Search Results (87)

Fungal endocarditis, despite being a rare diagnosis, has a higher morbidity and mortality rate compared to bacterial endocarditis. Candida species are the most common isolated pathogens involved in fungal endocarditis. Diagnosis is suspected in patients with underlying conditions such as cancer, myelodysplastic syndrome, diabetes, or intravascular catheters, where the modified Duke criteria apply. Management of the patient requires a multidisciplinary team (cardiologist, infectious diseases consultant, cardiac surgeon) along with antifungal treatment. We present the case of a 60-year-old male with biological prosthetic aortic valve replacement in the previous year for bicuspid aortic stenosis, admitted for a 5-day history of fever, nausea and minor urinary symptoms. The blood cultures were positive for Candida parapsilosis. Transthoracic cardiac ultrasound revealed a hypoechogenic mass attached to the aortic valve at the prosthetic fixation site. Although diagnosis was rapidly confirmed and treatment was administered shortly after first suspected, the patient developed, at first, cavernous sinus thrombosis and, later, fatal ST elevation myocardial infarction. The patient died despite efficient antifungal therapy, initially with Anidulafungin in monotherapy and later in combination with Fluconazole. The reported case emphasizes the importance of managing fungal endocarditis, the need for urgent diagnostic attention and multidisciplinary team approach by infectious diseases specialist, cardiologist, neurologist and heart surgeon. Full article

Feline infectious peritonitis (FIP) is a fatal but now treatable disease in cats caused by feline coronavirus (FCoV). This study prospectively investigated viral coinfections in 100 cats diagnosed with FIP and subsequently treated with oral GS-441524 (Bova UK) and their influence on outcome, focusing on viruses potentially associated with feline chronic gingivostomatitis (FCGS). Cats were tested for feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), feline calicivirus (FCV), feline herpesvirus (FHV), feline foamy virus (FFV), and feline gammaherpesvirus (FcaGHV1). Coinfections were identified at the following frequencies: FCV (27), FFV (22), FHV (6), FIV (4), FcaGHV1 (2), and FeLV (2, both progressive infections). FFV infection was significantly associated with FIV (p_F = 0.0021) and FHV (p_F = 0.0226) infection. FCGS was present in 25/97 cats with FCV infection being associated with FCGS (pF = 0.0032); no significant associa-tions were found for the other viruses and FCGS. The 42-day oral GS-441524 treatment’s success rate was 94% (five cats died, one relapsed). Coinfections did not significantly influence disease severity or treatment outcome, although the low number of cases for some pathogens warrants further investigation. However, advanced age was associated with treatment failure, potentially due to delayed diagnosis as FIP is considered to be less common in older individuals, or to age-related changes in immune function. In summary, viral coinfections, particularly with FCV, were common and should be considered in the clinical and hygienic management of cats with FIP. Full article

Introduction: Despite the advances in its prevention, invasive meningococcal disease (IMD) remains a serious health problem worldwide due to its high morbidity and mortality, including in Romania, with 22% mortality rate. The objectives were to describe the trends of IMD cases admitted to a tertiary care hospital in Romania, over 24 years, and the case fatality rate (CFR) by age, year of admission, and Neisseria meningitidis serogroups. Materials and Methods: A retrospective study was conducted in IMD patients admitted to the National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania, between 2001 and 2024. Results: A total of 256 IMD patients were admitted, 171 under fourteen years, out of which 75 were infants. Most cases were reported before 2008. The case distribution showed 90 patients (35%) with meningitis, 84 (32%) with meningococcaemia, and 82 (32%) with an association of both. Serogroup B was the most frequently and steadily found (58 cases). The overall CFR was 12%. CFR was highest in infants younger than 6 months (19%) and meningococcaemia cases (29%). Conclusions: In our study, IDM had the highest frequency and CFR in infants and meningococcaemia cases. The trends showed a decline in cases after 2008. Serogroup B was the most prevalent and stable strain over 24 years. Full article

Feline infectious peritonitis (FIP) is a severe viral disease with a very high fatality rate. GS-441524 is an adenosine analogue that acts as an antiviral and has shown promise in FIP treatment. However, its commercialization in some regions is not yet authorized. To evaluate the efficacy of GS-441524 based on the published literature, a systematic review was conducted. This systematic review was conducted using PubMed, ScienceDirect, and Google Scholar for studies published from 2018 onwards. Following PRISMA guidelines, 11 studies (totaling 650 FIP cases treated with GS-441524 alone or in combination) were included. Therapeutic efficacy was assessed by FIP form, clinical signs, and dosage. The overall treatment success rate was 84.6%. This rate was higher when GS-441524 was combined with other antivirals and lower in cases of wet FIP or those with neurological complications. Combination therapy with other antivirals may improve outcomes in complicated FIP cases, although further studies are needed. The GS-441524 dosages associated with the best outcomes were 5–10 mg/kg once daily (or equivalent subcutaneous dose), adjusted for FIP type, severity, and presence of neurological/ocular signs. Higher dosages can be used for severe cases or to prevent relapse, but splitting into twice-daily dosing may be necessary to avoid absorption issues. In summary, this synthesis indicates that GS-441524 is a highly promising treatment for FIP, with a high success rate among treated cases. Nevertheless, randomized controlled trials are needed to establish evidence-based therapeutic protocols tailored to different FIP presentations. Full article

Zaire Ebolavirus (EBOV) is one type of filovirus that causes the deadly EBOV disease, with an average fatality rate of around 50%. EBOV outbreaks are devastating and unpredictable and may emerge as the next global pandemic. As a BSL-4 pathogen, EBOV is inaccessible to regular biological laboratories. Therefore, EBOV virus-like particles (EBOV-VLPs) and EBOV pseudoviruses (EBOV-PVs) are utilized in the initial development of many potential therapies, for safety reasons and ease of procurement, as opposed to using infectious viruses. To investigate the host cell entry of EBOV and develop viral entry blockers, the EBOV model virions must accurately represent the morphological and mechanical properties of infectious EBOV virions. Due to the nanometer scale and irregular shape of EBOVs, these properties are challenging to characterize. In this research, state-of-the-art nanoscale characterization techniques are employed to examine the mechanical and structural elements of a selection of commonly used EBOV-approximating model virions. This study comprehensively determines the accuracy of EBOV approximation with a variety of model virions and the uniformity of mechanical and structural traits across different model virion types and preparation methods. This provides important implications for developing therapeutic treatments against EBOV using these model virions. Full article

Introduction: Listeria monocytogenes is the causative agent of listeriosis, a serious infectious disease with one of the highest case fatality rates among foodborne diseases affecting humans. Objectives: This study investigated the prevalence, antimicrobial resistance pattern and biofilm production capacity of L. monocytogenes isolated in meats. Materials: A total of 75 samples were analyzed, including fresh meats and meat preparations, in Northern Portugal. Methods: The strains were identified using morphological and molecular methods. Antimicrobial resistance was determined using the Kirby–Bauer disk diffusion method, against a panel of 12 antibiotics and the presence of the respective antimicrobial resistance genes was investigated by polymerase chain reaction (PCR). The ability to form biofilms was evaluated by the microtiter biofilm assay. Results: The overall prevalence of L. monocytogenes among screened samples was 17.33%. The isolates were resistant to trimethoprim-sulfamethoxazole (85.71%), ciprofloxacin (38.10%), meropenem (33.33%), tetracycline and erythromycin (28.57%), rifampicin (23.81%), and kanamycin (14.29%). Six isolates (28.57%) exhibited a multidrug-resistance profile. All strains showed positive result for the virulence gene specific to listeriolysin O (hlyA). In the genotypic resistance analysis of the strains, the genes identified were tetK (23.81%), aadA, tetL, bla_OXA-48 (14.29%), ermC, and msr(A/B) (4.76%). All isolates had the ability to form biofilms, with no significant differences in biofilm biomass production at 24 h and 48 h. Some of these strains showed a high capacity for biofilm production. Conclusions: These findings raise public health concerns due to resistance to first-line antibiotics and the biofilm-forming capacity of these isolates, which pose risks to the food industry. Enhanced monitoring and surveillance are essential to guide public health strategies in order to mitigate the threat posed by L. monocytogenes in food. Full article

Canine distemper virus (CDV) is the causative agent of a widespread infectious disease affecting both domestic and wild carnivores. Owing to its ability to cross species barriers and its high fatality rate in unvaccinated animals, CDV poses a significant conservation threat to endangered wildlife worldwide. To date, two distinct CDV lineages have been reported in Colombia, with cases documented separately in domestic dogs and wild peri-urban carnivores. This study aimed to detect and characterize the concurrent circulation of CDV in naturally infected domestic dogs and crab-eating foxes (Cerdocyon thous) from the same area in Colombia. Through molecular and phylogenetic analyses, we identified the South America/North America-4 lineage infecting both populations simultaneously. Our findings revealed high genetic variability, multiple virus reintroductions, and a close relationship with CDV strains previously detected in the United States. These results confirm the simultaneous circulation of CDV in the domestic and wildlife interface and underscore the urgent need for an integrated approach to CDV prevention and control involving both domestic and wildlife health interventions. Full article

Introduction: The objective of this study was to identify and analyze cases of pertussis hospitalized in 2024 that met the clinical criteria, epidemiological context, and laboratory confirmation through polymerase chain reaction (PCR) or serological testing for Bordetella pertussis. This study aimed to assess the age distribution of cases, vaccination rates, identify severe cases, and associated complications such as apnea, acute respiratory failure, and acute pneumonia. The findings aim to provide valuable data to enhance diagnostic and therapeutic strategies for managing pertussis in the pediatric population. Methods: We conducted a retrospective study from January to November 2024, involving pediatric patients admitted to the Pediatric Departments of the National Institute of Infectious Diseases “Prof. Dr. Matei Balş,” Bucharest, Romania, diagnosed with pertussis. The diagnosis was established based on epidemiological and clinical criteria and confirmed through laboratory tests, including serology or PCR testing. The selection criteria focused on hospitalized patients presenting clinical signs suggestive of pertussis, with laboratory confirmation. Results: Among the hospitalized patients, a significant proportion, 56.9%, were unvaccinated, while 12.5% had incomplete vaccination status. Common comorbidities contributing to increased hospitalization risk included prematurity, malnutrition, and asthma. Co-infections were identified in 32% of cases, with common pathogens such as measles, SARS-CoV-2, rhinovirus, and adenovirus. Respiratory complications were frequent, with apnea occurring in 51% of cases, pneumonia in 60%, and respiratory failure in 13.2%. Despite these complications, no fatalities were reported. Conclusions: This study highlights significant concerns related to low vaccination coverage in the pediatric population, emphasizing the importance of improving vaccination rates to prevent severe pertussis cases. The study also identifies the frequent occurrence of severe complications, including respiratory failure, apnea, and pneumonia, underlining the need for early intervention and effective management. Co-infections with respiratory pathogens further complicate diagnosis and treatment, underscoring the importance of comprehensive clinical evaluation in suspected cases of pertussis. Full article

Background: Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel tick-borne bunyavirus, causing the hemorrhagic infectious disease of SFTS, with a case fatality rate up to 30% due to the absence of effective therapeutic interventions. Therefore, it is urgent to develop safe and effective therapeutic drugs to control this viral hemorrhagic fever. Methods: The activity of verteporfin (VP), screened from an FDA-approved drugs library, against SFTSV, was systematically evaluated in Huh7 cells in a wide range of concentrations. We performed time-of-addition experiments with VP, along with binding, endocytosis, and membrane fusion assays, to determine which part of the SFTSV life cycle VP has its effect on. The potential targets of VP were detected by a drug affinity responsive target stability (DARTS) assay. Results: VP exhibited a potent anti-SFTSV activity by blocking the initial viral binding to the target cells during viral entry via significantly inducing the degradation of the viral Gn protein. Conclusions: The VP-induced inhibition of SFTSV binding, the first step of viral invasion, suggested that VP might be an ideal and potent anti-SFTSV agent due to its prophylaxis and therapeutic effects on viral infection. Full article

The re-emergence of the Nipah virus (NiV) in Kerala, India, following the tragic death of a 14-year-old boy, underscores the persistent threat posed by zoonotic pathogens and highlights the growing global public health challenge. With no vaccine or curative treatment available, and fatality rates as high as 94% in past outbreaks, the Nipah virus is a critical concern for health authorities worldwide. Transmitted primarily through contact with fruit bats or consumption of contaminated food, as well as direct human-to-human transmission, NiV remains a highly lethal and unpredictable pathogen. The World Health Organization has classified Nipah as a priority pathogen due to its alarming potential to cause widespread outbreaks and even trigger the next pandemic. Recent outbreaks in India and Bangladesh, occurring with seasonal regularity, have once again exposed the vulnerability of public health systems in containing this virus. This study explores the epidemiology, ecological factors driving transmission, and the public health response to NiV, emphasizing the role of zoonotic spillovers in pandemic preparedness. As the global community grapples with an increasing number of emerging infectious diseases, the Nipah virus stands as a stark reminder of the importance of coordinated surveillance, rapid containment measures, and the urgent development of novel strategies to mitigate the impact of this re-emerging threat. Full article

Background: Vaccination is one of the most effective ways of protecting individuals against serious infectious diseases and their fatal consequences. Objectives: The aim of this scoping review was to synthesize data on parental attitudes toward vaccination and identify factors influencing the motivators and barriers to children’s vaccination based on Polish studies. Methods: The scoping review process and reporting were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs) checklist. In the period between January 2014 and July 2024, the following databases were searched for publications: PubMed, Web of Science, Cochrane, Ebsco, and Scholar Google. Results: A total of 1531 potentially relevant records were reviewed, and 30 original publications from research samples collected in Poland were selected. According to the findings, vaccination rates varied between 100% and 70%, with parental acceptance levels for mandatory vaccination ranging from 99% to 65%. Parents most commonly cited the physician, the nurse, and the Internet as their primary sources of vaccination-related information. Moreover, parental primary motivators for vaccinating their children were prevention against infectious diseases, the opinion that vaccines are safe, and the belief that childhood vaccination is right and effective. The major barriers to vaccination were fear of vaccine side effects and the belief that vaccines are ineffective. Parents that were better educated, were of younger age, lived in cities, and had a higher income were much more likely to vaccinate their children. Conclusions: Understanding parental attitudes toward vaccination may help develop an educational program aimed at combating misinformation and increasing childhood vaccination coverage rates. Full article

Rabies is a fatal infectious disease that can be prevented with vaccination. The aim of this study was to evaluate the level of rabies knowledge among medical faculty students. This cross-sectional study included students in the medical faculty of a university hospital. The level of rabies knowledge was evaluated with a questionnaire evaluating 70 parameters. A total of 892 students participated in this study. Medical students knew that dogs and cats transmit rabies at high rates (96.9% and 87.4%, respectively) but understood less about other animals. Pregnancy (45.2%), being >65 years of age, having a chronic disease, and being immunosuppressed were indications for rabies vaccine, with rates between 31.4 and 37.4%. In total, 64.3% of respondents stated that the nearest health center should be approached to seek medical care, without first touching the wound. While indications for vaccination were correctly reported to be high after bites or scratches (74.2–94.6%), such indications were considered to be lower for other types of contact (46.2–66.6%). Indications for rabies immunoglobulin administration were correctly recognized at rates between 15.9% and 57.8%. Overall, the mean rabies knowledge level was 41.82 (Max. score 70). There was a statistically significant relationship between the total and subgroup rabies knowledge scores and class level, having taken a rabies course, a history of dog bites among the respondents or their family members, and possessing information about rabies. It was determined that the rabies knowledge levels among the students were insufficient. Having received lessons about rabies or a history of being bitten by an animal with suspected rabies were found to be important factors for increased knowledge about rabies. Full article

In children with acute leukemia (AL), the mortality rate from Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bloodstream infection (KPC-KpBSI) exceeds 50%, highest when active treatment is delayed. Neutropenic KPC-K. pneumoniae carriers are at high risk of KPC-KpBSI, and preemptive empiric antibiotic treatment (EAT) of febrile neutropenic episodes (FNEs) active against KPC-K. pneumoniae may reduce this mortality. We conducted an 8-year (2014–2021) retrospective observational study of 112 febrile neutropenic episodes (FNEs) in 32 children with AL who were KPC-K. pneumoniae carriers: standard EAT for 39 FNEs and active EAT for 73 FNEs (52 ceftazidime/avibactam (CAZAVI)-based and 21 colistin-based combinations, and 5 CAZAVI monotherapy). Successful outcomes (survival from FNE) were observed in 94%; seven were fatal, with four due to infectious causes. KPC-KpBSIs caused 10/112 FNEs, 10/20 g-negative BSIs, and 3 deaths. The mortality rate of KPC-KpBSI was 30%. Active EAT was successful in 97% of the FNEs, compared to 87% with standard EAT. All deaths from KPC-KpBSI occurred in patients who received standard EAT, while none occurred with active EAT. KPC-KpBSI mortality rate with initial inactive treatment was 60%. CAZAVI-based EAT was successful in all FNEs, with a higher success rate without any modification compared to colistin-based EAT, where nephrotoxicity occurred in 14%. Therefore, active EAT, mainly a CAZAVI-based combination, was effective, safe, and associated with low overall and KPC-KpBSI-related mortality. Full article

Pneumonia is an inflammation of lung tissue caused by various infectious microorganisms and noninfectious factors. It affects people of all ages, but vulnerable age groups are more susceptible. Imaging techniques, such as chest X-rays (CXRs), are crucial in early detection and prompt action. CXRs for this condition are characterized by radiopaque appearances or sometimes a consolidation in the affected part of the lung caused by inflammatory secretions that replace the air in the infected alveoli. Accurate early detection of pneumonia is essential to avoid its potentially fatal consequences, particularly in children and the elderly. This paper proposes an enhanced framework based on convolutional neural network (CNN) architecture, specifically utilizing a transfer-learning-based architecture (MobileNet V1), which has outperformed recent models. The proposed framework is improved using a hybrid method combining the operation of two optimization algorithms: the dung beetle optimizer (DBO), which enhances exploration by mimicking dung beetles’ navigational strategies, and Fick’s law algorithm (FLA), which improves exploitation by guiding solutions toward optimal areas. This hybrid optimization effectively balances exploration and exploitation, significantly enhancing model performance. The model was trained on 7750 chest X-ray images. The framework can distinguish between healthy and pneumonia, achieving an accuracy of 98.19 ± 0.94% and a sensitivity of 98 ± 0.99%. The results are promising, indicating that this new framework could be used for the early detection of pneumonia with a low cost and high accuracy, especially in remote areas that lack expertise in radiology, thus reducing the mortality rate caused by pneumonia. Full article

Marburg hemorrhagic fever (MHF) is a fatal infectious disease caused by Marburg virus (MARV) infection, and MARV has been identified as a priority pathogen for vaccine development by the WHO. The glycoprotein (GP) of MARV mediates viral adhesion and invasion of host cells and therefore can be used as an effective target for vaccine development. Moreover, DNA vaccines have unique advantages, such as simple construction processes, low production costs, and few adverse reactions, but their immunogenicity may decrease due to the poor absorption rate of plasmids. Lysosome-associated membrane protein 1 (LAMP1) can direct antigens to lysosomes and endosomes and has great potential for improving the immunogenicity of nucleic acid vaccines. Therefore, we constructed a DNA vaccine based on a codon-optimized MARV GP (ID MF939097.1) fused with LAMP1 and explored the effect of a LAMP targeting strategy on improving the immunogenicity of the MARV DNA vaccine. ELISA, ELISpot, and flow cytometry revealed that the introduction of LAMP1 into the MARV DNA candidate vaccine improved the humoral and cellular immune response, enhanced the secretion of cytokines, and established long-term immune protection. Transcriptome analysis revealed that the LAMP targeting strategy significantly enriched antigen processing and presentation-related pathways, especially the MHC class II-related pathway, in the candidate vaccine. Our study broadens the strategic vision for enhanced DNA vaccine design and provides a promising candidate vaccine for MHF prevention. Full article