Abstract
Background
There have been documented cases, although rare, of clinically significant infections caused by Hafnia alvei leading to infections such as bacteremia, pneumonia, UTI, meningitis, ...and empyema. H. alvei infections can be community-acquired or nosocomial. The published data for H. alvei in cancer patients is limited. The aim of this study was to characterize H. alvei infections including patient characteristics, antimicrobial susceptibility patterns, location of isolation, and microbial characteristics of isolates in cancer patients.
Methods
A retrospective cohort study was performed to review records of all consecutive patients with a positive H. alvei culture during the past 7 years. Variables included patient’s age, sex, underlying malignancy, neutrophil count, location and duration of infection, antimicrobial susceptibility patterns, hospital stay, co-isolates, and outcomes.
Results
A total of 15 patients with positive H. alvei cultures were identified at the Moffitt Cancer Center. There were 8 (53%) female and 7 (47%) male patients. The mean patient age was 65.7 ±15.8 yrs. All patients had underlying malignancies, most common type was solid organ malignancy in 11 patients (73%), and hematologic malignancies in 4 patients (27%). Two patients (13%) were neutropenic at the time of positive culture. H. alvei isolates were first identified in patients at a median of 8 days and an average of 11 days after admission to the hospital. Of the 15 isolates, 8 (53%) were monomicrobial and 7 (47%) were polymicrobial cultures (Table 1). Co-isolates and susceptibilities are shown in the Table 2 and 3.
Table 1
Demographic data for all identified patients
Table 2
Characteristics of H. alvei isolations
Table 3
H. alvei antibiotic susceptibility report
Conclusion
This study demonstrated that H. alvei is a truly rare pathogenic organism with only 15 documented cases of isolation over an 80-month time period at an academic cancer center. In patients with underlying malignancies, the organism tends to have a predilection for both the urinary tract and abdominal wounds, and can be isolated from pure cultures in the urine and with co-isolates in all other locations. Our study showed that resistance with H. alvei is usually with ampicillin and most of our isolates were resistant to cefazolin and cefoxitin. When infection does occur, isolates tend to be susceptible to standard antibiotics such as aminoglycosides and ciprofloxacin.
Disclosures
All Authors: No reported disclosures
ABSTRACT The middle Miocene rocks of the Chinji Formation, Siwaliks Hills, Pakistan are well known for their rich and diverse vertebrate fossil assemblages. Here new suid fossil remains of the ...extinct species Hyotherium pilgrimi described. The known stratigraphic range of Hyotherium is about 14 to 11 million years. This species is closer to its smaller European relative H. soemmeringi. The studied material includes isolated premolars and molars. This paper provides new insights of morphology of an extinct species of the suid, Hyotherium pilgrimi.
Background
Prolonged cold ischemic time (CIT) in deceased donor kidney transplantation (DDKT) has been associated with adverse graft outcomes. Virtual crossmatch (VXM) facilitates reliable prediction ...of crossmatch results based on the profile of human leukocyte antigen antibodies of the recipient and the donor in reduced time compared with a physical crossmatch (PXM). We hypothesized a shorter CIT since the implementation of the VXM in recipients of DDKT.
Methods
We conducted a retrospective cohort study of consecutive adult recipients of DDKT. The data were analyzed for differences in CIT before and after the implementation of VXM.
Results
After the exclusion of 59 recipients (age less than 18 years and/or CIT ≥ 20 hours), our study compared outcomes of 81 PXMs from February to June 2018 against 68 VXMs from February to June 2019. There were no statistical differences between groups based on donor age (P = .09), donor type (P = .38), kidney donor profile index (P = .43), or delayed graft function (P = .20). Recipients with VXM were older (58 vs 51 years, P = .002) and had a higher estimated post-transplant survival score (59% vs 46%, P = .01). The CIT was significantly lower for the VXM group (P = .04).
Conclusion
Our study demonstrated a significantly shorter CIT with VXM in DDKT recipients. Our study was limited with small sample size, but the trend of increased graft survival with higher estimated post-transplant scores and older recipients is encouraging as the donor pool expands with marginal kidneys and national sharing.
The stalk of the influenza virus hemagglutinin (HA) is an attractive target for antibody-based universal influenza virus vaccine development. While antibodies that target this part of the virus can ...be neutralizing, it has been shown in recent years that Fc receptor-mediated effector functions are of significant importance for the protective effect of anti-stalk antibodies. Several assays to measure Fc-Fc receptor interaction-based effector functions like antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis exist, but they suffer from limitations such as low throughput and high run-to-run variability. Reporter assays for antibody-dependent cellular cytotoxicity based on reporter cells that express luciferase upon engagement of human FcγRIIIa with the Fc of antigen-bound antibodies have been developed as well. These reporter assays can be used in a higher throughput setting with limited run-to-run assay variability but since they express only one Fc receptor, their biological relevance is unclear. Here we optimized an antibody-dependent cellular cytotoxicity reporter assay to measure the activity of antibodies to the conserved stalk domain of H1 hemagglutinin. The assay was then correlated to a CD107a-based degranulation assay, and a strong and significant correlation could be observed. This data suggests that the FcγRIIIa-based reporter assay is a good substitute for functional assays, especially in settings where larger sample numbers need to be analyzed.
Abstract
Background
COVID-19 disease became a global health care crisis and was declared pandemic by WHO in March 2020. Some studies have indicated that Solid Organ Transplant (SOT) patients may have ...increased morbidity and mortality while others showed no difference. Our study aims to investigate patients’ characteristics, disease course, management of COVID-19 and outcomes in our SOT patient population.
Methods
We conducted a retrospective cohort study of all consecutive SOT recipients who were admitted to our transplant center from March 2020 to April 2021 with COVID-19 infection. Data was collected from the electronic medical records after receiving Institutional Review Board approval. Table 1Study Population Demographics
Figure 1 Age and Gender distribution of the study population
Results
A total of 135 patients met inclusion criteria. Average age at the time of COVID-19 diagnosis was 56.38±12.93 years. Majority of the patients (54%) were kidney transplant recipients. Out of the total, 28% of the patients required supplemental oxygen and 14% required intensive care unit (ICU) care. A total of 12 patients (9%) required intubation and mechanical ventilation. 21% of the patients were treated with Remdesivir and 30% met criteria for the use of corticosteroids. Unfortunately, 11 patients (8%) of the patients died from COVID-19 infection and its complications. Of those 11 patients 5 were treated with Remdesivir and 10 were treated Corticosteroids. None of the patients met the criteria for ECMO (Extra Corporeal Membrane Oxygenation). Figure 2Study Population Distribution of the Types of Transplants at time of COVID-19 infection
Figure 3 Outcomes - Admission to ICU and Mortality
Figure 4 COVID-19 Therapies and Outcomes in the SOT Recipients
Conclusion
Our study showed a higher mortality rate in SOT patients compared to general population. Treatment with Remdesivir and Corticosteroids improved the overall mortality rate but had no benefit in patients with critical illness requiring ICU level care. COVID vaccination significantly improved the outcome, and the major limitation of the study was COVID vaccination information was not included since the study was initiated prior to introduction of vaccines. More studies with larger sample size and vaccine data need to be conducted to accurately determine the outcome of COVID-19 infection in this patient population.
Disclosures
All Authors: No reported disclosures.
Background
The incidence of alcoholic liver disease (ALD) has increased, causing it to become a primary indication for liver transplantation in the United States. We hypothesized an association ...between alcohol taxation and prevalence of ALD.
Methods
We conducted a retrospective study of united network for organ sharing (UNOS) waitlist additions for liver transplantation between January 2007 and December 2016. We also analyzed the average excise tax (2007-2016) for beer, wine, and spirits in listing states of liver transplant waitlist additions (LTWA).
Results
There were 104 805 adult UNOS LTWA with assigned diagnoses, an annual increase from 22% to 28%. There were 24 316 LTWA with ALD diagnosis. The mean value for beer tax was significantly lower for ALD patients than for non-ALD patients across all age groups (P < .001). The analysis demonstrated significantly more ALD in waitlisted patients 35-54 years of age (30%), compared with 18-34 years (10%) and ≥55 years (20%), P < .001. The data confirmed significantly more ALD Medicaid patients in the 35-54 year age group (28%) compared with other age groups, P < .001.
Discussion
Our research demonstrated an association between lower beer tax and higher ALD prevalence across all age groups. We found a larger percentage of middle-aged (35-54 years) Medicaid patients listed with ALD. These findings raise the need for further investigation of a potential public health concern for an association between ALD and beer tax, especially for middle-aged patients of lower socioeconomic status.
Semen traits play the vital role in determining the fertility of a broiler breeder flock; however, it can be influenced by several factors. This experiment was carried out to assess some of these ...factors affecting the semen. A total of 89 male birds and 960 hens of 20-week-old broiler breeder (2215 g ± 7.5%) were divided into two main groups; one was kept in cages (AIC) and another group was kept on deep litter floor (AIF), while both these groups were subjected to AI. The male birds of aforementioned groups (44 males and 480 females) were further divided into 4 sub-groups (11 males and 120 females) to execute different semen collection frequencies i.e., 2, 3, 4, and 5th days’ interval. The impact of time duration between semen collection and insemination on sperm kinematics was monitored. The quantitative and qualitative analysis of semen including sperm concentration and sperm kinematics of the collected semen was conducted through a computer-assisted sperm analyzer (CASA) and ONGO machine (working on the CASA principle). Resultantly, the data revealed that the studied parameters of semen were deteriorated with the progression of age of male birds, while the group of males with standard body weight produced the best semen quantitatively and qualitatively followed by overweight particularly during the post peak phase (46–65 = 20 weeks). Although the 3rd day, semen collection frequency was found better for quality, the higher quantity of semen was achieved when males were being collected at the intervals of 4th and 5th day respectively regardless of housing systems. Significant decline in sperm kinematics was recorded with the progression of semen holding duration at the temperature of poultry farm. Furthermore, the highest contamination of
E. coli
,
Salmonella
, and
Mycoplasma gallisepticum
was recorded in the reproductive tract of hens and semen of the AIF group as compared to AIC. Thus, conclusion can be settled that the semen properties are significantly affected by age, body weight, and semen collection intervals in both housing systems, while sperm kinematics is being disrupted with the progression of holding duration. Although housing systems could affect the semen insignificantly, yet lesser contamination was recorded in semen and in the reproductive tract of hens of AIC.
Abstract
When mRNA vaccines were rolled out under EUA, it was observed that a single vaccination, already protected vaccinees from severe disease, even before neutralizing antibodies appearded. To ...better understand the underlying mechanism of protection, we vaccinated hamsters once with a suboptimal dose of Pfizer/BioNTech COVID-19 mRNA vaccine (5mg/animal). Four weeks post vaccination, animals were challenged with different variants of SARS-CoV-2. Vaccination resulted in antibody ELISA titers against SARS-CoV-2 spike protein, but antibody titers were too low for efficient neutralization of antigenically matching USA-WA1/2020 (WA1) or drifted variants of concern (Alpha, Beta, Delta and Mu). Nevertheless, suboptimal vaccination resulted in reduced morbidity for WA1 and Alpha-challenged animals and complete control of lung virus titers for WA1, Alpha and Delta but with breakthrough infection for the antigenically more distant Beta and Mu. Moreover, T cell responses were higher in vaccinated animals compared to unvaccinated ones at 5 days post infection, suggesting a recall of vaccine-primed T cells. Infection with different SARS-CoV-2 variants also back-boosted neutralizing antibody responses against the challenge virus and in the case of the variants of concern, against the antigenically distant but vaccine-matched WA1. Transcriptomic analysis of host immune responses to infection reflects both vaccination status and disease course, is further compared with lung pathology and suggests a role for interstitial lung macrophages in vaccine-mediated protection. In summary, protection after suboptimal vaccination against SARS-CoV-2 challenge in hamsters correlates with recall of both vaccine-induced B- and T-cell responses.
This study was also partly funded by CRIPT (Center for Research on Influenza Pathogenesis and Transmission), a NIH NIAID funded Center of Excellence for Influenza Research and Response (CEIRR, contract number 75N93021C00014) to A.G.S and M.S. and by R01 AI160706 to M.S.
Abstract
It is unclear to what extent pre-existing antibody-mediated immunity shapes influenza virus infection in humans. Similarly, the influence of previous history of influenza vaccination on ...disease severity and clinical outcome is not well understood. In here, we aimed to determine the balance of pre-existing antibodies against the hemagglutinin (HA) and neuraminidase (NA) protein of influenza virus that correlates with protection in humans. We measured hemagglutination inhibition (HI) titers and anti-HA (stalk and full-length) and anti-NA antibodies at the onset of the influenza infection on a cohort of H1N1/Cal09 influenza virus-infected patients (solid organ transplant recipients, SOTRs). Results demonstrated that the antecedent of TIV vaccination was the only controllable factor associated with lower risk of severity of disease in influenza virus-infected SOTRs. The presence of lower respiratory symptoms (LRS) significantly determined disease outcome at hospital admission (severe vs. mild, 9, 75% vs. 19, 32·1%, OR 95% 6·3, p=0·01). Moreover, a predicted probability curve for both anti-HA full-length and stalk (OR 0·13, p=0·02 and OR 0·06, p=0·03, respectively) demonstrated that the probability of developing LRS decreased with increasing assay log-values. However, multivariate logit model adjusted for HI, anti-HA (full-length and stalk) and anti-NA titers demonstrated that only anti-HA stalk antibodies were independently associated with influenza severity. Our study demonstrated that when HI antibodies fail to confer protection from symptomatic influenza infection, pre-existing HA stalk antibodies protected against severe disease in SOTRs.
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