scholarly journals Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018

2021 ◽  
Vol 9 ◽  
Author(s):  
Elena Chiappini ◽  
Francesca Larotonda ◽  
Catiuscia Lisi ◽  
Vania Giacomet ◽  
Paola Erba ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Opportunistic Infections ◽  
Mortality Rates ◽  
Mortality And Morbidity ◽  
Clinical Events ◽  
Drug Classes ◽  
Combined Antiretroviral Therapy ◽  
Class B ◽  
Steep Decrease ◽  
Hiv 1

Background: Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited.Methods: An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018.Results: Three hundred and fifty-four (32%) AIDS events and 26 (2%) deaths occurred overtime. Mortality rates decreased from 0.4/100 person-years in 2001–2006 to 0.27/100 person-years in 2007–2012 and 0.07/100 person-years in 2013–2018. Notably, 92% of the dead children were born in Italy, but only 50% were followed-up since birth or within three months of age. Seventy three percent of children had started cART at age ≥6 months; 23% were treated for <30 days before death. B and C clinical events progressively decreased (P < 0.0001). Opportunistic infections significantly decreased over time, but still were the most common events in all the periods (6.76/100 person-years in 2013–2018). In the last period, severe bacterial infections were the most common ones. Cancer rates were 0.07/100; 0.17/100; 0.07/100 person-years in the three periods, respectively.Conclusions: Progressive reductions both in mortality and in rates of class B and C clinical events and OIs have been observed during the cART era. However, deaths were still registered; more than half of dead children were enrolled after birth and had belatedly started cART.

Probiotics Slow the Growth of Pathogenic Bacteria

2019 ◽  
Vol 14 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Rowles H. L.
Keyword(s):  
Growth Rate ◽  
Bacterial Infections ◽  
Pathogenic Bacteria ◽  
Diarrheal Disease ◽  
Growth Curves ◽  
Mortality Rates ◽  
Controlled Delivery ◽  
E Coli ◽  
Multiple Strains ◽  
Commercial Probiotics

Probiotics are live microorganisms, which when ingested in sufficient amounts, confer health benefits to the host by improving the gut microflora balance. The purpose of this research was to determine whether commercial probiotic products containing multitude of commensal bacteria would reduce the growth rate of pathogenic bacteria, specifically Escherichia coli and Salmonella typhimurium. Growth curves were established, and the growth rates were compared for samples of E. coli, S. typhimurium, Nature’s Bounty Controlled Delivery probiotic, Sundown Naturals Probiotic Balance probiotic, and cocultures of the pathogenic bacteria mixed with the probiotics. The findings of this research were that the commercial probiotics significantly reduced the growth rate of E. coli and S. typhimurium when combined in cocultures. Probiotics containing multiple strains may be taken prophylactically to reduce the risk of bacterial infections caused by E. coli and S. typhimurium. Probiotics could be used to reduce the high global morbidity and mortality rates of diarrheal disease.

The Discovery and Development of Oxalamide and Pyrrole Small Molecule Inhibitors of gp120 and HIV Entry - A Review

2019 ◽  
Vol 19 (18) ◽  
pp. 1650-1675 ◽  
Author(s):  
Damoder Reddy Motati ◽  
Dilipkumar Uredi ◽  
E. Blake Watkins
Keyword(s):  
Small Molecule ◽  
Viral Entry ◽  
Biological Evaluation ◽  
New Drugs ◽  
Design Synthesis ◽  
Mortality And Morbidity ◽  
Glycoprotein Gp120 ◽  
Hiv Entry ◽  
Immunodeficiency Syndrome ◽  
Hiv 1

Human immunodeficiency virus type-1 (HIV-1) is the causative agent responsible for the acquired immunodeficiency syndrome (AIDS) pandemic. More than 60 million infections and 25 million deaths have occurred since AIDS was first identified in the early 1980s. Advances in available therapeutics, in particular combination antiretroviral therapy, have significantly improved the treatment of HIV infection and have facilitated the shift from high mortality and morbidity to that of a manageable chronic disease. Unfortunately, none of the currently available drugs are curative of HIV. To deal with the rapid emergence of drug resistance, off-target effects, and the overall difficulty of eradicating the virus, an urgent need exists to develop new drugs, especially against targets critically important for the HIV-1 life cycle. Viral entry, which involves the interaction of the surface envelope glycoprotein, gp120, with the cellular receptor, CD4, is the first step of HIV-1 infection. Gp120 has been validated as an attractive target for anti-HIV-1 drug design or novel HIV detection tools. Several small molecule gp120 antagonists are currently under investigation as potential entry inhibitors. Pyrrole, piperazine, triazole, pyrazolinone, oxalamide, and piperidine derivatives, among others, have been investigated as gp120 antagonist candidates. Herein, we discuss the current state of research with respect to the design, synthesis and biological evaluation of oxalamide derivatives and five-membered heterocycles, namely, the pyrrole-containing small molecule as inhibitors of gp120 and HIV entry.

scholarly journals Human Mucosal Mast Cells Capture HIV-1 and Mediate Viraltrans-Infection of CD4+T Cells

2015 ◽  
Vol 90 (6) ◽  
pp. 2928-2937 ◽  
Author(s):  
Ai-Ping Jiang ◽  
Jin-Feng Jiang ◽  
Ji-Fu Wei ◽  
Ming-Gao Guo ◽  
Yan Qin ◽  
...  
Keyword(s):  
T Cells ◽  
Mast Cells ◽  
Cell Surface ◽  
Bacterial Infections ◽  
Mucosal Mast Cells ◽  
Mucosal Tissues ◽  
Viral Particles ◽  
Molecular Patterns ◽  
Hiv 1

ABSTRACTThe gastrointestinal mucosa is the primary site where human immunodeficiency virus type 1 (HIV-1) invades, amplifies, and becomes persistently established, and cell-to-cell transmission of HIV-1 plays a pivotal role in mucosal viral dissemination. Mast cells are widely distributed in the gastrointestinal tract and are early targets for invasive pathogens, and they have been shown to have increased density in the genital mucosa in HIV-infected women. Intestinal mast cells express numerous pathogen-associated molecular patterns (PAMPs) and have been shown to combat various viral, parasitic, and bacterial infections. However, the role of mast cells in HIV-1 infection is poorly defined. In this study, we investigated their potential contributions to HIV-1 transmission. Mast cells isolated from gut mucosal tissues were found to express a variety of HIV-1 attachment factors (HAFs), such as DC-SIGN, heparan sulfate proteoglycan (HSPG), and α4β7 integrin, which mediate capture of HIV-1 on the cell surface. Intriguingly, following coculture with CD4+T cells, mast cell surface-bound viruses were efficiently transferred to target T cells. Prior blocking with anti-HAF antibody or mannan before coculture impaired viraltrans-infection. Cell-cell conjunctions formed between mast cells and T cells, to which viral particles were recruited, and these were required for efficient cell-to-cell HIV-1 transmission. Our results reveal a potential function of gut mucosal mast cells in HIV-1 dissemination in tissues. Strategies aimed at preventing viral capture and transfer mediated by mast cells could be beneficial in combating primary HIV-1 infection.IMPORTANCEIn this study, we demonstrate the role of human mast cells isolated from mucosal tissues in mediating HIV-1trans-infection of CD4+T cells. This finding facilitates our understanding of HIV-1 mucosal infection and will benefit the development of strategies to combat primary HIV-1 dissemination.

scholarly journals Zinc deficiency may play a crucial role in dialysis-associated bacterial infections

2020 ◽  
Vol 11 (1) ◽  
pp. e9-e9
Author(s):  
Zahra Lotfi ◽  
Abbas Ali Zeraati ◽  
Elaheh Dashti ◽  
Tina Zeraati ◽  
Maryam Arghiany ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Bacterial Infections ◽  
Critical Role ◽  
Serum Zinc ◽  
Zinc Level ◽  
Healthy Individuals ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
The Mean

Introduction: Systemic bacterial infections are a common cause of mortality and morbidity in hemodialysis patients. Zinc has a critical role in several immune system functions. Patients who have enough amounts of zinc are able to better face infections caused by various pathogens in comparison to those with zinc insufficiency Objective We sought to assess the role of zinc deficiency in dialysis-associated bacterial infections. Patients and Methods: Eighty-Three adult patients with end-stage renal disease (ESRD) on hemodialysis including 43 patients with bacterial infectious complications and 40 non-infected patients as well as 41 healthy individuals were enrolled. Clinical data, laboratory values including serum zinc level and imaging findings were collected. SPSS was utilized to analyze the data with a significance cutoff set at P < 0.05. Results: Out of 124 participants, 80 (64.51%) were males and 44 (35.49%) were females. The mean age of infected hemodialysis group, non-infected hemodialysis group, and healthy controls were 50.8 ± 16.25, 49.1 ± 18.1, and 56.3 ± 18.2 years, respectively. Catheter site infection (37.3%) and urinary tract infection (30.2%) were the most common infections. The mean serum zinc concentration was significantly lower in the infected patients, compared to non-infected patients and healthy individuals (P < 0.001). Conclusion: The ESRD patients on hemodialysis have lower serum zinc levels which are associated with increased risk of bacterial infection. The role of screening for zinc deficiency and use of supplemental zinc in these patients need to be studied.

scholarly journals Antimicrobial Synergy of Silver-Platinum Nanohybrids With Antibiotics

2021 ◽  
Vol 11 ◽  
Author(s):  
Bansi Ranpariya ◽  
Gayatri Salunke ◽  
Srikanta Karmakar ◽  
Kaushik Babiya ◽  
Santosh Sutar ◽  
...  
Keyword(s):  
Biofilm Formation ◽  
Bacterial Infections ◽  
Bacterial Biofilm ◽  
Antimicrobial Drugs ◽  
Mortality And Morbidity ◽  
Green Route ◽  
Antimicrobial Synergy ◽  
First Time ◽  
Tuber Extract ◽  
Powerful Strategy

Various bacterial pathogens are responsible for nosocomial infections resulting in critical pathophysiological conditions, mortality, and morbidity. Most of the bacterial infections are associated with biofilm formation, which is resistant to the available antimicrobial drugs. As a result, novel bactericidal agents need to be fabricated, which can effectively combat the biofilm-associated bacterial infections. Herein, for the first time we report the antimicrobial and antibiofilm properties of silver-platinum nanohybrids (AgPtNHs), silver nanoparticles (AgNPs), and platinum nanoparticles (PtNPs) against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The AgPtNHs were synthesized by a green route using Dioscorea bulbifera tuber extract at 100°C for 5 h. The AgPtNHs ranged in size from 20 to 80 nm, with an average of ∼59 nm. AgNPs, PtNPs, and AgPtNHs showed a zeta potential of −14.46, −1.09, and −11.39 mV, respectively. High antimicrobial activity was observed against P. aeruginosa and S. aureus and AgPtNHs exhibited potent antimicrobial synergy in combination with antibiotics such as streptomycin, rifampicin, chloramphenicol, novobiocin, and ampicillin up to variable degrees. Interestingly, AgPtNHs could inhibit bacterial biofilm formation significantly. Hence, co-administration of AgPtNHs and antibiotics may serve as a powerful strategy to treat bacterial infections.

scholarly journals EVALUATING THE ETIOLOGY AND DISEASE SPECIFIC CLINICAL PROFILES OF ACUTE UNDIFFERENTIATED FEBRILE ILLNESS

2020 ◽  
pp. 73-75
Author(s):  
Dharmendra Prasad ◽  
Sumit Kumar ◽  
Raj Kumar Deepak ◽  
Mahendra Kumar ◽  
Debarshi Jana
Keyword(s):  
Bacterial Infections ◽  
Local Community ◽  
Febrile Illness ◽  
Medicine Department ◽  
Medical College ◽  
Clinical Profiles ◽  
Acute Bacterial Infections ◽  
Typhus Fever ◽  
Hiv 1 ◽  
Disease Specific

Background: To evaluate the etiology and disease specific clinical profiles of acute undifferentiated febrile illness (AUFI) in Medicine Department of Govt. Medical College and Hospital, Bettiah, W. Champaran, Bihar. Methods: This 1 year prospective, observational study was conducted in Govt. Medical College and Hospital, Bettiah, Bihar from October 2019 to September 2020 in 150 patients. Clinical evaluation and relevant investigations like Blood culture; malarial parasites and febrile serology (acute and convalescent) were performed. Results and Observation: A total of 150 AUFI patients were evaluated: scrub typhus (19); malaria (3); enteric fever (2); dengue (11); leptospirosis (19); hantavirus (1), acute bacterial infections (14), HIV (1), hepatitis (1), and unclear diagnoses (79). Conclusion: This study reports discovery of dengue, typhus fever, leptospirosis, and rare disease like Hanta and more number undiagnosed cases ranging from 15% to 42% in local community. This shows that further research is required in identifying the etiology of undifferentiated fevers.

scholarly journals In-Hospital Mortality and Morbidity Among Patients Presenting with Intracranial Hemorrhage: A Single Center's Experience with Vitamin K Antagonists and the Direct Oral Anticoagulants

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3668-3668
Author(s):  
Christopher Cipkar ◽  
Sujitha Srinathan ◽  
Philip Chiang ◽  
Lana A Castellucci
Keyword(s):  
Hospital Mortality ◽  
Chart Review ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Bleeding Event ◽  
Mortality Rates ◽  
Clinical Impact ◽  
Mortality And Morbidity ◽  
Ottawa Hospital

Background Oral anticoagulants are the preferred therapy for the treatment of venous thromboembolism and for stroke prevention among patients with atrial fibrillation. Given their widespread use, clinicians must balance efficacy of anticoagulation with their associated bleeding risks. Specifically, intracranial hemorrhage (ICH) is the most feared complication as this form of bleeding has the highest mortality and morbidity. To date, clinical trials suggest a lower incidence of ICH and better safety profile among patients prescribed the direct oral anticoagulants (DOACs) compared with traditional vitamin k antagonists (VKAs). Although promising, further understanding is needed to appreciate the clinical impact once a DOAC-related bleeding event does occur. The aim of this study was to evaluate anticoagulation use, in-hospital mortality rates and functional outcome among patients presenting with ICH to a large tertiary care center in Canada. Methods In this study, we present data from a retrospective chart review of patients who presented to The Ottawa Hospital with ICH between January 2016 and December 2017. Patients were identified using ICD-10 codes from the Ottawa Hospital Data Warehouse. Patient demographics, type of anticoagulant/antiplatelet agent and indication for therapy were collected. The primary outcome was in-hospital mortality rates among patients prescribed oral anticoagulants compared with those not anticoagulated or on antiplatelet therapy. A secondary outcome was functional assessment of survivors at hospital discharge using the modified Rankin Scale (mRS), a validated tool used widely in contemporary stroke research to measure the degree of disability after a neurological event. Results 481 patients were identified in the Data Warehouse and manual chart review confirmed 429 patients diagnosed with ICH. Patients not taking any anticoagulant or antiplatelet therapy tended to be younger and had lengthier admissions with longer stays in the ICU. The most common indication for anticoagulation in those presenting with ICH was atrial fibrillation. Intraparenchymal bleeding was most common among patients on DOACs, while patients on warfarin tended to have more subdural hematomas (Table 1). In-hospital mortality was 45.8% in DOAC-related ICH, 29.4% in warfarin-related ICH and 15.5% in patients not on an anticoagulant or antiplatelet. Average modified Rankin Scale at the time of discharge was 4.52 in DOAC-related ICH, 4.23 in warfarin-related ICH and 3.2 in patients not on an anticoagulant or antiplatelet (Table 2). Conclusions In this cohort of patients presenting with ICH to a large academic hospital, the in-hospital mortality rate was higher in patients receiving oral anticoagulation compared to those not on anticoagulants. DOAC-related ICH tended to have worse outcomes with higher in-hospital mortality and worse functional outcomes among survivors on discharge. Although the DOACs are reported in the literature to have an overall lower incidence of ICH, further information is still needed to understand the clinical impact when a bleeding event does occur. Disclosures Castellucci: BMS: Honoraria; Pfizer: Honoraria; Bayer: Honoraria; LEO Pharma: Honoraria; Sanofi: Honoraria; Aspen: Honoraria; Servier: Honoraria.

scholarly journals Bacteriological profile and antibiogram of cancer patients admitted in intensive care unit of a tertiary care cancer hospital in central Kerala

2020 ◽  
Vol 8 (12) ◽  
pp. 4450
Author(s):  
Sanjana Ramakrishnan ◽  
Sourabh Radhakrishnan ◽  
Sonu Lazar Cyriac
Keyword(s):  
Cancer Patients ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
E Coli ◽  
Resistance To Penicillin ◽  
Study Laboratory

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.

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