Infektiöse Endokarditis

2019 ◽  
Vol 144 (02) ◽  
pp. 114-127
Author(s):  
Fabian Knebel ◽  
David Frumkin ◽  
Frank Flachskampf
Keyword(s):  
Infective Endocarditis ◽  
High Mortality ◽  
Mortality Rates ◽  
Bacterial Disease ◽  
Infektiöse Endokarditis ◽  
Mortality And Morbidity ◽  
Diagnosis And Therapy ◽  
Management Problems ◽  
Therapeutic Recommendations ◽  
Cardiac Implants

AbstractInfective endocarditis is a severe, mostly bacterial disease characterized by high mortality and morbidity. Both diagnosis and therapy are difficult, and mortality rates have not improved over decades. We review diagnostic and management problems, the disease's modern face in the era of widespread cardiac implants and valve interventions, and current diagnostic and therapeutic recommendations.

scholarly journals Surgical treatment of infective endocarditis in intravenous drug abusers

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alina Zubarevich ◽  
Marcin Szczechowicz ◽  
Anja Osswald ◽  
Jerry Easo ◽  
Arian Arjomandi Rad ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Drug Abuse ◽  
Infective Endocarditis ◽  
Mortality Rates ◽  
Blood Cultures ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Enterococcus Species ◽  
Function Impairment

Abstract Background Despite current progress in antibiotic therapy and medical management, infective endocarditis remains a serious condition presenting with high mortality rates. It also is a life-threatening complication in patients with a history of chronic intravenous drug abuse. In this study, we analyzed our institutional experience on the surgical therapy of infective endocarditis in patients with active intravenous drug abuse. The aim of the study is to identify the predictive factors of mortality and morbidity in this subgroup of patients. Methods Between 2007 and 2020, a total of 24 patients (7 female, mean age 38.5 ± 8.7) presenting with active intravenous drug abuse underwent a surgical treatment for the infective endocarditis at out center. The primary endpoint was survival at 30th day after the surgery. The secondary composite endpoint included freedom from death, recurrent endocarditis, re-do surgery, and postoperative stroke during the follow-up period. Mean follow-up was 4.2 ± 4.3 years. Results Staphylococcus species was the most common pathogen detected in the preoperative blood cultures. Infection caused by Enterococcus species as well as liver function impairment were identified as mortality predictor factors. Logistic EuroSCORE and EusoSCORE-II were also predictive factors for mortality in univariate analysis. Survival at 1 and 3 years was 78 and 72% respectively. Thirty-day survival was 88%. 30-day freedom from combined endpoint was 83% and after 1 and 3 years, 69 and 58% of the patients respectively were free from combined endpoint. Five patients (20.8%) were readmitted with recurrent infective endocarditis. Conclusion In patients presenting with active intravenous drug abuse, treatment of infective endocarditis should be performed as aggressively as possible and should be followed by antibiotic therapy to avoid high mortality rates and recurrent endocarditis. Early intervention is advisable in patients with an infective endocarditis and enterococcus species in the preoperative blood cultures, liver function deterioration as well as cardiac function impairment. Attention should be also payed to addiction treatment, due to the elevated relapse rate in patients who actively inject drugs. However, larger prospective studies are necessary to support our results. As septic shock is the most frequent cause of death, new treatment options, e.g. blood purification should be evaluated.

scholarly journals Antibiotic-Resistant Bacteria in Green Turtle (Chelonia mydas) Rearing Seawater

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1841
Author(s):  
Thanaporn Chuen-Im ◽  
Korapan Sawetsuwannakun ◽  
Pimmnapar Neesanant ◽  
Nakarin Kitkumthorn
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infection ◽  
High Mortality ◽  
Mortality Rates ◽  
Sea Turtle ◽  
Resistant Isolate ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Increased Risk

Antibiotic resistance of microorganisms is a serious health problem for both humans and animals. Infection of these bacteria may result in therapy failure, leading to high mortality rates. During an early intervention program process, the Sea Turtle Conservation Center of Thailand (STCCT) has faced high mortality rates due to bacterial infection. Previously, investigation of juvenile turtle carcasses found etiological agents in tissue lesions. Further determination of sea water in the turtle holding tanks revealed a prevalence of these causative agents in water samples, implying association of bacterial isolates in rearing water and infection in captive turtles. In this study, we examined the antibiotic resistance of bacteria in seawater from the turtle holding tank for a management plan of juvenile turtles with bacterial infection. The examination was carried out in three periods: 2015 to 2016, 2018, and 2019. The highest isolate numbers were resistant to beta-lactam, whilst low aminoglycoside resistance rates were observed. No gentamicin-resistant isolate was detected. Seventy-nine isolates (71.17%) were resistant to at least one antibiotic. Consideration of resistant bacterial and antibiotic numbers over three sampling periods indicated increased risk of antibiotic-resistant bacteria to sea turtle health. Essentially, this study emphasizes the importance of antibiotic-resistant bacterial assessment in rearing seawater for sea turtle husbandry.

scholarly journals Molecular Insights into the Fungus-Specific Serine/Threonine Protein Phosphatase Z1 in Candida albicans

mBio ◽  
2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Emily Chen ◽  
Meng S. Choy ◽  
Katalin Petrényi ◽  
Zoltán Kónya ◽  
Ferenc Erdődi ◽  
...  
Keyword(s):  
Candida Albicans ◽  
High Mortality ◽  
Protein Phosphatase ◽  
Cyclic Peptide ◽  
Fungal Infections ◽  
The United States ◽  
Mortality Rates ◽  
Regulatory Proteins ◽  
Structural Elements ◽  
Novel Targets

ABSTRACT The opportunistic pathogen Candida is one of the most common causes of nosocomial bloodstream infections. Because candidemia is associated with high mortality rates and because the incidences of multidrug-resistant Candida are increasing, efforts to identify novel targets for the development of potent antifungals are warranted. Here, we describe the structure and function of the first member of a family of protein phosphatases that is specific to fungi, protein phosphatase Z1 (PPZ1) from Candida albicans . We show that PPZ1 not only is active but also is as susceptible to inhibition by the cyclic peptide inhibitor microcystin-LR as its most similar human homolog, protein phosphatase 1α (PP1α [GLC7 in the yeast Saccharomyces cerevisiae ]). Unexpectedly, we also discovered that, despite its 66% sequence identity to PP1α, the catalytic domain of PPZ1 contains novel structural elements that are not present in PP1α. We then used activity and pulldown assays to show that these structural differences block a large subset of PP1/GLC7 regulatory proteins from effectively binding PPZ1, demonstrating that PPZ1 does not compete with GLC7 for its regulatory proteins. Equally important, these unique structural elements provide new pockets suitable for the development of PPZ1-specific inhibitors. Together, these studies not only reveal why PPZ1 does not negatively impact GLC7 activity in vivo but also demonstrate that the family of fungus-specific phosphatases—especially PPZ1 from C. albicans —are highly suitable targets for the development of novel drugs that specifically target C. albicans without cross-reacting with human phosphatases. IMPORTANCE Candida albicans is a medically important human pathogen that is the most common cause of fungal infections in humans. In particular, approximately 46,000 cases of health care-associated candidiasis occur each year in the United States. Because these infections are associated with high mortality rates and because multiple species of Candida are becoming increasingly resistant to antifungals, there are increasing efforts to identify novel targets that are essential for C. albicans virulence. Here we use structural and biochemical approaches to elucidate how a member of a fungus-specific family of enzymes, serine/threonine phosphatase PPZ1, functions in C. albicans . We discovered multiple unique features of PPZ1 that explain why it does not cross-react with, and in turn compete for, PP1-specific regulators, a long-standing question in the field. Most importantly, however, these unique features identified PPZ1 as a potential target for the development of novel antifungal therapeutics that will provide new, safe, and potent treatments for candidiasis in humans.

scholarly journals The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis: a propensity analysis

2009 ◽  
Vol 32 (16) ◽  
pp. 2027-2033 ◽  
Author(s):  
F. Thuny ◽  
S. Beurtheret ◽  
J. Mancini ◽  
V. Gariboldi ◽  
J.-P. Casalta ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Timing Of Surgery ◽  
Mortality And Morbidity ◽  
Propensity Analysis

scholarly journals How should an IACUC handle high mortality rates?

Lab Animal ◽  
2016 ◽  
Vol 45 (10) ◽  
pp. 355-355
Author(s):  
Jerald Silverman
Keyword(s):  
High Mortality ◽  
Mortality Rates

scholarly journals Advances on Greener Asymmetric Synthesis of Antiviral Drugs via Organocatalysis

2021 ◽  
Vol 14 (11) ◽  
pp. 1125
Author(s):  
Everton M. da Silva ◽  
Hérika D. A. Vidal ◽  
Arlene G. Corrêa
Keyword(s):  
Pharmaceutical Industry ◽  
Antiviral Activity ◽  
Asymmetric Synthesis ◽  
High Mortality ◽  
Viral Infections ◽  
Mortality Rates ◽  
Chiral Drugs ◽  
Stereogenic Centers ◽  
Synthetic Routes ◽  
New Compounds

Viral infections cause many severe human diseases, being responsible for remarkably high mortality rates. In this sense, both the academy and the pharmaceutical industry are continuously searching for new compounds with antiviral activity, and in addition, face the challenge of developing greener and more efficient methods to synthesize these compounds. This becomes even more important with drugs possessing stereogenic centers as highly enantioselective processes are required. In this minireview, the advances achieved to improve synthetic routes efficiency and sustainability of important commercially antiviral chiral drugs are discussed, highlighting the use of organocatalytic methods.

scholarly journals The nanocomposite fullerol reduces oxidative stress, pulmonary injury, and mortality in a rat model of acute lung injury

2021 ◽  
Author(s):  
Rosária Aires ◽  
Ildernandes Vieira-Alves ◽  
Leda Maria Coimbra-Campos ◽  
Marina Ladeira ◽  
Teresa Socarras ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
High Mortality ◽  
Therapeutic Potential ◽  
Ex Vivo ◽  
Mortality Rates ◽  
Kaplan Meier ◽  
Pulmonary Damage

BACKGROUND AND PURPOSE Acute lung injury (ALI) is a critical disorder that has high mortality rates, and pharmacological therapies are so far ineffective. The pathophysiology of ALI involves pulmonary oxidative stress and inflammatory response. Fullerol is a carbon nanocomposite that possesses antioxidant and anti-inflammatory properties. Here, we evaluated the therapeutic potential of fullerol and its mechanisms in a model of paraquat-induced ALI. EXPERIMENTAL APPROACH Rats were divided into ALI (paraquat alone), fullerol (paraquat plus fullerol), and control groups. Survival curves were estimated using the Kaplan-Meier method. The myeloperoxidase assay, ELISA, and hematoxylin and eosin staining were used to determine neutrophils infiltration, cytokines production, and histopathological parameters in lung samples, respectively. The antioxidant effect of fullerol was evaluated in vitro and ex vivo. KEY RESULTS Fullerol (0.01 to 0.3 mg/kg) markedly reduced the severe lung injury and high mortality rates observed in ALI rats. Moreover, fullerol (0.03 mg/kg) inhibited the reactive oxygen species formation and lipid peroxidation seen in lungs from ALI rats, and exhibited a potent concentration-dependent (10 to 10 mg/ml) in vitro antioxidant activity. Importantly, fullerol (0.03 mg/kg) inhibited neutrophils accumulation in bronchoalveolar lavage and lungs, and the increase in pulmonary levels of TNF-α, IL-1β, IL-6, and CINC-1 in ALI rats. CONCLUSIONS AND IMPLICATIONS Fullerol treatment was effective in reducing pulmonary damage and ALI-induced mortality, highlighting its therapeutic potential in an ALI condition. Searching for new pharmacological therapies to treat ALI may be desirable especially in view of the new coronavirus disease 2019 that currently plagues the world.

scholarly journals Abdominal surgery in autoimmune and autoimmune-related diseases: A review

2021 ◽  
Vol 6 (2) ◽  
pp. 76-87
Author(s):  
Erdal Uysal ◽  
◽  
Mehmet Dokur ◽  
Gokturk Maralcan
Keyword(s):  
Autoimmune Disease ◽  
Early Detection ◽  
Abdominal Surgery ◽  
Autoimmune Diseases ◽  
High Mortality ◽  
Indirect Effects ◽  
Mortality And Morbidity ◽  
Abdominal Organs ◽  
The Relationship ◽  
Significant Mortality

Autoimmune diseases can have a widespread effect throughout the system and can cause high mortality and morbidity, depending on their involvement in the abdominal organs and systems. Most of the abdominal organs are damaged as a result of the direct or/ and indirect effects of autoimmune diseases. Therefore, abdominal surgeries should be performed to eliminate any complications related to these effects. There could be a significant relationship between abdominal surgery and autoimmune and autoimmune-related diseases. The aim of this study was to reveal the possible relationship between autoimmune and autoimmune-related diseases that cause significant mortality and morbidity. In this way, we further aimed at increasing the awareness of clinicians on this subject, along with providing them with the related publications on autoimmune and autoimmune-related diseases and abdominal surgery. Taking all these into consideration, autoimmune and autoimmune-related diseases can also influence the abdominal organs. The influence may be directly related to the involvement of the organ and system as a result of the autoimmune disease or indirectly related to the influence of the organs and systems. Such influence leading to complications may require urgent or elective abdominal surgery, which can further cause high mortality and morbidity. Therefore, it is significant for all clinicians, especially surgeons, to be aware of the relationship between autoimmune diseases and abdominal surgery. The early detection and treatment of the complications related to the abdominal involvement of autoimmune and autoimmune-related diseases could decrease mortality and morbidity.

scholarly journals Phylogenetic analysis of canine parvoviruses from Turkey

2020 ◽  
Vol 76 (01) ◽  
pp. 6334-2020
Author(s):  
ZEYNEP AKKUTAY-YOLDAR ◽  
TAYLAN KOÇ B.
Keyword(s):  
High Mortality ◽  
Phylogenetic Trees ◽  
Clinical Symptoms ◽  
Phylogenetic Analyses ◽  
Canine Parvovirus ◽  
Mortality And Morbidity ◽  
Identity Match ◽  
Genomic Characterization

Canine parvovirus (CPV) type 2 is the causative agent of acute hemorrhagic enteritis and high mortality in the affected dogs. Numerous studies have been done to understand the origin of the virus and to exhibit new variants and circulating strains. This report describes the detection and genomic characterization of CPV strains from indoor and outdoor dogs in Ankara, Turkey. Samples were sent to our laboratory due to clinical symptoms in puppies. We tested blood and swab samples to determine the presence of canine parvovirus (CPV) in three puppies and two adult dogs by reverse transcription-polymerase chain reaction (RT-PCR) using VP2 (capsid protein) region primers of canine parvoviruses. Following that, to provide molecular characterization data Maximum Likelihood (ML) method was used for phylogenetic analyses. Constructed phylogenetic trees from the aligned nucleotide sequences revealed that our CPV strains demonstrated high genetic similarities, with 100% identity match on nucleotide alignments with each other and classified in CPV-2b genotypes.They have placed on a monophyletic clade as a sister branch with CPV VAC S quantum with 98.9% nucleotide homology. Our findings suggest that CPV-2b is actual and frequently seen variant in Turkey and shows high similarities with other CPV variants and a bit less with FPVs in Turkey and around the world. CPV causes high mortality and morbidity in dogs and to develop effective vaccines for protection of dogs in Turkey where there are few numbers of studies that have been done, field strains should be isolated and characterised.

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