Current Issue : October-December Volume : 2025 Issue Number : 4 Articles : 5 Articles
Since 2013, the World Health Organization has recommended the use of rapid molecular tests as the initial diagnostic step for Mycobacterium tuberculosis (MTB) infection to enhance the control of tuberculosis. In recent years, the prevalence of infections by nontuberculous mycobacteria (NTM) in humans has also risen, particularly in countries with low tuberculosis incidence, such as Italy. Therefore, the rapid dierentiation between NTM and Mycobacterium tuberculosis complex is crucial for timely therapeutic decisions. This study evaluates a new rapid molecular assay, Standard M10 MTB/NTM, designed to detect MTB, NTM, or co-detection in Mycobacteria Growth Indicator Tube cultures from dierent biological matrices. The assay was validated using 100 positive and 50 negative liquid mycobacteria cultures, already conrmed by specic real-time PCR and Sanger sequencing. Following optimization of assay conditions for culture sample processing and assessment of potential interference, Standard M10 demonstrated excellent sample stability, high specicity, and good sensitivity, identifying all 50 MTB and 49 NTM samples. Some limitations included the non-detection of M. celatum in one case and false positive results (MTB co-infection) in two NTB cases. Nevertheless, overall, the adoption of this test could be considered for laboratory management to enable rapid and eective sample targeting for subsequent diagnostic evaluation and treatment decision-making....
This study included deidentified antibiotic susceptibility results from outpatient urinary Escherichia coli isolates from Washington state which were tested at a large clinical laboratory during 2013–2019. Isolates were categorized as representing the first, second, third, or fourth-or-greater occurrence of infection in data from individual patients. We used logistic regression with the outcome of resistance, adjusting for year of antimicrobial susceptibility test, patient sex, patient age, and facility type. In cases of subsequent infection, we found a significant risk of resistance to levofloxacin, ciprofloxacin, ceftriaxone, trimethoprim-sulfa, nitrofurantoin, ampicillin, gentamicin, and amoxicillin-clavulanate. Our findings suggest that Escherichia coli isolates from recurrent urinary tract infections have a higher rate of resistance to most tested antibiotics than isolates from the first urinary tract infection in a given year. However, susceptibility frequencies did not differ significantly between antibiograms constructed using only the first occurrence in a patient and those constructed using all subsequent occurrences. These findings suggest that the traditional approach of including only the first occurrence of urinary Escherichia coli in a patient may underestimate levels of antibiotic resistance in a community. Such underestimation could negatively affect empiric therapeutic choices, health outcomes, and treatment costs....
SARS-CoV-2 continues to circulate with new variants of uncertain transmissibility and virulence arising over time and resulting in varying morbidity and mortality between and within countries. This study aimed to identify the predictors of mortality among hospitalized COVID-19 patients across the first five waves of the pandemic. We conducted a retrospective cohort study at Tigoni Level 4 Hospital in Kenya. The study included patients admitted between June 2020 to August 2022 who tested positive for SARS-CoV-2. Sociodemographic and clinical data were abstracted from patient records at the time of admission and throughout their hospital stay. We employed Cox proportional hazard regression analysis to estimate the time to event (discharge or death) and identify predictors of mortality. Both time-varying and non-time-varying covariates were included in the models. A total of 1985 patients were admitted, of whom 557 (28%) died. The median hospital stay was 4 (1.0–8.0) days and 9 (5.0–13.0) days for patients who died and those who were discharged alive, respectively. Compared to patients admitted during wave 1, those admitted during the subsequent waves had high risk of death estimated at adjusted HR: 1.66 (95% CI 1.2, 2.54), 5.17 (95% CI 3.55, 7.53), 2.62 (95% CI 1.87, 3.67), and 2.17 (95% CI 1.51, 3.11) for waves 2, 3, 4, and 5, respectively. A proportion of patients presented with persistent chest pain, cough, and hypoxia and continued oxygen therapy for more than two months. In addition, patients who had persistent fever, hypoxia, cough, and fatigue had a significant mortality risk (adjusted HR: 3.00; 95% CI: 1.81–4.98; HR: 1.97; 95% CI: 1.73–2.26; HR: 1.47; 95% CI: 1.24–1.75; HR: 1.64; 95% CI: 1.05–2.54). Conversely, patients who had low oxygen saturation and received oxygen at admission had a 76% (HR: 0.24; 95% CI: 0.13–0.42) reduction in mortality risk and in addition patients whose treatment was altered had a 49% reduction in mortality risk (HR: 0.51; CI: 0.45–0.58). Our study highlights the benefits of oxygen therapy on the outcome of COVID-19 patients and justifies the need to increase investments in oxygen especially in low-and-middle-income countries. It also confirms the need to analyze the pandemic by the different waves....
The CRISPR–Cas system has transformed molecular biology by providing precise tools for genome editing and pathogen detection. Originating from bacterial adaptive immunity, CRISPR technology identifies and cleaves genetic material from pathogens, thereby preventing infections. CRISPR–Cas9, the most widely utilized variant, creates double-stranded breaks in the target DNA, enabling genetic disruptions or edits. This approach has shown significant potential in antiviral therapies, addressing chronic infections, such as HIV, SARS-CoV-2, and hepatitis viruses. In HIV, CRISPR–Cas9 edits the essential viral genes and disrupts latent reservoirs, while CCR5 gene modifications render the T cells resistant to viral entry. Similarly, SARS-CoV-2 is targeted using CRISPR–Cas13d to inhibit the conserved viral genes, significantly reducing viral loads. Hepatitis B and C treatments leverage CRISPR technologies to target conserved genomic regions, limiting replication and expression. Emerging innovations, such as the PAC-MAN approach for influenza and base-editing systems to reduce off-target effects, further highlight the therapeutic versatility of CRISPR. Additionally, advances in Cas12a and Cas13 have driven the development of diagnostic platforms like DETECTR and SHERLOCK, which provide rapid and cost-effective viral detection. Innovative tools like AIOD-CRISPR enable accessible point-of-care diagnostics for early viral detection. Experimental approaches, such as targeting latent HSV-1 reservoirs, highlight the transformative potential of CRISPR in combating persistent infections....
Background: The identication of parasite- and stage-specic antigens is crucial for the development of new diagnostic tests for cystic echinococcosis (CE). We previously analysed the interleukin (IL)-4 response to T-specic peptides corresponding to the immunogenic regions of the ve antigen B (AgB) subunits, demonstrating that AgB1 is the most immunogenic protein and that the response to all AgB peptides is associated with viable cysts. However, the response in patients with CE3a (WHO-IWGE) cystic stage was not evaluated and no other immunological factors besides IL-4 were included in the analysis. Methods: Four study groups were dened: “CE3a group” (transitional cysts), “CE3b group” (active cysts), “CE4/CE5 group” (inactive cysts), and “NO CE-group” encompassing patients with non-CE cysts (controls). Whole blood was stimulated in vitro with the ve dierent T-specic peptide pools corresponding to the ve AgB subunits and with a pool containing all ve peptides’ pools (total pool). IL-4 and other immunological markers were evaluated by ELISA and a multiplex assay, respectively. Results: Twenty-four patients with CE (CE3a-group n = 3; CE3b-group n = 6; CE4/CE5- group n = 15) and 14 subjects with non-CE cysts were enrolled. IL-4 levels in response to AgB1 and AgB3 pools were signicantly increased in CE compared to NO CE groups (p = 0.0201, p = 0.0041). Within the CE patients, the highest IL-4 median level was observed in response to the AgB total pool, the AgB3 and AgB4 pools, followed by the AgB1 pool. Moreover, the IL-4 levels in response to the AgB1 pool were found to be signicantly higher in the CE3b group compared to the CE4/CE5 group (p = 0.0070), while no dierences were found for the CE3a group. As for other cytokines, we found higher IL-7 levels in response to the AgB4 pool in the CE4/CE5 group compared to the CE3b group (p = 0.0012), higher IL-2 levels in response to the AgB1 pool and AgB total pool in CE3b patients compared to controls (p = 0.0016), and higher IL-13 levels in response to the AgB total pool in patients with CE3b and CE4/CE5 cysts compared to NO CE (p = 0.0016; p = 0.0009). Conclusions: These results contribute to a beer knowledge of the immune interplay in the presence of CE and may be useful for further exploring the use of recombinant proteins/peptides in cytokine release assays for the diagnosis and follow-up of CE....
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