ABSTRACT
The widespread evolution of phenotypic resistance in clinical isolates over the years, coupled with the COVID-19 pandemic onset, has exacerbated the global challenge of antimicrobial resistance. This study aimed to explore changes in bacterial infection patterns and antimicrobial resistance during the COVID-19 pandemic. This study involved the periods before and during COVID-19: the pre-pandemic and pandemic eras. The surveillance results of bacterial isolates causing infections in cancer patients at an Egyptian tertiary oncology hospital were retrieved. The Vitek®2 or Phoenix systems were utilized for species identification and susceptibility testing. Statistical analyses were performed comparing microbiological trends before and during the pandemic. Out of 2856 bacterial isolates, Gram-negative bacteria (GNB) predominated (69.7%), and Gram-positive bacteria (GPB) comprised 30.3% of isolates. No significant change was found in GNB prevalence during the pandemic (P = 0.159). Elevated rates of Klebsiella and Pseudomonas species were demonstrated during the pandemic, as was a decrease in E. coli and Acinetobacter species (P < 0.001, 0.018, < 0.001, and 0.046, respectively) in hematological patients. In surgical patients, Enterobacteriaceae significantly increased (P = 0.012), while non-fermenters significantly decreased (P = 0.007). GPB species from either hematological or surgical wards exhibited no notable changes during the pandemic. GNB resistance increased in hematological patients to carbapenems, amikacin, and tigecycline and decreased in surgical patients to amikacin and cefoxitin (P < 0.001, 0.010, < 0.001, < 0.001, and 0.016, respectively). The study highlights notable shifts in the microbial landscape during the COVID-19 pandemic, particularly in the prevalence and resistance patterns of GNB in hematological and surgical wards.
Subject(s)
Anti-Bacterial Agents , COVID-19 , Drug Resistance, Bacterial , SARS-CoV-2 , Tertiary Care Centers , Humans , COVID-19/epidemiology , Tertiary Care Centers/statistics & numerical data , Egypt/epidemiology , Anti-Bacterial Agents/pharmacology , SARS-CoV-2/drug effects , Neoplasms , Microbial Sensitivity Tests , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Bacterial Infections/drug therapy , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/isolation & purification , Bacteria/drug effects , Bacteria/isolation & purification , Bacteria/classification , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/isolation & purification , Cancer Care Facilities , PandemicsABSTRACT
High blood pressure (hypertension), is a common medical condition, affecting millions of people and is associated with significant health risks. Exercise has been suggested to manage hypertension by inducing sweating and the corresponding loss of sodium and water from the body.Thus, a variety of epidemiological and clinical studies have been conducted to investigate the relationship between sweating and exercise-induced blood pressure reduction and its impacts on hypertension. The mechanisms underlying exercise-induced blood pressure reduction are complex and still not fully understood. However, several pathways have been suggested, including the loss of sodium and water through sweat, a decrease in peripheral resistance, and an improvement in endothelial function in the blood vessels. The decrease in sodium and water content in the body associated with sweating may result in a reduction in blood volume and thus a decrease in blood pressure. Moreover, the reduction in peripheral resistance is thought to be mediated by the activation of the nitric oxide synthase pathway and the release of vasodilators such as prostacyclin and bradykinin, which lead to vasodilation and, thus, a reduction in blood pressure. In conclusion, exercise-induced sweating and consequent sodium and water loss appear to be a reliable biological link to the blood pressure-reducing effects of exercise in hypertensive individuals. Additionally, the mechanisms underlying exercise-induced blood pressure reduction are complex and involve several biological pathways in the cardiovascular system. Therefore, understanding the role of sweat production in blood pressure management is important for developing effective exercise interventions to prevent and manage hypertension.
Subject(s)
Blood Pressure , Exercise , Hypertension , Sweating , Humans , Hypertension/physiopathologyABSTRACT
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by insulin resistance and chronic inflammation. Aerobic training (AT) and magnesium supplementation (Mg) have both been independently shown to have beneficial effects on glucose control and insulin sensitivity in individuals with T2DM. However, the potential synergistic effects of combining AT and Mg supplementation have not been extensively studied. This study aimed to investigate the effects of an 8-week AT and Mg supplementation on serum levels of insulin, glucose, leptin, adiponectin, TNF-α, IL-1ß, IL-6, NF-κB, as well as the expression of mir-155 and mir-21 in the visceral adipose tissue (VAT) of rats with T2DM. METHODS: For this experimental study, 32 male Wistar rats were induced with T2DM by a high-fat diet combined with a low-dose streptozotocin injection. The rats were randomly assigned to four groups: AT and Mg supplementation (AT + Mg), AT (5 days/week for 8 weeks), Mg supplementation (received daily supplementation of Mg chloride), and diabetic control (C). An 8-week AT program was implemented, with gradually increasing the intensity and duration to reach 25 m/min and 60 min in the 8th week, respectively. The training intensity was set at 50-60% of VO2max. The Mg groups were provided with rat diets containing 1000 mg/kg of Mg. The AT + Mg group received both interventions, while the C group served as the untreated control. Serum biomarkers were measured using enzyme-linked immunosorbent assay (ELISA), and VAT samples were collected for gene expression analysis using real-time polymerase chain reaction (PCR). RESULTS: Serum biomarker analysis revealed that the AT + Mg group had a significant decrease in fasting insulin (p = 0.001) and serum glucose (p = 0.001), as well as an increase in adiponectin levels compared to the C group (p = 0.002). Additionally, the AT + Mg group showed a significant reduction in serum leptin, TNF-α, IL-6, IL-1ß, and NF-κB, as well as downregulation of mir-155 and mir-21 in the VAT compared to the other groups. The AT group also showed improvements in several parameters, while the Mg group had fewer significant differences compared to the C group. CONCLUSION: The combination of AT and Mg supplementation provides a synergistic effect that improves serum biomarkers and downregulates pro-inflammatory microRNAs in the VAT of T2DM rats. Meanwhile, Mg supplementation alone does not have a significant effect on pro-inflammatory microRNAs in the VAT. These findings suggest that such combined interventions could be a promising strategy for managing T2DM, potentially ameliorating inflammatory states and improving metabolic health.