Minimally invasive sampling to identify leprosy patients with a high bacterial burden in the Union of the Comoros

The World Health Organization (WHO) endorsed diagnosis of leprosy (also known as Hansen’s disease) entirely based on clinical cardinal signs, without microbiological confirmation, which may lead to late or misdiagnosis. The use of slit skin smears is variable, but lacks sensitivity. In 2017–2018 during the ComLep study, on the island of Anjouan (Union of the Comoros; High priority country according to WHO, 310 patients were diagnosed with leprosy (paucibacillary = 159; multibacillary = 151), of whom 263 were sampled for a skin biopsy and fingerstick blood, and 260 for a minimally-invasive nasal swab. In 74.5% of all skin biopsies and in 15.4% of all nasal swabs, M. leprae DNA was detected. In 63.1% of fingerstick blood samples, M. leprae specific antibodies were detected with the quantitative αPGL-I test. Results show a strong correlation of αPGL-I IgM levels in fingerstick blood and RLEP-qPCR positivity of nasal swabs, with the M. leprae bacterial load measured by RLEP-qPCR of skin biopsies. Patients with a high bacterial load (≥50,000 bacilli in a skin biopsy) can be identified with combination of counting lesions and the αPGL-I test. To our knowledge, this is the first study that compared αPGL-I IgM levels in fingerstick blood with the bacterial load determined by RLEP-qPCR in skin biopsies of leprosy patients. The demonstrated potential of minimally invasive sampling such as fingerstick blood samples to identify high bacterial load persons likely to be accountable for the ongoing transmission, merits further evaluation in follow-up studies.

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Recent Advancement in the Diagnosis and Treatment of Leprosy

Current Topics in Medicinal Chemistry ◽

10.2174/1568026618666181025100434 ◽

2018 ◽

Vol 18 (18) ◽

pp. 1550-1558

Author(s):

Muhammad Aamir ◽

Asma Sadaf ◽

Sehroon Khan ◽

Shagufta Perveen ◽

Afsar Khan

Keyword(s):

Vitamin D ◽

Drug Treatment ◽

Mycobacterium Leprae ◽

Neglected Diseases ◽

Specific Drug ◽

Genetic Studies ◽

Vitamin D Receptors ◽

Micro Rnas ◽

Leprosy Patients ◽

Skin Biopsies

Background: Many of the tropical diseases are neglected by the researchers and medicinal companies due to lack of profit and other interests. The Drugs for Neglected Diseases initiative (DNDi) is established to overcome the problems associated with these neglected diseases. According to a report published by the WHO, leprosy (Hansen's disease) is also a neglected infectious disease. Methods: A negligible amount of advancements has been made in last few decades which includes the tools of diagnosis, causes, treatment, and genetic studies of the bacterium (Mycobacterium leprae) that causes leprosy. The diagnosis of leprosy at earlier stages is important for its effective treatment. Recent studies on vitamin D and its receptors make leprosy diagnosis easier at earlier stages. Skin biopsies and qPCR are the other tools to identify the disease at its initial stages. Results: Until now a specific drug for the treatment of leprosy is not available, therefore, Multi-Drug Therapy (MDT) is used, which is hazardous to health. Besides Mycobacterium leprae, recently a new bacterium Mycobacterium lepromatosis was also identified as a cause of leprosy. During the last few years the genetic studies of Mycobacterium leprae, the role of vitamin D and vitamin D receptors (VDR), and the skin biopsies made the treatment and diagnosis of leprosy easier at early stages. The studies of micro RNAs (miRNAs) made it easy to differentiate leprosy from other diseases especially from tuberculosis. Conclusion: Leprosy can be distinguished from sarcoidosis by quantitative study of reticulin fibers present in skin. The treatment used until now for leprosy is multi-drug treatment. The complete genome identification of Mycobacterium leprae makes the research easy to develop target specified drugs for leprosy. Rifampicin, identified as a potent drug, along with other drugs in uniform multi-drug treatment, has a significant effect when given to leprosy patients at initial stages. These are effective treatments but a specific drug for leprosy is still needed to be identified. The current review highlights the use of modern methods for the identification of leprosy at its earlier stages and the effective use of drugs alone as well as in combination.

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Endovascular Bariatric Surgery as Novel Minimally Invasive Technique for Weight Management in the Morbidly Obese: Review of the Literature

Nutrients ◽

10.3390/nu13082541 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2541

Author(s):

Giuseppe Massimo Sangiorgi ◽

Alberto Cereda ◽

Nicola Porchetta ◽

Daniela Benedetto ◽

Andrea Matteucci ◽

...

Keyword(s):

Bariatric Surgery ◽

Minimally Invasive ◽

Weight Management ◽

World Health ◽

Invasive Technique ◽

Morbidly Obese ◽

World Population ◽

Obese Patients ◽

The World ◽

Open Bariatric Surgery

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.

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Assessing viability of a minimally invasive autopsy technique in ascertaining the probable cause of death in patients who were SARS CoV19 positive at the time of their demise

Surgical and Experimental Pathology ◽

10.1186/s42047-021-00094-3 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Ajay H. Bhandarwar ◽

Girish D. Bakhshi ◽

Eham Arora ◽

Nikhil Dhimole ◽

Sanjay R. Bijwe ◽

...

Keyword(s):

Minimally Invasive ◽

Cause Of Death ◽

Histopathological Examination ◽

Health Hazard ◽

World Health ◽

Invasive Technique ◽

Tissue Samples ◽

Conventional Autopsy ◽

Minimally Invasive Autopsy ◽

Health Organization

Abstract Background SARS CoV-19 was declared as a pandemic by the World Health Organization (WHO), raising up challenges on various levels ranging from therapeutics to diagnostics. The conventional autopsy technique may pose a health hazard to health care workers. A minimally invasive autopsy technique can diminish this hazard. Materials and methods Between August and November 2020, 51 patients who were suffering from Covid-19 at the time of their demise were included. A novel minimally invasive ultrasound-guided technique for procuring tissue samples of major organs was employed which were thereafter subject to histopathological examination. A detailed review of the course in hospital was noted. An analysis was performed to correlate the cause of death ascertained from our minimally invasive technique with the cause of death ascertained clinically. Results There was adequate tissue sampling in 45 cases, where the minimally invasive autopsy technique confirmed the cause of death in all 45 cases (100%) and made it more specific in 5 cases (11.11%). Conclusion Minimally Invasive Autopsy is an easily reproducible technique which has the potential to strengthen the probable the cause of death with reasonable certainty while ensuring safety and ethics.

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Pattern of mycobacterial antigen detection in leprosy

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651995000100002 ◽

1995 ◽

Vol 37 (1) ◽

pp. 7-12 ◽

Cited By ~ 1

Author(s):

C. Pagliari ◽

M. I. S. Duarte ◽

M. N. Sotto

Keyword(s):

Particulate Material ◽

Antigen Detection ◽

Mycobacterial Antigen ◽

Material Characteristics ◽

Leprosy Patients ◽

Antigenic Material ◽

Skin Biopsies

Immunohistochemistry reaction (Peroxidase anti-peroxidase - PAP) was carried out on fifty-two skin biopsies from leprosy patients with the purpose to identify the antigenic pattern in mycobacteria and to study the sensitivity of this method. Five different patterns were found: bacillar, granular, vesicular, cytoplasmatic and deposits, classified according to the antigenic material characteristics. Deposits (thinely particulate material) appeared more frequently, confirming the immunohistochemistry sensitivity to detect small amounts of antigens even when this material is not detected by histochemical stainings.

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Genotyping of Mycobacterium leprae present on Ziehl-Neelsen-stained microscopic slides and in skin biopsy samples from leprosy patients in different geographic regions of Brazil

Memórias do Instituto Oswaldo Cruz ◽

10.1590/s0074-02762012000900021 ◽

2012 ◽

Vol 107 (suppl 1) ◽

pp. 143-149 ◽

Cited By ~ 13

Author(s):

Amanda Nogueira Brum Fontes ◽

Harrison Magdinier Gomes ◽

Marcelo Ivens de Araujo ◽

Edson Cláudio Araripe de Albuquerque ◽

Ida Maria Foschiani Dias Baptista ◽

...

Keyword(s):

Skin Biopsy ◽

Mycobacterium Leprae ◽

Leprosy Patients ◽

Geographic Regions

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Lung Microbiome Differentially Impacts Survival of Patients with Non-Small Cell Lung Cancer Depending on Tumor Stroma Phenotype

Biomedicines ◽

10.3390/biomedicines8090349 ◽

2020 ◽

Vol 8 (9) ◽

pp. 349 ◽

Cited By ~ 1

Author(s):

Olga Kovaleva ◽

Polina Podlesnaya ◽

Madina Rashidova ◽

Daria Samoilova ◽

Anatoly Petrenko ◽

...

Keyword(s):

Lung Cancer ◽

Normal Tissue ◽

Bacterial Load ◽

Alpha Diversity ◽

Tumor Stroma ◽

Small Cell ◽

Adjacent Normal Tissue ◽

Small Cell Lung ◽

Lung Microbiome ◽

High Bacterial Load

The link between a lung tumor and the lung microbiome is a largely unexplored issue. To investigate the relationship between a lung microbiome and the phenotype of an inflammatory stromal infiltrate, we studied a cohort of 89 patients with non-small cell lung cancer. The microbiome was analyzed in tumor and adjacent normal tissue by 16S rRNA amplicon sequencing. Characterization of the tumor stroma was done using immunohistochemistry. We demonstrated that the bacterial load was higher in adjacent normal tissue than in a tumor (p = 0.0325) with similar patterns of taxonomic structure and alpha diversity. Lung adenocarcinomas did not differ in their alpha diversity from squamous cell carcinomas, although the content of Gram-positive bacteria increased significantly in the adenocarcinoma group (p = 0.0419). An analysis of an inflammatory infiltrate of tumor stroma showed a correlation of CD68, iNOS and FOXP3 with a histological type of tumor. For the first time we showed that high bacterial load in the tumor combined with increased iNOS expression is a favorable prognostic factor (HR = 0.1824; p = 0.0123), while high bacterial load combined with the increased number of FOXP3+ cells is a marker of poor prognosis (HR = 4.651; p = 0.0116). Thus, we established that bacterial load of the tumor has an opposite prognostic value depending on the status of local antitumor immunity.

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High bacterial load in negative pressure wound therapy (NPWT) foams used in the treatment of chronic wounds

Wound Repair and Regeneration ◽

10.1111/wrr.12088 ◽

2013 ◽

Vol 21 (5) ◽

pp. 677-681 ◽

Cited By ~ 27

Author(s):

Erlangga Yusuf ◽

Xavier Jordan ◽

Martin Clauss ◽

Olivier Borens ◽

Mark Mäder ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Chronic Wounds ◽

Bacterial Load ◽

Wound Therapy ◽

High Bacterial Load

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Pneumococcal pneumonia and invasive pneumococcal disease: immunopathogenesis and diagnosis

Pneumologia ◽

10.2478/pneum-2019-0009 ◽

2019 ◽

Vol 68 (1) ◽

pp. 8-14

Author(s):

Gina Amanda ◽

Dianiati Kusumo Sutoyo ◽

Erlina Burhan

Keyword(s):

Immune System ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Pneumococcal Pneumonia ◽

Bacterial Load ◽

Adaptive Immune System ◽

Signs And Symptoms ◽

Community Acquired Pneumonia ◽

High Bacterial Load ◽

Droplet Nuclei

Abstract Streptococcus pneumoniae is the most common aetiology of community-acquired pneumonia (CAP). It has many virulence factors, the most important being a polysaccharide capsule (Cps). There are 97 different serotypes of pneumococcal based on Cps which include both colonization and invasive serotypes. Pneumococcal pneumonia may exist as a result of either aspiration of bacteria in the nasopharynx or inhalation of droplet nuclei which contains bacteria until they reach the lower respiratory tract. This condition will activate both innate and adaptive immune system. The diagnosis of pneumococcal pneumonia is established in a patient who has the signs and symptoms of pneumonia, accompanied by the detection of S. pneumoniae in microbiology examination. Pneumococcus may also penetrate into a normally sterile site such as bloodstream, meninges, and pleural cavity, and infection of pneumococcus in those sites are defined as an invasive pneumococcal disease (IPD). High bacterial load, dysfunction of the immune system, and co-colonization of another microorganism may also lead to IPD.

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