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Pulmonology 2023
Topics: Humans; Pneumonia; Opportunistic Infections
PubMed: 35864056
DOI: 10.1016/j.pulmoe.2022.06.004 -
The British Journal of Dermatology Apr 2022Staphylococcal and herpes simplex virus (HSV) infections are commonly recognized in atopic dermatitis (AD), but less is known about other types of infections.
BACKGROUND
Staphylococcal and herpes simplex virus (HSV) infections are commonly recognized in atopic dermatitis (AD), but less is known about other types of infections.
OBJECTIVES
To determine the risk of herpesvirus infections, serious infections and opportunistic infections in patients with AD.
METHODS
We conducted a population-based cohort study using UK-based electronic medical records data. Patients with AD were each matched to up to five unaffected patients on age, practice and index date. AD severity was defined using treatments as a proxy. Outcomes were incident herpesvirus infections [cytomegalovirus (CMV), Epstein-Barr virus (EBV), HSV or varicella zoster virus (VZV)], serious infections and opportunistic infections.
RESULTS
Among 409 431 children and 625 083 adults with AD matched to 1 809 029 children and 2 678 888 adults without AD, respectively, adjusted Cox regression models showed children and adults with AD had a 50-52% greater risk of HSV and 18-33% greater risk of VZV, with risk increasing in parallel with AD severity. CMV risk was elevated among children with AD [hazard ratio (HR) 2·50, 95% confidence interval (95% CI) 1·38-4·54] and adults with severe AD (HR 4·45, 95% CI 1·76-11·25). Patients with AD had a 26-40% increase in risk of serious infections, with severe AD carrying the greatest risk. Although rare, opportunistic infections were associated with all severities of AD in adults (overall HR 1·31, 95% CI 1·20-1·42), but were not associated with AD in children. All estimates remained consistent after excluding patients receiving immunosuppressive treatments for AD.
CONCLUSIONS
AD is significantly associated with herpesvirus infections, serious infections and opportunistic infections in a 'dose-dependent' manner with increasing severity. AD may increase susceptibility to infections exclusive of immunosuppressive medications.
Topics: Adult; Child; Cohort Studies; Dermatitis, Atopic; Epstein-Barr Virus Infections; Herpesvirus 3, Human; Herpesvirus 4, Human; Humans; Opportunistic Infections; Simplexvirus
PubMed: 34748650
DOI: 10.1111/bjd.20887 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim: Is to determine the features of the HIV infection and changes in indicators of endogenous intoxication and immunoreactivity depending on the clinical stage and...
OBJECTIVE
The aim: Is to determine the features of the HIV infection and changes in indicators of endogenous intoxication and immunoreactivity depending on the clinical stage and the level of CD4 lymphocytes.
PATIENTS AND METHODS
Materials and methods: 72 HIV-patients were examined. Comparison group included 40 healthy blood donors. Clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated.
RESULTS
Results:Main opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization, more often pulmonary tuberculosis; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. In groups where the distribution of patients depended on the level of CD4 cells - HIV (CD4≥500) and HIV (CD4≤499-200), index changes were more pronounced than in the HIV I and HIV III groups. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group: endogenous intoxication indexes were increased by 1,2-7,5 and 1,9-13,7 times in both groups respectively. Non-specific reactivity indexes were decreased by 1,2-1,6 and 1,3-1,6 times, respectively; nuclear index (NI) in groups was 3 and 3,4 times higher (p<0,05-0,001). Changes in indexes of inflammatory activity were observed (p<0,05-0,001).
CONCLUSION
Conclusions: Main diagnosed opportunistic infections were: oropharyngeal candidiasis; tuberculosis of different localization; and brain toxoplasmosis (p<0,05). Indices of endogenous intoxication and immunoreactivity are important objective criteria for diagnosis. The most significant changes in indexes were in the HIV IV clinical group and the HIV (CD4≤199) group (p<0,05-0,001).
Topics: AIDS-Related Opportunistic Infections; CD4-Positive T-Lymphocytes; HIV Infections; HIV Seropositivity; Humans; Laboratories
PubMed: 34090288
DOI: No ID Found -
Mycoses Sep 2019Aureobasidium pullulans and A. melanogenum are black-yeast-like surface colonisers and are commonly encountered as contaminants in the hospital. The species are able to... (Comparative Study)
Comparative Study
Aureobasidium pullulans and A. melanogenum are black-yeast-like surface colonisers and are commonly encountered as contaminants in the hospital. The species are able to produce melanin which play a role in protection against environmental stress and irradiation. Aureobasidium melanogenum shows higher frequency in opportunistic infections compared to A. pullulans. Comparative pathogenicity of opportunistic black yeasts between Aureobasidium pullulans and A. melanogenum to explain the observed differences in frequency in infection. Degrees of melanisation and thermotolerance were measured, and virulence of strains from different sources was examined in Galleria mellonela and murine infection models. Aureobasidium melanogenum responds with increased melanisation to temperature stress and generally survives at 37°C, A. pullulans on average scored less on these parameters. In the murine model, differences between species were not significant, but the melanised A. melanogenum group showed the highest virulence. This result was not reproducible in Galleria mellonella larvae at 25°C. The A. melanogenum black group showed higher pathogenicity in murine model, indicating that the combination of melanisation and thermotolerance rather than species affiliation is instrumental. Galleria larvae did not survive very well at 37°C, and hence, this model is judged insufficient to detect the small virulence differences observed in Aureobasidium.
Topics: Animals; Ascomycota; Disease Models, Animal; Female; Larva; Melanins; Mice; Moths; Mycoses; Opportunistic Infections; Thermotolerance; Virulence
PubMed: 31107996
DOI: 10.1111/myc.12931 -
Public Health Nursing (Boston, Mass.) Sep 2022In Canada, HIV diagnoses continue unabated, with many of these cases being identified at a late stage of infection. While current public health surveillance data does... (Review)
Review
OBJECTIVES
In Canada, HIV diagnoses continue unabated, with many of these cases being identified at a late stage of infection. While current public health surveillance data does not capture timing of diagnoses, locally, we identified a number of patients concurrently diagnosed with AIDS and HIV.
DESIGN
To understand the key characteristics, presenting symptoms, and risk factors associated with an AIDS diagnosis, we undertook a prospective chart review of HIV and AIDS diagnoses in Ottawa, Canada.
SAMPLE
Sixty seven charts of persons diagnosed with HIV and AIDS between 2015 and 2021 were reviewed.
MEASUREMENTS
Data were analyzed using descriptive statistics.
RESULTS
Results show some inconsistencies regarding HIV risk factors identified in published literature compared to those for persons diagnosed with AIDS in this study. Namely, patients in this review were more likely to be male, Black (from HIV-endemic regions), and heterosexual, and were diagnosed at critical stage in infection (total average CD4+ count of 92.9 cells/mm ) with 44.8% of patients concurrently diagnosed with one or more AIDS-related opportunistic infections.
CONCLUSIONS
The findings can be applied to strengthen HIV screening efforts in primary care settings, particularly among patients who present with persistent symptoms or illnesses related to chronic HIV infection. Additional considerations should be made for public health nurses to provide counseling and linkage to HIV testing/prevention services for patients at the time of an STI or Tuberculosis diagnosis and to increase AIDS-specific data collection.
Topics: AIDS-Related Opportunistic Infections; Acquired Immunodeficiency Syndrome; CD4 Lymphocyte Count; Female; HIV Infections; Humans; Male; Prospective Studies
PubMed: 35305282
DOI: 10.1111/phn.13065 -
Life Sciences Oct 2022This manuscript aims to explain the relationship between mucositis caused by 5-FU over gut bacterial species and susceptibility to opportunistic infection caused by P....
AIMS
This manuscript aims to explain the relationship between mucositis caused by 5-FU over gut bacterial species and susceptibility to opportunistic infection caused by P. aeruginosa.
MAIN METHODS
BALB/c mice were intraperitoneally treated with PBS or 5-FU. Bodyweight and faecal consistency were checked daily. Mice faecal DNA was extracted, and bacterial phylogenetic groups were analysed using qPCR or high-throughput sequencing. Immunofluorescence was used to evaluate BMDM activation by mice-treated faecal content. Mice were challenged intratracheally with virulent P. aeruginosa, and the CFU and histology were analysed. Faecal microbiota were transplanted to evaluate the gut microbiota and resistance to pulmonary P. aeruginosa recovery.
KEY FINDINGS
The animals treated with 5-FU presented mucositis with great weight loss, altered faecal consistency, bacterial gut dysbiosis and histological changes in the intestinal mucosa. Mice under 5-FU treatment were more susceptible to lung infection by the bacteria P. aeruginosa and had more extensive tissue damage during their lung infection with greater pro-inflammatory gene expression. It was observed that the mucositis remained in the groups with 5-FU even with the FMT. The results caused by mucositis in animals that received allogeneic FMT were reversed, however, with a decrease in P. aeruginosa susceptibility in animals treated with 5-FU and allogeneic FMT compared to animals treated with 5-FU and autologous FMT.
SIGNIFICANCE
Treatment with 5-FU in a murine model makes it more susceptible to pulmonary infection by the bacterium P. aeruginosa, FMT offers an opportunity to protect against this susceptibility to infection.
Topics: Animals; Antineoplastic Agents; Bacteria; Dysbiosis; Fluorouracil; Intestinal Mucosa; Mice; Mice, Inbred BALB C; Mucositis; Opportunistic Infections; Phylogeny; Pseudomonas Infections; Pseudomonas aeruginosa
PubMed: 35988752
DOI: 10.1016/j.lfs.2022.120890 -
Experimental and Clinical... Nov 2020The BK polyomavirus was isolated in 1971; it has been a significant risk factor for both graft dysfunction and failure in renal transplant recipients. So far, no... (Review)
Review
The BK polyomavirus was isolated in 1971; it has been a significant risk factor for both graft dysfunction and failure in renal transplant recipients. So far, no specific treatment option has been available for effective treatment or prophylaxis for BK virus infections. Although the use of heavy immunosuppression has been the main risk factor for BK virus infection, other risk factors are equally important, including elderly recipients, prior rejection episodes, male sex, human leukocyte antigen mismatching, prolonged cold ischemia time, pretransplant BK virus serostatus, and ureteral stenting. Regular follow-up for BK virus infections according to each institution's policy has been, so far, effective in detecting patients with BK virus viremia and consequently preventing allograft loss. The mainstay of management continues to be reduction of immunosuppression. However, newer options are providing new insights, such as cellular immunotherapy. In this review, we will address the diagnosis, screening, new diagnostic tools, and updated management of BK virus infections.
Topics: Adoptive Transfer; Antiviral Agents; BK Virus; Drug Substitution; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Immunosuppressive Agents; Immunotherapy; Kidney Transplantation; Opportunistic Infections; Polyomavirus Infections; Risk Assessment; Risk Factors; Treatment Outcome; Tumor Virus Infections
PubMed: 32552624
DOI: 10.6002/ect.2019.0254 -
International Journal of... 2020Talaromycosis is a rare deep fungal infection caused by . Currently, methamphetamine has become the second-largest drug abuse category in the world after cannabis and...
Talaromycosis is a rare deep fungal infection caused by . Currently, methamphetamine has become the second-largest drug abuse category in the world after cannabis and has become a serious public health problem. Methamphetamine can inhibit human immune system and increase the probability of pathogenic microorganism infection. On 8 October 2016, a 20-year-old man with a fever history of 2 months was admitted to our hospital. He had bloody stools and abdominal pain during hospitalization. There was no significant abnormality in physical examination. Because of the misdiagnosis, he underwent improper treatment. Periodic acid-Schiff stain (PAS) staining showed that the mucosa of distal ileum, ascending colon, transverse colon, and sigmoid colon were infiltrated by a large number of tissue cells, which contained a large number of blue purple particles. In addition, a large number of histiocytes and multinucleated giant cells can be seen in the lamina propria of ileum mucosa, and fungal spores can be seen in histiocytes. Finally, he was diagnosed as talaromycosis and took itraconazole 0.2 g twice a day. After 5 days, the temperature dropped to normal and the inflammation disappeared, and he continued to take itraconazole for 6 months. Due to the neglect of the history of drug abuse and the concealment, drug-related talaromycosis is often misdiagnosed. Pathological examination is warranted for diagnosis talaromycosis. This condition requires a long-term anti-fungal therapy.
Topics: Amphetamine-Related Disorders; Antifungal Agents; Central Nervous System Stimulants; Humans; Immunocompromised Host; Itraconazole; Male; Methamphetamine; Mycoses; Opportunistic Infections; Treatment Outcome; Young Adult
PubMed: 32674642
DOI: 10.1177/2058738420934611 -
Clinical Rheumatology Sep 2020Rheumatic manifestations remain an important clinical manifestation associated to HIV. To date after 4 decades of the onset of the HIV/AIDS pandemic, almost 37 million... (Review)
Review
Rheumatic manifestations remain an important clinical manifestation associated to HIV. To date after 4 decades of the onset of the HIV/AIDS pandemic, almost 37 million individuals are living with the infection, including close to 2 million of newly infected individuals. The status, however, of a considerable proportion of HIV/AIDS patients has changed from a near fatal disorder secondary to opportunistic infections to a chronic disease in which renal cardiovascular, diabetes, malignancy, and autoimmune co-morbid disorders have become prevalent and relevant. In addition, the spectrum of rheumatic disorders also has changed since the introduction of HAART and its diagnosis and treatment represents a challenge. The purpose of this review is to define and discuss the HIV-related rheumatic manifestations in the pre- and post-HAART eras.
Topics: Antiretroviral Therapy, Highly Active; Autoimmune Diseases; HIV Infections; Humans; Opportunistic Infections; Rheumatic Diseases
PubMed: 32297034
DOI: 10.1007/s10067-020-05082-8 -
Frontiers in Immunology 2021Infections are the major cause of morbidity and mortality in patients with primary immunodeficiency disease (PID). Timely and accurate microbiological diagnosis is... (Comparative Study)
Comparative Study
BACKGROUND
Infections are the major cause of morbidity and mortality in patients with primary immunodeficiency disease (PID). Timely and accurate microbiological diagnosis is particularly important in these patients. Metagenomic next-generation sequencing (mNGS) has been used for pathogen detection recently. However, few reports describe the use of mNGS for pathogen identification in patients with PID.
OBJECTIVE
To evaluate the utility of mNGS for detecting pathogens in patients with PID, and to compare it with conventional microbiological tests (CMT).
METHODS
This single center retrospective study investigated the diagnostic performance of mNGS for pathogens detection in PID patients and compared it with CMT. Sixteen PID patients with suspected infection were enrolled, and medical records were analyzed to extract detailed clinical characteristics such as gene variation, immune status, microbial distribution, time-consuming of mNGS and CMT, treatment, and outcomes.
RESULTS
mNGS identified pathogenic microbe in 93.75% samples, compared to 31.25% for culture and 68.75% for conventional methods, and detected an extra 18 pathogenic microorganisms including rare opportunistic pathogens and . Pathogen identification by mNGS required 48 hours, compared with bacterial culture for 3-7 days and even longer for fungus and culture.
CONCLUSIONS
mNGS has marked advantages over conventional methods for pathogenic diagnosis, particularly opportunistic pathogens and mixed infections, in patients with PID. This method might enable clinicians to make more timely and targeted therapeutic decisions, thereby improving the prognosis of these patients.
Topics: Adolescent; Bacterial Infections; Bacteriological Techniques; Child; Child, Preschool; Female; High-Throughput Nucleotide Sequencing; Host-Pathogen Interactions; Humans; Immunocompromised Host; Infant; Male; Metagenome; Metagenomics; Mycoses; Opportunistic Infections; Predictive Value of Tests; Primary Immunodeficiency Diseases; Reproducibility of Results; Retrospective Studies
PubMed: 34484193
DOI: 10.3389/fimmu.2021.696403