Search Results (1,769)

Antimicrobial resistance in infected chronic wounds present significant risk of complications (e.g., amputations, fatalities). This research aimed to formulate honey-loaded hydrocolloid film comprising gelatin and HPMC, for potential treatment of infected chronic wounds. Honeys from different sources (Cameroonian and Manuka) were used as the bioactive ingredients and their functional characteristics evaluated and compared. The formulated solvent cast films were functionally characterized for tensile, mucoadhesion and moisture handling properties. The morphology and physical characteristics of the films were also analyzed using FTIR, X-ray diffraction and scanning electron microscopy. Antibacterial susceptibility testing was performed to study the inhibition of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus by honey components released from the films. The % elongation values (8.42–40.47%) increased, elastic modulus (30.74–0.62 Nmm) decreased, the stickiness (mucoadhesion) (0.9–1.9 N) increased, equilibrium water content (32.9–72.0%) and water vapor transmission rate (900–298 gm² day⁻¹) generally decreased, while zones of inhibition (2.4–6.5 mm) increased with increasing honey concentration for 1 and 5% w/v, respectively. The results generally showed similar performance for the different honeys and demonstrate the efficacy of honey-loaded hydrocolloid films as potential wound dressing against bacterial growth and potential treatment of infected chronic wounds. Full article

In Africa, Rift Valley Fever poses a substantial risk to animal health, and human cases occur after contact with infected animals or their tissues. RVF has re-emerged in Uganda after nearly five decades, with multiple outbreaks recorded since 2016. We investigated a unique RVF outbreak associated with an animal abortion storm of 30 events and human cases on a dairy farm in Mbarara District, Western Uganda, in February 2023. Genomic analysis was performed, comparing animal and human RVF viruses (RVFV) circulating in the region. A cluster of thirteen human RVF cases and nine PCR-positive animals could directly be linked with the abortion storm. Overall, during the year 2023, we confirmed 61 human RVFV cases across Uganda, 88.5% of which were reported to have had direct contact with livestock, and a high case fatality rate of 31%. We recommend implementing extensive health education programs in affected communities and using sustainable mosquito control strategies to limit transmission in livestock, coupled with initiating animal vaccination trials in Uganda. Full article

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of seropositivity. Predictions of final mortality burden under an alternate policy scenario for Japan were calculated and the COVID-19 outcomes for China were assessed. Results: By 2025, Western countries (US, UK, Brazil and Italy) had cumulative mortality rates in the range of 3339–3548 deaths per million, about 6-fold higher than East Asian and New Zealand ‘zero-COVID’ countries. Moderate virus suppression in Japan produced the lowest cumulative mortality of the countries analyzed; if earlier policies had been maintained, the predicted cumulative mortality rate by 2025 would be one-tenth that of the US, UK, Brazil and Italy and one-half to one-third that of other zero-COVID countries. For China, transitioning from a zero-COVID policy in 2022–2023, the estimated 2025 cumulative mortality was 1607/million, half that of Western countries. Conclusions: To minimize COVID-19 mortality would require: (1) Innovation on systematic sampling of ambient airborne virus exposure to sustain low but non-zero virus levels across entire populations, and (2) seropositivity assessment (instead of mass PCR testing for new cases) for calibrating exposure management, and tracking and protecting high-risk populations. Full article

Objectives: There is a scarcity of studies on multisite infections (MSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). The primary objectives of this research were to determine the clinical characteristics of CRKP MSI, and the risk factors of infection and mortality. Methods: Patients with a CRKP bloodstream infection (BSI) were enrolled retrospectively between January 2017 and December 2021 in Xijing Hospital, China. The risk factors for CRKP MSI and mortality were evaluated. The demographic data, clinical and microbiological characteristics, therapy and outcomes were analyzed. Results: Among 101 patients, 74.3% (75/101) had a diagnosis of CRKP MSI, while 25.7% (26/101) of CRKP non-MSI. The overall case fatality rate was 42.6% (43/101). Multivariate analysis indicated that previous surgery (OR 3.971, 95% CI 1.504–10.480, p = 0.005) and ICU admission (OR 3.322, 95% CI 1.252–8.816, p = 0.016) were independent risk factors for CRKP MSI. ICU admission (OR 4.765, 95% CI 1.192–19.054, p = 0.027), a Pitt bacteremia score (PBS) > 4 (OR 3.820, 95% CI 1.218–11.983, p = 0.022) and thrombocytopenia (OR 8.650, 95% CI 2.573–29.007, p < 0.001) were independent risk factors for mortality due to CRKP MSI. Conclusions: Our findings confirmed that CRKP MSIs were associated with poorer outcomes. To improve prognosis, early screening of individuals at the highest risk is vital. Full article

Clostridium sordellii, which has recently been reclassified as Paeniclostridium sordellii and subsequently as Paraclostridium sordellii, is a rare human pathogen linked to infections of high morbidity and mortality, often presenting as fulminant toxic shock syndrome. Although most documented cases involve individuals with pre-existing health issues, such as immunosuppression and cancer, or those who have undergone specific gynecological procedures, there are few instances reported in otherwise healthy individuals. In this report, we present a case of fatality associated with P. sordellii infection in a young individual with a history of drug abuse, following post-mortem examinations. Additionally, we provide an updated review of the latest literature on this topic. Full article

The appearance rate of nutrients into systemic circulation affects hormones like insulin and through that efficiency of growth. This also affects mineral requirements critical for metabolism, notably phosphate (P), magnesium (Mg), and potassium (K). Fasting animals have a downregulated metabolism, upon which P, Mg, and K are exported from their cells into the blood and are subsequently excreted in their urine. Abrupt resumption of feed intake, especially of highly glycemic feeds, creates an acute need for these minerals, which can result in deficiency symptoms, particularly with P deficiency. In human medicine, this is called refeeding syndrome: a large meal after a period of fasting can prove fatal. Young animals seem to be especially sensitive, likely driven by their ability to grow rapidly and thus to drastically upregulate their metabolism in response to insulin. Symptoms of P deficiency are fairly a-specific and, consequently, not often recognized. They include edema, which makes it appear as if piglets are growing well, explaining the high gain/feed rate typically seen immediately after weaning, even when piglets are eating at or below the maintenance requirements. Phosphate deficiency can also result in hypoxia and hypercarbia, which may trigger ear necrosis, Streptococcus suis infections, or even death. Hypophosphatemia can also trigger rhabdomyolysis, which may contribute to tail-biting, but this requires further study. Arguably, when fasting cannot be avoided, diets for newly weaned piglets should be formulated to avoid these problems by lowering their glycemic load and by formulating diets according to the piglets’ actual requirements inspired by their genuine intake and health and not simply by extrapolating from older animals. Full article

Anoplocephala spp. are common equine tapeworm species in Europe, frequently found in grazing horses. Anoplocephala perfoliata is the most pathogenic, clinically significant species associated with gastrointestinal disorders, particularly colic, and can have a fatal outcome in some horses. The aim of this study was to determine the infection prevalence of Anoplocephala spp. in Serbia and to identify relevant risk factors. A total of 173 horses from various regions were tested using a combination of diagnostic methods: coprological analysis via combined sedimentation–flotation and the Mini-FLOTAC technique, as well as serological testing using a commercial ELISA test. The overall prevalence was 38.7%, with a higher number of positive cases being identified by serology. It was demonstrated that coprology and serology are complementary approaches for prevalence studies. Infection risk factors included high stocking density, free-roaming status and co-infection with nematodes, while lower rainfall and temperate climate were associated with reduced risk of tapeworm infection. These findings highlight the challenges of Anoplocephala spp. detection and provide insight into the epidemiology of equine tapeworm infection in Southeastern Europe. Full article

Background: Starting in early 2022, SARS-CoV-2 Omicron has driven large outbreaks in China, a predominantly infection-naive population with high inactivated vaccine coverage. This unique context provided a substantially less-confounded opportunity to evaluate how vaccination, public health, and social measures influenced severity. Methods: We systematically reviewed 86 studies (224 severity estimates) published from 2022 to 2024, reporting symptom and clinical severity outcomes (fever, cough, and sore throat; symptomatic, severe/critical, and fatal illness) of Omicron infections in China. Using meta-regression, we evaluated the associations of study setting, age group, vaccination status, predominant subvariants, and Oxford COVID-19 Government Response Tracker (OxCGRT) indices, including the Government Response Index (GRI), Containment and Health Index (CHI), and the Stringency Index (SI), with infection outcomes, adjusting for key confounders. Results: We found the primary or booster series of inactivated vaccines conferred strong protection against severe/critical illness (pooled relative risk (RR) 0.17 [95% CI: 0.09–0.33]) but did not reduce symptom frequency (RR 0.99 [95% CI: 0.95–1.02]). Each 10-unit increase in GRI or CHI was associated with 7% (95% CI: 1–12%) and 6% (95% CI: 1–10%) lower odds of symptomatic infection and 3% (95% CI: 1–4%) lower odds of severe/critical illness. Later subvariants (BA.5, BF.7, and XBB) showed 24–38% higher odds of upper respiratory symptoms versus BA.1. Conclusions: The data collection context significantly impacted severity estimates, with higher estimates from emergency hospitals. Overall, inactivated vaccines provided strong protection against severe/critical outcomes while stringent public health measures were associated with lower severity. Our findings underscore the importance of consistent and standardized protocols to produce reliable estimates of SARS-CoV-2 severity in evolving epidemiological contexts. Full article

Anseriformes (waterfowl) and Charadriiformes (shorebirds) are well-recognized natural reservoirs of low pathogenic (LP) influenza A viruses (IAVs). Historically, LP IAVs circulate among healthy individuals during seasonal, and often transcontinental, migrations. However, following the introduction of clade 2.3.4.4b highly pathogenic (HP) A/Goose/Guangdong/1/1996 lineage H5 IAV to North America in 2021, countless wild birds succumbed to fatal infections across the Western Hemisphere. Due to their small size and cryptic plumage patterns, opportunities for carcass recovery and postmortem evaluation in sanderlings (Calidris alba) and other shorebirds are rare. A multispecies mortality event in coastal Virginia, USA, in March–April 2024 included sanderlings among other wild bird species. Nine sanderlings underwent postmortem evaluation and clade 2.3.4.4b H5 IAV RNA was detected in pooled oropharyngeal-cloacal swabs from 11/11 individuals by real-time reverse transcription polymerase chain reaction. Histopathology was similar to that in waterfowl and included necrosis in the pancreas and brain and less commonly in the gonad, adrenal gland, spleen, liver, and intestine. Immunohistochemistry revealed IAV antigen labeling in necrotic neurons of the brain (neurotropism) and epithelial cells of the pancreas, gonad, and adrenal gland (epitheliotropism). Describing HP IAV-attributed pathology in shorebirds is key to understanding ecoepidemiology and population health threats in order to further document and compare pathogenesis among avian species. Full article

Leuconostoc spp. are vancomycin-resistant Gram-positive cocci that are used in food production and as pre- and probiotics. However, Leuconostoc spp. can also cause infections. In the present study, the records of patients with Leuconostoc spp. detection between January 2012 and March 2025 were analyzed, inclusive of the underlying risk factors. Leuconostoc spp. was isolated from 32 patients (21 male, 11 females), including nine patients with blood culture evidence. In the majority of patients, Leuconostoc spp. were obtained on the day of admission to the hospital or in the first few days thereafter, arguing against nosocomial acquisition. The median age of men and women (65.3 and 67.8 years) was similar, but seven of the 14 male patients over the age of 65 had the bacteria in blood culture. The female patients with blood culture evidence had suffered from peripartum thrombophlebitis and from anorexia nervosa (BMI 8.8 kg/m²). In contrast, men with Leuconostoc spp. in the blood culture had severe, limiting underlying diseases. While the two women survived, five of the seven blood-culture-positive men died. Overall, our results show that Leuconostoc spp. is mainly acquired in outpatient settings, but men are at a higher risk of acquisition. Colonized men over the age of 60 with severe underlying diseases have a high risk of systemic infection with a fatal outcome. Full article

We present a case of fatal necrotizing Staphylococcus aureus pneumonia with underlying influenza A (H3) infection. Next-generation-sequencing-based analysis revealed that the S. aureus isolate harbored the newly recognized exfoliative toxin etE2 gene. Molecular epidemiologic analysis showed that the isolate belonged to the MSSA ST152 lineage, harboring PVL genes and edinB co-located to etE2 as distinctive virulence factors. The etE2 gene is present in all isolates of this lineage co-located to the exotoxin gene edinB, both implicated in the destruction of tissue integrity. We alert as to the global emergence of this lineage causing serious infections in patients. Full article

Background/Objectives: The main objective of the study is to assess the clinical utility of microbial cell-free DNA (mcfDNA) in neutropenic patients diagnosed with acute myeloid leukemia (AML) undergoing chemotherapy in the outpatient setting. Neutropenia is a common complication in this patient cohort and enhances the risk of fatal opportunistic bacterial and fungal infections. Accurate and timely diagnosis of these infections in outpatient asymptomatic individuals is critical. Methods: Fourteen patients were studied in this prospective observational case series. Traditional blood cultures (BCs) were obtained when clinically indicated and blood samples were collected for plasma mcfDNA metagenomic sequencing up to two times a week at outpatient oncology appointments. Results were compared in identifying potential infectious agents. Results: BCs identified pathogens in only two patients, despite several cases where infection was suspected. In contrast, mcfDNA testing detected pathogens in 11 of the 14 patients, including bacteria, such as Staphylococcus aureus, and invasive fungi, such as Candida and Aspergillus species, and Pneumocystis jirovecii. Conclusions: In the outpatient setting, mcfDNA surveillance offers a more reliable method for detecting pathogens. This approach identified actionable microbiologic results in immunocompromised individuals who did not meet standard clinical criteria for suspicion of infection. Further research is required to confirm the potential of mcfDNA surveillance in an outpatient setting to guide more accurate treatment decisions, reduce extensive clinical investigations, and improve neutropenic patient outcomes. Full article

Background: Allogeneic hematopoietic stem cell transplant (Allo-HSCT) recipients are still at increased risk of severe COVID-19 infection. Vaccination is a critical strategy to protect this population. This real-world prospective cohort study aimed to evaluate the immune response and clinical outcomes of COVID-19 vaccines in Allo-HSCT recipients. Methods: Allo-HSCT recipients (median age: 48 years) who received either the BNT162b2 or CoronaVac vaccines were included. Antibodies against the SARS-CoV-2 spike protein were quantitatively measured using the chemiluminescent microparticle immunoassay. Patient- and vaccine-related factors affecting antibody responses were analyzed. Adverse events, including graft-versus-host disease (GVHD) and post-vaccine infections, were recorded. Results: Among 95 Allo-HSCT recipients, 86.3% achieved adequate antibody responses following COVID-19 vaccination. Patients receiving ≥3 vaccine doses showed significantly higher antibody titers compared to those with only 2 doses (OR: 0.11; 95% CI: 0.02–0.53; p = 0.006 **). The use of Ruxolitinib or Ibrutinib was associate with increased odds of low antibody response (OR: 38.39; 95% CI: 3.14–468.95; p = 0.004 **). Hypogammaglobulinemia (low serum IgG levels) was associated with a reduced antibody response (OR: 0.17; 95% CI: 0.03–0.96; p = 0.045 *), while no significant correlation was found between serum IgA levels and antibody responses (p = 0.672). Three cases of post-vaccine GVHD were observed, and no fatalities related to COVID-19 occurred during the study. Conclusions: COVID-19 vaccination is safe and effective in Allo-HSCT recipients, with stronger responses especially following ≥3 vaccine doses. Patients receiving GVHD treatment or with hypogammaglobulinemia exhibited impaired responses, emphasizing the need for tailored vaccination strategies and close monitoring in this population. Full article

Nocardia, an easily missed but potentially fatal opportunistic pathogen, can lead to serious infections like lung and brain abscesses. Intranasal inoculation (IN) is the traditional approach for constructing a Nocardia-induced pneumonia mice model, while it usually only results in limited local bacterial infection in the lungs. To comprehensively assess infection dynamics across distinct pulmonary inoculation routes in mice models, this study compared the pathogenicity of three different Nocardia farcinica pneumonia models established via IN, intratracheal aerosolization (ITA), and intratracheal instillation (ITI). C57BL/6J mice were infected with N. farcinica through IN, ITA and ITI with comparative analyses of bacterial distribution in lungs, survival rate, weight, bacterial load, inflammatory cytokines, histopathological characteristics and transcriptome differences. The findings suggest that ITA N. farcinica infections caused severer clinical symptoms, higher mortality, pulmonary bacterial load, levels of inflammatory cytokines in bronchoalveolar lavage fluid, and more significant histopathological damage to lungs than IN and ITI. Furthermore, ITA resulted in better lung bacterial distribution and delivery efficiency than ITI and IN. Transcriptome analysis of lungs from N. farcinica infected mice via IN, ITA and ITI revealed significant differential gene expression, whereas ITA route resulted in a larger fold change. ITA provides a more consistent and severe model of N. farcinica pneumonia in mice than IN and ITI, which can make the bacteria more evenly distributed in the lungs, leading to more severe pathological damage and higher mortality rates. In conclusion, ITA is an optimal route for developing animal models of N. farcinica pneumonia infections. Full article

Pseudorabies virus (PRV) can infect a wide range of animal species, including swine and rodents. Infection in pigs is associated with significant economic losses in the global pork industry and is characterized by acute, often fatal disease, as well as central nervous system (CNS) invasion, which leads to neurological manifestations. Although PRV replication has been extensively characterized in certain murine neuronal cell lines such as Neuro-2a, the mechanisms underlying PRV-induced neuroinflammatory injury and necroptosis remain largely unclear. In this study, Kunming mice and mouse astrocytes (C8-D1A) were infected with PRV-GXLB-2013 at different doses to evaluate neurological injury and inflammatory responses. Given that the NF-κB/MLKL signaling pathway was found to be activated during PRV infection, a selective MLKL inhibitor, necrosulfonamide (NSA), was applied to investigate the role of necroptosis in PRV-induced neuroinflammatory damage. Mice infected with higher viral doses showed increased mortality, severe neurological symptoms, elevated brain inflammation, and pathological changes. In C8-D1A cells, PRV infection significantly upregulated inflammatory cytokines and key components of the NF-κB/MLKL pathway. Importantly, NSA treatment markedly reduced these inflammatory responses, mitochondrial damage, and cellular necrosis. Collectively, these findings suggest that PRV infection triggers neuroinflammatory injury through the activation of necroptosis and the NF-κB/MLKL signaling pathway. This study provides novel mechanistic insights into PRV-induced neurological damage and highlights potential therapeutic targets for intervention. Full article