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1.
Viruses ; 13(9)2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34578306

RESUMO

Respiratory tract infections constitute a significant public health problem, with a therapeutic arsenal that remains relatively limited and that is threatened by the emergence of antiviral and/or antibiotic resistance. Viral-bacterial co-infections are very often associated with the severity of these respiratory infections and have been explored mainly in the context of bacterial superinfections following primary influenza infection. This review summarizes our current knowledge of the mechanisms underlying these co-infections between respiratory viruses (influenza viruses, RSV, and SARS-CoV-2) and bacteria, at both the physiological and immunological levels. This review also explores the importance of the microbiome and the pathological context in the evolution of these respiratory tract co-infections and presents the different in vitro and in vivo experimental models available. A better understanding of the complex functional interactions between viruses/bacteria and host cells will allow the development of new, specific, and more effective diagnostic and therapeutic approaches.


Assuntos
Coinfecção , Pneumonia Bacteriana/epidemiologia , Pneumonia Viral/epidemiologia , Gerenciamento Clínico , Suscetibilidade a Doenças , Interações Hospedeiro-Patógeno/imunologia , Humanos , Imunidade Inata , Microbiota , Pneumonia Bacteriana/etiologia , Pneumonia Viral/etiologia , Superinfecção
2.
Ann Intern Med ; 174(8): JC87, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34339227

RESUMO

SOURCE CITATION: Dinh A, Ropers J, Duran C, et al. Discontinuing ß-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet. 2021;397:1195-1203. 33773631.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia Bacteriana , Antibacterianos/efeitos adversos , Infecções Comunitárias Adquiridas/tratamento farmacológico , Método Duplo-Cego , Humanos , Pneumonia Bacteriana/tratamento farmacológico , Resultado do Tratamento , beta-Lactamas/efeitos adversos
3.
Medicine (Baltimore) ; 100(33): e26969, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414967

RESUMO

ABSTRACT: Although pulmonary mycobacterial infection is associated with acute respiratory distress syndrome (ARDS) in critically ill patients, its clinical implication on patients with ARDS has not been clearly elucidated. The aim of study was to investigate the clinical significance of pulmonary mycobacterial infection in patients with ARDS.Between January 2014 and April 2019, medical records of 229 patients with ARDS who met the Berlin criteria and received invasive mechanical ventilation in medical intensive care unit were reviewed. Clinical characteristics and the rate of mortality between patients with and without pulmonary mycobacterial infection were compared. Factors associated with a 28-day mortality were analyzed statistically.Twenty two (9.6%) patients were infected with pulmonary mycobacteria (18 with tuberculosis and 4 with non-tuberculous mycobacteria). There were no differences in baseline characteristics, the severity of illness scores. Other than a higher rate of renal replacement therapy required in those without pulmonary mycobacterial infection, the use of adjunctive therapy did not differ between the groups. The 28- day mortality rate was significantly higher in patients with pulmonary mycobacterial infection (81.8% vs 58%, P = .019). Pulmonary mycobacterial infection was significantly associated with 28-day mortality (hazard ratio 1.852, 95% confidence interval 1.108-3.095, P = .019).Pulmonary mycobacterial infection was associated with increased 28-day mortality in patients with ARDS.


Assuntos
Infecções por Mycobacterium/complicações , Pneumonia Bacteriana/complicações , Síndrome do Desconforto Respiratório/complicações , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/mortalidade , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/mortalidade , Pneumonia Bacteriana/microbiologia , Pneumonia Bacteriana/mortalidade , Síndrome do Desconforto Respiratório/microbiologia , Síndrome do Desconforto Respiratório/mortalidade , Estudos Retrospectivos , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/mortalidade
4.
Medicine (Baltimore) ; 100(32): e26906, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397923

RESUMO

RATIONALE: Mucinous cystadenoma is a benign tumor that is commonly found in the pancreas, ovaries, or appendix, but is rarely encountered in the lungs. Worldwide, only a few reported cases of these tumors originate in the lungs. Herein, we analyzed the imaging features of a case of pulmonary mucinous cystadenoma (PMCA). To the best of our knowledge, this is the first reported case of PMCA complicated by significant infection. PATIENT CONCERNS: A 57-year-old man was admitted to our hospital with blood in sputum for more than 2 months. Serum laboratory examination showed significantly elevated leukocyte and tumor marker, carcinoembryonic antigen. Enhanced thoracic computed tomography and whole-body positron emission tomography/computed tomography showed a cystic-solid ill-defined mass in the right upper lung. DIAGNOSIS: The tumor was considered malignant, both clinically and radiologically. INTERVENTIONS: The patient underwent right upper lobe tumor resection and mediastinal lymph node dissection. OUTCOMES: Postoperative specimen pathology was diagnosed as PMCA with infection. The patient was not administered any further treatment. The patient was alive without any recurrence or metastasis of the tumor after 2 years of follow-up. LESSONS: Preoperative diagnosis of PMCA with atypical imaging and clinical manifestations is extremely difficult. This is the first reported case of PMCA complicated by a significant infection that was misdiagnosed preoperatively as a malignancy.


Assuntos
Cistadenoma Mucinoso/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmão/diagnóstico por imagem , Pneumonia Bacteriana/diagnóstico , Cistadenoma Mucinoso/complicações , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/complicações , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Doenças Raras , Tomografia Computadorizada por Raios X
5.
J Immunol ; 207(4): 1112-1127, 2021 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-34341173

RESUMO

Klebsiella pneumoniae is a common cause of Gram-negative pneumonia. The spread of antibiotic-resistant and hypervirulent strains has made treatment more challenging. This study sought to determine the immunomodulatory, antibacterial, and therapeutic potential of purified murine stem cell Ag-1+ (Sca-1+) lung mesenchymal stem cells (LMSCs) using in vitro cell culture and an in vivo mouse model of pneumonia caused by K pneumoniae. Sca-1+ LMSCs are plastic adherent, possess colony-forming capacity, express mesenchymal stem cell markers, differentiate into osteogenic and adipogenic lineages in vitro, and exhibit a high proliferative capacity. Further, these Sca-1+ LMSCs are morphologically similar to fibroblasts but differ ultrastructurally. Moreover, Sca-1+ LMSCs have the capacity to inhibit LPS-induced secretion of inflammatory cytokines by bone marrow-derived macrophages and neutrophils in vitro. Sca-1+ LMSCs inhibit the growth of K pneumoniae more potently than do neutrophils. Sca-1+ LMSCs also possess the intrinsic ability to phagocytize and kill K. pneumoniae intracellularly. Whereas the induction of autophagy promotes bacterial replication, inhibition of autophagy enhances the intracellular clearance of K. pneumoniae in Sca-1+ LMSCs during the early time of infection. Adoptive transfer of Sca-1+ LMSCs in K. pneumoniae-infected mice improved survival, reduced inflammatory cells in bronchoalveolar lavage fluid, reduced inflammatory cytokine levels and pathological lesions in the lung, and enhanced bacterial clearance in the lung and in extrapulmonary organs. To our knowledge, these results together illustrate for the first time the protective role of LMSCs in bacterial pneumonia.


Assuntos
Infecções por Klebsiella , Células-Tronco Mesenquimais , Pneumonia Bacteriana , Animais , Klebsiella , Klebsiella pneumoniae , Pulmão , Camundongos
6.
Pan Afr Med J ; 38: 412, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381556

RESUMO

Non-tuberculous mycobacteria are uncommon pathogens in immunocompetent individuals. We report an unusual case of pneumonia with pleural effusion caused by co-infection with two species of non-tuberculous mycobacteria in an immunocompetent man in Nigeria. The case highlights the possibility of the occurrence of a disease caused by these pathogens in an unusual host in a setting where they are rarely isolated as well as the challenges faced in diagnosis.


Assuntos
Infecções por Mycobacterium não Tuberculosas/diagnóstico , Micobactérias não Tuberculosas/isolamento & purificação , Derrame Pleural/diagnóstico , Pneumonia Bacteriana/diagnóstico , Adulto , Humanos , Masculino , Infecções por Mycobacterium não Tuberculosas/microbiologia , Nigéria , Derrame Pleural/microbiologia , Pneumonia Bacteriana/microbiologia
7.
Medicine (Baltimore) ; 100(31): e26897, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397866

RESUMO

ABSTRACT: Although complication with non-mycobacterial pneumonia among patients with pulmonary tuberculosis (TB) may lead to poor prognosis, discrimination between TB complicated with and without non-mycobacterial pneumonia using radiological imaging has not been fully elucidated. We aimed to clarify the differences in chest computed tomography (CT) features between pulmonary TB patients with culture-positive and culture-negative sputum for non-mycobacteria.We retrospectively included consecutive patients admitted to our hospital from January 2013 to December 2015 for bacteriologically-confirmed pulmonary TB, who were tested by sputum culture for non-mycobacteria, and who underwent chest CT within 2 weeks before or after admission. Chest CT features were compared between pulmonary TB patients who had positive non-mycobacterial cultures and in those who had not.Of 202 patients with pulmonary TB, 186 (92%) were tested by sputum culture for non-mycobacteria and underwent chest CT. Among these, non-mycobacteria were isolated in 118 patients (63%), while 68 patients (37%) had negative cultures. Patients with a positive culture for non-mycobacteria were significantly older and had lower levels of physical activity and albumin, higher levels of C-reactive protein, and a greater number of respiratory failures. By CT, emphysematous lesions, ground-glass opacities, airspace consolidation, air-bronchogram, interlobular septal thickening, bronchiectasis, pleural effusion, pleural thickening, and lymph node enlargement were more frequently in patients with a positive culture for non-mycobacteria. These chest CT features could be helpful for detecting complication with non-mycobacterial pneumonia in patients with pulmonary TB.


Assuntos
Antibacterianos/uso terapêutico , Pulmão/diagnóstico por imagem , Pneumonia Bacteriana , Escarro/microbiologia , Tomografia Computadorizada por Raios X/métodos , Tuberculose Pulmonar , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/epidemiologia , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Bacteriana/epidemiologia , Prognóstico , Estudos Retrospectivos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia
8.
Pulm Med ; 2021: 6680232, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336282

RESUMO

Introduction: The SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test is useful for diagnosing COVID-19, and the RT-PCR positive rate is an important indicator for estimating the incidence rate and number of infections. COVID-19 pneumonia is also associated with characteristic findings on chest CT, which can aid in diagnosis. Methods: We retrospectively evaluated patient background characteristics, the number of cases, the positivity rate, and chest CT findings for positive and negative cases in 672 patients who underwent RT-PCR for suspected COVID-19 at our hospital between April 3 and August 28, 2020. In addition, we compared trends in the positive rates at approximately weekly intervals with trends in the number of new infections in Machida City, Tokyo. Results: The study included 323 men and 349 women, with a median age of 46 years (range: 1 month-100 years). RT-PCR findings were positive in 37 cases, and the positive rate was 5.51%. Trends in the positive rate at our hospital and the number of new COVID-19 cases in the city were similar during the study period. Among patients with positive results, 15 (40.5%) had chest CT findings, and 14 had bilateral homogeneous GGOs. Among patients with negative results, 190 had chest CT findings at the time of examination, and 150 were diagnosed with bacterial pneumonia or bronchitis, with main findings consisting of consolidations and centrilobular opacities. Only 11 of these patients exhibited bilateral homogeneous GGOs. Conclusion: Bilateral homogeneous GGOs are characteristic of COVID-19 pneumonia and may aid in the diagnosis of COVID-19.


Assuntos
COVID-19/diagnóstico por imagem , SARS-CoV-2/isolamento & purificação , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bronquite/diagnóstico por imagem , COVID-19/diagnóstico , Criança , Pré-Escolar , Feminino , Hospitais Municipais , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/diagnóstico por imagem , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tóquio , Adulto Jovem
9.
Washington, D.C.; PAHO; 2021-08-10.
em Espanhol | PAHO-IRIS | ID: phr-54637

RESUMO

The field guide on Surveillance of Bacterial Pneumonia and Meningitis in Children Aged Under 5 Years has become an important reference manual for health professionals in the Region of the Americas involved in epidemiological surveillance. It provides information on diseases, principal etiologic agents, available vaccines, laboratory procedures, and surveillance activities to detect and monitor cases, as well as data analysis to generate relevant information. This second edition describes some new developments as well as updating procedures to reflect advances in molecular testing for laboratory diagnoses and the availability of new vaccines.


Assuntos
Imunização , Vigilância , Pneumonia Bacteriana , Meningite , Meningites Bacterianas , Vigilância em Saúde Pública , Epidemiologia , Vacinas , Pneumonia
10.
Diagn Microbiol Infect Dis ; 101(3): 115477, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34358876

RESUMO

The aim of this study is to review bacterial isolates from respiratory samples of patients with severe COVID-19 disease during the first 2 months of the first wave in our hospital. A single-center retrospective observational study in critically ill adult patients was performed. A total of 1251 respiratory samples from 1195 patients were processed. Samples from 66 patients (5.52%) were determined to be microbiologically significant by a semi-quantitative culture. All patients received broad spectrum antibiotherapy as an empirical treatment. The isolated bacteria were mainly Enterobacterales followed by Staphylococcus aureus and Pseudomonas aeruginosa. Bacterial co-infections in ICU stay could seem not dependent on the virus that has produced the viral pneumonia similarly as with other respiratory viruses such as Influenza virus.


Assuntos
COVID-19/complicações , Coinfecção/diagnóstico , Pneumonia Bacteriana/complicações , Centros de Atenção Terciária , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
11.
Diagn Microbiol Infect Dis ; 101(3): 115507, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34364096

RESUMO

The FilmArray Pneumonia Panel has proven to be an effective tool for rapid detection of main respiratory pathogens. However, its rational use needs appropriate knowledge and formation regarding its indication and interpretation. Herein, we provide some advices to help with success of its daily routine use, particularly in critically ill ventilated COVID-19 patients. Clinical Trial registration number: NCT04453540.


Assuntos
COVID-19/complicações , Estado Terminal , Técnicas de Diagnóstico Molecular/métodos , Pneumonia Bacteriana/complicações , Respiração Artificial , SARS-CoV-2 , Algoritmos , Coinfecção/diagnóstico , Humanos , Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/microbiologia
12.
Medicine (Baltimore) ; 100(27): e26514, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232184

RESUMO

RATIONALE: Chlamydia psittaci (C psittaci) is a gram-negative obligate intracellular parasite, with birds as main hosts. The main route of infection in humans is inhalation of aerosols from contaminated animal excreta through the respiratory tract. The main manifestation of C psittaci infection is pneumonia. Patients suffering from severe infection are prone to sepsis and multiple organ failure. We report a case of simultaneous detection of C psittaci in blood and bronchoalveolar lavage fluid using metagenomic next-generation sequencing (mNGS) technology. PATIENT CONCERNS: The 71-year-old male patient was a farmer with a long history of raising poultry and initial symptoms of fever and muscle pain accompanied by limb weakness and paroxysmal cough. DIAGNOSES: The patient was diagnosed with sepsis, severe pneumonia, and multiple organ failure. INTERVENTIONS: Anti-infective therapy with doxycycline and meropenem was applied. OUTCOMES: The patient's body temperature and infection indicators improved and the chest X-ray findings showed the amelioration of lesions after 18 days of treatment. The patient was discharged without treatment on hospital day 19 due to financial constraints and subsequently died after 7 days. LESSONS: mNGS is an excellent diagnostic tool when specific pathogens are undetected by traditional assays.


Assuntos
Líquido da Lavagem Broncoalveolar/microbiologia , Chlamydophila psittaci/genética , Metagenômica/métodos , Pneumonia Bacteriana/diagnóstico , Psitacose/diagnóstico , Idoso , Chlamydophila psittaci/isolamento & purificação , Humanos , Masculino , Pneumonia Bacteriana/microbiologia , Psitacose/microbiologia
13.
Br J Anaesth ; 127(3): 405-414, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34229832

RESUMO

BACKGROUND: Allogeneic red blood cell (RBC) transfusion can induce immunosuppression, which can then increase the susceptibility to postoperative infection. However, studies in different types of surgery show conflicting results regarding this effect. METHODS: In this retrospective cohort study conducted in a tertiary referral centre, we included adult patients undergoing clean-contaminated surgery from 2014 to 2018. Patients who received allogeneic RBC transfusion from preoperative Day 30 to postoperative Day 30 were included into the transfusion group. The control group was matched for the type of surgery in a 1:1 ratio. The primary outcome was infection within 30 days after surgery, which was defined by healthcare-associated infection, and identified mainly based on antibiotic regimens, microbiology tests, and medical notes. RESULTS: Among the 8098 included patients, 1525 (18.8%) developed 1904 episodes of postoperative infection. Perioperative RBC transfusion was associated with an increased risk of postoperative infection after controlling for 27 confounders by multivariable regression analysis (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.39-1.84; P<0.001) and propensity score weighing (OR: 1.64; 95% CI: 1.45-1.85; P<0.001) and matching (OR: 1.70; 95% CI: 1.43-2.01; P<0.001), and a dose-response relationship was observed. The transfusion group also showed higher risks of surgical site infection, pneumonia, bloodstream infection, multiple infections, intensive care admission, unplanned reoperation, prolonged postoperative length of hospital stay, and all-cause death. CONCLUSIONS: Perioperative allogeneic RBC transfusion is associated with an increased risk of infection after clean-contaminated surgery in a dose-response manner. Close monitoring of infections and enhanced prophylactic strategies should be considered after transfusion.


Assuntos
Infecções Bacterianas/microbiologia , Transfusão de Eritrócitos/efeitos adversos , Hospedeiro Imunocomprometido , Assistência Perioperatória/efeitos adversos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Antibacterianos/uso terapêutico , Bacteriemia/imunologia , Bacteriemia/microbiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/imunologia , Infecções Bacterianas/mortalidade , Cuidados Críticos , Transfusão de Eritrócitos/mortalidade , Humanos , Tempo de Internação , Readmissão do Paciente , Assistência Perioperatória/mortalidade , Pneumonia Bacteriana/imunologia , Pneumonia Bacteriana/microbiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Procedimentos Cirúrgicos Operatórios/mortalidade , Infecção da Ferida Cirúrgica/imunologia , Infecção da Ferida Cirúrgica/microbiologia , Fatores de Tempo , Transplante Homólogo/efeitos adversos , Resultado do Tratamento
14.
J Infect Public Health ; 14(10): 1381-1388, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34215561

RESUMO

BACKGROUND: The characteristics, outcomes, and risk factors for in-hospital death of critically ill intensive care unit (ICU) patients with coronavirus disease-2019 (COVID-19) have been described in patients from Europe, North America and China, but there are few data from COVID-19 patients in Middle Eastern countries. The aim of this study was to investigate the characteristics, outcomes, and risk factors for in-hospital death of critically ill patients with COVID-19 pneumonia admitted to the ICUs of a University Hospital in Egypt. METHODS: Retrospective analysis of patients with COVID-19 pneumonia admitted between April 28 and July 29, 2020 to two ICUs dedicated to the isolation and treatment of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Cairo University Hospitals. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples and radiologic evidence of pneumonia. RESULTS: Of the 177 patients admitted to the ICUs during the study period, 160 patients had COVID-19 pneumonia and were included in the analysis (mean age: 60 ± 14 years, 67.5% males); 23% of patients had no known comorbidities. The overall ICU and hospital mortality rates were both 24.4%. The ICU and hospital lengths of stay were 7 (25-75% interquartile range: 4-10) and 10 (25-75% interquartile range: 7-14) days, respectively. In a multivariable analysis with in-hospital death as the dependent variable, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death, whereas greater PaO2/FiO2 ratio on admission to the ICU was associated with a lower risk. CONCLUSION: In this cohort of critically ill patients with COVID-19 pneumonia, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death.


Assuntos
COVID-19 , Pneumonia Bacteriana , Idoso , Egito/epidemiologia , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
15.
Clin Nutr ESPEN ; 44: 204-210, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34330467

RESUMO

BACKGROUND & AIMS: Amino acids play an important role in immune responses and as neurotransmitters. During the course of a bacterial pneumonia episode, from the onset to the recovery phase, immune responses dramatically change, as does the metabolism of amino acids, a concept referred to as immuno-nutrition. We investigated the differences in plasma amino acid levels (PAA) between the acute and recovery phases in individuals with community-acquired pneumonia (CAP) and healthy controls. METHODS: Two groups of participants were recruited: Healthy adults aged over 60 years and patients hospitalized with CAP. Samples were collected on Day 0 (the day of admission) and Day 7 (after 6-8 days treatment). RESULTS: A total of 93 healthy adults and 60 patients with CAP participated in the study. Of those with CAP, 43 had their amino acids measured on Day 7. Patients with CAP had markedly decreased PAA of 12 amino acids on Day 0. Citrulline, histidine, and tryptophan remained low in male, while aspartic acid, asparagine, ornithine, proline, and threonine were higher on Day 7 in both males and females. Phenylalanine increased at Day 0 and Day7. CONCLUSIONS: The findings suggest that the host response against bacterial infection changed the plasma amino acid levels. PAA on Day 7 (representing convalescence) continued to display an amino acid profile distinct from that observed in healthy individuals. Based on these findings, reconsideration for providing amino acids to patients with bacterial pneumonia should be needed depending on stage of the pneumonia from the perspective of immuno-nutrition.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia Bacteriana , Citrulina , Feminino , Hospitalização , Humanos , Masculino , Estado Nutricional
16.
Diagn Microbiol Infect Dis ; 101(3): 115476, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34303085

RESUMO

Among critically ill COVID-19 patients, bacterial coinfections may occur, and timely appropriate therapy may be limited with culture-based microbiology due to turnaround time and diagnostic yield challenges (e.g. antibiotic pre-exposure). We performed a systematic review and meta-analysis of the impact of BioFire® FilmArray® Pneumonia Panel in detecting bacteria and clinical management among critically ill COVID-19 patients admitted to the ICU. Seven studies with 558 patients were included. Antibiotic use before respiratory sampling occurred in 28-79% of cases. The panel incidence of detections was 33% (95% CI 0.25 to 0.41, I2=32%) while culture yielded 18% (95% CI 0.02 to 0.45; I2=93%). The panel was associated with approximately a 1 and 2 day decrease in turnaround for identification and common resistance targets, respectively. The panel may be an important tool for clinicians to improve antimicrobial use in critically ill COVID-19 patients.


Assuntos
COVID-19/complicações , COVID-19/patologia , Coinfecção/diagnóstico , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/diagnóstico , SARS-CoV-2/isolamento & purificação , Estado Terminal , Humanos , Técnicas de Diagnóstico Molecular , Pneumonia Bacteriana/microbiologia , Sensibilidade e Especificidade
17.
Nucleic Acids Res ; 49(12): 6756-6770, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34139014

RESUMO

The ability to fine tune global gene expression in response to host environment is critical for the virulence of pathogenic bacteria. The host temperature is exploited by the bacteria as a cue for triggering virulence gene expression. However, little is known about the mechanism employed by Pseudomonas aeruginosa to response to host body temperature. CspA family proteins are RNA chaperones that modulate gene expression. Here we explored the functions of P. aeruginosa CspA family proteins and found that CspC (PA0456) controls the bacterial virulence. Combining transcriptomic analyses, RNA-immunoprecipitation and high-throughput sequencing (RIP-Seq), we demonstrated that CspC represses the type III secretion system (T3SS) by binding to the 5' untranslated region of the mRNA of exsA, which encodes the T3SS master regulatory protein. We further demonstrated that acetylation at K41 of the CspC reduces its affinity to nucleic acids. Shifting the culture temperature from 25°C to 37°C or infection of mouse lung increased the CspC acetylation, which derepressed the expression of the T3SS genes, resulting in elevated virulence. Overall, our results identified the regulatory targets of CspC and revealed a regulatory mechanism of the T3SS in response to temperature shift and host in vivo environment.


Assuntos
Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Regulação Bacteriana da Expressão Gênica , Proteínas de Choque Térmico/metabolismo , Pseudomonas aeruginosa/genética , Transativadores/genética , Sistemas de Secreção Tipo III/genética , Células A549 , Acetilação , Animais , Proteínas de Bactérias/biossíntese , Humanos , Camundongos , Pneumonia Bacteriana/microbiologia , Regiões Promotoras Genéticas , Biossíntese de Proteínas , Pseudomonas aeruginosa/metabolismo , Pseudomonas aeruginosa/patogenicidade , Transativadores/biossíntese , Virulência
18.
J Biomed Nanotechnol ; 17(6): 1217-1228, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34167634

RESUMO

Herein, we have designed and developed a heteromultivalent chitosan base α-Fe2O3/Gadofullerene (GdF) hybrid composite through a simple chemical precipitation method. Unlike other methods, the addition of external stabilizing agents to generate GdF nanoparticles (NPs) was not necessary herein. The prepared chitosan-α-Fe2O3/GdF hybrid nanocomposites were characterized using UV, FT-IR, XRD and morphological microscopic analyses. The results showed that α-Fe2O3 and GdF hybrid nanocomposites were successfully grown on the surface of chitosan. The FT-IR vibration peaks showed the formation of Fe2O3 NPs, and the vibration peak for Fe-O was 568 cm-1. The broad absorption peak observed in the range of 250-350 nm and a sharp absorption peak at 219 nm represents the UV absorption of the synthesized hybrid composites. XRD pattern showed sharp peaks of crystallinity and purity of α-Fe2O3 nanoparticles. Finally, the synthesized chitosan-α-Fe2O3/GdF hybrid composites were screened for their antibacterial resistance against the Escherichia coli, Pseudomonas aeruginosa, Bacilus subtilis, and Staphylococcus aereus. In addition, in vitro biocompatibility results exhibited that developed hybrid samples have provided high cell compatibility with fibroblast (L929) cell line. The in vivo bio inspired nanotherapeutics have the potential action to effective inhibition ability on antibiotic-resistant P. aeruginosa, which has been main factor of inducing pneumonia. In conclusion, we expect biomimicking systems combined with the effective antibacterial agent could be the suitable next generation therapeutic potential factors for prevention and treatment of antibiotic-resistant pneumonia.


Assuntos
Quitosana , Pneumonia Bacteriana , Antibacterianos/farmacologia , Compostos Férricos , Fulerenos , Humanos , Espectroscopia de Infravermelho com Transformada de Fourier
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