Factors associated with mortality or survival of patients with tuberculosis: an integrative review

Objective: To identify factors associated with mortality or survival of patients with isolated Tuberculosis (TB) or TB/HIV co-infection. Methods: A literature review was performed in the following databases: PubMed, Web of Science, Scopus, Health Virtual Library, and SciELO sing the following search terms: “Survival” OR “Mortality” AND “Epidemiological factors” OR “Epidemiological determinants” OR “Associated factors.” Recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes methodology were used. Results: The factors associated with mortality or reduced survival were male sex, age >30 years in TB/HIV co-infection cases, advanced age in isolated TB cases, low schooling or up to 8 years of schooling, unemployment, TB/HIV co-infection, recent diagnosis of HIV, CD4 <50 cells, other immunosuppressive diseases, diabetes, renal disease, smoking, alcoholism, weight loss, and recently treatment started. Final considerations: Factors associated with TB mortality or survival did not differ from those associated with TB morbidity. However, excluding TB/HIV co-infection, the socioeconomic factors are evidenced.

Pfizer-BioNTech and Sinopharm: A Comparative Study on Post-Vaccination Antibody Titers

COVID-19 (coronavirus disease 2019) vaccines induce immunity through different mechanisms. The aim of this study is to compare the titers of specific antibodies in subjects vaccinated with either the Pfizer-BioNTech COVID-19 vaccine or the Sinopharm vaccine. This prospective observational cohort included Jordanian adults vaccinated with two doses, 21 days apart, of either of the two aforementioned vaccines. Titers were collected 6 weeks after the administration of the second dose. Overall, 288 participants were included, of which 141 were administered the Pfizer-BioNTech vaccine, while 147 were administered the Sinopharm vaccine. Remarkably, 140 (99.3%) of the Pfizer-BioNTech vaccine recipients had positive IgG titers, while 126 (85.7%) of Sinopharm recipients had positive IgG (p < 0.001). The mean titer for IgG among Pfizer-BioNTech recipients was 515.5 ± 1143.5 BAU/mL, compared to 170.0 ± 230.0 BAU/mL among Sinopharm subjects (p < 0.001). Multivariable regression analysis showed that the Pfizer-BioNTech vaccine positively correlated with positive IgG titers (OR: 25.25; 95% CI: 3.25–196.15; p = 0.002), compared with a negative effect of cardiovascular diseases (OR: 0.33; 95% CI: 0.11–0.99; p = 0.48) on IgG titers. In conclusion, fully vaccinated recipients of the Pfizer-BioNTech vaccine had superior quantitative efficiency compared to Sinopharm recipients. A booster dose is supported for Sinopharm recipients, or those with chronic immunosuppressive diseases.

TOXOPLASMOSIS AND CONGENITAL DISTURBANCE

Toxoplasmosis is a disease caused by intracellular protozoan parasites called Toxoplasma gondii. The animal and human could suffer from infections through different routes involving diets, non-hygienic habit, contacts to soil, as well as blood transfusions and organs grafting. Some people with immune-compromised status are at a high risk of infection; examples of these groups are pregnant women, fetuses, and newborns. This study aimed to evaluate the role of Toxoplasma infection in the manifestation of abortions and other congenital disturbances among married women aged 18 to 45 years in Maysan city (in the south of Iraq). Inclusion criteria include the study group with a history of infection with Toxoplasma gondii (100 females) and for controls, those who were free from toxoplasmosis (100 females). Exclusion criteria were pregnant women, unmarried women, and those suffering from immunosuppressive diseases. The serum samples were tested for IgG and IgM against Toxoplasma gondii antigens by using the Biomerieux Mini VIDAS automated immunoassay system, which depended on the principle of Enzyme-Linked Fluorescent Assay (ELFA) technology. The study revealed that infected non-aborted women were 14 (14%), while non-infected non-aborted women were 24 (24%). Infected women with one case of abortion were sixty (60.0%), while non-infected women with one case of abortion were 40 (40.0%). The infected women who had two abortion cases and those infected ones who had more than two cases of abortions were 26 (26%) and 14 (14%), respectively. There was a statistically significant difference between infected and uninfected women regarding abortion (p 0.01). It has been found that there were highly significant differences between infected and non-infected women concerning anomalies and deliveries by cesarean sections (p-value = 0.001). There was a statically significant difference (p-value =0.01) between infected and non-infected women concerning their deliveries with or without premature babies.

Steroid therapy does not affect the rate of indeterminate results with the T-SPOT.TB interferon gamma release assay

Background: The underlying causes of indeterminate (invalid) interferon-gamma release assays are not clear and predictors of indeterminate results do not exist. To date the effect of steroid concomitant therapy on the rate of indeterminate tests is unknown. Methods: We performed a retrospective analysis of the results of 1339 tests, including clinical data from patient records, of which 914 were suitable for complete data analysis.Results: 130 (15.2 %) tests were positive and 719 (83.8 %) were negative, 9 tests (1 %) were borderline positive (according to manufacturer’s definition). Indeterminate results (56 (6.1 %) arose from failure of the negative control in 24 (42.9 %) and failure of the positive control in 32 (57.1 %) tests. Of 914 patients, 196 were taking cortisone at the time of testing; among these patients 180 (91.8 %) returned a valid result and 16 (8.2 %) an indeterminate result compared to 40 indeterminate tests of 718 (5.6 %) results from patients not on corticosteroid therapy at the time of testing (p = 0.180), (relative risk [RR] 1.46, [95 % CI 0.84 to 2.56]). No significant difference in the rate of indeterminate results was found with immunosuppressive diseases or medications other than with HIV; among HIV-positive patients, 11 (11.7 %) had an indeterminate test result, compared to 45 (5.5 %) in HIV-negative individuals (p =0.017, relative risk [RR] 2.13, [95 % CI 1.14 to 3.98]).Conclusions: steroid therapy does not have an effect whereas HIV positivity has a negative effect on the number of indeterminate results in the T-Spot.TB test.

Nocardia Infection in patients with pemphigus Vulgaris in Tehran, Iran

Objective: Nocardiosis is an opportunistic infection in individuals who had organ transplants and in patients with immunosuppressive diseases, such as pemphigus vulgaris (PV), diabetes mellitus, and HIV. Nocardiosis rate has not been assessed in Iranian PV patients, and this was the first study to estimate nocardiosis rate in these patients. : In this study, 103 PV patients have been studied. BAL samples were obtained and direct smear was analyzed by PAS staining. Samples were cultured on antibiotic containing blood and chocolate agar media. DNA extraction and PCR were performed on positive cultures, and final identification was done by 16S rRNA gene sequencing. Drug susceptibility testing was done by micro-broth dilution method. Results: Four positive cultures (3.88%) were found in the samples (n = 103). According to sequence analysis, 2 isolates were identified as N. cyriacigeorgica and 2 as N. otitidiscaviarum and N. cerradoensis. N. cerradoensis isolated from an invasive brain infection. Isolated bacteria were susceptible to majority of the tested antibiotics, except 1 isolate of N. cyriacigeorgica and isolate of N. cerradoensis. This was the first isolation of N. cerradoensis of human infection in Asia. PV patients are as susceptible to nocardiosis as other immunocompromised patients.

The Roles of MicroRNAs (miRNAs) in Avian Response to Viral Infection and Pathogenesis of Avian Immunosuppressive Diseases

MicroRNAs (miRNAs) are a class of non-coding small RNAs that play important roles in the regulation of various biological processes including cell development and differentiation, apoptosis, tumorigenesis, immunoregulation and viral infections. Avian immunosuppressive diseases refer to those avian diseases caused by pathogens that target and damage the immune organs or cells of the host, increasing susceptibility to other microbial infections and the risk of failure in subsequent vaccination against other diseases. As such, once a disease with an immunosuppressive feature occurs in flocks, it would be difficult for the stakeholders to have an optimal economic income. Infectious bursal disease (IBD), avian leukemia (AL), Marek’s disease (MD), chicken infectious anemia (CIA), reticuloendotheliosis (RE) and avian reovirus infection are on the top list of commonly-seen avian diseases with a feature of immunosuppression, posing an unmeasurable threat to the poultry industry across the globe. Understanding the pathogenesis of avian immunosuppressive disease is the basis for disease prevention and control. miRNAs have been shown to be involved in host response to pathogenic infections in chickens, including regulation of immunity, tumorigenesis, cell proliferation and viral replication. Here we summarize current knowledge on the roles of miRNAs in avian response to viral infection and pathogenesis of avian immunosuppressive diseases, in particular, MD, AL, IBD and RE.

Is there a correlation between canine adult-onset demodicosis and other diseases?

Demodicosis is frequently seen in small animal practice. In older dogs, it is often associated with immunosuppression and immunosuppressive diseases. The aim of this study was to evaluate a larger number of dogs with adult-onset demodicosis (AOD) at the veterinary teaching hospitals of the University of Sydney/Australia and the University of Munich/Germany. Breed predispositions were compared with the two control populations. Of more than 20 000 dogs and 15 000 in each respective hospital population, 54 dogs in Munich and 68 dogs in Sydney were diagnosed with AOD at a mean age of 8 years. Breed predispositions were seen for West Highland White Terriers in Munich (p<0.0001) and Maltese Terriers and Shih Tzus in Sydney (p<0.01). Concurrent diseases were confirmed in approximately 40% of the dogs both in Munich and Sydney. A significant association was only found between AOD and hyperglucocorticoidism, hypothyroidism and (in Munich) leishmaniosis. Neoplastic diseases were not significantly more common in dogs with demodicosis than in the total population at both locations (p>0.05). Consequently, dogs with AOD should be evaluated for concurrent hyperglucocorticoidism and hypothyroidism, and, in areas of the world where this is prevalent, also for leishmaniosis.