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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Elimination of schistosomiasis requires multifactorial diagnostics: evidence from high- and low-prevalence areas in the Nile Delta, Egypt.

Infectious Diseases of Poverty

Schistosomiasis is one of the neglected tropical diseases (NTDs) selected for worldwide elimination in the near future. Egypt has made strong progress against its two endemic species of Schistosoma mansoni and S. haematobium. The former is prevalent in the Nile Delta with the latter dominating in the Nile south of Cairo. Innovative efforts are needed to reach the goal as further reduction of the prevalence has stalled due to ongoing transmission. In this study we aimed to explore the difference between low and high prevalence villages with regard to knowledge attitude and practice about schistosomiasis, utilization of health services, infection and transmission indices.

A hybrid cross-sectional longitudinal study was conducted with three annual follow-ups conducted during 1994-1996. We used a representative systematic random sampling technique investigating 993 individuals from the high prevalence village and 614 from the low prevalence village. Data were analyzed using SPSS, comparing proportions with the Chi square test and means with the Student t test, and ANOVA.

Compliance of faecal sampling and chemotherapy was above 70% in both villages over the whole study period. Selective praziquantel treatment resulted in a significant reduction of prevalence and intensity of infection in both villages, dropping from 35.8% prevalence to 20.6%, in the low-prevalence village, and from 69.5 to 45.9% in the high-prevalence one. Intensity of infection at the base line was 30 eggs per gram (EPG) of stool in the low-prevalence village versus 105 EPG in the high-prevalence village. However, after the second round, reinfection rebounded by 22% in the high-prevalence village, while a slight improvement of the infection indices was demonstrated in the low-prevalence one. The level of knowledge was modest in both villages: people knew about self-protection and treatment, but not much about the role of human excreta for schistosomiasis transmission. While all participants maintained that using the water from the canals was inevitable, inhabitants in the high-prevalence village showed significantly lower scores reflecting higher water contact compared to the low-prevalence one. Many of them (67%) did not utilize the health centre at all compared to 26% of the people in the low-prevalence village. Interestingly, private clinics were seen as the primary source of health care by both villages, but more frequently so in the high-prevalence village (used by 87.2% of the inhabitants) compared to the low-prevalence one (59.8%).

Even if chemotherapy works well as reflected by the observed downregulation of intensity of infection in both villages, reinfection continued due to difficulties to avoid water contact. Efforts must be made to make people understand the role of human excreta for transmission. There is also a need to make people better trust the medical services available.

Evaluation of the effect of contezolid (MRX-I) on the corrected QTc interval: a randomized, double-blind, placebo- and positive-controlled crossover study in healthy Chinese volunteers.

Antimicrobial Agents and Chemotherapy

Contezolid (MRX-I), a new oxazolidinone, is an antibiotic in development for treating complicated skin and soft tissue infections (cSSTI) caused by...

CMV myocarditis in solid organ transplant recipients: A case series and review of literature.

Transplant Infectious Disease

Cytomegalovirus (CMV) is a DNA-virus of the Herpesviridae family and is estimated to affect 15-30% of high-risk solid organ transplant recipients. ...

Daptomycin Perioperative Prophylaxis for the Prevention of Vancomycin-Resistant Enterococcus Infection in Colonized Liver Transplant Recipients.

Transplant Infectious Disease

Vancomycin-resistant Enterococcus (VRE)-colonized liver transplantation (LT) recipients have increased post-LT morbidity, mortality, and higher rates of VRE infections compared to their non-colonized counterparts. Pre-LT screening for VRE colonization and inclusion of daptomycin in the perioperative antibiotic prophylaxis regimen may mitigate this risk.

We performed a retrospective chart review of liver transplant recipients aged ≥ 18 years between 2013 and August 2019 to identify pre-LT VRE-colonized recipients and whether they received daptomycin perioperative prophylaxis (DPP). Demographic and clinical characteristics, including risk factors for VRE infection, were collected. Outcomes measured were VRE-related infection and all-cause mortality within 90 days of LT.

Of the 27 VRE-colonized liver transplant recipients within the study period, 25 received DPP. All recipients were admitted to the intensive care unit post-operatively, six (24%) required reoperation, fifteen (60%) required renal replacement therapy, and eight (32%) experienced post-operative hemorrhage within 90 days post-transplant. Two recipients (8%) experienced acute cellular rejection, but no primary graft failure was seen within 90 days. Among those who received DPP, no infections related to VRE nor death were seen within 90-days of LT. The two VRE-colonized recipients who did not receive DPP both developed VRE bacteremia in the early post-LT period.

Despite having multiple risk factors for post-LT VRE infection, VRE-colonized recipients who received DPP did not develop VRE-related infections in the first 90 days post-LT. Our experience demonstrates that pre-LT VRE screening and DPP may be associated with a reduction in VRE infection in the early-post LT period, but this strategy warrants further evaluation in prospective studies.

Near point-of-care, point-mutation test to detect drug resistance in HIV-1: a validation study in a Mexican cohort.

AIDS

Pre-treatment HIV-drug-resistance (PDR, HIVDR) to non-nucleoside reverse transcriptase inhibitors (NNRTIs) is increasing globally. NNRTIs continue to be used as 1st-line antiretroviral therapy (ART) in some communities due to the cost of dolutegravir-based ART or dolutegravir-associated adverse events. A simplified version of the oligonucleotide ligation assay (OLA), "OLA-Simple", is a low-cost, near point-of-care assay that provides ready-to-use lyophilized reagents and reports HIVDR mutations as colored lines on lateral flow strips. Our objective was to design and validate OLA-Simple for a Mexican cohort.

Plasma RNA was tested using OLA-Simple kits. OLA-Simple lateral flow strips were read by in-house software and were classified as mutant or wild-type at each codon. The comparison of results by OLA-Simple and Miseq was used to generate receiver operating characteristic (ROC) curves.

OLA-Simple PCR amplified 59/60 specimens and successfully genotyped 287/295 codons, with 8/295 (2.7%) indeterminate results. Compared to MiSeq, OLA-Simple gave 5/295 (1.7%) false-positive and 4/295 (1.4%) false-negative results. Excluding indeterminate results, OLA-Simple classified mutant with an accuracy of 97.4% and 98.8% when using thresholds at 10% and 25% mutant within an individual's HIV quasispecies, respectively.

Compared to MiSeq, OLA-Simple detected HIVDR with high sensitivity and accuracy. OLA-Simple could expand access to affordable and rapid HIVDR testing to guide appropriate ART choices in populations using NNRTI-based ART.

Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV pre-exposure prophylaxis.

AIDS

The optimal screening frequency of sexually transmitted infections (STIs) for men who have sex with men (MSM) and transgender women (TGW) on HIV pre-exposure prophylaxis (PrEP) is unclear, with current guidelines recommending screening every three to six months. We aimed to determine the number of STIs for which treatment would have been delayed without quarterly screening.

The proportion of gonorrhea, chlamydia, and syphilis infections for which treatment would have been delayed had screening been conducted every six versus every three months was determined by taking the number of asymptomatic STIs at weeks 12 and 36 divided by the total number of infections during the study follow-up period for each STI.

50.9% of participants had an STI during follow-up. If screening had been conducted only semiannually or based on symptoms, identification of 34.3% of gonorrhea, 40.0% of chlamydia, and 20.4% of syphilis infections would have been delayed by up to three months. The vast majority of participants (89.2%) with asymptomatic STIs reported condomless anal sex and had a mean of 8.1 partners between quarterly visits.

Quarterly STI screening among MSM on PrEP could prevent a substantial number of partners from being exposed to asymptomatic STIs and decrease transmission.

clinicaltrials.gov Identifier: NCT# 01632995.

Health related behaviors among HIV-infected people who are successfully linked to care: an institutional-based cross-sectional study.

Infectious Diseases of Poverty

By the end of October 2019, there were 958 thousand people were reported living with HIV/AIDS in China. Unhealthy lifestyle factors, such as smoking, drinking alcohol, using illicit drugs and no physical activity have been found to mitigate the positive impact of antiretroviral therapy (ART) on viral load and HIV-related quality of life. Moreover, risky sexual behavior among HIV-positive persons places their partners at risk for HIV transmission and other sexually transmitted infections. The aim of the study is to determine the prevalence of unhealthy behavior of people living with HIV/AIDS and related influencing factors, particularly those that are closely connected with HIV infection and ART effects.

An institutional based cross-sectional study design was used to collect data from people living with HIV/AIDS (PLWHA) in Beijing and Yunnan Province. The following information was included in the questionnaire survey: social-demographic characteristics, health behavior information, sexual risk behaviors. Binary logistic regression model was conducted to analyze the influencing factors of unhealthy general health behaviors and risky sexual behaviors.

In total, 2575 PLWHA were included in the study and 78.3% (2017/2575) were male. For the general health behaviors, 34.2% (987/2544) smoke; 33.8% (870/2575) drank alcohol and 2.3% (49/2134) reported the use of illicit drugs in the previous 6 months. From the sexual behaviors perspective, 59.0% (1519/2575) had sex in the previous 6 months. Among people who had sex, 92.0% (1398/1519) had fixed sexual partners. Among those with no fixed sexual partner, 38.0% (46/121) had more than three partners. Among men who had sex, 34.7% (448/1292) reported having sex with men in the previous 6 months and 16.7% (75/448) of these had group sexual activity. Among participants, 72.2% (1053/1458) used condoms every time they had sex while 6.4% (94/1458) of people never used condom. Male people living with HIV/AIDS were more likely to have sexual risk behaviors (adjusted odds ratio [OR] = 2.208, 95% confidence interval [CI]: 1.147-4.252) and unhealthy general health behaviors (adjusted OR = 2.029, 95% CI: 1.480-2.783). The odds of higher risk sexual behaviors was 1.546 times (95% CI: 1.302-1.827, P = 0.001) greater among participants who drank alcohol compared with their non-drinking counterparts.

PLWHA is a group that is vulnerable to problematic health behaviors, especially for men who were more likely to drink alcohol, have more sexual partners, more sexual risk behaviors including group sexual activity, not using condoms and using drugs. Therefore, interventions focusing on gender-specific risk behaviors reduction for people living with HIV/AIDS are now necessary to control the spread of HIV infection and improve the efficacy of antiviral treatment.

Population dynamics, pathogen detection and insecticide resistance of mosquito and sand fly in refugee camps, Greece.

Infectious Diseases of Poverty

As of 2015 thousands of refugees are being hosted in temporary refugee camps in Greece. Displaced populations, travelling and living under poor conditions with limited access to healthcare are at a high risk of exposure to vector borne disease (VBD). This study sought to evaluate the risk for VBD transmission within refugee camps in Greece by analyzing the mosquito and sand fly populations present, in light of designing effective and efficient context specific vector and disease control programs.

A vector/pathogen surveillance network targeting mosquitoes and sand flies was deployed in four temporary refugee camps in Greece. Sample collections were conducted bi-weekly during June-September 2017 with the use of Centers for Disease Control (CDC) light traps and oviposition traps. Using conventional and molecular diagnostic tools we investigated the mosquito/sand fly species composition, population dynamics, pathogen infection rates, and insecticide resistance status in the major vector species.

Important disease vectors including Anopheles sacharovi, Culex pipiens, Aedes albopictus and the Leishmania vectors Phlebotomus neglectus, P. perfiliewi and P. tobbi were recorded in the study refugee camps. No mosquito pathogens (Plasmodium parasites, flaviviruses) were detected in the analysed samples yet high sand fly Leishmania infection rates are reported. Culex pipiens mosquitoes displayed relatively high knock down resistance (kdr) mutation allelic frequencies (ranging from 41.0 to 63.3%) while kdr mutations were also detected in Ae. albopictus populations, but not in Anopheles and sand fly specimens. No diflubenzuron (DFB) mutations were detected in any of the mosquito species analysed.

Important disease vectors and pathogens in vectors (Leishmania spp.) were recorded in the refugee camps indicating a situational risk factor for disease transmission. The Cx. pipiens and Ae. albopictus kdr mutation frequencies recorded pose a potential threat against the effectiveness of pyrethroid insecticides in these settings. In contrast, pyrethroids appear suitable for the control of Anopheles mosquitoes and sand flies and DFB for Cx. pipiens and Ae. albopictus larvicide applications. Targeted actions ensuring adequate living conditions and the establishment of integrated vector-borne disease surveillance programs in refugee settlements are essential for protecting refugee populations against VBDs.

HIV protease inhibitor ritonavir induces renal fibrosis and dysfunction: role of platelet-derived TGF-β1 and intervention via anti-oxidant pathways.

AIDS

Chronic kidney disease (CKD) with tubular injury and fibrosis occurs in HIV infection treated with certain protease inhibitor (PI)-based antiretroviral therapies. The pathophysiology is unclear.

C57BL/6 mice, wild-type and deficient in platelet TGF-β1, were given RTV (10 mg/kg) or vehicle daily for 8 weeks. Select groups were exposed to CO (250 ppm) for 4 hours after RTV or vehicle injection. Renal pathology, fibrosis, and TGF-β1- and Nrf2-based signaling were examined by histology, immunofluorescence, and flow cytometry. Renal damage and dysfunction were assessed by KIM-1 and cystatin C ELISAs. Clinical correlations were sought among HIV-infected individuals.

RTV induced glomerular and tubular injury, elevating urinary KIM-1 (p = 0.004). It enhanced TGF-β1-related signaling, accompanied by kidney fibrosis, macrophage polarization to an inflammatory phenotype, and renal dysfunction with cystatin C elevation (p = 0.008). Mice with platelet TGF-β1 deletion were partially protected from these abnormalities. CO inhibited RTV-induced fibrosis and macrophage polarization in association with upregulation of Nrf2 and heme oxygenase-1 (HO-1). Clinically, HIV infection correlated with elevated cystatin C levels in untreated women (n = 17) vs. age-matched controls (n = 19; p = 0.014). RTV-treated HIV+ women had further increases in cystatin C (n = 20; p = 0.05), with parallel elevation of HO-1.

Platelet TGF-β1 contributes to RTV-induced kidney fibrosis and dysfunction, which may be amenable to anti-oxidant interventions.

Factors associated with psoriasis in a French Nationwide HIV cohort: the independent role of HLA-B*57: 01.

AIDS

Psoriasis is a T-cell-mediated inflammatory disease with genetic factors involved in its etiopathogenesis. In non-HIV populations, HLA-B*57:01 has been associated with a higher risk of psoriasis. The aim of this study was to investigate demographic and immunovirological characteristics associated with psoriasis, and to assess whether HLA-B*57:01 is associated with psoriasis among people living with HIV (PLHIV) followed in a large French multicenter Dat'AIDS cohort.

All PLHIV followed up from January 2000 to December 2018 with an available result for HLA-B*57:01 were included. Logistic regression models were used to identify associations between psoriasis (outcome variable) and explanatory variables.

Among 31,076 PLHIV, the overall prevalence of psoriasis and HLA-B*57:01 were 2.25% and 4.73%, respectively and varied according to ethnicity. By multivariate analysis, male gender (OR 1.81 [95% CI, 1.46 - 2.24], p < 10), positive HLA-B*57:01 (OR 2.66 [95% CI, 2.12 - 3.33], p < 10), nadir CD4 cell count <200/mm (OR 1.41 [95% CI, 1.19 - 1.67], p < 10) and positive HCV serology (OR 1.45 [95% CI, 1.20 - 1.76], p < 10) were significantly associated with a higher risk of psoriasis. Being born in West and Central Africa (OR 0.15 [95% CI, 0.10 - 0.25], p < 10), the Caribbean islands (OR 0.14 [95% CI, 0.05 - 0.45], p = 0.0008) or Latin America (OR 0.31 [95% CI, 0.14 - 0.69], p = 0.004) was associated with a lower risk of psoriasis compared to patients born in mainland France.

PLHIV carrying HLA-B*57:01 have around a 3-fold increased risk of psoriasis. This association might provide a possible explanation for the observed differences in psoriasis prevalence between ethnic groups.

Reported Preexposure Prophylaxis (PrEP) Use Among Male Sex Partners of HIV-Positive Men-2016-2018.

AIDS

To estimate the proportion of U.S. HIV-positive men who report a male HIV-negative/unknown status (HIV-discordant) sexual partner taking PrEP, and the use of multiple HIV prevention strategies within partnerships.

We used data collected during June 2016-May 2018 among sexually-active HIV-positive men who had ≥1 HIV-discordant male partner (N = 1,871) to estimate the weighted prevalence of reporting ≥1 partner taking PrEP. Among HIV-discordant partnerships (N = 4,029), we estimated PrEP use, viral suppression among HIV-positive partners, and condomless anal sex. We evaluated significant (p < 0.05) differences between groups using prevalence ratios with predicted marginal means.

Twenty-eight percent of sexually-active HIV-positive MSM reported ≥ 1 HIV-discordant male partner taking PrEP. Twenty percent of HIV-discordant partners were reported to be taking PrEP; 73% were taking PrEP or the HIV-positive partner was virally suppressed. PrEP use was lower among black and Hispanic partners compared with white partners (12% and 19% vs. 27%). Fewer black than white MSM were in partnerships in which PrEP was used or the HIV-positive partner had sustained viral suppression (69% vs. 77%). Condomless anal intercourse was more prevalent in partnerships involving PrEP use and in partnerships involving either PrEP use or sustained viral suppression among the HIV-positive partner.

PrEP use was reported among 1 in 5 partners, with disparities between black and white partners. Increasing PrEP use and decreasing racial/ethnic disparities could reduce disparities in HIV incidence and help end the U.S. HIV epidemic.

Organ Transplantation in Persons with HIV.

AIDS

: With current antiretroviral therapy, the lifespan of newly diagnosed persons with HIV (PWH) approaches that of uninfected persons. However, metab...