in controls than adult or child asthmatics or COPD patients. Significance The results show the bronchial tree to contain a characteristic microbiota, and suggest that this microbiota is disturbed in asthmatic airways.
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Affiliation(s)
- Markus Hilty
- National Heart and Lung Institute, Imperial College London, London, England
| | - Conor Burke
- Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland
| | - Helder Pedro
- Instituto Gulbenkian de Ciência, Instituto de Tecnologia Química e Biológica, Oeiras, Portugal
- Department of Mathematics, University of California, Berkeley, California, United States of America
| | - Paul Cardenas
- National Heart and Lung Institute, Imperial College London, London, England
| | - Andy Bush
- National Heart and Lung Institute, Imperial College London, London, England
| | - Cara Bossley
- National Heart and Lung Institute, Imperial College London, London, England
| | - Jane Davies
- National Heart and Lung Institute, Imperial College London, London, England
| | - Aaron Ervine
- Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland
| | - Len Poulter
- Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland
| | - Lior Pachter
- Department of Mathematics, University of California, Berkeley, California, United States of America
| | - Miriam F. Moffatt
- National Heart and Lung Institute, Imperial College London, London, England
| | - William O. C. Cookson
- National Heart and Lung Institute, Imperial College London, London, England
- * E-mail:
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Picone O, Ami O, Vauloup-Fellous C, Martinez V, Guillet M, Dupont-Bernabé C, Donnadieu AC, Trichot C, Senat MV, Fernandez H, Frydman R. Pandémie de grippe A H1N1 2009 et grossesse : épidémiologie, diagnostic et prise en charge. ACTA ACUST UNITED AC 2009; 38:615-28. [DOI: 10.1016/j.jgyn.2009.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 09/18/2009] [Accepted: 09/23/2009] [Indexed: 12/16/2022]
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Novel swine-origin influenza A virus in humans: another pandemic knocking at the door. Med Microbiol Immunol 2009; 198:175-83. [PMID: 19543913 DOI: 10.1007/s00430-009-0118-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Indexed: 12/27/2022]
Abstract
Influenza A viruses represent a continuous pandemic threat. In April 2009, a novel influenza A virus, the so-called swine-origin influenza A (H1N1) virus (S-OIV), was identified in Mexico. Although S-OIV originates from triple-reassortant swine influenza A (H1) that has been circulating in North American pig herds since the end of the 1990s, S-OIV is readily transmitted between humans but is not epidemic in pigs. After its discovery, S-OIV rapidly spread throughout the world within few weeks. In this review, we sum up the current situation and put it into the context of the current state of knowledge of influenza and influenza pandemics. Some indications suggest that a pandemic may be mild but even "mild" pandemics can result in millions of deaths. However, no reasonable forecasts how this pandemic may develop can be made at this time. Despite stockpiling by many countries and WHO, antiviral drugs will be limited in case of pandemic and resistances may emerge. Effective vaccines are regarded to be crucial for the control of influenza pandemics. However, production capacities are restricted and development/production of a S-OIV vaccine will interfere with manufacturing of seasonal influenza vaccines. The authors are convinced that S-OIV should be taken seriously as pandemic threat and underestimation of the menace by S-OIV to be by far more dangerous than its overestimation.
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