Detection of Closteridium difficile in patients with Hematological Malignancies: A Stool Based Immunochromatographic study

2021 ◽  
pp. 5010-5014
Author(s):  
Suha A. AL-Fakhar ◽  
Saad Hasan Mohammed Ali ◽  
Khalil Ismail A. Mohammed ◽  
Wifaq M. Ali ◽  
Jinan M. Mousa
Keyword(s):  
Risk Factors ◽  
Cellular Immunity ◽  
Clinical Symptoms ◽  
Fungal Infections ◽  
Lymphocytic Leukemia ◽  
Teaching Hospitals ◽  
Number Of Patients ◽  
Hospital Patients ◽  
Stool Samples ◽  
Fresh Stool

Background: Diarrhea is a common problem in patients with hematologic disease and in patients with immuno compromising conditions. Objective: The aim of the study was to evaluate the presence risk factors that leading to acquire infection with Cl. difficile in children infected sever diarrhea in and immuno compromised patients. Material and Methods: The study was performed on freshly collected stool samples among 32 patients (13 females,19 males) with acute diarrheal in children their ages (1.5 months – 1.3 years) admitted to Pediatric Teaching Hospitals and adults admitted to Baghdad Teaching Hospital (patients with low cellular immunity like ALL, AML (20-75years) from April 2017 to April 2019. A questionnaire was completed for each patient name, age, gender, clinical symptoms like fever, diarrhea, constipation and, abdominal pain. The criteria included also, the risk factors that leading to suppression of cellular immunity. Fresh stool samples were tested by immunochromatographic assay for antigenic detection of Clostridium difficile Ag. Results: C. Idifficile antigen was identified only in three stool samples of male their mean ± S.D. was (24.75-24.37) from 32 patients (13 females,19 males) their ages rang (1.5months-75years), seven of them suffered blood malignancies (such as AML, ALL), while 21patients (seven of them babies) suffered from acute diarrhea with different causes (E. histolytica and fungal infections). All patients had fever, flatulence and abdominal patients, while 4 of patients with low cellular immunity. Conclusion: Cl. diffcile antigen present only few number of patients in three stool samples of maleswho suffered from sever diarrhea, or ALL (acute lymphocytic leukemia), or NHL (non-hodgkinse lymphoma).

scholarly journals A Study on Prevalence and Characterization of Candida Species in Immunocompromised Patients

2021 ◽  
Author(s):  
Dhanapal Nandini ◽  
J. Manonmoney ◽  
J. Lavanya ◽  
K.V. Leela ◽  
Sujith
Keyword(s):  
Risk Factors ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Predisposing Factors ◽  
Immunocompromised Patients ◽  
Candida Spp ◽  
Gram Staining ◽  
Number Of Patients ◽  
Candida Infections ◽  
Associated Risk Factors

Candida spp. is one among the major causes of nosocomial infection, with candidemia gaining increasing prevalence worldwide in parallel with mortality rates ranging from 10-49%. Epidemiology and predisposing factors of candidemia have changed since the number of patients receiving transplants and immunosuppressive therapy, the use of broadspectrum antimicrobials, and the number of AIDS patients have increased. Candidemia is more common among patients with subcutaneous and cutaneous candida infections, through percutaneous inoculation. Major predisposing factors for invasive candidiasis includes neutropenia, haematological malignancies, bone marrow transplantation, total parenteral nutrition, chemotherapy, invasive procedures, and immune-suppressive agents. This study analyses the risk factors of immunocompromised patients with candidemia and antibiogram of Candida spp. isolated from ICU patients. To evaluate the prevalence, distribution and antibiogram of Candida spp., associated risk factors, and outcome in candidemia patients. Blood samples received from patients with clinically suspected fungal infections were subjected to gram staining, culture, sugar assimilation & fermentation, Candida Chrome agar (CCA) & Corn meal agar for identification and speciation. Antifungal susceptibility tests were performed by disk-diffusion tests. Among a total of 337 samples received, 22 (6.5%) samples were positive for candida infections, of which Candida tropicalis 9 (41%) was the predominant isolate followed by C. albicans 5 (23%), Candida glabrata 4 (18%), Candida parapsilosis 2 (9%) and Candida krusei 2 (9%). Male patients had a higher prevalence of candidemia 15 (68.2%). Among the age group of 51-70 years, uncontrolled DM(Diabetes mellitus) and CKD (chronic kidney disease) were found to be the predominant co-morbidities with candidemia.

scholarly journals Molecular epidemiology, risk factors, species distribution, antifungal susceptibility and outcome of candidemia in the capital of Iran: a prospective study

2020 ◽  
Author(s):  
Mohammad Kord ◽  
Mohammadreza Salehi ◽  
Seyed Jamal Hashemi ◽  
Sassan Rezaie ◽  
Ayda Maleki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Epidemiology ◽  
Species Distribution ◽  
Clinical Symptoms ◽  
Antifungal Susceptibility ◽  
Underlying Disease ◽  
Antifungal Drugs ◽  
Teaching Hospitals ◽  
A Prospective Study ◽  
Underlying Diseases

Abstract Background Candidemia is a major cause of morbidity and mortality among patients receiving immunosuppressive therapy and those hospitalized with serious underlying diseases despite the commencement of antifungal therapy. We investigated the molecular epidemiology, clinical characteristics, comorbidity risk factors, species distribution, antifungal susceptibility profile, and outcome of candidemia to provide appropriate perspectives in Tehran, Iran. Methods A prospective observational study of all patients diagnosed with candidemia was performed at two referral teaching hospitals in Tehran. Demographic characteristics, underlying diseases, risk factors, clinical symptoms, and laboratory analyses were mined. Results One-hundred and fifty-two Candida isolates from 89 patients with candidemia were recovered. The overall crude mortality was 47.2%. The most common underlying disease was sepsis (48.3%) followed by malignancy (46.1%), renal failure/ dialysis (43.8%), and Hypertension (40.0%). C. albicans (43.8%) was the most frequent causative agent followed by C. glabrata (21.3%), C. parapsilosis complex (15.7%), C. tropicalis (11.2%), and C. lusitaniae (3.4%). Result of antifungal susceptibility test show that activity of all the four azole antifungal agents was low against non-albicans Candida species, especially C. tropicalis. Conclusion Increase in non-albicans Candida species with reduced susceptibility to antifungal drugs might be alarming in high-risk patients. Therefore, accurate knowledge of predisposing factors and epidemiological patterns in candidemia are effective steps for managing and decreasing the mortality rate in candidemia.

Epidemiology and risk factors of invasive fungal infections in a large cohort of patients with chronic lymphocytic leukemia

2016 ◽  
Vol 35 (4) ◽  
pp. 925-928 ◽  
Author(s):  
Andrea Visentin ◽  
Carmela Gurrieri ◽  
Silvia Imbergamo ◽  
Federica Lessi ◽  
Speranza Antonia Di Maggio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Lymphocytic Leukemia ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Large Cohort ◽  
Lymphocytic Leukemia

scholarly journals Chronic lymphocytic leukemia in general practice

2021 ◽  
Vol 27 (1-2) ◽  
pp. 40-46
Author(s):  
Ljiljana Đurović
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Blood Count ◽  
Complete Blood Count ◽  
Clinical Symptoms ◽  
Pathological Finding ◽  
Lymphocytic Leukemia ◽  
Medical Council ◽  
Time Space ◽  
Breath Sounds ◽  
Number Of Patients

Introduction: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults, rarely affecting children. It is more common in males over 60. Etiopathogenetically, it represents an abnormal proliferation of lymphocytes in the bone marrow, which are dysfunctional although morphologically similar to mature ones. Case report: Female patient, 66, a housewife, comes for an examination due to fatigue lasting about a month and weight loss of 3-4 kg. She denies other health problems. On the examination, she is alert, oriented to time, space, and persons, eupnoeic, lymphadenopathy on the neck, axillae and groins. She gives away the impression of a patient with mild clinical symptoms. Clinical examination: clear breath sounds in all lung fields, regular heartbeat, clear tones, BP 140/80 mmHg, abdomen at chest level, painless to palpation, liver not palpable, and spleen palpated 2 cm below the costal arch. CBC (complete blood count) showed an increased number of leukocytes 181.30x109 /L and lymphocytosis 92.2%, other parameters were normal. She was referred to the hematologist in the Kraljevo General Hospital, where further diagnostics were performed. Blood count was repeated, Chest X-ray was performed, ultrasound (US) of the abdomen neck, axillae, groins, and heart, virology tests, ENT examination. Abdominal US showed a pathological finding with enlarged liver, spleen, lymph nodes (LN). ENT examination: enlarged tonsils, other findings unremarkable. Since chronic lymphocytic leukemia was suspected, she was referred to the Clinical Center of Serbia. Immunophenotyping (IF) and computed tomography (CT) of the neck, chest, and abdomen were performed. The diagnosis of CLL was confirmed. A Medical Council decided to perform immunochemotherapy (IHT) with fludarabine and rituximab. After 6 received cycles, the patient feels well and the CBC parameters are normal. Conclusion: CLL may be asymptomatic or nonspecific and with mild symptoms in a large number of patients. Therefore, blood tests with leukocytosis and absolute lymphocytosis findings are crucial to suspect the disease and perform further diagnostics.

Bladder dysfunction in women with diabetes mellitus

2019 ◽  
pp. 34-40
Author(s):  
Thi Bich Ngoc Hoang ◽  
Hai Thuy Nguyen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Bladder Dysfunction ◽  
Clinical Symptoms ◽  
Residual Volume ◽  
Cross Sectional ◽  
Diabetic Cystopathy ◽  
Postvoid Residual ◽  
Postvoid Residual Volume

Introduction: Lower urinary tract dysfunctions secondary to type 2 DM are common, chronic and costly disorders. The incidence of diabetic bladder dysfunction was estimated range between 43% and 87% for type 1 and 25% for type 2 diabetes. Ultrasonography is an easy-to-use, fast, safe, non-invasive, painless, pleasant and valuable method of assessing Bladder Post-Void Residual Volume (PVR). Aim: To investigate prevalence of bladder dysfunction and its relation with risk factors, clinical features of diabetic cystopathy in women with diabetes, to identify the values predicting to have postvoid residual volume of the risk factors. Methods: A cross sectional descriptive study, a cohort of 84 female inpatients and outpatients with diabetes mellitus who were treated at Hue University of Medicine and Pharmacy Hospital from 08/2017 to 08/2019 and 84 healthy control subjects were enrolled, the patients were carried out clinical finding, taken blood tests, and estimated postvoid residual volume using 2D ultrasound. Results: the postvoid residual volume was presented in 67 cases (79.80%), the clinical symptoms of diabetic cystopathy were reported in 75% of women with diabetes. Blood glucose, HbA1c, clinical symptoms of diabetic cystopathy, postural hypotension and diabetic peripheral neuropathy were associated with postvoid residual volume. The HbA1c level had a great capability to predict who had postvoid residual volume, at HbA1c cutoff value of 9.1%, Se 65.67%, Sp 94.12%, AUC 0.811, p < 0.001. Conclusion: Bladder dysfunction made up a highly prevalent in women with poor glycemic control. Key words: bladder dysfunction, diabetic cystopathy, bladder postvoid residual volume (PVR)

An Analysis of Dental Implants Survival and Success

2018 ◽  
Vol 69 (9) ◽  
pp. 2465-2466
Author(s):  
Iustin Olariu ◽  
Roxana Radu ◽  
Teodora Olariu ◽  
Andrada Christine Serafim ◽  
Ramona Amina Popovici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Medical History ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Health Related

Osseointegration of a dental implant may encounter a variety of problems caused by various factors, as prior health-related problems, patients� habits and the technique of the implant inserting. Retrospective cohort study of 70 patients who received implants between January 2011- April 2016 in one dental unit, with Kaplan-Meier method to calculate the probability of implants�s survival at 60 months. The analysis included demographic data, age, gender, medical history, behavior risk factors, type and location of the implant. For this cohort the implants�survival for the first 6 months was 92.86% compared to the number of patients and 97.56% compared to the number of total implants performed, with a cumulative failure rate of 2.43% after 60 months. Failures were focused exclusively on posterior mandible implants, on the percentage of 6.17%, odds ratio (OR) for these failures being 16.76 (P = 0.05) compared with other localisations of implants, exclusively in men with median age of 42 years.

A Unique Case of Cutaneous Cunninghamella infection in an Immunocompromised Patient (Preprint)

2020 ◽  
Author(s):  
Mauricio Portillo ◽  
Shyam Allamaneni ◽  
Richard Goodman
Keyword(s):  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Lymphocytic Leukemia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Unique Case ◽  
Systemic Complications ◽  
Prompt Treatment ◽  
Mode Of Transmission ◽  
And Control

UNSTRUCTURED Cunninghamella species are an extremely rare cause of fungal infections. The usual mode of transmission is through inhalation however rare cases of cutaneous spread have been reported. The objective of this clinical case report is to highlight the uniqueness of which the patient acquired the infection, the progression, and control of it. A 57-year-old male with chronic lymphocytic leukemia was found to have an abscess next to his peripherally inserted central catheter (PICC) line. The abscess culture grew back Cunninghamella and was debrided and treated with a novel antifungal. The fungal infection was controlled and the total timeframe took 28 days. Rapid recognition and prompt treatment demonstrate the prevention of rapidly progressive angioinvasian and further systemic complications. This case also proves that a novel antifungal may be appropriate in controlling the spread of Cunninghamella species.

scholarly journals 1095. Investigation of Risk Factors Associated with Serious Bacterial, Viral and Invasive Fungal Infections in Hematologic Patients on Ibrutinib

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S576-S577
Author(s):  
Thomas Holowka ◽  
Harry Cheung ◽  
Maricar F Malinis ◽  
Sarah Perreault ◽  
Iris Isufi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infections ◽  
Antimicrobial Prophylaxis ◽  
Hematologic Malignancy ◽  
Invasive Fungal Infections ◽  
Risk Of Infection ◽  
Factors Associated ◽  
Serious Infection ◽  
Increased Risk ◽  
Serious Infections

Abstract Background Ibrutinib is a tyrosine kinase inhibitor used to treat hematologic malignancies that may increase the risk of serious infection including invasive fungal infections (IFI). In a study of 378 patients with hematologic malignancy on ibrutinib, serious infection and IFI occurred in 11% and 4% respectively (Varughese et al. Clin Infect Dis). The primary aims of our study were to determine the incidence of serious infection and associated risk factors in patients on ibrutinib. Methods We performed a retrospective analysis of patients with hematologic malignancy prescribed ibrutinib for ≥ 1 week at Yale New Haven Hospital from 2014 to 2019 to identify serious infections defined as those requiring inpatient management. We collected demographic, clinical and oncologic data. Chi-squared tests were used to determine factors associated with an increased risk of infection. Results A total of 254 patients received ibrutinib including 156 with CLL, 89 with NHL and 9 with other leukemias. Among these, 21 underwent HSCT, 9 complicated by GVHD. There were 51 (20%) patients with serious infections including 45 (17.7%) bacterial, 9 (3.5%) viral and 5 (2%) IFI (1 pulmonary cryptococcosis, 4 pulmonary aspergillosis). Anti-mold prophylaxis was prescribed to 7 (2.8%) patients, none of whom developed IFI. Risk factors associated with serious infection included ECOG score ≥ 2 (OR 4.6, p &lt; 0.001), concurrent steroid use (≥ 10 mg prednisone daily for ≥ 2 weeks; OR 3.0, p &lt; 0.001), neutropenia (OR 3.6, p &lt; 0.01), lymphopenia (OR 2.4, p &lt; 0.05) and maximum ibrutinib dose of 560 mg (OR 2, p &lt; 0.05). There was a dose dependent increase in infections based on number of chemotherapy regimens prior to ibrutinib initiation: 14.3% with 0, 19.7% with 1-2 and 28.7% with ≥ 3 prior treatments. Conclusion The incidence of serious infection in hematologic patients on ibrutinib was higher than previously reported (20% versus 11%) but the rate of IFI was lower (2% versus 4%). High ECOG score, leukopenia, steroids, and higher ibrutinib doses were associated with an increased risk for serious infection. Targeted antimicrobial prophylaxis should be considered for patients on ibrutinib with these risk factors. Improving functional status may also reduce the risk of infection in patients on ibrutinib. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Masato Ise ◽  
Eiji Nakata ◽  
Yoshimi Katayama ◽  
Masanori Hamada ◽  
Toshiyuki Kunisada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Soft Tissue ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Soft Tissue Tumors ◽  
Number Of Patients ◽  
Primary Bone ◽  
Associated Risk Factors ◽  
Numeric Rating

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

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