scholarly journals High Frequency of Enterocytozoon bieneusi Genotype WL12 Occurrence among Immunocompromised Patients with Intestinal Microsporidiosis

2021 ◽  
Vol 7 (3) ◽  
pp. 161
Author(s):  
Mariem Messaoud ◽  
Salma Abbes ◽  
Mayssa Gnaien ◽  
Yasmine Rebai ◽  
Aicha Kallel ◽  
...  
Keyword(s):  
High Frequency ◽  
Minimum Spanning Tree ◽  
Phylogenetic Analyses ◽  
Organ Transplant ◽  
Enterocytozoon Bieneusi ◽  
Health Concern ◽  
Common Source ◽  
Immunocompromised Patients ◽  
Hospital Stays ◽  
Frequency Occurrence

Microsporidiosis is an emerging opportunistic infection causing severe digestive disorders in immunocompromised patients. The aim of this study was to investigate the prevalence of intestinal microsporidia carriage among immunocompromised patients hospitalized at a major hospital complex in the Tunis capital area, Tunisia (North Africa), and perform molecular epidemiology and population structure analyses of Enterocytozoon bieneusi, which is an emerging fungal pathogen. We screened 250 stool samples for the presence of intestinal microsporidia from 171 patients, including 81 organ transplant recipients, 73 Human Immunodeficiency Virus (HIV)-positive patients, and 17 patients with unspecified immunodeficiency. Using a nested PCR-based diagnostic approach for the detection of E. bieneusi and Encephalitozoon spp., we identified 18 microsporidia-positive patients out of 171 (10.5%), among which 17 were infected with E. bieneusi. Microsporidia-positive cases displayed chronic diarrhea (17 out of 18), which was associated more with HIV rather than with immunosuppression other than HIV (12 out of 73 versus 6 out of 98, respectively, p = 0.02) and correlated with extended hospital stays compared to microsporidia-negative cases (60 versus 19 days on average, respectively; p = 0.001). Strikingly, internal transcribed spacer (ITS)-based genotyping of E. bieneusi strains revealed high-frequency occurrence of ITS sequences that were identical (n = 10) or similar (with one single polymorphic site, n = 3) to rare genotype WL12. Minimum-spanning tree analyses segregated the 17 E. bieneusi infection cases into four distinct genotypic clusters and confirmed the high prevalence of genotype WL12 in our patient population. Phylogenetic analyses allowed the mapping of all 17 E. bieneusi strains to zoonotic group 1 (subgroups 1a and 1b/1c), indicating loose host specificity and raising public health concern. Our study suggests a probable common source of E. bieneusi genotype WL12 transmission and prompts the implementation of a wider epidemiological investigation.

scholarly journals Hepatitis E Virus Quasispecies and the Outcome of Acute Hepatitis E in Solid-Organ Transplant Patients

2012 ◽  
Vol 86 (18) ◽  
pp. 10006-10014 ◽  
Author(s):  
Sebastien Lhomme ◽  
Florence Abravanel ◽  
Martine Dubois ◽  
Karine Sandres-Saune ◽  
Lionel Rostaing ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Acute Hepatitis ◽  
Hepatitis E Virus ◽  
Organ Transplant ◽  
Hepatitis E ◽  
Solid Organ Transplant ◽  
First Year ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Serum Concentrations

Hepatitis E virus (HEV) infections are responsible for chronic hepatitis in immunocompromised patients, and this can evolve to cirrhosis. Like all RNA viruses, HEV exists as a mixture of heterogeneous viruses defining quasispecies. The relationship between the genetic heterogeneity described as a quasispecies, cytokine secretion, and the outcome of acute hepatitis in immunocompromised patients remains to be elucidated. We cloned and sequenced the region encoding the M and P capsid domains of HEV from eight solid-organ transplant (SOT) patients with acute HEV infection who subsequently cleared the virus and from eight SOT patients whose infection became chronic. We analyzed the cytokines and chemokines in the sera of these SOT patients by multianalyte profiling. The nucleotide sequence entropy and genetic distances were greater in patients whose infections became chronic. A lowerKa/Ksratio was associated with the persistence of HEV. The patients who developed chronic infection had lower serum concentrations of interleukin-1 (IL-1) receptor antagonist and soluble IL-2 receptor. Increased concentrations of the chemokines implicated in leukocyte recruitment to the liver were associated with persistent infection. Those patients with chronic HEV infection and progressing liver fibrosis had less quasispecies diversification during the first year than patients without liver fibrosis progression. Great quasispecies heterogeneity, a weak inflammatory response, and high serum concentrations of the chemokines involved in leukocyte recruitment to the liver in the acute phase were associated with persistent HEV infection. Slow quasispecies diversification during the first year was associated with rapidly developing liver fibrosis.

Molecular diagnosis and antifungal resistance and biofilm production profiles among Candida species isolated from immunocompromised patients at Menoufia University Hospitals

2020 ◽  
Vol 29 (3) ◽  
pp. 37-45
Author(s):  
Mabrouk M Ghonaim ◽  
Azza Z. Labeeb ◽  
Alyaa I. Eliwa ◽  
Eman H. Salem
Keyword(s):  
Candida Species ◽  
Biofilm Formation ◽  
Antifungal Susceptibility ◽  
High Sensitivity ◽  
Antifungal Resistance ◽  
Common Source ◽  
Immunocompromised Patients ◽  
University Hospitals ◽  
Biofilm Production ◽  
Vitek 2

Background: Accurate and rapid identification of Candida species is necessary for proper diagnosis and treatment of candidiasis due to emergences of drug-resistant strains especially among immunocompromised patients. Objectives: Identification of Candida clinical isolates to the species level using different phenotypic and molecular methods. Biofilm-forming ability and antifungal resistance were also studied. Methodology: Sixty-nine Candida strains were isolated from 220 immunocompromised patients. Identification was performed using chromogenic Candida agar, VITEK 2 system and multiplex polymerase chain reaction (PCR). Biofilm formation was detected by the tube method and antifungal susceptibility was tested using the VITEK2 system. Results: The most common source of Candida isolates was from urine (33.3%) and ICUs (56.6%). VITEK 2 system detected 9 spp.: C. albicans (34.8%), C. tropicalis (21.7%), C. famata (8.7%), C. lusitaniae (7.2%), C. cruzi (7.2%), C. ciferri (5.8%), C. dubliniensis (5.8%), C. parapsilosis (5.8 %) and C. glabrata. Candida isolates showed high resistance to flucytocine (49.3%), and high sensitivity to fluconazole, micafungin, voriconazole and caspofungin (88.4%, 81.2% and 81.2 % respectively). Only 30.4% of all Candida isolates were biofilm producers. There was a positive relationship between antifungal resistance and biofilm formation among Candida isolates. Conclusion: C. albicans was the predominant species. Chromogenic Candida agar and VITEK 2 system were valuable tests compared to PCR in speciation of Candida isolates. Antifungal susceptibility was significantly related to biofilm production and its evaluation is important for proper treatment..

The Integrated Ocean Observing System High-Frequency Radar Network: Status and Local, Regional, and National Applications

2010 ◽  
Vol 44 (6) ◽  
pp. 122-132 ◽  
Author(s):  
Jack Harlan ◽  
Eric Terrill ◽  
Lisa Hazard ◽  
Carolyn Keen ◽  
Donald Barrick ◽  
...  
Keyword(s):  
High Frequency ◽  
Surface Current ◽  
Water Quality Monitoring ◽  
Velocity Fields ◽  
Common Source ◽  
Integrated Network ◽  
High Frequency Radar ◽  
Radar Network ◽  
Network Status ◽  
Ocean Observing

AbstractA national high-frequency radar network has been created over the past 20 years or so that provides hourly 2-D ocean surface current velocity fields in near real time from a few kilometers offshore out to approximately 200 km. This preoperational network is made up of more than 100 radars from 30 different institutions. The Integrated Ocean Observing System efforts have supported the standards-based ingest and delivery of these velocity fields to a number of applications such as coastal search and rescue, oil spill response, water quality monitoring, and safe and efficient marine navigation. Thus, regardless of the operating institution or location of the radar systems, emergency response managers, and other users, can rely on a common source and means of obtaining and using the data. Details of the history, the physics, and the application of high-frequency radar are discussed with successes of the integrated network highlighted.

scholarly journals A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Oluwaseun Shogbesan ◽  
Dilli Ram Poudel ◽  
Samjeris Victor ◽  
Asad Jehangir ◽  
Opeyemi Fadahunsi ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
English Language ◽  
Fecal Microbiota Transplantation ◽  
Secondary Infection ◽  
Organ Transplant ◽  
Fecal Microbiota ◽  
Immunocompromised Patients ◽  
Serious Adverse Events ◽  
Fecal Microbiota Transplant ◽  
Immunosuppressant Medications

Background. Fecal microbiota transplantation (FMT) has been shown to be effective in recurrent Clostridium difficile (CD) infection, with resolution in 80% to 90% of patients. However, immunosuppressed patients were often excluded from FMT trials, so safety and efficacy in this population are unknown. Methods. We searched MEDLINE and EMBASE for English language articles published on FMT for treatment of CD infection in immunocompromised patients (including patients on immunosuppressant medications, patients with human immunodeficiency virus (HIV), inherited or primary immunodeficiency syndromes, cancer undergoing chemotherapy, or organ transplant, including-bone marrow transplant) of all ages. We excluded inflammatory bowel disease patients that were not on immunosuppressant medications. Resolution and adverse event rates (including secondary infection, rehospitalization, and death) were calculated. Results. Forty-four studies were included, none of which were randomized designs. A total of 303 immunocompromised patients were studied. Mean patient age was 57.3 years. Immunosuppressant medication use was the reason for the immunocompromised state in the majority (77.2%), and 19.2% had greater than one immunocompromising condition. Seventy-six percent were given FMT via colonoscopy. Of the 234 patients with reported follow-up outcomes, 207/234 (87%) reported resolution after first treatment, with 93% noting success after multiple treatments. There were 2 reported deaths, 2 colectomies, 5 treatment-related infections, and 10 subsequent hospitalizations. Conclusion. We found evidence that supports the use of FMT for treatment of CD infection in immunocompromised patients, with similar rates of serious adverse events to immunocompetent patients.

scholarly journals Hepatitis E Virus Immunopathogenesis

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1180
Author(s):  
Kush Kumar Yadav ◽  
Scott P. Kenney
Keyword(s):  
Hepatitis E Virus ◽  
Organ Transplant ◽  
Hepatitis E ◽  
Oral Route ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
In Vivo Models ◽  
Transplant Patients

Hepatitis E virus is an important emerging pathogen producing a lethal impact on the pregnant population and immunocompromised patients. Starting in 1983, it has been described as the cause for acute hepatitis transmitted via the fecal–oral route. However, zoonotic and blood transfusion transmission of HEV have been reported in the past few decades, leading to the detailed research of HEV pathogenesis. The reason behind HEV being highly virulent to the pregnant population particularly during the third trimester, leading to maternal and fetal death, remains unknown. Various host factors (immunological, nutritional, hormonal) and viral factors have been studied to define the key determinants assisting HEV to be virulent in pregnant and immunocompromised patients. Similarly, chronic hepatitis is seen particularly in solid organ transplant patients, resulting in fatal conditions. This review describes recent advances in the immunopathophysiology of HEV infections in general, pregnant, and immunocompromised populations, and further elucidates the in vitro and in vivo models utilized to understand HEV pathogenesis.

scholarly journals Deep Neck Space Infections in Northern Ghana

2020 ◽  
pp. 265-270
Author(s):  
Theophilus Adjeso ◽  
Mawutor Dzogbefia ◽  
Edem Kojo Dzantor
Keyword(s):  
Antibiotic Use ◽  
Northern Ghana ◽  
Common Source ◽  
Odontogenic Infections ◽  
Source Of Infection ◽  
Lethal Complications ◽  
Deep Neck Space Infections ◽  
Hospital Stays ◽  
Age Range ◽  
Tamale Teaching Hospital

Background: Deep neck space infections (DNSI) continue to pose a challenge due to its potentially lethal complications that can arise despite the reduced prevalence as a result of widespread antibiotic use and improved dental care. We conducted a review of our experience with DNSI at the Ear, Nose and Throat (ENT) Unit, Tamale Teaching Hospital (TTH). Materials and Methods: We performed a retrospective analysis of patients hospitalized with a diagnosis DNSI at the ENT Unit, TTH from January 2013 to June 2020. Parameters analyzed included the age and sex distribution of patients, source of infection, sites involved, duration of admission and outcomes. Data analysis was done using SPSS version 20.0 (Chicago, IBM 2010). Results: The study involved 135 cases of DNSIs with age range of 5 months to 76 years (35.7± 19.0 years). Majority of the DNSIs cases occurred within the third decade of life and slightly more common among males (50.4%). The duration of hospital stays ranged from a day to 41 days (10.1± 8.2 days). Multi-space abscesses were the most common diagnosed DNSIs with odontogenic infections (63%) being the most common source of DNSIs. Majority (83.7%) of the patients were successfully treated with a mortality rate of 12.6%. Conclusion: DNSIs was most common among males with patients in their third decade most affected. Odontogenic infections were the most common source of DNSI with multi-space abscesses being the most common presentation. Majority of the patients were treated successfully.

scholarly journals Screening of opportunistic Encephalitozoon intestinalis and Enterocytozoon bieneusi in immunocompromised patients in Slovakia

2019 ◽  
Vol 27 (4) ◽  
pp. 330-334 ◽  
Author(s):  
Monika Halánová ◽  
Alexandra Valenčáková ◽  
Pavol Jarčuška ◽  
Miloš Halán ◽  
Oľga Danišová ◽  
...  
Keyword(s):  
Enterocytozoon Bieneusi ◽  
Immunocompromised Patients ◽  
Encephalitozoon Intestinalis

scholarly journals Cryptoccal meningitis in non-HIV, non-organ transplant diabetic patients

2021 ◽  
Vol 8 (4) ◽  
pp. 591
Author(s):  
Sneha Biradar ◽  
Balakrishna Teli
Keyword(s):  
Human Immunodeficiency Virus ◽  
Organ Transplant ◽  
Case Series ◽  
Central Nervous System Disease ◽  
Diabetic Patients ◽  
Immunocompromised Patients ◽  
Current Case ◽  
Infected People ◽  
System Disease ◽  
Immunodeficiency Virus

Cryptococcosis is an important opportunistic fungal infection and also cause of death due to central nervous system disease among patients with human immunodeficiency virus worldwide. Most of the cases occur in immunocompromised patients like HIV infected people, people with organ transplants and on immunosuppressants. Nowdays there is increase in cases of cryptoccal meningitis among diabetic patients. Current case series includes cryptococcal meningitis among diabetic patients after ruling out of other immunocompromised states. 

scholarly journals 865. Acanthamoeba Disease Associated With the Practice of Nasal Rinsing in Immunocompromised Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S22-S22 ◽  
Author(s):  
Jennifer Cope ◽  
Shantanu Roy ◽  
Ibne Ali
Keyword(s):  
Tap Water ◽  
Organ Transplant ◽  
The United States ◽  
Case Report Form ◽  
Solid Organ ◽  
Immunocompromised Patients ◽  
Free Living ◽  
Transplant Patients ◽  
Route Of Transmission ◽  
Free Living Ameba

Abstract Background The genus Acanthamoeba are free-living amebae found worldwide in water, including tap water, and soil that can cause rare but severe infections of the eye, skin, and central nervous system. Acanthamoeba spp. generally cause disease in immunocompromised persons, including those with HIV, hematologic malignancies, and solid organ transplants. The route of transmission and incubation period are not well known in humans, but animal studies have shown that disease can be produced via the intranasal, intrathecal, and intravenous routes. We describe 5 cases of Acanthamoeba disease among immunocompromised patients who practiced nasal rinsing prior to becoming ill. Methods The Centers for Disease Control and Prevention (CDC) offers a clinical consultation service for free-living ameba infections and maintains a Free-living Ameba laboratory with confirmatory diagnostic testing capabilities. When an Acanthamoeba case is confirmed in the United States, details about the case are collected on a standardized case report form which includes questions about the case–patient’s water and soil exposure prior to becoming ill. Questions about nasal rinsing were added to the form in 2011. Results Five Acanthamoeba case patients in CDC’s free-living ameba database were reported to have performed nasal rinsing prior to becoming ill. The median age was 60 years (range 36–73 years) and 3 of 5 patients were female. Two were solid-organ transplant patients (heart and kidney), 2 had chronic lymphocytic leukemia, and 1 had HIV. Three patients presented only with encephalitis and died. The 2-organ transplant patients had a combination of rhinosinusitis, osteomyelitis, and skin lesions. One survived and the other died, the cause of which was unrelated to Acanthamoeba. All reported using tap water to perform nasal rinsing, most for sinus congestion using a neti pot or similar device and one for religious purposes. Conclusion Acanthamoeba is an inhabitant of water, including treated tap water. Immunocompromised patients, like those presented here, might be at risk for infections caused by Acanthamoeba transmitted via tap water used for nasal rinsing. Clinicians caring for immunocompromised patients should advise their patients not to use tap water for nasal or sinus rinsing. Disclosures All authors: No reported disclosures.

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