Search Results (533)

This case describes an outbreak of salmonellosis caused by Salmonella enterica subspecies enterica serotype Agona in a Rottweiler breeding kennel, associated with raw meat-based diet (RMBD) of unlicensed origin. The report presents the clinical, epidemiological, and microbiological characteristics of the outbreak, as well as the control and preventive measures undertaken. Methods: Samples of faeces, vomit, raw food, and environmental surfaces were collected and examined. The isolated pathogen was identified using bacteriological culture, biochemical testing, MALDI-TOF mass spectrometry, and serotyping according to the White–Kauffmann–Le Minor scheme. Antimicrobial susceptibility was determined by the broth microdilution method in accordance with standards of Clinical and Laboratory Standards Institute (CLSI). Results: Clinical signs included vomiting, diarrhoea, lethargy, and dehydration without fever, with disease exacerbation observed in post-partum animals. Extensive carriage and faecal shedding of S. Agona were detected in affected dogs, along with widespread contamination of food and the kennel environment. The isolate was susceptible to some antimicrobial agents but resistant to cephalexin, aminoglycosides, lincosamides, macrolides, and fusidic acid, and showed intermediate susceptibility to polymyxin B. Following discontinuation of raw meat feeding, targeted antimicrobial therapy, and environmental disinfection, all dogs recovered, and subsequent tests for Salmonella spp., were negative. All human contacts also tested negative. Conclusions: This represents the first documented outbreak of S. Agona infection in dogs in Bulgaria linked to a RMBD. The findings emphasise the importance of feed safety, biosecurity, and traceability of feed sources in kennels, as well as the potential zoonotic risk associated with raw feeding practices. The diagnostic and therapeutic measures implemented in this case provide an effective model for managing similar epidemiological events within the One Health framework. Full article

Background and clinical significance: Tranexamic acid (TXA) is commonly used for menorrhagia. Common side effects include diarrhoea, nausea, and vomiting. However, more serious and rare side effects, including embolism, thrombosis, and seizures, are less commonly considered. Case presentation: We report the case of a 39-year-old woman of Asian origin who presented after a first-time seizure while driving, following starting tranexamic acid for menorrhagia seven days prior. She complained of a headache, nausea, neck stiffness, floaters, and blurred vision. Her lactate was elevated on presentation. On examination there were no neurologic abnormalities. A computed tomography (CT) head scan showed acute haemorrhagic foci along the left temporal lobe. This prompted a CT venography, which showed filling defects in the left transverse and sigmoid sinuses, in keeping with cerebral venous sinus thrombosis. MRI of the head further showed a blooming artefact, indicating secondary thrombosis of the lateral tentorial sinus on the left side extending into the vein of Labbe. Following the diagnosis of cerebral venous sinus thrombosis, the patient was started on regular levetiracetam as well as a therapeutic dose of low molecular weight heparin. Since the initial episode, she has been seizure-free for over three months now. Conclusions: This case highlights the importance of considering less common side effects of tranexamic acid in patients who are taking TXA and are presenting with first-time seizures and headaches. These patients should be monitored for embolic-related intracranial events. A careful diagnostic approach, including cerebrovascular imaging, is essential for an accurate diagnosis and effective treatment. Full article

Background: Neoadjuvant chemotherapy (NACT) is widely used in patients with high-risk HER2-amplified (HER2+) or triple negative early breast cancer (TNBC). Advantages of NACT include allowing less extensive surgery, assessing response to treatment and guiding adjuvant therapy. NACT-related toxicities are common and can result in treatment alterations and hospitalisation, which may adversely impact outcomes. Aim: To assess NACT treatment in Hawke’s Bay (HB), New Zealand, by evaluating pathologic complete response (pCR) rates and toxicities of different regimens. Method: Data were retrospectively obtained from medical records of NACT patients. pCR rates were compared to results from the previous literature. Toxicity was assessed by recording severe (grade 3 or above) toxicities, treatment-limiting toxicities (those leading to dose reductions, dose delays or early cessation) and hospitalisations for different NACT regimens. Results: A total of 71 NACT patients were included. pCR rates for HER2+ disease and TNBC were 19/45 (42%) and 8/24 (33%), respectively. The most common severe toxicities were diarrhoea, anaemia and febrile neutropaenia (all 16%) in FEC-D (5-fluorouracil/epirubicin/cyclophosphamide + docetaxel +/− carboplatin +/− immunotherapy) patients, neutropaenia (50%) in FEC-DH (FEC-D + trastuzumab +/− pertuzumab) patients and diarrhoea (38%) in TCH (docetaxel/carboplatin/trastuzumab +/− pertuzumab) patients. Comparing treatment-limiting toxicity in FEC-DH vs. TCH, 9/16 (56%) vs. 13/21 (62%) had dose reduction, 2/16 (13%) vs. 8/21 (38%) had dose delay, 1/16 (6%) vs. 5/21(24%) had early cessation and 6/16 (38%) vs. 13/21 (62%) were hospitalised, respectively. Conclusions: NACT was associated with high rates of severe and treatment-limiting toxicity. Despite this, pCR rates were consistent with the previous literature. With the caveat of small patient numbers, FEC-DH-based therapy was associated with fewer dosing delays, early cessations and hospitalisations compared with TCH-based therapy. Full article

Several different pathogens, including Escherichia coli, are strongly associated with calf diarrhoea. The population diversity of intestinal E. coli within each diarrhetic calf and between diarrhetic calves is not well understood. In the present study, 391 faecal samples were obtained during 2023–2024 from Danish dairy calves with diarrhoea. Semi-quantified growth estimates of E. coli after culturing did not reflect the diarrhetic grade nor whether E. coli was the only pathogen observed in the sample. From each sample, five isolates were subjected to multiple-locus variable-number tandem repeat analysis (MLVA) and revealed that 70% of faecal samples contained more than one type of E. coli. Genotyping, sequence typing and in silico serotyping showed a large diversity of E. coli between faecal samples. Surprisingly, isolates with a genotype representing mixed features of Diffusely adhering E. coli/Extraintestinal pathogenic E. coli were found in 25% of the isolates, while the classic Enterotoxigenic E. coli genotype was only observed in 5% of the isolates, and only 4% of the faecal samples were positive for E. coli F5 (K99) fimbriae, as determined by PCR. In conclusion, a diverse population of (non-F5) E. coli is associated with diarrhoea in calves. High genomic diversity of E. coli within samples needs to be considered when selecting only one isolate for antimicrobial resistance profiling and vaccination measurements. Full article

Implementation of molecular detection methodology of Shiga toxin-producing Escherichia coli (STEC) in Danish patients began in 1997. Since then, changes in molecular detection methods and diagnostic criteria have led to the present situation, in which almost all diarrhoeal stool specimens are examined for STEC. Whole genome sequencing (WGS) of STEC isolates referred to the national reference laboratory has increased the detailed characterisation, and revealed a large spectrum, of STEC types, including cross-over pathotypes typically associated with extraintestinal disease or traveller’s diarrhoea. Association of subtype stx2a (and stx2d) with the risk of developing haemolytic uraemic syndrome (HUS) was confirmed. These changes have resulted in an increase in the number of diagnosed STEC cases from 31 cases in 1997 to 1432 in 2023. Similar increases in Europe have also been recorded. Culture of STEC is, on the other hand, declining, which poses a challenge to the identification of multiple STEC infections and outbreaks. Syndromic (PCR) test panels have also resulted in an increase in the detection of multiple microorganisms. Double or triple infections have increased the role of clinical microbiologists in interpreting and assessing the significance of diagnostic results and have also increased the need for high-quality curation of surveillance data. Full article

Background: Adherence to tyrosine kinase inhibitors (TKIs), the first-line treatment for renal cell carcinoma (RCC), is critical to ensure intended treatment outcomes. However, 75% of patients with RCC have persistency gaps (>7 days) within the first 90 days after initiating TKIs. This study explored factors affecting TKI adherence in RCC patients to inform future interventions. Methods: A retrospective cohort study was conducted at a specialist oncology hospital in Northwest England from October 2020 to October 2022 on patients with RCC treated with TKIs. TKI prescriptions and persistence gaps (>7 days) were identified from electronic dispensing records. Factors associated with persistence gaps were retrieved by reviewing patients’ clinical records. We used descriptive statistics to summarise the results and Kaplan–Meier analysis to assess the probability and the time to the first gap, stratified by adverse drug effect (ADE)-related and non-ADE-related gaps. Results: Among 165 included patients, 611 persistence gaps were identified. ADEs accounted for 59% (n = 464) of 787 recorded factors, with diarrhoea being the most frequent ADE (9.5%). Patients holding leftover TKIs were the primary (15.1%) non-ADE factor for persistency gaps. At least one gap was observed with 82% of patients (n = 135); 19% had ≥5 ADE-related gaps, and 25% had ≥5 non-ADE-related gaps. ADE-related gaps typically occurred within the first three months (50%), while non-ADE-related gaps were not time-dependent. Conclusions: ADEs, including diarrhoea and pain-related reactions, were the most frequently reported issues affecting TKI persistency in patients with RCC. These ADEs are likely to impact patients’ quality of life and adherence. Future qualitative research is warranted to explore patients’ care needs and additional factors such as health literacy and self-efficacy. Full article

Background: Post-colonoscopy syndrome is an emerging clinical entity characterised by the onset of gastrointestinal symptoms following a colonoscopy. The current management of this syndrome has not yet been established, although probiotics have been proposed. The therapeutic potential of a combination nutraceutical compound based on HBQ-Complex^®, butyrate, and probiotics (Lactobacillus acidophilus, Bifidobacterium animalis, and Lactiplantibacillus plantarum) in this setting remains unknown. Methods: A retrospective, multicentre, observational study was conducted in adult patients undergoing colonoscopy in the absence of known gastrointestinal diseases, assessing the onset of upper and lower gastrointestinal symptoms post-colonoscopy immediately after the procedure (T₀), at 2 weeks (T₁), and 4 weeks (T₂) thereafter, using a VAS (0–10). Two groups were analysed, one undergoing nutraceutical supplementation and a control group. Results: A total of 599 patients were included (64.9% receiving nutraceutical supplementation and 35% in the control group). Several variations were observed involving the treated group compared to the control for abdominal pain (59.9% vs. 33.3%), meteorism (64.9% vs. 35.1%), diarrhoea (46.9% vs. 19.5%), and bloating (59.3% vs. 26.7%) (p < 0.001 for all). Logistic regression analysis showed a reduction in constipation (OR: 3.344) and bloating (OR: 3.791) scores. Conclusions: Nutraceutical supplementation based on this combinational compound was associated with a reduction in gastrointestinal symptoms arising after colonoscopy, suggesting potential benefit in this setting. These findings pose a rationale for controlled prospective studies to confirm such evidence in broader clinical settings. Full article

Escherichia coli is a significant cause of Neonatal Calf Diarrhoea (NCD). Its extensive antigenic diversity, coupled with the ability to acquire antimicrobial resistance determinants, hampers treatment effectiveness and compromises the control measures. This study investigated the link between the presence of multidrug-resistant (MDR) E. coli and virulence factors (VFs) in NCD from central France (Departments of Cantal, Haute-Loire, Loire, and Puy-de-Dôme), between 2016 and 2022. E. coli was identified at TERANA Laboratories, France, using API 20E (BioMérieux^®) and MALDI-TOF Mass Spectrometry. Virulence factors, namely adhesins, were assessed with the slide agglutination method, and antimicrobial susceptibility testing was conducted across various antimicrobial classes. Out of 2367 E. coli strains isolated from cases of NCD, a high percentage were resistant to aminopenicillins (88.8%), aminoglycosides (89.1%), tetracyclines (79.7%), quinolones (48.4%), and sulphonamides (42.4%). More than half (58.6%) carried VFs, and 84.9% exhibited MDR profile, of which 61.34% (1233/2010) also harboured VFs. The adhesin CS31A-producing E. coli was the most prevalent, followed by the fimbrial adhesins F5 and F17 (60.8%, 20.0%, and 8.3%, respectively), all of which were associated with a high prevalence of MDR strains (79.1–93.9%). The highest occurrence of MDR profiles was observed in E. coli strains carrying CS31A and in those lacking VFs, both groups showing co-resistance to aminopenicillins, aminoglycosides, and tetracyclines or sulphonamides. The calf production sector may act as a reservoir for MDR E. coli strains, regardless of the presence of VFs, posing a major threat to public health and safety. Full article

Background/Objectives: A new multivalent vaccine (DIVENCE^® PENTA), containing Bovine viral diarrhoea virus (BVDV) types 1 and 2 recombinant proteins, live gE/tk double gene deleted Bovine Herpesvirus type 1 (BoHV-1 or IBR), live attenuated Bovine respiratory syncytial virus (BRSV) and inactivated parainfluenza-3 virus (PI-3) has been designed to protect cattle against the main viral pathogens associated with Bovine respiratory disease (BRD). The aim of this study was to demonstrate the efficacy of DIVENCE^® PENTA against experimental infections with BVDV-1, BVDV-2, IBR, BRSV and PI-3 in young calves. Methods: Ten-week-old calves were given two intramuscular doses three weeks apart. The efficacy was evaluated by means of an experimental challenge three weeks after vaccination. Serology, clinical signs, rectal temperature, white blood cell count, viral shedding and lung lesions were monitored after the challenge. Results/Conclusions: The results demonstrated a significant sparing of BRD in calves vaccinated with DIVENCE^® PENTA, as evidenced by fewer clinical signs, lower rectal temperatures, reduced viral shedding and less severe pulmonary lesions compared to control animals. A significant reduction in hyperthermia, leukopenia and viraemia post-challenge was also observed, highlighting the efficacy of the multivalent vaccine against BVDV types 1 and 2, IBR, BRSV and PI-3 in young calves. Full article

Neonatal calf diarrhoea (NCD) is the leading cause of mortality in calves under 30 days old. Although several pathogens are usually involved in outbreaks, most previous research has focused on specific enteropathogens or on the four agents traditionally associated with this syndrome. This study aimed to determine the prevalence of thirteen enteropathogens in 420 diarrhoeic calves under a month of age from north-western Spain and to identify the most frequent co-occurrences. Four diarrhoeagenic pathotypes of Escherichia coli, bovine rotavirus A, coronavirus, norovirus, nebovirus and torovirus were identified using qPCR. Presence of Salmonella spp. was studied using a serum agglutination test. A direct immunofluorescence assay was employed to identify Cryptosporidium and Giardia duodenalis oo/cysts. Eimeria oocysts were found by the floatation technique. Our results confirm the co-occurrence of agents in most cases of NCD. A total of 172 pathogen combinations, involving up to seven agents, were identified. Cases involving one or more viral agents and Cryptosporidium parvum were predominant, maybe because viral immunosuppression facilitates the protozoan life-cycle. The frequent detection of agents typically overlooked in the aetiological diagnosis of NCD suggests that they may play a role in this syndrome and thus should be included in routine diagnostic panels, allowing implementing the most effective control measures. Full article

Background: Rhamnogalacturonan-I (RG-I) is a pectic polysaccharide with emerging prebiotic and immunomodulatory potential. This randomised, double-blind, placebo-controlled trial (ID: NCT06081972) evaluated the effects of carrot-derived RG-I (cRG-I) supplementation, compared to placebo (maltodextrin), on gut microbiota composition and immune cell activation in healthy adults. Methods: A total of 54 participants (18–70 years old) were randomised in a double-blind manner to receive either 500 mg/day of cRG-I or placebo for four weeks. Pre-screening ensured balanced randomisation based on habitual fibre intake and faecal Bifidobacterium counts. Questionnaires assessed potential gut health and well-being effects, while in vitro and ex vivo models were used to evaluate effects on intestinal permeability. Results: cRG-I was well tolerated with excellent compliance. Faecal Bifidobacterium counts increased significantly, peaking at week 3. Isobutyric acid levels rose, though no other SCFAs differed. Immunologically, cRG-I enhanced the percentage of circulating myeloid dendritic cells expressing activation markers (CD86, HLA-DR) on. Stool consistency improved slightly. Preclinical models further showed that cRG-I and its fermentation products protected intestinal barrier integrity under stress. Conclusion: These results support cRG-I as a safe, low-dose dietary intervention capable of beneficially modulating gut microbiota, immune responses, and barrier function in healthy adults within a short supplementation period. Full article

The incidence of infectious diseases in children may be affected by climate change-related disaster risks that increase as extreme weather events become more frequent. Therefore, this research aims to diagnose the impact of such disaster risks on the disease incidence, focusing on diarrhoea, dengue haemorrhagic fever (DHF), and acute respiratory infection (ARI), commonly experienced by children. To accomplish this task, we construct integer-valued autoregressive (INAR) models for the number of disease cases among children in several age groups, with an overdispersed distributional assumption to account for its variability that exceeds its central tendency. Additionally, we include the numbers of floods, landslides, and extreme weather events at previous times as explanatory variables. In particular, we consider a case study in Indonesia, a tropical country highly vulnerable to the aforementioned climate change-related diseases and disasters. Using monthly data from January 2010 to December 2024, we find that the incidence of diarrhoea in children is positively impacted by landslides (but negatively affected by floods and extreme weather events). Landslides, frequently caused by excessive rainfall, also increase DHF incidence. Furthermore, the increased incidence of ARI is driven by extreme weather conditions, which are more apparent during and after COVID-19. These findings offer insights into how climate scenarios may increase children’s future health risks. This helps shape health strategies and policy responses, highlighting the urgent need for preventive measures to protect future generations. Full article

Background/Objectives: Gastric, oesophageal, and pancreatic cancers are common worldwide, with low but improving survival rates due to advances in curative treatments. However, these treatments often cause long-term nutrition impact symptoms that are frequently overlooked, leading to malnutrition and poorer health outcomes. This review explored the types of nutrition impact symptoms following curative-intent treatment for upper gastrointestinal (UGI) cancers and assessed their impact on nutrition status. Methods: A systematic search of four electronic databases identified studies involving adults treated with curative intent for UGI cancers. Included studies reported both nutrition impact symptoms and nutrition outcomes using validated tools. Study quality was assessed, and results were synthesised narratively. Results: Eleven studies (n = 953 participants), predominantly from the Asia–Pacific region, met the inclusion criteria. Participants were mostly male (68%), with surgery as the primary treatment (91%). Most studies (n = 10) used validated assessment tools to identify nutrition impact symptoms. Reflux was the most commonly reported symptom (n = eight studies), followed by abdominal pain and diarrhoea. Nutrition status was assessed using various validated tools: Patient-Generated Subjective Global Assessment (n = six studies, 55%), Mini Nutritional Assessment (n = two studies, 18%), and Global Leadership Initiative on Malnutrition as well as Subjective Global Assessment and Prognostic Nutritional Index (both n = one study, 9%). Malnutrition prevalence was up to 87% one year post-treatment. Conclusions: Nutrition impact symptoms are common and persistent after curative-intent treatment for UGI cancers. Future research should incorporate validated assessment tools and extend follow-up beyond 12 months. Integrating long-term, tailored dietetic support to identify and manage symptoms post-treatment is vital to improve outcomes for patients. Full article

Cinnamaldehyde (CA) is a potential substitute for antibiotic growth promoters in animal breeding. In this study, we investigated its effects as a dietary supplement on growth performance, serum antioxidant capacity, intestinal digestive enzyme activities, intestinal morphology, and caecal microbiota in meat rabbits. Weaned meat rabbits (n = 450) were randomly assigned to five groups, Groups A, B, C, D, and E, and fed 0, 50, 100, 150, and 200 mg/kg CA diets, respectively, for 47 days. Biological samples including serum (antioxidants), duodenal/caecal content (enzymes), intestinal tissue (morphology), and caecal digesta (microbiota) were collected at day 47 postweaning for analysis. Groups C and D showed significantly higher final body weights than Group A, with Group D (150 mg/kg CA) demonstrating superior growth performance including 11.73% longer duodenal villi (p < 0.05), 28.6% higher microbial diversity (p < 0.01), and 62% lower diarrhoea rate versus controls. Digestive enzyme activity as well as serum antioxidant capacity increased with increasing CA dose, Microbiota analysis revealed CA increased fibre-fermenting Oscillospiraceae (+38%, p < 0.01) while reducing Ruminococcaceae (−27%, p < 0.05). Thus, dietary CA supplementation at 150 mg/kg was identified as the optimal CA dose for improving meat rabbit production. These findings highlight CA as a functional feed additive for promoting sustainable rabbit production. Full article

During commercial pig production, weaning is a major stressor that disrupts the gut microbiome, compromises intestinal barrier integrity, and increases the susceptibility of piglets to pathogens. This often results in post-weaning diarrhoea (PWD), leading to growth retardation, morbidity, and economic loss. This study investigated the effects of dietary xylo-oligosaccharide (XOS) supplementation on the growth performance and gut health of 216 piglets with naturally occurring PWD. Piglets received either 0 (CON), 50 (XOS-50), or 500 (XOS-500) mg XOS/kg feed from weaning at 28 days of age (d1) for 54 days. XOS-500 significantly improved body weight at d22 and d54, but had no effect on average daily gain, daily feed intake (DFI), or feed conversion ratio. The intestinal microbiota alpha-diversity was unaffected by XOS, though jejunal beta diversity differed between CON and XOS-500 groups at d22. Jejunal Chao richness correlated positively with d54 body weight, while ileal Chao richness correlated negatively with DFI. Salmonella was present in all diet groups but did not differ in abundance; however, the levels were negatively correlated with alpha diversity. XOSs increased Lactobacillus (d22, d54) and Clostridium_XI (d22), while reducing Veillonellaceae spp. (d22). XOSs reduced jejunal goblet cell (GC) density at d22 but increased duodenal and jejunal GCs and reduced duodenal crypt depth at d54. XOSs upregulated the genes for the tight junction proteins CLDN2, CLDN3, ALPI, and ZO-1, while downregulating the cytokine IL-8. These findings highlight XOSs’ potential to improve growth and gut health in weaning piglets with naturally occurring PWD, to maintain productivity and enhance welfare. Full article