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Transplantation Proceedings Oct 2023Hyperammonemia after lung transplantation is a rare but potentially fatal condition. A 59-year-old male patient affected by pulmonary fibrosis underwent an uncomplicated...
Hyperammonemia after lung transplantation is a rare but potentially fatal condition. A 59-year-old male patient affected by pulmonary fibrosis underwent an uncomplicated bilateral lung transplant. Fourteen days after the procedure, the patient developed severe encephalopathy caused by elevated serum ammonia levels. Ureaplasma parvum and Mycoplasma hominis were found on bronchial aspirate and urinary samples as well as on pharyngeal and rectal swabs. Despite the initiation of multimodal therapy, brain damage due to hyperosmolarity was so extensive to evolve into brain death. The autopsy revealed glutamine synthetase hypo-expression in the hepatic tissue. The pathophysiology of hyperammonemia syndrome in lung transplant recipients remains unclear. Previous studies have described the presence of disorders of glutamine synthetase, while others considered the infection with urea-splitting microorganisms as a cause of hyperammonemia syndrome. Our report describes the case of a patient who developed hyperammonemia after a lung transplant in which both the aforementioned etiologies were documented. A high level of clinical suspicion for hyperammonemia syndrome should be maintained in lung transplant recipients. Timely recognition and treatment are critical to prevent the potentially dreadful evolution of this severe complication.
PubMed: 37537075
DOI: 10.1016/j.transproceed.2023.07.003 -
Scientific Reports Jul 2023With an incidence of more than > 1,000,000/day, sexually transmitted diseases remain a major challenge for health care systems worldwide. To reduce disease burden,...
With an incidence of more than > 1,000,000/day, sexually transmitted diseases remain a major challenge for health care systems worldwide. To reduce disease burden, complications, and spread, rapid diagnosis permitting early therapy is pivotal. The range of pathogens is wide and co-infections are common. This complicates pre-analytics, which are based on different laboratory techniques with potentially long turnaround times, e.g., cultivation and multistep serologies. Multiplex PCR provides the opportunity to overcome these limitations. In this study, we evaluated a novel assay, the Euroarray STI-11 microarray (EA; Euroimmun Medizinische Labordiagnostika), for the detection of eight obligate or facultative pathogens. Three-hundred-thirteen clinical specimens, which had been tested and pre-characterized for STI causing agents as part of routine diagnostics, were used as cases and controls in this retrospective study. The EA detected 34/44 Chlamydia trachomatis, 48/50 HSV-1, 50/50 HSV-2, 48/48 Mycoplasma hominis, 45/47 Neisseria gonorrhoeae, 9/11 Treponema pallidum, 46/46 Ureaplasma parvum, and 49/49 Ureaplasma urealyticum infections, respectively. 293 samples were EA positive, with polymicrobial infections (positive for two to six microbial or viral agents) detected in 130/293 cases. Specificities were 100% in the respective control groups (n = 18-48 depending on targeted pathogen) except for N. gonorrhoeae (25/26) and U. urealyticum (44/45). The broad spectrum of obligate and facultative pathogens targeted by the EA makes it a valuable tool in the setting of STI diagnostics and surveillance. The test has the potential to diagnose diseases neglected or overlooked in routine clinical practice. Besides a low sensitivity for C. trachomatis, the EA demonstrated high performance for all analyzed parameters. Further studies are warranted in order to capture a larger variety of the tested pathogens.
Topics: Humans; Retrospective Studies; Sexually Transmitted Diseases; Chlamydia trachomatis; Ureaplasma; Neisseria gonorrhoeae
PubMed: 37452127
DOI: 10.1038/s41598-023-38121-w -
Molecular Immunology Aug 2023Spontaneous preterm birth (sPTB) is a global health concern and it is the most prevalent cause of infant mortality and morbidity with occurrence rate of 5 - 18%...
Spontaneous preterm birth (sPTB) is a global health concern and it is the most prevalent cause of infant mortality and morbidity with occurrence rate of 5 - 18% worldwide. Studies suggest infection and infection-driven activation of inflammatory responses are the potential risk factors for sPTB. MicroRNAs (miRNAs) are thought to control the expression of several immune genes, making them crucial components of the intricate immune regulatory network and the dysregulation of miRNAs in placenta has been associated to several pregnancy-related complications. However, studies on possible role of miRNAs in immunomodulation of cytokine signalling in infection-associated sPTB are scarce. Present study aimed to investigate expression/ correlation of a few circulating miRNAs (miR-223, -150-5p, -185-5p, -191-5p), miRNA target genes and associated cytokines in sPTB women found infected with Chlamydia trachomatis/ Mycoplasma hominis/ Ureaplasma urealyticum. Non-heparinized blood and placental sample were collected from 140 sPTB and 140 term women visiting Safdarjung hospital, New Delhi (India) for conducting PCR and RT-PCR for pathogen detection and miRNA/ target gene/ cytokine expression, respectively. Common target genes of differentially expressed miRNAs were obtained from databases. The correlation between select target genes/ cytokines and serum miRNAs was determined by Spearman's rank correlation. 43 sPTB were infected with either pathogen and a significant upregulation of serum miRNAs was observed. However, miR-223 and 150-5p showed maximum fold-change (4.78 and 5.58, respectively) in PTB versus control group. IL-6ST, TGF-β R3 and MMP-14 were important target genes among 454 common targets, whereas, IL-6 and TGF-β were associated cytokines. miR-223 and 150-5p showed significant negative correlation with IL-6ST/ IL-6/ MMP-14 and positive correlation with TGF-β R3/ TGF-β. A significant positive correlation was found between IL-6ST and IL-6, TGF-β R3 and TGF-β. However, miR-185-5p and 191-5p were not significantly correlated. Although post-transcriptional validation is required, yet on the basis of mRNA findings, the study concludes that miR-223 and 150-5p are apparently of clinical importance in regulation of inflammatory processes during infection-associated sPTB.
Topics: Infant, Newborn; Humans; Female; Pregnancy; Matrix Metalloproteinase 14; Premature Birth; Interleukin-6; Placenta; MicroRNAs; Transforming Growth Factor beta; Cytokines; Immunomodulation
PubMed: 37285685
DOI: 10.1016/j.molimm.2023.05.009 -
Orthopedics 2024Postoperative deep infection is usually identified by microbial culture. However, frequent false-negative results have severely limited effective treatment. We report a...
Postoperative deep infection is usually identified by microbial culture. However, frequent false-negative results have severely limited effective treatment. We report a rare case of intra-articular and paravertebral infection after total knee arthroplasty caused by and , with multiple negative microbial culture results. Eventually, the pathogens were identified using metagenomic high-throughput sequencing, and the patient was successfully treated with several "old" antibiotics. We analyze the clinical characteristics of this patient and systematically describe the application of high-throughput sequencing and antibiotics. [. 2024;47(1):e52-e56.].
Topics: Humans; Mycoplasma Infections; Arthroplasty, Replacement, Knee; Ureaplasma Infections; Ureaplasma urealyticum; Anti-Bacterial Agents; Postoperative Complications
PubMed: 37276443
DOI: 10.3928/01477447-20230531-04 -
Urologia Aug 2023The aim of this study was to assess the presence of agents, their distribution between male and female, and differences in antibiotic susceptibility in samples sent...
BACKGROUND
The aim of this study was to assess the presence of agents, their distribution between male and female, and differences in antibiotic susceptibility in samples sent from Hisar Intercontinental Hospital's various clinics with the preliminary diagnosis of genitourinary system infection.
METHODS
The Mycoplasma IES test was used to identify and , and to determine antibiotic susceptibility results, in samples taken from patients. The findings of mycoplasma and ureaplasma culture testing samples requested between 2014 and 2021 were evaluated retrospectively from our records.
RESULTS
was found to be positive in 7.37% of the examinations, was found to be positive in 34.98% of the examinations, and either of them were found to be positive in 22.01% of the examinations. The growth rate of and/or was determined to be 24.95% in females and 10.13% in males, with the growth rate in females being greater and statistically significant ( < 0.001). According to the antibiotic susceptibility test results, clarithromycin (R 17.91%) was the most susceptible antibiotic overall for both microorganisms, while clindamycin (R 90.28%) was the most resistant. Depending on the sex, clarithromycin (R 18.40%) was found to be the most susceptible antibiotic in females, and levofloxacin (R 10.87%) to be the most susceptible in males.
CONCLUSION
Given the presence of and infections, especially in the presence of risky conditions such as pregnancy, laboratory tests for the diagnosis of these agents should be used in such studies since no urogenital infections were detected in the routine cultures of the patients followed up with the suspicion of urogenital infection. Gender differences should also be considered as a parameter in the preference of antibiotics.
Topics: Pregnancy; Humans; Male; Female; Mycoplasma; Ureaplasma; Retrospective Studies; Clarithromycin; Mycoplasma Infections; Ureaplasma urealyticum; Mycoplasma hominis; Anti-Bacterial Agents; Urinary Tract Infections
PubMed: 36537833
DOI: 10.1177/03915603221143422