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1.
Guilherme Bricks Jorge Figueiredo Senise Henrique Pott Junior Giuliano Grandi Amanda Passarini Débora Bellini Caldeira Dimas Carnaúba Junior Hamilton Antonio Bonilha de Moraes Celso Franscisco Hernandes Granato Adauto Castelo 《The Brazilian journal of infectious diseases》2018,22(2):85-91
Background and aims
Hepatitis E virus infection in patients with underlying chronic liver disease is associated with liver decompensation and increased lethality. The seroprevalence of hepatitis E virus in patients with chronic hepatitis C in Brazil is unknown. This study aims to estimate the seroprevalence of hepatitis E virus in patients with chronic hepatitis C and to describe associated risk factors.Methods
A total of 618 patients chronically infected with hepatitis C virus from three reference centers of São Paulo, Brazil were included. Presence of anti-HEV IgG was assessed by enzyme-linked immunosorbent assay (WANTAI HEV-IgG ELISA).Results
Out of the 618 patients tested, 10.2% turned out positive for anti-HEV IgG (95% CI 8.0–12.8%). Higher seroprevalence was found independently associated with age over 60 years (OR = 2.04; p = 0.02) and previous contact with pigs (OR = 1.99; p = 0.03).Conclusions
Patients with chronic hepatitis C are under risk of hepatitis E virus superinfection in São Paulo. Contact with pigs is a risk factor for the infection, suggesting a possible zoonosis with oral transmission. 相似文献2.
M. Bedolla-Barajas F. Javier Ramírez-Cervantes J. Morales-Romero J. Jesús Pérez-Molina C. Meza-López N. Delgado-Figueroa 《Allergologia et immunopathologia》2018,46(1):31-38
Introduction
The commonly held notion that a rural environment decreases the frequency of allergic diseases has proven to be inconsistent amongst children.Objective
Our objective was to contrast the prevalence of bronchial asthma (BA), allergic rhinitis (AR), and atopic dermatitis (AD) between children that live in a rural environment and those that live in urban areas.Methods
We carried out a cross-sectional study amongst children aged six to seven; they were selected through probabilistic, stratified and conglomerated sampling. The prevalence of BA, AR, and AD was identified with the use of the questionnaire provided by The International Study of Asthma and Allergies in Childhood, additionally, we inquired about each child's family history of atopy, their exposure to farm animals, the intake of unpasteurised cow's milk, and the number of siblings related to every child. We used logistic regression and multivariate analysis to determine the correlation between asthma, allergic diseases, and rural environment.Results
We included 189/1003 (18.8%) children from a rural environment, and 814/1003 (81.2%) from an urban area. BA and AR were associated to a family history of atopy (OR = 2.15, p = 0.001; OR = 2.58, p = 0.002, respectively). BA was more prevalent in males (OR = 1.92, p = 0.007). Notably, a higher number of siblings seems to protect against AR (OR = 0.45, p = 0.008). A paternal history of allergies was associated to AD.Conclusions
In our study, we were unable to find protective factors in a rural environment that might decrease the prevalence of asthma or allergic diseases. 相似文献3.
Ebrahim Eskandari-Nasab Mehdi Moghadampour Arezoo Tahmasebi Abolghasem Asadi-Saghandi 《The Indian journal of tuberculosis》2018,65(3):200-207
Background
Cytokines are fundamental elements in mediating and stimulating the immune response against tuberculosis (TB). Growing evidence indicated that polymorphisms in the interleukin-17 (IL-17) A and F genes are implicated in TB.Objectives
This meta-analysis was aimed to re-evaluate and update the relationship between IL-17A rs2275913 G/A and IL17F rs763780 T/C polymorphisms and TB risk.Methods
Using inclusive searches of the PubMed, MEDLINE, EMBASE, Web of Science and Elsevier Science Direct, we identified outcome data from all articles estimating the association between IL-17 A and F polymorphisms and TB risk.Results
A total of 15 studies comprising 7130 patients and 7540 controls were included. Our pooled analysis demonstrated that the IL-17A rs2275913 G/A SNP was not associated with the risk of TB in overall, or in Asians and Caucasians, but it conferred resistance to TB in Latin Americans using allele (OR = 0.53), codominant (OR = 0.53 and 0.38), dominant (OR = 0.49) and recessive (OR = 0.46) inheritance models. For IL-17F rs763780 T/C, the pooled evidence indicated that this variation was a risk factor for TB in allele (C vs T) and dominant (TC+CC vs TT) models in overall (OR of 1.35) and among Asians (OR = 1.40), but not in Caucasians.Conclusion
In summary, our meta-analysis suggested that the IL-17A rs2275913 was a protective factor against TB, but ?17F rs763780 T/C was a risk factor for TB. 相似文献4.
Andrii Dudnyk Svitlana Blyzniuk Oleksandr Pavel’chuk Olena Zakharchenko Dmytro Butov Sergiі Zaіkov 《The Indian journal of tuberculosis》2018,65(1):63-69
Tuberculosis (TB) may have a similar spirometry findings as a chronic obstructive pulmonary disease but the prevalence of TB-induced airflow obstruction (AO) is still unknown.
Objectives
To measure frequency of AO in new TB cases at the beginning of treatment and to evaluate factors associated with obstructive abnormalities following TB diagnosis.Materials and Methods
317 patients that have no history of prior AO were recruited into the study with a median age of 39.0 years (IQR, 30.0–49.0). AO was defined using the FEV1/F(VC) < LLN.Results
AO was detected in 29.97% (95/317) new TB cases. These patients had a more severe clinical manifestation of TB with a greater likelihood of cough, OR = 5.47 (95%CI 1.90–15.70) and wheezing, OR = 10.51 (95%CI 5.72–19.27), p < 0.001. The frequency of AO was positively associated with bronchoscopic evidence of narrowing of the main airways. Furthermore, from multiple logistic regression analysis we would assume that higher FEV1 value in TB patients with AO was related to greater BMI and inversely associated with older age, female sex and radiographic extent (p < 0.05).Conclusions
Obstructive pattern on spirometry frequently occurs in new TB cases without previously detected AO. This category of patients should be targeted for detailed follow-up, particularly, in high TB burden countries. 相似文献5.
M. Bedolla-Barajas J. Morales-Romero B.Y. Gaxiola-Arredondo G. Alcalá-Padilla E. Romero-Velarde 《Allergologia et immunopathologia》2018,46(6):539-545
Background
Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy.Objective
To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization.Methods
This was a hospital-based case–control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization.Results
The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07–0.36, p < 0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR = 5.54 (95% CI: 2.41–12.7, p < 0.0001).Conclusion
Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings. 相似文献6.
N. Behniafard A.A. Amirzargar M. Gharagozlou F. Delavari S. Hosseinverdi S. Sotoudeh E. Farhadi M. Mahmoudi M. Khaledi Z.G. Moghaddam A. Aghamohammadi N. Rezaei 《Allergologia et immunopathologia》2018,46(2):155-159
Background
Atopic dermatitis is an inflammatory skin disease in which both genetic and environmental factors interact to determine the susceptibility and severity of the disease.Objective
The aim of this study was to determine the association between atopic dermatitis and IL-10 and TGF-β1 gene polymorphisms.Methods
The allele and genotype frequencies of genes encoding for IL-10 and TGF-β1 were investigated in 89 patients with atopic dermatitis in comparison with 138 in the control group using the PCR-SSP method.Results
A significant increase was found in the frequency of the TGF-β1 codon 10/C allele among patients (p < 0.001, OR = 6.77), whereas a significant decrease was observed in the frequency of the T allele at the same position (p < 0.001, OR = 0.14). The frequency of the TGF-β1 codon 25/G allele in the control group was significantly higher than among patients (p < 0.001, OR = 0.08). A significant positive correlation was seen between CC (p < 0.001, OR = 15.10) and CG (p < 0.001) genotypes and AD at codons 10 and 25, respectively. The most frequent haplotypes among patients was TGF-β1 CG which was significantly higher than in the control subjects (50% in patients vs. 39.9% in controls, p = 0.042). A significant increase was found in the frequency of TGF-β CC (36% in patients vs. 7.6% in controls, p < 0.001) and TC (14% in patients vs. 0% in controls, p < 0.001) haplotypes among patients compared to controls. By contrast, the TGF-β1 TG haplotype was significantly lower in patients than controls (0% in patients vs. 52.5% in controls, p < 0.001). There were no significant differences in the frequency of alleles, genotypes and haplotypes of the IL-10 gene.Conclusions
We found a strong association between the polymorphisms of the TGF-β1 gene at codon 10 and codon 25 positions and atopic dermatitis. 相似文献7.
Background
Treatment success in multi-drug resistant tuberculosis under programmatic conditions has been far from satisfactory. Knowledge of the factors predicting treatment outcome can guide us to take appropriate corrective measures for better results. However, there is a scarcity of data on these predictors in Indian patients. The present study was sought to evaluate association of different patient and disease specific factors with treatment outcome in MDR-TB patients.Methods
It was a retrospective study that involved evaluation of data of MDR-TB patients who were started on Cat-IV treatment between January 2012 and December 2014. Medical records of 256 patients were scrutinized and necessary information on possible predicting factors like age, gender, body mass index, co-morbidities, previous TB treatment, blood investigations, treatment adherence, culture conversion time, etc. was retrieved. These factors were analyzed for their possible association with treatment outcome.Results
Of the 256 patients, 132 (51.6%) achieved successful outcome after Cat-IV anti-TB regimen. On multivariate logistic regression analysis age (adjusted OR = 0.95; 95% CI 0.91–0.98; p = 0.01), serum albumin level (adjusted OR = 3.71; 95% CI: 1.22–11.3; p = 0.02) and treatment adherence (adjusted OR = 4.52; 95% CI: 1.2–16.6; p = 0.02) were independently associated with treatment success. Co-morbidities like diabetes and alcoholism and previous anti-TB treatment didn’t affect the treatment end result significantly.Conclusion
The treatment outcome in MDR-TB has not significantly improved since the inception of DOTS-Plus strategy. Interventions to improve nutrition and treatment adherence might help to improve the success rate in MDR-TB treatment. 相似文献8.
Razieh Anari Reza Amani Seyed Mahmoud Latifi Masoud Veissi Hajieh Shahbazian 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2017,11(1):37-41
Aim
Obesity and diabetes are contributed to cardiovascular disease risk. The current study was performed to evaluate the association of central and general obesity and cardio-metabolic risk factors, including dyslipidemia and hypertension in T2DM patients.Methods
This was a cross-sectional study in T2DM adults. Body mass index (BMI) was used to identify general obesity and waist circumference (WC) was measured to define abdominal obesity (based on ATP III). Biochemical analyses, and anthropometric and blood pressure measurements were done for all participants.Results
Participants with central obesity showed significantly higher systolic (132.5 mmHg vs. 125.4 mmHg, p = 0.024) and diastolic blood pressures (84.9 mmHg vs. 80 mmHg, p = 0.007) than participants without obesity. Dyslipidemia was more prevalent in all participants either by BMI (98.3% vs. 97%, 95% CI: 0.18–17.53) or by WC (97.2% vs. 98%, 95% CI: 0.07–7.19). Abdominal adiposity in diabetic subjects showed significant reverse association with high level of physical activity (OR = 0.22, 95% CI: 0.06–0.85). Hypertriglyceridemia rate was increased with both central (OR = 2.11; p = 0.040) and general obesity (OR = 2.68; p = 0.021). After adjustment for energy intake and age, females had higher risk of general (OR = 4.57, 95% CI = 1.88–11.11) and central obesity (OR = 7.93, 95% CI = 3.48–18.08).Conclusions
Females were more susceptible to obesity. Hypertension was associated with both obesity measures. Dyslipidemia, except for hypertriglyceridemia, was correlated to neither abdominal nor general obesity. 相似文献9.
Xiandong Gu Xuming Luo Xiongbiao Wang Jihong Tang Wei Yang Zhuying Cai 《Primary Care Diabetes》2018,12(5):460-466
Background
The aim of this study was to explore the correlation between obstructive sleep apnea (OSA) and diabetic neuropathy.Materials and methods
After working out searching strategy, literatures were screened from the electronic databases: PubMed, Embase, and the Cochrane library. R 3.12 was utilized to perform meta-analysis, and odds ratio (OR) and its 95% confidence interval (CI) were used to present effect size. Heterogeneity was assessed by χ2-based Q test and I2 statistics. Publication bias was estimated by Egger’s test and sensitivity was evaluated by leave one out methods.Results
According to the criteria, a total of 11 studies with 1842 patients were enrolled in this study. With a significant heterogeneity (Q = 31.83, I2 = 68.60%), the random effects model was utilized to assess the effect size of pooled data. A remarkable correlation was identified OSA and diabetic neuropathy (OR = 1.84, 95% CI: 1.18–2.87) without publication bias (t = 1.68, P = 0.13). Meanwhile, the result of leave one out performed a well sensitivity. Moreover, the subgroup analyses presented that OSA was significantly correlated with type 1 diabetic neuropathy (OR = 1.97, 95% CI: 1.19–3.25), but no remarkable correlation was identified between OSA and type 1 (OR = 1.84, 95% CI: 0.86–3.93) or 1 + 2 (OR = 1.30, 95% CI: 0.43–3.92) diabetic neuropathy.Conclusion
OSA was significantly correlated with neuropathy in type 1 diabetes, but not in type 2 and type 1 + 2 diabetes. 相似文献10.
Leonardo Hideto Nagaya Mauro José Costa Salles Lucas Sadawo Chagas Takikawa Marcelo Fregoneze Pedro Doneux Luciana Andrade da Silva Guilherme do Val Sella Alberto Naoki Miyazaki Sergio Luiz Checchia 《The Brazilian journal of infectious diseases》2017,21(6):613-619
Purposes
Shoulder arthroplasty (SA) has been performed by many years for the treatment of several conditions, including osteoarthritis and proximal humeral fractures following trauma. Surgical site infection (SSI) following Shoulder arthroplasty remains a challenge, contributing to increased morbidity and costs. Identification of risk factors may help implementing adequate strategies to prevent infection. We aimed to identify pre- and intra-operative risk factors associated with deep infections after Shoulder arthroplasty.Methods
An unmatched case-control study was conducted to describe the prevalence, clinical and microbiological findings, and to evaluate patient and surgical risk factors for prosthetic shoulder infection (PSI), among 158 patients who underwent SA due to any reason, at a tertiary public university institution. Risk factors for PSI was assessed by uni- and multivariate analyses using multiple logistic regression.Results
168 SA from 158 patients were analyzed, with an overall infection rate of 9.5% (16/168 cases). Subjects undergoing SA with American Society of Anesthesiologists (ASA) grade III or higher (odds ratio [OR] = 5.30, 95% confidence interval [CI] = 1.58–17.79, p < 0.013) and presenting local hematoma after surgery (odds ratio [OR] = 7.10, 95% confidence interval [CI] = 1.09–46.09, p = 0.04) had higher risk for PSI on univariate analysis. However, only ASA score grade III or higher remained significant on multivariate analysis (OR = 4.74, 95% CI = 1.33–16.92, p = 0.016). Gram-positive cocci and Gram-negative bacilli were equally isolated in 50% of cases; however, the most commonly detected bacterium was Pseudomonas aeruginosa (18.7%).Conclusion
This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified. 相似文献11.
Srujitha Marupuru Padmanav Senapati Swathi Pathadka Sonal Sekhar Miraj Mazhuvancherry Kesavan Unnikrishnan Mohan K. Manu 《The Brazilian journal of infectious diseases》2017,21(3):312-316
Background
World Health Organization estimated that people with diabetes (DM) are at 2–3 times higher risk for tuberculosis (TB). Studies have shown that DM not only increases the risk of active TB, but also puts co-affected persons at increased risk of poor outcomes.Objectives
To determine the protective effect of metformin against TB in DM patients and also, to investigate the relationship between poor glycemic control and TB.Methods
A case–control study was conducted over 8 months, where cases and controls were selected based on the inclusion and exclusion criteria of the study. The diabetics diagnosed with TB were selected as study group (SG = 152) and without TB were as control group (CG = 299). Exposure status of metformin in both groups were analyzed.Results
The mean (SD) age of both CG and SG were 55.54 ± 11.82 and 52.80 ± 11.75, respectively. Majority of the subjects in the study were males. The mean hospital stay of SG and CG were 7 days and 6 days, respectively. Poor glycemic control (HbA1c > 8) observed in SG (51.7%) vs CG (31.4%). HbA1c value <7 is associated protective factor for TB occurrence [OR = 0.52 (95% CI 0.29–0.93)]. The protective effect of metformin against TB was 3.9-fold in diabetics (OR = 0.256, 0.16–0.40).Conclusion
Poor glycemic control among diabetics is a risk factor for TB occurrence. The result shows metformin use is a protective agent against TB infection in diabetics. Hence, incorporation of metformin into standard clinical care would offer a therapeutic option for the prevention of TB. 相似文献12.
Karimollah Hajian-Tilaki Behzad Heidari 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):129-134
Aims
The objective of this study was to determine the prevalence and the associated factors of metabolically unhealthy in normal-weight and metabolically healthy in obese.Methods
We analyzed the data of a representative sample of 986 participants recruited among adult population of north of Iran. Data were collected regarding demographic characteristics, lifestyle, body mass index, abdominal obesity measures, blood pressure, and lipid profiles. The participants were classified as metabolically healthy obese (MHO) and metabolically unhealthy normal-weight (MUNW). Metabolically unhealthy was defined as the presence of? ≥2 non-obese components of metabolic syndrome based on ATP III criteria.Results
The prevalence rate of MUNW and MHO accounted for 17.2% and 15.1% respectively. Mean age of participants with metabolically unhealthy was significantly greater than metabolically healthy in both normal weight and overweight/obese (P = 0.001). The results of multiple logistic regression analysis showed in normal-weight individuals, a significant association of MUNW was found with age group of 50–59 years(OR = 3.83, 95%CI: 1.71-8.57) and 60–70 years by OR = 4.74(95%CI:1.79-12.54) as compared with age group of 20–29 years. It was also associated with current smoking. While metabolically healthy state in overweight/obese was inversely associated with age 50–59 years by OR = 0.26 (95%CI:0.13-0.54) and age 60–70 years by OR = 0.15 (95%CI:0.05- 0.39) and higher WC by OR = 0.47 (95%CI:0.31-0.72) but positively associated with female-sex by OR = 1.74 (95%CI:1.07-2.82).Conclusion
Aging and smoking are significantly associated with metabolic abnormalities in normal-weight while aging, abdominal obesity negatively and female positively associated with metabolically healthy in obese. 相似文献13.
Thiago Nascimento do Prado Jayant V. Rajan Angélica Espinosa Miranda Elias dos Santos Dias Lorrayne Beliqui Cosme Lia Gonçalves Possuelo Mauro N. Sanchez Jonathan E. Golub Lee W. Riley Ethel Leonor Maciel 《The Brazilian journal of infectious diseases》2017,21(2):162-170
Background
TB patients co-infected with HIV have worse treatment outcomes than non-coinfected patients. How clinical characteristics of TB and socioeconomic characteristics influence these outcomes is poorly understood. Here, we use polytomous regression analysis to identify clinical and epidemiological characteristics associated with unfavorable treatment outcomes among TB-HIV co-infected patients in Brazil.Methods
TB-HIV cases reported in the Brazilian information system (SINAN) between January 1, 2001 and December 31, 2011 were identified and categorized by TB treatment outcome (cure, default, death, and development of MDR TB). We modeled treatment outcome as a function of clinical characteristics of TB and patient socioeconomic characteristics by polytomous regression analysis. For each treatment outcome, we used cure as the reference outcome.Results
Between 2001 and 2011, 990,017 cases of TB were reported in SINAN, of which 93,147 (9.4%) were HIV co-infected. Patients aged 15–19 (OR = 2.86; 95% CI: 2.09–3.91) and 20–39 years old (OR = 2.30; 95% CI: 1.81–2.92) were more likely to default on TB treatment than those aged 0–14 years old. In contrast, patients aged ≥60 years were more likely to die from TB (OR = 2.22; 95% CI: 1.43–3.44) or other causes (OR = 2.86; 95% CI: 2.14–3.83). Black patients were more likely to default on TB treatment (OR = 1.33; 95% CI: 1.22–1.44) and die from TB (OR = 1.50; 95% CI: 1.29–1.74). Finally, alcoholism was associated with all unfavorable outcomes: default (OR = 1.94; 95% CI: 1.73–2.17), death due to TB (OR = 1.46; 95% CI: 1.25–1.71), death due to other causes (OR = 1.38; 95% CI: 1.21–1.57) and MDR-TB (OR = 2.29; 95% CI: 1.46–3.58).Conclusions
Socio-economic vulnerability has a significant effect on treatment outcomes among TB-HIV co-infected patients in Brazil. Enhancing social support, incorporation of alcohol abuse screening and counseling into current TB surveillance programs and targeting interventions to specific age groups are interventions that could improve treatment outcomes. 相似文献14.
Per Lundberg Rune Andersson Elizabeth S. Machado Tomaz Pinheiro da Costa Cristina Barroso Hofer 《The Brazilian journal of infectious diseases》2018,22(5):412-417
Background
Perinatally HIV-infected children are surviving into adulthood, and getting pregnant. There is a scarcity of information on health and pregnancy outcomes in these women.Aim
To evaluate characteristics related to HIV disease and pregnancy outcomes in perinatally infected women, and to compare these women with a group of youth with behaviorally acquired HIV-infection, at a reference hospital in Rio de Janeiro, Brazil.Methods
A cohort study. Epidemiological, clinical, and laboratory data were compared between perinatally (PHIV) and behaviorally HIV-infected (BHIV) pregnant youth with the primary aim to study pregnancy outcomes in the PHIV group and compare with outcomes to BHIV group.Results
Thirty-two pregnancies occurred in PHIV group, and 595 in BHIV group. A total of seven (22%) PHIV women and 64 (11%) BHIV women had a premature delivery (p = 0.04), however, when adjusting for younger age at pregnancy, and antiretroviral therapy initiation in 1st trimester of pregnancy (OR = 18.66, 95%CI = 5.52–63.14), the difference was no longer significant. No cases of mother-to-child HIV transmission (MTCT) were observed in the PHIV group while there was a 2% MTCT rate in BHIV group.Conclusion
Pregnancy among PHIV was as safe as among BHIV. The differences between those groups were probably related to treatment and prolonged care in the first group. 相似文献15.
Soraya Mediero Ana Boto de los Bueis Karina Spiess Mariana Díaz-Almirón Almudena del Hierro Zarzuelo Isabel Villalaín Rodes Adela García Perea 《Enfermedades infecciosas y microbiología clínica》2018,36(7):409-416
Introduction
To study antibiotic susceptibility in bacterial keratitis (BK), its profile over 10 years and its influence on ophthalmological practice.Methods
Retrospective review of BK with positive corneal scraping over a 10-year period. Risk factors for keratitis, visual acuity (VA), empirical topical treatment, corneal infection characteristics and outcomes were analyzed for BK due to Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa and Propionibacterium acnes.Results
389 positive corneal scrapings were collected. All Gram-positive bacteria were susceptible to vancomycin. P. aeruginosa demonstrated >90% sensitivity to the most-commonly-used topical antibiotics. Susceptibility to methicillin was 90.2% for S. aureus and 66.3% for S. epidermidis. The results of 215 patients were available. 1.9% required enucleation and 2.8% required surgical treatments. Final VA improved after treatment in keratitis due to S. aureus (p = 0.026) and S. epidermidis (p = 0.005). There was a correlation between S. aureus resistance to methicillin (p = 0.002) and levofloxacin (p = 0.043) and enucleation (20% and 10%, respectively) compared with a 0% rate of enucleation in S. aureus-susceptible keratitis.Conclusions
BK due to S. pneumoniae is very aggressive irrespective of antibiotic sensitivity. S. aureus was frequently isolated in patients with systemic diseases. It causes severe keratitis and remains moderately resistant to methicillin and levofloxacin. For this reason, keeping vancomycin in empirical regimens is believed to be necessary. 相似文献16.
Rolando Paternina-de la Ossa Seila Israel do Prado Maria Célia Cervi Denissani Aparecida Ferrari dos Santos Lima Roberto Martinez Fernando Bellissimo-Rodrigues 《The Brazilian journal of infectious diseases》2018,22(5)
Background
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is spreading worldwide, but little is known about the epidemiology of this pathogen in Brazil.Objective
To evaluate clinical and microbiological features of children with S. aureus infections admitted to a university hospital.Methods
This was a cross-sectional study evaluating the potential risk factors for CA-MRSA, and a retrospective cohort evaluating in-hospital clinical outcomes. To include patients with both community and hospital-associated infections, we screened the results of the microbiological laboratory tests from January 1, 2012, to December 31, 2016. According to the phenotype, we classified the isolates in Methicillin-Susceptible S. aureus (MSSA), Hospital-Associated Methicillin-Resistant S. aureus (HA-MRSA), and CA-MRSA. Clinical data were collected from the patients’ medical records.Results
We identified 279 cases of S. aureus infections (MSSA = 163, CA-MRSA = 69, HA-MRSA = 41). Overall, the incidence density of CA-MRSA and MSSA infections increased while the HA-MRSA incidence density decreased over the study period. CA-MRSA infected patients were more likely to present with skin and soft tissue infections (OR: 2.83, 95%CI: 1.54–5.33, p < 0.001) and osteomyelitis (OR: 4.76; 95%CI: 1.16–22.71, p = 0.014) when compared to MSSA and HA-MRSA infections. Unadjusted case fatality rates were similar between MSSA-infected patients (3.14%, 5/159) and CA-MRSA infected patients (3.80%, 3/79, p = 0.792), while HA-MRSA infected patients were more likely to die in the hospital (12.20%, 5/41, p = 0.013).Conclusions
CA-MRSA is an emergent pediatric pathogen in Brazil. Our results highlight the relevance of choosing an appropriate initial antimicrobial drug for treating children with severe S. aureus infections. 相似文献17.
Ramya Kateel Alfred J. Augustine Shivananda Prabhu Sheetal Ullal Manohar Pai Prabha Adhikari 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):27-30
Aim
To evaluate the clinical and microbiological profile of diabetic foot ulcer patients admitted to a tertiary care hospital.Methodology
This study recruited 120 diabetic foot ulcer patients of all grade. Their medical records were evaluated retrospectively.Results
We found that median age of patient was 60(52, 67.75) years. 68.3% of patients were males. Median duration of diabetes mellitus was 15(10, 20) years. Mean HbA1C and fasting glucose was 10.3 ± 2.3 and 167.6 ± 52.42 respectively. Neuropathy (35%) and peripheral vascular disease (23.3%) was major micro vascular and macro vascular complication associated. Different locations of ulcers were toe (23.3%), sole (20%), dorsum (18.3%), shin (16.6%), heel (13.3%), and ankle (8.3%). Bacterial infection was seen in 81.66% patients out of which 23.3% had poly microbial infection.Conclusion
Diabetic foot ulcer patient had poor blood glucose control with elevated HbA1C and fasting blood glucose level. Neuropathy and peripheral vascular disease, hypertension were major complications. Staphylococcus aureus, Pseudomonas aeruginosa were common infecting bacteria. 相似文献18.
Adrian Gerald McNicholl Julio Ducons Jesús Barrio Luis Bujanda Montserrat Forné-Bardera Reyes Aparcero Julio Ponce Robin Rivera José María Dedeu-Cuso Pilar Garcia-Iglesias Miguel Montoro Alicia Bejerano Yolanda Ber-Nieto Belen Madrigal Eva Zapata Carmen Loras-Alastruey Manuel Castro Andrea Nevarez Javier P. Gisbert 《Gastroenterologia y hepatologia》2017,40(10):651-657
Background
Rapid Urease Test (RUT) is a simple, cheap and relatively fast method for diagnosing Helicobacter pylori infection. It is therefore the preferred method used for patients undergoing gastroscopy. Most kits require 24 h to give results. The new Ultra-Rapid Urease Test (URUT) kit by Biohit® requires less than 1 h.Objective
To determine URUT's diagnostic accuracy.Method
Prospective, blind, multi-centre study involving dyspeptic patients. One corpus biopsy and three antral biopsies were obtained during gastroscopy for standard histological analysis, RUT and URUT. The URUT result was checked after 1 min, 5 min, 30 min and 60 min and the RUT was checked over the course of 24 h. Histology was used as the gold standard test.Results
144 patients were included, 68% female, with a mean age of 49 years old; 50% were H. pylori positive. RUT and URUT diagnoses were correct in 85.9% and 90% of the cases, respectively. The mean waiting time for a positive RUT result was 6 h. The sensitivity, specificity, and positive and negative predictive values for RUT were, respectively, 82%, 90%, 89% and 84%. The URUT's results were similar (85%, 94%, 94% and 87%). These figures improved when patients taking PPIs were excluded (RUT: 86%, 91%, 93% and 83%; URUT: 91%, 94%, 96% and 89%). No statistically significant differences were found when comparing RUT and URUT distributions of correct diagnoses (McNemar's Test, p = 0.3) but there was a tendency towards better results with the URUT.Conclusion
The URUT is equivalent to (or slightly better than) the traditional RUT in diagnosing H. pylori infection, and provides results in less than an hour. 相似文献19.
Ken Yan Thong Mahender Yadagiri Dennis Joseph Barnes David Stuart Morris Tahseen Ahmad Chowdhury Ling Ling Chuah Anthony Michael Robinson Stephen Charles Bain Karen Ann Adamson Robert Elford John Ryder 《Primary Care Diabetes》2018,12(1):45-50
Introduction
Treatment of type 2 diabetes with sodium–glucose cotransporter 2 (SGLT2) inhibitors may result in genital fungal infections. We investigated possible risk factors for developing such infections among patients treated with the SGLT2 inhibitor dapagliflozin.Methods
The Association of British Clinical Diabetologists (ABCD) collected data on patients treated with dapagliflozin in routine clinical practice from 59 diabetes centres. We assessed possible associations of patient’s age, diabetes duration, body mass index, glycated haemoglobin, renal function, patient sex, ethnicity and prior genital fungal infection, urinary tract infection, urinary incontinence or nocturia, with the occurrence of ≥1 genital fungal infection within 26 weeks of treatment.Results
1049 out of 1116 patients (476 women, 573 men) were analysed. Baseline characteristics were, mean ± SD, age 56.7 ± 10.2 years, BMI 35.5 ± 6.9 kg/m2 and HbA1c 9.4 ± 1.5%. Only patient sex (13.2% women vs 3.3% men) and prior history of genital fungal infection (21.6% vs 7.3%) were found to be associated with occurrence of genital fungal infections after dapagliflozin treatment, adjusted OR 4.22 [95%CI 2.48,7.19], P < 0.001 and adjusted OR 2.41 [95% CI 1.04,5.57], P = 0.039, respectively.Conclusion
Women and patients with previous genital fungal infections had higher risks of developing genital fungal infections with dapagliflozin treatment. 相似文献20.
Mercedes Ramas Maria G. Donday Adrian G. McNicholl Javier P. Gisbert 《Gastroenterologia y hepatologia》2017,40(10):658-662