Articles de revues : « Infections »

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Glózik, Ágnes. « Az infekciókontroll mérföldkövei – történelmi kitekintés ». Kaleidoscope history 10, n^o 21 (2020) : 313–23. http://dx.doi.org/10.17107/kh.2020.21.313-323.

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Infectious diseases and epidemics associated since ever the men’s history. In each historical age, arose different methods and theories about treating and preventing infectious diseases. It is important to separate hospital-acquired infections and community-acquired infectious diseases. Within epidemiology, a specific branch deals with nosocomial infections. The most important goal is their prevention named as infection control. To be able to assess the extent of current progress in nosocomial infections, it is important to understand the history of infection control, which is nowadays a worldwide program because healthcare-associated infections affected hundreds of millions of patients every year.

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Kucukardali, Yasar, Oral Oncul, Erdogan Kunter, Vedat Turhan, Emrullah Solmazgul, Hakan Terekeci, Ozkan Sayan et Cagatay Oktenli. « Community acquired infections in elderly population ». Open Medicine 4, n^o 2 (1 juin 2009) : 171–78. http://dx.doi.org/10.2478/s11536-008-0072-4.

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AbstractIn geriatric practice, data regarding infections including the epidemiology, morbidity, and mortality are lacking. Our aim was to evaluate the frequency, location, microbiological and laboratory characteristics of infectious diseases in elderly population admitted to a training hospital. The patients were included total of 330 patients, aged over 65 with infection, seen between January 1, 2005 and January 1, 2006. In the result, of patients 136 (41%) had respiratory system infection, 90 (27%) urinary system infection, 39 (12%) gastrointestinal system infection, 34 (10%) bloodstream infections, 17 (5%) soft tissue infection, 8 (2%) central nervous system infections, and 6 (2%) others. Average length of hospitalization was 8.6±7.7 days. Mortality rate from all causes was 57 (17%). The most common infections in elderly patients were respiratory tract and urinary system infections, and there were no fever, leukocytes and high CRP levels in approximately 1/3 of cases. Infectious diseases may occur even in the absence of such infection indicators as fever, raised WBC count and high CRP level in the elderly population.

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Xu, Yin, Kelsi A. Smith, Ayako Hiyoshi, Fredrik Piehl, Tomas Olsson et Scott Montgomery. « Hospital-diagnosed infections before age 20 and risk of a subsequent multiple sclerosis diagnosis ». Brain 144, n^o 8 (9 mars 2021) : 2390–400. http://dx.doi.org/10.1093/brain/awab100.

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Abstract The involvement of specific viral and bacterial infections as risk factors for multiple sclerosis has been studied extensively. However, whether this extends to infections in a broader sense is less clear and little is known about whether risk of a multiple sclerosis diagnosis is associated with other types and sites of infections such as the CNS. This study aims to assess if hospital-diagnosed infections by type and site before age 20 years are associated with risk of a subsequent multiple sclerosis diagnosis and whether this association is explained entirely by infectious mononucleosis, pneumonia, and CNS infections. Individuals born in Sweden between 1970 and 1994 were identified using the Swedish Total Population Register (n = 2 422 969). Multiple sclerosis diagnoses from age 20 years and hospital-diagnosed infections before age 20 years were identified using the Swedish National Patient Register. Risk of a multiple sclerosis diagnosis associated with various infections in adolescence (11–19 years) and earlier childhood (birth–10 years) was estimated using Cox regression, with adjustment for sex, parental socio-economic position, and infection type. None of the infections by age 10 years were associated with risk of a multiple sclerosis diagnosis. Any infection in adolescence increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.33, 95% confidence interval 1.21–1.46) and remained statistically significant after exclusion of infectious mononucleosis, pneumonia, and CNS infection (hazard ratio 1.17, 95% confidence interval 1.06–1.30). CNS infection in adolescence (excluding encephalomyelitis to avoid including acute disseminated encephalitis) increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.85, 95% confidence interval 1.11–3.07). The increased risk of a multiple sclerosis diagnosis associated with viral infection in adolescence was largely explained by infectious mononucleosis. Bacterial infections in adolescence increased risk of a multiple sclerosis diagnosis, but the magnitude of risk reduced after excluding infectious mononucleosis, pneumonia and CNS infection (hazard ratio 1.31, 95% confidence interval 1.13–1.51). Respiratory infection in adolescence also increased risk of a multiple sclerosis diagnosis (hazard ratio 1.51, 95% confidence interval 1.30–1.75), but was not statistically significant after excluding infectious mononucleosis and pneumonia. These findings suggest that a variety of serious infections in adolescence, including novel evidence for CNS infections, are risk factors for a subsequent multiple sclerosis diagnosis, further demonstrating adolescence is a critical period of susceptibility to environmental exposures that raise the risk of a multiple sclerosis diagnosis. Importantly, this increased risk cannot be entirely explained by infectious mononucleosis, pneumonia, or CNS infections.

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Kinnunen, Susanna, Pauli Karhapää, Auni Juutilainen, Patrik Finne et Ilkka Helanterä. « Secular Trends in Infection-Related Mortality after Kidney Transplantation ». Clinical Journal of the American Society of Nephrology 13, n^o 5 (5 avril 2018) : 755–62. http://dx.doi.org/10.2215/cjn.11511017.

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Background and objectivesInfections are the most common noncardiovascular causes of death after kidney transplantation. We analyzed the current infection-related mortality among kidney transplant recipients in a nationwide cohort in Finland.Design, setting, participants, & measurementsAltogether, 3249 adult recipients of a first kidney transplant from 1990 to 2012 were included. Infectious causes of death were analyzed, and the mortality rates for infections were compared between two eras (1990–1999 and 2000–2012). Risk factors for infectious deaths were analyzed with Cox regression and competing risk analyses.ResultsAltogether, 953 patients (29%) died during the follow-up, with 204 infection-related deaths. Mortality rate (per 1000 patient-years) due to infections was lower in the more recent cohort (4.6; 95% confidence interval, 3.5 to 6.1) compared with the older cohort (9.1; 95% confidence interval, 7.6 to 10.7); the incidence rate ratio of infectious mortality was 0.51 (95% confidence interval, 0.30 to 0.68). The main causes of infectious deaths were common bacterial infections: septicemia in 38% and pulmonary infections in 45%. Viral and fungal infections caused only 2% and 3% of infectious deaths, respectively (such as individual patients with Cytomegalovirus pneumonia, Herpes simplex virus meningoencephalitis, Varicella zoster virus encephalitis, and Pneumocystis jirovecii infection). Similarly, opportunistic bacterial infections rarely caused death; only one death was caused by Listeria monocytogenes, and two were caused by Mycobacterium tuberculosis. Only 23 (11%) of infection-related deaths occurred during the first post-transplant year. Older recipient age, higher plasma creatinine concentration at the end of the first post-transplant year, diabetes as a cause of ESKD, longer pretransplant dialysis duration, acute rejection, low albumin level, and earlier era of transplantation were associated with increased risk of infectious death in multivariable analysis.ConclusionsThe risk of death due to infectious causes after kidney transplantation in Finland dropped by one half since the 1990s. Common bacterial infections remained the most frequent cause of infection-related mortality, whereas opportunistic viral, fungal, or unconventional bacterial infections rarely caused deaths after kidney transplantation.

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Lobzin, Yu V., S. V. Rychkova, A. N. Uskov, N. V. Skripchenko et V. V. Fedorov. « Current trends in paediatric infections in the Russian Federation ». Kuban Scientific Medical Bulletin 27, n^o 4 (14 août 2020) : 119–33. http://dx.doi.org/10.25207/1608-6228-2020-27-4-119-133.

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The onset of 2020 clearly demonstrated that infection agents pose a major threat to mankind. Current infectiology is shaped by resurrection of “old” seemingly forgotten infections, emergence of “new” infection agents, unusual combinations of known agents, evolving resistance of microorganisms to antibacterial drugs, transformation of human microbiome leading to distortions in herd immunity and, ultimately, emergence of healthcare-related infectious diseases, not letting alone threats of bioterror. Infection agents evolve together with mankind. Novel facets emerge in infectiology, alongside with trends in diagnosis, treatment and prevention of infectious diseases that become more diverse as the list of pathogens grows. Human and infection agent links extend beyond antagonistic relations towards symbiosis. Microorganisms adapt quickly in the new technogenic environment giving rise to novel pathogens and making it unlikely for the mankind to get free from infections any time soon.The total economic damage from infectious diseases increases by year, despite continuous improvement in therapy. Infectious mortality in children aged 0 to 14 years is the top fourth among other causes of death. The work assesses comparative dynamics of “common” childhood infections in the Russian Federation during 2018–2020. We analyse ofﬁcial statistics on paediatric infectious morbidity, comparative dynamics of main infectious diseases (acute respiratory diseases, intestinal infections of bacterial and viral nature, neuroinfections, anthropozoonotic infections, viral hepatitises), assess trends in morbidity of vaccine-preventable infections in children and adults in the Russian Federation, with greater detail towards selected regions, from January 2018 to April 2020.

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Ayaz, Caglayan Merve, Serdar Ceylan, Vural Taner Yılmaz, Haydar Adanır et Özge Turhan. « Timeline and Incidence of Infectious Complications in Older Transplant Recipients During the First Year Post-Transplantation ». Pathogens 13, n^o 12 (2 décembre 2024) : 1061. https://doi.org/10.3390/pathogens13121061.

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The number of older adults undergoing organ transplantation, and waiting lists are increasing. The epidemiological data on infections in older transplant patients are scarce. The objective of the study was to investigate the incidence and distribution of infectious complications in older patients according to post-transplant periods. This retrospective study was conducted in a university hospital between 1 January 2018 and 31 March 2023. All infectious episodes were analyzed over three post-transplant periods. Forty-four patients were enrolled. The median age was 67 years (min: 65 and max: 87 years). Patients experienced a total of 98 infectious episodes. The median number of infectious events per patient was 1.0 (min: 0 and max: 8). The overall incidence rate of infectious events was 2.18 infectious episodes per 1000 transplant days. Of the patients at risk, 18.2% had 12 (12.4% of all infections) infections in the first month (9.09 episodes per 1000 transplant days), 56.8% had 52 (53.1%) infections between 1 and 6 months (7.88 episodes per 1000 transplant days), and 40.9% had 34 (35%) infections >6–12 months post-transplant (0.92 episodes per 1000 transplant days) The most prevalent type of infection was bacterial (79.6%, n = 78) followed by viral (18.4%, n = 18) and fungal (2.0%, n = 2) infections. The overall mortality rate of the 44 patients was 13.6%. The bacterial infections were more prevalent, and the incidence of infection was high during all post-transplant periods. These results may guide infection management in older transplant patients.

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Epperla, Narendranath, Mirela Anghelina, Qiuhong Zhao, Akwasi Agyeman, James S. Blachly, Kerry A. Rogers, Gerard Lozanski, Christopher C. Oakes, Michael R. Grever et Leslie Andritsos. « Infection at the Time of Initial Therapy for Hairy Cell Leukemia Is Associated with Inferior Time to Next Treatment ». Blood 132, Supplement 1 (29 novembre 2018) : 2305. http://dx.doi.org/10.1182/blood-2018-99-119951.

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Abstract Introduction: Hairy Cell Leukemia (HCL) is a rare, chronic hematological malignancy that makes up approximately 2% of all leukemias. HCL patients are at a markedly increased risk for infection related to a combination of disease-related and treatment-related immunosuppression which has been well described in the literature. However, the significance of infection prior to initiation of HCL therapy and its impact on the subsequent selection of HCL treatment, or outcomes, is not well described. Using the HCL patient data registry, we report here the impact of antecedent infection on the treatment patterns and outcomes of HCL patients. Methods: We evaluated adult (≥18 years) patients with HCL who had information regarding antecedent infections and subsequent HCL treatment during 1984-2018. The primary endpoint was progression-free survival (PFS-1). Secondary endpoint included time to next treatment (TTNT). PFS-1 was measured from the date of first HCL treatment to date of progression/death or last follow-up. TTNT was defined as the time from first HCL treatment to initiation of second HCL treatment. The study population was stratified into 3 groups based on the presence or absence of antecedent infections: no infection prior to first HCL treatment (no infection group), infection within 30 days prior to first HCL treatment (infection1 group) and infection >30 days prior to first HCL treatment (infection2 group). Fisher's exact test or Kruskal-Wallis test was used to compare the characteristics among the no infection and infection groups and the Cox proportional hazard model was used to evaluate the association with PFS-1 and TTNT. Results: A total of 205 HCL patients who had information regarding antecedent infections and subsequent HCL treatment were eligible for the study. Among these, 144 (70%) belonged to the no infection group, while 26 patients (13%) belonged to infection1 group and 35 (17%) to infection2 group. Patient characteristics are shown in Table 1 with a breakdown between the three groups. The majority of the patients were Caucasian with a male preponderance and had classic HCL. The patients in the infection1 group had a lower median WBC (K/uL) (1.9 vs 3.1 vs 2.9), particularly the absolute neutrophil count (K/uL) (0.4 vs 0.7 vs 0.8) and significantly lower median hemoglobin (gm%) (10.1 vs 12.2 vs 12.4) relative to the no infection and infection2 groups, respectively (p=0.01). Similarly, a greater proportion of patients in the infection1 group had significant comorbidities (including pulmonary, gastrointestinal and hepatic disease) relative to no infection and infection2 groups as shown in Table 1. The majority of patients received purine nucleoside analogs as their first HCL treatment (no infection group=92%, infection1 group=85%, infection2 group=94%). The median PFS-1 (in years) was better in the no infection group compared to the infection1 group but was not statistically significant (17.0 [95% CI=7.9-not reached (NR)] vs 8.8 [95% CI=4.2-NR], respectively, p=0.98, Figure 1). However, the median TTNT (in years) was significantly longer for HCL patients with no infection versus the infection1 group (6.3 [95% CI=5.4-7.8] vs 3.6 [95% CI=0.7-NR], respectively, p=0.001, Figure 1). On subgroup analysis, relative to the no infection group, median PFS-1 (in years) was not significantly different in infection1 group treated with Pentostatin (10.7 [95% CI=3.53-NR] vs NR [95% CI=1.38-NR], respectively, p=0.43), however, the median PFS-1 (in years) was shorter in the infection1 group treated with Cladribine (17.0 [95% CI=7.67-NR] vs 4.0 [95% CI=2.00-NR], respectively), although not reaching statistical significance (p=0.09) probably due to small sample size. Conclusion: In this large series of HCL patients who received treatment, we show that the patients who had infections at the time of HCL treatment have a significantly shorter TTNT. The reasons for this are unclear but may indicate that patients were unable to receive treatment in a timely manner because of the infection, or were unable to complete treatment because of complications. The significant difference in hemoglobin between the infection1 and other groups indicates the possibility that these patients had more advanced HCL at the time of diagnosis. These findings indicate the potential long term negative impact of infections in patients who need treatment for HCL and reinforce the need for careful management in this setting. Disclosures Lozanski: Beckman: Research Funding; Coulter: Research Funding; Stem Line: Research Funding; Genentech: Research Funding; Novartis: Research Funding; BI: Research Funding. Andritsos:HCLF: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy.

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Garwood, Robert A., Robert G. Sawyer, Lee Thompson et Reid B. Adams. « Infectious Complications after Hepatic Resection ». American Surgeon 70, n^o 9 (septembre 2004) : 787–92. http://dx.doi.org/10.1177/000313480407000908.

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The purpose of this study was to assess the characteristics of surgical infections after hepatic resection (HR) to identify factors accounting for increased postoperative mortality. Advances in operative technique and care have decreased morbidity and mortality after HR. However, infections after HR continue to be a major contributor to postoperative morbidity and mortality. All HR done during a 7-year period were analyzed and compared to our prospective surgical infection database. Factors contributing to infectious complications and mortality were identified. HR (n = 207) were performed with an overall mortality of 5.8 per cent. Nine patients (3.3%) had 18 infections; 6 (60%) had multiple infection sites, most commonly the peritoneum, blood, or wound. Three infected patients died. Lung and line infections occurred in 2 (67%) infection-related deaths. No single comorbidity increased postoperative infection risk, but an average of 6.7 co-morbid conditions were present. All infection-related deaths were associated with ventilator-dependence. All infection-related deaths occurred after resection of a mean of four segments. Additional procedures at the time of HR, operative drains, or transfusion requirements did not impact infectious complications or mortality. Methicillin-resistant Staphylococcus sp. was isolated in all infection-related deaths. The mean time from HR to initiation of treatment was 8 days for infection survivors and 13.3 days for infection-related deaths. Infectious mortality after HR remains significant. Contributing risk factors are advanced age, multiple comorbid conditions, and extent of HR. Ventilator-dependence and delays in antibiotic therapy were associated with infectious mortality. Although gram-negative enteric infections were more common, abdominal, lung, and line infections with gram-positive cocci had higher associated mortality; especially when antibiotic resistant strains were present.

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Pockaj, B. A., S. L. Topalian, S. M. Steinberg, D. E. White et S. A. Rosenberg. « Infectious complications associated with interleukin-2 administration : a retrospective review of 935 treatment courses. » Journal of Clinical Oncology 11, n^o 1 (janvier 1993) : 136–47. http://dx.doi.org/10.1200/jco.1993.11.1.136.

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PURPOSE To determine if interleukin-2 (IL-2)-treated patients are prone to develop clinically significant infections, a retrospective review of 519 patients who received 935 treatment courses over a 38-month period was conducted. MATERIALS AND METHODS Treatment records of patients receiving intravenous (IV) bolus IL-2 were reviewed. Clinically significant infectious episodes were identified by retrieving data on antibiotic usage and cross-referencing this with microbiology records and chart review. RESULTS One hundred thirty-nine documented infectious episodes occurred in 122 treatment courses (13.0%); 11 courses were associated with more than one episode of infection. Predominantly urinary tract infections (6.8%) and infections related to IV catheters (5.3%) were encountered. Fifty-eight percent of the catheter-related infections were associated with bacteremia. Other infections included respiratory tract infections (1.0%), skin/muscle infections (0.9%), and miscellaneous infections (0.9%). Bacteria were isolated from the majority of infections. Almost all patients were successfully treated for their infection, with only two septic deaths (0.2%). No difference was noted in infected versus non-infected patients with regard to diagnosis or previous therapy. There was a significant tendency for those patients who developed infection to be older (P2 = .002, Mantel test for trend). Risk factors for the development of infection included vascular access catheters, open wounds, biliary obstruction, or incomplete treatment of previous infections. Over the 3-year study period, the incidence of infection declined from 23% to 7% (P2 < .0001, Mantel test for trend) due to rigorous patient screening, vigilant monitoring for infection, liberal use of antibiotics for suspected infection, and use of prophylactic antibiotics for central venous catheter placement. CONCLUSION Although treatment with IL-2 may be associated with a slightly increased incidence of bacterial infections, these infections can be successfully managed in the great majority of cases.

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Ramírez-Soto, Max Carlos, Andrés Tirado-Sánchez et Alexandro Bonifaz. « Ocular Sporotrichosis ». Journal of Fungi 7, n^o 11 (10 novembre 2021) : 951. http://dx.doi.org/10.3390/jof7110951.

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Sporotrichosis is a subacute or chronic mycosis predominant in tropical and subtropical regions. It is an infection of subcutaneous tissue caused by Sporothrix fungus species, but occasionally resulting in an extracutaneous condition, including osteoarticular, pulmonary, nervous central system, and ocular disease. Cases of ocular sporotrichosis are rare, but reports have been increasing in recent decades. Ocular infections usually occur in hyperendemic areas of sporotrichosis. For its classification, anatomic criteria are used. The clinical presentation is the infection in the ocular adnexal and intraocular infection. Ocular adnexa infections include palpebral, conjunctivitis, and infections of the lacrimal sac. Intraocular infection includes exogenous or endogenous endophthalmitis. Most infections in the ocular adnexal have been reported in Brazil, China and Peru, and intraocular infections are limited to the USA and Brazil. Diagnosis is performed from Sporothrix isolation in the mycological examination from ocular or skin samples. Both sporotrichosis in the ocular adnexa and intraocular infection can mimic several infectious and non-infectious medical conditions. Ocular adnexa infections are treated with potassium iodide and itraconazole. The intraocular infection is treated with amphotericin B. This review describes the clinical findings and epidemiological, diagnosis, and treatment of ocular sporotrichosis.

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Schultalbers, Marie, Tammo L. Tergast, Nicolas Simon, Abdul-Rahman Kabbani, Markus Kimmann, Christoph Höner zu Siederdissen, Svetlana Gerbel, Michael P. Manns, Markus Cornberg et Benjamin Maasoumy. « Frequency, characteristics and impact of multiple consecutive nosocomial infections in patients with decompensated liver cirrhosis and ascites ». United European Gastroenterology Journal 8, n^o 5 (13 mars 2020) : 567–76. http://dx.doi.org/10.1177/2050640620913732.

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Background Nosocomial infections are a particular threat for patients with liver cirrhosis. It is not uncommon that individuals develop even several consecutive infections during a single hospital stay. We aimed to investigate the impact and characteristics of multiple, consecutive nosocomial infections. Methods A total of 514 consecutive patients with liver cirrhosis and ascites were included and followed up for 28 days for nosocomial infection, death or liver transplantation (LTx). Laboratory values were assessed at the time of hospitalization as well as at the onset of each new infectious episode. Results 58% ( n = 298) of the patients developed at least one nosocomial infection and in 23% ( n = 119) even multiple infections were documented during a single hospital stay. Consecutive infections usually occurred shortly after the previous episode. Spontaneous bacterial peritonitis (SBP) was the most common infection. However, the proportion of SBP declined from 43% at the first to only 31% at the third nosocomial infection ( p = 0.096). In contrast, the likelihood for other, less common types of infection such as blood stream infections increased. Third nosocomial infections were also more likely to be linked to the detection of fungal pathogens (21% vs. 52%; p = 0.001). Each additional infectious episode had a dramatic detrimental impact on LTx-free survival that was independent from the stage of liver disease (adjusted-HR: 6.76, p = 0.002 for first nosocomial infection; adjusted-HR: 14.69, p<0.001 for second nosocomial infection; adjusted-HR: 24.95, p<0.001 for third nosocomial infection). Conclusion In patients with decompensated liver cirrhosis LTx-free survival significantly decreases with every consecutive infectious episode. Development of prevention strategies is urgently required.

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Jayasree, T., et Mustafa Afzal. « Implementation of Infection Control Practices to Manage Hospital Acquired Infections ». Journal of Pure and Applied Microbiology 13, n^o 1 (31 mars 2019) : 591–97. http://dx.doi.org/10.22207/jpam.13.1.68.

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Shkarin, V. V., et N. V. Saperkin. « Interaction of concurrent infection pathogens in complex comorbidity (theoretical and practical issues) ». Russian Medical Inquiry 5, n^o 11 (2021) : 737–43. http://dx.doi.org/10.32364/2587-6821-2021-5-11-737-743.

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In case of co-infections, the human body and the pathogen form a complex parasitic system. Also, the development of the infectious process is possible according to the following scenarios: infectious process activation caused by all pathogens; predominant activation of one of the infectious processes; absence of the infectious process activation; absence of combined infection interaction. Infectious pathogens affect the human body in different ways both at the site of permeation, launching a cascade of pathological processes, and at the site of the main localization. The formation of complex comorbidity depends on the non-specific immune defense, the biological properties of pathogens, the simultaneity or sequence of infection, the intervals between infection with various pathogens, etc. This article discusses the reasons for the predominance of one of the disease clinical manifestations in concurrent infections: synergism, antagonistic microorganisms, the chain of infection, the incubation period duration. The following variants of the co-infection course and their influence on complex comorbidity are considered: the dominance of one infection clinical manifestations; the same severity of symptoms of all infections, or the formation of a more severe clinical picture compared to single infections; the aggravating effect of one infection on another; the clinical picture overlap of one infection on another. KEYWORDS: mixed infection, concurrent infection, complex comorbidity, etiology, interaction of pathogens, parasitic system, infectious process, epidemic process. FOR CITATION: Shkarin V.V., Saperkin N.V. Interaction of concurrent infection pathogens in complex comorbidity (theoretical and practical issues). Russian Medical Inquiry. 2021;5(11):737–743 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-737-743.

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Innocenti, T., J. Roselli, E. N. Lynch, P. Apolito, L. Parisio, S. Bagnoli, G. Macrì et al. « P491 Infectious risk of vedolizumab compared with other biological agents in the treatment of Inflammatory Bowel Disease ». Journal of Crohn's and Colitis 15, Supplement_1 (1 mai 2021) : S476. http://dx.doi.org/10.1093/ecco-jcc/jjab076.614.

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Abstract Background Vedolizumab (VDZ) is a gut selective anti-α 4β 7 integrin antibody for the treatment of Inflammatory Bowel Disease with a well-known optimal safety profile. We aimed to compare the risk of infections of VDZ with that of anti-TNF drugs and ustekinumab, in patients with both ulcerative colitis (UC) and Crohn’s disease (CD). Methods All CD and UC patients undergoing biological treatment at our centre between June 2013 and June 2020 were retrospectively included. All infectious complications were registered, considering both inpatient and outpatient events. A comparison of exposure-adjusted infection rate of vedolizumab with that of anti-TNF drugs and ustekinumab was carried out, with a specific focus on the rate of gut infections. All infection rates were expressed in events per patient-years (PYs). Results The overall exposure-adjusted infection rate was 11.5/100 PYs. Detailed information about the infectious complications related to the different biologics is reported in Table 1. The most common infections were respiratory tract infections, cutaneous infections, HSV infections/reactivations, and gut infections. The rate of serious infections was 1.3/100 PYs. Among the 85 patients who were on a VDZ therapy, 17 (3 CD and 14 UC, median age 64, IQR 31–68) suffered an infectious complication. The exposure-adjusted incidence rate for vedolizumab was 17.5/100 PYs, with CD patients having a lower infection risk compared with UC patients (p = 0.035). Gut infections were observed in 3.0% of the whole patient population (1.5/100 PYs) and were more common in the VDZ group (p = 0.0001). Conclusion Our study confirms the good safety profile of vedolizumab. Among patients treated with vedolizumab, those with UC have a higher risk of developing infectious complications. Patients treated with vedolizumab have a higher risk of gut infections compared with patients treated with anti-TNF drugs or ustekinumab. Presumably, this could be due to the gut-selective mechanism of action of vedolizumab.

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Curley, Tara E., Emily Ansusinha et Rana F. Hamdy. « 1514. Factors Associated with an Infectious Diseases Consultation for Pediatric Staphylococcus aureus Bacteremia ». Open Forum Infectious Diseases 6, Supplement_2 (octobre 2019) : S550—S551. http://dx.doi.org/10.1093/ofid/ofz360.1378.

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Abstract Background Staphylococcal aureus bacteremia is associated with substantial morbidity in children. An infectious diseases consultation is associated with decreased mortality in adults with S. aureus bacteremia, but this has not yet been shown in a pediatric population. Methods This was a retrospective cohort study of children <18 years old hospitalized at Children’s National Medical Center with S. aureus bacteremia between January 1, 2012 and December 31, 2016. We excluded children with polymicrobial infections, those with a concurrent culture-proven infection, and those transferred with incomplete records. Structured manual chart review was used to collect demographic information, underlying comorbidities, type of admission (ICU or non-ICU), epidemiologic classification (hospital- or community-onset), primary source of infection, and methicillin resistance (MRSA or MSSA). A multivariable logistic regression analysis was performed to identify factors associated with having an infectious diseases consultation. Results We identified 171 episodes of S. aureus bacteremia; 27.5% occurred in infants <12 months old, 65.5% occurred in males, 38% occurred in ICU patients, and 18.1% were methicillin-resistant S. aureus (MRSA). The most common primary sources of infection were musculoskeletal (38%), catheter-related (18.1%), and skin/soft-tissue infections (17%). The majority (70.2%) received an infectious diseases consultation. In univariable analysis, ID consultation was more frequent among infections with the following characteristics: non-neonates (74.2% vs. 45.8%; P = 0.007), community-acquired (78.7% vs. 45.5%; P < 0.01), no underlying comorbidities (97.0% vs. 53.3%; P < 0.001), musculoskeletal (98.5%) or endovascular (100%) source of infection, and MRSA (100%). In a multivariable logistic regression analysis, musculoskeletal infections, endovascular infections, and MRSA had significantly higher odds of receiving an infectious diseases consultation. Conclusion Children with S. aureus bacteremia were more likely to receive an infectious diseases consultation if presenting with musculoskeletal infections, endovascular infections, or MRSA. Disclosures All authors: No reported disclosures.

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Razak, Kamarul Arifin Abdul, Terence Michal Dass, Tan Weng Liang, Yogeshwarran Nadeson et Karenjit Kaur. « Crab bite causing shewanella putrefaciens infection : Introduction to a possibly deadly and emerging threat ». Orthopaedic Journal of Sports Medicine 8, n^o 5_suppl5 (1 mai 2020) : 2325967120S0004. http://dx.doi.org/10.1177/2325967120s00046.

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Shewanella species are gram-negative bacteria found in warm, temperate regions and are normal microflora of the marine environment1. Human infections are unusual and have a restricted geographic distribution. Presentation: A 45 years old lady was bitten by a crab while preparing to cook it. She developed fever and swelling of the right thumb with hemoserous discharge and blackish discolouration.Upon examination, the thumb was erythematous and swollen with a hematoma filled blister formation over the dorsal aspect. Deblistering was done and fluid samples were sent for culture and sensitivity which later returned as Shewanella Putrefaciens. Empirically she was started on IV Augmentin. Discussion: Most common clinical manifestation associated with Shewanella spp are superficial soft tissue infection1. Other reported clinical features are primary and secondary bacteremia, hepatobiliary, bone, joint and CNS infection, endocarditis, eye, ear and respiratory infection2. Antibiotics susceptibility includes aminoglycosides, 3rd and 4th generation cephalosporins, carbapenems and fluoroquinolones1. About 79% of patients have underlying conditions such as diabetes mellitus, venous congestion and heart failure; they are immunocompromised, as is our patient3. Conclusion: Proper handling of seafood during preparation should be encouraged as a simple bite may turn deadly. Initiation of antibiotics according to suspected organisms should be performed to prevent worsening of soft tissue infections. References: Diaz, J.H, Lopez, F.A Skin, Soft Tissue and Systemic Bacterial Infections Following Aquatic Injuries and Exposures. The American Journal of the Medical Sciences, 349(3), 269275 Finkelstein,R, Oren,I. Soft Tissue Infections Caused by Marine Bacterial Pathogens: Epidemiology, Diagnosis, and Management. Current Infectious Disease Report (2011)13(5):470–477 N. Vignier et al; Human Infection with Shewanella putrefaciens and S. algae: Report of 16 Cases in Martinique and Review of the Literature; Am. J. Trop. Med. Hyg., 89(1), 2013, pp. 151–156

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Nohra, Eden, Rachel D. Appelbaum, Michael Steven Farrell, Thomas Carver, Hee Soo Jung, Jordan Michael Kirsch, Lisa M. Kodadek et al. « Fever and infections in surgical intensive care : an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document ». Trauma Surgery & ; Acute Care Open 9, n^o 1 (juin 2024) : e001303. http://dx.doi.org/10.1136/tsaco-2023-001303.

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The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections. The purpose of this clinical consensus document, created by the American Association for the Surgery of Trauma Critical Care Committee, is to synthesize the available evidence, and to provide practical recommendations. We discuss the evaluation of fever, the indications to obtain cultures including urine, blood, and respiratory specimens for diagnosis of infections, the use of procalcitonin, and the decision to initiate empiric antibiotics. We then describe the treatment of common infections, specifically ventilator-associated pneumonia, catheter-associated urinary infection, catheter-related bloodstream infection, bacteremia, surgical site infection, intra-abdominal infection, ventriculitis, and necrotizing soft tissue infection.

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Solodovnikova, O. N., A. Yu Diagileva et A. A. Ploskireva. « Inosine pranobex in the treatment of children with acute respiratory viral infections. Non-interventional observation program ‘Ambulatory’ ». Voprosy praktičeskoj pediatrii 16, n^o 6 (2021) : 167–72. http://dx.doi.org/10.20953/1817-7646-2021-6-167-172.

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Respiratory infections are currently very common among children of different ages. Acute upper respiratory tract infections usually accounted for more than 88% of all infectious and parasitic diseases, which is consistent with data for the last 10 years. Therefore, the issues related to both causal and pathogenetic therapy for viral infections in children remain highly relevant. Key words: acute respiratory viral infections, children, infectious diseases, acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, acute upper respiratory tract infection not otherwise specified

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Tsantes, Andreas, Dimitrios Papadopoulos, Georgia Vrioni, Spyridon Sioutis, George Sapkas, Ahmed Benzakour, Thami Benzakour et al. « Spinal Infections : An Update ». Microorganisms 8, n^o 4 (27 mars 2020) : 476. http://dx.doi.org/10.3390/microorganisms8040476.

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Spinal infection poses a demanding diagnostic and treatment problem for which a multidisciplinary approach with spine surgeons, radiologists, and infectious disease specialists is required. Infections are usually caused by bacterial microorganisms, although fungal infections can also occur. The most common route for spinal infection is through hematogenous spread of the microorganism from a distant infected area. Most patients with spinal infections diagnosed in early stages can be successfully managed conservatively with antibiotics, bed rest, and spinal braces. In cases of gross or pending instability, progressive neurological deficits, failure of conservative treatment, spinal abscess formation, severe symptoms indicating sepsis, and failure of previous conservative treatment, surgical treatment is required. In either case, close monitoring of the patients with spinal infection with serial neurological examinations and imaging studies is necessary.

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Higurashi, Takuma, Shigeki Tamura, Noboru Misawa et Nobuyuki Horita. « Trends in Gastrointestinal Infections during the COVID-19 Pandemic and Concerns of Post-Pandemic Resurgence in Japan ». Diseases 12, n^o 1 (21 décembre 2023) : 4. http://dx.doi.org/10.3390/diseases12010004.

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The impact of the COVID-19 pandemic was very broad and substantial, affecting a variety of fields worldwide. In Japan, the infection began spreading in March 2020. At that time, the government alerted people to cancel overseas travel, and encouraged wearing of masks, handwashing, sanitizing and keeping social distance. We sought to determine how COVID-19 infections affected other infectious diseases by investigating the trends in seven gastrointestinal infections that are listed among the 77 important infectious diseases designated by the National Institute of Infectious Diseases. We compared seven gastrointestinal infectious diseases, namely cholera, bacterial dysentery, enterohemorrhagic Escherichia coli, typhoid fever, paratyphoid fever, amoebic dysentery, and giardiasis, in terms of numbers of new cases before the COVID-19 pandemic (2012–2019) and during the pandemic (2020–2022). During the COVID-19 pandemic period (2020–2022), the incidence of the seven infections decreased significantly (p < 0.05) compared with before the pandemic (2012–2019). The sharp and significant decline in incidence of these seven infections in Japan during the COVID-19 pandemic period (2020–2022) appears to be due to restrictions on overseas travel and strict anti-infection measures, such as self-quarantine and encouragement of handwashing and sanitizing. The number of new cases of gastrointestinal infections in Japan is expected to increase in 2024 as these measures lapse. It is important for physicians to continue to monitor trends in gastrointestinal infections and educate people about proper infection prevention.

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Poslova, L. Yu. « Clinical and epidemiological features of viral infections in the children's non-infectious multidisciplinary medical organization ». Medical Almanac, n^o 3-4 (14 octobre 2019) : 65–72. http://dx.doi.org/10.21145/2499-9954-2019-3-65-72.

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The article presents generalized clinical and epidemiological features of viral infections in children's noninfectious multidisciplinary hospital based on the results of a multi-year comprehensive study. The study was conducted for 12 years (2006–2017), included 16615 patients, including those diagnosed with «Acute respiratory viral infection» – 6104 patients, with a diagnosis of «Acute intestinal viral infection» – 1934 patients. A total of 193017 microbiological studies were conducted, including molecular genetic studies. It was found that the overall incidence of viral infections in children's non-infectious multidisciplinary hospital was 21.1 [95% CI 20.3-21.9] per 1000 hospitalized patients (according to long-term average data). The main nosological groups of viral infections were respiratory infections, enteric infections, intrauterine infections and parenteral viral hepatitis. Viral infections in in children's non-infectious multidisciplinary hospital were characterized by the following clinical and epidemiological features: high incidence; age group at risk – children under 3 years; features of clinical picture with «masks» of noncommunicable pathology; presence of combined infections; high level of virus transmission; high frequency of infections, brought into the hospital; prevalence of healthcare-associated infections in the general structure of morbidity with outbreak and involvement in the epidemic process of children and adults; uneven distribution of morbidity and carriers in departments; presence of nosocomial circulation of viruses.

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Bukhsh, Ayman, Faisal Alalhareth, Manal Alhashem, Haneen Alharbi, Sarah Aljadani, Hassan Alshehri, Abdullah Aldamkh et al. « Surgical and Non-Surgical Maxillofacial Infections ». Journal of Healthcare Sciences 02, n^o 11 (2022) : 429–34. http://dx.doi.org/10.52533/johs.2022.21115.

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One of the most common infectious processes known to ancient and modern medicine alike, the majority of these illnesses are odontogenic in identity. The majority of these infections can be treated surgically, including drainage, endodontic treatment, and exodontia in order to be controlled without resorting to antimicrobials. Due to the intricate anatomy involved and the potential for catastrophic medical problems even with expert therapy, severe space infections pose a difficult dilemma for maxillofacial surgeons. Because of the proximity of the submandibular and submental areas, infections can also affect several spaces. Streptococcus pyogenes, a Gram-positive aerobic pathogen, was found to be the most frequent organism linked to orofacial infection. Possibly deadly consequences that may appear after MSI include septicemia, airway compromise, cavernous sinus thrombosis, necrotizing fasciitis, and mediastinitis. Deep space maxillofacial and cervicofacial infections should be managed according to certain principles, including immediate and prompt evaluation of the infection's extent based on anatomical location, rate of development, and possibility for airway impairment. Penicillin is still the preferred empiric medication, at least for outpatients, according to recent data on the antibiotic sensitivity of the most frequently identified bacteria of odontogenic infections. With respect to surgical intervention, many surgeons have been shown to favor tracheotomy to endotracheal intubation for maintaining the airway in patients with airway blockage. In contrast to those who receive endotracheal intubation, patients with severe cervicofacial infections who receive tracheotomy for airway support have been shown to have a shorter stay in critical care, experience fewer problems, and pay less overall. After assessing the host immunity, early definite operative therapy is essential for halting the infection's spread.

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Anoun, Jihed, Mariem Ajmi, Salma Riahi, Yosra Dhaha, Donia Mbarki, Imen ben Hassine, Wiem Romdhane et al. « Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in bacterial infections : contributions to diagnostic strategies in a tertiary care hospital in Tunisia ». F1000Research 13 (25 septembre 2024) : 978. http://dx.doi.org/10.12688/f1000research.146952.2.

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Background Bacterial infections continue to pose a global health challenge, driven by antibiotic resistance and septicemia. This study aimed to assess the diagnostic utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in bacterial infections versus non-infectious causes of inflammation. Methods A prospective study included 164 adult patients who were divided into two groups: a group of patients with confirmed bacterial infections and a second group of patients with other diagnoses (inflammatory pathologies, neoplasms, venous thromboembolic diseases, etc.). NLR and PLR values were compared between the bacterial infection group and the non-infectious causes group and the diagnostic performances of NLR and PLR for detecting bacterial infections were evaluated in comparison with other infection markers. Results NLR and PLR were significantly higher in bacterial infections (p < 10^-6), and NLR was correlated positively with inflammation markers. NLR and PLR demonstrated significant potential in diagnosing bacterial infections, with an AUC of 0.72 and 0.60, respectively, using the following cutoff values: 4.3 for NLR and 183 for PLR. Conclusion These findings underscore the importance of NLR and PLR as adjunctive tools for bacterial infection diagnosis.

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Anoun, Jihed, Mariem Ajmi, Salma Riahi, Yosra Dhaha, Donia Mbarki, Imen ben Hassine, Wiem Romdhane et al. « Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in bacterial infections : contributions to diagnostic strategies in a tertiary care hospital in Tunisia ». F1000Research 13 (29 août 2024) : 978. http://dx.doi.org/10.12688/f1000research.146952.1.

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Background Bacterial infections continue to pose a global health challenge, driven by antibiotic resistance and septicemia. This study aimed to assess the diagnostic utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in bacterial infections versus non-infectious causes of inflammation. Methods A prospective study included 164 adult patients who were divided into two groups: a group of patients with confirmed bacterial infections and a second group of patients with other diagnoses (inflammatory pathologies, neoplasms, venous thromboembolic diseases, etc.). NLR and PLR values were compared between the bacterial infection group and the non-infectious causes group and the diagnostic performances of NLR and PLR for detecting bacterial infections were evaluated in comparison with other infection markers. Results NLR and PLR were significantly higher in bacterial infections (p < 10^-6), and NLR was correlated positively with inflammation markers. NLR and PLR demonstrated significant potential in diagnosing bacterial infections, with an AUC of 0.72 and 0.60, respectively, using the following cutoff values: 4.3 for NLR and 183 for PLR. Conclusion These findings underscore the importance of NLR and PLR as adjunctive tools for bacterial infection diagnosis.

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Li, Hong, Yan Yang, Jiake Chen, Qingyu Li, Yifeng Chen, Yilin Zhang, Shaojian Cai et al. « Epidemiological Characteristics of Overseas-Imported Infectious Diseases Identified through Airport Health-Screening Measures : A Case Study on Fuzhou, China ». Tropical Medicine and Infectious Disease 9, n^o 6 (20 juin 2024) : 138. http://dx.doi.org/10.3390/tropicalmed9060138.

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Background: This study aimed to examine the epidemiological characteristics of imported infections and assess the effectiveness of border health screening in detecting imported diseases. Methods: We obtained infection data for 2016 to 2019 from the Fuzhou Changle International Airport Infection Reporting System. The demographic, temporal, and spatial characteristics of travel-related infections were analyzed using r×c contingency tables, the Cochran–Armitage trend test, and seasonal-trend decomposition using LOESS (STL). Detection rates were used as a proxy for the effectiveness of border health-screening measures. Results: Overall, 559 travel-related infections were identified during the study period, with 94.3% being imported infections. Airport health screening demonstrated an overall effectiveness of 23.7% in identifying travel-associated infections. Imported infections were predominantly identified in males, with 55.8% of cases occurring in individuals aged 20–49. The peak periods of infection importation were from January to February and from May to August. The infectious diseases identified were imported from 25 different countries and regions. All dengue fever cases were imported from Southeast Asia. Most notifiable infections (76.0%) were identified through fever screening at the airport. Conclusion: The increasing number of imported infections poses a growing challenge for public health systems. Multifaceted efforts including surveillance, vaccination, international collaboration, and public awareness are required to mitigate the importation and spread of infectious diseases from overseas sources.

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Navarra, SV, et MSN Leynes. « Infections in systemic lupus erythematosus ». Lupus 19, n^o 12 (octobre 2010) : 1419–24. http://dx.doi.org/10.1177/0961203310374486.

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Infections are an important cause of morbidity and mortality in systemic lupus erythematosus (SLE). Survival rates for SLE patients in developing countries are comparatively lower than those reported in industrialized countries, with early death from infection and active disease. In addition to the role of immunosuppressive agents in enhancing susceptibility to infection, infectious agents are also known to trigger lupus disease expression and activity. The endemicity of certain infections like tuberculosis further poses a special health issue in developing countries.

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Kasprzak, Annika, Julia Andresen, Barbara Hildebrandt, Kathrin Nachtkamp, Andrea Kündgen, Guido Kobbe, Norbert Gattermann et Ulrich Germing. « Severe Anemia Is Associated with a Risk of Infection in Patients with Myelodysplastic Syndromes ». Blood 138, Supplement 1 (5 novembre 2021) : 4668. http://dx.doi.org/10.1182/blood-2021-151288.

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Abstract Introduction: Infections are a well-recognized complication in patients (pts) with myelodysplastic syndromes (MDS) that contribute substantially to the morbidity and mortality particularly in pts suffering from neutropenia. Neutropenia and other immune defects including impaired neutrophil function have been reported to be predisposing factors for severe infections. Furthermore, some of the therapies may worsen neutropenia and lead to an additional risk factor to develop infectious episodes. Since infectious complications are no primary endpoint in clinical trials epidemiological data on infections in large cohorts of MDS pts is sparse. Methods: We performed a retrospective analysis of 3.787 MDS-patients from the Duesseldorf MDS Registry who were diagnosed between 1980 and 2018. Infectious complications were defined as clinical symptoms of infection associated with the need for antibiotic and/or antifungal therapy, and/or the isolation of a pathogen and/or an identifiable site of infection by physical examination. Infectious episodes were categorized as fever of unknown origin, microbiologically or clinically documented infection. Results: Amongst our study cohort, 42% of the pts suffered from at least one infectious complication of any type during the course of their disease. Most infectious diseases were of bacterial origin (34.7%) and in 17% a pathogen was isolated. Pneumonia was the most common site of infection (64%). Pts who experienced at least one infectious episode had a significant poorer overall survival (OS) than pts without such events (21 vs 37 months, p<0.001). Pts with a higher risk disease according to the IPSS-R had fewer infections during the course of the disease than pts with a lower-risk MDS (487 total infections vs 1481, p<0.001). Nevertheless, the presence of any infectious episode lead to an inferior OS in lower-risk (40 vs 29 months, p<0.001) as well as in higher-risk disease (38 vs 24 months, p=0.006). In univariate analyses comparing pts who had no infections versus those who had one or more, pts with older age (>65 years) tended to have a higher incidence of infectious episodes (p<0.001). In addition, patients older than 65 suffering from infections had a shorter OS than patients who did not experience an infectious complication. The difference in OS was highly significant with 16 months for pts suffering from infectious complications compared to 24 months (p<0.001). Likewise, an excruciating higher incidence of infections was noted in MDS pts compared to infections incidence in a non-MDS population in Germany. The risk of a 65-year-old or older MDS pt to suffer from pneumonia was 6.9 times higher compared to a non-MDS pt of the same age. We found a highly significant negative correlation between the depth of cytopenia in all three myeloid lineages and the presence of infections (p<0.001), suggesting that patients with severe cytopenia suffer from infectious episodes more frequently. However, pts with an isolated neutropenia having an absolute neutrophil count below a threshold of 0.8 × 10 9/L and suffering from infectious episodes had no inferior OS than neutropenic pts without any infection (25 vs 32 months, p=0.583). Pts with isolated severe thrombocytopenia with a platelet count <50 × 10 9/L had a similar OS of 26 months for pts with infectious complications. The difference in OS between pts with and without infections was even more pronounced in this group (26 vs 48 months, p=0.002). Still, a low hemoglobin (Hb) level <9g/dl appeared to be the most significant risk factor for pts with infections, resulting in the poorest OAS of only 17 months in pts with isolated anemia suffering from infections. In multivariate analyses, we found that Hb <9g/dl, followed by ANC <0.8 × 10 9/L, were independently associated with the risk to suffer from an infection during the disease. In addition, a Hb <9g/dl was the most important blood count parameter with regard to OS when compared to platelets <50 × 10 9/L, and ANC <0.8 × 10 9/L. Conclusion: The incidence of infections significantly increases in pts with advanced age. MDS-pts in general are more vulnerable for infection-related morbidity and mortality than non-MDS-pts. Low hemoglobin and platelet counts were both found to be associated with a worse prognosis compared to low neutrophil counts. The appearance of at least one infectious episode leads to an inferior Disclosures Nachtkamp: Jazz: Speakers Bureau; bsh medical: Speakers Bureau; Celgene: Other: Travel Support. Kobbe: Celgene: Research Funding. Gattermann: Celgene: Honoraria; Takeda: Research Funding; Novartis: Honoraria. Germing: Novartis: Honoraria, Research Funding; Jazz Pharmaceuticals: Honoraria; Celgene: Honoraria; Bristol-Myers Squibb: Honoraria, Other: advisory activity, Research Funding; Janssen: Honoraria.

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VARKAL, Gizem, İpek TÜRK, Özlem DOĞAN AĞBUGA, Mehmet Ali AŞIK, Şerife Şeyda ZENGİN ACEMOĞLU, Kaniye AYDIN, Didem ARSLAN et Hüseyin Turgut Elbek ÖZER. « Infections and causative microorganisms in patients with ANCA-associated vasculitis ». Cukurova Medical Journal 48, n^o 1 (31 mars 2023) : 253–60. http://dx.doi.org/10.17826/cumj.1218642.

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Purpose: The aim of this study was to detect infections requiring hospitalization in patients with ANCA-associated vasculitis (AAV). Materials and Methods: This is a single-center, retrospective study conducted in Turkish patients with AAV. Infection episodes requiring hospitalization, reproducing pathogens, laboratory findings, immunosuppressive treatments given for the treatment of vasculitis, and the relationship with the infection were evaluated. Results: Seventy-four patients diagnosed with AAV were included in the study. Hospitalization due to infection was observed in 36 of the patients. The coexistence of diabetes mellitus (DM) was found to be significantly higher in the infected patient group. Cyclophosphamide (CYC) treatment found to increase risk of infection. More than 80% of the infected patient group presented with renal involvement (80.6%). A total of 68 infectious episodes were seen in 36 patients. The most common involvement of infection was the respiratory tract with a rate of 70.6%. Gram-negative bacteria were the most common pathogen, especially Pseudomonas aeruginosa. With the effect of the pandemic, SARS-CoV-2 has come to the fore among viral infections. Aspergillosis was the most frequently detected among fungal infections. Besides, aspergillosis was the cause of 85.7% (6 episodes) of fungal infections. Lymphopenia was observed in 76.5% of the infection episodes. 57.4% of infections developed in the first year of the induction therapy. The most frequently used immunosuppressive therapy for the treatment of vasculitis in infectious episodes was CYC (41.2%). Conclusion: Managing infections during the vasculitis treatment is crucially important. Lymphopenia, kidney involvement, DM and immunosuppressive therapy are factors that increase the risk of infection. Clinicians should take preventive measure especially for respiratory tract infections and gram-negative bacteria as pathogens.

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De Valence de Minardière, Benjamin, Marion Delaune, Yann Nguyen, Vincent Jachiet, Mael Heiblig, Alexis Jean, Stanislas Rieschert et al. « Serious Infections in Patients with Vexas Syndrome : A Study from the French Vexas Group ». Blood 142, Supplement 1 (28 novembre 2023) : 5599. http://dx.doi.org/10.1182/blood-2023-178254.

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Background VEXAS (Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic) syndrome is an autoinflammatory monogenic disease caused by inactivating somatic mutations in the UBA1 gene and characterized by heterogenous systemic auto-inflammation and progressive hematologic manifestations. Its management is not consensual but often include biologic DMARDs or azacitidine in case of association with myelodysplastic syndrome. Prognosis appears to be poor, with substantial morbidity and mortality mainly caused by infection. The aim of this study was to describe the spectrum of serious infectious complications and their potential risk factors in VEXAS patients. Methods We conducted a retrospective multicenter study including patients with genetically proven VEXAS syndrome from the French VEXAS registry. Episode of serious infections (defined as an infection leading to hospitalization and/or intravenous infectious treatments and/or death) were described, and their risk factors analyzed with multivariable Cox proportional hazard models.These patients were compared to a cohort of 50 VEXAS patients without serious infection after at least one year of follow-up since diagnosis. Results Seventy-four patients (99% male, median [IQR] age at VEXAS onset of 68 [63-75] years) with 133 serious infections were included. Infections occurred despite anti-infective prophylaxis in 46% of cases. The main immunosuppressive drugs received at the time of infection were JAK inhibitors (29%), biologics (21%) and azacitidine (11%), while 16% of infections occurred without treatment (no immunosuppressant or corticosteroids ≤ 10 mg/d).The most common sites of infection were lung (59%), skin (10%) and urinary tract (9%). Microbiological confirmation was obtained for 76%: 52% bacterial, 30% viral, 15% fungal and 3% mycobacterial. Among pulmonary infections, the main infectious agents were SARS-CoV-2 (28%), Legionella pneumophila (21%) and Pneumocystis jivoreci (19%) (Figure 1). Invasive fungal infections accounted for 11% of all infections. Nearly 20% of pulmonary infections occurred in the absence of treatment with a high prevalence of L. pneumophila (42%) and P. jivoreci (17%) infections. In multivariate analysis, age >75 years (HR [95%CI] 1.91 [1.05-3.47]), p.Met41Val mutation (2.44 [1.05-5.63]) and arthralgia (2.03 [1.16-3.56]) were associated with the risk of first serious episode of infections. Among treatments, JAK inhibitors were the most associated with serious infections (4.51 [2.19-9.26] compared to biologics and azacitidine. After a median follow-up of 4.4 [2.5-7.7] years, 27 (36%) patients died including 15 (56%) due to serious infection. Conclusion VEXAS syndrome is associated with a high incidence of serious infections especially in patients carrying the p.Met41Val mutation. The high frequency of atypical infections such as legionellosis and invasive fungal infections in patient without immunosuppressive treatment might suggest an intrinsic immunodeficiency of the disease. JAK inhibitors, used as first-line treatment, are particularly at risk of serious infections occurring early after initiation.

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Burmistrov, E. M., T. N. Rybalkina, N. V. Karazhas, R. E. Boshyan, P. A. Veselovsky, M. Yu Lysenkova, E. R. Meskina et T. V. Stashko. « DETECTION OF HERPESVIRUS INFECTIONS IN CHILDREN OF THE FIRST SIX MONTHS OF LIFE ». Journal of microbiology epidemiology immunobiology, n^o 5 (28 octobre 2018) : 87–92. http://dx.doi.org/10.36233/0372-9311-2018-5-87-92.

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Aim. To evaluate a possible role of herpes viruses in the pathogenesis of various infectious diseases of children in the first six months of life, including acute gastroenteritis and identify the markers of herpesvirus infections which occur most frequently. Materials and methods. Samples of biological materials (blood serum and blood cells, breast milk, urine, feces) were studied in 35 children aged 14 days to 5 months who are being treated in MRRCI Vladimirsky with diagnoses of «acute infectious gastroenteritis of unspecified etiology» (n=24), «urinary tract infection» (n=6), «intrauterine infection» (n=5) and of their mothers. To determine the antibodies of IgM, IgG in serum, an enzyme immunoassay was used, to detect common antigens of viruses in blood cells, urine, breast milk - an indirect reaction of immunofluorescence, to detect early antigens of viruses and their reproduction - a rapid cultural method. Results. Infection with herpesviruses was found in 85% of children and 91% of mothers, with the most often identified markers of active forms of infection caused by the herpes simplex virus. In children with a diagnosis of acute infectious gastroenteritis of unspecified etiology, no pathogens of viral and bacterial intestinal infections were detected in a large number of active forms of herpesviral infections in both children and their mothers (33% and 91%, respectively). As well as mothers and their children, there have been cases of mixed infections caused by associations of herpesviruses, most often with HSV. Conclusion. Detection of active forms of herpesviral infections in the absence of positive results in studies on viral and bacterial intestinal infections make it possible to assume that herpesviruses can participate in the etiology of these diseases and cause infectious complications in this pathology, as well as often act as a co-infection. An important epidemiological importance has a large number of identified latent forms of herpesvirus infections, because when exposed to adverse factors they can go into active forms.

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Harris, Courtney, Lara Coakley, Mandeep R. Mehra, Hari R. Mallidi, Lindsey R. Baden et Ann E. Woolley. « 94. Infectious Complications of Left Ventricular Assist Devices ». Open Forum Infectious Diseases 8, Supplement_1 (1 novembre 2021) : S60. http://dx.doi.org/10.1093/ofid/ofab466.094.

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Abstract Background Left ventricular assist devices (VAD) have significantly increased survival for patients with advanced heart failure. While advancements in devices during the past 10 years have improved thrombotic and bleeding complications, infection remains a significant cause of morbidity and mortality. We assessed the incidence and risk factors of VAD infections at our institution. Methods A single center, retrospective study of patients who had VAD implanted between January 2007 and December 2020 was performed. Patients with concurrent right sided mechanical circulatory support devices were excluded. Patient demographics, clinical characteristics, labs, microbiology data, and antimicrobials were obtained from the electronic medical records. Clinical outcomes were adjudicated by 2 independent physicians. VAD infections were classified using the ISHLT 2011 guidelines. Results 241 patients had durable VAD implanted in this 14-year period, with a median time of 3 years follow-up. 134 (56%) patients had a clinically significant infection; 42 (31.3%) were VAD specific infections, 42 (31.3%) were VAD related, and 50 (37.4%) were non-VAD related. 95% of VAD specific infections were driveline site infections. 98% of patients with VAD related infections had a concurrent blood stream infection. Of the 50 non-VAD infections, 72% involved either a lower respiratory, urinary tract, or Clostridium difficile infection. Median time from VAD implantation to infection was 5 months. 44 (32.8%) had their first infection during the index hospitalization, of which 27 (61.4%) were non-VAD infections. 78 (58.2%) had one infection, compared with 38 (28.4%) who had two or more infections. 17 (12.7%) had recurrence of their initial infection and 6 (35%) occurred despite being on suppressive antibiotics. 48 of 134 (36%) infected patients were transplanted. 57 of 134 (42.5%) died compared to 33 of 107 (31%) without an infection. Conclusion More than half of VAD patients at our center during a 14-year time period had an infectious complication and higher mortality rate compared to those without an infectious complication. Further studies are needed to assess the immunologic risk factors for the increased risk of non-device associated infections in VAD patients. Disclosures Mandeep R. Mehra, MD, Abbott (Consultant)Baim Institute for Clinical Research (Consultant)FineHeart (Consultant)NupulseCV (Consultant) Ann E. Woolley, MD, MPH, COVAX (Consultant)

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Thangaraj, Abarna, Reva Tyagi, Deepti Suri et Sudhir Gupta. « Infections in Disorders of Immune Regulation ». Pathogens 13, n^o 3 (17 mars 2024) : 259. http://dx.doi.org/10.3390/pathogens13030259.

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Primary immune regulatory disorders (PIRDs) constitute a spectrum of inborn errors of immunity (IEIs) that are primarily characterized by autoimmunity, lymphoproliferation, atopy, and malignancy. In PIRDs, infections are infrequent compared to other IEIs. While susceptibility to infection primarily stems from antibody deficiency, it is sometimes associated with additional innate immune and T or NK cell defects. The use of immunotherapy and chemotherapy further complicates the immune landscape, increasing the risk of diverse infections. Recurrent sinopulmonary infections, particularly bacterial infections such as those associated with staphylococcal and streptococcal organisms, are the most reported infectious manifestations. Predisposition to viral infections, especially Epstein–Barr virus (EBV)-inducing lymphoproliferation and malignancy, is also seen. Notably, mycobacterial and invasive fungal infections are rarely documented in these disorders. Knowledge about the spectrum of infections in these disorders would prevent diagnostic delays and prevent organ damage. This review delves into the infection profile specific to autoimmune lymphoproliferative syndrome (ALPS), Tregopathies, and syndromes with autoimmunity within the broader context of PIRD. Despite the critical importance of understanding the infectious aspects of these disorders, there remains a scarcity of comprehensive reports on this subject.

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Makhmutov, R. F. « Assessment of cytokine and humoral status children with primary Epstein-Barr viral infection, recurrent respiratory infections and adenoviral infection ». Siberian Medical Review, n^o 4 (2021) : 80–84. http://dx.doi.org/10.20333/25000136-2021-4-80-84.

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Aim of study. To assess the humoral and cytokine status in children with infectious mononucleosis (induced by Epstein-Barr virus), recurrent respiratory infections and adenoviral infection. Material and methods. Indices of humoral (IgА, IgМ and IgG immunoglobulins) and cytokine (IFN-α and IFN-γ interferons, IL-1β and IL-6 interleukins) immunity were evaluated in 93 children with infectious mononucleosis (induced by Epstein-Barr virus (EBV)), 167 children with recurrent respiratory infections of the upper respiratory tract (RRI) and 76 children with adenoviral infection (AI) aged 1 to 18 years as well as 90 children of the same age without diseases associated with lymphoproliferative syndrome and with no medical illnesses exacerbating at the moment of study. Results. A decrease in virus resistance of children with viral infections combined with the lymphoproliferative syndrome was manifested by a 1.5 to 2-fold decrease of IFN-α and IFN-γ. Signifi cantly elevated levels of IL-1β and IL-6 anti-infl ammatory interleukins in children with viral infections combined with the lymphoproliferative syndrome attested to severe progression of the pathological process, predominantly in infectious mononucleosis (induced by EpsteinBarr virus). Results of analysis of cytokines in peripheral blood during infectious diseases may be considered as additional laboratory criteria for differential diagnosis of diseases accompanied by the lymphoproliferative syndrome. Conclusion. While interferons suppress viral replication, investigation of the cytokine status of children with infectious mononucleosis (induced by EpsteinBarr virus), recurrent respiratory infections and adenoviral infection is especially relevant for practical healthcare.

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ALKAN, Gülsüm, Hatice TÜRK DAĞI, Melike EMİROĞLU, Rumeysa İPTEŞ, Şadiye Kübra TÜTER ÖZ, Meltem KIYMAZ et Muslu Kazım KÖREZ. « Evaluation of Staphylococcus aureus Infections in Children ». Pediatric Practice and Research 11, n^o 2 (15 juillet 2023) : 53–60. http://dx.doi.org/10.21765/pprjournal.1306689.

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Aim: Staphylococcus aureus is the most common infectious agent worldwide which leads to morbidity and mortality. Community and hospital acquired infections can range to skin infections to life-threatening infections. In our study, we attempted to evaluate demographic, clinical, and laboratory parameters and the prognosis of children with S. aureus infection. Methods: Children infected with S. aureus at the Department of Paediatric Infectious Disease, Selcuk University Faculty of Medicine, from 2014 to 2022 were analysed retrospectively. Patients were evaluated for MRSA, MSSA, and community or hospital-acquired infections. Results: A total of 116 children's detected specimens were collected; 31.9% contained MRSA and 68.1% contained MSSA. The proportion of community-acquired (CA) infections was 88.8%, while hospital-acquired (HA) infections were 11.2%. MSSA was more common in the CA-S. aureus group, while MRSA was more common in the HA-S. aureus group (p=.025). The most common clinical manifestations included soft tissue infection, lymphadenitis, cutaneous infection, osteomyelitis, and septic arthritis. Each patient was treated with antibiotics, 77.59% of patients was required hospitalization. In 62.9% of the patients, surgical intervention (drainage or debridement) was performed. Despite 86.2% of the patients were cured, infection persisted in nine patients with epidermolysis bullosa, CIPA syndrome, and bone implants. One patient with shunt meningitis died. Conclusions: S. aureus cause both CA and HA superficial or invasive infections, in children. Especially in life-threatening infections, appropriate antibiotic therapy is critical for preventing mortality until an antibiogram culture result is obtained. The patient's clinical condition and regional antibiotic resistance should be considered when prescribing antibiotics empirically.

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Silwal, Prashanta, Jin Kim, Jae-Min Yuk et Eun-Kyeong Jo. « AMP-Activated Protein Kinase and Host Defense against Infection ». International Journal of Molecular Sciences 19, n^o 11 (6 novembre 2018) : 3495. http://dx.doi.org/10.3390/ijms19113495.

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5′-AMP-activated protein kinase (AMPK) plays diverse roles in various physiological and pathological conditions. AMPK is involved in energy metabolism, which is perturbed by infectious stimuli. Indeed, various pathogens modulate AMPK activity, which affects host defenses against infection. In some viral infections, including hepatitis B and C viral infections, AMPK activation is beneficial, but in others such as dengue virus, Ebola virus, and human cytomegaloviral infections, AMPK plays a detrimental role. AMPK-targeting agents or small molecules enhance the antiviral response and contribute to the control of microbial and parasitic infections. In addition, this review focuses on the double-edged role of AMPK in innate and adaptive immune responses to infection. Understanding how AMPK regulates host defenses will enable development of more effective host-directed therapeutic strategies against infectious diseases.

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Ivanov, A. A., et T. V. Kulichenko. « Assessing the Diagnostic Significance of Herpes Virus Infections’ Serological Markers in Children : Overdiagnosis or Clinically Relevant Studies ? Retrospective Study ». Current Pediatrics 22, n^o 1 (25 février 2023) : 52–58. http://dx.doi.org/10.15690/vsp.v22i1.2519.

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Background. Nowadays, population generally has high contamination with herpes virus infections. Infection commonly is asymptomatic, and the virus persists in the human body over a lifetime. Excessive diagnosis of herpes virus infections as well as overestimation of their role in the genesis of various diseases in immunocompetent people are common in Russian pediatrics.Objective. The aim of the study is to assess the frequency and efficacy of serological testing in the suspected correlation of herpes virus infections and infectious and somatic diseases in a multidisciplinary hospital.Methods. The study included patients hospitalized in the multidisciplinary hospital in Moscow, who were assigned serological examination for herpes viruses. The laboratory study was carried out by enzyme-linked immunosorbent assay with the revealing the markers of herpes simplex virus type 1 and 2, Epstein-Barr virus, and cytomegalovirus. The results of the examination were analyzed according to the nosology and their role in diagnosis and management.Results. The identification of herpes virus infections’ markers was performed for 996 patients undergoing medical treatment in 17 different hospital departments within 2 months. Most commonly the examination was prescribed in infectious disease, pediatric, and hematological departments and covered more than 140 different nosologies. Acute respiratory infection, reactive arthritis, thrombocytopenia, infectious mononucleosis, acute tonsillitis, gastrointestinal pathology, acute bronchitis, and pneumonia were the most common nosologies. Positive markers of acute infection were revealed in 1.71% of cases for HSV-1/HSV-2, in 4.89% — for EBV, in 3.81% — for CMV. Moreover, positive results of serological examination were mostly noted in the cases of infectious diseases: infectious mononucleosis, tonsillitis, or acute respiratory infections. Tests were assigned for all three infections at the same time in most cases.Conclusion. Widespread examination for herpes virus infections is the typical variant of overdiagnosis and it is usually less informative. Generally positive markers are observed in typical course of herpes virus infections when clinical picture is enough for diagnosis verification.

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Tuna, Ayşegül. « Infection diseases that can be seen post-earthquake ». Intercontinental Journal of Emergency Medicine 1, n^o 1 (30 mars 2023) : 4–10. http://dx.doi.org/10.51271/icjem-0002.

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Due to uncontrolled urbanization and rapid population growth, earthquakes can have major effects on human life, society and economic systems. Infectious diseases can be seen depending on the factors that facilitate the development of infection in the long term after earthquakes. Lack of clean water, food and hygiene are important causes of infection for individuals. Problems in the city's mains systems such as water and electricity are also among the reasons that increase the possibility of infection. Lack of adequate medication may cause delays in treatment. For this reason, the surveillance of infectious diseases, which increased after the earthquake, has an important place in the fight against infectious diseases and epidemics. Latent infections such as skin and soft tissue infections, gastroenteritis due to contaminated food and water, respiratory system infections transmitted by droplets, rash diseases and meningitis, tuberculosis due to migrations and limited treatments increase after earthquakes.

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Britkova, T. A., K. E. Panteleev et O. A. Pazinenko. « Clinical and etiological characteristics of mixed infections in children in the Izhevsk hospital ». CHILDREN INFECTIONS 21, n^o 4 (24 novembre 2022) : 53–56. http://dx.doi.org/10.22627/2072-8107-2022-21-4-53-56.

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Aim: to study the structure, features of the findings and treatment of mixed infections in children at the present stage.Materials and methods. 85 case histories of children aged 5 months to 17 years and 10 months were examined, the final diagnosis of which included 2 or more infections on the basis of the children's infectious diseases department City Clinical Hospital № 7 of Izhevsk. Children with acute infectious pathology (acute intestinal infections, acute respiratory infections, herpes infections) are hospitalized in this hospital. Diagnostic methods: polymerase chain reaction, ELISA, bacteriological.Results. Mixed infections are equally common in both boys and girls, while there is a predominance of mixed infections in young children (up to 1 year and from 1 year to 3 years) 62.4%. The structure of infectious morbidity is consistently dominated by acute enteric infection – 83.5% cases and acute respiratory infections – 53.0% cases. The progression of SARS-CoV-2-associated and herpes-associated mixed infections is characterized by a pronounced polymorphism of clinical manifestations. The etiological factor for each nosology was deciphered only in 17.7%; in 43.5% of cases, only one etiological factor was verified in the laboratory; in 38.8% of cases, no etiological factor was confirmed in the laboratory.

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Pizzigallo, Eligio, Delia Racciatti et Valeria Gorgoretti. « EBV CHRONIC INFECTIONS ». Mediterranean Journal of Hematology and Infectious Diseases 2, n^o 1 (9 août 2010) : e2010022. http://dx.doi.org/10.4084/mjhid.2010.022.

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The infection from Epstein-Barr virus (EBV) or virus of infectious mononucleosis, together with other herpesviruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and eventually with the “shedding”, it is still not clear if this virus can determine chronic infectious diseases, more or less evolutive. These diseases could include some pathological conditions actually defined as “idiopathic”and characterized by the “viral persistence” as the more credible pathogenetic factor. Among the so-called idiopathic syndromes, the “chronic fatigue syndrome” (CFS) aroused a great interest around the eighties of the last century when, just for its relationship with EBV, it was called “chronic mononucleosis” or “chronic EBV infection”. Today CFS, as defined in 1994 by the CDC of Atlanta (USA), really represents a multifactorial syndrome characterized by a chronic course, where reactivation and remission phases alternate, and by a good prognosis. The etiopathogenetic role of EBV is demonstrated only in a well-examined subgroup of patients, while in most of the remaining cases this role should be played by other infectious agents - able to remain in a latent or persistent way in the host – or even by not infectious agents (toxic, neuroendocrine, methabolic, etc.). However, the pathogenetic substrate of the different etiologic forms seems to be the same, much probably represented by the oxidative damage due to the release of pro-inflammatory cytokines as a response to the triggering event (infectious or not infectious). Anyway, recently the scientists turned their’s attention to the genetic predisposition of the subjects affected by the syndrome, so that in the last years the genetic studies, together with those of molecular biology, received a great impulse. Thanks to both these studies it was possibile to confirm the etiologic links between the syndrome and EBV or other herpesviruses or other persistent infectious agents. The mechanisms of EBV latency have been carefully examined both because they represent the virus strategy to elude the response of the immune system of the host, and because they are correlated with those oncologic conditions associated to the viral persistence, particularly lymphomas and lymphoproliferative disorders. Just these malignancies, for which a pathogenetic role of EBV is clearly documented, should represent the main clinical expression of a first group of chronic EBV infections characterized by a natural history where the neoplastic event aroused from the viral persistence in the resting B cells for all the life, from the genetic predisposition of the host and from the oncogenic potentialities of the virus that chronically persists and incurs reactivations. Really, these oncological diseases should be considered more complications than chronic forms of the illness, as well as other malignancies for which a viral – or even infectious - etiology is well recognized. The chronic diseases, in fact, should be linked in a pathogenetic and temporal way to the acute infection, from whom start the natural history of the following disease. So, as for the chronic liver diseases from HBV and HCV, it was conied the acronym of CAEBV (Chronic Active EBV infection), distinguishing within these pathologies the more severe forms (SCAEBV) mostly reported in Far East and among children or adolescents. Probably only these forms have to be considered expressions of a chronic EBV infection “sensu scrictu”, together with those forms of CFS where the etiopathogenetic and temporal link with the acute EBV infection is well documented. As for CFS, also for CAEBV the criteria for a case definition were defined, even on the basis of serological and virological findings. However, the lymphoproliferative disorders are excluded from these forms and mantain their nosographic (e.g. T or B cell or NK type lymphomas) and pathogenetic collocation, even when they occur within chronic forms of EBV infection. In the pathogenesis, near to the programs of latency of the virus, the genetic and environmental factors, independent from the real natural history of EBV infection, play a crucial role. Finally, it was realized a review of cases - not much numerous in literature – of chronic EBV infection associated to chronic liver and neurological diseases, where the modern techniques of molecular biology should be useful to obtain a more exact etiologic definition, not always possibile to reach in the past. The wide variety of clinical forms associated to the EBV chronic infection makes difficult the finding of a univocal pathogenetic link. There is no doubt, however, that a careful examination of the different clinical forms described in this review should be useful to open new horizons to the study of the persistent viral infections and the still not well cleared pathologies that they can induce in the human host.

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Stolley, Michael, et David Masopust. « First lung infection permanently enlarges LN and enhances new T cell responses ». Journal of Immunology 212, n^o 1_Supplement (1 mai 2024) : 0170_5961. http://dx.doi.org/10.4049/jimmunol.212.supp.0170.5961.

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Abstract Humans experience about four respiratory infections per year. Immunology and vaccinology studies in mice are typically performed in naïve specific pathogen free (SPF) animals responding to their very first respiratory challenge. We found that the first respiratory infection induces lifelong enlargement of lung-draining mediastinal LNs. Furthermore, infection-experienced medLNs supported better naïve T cell surveillance and effector responses to new unrelated infections and engendered more biased accumulation and memory establishment within the lung. Moreover, we observed that weight loss induced by influenza infection was substantially reduced in mice that had recovered from a previous unrelated respiratory viral challenge. These data show that the lack of infectious history in SPF mice alters their immune response to lung infections. Preclinical vaccination and immunology studies should consider the previous infectious experience of the model organism.

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Khusnutdinova, Tatyana A. « Urinary tract infections in obstetrics and gynecology : current issues of diagnosis and antibiotic therapy ». Journal of obstetrics and women's diseases 68, n^o 6 (19 février 2020) : 19–28. http://dx.doi.org/10.17816/jowd68619-28.

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Urinary tract infections are among the most common infectious diseases in women and often complicate the course of pregnancy. This article reviews current scientific and methodical literature on the management of pregnant women with urinary tract infection. Aspects of clinical importance of urinary tract infections during pregnancy (epidemiology, clinical manifestations, and complications) are discussed, with current recommendations for diagnosis and management of urinary tract infections summarized. Special attention is paid to the problem of antibiotic resistance of urinary tract infection pathogens.

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Kimmel, Martin. « Infekt-assoziierte Glomerulonephritiden ». DMW - Deutsche Medizinische Wochenschrift 145, n^o 04 (février 2020) : 240–47. http://dx.doi.org/10.1055/a-0974-9420.

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AbstractGlomerulonephritis, secondary to bacterial, or, more rarely, viral or parasitic infections, is called infection-associated. The epidemiology of infection-associated glomerulonephritis has changed in recent decades. For a long time, the classic form has been acute poststreptococcal glomerulonephritis (APGN), but in developed countries its incidence has declined sharply. However, there is an increase in staphylococcal associated glomerulonephritis (SAGN). The clinical manifestations of APGN and SAGN are different: APGN typically presents with a glomerulonephritis after an infectious latency period (post-infectious), while SAGN typically shows an immune complex glomerulonephritis concomitant with infection (para-infectious). SAGN often presents with an occult infections in older patients with multiple comorbidities.

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Soeiro, Emilia Maria Dantas, Vera Hermina Koch, Maria Danisi Fujimura et Yassuhiko Okay. « Influence of nephrotic state on the infectious profile in childhood idiopathic nephrotic syndrome ». Revista do Hospital das Clínicas 59, n^o 5 (2004) : 273–78. http://dx.doi.org/10.1590/s0041-87812004000500009.

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Patients with idiopathic nephrotic syndrome present alterations in their cellular and humoral immune reactions that predispose them to the development of infectious processes. PURPOSE: To characterize the infectious processes in patients with idiopathic nephrotic syndrome. PATIENTS AND METHODS: Ninety-two children and adolescents with idiopathic nephrotic syndrome were assessed retrospectively. The types of infection were grouped as follows: upper respiratory tract infections; pneumonia; skin infections; peritonitis; diarrhea; urinary tract infection ; herpes virus; and others. The patients were divided into 2 groups: Group I (steroid-responsive) n = 75, with 4 subgroups-IA (single episode) n = 10, IB (infrequent relapsers) n = 5, IC (frequent relapsers) n = 14, and ID (steroid-dependent) n = 46; and Group II (steroid-resistant) n = 17. The incidence-density of infection among the patients was assessed throughout the follow-up period. Comparisons for each group and subgroup were done during the periods of negative and nephrotic proteinuria. RESULTS: The analysis revealed a greater incidence-density of infections during the period of nephrotic proteinuria in all the groups and subgroups, with the exception of subgroup IA. During the period of nephrotic proteinuria, subgroups IC, ID, and Group II presented a greater incidence-density of infections as compared to subgroup IA. For the period of negative proteinuria, there was no difference in the incidence-density of infections between the groups and subgroups. Upper respiratory tract infections were the most frequent infectious processes. CONCLUSION: The nephrotic condition, whether as part of a course of frequent relapses, steroid dependence, or steroid resistance, conferred greater susceptibility to infection among the patients with idiopathic nephrotic syndrome. The results of this study suggest that the best preventive action against infection in this disease is to control the nephrotic state.

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Lima, Ana Lucia L., Priscila R. Oliveira, Vladimir C. Carvalho, Eduardo S. Saconi, Henrique B. Cabrita et Marcelo B. Rodrigues. « Periprosthetic Joint Infections ». Interdisciplinary Perspectives on Infectious Diseases 2013 (2013) : 1–7. http://dx.doi.org/10.1155/2013/542796.

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Implantation of joint prostheses is becoming increasingly common, especially for the hip and knee. Infection is considered to be the most devastating of prosthesis-related complications, leading to prolonged hospitalization, repeated surgical intervention, and even definitive loss of the implant. The main risk factors to periprosthetic joint infections (PJIs) are advanced age, malnutrition, obesity, diabetes mellitus, HIV infection at an advanced stage, presence of distant infectious foci, and antecedents of arthroscopy or infection in previous arthroplasty. Joint prostheses can become infected through three different routes: direct implantation, hematogenic infection, and reactivation of latent infection. Gram-positive bacteria predominate in cases of PJI, mainlyStaphylococcus aureusandStaphylococcus epidermidis. PJIs present characteristic signs that can be divided into acute and chronic manifestations. The main imaging method used in diagnosing joint prosthesis infections is X-ray. Computed tomography (CT) scan may assist in distinguishing between septic and aseptic loosening. Three-phase bone scintigraphy using technetium has high sensitivity, but low specificity. Positron emission tomography using fluorodeoxyglucose (FDG-PET) presents very divergent results in the literature. Definitive diagnosis of infection should be made by isolating the microorganism through cultures on material obtained from joint fluid puncturing, surgical wound secretions, surgical debridement procedures, or sonication fluid. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic infections in arthroplasty cases. Treatment in a single procedure is appropriate in carefully selected cases.

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Muco, Ermira, Amarildo Blloshmi, Engjellushe Jonuzi et Agron Dogjani. « The Role of the Infectious Disease Specialists in the Trauma Surgical Team. » Albanian Journal of Trauma and Emergency Surgery 8, n^o 2 (20 juillet 2024) : 1520–24. http://dx.doi.org/10.32391/ajtes.v8i2.401.

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Introduction: Infection is a significant cause of posttraumatic morbidity and prolonged hospitalization. Nosocomial infections are a frequent complication of trauma patients admitted to the intensive care unit (ICU). Trauma is predisposed to infections by various mechanisms, while intravascular catheters, endotracheal tubes, and urinary catheters create suitable environments for nosocomial infection during treatment. Following trauma, wound contamination with aerobic and anaerobic bacteria should always be suspected. Material and Methods: In this paper, we want to review the literature regarding the role of infectious disease (ID) specialists in the trauma team and compare it with the situation in our country. Discussion: Infections in trauma are developed because of endogenous bacteremia or as a result of exogenous bacteremia. Since infection significantly prolongs the hospitalization of trauma patients, the infection disease specialist plays a crucial role in preventing and treating infections in collaboration with the surgeon and other trauma team members. The duration of antibiotic treatment is significant. A shorter duration will result in fewer side effects and allergic reactions and reduce long-term antibiotic resistance. Conclusions: The infectious disease specialist is not a standalone figure but an integral part of the trauma team. Their role is not limited to implementing protocols and using appropriate antibiotics before, during, and after surgical procedures. They also closely follow the patients, identifying those with a greater predisposition to develop infections. This collaborative approach is crucial for successfully preventing and managing infections in trauma patients.

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Espinosa-Tamez, Priscilla, Martin Lajous, Carlos Cantú-Brito, Ruy Lopez-Ridaura, Adriana Monge, Elsa Yunes, Beatriz L. Rodríguez, Luis Espinosa, José Sifuentes-Osornio et Andres Catzin-Kuhlmann. « Association of recurrent common infections and subclinical cardiovascular disease in Mexican women ». PLOS ONE 16, n^o 1 (26 janvier 2021) : e0246047. http://dx.doi.org/10.1371/journal.pone.0246047.

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Background Acute and agent-specific chronic infections have been associated with increased cardiovascular risk, however data on the burden of common recurrent infections on cardiovascular disease is limited. We hypothesized women with greater exposure to uncomplicated common infectious events had an increased risk of subclinical cardiovascular disease (sCVD). Methods In a cross-sectional study, we assessed the relation of recurrent infections and carotid artery intima-media thickness (IMT) in 1946 disease-free women from the Mexican Teachers’ Cohort. Through 2012–2016, participants answered structured questions on respiratory, urinary and vaginal infections during the previous year and their IMT was measured using ultrasound by standardized neurologists. We defined sCVD as mean right and left IMT ≥0.8 mm or the presence of atheromatous plaque. Multivariable linear and logistic regression analyses were used to evaluate the association of infectious events with IMT and sCVD adjusting for age, sociodemographic, and cardiovascular risk factors. Results Among participants (50±5 years) 13% reported no infections, 20% one infection and 67% three or more episodes. Overall prevalence of sCVD was 12%(n = 240). Adjusted models for logistic regression showed that women with 2 or more infections had 91% higher odds of sCVD (OR 1.91; 95%CI 1.16, 3.13) compared to women without infections (p-trend:0.015). Sub-analyses by type of infection resulted not significant. Linear regression analysis did not show a significant association between mean IMT and recurrent infections. Conclusions Recurrent infectious events in young adult women are associated with greater sCVD, which supports the hypothesis of low-grade chronic inflammation in the pathophysiology of cardiovascular disease.

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Ochs, L., XO Shu, J. Miller, H. Enright, J. Wagner, A. Filipovich, W. Miller et D. Weisdorf. « Late infections after allogeneic bone marrow transplantations : comparison of incidence in related and unrelated donor transplant recipients ». Blood 86, n^o 10 (15 novembre 1995) : 3979–86. http://dx.doi.org/10.1182/blood.v86.10.3979.bloodjournal86103979.

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Infectious complications are a major cause of morbidity and mortality after allogeneic bone marrow transplantation (BMT). We have evaluated the incidence of late infections (beyond day +50) in recipients of related (RD) and unrelated donor (URD) allogeneic BMT, factors associated with increased risks of infection, and the impact of the late infections on survival. Between 1989 and 1991, 249 patients received an RD (n = 151) or URD (n = 98) allogeneic BMT at the University of Minnesota and all late infections were investigated. Three hundred sixty-seven late infectious events developed in 162 patients between 50 days and 2 years after BMT. The incidence of any late infection was greater in URD versus RD recipients (84.7% v 68.2%, respectively; P = .009). In multivariate analysis, advanced graft- versus-host disease (GVHD) was significantly associated with late infections. The effect of GVHD was apparent only in RD recipients (relative risk [RR], 2.29; P = .003), whereas URD recipients, with or without GVHD, had more late infections compared with RD recipients without GVHD. Multivariate analysis showed that late posttransplantation infections were the dominant independent factor associated with increased nonrelapse mortality (RR, 5.5; P = .0001), resulting in improved 3-year survival for RD versus URD recipients (49.9% +/- 8% v 34.4% +/- 10%; P = .004). In this study, we observed that late infections are more frequent in URD recipients, resulting in substantially higher nonrelapse mortality. This prolonged period of increased infectious risk in URD recipients suggests the need for aggressive surveillance and therapy of late infections and perhaps prolonged antibiotic prophylaxis for all URD BMT recipients.

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Manapova, E. R., V. H. Fazylov et A. T. Beshimov. « SEXUALLY-TRANSMITTED INFECTIONS IN HIV INFECTED PATIENTS ». HIV Infection and Immunosuppressive Disorders 11, n^o 1 (7 avril 2019) : 71–74. http://dx.doi.org/10.22328/2077-9828-2019-11-1-71-74.

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Sexually-transmitted infections are among the most well-known risk factors for HIV infection. The problem of combined diseases of STIs and HIV in infected people is represented by few works in the domestic scientific literature, therefore further study of this issue is required. Objective: to identify the prevalence of sexually transmitted infections in HIV-infected patients at the time of registration. Materials and methods. 49 clinical histories of patients with HIV infection were analyzed and studied at the Republican Center for the Prevention and Control of AIDS and Infectious Diseases of the Ministry of Health of the Republic of Tatarstan. Results. STIs with the prevalence of urogenital chlamydia, ureaplasmosis and mycoplasmosis in the oligosymptomatic clinical course were registered in 63% of patients (predominantly women — 67% of cases) with HIV infection in the natural infectious process course. Patients with HIV infection and syphilis showed lower level of CD4 lymphocytes and high levels of HIV RNA viral load.

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Autore, Francesco, Andrea Visentin, Marina Deodato, Candida Vitale, Eugenio Galli, Alberto Fresa, Rita Fazzi et al. « Chronic Obstructive Pulmonary Disease and Previous Infections Have Impact on Infectious Complications in Patients with Chronic Lymphocytic Leukemia Treated with Venetoclax : A Multicentre Seifem Study ». Blood 142, Supplement 1 (28 novembre 2023) : 6529. http://dx.doi.org/10.1182/blood-2023-181037.

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Introduction. Infections are a major source of morbidity and mortality in patients with Chronic Lymphocytic Leukemia (CLL). The development of targeted agents decreased the rate of these complications in comparison to standard chemoimmunotherapy regimens. However, these patients often elderly, with other comorbidities, heavily treated, experienced serious infections. The aim of our study was to evaluate the incidence of clinically or microbiologically documented bacterial, fungal and viral infectious complications in CLL patients treated with venetoclax. Methods. The retrospective multicenter study included CLL patients treated since 2017 with venetoclax single agent until progression or toxicity or venetoclax plus anti-CD20 antibody (mainly rituximab as part of VR protocol for 24 months or obinutuzumab as part of VO protocol for 12 months). Results. A total of 287 patients with CLL received venetoclax during the study period from 16 different institutions: 151 patients (52.6%) as monotherapy and 136 (47.4%) associated to anti-CD20 antibody. Basal characteristics of the whole population and of the two groups are summarized in Table 1. Patients of the first group were older, more frequently had del17/TP53mut, renal impairment and lower basal levels of IgG. They also showed more previous infections in the 12 months before the beginning of the treatment with venetoclax. We registered 284 infections of any grade. When comparing time of first infection between the patients treated with venetoclax and those treated with venetoclax plus anti-CD20 antibody, we registered a trend toward a higher rate of infection in the latter group after the first year (p=0.066). This difference was not confirmed when we focused on infections of grade 3-4 (p=0.521). One-hundred eighty-one infections of grade 1-2 developed in 114 patients (39.7%) during the study. Most of the infections involved the respiratory tract (106 events, 58.6%), followed by genitourinary tract (23, 12.7%) and gastrointestinal one (16, 8.8%). Pathogens implicated in the infections were isolated only in 57 (31.5%) cases: 36 viral, 18 bacterial and 3 fungal. We recorded 103 episodes of infections of grade 3-4, occurred in 73 patients (25.4%). The most common site of infection involved the respiratory tract (71 events, 68.9%), then we registered sepsis (13, 12.6%) and gastrointestinal tract infections (7 events, 6.8%). Of 103 severe infections, 64 (62.1%) were microbiologically proven, of whom 40 were viral, 21 bacterial and 3 fungal. When comparing patients with and without infection, COPD (p<0.001, OR 3.75), previous infections in the last 12 months (p<0.001, OR 3.15), renal impairment CrCl<70 (p = 0.049, OR 1.62), previous treatments (p=0.023; OR 1.196) and stage A (p=0.001; OR 0.2) were more frequently associated with infection in univariate analysis. In multivariate analysis COPD (p <0.001, OR 5.39) and previous infections (p=0.001, OR 2.57) resulted significant. Stratifying patients according to COPD and previous infections in the last 12 months we obtained 3 groups significantly different in terms of infective risk (p <0.001; figure 1). When considering only grade 3-4 infections, risk factors significant in the univariate analysis were COPD (p <0.001, OR 3.23), smoke (p=0.033, OR 1.98) and previous infections (p=0.020, OR 1.91). COPD was the unique significant variable in multivariate analysis (p=0.008, OR 2.62). Treatment was withdrawn for infections in 80 patients (27.9%): in 58 (20.2%) treatment was temporarily discontinued, while in 22 (7.7%) discontinuation was permanent. The infections that caused definitive withdrawals were mainly pneumonia (12 cases, 6 of whom from SarS-CoV2 infection) and sepsis (8 cases, 5 of whom after a SarS-CoV2 infection). A total of 83 patients (28.9%) died and the median OS was 55 months. The main causes of death were CLL progression in 36 cases and infection in 22 cases. Conclusions. This is a real-life study on 287 patients affected by LLC treated with venetoclax with the aim to describe the infectious complications in such population in routine clinical practice. The analysis found a significant rate of infections, most of grade 1-2: 39.7% of the patients experienced a grade 1-2 infection; 25.4% a grade 3-4 infection. The identification of additional infectious risk factors found a role of comorbidities such as COPD and previous infections; COPD resulted a risk factor also for infections of grade 3-4.

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Solovkova, N. R., et V. V. Voitsekhovsky. « Infectious complications during programmed therapy for multiple myeloma ». Bulletin Physiology and Pathology of Respiration, n^o 94 (27 décembre 2024) : 71–79. https://doi.org/10.36604/1998-5029-2024-94-71-79.

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Introduction. Monitoring infectious complications during the programmed therapy of hematological malignancies remains a critical issue in modern hematology. Aim. To examine the frequency and nature of infectious complications in patients with multiple myeloma (MM) treated at the Irkutsk Regional Clinical Hospital from 2016 to 2023. Materials and methods. A total of 450 medical records of MM patients who underwent programmed chemotherapy (CT) from 2016 to 2023 were analyzed. Among these, 213 patients (47%) were diagnosed with various infectious complications. These patients were divided into two groups: Group 1 consisted of 100 patients who received CT from 2016 to 2019, while Group 2 included 113 patients treated from 2020 to 2023. Results. The most common infectious complications associated with MM were bacterial pneumonia (41% in 2016-2019 and 18% in 2020-2023), fever of unknown origin (20% in 2016-2019 and 22% in 2020-2023), urinary tract infections (20% in 2016-2019 and 8.8% in 2020-2023), cytomegalovirus (CMV) infection (9% in 2016-2019 and 18.5% in 2020-2023), and in 2020-2023, the emergence of novel coronavirus infection (observed in 17% of MM patients). The majority of infectious complications occurred during the remission induction phase. A significant decrease in bacterial pneumonia (p<0.001) and urinary tract infections (p=0.020) was observed in 2020-2023 compared to 2016-2019, while an increase in CMV infection was noted (p=0.045). Other infectious complications, including gastrointestinal infections, mucositis, herpes infections, and skin and ENT infections, were infrequently reported during the study period. Conclusion. The study revealed new data that can be used to predict the development of infectious complications at various stages of programmed therapy for MM and to formulate effective preventive measures in clinical practice.

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