scholarly journals Antibiotic Heteroresistance in Klebsiella pneumoniae

2021 ◽  
Vol 23 (1) ◽  
pp. 449
Author(s):  
Karolina Stojowska-Swędrzyńska ◽  
Adrianna Łupkowska ◽  
Dorota Kuczyńska-Wiśnik ◽  
Ewa Laskowska
Keyword(s):  
Klebsiella Pneumoniae ◽  
Genetic Instability ◽  
Multidrug Resistant ◽  
Therapeutic Strategies ◽  
World Health ◽  
Increased Risk ◽  
The World ◽  
Health Organization ◽  
Tract Infections ◽  
Critical Public Health

Klebsiella pneumoniae is one of the most common pathogens responsible for infections, including pneumonia, urinary tract infections, and bacteremias. The increasing prevalence of multidrug-resistant K. pneumoniae was recognized in 2017 by the World Health Organization as a critical public health threat. Heteroresistance, defined as the presence of a subpopulation of cells with a higher MIC than the dominant population, is a frequent phenotype in many pathogens. Numerous reports on heteroresistant K. pneumoniae isolates have been published in the last few years. Heteroresistance is difficult to detect and study due to its phenotypic and genetic instability. Recent findings provide strong evidence that heteroresistance may be associated with an increased risk of recurrent infections and antibiotic treatment failure. This review focuses on antibiotic heteroresistance mechanisms in K. pneumoniae and potential therapeutic strategies against antibiotic heteroresistant isolates.

scholarly journals Covid-19 and Acute Kidney Injury: Recent Updates

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Recent Literature ◽  
Kidney Injury ◽  
World Health ◽  
Related Disease ◽  
Increased Risk ◽  
The World ◽  
Health Organization

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 

A global perspective on suicides and suicide attempts

2021 ◽  
pp. 93-98
Author(s):  
Elise Paul
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Global Perspective ◽  
World Health ◽  
Populations At Risk ◽  
Increased Risk ◽  
World Mental Health Survey ◽  
The World ◽  
Health Organization ◽  
Ongoing Monitoring

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.

scholarly journals Avibactam Restores the Susceptibility of Clinical Isolates of Stenotrophomonas maltophilia to Aztreonam

2017 ◽  
Vol 61 (10) ◽  
Author(s):  
Maria F. Mojica ◽  
Krisztina M. Papp-Wallace ◽  
Magdalena A. Taracila ◽  
Melissa D. Barnes ◽  
Joseph D. Rutter ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
World Health ◽  
Combination Therapies ◽  
Content Type ◽  
Medical Need ◽  
The World ◽  
Health Organization

ABSTRACT Stenotrophomonas maltophilia is an emerging opportunistic pathogen, classified by the World Health Organization as one of the leading multidrug-resistant organisms in hospital settings. The need to discover novel compounds and/or combination therapies for S. maltophilia is urgent. We demonstrate the in vitro efficacy of aztreonam-avibactam (ATM-AVI) against S. maltophilia and kinetically characterize the inhibition of the L2 β-lactamase by avibactam. ATM-AVI overcomes aztreonam resistance in selected clinical strains of S. maltophilia, addressing an unmet medical need.

scholarly journals Vitamin D and atherosclerosis

2021 ◽  
Vol 12 (1) ◽  
pp. 99-108
Author(s):  
Vesna Lazić ◽  
Biljana Mijović ◽  
Miloš Maksimović ◽  
Olivera Rašević ◽  
Maida Mulić ◽  
...  
Keyword(s):  
Physical Activity ◽  
Vitamin D ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
World Health ◽  
Risk Marker ◽  
Increased Risk ◽  
The World ◽  
Calcium And Phosphorus ◽  
Health Organization

Cardiovascular diseases rank first on the mortality list globally or 31%. The basic measure of prevention in accordance with the recommendations of the World Health Organization is a change in risk lifestyle in terms of diet, physical activity, tobacco and alcohol consumption. Vitamin D was previously recognized as a regulator of calcium and phosphorus ratio, bone remodeling or the main controller of skeletal pathophysiology. However, vitamin D enjoys great interest in clinical and epidemiological research in terms of its possible impact on reducing the risk of cardiovascular diseases. Among other things, vitamin D deficiency is associated with an increased risk of endothelial dysfunction. Although the deficiency has been identified as a risk marker for cardiovascular diseases, the mechanism of action of vitamin D on the path from endothelial dysfunction to cardiovascular diseases has not been fully revealed. The findings in this segment of activity of vitamin D would be significant in terms of reducing morbidity and mortality from cardiovascular diseases.

scholarly journals The Great Masquerader: Tuberculosis Presenting as Community-Acquired Pneumonia

2020 ◽  
Vol 41 (04) ◽  
pp. 592-604
Author(s):  
Keertan Dheda ◽  
Edson Makambwa ◽  
Aliasgar Esmail
Keyword(s):  
Community Acquired Pneumonia ◽  
Sub Saharan Africa ◽  
World Health ◽  
Limited Data ◽  
Common Cause ◽  
The World ◽  
Diagnostic Approaches ◽  
Sub Saharan ◽  
Health Organization ◽  
Tract Infections

AbstractAccording to World Health Organization estimates, tuberculosis (TB) and lower respiratory tract infections (LRTIs) are both among the top 10 global causes of death. TB and community-acquired pneumonia (CAP), if mortality estimates are combined, would rank as the third most common cause of death globally. It is estimated that each year there are approximately 10 million new cases of TB that are associated with approximately 1.2 million deaths, and almost 450 million new episodes of LRTI (synonymous with CAP) with approximately 4 million associated deaths. Globally, Streptococcus pneumoniae remains the most common cause of CAP. However, although well documented, it is not widely appreciated that in several parts of the world, including sub-Saharan Africa, Asia, and South America, Mycobacterium tuberculosis is an important cause of CAP, if not the most common organism isolated in such settings. Thus, CAP due to M. tuberculosis is not uncommon in some parts of the world with up to a third of cases being attributable to M. tuberculosis. Consequently, TB remains an important clinical entity in the intensive care unit in these settings. Despite its frequency and importance, there are very limited data about TB CAP. In this review we discussed the epidemiology, immunopathogenesis, clinical presentation, diagnosis, management, prognosis, and prevention of TB CAP. The utility of newer diagnostic approaches is highlighted.

Oxidative and haemostatic effects of copper, manganese and mercury, alone and in combination at physiologically relevant levels: An ex vivo study

2018 ◽  
Vol 38 (4) ◽  
pp. 419-433 ◽  
Author(s):  
MJ van Rensburg ◽  
M van Rooy ◽  
MJ Bester ◽  
JC Serem ◽  
C Venter ◽  
...  
Keyword(s):  
World Health Organization ◽  
Ex Vivo ◽  
Thrombus Formation ◽  
World Health ◽  
Anthropogenic Activity ◽  
Increased Risk ◽  
Metal Levels ◽  
The World ◽  
Subsequent Exposure ◽  
Health Organization

Water contamination with metals due to anthropogenic activity is increasing and subsequent exposure increases the risk of associated toxicity. Exposure is not limited to a single metal but usually involves mixtures of different metals at different concentrations. Little is known about the contribution of this type of exposure, in humans, to the development of non-communicable diseases such as cardiovascular disease, and an increased risk to thrombosis. The World Health Organization has established limits for metal levels in drinking water and this includes levels for copper (Cu), manganese (Mn) and mercury (Hg). In this study, at 100X these limits, the ability of the metals’ oxidative effects as catalysts of the Fenton reaction and/or ability to bind glutathione (GSH) were determined. The haemostatic effects of these metals, alone and in combination, at the World Health Organization limit were then evaluated. The ultrastructural and viscoelastic alterations of exposed ex vivo whole blood were also evaluated using scanning electron microscopy and thromboelastography® (TEG), respectively. Cu, alone and in combination with Mn and/or Hg, induced hydroxyl radical formation and reduced GSH levels. Ex vivo exposure caused deformation of erythrocytes and accelerated platelet activation especially for Cu, alone and in combination, with Mn. Reduction in the lysis potential of the clot was also observed for all combinations, especially Cu in combination with Hg as well as Mn alone. Although the TEG findings were not statistically significant, the trends indicate that the exposure to these metals, alone and in combination, adversely affects thrombus formation in ex vivo blood, thereby potentially increasing the risk in exposed individuals for thrombosis.

Polycythaemia vera

2020 ◽  
pp. 113-125
Author(s):  
Tiziano Barbui ◽  
Tariq I. Mughal ◽  
Guido Finazzi
Keyword(s):  
World Health ◽  
Polycythaemia Vera ◽  
First Line ◽  
First Line Therapy ◽  
Increased Risk ◽  
The World ◽  
Recent Phase ◽  
Health Organization ◽  
Cell Disorder ◽  
Acute Myeloid

Polycythaemia vera (PV) is a clonal stem cell disorder characterized by erythrocytosis and associated with burdensome symptoms, risk of thrombohaemorrhagic complications, and transformation to myelofibrosis and acute myeloid leukaemia. Diagnostic criteria are very recently revised by the World Health Organization (WHO) based on haemoglobin and haematocrit levels, bone marrow morphology consistent with trilineage proliferation and presence of the JAK2 V617 mutation. Cytoreductive therapy is indicated in patients at increased risk of thrombosis. Hydroxyurea (HU) remains the most commonly used first-line cytoreductive therapy and interferon (IFN) is used either at failure of HU or in selected patients as first-line therapy. A recent phase 3 trial has shown the superiority of the JAK1/2 inhibitor ruxolitinib in comparison to best available treatment in HU-intolerant or resistant patients.

scholarly journals Prophylaxis and Treatment against Klebsiella pneumoniae: Current Insights on This Emerging Anti-Microbial Resistant Global Threat

2021 ◽  
Vol 22 (8) ◽  
pp. 4042
Author(s):  
Vanessa Arato ◽  
Maria Michelina Raso ◽  
Gianmarco Gasperini ◽  
Francesco Berlanda Scorza ◽  
Francesca Micoli
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Outer Membrane Proteins ◽  
Opportunistic Pathogen ◽  
Multidrug Resistant ◽  
World Health ◽  
Current Status ◽  
Middle Income ◽  
Health Organization ◽  
Global Threat

Klebsiella pneumoniae (Kp) is an opportunistic pathogen and the leading cause of healthcare-associated infections, mostly affecting subjects with compromised immune systems or suffering from concurrent bacterial infections. However, the dramatic increase in hypervirulent strains and the emergence of new multidrug-resistant clones resulted in Kp occurrence among previously healthy people and in increased morbidity and mortality, including neonatal sepsis and death across low- and middle-income countries. As a consequence, carbapenem-resistant and extended spectrum β-lactamase-producing Kp have been prioritized as a critical anti-microbial resistance threat by the World Health Organization and this has renewed the interest of the scientific community in developing a vaccine as well as treatments alternative to the now ineffective antibiotics. Capsule polysaccharide is the most important virulence factor of Kp and plays major roles in the pathogenesis but its high variability (more than 100 different types have been reported) makes the identification of a universal treatment or prevention strategy very challenging. However, less variable virulence factors such as the O-Antigen, outer membrane proteins as fimbriae and siderophores might also be key players in the fight against Kp infections. Here, we review elements of the current status of the epidemiology and the molecular pathogenesis of Kp and explore specific bacterial antigens as potential targets for both prophylactic and therapeutic solutions.

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