Infectious Medicine最新文献

{"title":"Protection conferred by booster vaccine doses in hospitalized patients with COVID-19 during the SARS-CoV-2 Omicron BA.2 and BA.5 epidemics from 2022 to 2023 in Greece","authors":"Helena C. Maltezou ,&nbsp;Maria N. Gamaletsou ,&nbsp;Maria Chini ,&nbsp;Vasileios Petrakis ,&nbsp;Vasiliki Rapti ,&nbsp;Theodoros V. Giannouchos ,&nbsp;Eleni Karantoni ,&nbsp;Konstantinos Kounouklas ,&nbsp;Panagiota Stamou ,&nbsp;Αmalia Karapanou ,&nbsp;Dimitrios Basoulis ,&nbsp;Andrianna-Chrysovalanto Verykokkou ,&nbsp;Kyriakos Souliotis ,&nbsp;Periklis Panagopoulos ,&nbsp;Dimitrios Hatzigeorgiou ,&nbsp;Garyfalia Poulakou ,&nbsp;Konstantinos N. Syrigos ,&nbsp;Nikolaos V. Sipsas","doi":"10.1016/j.imj.2024.100144","DOIUrl":"10.1016/j.imj.2024.100144","url":null,"abstract":"<div><h3>Background</h3><div>To estimate the protection that coronavirus disease 2019 (COVID-19) vaccine doses conferred to hospitalized patients with COVID-19 against adverse outcomes and longer length of stay during the Omicron BA.2 and BA.5 subvariant epidemics in Greece.</div></div><div><h3>Methods</h3><div>The study was conducted from November 2022 to May 2023. Multivariable logistic and negative binomial regression models were applied to estimate the association between any adverse outcomes and length of stay with the number of COVID-19 vaccine doses.</div></div><div><h3>Results</h3><div>We studied 962 patients (median age: 78 years; mean length of stay: 9.2 days), of whom 847 (88.0%) had ≥ 1 comorbidity. Of these, 39 (4.0%) were admitted to the intensive care unit, 44 (4.6%) received invasive mechanical ventilation, and 110 (11.4%) died in hospital. There were 184 (19.1%) unvaccinated patients, 125 (13.0%) with one or two vaccine doses, and 653 (67.9%) with ≥ 3 doses. In multivariable analyses, patients with ≥ 3 doses had lower odds of experiencing any adverse outcomes (adjusted odds ratio: 0.57; 95% confidence interval [CI]: 0.37–0.86) compared with unvaccinated patients. On average, patients with one or two doses and those with ≥ 3 had decreased length of hospital stay (−1.5 days [95% CIs: −2.6 to −0.4] and −2.8 days [95% CIs: −4.1 to −1.4], respectively] compared with unvaccinated patients. Other characteristics consistently associated with adverse outcomes and longer length of stay included older age, having three or more comorbidities compared with none, and being admitted to the hospital two or more weeks post-diagnosis.</div></div><div><h3>Conclusions</h3><div>A history of ≥ 3 vaccine doses conferred significant protection against any adverse outcome and longer length of stay in hospitalized patients with COVID-19.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vagal nerve stimulation for the management of long COVID symptoms","authors":"Malik W.Z. Khan ,&nbsp;Muhammad Ahmad ,&nbsp;Salma Qudrat ,&nbsp;Fatma Afridi ,&nbsp;Najia Ali Khan ,&nbsp;Zain Afridi ,&nbsp;Fahad ,&nbsp;Touba Azeem ,&nbsp;Jibran Ikram","doi":"10.1016/j.imj.2024.100149","DOIUrl":"10.1016/j.imj.2024.100149","url":null,"abstract":"<div><div>This review investigates the therapeutic potential of vagal nerve stimulation (VNS) in managing long COVID, a condition marked by persistent symptoms following acute SARS-CoV-2 infection. Long COVID manifests as ongoing fatigue, cognitive impairment, and autonomic dysfunction, hypothesized to arise from sustained inflammatory and neurological dysregulation. The vagus nerve, central to modulating systemic inflammation and autonomic homeostasis, represents a promising therapeutic target for symptom alleviation through VNS. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science to identify studies evaluating VNS in the context of long COVID. Preliminary evidence from small-scale pilot studies suggests VNS may attenuate systemic inflammation through activation of the cholinergic anti-inflammatory pathway (CAP), thus restoring autonomic balance and ameliorating symptoms such as fatigue, cognitive dysfunction, and anxiety. In targeting the inflammatory cascade that underlies both acute COVID-19 pathophysiology and its prolonged sequelae, VNS holds potential as an innovative intervention for persistent post-viral symptoms. While these initial findings indicate promise, current data remain limited in scope and robustness, underscoring the need for larger, controlled trials to validate the efficacy and mechanisms of VNS in long COVID management. Establishing a clearer understanding of VNS's impact on inflammation and autonomic regulation in this context is crucial to inform clinical guidelines and therapeutic strategies for long COVID, potentially offering a targeted approach for mitigating this disabling condition.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nipah virus resurgence: a call for preparedness across states","authors":"Manya Soni ,&nbsp;Vijay Kumar ,&nbsp;Mahendra Pratap Singh ,&nbsp;Muhammed Shabil ,&nbsp;Sanjit Sah","doi":"10.1016/j.imj.2024.100145","DOIUrl":"10.1016/j.imj.2024.100145","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging computer-aided design and artificial intelligence to develop a next-generation multi-epitope tuberculosis vaccine candidate","authors":"Li Zhuang ,&nbsp;Awais Ali ,&nbsp;Ling Yang ,&nbsp;Zhaoyang Ye ,&nbsp;Linsheng Li ,&nbsp;Ruizi Ni ,&nbsp;Yajing An ,&nbsp;Syed Luqman Ali ,&nbsp;Wenping Gong","doi":"10.1016/j.imj.2024.100148","DOIUrl":"10.1016/j.imj.2024.100148","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a global public health challenge. The existing Bacillus Calmette–Guérin vaccine has limited efficacy in preventing adult pulmonary TB, necessitating the development of new vaccines with improved protective effects.</div></div><div><h3>Methods</h3><div>Computer-aided design and artificial intelligence technologies, combined with bioinformatics and immunoinformatics approaches, were used to design a multi-epitope vaccine (MEV) against TB. Comprehensive bioinformatics analyses were conducted to evaluate the physicochemical properties, spatial structure, immunogenicity, molecular dynamics (MD), and immunological characteristics of the MEV.</div></div><div><h3>Results</h3><div>We constructed a MEV, designated ZL12138L, containing 13 helper T lymphocyte epitopes, 12 cytotoxic T lymphocyte epitopes, 8 B-cell epitopes, as well as Toll-like receptor (TLR) agonists and helper peptides. Bioinformatics analyses revealed that ZL12138L should exhibit excellent immunogenicity and antigenicity, with no toxicity or allergenicity, and had potential to induce robust immune responses and high solubility, the immunogenicity score was 4.14449, the antigenicity score was 0.8843, and the immunological score was 0.470. Moreover, ZL12138L showed high population coverage for human leukocyte antigen class I and II alleles, reaching 92.41% and 90.17%, respectively, globally. Molecular docking analysis indicated favorable binding affinity of ZL12138L with TLR-2 and TLR-4, with binding energies of −1173.4 and −1360.5 kcal/mol, respectively. Normal mode analysis and MD simulations indicated the stability and dynamic properties of the vaccine construct. Immune simulation predictions suggested that ZL12138L could effectively activate innate and adaptive immune cells, inducing high levels of Type 1 T helper cell cytokines.</div></div><div><h3>Conclusions</h3><div>This study provides compelling evidence for ZL12138L as a promising TB vaccine candidate. Future research will focus on experimental validation and further optimization of the vaccine design.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges and eponyms in tuberculous arthritis","authors":"Jacob Draves ,&nbsp;Halil Tekiner ,&nbsp;Steven H. Yale ,&nbsp;Eileen S. Yale","doi":"10.1016/j.imj.2024.100139","DOIUrl":"10.1016/j.imj.2024.100139","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain fog across the Mediterranean","authors":"Souheil Zayet","doi":"10.1016/j.imj.2024.100140","DOIUrl":"10.1016/j.imj.2024.100140","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular fibrosis and extracellular matrix remodelling in post-COVID 19 conditions","authors":"Anna Kamdar ,&nbsp;Robert Sykes ,&nbsp;Cameron R. Thomson ,&nbsp;Kenneth Mangion ,&nbsp;Daniel Ang ,&nbsp;Michelle AW Lee ,&nbsp;Tom Van Agtmael ,&nbsp;Colin Berry","doi":"10.1016/j.imj.2024.100147","DOIUrl":"10.1016/j.imj.2024.100147","url":null,"abstract":"<div><div>Causal associations between viral infections and acute myocardial injury are not fully understood, with mechanisms potentially involving direct cardiovascular involvement or systemic inflammation. This review explores plausible mechanisms of vascular fibrosis in patients with post-COVID-19 syndrome, focusing on extracellular matrix remodelling. Despite global attention, significant mechanistic or translational breakthroughs in the management of post-viral syndromes remain limited. No effective pharmacological or non-pharmacological interventions are currently available for patients experiencing persistent symptoms following COVID-19 infection. The substantial expansion of scientific knowledge resulting from collaborative efforts by medical experts, scientists, and government organisations in undertaking COVID-19 research could inform treatment strategies for other post-viral syndromes and respiratory illnesses. There is a critical need for clinical trials to evaluate potential therapeutic candidates, providing evidence to guide treatment decisions for post-COVID-19 syndromes.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 4","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of isoniazid resistance and genetic mutations in isoniazid-resistant and rifampicin-susceptible Mycobacterium tuberculosis in China","authors":"Dongxin Liu ,&nbsp;Bing Zhao ,&nbsp;Yang Zheng ,&nbsp;Xichao Ou ,&nbsp;Shengfen Wang ,&nbsp;Yang Zhou ,&nbsp;Yuanyuan Song ,&nbsp;Hui Xia ,&nbsp;Qiang Wei ,&nbsp;YanLin Zhao","doi":"10.1016/j.imj.2024.100129","DOIUrl":"10.1016/j.imj.2024.100129","url":null,"abstract":"<div><h3>Background</h3><p>Patients with tuberculosis resistant to isoniazid but susceptible to rifampicin (H^r-R^s TB) remain a neglected demographic, despite a high disease burden and poor outcomes of these patients. The aim of this study was to investigate the characteristics of isoniazid-resistance-related mutations in <em>Mycobacterium tuberculosis</em> and resistance rates to drugs included in WHO-recommended regimens for H^r-R^s patients.</p></div><div><h3>Methods</h3><p><em>Mycobacterium tuberculosis</em> isolates (<em>n</em> = 4922) obtained from national tuberculosis drug-resistance surveillance were subjected to whole-genome sequencing to identify H^r-R^s strains. The minimal inhibitory concentrations (MICs) were established for the H^r-R^s strains to determine the isoniazid resistance levels. We also identified drug-resistance-associated mutations for five drugs (fluoroquinolones, ethambutol, pyrazinamide, streptomycin, and amikacin) in the H^r-R^s strains.</p></div><div><h3>Results</h3><p>Of the 4922 strains, 384 (7.8 %) were H^r-R^s. The subculture of seven strains failed, so 377 (98.2 %) strains underwent phenotypic MIC testing. Among the 384 genotypic H^r-R^s strains, 242 (63.0 %) contained the <em>katG</em> Ser315Thr substitution; 115 (29.9 %) contained the -15C&gt;T in the promoter region of the <em>fabG1</em> gene; and 16 (4.2 %) contained Ser315Asn in the <em>katG</em> gene. Of the 239 strains with the Ser315Thr substitution, 229 (95.8 %) had MIC ≥ 2 µg/mL, and of the 114 strains with the -15C&gt;T mutation, 103 (90.4 %) had 0.25 µg/mL ≤ MIC ≤ 1 µg/mL. The genotypic resistance rates were 0.8 % (3/384) for pyrazinamide, 2.3 % (9/384) for ethambutol and fluoroquinolones; 39.6 % (152/384) of the strains were resistant to streptomycin, but only 0.5 % (2/384) of the strains were resistant to amikacin.</p></div><div><h3>Conclusion</h3><p>Ser315Thr in <em>katG</em> was the predominant mutation conferring the H^r-R^s phenotype, followed by the <em>fabG1</em> -15C&gt;T mutation. The combination of rifampicin, pyrazinamide, ethambutol, and levofloxacin should be effective in the treatment of patients with H^r-R^s tuberculosis because the resistance rates for these drugs in China are low.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X24000431/pdfft?md5=26b8dfceffc196520c45425a907da6a7&pid=1-s2.0-S2772431X24000431-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular tuberculosis associated with Epstein-Barr virus myelitis: A case report","authors":"Fakhri Alahyari ,&nbsp;Raheleh Halabian ,&nbsp;Javad Hosseini Nejad","doi":"10.1016/j.imj.2024.100132","DOIUrl":"10.1016/j.imj.2024.100132","url":null,"abstract":"<div><p>Ocular tuberculosis (OTB) is a chronic eye infection caused by <em>Mycobacterium tuberculosis</em>. Some cases of myelitis are associated with <em>Epstein-Barr virus</em> (EBV), with 1-5% of EBV infections leading to neurologic complications. We describe a 34-year-old Iranian woman with OTB and EBV coinfection. Despite initial success with anti-TB agents, the disease progressed, necessitating enucleation. <em>Mycobacterium tuberculosis</em> was detected by a tuberculin coagulation test, and EBV was confirmed via polymerase chain reaction. MRI showed plaques in the spinal cord and brain. The patient was treated with anti-TB and antiretroviral agents. Recognizing TB in the differential diagnosis of EBV myelitis is crucial.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X24000467/pdfft?md5=3bd8069dc0ad02ebfc30d16a4483f1e4&pid=1-s2.0-S2772431X24000467-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery: A 10-year surveillance study in a Chinese tertiary hospital","authors":"Zhenghao Yu ,&nbsp;Xinlou Li ,&nbsp;Chenglong Lv ,&nbsp;Yao Tian ,&nbsp;Jijiang Suo ,&nbsp;Zhongqiang Yan ,&nbsp;Yanling Bai ,&nbsp;Bowei Liu ,&nbsp;Liqun Fang ,&nbsp;Mingmei Du ,&nbsp;Hongwu Yao ,&nbsp;Yunxi Liu","doi":"10.1016/j.imj.2024.100128","DOIUrl":"10.1016/j.imj.2024.100128","url":null,"abstract":"<div><h3>Background</h3><p>Ventilator-associated pneumonia (VAP) is a significant and common health concern. The epidemiological landscape of VAP is poorly understood in neurosurgery patients. This study aimed to explore the epidemiology of VAP in this population and devise targeted surveillance, treatment, and control efforts.</p></div><div><h3>Methods</h3><p>A 10-year retrospective study spanning 2011 to 2020 was performed in a large Chinese tertiary hospital. Surveillance data was collected from neurosurgical patients and analyzed to map the demographic and clinical characteristics of VAP and describe the distribution and antimicrobial resistance profile of leading pathogens. Risk factors associated with the presence of VAP were explored using boosted regression tree (BRT) models.</p></div><div><h3>Results</h3><p>Three hundred ten VAP patients were identified. The 10-year incidence of VAP was 16.21 per 1000 ventilation days. All-cause mortality was 6.1%. The prevalence of gram-negative bacteria, fungi, and gram-positive bacteria among the 357 organisms isolated from VAP patients was 86.0%, 7.6%, and 6.4%, respectively; most were multidrug-resistant organisms. <em>Acinetobacter baumannii, Klebsiella pneumoniae</em>, and <em>Pseudomonas aeruginosa</em> were the most common pathogens. The prevalence of carbapenem-resistant <em>A. baumannii, P. aeruginosa,</em> and <em>K. pneumoniae</em> was high and increased over time in the study period. The BRT models revealed that VAP was associated with number of days of ventilator use (relative contribution, 47.84 ± 7.25), Glasgow Coma Scale score (relative contribution, 24.72 ± 5.67), and tracheotomy (relative contribution, 21.50 ± 2.69).</p></div><div><h3>Conclusions</h3><p>Our findings provide a better understanding of the epidemiology of VAP and its risk factors in neurosurgery patients.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"3 3","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772431X2400042X/pdfft?md5=1f910e6f40248a5c95744cd1bd21f27c&pid=1-s2.0-S2772431X2400042X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}