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Wu S, Dai F, Wen Y, Luo C, Wu C. Development and validation of a nomogram for predicting CRBSI in hemodialysis: a retrospective cohort study. BMC Nephrol 2025; 26:255. [PMID: 40410752 PMCID: PMC12100912 DOI: 10.1186/s12882-025-04172-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Accepted: 05/09/2025] [Indexed: 05/25/2025] Open
Abstract
OBJECTIVES To develop and validate of a nomogram for predicting Catheter related bloodstream infection(CRBSI) in patients with maintenance hemodialysis. METHODS This was a retrospective cohort study.A total of 756 patients underwent hemodialysis between January 2017 to December 2021 in purification center of the Affiliated Hospital of Changsha Central Hospital, University of South China were enrolled in this research.The demographic data, hemodialysis data, laboratory indexes of the patients were analyzed. Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of CRBSI in hemodialysis patients and a nomogram model was established.Area under the receiver operating characteristic curve(AUC) and Hosmer-Lemeshow(H-L)test were used to verify the discrimination and calibration of the model. RESULTS Among the 756 hemodialysis patients,64 patients developed CRBSI, with an incidence rate of 8.5%(64/756).The results of multivariate analysis showed that combined with diabetes mellitus、dialysis age、catheter retention time、C-reactive protein and procalcitonin were independent risk factors for CRBSI in hemodialysis patients(P < 0.05).The receiver operating characteristic curve analysis showed that the AUC of the model was 0.88 and the H-L test results showed that the model had good goodness of fit(χ2 = 5, P = 0.7).The internal validation of the prediction model showed an AUC of 0.82, and the H-L results showed (χ2 = 11, P = 0.2), indicating that the model has a good prediction performance and high accuracy. CONCLUSION An easy-to-use nomogram for prediction of CRBSI in hemodialysis patients is well developed.This risk assessment tool can effectively identify patients at high risk of CRBSI and may be useful for optimizing catheter management.
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Affiliation(s)
- Shan Wu
- School of Nursing, University of South China, Hengyang, China
| | - Fan Dai
- Ji'an Vocational and Technical College, Ji'an, China
| | - Yanhong Wen
- Neurology Intensive Care Unit, Changsha Central Hospital Affiliated to University of South China, Changsha, China
| | - Chang Luo
- Neurology Intensive Care Unit, Changsha Central Hospital Affiliated to University of South China, Changsha, China
| | - Chuanfang Wu
- Department of Nursing, Changsha Central Hospital Affiliated to University of South China, Changsha, China.
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Yang L, Lu G, Diao H, Zhang Y, Wang Z, Liu X, Ma Q, Yu H, Li Y. Predicting infections with multidrug-resistant organisms (MDROs) in neurocritical care patients with hospital-acquired pneumonia (HAP): development of a novel multivariate prediction model. Microbiol Spectr 2025:e0246024. [PMID: 40372026 DOI: 10.1128/spectrum.02460-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Accepted: 03/21/2025] [Indexed: 05/16/2025] Open
Abstract
Hospital-acquired pneumonia (HAP) is prevalent in the neuro-intensive care unit (NICU), significantly increasing susceptibility to infections with multidrug-resistant organisms (MDROs), which result in high mortality rates and substantial healthcare burdens. Recognition and intervention are paramount. This study aimed to build a prediction model for MDRO infections among NICU patients with HAP. Clinical and laboratory data were collected from the NICU of a grade-A tertiary hospital. Five machine learning models (logistic regression, classification tree, support vector machine, random forest, and K-nearest neighbor) were evaluated based on sensitivity, specificity, accuracy, and receiver operating characteristic curves. A nomogram was developed using the model that performed best in MDRO infection prediction. The performance and clinical utility were assessed using the calibration curve, Brier score, and decision curve analysis. Among 791 neurocritical care patients with HAP, 172 (21.7%) were diagnosed with MDRO infections. The prediction model established by logistic regression exhibited the best performance, with an area under the curve of 0.805. Length of NICU stay (odds ratio [OR] 1.078; 95% confidence interval [CI], 1.070-1.141; P < 0.000), number of antibiotics used (OR 1.391; 95% CI, 1.138-1.700; P = 0.001), diabetes (OR 1.775; 95% CI, 1.006-3.133; P = 0.048), and carbamide (OR 1.038; 95% CI, 1.003-1.074; P = 0.035) were significantly correlated with MDRO infections and incorporated into the nomogram. The model demonstrated good calibration (Brier score 0.137). This model can provide clinicians with a tool for prevention and management of MDRO infections in NICU patients with HAP.IMPORTANCEPatients with hospital-acquired pneumonia (HAP) in the neuro-intensive care unit (NICU) are at a high risk of developing multidrug-resistant organism (MDRO) infections owing to complex conditions, critical illness, and frequent invasive procedures. However, studies focused on constructing prediction models for assessing the risk of MDRO infections in neurocritically ill patients with HAP are lacking at present. Therefore, this study aims to establish a reliable and easy-to-use nomogram for predicting the risk of MDRO infections in patients with HAP admitted to the NICU. Four easily accessed variables were included in the model, including length of NICU stay, number of antibiotics used, diabetes, and carbamide. This nomogram might help in the prediction and implementation of targeted interventions against infections with MDRO among patients with HAP in the NICU.
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Affiliation(s)
- Lin Yang
- Department of Neurosurgery, Yizheng People's Hospital, Yizheng, Jiangsu Province, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Haiqing Diao
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yang Zhang
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Zhiyao Wang
- Neuro-Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
- Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Xiaoguang Liu
- Neuro-Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
- Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Qiang Ma
- Neuro-Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
- Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Hailong Yu
- Neuro-Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Yuping Li
- Neuro-Intensive Care Unit, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
- Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
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Mojaddidi MA, Aboonq M, Alqahtani SA. Glycemic control and vaccine response: the role of mucosal immunity after vaccination in diabetic patients. Front Immunol 2025; 16:1577523. [PMID: 40406123 PMCID: PMC12095022 DOI: 10.3389/fimmu.2025.1577523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2025] [Accepted: 04/10/2025] [Indexed: 05/26/2025] Open
Abstract
This review explores the critical interplay between glycemic control, mucosal immunity, and vaccine response in diabetic patients. Diabetes mellitus, characterized by impaired glucose regulation, significantly impacts immune function, particularly at mucosal surfaces. Poor glycemic control diminishes vaccine-induced antibody responses and compromises mucosal defenses, such as secretory IgA production, increasing susceptibility to infections. We synthesize evidence highlighting the importance of optimizing glycemic management prior to vaccination to enhance immunogenicity. Furthermore, we examine the potential of personalized vaccination strategies, tailored to individual glycemic status, age, BMI, and kidney function, to improve vaccine efficacy in this vulnerable population. Additionally, we discuss the role of adjunct therapies, including probiotics, nutritional interventions, and lifestyle modifications, in modulating the gut microbiota and reinforcing mucosal barrier integrity. This review underscores the necessity for an interdisciplinary approach, integrating metabolic management with innovative vaccine designs, to maximize protection against infectious diseases in diabetic patients. Future research should prioritize longitudinal studies assessing both systemic and mucosal immunity and refine personalized vaccination strategies to ensure robust and durable protection.
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T N VV, Premnath M, Stanley JV, Paul N, Mathew J, Radhakrishnan EK. Whole genome sequencing based prediction of antimicrobial resistance evolution among the predominant bacterial pathogens of diabetic foot ulcer. World J Microbiol Biotechnol 2025; 41:161. [PMID: 40312599 DOI: 10.1007/s11274-025-04362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2025] [Indexed: 05/03/2025]
Abstract
Emerging antibiotic resistance among bacterial pathogens of diabetic foot ulcers (DFUs) cause a significant threat to the human health. In the study, deep ulcer swabs were collected from 70 diabetic patients with foot ulcer. Among the 187 bacterial strains purified from the same, major representations were identified to be from Klebsiella pneumoniae and Staphylococcus spp. Here, polymicrobial infection (87.14%) was found to be more prevalent than monomicrobial (12.86%). From the antibiotic susceptibility test results, 34 bacterial isolates were identified as MDR pathogens with resistance to β-lactam and carbapenem classes of antibiotics. Furthermore, molecular screening has revealed the presence of antibiotic resistance gene such as blaSHV,blaCTX-M, blaTEM,blaOXA-48, NDM-1, mecA and blaZ genes among the isolates studied. Biofilm analysis has further revealed 31 strains to have strong and 3 with moderate biofilm production property. Among the MDR strains, K. pneumoniae (DFU2.2) and methicillin-resistant S. aureus (MRSA) (DFU24.3) were subjected to the whole-genome sequencing (WGS) based analysis due to their significant role in the chronicity of DFUs. The resistome prediction from the WGS data of DFU2.2 has revealed it to have the presence of a novel extended β-lactamase gene blaSHV-106 which has not been reported previously from India. Pan-genome analysis of DFU2.2 and DFU24.3 has also provided detailed insight into the genetic diversity, evolution, and pathogenic potential of the selected strains. The findings of this study hence suggest the emerging AMR to be one of the major risk factors challenging the therapeutic response of DFUs, the incidence of which is alarmingly high.
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Affiliation(s)
- Vipina Vinod T N
- School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686560, India
| | - Manjusha Premnath
- School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686560, India
| | - Jos V Stanley
- Department of General Surgery, Government Medical College, Kottayam, Kerala, 686008, India
| | - Nimmy Paul
- Department of Microbiology, Government Medical College, Kottayam, Kerala, 686008, India
| | - Jyothis Mathew
- School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686560, India
| | - E K Radhakrishnan
- School of Biosciences, Mahatma Gandhi University, Kottayam, Kerala, 686560, India.
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Ambat JM, Ito M, Yokoyama T, Takahashi Y. A case of extraocular muscle pyomyositis in an elderly patient with diabetes mellitus. Orbit 2025; 44:232-235. [PMID: 38913987 DOI: 10.1080/01676830.2024.2370055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024]
Abstract
Pyomyositis is a bacterial infection of skeletal muscle leading to abscess formation. Younger males are predominantly involved, but pyomyositis may occur in all ages and sexes. Underlying systemic disease or accompanying immunocompromised states may increase the risk of pyomyositis. This is a report of a 72-year-old, male, with uncontrolled diabetes mellitus, presenting initially as a case of orbital cellulitis. Magnetic resonance imaging confirmed the presence of an abscess in the left lateral rectus. Antibiotic therapy was promptly initiated, and drainage of the abscess was performed via a transconjunctival approach. Pyomyositis resolved post-surgery and medical therapy. Residual exotropia was noted at the eighth month of follow-up necessitating subsequent strabismus surgery. Nine months post-treatment, left lateral rectus pyomyositis did not recur.
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Affiliation(s)
- Jose Miguel Ambat
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan
| | - Mayari Ito
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan
| | - Tatsuro Yokoyama
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan
- Department of Ophthalmology, TMG Asaka Medical Center, Asaka, Japan
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan
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Khatun MH, Sami SA, Mim FS, Kumar P, Islam A, Al Mahamud Rian I, Rahman MA, Riya SI, Lokman M, Mamun A, Haque MA, Yeasmin MS, Rana GMM, Barmon J. Unveiling Pharmacological Promise of Mangifera indica (Haribhanga) Peel Extract: Exploring an Untapped Cultivar Through Biochemical and Computational Approaches. SCIENTIFICA 2025; 2025:6516268. [PMID: 40225279 PMCID: PMC11986926 DOI: 10.1155/sci5/6516268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 01/22/2025] [Indexed: 04/15/2025]
Abstract
The Haribhanga is one of the most renowned varieties of mango native to the Rangpur region of Bangladesh. The study aimed to explore the in vitro and in vivo pharmacological potentialities of the methanolic extract of Mangifera indica (Haribhanga) (MEMI) peel. The antioxidant, antimicrobial, and antiarthritic activities of MEMI peel were conducted by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging, disc diffusion, and protein denaturation assays, respectively. The extract was administered to STZ-induced diabetic mice for 7 days for the observation of blood glucose, body weight, lipid profile, and liver enzyme levels. The gas chromatography-mass spectrometry (GC-MS) analysis was performed to identify phytochemicals in the extract. Subsequently, molecular docking was conducted to predict the binding affinity of the identified compounds. The MEMI peel exhibited notable antioxidant potentiality with an IC50 value of 4.43 ± 0.68 μg/mL and antimicrobial activity against Bacillus cereus with a zone of inhibition of 20.67 ± 1.52 mm. Furthermore, MEMI peel demonstrated substantial antiarthritic activity, with the highest inhibition of denaturation of protein (88%) observed at the highest dose (500 μg/mL). In the in vivo experiments, MEMI peel led to a significant increase in high-density lipoprotein (p < 0.001, p < 0.05), with a significant decrease in blood glucose (p < 0.001), triglycerides, total cholesterol, and low-density lipoprotein (p < 0.0001) in STZ-induced diabetic mice. Comparing the diabetic control mice, the MEMI peel substantially decreased (p < 0.001) the high serum levels of aspartate aminotransferase and alanine aminotransferase. Moreover, the extract significantly improved the body weight (p < 0.001) of diabetic mice after 7 days of treatment. GC-MS analysis identified 28 bioactive compounds, primarily fatty acid esters in the MEMI peel. Di-n-octyl phthalate, terpinen-4-ol, 8,11,14-docosatrienoic acid methyl ester, and phenol, 2-methoxy-4-(2-propenyl)-acetate exhibited the most favorable binding potential in molecular docking studies. The results suggest that MEMI peel possesses antimicrobial, antiarthritic, antidiabetic, antihyperlipidemic, and liver enzyme protective activities as a promising antioxidant.
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Affiliation(s)
- Mst. Hajera Khatun
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Saad Ahmed Sami
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Farhana Sultana Mim
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Pappu Kumar
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Ariful Islam
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Injamam Al Mahamud Rian
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Md. Ashikur Rahman
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Sharmin Islam Riya
- Department of Pharmacy, School of Science and Technology, Varendra University, Rajshahi 6204, Bangladesh
| | - Md. Lokman
- Department of Pharmacy, Faculty of Biological Sciences, University of Chittagong, Chattogram 4331, Bangladesh
| | - Al Mamun
- Department of Pharmacy, Faculty of Science, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md. Anwarul Haque
- Department of Pharmacy, Faculty of Science, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Mst. Sarmina Yeasmin
- BCSIR Rajshahi Laboratories, Bangladesh Council of Scientific and Industrial Research, Rajshahi 6206, Bangladesh
| | - G. M. Masud Rana
- BCSIR Rajshahi Laboratories, Bangladesh Council of Scientific and Industrial Research, Rajshahi 6206, Bangladesh
| | - Jaytirmoy Barmon
- BCSIR Rajshahi Laboratories, Bangladesh Council of Scientific and Industrial Research, Rajshahi 6206, Bangladesh
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Yossapol M, Srinontong P, Aengwanich W, Panil M, Somsup S, Odoi JO, Wandee J. Exploring the Therapeutic Potential of Antibiotics in Hyperglycemia-Induced Macrophage Dysfunctions. Antibiotics (Basel) 2025; 14:198. [PMID: 40001441 PMCID: PMC11851781 DOI: 10.3390/antibiotics14020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2025] [Revised: 02/06/2025] [Accepted: 02/10/2025] [Indexed: 02/27/2025] Open
Abstract
Background: Diabetes mellitus exacerbates immune dysfunction, leading to higher susceptibility to infections. This study investigated the effects of antibiotics on macrophage functions under high glucose conditions to mimic a diabetic context. Methods: Using murine macrophage cell line RAW 264.7, the present study evaluated the cytotoxicity, phagocytosis, bactericidal activity, and pro-inflammatory cytokine production after treatment with four antibiotics: oxytetracycline, ciprofloxacin, sulfamethoxazole-trimethoprim, and cefotaxime. Results: All antibiotics demonstrated no cytotoxicity across 1×-8× MIC concentrations. Hyperglycemia significantly impaired macrophage phagocytosis and bactericidal activity while inducing pro-inflammatory mediator markers, IL-1, IL-6, TNF-α, and iNOS. Only ciprofloxacin significantly improved phagocytic achieving levels comparable to the low glucose control. Treatments with ciprofloxacin, sulfamethoxazole-trimethoprim, and cefotaxime significantly enhanced bactericidal activity without altering the pro-inflammatory cytokine profile. Conclusions: These findings underscore the negative effect of high glucose on macrophage functions and suggest that ciprofloxacin may be a potential therapeutic option for diabetes-associated infections.
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Affiliation(s)
- Montira Yossapol
- Faculty of Veterinary Sciences, Mahasarakham University, Mahasarakham 44000, Thailand; (M.Y.); (P.S.); (W.A.)
- Bioveterinary Research Unit, Mahasarakham University, Mahasarakham 44000, Thailand
| | - Piyarat Srinontong
- Faculty of Veterinary Sciences, Mahasarakham University, Mahasarakham 44000, Thailand; (M.Y.); (P.S.); (W.A.)
- Bioveterinary Research Unit, Mahasarakham University, Mahasarakham 44000, Thailand
| | - Worapol Aengwanich
- Faculty of Veterinary Sciences, Mahasarakham University, Mahasarakham 44000, Thailand; (M.Y.); (P.S.); (W.A.)
- Bioveterinary Research Unit, Mahasarakham University, Mahasarakham 44000, Thailand
| | - Monchaya Panil
- Allpet Small Animal and Exotic Hospital, Bang Khae, Bangkok 10160, Thailand;
| | - Supissara Somsup
- 101 Small Animal Hospital, Muang Roi Et, Roi Et 45000, Thailand;
| | - Justice Opare Odoi
- Animal Health Division, Animal Research Institute, Council of Scientific and Industrial Research, Accra P.O. Box AH20, Ghana;
| | - Jaroon Wandee
- Faculty of Veterinary Sciences, Mahasarakham University, Mahasarakham 44000, Thailand; (M.Y.); (P.S.); (W.A.)
- Bioveterinary Research Unit, Mahasarakham University, Mahasarakham 44000, Thailand
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Ergin M, Budin M, Canbaz SB, Ciloglu O, Salber J, Gehrke T, Citak M. Microbial Diversity of Periprosthetic Joint Infections in Diabetic and Nondiabetic Patients Following Hip Arthroplasty. J Arthroplasty 2025; 40:494-498. [PMID: 39187168 DOI: 10.1016/j.arth.2024.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is a major complication following hip arthroplasty, leading to prolonged hospital stays, increased health care costs, and major morbidity. Diabetes mellitus is a prevalent comorbidity among hip arthroplasty patients, contributing to an increased risk of surgical complications, including infections. However, limited evidence exists regarding the microbial profiles of PJIs in diabetic patients compared to nondiabetic counterparts. METHODS We conducted a retrospective cohort study to investigate the microbial diversity of PJIs in diabetic and nondiabetic patients following hip arthroplasty. Medical records of patients who underwent hip arthroplasty procedures between 1996 and 2021 were reviewed. Patients diagnosed with PJI, based on the international consensus meeting, were included in the study. Microbiological data, including culture results, and risk factors were collected and analyzed. A total of 4,261 culture-positive patients diagnosed with PJI following hip arthroplasty were included in the analysis. RESULTS Microbiological analysis revealed a diverse spectrum of microbial pathogens, with Staphylococcus species being the most commonly isolated pathogen. Comparison between diabetic and nondiabetic patients revealed differences in the microbial profiles of PJIs, with diabetic patients more likely to be infected with specific pathogens, including Candida albicans (P = 0.01 odds ratio (OR) 2.8, confidence interval (CI) 1.2 to 6.2), Klebsiella pneumoniae (P = 0.03 OR 2.4, CI 1.0 to 5.6), Staphylococcus aureus (P = 0.04 OR 1.3, CI 1.0 to 1.8), Staphylococcus epidermidis (P < 0.001 (R 1.7, CI 1.4 to 2.2), Polymicrobial infections (P < 0.001 OR 1.5, CI 1.2 to 1.8), and Clostridium perfringens (P = 0.04 OR 5.9, CI 1.0 to 33.1). CONCLUSIONS Our study provides valuable insights into the microbial diversity of PJIs in diabetic and nondiabetic patients following hip arthroplasty. The identification of a tendency to different microbial profiles in diabetic patients underscores the need for tailored approaches to infection prevention and management in this high-risk population. Further research is needed to elucidate the underlying mechanisms and develop targeted interventions to improve patient outcomes.
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Affiliation(s)
- Musa Ergin
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany; Department of Orthopedics and Traumatology, Cihanbeyli State Hospital, Konya, Turkey
| | - Maximilian Budin
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany
| | - Sebati B Canbaz
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany
| | - Osman Ciloglu
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany
| | - Jochen Salber
- Department of Surgery, Ruhr-University Bochum, Bochum, Germany
| | - Thorsten Gehrke
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany
| | - Mustafa Citak
- ENDO-Klinik Hamburg Department of Orthopaedic Surgery, Hamburg, Germany
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Karina D, Heldayani I, Hidayat W. Oral Opportunistic Infection Induced by Stress and Silent Type 2 Diabetes Mellitus in Young Adult Patient: A Case Report. Int Med Case Rep J 2025; 18:59-66. [PMID: 39822734 PMCID: PMC11735534 DOI: 10.2147/imcrj.s488127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 11/20/2024] [Indexed: 01/19/2025] Open
Abstract
Introduction Opportunistic infections (IO) are infections of microbiota (fungi, viruses, bacteria, or parasites) that generally do not cause disease but turn into pathogens when the body's defense system is compromised. This can be triggered by various factors, one of which is due to a weakened immune system due to Diabetes Mellitus (DM), which increases the occurrence of opportunistic infections, especially in the oral cavity. Fungal (oral candidiasis) and viral (recurrent intraoral herpes) infections can occur in the oral cavity of DM patients. Recurrent intraoral herpes (RIH) is generally a recurrent herpes virus infection with one of the triggers being stress. Objective To determine the role of stress and silent type 2 DM and which is thought to trigger opportunistic infections in oral cavity. Case A 34-year-old man was referred with complaints of white patches in the mouth, sore throat a difficulty swallowing and opening the mouth. Extraoral examination, yellow-black crusts were found on the lips. Intraoral and tongue examination revealed white plaque that could be scraped off, and a mouth mirror was attached. The hard palate showed vesicles that spread to the soft palate. Laboratory tests were abnormal for blood sugar, anti-HSV-1 IgG, and presence of hyphae. Mild anxiety and moderate stress. The working diagnosis was pseudomembranous candidiasis RIH, exfoliative cheilitis, and xerostomia. Differential diagnosis was erythema multiforme. Case Management Pharmacologic dental management was fluconazole injection, acyclovir, NaCL 0.9%, chlorine dioxide mouthwash, and petroleum jelly. Non-pharmacologic therapy dental included oral hygiene instruction and education on oral therapy and referral to the internal medicine clinic for DM management. After two weeks of collaborative treatment between oral medicine and internal medicine, there was significant improvement. Conclusion Silent type 2 DM and stress can cause a decrease in the immune system, triggering opportunistic infections, namely RIH and candidiasis.
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Affiliation(s)
- Dhini Karina
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Iin Heldayani
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Wahyu Hidayat
- Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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10
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Liu T, Zhou L, Chen Y, Lin J, Zhu H. Semaglutide outperforms insulin in restoring neutrophil function against implant-related infection in diabetic and obese mice: experimental research. Int J Surg 2025; 111:273-282. [PMID: 38935106 PMCID: PMC11745711 DOI: 10.1097/js9.0000000000001896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Bone and joint infections (BJI) are a significant complication after arthroplasty and fracture fixation, particularly challenging in patients with type 2 diabetes mellitus (T2DM) and obesity. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has shown efficacy in managing T2DM and obesity. However, its impact on BJI risk and neutrophil function remains unclear. To investigate whether preoperative semaglutide treatment (1) reduces the risk of BJI in diabetic and obese mice undergoing intra-articular implants, and (2) outperforms insulin in restoring neutrophil function to mitigate implant-related infection. METHODS A C57BL/6 mouse model of T2DM/obesity was induced using a high-fat diet (HFD) for 12 weeks. Mice received preoperative insulin or semaglutide therapy for 1-28 days. BJI risk was assessed using an intra-articular-implant model challenged with Staphylococcus aureus or Escherichia coli . The neutrophil function was evaluated through bactericidal activity, superoxide production, and migration ability. RESULTS Semaglutide treatment led to a significant and sustained reduction in body weight and improved glucose tolerance in HFD mice. Both insulin and semaglutide therapies significantly reduced BJI risk, with semaglutide showing a more pronounced effect over time. Semaglutide therapy also enhanced neutrophil bactericidal activity, superoxide production, and migration ability compared to insulin therapy. CONCLUSIONS Preoperative semaglutide treatment effectively reduces BJI risk and improves neutrophil function in diabetic and obese mouse models. These findings suggest that semaglutide may be a promising pharmacological intervention to mitigate infection risk in orthopedic patients with T2DM or obesity.
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Affiliation(s)
- Tiexin Liu
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- National Center for Orthopedics, Shanghai, People’s Republic of China
| | - Lenian Zhou
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- National Center for Orthopedics, Shanghai, People’s Republic of China
| | - Yiwei Chen
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- National Center for Orthopedics, Shanghai, People’s Republic of China
| | - Junqing Lin
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- National Center for Orthopedics, Shanghai, People’s Republic of China
| | - Hongyi Zhu
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- National Center for Orthopedics, Shanghai, People’s Republic of China
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Nasution MAS, Aruan BMB, Suandy S, Velaro AJ, Firsty NN. Risk factors of urinary tract infection through demographic and laboratory markers among benign prostate hyperplasia patients: a single-center study. Folia Med (Plovdiv) 2024; 66:818-824. [PMID: 39774352 DOI: 10.3897/folmed.66.e137393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 11/29/2024] [Indexed: 01/11/2025] Open
Abstract
INTRODUCTION Prostate enlargement known as benign prostatic hyperplasia (BPH) increases the risk of infection in the urinary tract by obstructing or blocking the prostatic portion of the urethra. This disease becomes more common as people age.
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12
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Kota S, Dumpala P, Sajja R, Anantha R. Investigation of functional characteristics of copper/copper oxide nanoparticles synthesized with Moringa oleifera and Musa sps. extracts: in-vitro and porcine study. Sci Rep 2024; 14:30857. [PMID: 39730548 DOI: 10.1038/s41598-024-81169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 11/25/2024] [Indexed: 12/29/2024] Open
Abstract
The study analyzed the aqueous leaf extracts of Moringa oleifera and Musa sps. for phytochemical components, including flavonoids, sterols, saponins, tannins, and glycosides. The LC-MS analysis revealed gingerol, vicenin-2, caffeic acid, quercetin, and other compounds in the extracts. The synthesized MO- and MS- CuNPs (copper nanoparticles) exhibited plasmon resonance at 320 and 480 nm respectively, and Cu(II)-O stretching vibrations, manifested by their Fourier Transform Infrared (FT-IR) spectra. Thermogravimetric analysis showed that MO-/MS-CuNPs experienced a total weight loss of 80.2% and 68% respectively. Further, the EDS analysis revealed that MO-CuNPs have a copper content of 20%, while MS-CuNPs is 32%. The X-ray diffraction (XRD) patterns of the annealed MO and MS-CuNPs indicate the presence of both the cubic phase of copper (Cu) and the monoclinic tenorite phase of copper oxide (CuO). The percent DPPH scavenging activity of MO- and MS-CuNPs is 34.4 and 28.8, and by KMnO4 is 63.8 and 47.3% respectively. The behavior of CuNPs exhibited an asymmetrical response, with greater inhibition of Gram-negative bacteria compared to Gram-positive bacteria. CuNPs and medicinal plant-derived carbon dots were integrated into nanofibrous electrospun biopolymer scaffolds for wound care, demonstrating 100% wound healing in Yorkshire pigs full thickness excision wounds after 34 days.
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Affiliation(s)
- Sobha Kota
- Department of Chemical Engineering, RVR & JC College of Engineering (A), Guntur, Andhra Pradesh, 522019, India.
| | - Pradeep Dumpala
- Department of Chemical Engineering, RVR & JC College of Engineering (A), Guntur, Andhra Pradesh, 522019, India
| | - Radhika Sajja
- Department of Mechanical Engineering, RVR & JC College of Engineering (A), Guntur, Andhra Pradesh, 522019, India
| | - Ratnakumari Anantha
- Department of Chemical Engineering, RVR & JC College of Engineering (A), Guntur, Andhra Pradesh, 522019, India
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Pipitò L, Baldino G, Bartoloni G, Sanguinetti M, Ventura Spagnolo E, Cascio A. Fulminant Invasive Aspergillosis in a Previously Healthy Woman After Cesarean Section and a Review of the Literature. Infect Dis Rep 2024; 16:1263-1273. [PMID: 39728022 DOI: 10.3390/idr16060100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2024] [Revised: 12/12/2024] [Accepted: 12/16/2024] [Indexed: 12/28/2024] Open
Abstract
Background: Invasive aspergillosis is an extremely rare condition in healthy and immunocompetent individuals, and very few cases have been reported in previously healthy, pregnant, or postpartum women. Method: We describe a case of invasive aspergillosis in a puerperal patient and present literature review results. Case: We present a case of fulminant invasive pulmonary aspergillosis with cerebral, cardiac, and gastric involvement in a young woman, occurring a few days after an elective cesarean section. The patient succumbed after intensive care unit admission, and the diagnosis was made postmortem through autopsy. Conclusion: A total of 20 cases of invasive aspergillosis have been previously reported in pregnant or postpartum women, with high mortality. The risk of opportunistic fungal infections during pregnancy and postpartum should not be underestimated.
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Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties G D'Alessandro, University of Palermo, 90133 Palermo, Italy
- Infectious and Tropical Diseases Unit, Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico P. Giaccone, 90127 Palermo, Italy
| | - Gennaro Baldino
- Legal Medicine Section, Biomorf Department, Messina University, 98122 Messina, Italy
| | - Giovanni Bartoloni
- Department of Pathology, Garibaldi Hospital ARNAS Garibaldi, 95125 Catania, Italy
| | - Maurizio Sanguinetti
- Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | | | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties G D'Alessandro, University of Palermo, 90133 Palermo, Italy
- Infectious and Tropical Diseases Unit, Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico P. Giaccone, 90127 Palermo, Italy
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Hamdan A, AbuHaweeleh MN, Al-Qassem L, Kashkoul A, Alremawi I, Hussain U, Khan S, ElBadway MMS, Chivese T, Farooqui HH, Zughaier SM. Prevalence of Antimicrobial Resistance Among the WHO's AWaRe Classified Antibiotics Used to Treat Urinary Tract Infections in Diabetic Women. Antibiotics (Basel) 2024; 13:1218. [PMID: 39766608 PMCID: PMC11672800 DOI: 10.3390/antibiotics13121218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 12/11/2024] [Accepted: 12/13/2024] [Indexed: 01/11/2025] Open
Abstract
Background and Objectives: Diabetes is linked to a higher risk of urinary tract infections (UTIs) in women, often leading to recurrent antibiotic treatments. Frequent antibiotic use for UTIs can contribute to antimicrobial resistance (AMR), a critical public health threat that increases treatment failure. This study investigated the prevalence of AMR and its associated factors among women with UTIs, comparing those with and without diabetes. Results: The study population had a mean age of 52 years (SD = 23) for the women without diabetes and 68 years (SD = 14) for those with diabetes. Resistance was highest for cefazolin and levofloxacin in the Access and Watch antibiotic groups, while ciprofloxacin was the most frequently prescribed antibiotic. AMR prevalence was 35.7% among the women with diabetes and 21.3% among those without. After adjustment, AMR was significantly associated with both uncomplicated diabetes (OR 1.14, 95% CI 1.08-1.21) and complicated diabetes (OR 1.54, 95% CI 1.45-1.64), as well as with higher numbers of prescribed antibiotics (OR 277.39, 95% CI 253.79-303.17). Methods: Using a cross-sectional cohort from the Physionet database, we analyzed data on 116,902 female participants treated for UTIs, including their antibiotic exposure, diabetes status, comorbidities, and hospital admission details. Antimicrobials were classified per the WHO's AWaRe criteria. The primary outcome was AMR identified in urine cultures, and the association with diabetes status was evaluated using multivariable logistic regression. Conclusions: Our findings highlight the need for focused antimicrobial stewardship in women with diabetes to reduce the AMR rates in this vulnerable group.
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Affiliation(s)
- Ahmad Hamdan
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Mohannad N. AbuHaweeleh
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Leena Al-Qassem
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Amira Kashkoul
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Izzaldin Alremawi
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Umna Hussain
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Sara Khan
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Menatalla M. S. ElBadway
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (T.C.); (H.H.F.)
| | - Habib H. Farooqui
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (T.C.); (H.H.F.)
| | - Susu M. Zughaier
- College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; (A.H.); (M.N.A.); (L.A.-Q.); (A.K.); (I.A.); (U.H.); (S.K.); (M.M.S.E.)
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Mwansa CML, Babiker A, Satola S, Logan LK, Nadimpalli ML. Associations between neighbourhood-level median household income and outpatients' risk of antibiotic non-susceptible uropathogens in a major urban centre, USA. JAC Antimicrob Resist 2024; 6:dlae179. [PMID: 39502742 PMCID: PMC11535660 DOI: 10.1093/jacamr/dlae179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 10/21/2024] [Indexed: 11/08/2024] Open
Abstract
Introduction Resistance to first-line antibiotics among urinary tract infections continues to rise, but how neighbourhood-level socioeconomic status impacts this risk remains unclear. We examined the effect of neighbourhood-level income on a patient's risk of having a uropathogen non-susceptible to trimethoprim/sulfamethoxazole (TMP/SMX) or nitrofurantoin. Methods We used electronic health record data and antibiotic susceptibility test results for urinary Escherichia coli and Klebsiella pneumoniae collected at Emory Healthcare outpatient facilities in greater Atlanta between October 2022 and September 2023. We determined patients' block group median household income (MHI) using their residential addresses and 2017-21 US census data. We performed a logistic regression with a priori risk factors using a generalized estimating equation, with subgroup analysis by organism and for patients with diabetes mellitus. Results We included 9325 urine E. coli and K. pneumoniae isolates from 3867 outpatients. Compared to uropathogenic E. coli, K. pneumoniae were more likely to be non-susceptible to nitrofurantoin (P < 0.001) and less likely to be non-susceptible to TMP/SMX (P < 0.001). Compared to the lowest MHI quintile, patients in the highest MHI quintile neighbourhoods had 0.78 odds of harbouring a non-susceptible uropathogen (95% CI: 0.64, 0.95) after controlling for patient age, sex and race/ethnicity, along with neighbourhood-level characteristics. This association was stronger for K. pneumoniae infections and non-significant among people with diabetes. Conclusions Higher neighbourhood-level MHI was associated with lower individual risk of harbouring a first-line antibiotic-non-susceptible uropathogen.
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Affiliation(s)
- Chanda M L Mwansa
- Hubert Department of Global Health, Emory Rollins School of Public Health, Atlanta, GA, USA
| | - Ahmed Babiker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Satola
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Latania K Logan
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Maya L Nadimpalli
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, 1518 Clifton Road NE, Claudia Nance Rollins Room 6009, Atlanta, GA 30322, USA
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16
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Zhang Y, Yan Y, Sun L, Wang Y. Stress hyperglycemia ratio is a risk factor for mortality in trauma and surgical intensive care patients: a retrospective cohort study from the MIMIC-IV. Eur J Med Res 2024; 29:558. [PMID: 39568043 PMCID: PMC11580232 DOI: 10.1186/s40001-024-02160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 11/16/2024] [Indexed: 11/22/2024] Open
Abstract
BACKGROUND Stress hyperglycemia ratio (SHR) can reduce the impact of baseline glucose on the stress hyperglycemia level. Studies have shown that SHR is associated with adverse outcomes. However, its relationship with the prognosis of trauma/surgical ICU patients has not been fully studied. The objective of this study was to explore the relationship between SHR and the short-term and long-term mortality in trauma/surgical ICU patients. METHODS Clinical data of trauma/surgical ICU patients were extracted from MIMIC-IV. The primary outcome was 28-day all-cause mortality, and the secondary outcome was 365-day all-cause mortality. Boruta algorithm was used to screen the important features related to the 28-day mortality, and Kaplan-Meier curve, Cox proportional hazards regression, and restricted cubic spline were used to explore the relationship between SHR and clinical outcomes. RESULTS A total of 1744 patients were included, of whom 786 were male and 958 were female. The 28-day and 365-day mortality rates were 14.7% and 27.2%, respectively. Multivariate Cox proportional hazards analysis showed that an increase in SHR was significantly associated with an increased risk of 28-day mortality [HR (95% CI) 1.30 (1.07, 1.58), p = 0.009] and 365-day mortality [HR (95% CI) 1.05 (1.02-1.09), p = 0.005]. Restricted cubic spline curve showed that the relationship between SHR and survival rate was "U-shaped". CONCLUSIONS Increase in SHR is associated with an increased risk of 28-day and 365-day all-cause mortality in trauma/surgical ICU patients.
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Affiliation(s)
- Yingying Zhang
- Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, 215031, Jiangsu Province, China
| | - Yu Yan
- Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, 215031, Jiangsu Province, China
| | - Lele Sun
- Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, 215031, Jiangsu Province, China
| | - Yibo Wang
- Department of Anesthesiology, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, 214000, Jiangsu Province, China.
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Shiue SJ, Wu MS, Chiang YH, Lin HY. Bacteriophage-cocktail hydrogel dressing to prevent multiple bacterial infections and heal diabetic ulcers in mice. J Biomed Mater Res A 2024; 112:1846-1859. [PMID: 38706446 DOI: 10.1002/jbm.a.37728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Bacteriophage (phage) has been reported to reduce the bacterial infection in delayed-healing wounds and, as a result, aiding in the healing of said wounds. In this study we investigated whether the presence of phage itself could help repair delayed-healing wounds in diabetic mice. Three strains of phage that target Salmonella enterica, Escherichia coli, and Pseudomonas aeruginosa were used. To prevent the phage liquid from running off the wound, the mixture of phage (phage-cocktail) was encapsulated in a porous hydrogel dressing made with three-dimensional printing. The phage-cocktail dressing was tested for its phage preservation and release efficacy, bacterial reduction, cytotoxicity with 3T3 fibroblast, and performance in repairing a sterile full-thickness skin wound in diabetic mice. The phage-cocktail dressing released 1.7%-5.7% of the phages embedded in 24 h, and reduced between 37%-79% of the surface bacteria compared with the blank dressing (p <.05). The phage-cocktail dressing exhibited no sign of cytotoxicity after 3 days (p <.05). In vivo studies showed that 14 days after incision, the full-thickness wound treated with a phage-cocktail dressing had a higher wound healing ratio compared with the blank dressing and control (p <.01). Histological analysis showed that the structure of the skin layers in the group treated with phage-cocktail dressing was restored in an orderly fashion. Compared with the blank dressing and control, the repaired tissue in the phage-cocktail dressing group had new capillary vessels and no sign of inflammation in its dermis, and its epidermis had a higher degree of re-epithelialization (p <.05). The slow-released phage has demonstrated positive effects in repairing diabetic skin wounds.
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Affiliation(s)
- Sheng-Jie Shiue
- Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Shun Wu
- Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsien Chiang
- Graduate Institute of Chemical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Hsin-Yi Lin
- Graduate Institute of Chemical Engineering, National Taipei University of Technology, Taipei, Taiwan
- Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan
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Niu CY, Yao BT, Tao HY, Peng XG, Zhang QH, Chen Y, Liu L. Leukopenia-a rare complication secondary to invasive liver abscess syndrome in a patient with diabetes mellitus: A case report. World J Gastrointest Surg 2024; 16:3343-3349. [PMID: 39575291 PMCID: PMC11577412 DOI: 10.4240/wjgs.v16.i10.3343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 09/06/2024] [Accepted: 09/14/2024] [Indexed: 09/27/2024] Open
Abstract
BACKGROUND Thrombocytopenia is a common complication of invasive liver abscess syndrome (ILAS) by Klebsiella pneumoniae (K. pneumoniae) infection, which indicates severe infection and a poor prognosis. However, the presence of leukopenia is rare. There are rare reports on leukopenia and its clinical significance for ILAS, and there is currently no recognized treatment plan. Early and broad-spectrum antimicrobial therapy may be an effective therapy for treating ILAS and improving its prognosis. CASE SUMMARY A 55-year-old male patient who developed fever, chills, and abdominal distension without an obvious cause presented to the hospital for treatment. Laboratory tests revealed thrombocytopenia, leukopenia, and multiple organ dysfunction. Imaging examinations revealed an abscess in the right lobe of the liver and thrombophlebitis, and K. pneumoniae was detected in the blood cultures. Since the patient was diabetic and had multi-system involvement, he was diagnosed with ILAS accompanied by leukopenia and thrombocytopenia. After antibiotic treatment and systemic supportive therapy, the symptoms disappeared, and the patient's condition almost completely resolved. CONCLUSION Leukopenia is a rare complication of ILAS, which serves as an indicator of adverse prognostic outcomes and the severity of infection.
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Affiliation(s)
- Chun-Yan Niu
- Department of Gastroenterology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Bang-Tao Yao
- Department of Ophthalmology, Nanjing Lishui People’s Hospital, Nanjing 211200, Jiangsu Province, China
| | - Hua-Yi Tao
- Department of Gastroenterology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Xin-Gui Peng
- Department of Medical Imaging, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Qing-Hua Zhang
- Department of Medical Imaging, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Yue Chen
- Department of Gastroenterology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
| | - Lu Liu
- Department of Gastroenterology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
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Pavlou AM, Papachristou E, Bonovolias I, Anagnostou E, Anastasiadou P, Poulopoulos A, Bakopoulou A, Andreadis D. Pancreatic Differentiation of Oral Minor Salivary Gland Stem Cells. Stem Cell Rev Rep 2024; 20:1944-1953. [PMID: 38967770 DOI: 10.1007/s12015-024-10757-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Stem cells from various sources including major salivary glands have been used to establish pancreatic differentiation in an attempt to provide new treatment options for patients with diabetes mellitus. In contrast, the potential of using the more easily accessible intraoral minor salivary glands has not been evaluated so far. MATERIALS AND METHODS Salivary stem cells were isolated from normal labial minor salivary glands that were removed during the excision of a mucocele and were attempted to differentiate into pancreatic cell lines using a culture medium enriched with activin A, retinoic acid and GLP-1.Real time RT-PCR was used to evaluate the expression of the genes of pancreatic transcription factors MafA, Ptf1a, Hb9 and Arx. Complementary, 22 labial minor salivary gland paraffin-embedded specimens were examined using immunohistochemistry for the presence of the relevant gene products of the pancreatic transcription factors Arx, MafA, Ptf1a and Pdx1. RESULTS The differentiated salivary stem cells(cells of passage 3) expressed the genes of the pancreatic transcription factors MafA, Ptf1a, Hb9 and Arx even on the first day of the experiment while immunohistochemistry also confirmed the presence of the protein products of Arx, MafA, Ptf1a as well as Pdx1[> 50% of the specimens for Arx(5/8) and MafA(7/8), < 50% for Ptf1a(5/11) and Pdx1(5/11)] in ducts, mesenchymal connective tissue and acinar cells. CONCLUSIONS Labial minor salivary glands may share gene and protein characteristics with pancreas suggesting a possible usefulness for pancreatic regeneration or substitution in cases of deficiency.
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Affiliation(s)
- Achilleia-Maria Pavlou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Eleni Papachristou
- Department of Fixed Prosthesis and Implant Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Ioannis Bonovolias
- Department of Fixed Prosthesis and Implant Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Eleftherios Anagnostou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Pinelopi Anastasiadou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Athanasios Poulopoulos
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Fixed Prosthesis and Implant Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Gohil NV, Gandara FF, Gohil H, Gurajala S, Innocent DC, Tesfaye T, Praticò D. Prevalence of Antibiotic Resistance in Older Adults and Alzheimer's Disease Patients: A Systematic Review and Meta-Analysis. J Alzheimers Dis Rep 2024; 8:1241-1251. [PMID: 39434821 PMCID: PMC11491939 DOI: 10.3233/adr-240057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/15/2024] [Indexed: 10/23/2024] Open
Abstract
Background Antibiotic resistance is a global health concern, and its prevalence among older adults and Alzheimer's disease (AD) patients is gaining attention. Understanding the extent of antibiotic resistance in these populations is critical for designing targeted interventions. Objective The objective of this systematic review and meta-analysis was to determine the prevalence of antibiotic resistance in older adults and AD patients with a focus on quantitative studies in order to provide comprehensive insights into the current landscape. Methods To identify relevant studies, we conducted a thorough search of the PubMed, Scopus, CINAHL, and Web of Science databases. Only studies involving adults and AD patients, published in English, and reporting quantitative data on antibiotic resistance prevalence were considered. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used to assess quality. The data was summarized by using Revman 5.4.1. Results A total of six studies met the final criteria for selection and results from the meta-analysis found a pooled prevalence odds ratio of OR = 1.27 (95% CI: [0.99, 1.63], Z = 1.87, p = 0.06). The studies showed significant heterogeneity (I2 = 100%, p < 0.00001), emphasizing the need for cautious interpretation. Conclusions The findings indicate a potential trend of increased antibiotic resistance in older adults and AD patients, though statistical significance was not achieved for both. The significant heterogeneity highlights the complexity of resistance patterns in these populations, necessitating additional research for tailored interventions.
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Affiliation(s)
| | - Fabio Fuentes Gandara
- Department of Natural and Exact Sciences, Universidad de la Costa, Barranquilla, Colombia
| | - Harshal Gohil
- Department of Community Medicine, GMERS Medical College, Panchmahal, Godhra, Gujarat, India
| | - Swathi Gurajala
- College of Applied Medical Sciences in Jubail, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Domenico Praticò
- Alzheimer’s Center at Temple, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Yu XL, Zhou LY, Huang X, Li XY, Pan QQ, Wang MK, Yang JS. Urgent call for attention to diabetes-associated hospital infections. World J Diabetes 2024; 15:1683-1691. [PMID: 39192868 PMCID: PMC11346093 DOI: 10.4239/wjd.v15.i8.1683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/14/2024] [Accepted: 06/07/2024] [Indexed: 07/25/2024] Open
Abstract
In this editorial, we discuss the recent article by Zhao et al published in the World Journal of Diabetes, which highlights the importance of recognizing the risk indicators associated with diabetes mellitus (DM). Given the severe implications of healthcare-associated infections (HAIs) in hospitalized individuals- such as heightened mortality rates, prolonged hospitalizations, and increased costs- we focus on elucidating the connection between DM and nosocomial infections. Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection, with some already harboring co-infections upon admission. Notably, DM is an important risk factor for nosocomial urinary tract infections and surgical site infections, which may indirectly affect the occurrence of nosocomial bloodstream infections, especially in patients with DM with poor glycemic control. Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive, attention to this potential association is warranted. Hospitalized patients with DM should prioritize meticulous blood glucose management, adherence to standard operating procedures, hand hygiene pra-ctices, environmental disinfection, and rational use of drugs during hospitalization. Further studies are imperative to explore the main risk factors of HAIs in patients with DM, enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.
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Affiliation(s)
- Xue-Lu Yu
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Li-Yun Zhou
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xiao Huang
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xin-Yue Li
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Qing-Qing Pan
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ming-Ke Wang
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ji-Shun Yang
- Medical Care Center, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
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22
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Maity S, Leton N, Nayak N, Jha A, Anand N, Thompson K, Boothe D, Cromer A, Garcia Y, Al-Islam A, Nauhria S. A systematic review of diabetic foot infections: pathogenesis, diagnosis, and management strategies. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1393309. [PMID: 39165660 PMCID: PMC11333436 DOI: 10.3389/fcdhc.2024.1393309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/17/2024] [Indexed: 08/22/2024]
Abstract
Background Diabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention. Methods The researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews and Dissemination, University of York (CRD42021277788). This review provides a comprehensive overview of the microbial spectrum and antibiotic susceptibility patterns observed in diabetic foot infections. Results The search through the databases finally identified 13 articles with 2545 patients from 2021 to 2023. Overall, the predominant Gram-positive microbial species isolated were Staphylococcus aureus, Enterococcus fecalis, Streptococcus pyogenes, Streptococcus agalactiae, and Staphylococcus epidermidis. Whereas the predominant Gram-negative included Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa. Conclusion Diabetic foot infections represent a complex and multifaceted clinical entity, necessitating a holistic approach to diagnosis, management, and prevention. Limited high-quality research data on outcomes and the effectiveness of guideline recommendations pose challenges in updating and refining existing DFI management guidelines. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277788, identifier CRD42021277788.
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Affiliation(s)
- Sabyasachi Maity
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s University School of Medicine, St. George’s, Grenada
| | - Noah Leton
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s University School of Medicine, St. George’s, Grenada
| | - Narendra Nayak
- Department of Microbiology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Ameet Jha
- Department of Anatomy, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Nikhilesh Anand
- Department of Medical Education, School of Medicine, The University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Kamala Thompson
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Danielle Boothe
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Alexandra Cromer
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Yaliana Garcia
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Aliyah Al-Islam
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
| | - Samal Nauhria
- Department of Pathology, St. Matthews University School of Medicine, Grand Cayman, Cayman Islands
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Savitskii MV, Moskaleva NE, Brito A, Markin PA, Zigangirova NA, Soloveva AV, Sheremet AB, Bondareva NE, Lubenec NL, Tagliaro F, Tarasov VV, Tatzhikova KA, Appolonova SA. Pharmacokinetics, tissue distribution, bioavailability and excretion of the anti-virulence drug Fluorothiazinon in rats and rabbits. J Antibiot (Tokyo) 2024; 77:382-388. [PMID: 38491136 DOI: 10.1038/s41429-024-00719-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/15/2024] [Accepted: 03/06/2024] [Indexed: 03/18/2024]
Abstract
Growing antimicrobial resistance has accelerated the development of anti-virulence drugs to suppress bacterial toxicity without affecting cell viability. Fluorothiazinon (FT), an anti-virulence, type three secretion system and flagella motility inhibitor which has shown promise to suppress drug-resistant pathogens having the potential to enhance the efficacy of commonly prescribed antibiotics when used in combination. In this study we characterized the pharmacokinetics, tissue distribution, bioavailability and excretion of FT in rats and rabbits. FT presented a dose-proportional linear increase in the blood of rats. Tissue distribution profiling confirmed that FT distributes to all organs being substantially higher than in the blood of rats. The bioavailability of FT was higher when administered with starch than with water implying FT should be ideally dosed with food. FT was primarily excreted in the feces in rats and rabbits while negligible amounts are recovered from the urine.
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Affiliation(s)
- Mark V Savitskii
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Natalia E Moskaleva
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
- World Class Research Center Digital Biodesign and Personalized Healthcare, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
| | - Alex Brito
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Pavel A Markin
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Nailya A Zigangirova
- National Research Center for Epidemiology and Microbiology named after N. F. Gamaleya, Russian Health Ministry, Moscow, Russian Federation
| | - Anna V Soloveva
- National Research Center for Epidemiology and Microbiology named after N. F. Gamaleya, Russian Health Ministry, Moscow, Russian Federation
| | - Anna B Sheremet
- National Research Center for Epidemiology and Microbiology named after N. F. Gamaleya, Russian Health Ministry, Moscow, Russian Federation
| | - Natalia E Bondareva
- National Research Center for Epidemiology and Microbiology named after N. F. Gamaleya, Russian Health Ministry, Moscow, Russian Federation
| | - Nadezhda L Lubenec
- National Research Center for Epidemiology and Microbiology named after N. F. Gamaleya, Russian Health Ministry, Moscow, Russian Federation
| | - Franco Tagliaro
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vadim V Tarasov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Kristina A Tatzhikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Svetlana A Appolonova
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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24
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Kiryowa HM, Buwembo W, Munabi IG, Mwaka ES, Rwenyonyi CM, Kaddumukasa M, Kiguli S. A comparison of oral bacteriome isolated from periodontal pockets of participants with or without diabetes mellitus in Uganda: a case control study. BMC Res Notes 2024; 17:146. [PMID: 38778408 PMCID: PMC11112893 DOI: 10.1186/s13104-024-06804-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE Diabetes mellitus predisposes patients to increased incidence and severe forms of periodontal disease. Currently, information on the bacterial diversity of patients with diabetes mellitus and periodontitis in Uganda is scanty. This study set out to describe the bacteria associated with periodontitis in patients with diabetes mellitus in Uganda, as part of a larger study describing the association between periodontal disease and diabetes mellitus. RESULTS This was a case control involving 45 samples of gingival crevicular fluid collected from participants with periodontitis, the cases being 26 participants with diabetes mellitus and controls 19 participants without diabetes mellitus. Sequencing using the 16s Oxford nanopore long read protocol was followed by a bioinformatics analysis pipeline for alpha and beta diversity indices in the two groups. Multivariate tests were done to determine the differences in the bacterial composition in the two groups. Of the 739 Operational Taxonomic Units and 500 phyla identified, 37.9% (280/739) were from participants with diabetes mellitus. Analysis of beta diversity revealed a dissimilarity between the two study groups (CAP score = 0) with a significant association noted between periodontitis and the subgingival bacteria (P = 0.001). Diabetes mellitus reduced the quantity and altered the composition of the subgingival microbiome in the study participants.
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Affiliation(s)
- Haruna Muhmood Kiryowa
- School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - William Buwembo
- School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Ian Guyton Munabi
- School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Erisa Sabakaki Mwaka
- School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | | | - Mark Kaddumukasa
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Sarah Kiguli
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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25
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Erickson EL, Freeman TE, Sun S, Koch B, Allen DZ, Sethia R, deSilva B, Matrka L. Recurrent respiratory papillomatosis disease course in immunosuppressed populations. J Laryngol Otol 2024; 138:576-580. [PMID: 37877153 DOI: 10.1017/s0022215123001470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
OBJECTIVE Recurrent respiratory papillomatosis is a benign manifestation of human papillomavirus types 6 and 11 in the respiratory tract. Disease is recurrent, and factors predicting these recurrences and severity of disease are incompletely characterised. This retrospective cohort study examined the relationship of immunosuppression with recurrent respiratory papillomatosis morbidity. METHODS A retrospective cohort of 97 adult patients with recurrent respiratory papillomatosis treated at a tertiary referral centre from 2005 to 2020 was conducted. Measures assessed included inter-surgical interval, Voice Handicap Index ('VHI-10') and anatomical Derkay scores. RESULTS Bivariate analyses comparing average inter-surgical interval, Voice Handicap Index and Derkay scores in immunosuppressed and healthy patients were insignificant. When controlling for diabetes mellitus and comparing immunosuppressed to healthy patients, inter-surgical interval and Voice Handicap Index change were insignificant (p = 0.458 and p = 0.465, respectively). CONCLUSION Recurrent respiratory papillomatosis morbidity for immunosuppressed patients did not significantly differ from that of immunocompetent patients.
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Affiliation(s)
| | | | - Shuai Sun
- Ohio State University Department of Public Health, Columbus, OH, USA
| | - Brandon Koch
- Ohio State University Department of Public Health, Columbus, OH, USA
| | - David Z Allen
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rishabh Sethia
- Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brad deSilva
- Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Laura Matrka
- Ohio State University Wexner Medical Center, Columbus, OH, USA
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26
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Wang M, Li W, Wang H, Song P. Development and validation of machine learning-based models for predicting healthcare-associated bacterial/fungal infections among COVID-19 inpatients: a retrospective cohort study. Antimicrob Resist Infect Control 2024; 13:42. [PMID: 38616284 PMCID: PMC11017584 DOI: 10.1186/s13756-024-01392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/30/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND COVID-19 and bacterial/fungal coinfections have posed significant challenges to human health. However, there is a lack of good tools for predicting coinfection risk to aid clinical work. OBJECTIVE We aimed to investigate the risk factors for bacterial/fungal coinfection among COVID-19 patients and to develop machine learning models to estimate the risk of coinfection. METHODS In this retrospective cohort study, we enrolled adult inpatients confirmed with COVID-19 in a tertiary hospital between January 1 and July 31, 2023, in China and collected baseline information at admission. All the data were randomly divided into a training set and a testing set at a ratio of 7:3. We developed the generalized linear and random forest models for coinfections in the training set and assessed the performance of the models in the testing set. Decision curve analysis was performed to evaluate the clinical applicability. RESULTS A total of 1244 patients were included in the training cohort with 62 healthcare-associated bacterial/fungal infections, while 534 were included in the testing cohort with 22 infections. We found that patients with comorbidities (diabetes, neurological disease) were at greater risk for coinfections than were those without comorbidities (OR = 2.78, 95%CI = 1.61-4.86; OR = 1.93, 95%CI = 1.11-3.35). An indwelling central venous catheter or urinary catheter was also associated with an increased risk (OR = 2.53, 95%CI = 1.39-4.64; OR = 2.28, 95%CI = 1.24-4.27) of coinfections. Patients with PCT > 0.5 ng/ml were 2.03 times (95%CI = 1.41-3.82) more likely to be infected. Interestingly, the risk of coinfection was also greater in patients with an IL-6 concentration < 10 pg/ml (OR = 1.69, 95%CI = 0.97-2.94). Patients with low baseline creatinine levels had a decreased risk of bacterial/fungal coinfections(OR = 0.40, 95%CI = 0.22-0.71). The generalized linear and random forest models demonstrated favorable receiver operating characteristic curves (ROC = 0.87, 95%CI = 0.80-0.94; ROC = 0.88, 95%CI = 0.82-0.93) with high accuracy, sensitivity and specificity of 0.86vs0.75, 0.82vs0.86, 0.87vs0.74, respectively. The corresponding calibration evaluation P statistics were 0.883 and 0.769. CONCLUSIONS Our machine learning models achieved strong predictive ability and may be effective clinical decision-support tools for identifying COVID-19 patients at risk for bacterial/fungal coinfection and guiding antibiotic administration. The levels of cytokines, such as IL-6, may affect the status of bacterial/fungal coinfection.
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Affiliation(s)
- Min Wang
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Wenjuan Li
- Department of Medical Big Data, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Hui Wang
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China
| | - Peixin Song
- Department of Infection Management, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School,Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210009, China.
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27
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Sechovcová H, Mahayri TM, Mrázek J, Jarošíková R, Husáková J, Wosková V, Fejfarová V. Gut microbiota in relationship to diabetes mellitus and its late complications with a focus on diabetic foot syndrome: A review. Folia Microbiol (Praha) 2024; 69:259-282. [PMID: 38095802 DOI: 10.1007/s12223-023-01119-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/11/2024]
Abstract
Diabetes mellitus is a chronic disease affecting glucose metabolism. The pathophysiological reactions underpinning the disease can lead to the development of late diabetes complications. The gut microbiota plays important roles in weight regulation and the maintenance of a healthy digestive system. Obesity, diabetes mellitus, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy are all associated with a microbial imbalance in the gut. Modern technical equipment and advanced diagnostic procedures, including xmolecular methods, are commonly used to detect both quantitative and qualitative changes in the gut microbiota. This review summarises collective knowledge on the role of the gut microbiota in both types of diabetes mellitus and their late complications, with a particular focus on diabetic foot syndrome.
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Affiliation(s)
- Hana Sechovcová
- Laboratory of Anaerobic Microbiology, Institute of Animal Physiology and Genetics, CAS, Vídeňská, 1083, 142 20, Prague, Czech Republic
- Faculty of Agrobiology, Food and Natural Resources, Department of Microbiology, Nutrition and Dietetics, Czech University of Life Sciences, Prague, Czech Republic
| | - Tiziana Maria Mahayri
- Laboratory of Anaerobic Microbiology, Institute of Animal Physiology and Genetics, CAS, Vídeňská, 1083, 142 20, Prague, Czech Republic.
- Department of Veterinary Medicine, University of Sassari, 07100, Sassari, Italy.
| | - Jakub Mrázek
- Laboratory of Anaerobic Microbiology, Institute of Animal Physiology and Genetics, CAS, Vídeňská, 1083, 142 20, Prague, Czech Republic
| | - Radka Jarošíková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jitka Husáková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Veronika Wosková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Vladimíra Fejfarová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
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28
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He J, Zhou S, Wang J, Sun B, Ni D, Wu J, Peng X. Anti-inflammatory and anti-oxidative electrospun nanofiber membrane promotes diabetic wound healing via macrophage modulation. J Nanobiotechnology 2024; 22:116. [PMID: 38493156 PMCID: PMC10943854 DOI: 10.1186/s12951-024-02385-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND In the inflammatory milieu of diabetic chronic wounds, macrophages undergo substantial metabolic reprogramming and play a pivotal role in orchestrating immune responses. Itaconic acid, primarily synthesized by inflammatory macrophages as a byproduct in the tricarboxylic acid cycle, has recently gained increasing attention as an immunomodulator. This study aims to assess the immunomodulatory capacity of an itaconic acid derivative, 4-Octyl itaconate (OI), which was covalently conjugated to electrospun nanofibers and investigated through in vitro studies and a full-thickness wound model of diabetic mice. RESULTS OI was feasibly conjugated onto chitosan (CS), which was then grafted to electrospun polycaprolactone/gelatin (PG) nanofibers to obtain P/G-CS-OI membranes. The P/G-CS-OI membrane exhibited good mechanical strength, compliance, and biocompatibility. In addition, the sustained OI release endowed the nanofiber membrane with great antioxidative and anti-inflammatory activities as revealed in in vitro and in vivo studies. Specifically, the P/G-CS-OI membrane activated nuclear factor-erythroid-2-related factor 2 (NRF2) by alkylating Kelch-like ECH-associated protein 1 (KEAP1). This antioxidative response modulates macrophage polarization, leading to mitigated inflammatory responses, enhanced angiogenesis, and recovered re-epithelization, finally contributing to improved healing of mouse diabetic wounds. CONCLUSIONS The P/G-CS-OI nanofiber membrane shows good capacity in macrophage modulation and might be promising for diabetic chronic wound treatment.
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Affiliation(s)
- Jibing He
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, P. R. China
| | - Shasha Zhou
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai, 201620, P. R. China
| | - Jiaxing Wang
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, P. R. China
| | - Binbin Sun
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai, 201620, P. R. China
| | - Dalong Ni
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P. R. China.
| | - Jinglei Wu
- Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai, 201620, P. R. China.
| | - Xiaochun Peng
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, P. R. China.
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29
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Morata Ruiz L, Ruggieri A, Falcone M, Pasquau Liaño J, Gentile I, Salavert Lletí M, Moreno Núñez L, Cascio A, Tascini C, Loeches Yagüe M, De Rosa FG, Ori A, Comandini A, Cattaneo A, Grossi PA. Dalbavancin real-life utilization among diabetic patients suffering from infections in Italy and Spain: The DALBADIA retrospective cohort study. J Glob Antimicrob Resist 2024; 36:200-209. [PMID: 38211660 DOI: 10.1016/j.jgar.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To retrospectively describe the patterns of use of dalbavancin for treating infections in diabetic patients in Italian and Spanish standard clinical practice. METHODS DALBADIA [NCT04959799] was a multicentre, observational, retrospective cohort study, conducted in Italy and Spain. The study enrolled 97 adults with type 1 or 2 diabetes mellitus, treated with dalbavancin as per standard clinical practice for a Gram-positive bacterial infection or the Gram-positive component of a mixed infection. RESULTS Dalbavancin was used to treat cellulitis (18/92 patients, 19.6%), followed by prosthetic joint infection (14 patients, 15.2%), endocarditis (13 patients, 14.1%), and primary bacteraemia (10 patients, 10.9%); 78/92 (84.8%) patients had Gram-positive infections only, and 14 (15.2%) had mixed infections. The most frequently isolated microorganisms were Staphylococcus aureus in 43 (55.8% of the patients with microbial isolation), 25.6% of which methicillin-resistant; Staphylococcus epidermidis in 13 (16.9%), 53.8% of which methicillin-resistant; Enterococcus faecalis in 11 (14.3%). The main reason for the dalbavancin choice was the intent to simplify the antibiotic regimen (81.5% of cases). A multidisciplinary team participated in the treatment choice process for 53 (57.6%) patients. Dalbavancin was given as first-line antibiotic in 34 (37.0%) patients and administered as one infusion in 32 (34.8%), and as two infusions in 39 (42.4%). In total, 57/62 (91.9%) eligible patients with available assessment were judged clinically cured or improved at the end of observation. CONCLUSION In clinical practice, dalbavancin was used in diabetic patients to treat ABSSSIs and other difficult-to-treat infections with a favourable safety profile and a high rate of positive clinical responses.
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Affiliation(s)
- Laura Morata Ruiz
- Hospital Clìnic, Department of Infectious Diseases, University of Barcelona, Barcelona, Spain
| | | | - Marco Falcone
- AOU Pisana PO Cisanello, UO Malattie Infettive, University of Pisa, Pisa, Italy
| | - Juan Pasquau Liaño
- Hospital Universitario Virgen de las Nieve, Unidad de Enfermedades Infecciosas, Granada, Spain
| | - Ivan Gentile
- AOU Federico II, Malattie Infettive, Patologia Clinica e Medicina Interna, Università di Napoli Federico II, Naples, Italy
| | - Miguel Salavert Lletí
- Hospital Universitario y Politécnico La Fe, Unidad de Enfermedades Infecciosas, Valencia, Spain
| | - Leonor Moreno Núñez
- Hospital Universitario Fundación Alcorcón, Enfermedades Infecciosas, Madrid, Spain
| | - Antonio Cascio
- AOU Policlinico Giaccone, UOC Malattie Infettive e Tropicali, Palermo, Italy
| | | | | | - Francesco Giuseppe De Rosa
- Ospedale Cardinal Massaia, SC Malattie Infettive, Asti, Italy, AOU Città della Salute e Scienza, Presidio Molinette, Turin, Italy
| | | | | | | | - Paolo Antonio Grossi
- ASST Sette Laghi, SC Malattie Infettive e Tropicali, University of Insubria, Varese, Italy
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30
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Jokar J, Abdulabbas HT, Javanmardi K, Mobasher MA, Jafari S, Ghasemian A, Rahimian N, Zarenezhad A, ُSoltani Hekmat A. Enhancement of bactericidal effects of bacteriophage and gentamicin combination regimen against Staphylococcus aureus and Pseudomonas aeruginosa strains in a mice diabetic wound model. Virus Genes 2024; 60:80-96. [PMID: 38079060 DOI: 10.1007/s11262-023-02037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/17/2023] [Indexed: 02/15/2024]
Abstract
Diabetic patients are more susceptible to developing wound infections resulting in poor and delayed wound healing. Bacteriophages, the viruses that target-specific bacteria, can be used as an alternative to antibiotics to eliminate drug-resistant bacterial infections. Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) are among the most frequently identified pathogens in diabetic foot ulcers (DFUs). The aim of this study was assessment of bacteriophage and gentamicin combination effects on bacterial isolates from DFU infections. Specific bacteriophages were collected from sewage and animal feces samples and the phages were enriched using S. aureus and P. aeruginosa cultures. The lytic potential of phage isolates was assessed by the clarity of plaques. We isolated and characterized four lytic phages: Stp2, Psp1, Stp1, and Psp2. The phage cocktail was optimized and investigated in vitro. We also assessed the effects of topical bacteriophage cocktail gel on animal models of DFU. Results revealed that the phage cocktail significantly reduced the mortality rate in diabetic infected mice. We determined that treatment with bacteriophage cocktail effectively decreased bacterial colony counts and improved wound healing in S. aureus and P. aeruginosa infections, especially when administrated concomitantly with gentamicin. The application of complementary therapy using a phage cocktail and gentamicin, could offer an attractive approach for the treatment of wound diabetic bacterial infections.
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Affiliation(s)
- Javad Jokar
- Department of Tissue Engineering, Faculty of Medicine, Fasa University of Medical Science, Fasa, Iran
| | - Hussein T Abdulabbas
- Department of Medical Microbiology, Medical College, Al Muthanna University, Samawah, Al Muthann, Iraq
| | - Kazem Javanmardi
- Department of Physiology, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Ali Mobasher
- Department of Biotechnology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Shima Jafari
- Department of Biotechnology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abdolmajid Ghasemian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Niloofar Rahimian
- Department of Biotechnology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Zarenezhad
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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Zhang QL, Zhang Y, Lin LL, Meng F, Yan L. A Review of Mobile Device Interventions for Continuous Nursing of Patients Undergoing Maintenance Haemodialysis. J Multidiscip Healthc 2024; 17:317-324. [PMID: 38284118 PMCID: PMC10812693 DOI: 10.2147/jmdh.s447715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024] Open
Abstract
Background Maintenance haemodialysis (MHD) has been one of the most important renal replacement therapies for patients with end-stage renal disease in recent years. Continuous nursing is considered a prerequisite for high-quality healthcare and is crucial for medical staff, patients and their families. Providing continuous nursing services for patients with chronic diseases via mobile medical means can effectively improve the quality of life of medical staff. Objective To summarise the application of various mobile device intervention methods for medical patients receiving MHD to provide a reference for the development of mobile health in the continuous nursing of patients undergoing this procedure. Methods We conducted a systematic literature search in the following databases: PubMed, Web of Science, Scopus, and CNKI. The literature on the application of various mobile medical methods for nursing patients receiving MHD, both domestic and international, is retrospectively reviewed. The current research results and the existing problems are summarised. Results A total of 18 studies were reviewed, which showed that Chinese researchers have preliminarily explored the relevant problems of applying mobile healthcare to the continuous nursing of patients receiving haemodialysis and have achieved some effective applications. Based on the "Internet+" medical concept, providing follow-up, health guidance, psychological counselling and other continuous nursing services for patients with chronic diseases via mobile medical means can effectively improve the work efficiency of medical staff, as well as the self-management ability and compliance of patients. Conclusion Mobile health has great potential and prospects in the continuous nursing of patients receiving MHD, For instance, a WeChat-based intervention could improve patients' satisfaction and trust in nurses. But it also requires further research and improvement to ensure its quality and safety.
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Affiliation(s)
- Qing-Lai Zhang
- Department of Nephrology, Hemodialysis Center, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Yue Zhang
- Department of Nephrology, Hemodialysis Center, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Li-Li Lin
- Department of Nephrology, Hemodialysis Center, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Fei Meng
- Department of Nephrology, Hemodialysis Center, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, People’s Republic of China
| | - Li Yan
- Department of Nephrology, Hemodialysis Center, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100020, People’s Republic of China
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Radan M, Ćujić Nikolić N, Kuzmanović Nedeljković S, Mutavski Z, Krgović N, Stević T, Marković S, Jovanović A, Živković J, Šavikin K. Multifunctional Pomegranate Peel Microparticles with Health-Promoting Effects for the Sustainable Development of Novel Nutraceuticals and Pharmaceuticals. PLANTS (BASEL, SWITZERLAND) 2024; 13:281. [PMID: 38256834 PMCID: PMC10821027 DOI: 10.3390/plants13020281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024]
Abstract
Recovering the bioactive components from pomegranate peel (PP) in the fruit-processing industry has attracted great attention in terms of minimizing the waste burden, as well as providing a new source of a multitude of functional compounds. The present study aimed to develop a feasible microencapsulation process of PP extract by using pectin and a pectin/2-hydroxypropyl-β-cyclodextrin (HP-β-CD) blend as coating materials. Microsized powders obtained by a spray drying technique were examined in terms of technological characteristics, exhibiting high powder yield and desirable moisture content, flowability, and cohesive properties. Assuming that the interactions with the used biopolymers occur on the surface hydrophobic domain, their presence significantly improved the thermal stability of the microencapsulated powders up to 200 °C. The health-promoting effects of PP have been associated with its high content in ellagitannins, particularly punicalagin. The obtained PP powders exhibited strong antioxidant and hypoglycemic potential, while an antimicrobial assay revealed their potent activity against Gram-positive bacteria. Additionally, an in vitro release study suggested that the used biopolymers can modify the release of target bioactive compounds, thus establishing a basis for developing an oral-controlled release system. Altogether, biowaste valorization from PP by the production of effective multifunctional microsized powders represents a sustainable way to obtain novel nutraceuticals and/or pharmaceuticals.
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Affiliation(s)
- Milica Radan
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | - Nada Ćujić Nikolić
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | | | - Zorana Mutavski
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | - Nemanja Krgović
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | - Tatjana Stević
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | - Smilja Marković
- Institute of Technical Sciences of SASA, Knez Mihailova 35/IV, 11000 Belgrade, Serbia;
| | - Aleksandra Jovanović
- Institute for the Application of Nuclear Energy INEP, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia;
| | - Jelena Živković
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
| | - Katarina Šavikin
- Institute for Medicinal Plants Research “Dr. Josif Pančić”, Tadeuša Košćuška 1, 11000 Belgrade, Serbia (T.S.)
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Nisa TT, Nakatani D, Kaneko F, Takeda T, Nakata K. Antimicrobial resistance patterns of WHO priority pathogens isolated in hospitalized patients in Japan: A tertiary center observational study. PLoS One 2024; 19:e0294229. [PMID: 38206949 PMCID: PMC10783704 DOI: 10.1371/journal.pone.0294229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 10/29/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND After issuing the "Global action plan on antimicrobial resistance" in 2015, the World Health Organization (WHO) established a priority pathogens list for supporting research and development of novel antimicrobials. We conducted a comprehensive analysis of the WHO priority organisms in a Japanese tertiary hospital to apprehend the local AMR epidemiology. METHODS Data were obtained from electrical medical records in Osaka University Hospital between January 2010 and March 2021. The critical, high, and medium "priority pathogens list" categories of the WHO were used to compare results between the early (2010-2015) and late (2016-2021) phases. RESULTS Out of 52,130 culture-positive specimens, a total of 9,872 (18.9%) contained WHO priority isolates. In comparison to early phases, late phases were likely to have higher rates of carbapenem resistance in Pseudomonas aeruginosa (15.7% vs 25.0%, P<0.001), 3rd generation cephalosporin resistance in Escherichia coli (11.5% vs 17.8%, P<0.001) as well as Klebsiella pneumoniae (1.6% vs 4.4%, P<0.001), and ampicillin resistance in Haemophilus influenzae (2.4% vs 3.9%, P<0.001). After 2015, however, the proportion of methicillin-resistant and vancomycin-intermediate Staphylococcus aureus was low. In this study, in-hospital mortality was comparable among patients with resistance to the three WHO priority pathogen types: critical (5.9%), high (3.9%), and medium (3.8%), and no significant change was observed between two phases in each category. However, significant interactions for in-hospital mortality were observed in subgroup analyses between "critical priority" AMR and the presence of comorbid conditions, such as chronic kidney disease or diabetes mellitus. CONCLUSIONS To implement better antimicrobial stewardship policies and practices, local priority pathogens and "high-risk" patients for in-hospital death need to be acknowledged and evaluated periodically.
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Affiliation(s)
- Tania Tabassum Nisa
- Department of Global and Innovative Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Daisaku Nakatani
- Department of Global and Innovative Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Fumie Kaneko
- Department of Global and Innovative Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Toshihiro Takeda
- Department of Medical Informatics, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Ken Nakata
- Department of Global and Innovative Medicine, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
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Li J, Hou X, Xiao J, Zhu L, Deng Y, Li Z, Zhao Z, Luo Z, Wei H. Synthesis of New Derivatives of Berberine Canagliflozin and Study of Their Antibacterial Activity and Mechanism. Molecules 2024; 29:273. [PMID: 38202855 PMCID: PMC10780567 DOI: 10.3390/molecules29010273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The isoquinoline alkaloid berberine, derived from Coptidis rhizoma, exhibits antibacterial, hypoglycemic, and anti-inflammatory properties. Canagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. We synthesized compounds B9OC and B9OBU by conjugating canagliflozin and n-butane at the C9 position of berberine, aiming to develop antimicrobial agents for combating bacterial infections worldwide. We utilized clinically prevalent pathogenic bacteria, namely Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa, to investigate the antibacterial efficacy of B9OC. This was accomplished through the determination of the MIC80 values, analysis of bacterial growth curves, evaluation of biofilm formation using crystal violet staining, assessment of impact on bacterial proteins via SDS-PAGE analysis, and observation of alterations in bacterial morphology utilizing field emission scanning electron microscopy. Meanwhile, the ADMET of compound B9OC was predicted using a computer-aided method. The findings revealed that B9OC exhibited lower minimal inhibitory concentrations against all three bacteria compared to berberine alone or in combination with canagliflozin. The minimal inhibitory concentrations (MICs) of B9OC against the three experimental strains were determined to be 0.035, 0.258, and 0.331 mM. However, B9OBu exhibited a lower level of antimicrobial activity compared to berberine. The compound B9OC exhibits a broad spectrum of antibacterial activity by disrupting the integrity of bacterial cell walls, leading to cellular rupture and the subsequent degradation of intracellular proteins.
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Affiliation(s)
- Jinsheng Li
- Department of Pharmacology, Shaanxi University of Chinese Medicine, Xianyang 712046, China; (J.L.); (X.H.); (H.W.)
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Xueli Hou
- Department of Pharmacology, Shaanxi University of Chinese Medicine, Xianyang 712046, China; (J.L.); (X.H.); (H.W.)
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Jinlong Xiao
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Li Zhu
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Yujie Deng
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Ziyi Li
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Zijian Zhao
- Department of Pharmacology, Shaanxi University of Chinese Medicine, Xianyang 712046, China; (J.L.); (X.H.); (H.W.)
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Zhenghong Luo
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua University, Huaihua 418000, China
| | - Hao Wei
- Department of Pharmacology, Shaanxi University of Chinese Medicine, Xianyang 712046, China; (J.L.); (X.H.); (H.W.)
- School of Chemistry and Materials Science, Huaihua University, Huaihua 418000, China; (J.X.); (L.Z.); (Y.D.); (Z.L.)
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Yassin AE, Albekairy AM, Omer ME, Almutairi A, Alotaibi Y, Althuwaini S, Alaql OA, Almozaai SS, Almutiri NM, Alluhaim W, Alzahrani RR, Alterawi AM, Halwani MA. Chitosan-Coated Azithromycin/Ciprofloxacin-Loaded Polycaprolactone Nanoparticles: A Characterization and Potency Study. Nanotechnol Sci Appl 2023; 16:59-72. [PMID: 38146545 PMCID: PMC10749578 DOI: 10.2147/nsa.s438484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Antimicrobial resistance is a major health hazard worldwide. Combining azithromycin (AZ) and ciprofloxacin (CIP) in one drug delivery system was proposed to boost their antibacterial activity and overcome resistance. This study aims to improve azithromycin and ciprofloxacin activity by co-encapsulating them inside chitosan-coated polymeric nanoparticles and evaluating their antibacterial activity. Methods The double emulsion method was employed to co-encapsulate AZ/CIP inside chitosan-coated polymeric nanoparticles. The formulations were evaluated for their nanoparticle size, size distribution, and zeta potential. Differential scanning calorimetry (DSC) analysis characterized the formula's thermal sustainability. Encapsulation efficiency was measured by HPLC and spectrophotometric analysis. Morphological studies used the Transmission Electron Microscopy (TEM). The in vitro release profiles of both AZ and CIP were monitored utilizing the dialysis membrane bag method. The micro-dilution assay assessed the antimicrobial activity against a clinical isolate of Klebsiella pneumoniae. Results The prepared AZ/CIP-poly-caprolactone nanoparticles were spherical; their size range was 184.0 ± 3.3-190.4 ± 5.6 nm and had high size uniformity (poly-dispersity index below 0.2). The zeta potential ranged from -21.2 ± 2.4 to -27.0 ± 2.5 mV, while chitosan-coated nanoparticles showed a positive zeta potential value ranging from 8 to 11 mV. The thermal study confirmed the amorphous state of both antibiotics inside the nanoparticles. The results of the in vitro release study indicated a slow and uniform rate of release for both drugs extended over 4-days, with a faster rate in the case of AZ. The MIC values reported for both chitosan-coated NP have been tremendously reduced by at least 15 folds of pure CIP and more than 60 folds of pure AZ. Conclusion The co-encapsulation of AZ/CIP into chitosan-coated polymeric nanoparticles has been successfully achieved. The produced particles showed many beneficial attributes of uniform particle sizes below 200 nm and high zeta potential values. Chitosan-coated polymeric nanoparticles extensively enhanced the antibacterial activity of both AZ/CIP against bacteria.
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Affiliation(s)
- Alaa Eldeen Yassin
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulkareem M Albekairy
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mustafa E Omer
- Pharmacy Program, College of Health and Sport Sciences, University of Bahrain, Zallaq, Bahrain
| | - Arwa Almutairi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Yousef Alotaibi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Salem Althuwaini
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Osama Aql Alaql
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Shahad S Almozaai
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nouf Mohammed Almutiri
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Wed Alluhaim
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Raghad R Alzahrani
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Asma M Alterawi
- Department of Pharmaceutics and Center for Pharmaceutical Engineering and Sciences, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, 23298, USA
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Majed A Halwani
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Moslemi A, Shokohi T, Salimi M, Faeli L, Davoodi L, Kashi Z, Abastabar M, Haghani I, Mayahi S, Aghili SR. Clinic-mycological spectrum of Candida infection in diabetic foot ulcers in a tertiary care hospital. Curr Med Mycol 2023; 9:9-16. [PMID: 38983618 PMCID: PMC11230143 DOI: 10.22034/cmm.2024.345165.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 07/11/2024] Open
Abstract
Background and Purpose In diabetic foot ulcers, if fungal agents, such as Candida species penetrate the cutaneous or depth of the ulcer, it can increase the wound severity and make it more difficult to heal. Materials and Methods A cross-sectional study was performed on 100 diabetic patients with a foot ulcer from December 2019 to November 2020 in northern Iran. Patient data and wound grades were recorded in a questionnaire. Candida infection was confirmed by direct microscopic examination and culture. To identify the causative agent, polymerase chain reaction-restriction fragment length polymorphism using MspI enzyme and the partial amplification of hyphal wall proteins (HWP1) gene were performed. Results Mean age of the participants was 62.1 ± 10.8 years old, and 95% of them had type 2 diabetes. Moreover, more than 83% of them had diabetes for a duration of 10 years. In addition, 59% of the patients were male, and 66% > of them had poor education levels. Besides, 99% of them were married, and 52% were rural. Furthermore, 95% of the participants had neuropathic symptoms and 88% used antibiotics. The HbA1C level was > 9% in 69% of them, and the mean ulcer grade of the patients was 2.6±1.05. Candida infection was detected in 13% of the deep tissue and 7% of the tissue surrounding the wound. The predominant Candida isolate was C. parapsilosis (71.5%) and C. albicans (14.3%). Infections caused by filamentous fungi were not detected. There was a statistically significant relationship between Candida infection and gender, rural lifestyle, HbA1C, and ulcer grade. Conclusion Mycological evaluations of diabetic foot ulcers are often ignored. The present study revealed that C. parapsilosis is the most common causative agent of deep-seated foot ulcer infection in these patients and may require specific treatment. Therefore, more attention of physicians to Candida infections, early diagnosis, and prompt treatment can help accelerate wound healing and prevent amputation.
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Affiliation(s)
- Azam Moslemi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Salimi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Faeli
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Kashi
- Diabetes Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Reza Aghili
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Sankhuu Y, Altaisaikhan O, Battsogt MO, Byambasukh O, Khasag A. Diabetes-Related Mortality in a Developing Country: An Exploration of Tertiary Hospital Data. J Clin Med 2023; 12:6687. [PMID: 37892825 PMCID: PMC10606993 DOI: 10.3390/jcm12206687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: Given the growing global diabetes crisis, this study examined the causes of mortality in diabetic patients at a Mongolian tertiary care hospital. (2) Between 2017 and 2021, data from 100 individuals with diabetes (53% male, mean age 58.5 years, duration of diabetes, 9.6 years, HbA1c level, 9.7%, 11.1% type 1 diabetes) were reviewed. (3) Results: The predominant cause of mortality was sepsis, accounting for 65.0% of cases and emerging as a contributing factor in 75.0% of instances. Renal failure constituted the second leading cause of death, accounting for 19.0% of mortalities. Other contributing factors included chronic liver disease (6.0%) and ARDS (3.0%). Regarding sepsis, the individuals affected were relatively younger (57.5 ± 11.2 vs. 61.7 ± 11.2, p = 0.988), with a slightly higher prevalence among female patients (77.4%) and those with T1DM (81.8%), though these differences were not statistically significant (p > 0.05). Patients with sepsis exhibited lower BMI values (26.7 ± 4.1 vs. 28.5 ± 6.2, p = 0.014) and poorer glycemic control (9.8 ± 3.1 vs. 9.6 ± 5.1, p = 0.008); (4) Conclusions: This hospital-based data analysis in Mongolia highlights sepsis as the primary cause of mortality among diabetes patients in tertiary hospitals regardless of age, gender, or diabetes type while also indicating a potential association between a lower BMI, poor glycemic control, smoking, and the risk of sepsis.
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Affiliation(s)
- Yanjmaa Sankhuu
- Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia; (Y.S.); (M.-O.B.)
- Department of Endocrinology and Diabetes, First Central Hospital of Mongolia, Ulaanbaatar 210648, Mongolia
| | - Odgarig Altaisaikhan
- Department of Health Research, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia;
| | - Munkh-Od Battsogt
- Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia; (Y.S.); (M.-O.B.)
- Department of Endocrinology and Diabetes, First Central Hospital of Mongolia, Ulaanbaatar 210648, Mongolia
| | - Oyuntugs Byambasukh
- Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia; (Y.S.); (M.-O.B.)
| | - Altaisaikhan Khasag
- Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 13270, Mongolia; (Y.S.); (M.-O.B.)
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Panjaitan NSD, Hartanti MD, Rinendyaputri R. Response on Article "A Sustained-Release Nanosystem with MRSA Biofilm-Dispersing and -Eradicating Abilities Accelerates Diabetic Ulcer Healing" [Letter]. Int J Nanomedicine 2023; 18:4633-4634. [PMID: 37600120 PMCID: PMC10438432 DOI: 10.2147/ijn.s434271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Novaria Sari Dewi Panjaitan
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Center, Cibinong - Bogor, West Java, Indonesia
| | - Monica Dwi Hartanti
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Center, Cibinong - Bogor, West Java, Indonesia
- Department of Medical Biology, Faculty of Medicine, Universitas Trisakti, West Jakarta, Indonesia
| | - Ratih Rinendyaputri
- Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Center, Cibinong - Bogor, West Java, Indonesia
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Girma A, Aemiro A, Workineh D, Tamir D. Magnitude, Associated Risk Factors, and Trend Comparisons of Urinary Tract Infection among Pregnant Women and Diabetic Patients: A Systematic Review and Meta-Analysis. J Pregnancy 2023; 2023:8365867. [PMID: 37545868 PMCID: PMC10403334 DOI: 10.1155/2023/8365867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 01/12/2023] [Accepted: 05/19/2023] [Indexed: 08/08/2023] Open
Abstract
Urinary tract infection (UTI) remains the most common bacterial infection that affects millions of people around the world, especially pregnant women (PW) and people with diabetes mellitus (DM). This systematic review and meta-analysis was aimed at finding the pooled prevalence of UTI and its associated risk factors among PW and DM patients. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, Google Engine, and University Library Databases. "Prevalence," "urinary tract infection," "associated factors," "pregnant women," "diabetic patients," and "Ethiopia" were search terms used for this study. For critical appraisal, PRISMA-2009 was applied. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random effect model was used to calculate the pooled prevalence of UTI and its associated factors among both patients, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 7271 participants were included in the 25 eligible studies. The pooled prevalence of UTI in Ethiopia among both patients was 14.50% (95% CI: 13.02, 15.97), of which 14.21% (95% CI: 12.18, 16.25) and 14.75% (95% CI: 12.58, 16.92) were cases of DM and PW, respectively. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (19.84%) and in studies conducted from 2018 to 2022 (14.68%). Being female (AOR: 0.88, and 95% CI: 0.11, 1.65, P = 0.01) and having an income level ≤ 500ETB (AOR: 4.46, and 95% CI: -1.19, 10.12, P = 0.03) were risk factors significantly associated with UTI among patients with DM and PW, respectively. Furthermore, a history of catheterization (AOR = 5.58 and 95% CI: 1.35, 9.81, P < 0.01), urinary tract infection (AOR: 3.52, and 95% CI: 1.96, 5.08, P < 0.01), and symptomatic patients (AOR: 2.32, and 95% CI: 0.57, 4.06, P < 0.01) were significantly associated with UTI in both patients. Early diagnosis and appropriate medication are necessary for the treatment of UTI in patients with DM and PW.
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Affiliation(s)
- Abayeneh Girma
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awlia, Ethiopia
| | - Aleka Aemiro
- Department of Biology, College of Natural and Computational Science, Mekdela Amba University, P.O. Box 32, Tulu Awlia, Ethiopia
| | - Dereba Workineh
- Department of Biology, College of Natural and Computational Science, Mizan-Tepi University, P.O. Box 121, Tepi, Ethiopia
| | - Dessalew Tamir
- Department of Veterinary Science, College of Agriculture and Environmental Sciences, Debre Tabor University, P.O. Box 272, Debre Tabor, Ethiopia
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Rajab AAH, Hegazy WAH. What’s old is new again: Insights into diabetic foot microbiome. World J Diabetes 2023; 14:680-704. [PMID: 37383589 PMCID: PMC10294069 DOI: 10.4239/wjd.v14.i6.680] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/20/2023] [Accepted: 04/10/2023] [Indexed: 06/14/2023] Open
Abstract
Diabetes is a chronic disease that is considered one of the most stubborn global health problems that continues to defy the efforts of scientists and physicians. The prevalence of diabetes in the global population continues to grow to alarming levels year after year, causing an increase in the incidence of diabetes complications and health care costs all over the world. One major complication of diabetes is the high susceptibility to infections especially in the lower limbs due to the immunocompromised state of diabetic patients, which is considered a definitive factor in all cases. Diabetic foot infections continue to be one of the most common infections in diabetic patients that are associated with a high risk of serious complications such as bone infection, limb amputations, and life-threatening systemic infections. In this review, we discussed the circumstances associated with the high risk of infection in diabetic patients as well as some of the most commonly isolated pathogens from diabetic foot infections and the related virulence behavior. In addition, we shed light on the different treatment strategies that aim at eradicating the infection.
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Affiliation(s)
- Azza A H Rajab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagzig 44511, Egypt
| | - Wael A H Hegazy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagzig 44511, Egypt
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Mittal G, Jakhar P, Patel A, Bhagwat DP. Pharmacokinetic assessment of cefpodoxime proxetil in diabetic rats. J Diabetes Metab Disord 2023; 22:385-392. [PMID: 37255782 PMCID: PMC10225406 DOI: 10.1007/s40200-022-01156-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/30/2022] [Indexed: 06/01/2023]
Abstract
Purpose In diabetes, multi-organ level dysfunction arising from metabolic complications is reported to influence the pharmacokinetics (PK) profile of many drugs. Hence, the present study was planned in rats to evaluate the effect of diabetes on the PK profile of cefpodoxime, a widely prescribed oral antibiotic. Method PK profile of cefpodoxime was assessed after oral administration of cefpodoxime proxetil (10 and 20 mg/kg) and intravenous (i.v) administration of cefpodoxime sodium (10 mg/kg) in normal and streptozotocin induced diabetic rats. To evaluate the impact of diabetes on oral absorption and serum protein binding, in situ intestinal permeability and in vitro serum protein binding studies were performed for cefpodoxime using Single Pass Intestinal Perfusion model (SPIP) and ultracentrifugation technique, respectively. Result In diabetic rats, there was significant (p < 0.01) decrease in maximum concentration (Cmax) and area under the curve (AUC) of cefpodoxime by both oral and intravenous route, which was attributed to augmented clearance of cefpodoxime. There was no change in the time to achieve Cmax (Tmax) suggesting no alteration in oral absorption which was further confirmed through unaltered intestinal permeability in diabetic rats. The protein binding in diabetic rats also remained unchanged, indicating no influence of protein binding on elevated clearance. Conclusion The plasma exposure of cefpodoxime, a renally eliminated drug was significantly lowered in diabetic rats due to enhanced glomerular filtration. However, this observation needs to be confirmed through well controlled clinical trials.
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Affiliation(s)
- Garima Mittal
- Department of Pharmacy, Panipat Institute of Engineering and Technology, Panipat, Haryana India
| | - Priyanka Jakhar
- Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Ropar, Punjab India
| | - Anasuya Patel
- Wockhardt Research Centre, Chikalthana, Aurangabad, Maharashtra India
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Ramasubbu K, Padmanabhan S, Al-Ghanim KA, Nicoletti M, Govindarajan M, Sachivkina N, Rajeswari VD. Green Synthesis of Copper Oxide Nanoparticles Using Sesbania grandiflora Leaf Extract and Their Evaluation of Anti-Diabetic, Cytotoxic, Anti-Microbial, and Anti-Inflammatory Properties in an In-Vitro Approach. FERMENTATION-BASEL 2023. [DOI: 10.3390/fermentation9040332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Green methods of synthesizing nanoparticles are safer than chemical and physical methods, as well as being eco-friendly and cost-efficient. In this study, we use copper oxide nanoparticles (CuO NPs) fabricated with Sesbania grandiflora (Sg) (Hummingbird tree) leaves to test the effectiveness of green synthesizing methods. The attained Sg-CuO NPs physical and optical nature is characterized by UV-Vis spectroscopy Differential Reflectance Spectroscopy (UV-Vis DRS), Fourier Transform Infra-Red spectroscopy (FTIR), X-ray Diffraction spectroscopy (XRD), Scanning Electron Microscope (SEM), and Energy Dispersive X-ray Analysis (EDAX). UV-Vis spectrum for Sg-CuO NPs revealed a peak at 410 nm. SEM images showed the aggregation of needle-shaped particles, at a size of 33 nm. The amylase and glucosidase enzymes were inhibited by the Sg-CuO NPs up to 76.7% and 72.1%, respectively, indicating a possible antihyperglycemic effect. Fabricated Sg-CuO NPs disclosed the excellent inhibition of DPPH-free radicle formation (89.7%) and repressed protein degradation (81.3%). The results showed that Sg-CuO NPs display good anti-bacterial activity against the gram-negative (Escherichia coli and Pseudomonas aeruginosa) and gram-positive (Staphylococcus aureus). Cytotoxicity of the Sg-CuO NPs was determined using anIC50 of 37 μg/mL. Sg-CuO NPs have shown promising anti-diabetic, anti-oxidant, protein degradation-inhibiting, and anti-microbial properties. Our findings have shown that synthesized Sg-CuO NPs have biological activities that may be utilized to treat bacterial infections linked to hyperglycemia.
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Pari B, Gallucci M, Ghigo A, Brizzi MF. Insight on Infections in Diabetic Setting. Biomedicines 2023; 11:971. [PMID: 36979949 PMCID: PMC10046483 DOI: 10.3390/biomedicines11030971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The correlation between diabetes mellitus and infectious diseases is widely recognized. DM patients are characterized by the impaired function of the immune system. This translates into the occurrence of a variety of infections, including urinary tract, skin and surgical site infections, pneumonia, tuberculosis, and, more recently, SARS-CoV-2. Hyperglycemia has been identified as a relevant factor contributing to unfavorable outcomes in hospitalized patients including SARS-CoV-2 patients. Several studies have been performed proving that to maintain the proper and stringent monitoring of glycemia, a balanced diet and physical activity is mandatory to reduce the risk of infections and their associated complications. This review is focused on the mechanisms accounting for the increased susceptibility of DM patients to infections, with particular attention to the impact of newly introduced hypoglycemic drugs in sepsis management.
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Affiliation(s)
| | | | | | - Maria Felice Brizzi
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy
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Cheong HS, Chang Y, Kim Y, Joo EJ, Kwon MJ, Wild SH, Byrne CD, Ryu S. Glycaemic status, insulin resistance, and risk of infection-related mortality: a cohort study. Eur J Endocrinol 2023; 188:7033310. [PMID: 36757815 DOI: 10.1093/ejendo/lvad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/11/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
IMPORTANCE The impact of non-diabetic hyperglycaemia and insulin resistance on infection-related mortality risk remains unknown. OBJECTIVE We investigated the association of glycaemic status and insulin resistance with infection-related mortality in individuals with and without diabetes. DESIGN Cohort study based on Kangbuk Samsung Health Study and national death records. PARTICIPANTS About 666 888 Korean adults who underwent fasting blood measurements including glucose, glycated haemoglobin (HbA1c), and insulin during health-screening examinations were followed for up to 15.8 years. MAIN OUTCOME AND MEASURES Infection-related mortality, therefore we used Cox proportional hazards regression analyses to estimate hazard ratios (HRs) and 95% CIs for infection-related mortality. Vital status and infection-related mortality were ascertained through national death records. Variable categories were created based on established cut-offs for glucose and HbA1c levels and homeostatic model assessment of insulin resistance (HOMA-IR) quintiles. RESULTS During a median follow-up of 8.3 years, 313 infectious disease deaths were dentified. The associations of glucose and HbA1c levels with infection-related mortality were J-shaped (P for quadratic trend<.05). The multivariable-adjusted HR (95% CIs) for infection-related mortality comparing glucose levels <5, 5.6-6.9, and ≥7.0 mmol/L to 5.0-5.5 mmol/L (the reference) were 2.31 (1.47-3.64), 1.65 (1.05-2.60), and 3.41 (1.66-7.00), respectively. Among individuals without diabetes, the multivariable-adjusted HR for infection-related mortality for insulin resistance (HOMA-IR ≥75th centile versus <75th centile) was 1.55 (1.04-2.32). CONCLUSIONS AND RELEVANCE Both low and high glycaemic levels and insulin resistance were independently associated with increased infection-related mortality risk, indicating a possible role of abnormal glucose metabolism in increased infection-related mortality.
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Affiliation(s)
- Hae Suk Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 04514
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea, 06355
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
| | - Eun-Jeong Joo
- Division of Infectious Diseases, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
| | - Min-Jung Kwon
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
| | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom, EH8 9AG
| | - Christopher D Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom, SO16 6YD
- National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom, SO16 6YD
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 03181
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 04514
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea, 06355
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Vázquez-Ramos VR, Pérez-Serrano RM, García-Solís P, Solís-Sainz JC, Espinosa-Cristóbal LF, Castro-Ruíz JE, Domínguez-Pérez RA. Root canal microbiota as an augmented reservoir of antimicrobial resistance genes in type 2 diabetes mellitus patients. J Appl Oral Sci 2023; 30:e20220362. [PMID: 36753071 DOI: 10.1590/1678-7757-2022-0362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/06/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Antimicrobial resistance is a global public health problem. Root canal microbiota associated with apical periodontitis represents a well-known reservoir of antimicrobial resistance genes (ARGs). However, the effect of type 2 diabetes mellitus (T2DM) in this reservoir is unknown. This study aimed to establish if root canal microbiota associated with apical periodontitis in T2DM patients is an augmented reservoir by identifying the prevalence of nine common ARGs and comparing it with the prevalence in nondiabetic patients. METHODOLOGY This cross-sectional study included two groups: A T2DM group conformed of 20 patients with at least ten years of living with T2DM and a control group of 30 nondiabetic participants. Premolar or molar teeth with pulp necrosis and apical periodontitis were included. A sample was collected from each root canal before endodontic treatment. DNA was extracted, and ARGs were identified by polymerase chain reaction. RESULTS tetW and tetM genes were the most frequent (93.3 and 91.6%, respectively), while ermA was the least frequent (8.3%) in the total population. The distribution of the ARGs was similar in both groups, but a significant difference (p<0.005) was present in ermB, ermC, cfxA, and tetQ genes, being more frequent in the T2DM group. A total of eighty percent of the T2DM patients presented a minimum of four ARGs, while 76.6% of the control group presented a maximum of three. CONCLUSIONS Root canal microbiota associated with apical periodontitis in T2DM patients carries more ARGs. Therefore, this pathological niche could be considered an augmented reservoir.
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Affiliation(s)
- Víctor Rafael Vázquez-Ramos
- Universidad Autónoma de Querétaro, Facultad de Medicina, Laboratorio de Investigación Odontológica Multidisciplinaria, Santiago de Querétaro, México
| | - Rosa Martha Pérez-Serrano
- Universidad Autónoma de Querétaro, Facultad de Medicina, Laboratorio de Investigación Odontológica Multidisciplinaria, Santiago de Querétaro, México
| | - Pablo García-Solís
- Universidad Autónoma de Querétaro, Facultad de Medicina, Departamento de Investigación Biomédica, Santiago de Querétaro, México
| | - Juan Carlos Solís-Sainz
- Universidad Autónoma de Querétaro, Facultad de Medicina, Departamento de Investigación Biomédica, Santiago de Querétaro, México
| | - León Francisco Espinosa-Cristóbal
- Universidad Autónoma de Ciudad Juárez, Instituto de Ciencias Biomédicas, Programa de Maestría en Ciencias Odontológicas, Departamento de Estomatología, Ciudad Juárez, México
| | - Jesús Eduardo Castro-Ruíz
- Universidad Autónoma de Querétaro, Facultad de Medicina, Laboratorio de Investigación Odontológica Multidisciplinaria, Santiago de Querétaro, México
| | - Rubén Abraham Domínguez-Pérez
- Universidad Autónoma de Querétaro, Facultad de Medicina, Laboratorio de Investigación Odontológica Multidisciplinaria, Santiago de Querétaro, México
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Mucormycosis and Aspergillosis Infection Following Maxillofacial Trauma: Case Report. Indian J Otolaryngol Head Neck Surg 2023:1-5. [PMID: 36777925 PMCID: PMC9899331 DOI: 10.1007/s12070-023-03492-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/13/2023] [Indexed: 02/07/2023] Open
Abstract
An invasive fungal infection caused by saprophytic and aerobic fungi Rhizopus, Rhizomucor, and Cunninghamella genera of the family Mucoraceae is known as Mucormycosis. Typically, Mucormycosis manifests in patients with conditions like uncontrolled diabetes, renal failure, patients receiving chemotherapy, long term steroid therapy or patients who are immunocompromised such as Acquired Immuno Deficiency Syndrome. The authors report a case of mixed opportunistic fungal infection of Mucormycosis and Aspergillosis following maxillofacial trauma that was treated by both medical and surgical line of management.
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Lee DH, Yang B, Gu S, Kim EG, Kim Y, Kang HK, Choe YH, Jeon HJ, Park S, Lee H. Influenza vaccination trend and related factors among patients with diabetes in Korea: Analysis using a nationwide database. Front Endocrinol (Lausanne) 2023; 14:1077846. [PMID: 36817596 PMCID: PMC9935563 DOI: 10.3389/fendo.2023.1077846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Subjects with diabetes are at higher risk of serious influenza-related complications. We aimed to investigate the yearly trend of influenza vaccination and factors associated with being unvaccinated for influenza in subjects with diabetes using a nationwide observational study performed within the recent decade. METHODS Among 105,732 subjects from the Korea National Health and Nutrition Examination Survey between 2007 and 2019, 8,632 with diabetes were included. We investigated the yearly trend of influenza vaccination and factors associated with being unvaccinated for influenza. RESULTS During the study period, the prevalence of influenza vaccination in subjects with diabetes showed a tendency to increase every year, reaching almost 60% in 2019, which was higher than the rate in subjects without diabetes. Younger age (adjusted hazard ratio (aHR) [95% CI] 11.29 [8.63-14.75] for < 50 years; 6.16 [5.21-7.29] for 50-65 years), male (aHR 1.67 [1.52-1.87]), current smoker (aHR 1.31 [1.00-1.72], lower-income status (aHR 1.46 [1.17, 1.84]), and high education level (aHR 1.30 [1.01-1.67]) were associated with being unvaccinated. Also, a poorer glycemic control with HbA1c ≥ 9% was found to be correlated with unvaccinated status (aHR 1.48 [1.15-1.90]). CONCLUSION The influenza vaccination rate is still unsatisfactory in subjects with diabetes. Young age, males, low-income level, high education level, and poor glycemic control were associated with unvaccinated status. Considering the risk-benefits of influenza vaccination in patients with diabetes, physicians should make an effort to increase vaccination rates, especially in low vaccination rate groups.
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Affiliation(s)
- Dong-Hwa Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Seonhye Gu
- Department of Epidemiology and Health Informatics, Korea University, Seoul, Republic of Korea
| | - Eung-Gook Kim
- Department of Biochemistry, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Youlim Kim
- Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyung Koo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Yeong Hun Choe
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Internal Medicine, Chonbuk National University Hospital-Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hyun Jeong Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Seungyong Park
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Internal Medicine, Chonbuk National University Hospital-Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Tegegne KD, Wagaw GB, Gebeyehu NA, Yirdaw LT, Shewangashaw NE, Kassaw MW. Prevalence of urinary tract infections and risk factors among diabetic patients in Ethiopia, a systematic review and meta-analysis. PLoS One 2023; 18:e0278028. [PMID: 36649227 PMCID: PMC9844928 DOI: 10.1371/journal.pone.0278028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/08/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Urinary tract infection (UTI) is a common clinical problem that comprises 1-6% of medical referrals and includes urinary tract, bladder, and kidney infections. UTI is the most commonly occurring infectious disease in diabetic patients. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of urinary tract infection and its associated factors in Ethiopia. METHODS The online libraries of PubMed, Google Scholar, Scopus, and Science Direct, were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, and publication year. Meta-regression analysis using study-level covariates as predictors of study-level estimates to explore the determinants of potential heterogeneity in our pooled estimates. The pooled odds ratio for related covariates was also calculated. RESULTS Out of 1128 studies assessed, 14 met our criteria and were included in the study. A total of 3773 people were included in the study. The prevalence of urinary tract infection was estimated to be 15.97% (95% CI: 12.72-19.23). According to subgroup analysis, the highest prevalence was observed in the SNNP region (19.21%) and studies conducted in and after 2018 (17.98%). Being female (AOR = 3.77; 95% CI: 1.88, 5.65), being illiterate (AOR = 5.29; 95% CI: 1.98, 8.61), prior urinary tract infection history (AOR = 3.04; 95% CI: 2.16-3.92) were the predictor of urinary tract infection. CONCLUSION The prevalence of urinary tract infections was high in Ethiopia. Female gender, illiteracy, and prior UTI history were associated with urinary tract infections. Since UTIs in diabetic patients has serious medical and public health consequence, screening of UTIs in diabetic patients and early initiation of treatment should become a public health priority.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Gebeyaw Biset Wagaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolita Sodo University, Wolita Sodo, Ethiopia
| | - Lehulu Tilahun Yirdaw
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Multidrug-Resistant Escherichia coli Causing Urinary Tract Infections among Controlled and Uncontrolled Type 2 Diabetic Patients at Laquintinie Hospital in Douala, Cameroon. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:1250264. [PMID: 36624799 PMCID: PMC9825230 DOI: 10.1155/2022/1250264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/02/2023]
Abstract
Urinary tract infections (UTIs) in patients with diabetes are a major public health problem worldwide, particularly in developing countries. This study assessed the resistance profile of Escherichia coli and biochemical abnormalities in controlled and uncontrolled type 2 diabetic patients. A cross-sectional study was conducted at the Douala Laquintinie Hospital from January, 2020, to July, 2021, on the diabetic and nondiabetic participants. The clinical symptoms and biochemical parameters of patient having UTIs were measured using standard methods. E. coli was isolated from urine and an antibiotic susceptibility test was performed using the Kirby-Bauer Agar diffusion method. A total of 851 participants were included with a mean age of 48.54 years. Three hundred and forty-six (40.67%) were nondiabetic, 226 (26.56%) were diabetic patients with balanced blood sugar levels (i.e., glycosylated haemoglobin (HbA1c) is normal), and 279 (32.78%) were diabetic patients with unbalanced blood sugar levels (i.e., patients having an abnormal HbA1c). The prevalence of UTI caused by E. coli was significantly (p < 0.001) higher in diabetics with unbalanced blood sugar levels (15.41%) and diabetics with balanced blood sugar levels (9.73%) compared to nondiabetics (0.87%). Significant (p < 0.001) high frequencies of polyuria (48.39%), proteinuria (29.75%), leukocyturia (27.96%), and polyphagia (8.24%) were observed in diabetic participants with unbalanced blood sugar levels. Significantly (p < 0.001) high average values of aspartate transaminase (25.34; 27.07; 29.93), alanine transaminase (26.08; 27.38; 28.20), creatininemia (8.15; 9.67; 11.31), total cholesterol (1.57; 1.83; 2.63), and atherogenic index (3.81; 6.56; 11.73) were noted in nondiabetics, balanced, and unbalanced blood glucose diabetics, respectively. E. coli showed a high level of resistance to ciprofloxacin (30%), amoxicillin (10.8%), and ofloxacin (9.3%) in diabetic participants with unbalanced blood sugar levels. The antibiotic resistance patterns of the E. coli to triple, quadruple, and quintuple antibiotics were higher when participants had diabetes and even more when diabetes was not controlled. The present findings underline an increased susceptibility of diabetic patients with unbalanced blood sugar levels to multidrug resistant E. coli. Further studies should be conducted to determine the causal association between uncontrolled diabetes and bacterial multidrug resistance.
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Muacevic A, Adler JR, Guia Lopes ML, Camacho C. Fournier's Gangrene Mimicking Acute Epididymo-Orchitis in an Undiagnosed Diabetic Patient. Cureus 2022; 14:e32588. [PMID: 36654634 PMCID: PMC9840810 DOI: 10.7759/cureus.32588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Fournier's gangrene (FG) is an infectious disease characterized by necrotizing fasciitis of the perineal, perianal, or genital area associated with aging, male gender, diabetes mellitus (DM), alcoholism, trauma, and immunosuppression states. It can rapidly evolve into sepsis, septic shock, and multiorgan failure with a high mortality rate. We present the case of a 55-year-old man who developed a severe FG, initially assumed as an epididymo-orchitis with new-onset DM. The early identification and treatment resulted in a favorable outcome, being discharged from the hospital after 21 days. Diabetic patients are more susceptible to having severe infections such as FG, hence the importance of adequate metabolic control and increased suspicion to prevent fatal complications.
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