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2.
BMC Infect Dis ; 22(1): 671, 2022 Aug 04.
Article in English | MEDLINE | ID: mdl-35927711

ABSTRACT

BACKGROUND: Hand, foot, and mouth disease (HFMD) is a common child infectious disease caused by more than 20 enterovirus (EV) serotypes. In recent years, enterovirus A71 (EV-A71) has been replaced by Coxsackievirus A6 (CV-A6) to become the predominant serotype. Multiple EV serotypes co-circulate in HFMD epidemics, and this study aimed to investigate the etiological epidemic characteristics of an HFMD outbreak in Kunming, China in 2019. METHODS: The clinical samples of 459 EV-associated HFMD patients in 2019 were used to amplify the VP1 gene region by the three sets of primers and identify serotypes using the molecular biology method. Phylogenetic analyses were performed based on the VP1 gene. RESULTS: Three hundred and forty-eight cases out of 459 HFMD patients were confirmed as EV infection. Of these 191 (41.61%) were single EV infections and 34.20% had co-infections. The EVs were assigned to 18 EV serotypes, of which CV-A6 was predominant (11.33%), followed by CV-B1 (8.93%), CV-A4 (5.23%), CV-A9 (4.58%), CV-A 16 (3.49%) and CV-A10 and CVA5 both 1.96%. Co-infection of CV-A6 with other EVs was present in 15.25% of these cases, followed by co-infection with CV-A16 and other EVs. The VP1 sequences used in the phylogenetic analyses showed that the CV-A6, CV-B1 and CV-A4 sequences belonged to the sub-genogroup D3 and genogroups F and E, respectively. CONCLUSION: Co-circulation and co-infection of multiple serotypes were the etiological characteristic of the HFMD epidemic in Kunming China in 2019 with CV-A-6, CV-B1 and CV-A4 as the predominant serotypes. This is the first report of CV-B1 as a predominant serotype in China and may provide valuable information for the diagnosis, prevention and control of HFMD.


Subject(s)
Coinfection , Enterovirus A, Human , Enterovirus Infections , Enterovirus , Hand, Foot and Mouth Disease , Child , China/epidemiology , Coinfection/epidemiology , Enterovirus/genetics , Enterovirus B, Human , Enterovirus Infections/epidemiology , Hand, Foot and Mouth Disease/epidemiology , Humans , Infant , Mass Vaccination , Phylogeny
3.
PLoS One ; 17(8): e0272375, 2022.
Article in English | MEDLINE | ID: mdl-35913964

ABSTRACT

BACKGROUND: Evidence around prevalence of bacterial coinfection and pattern of antibiotic use in COVID-19 is controversial although high prevalence rates of bacterial coinfection have been reported in previous similar global viral respiratory pandemics. Early data on the prevalence of antibiotic prescribing in COVID-19 indicates conflicting low and high prevalence of antibiotic prescribing which challenges antimicrobial stewardship programmes and increases risk of antimicrobial resistance (AMR). AIM: To determine current prevalence of bacterial coinfection and antibiotic prescribing in COVID-19 patients. DATA SOURCE: OVID MEDLINE, OVID EMBASE, Cochrane and MedRxiv between January 2020 and June 2021. STUDY ELIGIBILITY: English language studies of laboratory-confirmed COVID-19 patients which reported (a) prevalence of bacterial coinfection and/or (b) prevalence of antibiotic prescribing with no restrictions to study designs or healthcare setting. PARTICIPANTS: Adults (aged ≥ 18 years) with RT-PCR confirmed diagnosis of COVID-19, regardless of study setting. METHODS: Systematic review and meta-analysis. Proportion (prevalence) data was pooled using random effects meta-analysis approach; and stratified based on region and study design. RESULTS: A total of 1058 studies were screened, of which 22, hospital-based studies were eligible, compromising 76,176 of COVID-19 patients. Pooled estimates for the prevalence of bacterial co-infection and antibiotic use were 5.62% (95% CI 2.26-10.31) and 61.77% (CI 50.95-70.90), respectively. Sub-group analysis by region demonstrated that bacterial co-infection was more prevalent in North American studies (7.89%, 95% CI 3.30-14.18). CONCLUSION: Prevalence of bacterial coinfection in COVID-19 is low, yet prevalence of antibiotic prescribing is high, indicating the need for targeted COVID-19 antimicrobial stewardship initiatives to reduce the global threat of AMR.


Subject(s)
Bacterial Infections , COVID-19 , Coinfection , Adult , Anti-Bacterial Agents/therapeutic use , Bacteria , Bacterial Infections/drug therapy , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , COVID-19/drug therapy , COVID-19/epidemiology , Coinfection/drug therapy , Coinfection/epidemiology , Coinfection/microbiology , Humans , Prevalence
4.
BMC Res Notes ; 15(1): 271, 2022 Aug 03.
Article in English | MEDLINE | ID: mdl-35922804

ABSTRACT

OBJECTIVE: To perform a molecular screening to detect infections by the mayaro virus and possible coinfections with Chikungunya during an outbreak in the state of Tocantins/Brazil in 2017. RESULTS: Of a total 102 samples analyzed in this study, 6 cases were identified with simultaneous infection between mayaro and chikungunya viruses (5.88%). In these 6 samples, the mean Cycle threshold (Ct) for CHIKV was 26.87 (SD ± 10.54) and for MAYV was 29.58 (SD ± 6.34). The mayaro sequences generated showed 95-100% identity to other Brazilian sequences of this virus and with other MAYV isolates obtained from human and arthropods in different regions of the world. The remaining samples were detected with CHIKV monoinfection (41 cases), DENV monoinfection (50 cases) and coinfection between CHIKV/DENV (5 cases). We did not detect MAYV monoinfections.


Subject(s)
Chikungunya Fever , Chikungunya virus , Coinfection , Dengue , Brazil/epidemiology , Chikungunya Fever/diagnosis , Chikungunya Fever/epidemiology , Chikungunya virus/genetics , Coinfection/epidemiology , Dengue/epidemiology , Disease Outbreaks , Humans
5.
Comput Math Methods Med ; 2022: 7192795, 2022.
Article in English | MEDLINE | ID: mdl-35928967

ABSTRACT

Recently, violence, racism, and their coexistence have been very common issues in most nations in the world. In this newly social science discipline mathematical modelling approach study, we developed and examined a new violence and racism coexistence mathematical model with eight distinct classes of human population (susceptible, violence infected, negotiated, racist, violence-racism coinfected, recuperated against violence, recuperated against racism, and recuperated against the coinfection). The model takes into account the possible controlling strategies of violence-racism coinfection. All the submodels and the violence-racism coexistence model equilibrium points are calculated, and their stabilities are analyzed. The model threshold values are derived. As a result of the model qualitative analysis, the violence-racism coinfection spreads under control if the corresponding basic reproduction number is less than unity, and it propagates through the community if this number exceeds unity. Moreover, the sensitivity analysis of the parameter values of the full model is illustrated. We have applied MATLAB ode45 solver to illustrate the numerical results of the model. Finally, from qualitative analysis and numerical solutions, we obtain relevant and consistent results.


Subject(s)
Coinfection , Communicable Diseases , Racism , Basic Reproduction Number , Communicable Diseases/epidemiology , Humans , Models, Theoretical , Violence
6.
PLoS One ; 17(8): e0272094, 2022.
Article in English | MEDLINE | ID: mdl-35925877

ABSTRACT

BACKGROUND: Malaria elimination effort is hampered not only by the lack of effective medication but also due to the lack of sensitive diagnostic tools to detect infections with low levels of parasitemia. Therefore, more sensitive and specific high-throughput molecular diagnostic approaches are needed for accurate malaria diagnosis. METHODS: In the present study, the performance of a novel single-tube MC004 real-time polymerase chain reaction (PCR) assay (MRC-Holland, Amsterdam, the Netherlands) was assessed for the detection of infection and discrimination of Plasmodium species. Blood samples (n = 150) were collected from malaria suspected patients at Adama malaria diagnosis and treatment centre, Adama, central Ethiopia. The positive predictive value (PPV), negative predictive value (NPV), analytical sensitivity and specificity of the assay were assessed against the conventional microscopic method. RESULTS: Plasmodium species were detected in 59 (39.3%) of the samples by microscopy and in 62 (41.3%) by the novel MC004 RT-PCR. Plasmodium vivax, Plasmodium falciparum and mixed infections with Plasmodium falciparum & Plasmodium vivax accounted for 47.5%, 40.6% and 11.9% respectively as detected by microscopy. The MC004 RT-PCR assay identified 59.7% and 40.3% of the samples positive for Plasmodium vivax and Plasmodium falciparum respectively. The sensitivity, specificity, PPV, and NPV of the MC004 RT-PCR assay were 95.8%, 97.8%, 92%, and 98.9%, respectively. No mixed infections were detected using the MC004 assay. CONCLUSION: The MC004 RT-PCR assay is a useful tool for the early detection of malaria and identification of Plasmodium species with a high degree of sensitivity and specificity. Due to its high sensitivity, and simplicity (being a single-tube assay), the MC004 is suitable for use in clinical settings and epidemiological studies.


Subject(s)
Coinfection , Malaria, Falciparum , Malaria, Vivax , Malaria , Plasmodium , Humans , Malaria/diagnosis , Malaria, Falciparum/diagnosis , Malaria, Vivax/diagnosis , Plasmodium/genetics , Plasmodium falciparum/genetics , Plasmodium vivax/genetics , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity
7.
J Immunol ; 209(4): 760-771, 2022 Aug 15.
Article in English | MEDLINE | ID: mdl-35914833

ABSTRACT

Influenza-associated bacterial superinfections have devastating impacts on the lung and can result in increased risk of mortality. New strains of influenza circulate throughout the population yearly, promoting the establishment of immune memory. Nearly all individuals have some degree of influenza memory before adulthood. Due to this, we sought to understand the role of immune memory during bacterial superinfections. An influenza heterotypic immunity model was established using influenza A/Puerto Rico/8/34 and influenza A/X31. We report in this article that influenza-experienced mice are more resistant to secondary bacterial infection with methicillin-resistant Staphylococcus aureus as determined by wasting, bacterial burden, pulmonary inflammation, and lung leak, despite significant ongoing lung remodeling. Multidimensional flow cytometry and lung transcriptomics revealed significant alterations in the lung environment in influenza-experienced mice compared with naive animals. These include changes in the lung monocyte and T cell compartments, characterized by increased expansion of influenza tetramer-specific CD8+ T cells. The protection that was seen in the memory-experienced mouse model is associated with the reduction in inflammatory mechanisms, making the lung less susceptible to damage and subsequent bacterial colonization. These findings provide insight into how influenza heterotypic immunity reshapes the lung environment and the immune response to a rechallenge event, which is highly relevant to the context of human infection.


Subject(s)
Bacterial Infections , Coinfection , Influenza, Human , Methicillin-Resistant Staphylococcus aureus , Orthomyxoviridae Infections , Superinfection , Adult , Animals , CD8-Positive T-Lymphocytes , Humans , Lung , Mice , Mice, Inbred C57BL , Superinfection/microbiology
8.
Microbiome ; 10(1): 118, 2022 08 04.
Article in English | MEDLINE | ID: mdl-35922873

ABSTRACT

BACKGROUND: Antimicrobials are used in food-producing animals for purposes of preventing, controlling, and/or treating infections. In swine, a major driver of antimicrobial use is porcine reproductive and respiratory syndrome (PRRS), which is caused by a virus that predisposes infected animals to secondary bacterial infections. Numerous antimicrobial protocols are used to treat PRRS, but we have little insight into how these treatment schemes impact antimicrobial resistance (AMR) dynamics within the fecal microbiome of commercial swine. The aim of this study was to determine whether different PRRS-relevant antimicrobial treatment protocols were associated with differences in the fecal microbiome and resistome of growing pigs. To accomplish this, we used a metagenomics approach to characterize and compare the longitudinal wean-to-market resistome and microbiome of pigs challenged with PRRS virus and then exposed to different antimicrobial treatments, and a group of control pigs not challenged with PRRS virus and having minimal antimicrobial exposure. Genomic DNA was extracted from pen-level composite fecal samples from each treatment group and subjected to metagenomic sequencing and microbiome-resistome bioinformatic and statistical analysis. Microbiome-resistome profiles were compared over time and between treatment groups. RESULTS: Fecal microbiome and resistome compositions both changed significantly over time, with a dramatic and stereotypic shift between weaning and 9 days post-weaning (dpw). Antimicrobial resistance gene (ARG) richness and diversity were significantly higher at earlier time points, while microbiome richness and diversity were significantly lower. The post-weaning shift was characterized by transition from a Bacteroides-dominated enterotype to Lactobacillus- and Streptococcus-dominated enterotypes. Both the microbiome and resistome stabilized by 44 dpw, at which point the trajectory of microbiome-resistome maturation began to diverge slightly between the treatment groups, potentially due to physical clustering of the pigs. Challenge with PRRS virus seemed to correspond to the re-appearance of many very rare and low-abundance ARGs within the feces of challenged pigs. Despite very different antimicrobial exposures after challenge with PRRS virus, resistome composition remained largely similar between the treatment groups. Differences in ARG abundance between the groups were mostly driven by temporal changes in abundance that occurred prior to antimicrobial exposures, with the exception of ermG, which increased in the feces of treated pigs, and was significantly more abundant in the feces of these pigs compared to the pigs that did not receive post-PRRS antimicrobials. CONCLUSIONS: The fecal microbiome-resistome of growing pigs exhibited a stereotypic trajectory driven largely by weaning and physiologic aging of the pigs. Events such as viral illness, antimicrobial exposures, and physical grouping of the pigs exerted significant yet relatively minor influence over this trajectory. Therefore, the AMR profile of market-age pigs is the culmination of the life history of the individual pigs and the populations to which they belong. Disease status alone may be a significant driver of AMR in market-age pigs, and understanding the interaction between disease processes and antimicrobial exposures on the swine microbiome-resistome is crucial to developing effective, robust, and reproducible interventions to control AMR. Video Abstract.


Subject(s)
Anti-Infective Agents , Coinfection , Microbiota , Porcine Reproductive and Respiratory Syndrome , Porcine respiratory and reproductive syndrome virus , Animals , Anti-Bacterial Agents/pharmacology , Anti-Infective Agents/pharmacology , Metagenomics , Microbiota/genetics , Porcine Reproductive and Respiratory Syndrome/drug therapy , Porcine respiratory and reproductive syndrome virus/genetics , Swine
9.
Front Public Health ; 10: 855989, 2022.
Article in English | MEDLINE | ID: mdl-35968434

ABSTRACT

Purpose: A reduction of 80% in new Hepatitis C virus (HCV) infection is expected by 2030. However, high HCV reinfection rates have been reported among the high-risk population. This meta-analysis aimed to assess the HCV reinfection rate after successful treatment of HIV-1 coinfected MSM populations. Methods: Bibliographic databases were searched and a random-effect model was utilized to calculate the pooled HCV reinfection rate. Sub-group and meta-regression were used to explore heterogeneity among selected studies. A funnel plot and Egger's regression test were performed to estimate the publication bias. Results: Sixteen studies with 9,017.2 person-years (PY) follow-up were included. The overall HCV reinfection rate following successful treatment among HIV-1-infected MSM was 5.27/100 PY (95% CI, 3.98, 6.96). Lower reinfection rates were observed in developed parts of Europe (5.28/100 PY; 95% CI, 3.73, 6.84) and North America (3.92/100 PY; 95% CI, 1.67, 6.17). Reinfection rates among people with HCV test intervals of fewer than 6 months (7.59/100 PY; 95% CI: 5.15, 10.03) were significantly higher than those with more than 6 months test interval (2.88/100 PY; 95% CI: 2.26, 3.50), with an adjusted RR of 1.86 (95% CI, 1.06, 3.13). The adjusted study factors explained 91.03% the of studies' heterogeneity. Conclusion: HCV reinfection rate was high in successfully treated MSM who were coinfected with HIV-1. A shorter HCV test interval may help to explore more HCV reinfections. HCV reinfection rate studies from HIV-1 coinfected MSM in underdeveloped countries are urgently needed. Meta registration: PROSPERO: CRD42021285206, URL: https://www.crd.york.ac.uk/prospero/.


Subject(s)
Coinfection , HIV Infections , HIV-1 , Hepatitis C , Sexual and Gender Minorities , Coinfection/epidemiology , HIV Infections/epidemiology , Hepacivirus , Hepatitis C/epidemiology , Homosexuality, Male , Humans , Incidence , Male , Reinfection
10.
BMC Med Res Methodol ; 22(1): 223, 2022 Aug 12.
Article in English | MEDLINE | ID: mdl-35962372

ABSTRACT

BACKGROUND: Depression is common in the human immunodeficiency virus (HIV)-hepatitis C virus (HCV) co-infected population. Demographic, behavioural, and clinical data collected in research settings may be of help in identifying those at risk for clinical depression. We aimed to predict the presence of depressive symptoms indicative of a risk of depression and identify important classification predictors using supervised machine learning. METHODS: We used data from the Canadian Co-infection Cohort, a multicentre prospective cohort, and its associated sub-study on Food Security (FS). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was administered in the FS sub-study; participants were classified as being at risk for clinical depression if scores ≥ 10. We developed two random forest algorithms using the training data (80%) and tenfold cross validation to predict the CES-D-10 classes-1. Full algorithm with all candidate predictors (137 predictors) and 2. Reduced algorithm using a subset of predictors based on expert opinion (46 predictors). We evaluated the algorithm performances in the testing data using area under the receiver operating characteristic curves (AUC) and generated predictor importance plots. RESULTS: We included 1,934 FS sub-study visits from 717 participants who were predominantly male (73%), white (76%), unemployed (73%), and high school educated (52%). At the first visit, median age was 49 years (IQR:43-54) and 53% reported presence of depressive symptoms with CES-D-10 scores ≥ 10. The full algorithm had an AUC of 0.82 (95% CI:0.78-0.86) and the reduced algorithm of 0.76 (95% CI:0.71-0.81). Employment, HIV clinical stage, revenue source, body mass index, and education were the five most important predictors. CONCLUSION: We developed a prediction algorithm that could be instrumental in identifying individuals at risk for depression in the HIV-HCV co-infected population in research settings. Development of such machine learning algorithms using research data with rich predictor information can be useful for retrospective analyses of unanswered questions regarding impact of depressive symptoms on clinical and patient-centred outcomes among vulnerable populations.


Subject(s)
Coinfection , HIV Infections , Hepatitis C , Canada/epidemiology , Coinfection/diagnosis , Coinfection/epidemiology , Depression/diagnosis , Depression/epidemiology , Female , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/epidemiology , Hepacivirus , Hepatitis C/complications , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Humans , Male , Middle Aged , Prospective Studies , Retrospective Studies , Supervised Machine Learning
11.
Nat Microbiol ; 7(8): 1127-1140, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35918423

ABSTRACT

Coronavirus disease 2019 (COVID-19)-associated invasive fungal infections are an important complication in a substantial number of critically ill, hospitalized patients with COVID-19. Three groups of fungal pathogens cause co-infections in COVID-19: Aspergillus, Mucorales and Candida species, including Candida auris. Here we review the incidence of COVID-19-associated invasive fungal infections caused by these fungi in low-, middle- and high-income countries. By evaluating the epidemiology, clinical risk factors, predisposing features of the host environment and immunological mechanisms that underlie the pathogenesis of these co-infections, we set the scene for future research and development of clinical guidance.


Subject(s)
COVID-19 , Coinfection , Invasive Fungal Infections , Mycoses , Candida , Coinfection/epidemiology , Humans , Mycoses/epidemiology
12.
Crit Care ; 26(1): 236, 2022 Aug 03.
Article in English | MEDLINE | ID: mdl-35922860

ABSTRACT

BACKGROUND: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients. METHODS: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method. RESULTS: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO. CONCLUSIONS: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021).


Subject(s)
COVID-19 , Coinfection , Pneumonia, Bacterial , Pneumonia, Viral , Adrenal Cortex Hormones/therapeutic use , Adult , Anti-Bacterial Agents/therapeutic use , COVID-19/complications , COVID-19/epidemiology , COVID-19 Testing , Coinfection/drug therapy , Coinfection/epidemiology , Critical Illness , Humans , Intensive Care Units , Pandemics , Pneumonia, Bacterial/drug therapy , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology
13.
PLoS Negl Trop Dis ; 16(8): e0010596, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35939503

ABSTRACT

BACKGROUND: Co-infection, especially with pathogens of dissimilar genetic makeup, may result in a more devastating impact on the host. Investigations on co-infection with neglected zoonotic pathogens in wildlife are necessary to inform appropriate prevention and control strategies to reduce disease burden in wildlife and the potential transmission of these pathogens between wildlife, livestock and humans. This study assessed co-exposure of various Kenyan wildflife species with Brucella spp, Coxiella burnetii and Rift Valley fever virus (RVFV). METHODOLOGY: A total of 363 sera from 16 different wildlife species, most of them (92.6%) herbivores, were analysed by Enzyme-linked immunosorbent assay (ELISA) for IgG antibodies against Brucella spp, C. burnetii and RVFV. Further, 280 of these were tested by PCR to identify Brucella species. RESULTS: Of the 16 wildlife species tested, 15 (93.8%) were seropositive for at least one of the pathogens. Mean seropositivities were 18.9% (95% CI: 15.0-23.3) for RVFV, 13.7% (95% CI: 10.3-17.7) for Brucella spp and 9.1% (95% CI: 6.3-12.5) for C. burnetii. Buffaloes (n = 269) had higher seropositivity for Brucella spp. (17.1%, 95% CI: 13.0-21.7%) and RVFV (23.4%, 95% CI: 18.6-28.6%), while giraffes (n = 36) had the highest seropositivity for C. burnetii (44.4%, 95% CI: 27.9-61.9%). Importantly, 23 of the 93 (24.7%) animals positive for at least one pathogen were co-exposed, with 25.4% (18/71) of the positive buffaloes positive for brucellosis and RVFV. On molecular analysis, Brucella DNA was detected in 46 (19.5%, CI: 14.9-24.7) samples, with 4 (8.6%, 95% CI: 2.2-15.8) being identified as B. melitensis. The Fisher's Exact test indicated that seropositivity varied significantly within the different animal families, with Brucella (p = 0.013), C. burnetii (p = <0.001) and RVFV (p = 0.007). Location was also significantly associated (p = <0.001) with Brucella spp. and C. burnetii seropositivities. CONCLUSION: Of ~20% of Kenyan wildlife that are seropositive for Brucella spp, C. burnetii and RVFV, almost 25% indicate co-infections with the three pathogens, particularly with Brucella spp and RVFV.


Subject(s)
Brucella , Coinfection , Coxiella burnetii , Rift Valley Fever , Rift Valley fever virus , Animals , Animals, Wild , Brucella/genetics , Buffaloes , Coinfection/epidemiology , Coinfection/veterinary , Coxiella burnetii/genetics , Humans , Kenya/epidemiology , Rift Valley fever virus/genetics , Seroepidemiologic Studies , Zoonoses
14.
J Coll Physicians Surg Pak ; 32(8): 1033-1036, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35932128

ABSTRACT

OBJECTIVE: To compare the HIV-related ocular manifestations between HAART-naïve (Highly active antiretroviral therapy) and HAART-treated patients. STUDY DESIGN: Observational (comparative) Study. Place and Duration of the Study: Department of Ophthalmology and Family Care Centre of Hayatabad Medical Complex, Peshawar, Pakistan, from October 2019 to July 2021. METHODOLOGY: HIV-infected patients, who were receiving HAART treatment as well as HAART-naïve, were recruited. A complete ocular examination was performed to check for HIV-related ocular manifestations. Anterior and posterior segment findings were recorded and compared between the two groups. RESULTS: Of the 80 participants (40 in each group), 62 (77.5%) were males and 18 (22.5) were females with no significant difference between the groups for either gender (p=1.0). A significant difference, between the two groups, was found in the mean duration (838.64 + 908.16 days) of HIV infection at the time of recruitment (p<0.001). HIV-related ocular manifestations were found in 6 (7.5%) with no statistically significant difference between the two groups (p=1.0). Similarly, the involvement of systemic co-infections was found in 6 (7.5%) with no statistically significant difference between the groups (p=0.675). CONCLUSION: There was no difference in both groups when analysed for HIV-related ocular manifestations or systemic co-infections. The authors' finding contradict with some of the previously published data. Therefore, it is recommended that further research should be carried out to reach definite conclusion. KEY WORDS: HIV, Eye manifestations, Acquired immunodeficiency syndrome, Highly active antiretroviral therapy, HIV-related opportunistic infections, Pakistan.


Subject(s)
Coinfection , HIV Infections , Ophthalmology , Antiretroviral Therapy, Highly Active/adverse effects , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Male , Pakistan/epidemiology
15.
Epidemiol Mikrobiol Imunol ; 71(2): 93-101, 2022.
Article in English | MEDLINE | ID: mdl-35940863

ABSTRACT

AIM: The aim is to characterize in more detail the group of HIV-positive persons in the Czech Republic diagnosed with tuberculosis (TB) in 2000-2020. MATERIAL AND METHODS: Data sources were mainly the national online TB register (RTBC), which is part of the information system of the Public Health Service, and the national electronic register of HIV-positive persons (RHIV) maintained by the National Reference Laboratory for HIV/AIDS of the National Institute of Public Health. RESULTS: Of 3,763 TB cases reported to the RHIV since 1985 and 16,212 TB cases reported to the RTBC since 2000, 91 occurred in 88 HIV-positive persons (69 males and 22 females) between 2000 and 2020. Sixty-five (74%) of the 88 HIV-positive persons were foreign born. Twenty-six per cent of TB cases were screened for HIV. The mean age of patients with TB/HIV coinfection was 35 years. The largest number of coinfected persons (35 cases) were from the capital city of Prague. Pulmonary TB was detected in 84 cases. Ninety-two per cent of the TB cases were bacteriologically confirmed, and 10 cases were multidrug-resistant TB. At the time of TB diagnosis, the median CD4+ lymphocyte count was 91.5 cells per mm3 of blood. TB was the most common reason for HIV testing in the analysed cohort (23 cases). The most common mode of HIV transmission was sexual intercourse (heterosexual in 39 cases and homosexual in 13 cases). Treatment success at 12-month follow-up was only recorded in 32% of cases of culture-positive pulmonary TB in HIV-positive patients. CONCLUSIONS: TB/HIV co-infection remains a serious health concern, especially in the foreign-born residents of the Czech Republic. Of foreign-born persons with TB, 42% were tested for HIV over the 21-year study period, with their percentage increasing over the years. Almost 6% of them tested HIV positive. The most relevant finding is that treatment success was only recorded for less than one third of HIV-positive persons with culture-positive pulmonary TB and that every fourth patient with TB/HIV died before or during TB treatment.


Subject(s)
Coinfection , HIV Infections , Tuberculosis, Multidrug-Resistant , Tuberculosis, Pulmonary , Tuberculosis , Adult , Coinfection/epidemiology , Czech Republic/epidemiology , Female , HIV Infections/complications , HIV Infections/epidemiology , Humans , Incidence , Male , Tuberculosis/complications , Tuberculosis/epidemiology , Tuberculosis, Multidrug-Resistant/epidemiology
16.
Med Trop Sante Int ; 2(2)2022 06 30.
Article in French | MEDLINE | ID: mdl-35919257

ABSTRACT

Introduction: Syphilis is a sexually transmitted disease. All organs might be affected, but ocular syphilis occurs only in 0.6 percent of patients. A resurgence of syphilis cases has been observed for several years in many countries, especially in HIV-infected subjects. These patients often present with concomitant primary and secondary lesions or extensive presentations of syphilis. Case reports: We report 2 patients with syphilitic uveitis diagnosed and treated at the department of infectious diseases at the University hospital of Marrakech. Ocular involvement was inaugural in both HIV patients. Each had a specific treatment, but none had a complete recovery of visual function; the first patient was treated by ceftriaxone and the second one was treated by penicillin. Conclusion: Syphilis must be discussed in all patients diagnosed with uveitis or papillitis. The diagnosis should be suspected in cases of eye inflammation even in the absence of favourable clinical presentation or anamnesis. Search for HIV co-infection should be systematic. Although not evidence-based, prompt therapy may lead to functional recovery. Ceftriaxone could be a suitable alternative to penicillin in the treatment of early syphilis in HIV-infected patients. This treatment has a concomitant effectiveness even for asymptomatic forms of neurosyphilis. Ocular syphilis is a form of neurosyphilis and requires neurosyphilis therapy regardless of when it develops after primary infection.Conventional syphilis staging is of little use in understanding ocular syphilis. Co-infection between HIV and ocular syphilis is common, but does not affect response to a neurosyphilis regimen of penicillin in the short term.


Subject(s)
Coinfection , Endophthalmitis , Eye Infections, Bacterial , HIV Infections , Neurosyphilis , Syphilis , Uveitis , Ceftriaxone/therapeutic use , Coinfection/drug therapy , Endophthalmitis/complications , Eye Infections, Bacterial/diagnosis , HIV Infections/complications , Humans , Morocco , Neurosyphilis/complications , Penicillins/therapeutic use , Syphilis/complications , Uveitis/diagnosis
17.
Pediatr Infect Dis J ; 41(9): e377-e382, 2022 Sep 01.
Article in English | MEDLINE | ID: mdl-35797707

ABSTRACT

BACKGROUND: Toxoplasmosis and cytomegalovirus (CMV) congenital infection present with similar clinical pictures. Both infections have long-term sequelae that can be mitigated by early detection and treatment. Coinfection is uncommonly reported. METHODS: Dichorionic diamniotic twins born at 35 weeks of gestation were investigated for congenital infections due to abnormalities on the antenatal scan at 31 weeks of gestation. Antenatal investigations were delayed due to late booking and delay in maternal investigations. In the neonatal period, they suffered discordant symptoms and were both investigated for Toxoplasma gondii infection. This diagnosis was confirmed in twin 2 but proved difficult in twin 1 who had a weakly positive polymerase chain reaction with inconclusive serology. Twin 1 was also diagnosed with congenital CMV, further complicating the clinical picture. Toxoplasmosis can cause long-term sequelae, and definitive diagnosis requires serology at 12 months of age; in view of this, treatment for congenital toxoplasmosis was initiated in both twins. Twin 1 was also treated for congenital CMV. RESULTS: Due to limitations in serological investigations in neonates, diagnosing congenital toxoplasmosis can be challenging, and initiating treatment may be warranted in suspected cases, given the risk of infective complications. Discordant presentations between twins are known in congenital toxoplasmosis and CMV, but coinfection has rarely been reported without concurrent immunocompromise. A high index of suspicion should be maintained in the twin of an infected neonate, and the possibility of multiple infections should be considered. Multidisciplinary working is crucial in reaching a diagnosis and treating appropriately.


Subject(s)
Coinfection , Cytomegalovirus Infections , Fetal Diseases , Pregnancy Complications, Infectious , Toxoplasmosis, Congenital , Toxoplasmosis , Cytomegalovirus , Cytomegalovirus Infections/congenital , Female , Fetal Diseases/diagnosis , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Toxoplasmosis, Congenital/diagnosis , Twins, Dizygotic
18.
Front Immunol ; 13: 909011, 2022.
Article in English | MEDLINE | ID: mdl-35784278

ABSTRACT

Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is an infectious disease that poses severe threats to global public health and significant economic losses. The COVID-19 global burden is rapidly increasing, with over 246.53 million COVID-19 cases and 49.97 million deaths reported in the WHO 2021 report. People with compromised immunity, such as tuberculosis (TB) patients, are highly exposed to severe COVID-19. Both COVID-19 and TB diseases spread primarily through respiratory droplets from an infected person to a healthy person, which may cause pneumonia and cytokine storms, leading to severe respiratory disorders. The COVID-19-TB coinfection could be fatal, exacerbating the current COVID-19 pandemic apart from cellular immune deficiency, coagulation activation, myocardial infarction, and other organ dysfunction. This study aimed to assess the pathogenesis of SARS-CoV-2-Mycobacterium tuberculosis coinfections. We provide a brief overview of COVID19-TB coinfection and discuss SARS-CoV-2 host cellular receptors and pathogenesis. In addition, we discuss M. tuberculosis host cellular receptors and pathogenesis. Moreover, we highlight the impact of SARS-CoV-2 on TB patients and the pathological pathways that connect SARS-CoV-2 and M. tuberculosis infection. Further, we discuss the impact of BCG vaccination on SARS-CoV-2 cases coinfected with M. tuberculosis, as well as the diagnostic challenges associated with the coinfection.


Subject(s)
COVID-19 , Coinfection , Mycobacterium tuberculosis , Tuberculosis , Humans , Pandemics , SARS-CoV-2 , Tuberculosis/epidemiology
19.
Poult Sci ; 101(8): 101983, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35793601

ABSTRACT

Enterococci and Escherichia coli are opportunistic pathogens of poultry and are associated with embryo and neonatal chick mortality. We have recently demonstrated that 56% of dead broiler chicken embryos in commercial hatcheries in western Canada were due to the coinfection of Enterococcus species and E. coli. The objective of this study was to investigate the host-pathogen interactions of Enterococcus faecalis and E. coli in developing chicken embryos. Embryonating eggs at 12 d of incubation were dipped in a solution of E. faecalis and/or E. coli for 30 s to expose the eggshell to study the migration and colonization of E. faecalis and E. coli in the internal organs of chicken embryos and subsequent neonatal chicken mortality following hatch. A multidrug-resistant E. faecalis isolate from a dead chicken embryo and an E. faecalis isolate from a case of yolk sac infection were able to colonize the internal organs of chicken embryos rapidly compared to an E. faecalis isolate from a healthy chicken without affecting viability or hatchability of embryos. Although E. faecalis colonized internal organs of chicken embryos, no evidence of inflammation of these organs nor the expression of virulence genes of E. faecalis was observed. Although E. faecalis and E. coli alone did not affect the viability of embryos, a significantly high neonatal chicken mortality (27%) was observed following exposure of embryos to both E. faecalis and E. coli. Upregulation of IL-1 and CXCR4 was evident 48 h before peak mortality of neonatal chickens; this could suggest a possible link of cytokine dysregulation to increased mortality in coinfected neonatal chickens. However, further studies are warranted to investigate this issue vis-à-vis coinfection with E. faecalis and E. coli in chicken embryos and neonatal chickens.


Subject(s)
Coinfection , Escherichia coli Infections , Poultry Diseases , Animals , Chick Embryo , Chickens , Coinfection/veterinary , Enterococcus/genetics , Enterococcus faecalis/genetics , Escherichia coli , Escherichia coli Infections/veterinary , Ovum , Virulence/genetics
20.
Taiwan J Obstet Gynecol ; 61(4): 634-640, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35779913

ABSTRACT

OBJECTIVE: Prematurity is the most important prognostic factor for infants born following preterm premature rupture of membranes (PPROM). Therefore, when PPROM occurs between 22 and 33 weeks of gestation, prolonging pregnancy is recommended. Determination of management strategies requires screening for the presence of intra-amniotic infection or inflammation at the time of PPROM diagnosis. If intra-amniotic infection/inflammation is not detected, it is important to monitor the patient to diagnose any new infection/inflammation. We examined the period from PPROM to secondary intra-amniotic infection/inflammation and associated factors. MATERIALS AND METHODS: This retrospective study was conducted at a single facility. We examined 26 patients who experienced PPROM between 26 and 33 weeks of gestation and were negative for intra-amniotic infection/inflammation at the time of diagnosis and underwent serial amniocentesis. Antibiotic therapy comprising ampicillin, amoxicillin, and clarithromycin for 7 days was started after the first amniocentesis. The period from PPROM to secondary intra-amniotic infection/inflammation was analyzed using a Kaplan-Meier survival curve. The onset of intra-amniotic infection/inflammation was considered as the time at which amniotic fluid bacterial culture results became positive, the time when amniotic fluid Interleukin (IL)-6 increased beyond 2.6 ng/mL, or the day of delivery if histological chorioamnionitis was observed in the delivered placenta. Patients were treated as censored if no intra-amniotic infection/inflammation could be confirmed in the amniotic fluid and delivered placenta. RESULTS: The median time from PPROM to secondary intra-amniotic infection/inflammation was 18 days. Six patients developed intra-amniotic infection/inflammation, while 13 patients without intra-amniotic infections/inflammation delivered fewer than 7 days after PPROM. No confounding factors at the time of PPROM diagnosis were associated with the time from PPROM until secondary intra-amniotic infection/inflammation. CONCLUSIONS: The time between PPROM and onset of secondary intra-amniotic infection/inflammation appears prolonged. Treatments other than antimicrobial agents may need to be added to prolong pregnancy.


Subject(s)
Chorioamnionitis , Coinfection , Fetal Membranes, Premature Rupture , Amniotic Fluid/chemistry , Amniotic Fluid/microbiology , Chorioamnionitis/diagnosis , Female , Fetal Membranes, Premature Rupture/microbiology , Humans , Inflammation/diagnosis , Interleukin-6 , Pregnancy , Retrospective Studies
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