Pseudomonas aeruginosa belongs to the group of three “critical priority” multi-drug-resistant pathogens listed by WHO and is responsible for severe and often deadly infections such as bloodstream ...infections and pneumonia. Staphylococcus aureus is also a “high priority” pathogen which is a major cause of serious nosocomial infections such as bacteremia, sepsis, and endocarditis. Owing to their ability to adapt resistance to almost any antibiotics, vaccines against these pathogens are urgently required. These pathogens express structurally unique and densely functionalized glycans on their surfaces which are absent on the host cells. Such carbohydrate antigens are valuable targets for the development of glycoconjugate vaccines and diagnostics. Here, we report the first total synthesis of the conjugation-ready trisaccharide repeating unit of Pseudomonas aeruginosa O11 via a highly stereoselective and efficient assembly of a rare l-fucosamine- and d-fucosamine-containing 1,2-cis-linked disaccharide motif and its regioselective glycosylation at O3. A systematic study was conducted for the notoriously difficult glycosylation with the most unreactive axial 4-OH of the rare disaccharide, and the successful outcome was utilized to accomplish the total synthesis of an aminopropyl linker-attached trisaccharide repeating unit of Staphylococcus aureus capsular polysaccharide type 5, which is also a potential antigen for immunotherapy and vaccine development. The judicious selection of protecting groups and reaction conditions allowed the stereoselective assembly and selective functional group interconversions to access the structurally complex linker-attached trisaccharide repeating units, which are valuable tools for immunological evaluation and vaccine development. The strategy is useful for the synthesis of other structurally related complex glycans.
Cilj: Utvrditi osobine i ishode liječenja bolesnika liječenih zbog infekcijskog endokarditisa (IE) u tercijarnom referentnom centru. Ispitanici i metode: U retrospektivno presječno istraživanje od ...siječnja 2012. do prosinca 2020. uključen je 101 bolesnik s dijagnozom IE. Analizirani su klinički i demografski podaci, ranije bolesti, primjena lijekova s imunosupresivnim učinkom, intravenska primjena droga, simptomi prilikom prijama, vrijednosti hematoloških i biokemijskih pokazatelja, nalazi mikrobiološke obrade, trajanje i ishodi liječenja (otpust, premještaj na kardiokirurgiju, smrt). Rezultati: Najčešći čimbenici srčano-žilnog rizika bili su arterijska hipertenzija (35,6%), pušenje (22,8%) i kronično zatajivanje bubrega (13,1%), dok je kod 7,9% bolesnika zabilježena intravenska primjena droga. Najčešći simptomi zabilježeni prilikom prijama bolesnika bili su povišena tjelesna temperatura (92%) i novonastali ili pojačan intenzitet od ranije poznatog srčanog šuma (77%). Najčešće zahvaćeni prirodni zalistak bio je mitralni (32,67%), a umjetni aortni (18,82%). Najčešći uzročnici IE bili su Streptococcus viridans (23,8%), meticilin osjetljivi Staphylococcus aureus (22,8%) i enterokok (16,8%), a negativan nalaz hemokultura zabilježen je u 15,8 % bolesnika. U liječenju su najčešće korišteni beta-laktamski antibiotici (92,22%), gentamicin (33,7%) i vankomicin (17,8%). Na kućno liječenje otpušteno je 62,4% bolesnika, 22,7% ih je podvrgnuto kardiokirurškom zahvatu, dok je u 14,9% bolesnika zabilježen smrtni ishod. Jedini predskazatelj smrti bila je dob bolesnika (> 65 godina). Zaključci: Osobine naših bolesnika su podudarne, a ishodi bolesti povoljniji u odnosu na rezultate zabilježene u ustanovama iste razine u zemljama zapadnoga svijeta. Jedini nezavisni predskazatelj smrti u naših bolesnika s IE bila je dob veća od 65 godina.
Objective: To determine the characteristics and outcomes of patients treated for infectious endocarditis (IE) at the tertiary referral centre. Patients and methods: A retrospective cross-sectional study in the period from January 2012 to December 2020 included 101 IE patients. Clinical and demographic data, previous diseases, administration of immunosuppressive drugs, intravenous drug use, symptoms on admission, values of hematological and biochemical parameters, microbiological processing findings, duration and outcomes (discharge, cardiac surgery, death) were analyzed.Results: The most common cardiovascular risk factors were arterial hypertension (35.6%), smoking (22.8%), and chronic renal failure (13.1%); intravenous administration of narcotics was reported in 7.9% of patients. The most common symptoms observed on admission were fever (92%) and new or increased intensity of previously known cardiac murmur (77%). The most commonly affected natural valve was the mitral (32.67%); the most commonly affected artificial valve was the aortic (18.82%). The most common causative agents were Streptococcus viridans (23.8%), methicillin-sensitive Staphylococcus aureus (22.8%) and enterococci (16.8%); a negative blood culture was obtained in 15.8% of patients. Beta-lactam antibiotics (92.22%), gentamicin (33.7%) and vancomycin (17.8%) were most commonly used antimicrobial agents. 62.4% of patients were discharged from hospital, 22.7% of patients underwent cardiac surgery, and 14.9% of patients died. The only independent predictor of death was the age (> 65 years). Conclusions: The characteristics of our patients are consistent and the outcomes of patients are more favorable compared to the results recorded in institutions of the same level in the countries of the Western world. The only independent predictor of death in our IE patients was age greater than 65 years.
Zusammenfassung
Die perioperative Antibiotikaprophylaxe (PAP) hat das Ziel, postoperative Wundinfektionen und Infektionskomplikationen (insbesondere bakterielle Endokarditis oder septische Arthritis) ...bei chirurgischen Eingriffen zu vermeiden. Die PAP hat sich besonders bei Eingriffen bewährt, bei denen die Infektionsraten auch ohne Berücksichtigung der patientenbezogenen Risikofaktoren insgesamt hoch sind (wie für orthopädische Eingriffe oder die Versorgung von Frakturen). Auch Operationen mit Eröffnung der Atemwege, des Verdauungs‐, Genital‐ oder Harntrakts gelten als mit Infektionsrisiko behaftet und können eine PAP erfordern. In der Dermatochirurgie sind Infektionskomplikationen insgesamt verhältnismäßig selten und variieren in Abhängigkeit von der Lokalisation, Komplexität des Eingriffes und der Patientenkohorte zwischen 1% und 11%. Daher spiegeln die allgemeinchirurgischen Empfehlungen bezüglich der PAP die Bedürfnisse der Dermatochirurgie nur begrenzt wider. Im Gegensatz zu den USA, wo eine entsprechende Empfehlung vorliegt, existiert in Deutschland zurzeit keine speziell für dermatochirurgische Eingriffe konzipierte Leitlinie zur Anwendung von PAP. In Abwesenheit evidenzbasierter Empfehlungen wird die PAP durch die Erfahrung der einzelnen Operateure geprägt, was zu einer heterogenen Anwendung antimikrobieller Substanzen führt. In der vorliegenden Arbeit wird die aktuelle wissenschaftliche Literatur zu dem Thema zusammengefasst und die daraus resultierende Empfehlung zur Anwendung der PAP in Abhängigkeit von eingriffs‐ und patientenbezogenen Risikofaktoren formuliert.
Streptococcus suis (S. suis) is a gram-positive bacterial pathogen in pigs which can cause serious infections in human including meningitis, and septicaemia resulting in serious complications. There ...were discrepancies between different data and little is known concerning associated risk factors of S. suis. A systematic review and meta-analysis was conducted to investigate on S. suis infection risk factors in human. We searched eight relevant databases using the MeSH terms "Streptococcus suis" OR "Streptococcus suis AND infection" limited in human with no time nor language restriction. Out of 4,999 articles identified, 32 and 3 studies were included for systematic review and meta-analysis respectively with a total of 1,454 Streptococcus suis cases reported. S. suis patients were generally adult males and the elderly. The mean age ranged between 37 to 63 years. Meningitis was the most common clinical manifestation, and deafness was the most common sequelae found among survivors followed by vestibular dysfunction. Infective endocarditis was also noted as among the most common clinical presentations associated with high mortality rate in a few studies. Meta-analyses categorized by type of control groups (community control, and non-S. suis sepsis) were done among 850 participants in 3 studies. The combined odd ratios for studies using community control groups and non-S. Suis sepsis as controls respectively were 4.63 (95% CI 2.94-7.29) and 78.00 (95% CI 10.38-585.87) for raw pork consumption, 4.01 (95% CI 2.61-6.15) and 3.03 (95% CI 1.61-5.68) for exposure to pigs or pork, 11.47, (95% CI 5.68-23.14) and 3.07 (95% CI 1.81-5.18) for pig-related occupation and 3.56 (95% CI 2.18-5.80) and 5.84 (95% CI 2.76-12.36) for male sex. The results were found to be significantly associated with S. suis infection and there was non-significant heterogeneity. History of skin injury and underlying diseases were noted only a small percentage in most studies. Setting up an effective screening protocol and public health interventions would be effective to enhance understanding about the disease.
Staphylococcus aureus is the cause of serious vascular infections such as sepsis and endocarditis. These infections are notoriously difficult to treat, and it is believed that the ability of S. ...aureus to invade endothelial cells and persist intracellularly is a key mechanism for persistence despite ongoing antibiotic treatment. Here, we used dual RNA sequencing to study the simultaneous transcriptional response of S. aureus and human endothelial cells during in vitro infections. We revealed discrete and shared differentially expressed genes for both host and pathogen at the different stages of infection. While the endothelial cells upregulated genes involved in interferon signalling and antigen presentation during late infection, S. aureus downregulated toxin expression while upregulating genes related to iron scavenging. In conclusion, the presented data provide an important resource to facilitate functional investigations into host-pathogen interaction during S. aureus invasive infection and a basis for identifying novel drug target sites.
Herein, the interaction of the fourth-generation fluoroquinolone antibiotic drug, moxifloxacin hydrochloride (MFH), which is extensively used for the treatment of wider ranges of bacterial ...infections, like pneumonia, endocarditis, tuberculosis, and other complicated dermal lesions, and cetyltrimethylammonium bromide (CTAB, a cationic surfactant) has been observed by conductivity method in aqueous, alcoholic (C
2
H
5
OH, C
3
H
7
OH-2), and diol (C
2
H
4
(OH)
2
, C
3
H
6
(OH)
2
) solutions. For all of the MFH + CTAB cases studied, the appearance of a critical micelle concentration (cmc) demonstrated that the micellar system is dependent on the variation of temperature and the concentration of different additives. A change in the value of cmc manifests the existence of strong interaction prevailing amongst MFH and CTAB molecules. In presence of alcohols/diols, the value of cmc for the MFH + CTAB system was found higher compared to those values obtained for the MFH + CTAB system carried out in H
2
O, which indicates a favourable micellization process. The values of counter-ion dissociation were also found to be dependent on temperature. The
values were observed negative, which, again, manifests a spontaneous micellization process. The free energy of transfer (
) and the enthalpy-entropy compensation were also calculated and discussed.
The aim of the study was to compare background characteristics, microbiology and outcome of patients with right-sided and left-sided intravenous drug use (IDU) associated infective endocarditis (IE). ...A nationwide retrospective study using the Swedish Registry on Infective Endocarditis between 2008 and 2019 was conducted. A total of 586 people with IDU-IE were identified and divided into left-sided (n = 204) and right-sided (n = 382) IE. Descriptive statistics, Cox-regression and Kaplan-Meier survival estimates were used. The mean age of patients in the left-sided group was 46 years compared to 35 years in the right-sided group, p < 0.001. Left-sided IE had a higher proportion of females. Staphylococcus aureus was the causative pathogen in 48% of cases in the left-sided group compared to 88% in the right-sided group. Unadjusted and adjusted long-term survival was better in right-sided IE compared to left-sided IE. Independent predictors of long-term mortality were increasing age, end-stage renal disease, nosocomial infection, brain emboli and left-sided IE. Left-sided IE was common in people with IDU but the proportion of females with left-sided IE was low. S. aureus was twice as common in right-sided IE compared to left-sided IE, and the long-term prognosis of right sided IDU-associated IE was better compared to left-sided IE despite the fact that few were operated.
Pandrug-resistant (PDR) K. pneumoniae refractory to conventional treatment has been reported worldwide, causing a huge burden on the healthcare system, patient safety and the economy. K. pneumoniae ...is a prominent opportunistic pathogen causing hospital-acquired and community-acquired infections, but is rarely associated with infective endocarditis. Currently, there are sparse data guiding the optimal regimen when commonly used antibiotics fail, notably for the treatment of endocarditis infections. Here we report our experience in treating a 40-year-old female with PDR K. pneumoniae infection of cardiovascular implantable electronic device (CIED) and right-sided infective endocarditis. Initial susceptibility testing of the incriminated pathogen showed an apparent susceptibility to colistin but the prolonged course of colistin, gentamicin and meropenem did not resolve the infection. However, the synergistic combinations of aztreonam with ceftazidime-avibactam was able to overcome resistance and clear the infection rapidly. Genome sequencing showed that the PDR K. pneumoniae isolate belongs to the international high-risk clone ST14. The isolate harbored genes encoding NDM-1, OXA-48, CTX-M-14b, SHV-28 and OXA-1, explaining resistance to all β-lactams, including carbapenems. It carried the armA gene conferring resistance to all clinically important aminoglycosides and had alterations in GyrA, ParC and MgrB, explaining resistance to ciprofloxacin and colistin.
Srce kao uzrok moždanog udara Bodrožić Džakić Poljak, Tomislava
Medicus (Zagreb, Croatia : 1992),
05/2022, Letnik:
31, Številka:
1 Moždani udar
Journal Article
Recenzirano
Odprti dostop
Kardiovaskularne bolesti najčešći su uzrok mortaliteta u cijelom svijetu. U ovu skupinu najčešće se ubrajaju ishemijska bolest srca i moždani udar. Budući da je patofiziološki mehanizam nastanka ove ...dvije bolesti vrlo sličan, ali i jako usko povezan, potrebno je proširiti medicinsko znanje jer sa sve duljim životnim vijekom raste broj komorbiditeta te postaje klinički izazov liječiti bolesnike s različitim spektrom bolesti. Jedan od najčešćih uzroka moždanog udara je fibrilacija atrija, a liječenje je dominantno usmjereno u kontrolu srčanog ritma i/ili srčane frekvencije uz primjenu antikoagulantne terapije. Osim fibrilacije atrija postoje i drugi, ali rjeđi kardiogeni uzroci moždanog udara, a postavljanje dijagnoze i liječenje istih je ipak drugačije, ovisno o etiologiji.
Staphylococcus is one of the most common types of bacteria in Asia that causes local infectious diseases of the skin, nose, urethra, vagina, digestive tract, pneumonia, endocarditis, septic ...arthritis, and septicemia. Staphylococcus aureus and Staphylococcus epidermidis are the most common types of Staphylococcus in Asia. Tea plants contain bioactive compounds and endophytic bacteria which are widely used as antimicrobial agents. Endophytic bacteria are bacteria that exist in plant tissues, not pathogenic, and have the ability as the host plant. The purpose of this study was to determine the antibacterial activity of endophytic bacterial isolates of tea plants (Camellia sinensis) against the growth of Staphylococcus aureus and Staphylococcus epidermidis bacteria. The antibacterial activity test of endophytic bacteria of tea plants includes a series of processes such as sample selection, surface sterilization of samples, isolation of endophytic bacteria in agar medium, screening, suspension of endophytic bacteria in 0.9 % NaCl and standardized with 0.5 McFarland, making endophytic bacterial culture in nutrient broth medium, making endophytic bacterial supernatant and antibacterial activity test with paper disc diffusion method. The result is that there is an antibacterial activity from the endophytic bacterial supernatant isolates B14, B23, and A2 to the growth of Staphylococcus aureus and Staphylococcus epidermidis. The best antibacterial activity was found in endophytic bacterial B14 isolates with inhibition zones of 7.75 mm and 12.5 mm followed by B23 isolates with 7.5 mm and 8.25 mm inhibition zones and A2 isolates with large inhibition zones of 7.42 mm and 8.16 mm. Endophytic bacteria of tea plants showed antibacterial activity against the growth of Staphylococcus aureus and Staphylococcus epidermidis.
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