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Bongomin F, Kibone W, Atulinda L, Morgan B, Ocansey B, Storer ISR, van Rhijn N, Muzoora C, Denning DW, Hamer DH. Frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa: a scoping review. Clin Microbiol Infect 2024; 30:592-600. [PMID: 38145865 DOI: 10.1016/j.cmi.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Fungal infections are common in HIV-infected individuals and significantly contribute to mortality. However, a substantial number of cases are undiagnosed before death. OBJECTIVE To determine the frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa. METHODS We conducted a scoping review of autopsy studies conducted in Africa. DATA SOURCES PubMed, Scopus, Web of Science, Embase, Google Scholar, and African Journal Online. STUDY ELIGIBILITY CRITERIA The review encompasses studies published from inception to September 2023, and no language restrictions were imposed during the search process. We included studies that reported histopathological or microbiological evidence for the diagnosis of fungal infections and other pathogens. DATA SYNTHESIS Data were summarized using descriptive statistics and no meta-analysis was performed. RESULTS We examined 30 articles reporting studies conducted between 1991 and 2019, encompassing a total of 13 066 HIV-infected decedents across ten African countries. In five studies, the autopsy type was not specified. Among those studies with specified autopsy types, 20 involved complete diagnostic autopsies, whereas 5 were categorized as partial or minimally invasive autopsies. There were 2333 pathogens identified, with 946 (40.5%) being mycobacteria, 856 (36.7%) fungal, 231 (3.8%) viral, 208 (8.9%) parasitic, and 92 (3.9%) bacterial. Of the 856 fungal pathogens identified, 654 (28.0%) were Cryptococcus species, 167 (7.2%) Pneumocystis jirovecii, 16 (0.69%) Histoplasma species, 15 (0.64%) Aspergillus species, and 4 (0.17%) Candida species. Other major non-fungal pathogens identified were cytomegalovirus 172 (7.37%) and Toxoplasma gondii 173 (7.42%). CONCLUSIONS Invasive fungal infections occur in over one-third of people who succumb to HIV in Africa. In addition to cryptococcosis and Pneumocystis jirovecii pneumonia, integrating other priority fungal pathogen detection and management strategies into the broader framework of HIV care in Africa is recommended. This involves increasing awareness regarding the impact of fungal infections in advanced HIV disease and strengthening diagnostic and treatment capacity.
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Affiliation(s)
- Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
| | - Winnie Kibone
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - Linda Atulinda
- Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - Bethan Morgan
- Trust Library Services, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Bright Ocansey
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Isabelle S R Storer
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Norman van Rhijn
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Conrad Muzoora
- Department of Internal Medicine, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - David W Denning
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; National Emerging Infectious Disease Laboratory, Boston, MA, USA; Center for Emerging Infectious Diseases Policy & Research, Boston University, Boston, MA, USA
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Benchetrit A, Messina F, Matteo M, Vázquez M, Paul R, Gil Zbinden G, Costa N, Santiso G. Microsporum canis pseudomycetoma and disseminated Mycobacterium genavense infection in an HIV/AIDS patient, an unusual combination. Rev Argent Microbiol 2024:S0325-7541(24)00037-3. [PMID: 38644065 DOI: 10.1016/j.ram.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/27/2023] [Accepted: 02/23/2024] [Indexed: 04/23/2024] Open
Abstract
Pseudomycetomas are rare fungal subcutaneous infections caused by dermatophytes, which are mainly observed in immunocompromised patients. Mycobacterium genavense is considered an opportunistic pathogen in people living with HIV/AIDS (PLWHA), clinically resembling the presentation of Mycobacterium avium complex (MAC). Here, we describe the case of a 26-year-old PLWHA with a 3-month history of a 4cm tumoral, duroelastic and painful lesion located on the back. Histopathology of the tumoral lesion revealed chronic granulomatous inflammation with grains composed of PAS-positive and Grocott-positive septate hyphae, as well as acid-fast bacilli (AFB). Culture on Sabouraud and lactrimel agar developed colonies that were later identified as Microsporum canis. In successive samples, the AFB were identified as M. genavense by restriction analysis of PCR products. Immunocompromised PLWHA not only suffer increased susceptibility to diseases due to unusual pathogens but also atypical clinical presentation of frequently encountered pathogens.
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Affiliation(s)
- Andrés Benchetrit
- Sala 21, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Messina
- Unidad Micología, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mario Matteo
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Vázquez
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Roxana Paul
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Carlos Malbrán, Buenos Aires, Argentina
| | - Germán Gil Zbinden
- Servicio de Anatomía Patológica, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nora Costa
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Santiso
- Unidad Micología, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
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Huff HV, Sportiello K, Bearden DR. Central Nervous System Complications of HIV in Children. Curr HIV/AIDS Rep 2024; 21:40-51. [PMID: 38252368 DOI: 10.1007/s11904-024-00689-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Affiliation(s)
- Hanalise V Huff
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Building 10, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Kristen Sportiello
- Department of Neurology, Division of Child Neurology, University of Rochester Medical Center, 160 Elmwood Ave, Rochester, NY, 14618, USA
| | - David R Bearden
- Department of Educational Psychology, University of Zambia, Independence Ave, Lusaka, Zambia.
- Department of Neurology, Division of Child Neurology, University of Rochester Medical Center, 160 Elmwood Ave, Rochester, NY, 14618, USA.
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Ossanai Schoenardie B, Oliveira Almeida R, Hanemann T, Ossanai Schoenardie A, Ribeiro AL, Catucci Boza J. Unmet needs in the management of psoriasis in Latin America: a systematic review. An Bras Dermatol 2024; 99:244-258. [PMID: 38061962 PMCID: PMC10943312 DOI: 10.1016/j.abd.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Psoriasis is a chronic, systemic inflammatory disease with a worldwide prevalence of approximately 2%. Currently, despite the difficulties faced every day by patients and physicians in low-resource countries, literature describing the exact needs of psoriasis treatment in Latin America remains scarce. OBJECTIVE To investigate the unmet needs in psoriasis treatment in Latin America. METHODS The authors conducted a systematic review following PRISMA statements in PubMed, Embase, and LILACS of studies published from January 2011 to March 2021 addressing challenges in psoriasis treatment in Latin America. RESULTS The search strategy identified 3,837 articles, of which 19 were included in the final analysis. Most were from Brazil (58%; n=11), all were observational, and most were cross-sectional (84%; n=16). Difficulties faced by psoriasis patients in Latin America included the high prevalence of opportunistic and endemic infections (42% of the studies addressed this matter; n=8), delay in diagnosis (5%; n=1), work productivity impairment (16%; n=3), limited access to medication/medical care (37%; n=7), poor adherence to treatment (5%; n=1) and poor adherence to guidelines (11%; n=2). STUDY LIMITATIONS Number and quality of studies currently available on this subject. CONCLUSIONS Current psoriasis guidelines do not always account for epidemiological, financial, and cultural characteristics. Most studies available are from Brazil, which might not accurately represent Latin America as a whole. In a region where neglected diseases and scarce resources remain a reality, it is imperative that dermatological training be offered to primary care providers, allowing for standardized conduct and earlier diagnosis.
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Affiliation(s)
| | | | - Thaísa Hanemann
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - André Lucas Ribeiro
- Department of Rheumatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Juliana Catucci Boza
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Aerts R, Ricaño-Ponce I, Bruno M, Mercier T, Rosati D, Maertens J, Kumar V, Carvalho A, Netea MG, Hoenigl M. Circulatory Inflammatory Proteins as Early Diagnostic Biomarkers for Invasive Aspergillosis in Patients with Hematologic Malignancies-an Exploratory Study. Mycopathologia 2024; 189:24. [PMID: 38407673 PMCID: PMC10896822 DOI: 10.1007/s11046-024-00831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/09/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Invasive aspergillosis (IA) is a major cause of mortality in immunocompromised patients and it is difficult to diagnose because of the lack of reliable highly sensitive diagnostics. We aimed to identify circulating immunological markers that could be useful for an early diagnosis of IA. METHODS We collected longitudinally serum samples from 33 cases with probable/proven IA and two matched control cohorts without IA (one with microbiological and clinical evidence of bacterial or viral non-fungal pneumonia and one without evidence of infection, all matched for neutropenia, primary underlying disease, and receipt of corticosteroids/other immunosuppressants) at a tertiary university hospital. In addition, samples from an independent cohort (n = 20 cases of proven/probable IA and 20 matched controls without infection) were obtained. A panel of 92 circulating proteins involved in inflammation was measured by proximity extension assay. A random forest model was used to predict the development of IA using biomarkers measured before diagnosis. RESULTS While no significant differences were observed between IA cases and infected controls, concentrations of 30 inflammatory biomarkers were different between cases and non-infected controls, of which nine were independently replicated: PD-L1, MMP-10, Interleukin(IL)-10, IL-15RA, IL-18, IL-18R1, CDCP1, CCL19 and IL-17C. From the differential abundance analysis of serum samples collected more than 10 days before diagnosis and at diagnosis, increased IL-17C concentrations in IA patients were replicated in the independent cohort. CONCLUSIONS An increased circulating concentration of IL-17C was detected both in the discovery and independent cohort, both at the time of diagnosis and in samples 10 days before the diagnosis of IA, suggesting it should be evaluated further as potential (early) biomarker of infection.
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Affiliation(s)
- Robina Aerts
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium.
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Isis Ricaño-Ponce
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mariolina Bruno
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Toine Mercier
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Diletta Rosati
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johan Maertens
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Vinod Kumar
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, 4806-909, Braga/Guimarães, Portugal
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
- Laboratory of Chemical Biology, Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Immunology and Metabolism, Life & Medical Sciences Institute, University of Bonn, Bonn, Germany
| | - Martin Hoenigl
- Biotech Med, Graz, Austria.
- Translational Medical Mycology Research Unit, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria.
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Tehrani S, Abbasian L, Dehghan Manshadi SA, Hasannezhad M, Ghaderkhani S, Keyvanfar A, Darvishi A, Aghdaee A. Vitamin D deficiency and oral candidiasis in patients with HIV infection: A case‒control study. BMC Infect Dis 2024; 24:217. [PMID: 38373939 PMCID: PMC10875808 DOI: 10.1186/s12879-024-09065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/27/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Oral candidiasis is a common opportunistic infection in patients with human immunodeficiency virus (HIV). In addition, most of these patients suffer from vitamin D deficiency. This study aimed to investigate the association between vitamin D levels and oral candidiasis in patients with HIV infection. METHODS This case‒control study was conducted on HIV-infected patients. Cases were patients with oral candidiasis diagnosed based on physical examinations. Controls were age- and sex-matched individuals without oral candidiasis. The levels of 25-OH vitamin D and other laboratory markers (CD4 count and viral load) were compared between the case and control groups. RESULTS A total of 104 cases and 102 controls were included in the study. The cases had significantly lower 25-OH vitamin D3 levels (MD = 33.86 ng/mL, 95% CI= (31.85, 35.87), P < 0.001) and CD4 counts (MD = 267.48 cells/mm3, 95% CI= (189.55, 345.41), P < 0.001) than the controls. In addition, viral load was significantly higher in cases than in controls (MD = 7.03 × 105 copies/mL, 95% CI= (4.46 × 105, 9.61 × 105), P < 0.001). The multivariate logistic regression analysis revealed that educational status (OR = 0.032, 95% CI= (0.002, 0.100), P < 0.001), current HAART (OR = 0.005, 95% CI= (0.001, 0.014), P < 0.001), history of oral candidiasis (OR = 20.114, 95% CI= (18.135, 21.957), P < 0.001), CD4 count (OR = 0.004, 95% CI= (0.001, 0.006), P < 0.001), viral load (OR = 12.181, 95% CI= (1.108, 133.392), P < 0.001), and vitamin D level (OR = 0.011, 95% CI= (0.008, 0.015), P < 0.001) were significantly associated with the risk of developing oral candidiasis. CONCLUSIONS Based on the findings, most patients with HIV infection suffer from vitamin D deficiency, especially those with oral candidiasis. Hypovitaminosis D was significantly associated with an increased risk of oral candidiasis. Thus, vitamin D supplementation may assist HIV-positive patients in improving their oral health and preventing oral candidiasis.
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Affiliation(s)
- Shabnam Tehrani
- Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ladan Abbasian
- Iranian Research Center for HIV/AIDS (IRCHA), Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Dehghan Manshadi
- Department of Infectious Disease and Tropical Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Malihe Hasannezhad
- Department of Infectious Disease and Tropical Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghaderkhani
- Department of Infectious Disease and Tropical Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Keyvanfar
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azar Darvishi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - AmirHossein Aghdaee
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Puplampu P, Asafu-Adjaye O, Harrison M, Tetteh J, Ganu VJ. Opportunistic Infections among newly diagnosed HIV patients in the largest tertiary facility in Ghana. Ann Glob Health 2024; 90:13. [PMID: 38370863 PMCID: PMC10870955 DOI: 10.5334/aogh.4149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Background Opportunistic infections (OIs) among newly diagnosed HIV patients are a marker for inadequateness of HIV awareness and testing. Despite global efforts at creating awareness for early detection, late HIV diagnosis and its associated OIs still exist. This study sought to determine the prevalence and patterns of OIs and associated factors among newly diagnosed HIV patients in Ghana. Methods A retrospective study using data extraction was conducted among 423 newly diagnosed HIV patients aged ≥18 years at the Korle-Bu Teaching Hospital from July 1st 2018 to December 2019. Multivariate logistic regression was adopted to assess factors associated to OIs. Analysis was performed using SPSS version 16, and p-value < 0.05 was deemed significant. Results The mean age of patients with a new HIV diagnosis was 40.15 ± 11.47 years. Male versus female sex differential was 30.3% and 69.7%, respectively. The prevalence of OIs among newly diagnosed HIV patients was 33.1% (95% CI = 34.6-44.1). About 70% (120/166) of patients with OIs were classified into WHO clinical stage III and IV. The most common OIs were candidiasis (oro-pharyhngeal-esophageal) (36.9%), and cerebral toxoplasmosis (19.9%). The odds of an OI at the time of HIV diagnosis among females was 51% lower than in males (aOR = 0.49, 95% CI = 0.28-0.86). Being employed increased the odds of OIs by 2.5 compared to the unemployed (aOR = 2.5; 95% CI = 1.11-5.61). Participants classified as World Health Organization (WHO) HIV clinical stage III and IV were 15.88 (95% CI = 9.41-26.79) times more likely to experience OIs. Conclusion One in three patients newly diagnosed with HIV presented with an opportunistic infection, with men more likely to experience such infections. Significant attention should be given to improving case-finding strategies, especially among men.
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Affiliation(s)
- Peter Puplampu
- Department of Medicine and Therapeutics University of Ghana Medical School, Accra, Ghana
| | | | - Marian Harrison
- Department of Internal Medicine, Ghana Police Hospital, Ghana
| | - John Tetteh
- Community Health Department, University of Ghana Medical School, Ghana
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Bhambhani D, Bhambhani G, Thomas S, Bhambhani S, Parlani S, Tandon R. Comparison Between Pre-COVID and Post-COVID Mucormycosis: A Systematic Review and Meta-analysis. J Maxillofac Oral Surg 2024; 23:135-144. [PMID: 38312959 PMCID: PMC10831006 DOI: 10.1007/s12663-023-02028-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/22/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Mucormycosis has emerged as one of the most fatal complications arising due to COVID-19, though it has to be mentioned that the disease is capable of causing serious illness even on its own. Objectives Through this investigation, we would review the threat that mucormycosis poses, in terms of its prevalence and degree of severity both in the pre- and post-COVID world. Materials and Methods A comprehensive examination of the studies published in online databases turned up 207 papers, 103 of which had undergone in-depth analysis, using both inclusion and exclusion criteria, shortlisting 15 studies that were appropriate for reviewing. Results The incidence of mucormycosis was linked to coronavirus in 7 of the 15 studies that were chosen. The remaining eight studies had sufferers of various systemic diseases, like HIV/AIDS and diabetes. Discussion All the cases suffered diabetes mellitus. Regardless of the time period of the chosen article, corticosteroids and antifungal medications were administered to all patients. There were noticeable differences in terms of mortality, predisposing factors, and virulence between pre-COVID and post-COVID mucormycosis. Summary and Conclusion The prevalence of systemic conditions such as diabetes in cases of mucormycosis has remained the same even after the incidence of this pandemic, showing that the basic treatment modalities continue to remain the same irrespective of the damage that corona virus has caused to the sufferer, although mucormycosis arising due to COVID-19 differs from mucormycosis that was incident before the advent of the pandemic.
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Affiliation(s)
| | - Garima Bhambhani
- Department of Public Health Dentistry, People’s College of Dental Sciences and Research Centre, Bhopal, 462037 India
| | - Shaji Thomas
- Department of Oral and Maxillofacial Surgery, People’s College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh 462037 India
| | - Suresh Bhambhani
- Department of General Medicine, Chirayu Medical College, Bhopal, Madhya Pradesh 462037 India
| | - Swapnil Parlani
- Department of Prosthodontics, Crown and Bridge, Bhopal, Madhya Pradesh 462037 India
| | - Riddhi Tandon
- Mahavir Institute of Medical Sciences and Research, Bhopal, India
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Money NP. Fungal thermotolerance revisited and why climate change is unlikely to be supercharging pathogenic fungi (yet). Fungal Biol 2024; 128:1638-1641. [PMID: 38341269 DOI: 10.1016/j.funbio.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
Thermotolerance has been viewed as an uncommon characteristic among the fungi and one of the reasons that less than 1% of the described species operate as opportunistic pathogens of humans. Growth at 37°C is certainly a requirement for a fungus that invades the body core, but tens of thousands of nonpathogenic species are also able to grow at this temperature. Ergo, body temperature does not serve as a thermal barrier to the development of infections by many harmless fungi. The absence of other virulence factors must be more demanding. This observation raises questions about the hypothetical links between climate change and the increasing number of life-threatening human mycoses. Given the widespread distribution of fungal thermotolerance and the 1°C (2°F) increase in global temperature over the last 140 years it seems unlikely that the warming climate has driven the evolution of more virulent strains of fungi. More compelling explanations for the changes in the behavior of fungi as disease agents include their adaptation to the widening use of azole antifungals in hospitals and the wholesale application of millions of tons of the same class of heterocyclic chemicals in agriculture. On the other hand, climate change is having a significant effect on the spread of human mycoses by extending the geographical range of pathogenic fungi. A related increase in fungal asthma caused by spore inhalation is another likely consequence of planetary change.
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Affiliation(s)
- Nicholas P Money
- Western Program and Department of Biology, Miami University, Oxford, OH, 45056, USA.
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Zhou R, Wu R, Wang L, Yang H. Increasing ratio of opportunistic infections associated with sunshine exposure and economic level burdening Chinese inflammatory bowel disease hospitalized patients: the first nationwide survey from 2014 to 2019. BMC Public Health 2024; 24:133. [PMID: 38195452 PMCID: PMC10777555 DOI: 10.1186/s12889-024-17635-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The rising prevalence of opportunistic infections (OIs) in inflammatory bowel disease (IBD) in conjunction with the use of biologics/immunosuppressive agents has garnered attention. However, there is a dearth of research on OIs in Mainland China. This study seeks to evaluate the national ratio trend of OIs in IBD and elucidate the influence of economic and climate factors on IBD patients with OIs and their outcomes. METHODS The nationwide data was obtained from the Inpatient medical record home page via the Health Statistics and Information Reporting System (HSRS). Patients diagnosed with IBD were enlisted for participation, and their demographic and clinical information, encompassing infection type, surgical procedures, and expenses, were gathered. The National Bureau of Statistics provided data on monthly sunshine exposure hours and yearly Gross Domestic Product (GDP). RESULTS Findings indicate that between 2014 and 2019, a total of 381,752 patients with IBD were admitted to hospitals, with 364,249 patients lacking OIs and 17,503 patients presenting with OIs. The annual proportion of OIs exhibited an upward trend, rising from 3.54% in 2014 to 4.81% in 2019. There was a significant correlation observed between individuals who identified as male, those who visited hospitals in southern regions, or those originating from areas with lower GDP or shorter sunshine exposure hours, and a higher incidence of OIs. Among patients diagnosed with either Crohn's disease (CD) or ulcerative colitis (UC), Clostridium difficile was found to be the most prevalent infection, followed by Epstein-Barr virus and cytomegalovirus. Furthermore, the occurrence of OIs was found to be associated with an increased rate of surgical interventions in UC patients. CONCLUSIONS The rising prevalence of OIs among hospitalized patients with IBD necessitates heightened attention towards mitigating associated risk factors, particularly among IBD patients residing in less developed regions or experiencing limited exposure to sunlight. This approach aims to minimize hospital stays and associated costs.
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Affiliation(s)
- Runing Zhou
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Ruixian Wu
- Center for Health Statistics and Information, National Health Commission, Beijing, 100044, China
| | - Li Wang
- Department of Epidemiology and Biostatistics, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, 100005, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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11
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Riceman MD, Sun C, Pierides J, Catford J, Nelson R, Ashokan A. Back pain in an Australian farmer: an unusual case of cryptococcal osteomyelitis. Med J Aust 2023; 219:523-525. [PMID: 37963416 DOI: 10.5694/mja2.52165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/15/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Michael D Riceman
- Queen Elizabeth Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
| | - Caitlyn Sun
- Queen Elizabeth Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
| | | | - Jennifer Catford
- Queen Elizabeth Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
| | - Renjy Nelson
- Queen Elizabeth Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
| | - Anushia Ashokan
- Queen Elizabeth Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
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12
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Baucher L, Lemiale V, Joseph A, Wallet F, Pineton de Chambrun M, Ferré A, Lombardi R, Platon L, Contejean A, Fuseau C, Calvet L, Pène F, Kouatchet A, Mokart D, Azoulay E, Lafarge A. Severe infections requiring intensive care unit admission in patients receiving ibrutinib for hematological malignancies: a groupe de recherche respiratoire en réanimation onco-hématologique (GRRR-OH) study. Ann Intensive Care 2023; 13:123. [PMID: 38055081 DOI: 10.1186/s13613-023-01219-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND In the last decade, Ibrutinib has become the standard of care in the treatment of several lymphoproliferative diseases such as chronic lymphocytic leukemia (CLL) and several non-Hodgkin lymphoma. Beyond Bruton tyrosine kinase inhibition, Ibrutinib shows broad immunomodulatory effects that may promote the occurrence of infectious complications, including opportunistic infections. The infectious burden has been shown to vary by disease status, neutropenia, and prior therapy but data focusing on severe infections requiring intensive care unit (ICU) admission remain scarce. We sought to investigate features and outcomes of severe infections in a multicenter cohort of 69 patients receiving ibrutinib admitted to 10 French intensive care units (ICU) from 1 January 2015 to 31 December 2020. RESULTS Median time from ibrutinib initiation was 6.6 [3-18] months. Invasive fungal infections (IFI) accounted for 19% (n = 13/69) of severe infections, including 9 (69%; n = 9/13) invasive aspergillosis, 3 (23%; n = 3/13) Pneumocystis pneumonia, and 1 (8%; n = 1/13) cryptococcosis. Most common organ injury was acute respiratory failure (ARF) (71%; n = 49/69) and 41% (n = 28/69) of patients required mechanical ventilation. Twenty (29%; n = 20/69) patients died in the ICU while day-90 mortality reached 55% (n = 35/64). In comparison with survivors, decedents displayed more severe organ dysfunctions (SOFA 7 [5-11] vs. 4 [3-7], p = 0.004) and were more likely to undergo mechanical ventilation (68% vs. 31%, p = 0.010). Sixty-three ibrutinib-treated patients were matched based on age and underlying malignancy with 63 controls receiving conventional chemotherapy from an historic cohort. Despite a higher median number of prior chemotherapy lines (2 [1-2] vs. 0 [0-2]; p < 0.001) and higher rates of fungal [21% vs. 8%, p = 0.001] and viral [17% vs. 5%, p = 0.027] infections in patients receiving ibrutinib, ICU (27% vs. 38%, p = 0.254) and day-90 mortality (52% vs. 48%, p = 0.785) were similar between the two groups. CONCLUSION In ibrutinib-treated patients, severe infections requiring ICU admission were associated with a dismal prognosis, mostly impacted by initial organ failures. Opportunistic agents should be systematically screened by ICU clinicians in this immunocompromised population.
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Affiliation(s)
- Louise Baucher
- Médecine Intensive Réanimation, Hôpital Saint Louis, AP-HP, Université Paris Cité, Paris, France.
- Sorbonne Université, Paris, France.
| | - Virginie Lemiale
- Médecine Intensive Réanimation, Hôpital Saint Louis, AP-HP, Université Paris Cité, Paris, France
| | - Adrien Joseph
- Médecine Intensive Réanimation, Hôpital Saint Louis, AP-HP, Université Paris Cité, Paris, France
| | - Florent Wallet
- Médecine Intensive Réanimation, Hospices Civils de Lyon, Lyon, France
| | - Marc Pineton de Chambrun
- Service de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital de La Pitié-Salpêtrière, Paris, France
- Sorbonne Université, INSERM, UMRS_1166-ICAN, Institut de Cardiométabolisme Et Nutrition (ICAN), 75013, Paris, France
| | - Alexis Ferré
- Réanimation Médico-Chirurgicale, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Romain Lombardi
- Médecine Intensive Réanimation, Hôpital Pasteur, Nice, France
| | - Laura Platon
- Médecine Intensive Réanimation, Hôpital Lapeyronie, Montpellier, France
| | | | - Charline Fuseau
- Hématologie, Institut de Cancérologie (ICANS), Strasbourg, France
| | - Laure Calvet
- Médecine Intensive Réanimation, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Frédéric Pène
- Médecine Intensive Réanimation, Hôpital Cochin, Paris, France
| | | | - Djamel Mokart
- Anesthésie Réanimation, Institut Paoli Calmettes, Marseille, France
| | - Elie Azoulay
- Médecine Intensive Réanimation, Hôpital Saint Louis, AP-HP, Université Paris Cité, Paris, France
| | - Antoine Lafarge
- Médecine Intensive Réanimation, Hôpital Saint Louis, AP-HP, Université Paris Cité, Paris, France
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13
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Bekolo C, Ndeso S, Gougue C, Moifo L, Mangala N, Tchendjou P, Mboh E, Ateudjieu J, Tendongfor N, Nsagha D, Halle-Ekane G, Choukem S. The effect of the Universal Test and Treat policy uptake on CD4 count testing and incidence of opportunistic infections among people living with HIV infection in Cameroon: a retrospective analysis of routine data. Dialogues Health 2023; 2:100120. [PMID: 38515498 PMCID: PMC10954022 DOI: 10.1016/j.dialog.2023.100120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/05/2023] [Accepted: 02/23/2023] [Indexed: 03/23/2024]
Abstract
Background Cameroon adopted and started implementing in 2016, the 'universal test and treat' (UTT) guidelines to fast-track progress towards the 95-95-95 ambitious targets to end the HIV epidemic. UTT has shown inconsistent results elsewhere and has not yet been assessed in Cameroon. We aimed to evaluate the effectiveness of this novel approach on the quality of care and health outcomes of people living with HIV (PLHIV). Methods A retrospective cohort design was conducted at The Nkongsamba Regional Hospital, using routine clinical service delivery data to measure uptake levels of UTT and CD4 testing, and to compare the incidence of opportunistic infections (OI) between PLHIV initiated on ART based on the "Universal Test and Treat" strategy and those initiated on ART based on the standard deferred approach between 2002 and 2020. Kaplan Meier plots and log-rank tests were used to compare OI events between the pre-UTT and post-UTT eras. The Cox regression model was used to screen for factors independently associated with the risk of acquisition of OI. Results The uptake of UTT ranged from 39.1% to 92.8% while baseline CD4 count testing reduced drastically from 89.4% to 0.4% between 2016 to 2020 respectively. The median delay in ART initiation declined significantly from 21 days (IQR: 9 - 113) in the pre-UTT era to the same day of diagnosis (IQR: 0 - 2) in the UTT era (p < 0.001). The incidence of all OI events reported was over five times higher during the UTT era than in the pre-UTT era [aHR = 5.55 (95% CI: 3.18 - 9.69), p < 0.001]. Conclusion The UTT policy has been effectively rolled out and has contributed to improved access to rapid and immediate ART initiation, but a higher incidence of OIs was observed with a rollback of baseline CD4 testing. We advocate for a return to routine baseline CD4 measurement to identify PLHIV who should benefit from interventions to prevent OIs for optimal outcomes under the UTT approach.
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Affiliation(s)
- C.E. Bekolo
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - S.A. Ndeso
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - C.P. Gougue
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - L.L. Moifo
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - N. Mangala
- Department of Gynaecology and Obstetrics, University of Douala, Douala, Cameroon
| | - P. Tchendjou
- Elizabeth Glaser Pediatric AIDS Foundation, EGPAF Yaounde, Yaounde, Cameroon
| | - E. Mboh
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - J. Ateudjieu
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - N. Tendongfor
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - D.S. Nsagha
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - G.E. Halle-Ekane
- Department of Obstetrics and Gynaecology, University of Buea, Buea, Cameroon
| | - S.P. Choukem
- Department of Internal Medicine and Specialities, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
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Ramonfaur D, Salto-Quintana JN, Aguirre-García GM, Hernández-Mata NM, Villanueva-Lozano H, Torre-Amione G, Martínez-Reséndez MF. Cumulative steroid dose in hospitalized patients and COVID-19-associated pulmonary aspergillosis. J Hosp Infect 2023; 142:26-31. [PMID: 37499762 DOI: 10.1016/j.jhin.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Severe COVID-19 elicits a hyperimmune response frequently amenable to steroids, which in turn increase the risk for opportunistic infections. COVID-19 associated pulmonary aspergillosis (CAPA) is a complication known to be associated with immunomodulatory treatment. The role of cumulative steroid dose in the development of CAPA is unclear. This study evaluates the relationship between cumulative steroid dose in hospitalized individuals with COVID-19 pneumonia and the risk for CAPA. METHODS This retrospective cohort study includes 135 hospitalized patients with PCR-confirmed COVID-19 pneumonia at a tertiary centre in north Mexico. Patients who developed CAPA were matched by age and gender to two controls with COVID-19 pneumonia who did not develop CAPA defined and classified as possible, probable, or proven according to 2020 ECMM/ISHAM criteria. Cumulative steroid dose in dexamethasone equivalents was obtained from admission until death, discharge, or diagnosis of CAPA (whichever occurred first). The risk of CAPA by the continuous cumulative steroid dose was assessed using a logistic regression model. RESULTS Forty-five patients were diagnosed with CAPA and matched to 90 controls. Mean age was 61 ± 14 years, and 72% were male. Mean cumulative steroid dose was 66 ± 75 mg in patients without CAPA vs 195 ± 226 mg in patients with CAPA (P<0.001). The risk for CAPA increased with higher cumulative dose of steroids (OR 1.0075, 95% CI: 1.0033-1.0116). CONCLUSIONS Patients who developed CAPA had a history of higher cumulative steroid dose during hospitalization. The risk for CAPA increases ∼8% for every 10 mg of dexamethasone used.
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Affiliation(s)
- D Ramonfaur
- Division of Postgraduate Medical Education, Harvard Medical School, Boston, MA, USA
| | - J N Salto-Quintana
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - G M Aguirre-García
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - N M Hernández-Mata
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - H Villanueva-Lozano
- Department of Infectious Diseases, ISSSTE Regional Monterrey, Monterrey, Nuevo Leon, Mexico
| | - G Torre-Amione
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico; The Methodist Hospital, Cornell University, Houston, TX, USA
| | - M F Martínez-Reséndez
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico; Epidemiological Surveillance Unit, Hospital San Jose-Tec Salud, Monterrey, Nuevo Leon, Mexico.
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15
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Gadama Y, Du Preez M, Carr J, Theron S, Albertyn C, Ssebambulidde K, Saylor D, Brey N, Henning F. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and Human Immunodeficiency virus infection: dilemmas in diagnosis and management: a case series. J Med Case Rep 2023; 17:457. [PMID: 37845760 PMCID: PMC10580653 DOI: 10.1186/s13256-023-04191-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently described autoimmune inflammatory disorder of the central nervous system (CNS). There is limited data on the association between Human Immunodeficiency virus (HIV) infection and MOGAD. We report three patients with HIV infection and myelin oligodendrocyte glycoprotein (MOG) antibodies in the setting of other central nervous system infections. CASE DESCRIPTIONS The first patient, a 44-year-old black African man, presented with acute disseminated encephalomyelitis (ADEM) with positive serum MOG antibodies. He made a significant recovery with corticosteroids but had a quick relapse and died from sepsis. The second patient, an 18-year-old black woman, presented with paraplegia and imaging revealed a longitudinally extensive transverse myelitis and had positive serum MOG antibodies. She remained paraplegic after methylprednisone and plasmapheresis treatments. Her rehabilitation was complicated by development of pulmonary embolism and tuberculosis. The third patient, a 43-year-old mixed-race woman, presented with bilateral painless visual loss. Her investigations were notable for positive MOG antibodies, positive Varicella Zoster Virus on cerebral spinal fluid (CSF) and hyperintense optic nerves on magnetic resonance imaging (MRI). Her vision did not improve with immunosuppression and eventually died from sepsis. CONCLUSION Our cases illustrate the diagnostic and management challenges of MOGAD in the setting of advanced HIV infection, where the risk of CNS opportunistic infections is high even without the use of immunosuppression. The atypical clinical progression and the dilemmas in the diagnosis and treatment of these cases highlight gaps in the current knowledge of MOGAD among people with HIV that need further exploration.
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Affiliation(s)
- Yohane Gadama
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Kamuzu University of Health Sciences, Blantyre, Malawi.
| | - Marié Du Preez
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jonathan Carr
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sarel Theron
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Christine Albertyn
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kenneth Ssebambulidde
- Research Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Naeem Brey
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Franclo Henning
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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Bharati J, Anandh U, Kotton CN, Mueller T, Shingada AK, Ramachandran R. Diagnosis, Prevention, and Treatment of Infections in Kidney Transplantation. Semin Nephrol 2023; 43:151486. [PMID: 38378396 DOI: 10.1016/j.semnephrol.2023.151486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Kidney transplant often is complicated by infections in the recipient from therapy-related and patient-related risk factors. Infections in kidney transplant recipients are associated with increased morbidity, mortality, and allograft dysfunction. There is a predictable timeline after kidney transplant regarding the types of pathogens causing infections, reflecting the net state of immunosuppression. In the early post-transplant period, bacterial infections comprise two thirds of all infections, followed by viral and fungal infections. Infections occurring early after kidney transplantation are generally the result of postoperative complications. In most cases, opportunistic infections occur within 6 months after kidney transplantation. They may be caused by a new infection, a donor-derived infection, or reactivation of a latent infection. Community-acquired pneumonia, upper respiratory tract infections, urinary tract infections, and gastrointestinal infections are the most common infections in the late period after transplantation when the net immunosuppression is minimal. It is crucial to seek information on the time after transplant, reflecting the net state of immunosuppression, previous history of exposure/infections, geography, and seasonal outbreaks. It is imperative that we develop regionally specific guidelines on screening, prevention, and management of infections after kidney transplantation.
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Affiliation(s)
- Joyita Bharati
- Section of Nephrology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
| | - Urmila Anandh
- Department of Nephrology, Amrita Hospitals, Faridabad, Delhi National Capital Region, India
| | - Camille N Kotton
- Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Thomas Mueller
- Renal Transplant Program, University Hospital of Zurich, Zurich, Switzerland
| | | | - Raja Ramachandran
- Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Ikinyom N, Lamwaka AV, Malagala AT, Ndyomugyenyi EK. Ethnobotanical study of nutraceutical plants used to manage opportunistic infections associated with HIV/AIDS in Acholi sub-region, Northern Uganda. Trop Med Health 2023; 51:50. [PMID: 37658427 PMCID: PMC10472741 DOI: 10.1186/s41182-023-00540-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/19/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Nutraceutical plants play a potential role as supportive treatment with antiretroviral drugs in the management of opportunistic infections associated with HIV/AIDS. There is limited documentation of nutraceutical plants in Northern Uganda and limited literature addressing processes to be adopted for quality assurance of herbal formulations in Uganda. This study aimed to document plant species with nutritional and medicinal properties used for managing opportunistic infections associated with HIV/AIDS by traditional medicine practitioners (TMPs), who included professional herbalists, herbal farmers and herbal sellers in Acholi sub region, Northern Uganda. METHODS An ethnobotanical study was carried out in Amuru, Gulu and Pader districts, Northern Uganda. Cross-sectional data were collected using purposive and snowball sampling techniques. A total of four hundred (378 women and 22 men) informants were selected. Data were collected using semistructured interviews, focus group discussions and direct observation. Data were analysed using descriptive statistics, familiarity index (FI), fidelity level (FL) and informant consensus factor (ICF). RESULTS This study recorded a total of 84 nutraceutical plant species, which are used to manage opportunistic infections associated with HIV/AIDS. Most abundant families were Leguminoceae, Asteraceae and Solanaceae. Six nutraceutical plants that had higher fidelity level and familiarity index values included Momordica foetida Schumach, Erigeron floribundus (Kunth) Sch. Bip, Mangifera indica L, Cajanus cajan L. Millsp, Eucalyptus globulus Labill and Cucurbita pepo L. Respondents' knowledge on nutraceutical plants had a positive significant correlation with age (R2 = 0.0524, p ≤ 0.01). The popular mode of preparation are decoctions/boiling in water (70%), while the most used route of administration is oral (76%). TMPs tried to ensure that during collection and processing, plant materials were free from contamination. TMPs reported limited knowledge on preservation techniques. CONCLUSIONS This study demonstrates the availability and diversity of nutraceutical plants in Uganda and reports methods of processing and administration used by TMPs. Both men and women used nutraceutical plants to manage opportunistic infections associated with HIV/AIDS and showed great extent of their traditional knowledge. Most of the nutraceutical plants in study area are wild and abundant; however, high percentage use of plant roots and bark threatens the sustainable use from the wild.
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Affiliation(s)
- Norah Ikinyom
- Department of Environment, Faculty of Agriculture and Environment, Gulu University, P.O. Box 166, Gulu, Uganda.
| | - Alice Veronica Lamwaka
- Department of Pharmacology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | | | - Elly Kurobuza Ndyomugyenyi
- Department of Animal Production and Range Management, Faculty of Agriculture and Environment, Gulu University, P.O.Box 166, Gulu, Uganda
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18
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Schwartz T, Hoornstra D, Øie E, Hovius J, Quarsten H. Case report: First case of Borrelia miyamotoi meningitis in an immunocompromised patient in Norway. IDCases 2023; 33:e01867. [PMID: 37577049 PMCID: PMC10412827 DOI: 10.1016/j.idcr.2023.e01867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/30/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023] Open
Abstract
Background Tick-borne disease caused by B. miyamotoi (BMD) usually manifest as a febrile illness in humans. Complications include relapsing fever and in rare occasions involvement of the central nervous system. Only a few cases of meningoencephalitis have been described, mostly in immunosuppressed patients. Case presentation A 70-year-old female receiving immunosuppressive rituximab therapy presented with frontal headache, dizziness, nausea, vomiting and chills. Clinical laboratory blood analyses were normal. Cerebrospinal fluid (CSF) was translucent and analysis showed increased leucocyte count (187 106/L) and elevated level of protein (1056 mg/L). Empiric antibiotic treatment was initiated. The patient showed an early symptomatic relief and 24 h after admission she was discharged from the hospital and antibiotic treatment was discontinued. Two weeks after hospitalisation the B. miyamotoi specific PCR turned out positive in both CSF and serum. At the time, the patient was recovered with mild residual headache. She was treated with high dose doxycycline and her subtle symptoms disappeared. Conclusions To our knowledge, we present the first patient with BMD-associated meningitis in Norway, one of eight cases reported worldwide. The patient had mild symptoms and received an early diagnosis. A more severe progression or relapse of disease may have been prevented by antibiotic treatment. BMD should be considered as causes of aseptic meningitis, especially in immunosuppressed patients living in endemic areas.
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Affiliation(s)
- Thomas Schwartz
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
- Oslo New University College, Oslo, Norway
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Erik Øie
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Joppe Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Hanne Quarsten
- Department of Medical Microbiology, Sørlandet Hospital, Kristiansand, Norway
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Nacher M, Rabier S, Lucarelli A, Hureau L, Adenis A, Hafsi N, Sabbah N. Diabetes in a hospital cohort of persons living with HIV: a descriptive and comparative study in French Guiana. BMC Infect Dis 2023; 23:470. [PMID: 37442942 DOI: 10.1186/s12879-023-08455-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/10/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In French Guiana (population 294,000) the prevalence of type 2 diabetes (10%) and of HIV(1.1%) are very high. Our objective was to determine the prevalence of diabetes and its complications in a HIV cohort. MATERIALS AND METHODS We enrolled HIV-infected persons followed in Cayenne, Kourou, and Saint Laurent du Maroni hospitals between January 1, 1992 and December 31, 2021 in the French Hospital Database for HIV (FHDH) a national database compiling data from all French regions. RESULTS There was no difference of diabetes prevalence between men (8.2%) and women (8.8%), P = 0.4. Patients with diabetes were older (56 years ± 13.4) than those without diabetes (44.7 years ± 13.6) and prevalence increased with age. The proportion of persons with diabetes was greater among virologically suppressed persons (10%) than those with a detectable viral load under antiretroviral treatment (5.8%). Persons with diabetes had substantially greater CD4 counts at diagnosis than persons without diabetes. The majority of macro and microvascular complications were observed in people with diabetes. Persons with diabetes and HIV were significantly less likely to have had AIDS (1.6 versus 2.2 per 100 person-years, respectively). Overall, 374 persons living with HIV of 4167 had died (9%) the proportion of persons with diabetes among the dead was greater than those who did not die 11.7% versus 8.1%, respectively, p = 0.017. However, persons with diabetes were older and hence died older, 62.3 years (SD = 1.9) for deceased persons with diabetes versus 50.4 years (SD = 0.8), P < 0.0001. However, using Cox regression to adjust for age, initial CD4 count, country of birth there was no significant difference in the Hazard for death between persons with diabetes and persons without diabetes (aHR = 0.99, 95%CI = 0.65-1.5), P = 0.9. CONCLUSIONS The prevalence of diabetes in our HIV cohort was high. Persons with diabetes had greater CD4 counts, earlier care, and greater virological suppression than persons without diabetes. There were no significant differences between persons with diabetes and without diabetes in terms of survival.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana.
- DFR Santé, Université de Guyane, Cayenne, 97300, French Guiana.
- COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana.
| | - Sebastien Rabier
- COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
| | - Aude Lucarelli
- COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
| | - Louise Hureau
- COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
- DFR Santé, Université de Guyane, Cayenne, 97300, French Guiana
- COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
| | - Nezha Hafsi
- Service d'endocrinologie diabétologie, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
| | - Nadia Sabbah
- Service d'endocrinologie diabétologie, Centre Hospitalier de Cayenne, Cayenne, 97300, French Guiana
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Priya MRK, Balasubramanian M, Nirmal CR, Dusthakeer A, Iyer PR. Determination of anti-tuberculosis activity of biosynthesized gold nanocompounds against M. tuberculosis H37RV. Indian J Tuberc 2023; 70:329-338. [PMID: 37562909 DOI: 10.1016/j.ijtb.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/14/2022] [Indexed: 08/12/2023]
Abstract
BACKGROUND The biosynthesis of gold nanoparticles using medicinal plants as reducing and stabilizing agent for synthesis is an emerging area of research due to their cost effectiveness and further diversified applications in various fields. People with HIV are prone to these opportunistic infections like TB due to the immunocompromised condition. In the present study, the nanoparticles and nanoconjugates were screened for effective anti-mycobacterial efficiency against opportunistic infections. METHODS Incidentally, the nanoparticles were biosynthesized using single plant extract. The biosynthesized nanoparticles were initially screened for effective anti-tuberculosis activity against Mycobacterium tuberculosis. Based on the effective antimicrobial activity, a nanoconjugate was biosynthesized combining three plant extracts for a cumulative activity. RESULTS The biosynthesized gold nanoparticles and nanoconjugates showed MIC demonstrating for 99% inhibition and MIC99 was found to be 6.42 μg/ml. Among all the 15 nanoparticles tested, seven NPs showed exceptional anti-TB activities NP1, NP2, NP6, NP7, NP10, NP12 and NP15 and the other nanoparticles exhibited varying degrees of inhibition - anti-TB activities. In the 12 nanoconjugate tested, seven nanoconjugate demonstrated exceptional anti-TB activities such as NCC1, NCC2, NCC5, NCC6, NCV1, NCV6 and NCV4. CONCLUSION The objective of the study was to identify the nanoparticles and nanoconjugates which demonstrated potential activity against M. tuberculosis so that a single nanoparticle or nanoconjugate can be targeted to treat patients with TB. Minimum Inhibitory Concentration (MIC) of the biosynthesized gold nanoparticles and nanoconjugates were determined against M. tuberculosis H37Rv.
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Affiliation(s)
- M R Kamala Priya
- Post Graduate and Research Department of Biotechnology, Women's Christian College, College Road, Chennai, 600006, Tamil Nadu, India
| | - Magizhaveni Balasubramanian
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chennai, 600031, Tamil Nadu, India
| | - Christy Rosaline Nirmal
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chennai, 600031, Tamil Nadu, India
| | - Azger Dusthakeer
- Department of Bacteriology, National Institute for Research in Tuberculosis, Chennai, 600031, Tamil Nadu, India
| | - Priya R Iyer
- Post Graduate and Research Department of Biotechnology, Women's Christian College, College Road, Chennai, 600006, Tamil Nadu, India.
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Gobbi MF, Ferreira MH, de Carvalho DLC, Silva GBL, Macari KSM, Neves LDJ, Santos PSDS, Junior LAVS, Melo WR, Antunes HS, De Macedo LD, Eduardo FDP, Bezinelli LM. Dental consensus on HSCT - Part II: dental Care during HSCT. Hematol Transfus Cell Ther 2023; 45:368-378. [PMID: 37321878 PMCID: PMC10499574 DOI: 10.1016/j.htct.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 06/17/2023] Open
Abstract
During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require professional oral care to act in the diagnosis and treatment of these conditions, as well as to develop prevention protocols to minimize patient's complications. Oral mucositis, opportunistic infections, bleeding, specific microbiota, taste, and salivary alterations are complications that can occur during HSCT and interfere with various aspects, such as pain control, oral intake, nutrition, bacteremia and sepsis, days of hospitalization and morbidity. Several guidelines have been published to address the role of professional oral care during the HSCT, we describe a consensus regarding these recommendations.
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Affiliation(s)
| | | | | | - Geisa Badauy Lauria Silva
- Serviço de Odontologia do Hospital Aráujo Jorge/Associação de Combate ao Câncer em Goiás, Goiânia, Goiás, Brazil
| | - Karina Silva Moreira Macari
- Departamento de Odontologia, Hospital de Câncer Infantojuvenil de Barretos do Hospital de Amor, Barretos, SP, Brazil
| | - Lilian de Jesus Neves
- Departamento de Odontologia, Hospital de Câncer Infantojuvenil de Barretos do Hospital de Amor, Barretos, SP, Brazil
| | - Paulo Sérgio da Silva Santos
- Departamento de Cirurgia, Estomatologia, Patologia e Radiologia da Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, Brazil
| | | | | | | | - Leandro Dorigan De Macedo
- Serviço de Odontologia e Estomatologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Brazil; Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Brazil
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Olivera PA, Lasa JS, Zubiaurre I, Jairath V, Abreu MT, Rubin DT, Reinisch W, Magro F, Rahier JF, Danese S, Rabaud C, Peyrin-Biroulet L. Opportunistic Infections in Patients with Inflammatory Bowel Disease Treated with Advanced Therapies: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Crohns Colitis 2023; 17:199-210. [PMID: 36087107 DOI: 10.1093/ecco-jcc/jjac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Advanced therapies for inflammatory bowel disease [IBD] could potentially lead to a state of immunosuppression with an increased risk of opportunistic infections [OIs]. We aimed to provide an update on the incidence of OIs among adult IBD patients in randomized controlled trials [RCTs] of approved biologics and small-molecule drugs [SMDs]. Also, we aimed to describe OI definitions utilized in RCTs, to ultimately propose a standardized definition. METHODS Electronic databases were searched from January 1, 1990, until April 16, 2022. Our primary outcome was incidence rate of overall OIs among IBD patients exposed and unexposed to biologics or SMDs. We also describe specific OIs reported in included trials, as well as definitions of OIs within studies when provided. RESULTS Ninety studies were included. The incidence rates of reported OIs were 0.42 and 0.21 per 100 person-years in patients exposed to advanced therapies and placebo, respectively. This was highest for anti-tumour necrosis factors [0.83 per 100 person-years] and Janus kinase inhibitors [0.55 per 100 person-years] and lowest for anti-integrins and ozanimod. On meta-analysis, no increased risk of OIs was observed. None of the studies provided a detailed definition of OIs, or a comprehensive list of infections considered as OIs. CONCLUSION Different mechanisms of action may have specific OI profiles. In the absence of a uniform definition of OIs, these estimates are less reliable. We propose a definition to be used in future studies to help provide standardized reporting. When using this definition, we saw significant differences in incidence rates of OIs across mechanisms of action.
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Affiliation(s)
- Pablo A Olivera
- IBD Unit, Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina
- Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Juan S Lasa
- IBD Unit, Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina
- Gastroenterology Department, Hospital Británico de Buenos Aires, Argentina
| | - Ignacio Zubiaurre
- Gastroenterology Department, Hospital Británico de Buenos Aires, Argentina
| | - Vipul Jairath
- Division of Gastroenterology, Department of Medicine, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Alimentiv Inc., London, ON, Canada
| | - Maria T Abreu
- Department of Medicine, Division of Gastroenterology, Crohn's and Colitis Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David T Rubin
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA
| | - Walter Reinisch
- Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Fernando Magro
- Department of Pharmacology & Therapeutics; CINTESIS, Faculty of Medicine University of Porto, and Department of Gastroenterology, Hospital de São João, Porto, Portugal
| | - Jean-François Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy
| | - Christian Rabaud
- Department of Infectious Disease, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Laurent Peyrin-Biroulet
- INSERM NGERE and Department of Hepatogastroenterology, Nancy University Hospital, Lorraine University, Vandoeuvre-lés-Nancy, France
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Özbek L, Topçu U, Manay M, Esen BH, Bektas SN, Aydın S, Özdemir B, Khostelidi SN, Klimko N, Cornely O, Zakhour J, Kanj SS, Seidel D, Hoenigl M, Ergönül Ö. COVID-19-associated mucormycosis: A systematic review and meta-analysis of 958 cases. Clin Microbiol Infect 2023:S1198-743X(23)00122-2. [PMID: 36921716 DOI: 10.1016/j.cmi.2023.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND Mucormycosis, a rare fungal infection, has shown an increase in the number of reported cases during the COVID-19 pandemic. OBJECTIVES To provide a comprehensive insight into the characteristics of COVID-19-associated mucormycosis (CAM), through a systematic review and meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science, Cochrane, CINAHL, Ovid MEDLINE, and FungiSCOPE. STUDY ELIGIBILITY CRITERIA Studies reporting individual-level information in adult CAM patients between January 1, 2020 and December 28, 2022. PARTICIPANTS Adults who developed mucormycosis during or after COVID-19. ASSESSMENT OF RISK OF BIAS Quality assessment was performed based on the National Institutes of Health Quality Assessment Tool for Case Series Studies. METHODS OF DATA SYNTHESIS Demographic information and clinical features were documented for each patient. Logistic regression analysis was used to predict the risk of mortality. RESULTS 958 individual cases reported from forty-five countries were eligible. 88.1% (844/958) were reported from low- or middle-income countries (LMIC). Corticosteroid use for COVID-19 (78.5%, 619/789) and diabetes (77.9%, 738/948) were common. Diabetic ketoacidosis (p<0.001), history of malignancy (p<0.001), underlying pulmonary (p=0.017) or renal disease (p<0.001), obesity (p<0.001), hypertension (p=0.040), age (>65 years) (p=0.001), Aspergillus co-infection (p=0.037), and tocilizumab use during COVID-19 (p=0.018) increased the mortality. CAM occurred on average 22 days after COVID-19 and 8 days after hospitalization. Diagnosis of mucormycosis in patients with Aspergillus co-infection and pulmonary mucormycosis was made on average 15.4 days (range 0-35) and 14.0 days (range 0-53) after hospitalization, respectively. Cutaneous mucormycosis accounted for <1% of cases. The overall mortality rate was 38.9% (303/780). CONCLUSION Mortality of CAM was high, and most reports were from LMIC countries. We detected novel risk factors for CAM such as older age, specific comorbidities, Aspergillus co-infection and tocilizumab use, in addition to previously identified factors.
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Nossent JC, Keen HI, Preen DB, Inderjeeth CA. Trends in Hospitalization for Tuberculosis and Other Opportunistic Infections in Australian Patients with Inflammatory Joint Diseases. Rheumatol Ther 2023; 10:563-573. [PMID: 36738423 PMCID: PMC10140214 DOI: 10.1007/s40744-023-00534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE As immune-modulating therapy has become the standard of care for idiopathic inflammatory joint diseases (IJD), we investigated whether this has changed the rates for hospitalization with opportunistic infections (OI). METHODS Administrative longitudinal state-wide health data identified patients hospitalized at least twice with diagnostic codes for rheumatoid arthritis (RA, n = 7730), psoriatic arthritis (PsA, n = 529) or axial spondylarthritis (AS, n = 1126) in Western Australia in the period 1985-2015. Overall incidence rates/1000 person-years (IR with 95% CI) for microbiologically confirmed OI (mycobacterial, fungal, and viral infections) during 180,963 person-years were analyzed across 10-year periods with IR trend rates analyzed by least square regression (R2) for all IJD categories. RESULTS A total of 2584 OI occurred with higher IR rates observed in RA (15.34, CI 14.71-15.99) than PsA (8.73, CI 7.14-10.56) and AS (10.88, CI 9.63-12.24) patients (p < 0.001). IR rates were highest for Candidiasis across all three IJD categories (IR 10.0 vs. 6.32 vs. 6.88, respectively), while Varicella-zoster (VZV) was most frequent non-candida OI (IR 2.83.0 vs. 1.50 vs. 1.49, respectively) followed by mycobacterial (IR 1.14 vs. 0.08 vs. 0.24, respectively) and other mycotic infections (IR 0.60 vs. 0.58 vs. 0.86, respectively). Over time, the IR for tuberculosis and pneumocystosis decreased and remained stable for VZV infections in RA patients, but IR for all other OI increased across all disease categories. OI admission associated with 6.5% (CI 5.6-7.5) in-hospital mortality. CONCLUSIONS Despite decreasing admission rates for tuberculosis and pneumocystosis in RA patients, an overall increase in mycotic and viral infection rates over time was seen across all three IJD. Together with a significant case fatality rate, this indicates continued efforts are needed to improve OI prevention in the management of IJD patients.
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Affiliation(s)
- Johannes C Nossent
- Department Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia.
- Rheumatology Group, School of Medicine, University Western Australia, 35 Stirling Highway (M503), Perth, Australia.
| | - Helen I Keen
- Rheumatology Group, School of Medicine, University Western Australia, 35 Stirling Highway (M503), Perth, Australia
- Department Rheumatology, Fiona Stanley Hospital, Perth, Australia
| | - David B Preen
- School of Population and Global Health, University Western Australia, Perth, Australia
| | - Charles A Inderjeeth
- Department Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia
- Rheumatology Group, School of Medicine, University Western Australia, 35 Stirling Highway (M503), Perth, Australia
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25
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Fang YF, Cao XH, Yao LY, Cao Q. Pulmonary cryptococcosis after immunomodulator treatment in patients with Crohn’s disease: Three case reports. World J Gastroenterol 2023; 29:758-765. [PMID: 36742174 PMCID: PMC9896616 DOI: 10.3748/wjg.v29.i4.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Corticosteroids and anti-tumor necrosis factor α mAbs are widely used to treat Crohn's disease (CD). However, one disadvantage of this treatment is impairment of normal immune function, leading to an increased risk of infection. Cryptococcus infection is an opportunistic infection that occurs mainly in immunocompromised patients and poses a significant diagnostic challenge in patients with CD.
CASE SUMMARY Here, we report three cases of pulmonary cryptococcosis in patients with CD after receiving immunomodulatory treatment. The patients presented with no or mild respiratory symptoms. Chest computed tomography scans revealed pulmonary nodules in the unilateral or bilateral lobes. Diagnoses were made using pathological examination and metagenomic sequencing. The patients were treated with fluconazole 400 mg once daily for 1 to 6 mo, and symptoms were resolved. Literature searches were conducted in PubMed, Web of Science, and Embase to retrieve previously reported cases and summarize patient characteristics.
CONCLUSION The incidence of cryptococcus infection has increased along with immunomodulator use. Clinical vigilance is required for early identification and standardized treatment.
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Affiliation(s)
- Yan-Fei Fang
- Department of Gastroenterology, Inflammatory Bowel Disease Center, Sir Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Xiang-Han Cao
- Department of Gastroenterology, Inflammatory Bowel Disease Center, Sir Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Ling-Ya Yao
- Department of Gastroenterology, Inflammatory Bowel Disease Center, Sir Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Qian Cao
- Department of Gastroenterology, Inflammatory Bowel Disease Center, Sir Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
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Meng S, Tang Q, Xie Z, Wu N, Qin Y, Chen R, Chen X, Chen X, Li Y, Shi M, Ye L, Liang H, Jiang J, Zhou B, Lin J. Spectrum and mortality of opportunistic infections among HIV/AIDS patients in southwestern China. Eur J Clin Microbiol Infect Dis 2023; 42:113-120. [PMID: 36413338 PMCID: PMC9816182 DOI: 10.1007/s10096-022-04528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022]
Abstract
We describe the opportunistic infections (OIs) of HIV/AIDS to understand the spectrum, mortality, and frequency of multiple coinfected OIs among HIV/AIDS patients in southern China, where OIs are severe. We carried out a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China, from Jan. 2011 to May. 2019. The chi-square test was used to analyze cross-infection; the Kaplan‒Meier analysis was used to compare mortality. A total of 12,612 HIV-infected patients were admitted to this cohort study. Among them, 8982 (71.2%) developed one or more OIs. The overall in-hospital mortality rate was 9.0%. Among the patients, 35.6% coinfected one OI, and 64.4% coinfected more than two OIs simultaneously. Almost half of the patients (60.6%) had CD4 + T-cell counts < 200 cells/μL. Pneumonia (39.8%), tuberculosis (35.3%), and candidiasis (28.8%) were the most common OIs. Coinfected cryptococcal meningitis and dermatitis are the most common combined OIs. The rate of anaemia (17.0%) was highest among those common HIV-associated complications. Multiple OIs are commonly found in hospitalized HIV/AIDS patients in southwestern China, which highlights the need for improved diagnosis and treatment.
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Affiliation(s)
- Sirun Meng
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
| | - Qiao Tang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Zhiman Xie
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
| | - Nianning Wu
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
| | - Yingmei Qin
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
| | - Rongfeng Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Xiaoyu Chen
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
| | - Xiu Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Yueqi Li
- Joint Laboratory for Emerging Infections Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi China
| | - Minjuan Shi
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Hao Liang
- Joint Laboratory for Emerging Infections Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi China
| | - Junjun Jiang
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China ,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Bo Zhou
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Jianyan Lin
- The Fourth People’s Hospital of Nanning, Nanning, 530023 Guangxi China
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Aerts R, De Vlieger G, Debaveye Y, Topal H, De Hertogh G, Lagrou K, Maertens J. Mucorales PCR in blood as an early marker of invasive gastrointestinal mucormycosis might decrease the delay in treatment: A case report. Med Mycol Case Rep 2022; 39:8-12. [PMID: 36590367 PMCID: PMC9794765 DOI: 10.1016/j.mmcr.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/16/2022] Open
Abstract
We describe the fatal case of a patient with gastric perforation due to ischemia and necrosis of the stomach secondary to generalized vascular thrombosis following allogeneic hematopoietic cell transplantation. Histopathological examination of the resected stomach, spleen and omentum unexpectedly showed fungal hyphae suggestive of invasive mucormycosis. We retrospectively performed Mucorales PCR (MucorGenius®, PathoNostics, Maastricht, The Netherlands) in blood and tissue samples of this patient. The PCR was positive 16 days before time of death and 9 days before abdominal pain.
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Affiliation(s)
- Robina Aerts
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium,Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium,Corresponding author. Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium.
| | - Greet De Vlieger
- Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium,Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, KU Leuven, Leuven, Belgium
| | - Yves Debaveye
- Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium,Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, KU Leuven, Leuven, Belgium
| | - Halit Topal
- Department of Visceral Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Gert De Hertogh
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium,Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Johan Maertens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium,Department of Hematology, University Hospitals Leuven, Leuven, Belgium
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Singh A, Ramalingam P, Dhingra S, Ravichandiran V, Murti K. Arsenic: a Culpable Element and a Possible Menace for HIV/AIDS Patients. Biol Trace Elem Res 2022; 200:4955-4966. [PMID: 35128593 DOI: 10.1007/s12011-022-03097-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/02/2022] [Indexed: 11/02/2022]
Abstract
Arsenic contamination has long been recognized as one of the most harmful environmental pollutants resulting from anthropogenic activity. Apart from being an environmental toxicant or pollutant, this culpable heavy metal also has detrimental effects on human health. People throughout the world are exposed to arsenic (As) mostly through polluted drinking water. Acute inorganic arsenic (iAs) poisoning causes nausea, vomiting, stomach discomfort, and severe diarrhea. As on long-term exposure is a potent carcinogen, characterized by IARC (International Agency for Research on Cancer). As levels are high mainly in Gangetic regions due to which the people living around are suffering the consequences. The carcinogenicity of As is well established but the immunotoxicity caused by it is still unknown. Some animal model supports the toxicity of As in the immune system as well, but in humans, mainly suffering from human immunodeficiency virus (HIV), it is not well established. iAs suppresses the immune system by acting on different targets and exacerbating infections. Although animal studies have demonstrated that arsenic trioxide (As2O3) reduces viral rebound and restores CD4 + count in vivo when coupled with antiretroviral medications, elemental AS may have devastating effects on the immune system of HIV patients, making them more prone to opportunistic infections (OIs). It is well known that in later stages of HIV infection, neurological problems also complicate the conditions such as cognitive impairment and AIDS dementia complex (ADC). Along with immunotoxicity, As has the potential to damage HIV patients' brains. This article addresses the immunotoxicity of arsenic and exacerbations caused by it, along with the neurotoxicity, particularly in HIV patients residing near the Gangetic belt.
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Affiliation(s)
- Akanksha Singh
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - P Ramalingam
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - V Ravichandiran
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
- Department of Natural Products, National Institute of Pharmaceutical Education and Research (NIPER), West Bengal, Kolkata, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India.
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Mantilla MJ, Chaves JJ, Parra-Medina R, Mantilla JC. Opportunistic infections as a cause of death in patients with autoimmune diseases: An autopsy-based study. Rev Esp Patol 2022; 55:230-235. [PMID: 36154728 DOI: 10.1016/j.patol.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/31/2021] [Accepted: 11/20/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Infections are an important cause of mortality in patients with autoimmune diseases and opportunistic infections account for a large percentage of these cases. It is often a clinical challenge to find a balance between immunosuppressive therapy and the risk of developing an infectious process. METHODS A retrospective, descriptive study of autopsy reports. RESULTS 15 patients with a premortem diagnosis of autoimmune disease were included. All patients died due to an opportunistic infection. The most commonly reported infection was tuberculosis, followed by invasive fungal infections. CONCLUSIONS The most prevalent pathogens were found in our autopsy-based study of patients with autoimmune diseases and opportunistic infections. Prevention and early detection strategies are vital in order to reach a correct diagnosis and begin the appropriate treatment as soon as possible.
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Affiliation(s)
| | - Juan José Chaves
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | - Rafael Parra-Medina
- Department of Pathology, Fundación Universitaria de Ciencias de la Salud, Hospital San José, Bogotá, Colombia
| | - Julio Cesar Mantilla
- Department of Pathology, Universidad Industrial de Santander, Hospital Universitario de Santander, Bucaramanga, Colombia.
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Núñez I, Crabtree-Ramirez B, Shepherd BE, Sterling TR, Cahn P, Veloso VG, Cortes CP, Padgett D, Gotuzzo E, Sierra-Madero J, McGowan CC, Person AK, Caro-Vega Y. Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors. Int J Infect Dis 2022; 122:469-475. [PMID: 35768025 PMCID: PMC9851270 DOI: 10.1016/j.ijid.2022.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/28/2022] [Accepted: 06/23/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES The aim of this study was to describe the incidence, clinical characteristics, and risk factors of late-onset opportunistic infections (LOI) in people who live with HIV (PWLHA) within the Caribbean, Central and South America network for HIV epidemiology. METHODS We performed a retrospective cohort study including treatment-naive PWLHA enrolled at seven sites (Argentina, Brazil, Chile, Peru, Mexico, and two sites in Honduras). Follow-up began at 6 months after treatment started. Outcomes were LOI, loss to follow-up, and death. We used a Cox proportional hazards model and a competing risks model to evaluate risk factors. RESULTS A total of 10,583 patients were included. Median follow up was at 5.4 years. LOI occurred in 895 (8.4%) patients. Median time to opportunistic infection was 2.1 years. The most common infections were tuberculosis (39%), esophageal candidiasis (10%), and Pneumocystis jirovecii (P. jirovecii) pneumonia (10%). Death occurred in 576 (5.4%) patients, and 3021 (28.5%) patients were lost to follow-up. A protease inhibitor-based regimen (hazard ratio 1.25), AIDS-defining events during the first 6 months of antiretroviral-treatment (hazard ratio 2.12), starting antiretroviral-treatment in earlier years (hazard ratio 1.52 for 2005 vs 2010), and treatment switch (hazard ratio 1.31) were associated with a higher risk of LOI. CONCLUSION LOI occurred in nearly one in 10 patients. People with risk factors could benefit from closer follow-up.
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Affiliation(s)
- Isaac Núñez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Infectología, Ciudad de México, México
| | - Brenda Crabtree-Ramirez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Infectología, Ciudad de México, México
| | | | | | - Pedro Cahn
- Fundación Huésped, Buenos Aires, Argentina
| | - Valdiléa G Veloso
- Instituto Nacional de Infectología Evandro Chagas, Rio de Janeiro, Brazil
| | | | - Denis Padgett
- Hospital Escuela Universitario, Tegucigalpa, Honduras
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Juan Sierra-Madero
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Infectología, Ciudad de México, México
| | | | - Anna K Person
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yanink Caro-Vega
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Infectología, Ciudad de México, México.
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31
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Lee J. [Cytomegalovirus Infection in Patients with Inflammatory Bowel Disease]. Korean J Gastroenterol 2022; 80:60-65. [PMID: 36004632 DOI: 10.4166/kjg.2022.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
A diagnostic evaluation for cytomegalovirus (CMV) infection is required in patients with inflammatory bowel disease (IBD) who do not respond to steroid or immunomodulatory treatment. However, there is no consensus on an accurate diagnostic method for CMV infection in patients with IBD, and it is difficult to clearly distinguish the exacerbation of ulcerative colitis from CMV colitis. According to several recent studies, the most accurate test method for CMV colitis is quantitative tissue DNA-quantitative PCR, which is recommended as the first-line diagnostic technique along with an immunohistochemistry stain. The benefit of antiviral therapy for CMV infection in patients with IBD is also controversial. Although the definition of viral load is unclear, antiviral therapy can lower the rate of colectomy in CMV infections with a high viral load in patients with IBD. This review presents the latest findings about CMV infections in IBD, based on recently reported studies.
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Affiliation(s)
- Jun Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
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32
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Pagano G, García A, Cancino-Abarca S, Hernández-Évole H, Olivas I, Marco F, Casaudoumecq A, Bodro M, Crespo G. COVID-19, rejection, and cutaneous mucormycosis in a long-term liver transplant recipient - the vicious cycle of immunosuppression and opportunistic infections. J Liver Transpl 2022; 7:100113. [PMID: 38013988 PMCID: PMC9276538 DOI: 10.1016/j.liver.2022.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Opportunistic infections, including fungal infections, are dreaded complications of liver transplantation, particularly early after transplant. We describe the case of a patient that presented 6 years after liver transplant with a Lichtheimia corymbifera-infected leg ulcer, following previous COVID-19 infection and moderate rejection requiring steroid pulses. The patient required long-term antifungal therapy, repeated surgical debridement and eventually wound coverage with meshed split-thickness skin graft. Our case illustrates the challenges in the treatment of cutaneous mucormycosis and highlights the difficulties in achieving an accurate balance between the risk of opportunistic infections and rejection in this population.
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Affiliation(s)
| | | | | | | | | | - Francesc Marco
- Microbiology
- Hospital Clénic, Villarroel 170, 08036, Barcelona, Spain; ISGlobal, Barcelona, Spain
- University of Barcelona, Spain
| | | | - Marta Bodro
- and Infectious Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spaing
| | - Gonzalo Crespo
- Departmens of Liver Transplant and Hepatology
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spaing
- Centro de Investigación Biomédica en Red-Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- University of Barcelona, Spain
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Young JAH, Jurdi NE, Rayes A, MacMillan ML, Holtan SG, Cao Q, Witte J, Arora M, Weisdorf DJ. Steroid sensitive acute GVHD, but not steroid dependent or steroid resistant, results in similar infection risk as no GVHD following allogeneic hematopoietic cell transplantation. Transplant Cell Ther 2022; 28:509.e1-509.e11. [PMID: 35577324 DOI: 10.1016/j.jtct.2022.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022]
Abstract
Patients with acute GVHD (aGVHD) have an increased risk for infectious complications after allogeneic hematopoietic cell transplantation (HCT), but the risk according to response to therapy is not well studied. We performed a retrospective analysis of the infectious complications for 1 year following allogeneic HCT at the University of Minnesota for 1143 pediatric and adult patients with and without aGVHD. Patients with aGVHD were classified into treatment response groups based on response to corticosteroids as first-line therapy: steroid sensitive (SS, n=114), steroid resistant (SR, n=103) and steroid dependent (SD, n=168) aGVHD. We observed that the cumulative incidence and density of infections for patients with SS aGVHD parallels those having no GVHD. Infection density (the number of infections that occurred per 100 days at risk) was greater for aGVHD than patients with no GVHD over both early and later post-transplant periods. For GVHD patients, among the infections developed from onset of aGVHD through 80 days of treatment, and until 1-year following transplantation, SS and SD patients had fewer bacterial and viral infections than SR patients. The overlap of non-relapse mortality between SS and SD GVHD patients is a function of SD GVHD being responsive to steroid therapy, even if continued therapy is required. In summary, while valid goals may include reducing unneeded antibacterial antibiotic therapy and preserving microbiome diversity, these data suggest that anti-infective therapy is justified by the density of infections observed during active GVHD treatment.
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Affiliation(s)
| | - Najla El Jurdi
- Blood and Marrow Transplantation Program, University of Minnesota
| | - Ahmad Rayes
- Blood and Marrow Transplantation Program, University of Minnesota; Department of Pediatrics, University of Minnesota
| | - Margaret L MacMillan
- Blood and Marrow Transplantation Program, University of Minnesota; Department of Pediatrics, University of Minnesota
| | - Shernan G Holtan
- Blood and Marrow Transplantation Program, University of Minnesota
| | - Qing Cao
- Biostatistics and Informatics, Clinical and Translational Science Institute, University of Minnesota
| | - Judy Witte
- Blood and Marrow Transplantation Program, University of Minnesota
| | - Mukta Arora
- Blood and Marrow Transplantation Program, University of Minnesota
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Regalla D, VanNatta M, Alam M, Malek AE. COVID-19-associated Cryptococcus infection (CACI): a review of literature and clinical pearls. Infection 2022; 50:1007-1012. [PMID: 35322336 PMCID: PMC8942802 DOI: 10.1007/s15010-022-01805-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/09/2022] [Indexed: 02/08/2023]
Abstract
Background Cryptococcal infection has been increasingly reported in patients with COVID-19 infection, but the epidemiological factors, presentation, diagnostic certainty, and outcome have not been well-described. Methods We reviewed the published cases of COVID-19-associated Cryptococcus infections (CACI) to shed the light on the burden of this infection. Results We identified 13 patients with confirmed cryptococcal infection. Cryptococcus infection was primarily seen in patients with severe COVID-19 disease who received corticosteroids therapy and admitted to the intensive care unit. Pulmonary CACI was the most common reported infection followed by cryptococcal meningitis. Conclusion In light of the high mortality rate, clinicians should maintain a high clinical suspicion of CACI in critically ill patients.
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Affiliation(s)
- Dinesh Regalla
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Mollie VanNatta
- Department of Pharmacy, Ochsner LSU Health Shreveport, Shreveport, LA, USA
| | - Mohammad Alam
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Alexandre E Malek
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
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Qassimi SA, Nusair A, Mooty M, Ajmal A, Abdel-Ghani S. Multiple concomitant life-threatening opportunistic infections due to uncontrolled hypercortisolism. IDCases 2022; 27:e01420. [PMID: 35145861 PMCID: PMC8801376 DOI: 10.1016/j.idcr.2022.e01420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/18/2022] Open
Abstract
Opportunistic infections associated with severe cortisol excess carry a high mortality rate and are most prevalent with ectopic ACTH syndrome. There are limited reports of these cases described in the literature. In this case report, we describe multiple severe life-threatening opportunistic infections due to endogenous hypercortisolism. Our patient, against numerous expectations, survived multiple opportunistic infections including disseminated invasive aspergillosis, Cytomegalovirus endophthalmitis and Pneumocystis Jirovecii pneumonia, reinforcing the need for multidisciplinary care for patients presenting with complicated hypercortisolism.
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Affiliation(s)
- Sarah Al Qassimi
- Medical Subspecialties Institute – Hospital Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Ahmad Nusair
- Medical Subspecialties Institute – Infectious Diseases, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Mohamad Mooty
- Medical Subspecialties Institute – Infectious Diseases, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Adnan Ajmal
- Medical Subspecialties Institute – Endocrinology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Saaid Abdel-Ghani
- Medical Subspecialties Institute – Hospital Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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36
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Subbaram K, Ali PSS, Ali S. Enhanced endocytosis elevated virulence and severity of SARS-CoV-2 due to hyperglycemia in type 2 diabetic patients. Gene Rep 2022; 26:101495. [PMID: 35043090 PMCID: PMC8758565 DOI: 10.1016/j.genrep.2022.101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/15/2022]
Abstract
Diabetes mellitus is a metabolic disease that causes hyperglycemia. In COVID-19 patients the severity of the disease depends on myriad factors but diabetes mellitus is the most important comorbidity. The current review was conducted to investigate the virulence of SARS-CoV-2 and disease severity of COVID-19 in type 2 diabetes mellitus patients and relevant treatment. The literature published in PubMed, Scopus, Web of Science, and Google Scholar was reviewed up to September 2021. The keywords including SARS-CoV-2, type 2 diabetes mellitus in COVID-19, hyperglycemia in COVID-19, opportunistic infections in type 2 diabetes mellitus and COVID-19 were used in different combinations. Hyperglycemic individuals over-express ACE-2 receptors in the lungs thus increasing the SARS-CoV-2 susceptibility and replication. Although dipeptidyl peptidase-4 plays an important role in glucose homeostasis, additionally it also stimulates the production of proinflammatory cytokines such as IL-6 and TNF-α creating a cytokine storm. Cytokine storm might be responsible for respiratory insufficiency in severe COVID-19 patients. Type 2 diabetes mellitus is associated with immunosuppression and the patients are prone to get many opportunistic infections. Type 2 diabetes mellitus patients with severe COVID-19 have lymphopenia. Moreover, in type 2 diabetes mellitus patients the neutrophils exhibit decreased chemotaxis, hydrogen peroxide production, and phagocytosis. Reduction in lymphocyte count and defective neutrophil capacity renders them with COVID-19 susceptible to opportunistic bacterial and fungal infections increasing the mortality rate. The opportunistic bacterial infections in COVID-19 patients were due to Staphylococcus aureus, Streptococcus pneumonia, and coagulase-negative Staphylococci, E. coli, Pseudomonas aeruginosa, and Klebsiella sp. In COVID-19 patients with type 2 diabetes mellitus, mucormycosis was found to be the most common fungal infection with a higher predilection to males. Hyperglycemia in COVID-19 patients with type 2 diabetes mellitus enhances the SARS-CoV-2 replication with an adverse outcome. A strong correlation exists between the poor prognosis of COVID-19 and type 2 diabetes mellitus. Proper glycemic control in COVID-19 patients with diabetes mellitus might lessen the severity of the disease.
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Key Words
- ACE-2, Angiotensin-converting enzyme 2
- ARDS, Acute respiratory distress syndrome
- ATP, Adenosine tri phosphate
- CLR, C-lectin type receptors
- COVID-19
- COVID-19, Coronavirus disease 2019
- Endocytosis
- GRP78, non-immune receptor glucose regulated protein 78
- Hyperglycemia
- IFN-1, Interferon-1
- MERS, Middle East respiratory syndrome
- NRP1, neuropilin-1
- Opportunistic infections
- SARS, Severe acute respiratory syndrome
- SARS-CoV-2
- SARS-CoV-2, Severe acute respiratory syndrome coronavirus-2
- T2DM, Type 2 diabetes mellitus
- TLR, toll-like receptors
- TMPRSS2, Transmembrane Serine Protease 2
- Type 2 diabetes mellitus
- WHO, World Health Organization
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Affiliation(s)
- Kannan Subbaram
- School of Medicine, The Maldives National University, Male', Maldives
| | - P Shaik Syed Ali
- School of Medicine, The Maldives National University, Male', Maldives
| | - Sheeza Ali
- School of Medicine, The Maldives National University, Male', Maldives
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Ananthegowda DC, Khatib MY, Ali HS, Al wraidat M, Imam Y. Cytomegalovirus meningoencephalitis in a case of severe COVID-19 Pneumonia. A case report. IDCases 2021; 26:e01346. [PMID: 34840957 PMCID: PMC8608663 DOI: 10.1016/j.idcr.2021.e01346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 01/07/2023] Open
Abstract
The use of steroids and other immune modulatory therapies in the treatment of severe COVID-19 pneumonia predisposes patients to the reemergence of opportunistic infections. Cytomegalovirus (CMV) reactivation can be one of them. A 55-year-old gentleman with severe COVID-19 pneumonia and hypoxic respiratory failure who was ventilated and received steroids but no other immunomodulatory drugs; had altered sensorium and multiple episodes of seizures in the later course of his illness. Brain MRI showed leptomeningeal enhancement and encephalopathy changes, electroencephalography (EEG) was suggestive of diffuse encephalopathy and his cerebrospinal fluid (CSF) analysis revealed high Cytomegalovirus PCR DNA titers (103,614). The patient made a complete recovery after treatment with Ganciclovir. Altered sensorium in cases of COVID-19 can be multifactorial. High index of suspicion for reactivation of dormant infections is warranted. CMV meningoencephalitis is one of the differential diagnoses. We believe this is the first case reported of CMV meningoencephalitis in the setting of severe COVID-19 infection.
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Affiliation(s)
- Dore C. Ananthegowda
- Medical Intensive Care Unit, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Y. Khatib
- Medical Intensive Care Unit, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Husain S. Ali
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar
| | - Mohamed Al wraidat
- Medical Intensive Care Unit, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Yahia Imam
- Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar
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Waly WR, Ismail MAGM, Abu-Sarea EY, Abd El Wahab WM. Intestinal parasitic infections and associated risk factors in diabetic patients: a case-control study. J Parasit Dis 2021; 45:1106-1113. [PMID: 34789996 DOI: 10.1007/s12639-021-01402-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022] Open
Abstract
Diabetes mellitus (DM) is a metabolic disease that puts the individual at immune-suppression state. The present study aims to detect the burden of intestinal parasites and associated risk factors among diabetic patients in a case-control study. Stool samples from 100 diabetic patients, and 100 non-diabetic controls attending Beni-Suef University Hospital were collected and processed by direct smear examination, concentration technique, permanent staining by modified Ziehl-Neelsen and modified trichrome stains, and culture on nutrient agar plates. The overall prevalence of intestinal parasites was 38%; higher in diabetic patients (44%) than control group (32%) with non-statistical significance. The most predominant intestinal parasites detected among diabetics were Blastocystis hominis (29%), followed by Cryptosporidium sp. (12%), Giardia lamblia (7%), Microsporidia sp. (5%), Entamoeba histolytica/dispar, Hymenolepis nana, and Capillaria philippinensis (each representing 2%). No statistical difference was detected between both groups in all parasites except for Microsporidia sp. (P = 0.008). In diabetic patients; age ≥ 41 years, living in rural areas, and patients having uncontrolled and complicated DM were significantly associated with intestinal parasitosis by univariate analysis (P = 0.016, 0.035, 0.014, 0.043) respectively. By multivariate analysis, age and rural residence were the only statistically significant risk factors (OR = 6.192, and 2.614) respectively. Intestinal parasites were highly associated with diarrhea (P < 0.001), and flatulence (P = 0.042) in the diabetic patients. Diabetic patients should be screened routinely for intestinal parasites, especially the opportunistic ones, and treated for their overall well-being.
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Affiliation(s)
- Walaa Ramadan Waly
- Department of Medical Parasitology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | - Enas Yahia Abu-Sarea
- Department of Medical Parasitology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Abstract
The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. The nasopharyngeal acquisition of pneumococcus, which exists as a pathobiont in the nasal cavity, is the initial step in virtually all pneumococcal diseases. Although the factors influencing nasal colonization and elimination are not fully understood, the adhesion of opportunistic pathogens to nasopharyngeal mucosa receptors and the eliciting of immune responses in the host are implicated in addition to bacterial microbiota properties and colonization resistance dynamics. Probiotics or synbiotic interventions may show promising and effective roles in the adjunctive treatment of dysbiosis; however, more studies are needed to characterize how these interventions can be applied in clinical practice in the future.
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Affiliation(s)
- Hyun Mi Kang
- Division of Pediatric Infectious Diseases, Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Division of Pediatric Infectious Diseases, Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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40
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. [Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU]. Med Intensiva 2021; 45:485-500. [PMID: 33994616 PMCID: PMC8086823 DOI: 10.1016/j.medin.2021.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, España
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, España
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, España
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublín, EIRE, Universidad de Barcelona, Barcelona, España
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, España
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla. Santander, España
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, España
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, España
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, España
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, España
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, España
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España
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Estella Á, Vidal-Cortés P, Rodríguez A, Andaluz Ojeda D, Martín-Loeches I, Díaz E, Suberviola B, Gracia Arnillas MP, Catalán González M, Álvarez-Lerma F, Ramírez P, Nuvials X, Borges M, Zaragoza R. Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU. Med Intensiva 2021; 45:485-500. [PMID: 34475008 PMCID: PMC8382590 DOI: 10.1016/j.medine.2021.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.
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Affiliation(s)
- Á Estella
- Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Departamento de Medicina, Facultad de Medicina de Cádiz, Jerez de la Frontera, Cádiz, Spain.
| | - P Vidal-Cortés
- Servicio de Medicina Intensiva, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Joan XXIII de Tarragona, Tarragona, Spain
| | - D Andaluz Ojeda
- Servicio de Medicina Intensiva, Hospital Universitario de Sanchinarro de Madrid, Madrid, Spain
| | - I Martín-Loeches
- PhD JFICMI Consultant in Intensive Care Medicine, CLOD Dublin Midlands Group, St James's University Hospital, Trinity Centre for Health Sciences, HRB-Welcome Trust St James's Hospital, Dublin, EIRE, Universidad de Barcelona, Barcelona, Spain
| | - E Díaz
- Servicio de Medicina Intensiva, Hospital Parc Tauli, Sabadell, Spain
| | - B Suberviola
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Gracia Arnillas
- Servicio de Medicina Intensiva, Hospital Universitario del Mar, Barcelona, Spain
| | - M Catalán González
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Álvarez-Lerma
- Servicio de Medicina Intensiva, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - P Ramírez
- Servicio de Medicina Intensiva, Hospital La Fe de Valencia, Valencia, Spain
| | - X Nuvials
- Servicio de Medicina Intensiva, Hospital Vall d'Hebrón, Barcelona, Spain
| | - M Borges
- Unidad Multidisciplinar de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Son Llatzer, IDISBA, Enfermedades Infecciosas UIB, Palma de Mallorca, Área de Sepsis e Infecciosas, Federación Ibérica y Panamericana de Medicina Intensiva (FEPIMCTI), Palma de Mallorca, Spain
| | - R Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, Spain
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42
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Craviotto V, Furfaro F, Loy L, Zilli A, Peyrin-Biroulet L, Fiorino G, Danese S, Allocca M. Viral infections in inflammatory bowel disease: Tips and tricks for correct management. World J Gastroenterol 2021; 27:4276-4297. [PMID: 34366605 PMCID: PMC8316900 DOI: 10.3748/wjg.v27.i27.4276] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/01/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.
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Affiliation(s)
- Vincenzo Craviotto
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
| | - Federica Furfaro
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
| | - Laura Loy
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
| | - Alessandra Zilli
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
| | - Laurent Peyrin-Biroulet
- Department of Hepato-Gastroenterology and Inserm U954, University Hospital of Nancy, Lorraine University, Nancy 54511, France
| | - Gionata Fiorino
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milano, Italy
| | - Silvio Danese
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milano, Italy
| | - Mariangela Allocca
- Humanitas Clinical and Research Center, IRCCS, Rozzano 20089, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milano, Italy
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43
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Margalit I, Yahav A, Ben Ari Y, Ben-Zvi H, Shoham A, Goldberg E, Weiler-Sagie M, Tau N, Muhsen K, Bishara J, Paul M, Bernstine H, Yahav D. The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in Management of Nocardiosis: A Retrospective Study and Review of the Literature. Infect Dis Ther 2021. [PMID: 34283408 DOI: 10.1007/s40121-021-00495-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction 18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is a well-established tool for managing metastatic infections. Nocardiosis, a primarily pulmonary infection, disseminates at high rates. Routine imaging includes chest CT and brain imaging. We examined the use of FDG-PET/CT in nocardiosis and assessed its contribution to diagnosis and management. Methods A retrospective study in two tertiary medical centers during 2011–2020. Individuals with nocardiosis for whom FDG-PET/CT was implemented for any reason were included and their medical records were reviewed. A board-certified nuclear medicine physician independently reviewed all scans. Additionally, a systematic review was conducted according to the PRISMA guidelines, to extract data from publications reporting FDG-PET/CT use for the management of nocardiosis. Results FDG-PET/CT contributed to the management of all seven patients who met inclusion criteria. It assisted in ruling out an underlying malignancy (29%, 2/7); establishing a wide infection extent (57%, 4/7); and affecting decisions regarding treatment (57%, 4/7), including drug regimen, oral step-down, and duration of therapy. We identified 20 published case reports on this topic. In 80% (16/20), FDG-PET/CT contributed to the management of nocardiosis similar to our study. In addition, in most of the literature cases, FDG-PET/CT guided the diagnostic biopsy. Conclusion FDG-PET/CT is valuable in the diagnosis and management of individuals with nocardiosis. The contribution of incorporating FDG-PET/CT to the management of individuals with nocardiosis and its role in monitoring treatment response and shortening treatment duration should be evaluated in prospective studies.
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44
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Góes LDM, Monteiro VDS, Souza ATOD. Case for diagnosis. Ulcer and papular lesions in a patient with diabete mellitus. Protothecosis. An Bras Dermatol 2021; 96:613-616. [PMID: 34266685 PMCID: PMC8441448 DOI: 10.1016/j.abd.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/11/2021] [Accepted: 03/30/2021] [Indexed: 11/15/2022] Open
Abstract
Protothecosis is a rare disease caused by achlorophilic algae of the genus Prototheca spp. In general, three clinical forms are observed: cutaneous, articular and systemic. The cutaneous form is the most common one. This study describes a patient with isolated erythematous papules and erythematous papular plaques in the scapular regions, with a previous histopathological diagnosis of cryptococcosis. New tests were conclusive for the diagnosis of protothecosis, caused by Prototheca wickerhamii.
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45
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:879-913. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab052' and 2*3*8=6*8 and 'bst4'='bst4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal
- Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
- Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
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46
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:879-913. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab052" and 2*3*8=6*8 and "nghj"="nghj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal
- Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
- Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
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47
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:879-913. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab052] [Citation(s) in RCA: 140] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal.,Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy.,Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal.,Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
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48
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal.,Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy.,Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal.,Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
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49
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:879-913. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab052%' and 2*3*8=6*8 and '9xi2'!='9xi2%] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal
- Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
- Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
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50
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Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, Albuquerque A, Allocca M, Esteve M, Farraye FA, Gordon H, Karmiris K, Kopylov U, Kirchgesner J, MacMahon E, Magro F, Maaser C, de Ridder L, Taxonera C, Toruner M, Tremblay L, Scharl M, Viget N, Zabana Y, Vavricka S. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:879-913. [PMID: 33730753 DOI: 10.1093/ecco-jcc/jjab052'||dbms_pipe.receive_message(chr(98)||chr(98)||chr(98),15)||'] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Affiliation(s)
- T Kucharzik
- Department of Gastroenterology, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - P Ellul
- Department of Medicine, Division of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - T Greuter
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland, and Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois CHUV, University Hospital Lausanne, Lausanne, Switzerland
| | - J F Rahier
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Yvoir, Belgium
| | - B Verstockt
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium, and Department of Chronic Diseases, Metabolism and Ageing, TARGID-IBD, KU Leuven, Leuven, Belgium
| | - C Abreu
- Infectious Diseases Service, Centro Hospitalar Universitário São João, Porto, Portugal
- Instituto de Inovação e Investigação em Saúde [I3s], Faculty of Medicine, Department of Medicine, University of Porto, Portugal
| | - A Albuquerque
- Gastroenterology Department, St James University Hospital, Leeds, UK
| | - M Allocca
- Humanitas Clinical and Research Center - IRCCS -, Rozzano [Mi], Italy
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - M Esteve
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - F A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - H Gordon
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - U Kopylov
- Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Kirchgesner
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Department of Gastroenterology, Paris, France
| | - E MacMahon
- Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Magro
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
- Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
| | - C Maaser
- Outpatient Department of Gastroenterology, Department of Geriatrics, Klinikum Lüneburg, University of Hamburg, Lüneburg, Germany
| | - L de Ridder
- Department of Paediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Taxonera
- IBD Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain
| | - M Toruner
- Ankara University School of Medicine, Department of Gastroenterology, Ankara, Turkey
| | - L Tremblay
- Centre Hospitalier de l'Université de Montréal [CHUM] Pharmacy Department and Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - M Scharl
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| | - N Viget
- Department of Infectious Diseases, Tourcoing Hospital, Tourcoing, France
| | - Y Zabana
- Hospital Universitari Mútua Terrassa, Digestive Diseases Department, Terrassa, Catalonia, and Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas CIBERehd, Madrid, Spain
| | - S Vavricka
- University Hospital Zürich, Department of Gastroenterology and Hepatology, Zürich, Switzerland
| |
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