Molecular characterization of Aeromonas hydrophila isolates from diseased fishes in district Kasur, Punjab, Pakistan / Caracterização molecular de isolados de Aeromonas hydrophila de peixes doentes no distrito de Kasur, Punjab, Paquistão

Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.

Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.

Molecular characterization of Aeromonas hydrophila isolates from diseased fishes in district Kasur, Punjab, Pakistan

Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.

Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.

Bacteriological profile and antibiotic susceptibility of blood culture from neonates in GMERS Medical College, Gandhinagar

Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants <28 days old. Neonatal sepsis contributes substantially to neonatal morbidity and mortality and is an ongoing major global public health challenge. Aim and Objectives: The objectives of this study were to study bacteriological profile and antibiotic susceptibility of blood culture from neonates in GMERS Medical College, Gandhinagar. Materials and Methods: For culture and antimicrobial susceptibility test, blood samples were taken from the suspected cases admitted in NICU. Total 271 blood culture positive NICU admitted patient with septicemia were taken in this study. Results: Total 271 septicemic neonates having blood culture positive septicemia, neonatal septicemia was predominantly caused by Gram-negative organism Klebsiella pneumoniae (40.60%). Among the all Gram-negative organisms, Piperacillin/Tazobactam was most sensitive drug followed by Meropenem. Moreover, for the all Gram-positive organism, vancomycin and linezolid were the most sensitive drugs. Conclusion: Neonatal septicemia is major cause of morbidity and mortality in India. Multiple antibiotic resistance among the isolates worsen the condition more. A high level of suspicions is needed on clinical ground for diagnosis. Judicious use of antibiotics should be promoted.

Neonatal plesiomonas shigelloides septicemia: case report and literature review / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal plesiomonas shigelloides (P. shigelloides) septicemia.Methods:The clinical data of a neonate with P.shigelloides septicemia admitted to the Department of Neonatology of our hospital were reviewed. Literature on this subject were searched in the following databases: CNKI, CQVIP database, Wanfang Database, SinoMed, PubMed and Web of Science (up to April 2022).The clinical characteristics of reported cases of neonatal P.shigelloides septicemia were analyzed.Results:Our patient was a full-term female neonate with symptoms of tachypnea, groaning, hypotension, septic shock and poor intestinal peristalsis. The cardiac and pulmonary ultrasound indicated pulmonary hypertension and right pleural effusion (empyema). The X-ray suggested pneumothorax. The blood culture showed P.shigelloides. Lumbar puncture and brain imaging showed no central nervous system involvement. After meropenem, penicillin and symptomatic treatment, the patient was cured and discharged without sequelae. In the literature review, 14 articles and 14 cases of neonatal P.shigelloides septicemia were found (a total of 15 cases including our case).All 15 cases had fever, 10 with convulsion/seizure, 8 had jaundice, 8 with respiratory distress/respiratory failure, 6 had feeding difficulty and 6 were irritable. Brain imaging features were hydrocephalus and panencephalitis. Antibiotics and symptomatic treatment were the main therapy. 8 cases died and 7 cases survived including 2 cases with neurological sequelae.Conclusions:Neonatal P.shigelloides septicemia has nonspecific manifestations, often involves multiple organs with significant neurological involvement and a high mortality rate.

Clinical application and effect analysis of remote multi-disciplinary team in the treatment of bubonic plague secondary to septicemic plague / 中华地方病学杂志

Objective:To study the remote multi-disciplinary team (MDT) model in diagnosis and treatment of plague, in order to provide scientific basis for clinical treatment of plague.Methods:A retrospective analysis was made on the diagnosis and treatment process of a case of bubonic plague, a sudden imported Class A infectious disease, which was secondary to septicemic plague, involving a remote MDT team consisting of the Infectious Diseases Department, Intensive Care Unit, Respiratory and Critical Care Department, Cardiology Department, Pharmacy Department, and Nosocomial Infection Department of the General Hospital of Ningxia Medical University.Results:The patient was a middle-aged female who was engaged in herding work on the grassland. The first symptom was a sudden pain in the left lower abdomen for three days, accompanied by chest tightness and shortness of breath. After hospitalization, blood culture indicated Yersinia, abdominal CT indicated left lower abdominal lymph node enlargement, and lymph node puncture fluid was positive for Yersinia pestis nucleic acid. Combined with clinical symptoms and signs, the patient was diagnosed as bubonic plague secondary to septicemic plague, and was isolated for treatment. After remote MDT consultation, comprehensive treatment was given, including anti-infection treatment of streptomycin and ciprofloxacin, short-term application of hormones, nutritional support, and local application of chloramphenicol ointment, etc. Secondary acute pancreatitis occurred during the course of the disease, which improved after symptomatic treatment. Finally, after 20 days of treatment, MDT expert group assessed that it met the discharge criteria. No abnormalities were found in follow-up visits outside the hospital. Conclusion:The remote MDT is effective in the treatment of bubonic plague secondary to septicemic plague, which is worth popularizing.

Perfil clínico-epidemiológico de pacientes classificados com o discriminador sepse possível no departamento de emergência / Perfil clínico-epidemiológico de los pacientes clasificados con el posible discriminador de sepsis en el servicio de urgencias / Clinical-epidemiological profile of patients classified with the possible sepsis discriminator in the emergency department

Objetivo: descrever o perfil clínico-epidemiológico de pacientes classificados com o discriminador "sepse possível" do Sistema Manchester de Classificação de Risco em um departamento de emergência terciário. Método: estudo observacional retrospectivo, realizado no período de janeiro de 2018 a dezembro de 2019. A amostra foi composta por 1522 pacientes. A coleta de dados foi realizada em dados de prontuário eletrônico. A análise foi realizada com o uso de estatística descritiva. Resultados: O sexo feminino foi majoritário (50,6%), com idade média de 63,7 anos (±15,48). A maioria dos atendimentos foi por demanda espontânea (74,1%), com tempos médios de espera para CR e tempo de CR de 3/4 e 4/3 minutos, em 2018 e 2019, respectivamente. Conclusão: É necessário associar o protocolo de classificação de risco, já instituído, outros mecanismos a fim de aprimorar o entendimento e o fluxo assistencial acerca de pacientes potencialmente sépticos.(AU)

Objective: The present study aims to describe the clinical profile of patients classified with the discriminator "possible sepsis" of the Manchester Risk Classification System in a terciary emergency department. Method: Retrospective observational study, carried out from January 2018 to December 2019. The sample composed of 1522 patients. Data collection was performed using electronic medical records. Analysis performed using descriptive statistics. Results: Females were the majority (50.6%), with a mean age of 63.7 years (±15.48). Most attendances were by spontaneous demand (74.1%), with average waiting times for risk classification and risk classification time of 3/4 and 4/3 minutes, in 2018 and 2019, respectively. Conclusion: It is necessary to associate the risk classification protocol, already in place, with other mechanisms in order to improve the understanding and care flow about potentially septic patients.(AU)

Objetivo: describir el perfil clínico-epidemiológico de los pacientes clasificados con el discriminador "posible sepsis" del Manchester Risk Classification System en un servicio de urgencias de tercer nivel. Método: estudio observacional retrospectivo, realizado de enero de 2018 a diciembre de 2019. La muestra estuvo compuesta por 1522 pacientes. La recolección de datos se realizó mediante historias clínicas electrónicas. El análisis se realizó mediante estadística descriptiva. Resultados: el sexo femenino fue mayoritario (50,6%), con una edad media de 63,7 años (±15,48). La mayoría de las atenciones fueron por demanda espontánea (74,1%), con tiempos promedio de espera para clasificación de riesgo y tiempo de clasificación de riesgo de 3/4 y 4/3 minutos, en 2018 y 2019, respectivamente. Conclusión: Es necesario asociar el protocolo de clasificación de riesgo, ya existente, con otros mecanismos para mejorar la comprensión y el flujo de atención sobre pacientes potencialmente sépticos.(AU)

Microbial Profile of Neonatal Septicemia and its Antibiogram Prevalent in a Tertiary Care Hospital of Western Odisha

Introduction : A disseminated disease with positive Blood Culture during the first month of life and encompasses various systemic infections of the newborn such as septicemia, meningitis, pneumonia, arthritis, osteomyelitis and Urinary Tract Infection is defined as Neonatal Sepsis. It is one of the leading causes of morbidity and mortality amongst neonates of developing countries. Aim : To determine the microbial profile of Blood Culture-positive Septicemia cases and study their antimicrobial susceptibility pattern. Materials and Methods : Blood Culture and C-reactive Protein (CRP) estimation were done for all 220 clinically suspected neonates. All the pure Bacterial and Candida isolates were identified using standard biochemical tests. Antimicrobial susceptibility testing was done for all bacterial isolates using the Kirby-Bauer disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results : Out of 220 cases, 68.2% were culture positive. Early-onset Neonatal Septicemia (EONS) cases were 74% and Late-onset Neonatal Septicemia (LONS) 26%. The male to female ratio was 1.9:1. Bacterial cases were 66% and 34% were due to Candida. Gram-negative isolates predominated, with Klebsiella pneumonia being the most common one. In the case of Gram-positive isolates, Staphylococcus aureus was most common. The best overall sensitivity of Gram-negative isolates was to Amikacin (100%), Colistin (100%), and Imipenem (96%). Grampositive isolates reported 100% sensitivity to Vancomycin, Teicoplanin and 97.4% to Linezolid. Conclusion : Gram-negative isolates were the leading cause of Sepsis in our study. Strict antimicrobial stewardship should be implemented to prevent the emergence of multi-drug resistant strains.

Características epidemiológicas de la endocarditis infecciosa. Experiencia de seis años / Epidemiological characteristics of infective endocarditis. Six years of experience

Resumen Introducción: La endocarditis infecciosa continúa siendo una condición amenazante para la vida, que puede afectar cualquier órgano y sistema, con alta mortalidad, atribuible principalmente a Staphylococcus aureus. Implica un reto diagnóstico y terapéutico, que requiere un cuidado multidisciplinario. Objetivo: Describir las características clínicas y microbiológicas en pacientes con endocarditis infecciosa. Materiales y método: Estudio observacional descriptivo basado en la revisión de historias clínicas en un centro médico de referencia en Medellín, Colombia, incluyendo pacientes mayores de 18 años hospitalizados durante el periodo de enero de 2011 a febrero de 2017. Resultados: 130 pacientes, con edad promedio de 53 años (± 16). La hipertensión arterial y la enfermedad renal crónica fueron la comorbilidad más frecuente (55% y 38%, respectivamente). La fiebre fue el síntoma cardinal (90%). Predominó la endocarditis infecciosa de válvula nativa (85.7%), afectando principalmente la mitral (40%). El agente etiológico más frecuente fue S. aureus (sensible a oxacilina 44%), y se complicaron con embolia el 52.5% y con falla cardiaca el 30.8%. La mortalidad intrahospitalaria fue del 39.2%. Conclusiones: La endocarditis infecciosa tiene variadas manifestaciones clínicas, entre las que destacan la embolia sistémica y la falla cardiaca aguda, que condicionan una mortalidad elevada (mayor que la reportada en otros estudios). El aislamiento microbiológico más frecuente es el bacteriano, principalmente S. aureus, como lo muestra la tendencia global.

Abstract Background: Infective endocarditis continues to be a life-threatening condition, can involve every organ system, with high mortality, attributable mainly to Staphylococcus aureus. It implies a diagnostic and therapeutic challenge, which requires multidisciplinary care. Objective: To describe the clinical and microbiological characteristics in patients with infectious endocarditis. Materials and method: Descriptive observational study, based on the review of medical records in a reference medical center in Medellín, Colombia. Including patients over 18 years hospitalized during the period from January 2011 to February 2017. Results: 130 patients, with an average age of 53 years (± 16). Hypertension and chronic kidney disease was the most common comorbidity (55% and 38%, respectively). Fever was the cardinal symptom (90%). Native valve infective endocarditis predominated (85.7%), mainly affecting the mitral valve (40%). The most frequent etiologic agent was Staphylococcus aureus (oxacillin sensitive 44%), embolism was the main complication by 52.5% followed by heart failure (30.8%). In-hospital mortality was 39.2%. Conclusions: Infective endocarditis has varied clinical manifestations, including systemic embolism and acute heart failure, which lead to high mortality (higher than that reported in other studies). The most frequent microbiological isolation is bacterial, mainly Staphylococcus aureus, as shown by the global trend.

Septicemia: As a result of erroneous parenteral administration of probiotic

Probiotics are formulations of live microbial cells that are administered orally to contribute to intestinal microbial balance. Bacillus clausiiis one such aerobic, spore-forming bacterium that is able to survive in the acidic environment of the stomach and is used as a probiotic. In the past few years, probiotic use has increased to a greater extent. However, there is growing global evidence that the use of probiotics in patients with organ failure, the immunocompromised state can cause infections, but it is extremely rare in immunocompetent persons when given through peroral route. However, it can cause severe sepsis in even immunocompetent individuals when given intravenously inadvertently. This case report shows the importance of establishing safety guidelines for probiotic use and particularly for dispensing probiotics in liquid formulations

Progress of plasma soluble CD14 subtype in neonatal septicemia / 国际儿科学杂志

Neonatal sepsis is a common infectious disease in the neonatal period, and its morbidity and mortality are increasing year by year.Its etiology and pathogenesis have not been fully elucidated.In recent years, studies have confirmed that plasma soluble CD14 subtype(sCD14-ST)plays a certain role in the pathogenesis of neonatal sepsis, and has a certain value in its diagnosis and prevention.The study found that sCD14-ST could be used as an indicator for early auxiliary diagnosis of neonatal sepsis, and the expression of sCD14-ST was positively correlated with the degree of neonatal sepsis.Early detection of sCD14-ST can predict neonatal sepsis.This article reviews the research on sCD14-ST and its application in neonatal sepsis.

Perfil clínico de pacientes com sepse internados em unidade de terapia intensiva: um estudo transversal / Clinical profile of patients with sepsis admitted to an intensive care unit: a cross-cutting study / Perfil clínico de pacientes con sepsis ingresados en unidad de cuidados intensivos: estudio transversal

Objetivo: identificar o perfil clínico de pacientes com sepse internados em Unidade de Terapia Intensiva. Método: pesquisa documental. A amostra contou com 50 prontuários de pacientes com quadro de sepse. A análise foi realizada através de estatística descritiva e teste de Qui-Quadrado de Pearson. O estudo foi aprovado pelo Comitê de Ética em Pesquisa sob número de protocolo 3.779.654. Resultados: idade média foi de 66,4 anos, prevaleceram os indivíduos do sexo masculino, que eram procedentes da emergência, com acesso venoso central e sondagem vesical de demora, sepse pulmonar, presença de distúrbios cardiovasculares e óbito como desfecho. Observou-se associação significativa entre distúrbios gastrointestinais e envelhecimento com sepse abdominal. Conclusão: é necessário o fortalecimento de políticas públicas de saúde voltadas para a qualificação dos profissionais com intuito de prevenir e reconhecer precocemente a sepse

Objective: to identify the clinical profile of patients with sepsis admitted to the Intensive Care Unit. Method: documentary research. The sample included 50 medical records of patients with sepsis. The analysis was performed using descriptive statistics and Pearson's Chi-Square test. The study was approved by the Research Ethics Committee under protocol number 3,779,654. Results: mean age was 66.4 years, males who came from the emergency room prevailed, with central venous access and indwelling urinary catheter, pulmonary sepsis, presence of cardiovascular disorders and death as an outcome. There was a significant association between gastrointestinal disorders and aging with abdominal sepsis. Conclusion: it is necessary to strengthen public health policies aimed at training professionals in order to prevent and early recognize sepsis

Objetivo: identificar el perfil clínico de los pacientes con sepsis ingresados en la Unidad de Cuidados Intensivos. Método: investigación documental. La muestra incluyó 50 historias clínicas de pacientes con sepsis. El análisis se realizó mediante estadística descriptiva y la prueba de chi-cuadrado de Pearson. El estudio fue aprobado por el Comité de Ética en Investigación con el número de protocolo 3.779.654. Resultados: la edad promedio fue de 66,4 años, predominaron los varones que acudieron a urgencias, con acceso venoso central y sonda vesical permanente, sepsis pulmonar, presencia de trastornos cardiovasculares y muerte como desenlace. Hubo una asociación significativa entre los trastornos gastrointestinales y el envejecimiento con sepsis abdominal. Conclusión: es necesario fortalecer las políticas de salud pública orientadas a la formación de profesionales para prevenir y reconocer precozmente la sepsis

Study on colonization of Group B Streptococcus in pregnant women of Mongolian and Han nationality and the status of neonatal early-onset septicemia / 中华急诊医学杂志

Objective:To explore the carrier status of group B streptococci (GBS) in pregnant women of Mongolian and Han nationality and the neonatal GBS infection in order to identify the high risk factors of GBS infection in Mongolian and Han newborns in this area.Methods:Totally 7289 pregnant women and their newborns born alive were tested for GBS in the Affiliated Hospital of Inner Mongolia Medical University from June 2017 to June 2020, and their newborns were cultured for GBS, and the venous blood of newborns delivered by GBS positive women were detected for anti-GBS capsular polysaccharide antibody level, in order to determine the high risk factors of neonatal GBS infection.Results:Among the 7289 pregnant women, 3136 were Mongolian pregnant women (2599 full-term delivery and 537 premature delivery) and 4153 were Han pregnant women (3541 full-term delivery and 612 premature delivery). The results of GBS test showed that the GBS carrier rate was 8.19% in the Mongolian preterm delivery group, 4.35% in the Mongolian term group, 11.93% in the Han preterm group, and 5.76% in the Han term group, indicating that the carrier rate of GBS in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality ( P < 0.05). Further comparing the GBS carrier rate of Mongolian and Han pregnant women, the GBS carrier rate of Mongolian pregnant women was significantly lower than that of Han pregnant women regardless of the premature delivery group and term group ( P < 0.05). (2) A total of 434 newborns were born by GBS positive parturients. The positive rates of GBS in Mongolian premature infants, Mongolian full-term infants, Han premature infants and Han full-term infants were 29.55%, 14.16%, 31.51% and 17.65%, respectively, suggesting that the positive rate of GBS in premature infants was significantly higher than that in full-term infants, regardless of Mongolian and Han nationality ( P<0.05). Further comparing the positive rate of GBS in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns, no matter the premature delivery group and the full-term group. (3) This study compared the incidence of early-onset GBS septicemia in Mongolian and Han newborns. The results showed that the incidence of early-onset GBS septicemia in Mongolian premature infants was 23.08%, and none in full-term infants. The incidence of early-onset GBS septicemia in Han premature infants was 26.09%. The incidence of early-onset GBS septicemia in term infants was 5.56%. The incidence of neonatal GBS septicemia in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality. By further comparing the incidence of GBS septicemia in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns regardless of the premature delivery group and the term group. (4) In both Mongolian and Han nationality, the level of anti-GBS capsular polysaccharide antibody in premature infants was significantly lower than that in term infants ( P < 0.05). (5) Regardless of the Mongolian and Han nationality, compared with GBS negative group, GBS positive rate was higher in pregnant women aged≥35 years old, with history of menstruation, miscarriage, vaginitis, floating population, and those who had not undergone pre-pregnancy examination,,which were the high risk factors for GBS-positive pregnant women during pregnancy. (6) In both Mongolian and Han nationality, the incidence of chorioamnionitis, puerperal infection, premature delivery and premature rupture of membranes in the GBS positive group was higher than that in the GBS negative group, and the incidence of fetal distress and neonatal asphyxia in the GBS positive group was also higher than that in the GBS negative group. Conclusions:The carrier rate of GBS in Mongolian pregnant women is lower than that in Han pregnant women, and positive GBS during pregnancy will increase the incidence of adverse maternal and fetal outcomes such as chorioamnionitis, puerperal infection, premature delivery, premature rupture of membranes, fetal distress, neonatal asphyxia and neonatal early-onset GBS septicemia. The high risk factors are maternal age ≥ 35 years old, history of menstruation, abortion, vaginitis, floating population, and infection without pre-pregnancy examination. We should attach great importance to the perinatal high risk factors and formulate corresponding intervention measures accordingly, and make rational use of antibiotics for prenatal prevention, so as to further reduce the incidence of early-onset GBS septicemia in newborns.

Sepsis mortality and the Human Development Index in Brazilian capitals: 1990-2016 / Mortalidade por sepse e Índice de Desenvolvimento Humano nas capitais brasileiras: 1990-2016 / Mortalidad por sepsis e Índice de Desarrollo Humano en las capitales brasileñas: 1990-2016

Background and Objectives: the Human Development Index is among the determinants associated with access to health services and sepsis assistance. This study aimed to describe the frequency of mortality from sepsis in Brazilian capitals and verify its correlation with the Human Development Index (HDI), in three-year periods that represented from the early 90's to 2016. Methods: a time series ecological epidemiology study, with consultation in secondary database involving Brazilian capital variables, population, deaths from sepsis and HDI. Correlation was assessed with Pearson's/Spearman's correlation coefficient. Results: the three highest mean coefficients of mortality from sepsis were observed in Rio Branco (9082.50), Manaus (6367.25) and Macapá (6085.25). A significant correlation was found between the mean mortality rate and the mean HDI in Aracaju (-0,999; p=0.001), Brasília (-0,991; p=0.009), Campo Grande (-0,977; p=0.023), Cuiabá (-0.983; p=0.017), Florianópolis (0.999; p=0.001), Goiânia (-0.997; p=0.003), Maceió (-0.987; p=0.013), Natal (-0.962; p=0.038), Palmas (-0.982; p=0.018) and Vitória (-0.998; p=0.002). Conclusion: there is a general correlation between the mean mortality coefficients and HDI. As HDI increases, there is a decrease in mortality from sepsis.(AU)

Justificativa e Objetivos: o Índice de Desenvolvimento Humano está entre os determinantes associados ao acesso aos serviços de saúde e assistência à sepse. Este estudo teve como objetivo descrever a frequência de mortalidade por sepse nas capitais brasileiras e verificar sua correlação com o Índice de Desenvolvimento Humano (IDH), em triênios que representaram do início da década de 90 a 2016. Métodos: estudo epidemiológico ecológico de série temporal, com consulta em banco de dados secundário envolvendo variáveis da capital brasileira, população, óbitos por sepse e IDH. A correlação foi avaliada com o coeficiente de correlação de Pearson/Spearman. Resultados: os três maiores coeficientes médios de mortalidade por sepse foram observados em Rio Branco (9.082,50), Manaus (6.367,25) e Macapá (6.085,25). Foi encontrada correlação significativa entre a taxa média de mortalidade e o IDH médio em Aracaju (-0,999; p=0,001), Brasília (-0,991; p=0,009), Campo Grande (-0,977; p=0,023), Cuiabá (-0,983 ; p=0,017), Florianópolis (0,999; p=0,001), Goiânia (-0,997; p=0,003), Maceió (-0,987; p=0,013), Natal (-0,962; p=0,038), Palmas (-0,982; p=0,018) e Vitória (-0,998; p=0,002). Conclusão: existe uma correlação geral entre os coeficientes médios de mortalidade e o IDH. À medida que o IDH aumenta, há uma diminuição na mortalidade por sepse.(AU)

Justificación y Objetivos: el Índice de Desarrollo Humano se encuentra entre los determinantes asociados al acceso a los servicios de salud y asistencia a la sepsis. Este estudio tuvo como objetivo describir la frecuencia de mortalidad por sepsis en las capitales brasileñas y verificar su correlación con el Índice de Desarrollo Humano (IDH), en períodos de tres años que representaron desde principios de la década de 1990 hasta 2016. Métodos: estudio de epidemiología ecológica de serie temporal, con consulta en base de datos secundaria involucrando variables de la capital brasileña, población, muertes por sepsis e IDH. La correlación se evaluó con el coeficiente de correlación de Pearson/Spearman. Resultados: los tres mayores coeficientes medios de mortalidad por sepsis se observaron en Rio Branco (9082,50), Manaus (6367,25) y Macapá (6085,25). Se encontró una correlación significativa entre la tasa de mortalidad media y el IDH medio en Aracaju (-0,999; p=0,001), Brasilia (-0,991; p=0,009), Campo Grande (-0,977; p=0,023), Cuiabá (-0,983 ; p=0,017), Florianópolis (0,999; p=0,001), Goiânia (-0,997; p=0,003), Maceió (-0,987; p=0,013), Natal (-0,962; p=0,038), Palmas (-0,982; p=0,018) y Victoria (-0,998; p=0,002). Conclusión: existe una correlación general entre los coeficientes medios de mortalidad y el IDH. A medida que aumenta el IDH, disminuye la mortalidad por sepsis.(AU)

Motile aeromonad septicemia (MAS) at Cyprinus carpio L, 1758 (Actinopterygii: Cyprinidae) in Lake Tödürge (Sivas/Turkey) / [Septicemia móvel por aeromonada (SMA) em Cyprinus carpio L, 1758 (Actinopterygii: Cyprinidae) no lago Tödürge (Sivas, Turquia)]

In this study, fish's morphologic and anatomic lesions caused by motile aeromonad septicemia (MAS) depending on environmental stress in carp, Cyprinus carpio population living in Lake Tödürge were identified. Various morphological and anatomical deformations and lesions were observed in the body of approximately 17% (252 fish specimens) of a total of 1488 carp samples. Bacteria are grown from all wipe samples. Bacterial colonies have a gray-white appearance with round, convex and smooth edges. 15-20 cfu colonies were observed in each aerop culture. As a result of analysis of wet wipe samples from infected fish's skin, gill, kidney and liver, it is determined that the bacteria which causes septicemia is Aeromonas sobria from the Aeromonadaceae family (with 99.2% confidence value). No bacteria were grown in cultures except A. sobria. Some symptoms of the infection are inflammation on different parts of the fish bodies, eruption on skin and scales, dermal necrosis, degeneration at soft rays of the fins, exophthalmos, and purulent liquid accumulation in the abdominal cavity, etc. Infected fish were most commonly encountered in July and August (water temperature above 20ºC), the lowest in October and November (water temperature below 10ºC).(AU)

Neste estudo, foram identificadas lesões morfológicas e anatômicas causadas por septicemia móvel por aeromônios (MPA), dependendo do estresse ambiental da carpa, a população de Cyprinus carpio que vive no lago Tödürge foi identificada. Várias deformações e lesões morfológicas e anatômicas foram observadas no corpo de aproximadamente 17% (252 amostras de peixes) de um total de 1488 amostras de carpa. As bactérias são cultivadas a partir de todas as amostras de limpeza. As colônias bacterianas têm uma aparência branco-acinzentada, com bordas arredondadas, convexas e lisas. Foram observadas 15-20 colônias de UFC em cada cultura de aerop. Como resultado da análise de amostras de lenços umedecidos da pele, brânquias, rins e fígado de peixes infectados, é determinado que a bactéria que causa a septicemia é a Aeromonas sobria, da família Aeromonadaceae (com valor de confiança de 99,2%). Nenhuma bactéria foi cultivada em culturas, exceto A. sobria. Alguns sintomas da infecção são inflamação em diferentes partes dos corpos dos peixes, erupção na pele e escamas, necrose dérmica, degeneração aos raios moles das barbatanas, exoftalmia e acúmulo de líquido purulento na cavidade abdominal, entre outros. Os peixes infectados eram encontrados com maior frequência em julho e agosto (temperatura da água acima de 20ºC), e eram menos comumente encontrados em outubro e novembro (temperatura da água abaixo de 10ºC).(AU)

Domestic status and systematic review of the use of probiotic in premature infants / 中华实用儿科临床杂志

A recent systematic evaluation analysis identified probiotic strains with efficacy on clinical outcomes related to premature infants, and found only a small number of single or hybrid strains of probiotics could reduce the mortality and complication rates.In this paper, the objective is to provide recommendations for a systematic evaluation of the literature on which strains can be used and which strains should not be used, and provide the status of corresponding preparations and applications in China.If the quality and safety of all product preparations can be satisfied and monitored, in order to reduce the incidence of such complications as infection in premature infants, the single strain of Lactobacillus rhamnosus or hybrid strains of Bifidobacterium infantis, Bifidobacterium lactis and Streptococcus thermophilus could be recommended.

A clinical study of spectrum of low platelet count to establish etiology, diagnosis, complications and prognosis in newborns admitted in Al-Ameen medical college hospital NICU, Bijapur, Karnataka, India

Background: In the newborn low platelet count is a common finding in both preterm and term newborn. It has been estimated that as many as 22% of all new borns admitted to NICU develop low platelet counts. A platelet count of less than 150,000/mL is defined as thrombocytopenia irrespective of the age of the individual.Methods: All the neonates underwent necessary blood investigations like Complete blood counts, (including platelet counts, HB estimation, Red cell indices and PCV), Capsular Polysaccharide - reactive protein. (CRP), Peripheral Smear study, Blood culture, BT, CT, PT, aPPT, Anti-platelet Antibodies.Results: The prevalence of thrombocytopenia in our study was 28%. The proportion of severe thrombocytopenia among the neonatal thrombocytopenia, 11.2% in our study.Conclusions: It can be concluded that thrombocytopenia is very much common in among our NICU admissions. Septicemia is its most important and most common cause.

Differential diagnoses in 83 dogs with icterus / Diagnósticos diferenciais em 83 cães com icterícia

Icterus (jaundice) is a yellowish pigmentation resulting from the depositing of bilirubin in tissues due to its high plasmatic concentration. The pathogenesis of icterus includes metabolic changes or obstructed bilirubin excretion and it is classified as pre-hepatic, hepatic and post-hepatic. This study aimed to evaluate and classify different causes of icterus in dogs during post mortem examination. These dogs were examined from 2014 to 2017, using macroscopic and histologic exams as well as ancillary tests. Eighty-three dogs were examined macroscopically and microscopically. They were separated into groups of icterus types: 24 (28.9%) dogs had pre-hepatic icterus, 45 (54.2%) had hepatic, 13 (15.7%) pre-hepatic and hepatic and one (1.2%) had post-hepatic icterus. Many factors were identified as a cause of icterus, including infectious agents (51/83), neoplasms (13/83), hepatic degeneration (11/83), chronic hepatic diseases (6/83), and obstructive causes (1/87). Among the infectious causes, leptospirosis, ehrlichiosis and disorders suggestive of septicemia were diagnosed. Neoplasms associated with icterus were cholangiocarcinoma, hemangiosarcoma and lymphoma. Other causes of icterus included degenerative diseases, such as lipidosis and glycogen degeneration. Hepatic fibrosis (cirrhosis) as a chronic disease and cholelithiasis also produced icterus. PCR was performed to confirm leptospirosis and ehrlichiosis. Samples of total DNA were used to amplify a fragment of a gene from Leptospira interrogans and Ehrlichia canis. In some dogs, co-infection of these agents was detected. The classification and identification of icterus etiologies in dogs is very important due to the number of diseases with this alteration, where ante mortem diagnosis is not always easily performed when some of these conditions are present.(AU)

Icterícia é a pigmentação amarelada decorrente da deposição de bilirrubina em tecidos devido à elevada concentração plasmática. A patogênese da icterícia inclui alterações no metabolismo ou na excreção de bilirrubina, sendo classificada em pré-hepática, hepática ou pós-hepática. O objetivo desse estudo foi identificar, avaliar e classificar as causas de icterícia em cães necropsiados de 2014 a 2017, associando as lesões macroscópicas, histológicas e exames complementares. Foram avaliados macro- e microscopicamente 83 cães com diferentes intensidades de icterícia. Os cães foram separados em grupos de acordo com o tipo de icterícia: 24 (28,9%) cães com icterícia pré-hepática, 45 (54,2%) cães com icterícia hepática, 13 (15,7%) com icterícia pré-hepática e hepática e um (1,2%) com icterícia pós-hepática. Foram identificadas várias etiologias associadas à icterícia, dentre elas pode-se destacar, agentes infecciosos (51/83), neoplasmas (13/83), processos degenerativos (11/83), crônicos (6/83) e obstrutivos (1/83). Dentre as causas infecciosas, destacam-se a leptospirose, a erliquiose e as lesões sugestivas de septicemia. Entre os neoplasmas associados com icterícia destacaram-se o colangiocarcinoma, hemangiossarcoma e linfoma. Outras causas de icterícia incluiriam os processos degenerativos como as degenerações gordurosa e glicogênica. Fibrose hepática (cirrose) e colelitíase foram também diagnosticados como causa de icterícia. A PCR foi utilizada para o diagnóstico confirmatório de leptospirose e erliquiose. Amostras de DNA total foram utilizadas para amplificar um fragmento dos genes de Leptospira interrogans e de Ehrlichia canis. Em alguns cães foi detectada co-infecção por estes agentes. A classificação e a identificação das causas de icterícia em cães são relevantes devido ao grande número de doenças que apresentam essa alteração, muitas vezes sem diagnóstico ante mortem.(AU)

Hydnora africana Derived Phytochemicals against Acetaldehyde Dehydrogenase of Aeromonas hydrophila Causing Septicemia

For drug discovery it takes approximately 6 years to expose in the market and for commercial uses. There are different procedure to get success in the drug discovery like preliminary phytochemical analysis, structural elucidation of the bioactive compound, preclinical test and clinical test etc. So to optimize the time for invention of new drug molecule, computer aided drug designing and molecular docking analysis is being used as one of the highly effective methodology. The phytochemical extraction of Hydnora africana plant was reported to inhibit the growth of Aeromonas hydrophilawhich cause Septicemia.“Biovia Discovery Studio” molecular docking methods give us opportunity to identify the effective molecule against the microbes. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” recommended that flavone can effectively deactivate the acetaldehyde dehydrogenase enzyme thereby interrupting the life cycle of the organism

Clinicoetiological profile and outcome of acute febrile illness with thrombocytopenia in children: a hospital based prospective study

'Background: Thrombocytopenia is often the most commonly encountered clinical condition in this routine practice. Etiological causes being numerous, often pose a challenge in evaluating and treating the patients. The objective of this study was to find out the different causes and clinical profile of fever with thrombocytopenia in children aged 1month to 14 year who were admitted in this set up.Methods: This was a prospective study done on 200 patients with thrombocytopenia admitted IMS AND SUM Hospital, BBSR with various complaints, during the period of 01 August 2017 to 01 August 2019. This study includes age group 1months to 14 years.Results: The highest incidence of thrombocytopenia belonged to the age group 11-14 years (22.5%) followed by 6-9 years (19.5%) and 3-6 years (18%). Incidence of thrombocytopenia was more in male child (58.5%) as compared to female child (41.5%). the most common cause of thrombocytopenia was dengue (50%), Scrub typhus (34%) septicaemia (17.5%) followed by malaria (10.5%). Among the infectious aetiology severe thrombocytopenia was seen more in dengue (25%) and scrub typhus (34.5%) but evidence of bleeding was seen more in sepsis (34.2%) even with higher platelet count which may be explained by associated multi organ failure.Conclusions: Infections like malaria, dengue, leptospirosis and septicaemia were the common causes of thrombocytopenia along with scrub typhus. Whenever thrombocytopenia is detected further investigations can help us in reaching a correct diagnosis in the majority of the cases so that appropriate treatment can be given and also to avoid unnecessary platelet transfusion to prevent transfusion related complications.

Absceso encefálico secundario a estafilococcemia: caso clínico / Brain abscess secondary to staphylococcemia: Case report

RESUMEN Los abscesos encefálicos son enfermedades infecciosas poco frecuentes. El Staphylococcus aureus tiene un papel importante como causa de infecciones intrahospitalaria y extrahospitalarias; la presentación más común es la infección de piel y tejidos blandos, aunque también puede afectar otros órganos, como corazón y cerebro. CASO: Una mujer de 19 años presentó artralgia de rodilla derecha, vómitos, petequias de 3 días de evolución. Se diagnosticó septicemia por S. aureus que había producido secundariamente un absceso cerebral en región parietal izquierda con sintomatología similar a un accidente cerebrovascular, por hemiparesia derecha. DISCUSION: El absceso encefálico es poco frecuente, y puede presentar sintomatología similar a una lesión vascular. Se asocia a varios factores de riesgo, y se debe tener en cuenta que hay tres mecanismos de entrada del microorganismo al sistema nervioso central. El diagnóstico en imagenológico y su tratamiento dependerá del antibiograma.

SUMMARY Brain abscesses are infrequent. Staphylococcus aureus has an important role as cause of intrahospital and extra hospital infections; the most common nosological entity is infection of soft tissues, although it can also affect other organs such as heart or brain. CASE: A 19-year-old woman presented with a 3-day course of arthralgia in the right knee, vomiting, and petechiae. S. aureus septicemia was diagnosed, presenting as an abscess with a stroke-like right hemiparesis. DISCUSSION: Brain abscesses are uncommon; presenting symptoms might be similar to a stroke. They are associated with several risk factors, three mechanisms of entry of the microorganism into the central nervous system have been recognized. The diagnosis is radiologic and its treatment will depend on the antibiogram.