The latest medical research on Infectious Disease

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about infectious disease gathered by our medical AI research bot.

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A remote management system for control and surveillance of echinococcosis: design and implementation based on internet of things.

Infectious Diseases of Poverty

As a neglected cross-species parasitic disease transmitted between canines and livestock, echinococcosis remains a global public health concern with a heavy disease burden. In China, especially in the epidemic pastoral communities on the Qinghai-Tibet Plateau, the harsh climate, low socio-economic status, poor overall hygiene, and remote and insufficient access to all owned dogs exacerbate the difficulty in implementing the ambitious control programme for echinococcosis. We aimed to design and implement a remote management system (RMS) based on internet of things (IoT) for control and surveillance of echinococcosis by combining deworming devices to realise long-distance smart deworming control, smooth statistical analysis and result display. New methods and tools are urgently needed to increase the deworming coverage and frequency, promote real-time scientific surveillance, and prevent transmission of echinococcosis in remoted transmission areas.

From 2016 to 2019, we had cooperated and developed the smart collar and smart feeder with the Central Research Institute of Shanghai Electric Group Co., Ltd. (Shanghai, China) and Shenzhen Jizhi Future Technology Co., Ltd. (Shenzhen, China). From September 2019 to March 2020, We had proposed the RMS based on IoT as a novel tool to control smart deworming devices to deliver efficient praziquantel (PZQ) baits to dogs regularly and automatically and also as a smart digital management platform to monitor, analyse, and display the epidemic trends of echinococcosis dynamically, in real time in Hezuo City, Gannan Tibetan Autonomous Prefecture, Gansu Province, China. Starting from January 2018, The RMS has been maintained and upgraded by Shanghai Yier Information Technology Co., Ltd (Shanghai, China). The database was based on MySQL tools and the Chi-square test was used to probe the difference and changes of variables in different groups.

The smart collars are fully capable of anti-collision, waterproof, and cold-proof performance, and the battery's energy is sufficient, the anti-collision rate, water-proof rate, cold-proof rate and voltage normal rate is 99.6% (521/523), 100.0% (523/523), 100.0% (523/523) and 100.0% (523/523), respectively. The RMS can accurately analyse the monitoring data and parameters including positive rates of canine faeces, and the prevalence of echinococcosis in the general population livestock, and children. The data of dogs deworming and surveillance for echinococcosis is able to be controlled using RMS and has expanded gradually in townships to the whole Hezuo region. The automatic delivering PZQ rate, collar positioning rate, deliver PZQ reminding rate, and fault report rate is 91.1% (1914/2102), 92.1% (13 580/14 745), 92.1% (1936/2102) and 84.7% (1287/1519), respectively. After using the RMS from 2019, the missing rate of monitoring data decreased from 32.1% (9/28) to 0 (0/16). A total of 48 administrators (3, 3, 8, 11, 23 at the provincial, municipal, county, township, village levels, respectively) participated in the questionnaire survey, with 93.8% of its overall satisfaction rate.

The existing difficulties and challenges in the way of prevention and control for echinococcosis can partially be resolved using the innovative, IoT-based technologies and tools. The proposed RMS advance the upgrade of existing manual prevention and control models for echinococcosis, especially in the current ongoing COVID-19 pandemic, as social distance and community blockade continue.

Distribution and factors associated with urogenital schistosomiasis in the Tiko Health District, a semi-urban setting, South West Region, Cameroon.

Infectious Diseases of Poverty

Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS.

In this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosoma haematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection.

The overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3-34.8] with geometric mean (GM) egg count of 28.7 (range: 2-450) eggs per 10 ml of urine. S. haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5-14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1-12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4-8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001).

Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.

Risk factors for developing severe COVID-19 in China: an analysis of disease surveillance data.

Infectious Diseases of Poverty

COVID-19 has posed an enormous threat to public health around the world. Some severe and critical cases have bad prognoses and high case fatality rates, unraveling risk factors for severe COVID-19 are of significance for predicting and preventing illness progression, and reducing case fatality rates. Our study focused on analyzing characteristics of COVID-19 cases and exploring risk factors for developing severe COVID-19.

The data for this study was disease surveillance data on symptomatic cases of COVID-19 reported from 30 provinces in China between January 19 and March 9, 2020, which included demographics, dates of symptom onset, clinical manifestations at the time of diagnosis, laboratory findings, radiographic findings, underlying disease history, and exposure history. We grouped mild and moderate cases together as non-severe cases and categorized severe and critical cases together as severe cases. We compared characteristics of severe cases and non-severe cases of COVID-19 and explored risk factors for severity.

The total number of cases were 12 647 with age from less than 1 year old to 99 years old. The severe cases were 1662 (13.1%), the median age of severe cases was 57 years [Inter-quartile range(IQR): 46-68] and the median age of non-severe cases was 43 years (IQR: 32-54). The risk factors for severe COVID-19 were being male [adjusted odds ratio (aOR) = 1.3, 95% CI: 1.2-1.5]; fever (aOR = 2.3, 95% CI: 2.0-2.7), cough (aOR = 1.4, 95% CI: 1.2-1.6), fatigue (aOR = 1.3, 95% CI: 1.2-1.5), and chronic kidney disease (aOR = 2.5, 95% CI: 1.4-4.6), hypertension (aOR = 1.5, 95% CI: 1.2-1.8) and diabetes (aOR = 1.96, 95% CI: 1.6-2.4). With the increase of age, risk for the severity was gradually higher [20-39 years (aOR = 3.9, 95% CI: 1.8-8.4), 40-59 years (aOR = 7.6, 95% CI: 3.6-16.3), ≥ 60 years (aOR = 20.4, 95% CI: 9.5-43.7)], and longer time from symtem onset to diagnosis [3-5 days (aOR = 1.4, 95% CI: 1.2-1.7), 6-8 days (aOR = 1.8, 95% CI: 1.5-2.1), ≥ 9 days(aOR = 1.9, 95% CI: 1.6-2.3)].

Our study showed the risk factors for developing severe COVID-19 with large sample size, which included being male, older age, fever, cough, fatigue, delayed diagnosis, hypertension, diabetes, chronic kidney diasease, early case identification and prompt medical care. Based on these factors, the severity of COVID-19 cases can be predicted. So cases with these risk factors should be paid more attention to prevent severity.

Core Antibiotic-Induced Transcriptional Signatures Reflect Susceptibility to All Members of an Antibiotic Class.

Antimicrobial Agents and Chemotherapy

Current growth-based antibiotic susceptibility testing (AST) is too slow to guide early therapy. We previously developed a diagnostic approach that...

Experience with Liposomal Amphotericin B in Outpatient Parenteral Antimicrobial Therapy (OPAT).

Antimicrobial Agents and Chemotherapy

Outpatient parenteral antimicrobial therapy (OPAT) is a safe, effective, and convenient treatment strategy for patients receiving intravenous antimicrobials in the outpatient setting; however, data is limited describing the use and safety of liposomal amphotericin B (L-AMB).

Records of patients receiving L-AMB OPAT between 1/1/2015 and 7/31/2018 were retrospectively reviewed. The primary objective was to describe the OPAT patient population discharged on L-AMB and evaluate factors associated with readmission and adverse events (AE). Analysis was performed to evaluate for predictors of worse outcomes.

Forty-two patients (67% male, median age 50 years) were identified, most commonly treated for histoplasmosis. The most common doses of L-AMB were 3 mg/kg (n=16, 38%) or 5 mg/kg (n=14, 33%) based on actual body weight. Twenty-six (62%) patients completed their anticipated course of L-AMB. Twenty-two (52%) patients were readmitted within 30 days of discharge, median time to readmission was 11 days (Interquartile range [IQR] 5-18). While hypokalemia and acute kidney injury (AKI) were common, occurring in 26 (62%) and 20 (48%), respectively, only 5 (12%) were readmitted to the hospital due L-AMB-associated AE. Ninety percent of patients achieved at least partial renal recovery within 30 days after L-AMB discontinuation. Factors significantly associated with AKI include higher L-AMB dose, lower serum potassium levels after therapy initiation, and receipt of potassium supplementation at discharge.

L-AMB is associated with significant AEs; however, these results suggest treatment is feasible in the outpatient setting with close monitoring, as the majority of AEs were managed effectively as an outpatient without long-term sequelae.

E. coli GyrA Tower Domain Interacts with QnrB1 Loop B and Plays an Important Role in QnrB1 Protection from Quinolone Inhibition.

Antimicrobial Agents and Chemotherapy

The Qnr pentapeptide repeat proteins interact with DNA gyrase and protect it from quinolone inhibition. The two external loops, particularly the la...

Compound FC-10696 Inhibits Egress of Marburg Virus.

Antimicrobial Agents and Chemotherapy

Marburg virus (MARV) VP40 protein (mVP40) directs egress and spread of MARV, in part, by recruiting specific host WW-domain containing proteins via...

Mechanisms and primary prevention of atherosclerotic cardiovascular disease among people living with HIV.

Current Opinion in Cell Biology

To highlight mechanisms of elevated risk of atherosclerotic cardiovascular disease (ASCVD) among people living with HIV (PLWH), discuss therapeutic strategies, and opportunities for primary prevention.

HIV-associated ASCVD risk is likely multifactorial and due to HIV-specific factors and traditional risk factors even in the setting of treated and suppressed HIV disease. Although a growing body of evidence suggests that inflammation and immune activation are key drivers of atherogenesis, therapies designed to lower inflammation including colchicine and low-dose methotrexate have not improved secondary cardiovascular endpoints among PLWH. Statins continue to be the mainstay of management of hyperlipidemia in HIV, but the impact of newer lipid therapies including proprotein convertase subtilisin/kexin type 9 inhibitors on ASCVD risk among PLWH is under investigation. Aside from the factors mentioned above, healthcare disparities are particularly prominent among PLWH and thus likely contribute to increased ASCVD risk.

Our understanding of mechanisms of elevated ASCVD risk in HIV continues to evolve, and the optimal treatment for CVD in HIV aside from targeting traditional risk factors remains unknown. Future studies including novel therapies to lower inflammation, control of risk factors, and implementation science are needed to ascertain optimal ways to treat and prevent ASCVD among PLWH.

What's new in bone disease and fractures in HIV?

Current Opinion in Cell Biology

People living with HIV (PWH) are at greater risk of low bone mineral density (BMD) and fractures compared to the general population. This narrative review summarises recent literature in the field, including the relative contribution of antiretroviral therapy and frailty to low BMD and fractures in PWH.

The body of evidence indicating less impact on BMD from the use of tenofovir alafenamide compared to tenofovir disoproxil fumarate continues to grow, although this has not yet translated into data supporting a reduction in fracture incidence. Frailty, common in PWH, is associated with both fractures and alterations in renal-bone metabolism, but is an area that is understudied in relation to interventions to reduce fracture risk in PWH.

Although a maturing field, research into interventions to reduce fracture incidence in PWH is lacking in both quantity and scope. Development of core outcome datasets for clinical trials along with trials focused on reducing or reversing frailty are required to guide improvements overall bone health outcomes in PWH.

Prevalence of Strongyloidiasis Among Cardiothoracic Organ Transplant Candidates in a Non-Endemic Region; A Single Center Experience with Universal Screening.

Transplant Infectious Disease

Disseminated strongyloidiasis and hyperinfection syndrome can cause significant morbidity and mortality after transplantation. Screening and treatm...

Current co-morbidities burden in patients living with HIV in low- and middle-income countries.

Current Opinion in Cell Biology

The present review aims to decipher common co-morbidities faced by people living with HIV in low- to middle-income countries, and in particular the sub-Saharan region, which hosts the majority of the HIV burden worldwide.

Well-controlled chronic HIV disease is strongly associated with an increased risk of developing cardiovascular disease. This is partly due to the natural aging process, however recent studies show that using antiretroviral therapy as well as the HIV disease itself may be predisposing factors to the development of cardiovascular diseases, creating a new burden for healthcare facilities in the region. Furthermore, newly completed studies assessing inflammation marker albuminuria and age-related syndrome frailty have been found in a higher prevalence than in non-HIV people, with increased morbidity and mortality.

As antiretroviral medication continues to be well supplied in the region and well tolerated by patients living with HIV, this group is now reckoning with cardiovascular ailments faced by all ageing population therefore there is a need for cardiovascular care systems to be better integrated within the existing, well-performing HIV care cascade to address this burden.

Frailty: the current challenge for aging people with HIV.

Current Opinion in Cell Biology

Older adults account for the majority of people with HIV (PWH) in high-income countries and have increasingly complex clinical profiles related to premature aging. Frailty is an important geriatric syndrome affecting a minority of PHW. Frailty negatively affects PHW's clinical status and quality of life. This review will update care providers on the current state of frailty that limits the healthspan of PWH.

Ongoing low-level HIV replication in treated PWH leads to immune activation and chronic inflammation contributing to the destabilization of normally autoregulated physiologic systems in response to environmental and biologic challenges characteristic of frailty. Understanding these underlying mechanisms will determine potential intervention options. Potentially reversible risk factors that promote progression to and reversion from the dynamic state of frailty are being studied and will help prevent frailty. Simple assessment tools and treatment strategies for frailty are being adapted for aging PWH.

Insight into underlying biologic mechanisms and adapting proven geriatric principles of interdisciplinary care will inform the healthy aging of PWH.