scholarly journals Seeking diagnostic and prognostic biomarkers for childhood bacterial pneumonia in sub-Saharan Africa: study protocol for an observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046590
Author(s):  
Clarissa Valim ◽  
Yekin Ajauoi Olatunji ◽  
Yasir Shitu Isa ◽  
Rasheed Salaudeen ◽  
Sarwar Golam ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
High Sensitivity ◽  
The Gambia ◽  
Sub Saharan Africa ◽  
Support Vector ◽  
Bacterial Disease ◽  
Blood Proteins ◽  
Study Results ◽  
Bacterial Aetiology

IntroductionClinically diagnosed pneumonia in children is a leading cause of paediatric hospitalisation and mortality. The aetiology is usually bacterial or viral, but malaria can cause a syndrome indistinguishable from clinical pneumonia. There is no method with high sensitivity to detect a bacterial infection in these patients and, as result, antibiotics are frequently overprescribed. Conversely, unrecognised concomitant bacterial infection in patients with malarial infections occur with omission of antibiotic therapy from patients with bacterial infections. Previously, we identified two combinations of blood proteins with 96% sensitivity and 86% specificity for detecting bacterial disease. The current project aimed to validate and improve these combinations by evaluating additional biomarkers in paediatric patients with clinical pneumonia. Our goal was to describe combinations of a limited number of proteins with high sensitivity and specificity for bacterial infection to be incorporated in future point-of-care tests. Furthermore, we seek to explore signatures to prognosticate clinical pneumonia.Methods and analysisPatients (n=900) aged 2–59 months presenting with clinical pneumonia at two Gambian hospitals will be enrolled and classified according to criteria for definitive bacterial aetiology (based on microbiological tests and chest radiographs). We will measure proteins at admission using Luminex-based immunoassays in 90 children with definitive and 160 with probable bacterial aetiology, and 160 children classified according to the prognosis of their disease. Previously identified diagnostic signatures will be assessed through accuracy measures. Moreover, we will seek new diagnostic and prognostic signatures through machine learning methods, including support vector machine, penalised regression and classification trees.Ethics and disseminationEthics approval has been obtained from the Gambia Government/Medical Research Council Unit The Gambia Joint Ethics Committee (protocol 1616) and the institutional review board of Boston University Medical Centre (STUDY00000958). Study results will be disseminated to the staff of the study hospitals, in scientific seminars and meetings, and in publications.Trial registration numberH-38462.

Bacterial Infection and Splenic Reticuloendothelial Function in Children with Hemoglobin SC Disease

PEDIATRICS ◽  
1983 ◽  
Vol 72 (1) ◽  
pp. 93-98
Author(s):  
George R. Buchanan ◽  
Susan J. Smith ◽  
Christine A. Holtkamp ◽  
John P. Fuseler
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Infection Risk ◽  
Bacterial Disease ◽  
Normal Children ◽  
Splenic Function ◽  
Focus Of Infection ◽  
Serious Bacterial Infections ◽  
Primary Focus ◽  
Hemoglobin Sc Disease

Although the epidemiology and pathophysiology of serious bacterial infection in homozygous sickle cell anemia (SS disease) have become increasingly well understood, information about infection risk and splenic reticuloendothelial function in hemoglobin SC disease is quite limited. Therefore, the type and frequency of invasive bacterial disease were examined in 51 children with SC disease followed for 370 person-years and splenic function was assessed in 31 patients by quantitation of pitted erythrocytes. Seven serious bacterial infections occurred in four of the patients, five due to Streptococcus pneumoniae and two to Haemophilus influenzae. A primary focus of infection was present in all episodes, none of which proved fatal. Although 30 episodes of pneumonia or chest syndrome occurred in 20 of the patients, a bacterial etiology was proven in only three instances. Splenic function was usually impaired, with a mean pit count of 7.1% ± 8.2% (range 0% to 22.9%). This is significantly greater than normal, but less than pit counts in patients with SS disease or asplenic subjects. Children with SC disease may have a greater risk of bacterial infection than normal children, but their infection rate is not nearly as high as that in patients with SS disease.

Evaluation and comparison of serum procalcitonin and heparin-binding protein levels as biomarkers of bacterial infection in cats

2020 ◽  
pp. 1098612X2095997
Author(s):  
Jae-Geum Cho ◽  
Ye-In Oh ◽  
Kun-Ho Song ◽  
Kyoung-Won Seo
Keyword(s):  
Bacterial Infection ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Bacterial Infections ◽  
Binding Protein ◽  
High Sensitivity ◽  
Heparin Binding ◽  
Protein Levels ◽  
Heparin Binding Protein ◽  
Valuable Marker

Objectives Although bacterial infection can lead to sepsis and high mortality, early and easy diagnosis of sepsis can improve survival. In cats, the diagnosis of systemic bacterial infection is quite challenging, and, usually, non-specific markers for inflammation are employed. In humans, procalcitonin, heparin-binding protein and absolute neutrophil count are biomarkers that are studied in bacterial infections and sepsis owing to their high sensitivity and specificity. Methods A total of 56 cats were categorised into 16 healthy cats and 40 bacterially infected cats, diagnosed by various examinations. In all cats, serum procalcitonin and heparin-binding protein levels were measured using ELISA and an absolute neutrophil count was performed. Results The median values of procalcitonin levels and absolute neutrophil count were significantly higher in the infection group than in the normal group, but heparin-binding protein levels were not. A procalcitonin level >366 pg/ml was a better biomarker of bacterial infection than heparin-binding protein and absolute neutrophil count (sensitivity: 67.5%; specificity: 93.8%). Procalcitonin was not correlated with heparin-binding protein ( r = 0.213, P = 0.115) and absolute neutrophil count ( r = 0.393, P = 0.003). Conclusions and relevance High procalcitonin levels in cats were associated with bacterial infection. Hence, procalcitonin could be a valuable marker for diagnosing bacterial infections in cats.

scholarly journals Procalcitonin Serum Level in Patients Aged 3-36 Months With Focal Fever Referred to Hospitals in Western Iran in 2020

2021 ◽  
Vol 8 (3) ◽  
pp. 98-101
Author(s):  
Ali Keramati ◽  
Sahereh Garaei ◽  
Shiva Roshankhah ◽  
Mojtaba Esmaeli
Keyword(s):  
Serum Level ◽  
Bacterial Infection ◽  
Plasma Levels ◽  
Bacterial Infections ◽  
Viral Infections ◽  
High Sensitivity ◽  
Pediatric Emergency ◽  
Reactive Protein ◽  
Level Measurement ◽  
The Mean

Background: Diagnosing viral and bacterial infectious diseases in children is of great importance. The conventional treatment for the given diseases has been proven relatively impractical and, therefore, finding a practical diagnostic method seems necessary. Measuring procalcitonin (PCT) levels in the blood is one of those useful tests which have high sensitivity and specificity compared to other methods. Moreover, many researchers have emphasized that the level of PCT in bacterial infections is significant. Therefore, PCT level measurement can be adopted as a highly effective factor for distinguishing bacterial infections from viral ones. Our study aimed to evaluate the plasma levels of PCT in children aged 3-36 months. Methods: In this study which was conducted in 2020 in Kermanshah, Iran, 49 children aged 3-36 months having focal fever and referring to the pediatric emergency department of Mohammad Kermanshahi and Imam Reza hospitals in Kermanshah were examined. Distinguishing bacterial infection from viral one was first made by a pediatrician using CBC diff-ESR-CRP tests. Results: The mean serum level of PCT in bacterial infections was significantly higher than that in viral infections. Furthermore, the mean of white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in bacterial infection was significantly higher than that in viral infection. Conclusions: According to our study findings, plasma levels of PCT could have been considered as a diagnostic indicator of the infection. Therefore, it was recommended that the evaluation of PCT plasma levels in children with infection be performed in early stages of the disease. However, it was also suggested that this evaluation be conducted after performing further investigations in this field.

scholarly journals Antibody-Dependent Enhancement of Bacterial Disease: Prevalence, Mechanisms, and Treatment

2021 ◽  
Vol 89 (4) ◽  
Author(s):  
Von Vergel L. Torres ◽  
Carrie F. Coggon ◽  
Timothy J. Wells
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Molecular Mechanisms ◽  
Vaccine Development ◽  
Viral Disease ◽  
Influenza Viruses ◽  
Bacterial Disease ◽  
Antibody Dependent Enhancement ◽  
Current Vaccine ◽  
Current Therapies

ABSTRACT Antibody-dependent enhancement (ADE) of viral disease has been demonstrated for infections caused by flaviviruses and influenza viruses; however, antibodies that enhance bacterial disease are relatively unknown. In recent years, a few studies have directly linked antibodies with exacerbation of bacterial disease. This ADE of bacterial disease has been observed in mouse models and human patients with bacterial infections. This antibody-mediated enhancement of bacterial infection is driven by various mechanisms that are disparate from those found in viral ADE. This review aims to highlight and discuss historic evidence, potential molecular mechanisms, and current therapies for ADE of bacterial infection. Based on specific case studies, we report how plasmapheresis has been successfully used in patients to ameliorate infection-related symptomatology associated with bacterial ADE. A greater understanding and appreciation of bacterial ADE of infection and disease could lead to better management of infections and inform current vaccine development efforts.

Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

2019 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Attabak Toofani Milani ◽  
Mahshid Mohammadian ◽  
Sadegh Rostaminasab ◽  
Roghayeh Paribananaem ◽  
Zohre Ahmadi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Diagnostic Test ◽  
Bacterial Infections ◽  
Intervention Studies ◽  
Antibiotic Use ◽  
Clinical Suspicion ◽  
Diagnostic Biomarker ◽  
Clinical Routine ◽  
Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

Colorectal Cancer Classification and Survival Analysis Based on an Integrated RNA and DNA molecular signature

2020 ◽  
Vol 15 ◽  
Author(s):  
Mohanad Mohammed ◽  
Henry Mwambi ◽  
Bernard Omolo
Keyword(s):  
Colorectal Cancer ◽  
Survival Analysis ◽  
Discriminant Analysis ◽  
Linear Discriminant Analysis ◽  
Negative Binomial ◽  
Sub Saharan Africa ◽  
Support Vector ◽  
Mutation Status ◽  
Linear Discriminant ◽  
Rnaseq Data

Background: Colorectal cancer (CRC) is the third most common cancer among women and men in the USA, and recent studies have shown an increasing incidence in less developed regions, including Sub-Saharan Africa (SSA). We developed a hybrid (DNA mutation and RNA expression) signature and assessed its predictive properties for the mutation status and survival of CRC patients. Methods: Publicly-available microarray and RNASeq data from 54 matched formalin-fixed paraffin-embedded (FFPE) samples from the Affymetrix GeneChip and RNASeq platforms, were used to obtain differentially expressed genes between mutant and wild-type samples. We applied the support-vector machines, artificial neural networks, random forests, k-nearest neighbor, naïve Bayes, negative binomial linear discriminant analysis, and the Poisson linear discriminant analysis algorithms for classification. Cox proportional hazards model was used for survival analysis. Results: Compared to the genelist from each of the individual platforms, the hybrid genelist had the highest accuracy, sensitivity, specificity, and AUC for mutation status, across all the classifiers and is prognostic for survival in patients with CRC. NBLDA method was the best performer on the RNASeq data while the SVM method was the most suitable classifier for CRC across the two data types. Nine genes were found to be predictive of survival. Conclusion: This signature could be useful in clinical practice, especially for colorectal cancer diagnosis and therapy. Future studies should determine the effectiveness of integration in cancer survival analysis and the application on unbalanced data, where the classes are of different sizes, as well as on data with multiple classes.

Crystalline ruthenium polypyridyl nanoparticles: a targeted treatment of bacterial infection with multifunctional antibacterial, adhesion and surface-anchoring photosensitizer properties

2021 ◽  
Author(s):  
Chenyang Yin ◽  
Zekun Wang ◽  
Xiaoyuan Ding ◽  
Xiaoqing Chen ◽  
Jingyuan Wang ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Antibacterial Therapy ◽  
Bacterial Infections ◽  
Targeted Treatment ◽  
Ruthenium Polypyridyl ◽  
Surface Anchoring ◽  
Antibacterial Materials

Photodynamic antibacterial therapy employs nanocomposites as an alternative to traditional antibiotics for the treatment of bacterial infections. However, many of these antibacterial materials are less effective towards bacteria than traditional...

scholarly journals Prevalence, distribution and antimicrobial susceptibility pattern of bacterial isolates from a tertiary Hospital in Malawi

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pizga Kumwenda ◽  
Emmanuel C. Adukwu ◽  
Ebot S. Tabe ◽  
Victor. C. Ujor ◽  
Pocha S. Kamudumuli ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Bacterial Infections ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Bacterial Isolates ◽  
Susceptibility Pattern ◽  
Management Options ◽  
Subsequent Increase ◽  
Antimicrobial Susceptibility Pattern

Abstract Background Bacterial infections are a significant cause of sickness and death in sub-Saharan Africa. This study aimed at establishing the prevalence, distribution and antimicrobial susceptibility pattern of major bacterial isolates from patients accessing medical care at a tertiary hospital in Malawi. Methods We retrospectively reviewed bacteria culture and antimicrobial susceptibility records for 4617 patients from 2002 to 2014 at Mzuzu Central Hospital (MCH). No inclusion and exclusion criteria were followed. Data was analysed using excel (Microsoft office, USA) and GraphPad prism 7 software programs. Results The most prevalent isolates were S. aureus (34.7%, n = 783), Klebsiella species (17.4%, n = 393) and Proteus species (11.4%, n = 256). Most microorganisms were isolated from adults (88.3%, n = 3889) and pus was the main source (69.3%, n = 1224). S. pneumoniae was predominantly isolated from cerebrospinal fluid (60.3%, n = 44) largely collected from children (88.2%, n = 64). Overall, most bacteria exhibited high resistance to all regularly used antimicrobials excluding ciprofloxacin. Conclusions Our report demonstrates an increase in bacterial infection burden in sites other than blood stream and subsequent increase in prevalence of antimicrobial resistance for all major isolates. Creating an epidemiological survey unit at MCH will be essential to help inform better treatment and management options for patients with bacterial infections.

Diagnostic tests for detecting Chlamydia trachomatis and Neisseria gonorrhoeae in rectal and pharyngeal specimens

2021 ◽  
Author(s):  
Paul C. Adamson ◽  
Jeffrey D. Klausner
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Bacterial Infections ◽  
Point Of Care ◽  
High Sensitivity ◽  
Population Level ◽  
The United States ◽  
Nucleic Acid Amplification ◽  
Point Of Care Test ◽  
Control And Prevention

Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.

Atypical Bacterial Infections Explained by a Concomitant Virus Infection

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 411-414
Author(s):  
Ron Dagan ◽  
Caroline B. Hall ◽  
Marilyn A. Menegus
Keyword(s):  
Early Childhood ◽  
Virus Infection ◽  
Bacterial Infection ◽  
Clinical Manifestation ◽  
Bacterial Infections ◽  
Recent Progress ◽  
Clinical Presentation ◽  
Virus Detection ◽  
Dual Infection ◽  
Dual Infections

Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.

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