scholarly journals 1006. Association of Development of Pneumonia and Virulence Gene Expression in Acinetobacter baumannii Isolated from Clinical Specimens

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S594-S594
Author(s):  
Ji Yun Bae ◽  
Ina Yun ◽  
Kang Il Jun ◽  
Chung-Jong Kim ◽  
Mi Ae Lee ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acinetobacter Baumannii ◽  
Multivariable Analysis ◽  
Virulence Gene ◽  
University Hospital ◽  
Univariable Analysis ◽  
Virulence Gene Expression ◽  
Radiologic Findings ◽  
Polymerase Chain ◽  
Respiratory Specimens

Abstract Background Not all Acinetobacter baumannii isolated from respiratory specimens are true pathogens. Distinguishing between true pathogens and colonizers is important to initiate early treatment and to reduce the unnecessary prescription of antibiotics. To determine the microbiological factors contributing to the development of A. baumannii pneumonia, we investigated the association between the expression level of known A. baumannii virulence genes such as ompA and hisF and pneumonia. Methods Patients in whose respiratory specimens A. baumannii was identified between January 2018 and January 2019 in a tertiary university hospital were recruited into this study. Relevant radiologic findings and more than 5 days of susceptible antibiotic prescription started within 3 days of bacterial isolation were considered as having pneumonia. The absence of radiologic findings of pneumonia until 7 days after the isolation of A. baumannii was defined as colonization. The expression of ompA and hisF was determined with quantitative reverse-transcription polymerase chain reaction. Host factors known to be associated with pneumonia and expression levels of virulent genes were compared between the groups. Results Overall, 246 patients in whose respiratory specimens A. baumannii was identified were recruited into this study. Among them, 17 and 24 patients were assigned to the pneumonia and colonizer groups, respectively. In the univariable analysis, ompA, ICU stay, and mechanical ventilation were significantly associated with pneumonia (p = 0.03, < 0.01, < 0.01 respectively). In the multivariable analysis, mechanical ventilation was significantly associated with pneumonia (OR = 9.75, p = 0.03). ompA expression was not significantly associated with pneumonia in the multivariable analysis (OR = 1.12, p = 0.75) (Table 1). ompA and hisF were significantly associated with the 30-day in-hospital mortality (p = 0.02, < 0.01). Table 1. Univariable and multivariable analysis of factors related to pneumonia Conclusion The association between increased ompA expression in A. baumannii and the development of pneumonia was not statistically significant after adjusting for patient factors. However, the relatively high expression of ompA in pneumonia patients and their association with increased mortality suggests the need for larger-scale prospective studies to draw a conclusion. Disclosures All Authors: No reported disclosures

scholarly journals POS0582 RHEUMATOID ARTHRITIS AND ORAL MICROBIOME: PREDICTORS OF DISTURBANCES AND ITS IMPLICATIONS. RESULTS FROM A COHORT AT TREATMENT WITH cs/b/tsDMARD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 524.2-524
Author(s):  
R. Dos-Santos ◽  
F. Otero ◽  
E. Perez-Pampín ◽  
A. Mera Varela
Keyword(s):  
Rheumatoid Arthritis ◽  
Periodontal Disease ◽  
Disease Activity ◽  
Multivariable Analysis ◽  
Oral Microbiome ◽  
University Hospital ◽  
Disease Course ◽  
Univariable Analysis ◽  
Multiple Species

Background:Oral microbiome (OM) seems to be significant in the pathogenesis of some immune-mediated diseases, such as rheumatoid arthritis (RA), psoriasis or inflammatory bowel disease.1 Some microorganisms, as Porphyromonas gingivalis have been related with the production of autoantibodies. Also it has been suggested that composition of OM could change RA disease course, being more difficult-to-treat and having higher disease activity scores.2Objectives:To identify which variables could predict the appearance of altered OM and its implications in clinical practice.Methods:Patients were recruited if they were diagnosed of RA and were at active treatment (biological, classical or targeted synthetic disease modifying anti-rheumatic drugs [b/cs/tsDMARDs]). Patients performed a dental review with a specialized odontologist that made an OM test (semiquantitative PCR), and oral health standards were instructed (following criteria of American Academy of Periodontology). Recruitment was made during 2020 in the Clinical University Hospital in Santiago de Compostela, Spain. Disease activity reevaluation was made 2 months later.Treatment, demographic and clinical data were collected from participants.Univariable logistic and linear regression were performed to identify predictors of OM. Variables with p<0.20 were selected for multivariable analysis.Stata 15.1 was used to perform statistical analysis.Results:47 patients were selected of whom 40 were female. Mean age was 55.43 years (SD 14.42). 30.77% were current or ex-smokers. Mean time since RA diagnosis was 14.89 years (SD 8.47). 63.83% were anti-citrullinated peptide autoantibody (ACPA) positive and 70.21% were rheumatoid factor (RF) positive, letting only 6 patients double negative. 46.81% had moderate/severe periodontal disease (PD). 32.61% of patients had any comorbidity. Mean DAS28 at the OM test was 2.67 (SD 1.28) and after 2 months 2.37 (SD 1.03). Mean C-reactive protein (CRP) was 0.64 mg/dl (SD 1.48) and median erythrocyte sedimentation rate (ESR) was 13 mm (IQR 7;27). All patients were under glucocorticoid treatment, 46 with bDMARD, 1 with tsDMARD and 46 with csDMARD. Treponema denticola was detected in 44.68% of patients, P. gingivalis in 29.79%, Actinomyces spp in 8.51%, Tanerella forsythia in 36.17% and Prevotella intermedia in 25.53%. Only 15 patients were full-negative for OM test.Univariable analysis identified RF positive, double autoantibody positive (RF and ACPA) and moderate/severe PD as potential predictors of the presence of at least one oral microorganism (p<0.20). Multivariable testing pointed out moderate/severe PD as predictor of the presence of at least one oral microorganism (OR 22.91 [CI95% 2.38-220.4] p=0.007).Univariable analysis identified higher age, presence of any comorbidity, RF positive, higher CRP, treatment with anti-tumour necrosis alpha (aTNF) and moderate/severe PD as potential predictors of the presence of multiple species in OM (p<0.20). Multivariable testing pointed out moderate/severe PD as predictor of the presence of multiple species in OM (ß 0.39 [95%CI 0.19-0.58] p=0.000).Conclusion:Oral microbiome is closely related with periodontal disease, added to our results, a relationship between OM and disease activity has been exposed. In this analysis the role of OM and autoantibody profile is manifest, as being double positive or RF positive is associated with the presence of altered OM. Also patients with high acute-phase reactants, active disease and under aTNF treatment could delineate a specific RA population under risk of altered OM, where intensive strategies for changing oral microbiome could have any repercussion in the disease course.References:[1]Chen, B., Zhao, Y., Li, S. et al. Variations in oral microbiome profiles in rheumatoid arthritis and osteoarthritis with potential biomarkers for arthritis screening. Sci Rep8, 17126 (2018).[2]R Bodkhe, B Balakrishnan, V Taneja. The role of microbiome in rheumatoid arthritis treatment. Ther Adv Musculoskelet Dis. 2019;11:1759720.Disclosure of Interests:None declared

scholarly journals Chest computed tomography in COVID-19 pneumonia: a retrospective study of 155 patients at a university hospital in Rio de Janeiro, Brazil

2021 ◽  
Vol 54 (1) ◽  
pp. 1-8
Author(s):  
Roberto Mogami ◽  
Agnaldo Jose Lopes ◽  
Ronaldo Carvalho Araújo Filho ◽  
Fernando Carlos Santos de Almeida ◽  
Alexandre Malta da Costa Messeder ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Ground Glass Opacity ◽  
Pulmonary Involvement ◽  
University Hospital ◽  
Chain Reaction ◽  
Ct Findings ◽  
Polymerase Chain ◽  
Ct Finding

Abstract Objective: To define diagnostic criteria for coronavirus disease 2019 (COVID-19) on computed tomography (CT); to study the correlation between CT and polymerase chain reaction (PCR) testing for infection with severe acute respiratory syndrome coronavirus 2; and to determine whether the extent of parenchymal involvement and the need for mechanical ventilation are associated with the CT findings and clinical characteristics of patients with COVID-19. Materials and Methods: This was a retrospective study of 155 patients with COVID-19 treated between March and May 2020. We attempted to determine whether the CT findings correlated with age and clinical variables, as well as whether the need for mechanical ventilation correlated with the extent of the pulmonary involvement. Results: On average, the patients with COVID-19 were older than were those without (mean age, 54.8 years vs. 45.5 years; p = 0.031). The most common CT finding (seen in 88.6%) was ground-glass opacity, which correlated significantly with a diagnosis of COVID-19 (p = 0.0001). The CT findings that correlated most strongly with the need for mechanical ventilation were parenchymal bands (p = 0.013), bronchial ectasia (p = 0.046), and peribronchovascular consolidations (p = 0.012). The presence of one or more comorbidities correlated significantly with more extensive parenchymal involvement (p = 0.023). For the diagnosis of COVID-19, CT had a sensitivity of 84.3%, a specificity of 36.7%, and an accuracy of 73.5% (p = 0.012 vs. PCR). Conclusion: The patterns of CT findings are useful for the diagnosis of COVID-19 and the evaluation of disease severity criteria. The presence of any comorbidity is associated with greater severity of COVID-19.

scholarly journals Relationship between Vancomycin MIC and Virulence Gene Expression in Clonal Complexes of Methicillin-Susceptible Staphylococcus aureus Strains Isolated from Left-Sided Endocarditis

2020 ◽  
Vol 64 (3) ◽  
Author(s):  
Juan M. Pericàs ◽  
Carlos Cervera ◽  
Cristina Garcia-de-la-Mària ◽  
Batu K. Sharma-Kuinkel ◽  
Rachelle Gonzales ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Multivariable Analysis ◽  
Virulence Gene ◽  
Mortality Rates ◽  
Content Type ◽  
Virulence Gene Expression ◽  
Vancomycin Mics ◽  
Genes Encoding

ABSTRACT Higher vancomycin MICs have been associated with more complicated courses and higher mortality rates in patients with Staphylococcus aureus bacteremia and infective endocarditis (IE). The aim of this study was to investigate whether the strains belonging to the cohort of 93 patients from a previously published study in which patients with strains with vancomycin MICs of ≥1.5 μg/ml presented higher mortality rates and systemic emboli than patients with strains with vancomycin MICs of <1.5 μg/ml had specific patterns of virulence factors, clonal complex (CC) types, or the ability to form biofilms. Vancomycin MICs were determined by Etest, and the isolates underwent spa typing to infer the CC, biofilm studies, a thrombin-induced platelet microbicidal assay, and multiplex PCR for the presence of virulence genes. We found no differences in genes encoding adhesins, toxins, or other putative virulence genes according to the vancomycin MIC group. CC30, CC34, and CC45 represented nearly half of the isolates, and there was no association with the vancomycin MIC. agr subgroups I and III predominated, with no association with the vancomycin MIC. Isolates with higher vancomycin MICs exhibited a poorer ability to form biofilms with and without the presence of vancomycin (2.03 versus 2.48 [P < 0.001], respectively, for isolates with higher vancomycin MICs and 2.60 versus 2.87 [P = 0.022], respectively, for isolates with lower vancomycin MICs). In the multivariable analysis, efb and V8 were risk factors for major emboli (adjusted odds ratio [aOR] = 7.5 and 95% confidence interval [CI] = 1.2 to 46.6 for efb, and aOR = 3.9 and 95% CI = 1.1 to 14.1 for V8), whereas no genotypic predictors of in-hospital mortality were found. No clear associations between genes encoding virulence factors, agr type, clonal complexes, mortality, and major embolic events according to vancomycin MIC group were found.

scholarly journals Evaluation of Virulence Gene Expression Patterns inAcinetobacter baumanniiUsing Quantitative Real-Time Polymerase Chain Reaction Array

2016 ◽  
Vol 181 (9) ◽  
pp. 1108-1113 ◽  
Author(s):  
Ford M. Lannan ◽  
Daniel K. O'conor ◽  
Joseph C. Broderick ◽  
Jamison F. Tate ◽  
Jacob T. Scoggin ◽  
...  
Keyword(s):  
Gene Expression ◽  
Polymerase Chain Reaction ◽  
Real Time ◽  
Expression Patterns ◽  
Virulence Gene ◽  
Gene Expression Patterns ◽  
Chain Reaction ◽  
Virulence Gene Expression ◽  
Polymerase Chain

scholarly journals Trimethylamine-N-Oxide Levels Are Similar in Asymptomatic vs. Symptomatic Cerebrovascular Atherosclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Miriam Heyse ◽  
Christine Schneider ◽  
Peter Monostori ◽  
Kathrin V. Schwarz ◽  
Jana Hauke ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebrovascular Disease ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Vascular Diseases ◽  
University Hospital ◽  
Large Artery ◽  
Univariable Analysis ◽  
Asymptomatic Patients ◽  
Symptomatic Stenosis

Introduction: Trimethylamine-N-oxide (TMAO) is correlated with atherosclerosis and vascular diseases such as coronary heart disease and ischemic stroke. The aim of the study was to investigate whether TMAO levels are different in symptomatic vs. asymptomatic cerebrovascular atherosclerosis.Methods: This was a prospective, case–control study, conducted at a tertiary care university hospital. Patients were included if they had large-artery atherosclerosis (TOAST criteria). Symptomatic patients with ischemic stroke were compared with asymptomatic patients. As primary endpoint, TMAO levels on admission were compared between symptomatic and asymptomatic patients. Univariable analysis was performed using Mann–Whitney U test and multivariable analysis using binary logistic regression. TMAO values were adjusted for glomerular filtration rate (GFR), age, and smoking.Results: Between 2018 and 2020, 82 symptomatic and asymptomatic patients were recruited. Median age was 70 years; 65% were male. Comparing symptomatic (n = 42) and asymptomatic (n = 40) patients, no significant differences were found in univariable analysis in TMAO [3.96 (IQR 2.30–6.73) vs. 5.36 (3.59–8.68) μmol/L; p = 0.055], GFR [87 (72–97) vs. 82 (71–90) ml/min*1.73 m2; p = 0.189] and age [71 (60–79) vs. 69 (67–75) years; p = 0.756]. In multivariable analysis, TMAO was not a predictor of symptomatic cerebrovascular disease after adjusting for age and GFR [OR 1.003 (95% CI: 0.941–1.070); p = 0.920]. In a sensitivity analysis, we only analyzed patients with symptomatic stenosis and excluded patients with occlusion of brain-supplying arteries. Again, TMAO was not a significant predictor of symptomatic stenosis [OR 1.039 (0.965–1.120), p = 0.311].Conclusion: TMAO levels could not be used to differentiate between symptomatic and asymptomatic cerebrovascular disease in our study.

scholarly journals COVID-19 Tracheostomy: Experience in a University Hospital With Intermediate Follow-up

2021 ◽  
pp. 088506662110434
Author(s):  
Rahul N Sood ◽  
Benjamin A. Palleiko ◽  
Daniel Alape-Moya ◽  
Mark W. Maxfield ◽  
Jonathan Holdorf ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Chart Review ◽  
Prolonged Mechanical Ventilation ◽  
Case Series ◽  
University Hospital ◽  
Procedural Information ◽  
Polymerase Chain ◽  
Promising Development

The benefits of percutaneous dilational tracheostomy (PDT) placement have been well documented in patients requiring prolonged mechanical ventilation. However, the data regarding the benefit of PDT in coronavirus-2019 (COVID-19) patients are scarce. The objective of this study is to evaluate the outcomes of a cohort of 37 patients who underwent tracheostomy as part of their COVID-19 care. Retrospective data from a series for 37 patients undergoing tracheostomy was collected using chart review. Primary outcomes included 30 and 60 day mortality, weaning rate, and decannulation rate. Secondary outcomes collected included admission demographics, comorbidities, and procedural information. Thirty-seven (37) patients requiring prolonged mechanical ventilation due to COVID-19. Of these 37 patients, 35 were alive 60 days post-PDT placement, 33 have been weaned from mechanical ventilation and 18 have been decannulated. The low mortality and high decannulation rates in this cohort in is a promising development in the care of critically ill COVID-19 patients. Of note, all participating physicians underwent routine polymerase chain reaction (PCR) testing for infection with the severe acute respiratory syndrome coronavirus-2 virus and no physician contracted COVID-19 as a result of their involvement. Overall, this case series describes the modified PDT technique used by our team and discusses the feasibility and potential benefit to PDT placement in COVID-19 patients requiring long-term mechanical ventilation.

scholarly journals Occurrence of blaTEM and blaCTXM Genes and Biofilm-Forming Ability among Clinical Isolates of Pseudomonas aeruginosa and Acinetobacter baumannii in Yaoundé, Cameroon

2020 ◽  
Vol 8 (5) ◽  
pp. 708
Author(s):  
Estelle Longla Madaha ◽  
Hortense Kamga Gonsu ◽  
Rhoda Nsen Bughe ◽  
Marie Christine Fonkoua ◽  
Collins Njie Ateba ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Pcr Amplification ◽  
Virulence Gene ◽  
Diffusion Method ◽  
Bacterial Genomes ◽  
Specific Pcr ◽  
Fermentative Bacteria ◽  
Its Gene ◽  
Polymerase Chain

Background: Pseudomonas aeruginosa (PSA) and Acinetobacter baumannii (ACB) are non-fermentative bacteria mostly associated with nosocomial infections in humans. Objective: This study aimed to determine the antimicrobial resistance profiles and virulence gene of PSA and ACB previously isolated from humans in selected health facilities in Yaoundé, Cameroon. Methods: A total of 77 and 27 presumptive PSA and ACB isolates, respectively, were collected from the Yaoundé teaching hospital. These isolates were previously isolated from various samples including pus, blood and broncho-alveolar lavage. The identities of the isolates were determined through polymerase chain reaction (PCR) amplification of PSA and ACB specific sequences. Antimicrobial susceptibility testing (AST) was performed using the Kirby–Bauer disc diffusion method. Phenotypical expression of AmpC β-lactamases (AmpC), extended spectrum β-lactamases (ESBLs) and metallo β-Lactamases (MBLs) were determined using the combined disc method. Bacterial genomes were screened for the presence of β-lactamases blaTEM and blaCTXM genes using specific PCR. The pathogenicity of PSA and ACB was assessed through amplification of the lasB, exoA, pslA and exoS as well as OmpA and csuE virulence genes, respectively. Results: Of the 77 presumptive PSA isolates, a large proportion (75 to 97.4%) were positively identified. All (100%) of the presumptive 27 ACB harbored the ACB-specific ITS gene fragment by PCR. Twenty five percent of the PSA isolates produced ESBLs phenotypically while more than 90% of these isolates were positive for the lasB, exoA, pslA and exoS genes. A large proportion (88%) of the ACB isolates harboured the OmpA and csuE genes. blaTEM and blaCTXM were detected in 17 and 4% of PSA, respectively, while a much higher proportion (70 and 29%) of the ACB isolates possessed these resistance determinants respectively. Conclusion: Our findings reveal the occurrence of both virulence and drug-resistant determinants in clinical PSA and ACB isolates from patients in health care settings in Yaoundé, Cameroon, thus suggesting their role in the pathological conditions in patients.

scholarly journals Factors related to mortality by pneumonia unrelated to mechanical ventilation

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e62553
Author(s):  
Jucinay Phaedra Silva Sanches ◽  
Carla Fernanda Tiroli ◽  
Erika Bernardo da Silva ◽  
Gabriela Machado Ezaias Paulino ◽  
Gilselena Kerbauy ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acinetobacter Baumannii ◽  
Poisson Regression ◽  
Retrospective Cohort ◽  
Multivariable Analysis ◽  
Klebsiella Pneumonia ◽  
Candida Spp ◽  
Significance Level ◽  
Antimicrobial Substances ◽  
Risk Of Death

Objective: to analyze the factors related to mortality by nosocomial pneumonia unrelated to mechanical ventilation. Methods: retrospective cohort study with a sample acquired using the 538 notification forms for health care-related infections. The relative risk was calculated and a multivariable analysis was carried out using Poisson regression with a significance level of 5%. Results: the multivariable analysis showed that being under 59 years old and taking only one antimicrobial drug were protective factors against death. The main microorganisms responsible for the increase in the risk of death were: Acinetobacter baumannii, Klebsiella pneumoniae and species of Candida (Candida spp). Conclusion: the factors related to mortality were being 60 years old or older, using two or more antimicrobial substances, and being affected by the microorganisms Acinetobacter baumannii, Klebsiella pneumonia, and species of Candida (Candida spp).

Vibrio harveyi virulence gene expression in vitro and in vivo during infection in black tiger shrimp Penaeus monodon

2020 ◽  
Vol 139 ◽  
pp. 153-160
Author(s):  
S Peeralil ◽  
TC Joseph ◽  
V Murugadas ◽  
PG Akhilnath ◽  
VN Sreejith ◽  
...  
Keyword(s):  
Gene Expression ◽  
Virulence Genes ◽  
Vibrio Harveyi ◽  
Penaeus Monodon ◽  
Challenge Test ◽  
Virulence Gene ◽  
Economic Losses ◽  
Virulence Gene Expression

Luminescent Vibrio harveyi is common in sea and estuarine waters. It produces several virulence factors and negatively affects larval penaeid shrimp in hatcheries, resulting in severe economic losses to shrimp aquaculture. Although V. harveyi is an important pathogen of shrimp, its pathogenicity mechanisms have yet to be completely elucidated. In the present study, isolates of V. harveyi were isolated and characterized from diseased Penaeus monodon postlarvae from hatcheries in Kerala, India, from September to December 2016. All 23 tested isolates were positive for lipase, phospholipase, caseinase, gelatinase and chitinase activity, and 3 of the isolates (MFB32, MFB71 and MFB68) showed potential for significant biofilm formation. Based on the presence of virulence genes, the isolates of V. harveyi were grouped into 6 genotypes, predominated by vhpA+ flaB+ ser+ vhh1- luxR+ vopD- vcrD+ vscN-. One isolate from each genotype was randomly selected for in vivo virulence experiments, and the LD50 ranged from 1.7 ± 0.5 × 103 to 4.1 ± 0.1 × 105 CFU ml-1. The expression of genes during the infection in postlarvae was high in 2 of the isolates (MFB12 and MFB32), consistent with the result of the challenge test. However, in MFB19, even though all genes tested were present, their expression level was very low and likely contributed to its lack of virulence. Because of the significant variation in gene expression, the presence of virulence genes alone cannot be used as a marker for pathogenicity of V. harveyi.

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