Infectious Disease Reports

9 pages, 861 KiB

Open AccessArticle

Proprotein Convertase Subtilisin Kexin 9 Inhibitor in Severe Sepsis and Septic Shock Patients in a Phase II Prospective Cohort Study—Preliminary Results

by Ziv Rosman, Yasmin Maor, Iris Zohar, Gingy Ronen Balmor, Miri Schamroth Pravda, Adam Lee Goldstein, Milena Tocut and Arie Soroksky

Infect. Dis. Rep. 2024, 16(6), 1036-1044; https://doi.org/10.3390/idr16060083 - 24 Oct 2024

Abstract

Sepsis is a life-threatening organ dysfunction syndrome caused by a dysregulated host response to infection that has a high mortality rate. Proprotein convertase subtilisin kexin 9 (PCSK9) is a serine protease secreted by the liver. Its binding to the low-density lipoprotein (LDL) receptor [...] Read more.

Sepsis is a life-threatening organ dysfunction syndrome caused by a dysregulated host response to infection that has a high mortality rate. Proprotein convertase subtilisin kexin 9 (PCSK9) is a serine protease secreted by the liver. Its binding to the low-density lipoprotein (LDL) receptor enhances its degradation, causing an increase in LDL levels in the blood. Objectives: Administering a PCSK9 inhibitor leading to an increase in lipid uptake by the liver may positively affect septic patients due to the increased removal of endotoxins. Methods: This preliminary study aimed to examine the safety of PCSK9 inhibitor use in septic and septic shock patients. We treated five septic patients in the intensive care unit with 300 mg of alirocumab following serious adverse events for 28 days. Results: Four of our patients did not experience any adverse events, and all of them survived. One patient died after discharge from the intensive care unit, and this death was presumably not related to the study drug. The patients rapidly recovered from the inflammatory stage of sepsis. Conclusions: Alirocumab appears safe in severe sepsis and septic shock patients. The outcome data are promising. Only a basic safety profile can be assessed based on this pilot study. Further study with a PCSK-9 inhibitor in septic or septic shock patients is required to further determine its benefit in ICU patients. Full article

(This article belongs to the Section Bacterial Diseases)

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6 pages, 208 KiB

Open AccessCase Report

Consideration of Antifungal Coverage in Treating Infections Related to Delayed Esophageal Perforation from Anterior Cervical Spine Hardware

by Kavita Prasad, John Ceremsak, Jean-Nicolas Gallant, Hannah G. Kay, Erin B. Gettler, Benjamin R. Campbell, Catherine R. Carlile, Byron F. Stephens, Sarah L. Rohde, Patty W. Wright and Christina T. Fiske

Infect. Dis. Rep. 2024, 16(6), 1030-1035; https://doi.org/10.3390/idr16060082 - 23 Oct 2024

Abstract

(1) Background/Objectives: Delayed esophageal perforation following anterior cervical (spine) discectomy and fusion (ACDF) is rare but can lead to serious infectious complications. The treatment usually involves hardware explanation and prolonged intravenous antibiotics; however, there are scarce reports about the microbiology of these infections [...] Read more.

(1) Background/Objectives: Delayed esophageal perforation following anterior cervical (spine) discectomy and fusion (ACDF) is rare but can lead to serious infectious complications. The treatment usually involves hardware explanation and prolonged intravenous antibiotics; however, there are scarce reports about the microbiology of these infections and corresponding targeted therapy. (2) Methods: Patients diagnosed or treated for delayed esophageal perforation after anterior cervical fusion between 2000–2020 at a tertiary medical center were studied. (3) Results: Seven patients with delayed esophageal perforation following ACDF were identified. The most common bacteria isolated included Streptococcus, Haemophilus, and Mycobacterium species. The cultures from five patients grew fungal species, including Candida albicans and C. glabrata. All the patients received several weeks of broad-spectrum antibiotics, and, notably, 5/7 patients received antifungal therapy targeting Candida. (4) Conclusions: Although the incidence of delayed esophageal perforation following ACDF is low, providers should remain aware of this entity due to the serious infectious complications. Most infections are polymicrobial in nature, and providers should consider empiric antifungal coverage specifically targeting Candida species when treating patients with this complication. Full article

(This article belongs to the Section Fungal Infections)

13 pages, 4081 KiB

Open AccessArticle

The Cumulative Variations of Respiratory Syncytial Virus Fusion Protein (F) in Ten Consecutive Years in China

by Fengjie Wang, Mingli Jiang, Zhenzhi Han, Yanpeng Xu, Yu Sun, Runan Zhu, Dongmei Chen, Qi Guo, Yutong Zhou, Yao Yao, Ling Cao, Dong Qu, Muya Li and Linqing Zhao

Infect. Dis. Rep. 2024, 16(5), 1017-1029; https://doi.org/10.3390/idr16050081 - 17 Oct 2024

Abstract

Background: Variations in the fusion (F) protein of respiratory syncytial virus (RSV) with main antigenic sites I–V and Ø may affect the development of RSV vaccines and therapies. Methods: In the study, 30 respiratory specimens positive for RSV were randomly selected from children [...] Read more.

Background: Variations in the fusion (F) protein of respiratory syncytial virus (RSV) with main antigenic sites I–V and Ø may affect the development of RSV vaccines and therapies. Methods: In the study, 30 respiratory specimens positive for RSV were randomly selected from children with acute lower respiratory infections (ALRI) in Beijing every year from 2012 to 2021 for F gene sequencing. Then, 300 F gene sequences and 508 uploaded to GenBank from China were subjected to phylogenetic analysis. Results: The results indicated the nucleotide identities were 95.4–100% among 446 sequences of RSV A, and 96.3–100% among 362 of RSV B. The most common variant loci were N80K (100.00%) and R213S (97.76%) for site Ø, and V384I/T (98.43%) for site I among sequences of RSV A, and M152I (100.00%), I185V (100.00%), and L172Q/H (94.48%) for site V, and R202Q (99.45%) for site Ø among sequences of RSV B. N276S appears in 95.29% sequences of RSV A, while S276N and N262 I/S appear in 1.38% and 0.55% sequences of RSV B, respectively. No variation was found in all sequences at the binding sites of 14N4 and motavizumab. Conclusions: There were cumulative variations of the RSV F gene, especially at some binding sites of antigenic sites. Full article

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12 pages, 18972 KiB

Open AccessCase Report

Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights

by Dana-Georgiana Nedelea, Diana Elena Vulpe, George Viscopoleanu, Alexandru Constantin Radulescu, Alexandra Ana Mihailescu, Sebastian Gradinaru, Mihnea Orghidan, Cristian Scheau, Romica Cergan and Serban Dragosloveanu

Infect. Dis. Rep. 2024, 16(5), 1005-1016; https://doi.org/10.3390/idr16050080 - 12 Oct 2024

Abstract

Objective: We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the intervention [...] Read more.

Objective: We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the intervention and subsequently experienced significant disease progression. Methods: Upon re-presentation in 2022, mild involvement of the T12-L1 vertebrae was recorded by imaging, leading to a percutaneous needle biopsy which confirmed tuberculosis. Despite undergoing anti-tuberculous therapy for one year, the follow-up in 2024 revealed extensive infection from T10 to S1, with large psoas abscesses and a pseudo-tumoral mass of the right thigh. The patient was ultimately submitted to a two-stage surgical intervention: anterior resection and reconstruction of T11-L1 with an expandable cage, followed by posterior stabilization from T8-S1. Results: Postoperative recovery was uneventful, with significant pain relief and no neurological deficits. The patient was discharged on a continued anti-tuberculous regimen and remains under close surveillance. Conclusions: This paper presents details on the challenges of diagnosis and management of severe spinal tuberculosis, with emphasis on the importance of timely intervention and multidisciplinary care. Full article

(This article belongs to the Special Issue Emerging Infections: Epidemiology, Diagnostics, Clinics and Evolution)

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13 pages, 2032 KiB

Open AccessArticle

Investigation of the Effect of the COVID-19 Pandemic Period on Respiratory Tract Viruses at Istanbul Medical Faculty Hospital, Turkey

by Sevim Mese, Aytaj Allahverdiyeva, Mustafa Onel, Hayriye Kırkoyun Uysal and Ali Agacfidan

Infect. Dis. Rep. 2024, 16(5), 992-1004; https://doi.org/10.3390/idr16050079 - 10 Oct 2024

Abstract

Aim: Respiratory viruses significantly impact public health, contributing to high morbidity and mortality rates in both children and adults. This study evaluates the distribution and incidence of respiratory tract viruses in our hospital from 2019 to 2022, focusing on changes post-COVID-19 pandemic. Material [...] Read more.

Aim: Respiratory viruses significantly impact public health, contributing to high morbidity and mortality rates in both children and adults. This study evaluates the distribution and incidence of respiratory tract viruses in our hospital from 2019 to 2022, focusing on changes post-COVID-19 pandemic. Material and Methods: Utilizing molecular methods, we analyzed nasopharyngeal swabs with the FTD Respiratory Pathogens 21 kit and the QIAStat Dx Respiratory Panel kit at Istanbul Faculty of Medicine. A total of 1186 viruses were detected in 2488 samples (47.6% of the total) examined with the FTD Respiratory Pathogens 21 kit between 2019 and 2022. Results: It was determined that the detection rates were 52.8% in 2019, 44.3% in 2020, 50.0% in 2021, and 40.0% in 2022. Notable changes in prevalence were observed for pandemic influenza A (IAV-H1N1pdm2009), parainfluenza virus (PIV)-3, rhinovirus (RV), and respiratory syncytial virus (RSV)-A/B (p < 0.05). RV consistently showed the highest detection rates across all years (17.6% to 7.9%). Additionally, 1276 viruses were detected in 1496 samples using the QIAStat DX kit, with 91.3% positivity in 2021 and 78.6% in 2022, highlighting the kit’s effectiveness in rapid diagnosis. Conclusions: This study enhances understanding of respiratory virus epidemiology during and after the pandemic, emphasizing the need for ongoing surveillance and strategic public health measures to address the evolving landscape of respiratory infections. Full article

(This article belongs to the Section Viral Infections)

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11 pages, 3829 KiB

Open AccessReview

Gallbladder Burkitt’s Lymphoma: A Literature Review Including a Case Report in a Child Living with HIV

by Nathalia Lopez Duarte, Ana Paula Silva Bueno, Bárbara Sarni Sanches, Gabriella Alves Ramos, Layanara Albino Batista, Thalita Fernandes de Abreu, Marcelo Gerardin Poirot Land and Cristiane Bedran Milito

Infect. Dis. Rep. 2024, 16(5), 981-991; https://doi.org/10.3390/idr16050078 - 10 Oct 2024

Abstract

Malignant lymphoma is an unusual form of gallbladder neoplasm. Almost all these tumors are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas. Herein, we present a literature review of gallbladder Burkitt’s lymphoma (BL) cases that includes also an unpublished case in an [...] Read more.

Malignant lymphoma is an unusual form of gallbladder neoplasm. Almost all these tumors are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas. Herein, we present a literature review of gallbladder Burkitt’s lymphoma (BL) cases that includes also an unpublished case in an HIV-infected child, observed by our center. The patient (a five-year-old black female child) attended the Federal Hospital of Lagoa, Rio de Janeiro, Brazil, underwent cholecystectomy, and the postoperative pathological analysis of the gallbladder revealed a diagnosis of BL (EBV-positive). Also, HIV serology was performed and returned positive. She was transferred to the Martagão Gesteira Institute of Pediatrics and Childcare for oncological treatment, dying from sepsis and disease progression about 18 months later. The patient did not undergo ART/cART. Previous cases of gallbladder BL were herein described and analyzed to characterize the clinicopathological features and possible similarities. BL can occur in the gallbladder both in the context of HIV infection and in the pediatric population. A biopsy is mandatory in cases with suggestive findings of lymphoma, and an early diagnosis can change the course of the disease. Furthermore, the case highlights the importance of an early initiation of ART/cART in people living with HIV (PLWH), especially in children. Full article

(This article belongs to the Section HIV-AIDS)

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4 pages, 185 KiB

Open AccessEditorial

The Battle beyond the Battlefield: War’s Influence on Antibiotic Resistance

by Guido Granata, Stefania Cicalini and Nicola Petrosillo

Infect. Dis. Rep. 2024, 16(5), 977-980; https://doi.org/10.3390/idr16050077 - 9 Oct 2024

Abstract

In July 2024, poliovirus was identified in Gaza, prompting the World Health Organization (WHO) to issue a warning regarding the potential for polio to spread in the region [...] Full article

25 pages, 421 KiB

Open AccessReview

Emerging Fungal Infections of the Central Nervous System in the Past Decade: A Literature Review

by Rita Lino, André Rodrigues Guimarães, Estela Sousa, Mariana Azevedo and Lurdes Santos

Infect. Dis. Rep. 2024, 16(5), 952-976; https://doi.org/10.3390/idr16050076 - 9 Oct 2024

Abstract

Introduction: Invasive fungal infections affecting the central nervous system (CNS) are a major health concern worldwide associated with high mortality rates. Their increased incidence is largely due to an increase in the vulnerable immunocompromised population, changing environmental factors, and development of more accurate [...] Read more.

Introduction: Invasive fungal infections affecting the central nervous system (CNS) are a major health concern worldwide associated with high mortality rates. Their increased incidence is largely due to an increase in the vulnerable immunocompromised population, changing environmental factors, and development of more accurate diagnostic methods. The aim of this article is to identify fungal causes of CNS infections that are recently emerging or have the potential to become emerging pathogens in the near future, as well as their clinical characteristics, including: Candida auris, Trichosporon spp., Blastomyces spp., Sporothrix spp., Talaromyces marneffei, Lomentospora prolificans, and Scedosporium spp. Methods: A review of the literature in PubMed in the last ten years was conducted to identify central nervous system infections caused by each of these fungi. Results: The review identified 10 cases caused by C. auris, 5 cases by Trichosporon spp., 82 cases by Blastomyces spp., 36 cases by Sporothrix spp., 21 cases by T. marneffei, 22 cases by Lomentospora prolificans, and 42 cases by Scedosporium spp. Discussion: The exact burden of these diseases remains difficult to ascertain, but their apparent rise underscores the urgent need for improved diagnostic, treatment, and management strategies against CNS fungal pathogens to improve outcomes against these life-threatening infections. Full article

(This article belongs to the Special Issue Emerging and Reemerging Infections of the Central Nervous System)

20 pages, 2950 KiB

Open AccessArticle

Application of PCR-Based Techniques for the Identification of Genetic Fingerprint Diversity of Dominant Bacteria in Fecal Samples of Children with Diarrhea in Vietnam

by Thi Quy Nguyen, Trong Khoa Dao, Hong Duong Nguyen, Thi Bich Thuy Phung, Thi Thanh Nga Pham, Thi Viet Ha Nguyen, Thi Huong Trinh, Huu Cuong Le, Thi Thu Hong Le and Thi Huyen Do

Infect. Dis. Rep. 2024, 16(5), 932-951; https://doi.org/10.3390/idr16050075 - 29 Sep 2024

Abstract

In Vietnam, diarrhea, especially persistent diarrhea, is one of the most common diseases in children, while a significant proportion of cases are negative with pathogens; thus, there is an urgent need to understand gut bacterial dysbiosis. In this study, bacteria in the fecal [...] Read more.

In Vietnam, diarrhea, especially persistent diarrhea, is one of the most common diseases in children, while a significant proportion of cases are negative with pathogens; thus, there is an urgent need to understand gut bacterial dysbiosis. In this study, bacteria in the fecal samples of five healthy and ten diarrheal children were separated from other residues, then adopted to extract their metagenomic DNA for evaluating their diversity based on V3 and V6–V8 regions and the 16S rRNA gene by PCR-RFLP and PCR-DGGE. As a result, bacterial metagenomic DNAs with high quality, quantity and diversity were successfully extracted using a GeneJET kit and a chemical protocol. A sequence analysis of 73 representative DNA fragments from gels indicated a remarkable bacterial dysbiosis in all groups of diarrhea. Viral diarrhea was characterized by extremely reduced bacterial diversity with the blossom of Bifidobacterium and Streptococcus. Streptococcus was also the most abundant in persistent diarrhea. Beneficial bacteria that may play a role in the self- rebalance in intestinal bacterial communities, such as Bifidobacterium, Lactobacillus, and Enterococcus, were seen in all diarrheal groups, while Bacteroides and Akkermansia muciniphila were seen in the healthy group but absent in the diarrheal groups. This study provides additional evidence for a relationship between intestinal bacterial dysbiosis and diarrhea in children, emphasizing an increase in Streptococcus. Full article

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10 pages, 703 KiB

Open AccessBrief Report

Assessment of Long-Term Changes in Knowledge and Attitudes of Household Contacts of COVID-19 Cases in Northern Spain

by Noelia Vera-Punzano, Vanessa Bullón-Vela, Carme Miret, Jéssica Pardos-Plaza, Manuel García Cenoz, Pere Godoy, Jesús Castilla, Àngela Domínguez, Diana Toledo and Iván Martínez-Baz

Infect. Dis. Rep. 2024, 16(5), 923-931; https://doi.org/10.3390/idr16050074 - 23 Sep 2024

Abstract

This study aims to describe the long-term changes in the knowledge of, and attitudes towards, COVID-19 and its preventive measures in northern Spain. A telephonic survey was performed among household contacts of COVID-19 cases in Catalonia and Navarre between May 2022 and December [...] Read more.

This study aims to describe the long-term changes in the knowledge of, and attitudes towards, COVID-19 and its preventive measures in northern Spain. A telephonic survey was performed among household contacts of COVID-19 cases in Catalonia and Navarre between May 2022 and December 2023. Knowledge and attitudes were assessed through 12 questions using a Likert scale, and responses were grouped as correct or incorrect. The change from baseline to the 6-month follow-up was evaluated with the absolute difference (AD) using the proportion of correct answers. At baseline, 299 subjects were contacted, of whom 63.2% (189) completed the 6-month follow-up. Correct knowledge of transmission (>85%) and the use of preventive measures (>92%) were observed at baseline and maintained over time. The attitudes towards face mask use remained adequate over the course of six months (>79%). However, attitudes regarding the use of face masks indoors (AD = −16.4%; p < 0.001) and those who thought that COVID-19 had a negative impact on their lives (AD = −16.5%; p < 0.001) decreased after 6 months. In the post-acute phase of the pandemic, household contacts maintained the correct level of knowledge towards COVID-19, while some attitudes decreased. These results should serve as a guide for health policy makers in decision-making in case of a new increase in the incidence of SARS-CoV-2. Full article

(This article belongs to the Section Infection Prevention and Control)

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9 pages, 2968 KiB

Open AccessArticle

Chikungunya-Driven Gene Expression Linked to Osteoclast Survival and Chronic Arthralgia

by Alysson Henrique Urbanski, Vanessa E. Maso, Felipe M. Martins, André Guilherme da Costa-Martins, Ana Paula B. do Nascimento Oliveira and Helder I. Nakaya

Infect. Dis. Rep. 2024, 16(5), 914-922; https://doi.org/10.3390/idr16050073 - 20 Sep 2024

Abstract

Chikungunya fever (CHIKF), caused by the Chikungunya virus (CHIKV), manifests as acute febrile illness often associated with polyarthritis and polyarthralgia. Although the acute symptoms resolve within two weeks, many patients experience prolonged joint pain and inflammation, resembling rheumatoid arthritis (RA). This study aimed [...] Read more.

Chikungunya fever (CHIKF), caused by the Chikungunya virus (CHIKV), manifests as acute febrile illness often associated with polyarthritis and polyarthralgia. Although the acute symptoms resolve within two weeks, many patients experience prolonged joint pain and inflammation, resembling rheumatoid arthritis (RA). This study aimed to identify molecular markers related to joint pain and chronicity in CHIKV-infected individuals by analyzing blood transcriptomes using bulk RNA sequencing. B- and T-cell receptor (BCR and TCR) diversity was assessed through computational analysis of RNA-seq data, revealing a significant reduction in CDR3 diversity in CHIKV-infected individuals compared to healthy controls. This reduced diversity was associated with the upregulation of genes involved in osteoclast differentiation and activation, particularly through the RANK/RANKL signaling pathway. These findings suggest a potential link between immune dysregulation and enhanced osteoclast activity, which may contribute to the persistence of joint pain in chronic CHIKF. Targeting osteoclast-related pathways could offer therapeutic strategies for managing chronic symptoms in CHIKF patients. Full article

(This article belongs to the Section Neglected Tropical Diseases)

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8 pages, 21693 KiB

Open AccessCase Report

A Case of Yellow Nail Syndrome Complicated with Pulmonary Infection Due to Nocardia cyriacigeorgica

by Qiuyu Li, Jiajia Zheng, Qiuyue Zhang, Ying Liang, Hong Zhu and Yongchang Sun

Infect. Dis. Rep. 2024, 16(5), 906-913; https://doi.org/10.3390/idr16050072 - 18 Sep 2024

Abstract

Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by nail bed changes, pulmonary involvement, and lymphatic drainage disorders. Pulmonary involvement usually manifests as bronchiectasis, bronchiolitis, and pleural effusion. There are few studies on yellow nail syndrome combined with opportunistic infection. Here, [...] Read more.

Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by nail bed changes, pulmonary involvement, and lymphatic drainage disorders. Pulmonary involvement usually manifests as bronchiectasis, bronchiolitis, and pleural effusion. There are few studies on yellow nail syndrome combined with opportunistic infection. Here, we report a case of clinically diagnosed YNS combined with Nocardia cyriacigeorgica infection and the course of treatment used, which can provide some useful information for clinicians to better understand this rare illness. Full article

(This article belongs to the Section Bacterial Diseases)

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12 pages, 526 KiB

Open AccessArticle

Obesity Parameters as Predictor of Poor Outcomes in Hospitalized Patients with Confirmed Mild-to-Moderate COVID-19

by Nadya R. V. Barus, Dicky Levenus Tahapary, Farid Kurniawan, Robert Sinto, Syahidatul Wafa, Wismandari Wisnu, Arif Mansjoer, Calysta Nadya Wijaya, Immanuel Felix, Tri Juli Edi Tarigan, Dante Saksono Harbuwono and Pradana Soewondo

Infect. Dis. Rep. 2024, 16(5), 894-905; https://doi.org/10.3390/idr16050071 - 12 Sep 2024

Abstract

(1) Background: This study aims to assess visceral fat values, waist circumference (WC), body mass index (BMI), and body fat percentage for their ability to predict poor outcomes during COVID-19 patients’ hospitalization; (2) Methods: This study was a prospective cohort of mild–moderate COVID-19 [...] Read more.

(1) Background: This study aims to assess visceral fat values, waist circumference (WC), body mass index (BMI), and body fat percentage for their ability to predict poor outcomes during COVID-19 patients’ hospitalization; (2) Methods: This study was a prospective cohort of mild–moderate COVID-19 patients hospitalized at Dr. Cipto Mangunkusumo National General Hospital from December 2020 to March 2021. This study includes hospitalized patients over 18 diagnosed with COVID-19 using RT-PCR. Patients who do not have chest radiography, waist circumference, a bioimpedance analyzer (BIA) error, or are unable to stand or mobilize during the examination are excluded from this study. Cox regression was used for multivariate analysis; (3) Results: The study included two hundred sixty-one patients. The median visceral fat value was 10 (equivalent to 100 cm²), the WC was 93.4 cm, the BMI was 26.1 kg/m², and the body fat percentage was 31.5%. Based on multivariate Cox regression, WC was statistically significant as an independent factor influencing poor outcomes in COVID-19 patients (RR 1.037 [95% CI 1.011–1.064]) along with COVID-19 degree of severity (RR 3.063 [95% CI 1.537–6.104]) and comorbidities (RR 2.123 [95% CI 1.017–4.435]); (4) Conclusions: Waist circumference can influence poor outcomes in confirmed COVID-19 patients during hospitalization. Full article

(This article belongs to the Section Viral Infections)

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6 pages, 199 KiB

Open AccessCase Report

HEV Infection in the Context of Prior HBV-Related Liver Injury: Case Series

by Mihaela-Cristina Olariu, Mihai-Cezar Filipescu, Andreea Marilena Pauna, Madalina Simoiu and Alina Maria Borcan

Infect. Dis. Rep. 2024, 16(5), 888-893; https://doi.org/10.3390/idr16050070 - 6 Sep 2024

Abstract

Hepatitis E virus (HEV) is a common cause of acute hepatitis, with increasing incidence in Europe, including Romania. Concurrently, Romania has a high prevalence of chronic hepatitis B (CHB). There is limited research on the clinical presentation and outcomes of HEV infection in [...] Read more.

Hepatitis E virus (HEV) is a common cause of acute hepatitis, with increasing incidence in Europe, including Romania. Concurrently, Romania has a high prevalence of chronic hepatitis B (CHB). There is limited research on the clinical presentation and outcomes of HEV infection in patients with pre-existing chronic hepatitis B (CHB), especially in resource-rich settings. Most literature data come from South, East, and Southeast Asia. A review of the literature on HEV and HBV co-infection indicates a severe prognosis, particularly in patients with underlying liver disease. However, the cases in this study, which did not display cirrhosis, showed varied outcomes. The role of anti-HBV treatment in improving prognosis remains uncertain and warrants further investigation. Acute HEV infection superimposed on chronic HBV infection poses significant clinical challenges, with outcomes ranging from full recovery to fatality. Preventive measures, including sanitation and vaccination against HBV, are crucial. More studies are needed to establish effective treatment protocols for this co-infection. In this study, we will analyze the clinical setting, diagnosis, particularities, and outcomes of five such cases of dual hepatotropic viral infection recorded over a period of 6 years (2018–2023) at a large Infectious Diseases clinic in Bucharest, Romania. Full article

8 pages, 876 KiB

Open AccessCommunication

Leptospirosis Incidence Post-Flooding Following Storm Daniel: The First Case Series in Greece

by Irene Poulakida, Ourania S. Kotsiou, Stylianos Boutlas, Despoina Stergioula, Georgia Papadamou, Konstantinos I. Gourgoulianis and Dimitrios Papagiannis

Infect. Dis. Rep. 2024, 16(5), 880-887; https://doi.org/10.3390/idr16050069 - 5 Sep 2024

Abstract

The present study investigates the public health impact of flooding on leptospirosis incidence after Storm Daniel in Thessaly, Greece, in September 2023. A notable increase in cases was observed, with seven cases of female patients and a mean age of 40.2 years, indicating [...] Read more.

The present study investigates the public health impact of flooding on leptospirosis incidence after Storm Daniel in Thessaly, Greece, in September 2023. A notable increase in cases was observed, with seven cases of female patients and a mean age of 40.2 years, indicating a significant risk among working-age adults. From the end of September to the beginning of November 2023, a total of 35 patients from flood-prone areas presented to the Emergency Department of the Tertiary University Hospital of Larissa. Diagnosis of leptospirosis was established by meeting the criteria suggested by the national public health organisation (EODY)-compatible clinical course, epidemiological exposure, molecular and serologic confirmation by the detection of immunoglobulin M antibodies to leptospira spp. using a commercially available enzyme-linked immunosorbent assay and real-time quantitative PCR for the molecular detection of leptospira. The larger part (84.6%) of leptospirosis cases were associated with contact with floodwater. The majority of these patients (71.4%) were from the prefecture of Larissa, followed by 14.3% from the prefecture of Karditsa, 8.6% from the prefecture of Trikala, and 5.7% from the prefecture of Magnesia. Occupational exposure and urbanisation were key risk factors. The most prevalent clinical feature was rash (69.2%), followed by fever (61.5%) and myalgia (30.7%). The findings emphasise the need for robust public health strategies, improved sanitation, rodent control, and protective measures for sanitation workers. The data highlight the broader implications of climate change on public health and the necessity for ongoing surveillance and community education to mitigate future outbreaks. Full article

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10 pages, 569 KiB

Open AccessArticle

Pertussis Notification Rate and Tdpa Vaccine/Booster Coverage in Adults: An Opportunity for an Epidemiological Observatory in Primary Care

by Francesco Lapi, Ettore Marconi, Iacopo Cricelli, Alessandro Rossi, Tecla Mastronuzzi, Giovanni Gabutti and Claudio Cricelli

Infect. Dis. Rep. 2024, 16(5), 870-879; https://doi.org/10.3390/idr16050068 - 2 Sep 2024

Abstract

Background: In recent years, Europe has experienced a significant increase in pertussis cases. One reason behind this rise is the decline in diphtheria–tetanus–pertussis (dTap) booster coverage among adults. Currently, Italy lacks a reliable monitoring system to track pertussis infections and vaccine coverage [...] Read more.

Background: In recent years, Europe has experienced a significant increase in pertussis cases. One reason behind this rise is the decline in diphtheria–tetanus–pertussis (dTap) booster coverage among adults. Currently, Italy lacks a reliable monitoring system to track pertussis infections and vaccine coverage among adults. We therefore evaluated the reliability of a primary care framework to respond to this need. Methods: Using an Italian primary care database for individuals aged 15 or above, we determined the pertussis infection notification rate and dTap vaccine/booster coverage for the timeframe of 2009–2022. Results: In the overall population, we obtained a lifetime occurrence rate of pertussis infections of 7.52 per 10,000 individuals. The annual incidence rates of pertussis infections ranged from 0.008 to 0.001 per 10,000 person-years between 2009 and 2022. A rising trend in dTap vaccine coverage rate (ranging from 8.72 to 16.54 vaccines per 10,000 individuals) was observed during the same period. Notably, those aged 65 or older, smokers, and/or individuals with immunodeficiencies were more likely to receive the dTap vaccine compared to the general population. Conclusions: Given the organization of the Italian public health system, this primary care network might act as a reliable epidemiological monitoring system to keep track of pertussis infections and dTap vaccine coverage in adults. Pertussis cases were underreported, and there was a low uptake of vaccines and boosters. Therefore, it is crucial to closely monitor pertussis notifications and dTap administrations and develop intervention strategies at the national level to enhance vaccine-related prevention. Full article

(This article belongs to the Special Issue New Advances in Drugs/Vaccines against Infectious Diseases)

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6 pages, 535 KiB

Open AccessCommunication

Ongoing Excess Hospitalizations for Severe Pediatric Group A Streptococcal Disease in 2023–2024—A Single-Center Report

by Nina Schöbi, Andrea Duppenthaler, Matthias Horn, Andreas Bartenstein, Kristina Keitel, Matthias V. Kopp, Philipp K. A. Agyeman and Christoph Aebi

Infect. Dis. Rep. 2024, 16(5), 864-869; https://doi.org/10.3390/idr16050067 - 2 Sep 2024

Abstract

A Europe-wide outbreak of invasive pediatric group A streptococcal infections (iGAS) began in fall 2022. Here, we report the evolution of GAS hospitalizations in children and adolescents during the second outbreak year in 2023–2024 at a tertiary center in Switzerland. Using prospective monitoring [...] Read more.

A Europe-wide outbreak of invasive pediatric group A streptococcal infections (iGAS) began in fall 2022. Here, we report the evolution of GAS hospitalizations in children and adolescents during the second outbreak year in 2023–2024 at a tertiary center in Switzerland. Using prospective monitoring of all in-patient GAS cases below 16 years of age, including those with iGAS, we compared case frequencies and clinical characteristics in three time periods (2013–2020; 2022–2023; 2023–2024). Annual GAS hospitalizations increased from a median of 25 cases (range 11–28) in 2013–2020 to 89 and 63 cases, respectively, in 2022–2023 and 2023–2024. iGAS cases evolved similarly (2013–2020, 4 cases (3–8); 2022–2023, 32 cases; 2023–2024, 21 cases). The decline in cases from 2022–2023 to 2023–2024 included all types of GAS organ involvement, except suppurative infections in the head area, which remained largely unchanged (48 vs. 45 cases). Pleural empyema declined from 13 to 7 cases, possibly explained by a poor overlap of the GAS and influenza curves, respectively, in 2023–2024 compared to 2022–2023. These data document the prolongation of the GAS outbreak into its second winter season in 2023–2024. Full article

(This article belongs to the Section Bacterial Diseases)

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18 pages, 1377 KiB

Open AccessReview

Atherosclerosis and Cardiovascular Complications in People Living with HIV: A Focused Review

by Michele Salvatore Paternò Raddusa, Andrea Marino, Benedetto Maurizio Celesia, Serena Spampinato, Carmen Giarratana, Emmanuele Venanzi Rullo, Bruno Cacopardo and Giuseppe Nunnari

Infect. Dis. Rep. 2024, 16(5), 846-863; https://doi.org/10.3390/idr16050066 - 1 Sep 2024

Abstract

The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such [...] Read more.

The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such as CVD. This paper explores the multifaceted relationship between HIV infection, ART, and cardiovascular health, focusing on the mechanisms by which HIV and ART contribute to increased cardiovascular risk, including the promotion of endothelial dysfunction, inflammation, immune activation, and metabolic disturbances. We highlight the critical roles of HIV-associated proteins—Tat, Nef, and gp120—in accelerating atherosclerosis through direct and indirect pathways that exacerbate endothelial damage and inflammation. Additionally, we address the persistent challenge of chronic inflammation and immune activation in PLWH, factors that are strongly predictive of non-AIDS-related diseases, including CVD, even in the context of effective viral suppression. The impact of ART on cardiovascular risk is examined, with particular attention to the metabolic implications of specific ART regimens, which can influence lipid profiles and body composition, thereby modifying CVD risk. The therapeutic potential of statins, aspirin, and emerging treatments such as PCSK9 inhibitors in mitigating cardiovascular morbidity and mortality among PLWH is discussed, alongside considerations for their use in conjunction with ART. Our review underscores the necessity for a comprehensive, multidisciplinary approach to cardiovascular care in PLWH, which integrates vigilant cardiovascular risk assessment and management with HIV treatment. As we navigate the evolving landscape of HIV care, the goal remains to optimize treatment outcomes while minimizing cardiovascular risk, ensuring that the gains in longevity afforded by ART translate into improved overall health and quality of life for PLWH. Full article

(This article belongs to the Section HIV-AIDS)

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10 pages, 591 KiB

Open AccessBrief Report

Wastewater Surveillance of Mpox during the Summer Season of 2023 in Slovenia

by Jan Rožanec, Natalija Kranjec, Ivana Obid, Andrej Steyer, Tjaša Cerar Kišek, Tom Koritnik, Mario Fafangel and An Galičič

Infect. Dis. Rep. 2024, 16(5), 836-845; https://doi.org/10.3390/idr16050065 - 29 Aug 2024

Abstract

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS [...] Read more.

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation. Full article

(This article belongs to the Topic Human Monkeypox Research)

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