Diagnostic accuracy of the 1,3-β-D-glucan test for pneumocystis pneumonia in a tertiary university hospital in Denmark: A retrospective study

Abstract 1,3-β-D-glucan (BG), a cell-wall component of most fungi including Pneumocystis (PC), is recommended by international guidelines for screening for pneumocystis pneumonia (PCP) in hematologic patients. We retrospectively validated the BG test in our tertiary university hospital. Forty-five patients (median age 53 years, 33% female) tested for PC by polymerase chain reaction (PCR) and/or immunoflourescence (IF)-microscopy with a stored blood sample within ±5 days of the PC test were tested by the Fungitell (cutoff <60 and >80 pg/ml). Cases had symptoms and radiology compatible with PCP and positive IF-microscopy (proven PCP, n = 8) or positive PCR (probable PCP, n = 10). Controls had no compatible symptoms/radiology and negative tests for PC on conventional testing (no PCP, n = 24), or positive PCR/IF-microscopy (colonized, n = 3). Median BG-levels were 1108 pg/ml (proven PCP), 612 pg/ml (probable PCP), 29 pg/ml (colonized), and 48 pg/ml (controls, P < 0.001). Compared to the PCP case/control classification, the BG test showed sensitivities of 83–89% and specificities of 64–74%, positive likelihood ratio (LR) of 3.2 and negative LR of 0.23 at recommended cutoff and moderate agreement between tests. Optimal cutoff was ≥73 pg/ml. In PCR-positive cases, the agreement between the BG test and IF-microscopy was 78–89% with fair/moderate agreement. Elevated BG levels were seen in controls with probable invasive fungal infections (n = 4), hemodialysis, bacterial infections and/or betalactams. To conclude, 11% of patients with PCP would be missed if the BG test had been used for diagnosing PCP. Specificity was moderate. Among PCR-positive patients, the BG test identified more cases than IF-microscopy. BG testing is potentially helpful but sensitivity is insufficient to exclude PCP.

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Infecções fúngicas e bacterianas em portadores de hiv hospitalizados

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2019.240282 ◽

2019 ◽

Vol 13 ◽

Author(s):

Rafael Lemes de Aquino ◽

Adriana Lemos Sousa Neto ◽

Lorena Silva Vargas ◽

Anaísa Filmiano Andrade Lopes ◽

Aline Maria Santos Aganhoto ◽

...

Keyword(s):

Bacterial Infections ◽

Fungal Infections ◽

Combined Therapy ◽

Cross Sectional Study ◽

Study Data ◽

University Hospital ◽

Cross Sectional ◽

Hiv Coinfection ◽

Quantitative Descriptive ◽

Immunodeficiency Syndrome

RESUMOObjetivo: investigar a ocorrência de infecções fúngicas e bacterianas nos pacientes portadores de HIV hospitalizados em um hospital universitário. Método: trata-se de estudo quantitativo, descritivo, retrospectivo, tipo transversal. Coletar-se-ão dados dos pacientes que estiveram internados em um hospital universitário, acometidos por infecção pelo HIV, por meio de pesquisa em prontuários impressos e eletrônicos. Resultados esperados: pretende-se conhecer a frequência de infecções fúngicas e bacterianas, especialmente a tuberculose, que acometem o paciente portador do HIV e a eficiência da hemocultura como diagnóstico de infecções bacterianas e fúngicas invasivas. Descritores: HIV; Coinfecção; Síndrome de Imunodeficiência Adquirida; Infecções Bacterianas; Infecção Hospitalar; Terapia Combinada. ABSTRACT Objective: to investigate the occurrence of fungal and bacterial infections in hospitalized HIV patients in a university hospital. Method: this is a quantitative, descriptive, retrospective, cross-sectional study. Data will be collected from patients who were hospitalized in a university hospital, suffering from HIV infection, through research in printed and electronic medical records. Expected results: we intend to know the frequency of fungal and bacterial infections, especially tuberculosis, that affects the patient with HIV and the efficiency of blood culture as a diagnosis of invasive bacterial and fungal infections. Descriptors: HIV; Coinfection; Acquired Immunodeficiency Syndrome; Bacterial Infections; Hospital Infection; Combined Therapy. RESUMEN Objetivo: investigar La ocurrencia de infecciones fúngicas y bacterianas en los pacientes portadores de VIH hospitalizados en un hospital universitario. Método: se trata de un estudio cuantitativo, descriptivo, retrospectivo, tipo transversal. Se recolectarán los datos de los pacientes que estuvieron internados en un hospital universitario, acometidos por infección por el VIH, por medio de investigaciones en prontuarios impresos y electrónicos. Resultados esperados: se pretende conocer la frecuencia de infecciones fúngicas y bacterianas, especialmente la tuberculosis, que afectan al paciente portador del VIH y la eficiencia de la hemocultura como diagnóstico de infecciones bacterianas y fúngicas invasivas. Descritores: VIH; Coinfección; Síndrome de Inmunodeficiencia Adquirida; Infecciones Bacterianas y Micosis; Infección Hospitalaria; Terapia Combinada.

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Application of Innovative Hydroxyapatite Materials in 3D Printing for Biocompatible Voice Implants

Revista de Chimie ◽

10.37358/rc.18.4.6211 ◽

2018 ◽

Vol 69 (4) ◽

pp. 840-842

Author(s):

Wojciech Musialik ◽

Marcin Nabialek ◽

Slawomir Letkiewicz ◽

Andrei Victor Sandu ◽

Katarzyna Bloch

Keyword(s):

3D Printing ◽

Surgical Procedures ◽

Bacterial Infections ◽

Fungal Infections ◽

Colloidal Silver ◽

Bone Implants ◽

External Ring ◽

Voice Prostheses ◽

3D Printers ◽

Silver Composite

The paper presents the possibility of using an innovative hydroxyapatite filament Ca10(PO4)6(OH)2 for printing in 3D printers of bone implants and the possibility of using it during implantation with voice prostheses. The introduction of an additional colloidal silver composite in voice implants will contribute to the reduction of bacterial infections, fungal infections and granulomatous hyperplasia. The creation of a stable external ring of the vocal fistula will remove complications associated with it with enlargement of the fistula and leakiness of voice implants. The ability to print with a hydroxyapatite filament will allow digital pre-surgery modeling of bone implants suited to the needs of surgical procedures.

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Heterocycle Compounds with Antimicrobial Activity

Current Pharmaceutical Design ◽

10.2174/1381612826666200206093815 ◽

2020 ◽

Vol 26 (8) ◽

pp. 867-904 ◽

Cited By ~ 2

Author(s):

Maria Fesatidou ◽

Anthi Petrou ◽

Geronikaki Athina

Keyword(s):

Heterocyclic Compounds ◽

Bacterial Infections ◽

Scientific Community ◽

Antimicrobial Agents ◽

Fungal Infections ◽

Biological Activities ◽

Literature Survey ◽

New Findings ◽

Wide Range ◽

Number Of Microorganisms

Background: Bacterial infections are a growing problem worldwide causing morbidity and mortality mainly in developing countries. Moreover, the increased number of microorganisms, developing multiple resistances to known drugs, due to abuse of antibiotics, is another serious problem. This problem becomes more serious for immunocompromised patients and those who are often disposed to opportunistic fungal infections. Objective: The objective of this manuscript is to give an overview of new findings in the field of antimicrobial agents among five-membered heterocyclic compounds. These heterocyclic compounds especially five-membered attracted the interest of the scientific community not only for their occurrence in nature but also due to their wide range of biological activities. Method: To reach our goal, a literature survey that covers the last decade was performed. Results: As a result, recent data on the biological activity of thiazole, thiazolidinone, benzothiazole and thiadiazole derivatives are mentioned. Conclusion: It should be mentioned that despite the progress in the development of new antimicrobial agents, there is still room for new findings. Thus, research still continues.

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Bacteremia Among Febrile Patients Attending Selected Healthcare Facilities in Ibadan, Nigeria

Clinical Infectious Diseases ◽

10.1093/cid/ciz516 ◽

2019 ◽

Vol 69 (Supplement_6) ◽

pp. S466-S473 ◽

Cited By ~ 4

Author(s):

Oluwafemi Popoola ◽

Aderemi Kehinde ◽

Veronica Ogunleye ◽

Oluwafemi J Adewusi ◽

Trevor Toy ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Bacterial Infections ◽

Common Species ◽

Epidemiological Studies ◽

Multidrug Resistant ◽

African Countries ◽

Healthcare Facilities ◽

Relative Contribution ◽

Polymerase Chain ◽

Ibadan Nigeria

Abstract Background The relative contribution of bacterial infections to febrile disease is poorly understood in many African countries due to diagnostic limitations. This study screened pediatric and adult patients attending 4 healthcare facilities in Ibadan, Nigeria, for bacteremia and malaria parasitemia. Methods Febrile patients underwent clinical diagnosis, malaria parasite testing, and blood culture. Bacteria from positive blood cultures were isolated and speciated using biochemical and serological methods, and Salmonella subtyping was performed by polymerase chain reaction. Antimicrobial susceptibility was tested by disk diffusion. Results A total of 682 patients were recruited between 16 June and 16 October 2017; 467 (68.5%) were <18 years of age. Bacterial pathogens were cultured from the blood of 117 (17.2%) patients, with Staphylococcus aureus (69 [59.0%]) and Salmonella enterica (34 [29.1%]) being the most common species recovered. Twenty-seven (79.4%) of the Salmonella isolates were serovar Typhi and the other 7 belonged to nontyphoidal Salmonella serovarieties. Thirty-four individuals were found to be coinfected with Plasmodium falciparum and bacteria. Five (14.7%) of these coinfections were with Salmonella, all in children aged <5 years. Antimicrobial susceptibility testing revealed that most of the Salmonella and Staphylococcus isolates were multidrug resistant. Conclusions The study demonstrates that bacteria were commonly recovered from febrile patients with or without malaria in this location. Focused and extended epidemiological studies are needed for the introduction of typhoid conjugate vaccines that have the potential to prevent a major cause of severe community-acquired febrile diseases in our locality.

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Community-acquired and hospital-acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia

Journal of Intensive Care ◽

10.1186/s40560-021-00526-y ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Kirstine K. Søgaard ◽

Veronika Baettig ◽

Michael Osthoff ◽

Stephan Marsch ◽

Karoline Leuzinger ◽

...

Keyword(s):

Intensive Care ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Bloodstream Infection ◽

Bacterial Infections ◽

Fungal Infections ◽

Icu Patients ◽

Hospital Acquired Infections ◽

Hospital Acquired

Abstract Objectives SARS-CoV-2 may cause acute lung injury, and secondary infections are thus relevant complications in patients with COVID-19 pneumonia. However, detailed information on community- and hospital-acquired infections among patients with COVID-19 pneumonia is scarce. Methods We identified 220 SARS-CoV-2-positive patients hospitalized at the University Hospital Basel, Switzerland (between 25 February and 31 May 2020). We excluded patients who declined the general consent (n = 12), patients without clinical evidence of pneumonia (n = 29), and patients hospitalized for < 24 h (n = 17). We evaluated the frequency of community- and hospital-acquired infections using respiratory and blood culture materials with antigen, culture-based, and molecular diagnostics. For ICU patients, all clinical and microbial findings were re-evaluated interdisciplinary (intensive care, infectious disease, and clinical microbiology), and agreement reached to classify patients with infections. Results In the final cohort of 162 hospitalized patients (median age 64.4 years (IQR, 50.4–74.2); 61.1% male), 41 (25.3%) patients were admitted to the intensive care unit, 34/41 (82.9%) required mechanical ventilation, and 17 (10.5%) of all hospitalized patients died. In total, 31 infections were diagnosed including five viral co-infections, 24 bacterial infections, and three fungal infections (ventilator-associated pneumonia, n = 5; tracheobronchitis, n = 13; pneumonia, n = 1; and bloodstream infection, n = 6). Median time to respiratory tract infection was 12.5 days (IQR, 8–18) and time to bloodstream infection 14 days (IQR, 6–30). Hospital-acquired bacterial and fungal infections were more frequent among ICU patients than other patients (36.6% vs. 1.7%). Antibiotic or antifungal treatment was administered in 71 (43.8%) patients. Conclusions Community-acquired viral and bacterial infections were rare among COVID-19 pneumonia patients. By contrast, hospital-acquired bacterial or fungal infections were frequently complicating the course among ICU patients.

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Modulation of the Tissue Expression Pattern of Zebrafish CRP-Like Molecules Suggests a Relevant Antiviral Role in Fish Skin

Biology ◽

10.3390/biology10020078 ◽

2021 ◽

Vol 10 (2) ◽

pp. 78

Author(s):

Melissa Bello-Perez ◽

Mikolaj Adamek ◽

Julio Coll ◽

Antonio Figueras ◽

Beatriz Novoa ◽

...

Keyword(s):

Gene Expression ◽

Bacterial Infections ◽

Quantitative Polymerase Chain Reaction ◽

Tissue Expression ◽

Interferon Response ◽

Fish Skin ◽

Tissue Expression Pattern ◽

Chain Reaction ◽

Polymerase Chain ◽

Antiviral Role

Recent studies suggest that short pentraxins in fish might serve as biomarkers for not only bacterial infections, as in higher vertebrates including humans, but also for viral ones. These fish orthologs of mammalian short pentraxins are currently attracting interest because of their newly discovered antiviral activity. In the present work, the modulation of the gene expression of all zebrafish short pentraxins (CRP-like proteins, CRP1-7) was extensively analyzed by quantitative polymerase chain reaction. Initially, the tissue distribution of crp1-7 transcripts and how the transcripts varied in response to a bath infection with the spring viremia of carp virus, were determined. The expression of crp1-7 was widely distributed and generally increased after infection (mostly at 5 days post infection), except for crp1 (downregulated). Interestingly, several crp transcription levels significantly increased in skin. Further assays in mutant zebrafish of recombinant activation gene 1 (rag1) showed that all crps (except for crp2, downregulated) were already constitutively highly expressed in skin from rag1 knockouts and only increased moderately after viral infection. Similar results were obtained for most mx isoforms (a reporter gene of the interferon response), suggesting a general overcompensation of the innate immunity in the absence of the adaptive one.

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Not just vegetations: focal myocardial changes in patients with fungal infections

Cardiology in the Young ◽

10.1017/s1047951120003674 ◽

2020 ◽

pp. 1-6

Author(s):

Nicole M. Cresalia ◽

Sonal T. Owens ◽

Terri L. Stillwell ◽

Mark D. Norris ◽

Sunkyung Yu ◽

...

Keyword(s):

Length Of Stay ◽

Bacterial Infections ◽

Fungal Infections ◽

Positive Culture ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Similar Proportion ◽

Retrospective Case ◽

Fungal Endocarditis ◽

Catheter Tip

Abstract Background: Fungal endocarditis classically involves dense heterogenous vegetations. However, several patients with fungal infections were noted to have myocardial changes ranging from focal brightening to nodular thickening of chordae or papillary muscles. This study evaluates whether these findings are associated with fungal infections. Methods: In a retrospective case–control study, paediatric inpatients with fungal infections (positive blood, urine, or catheter tip culture) in a 5-year period were matched 1:1 to inpatients without positive fungal cultures. Echocardiograms were scored on a 5-point scale by two independent readers for presence of myocardial brightenings, nodular thickenings, and vegetations. Clinical data were compared. Results: Of 67 fungal cases, positive culture sites included blood (n = 44), vascular catheter tip (n = 7), and urine (n = 29); several had multiple positive sites. “Positive” echo findings (score ≥ 2+) were more frequent in the Fungal Group (33 versus 18%, p = 0.04). Fungal Group patients with “positive” versus “negative” echo findings had similar proportion of bacterial infections. Among fungal cases, those with “positive” echo findings had longer hospital length of stay than cases with “negative” echos (median 58 versus 40 days, p = 0.03) but no difference in intensive care unit admission, extracorporeal membranous oxygenation support, or mortality. Conclusions: Myocardial and papillary muscle brightening with nodular thickening on echocardiogram appear to be associated with fungal infections. There may be prognostic implications of these findings as patients with “positive” echo have longer length of stay. Further studies are needed to better understand the mechanism and temporal progression of these changes and determine the prognostic value of this scoring system.

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C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i2.1639 ◽

2021 ◽

Vol 27 (2) ◽

pp. 212

Author(s):

Brigitte Rina Aninda Sidharta ◽

JB. Suparyatmo ◽

Avanti Fitri Astuti

Keyword(s):

Acute Leukemia ◽

Predictive Value ◽

Bacterial Infections ◽

Fungal Infections ◽

Lymphoblastic Leukemia ◽

Negative Likelihood Ratio ◽

Receiver Operating Curve ◽

High Morbidity ◽

C Reactive Protein ◽

Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

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An Effective Cell Coculture Platform Based on the Electrospun Microtube Array Membrane for Nerve Regeneration

Cells Tissues Organs ◽

10.1159/000477238 ◽

2017 ◽

Vol 204 (3-4) ◽

pp. 179-190 ◽

Cited By ~ 7

Author(s):

V. Chia-Hsuan Tseng ◽

Chee Ho Chew ◽

Wan-Ting Huang ◽

Yang-Kao Wang ◽

Ko-Shao Chen ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Chain Reaction ◽

Tissue Culture Polystyrene ◽

Coculture System ◽

Submicron Scale ◽

A Cell ◽

Polymerase Chain ◽

Transwell System ◽

Lower Expression ◽

Microtube Array

Recently, a novel substrate known as an electrospun polylactic acid (PLLA) microtube array membrane (MTAM) was successfully developed as a cell coculture platform. Structurally, this substrate is made up of one-to-one connected, ultrathin, submicron scale fibers that are arranged in an arrayed formation. Its unique structure confers several key advantages which are beneficial in a cell coculture system. In this study, the interaction between rat fetal neural stem cells (NSC) and astrocytes was examined by comparing the outcome of a typical Transwell-based coculture system and that of an electrospun PLLA MTAM-based coculture system. Compared to tissue culture polystyrene (TCP) and Transwell coculture inserts, a superior cell viability of NSC was observed when cultured in lumens of electrospun PLLA MTAM (with supportive immunostaining images). Reverse transcription polymerase chain reaction revealed a strong interaction between astrocytes and NSC through a higher expression of doublecortin and a lower expression of nestin. These data demonstrate that MTAM is clearly a better coculture platform than the traditional Transwell system.

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