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Topic Review
Framework for Diagnosis of Sepsis
Although the diagnosis of sepsis requires the identification of the three components of infection, a systemic inflammation response, and organ dysfunction, there is currently no consensus on gold-standard criteria. There are however suggested tools and tests, which have been proposed in international guidelines, including those produced by the Surviving Sepsis Campaign. Biomarkers play an important role in these tools and tests, and numerous heterogeneous studies have been performed to evaluate their respective clinical utility.
  • 284
  • 19 Feb 2024
Topic Review
Microbial Pathogens in Aquaponic Systems
The union of aquaculture and hydroponics is named aquaponics—a system where microorganisms, fish and plants coexist in a water environment. Bacteria are essential in processes which are fundamental for the functioning and equilibrium of aquaponic systems.
  • 281
  • 29 Nov 2023
Topic Review
Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains
Staphylococcus aureus (S. aureus) is a common pathogen involved in community- and hospital-acquired infections. Its biofilm formation ability predisposes it to device-related infections. Methicillin-resistant S. aureus (MRSA) strains are associated with more serious infections and higher mortality rates and are more complex in terms of antibiotic resistance.
  • 277
  • 07 Nov 2023
Topic Review
Joining Forces against Antibiotic Resistance
Antibiotic resistance is a significant global health concern that affects both human and animal populations. The One Health approach acknowledges the interconnectedness of human health, animal health, and the environment. It emphasizes the importance of collaboration and coordination across these sectors to tackle complex health challenges such as antibiotic resistance.
  • 269
  • 14 Sep 2023
Topic Review
COVID-19, HLH and Pregnant/Postpartum Women
The term ‘cytokine storm’ (CS) applies to a pathological autoimmune reaction when the interactions that lead to cytokine production are destabilised and may even lead to death. CS may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is noteworthy that many of the criteria used to diagnose haemophagocytic lymphohistiocytosis (HLH) are described as COVID-19 mortality predictors. Cytokine storms are considered to be an important cause of death in patients with the severe course of SARS-CoV-2 infection. Due to the fact that pregnant women are in an immunosuppressive state, viral pulmonary infections are more perilous for them—possible risks include miscarriage, intrauterine growth restriction or birth before the term; sometimes ventilation support is needed. HLH should be considered in pregnant and puerperal women suffering from moderately severe to severe COVID-19 and presenting with: fever unresponsive to antibiotic therapy, cytopenia, hepatitis and hyperferritinaemia.
  • 266
  • 26 Sep 2023
Topic Review
Parasitic Infections of Central Nervous System
The shifting landscape of parasitic infections affecting the central nervous system (CNS) is challenging the established paradigms in Europe. While traditionally confined to low- and middle-income countries, these infections are now encroaching upon non-endemic regions, propelled with escalating international travel, immunosuppression trends, and climatic variations.
  • 265
  • 01 Nov 2023
Topic Review
Pharmacokinetics-Pharmacodynamics of Surgical Antimicrobial Prophylaxis
Appropriate surgical antimicrobial prophylaxis (SAP) is an important measure in preventing surgical site infections (SSIs). Although antimicrobial pharmacokinetics–pharmacodynamics (PKPD) is integral to optimizing antibiotic dosing for the treatment of infections, there is less research on preventing infections postsurgery. Whereas clinical studies of SAP dose, preincision timing, and redosing are informative, it is difficult to isolate their effect on SSI outcomes. Antimicrobial PKPD aims to explain the complex relationship between antibiotic exposure during surgery and the subsequent development of SSI. It accounts for the many factors that influence the PKs and antibiotic concentrations in patients and considers the susceptibilities of bacteria most likely to contaminate the surgical site. 
  • 265
  • 08 Jan 2024
Topic Review
Neisseria gonorrhoeae Antimicrobial Resistance
The growing threat of antibiotic-resistant Neisseria gonorrhoeae, which causes gonorrhea, presents a current public health challenge. Over the years, the pathogen has developed resistance to different antibiotics, leaving few effective treatment options. High-level resistance to key drugs, including ceftriaxone, has become a concerning reality.
  • 263
  • 05 Jan 2024
Topic Review
Boutonneuse Fever in Southeastern Romania
Boutonneuse fever (BF) is an eruptive disease and is classified as a spotted fever, which is endemic in the Mediterranean basin (i.e., Marseille fever or Mediterranean spotted fever) and the Black Sea, caused by Rickettsia conorii, with dog ticks being a vector (i.e., Rhipicephalus sanguineus).
  • 262
  • 06 Dec 2023
Topic Review
Function of Extracellular Vesicles in Bacterial Lung Infections
Lung infections are one of the most common causes of death and morbidity worldwide. Both bacterial and viral lung infections cause a vast number of infections with varying severities. Extracellular vesicles (EVs) produced by different cells due to infection in the lung have the ability to modify the immune system, leading to either better immune response or worsening of the disease. It has been shown that both bacteria and viruses have the ability to produce their EVs and stimulate the immune system for that.
  • 261
  • 15 Nov 2023
Topic Review
Management of Biofilm Producing Methicillin-Resistant Staphylococcus aureus Infections
Since its initial description in the 1960s, methicillin-resistant Staphylococcus aureus (MRSA) has developed multiple mechanisms for antimicrobial resistance and evading the immune system, including biofilm production. MRSA is now a widespread pathogen, causing a spectrum of infections ranging from superficial skin issues to severe conditions like osteoarticular infections and endocarditis, leading to high morbidity and mortality. Biofilm production is a key aspect of MRSA’s ability to invade, spread, and resist antimicrobial treatments. Environmental factors, such as suboptimal antibiotics, pH, temperature, and tissue oxygen levels, enhance biofilm formation. Biofilms are intricate bacterial structures with dense organisms embedded in polysaccharides, promoting their resilience. The process involves stages of attachment, expansion, maturation, and eventually disassembly or dispersion. MRSA’s biofilm formation has a complex molecular foundation, involving genes like icaADBC, fnbA, fnbB, clfA, clfB, atl, agr, sarA, sarZ, sigB, sarX, psm, icaR, and srtA. Recognizing pivotal genes for biofilm formation has led to potential therapeutic strategies targeting elemental and enzymatic properties to combat MRSA biofilms. 
  • 253
  • 07 Feb 2024
Topic Review
Updates in Culture-Negative Endocarditis
Blood culture-negative infective endocarditis (BCNE) is a challenging condition associated with significant morbidity and mortality.
  • 246
  • 24 Aug 2023
Topic Review
Role of Biofilm in Urinary Tract Infections
Urinary tract infections (UTIs) are prevalent bacterial infections in both community and healthcare settings. They account for approximately 40% of all bacterial infections and require around 15% of all antibiotic prescriptions. Although antibiotics have traditionally been used to treat UTIs for several decades, the significant increase in antibiotic resistance in recent years has made many previously effective treatments ineffective. Biofilm on medical equipment in healthcare settings creates a reservoir of pathogens that can easily be transmitted to patients. Urinary catheter infections are frequently observed in hospitals and are caused by microbes that form a biofilm after a catheter is inserted into the bladder. Managing infections caused by biofilms is challenging due to the emergence of antibiotic resistance. 
  • 241
  • 11 Mar 2024
Topic Review
Babesia Parasite Species' Pathogenicity That Infect Dogs
Canine babesiosis is the most common tick-borne infection of dogs in many parts of the world. The disease severity is largely dependent on the infecting species of Babesia parasite and can vary from asymptomatic to a peracute presentation with a high mortality. 
  • 240
  • 09 Jan 2024
Topic Review
Plasmid-Mediated mcr Gene-Based Polymyxins
The polymyxin antibiotics colistin and polymyxin B have been recently revitalized as bactericidal drugs due to the increase in bacterial resistance to many commonly used antibiotics. Polymyxins were originally derived from the bacterium Paenibacillus polymyxa as the products of fermentation in the form of amphipathic lipopeptide molecules. Polymyxins were discovered in the 1940s to be cyclic lipodecapeptide antibiotics and recognized for therapeutic use in the 1950s. Polymyxins contain conserved components that consist of a d-Phe6-l-Leu7 segment, an N-terminal fatty acyl chain separated by cationic residues (l-α-γ-diaminobutyric acid (Dab)), and segments of the polar amino acid threonine (Thr). Polymyxins target the negatively charged outer membrane lipopolysaccharides (LPSs) of Gram-negative bacteria. Mobilized colistin resistance, mcr, genes are mainly associated with bacterial plasmids. These play an important role in the spread of colistin resistance because of their transferability among different strains in different environments. These mcr genes encode phosphoethanolamine-lipid A transferases that mediate the addition of PEA to the lipid A of an LPS at the 1′ and 4′ positions, causing a significant reduction in the overall negative charge on the bacterial outer membrane. This ultimately leads to the loss of binding affinity of an LPS to the cationic polymyxins and therefore resistance to their action.
  • 236
  • 17 Nov 2023
Topic Review
Multiplex PCR in Severe Bacterial Pneumonia Management
Pneumonia is a common and severe illness that requires prompt and effective management. Advanced, rapid, and accurate tools are needed to diagnose patients with severe bacterial pneumonia, and to rapidly select appropriate antimicrobial therapy, which must be initiated within the first few hours of care. Two multiplex molecular tests, Unyvero HPN and FilmArray Pneumonia+ Panel, have been developed using the multiplex polymerase chain reaction (mPCR) technique to rapidly identify pathogens and their main antibiotic resistance mechanisms from patient respiratory specimens. Performance evaluation of these tests showed strong correlations with reference techniques.
  • 234
  • 25 Jan 2024
Topic Review
Mechanisms of Vitamin D—Controlling Infections and Autoimmunity
Vitamin D is critical in protecting humans from hyper-inflammation, invasive pathogens, and autoimmunity risks and in maintaining good health. In contrast, low 25(OH)D status increases susceptibility to infections and developing autoimmunity. Data strongly suggested that maintaining serum 25(OH)D concentrations of more than 50 ng/mL is associated with significant risk reduction from viral and bacterial infections, sepsis, and autoimmunity. This is because, above this level, immune cells get sufficient diffusion of vitamin D and 25(OH)D from the circulation to generate intracellular calcitriol for their biological and physiological actions. Vitamin D deficiency treatment costs less than 0.01% of the cost of investigating worsening comorbidities associated with hypovitaminosis D. Despite cost-benefits, the prevalence of vitamin D deficiency remains high worldwide. This was clear among those who died from COVID-19 in 2020/21—most had severe vitamin D deficiency. Herein, the critical mechanisms of how immune cells maintain their robust activities are summarized.
  • 231
  • 15 Sep 2023
Topic Review
Sialylated-Glycan Bindings between SARS-CoV-2 Spike Protein and Cells
Consistent with well-established biochemical properties of coronaviruses, sialylated glycan attachments between SARS-CoV-2 spike protein (SP) and host cells are key to the virus’s pathology. SARS-CoV-2 SP attaches to and aggregates red blood cells (RBCs), as shown in many pre-clinical and clinical studies, causing pulmonary and extrapulmonary microthrombi and hypoxia in severe COVID-19 patients. SARS-CoV-2 SP attachments to the heavily sialylated surfaces of platelets (which, like RBCs, have no ACE2) and endothelial cells (having minimal ACE2) compound this vascular damage. Notably, experimentally induced RBC aggregation in vivo causes the same key morbidities as for severe COVID-19, including microvascular occlusion, blood clots, hypoxia and myocarditis.
  • 230
  • 27 Dec 2023
Topic Review
COVID-Associated Mucormycosis
COVID-19 has been responsible for widespread morbidity and mortality worldwide. Invasive mucormycosis has death rates scaling 80%. India, one of the countries hit worst by the pandemic, is also a hotbed with the highest death rates for mucormycosis. Cancer, a ubiquitously present menace, also contributes to higher case fatality rates. All three entities studied here are individual, massive healthcare threats. The danger of one disease predisposing to the other, the poor performance status of patients with all three diseases, the impact of therapeutics for one disease on the pathology and therapy of the others all warrant physicians having a better understanding of the interplay.
  • 227
  • 15 Sep 2023
Topic Review
The Initial Hepatitis B Virus-Hepatocyte Genomic Integrations
Hepatitis B virus (HBV) and its close relative woodchuck hepatitis virus (WHV) belong to the hepadnaviral family. Both are highly oncogenic DNA viruses, and their persistent infection and integration into the host’s hepatocyte genome are the main contributors to the development of hepatocellular carcinoma (HCC). 
  • 226
  • 23 Oct 2023
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