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Sharma Y, Mangoni AA, Shahi R, Horwood C, Thompson C. Recent temporal trends, characteristics and outcomes of patients with non-COVID-19 community-acquired pneumonia at two tertiary hospitals in Australia: an observational study. Intern Med J 2024; 54:1686-1693. [PMID: 39016078 DOI: 10.1111/imj.16469] [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: 04/29/2024] [Accepted: 06/16/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Community-acquired pneumonia (CAP) leads to considerable morbidity and mortality globally. However, data on CAP burden in Australia, especially during the coronavirus disease 2019 (COVID-19) pandemic, are limited. AIMS We characterised and assessed clinical outcomes of non-COVID-19 CAP hospitalisations over a 6-year period at two major hospitals in South Australia. METHODS All non-COVID-19 CAP hospitalisations were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian modification (ICD-10-AM) codes, between 1 January 2018 and 31 December 2023, at two tertiary hospitals in Adelaide. Clinical outcomes included in-hospital and 30-day mortality, length of stay (LOS) in, intensive care unit (ICU) admission and 30-day readmissions. Multilevel regression models were utilised to identify predictors of clinical outcomes. RESULTS Over the 6-year period, there were 7853 non-COVID-19 CAP hospitalisations, with a temporal increase from 100 per 100 000 population in 2018 to 208 per 100 000 population in 2023 (P < 0.001). The mean (SD) age was 75.1 (17.6) years, and 54.6% were males. The mean age declined over time (P < 0.05), while other characteristics remained stable. Streptococcus pneumoniae was the most commonly identified bacterium (21.8% of cases). In-hospital mortality occurred in 7.8% of patients, with 30-day mortality and readmission rates of 14.3% and 16.9% respectively. LOS declined significantly during the pandemic years; however, mortality remained stable over time. Frailty status, malnutrition and number of comorbidities significantly predicted 30-day mortality and LOS, in addition to pneumonia severity and ICU admission. CONCLUSIONS There has been an increasing trend of hospitalisations for non-COVID-19 CAP during the COVID-19 pandemic, with a concomitant trend towards shorter LOS and no significant shift in other clinical outcomes.
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Affiliation(s)
- Yogesh Sharma
- Department of Acute and General Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Arduino A Mangoni
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rashmi Shahi
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Chris Horwood
- Department of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Campbell Thompson
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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2
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Singh G, Loho T, Yulianti M, Aditianingsih D, Zakiyah LF, Masse SF, Triono MR. Factors associated with antibiotic resistance and survival analysis of severe pneumonia patients infected with Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa: A retrospective cohort study in Jakarta, Indonesia. SAGE Open Med 2024; 12:20503121241264097. [PMID: 39206228 PMCID: PMC11350540 DOI: 10.1177/20503121241264097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/31/2024] [Indexed: 09/04/2024] Open
Abstract
Background Antimicrobial resistance is one of the most significant challenges to global public health and the risk factors in severe pneumonia are constantly growing. Therefore, this study aimed to identify factors associated with antimicrobial resistance and conduct survival analysis of severe pneumonia patients with single and multiple pathogens in the National Referral Hospital, Jakarta, Indonesia. Methods A retrospective method was used, and secondary data were collected from severe pneumonia patients admitted to the intensive care unit at Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia, from January 2016 to December 2022. Respiratory specimens were collected through bronchial washing. Furthermore, univariate and multivariate analyses were performed to analyze factors associated with antimicrobial resistance. Kaplan‒Meier survival curves were generated with the log-rank test to compare 30-day mortality between patients infected with single, dual, and multiple pathogens. Results The results showed that a total of 333 patients from 415 enrolled were analyzed. Klebsiella pneumoniae (35.4%), Acinetobacter baumannii (29.3%), and Pseudomonas aeruginosa (15.4%) were the most frequently isolated Gram-negative pathogens. Factors associated with resistance to aminoglycoside, carbapenem, and quinolone were sepsis, cerebrovascular disease, and ventilator-associated pneumonia, as indicated by p < 0.05. In addition, the Kaplan-Meier curves showed that multiple pathogens influenced the survival rate of severe pneumonia patients (p < 0.05). Conclusions Sepsis, cerebrovascular disease, and ventilator-associated pneumonia were associated with antimicrobial resistance in severe pneumonia patients. The survival rate of patients infected with multiple pathogens was low. This suggests the importance of further awareness regarding empirical antibiotic stewardship and mortality assessment in severe pneumonia patients.
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Affiliation(s)
- Gurmeet Singh
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Tonny Loho
- Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Mira Yulianti
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Dita Aditianingsih
- Department of Anesthesiology and Intensive Care Unit, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Laila Fakhriyatuz Zakiyah
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Sudirman Fakhruddin Masse
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Muhammad Rizki Triono
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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3
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Adzic-Vukicevic T, Stosic M, Sumarac Z, Cvetkovic A, Markovic O, Maric D. Impact of serum chitotriosidase activity on tuberculosis treatment response: single center study from Serbia. BMC Pulm Med 2024; 24:385. [PMID: 39123152 PMCID: PMC11316431 DOI: 10.1186/s12890-024-03196-2] [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: 03/25/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The aim of our study was to investigate serum chitotriosidase level in tuberculosis patients, its relationship with microbiological and clinical parameters, and response to treatment. MATERIALS AND METHODS This longitudinal panel study included 149 patients with confirmed TB disease. Serum chitotriosidase activity was measured at the beginning and the end of treatment. Factors associated with chitotriosidase activity were explored using univariate and multivariable logistic regression analysis. RESULTS Out of 149 study participants, 71(47.7%) were female. The mean age was 53.0 (SD = 18.2). Majority of cases were new 118(79.2), predominantly 145 (97.3%) having pulmonary tuberculosis. More than half of the patients were sputum smear positive 91 (61.1%) while culture positive in 146 (98%) of them. According to radiological findings, cavitary lesions were found in 92 (63.4%) patients. Anti TB treatment was associated with significant decrease in serum chitotriosidase level (< 0.001). New TB treatment (OR = 4.41%;95% CI = 1.20-9.89), and cavitary lesions (OR = 3.86;95%CI = 0,59-26.57) were found to be significantly associated with decrease of chitotriosidase activity. CONCLUSIONS The results of our study showed that serum chitotriosidase values are strong biomarkers for starting anti TB treatment and for treatment monitoring, since decrease in serum chitotriosidase level can predict favorable treatment response in patients with tuberculosis. Further studies are needed to explore these, and other factors associated with chitotriosidase activity among tuberculosis patients.
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Affiliation(s)
- Tatjana Adzic-Vukicevic
- Faculty of Medicine, Department for Internal Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Maja Stosic
- Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia.
- Faculty for Health and Business Studies, University "Singidunum", Valjevo, Serbia.
| | - Zorica Sumarac
- Department for Biochemistry, University Clinical Center of Serbia, Belgrade, Serbia
- University Business Academy, Novi Sad, Serbia
| | | | - Ognjen Markovic
- Department for Internal Medicine, Health Center Bratunac, Bratunac, Bosnia and Herzegovina
| | - Dragana Maric
- Faculty of Medicine, Department for Internal Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Pulmonology, University Clinical Center of Serbia, Belgrade, Serbia
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4
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Ben Selma W, Alibi S, Ferjeni M, Ghezal S, Gallala N, Belghouthi A, Gargouri A, Marzouk M, Boukadida J. Synergistic activity of Thymus capitatus essential oil and cefotaxime against ESBL-producing Klebsiella pneumoniae. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2936-2946. [PMID: 37952172 DOI: 10.1080/09603123.2023.2280149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
The objective of the current study was to evaluate the interaction between Tunisian Thymus capitatus essential oil (EO) and cefotaxime against Extended-Spectrum Beta-lactamases (ESBLs) producing Klebsiella pneumoniae hospital strains. GC-MS revealed that the major component of EO was found to be carvacrol (69.28%). The EO exerts an advanced bactericidal effect against all strains. Synergy between EO and cefotaxime was obtained by combined disk diffusion and checkerboard techniques. Combined use of EO and cefotaxime reduced the MIC of imipenem by 8- to 128-fold for all strains (fractional inhibitory concentration index ˂ 0.5, synergy). The time kill curve assay confirmed the advanced activity of combinatory effects of EO and cefotaxime, with total reduce of bacterial number (CFU/mL) after 6 h of culture. Synergistic activity of the combination between EO and cefotaxime constitute an important strategy as therapeutical option to combat infections caused by ESBLs producing Klebsiella pneumoniae.
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Affiliation(s)
- Walid Ben Selma
- Department of Biochemistry, Faculty of Medicine, Laboratory of biological and genetic markers studying for early diagnosis and follow-up of neurological diseases (LR18ES47), Sousse, Tunisia
- Higher Institute of Applied Sciences and Technology, Mahdia, Tunisia
| | - Sana Alibi
- Research Unit Analysis and Process Applied to the Environment UR17ES32, Higher Institute of Applied Sciences and Technology, Mahdia, Tunisia
| | - Mohamed Ferjeni
- Department of Biochemistry, Faculty of Medicine, Laboratory of biological and genetic markers studying for early diagnosis and follow-up of neurological diseases (LR18ES47), Sousse, Tunisia
| | - Samira Ghezal
- Laboratory of Microbiology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Najla Gallala
- Laboratory of Microbiology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Amir Belghouthi
- Laboratory of Microbiology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Ali Gargouri
- Biotechnology center of Sfax, Laboratory of Molecular biology, Sfax, Tunisia
| | - Manel Marzouk
- Department of Biochemistry, Faculty of Medicine, Laboratory of biological and genetic markers studying for early diagnosis and follow-up of neurological diseases (LR18ES47), Sousse, Tunisia
- Laboratory of Microbiology, Farhat Hached University Hospital, Sousse, Tunisia
- Department of Microbiology, Faculty of medicine, University of Sousse, Sousse, Tunisia
| | - Jalel Boukadida
- Department of Biochemistry, Faculty of Medicine, Laboratory of biological and genetic markers studying for early diagnosis and follow-up of neurological diseases (LR18ES47), Sousse, Tunisia
- Laboratory of Microbiology, Farhat Hached University Hospital, Sousse, Tunisia
- Department of Microbiology, Faculty of medicine, University of Sousse, Sousse, Tunisia
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Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, Todi SK, Mohan A, Hegde A, Jagiasi BG, Krishna B, Rodrigues C, Govil D, Pal D, Divatia JV, Sengar M, Gupta M, Desai M, Rungta N, Prayag PS, Bhattacharya PK, Samavedam S, Dixit SB, Sharma S, Bandopadhyay S, Kola VR, Deswal V, Mehta Y, Singh YP, Myatra SN. Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024; 28:S104-S216. [PMID: 39234229 PMCID: PMC11369928 DOI: 10.5005/jp-journals-10071-24677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 09/06/2024] Open
Abstract
How to cite this article: Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, et al. Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(S2):S104-S216.
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Affiliation(s)
- Gopi C Khilnani
- Department of Pulmonary, Critical Care and Sleep Medicine, PSRI Hospital, New Delhi, India
| | - Pawan Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Atul P Kulkarni
- Division of Critical Care Medicine, Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Dhruva Chaudhry
- Department of Pulmonary and Critical Care Medicine, University of Health Sciences, Rohtak, Haryana, India
| | - Kapil G Zirpe
- Department of Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Subhash K Todi
- Department of Critical Care, AMRI Hospital, Kolkata, West Bengal, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Ashit Hegde
- Department of Medicine & Critical Care, P D Hinduja National Hospital, Mumbai, India
| | - Bharat G Jagiasi
- Department of Critical Care, Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai, Maharashtra, India
| | - Bhuvana Krishna
- Department of Critical Care Medicine, St John's Medical College and Hospital, Bengaluru, India
| | - Camila Rodrigues
- Department of Microbiology, P D Hinduja National Hospital, Mumbai, India
| | - Deepak Govil
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Divya Pal
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Jigeeshu V Divatia
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mansi Gupta
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mukesh Desai
- Department of Immunology, Pediatric Hematology and Oncology Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Narendra Rungta
- Department of Critical Care & Anaesthesiology, Rajasthan Hospital, Jaipur, India
| | - Parikshit S Prayag
- Department of Transplant Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
| | - Pradip K Bhattacharya
- Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Srinivas Samavedam
- Department of Critical Care, Ramdev Rao Hospital, Hyderabad, Telangana, India
| | - Subhal B Dixit
- Department of Critical Care, Sanjeevan and MJM Hospital, Pune, Maharashtra, India
| | - Sudivya Sharma
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Susruta Bandopadhyay
- Department of Critical Care, AMRI Hospitals Salt Lake, Kolkata, West Bengal, India
| | - Venkat R Kola
- Department of Critical Care Medicine, Yashoda Hospitals, Hyderabad, Telangana, India
| | - Vikas Deswal
- Consultant, Infectious Diseases, Medanta - The Medicity, Gurugram, Haryana, India
| | - Yatin Mehta
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Yogendra P Singh
- Department of Critical Care, Max Super Speciality Hospital, Patparganj, New Delhi, India
| | - Sheila N Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Rotini G, de Mangou A, Combe A, Jabot J, Puech B, Dangers L, Nativel M, Allou N, Miltgen G, Vidal C. Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii. Am J Trop Med Hyg 2024; 111:136-140. [PMID: 38834085 PMCID: PMC11229653 DOI: 10.4269/ajtmh.23-0820] [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: 12/06/2023] [Accepted: 02/12/2024] [Indexed: 06/06/2024] Open
Abstract
Acinetobacter baumannii (Ab) is a well-known nosocomial pathogen that has emerged as a cause of community-acquired pneumonia (CAP) in tropical regions. Few global epidemiological studies of CAP-Ab have been published to date, and no data are available on this disease in France. We conducted a retrospective chart review of severe cases of CAP-Ab admitted to intensive care units in Réunion University Hospital between October 2014 and October 2022. Eight severe CAP-Ab cases were reviewed. Median patient age was 56.5 years. Sex ratio (male-to-female) was 3:1. Six cases (75.0%) occurred during the rainy season. Chronic alcohol use and smoking were found in 75.0% and 87.5% of cases, respectively. All patients presented in septic shock and with severe acute respiratory distress syndrome. Seven patients (87.5%) presented in cardiogenic shock, and renal replacement therapy was required for six patients (75.0%). Five cases (62.5%) presented with bacteremic pneumonia. The mortality rate was 62.5%. The median time from hospital admission to death was 3 days. All patients received inappropriate initial antibiotic therapy. Acinetobacter baumannii isolates were all susceptible to ceftazidime, cefepime, piperacillin-tazobactam, ciprofloxacin, gentamicin, and imipenem. Six isolates (75%) were also susceptible to ticarcillin, piperacillin, and cotrimoxazole. Severe CAP-Ab has a fulminant course and high mortality. A typical case is a middle-aged man with smoking and chronic alcohol use living in a tropical region and developing severe CAP during the rainy season. This clinical presentation should prompt administration of antibiotic therapy targeting Ab.
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Affiliation(s)
- Giacomo Rotini
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Axel de Mangou
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Agathe Combe
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Julien Jabot
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Bérénice Puech
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Laurence Dangers
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Mathilde Nativel
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Nicolas Allou
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
| | - Guillaume Miltgen
- Department of Microbiology, Felix Guyon University Hospital, Saint-Denis, France
- UMR PIMIT, CNRS 9192, INSERM U1187, IRD 249, University of Reunion, Saint-Clotilde, France
| | - Charles Vidal
- Department of Intensive Care Medicine, Felix Guyon University Hospital, Saint-Denis, France
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Febbo J, Dako F. Pulmonary Infection. Clin Chest Med 2024; 45:373-382. [PMID: 38816094 DOI: 10.1016/j.ccm.2024.02.009] [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] [Indexed: 06/01/2024]
Abstract
Pneumonia is a significant cause of morbidity and mortality in the community and hospital settings. Bacterial, viral, mycobacterial, and fungal pathogens are all potential causative agents of pulmonary infection. Chest radiographs and computed tomography are frequently utilized in the assessment of pneumonia. Learning the imaging patterns of different potential organisms allows the radiologist to formulate an appropriate differential diagnosis. An organism-based approach is used to discuss the imaging findings of different etiologies of pulmonary infection.
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Affiliation(s)
- Jennifer Febbo
- Department of Radiology, University of New Mexico, 2211 Lomas Boulevard NE, Albuquerque, NM 87106, USA.
| | - Farouk Dako
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Donner 1, Philadelphia, PA 19104, USA
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8
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Lu S, Shuai Z, Lu Y. The dose-response relationship between physical activity and the risk of death from pneumonia in middle-aged and older adults: A meta-analysis. Medicine (Baltimore) 2024; 103:e38220. [PMID: 38787979 PMCID: PMC11124747 DOI: 10.1097/md.0000000000038220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Deaths from COVID-19 are concentrated in older adults, and studies have reported that physical activity (PA) can reduce the risk of death from pneumonia. METHODS Eight cohort studies and 2 case-control studies were included according to the inclusion and exclusion criteria established in this meta-analysis study followed the PRISMA guideline, 8 cohort studies and 2 case-control studies were finally included. Then, the research objects in these studies were classified to further study the dose-response relationship and non-dose-response relationship. RESULTS The highest dose of PA reduced the risk of death by 59% (risk ratio = 0.41; 95% confidence interval: 0.23-0.58) compared with the lowest dose of PA in middle-aged and elderly people. Furthermore, when the PA level was <10 m/wk, the risk of death from pneumonia was reduced by 6% every 4.5 MET-h/wk increase. At a PA level > 10 m/wk, the risk of death from pneumonia increased by 5% every 4.5 MET-h/wk increase. At a PA level > 30 m/wk, PA is a risk factor for pneumonia-related death in middle-aged and elderly people. CONCLUSIONS This meta-analysis showed that PA was associated with a reduced risk of dying from pneumonia in middle-aged and older adults, and that there was a significant nonlinear negative dose-response relationship between PA levels and the risk of dying from pneumonia. Therefore, moderate exercise was recommended.
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Affiliation(s)
- Songtao Lu
- School of Sports and School of Physical Education, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
- School of Sports and School of Physical Education, Central China Normal University, Wuhan, Hubei Province, China
| | - Zhiqi Shuai
- School of Sports and School of Physical Education, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
| | - Yunfei Lu
- School of Sports and School of Physical Education, Wuhan University of Science and Technology, Wuhan, Hubei Province, China
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9
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Kakati B, Singh R, Mittal G, Koul N. Comparative performance of biofire pneumonia panel and standard culture-based methods for diagnosing pneumonia in critically ill patients: Impact on antibiotic stewardship. Indian J Med Microbiol 2024; 49:100564. [PMID: 38649113 DOI: 10.1016/j.ijmmb.2024.100564] [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: 10/19/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Lower respiratory tract infections (LRTIs) are a common cause of morbidity and mortality worldwide. Accurate identification of the pathogens causing LRTIs is crucial for ensuring of diagnostic and antibiotic stewardship. The Biofire Pneumonia Panel (BFPP) is a molecular diagnostic test that allows rapid detection of various bacterial and viral pathogens. In this study, we compared the performance of BFPP with standard culture methods for the detection of pathogens. MATERIALS AND METHODS Respiratory samples from 70 patient with suspected LRTIs were tested using both BFPP and standard culture methods. The distribution of isolated bacterial pathogens was analyzed, and the sensitivity and specificity of BFPP were calculated. Additionally, the performance of BFPP in detecting antimicrobial resistance genes was evaluated. The results were compared with those obtained from VITEK-2 antimicrobial susceptibility testing and culture-based methods. RESULTS Among the suspected LRTI cases, BFPP identified a single pathogen in 32.8% of cases and multiple pathogens in 40% of cases. The standard culture method detected a single pathogen in 47.1% of cases. BFPP showed a sensitivity of 93.9% and a specificity of 45.9% for the total sample. The performance of BFPP in detecting antimicrobial resistance genes varied for different pathogens with overall sensitivity of 40.1% and specificity of 95.9%. CONCLUSION The Biofire Pneumonia Panel (BFPP) demonstrated high sensitivity for several bacterial pathogens, indicating its potential as a rapid diagnostic tool. However, its performance varied for different microorganisms, and it had limitations in detecting certain pathogens and antimicrobial resistance genes for which still required more further studies to explore different resistance gene mechanism that can be incorporated in this panel in future. The BFPP can complement standard culture methods as a rapid tool in the diagnosis of LRTIs.
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Affiliation(s)
- Barnali Kakati
- Dept. of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jollygrant, Dehradun, Uttarakhand, India.
| | - Rajender Singh
- Dept. of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jollygrant, Dehradun, Uttarakhand, India.
| | - Garima Mittal
- Dept. of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jollygrant, Dehradun, Uttarakhand, India.
| | - Nupur Koul
- Dept. of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jollygrant, Dehradun, Uttarakhand, India.
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10
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Vaquer A, Adrover-Jaume C, Clemente A, Viana J, Rodríguez R, Rojo-Molinero E, Oliver A, de la Rica R. OriPlex: Origami-enabled multiplexed detection of respiratory pathogens. Biosens Bioelectron 2024; 257:116341. [PMID: 38677019 DOI: 10.1016/j.bios.2024.116341] [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: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Origami biosensors leverage paper foldability to develop total analysis systems integrated in a single piece of paper. This capability can also be utilized to incorporate additional features that would be difficult to achieve with rigid substrates. In this article, we report a new design for 3D origami biosensors called OriPlex, which leverages the foldability of filter paper for the multiplexed detection of bacterial pathogens. OriPlex immunosensors detect pathogens by folding nanoparticle reservoirs containing different types of nanoprobes. This releases antibody-coated nanoparticles in a central channel where targets are captured through physical interactions. The OriPlex concept was demonstrated by detecting the respiratory pathogens Pseudomonas aeruginosa (PA) and Klebsiella pneumoniae (KP) with a limit of detection of 3.4·103 cfu mL-1 and 1.4·102 cfu mL-1, respectively, and with a turn-around time of 25 min. Remarkably, the OriPlex biosensors allowed the multiplexed detection of both pathogens spiked into real bronchial aspirate (BAS) samples at a concentration of 105 cfu mL-1 (clinical infection threshold), thus demonstrating their suitability for diagnosing lower tract respiratory infections. The results shown here pave the way for implementing OriPlex biosensors as a screening test for detecting superbugs requiring personalized antibiotics in suspected cases of nosocomial pneumonia.
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Affiliation(s)
- Andreu Vaquer
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Cristina Adrover-Jaume
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; Department of Chemistry, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Antonio Clemente
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain.
| | - Julia Viana
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
| | - Rocío Rodríguez
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain
| | - Estrella Rojo-Molinero
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
| | - Antonio Oliver
- Microbiology Department, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain
| | - Roberto de la Rica
- Multidisciplinary Sepsis Group, Hospital Universitario Son Espases, Health Research Institute of Balearic Islands (IdISBa), Palma de Mallorca, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III Madrid, Spain.
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11
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Darkwah S, Kotey FCN, Ahenkorah J, Adutwum-Ofosu KK, Donkor ES. Sepsis-Related Lung Injury and the Complication of Extrapulmonary Pneumococcal Pneumonia. Diseases 2024; 12:72. [PMID: 38667530 PMCID: PMC11049144 DOI: 10.3390/diseases12040072] [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: 10/03/2023] [Revised: 11/18/2023] [Accepted: 11/26/2023] [Indexed: 04/28/2024] Open
Abstract
Globally, sepsis and pneumonia account for significant mortality and morbidity. A complex interplay of immune-molecular pathways underlies both sepsis and pneumonia, resulting in similar and overlapping disease characteristics. Sepsis could result from unmanaged pneumonia. Similarly, sepsis patients have pneumonia as a common complication in the intensive care unit. A significant percentage of pneumonia is misdiagnosed as septic shock. Therefore, our knowledge of the clinical relationship between pneumonia and sepsis is imperative to the proper management of these syndromes. Regarding pathogenesis and etiology, pneumococcus is one of the leading pathogens implicated in both pneumonia and sepsis syndromes. Growing evidence suggests that pneumococcal pneumonia can potentially disseminate and consequently induce systemic inflammation and severe sepsis. Streptococcus pneumoniae could potentially exploit the function of dendritic cells (DCs) to facilitate bacterial dissemination. This highlights the importance of pathogen-immune cell crosstalk in the pathophysiology of sepsis and pneumonia. The role of DCs in pneumococcal infections and sepsis is not well understood. Therefore, studying the immunologic crosstalk between pneumococcus and host immune mediators is crucial to elucidating the pathophysiology of pneumonia-induced lung injury and sepsis. This knowledge would help mitigate clinical diagnosis and management challenges.
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Affiliation(s)
- Samuel Darkwah
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (J.A.); (K.K.A.-O.)
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (J.A.); (K.K.A.-O.)
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
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12
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Fan C, Yang M, Mao Y, Fang B, He Y, Li R, Qian S. Effect of Antimicrobial Stewardship 2018 on severe pneumonia with bacterial infection in paediatric intensive care units. J Glob Antimicrob Resist 2024; 36:444-452. [PMID: 37935333 DOI: 10.1016/j.jgar.2023.10.017] [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: 08/29/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVES Antimicrobial Stewardship 2018 (ASP 18) in China emphasizes the hierarchical control of antimicrobial drugs and the management of physicians' prescribing authority, especially in children. The purpose of this study was to assess the effect of implementation of ASP 2018 on antibiotic consumption, resistance, and treatment outcomes in children with severe pneumonia from bacterial infections. METHODS A single center, retrospective study was conducted on 287 children with severe bacterial pneumonia, including 165 patients before intervention (May 2016-April 2018) and 122 patients after intervention (May 2018-April 2020). The antimicrobial resistance rates, antibiotic consumption, and clinical outcomes of the two periods were compared. RESULTS After the implementation of ASP 2018, Staphylococcus aureus (17.9%) became the predominant Gram-positive bacterium. The resistance of Streptococcus pneumoniae to clindamycin, erythromycin, and tetracycline was significantly reduced (P < 0.001), and Staphylococcus aureus to tetracycline also decreased (P = 0.034). In addition, Klebsiella pneumoniae (18.4%) replaced Pseudomonas aeruginosa (9.5%) as the most common Gram-negative bacterium. The resistance rates of Klebsiella pneumoniae to amoxicillin/clavulanic acid (AMC) and trimethoprim/sulfamethoxazole (SXT), and Acinetobacter baumannii to cefotaxime and SXT decreased significantly (P < 0.02). Total consumption (DDD/100 patient-days) of five antibiotics (cephalosporins, carbapenems, macrolides, antifungal agents, and linezolid) showed a decreasing trend, and the decrease in antifungal agents and linezolid was the most significant (27.4% and 25.6%, P < 0.001). The isolation rate of multidrug-resistant (MDR) strains decreased significantly from the highest, 16.8%, before intervention to 6.7% after intervention (P < 0.001). CONCLUSION Our data indicate that the implementation of antimicrobial management strategies has significantly reduced the consumption of antibiotics and the occurrence of antimicrobial resistance in children with severe bacterial pneumonia in PICU.
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Affiliation(s)
- Chaonan Fan
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Mei Yang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yiyang Mao
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Boliang Fang
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yushan He
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Rubo Li
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Suyun Qian
- Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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13
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Dung TTN, Phat VV, Vinh C, Lan NPH, Phuong NLN, Ngan LTQ, Thwaites G, Thwaites L, Rabaa M, Nguyen ATK, Duy PT. Development and validation of multiplex real-time PCR for simultaneous detection of six bacterial pathogens causing lower respiratory tract infections and antimicrobial resistance genes. BMC Infect Dis 2024; 24:164. [PMID: 38326753 PMCID: PMC10848345 DOI: 10.1186/s12879-024-09028-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Streptococcus pneumoniae and Staphylococcus aureus are major bacterial causes of lower respiratory tract infections (LRTIs) globally, leading to substantial morbidity and mortality. The rapid increase of antimicrobial resistance (AMR) in these pathogens poses significant challenges for their effective antibiotic therapy. In low-resourced settings, patients with LRTIs are prescribed antibiotics empirically while awaiting several days for culture results. Rapid pathogen and AMR gene detection could prompt optimal antibiotic use and improve outcomes. METHODS Here, we developed multiplex quantitative real-time PCR using EvaGreen dye and melting curve analysis to rapidly identify six major pathogens and fourteen AMR genes directly from respiratory samples. The reproducibility, linearity, limit of detection (LOD) of real-time PCR assays for pathogen detection were evaluated using DNA control mixes and spiked tracheal aspirate. The performance of RT-PCR assays was subsequently compared with the gold standard, conventional culture on 50 tracheal aspirate and sputum specimens of ICU patients. RESULTS The sensitivity of RT-PCR assays was 100% for K. pneumoniae, A. baumannii, P. aeruginosa, E. coli and 63.6% for S. aureus and the specificity ranged from 87.5% to 97.6%. The kappa correlation values of all pathogens between the two methods varied from 0.63 to 0.95. The limit of detection of target bacteria was 1600 CFU/ml. The quantitative results from the PCR assays demonstrated 100% concordance with quantitative culture of tracheal aspirates. Compared to culture, PCR assays exhibited higher sensitivity in detecting mixed infections and S. pneumoniae. There was a high level of concordance between the detection of AMR gene and AMR phenotype in single infections. CONCLUSIONS Our multiplex quantitative RT-PCR assays are fast and simple, but sensitive and specific in detecting six bacterial pathogens of LRTIs and their antimicrobial resistance genes and should be further evaluated for clinical utility.
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Affiliation(s)
- Tran Thi Ngoc Dung
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
| | - Voong Vinh Phat
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
| | - Chau Vinh
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
| | | | | | | | - Guy Thwaites
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Louise Thwaites
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Maia Rabaa
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Anh T K Nguyen
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Thanh Duy
- Molecular Epidemiology Group, Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, Ward 1, District 5, Ho Chi Minh City, Vietnam.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK.
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14
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Torres A, Kuraieva A, Stone GG, Cillóniz C. Systematic review of ceftaroline fosamil in the management of patients with methicillin-resistant Staphylococcus aureus pneumonia. Eur Respir Rev 2023; 32:230117. [PMID: 37852658 PMCID: PMC10582922 DOI: 10.1183/16000617.0117-2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/30/2023] [Indexed: 10/20/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for an array of problematic community- and healthcare-acquired infections, including pneumonia, and is frequently associated with severe disease and high mortality rates. Standard recommended treatments for empiric and targeted coverage of suspected MRSA in patients with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP), are vancomycin and linezolid. However, adverse events such as acute kidney injury and Clostridium difficile infection have been associated with these antibiotics. Ceftaroline fosamil is a β-lactam/extended-spectrum cephalosporin approved for the treatment of adults and children with CAP and complicated skin and soft tissue infections. Ceftaroline has in vitro activity against a range of common Gram-positive bacteria and is distinct among the β-lactams in retaining activity against MRSA. Due to the design of the pivotal randomised controlled trials of ceftaroline fosamil, outcomes in patients with MRSA CAP were not evaluated. However, various reports of real-world outcomes with ceftaroline fosamil for pneumonia caused by MRSA, including CAP and HAP/VAP, been published since its approval. A systematic literature review and qualitative analysis of relevant publications was undertaken to collate and summarise relevant published data on the efficacy and safety of ceftaroline fosamil in patients with MRSA pneumonia. While relatively few real-world outcomes studies are available, the available data suggest that ceftaroline fosamil is a possible alternative to linezolid and vancomycin for MRSA pneumonia. Specific scenarios in which ceftaroline fosamil might be considered include bacteraemia and complicating factors such as empyema.
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Affiliation(s)
- Antoní Torres
- Dept of Pulmonology, Hospital Clinic, University of Barcelona, IDIBAPS, ICREA, CIBERES, Barcelona, Spain
| | | | | | - Catia Cillóniz
- Dept of Pulmonology, Hospital Clinic, University of Barcelona, IDIBAPS, ICREA, CIBERES, Barcelona, Spain
- Faculty of Health Sciences, Continental University, Huancayo, Peru
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15
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A J, S S S, K S, T S M. Extracellular vesicles in bacterial and fungal diseases - Pathogenesis to diagnostic biomarkers. Virulence 2023; 14:2180934. [PMID: 36794396 PMCID: PMC10012962 DOI: 10.1080/21505594.2023.2180934] [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: 02/17/2023] Open
Abstract
Intercellular communication among microbes plays an important role in disease exacerbation. Recent advances have described small vesicles, termed as "extracellular vesicles" (EVs), previously disregarded as "cellular dust" to be vital in the intracellular and intercellular communication in host-microbe interactions. These signals have been known to initiate host damage and transfer of a variety of cargo including proteins, lipid particles, DNA, mRNA, and miRNAs. Microbial EVs, referred to generally as "membrane vesicles" (MVs), play a key role in disease exacerbation suggesting their importance in pathogenicity. Host EVs help coordinate antimicrobial responses and prime the immune cells for pathogen attack. Hence EVs with their central role in microbe-host communication, may serve as important diagnostic biomarkers of microbial pathogenesis. In this review, we summarize current research regarding the roles of EVs as markers of microbial pathogenesis with specific focus on their interaction with host immune defence and their potential as diagnostic biomarkers in disease conditions.
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Affiliation(s)
- Jnana A
- Department of Biotechnology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Sadiya S S
- Department of Biotechnology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Satyamoorthy K
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Murali T S
- Department of Biotechnology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, India
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Mazwi S, van Blydenstein SA, Mukansi M. Ventilator-associated pneumonia in an academic intensive care unit in Johannesburg, South Africa. Afr J Thorac Crit Care Med 2023; 29:10.7196/AJTCCM.2023.v29i4.154. [PMID: 38078286 PMCID: PMC10699432 DOI: 10.7196/ajtccm.2023.v29i4.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/10/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Ventilator-associated pneumonia (VAP) has an estimated incidence of 10 - 41.5 events per 1 000 ventilator days in developing countries, and carries high mortality. Little is known about the incidence and outcomes of VAP in Johannesburg, South Africa. OBJECTIVES To describe VAP in a tertiary public hospital in Johannesburg, assess the microbiological pathogens associated with VAP (both early and late), and outline the outcomes of these patients. METHODS The study was a retrospective record review of patients admitted to the Helen Joseph Hospital intensive care unit (ICU) between March 2013 and January 2016. RESULTS VAP developed in 24/842 ventilated patients (2.9%; 95% confidence interval (CI) 1.8 - 4.2), with an incidence of 23 events per 1 000 ventilator days, during the study period. Of these patients, one-third (29.2%) died and 70.8% were discharged from the ICU. Late-onset VAP (onset ≥5 days after intubation, incidence 45.8%) was associated with higher mortality (54.6%) than early-onset VAP (onset within 4 days after intubation, incidence 54.2% and mortality 7.7%). Commonly isolated organisms were Klebsiellai pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. There was a trend towards an increased risk of multidrug-resistant organisms with late-onset VAP (adjusted relative risk 2.26; 95% CI 0.92 - 5.57; p=0.077) and airway access through a tracheostomy (relative risk 1.68; 95% CI 0.78 - 3.57). CONCLUSION The study showed a low to moderate incidence of VAP of 23 events per 1 000 ventilator days. A tracheostomy and late-onset VAP were associated with infection by drug-resistant organisms. The mortality rate was 29.2% in this setting, with a seven-fold increase in mortality with late-onset VAP. STUDY SYNOPSIS What the study adds. This study helps to improve understanding of the incidence of ventilator-associated pneumonia in South Africa, a low- to middle-income country, and the commonly encountered causative pathogens. It indicates the importance of a short intensive care unit (ICU) stay as a target outcome for prevention of nosocomial infections and other complications.Implications of the findings. The study: reinforces the importance of preventive mesures in the ICU and keeping up to date with the evidence in the fieldhighlights the importance of knowing local microbial resistance patterns in order to develop precise antibiogramsshows the need for research in ICU care for people of advanced age, and the impact that admission rationing has on our ICU populations.
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Affiliation(s)
- S Mazwi
- Division of Internal Medicine, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - S A van Blydenstein
- Division of Pulmonology, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Mukansi
- Division of Critical Care, Helen Joseph Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Martin-Loeches I, Reyes LF, Nseir S, Ranzani O, Povoa P, Diaz E, Schultz MJ, Rodríguez AH, Serrano-Mayorga CC, De Pascale G, Navalesi P, Panigada M, Coelho LM, Skoczynski S, Esperatti M, Cortegiani A, Aliberti S, Caricato A, Salzer HJF, Ceccato A, Civljak R, Soave PM, Luyt CE, Ekren PK, Rios F, Masclans JR, Marin J, Iglesias-Moles S, Nava S, Chiumello D, Bos LD, Artigas A, Froes F, Grimaldi D, Taccone FS, Antonelli M, Torres A. European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI. Intensive Care Med 2023; 49:1212-1222. [PMID: 37812242 PMCID: PMC10562498 DOI: 10.1007/s00134-023-07210-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/22/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Lower respiratory tract infections (LRTI) are the most frequent infectious complication in patients admitted to the intensive care unit (ICU). We aim to report the clinical characteristics of ICU-admitted patients due to nosocomial LRTI and to describe their microbiology and clinical outcomes. METHODS A prospective observational study was conducted in 13 countries over two continents from 9th May 2016 until 16th August 2019. Characteristics and outcomes of ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), ICU hospital-acquired pneumonia (ICU-HAP), HAP that required invasive ventilation (VHAP), and HAP in patients transferred to the ICU without invasive mechanical ventilation were collected. The clinical diagnosis and treatments were per clinical practice and not per protocol. Descriptive statistics were used to compare the study groups. RESULTS 1060 patients with LRTI (72.5% male sex, median age 64 [50-74] years) were included in the study; 160 (15.1%) developed VAT, 556 (52.5%) VAP, 98 (9.2%) ICU-HAP, 152 (14.3%) HAP, and 94 (8.9%) VHAP. Patients with VHAP had higher serum procalcitonin (PCT) and Sequential Organ Failure Assessment (SOFA) scores. Patients with VAP or VHAP developed acute kidney injury, acute respiratory distress syndrome, multiple organ failure, or septic shock more often. One thousand eight patients had microbiological samples, and 711 (70.5%) had etiological microbiology identified. The most common microorganisms were Pseudomonas aeruginosa (18.4%) and Klebsiella spp (14.4%). In 382 patients (36%), the causative pathogen shows some antimicrobial resistance pattern. ICU, hospital and 28-day mortality were 30.8%, 37.5% and 27.5%, respectively. Patients with VHAP had the highest ICU, in-hospital and 28-day mortality rates. CONCLUSION VHAP patients presented the highest mortality among those admitted to the ICU. Multidrug-resistant pathogens frequently cause nosocomial LRTI in this multinational cohort study.
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Affiliation(s)
- Ignacio Martin-Loeches
- St James's University Hospital, Trinity College, Dublin 8, D08 NHY, Ireland.
- Universidad de Barcelona, CIBERes, Barcelona, Spain.
| | - Luis Felipe Reyes
- Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia, Colombia
- Clinica Universidad de La Sabana, Chia, Colombia
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Saad Nseir
- University Hospital of Lille, Lille, France
| | | | - Pedro Povoa
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - Emili Diaz
- Corporacio Sanitaria Parc Tauli, Sabadell, Spain
| | - Marcus J Schultz
- Academic Medical Center, Amsterdam, The Netherlands
- Department of Intensive Care Laboratory for Experimental Intensive Care and Anesthesiology (LEICA), Amsterdam, The Netherlands
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK
| | | | - Cristian C Serrano-Mayorga
- Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia, Colombia
- Clinica Universidad de La Sabana, Chia, Colombia
| | | | - Paolo Navalesi
- Magna Graecia University, Catanzaro, Italy
- Sant'Andrea (ASL VC), Vercelli, Italy
| | - Mauro Panigada
- Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | | - Stefano Aliberti
- Medical University of Silesia, Katowice, Poland
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Respiratory Unit, Milan, Italy
| | | | - Helmut J F Salzer
- Department of Internal Medicine 4-Pneumology, Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Division of Infectious Diseases and Tropical Medicine, Kepler University Hospital, Linz, Austria
| | | | - Rok Civljak
- "Dr. Fran Mihaljevic" University Hospital for Infectious Diseases, Zagreb, Croatia
| | | | | | | | - Fernando Rios
- Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | - Joan Ramon Masclans
- Hospital del Mar, Barcelona, Spain
- Intensive Care Medicine, Hospital del Mar & IMIM, Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Judith Marin
- Intensive Care Medicine, Hospital del Mar & IMIM, Barcelona, Spain
| | | | - Stefano Nava
- S. Orsola-Malpighi Hospital, Bologna, Italy
- Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | | | - Lieuwe D Bos
- Academic Medical Center, Amsterdam, The Netherlands
| | | | | | - David Grimaldi
- Hospital Erasme Universit Libre de Bruxelles, Brussels, Belgium
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Chang C, Wang H, Zhang L, Hao J, Wang X, Wang Y, Qi F, Lou J, Zhao J, Dong J. Clinical Efficiency of Metagenomic Next-Generation Sequencing in Sputum for Pathogen Detection of Patients with Pneumonia According to Disease Severity and Host Immune Status. Infect Drug Resist 2023; 16:5869-5885. [PMID: 37700802 PMCID: PMC10493106 DOI: 10.2147/idr.s419892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose Severe pneumonia causes the highest mortality rate in immunocompromised patients. This study aimed to investigate the pathogen diagnostic efficacy of metagenomic next-generation sequencing (mNGS) using sputum sample in patients with pneumonia according to patients' disease severity and immune conditions. Patients and Methods A total of 180 patients suffering from pneumonia were recruited, and sputum samples were collected in duplicate for pathogen detection by both conventional microbiological tests (CMT) and mNGS. Then, the performance of pathogen identification was examined between two methods, according to disease severity and patients' immune status. Results In comparison to CMT, mNGS had higher positivity rates in all patients with pneumonia (85.0% vs 62.2%, P=9.445e-07). The most commonly detected microorganism in sputum of pneumonia patients was Acinetobacter baumannii (42/180, 23.3%) in bacterum level, Candida albicans in fungus level (44/180, 24.4%), and Human herpesvirus 1 (39/180, 27.5%) in virus level. However, for mNGS results, Candida albicans in 34.9% of positive patients, and Human herpesvirus 1 in 7.7% of positive cases were confirmed as pathogens causing pneumonia. Acinetobacter baumannii detected by mNGS in 75% of positive patients was diagnosed as pathogen of pneumonia. The microorganism profile of sputum mNGS differed according to disease severity and immune status of patients. Pneumocystis jirovecii was more likely to infect immunocompromised patients (P=0.002). Pseudomonas aeruginosa (14.8% vs 0.0%, P=0.008) and Human herpesvirus 1 (26.1% vs 5.3%, P=0.004) had higher infection rate in patients with severe pneumonia compared with non-severe cases. mNGS had overwhelming advantages over CMT in detecting a lot of microorganisms including Streptococcus pneumoniae, Enterococcus faecium, Pneumocystis jirovecii, and majority of viruses. Conclusion mNGS is a complementary tool of CMT for detecting suspected pathogens for patients with lower respiratory infections. The interpretation of opportunistic pathogens identified by mNGS is challenging, and needs comprehensive consideration of sequencing data and clinical factors.
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Affiliation(s)
- Can Chang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
| | - Huan Wang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
| | - Lianjun Zhang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
| | - Junling Hao
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
| | - Xiaoning Wang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
| | - Yaoyao Wang
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, 201204, People’s Republic of China
| | - Fei Qi
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, 201204, People’s Republic of China
| | - Jingwei Lou
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, 201204, People’s Republic of China
| | - Jiangman Zhao
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, 201204, People’s Republic of China
| | - Junying Dong
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Heze Branch, Heze, Shandong, 274000, People’s Republic of China
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Ablakimova N, Mussina AZ, Smagulova GA, Rachina S, Kurmangazin MS, Balapasheva A, Karimoldayeva D, Zare A, Mahdipour M, Rahmanifar F. Microbial Landscape and Antibiotic-Susceptibility Profiles of Microorganisms in Patients with Bacterial Pneumonia: A Comparative Cross-Sectional Study of COVID-19 and Non-COVID-19 Cases in Aktobe, Kazakhstan. Antibiotics (Basel) 2023; 12:1297. [PMID: 37627717 PMCID: PMC10451206 DOI: 10.3390/antibiotics12081297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/30/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
This cross-sectional study investigated the microbial landscape and antibiotic-resistance patterns in patients with bacterial pneumonia, with a focus on the impact of COVID-19. Sputum samples from individuals with bacterial pneumonia, including coronavirus disease 2019-positive polymerase chain reaction (COVID-19-PCR+), COVID-19-PCR- and non-COVID-19 patients, were analyzed. Surprisingly, the classic etiological factor of bacterial pneumonia, Streptococcus pneumoniae, was rarely isolated from the sputum samples. Furthermore, the frequency of multidrug-resistant pathogens was found to be higher in non-COVID-19 patients, highlighting the potential impact of the pandemic on antimicrobial resistance. Strains obtained from COVID-19-PCR+ patients exhibited significant resistance to commonly used antibiotics, including fluoroquinolones and cephalosporins. Notably, the ESKAPE pathogens, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter cloacae, and Enterobacter aerogenes, were identified among the isolated microorganisms. Our findings underscore the urgent need for infection control measures and responsible antibiotic use in healthcare settings, as well as the importance of enhancing pneumonia diagnostics and implementing standardized laboratory protocols.
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Affiliation(s)
- Nurgul Ablakimova
- Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe 030012, Kazakhstan; (A.Z.M.); (G.A.S.); (A.B.)
| | - Aigul Z. Mussina
- Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe 030012, Kazakhstan; (A.Z.M.); (G.A.S.); (A.B.)
| | - Gaziza A. Smagulova
- Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe 030012, Kazakhstan; (A.Z.M.); (G.A.S.); (A.B.)
| | - Svetlana Rachina
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia;
| | - Meirambek S. Kurmangazin
- Department of Infectious Disease, West Kazakhstan Marat Ospanov Medical University, Aktobe 030012, Kazakhstan;
| | - Aigerim Balapasheva
- Department of Pharmacology, West Kazakhstan Marat Ospanov Medical University, Aktobe 030012, Kazakhstan; (A.Z.M.); (G.A.S.); (A.B.)
| | - Dinara Karimoldayeva
- Respiratory Medicine and Allergology Department, Aktobe Medical Center, Aktobe 030017, Kazakhstan;
| | - Afshin Zare
- PerciaVista R & D Co., Shiraz 71676-83745, Iran;
| | - Mahdi Mahdipour
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz 51666-53431, Iran;
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz 51666-53431, Iran
| | - Farhad Rahmanifar
- Department of Basic Sciences, School of Veterinary Medicine, Shiraz University, Shiraz 71348-14336, Iran;
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Mussema A, Beyene G, Gudina EK, Alelign D, Mohammed T, Bawore SG, Seid AM, Tadesse W, Gashaw M. Bacterial etiology, antimicrobial resistance and factors associated with community acquired pneumonia among adult hospitalized patients in Southwest Ethiopia. IRANIAN JOURNAL OF MICROBIOLOGY 2023; 15:492-502. [PMID: 38045716 PMCID: PMC10692968 DOI: 10.18502/ijm.v15i4.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background and Objectives Antibiotic resistance is a significant problem that restricts the options for treating bacterial pneumonia. This research aimed to determine the bacterial causes of pneumonia and antibiotic resistance among hospitalized patients in southwest Ethiopia. Materials and Methods We collected and analyzed 150 sputum samples from individuals with community-acquired pneumonia from April 1st to October 30th, 2019. Standard bacteriological procedures were used to identify the bacteria. Kirby Bauer's disk diffusion method was used to assess the bacteria's susceptibility patterns. Production of carbapenemase and extended-spectrum-lactamase were confirmed phenotypically. Odds ratios and the chi-square test were computed. Results On the whole, bacterial pathogens were verified in 50% of the sputum samples. The predominant bacterial isolates were Klebsiella species, followed by Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus pneumoniae. About 77.5% of isolates were multidrug resistant. Moreover, 40.5% and 10.8% of the isolates were ESBL and carbapenemase producers, respectively. Aging, tobacco smoking, previous history of pneumonia, heart disease, and chronic respiratory disease had association with sputum culture-positivity. Conclusion As a result, it is important to regularly monitor the bacterial etiologies and their patterns of resistance. Additionally, sociodemographic and clinical characteristics should all be taken into account while managing patients with pneumonia empirically in this context.
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Affiliation(s)
- Abdulhakim Mussema
- Department of Medical Microbiology, School of Medical Laboratory Science, Wachemo University, Hosanna, Ethiopia
- Department of Medical Microbiology, School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia
| | - Getenet Beyene
- Department of Medical Microbiology, School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia
| | - Esayas Kebede Gudina
- Department of Internal Medicine, School of Medicine, Jimma University, Jimma, Ethiopia
| | - Dagninet Alelign
- Department of Medical Microbiology, School of Medical Laboratory Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tofik Mohammed
- Department of Internal Medicine, School of Medicine, Arba Minch University, Arba Minch, Ethiopia
| | - Solomon Gebre Bawore
- Department of Medical Microbiology, School of Medical Laboratory Science, Wachemo University, Hosanna, Ethiopia
| | - Abdurezak Mohammed Seid
- Department of Medical Microbiology, School of Medical Laboratory Science, Wachemo University, Hosanna, Ethiopia
| | - Wondwossen Tadesse
- Department of Medical Microbiology, School of Medical Laboratory Science, Wachemo University, Hosanna, Ethiopia
| | - Mulatu Gashaw
- Department of Medical Microbiology, School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia
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21
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Yang R, Duan Y, Wang D, Liu Q. Developing a Preliminary Clinical Prediction Model for Prognosis of Pneumonia Complicated with Heart Failure Based on Metagenomic Sequencing. Crit Care Res Pract 2023; 2023:5930742. [PMID: 37497269 PMCID: PMC10368513 DOI: 10.1155/2023/5930742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/23/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023] Open
Abstract
Background The predictive factors of prognosis in patients with pneumonia complicated with heart failure (HF) have not been fully investigated yet, especially with the use of next-generation sequencing (NGS) of metagenome. Methods Patients diagnosed with pneumonia complicated with HF were collected and divided into control group and NGS group. Univariate and multivariate logistic regression and LASSO regression analysis were conducted to screen the predictive factors for the prognosis, followed by nomogram construction, ROC curve plot, and internal validation. Data analysis was conducted in SPSS and R software. Results The NGS of metagenome detected more microbial species. Univariate and multivariate logistic regression and LASSO regression analysis revealed that Enterococcus (χ2 = 7.449, P = 0.006), Hb (Wals = 6.289, P = 0.012), and ProBNP (Wals = 4.037, P = 0.045) were screened out as potential predictive factors for the prognosis. Nomogram was constructed with these 3 parameters, and the performance of nomogram was checked in ROC curves (AUC = 0.772). The specificity and sensitivity of this model were calculated as 0.579 and 0.851, respectively, with the threshold of 0.630 in ROC curve. Further internal verification indicated that the predictive value of our constructed model was efficient. Conclusion This study developed a preliminary clinical prediction model for the prognosis of pneumonia complicated with HF based on NGS of metagenome. More objects will be collected and tested to improve the predictive model in the near future.
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Affiliation(s)
- Rongyuan Yang
- The Second Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Guangzhou, Guangdong 519015, China
| | - Yong Duan
- Department of Cardiovascular Medicine, The Third Hospital of Changsha, Changsha 410000, China
| | - Dawei Wang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China
| | - Qing Liu
- The Second Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Guangzhou, Guangdong 519015, China
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22
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Sehim AE, Amin BH, Yosri M, Salama HM, Alkhalifah DH, Alwaili MA, Abd Elghaffar RY. GC-MS Analysis, Antibacterial, and Anticancer Activities of Hibiscus sabdariffa L. Methanolic Extract: In Vitro and In Silico Studies. Microorganisms 2023; 11:1601. [PMID: 37375103 DOI: 10.3390/microorganisms11061601] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
The emergence of bacteria that are resistant to several antibiotics has represented a serious hazard to human health globally. Bioactive metabolites from medicinal plants have a wide spectrum of therapeutic possibilities against resistant bacteria. Therefore, this study was performed to investigate the antibacterial efficacy of various extracts of three medicinal plants as Salvia officinalis L., Ziziphus spina-christi L., and Hibiscus sabdariffa L. against pathogenic Gram-negative Enterobacter cloacae (ATCC13047), Pseudomonas aeruginosa (RCMB008001), Escherichia coli (RCMB004001), and Gram-positive Staphylococcus aureus (ATCC 25923), bacteria using the agar-well diffusion method. Results revealed that, out of the three examined plant extracts, the methanol extract of H. sabdariffa L. was the most effective against all tested bacteria. The highest growth inhibition (39.6 ± 0.20 mm) was recorded against E. coli. Additionally, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the methanol extract of H. sabdariffa were detected in the case of all tested bacteria. Moreover, an antibiotic susceptibility test revealed that all tested bacteria showed multidrug resistance (MDR). While 50% of tested bacteria were sensitive and 50% were intermediately sensitive to piperacillin/tazobactam (TZP) based on the inhibition zone but still less than the extract. Synergistic assay demonstrated the promising role of using a combination of H. sabdariffa L. and (TZP) against tested bacteria. A surface investigation using a scanning electron microscope of the E. coli treated with TZP, extract, or a combination of the two revealed extremely considerable bacterial cell death. In addition, H. sabdariffa L. has a promising anticancer role versus Caco-2 cells with IC50 of 17.51 ± 0.07 µg/mL and minimal cytotoxicity upon testing versus Vero cells with CC50 of 165.24 ± 0.89 µg/mL. Flow cytometric analysis confirmed that H. sabdariffa extract significantly increased the apoptotic rate of Caco-2-treated cells compared to the untreated group. Furthermore, GC-MS analysis confirmed the existence of various bioactive components in the methanol hibiscus extract. Utilizing molecular docking with the MOE-Dock tool, binding interactions between n-Hexadecanoic acid, hexadecanoic acid-methyl ester, and oleic acid, 3-hydroxypropyl ester were evaluated against the target crystal structures of E. coli (MenB) (PDB ID:3T88) and the structure of cyclophilin of a colon cancer cell line (PDB ID: 2HQ6). The observed results provide insight into how molecular modeling methods might inhibit the tested substances, which may have applications in the treatment of E. coli and colon cancer. Thus, H. sabdariffa methanol extract is a promising candidate to be further investigated for developing alternative natural therapies for infection treatment.
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Affiliation(s)
- Amira E Sehim
- Botany and Microbiology Department, Faculty of Science, Benha University, Benha 13518, Egypt
| | - Basma H Amin
- The Regional Center for Mycology and Biotechnology, Al-Azhar University, Cairo 11787, Egypt
| | - Mohammed Yosri
- The Regional Center for Mycology and Biotechnology, Al-Azhar University, Cairo 11787, Egypt
| | - Hanaa M Salama
- Department of Chemistry, Faculty of Science, Port Said University, Port Said 42521, Egypt
| | - Dalal Hussien Alkhalifah
- Department of Biology, Collage of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Maha Abdullah Alwaili
- Department of Biology, Collage of Science, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Rasha Y Abd Elghaffar
- Botany and Microbiology Department, Faculty of Science, Benha University, Benha 13518, Egypt
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23
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Zhang L, Lu F, Wang Y, Ji J, Xu Y, Huang Y, Zhang M, Li M, Xia J, Wang B. Methodological comparison of bronchoalveolar lavage fluid-based detection of respiratory pathogens in diagnosis of bacterium/fungus-associated pneumonia in critically ill patients. Front Public Health 2023; 11:1168812. [PMID: 37255757 PMCID: PMC10225631 DOI: 10.3389/fpubh.2023.1168812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/12/2023] [Indexed: 06/01/2023] Open
Abstract
Background Bacterium/fungus-associated pneumonia (BAP/FAP) is the prominent cause of high mortality and morbidity with important clinical impacts globally. Effective diagnostic methods and proper specimen types hopefully facilitate early diagnosis of pneumonia and prevent spread of drug-resistant bacteria/fungi among critically ill patients. Methods In the present study, 342 bronchoalveolar lavage fluid (BALF) samples were collected from critically ill patients with pulmonary infections between November 2020 and March 2021. The BALF materials were comparatively employed to screen BAP/FAP through microscopy, culture, antigenic marker and PCR-based methods. The limit of detection (LOD) of cultures and PCR for bacteria/fungi was determined by serial dilution assays. Specimen slides were prepared with Gram staining for microscopic examinations. Microbial cultures and identifications underwent routine clinical protocols with the aid of mass spectrometry. (1,3)-β-D-glucan and galactomannan tests with BALF were carried out accordingly. Direct detection of pathogens in BALF was achieved through PCR, followed by sequencing and BLAST in GenBank database for pathogenic identification. The subjects' demographic and clinical characteristics were well evaluated. Results BAP/FAP was identified in approximately 47% of the subjects by the BALF-based PCR. The PCR-based diagnostic methods showed improved detection performance for fungi with good LOD, but performed similarly for bacteria, when compared to the cultures. There was poor agreement among traditional microscopy, culture and PCR assays for bacterial detections (kappa value, 0.184 to 0.277). For overall bacterial/fungal detections, the microscopy showed the lowest detecting rate, followed by the cultures, which displayed a slightly higher sensitivity than the microscopy did. The sensitivity of PCR was much higher than that of the other means of interest. However, the traditional cultures rather than antigenic marker-based approaches were moderately consistent with the PCR-based methods in fungal species identification, particularly for Candida and Aspergillus spp. Our findings further revealed that the age, length of hospital stay, invasive procedures and cerebral diseases were likely considered as main risk factors for BAP/FAP. Conclusion Screening for BALF in critically ill patients with suspected pneumonia pertaining high risk factors using combined PCR-based molecular detection strategies would hopefully contribute to early diagnosis of BAP/FAP and improved prognosis of the patients.
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Affiliation(s)
- Luwen Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Fanbo Lu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yuerong Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Juanjuan Ji
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ying Huang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Min Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Moyan Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jinxing Xia
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Bo Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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24
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Mang L, Canadas-Quesada F, Carabias-Orti J, Combarro E, Ranilla J. Cochleogram-based adventitious sounds classification using convolutional neural networks. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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25
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Bhavnani SM, Hammel JP, Lakota EA, Trang M, Bader JC, Bulik CC, VanScoy BD, Rubino CM, Huband MD, Friedrich L, Steenbergen JN, Ambrose PG. Pharmacokinetic-Pharmacodynamic Target Attainment Analyses Evaluating Omadacycline Dosing Regimens for the Treatment of Patients with Community-Acquired Bacterial Pneumonia Arising from Streptococcus pneumoniae and Haemophilus influenzae. Antimicrob Agents Chemother 2023; 67:e0221321. [PMID: 36946741 PMCID: PMC10112269 DOI: 10.1128/aac.02213-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Omadacycline, a novel aminomethylcycline with in vitro activity against Gram-positive and -negative organisms, including Streptococcus pneumoniae and Haemophilus influenzae, is approved in the United States to treat patients with community-acquired bacterial pneumonia (CABP). Using nonclinical pharmacokinetic-pharmacodynamic (PK-PD) targets for efficacy and in vitro surveillance data for omadacycline against S. pneumoniae and H. influenzae, and a population pharmacokinetic model, PK-PD target attainment analyses were undertaken using total-drug epithelial lining fluid (ELF) and free-drug plasma exposures to evaluate omadacycline 100 mg intravenously (i.v.) every 12 h or 200 mg i.v. every 24 h (q24h) on day 1, followed by 100 mg i.v. q24h on day 2 and 300 mg orally q24h on days 3 to 5 for patients with CABP. Percent probabilities of PK-PD target attainment on days 1 and 2 by MIC were assessed using the following four approaches for selecting PK-PD targets: (i) median, (ii) second highest, (iii) highest, and (iv) randomly assigned total-drug ELF and free-drug plasma ratio of the area under the concentration-time curve to the MIC (AUC/MIC ratio) targets associated with a 1-log10 CFU reduction from baseline. Percent probabilities of PK-PD target attainment based on total-drug ELF AUC/MIC ratio targets on days 1 and 2 were ≥91.1% for S. pneumoniae for all approaches but the highest target and ≥99.2% for H. influenzae for all approaches at MIC90s (0.12 and 1 μg/mL for S. pneumoniae and H. influenzae, respectively). Lower percent probabilities of PK-PD target attainment based on free-drug plasma AUC/MIC ratio targets were observed for randomly assigned and the highest free-drug plasma targets for S. pneumoniae and for all targets for H. influenzae. These data provided support for approved omadacycline dosing regimens to treat patients with CABP and decisions for the interpretive criteria for the in vitro susceptibility testing of omadacycline against these pathogens.
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Affiliation(s)
- Sujata M Bhavnani
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Jeffrey P Hammel
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Elizabeth A Lakota
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Michael Trang
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Justin C Bader
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Catharine C Bulik
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | - Brian D VanScoy
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
| | | | | | | | | | - Paul G Ambrose
- Institute for Clinical Pharmacodynamics, Inc., Schenectady, New York, USA
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26
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Factors Affecting Incidence of Ventilator-Associated Pneumonia With Multidrug-Resistant Microbes in Intensive Care Unit. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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27
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Hussein MM, Shaheen MA, Sleem AM, Mahmoud FM, Ishak SR. Increased antimicrobial resistance in bacterial pneumonia among Egyptian Children during the COVID-19 pandemic. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2023; 17:17. [PMCID: PMC10026231 DOI: 10.1186/s43168-023-00193-7] [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: 03/28/2023] Open
Abstract
Background Pneumonia is the major cause of morbidity and mortality among children worldwide. During the COVID-19 pandemic, the use of antibiotics increased which led to the development of antibiotic-resistant strains of pathogenic organisms causing pneumonia in children. So, studies should be directed to register antimicrobial resistance in each country and to develop local antimicrobial stewardship. This study aimed to identify the distribution of bacteria causing pneumonia among Egyptian children in the year 2020 and their antimicrobial sensitivity. A cross-sectional study was done, it included fifty immunocompetent children with pneumonia admitted to Children's Hospital, Ain-Shams University from June 2020 to December 2020. Bacterial cultures were done on sputum collected using cough swab, or endotracheal tube aspirate, with their antimicrobial sensitivity. Results Thirty children had Community-acquired pneumonia (CAP), while twenty had Hospital-acquired pneumonia (HAP). Streptococcus pneumonia was the most frequently cultured organism in CAP group 7/30 (23.3%). The sensitivity results found linezolid (50%), followed by fluoroquinolones to be the least resistant. While in the HAP group, Klebsiella pneumonia 9/20 (45%) was the most common organism. Colistin (90%) followed by tigecycline (50%), Amikacin (35%), fluoroquinolones (25%), gentamicin (25%), and imipenem (20%) had the least resistance in the HAP group. Conclusion No pathognomonic shift of the bacteria that causes pediatric pneumonia was detected. Although, an increase in antimicrobial resistance was noticed.
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Affiliation(s)
- Mahitab Morsy Hussein
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Malak Ali Shaheen
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Fatma Mostafa Mahmoud
- grid.7269.a0000 0004 0621 1570Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sally Raafat Ishak
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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28
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Peng Y, Chen W, Huang F, Geng M, Li X, Zhang F, Zhu W, Meng L, Holmdahl R, Xu J, Lu S. SLC38A6 expression in macrophages exacerbates pulmonary inflammation. Respir Res 2023; 24:33. [PMID: 36707853 PMCID: PMC9881254 DOI: 10.1186/s12931-023-02330-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/14/2023] [Indexed: 01/28/2023] Open
Abstract
Pulmonary inflammation involves complex changes of the immune cells, in which macrophages play important roles and their function might be influenced by metabolism. Slc38a6 acts as a carrier of nutrient for macrophages (Mφ) to exert the function. In this study, pneumonia patient blood was found up-regulated SLC38A6 expression, which correlated with monocytes number and white blood cell number. The similar result was also shown in LPS induced sepsis mice. To reveal the key role of Slc38a6, we used systemic and conditional knock-out mice. Either systemic or LyzCRE specific knock-out could alleviate the severity of sepsis mice, reduce the proinflammatory cytokine TNF-α and IL-1β expression in serum and decrease the monocytes number in bronchial alveolar lavage and peritoneal lavage via flow cytometry. In order to reveal the signal of up-regulated Slc38a6, the Tlr4 signal inhibitor TAK242 and TLR4 knock-out mice were used. By blocking Tlr4 signal in macrophages via TAK242, the expression of Slc38a6 was down-regulated synchronously, and the same results were also found in Tlr4 knock-out macrophages. However, in the overexpressed Slc38a6 macrophages, blocking Tlr4 signal via TAK242, 20% of the mRNA expression of IL-1β still could be expressed, indicating that up-regulated Slc38a6 participates in IL-1β expression process. Collectively, it is the first time showed that an amino acid transporter SLC38A6 up-regulated in monocytes/macrophages promotes activation in pulmonary inflammation. SLC38A6 might be a promising target molecule for pulmonary inflammation treatment.
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Affiliation(s)
- Yizhao Peng
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Weichao Chen
- grid.452902.8First Department of Respiratory Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710003 China
| | - Fumeng Huang
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Manman Geng
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China ,grid.452672.00000 0004 1757 5804National Joint Engineering Research Center of Biodiagnostics and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710004 China
| | - Xiaowei Li
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China ,grid.452672.00000 0004 1757 5804National Joint Engineering Research Center of Biodiagnostics and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710004 China
| | - Fujun Zhang
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Wenhua Zhu
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Liesu Meng
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Rikard Holmdahl
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China ,grid.452672.00000 0004 1757 5804National Joint Engineering Research Center of Biodiagnostics and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710004 China ,grid.4714.60000 0004 1937 0626Section for Medical Inflammation Research, Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Jing Xu
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China
| | - Shemin Lu
- grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi 710061 China ,grid.452902.8First Department of Respiratory Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710003 China ,grid.43169.390000 0001 0599 1243Institute of Molecular and Translational Medicine (IMTM), and Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061 China ,grid.452672.00000 0004 1757 5804National Joint Engineering Research Center of Biodiagnostics and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710004 China
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Neutrophil trafficking to the site of infection requires Cpt1a-dependent fatty acid β-oxidation. Commun Biol 2022; 5:1366. [PMID: 36513703 PMCID: PMC9747976 DOI: 10.1038/s42003-022-04339-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
Cellular metabolism influences immune cell function, with mitochondrial fatty acid β-oxidation and oxidative phosphorylation required for multiple immune cell phenotypes. Carnitine palmitoyltransferase 1a (Cpt1a) is considered the rate-limiting enzyme for mitochondrial metabolism of long-chain fatty acids, and Cpt1a deficiency is associated with infant mortality and infection risk. This study was undertaken to test the hypothesis that impairment in Cpt1a-dependent fatty acid oxidation results in increased susceptibility to infection. Screening the Cpt1a gene for common variants predicted to affect protein function revealed allele rs2229738_T, which was associated with pneumonia risk in a targeted human phenome association study. Pharmacologic inhibition of Cpt1a increases mortality and impairs control of the infection in a murine model of bacterial pneumonia. Susceptibility to pneumonia is associated with blunted neutrophilic responses in mice and humans that result from impaired neutrophil trafficking to the site of infection. Chemotaxis responsible for neutrophil trafficking requires Cpt1a-dependent mitochondrial fatty acid oxidation for amplification of chemoattractant signals. These findings identify Cpt1a as a potential host determinant of infection susceptibility and demonstrate a requirement for mitochondrial fatty acid oxidation in neutrophil biology.
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Cedrone F, Catalini A, Stacchini L, Berselli N, Caminiti M, Mazza C, Cosma C, Minutolo G, Di Martino G. The Role of Gender in the Association between Mental Health and Potentially Preventable Hospitalizations: A Single-Center Retrospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14691. [PMID: 36429414 PMCID: PMC9690620 DOI: 10.3390/ijerph192214691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Psychiatric disorders and substance abuse are barriers that limit access to timely treatment and can lead to Potentially Preventable Hospitalizations (PPH). The aim of this study is to identify the role played by gender in the association between mental health and PPH. Hospital discharge records (HDRs) from the Local Health Authority of Pescara (Italy) from 2015 to 2021 were examined and PPH were measured according to Prevention Quality Indicators (PQIs) provided by the Agency for Healthcare Research and Quality. In total, 119,730 HDRs were eligible for the study and 21,217 patients fell into the PQI categories. Mental health disorders and addictions were extracted from the HDRs through the Elixhauser Enhanced ICD-9-CM algorithm. The association between PQI hospitalization and some predictors considered was evaluated with multivariate logistic regression models. In males and females, alcohol abuse showed a protective role towards preventable admissions for PQI-90 (all types of conditions) and PQI-92 (chronic conditions). In contrast, there is a gender gap in accessibility to primary health care, especially for acute conditions leading to PPH. Indeed, in males, PQI-91 admissions for acute conditions were found to be positively associated with drug abuse, psychosis, and depression, whereas this was not the case for females.
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Affiliation(s)
- Fabrizio Cedrone
- Health Management of “S. Spirito” Hospital, Local Health Authority of Pescara, 65100 Pescara, Italy
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60100 Ancona, Italy
| | - Lorenzo Stacchini
- Department of Health Science, University of Florence, 50100 Florence, Italy
| | - Nausicaa Berselli
- Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Marta Caminiti
- Department of Medicine and Surgery—Sector of Public Health, University of Perugia, 06100 Perugia, Italy
| | - Clara Mazza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudia Cosma
- Department of Health Science, University of Florence, 50100 Florence, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, 65100 Pescara, Italy
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Saleem M, Syed Khaja AS, Hossain A, Alenazi F, Said KB, Moursi SA, Almalaq HA, Mohamed H, Rakha E. Molecular Characterization and Antibiogram of Acinetobacter baumannii Clinical Isolates Recovered from the Patients with Ventilator-Associated Pneumonia. Healthcare (Basel) 2022; 10:2210. [PMID: 36360551 PMCID: PMC9690950 DOI: 10.3390/healthcare10112210] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 08/27/2023] Open
Abstract
A 2-year prospective study carried out on ventilator-associated pneumonia (VAP) patients in the intensive care unit at a tertiary care hospital, Hail, Kingdom of Saudi Arabia (KSA), revealed a high prevalence of extremely drug-resistant (XDR) Acinetobacter baumannii. About a 9% increase in the incidence rate of A. baumannii occurred in the VAP patients between 2019 and 2020 (21.4% to 30.7%). In 2019, the isolates were positive for IMP-1 and VIM-2 (31.1% and 25.7%, respectively) as detected by PCR. In comparison, a higher proportion of isolates produced NDM-1 in 2020. Here, we observed a high proportion of resistant ICU isolates towards the most common antibiotics in use. Colistin sensitivity dropped to 91.4% in the year 2020 as compared to 2019 (100%). Thus, the finding of this study has a highly significant clinical implementation in the clinical management strategies for VAP patients. Furthermore, strict implementation of antibiotic stewardship policies, regular surveillance programs for antimicrobial resistance monitoring, and screening for genes encoding drug resistance phenotypes have become imperative.
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Affiliation(s)
- Mohd Saleem
- Department of Pathology, College of Medicine, University of Hail, Hail 55476, Saudi Arabia
| | | | - Ashfaque Hossain
- Department of Medical Microbiology and Immunology, RAK Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates
| | - Fahaad Alenazi
- Department of Pharmacology, College of Medicine, University of Hail, Hail 55476, Saudi Arabia
| | - Kamaleldin B. Said
- Department of Pathology, College of Medicine, University of Hail, Hail 55476, Saudi Arabia
| | - Soha Abdallah Moursi
- Department of Pathology, College of Medicine, University of Hail, Hail 55476, Saudi Arabia
| | - Homoud Abdulmohsin Almalaq
- Hail Health Cluster, King Khalid Hospital, College of Pharmacy, King Saud University, Riyadh 55421, Saudi Arabia
| | - Hamza Mohamed
- Department of Anatomy, College of Medicine, University of Hail, Hail 55476, Saudi Arabia
| | - Ehab Rakha
- Laboratory Department, King Khalid Hospital, Hail 55421, Saudi Arabia
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura 7650030, Egypt
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32
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Efficacy of empiric macrolides versus fluoroquinolones in community-acquired pneumonia associated with atypical bacteria: A meta-analysis. Respir Med Res 2022; 82:100931. [DOI: 10.1016/j.resmer.2022.100931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/11/2022] [Accepted: 06/04/2022] [Indexed: 11/22/2022]
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Barimani MJ. Legionella: An uncommon cause of community-acquired pneumonia. JAAPA 2022; 35:38-42. [PMID: 36165547 DOI: 10.1097/01.jaa.0000873792.00538.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Legionnaires disease is an important, relatively uncommon, yet well known form of atypical community-acquired pneumonia (CAP). If not appropriately treated in the early stage of infection, it can be fatal. Several factors increase the risk of contracting Legionnaires disease, including age over 50 years, chronic cardiovascular disease, underlying respiratory disease, chronic renal disease, diabetes, smoking, any immunosuppressing condition, travel history, and certain types of employment. Legionnaires disease can present without the usual symptoms associated with pneumonia. The incidence of Legionnaires disease is increasing, and because of its morbidity and mortality, clinicians should consider it in the differential when treating patients with CAP. This article reviews the pathophysiology and treatment of Legionnaires disease and when to refer patients to tertiary centers for higher levels of care, including extracorporeal membrane oxygenation.
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Affiliation(s)
- Mark J Barimani
- Mark J. Barimani practices at Penn Medicine Kennett Family Practice in Kennett Square, Pa., and at AFC Urgent Care in Downingtown, Pa., and is a doctor of medical science candidate at A.T. Still University in Mesa, Ariz. The author has disclosed no potential conflicts of interest, financial or otherwise
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34
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Roland H, Brown A, Rousselot A, Freeman N, Wieting JM, Bergman S, Mondal D. Osteopathic Manipulative Treatment Decreases Hospital Stay and Healthcare Cost in the Neonatal Intensive Care Unit. MEDICINES (BASEL, SWITZERLAND) 2022; 9:49. [PMID: 36286582 PMCID: PMC9607199 DOI: 10.3390/medicines9100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients' recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care.
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Affiliation(s)
- Hannah Roland
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Amanda Brown
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Amy Rousselot
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - Natalie Freeman
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
| | - J. Michael Wieting
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA
| | - Stephen Bergman
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, USA
| | - Debasis Mondal
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 9737 Cogdill Road, Knoxville, TN 37932, USA
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Wrotek A, Robakiewicz J, Pawlik K, Rudzinski P, Pilarska I, Jaroń A, Imiełowska A, Jarzębowska M, Zabłocka K, Jackowska T. The Etiology of Community-Acquired Pneumonia Correlates with Serum Inflammatory Markers in Children. J Clin Med 2022; 11:5506. [PMID: 36233374 PMCID: PMC9571658 DOI: 10.3390/jcm11195506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/22/2022] Open
Abstract
Community-acquired pneumonia (CAP) severely affects pediatric hospitalizations. This study assessed the contribution of CAP to hospitalizations, its etiology in relationship with age, and the inflammatory markers. Between 2013 and 2018, 1064 CAP patients were hospitalized and diagnosed with bacterial/possibly bacterial pneumonia (BP), viral/possibly viral pneumonia (VP) and atypical pneumonia (AP). The etiology was confirmed using blood/pleural fluid culture/polymerase chain reaction (PCR), rapid antigen test/PCR in nasopharyngeal swabs, or serological studies. CAP accounted for 9.9% of hospitalizations and 14.8% of patient days. BP was diagnosed in 825 (77.5%), VP in 190 (17.9%), and AP in 49 (4.6%) cases; the confirmed etiology (n = 209; 20%) included mostly influenza (39%; n = 82), respiratory syncytial virus (RSV, 35%; n = 72), and Mycoplasma pneumoniae (19%; n = 39). VP frequency decreased with age (41% in < 3 mo to 9% in ≥ 60 mo), in contrast to AP (13% in ≥ 60 mo). Among the analyzed parameters, the best differentiating potential was shown by: C-reactive protein (CRP, AUCBP-VP = 0.675; 95% CI: 0.634−0.715), procalcitonin (AUCBP-AP = 0.73; 95% CI: 0.67−0.794), and CRP/procalcitonin (AUCAP-VP = 0.752; 95% CI: 0.67−0.83); a good positive predictive value (88.8%, 98.3%, and 91.6%, respectively) but a low negative predictive value (29.5%, 13.1%, and 40.7%, respectively) was observed. CAP influences hospital patient days more than the crude number of patients would suggest. On a clinical basis, BP is mainly recognized, although viral pneumonia is confirmed most often. RSV and influenza are responsible for a huge percentage of hospitalized cases, as well as M. pneumoniae in children aged ≥ 5 years. Serum inflammatory markers may help differentiate etiological factors.
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Affiliation(s)
- August Wrotek
- Department of Pediatrics, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
- Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Julita Robakiewicz
- Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Katarzyna Pawlik
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Patryk Rudzinski
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Izabela Pilarska
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Aleksandra Jaroń
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Aleksandra Imiełowska
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Małgorzata Jarzębowska
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Katarzyna Zabłocka
- Student Research Group at the Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
| | - Teresa Jackowska
- Department of Pediatrics, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
- Department of Pediatrics, The Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland
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36
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Yao MX, Cheng JY, Liu Y, Sun J, Hua DX, He QY, Liu HY, Fu L, Zhao H. Cross-sectional and longitudinal associations of serum Cysteine-rich 61 with severity and prognosis among community-acquired pneumonia patients in China. Front Med (Lausanne) 2022; 9:939002. [PMID: 36035395 PMCID: PMC9403795 DOI: 10.3389/fmed.2022.939002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCysteine-rich 61 (CYR61) is implicated in many pulmonary diseases. However, the relationship between CYR61 and community-acquired pneumonia (CAP) patients was unknown. This research aimed to estimate the correlations of serum CYR61 with severity and prognosis in CAP patients through a prospective cohort study.MethodsAll 541 CAP patients were enrolled in this study. Fasting venous blood was collected. Clinical characteristics and demographic information were obtained. CYR61 and inflammatory cytokines were detected in serum using ELISA.ResultsSerum CYR61 was gradually increased in parallel with severity scores in CAP patients. Correlative analysis indicated that serum CYR61 was strongly associated with many clinical parameters in CAP patients. Moreover, mixed logistic and linear regression models found that there were positive correlations between serum CYR61 and CAP severity scores after adjusted for age, BMI, and respiratory rate. Stratified analyses suggested that age affected the associations between serum CYR61 and severity scores. On admission, higher serum CYR61 levels elevated the risks of mechanical ventilation, vasoactive agent, ICU admission, death, and longer hospital stays during hospitalization. Moreover, serum CYR61 in combination with severity scores upregulated the predictive capacities for severity and death than single serum CYR61 or severity scores in CAP patients.ConclusionThere are significantly positive dose-response associations of serum CYR61 on admission with the severity and adverse prognostic outcomes, demonstrating that CYR61 is involved in the pathophysiology of CAP. Serum CYR61 may be used as a potential biomarker for the diagnosis and prognosis in CAP patients.
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Affiliation(s)
- Meng-Xing Yao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jia-Yi Cheng
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Liu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing Sun
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dong-Xu Hua
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qi-Yuan He
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hong-Yan Liu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lin Fu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Toxicology, Anhui Medical University, Hefei, China
- *Correspondence: Lin Fu, ;
| | - Hui Zhao
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Hui Zhao,
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37
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Polymyxin B in Combination with Glycerol Monolaurate Exerts Synergistic Killing against Gram-Negative Pathogens. Pathogens 2022; 11:pathogens11080874. [PMID: 36014995 PMCID: PMC9413120 DOI: 10.3390/pathogens11080874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 02/01/2023] Open
Abstract
The rapid emergence and spread of multidrug-resistant (MDR) bacterial pathogens pose a serious danger to worldwide human health, and resistance to last-resort drugs, such as polymyxins, is being increasingly detected in MDR Gram-negative pathogens. There is an urgent need to find and optimize combination therapies as an alternative therapeutic strategy, with a dry pipeline in novel antibiotic research and development. We found a monoester formed from the combination of lauric acid and glycerol, glycerol monolaurate (GML), possessing prominent antibacterial and anti-inflammatory activity. However, it is still unclear whether GML in combination could increase antimicrobial activity. Here, we reported that polymyxin B (PMNB) combined with GML exhibited a synergistic antimicrobial impact on Gram-negative strains in vitro, including clinical MDR isolates. This synergistic antimicrobial activity correlated with the destruction of bacterial cell structures, eradication of preformed biofilms, and increased reactive oxygen species (ROS) accumulation. We also showed that PMNB synergized with GML effectively eliminated pathogens from bacterial pneumonia caused by Klebsiella pneumoniae to rescue mice. Our research demonstrated that the PMNB and GML combination induced synergistic antimicrobial activity for Gram-negative pathogens in vitro and in vivo. These findings are of great importance for treating bacterial infections and managing the spread of infectious diseases.
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38
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Rögnvaldsson KG, Bjarnason A, Kristinsson K, Bragason HT, Erlendsdóttir H, Þorgeirsson G, Gottfreðsson M. Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long-term nationwide study. J Intern Med 2022; 292:321-332. [PMID: 35315156 PMCID: PMC9543431 DOI: 10.1111/joim.13485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pneumonia is commonly caused by Streptococcus pneumoniae (pneumococcus) and associated with subsequent cardiovascular complications and increased mortality. Potential short-term survival benefits conferred by acetylsalicylic acid (ASA) use in pneumonia remain controversial, and long-term outcomes have not been studied. OBJECTIVES To evaluate the association between ASA use and survival for up to 1 year following bacteremic pneumococcal pneumonia. METHODS All bacteremic pneumococcal episodes in Iceland from 1975 to 2019 were reviewed. The study cohort consisted of individuals at least 18 years of age with symptoms and imaging results consistent with pneumonia. Differences in survival were assessed at 30 days, 90 days and 1 year using propensity score weighting (inverse probability weighting). Splitting and stratifying on survival at 7 days was done for the 30-day survival, because of nonproportionality. RESULTS In total, 815 bacteremic pneumococcal pneumonia episodes (median age 67 years, females 48%) were identified. Cox regression using propensity score weighting on the association of ASA with survival at 30 days showed an average hazard ratio (HR) of 0.60 (95% confidence interval [CI] 0.34-1.05). A significantly improved survival was observed within 7 days (HR = 0.42, 95% CI 0.19-0.92) but not during days 7-30 (HR = 1.08, 95% CI 0.46-2.55). ASA was associated with survival at 90 days (HR = 0.53, 95% CI 0.32-0.87) and 1 year (HR = 0.48, 95% CI 0.31-0.75). CONCLUSION Use of ASA upon admission for bacteremic pneumococcal pneumonia is associated with significantly reduced mortality for up to 1 year after diagnosis. ASA therapy in patients with pneumonia and other infectious syndromes warrants further study.
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Affiliation(s)
| | - Agnar Bjarnason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Karl Kristinsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Akutklinikken, Rikshospitalet, Oslo, Norway
| | - Hörður T Bragason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Helga Erlendsdóttir
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Guðmundur Þorgeirsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Magnús Gottfreðsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
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Kunutsor SK, Voutilainen A, Laukkanen JA. Serum copper-to-zinc ratio and risk of incident pneumonia in caucasian men: a prospective cohort study. Biometals 2022; 35:921-933. [PMID: 35781862 PMCID: PMC9546975 DOI: 10.1007/s10534-022-00414-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/11/2022] [Indexed: 12/03/2022]
Abstract
Serum copper (Cu) and zinc (Zn), essential micronutrients that have important immunomodulatory and antimicrobial properties, are biomarkers of ageing. Serum Cu/Zn-ratio may be a more reliable marker for age-related degenerative conditions compared with serum Cu or Zn alone. We aimed to assess the association between Cu/Zn-ratio and the risk of incident pneumonia in a prospective cohort study. Serum levels of Cu and Zn were measured at baseline using atomic absorption spectrometry in 2503 men aged 42–61 years in the Kuopio Ischemic Heart Disease prospective cohort study. Hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident pneumonia using Cox regression models. A total of 599 cases of pneumonia occurred during a median follow-up of 26.1 years. Serum Cu/Zn-ratio and Cu were each linearly associated with incident pneumonia. A unit increase in Cu/Zn-ratio was associated with an increased risk of pneumonia in analysis adjusted for potential confounders including C-reactive protein (HR 1.65; 95% CI 1.17–2.33). The corresponding adjusted HR (95% CI) was 2.04 (1.22–3.40) for serum Cu. The association between serum Zn and pneumonia was curvilinear. Compared to the bottom tertile of Zn, the multivariable adjusted HRs (95% CIs) for incident pneumonia were 0.68 (0.55–0.83) and 0.96 (0.79–1.16) for the middle and top tertiles of Zn, respectively. Further analysis in the same participants showed that Cu/Zn-ratio might be a stronger risk indicator for pneumonia than serum C-reactive protein. In middle-aged and older Finnish men, increased serum Cu/Zn-ratio and Cu concentrations are each linearly associated with an increased risk of incident pneumonia.
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Affiliation(s)
- Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK.
- Department of Medicine, Central Finland Health Care District Hospital District, Jyvaskyla, Finland.
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Department of Medicine, Central Finland Health Care District Hospital District, Jyvaskyla, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
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40
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Salvador M, Marqués-Fernández JL, Bunge A, Martínez-García JC, Turcu R, Peddis D, García-Suárez MDM, Cima-Cabal MD, Rivas M. Magnetic Nanoclusters Increase the Sensitivity of Lateral Flow Immunoassays for Protein Detection: Application to Pneumolysin as a Biomarker for Streptococcus pneumoniae. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:2044. [PMID: 35745381 PMCID: PMC9228753 DOI: 10.3390/nano12122044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022]
Abstract
Lateral flow immunoassays for detecting biomarkers in body fluids are simple, quick, inexpensive point-of-care tests widely used in disease surveillance, such as during the coronavirus disease 2019 (COVID-19) pandemic. Improvements in sensitivity would increase their utility in healthcare, food safety, and environmental control. Recently, biofunctional magnetic nanoclusters have been used to selectively label target proteins, which allows their detection and quantification with a magneto-inductive sensor. This type of detector is easily integrated with the lateral flow immunoassay format. Pneumolysin is a cholesterol-dependent cytolysin and one of the most important protein virulence factors of pneumonia produced by Streptococcus pneumoniae. It is recognized as an important biomarker for diagnosis in urine samples. Pneumonia is the infectious disease that causes the most deaths globally, especially among children under five years and adults over 65 years, most of them in low- and middle-income countries. There especially, a rapid diagnostic urine test for pneumococcal pneumonia with high sensitivity and specificity would be helpful in primary care. In this work, a lateral flow immunoassay with magnetic nanoclusters conjugated to anti-pneumolysin antibodies was combined with two strategies to increase the technique's performance. First, magnetic concentration of the protein before the immunoassay was followed by quantification by means of a mobile telephone camera, and the inductive sensor resulted in detection limits as low as 0.57 ng (telephone camera) and 0.24 ng (inductive sensor) of pneumolysin per milliliter. Second, magnetic relocation of the particles within the test strip after the immunoassay was completed increased the detected signal by 20%. Such results obtained with portable devices are promising when compared to non-portable conventional pneumolysin detection techniques such as enzyme-linked immunosorbent assays. The combination and optimization of these approaches would have excellent application in point-of-care biodetection to reduce antibiotic misuse, hospitalizations, and deaths from community-acquired pneumonia.
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Affiliation(s)
- María Salvador
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33203 Gijón, Spain; (M.S.); (J.L.M.-F.); (J.C.M.-G.)
- Institute of Structure of Matter—National Research Council (CNR), 00016 Monterotondo Scalo (RM), Rome, Italy;
| | - José Luis Marqués-Fernández
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33203 Gijón, Spain; (M.S.); (J.L.M.-F.); (J.C.M.-G.)
| | - Alexander Bunge
- National Institute for Research and Development of Isotopic and Molecular Technologies, 400293 Cluj-Napoca, Romania; (A.B.); (R.T.)
| | - José Carlos Martínez-García
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33203 Gijón, Spain; (M.S.); (J.L.M.-F.); (J.C.M.-G.)
| | - Rodica Turcu
- National Institute for Research and Development of Isotopic and Molecular Technologies, 400293 Cluj-Napoca, Romania; (A.B.); (R.T.)
| | - Davide Peddis
- Institute of Structure of Matter—National Research Council (CNR), 00016 Monterotondo Scalo (RM), Rome, Italy;
- Department of Chemistry and Industrial Chemistry, Università degli Studi di Genova, 16146 Genova, Italy
| | - María del Mar García-Suárez
- Escuela Superior de Ingeniería y Tecnología (ESIT), Universidad Internacional de la Rioja (UNIR), Avenida de la Paz, 137, 26006 Logroño, Spain; (M.d.M.G.-S.); (M.D.C.-C.)
| | - María Dolores Cima-Cabal
- Escuela Superior de Ingeniería y Tecnología (ESIT), Universidad Internacional de la Rioja (UNIR), Avenida de la Paz, 137, 26006 Logroño, Spain; (M.d.M.G.-S.); (M.D.C.-C.)
| | - Montserrat Rivas
- Department of Physics & IUTA, University of Oviedo, Campus de Viesques, 33203 Gijón, Spain; (M.S.); (J.L.M.-F.); (J.C.M.-G.)
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Rathbun KP, Bourgault AM, Sole ML. Oral Microbes in Hospital-Acquired Pneumonia: Practice and Research Implications. Crit Care Nurse 2022; 42:47-54. [PMID: 35640896 PMCID: PMC9923822 DOI: 10.4037/ccn2022672] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Hospital-acquired pneumonia accounts for 25% of all health care-associated infections and is classified as either ventilator-associated or non-ventilator-associated pneumonia. Hospital-acquired pneumonia most frequently results from aspiration of oropharyngeal secretions into the lungs. Although preventive measures for ventilator-associated pneumonia are well established, few preventive measures exist for the nonventilator type. OBJECTIVE To (1) explore oral microbes associated with ventilator-associated and non-ventilator-associated pneumonia in acutely ill, adult hospitalized patients, and (2) provide evidence-based recommendations for measures to prevent pneumonia in hospitalized patients. METHODS A literature search was conducted using CINAHL, Academic Search Premier, Medline, and the Cochrane Library. RESULTS Ten studies were found that identified common oral microbes in ventilator-associated and non-ventilator-associated pneumonia, including Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, S aureus, and Streptococcus pneumoniae. Collectively, oral colonization with E coli, P aeruginosa, methicillin-resistant S aureus, and S aureus increased the risk of nonventilator pneumonia. Findings also suggested microaspiration of colonized oral microbes into the lungs. Non-ventilator-associated pneumonia had similar colonization rates of gram-positive and gram-negative bacteria, whereas ventilator-associated pneumonia had greater colonization with gram-negative bacteria. The literature did not indicate a standard of oral care effective in all patient populations. DISCUSSION Oral care is an effective intervention to prevent hospital-acquired pneumonia by reducing pathogenic oral microbial colonization. The impact of different methods and timing of oral care on oral microbes should be further explored, particularly in patients not receiving mechanical ventilation. CONCLUSIONS Findings reaffirm the importance of consistent oral care in hospitalized patients. In addition, practices should be different in patients receiving mechanical ventilation versus patients not receiving ventilation. Results may also provide knowledge to inform future preventive measures for pneumonia, particularly for nonventilator pneumonia.
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Affiliation(s)
- Kimberly Paige Rathbun
- Kimberly Paige Rathbun is a PhD student, predoctoral fellow, and graduate student research assistant at the University of Central Florida College of Nursing, Orlando
| | - Annette M Bourgault
- Annette M. Bourgault is an associate professor at the University of Central Florida College of Nursing
| | - Mary Lou Sole
- Mary Lou Sole is dean, professor, and Orlando Health Endowed Chair in Nursing at the University of Central Florida College of Nursing
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Aceil J, Avci FY. Pneumococcal Surface Proteins as Virulence Factors, Immunogens, and Conserved Vaccine Targets. Front Cell Infect Microbiol 2022; 12:832254. [PMID: 35646747 PMCID: PMC9133333 DOI: 10.3389/fcimb.2022.832254] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Streptococcus pneumoniae is an opportunistic pathogen that causes over 1 million deaths annually despite the availability of several multivalent pneumococcal conjugate vaccines (PCVs). Due to the limitations surrounding PCVs along with an evolutionary rise in antibiotic-resistant and unencapsulated strains, conserved immunogenic proteins as vaccine targets continue to be an important field of study for pneumococcal disease prevention. In this review, we provide an overview of multiple classes of conserved surface proteins that have been studied for their contribution to pneumococcal virulence. Furthermore, we discuss the immune responses observed in response to these proteins and their promise as vaccine targets.
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Moeinafshar A, Rezaei N. Introductory Chapter: Pneumonia. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.103675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Assefa M. Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns. Pneumonia (Nathan) 2022; 14:4. [PMID: 35509063 PMCID: PMC9069761 DOI: 10.1186/s41479-022-00096-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/11/2022] [Indexed: 12/27/2022] Open
Abstract
Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia were A. baumannii, K. pneumoniae, and P. aeruginosa, with A. baumannii isolated particularly in VAP patients and the elderly. In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization. S. maltophilia was reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future.
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Affiliation(s)
- Muluneh Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
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Serum C-reactive protein-to-albumin ratio is a potential risk indicator for pneumonia: Findings from a prospective cohort study. Respir Med 2022; 199:106894. [DOI: 10.1016/j.rmed.2022.106894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022]
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de Mangou A, Combe A, Coolen-Allou N, Miltgen G, Traversier N, Belmonte O, Vandroux D, Bohrer M, Cousty J, Caron M, Vidal C, Allyn J, Allou N. Severe community-acquired pneumonia in Reunion Island: Epidemiological, clinical, and microbiological characteristics, 2016-2018. PLoS One 2022; 17:e0267184. [PMID: 35427402 PMCID: PMC9012352 DOI: 10.1371/journal.pone.0267184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/04/2022] [Indexed: 12/17/2022] Open
Abstract
PURPOSE No data are available on severe community-acquired pneumonia (CAP) in the French overseas department of Reunion Island. This is unfortunate as the microorganisms responsible for the disease are likely to differ from those in temperate regions due to a tropical climate and proximity to other islands of the Indian Ocean region. The aim of this study was to assess the epidemiological, clinical, prognosis, and microbiological characteristics of patients with severe CAP in Reunion Island. MATERIALS AND METHODS This retrospective study evaluated all patients with CAP aged >18 years and hospitalized in one of the two intensive care units of Reunion Island between 2016 and 2018. Microorganisms were identified by culture from blood and respiratory samples, multiplex polymerase chain reaction from respiratory samples, urinary antigen tests, and serology. RESULTS Over the study period, 573 cases of severe CAP were recorded, with a mean incidence of 22 per 100,000 person-years. The most frequently isolated microorganism was influenza (21.9%) followed by Streptococcus pneumoniae (12%). The influenza virus was detected in affected patients all year round. Twenty-four patients with severe CAP came from another island of the Indian Ocean region (4.2%), mainly Madagascar (>50%). Two of these patients presented with melioidosis and 4 were infected with Acinetobacter spp. CONCLUSIONS Our findings have major implications for the management of severe CAP in tropical regions. The most frequently isolated microorganism in patients with severe CAP in Reunion Island is influenza followed by S. pneumoniae. Physicians should be aware that influenza is the main cause of severe CAP in patients living in or returning from Reunion Island, where this virus circulates all year round.
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Affiliation(s)
- Axel de Mangou
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Agathe Combe
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Nathalie Coolen-Allou
- Respiratory Disease, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Guillaume Miltgen
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion, Saint-Denis, France
| | - Nicolas Traversier
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Olivier Belmonte
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - David Vandroux
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Michel Bohrer
- Department of Medical Information, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
| | - Julien Cousty
- Intensive Care Unit, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre, France
| | - Margot Caron
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Charles Vidal
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Jérôme Allyn
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- Clinical Informatic Department, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
| | - Nicolas Allou
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- Clinical Informatic Department, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
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Suresh A, Rao TC, Solanki S, Suresh MV, Menon B, Raghavendran K. The holy basil administration diminishes the NF-kB expression and protects alveolar epithelial cells from pneumonia infection through interferon gamma. Phytother Res 2022; 36:1822-1835. [PMID: 35233841 PMCID: PMC9018535 DOI: 10.1002/ptr.7428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/07/2022]
Abstract
Bacterial pneumonia is one of the most important causes of mortality in the United States. The bacteria Klebsiella pneumoniae (KP) accounts for a significant proportion of community and hospital-acquired infections. Here, we determine that the holy basil (Ocimum sanctum) extract improves cell viability and dampens the proinflammatory cytokine response in an in vitro model of pneumonia. For this, A549, a human alveolar basal epithelial cell line, was subjected to a lethal KP model following a 24-hr pretreatment with basil extract. Bacteremia, cell viability, apoptosis, MTT assay, phagocytic capacity, cytokines, and Khe gene expression were assessed in these cells following pneumonia. Cell morphology analysis showed that holy basil protected A549 cells from KP infection-mediated effects by inhibiting cell death due to apoptosis. Additionally, in the presence of basil, A549 cells demonstrated significantly higher bactericidal capacity and phagocytosis. Administration of holy basil led to reduced expression of hypoxia-inducible factor-1/2a, nuclear factor kappa B, and Khe in the KP-infected cells while increasing interferon (IFN)-γ expression. Our results suggest that basil significantly reduced cell death in the setting of KP infection, likely via attenuation of cytokine and IFN-γ mediated signaling pathways. Holy basil is a promising therapeutic agent for managing and treating bacterial pneumonia based on its potency.
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Affiliation(s)
| | - Tejeshwar C. Rao
- Department of Cell, Developmental, and Integrative Biology, the University of Alabama at Birmingham, Birmingham AL 35294
| | - Sumeet Solanki
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | | | - Bindu Menon
- Department of Medical Education & Physiology/Pharmacology, University of Toledo, OH
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Kamel NA, Alshahrani MY, Aboshanab KM, El Borhamy MI. Evaluation of the BioFire FilmArray Pneumonia Panel Plus to the Conventional Diagnostic Methods in Determining the Microbiological Etiology of Hospital-Acquired Pneumonia. BIOLOGY 2022; 11:biology11030377. [PMID: 35336751 PMCID: PMC8945136 DOI: 10.3390/biology11030377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 01/13/2023]
Abstract
Hospital-acquired pneumonia (HAP) is a substantial public health issue that is associated with high mortality rates and is complicated by an arsenal of microbial etiologies, expressing multidrug-resistant phenotypes, rendering relatively limited therapeutic options. BioFire FilmArray Pneumonia Panel plus (BFPP) is a simple multiplexed PCR system that integrates sample preparation, nucleic acid extraction, amplification, and analysis of microbial etiology, with a turnaround time of about one hour. In comparison to standard culture methods, BFPP is simpler, easier to perform, and can simultaneously detect the most common pathogens involved in lower respiratory tract infections (34 targets). Accordingly, we evaluated the diagnostic performance of the multiplexed BFPP for the rapid detection of 27 clinically relevant respiratory pathogens and 7 genetic markers among 50 HAP cases admitted to the intensive care unit (ICU), who submitted mini-bronchoalveolar (mBAL) specimens. In comparison to standard culture methods, BFPP showed an overall sensitivity of 100% [95% CI; 90-100] and overall specificity of 90% [95% CI; 87.4-92.5] among all the tested bacterial targets. BFPP identified 11 viral targets (22%) among the tested specimens. The BFPP semi-quantitative analysis showed a concordance rate of 47.4% among positive culture specimens. For the investigation of the antibiotic resistance genes, BFPP showed a positive percent agreement (PPA), a negative percent agreement (NPA), and an overall percent agreement (OPA), reaching 97% [95% CI; 90-100], 95% [95% CI; 91.5-97], and 95% [95% CI; 93-97], respectively, with standard antibiotic sensitivity testing. In conclusion, BFPP has the potential to enhance the rapid microbiological diagnosis of HAP cases, and could aid in tailoring appropriate antibiotic therapies.
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Affiliation(s)
- Noha A. Kamel
- Department of Microbiology, Faculty of Pharmacy, Misr International University (MIU), Cairo P.O. Box 19648, Egypt; (N.A.K.); (M.I.E.B.)
| | - Mohammad Y. Alshahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, P.O. Box 61413, Abha 9088, Saudi Arabia;
| | - Khaled M. Aboshanab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity St., Abbassia, Cairo P.O. Box 11566, Egypt
- Correspondence: ; Tel.:+20-1007582620
| | - Mervat I. El Borhamy
- Department of Microbiology, Faculty of Pharmacy, Misr International University (MIU), Cairo P.O. Box 19648, Egypt; (N.A.K.); (M.I.E.B.)
- International Medical Center, Clinical Microbiology Laboratory, Cairo P.O. Box 11451, Egypt
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Khan K, Jalal K, Khan A, Al-Harrasi A, Uddin R. Comparative Metabolic Pathways Analysis and Subtractive Genomics Profiling to Prioritize Potential Drug Targets Against Streptococcus pneumoniae. Front Microbiol 2022; 12:796363. [PMID: 35222301 PMCID: PMC8866961 DOI: 10.3389/fmicb.2021.796363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/28/2021] [Indexed: 02/01/2023] Open
Abstract
Streptococcus pneumoniae is a notorious pathogen that affects ∼450 million people worldwide and causes up to four million deaths per annum. Despite availability of antibiotics (i.e., penicillin, doxycycline, or clarithromycin) and conjugate vaccines (e.g., PCVs), it is still challenging to treat because of its drug resistance ability. The rise of antibiotic resistance in S. pneumoniae is a major source of concern across the world. Computational subtractive genomics is one of the most applied techniques in which the whole proteome of the bacterial pathogen is gradually reduced to a limited number of potential therapeutic targets. Whole-genome sequencing has greatly reduced the time required and provides more opportunities for drug target identification. The goal of this work is to evaluate and analyze metabolic pathways in serotype 14 of S. pneumonia to identify potential drug targets. In the present study, 47 potent drug targets were identified against S. pneumonia by employing the computational subtractive genomics approach. Among these, two proteins are prioritized (i.e., 4-oxalocrotonate tautomerase and Sensor histidine kinase uniquely present in S. pneumonia) as novel drug targets and selected for further structure-based studies. The identified proteins may provide a platform for the discovery of a lead drug candidate that may be capable of inhibiting these proteins and, therefore, could be helpful in minimizing the associated risk related to the drug-resistant S. pneumoniae. Finally, these enzymatic proteins could be of prime interest against S. pneumoniae to design rational targeted therapy.
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Affiliation(s)
- Kanwal Khan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Khurshid Jalal
- HEJ Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Ajmal Khan
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Reaz Uddin
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
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Global Perspective of Legionella Infection in Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031907. [PMID: 35162928 PMCID: PMC8835084 DOI: 10.3390/ijerph19031907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/11/2021] [Accepted: 01/20/2022] [Indexed: 01/27/2023]
Abstract
Legionnaires’ disease (LD) (Legionella) is a common cause of community-acquired pneumonia (CAP) in those requiring hospitalization. Geographical variation in the importance of Legionella species as an aetiologic agent of CAP is poorly understood. We performed a systematic review and meta-analysis of population-based observational studies that reported the proportion of Legionella infection in patients with CAP (1 January 1990 to 31 May 2020). Using five electronic databases, articles were identified, appraised and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality of the included studies was assessed using the Newcastle–Ottawa Scale. Univariate and multivariate meta-regression analyses were conducted using study design, WHO region, study quality and healthcare setting as the explanatory variables. We reviewed 2778 studies, of which 219 were included in the meta-analysis. The mean incidence of CAP was 46.7/100,000 population (95% CI: 46.6–46.8). The mean proportion of Legionella as the causative agent for CAP was 4.6% (95% CI: 4.4 to 4.7). Consequently, the mean Legionella incidence rate was 2.8/100,000 population (95% CI: 2.7–2.9). There was significant heterogeneity across all studies I2 = 99.27% (p < 0.0001). After outliers were removed, there was a decrease in the heterogeneity (I2 = 43.53%). Legionella contribution to CAP has a global distribution. Although the rates appear highest in high income countries in temperate regions, there are insufficient studies from low- and middle-income countries to draw conclusions about the rates in these regions. Nevertheless, this study provides an estimate of the mean incidence of Legionella infection in CAP, which could be used to estimate the regional and global burden of LD to support efforts to reduce the impact of this infection as well as to fill important knowledge gaps.
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