Infections in Patients With Cirrhosis Have a Changing Profile Over Time and Are Linked to a Higher Risk of Death Compared to Patients Without Cirrhosis

Introduction: Intensive care outcomes in patients with cirrhosis are relatively poor. The comparison between outcomes, especially related to infections, remains unclear in those with and without cirrhosis. With the emergence of resistant and fungal organisms, the changes in infection profiles over time are important to analyze. The aim of this study is to determine the impact of cirrhosis and infections on inpatient death over time in a qSOFA-matched cohort of patients with and without cirrhosis. Method(s): Inpatients admitted to ICUs throughout 2015-2021 were analyzed. Patients with cirrhosis were matched 1:1 by age, gender, and admission qSOFA to patients without;COVID-positive patients were excluded. Admission demographics, labs, the reasons for ICU transfer, infections, and inpatient death or hospice referral were obtained for each patient. Comparisons were made between patients with and without cirrhosis and those who died/referred to hospice versus not. Logistic regression for death/hospice was performed. In patients with cirrhosis, the culture results were compared over the years. Result(s): 1669 patients;833 cirrhosis and 836 non-cirrhosis patients were included. Patients with cirrhosis had higher rates of infection, positive culture, abdominal infection, and bacteremia. They also had higher gram-positive and fungal infections with a higher rate of VRE. They showed a greater organ failure load, death, and hospice referral compared to patients without cirrhosis. Logistic regression showed that cirrhosis (OR 4.0, p< 0.0001), admission qSOFA (1.60, p< 0.0001), WBC (1.02, p=0.003), reasons for ICU (altered mental status 1.69, hypotension 1.79, renal support 2.77, respiratory failure 1.79, CVA 1.96, all p< 0.0001) with Infection (1.77, p< 0.0001, >1 microbe isolated 1.86, p=0.05) were risk factors for death/hospice. The infection trend in the cirrhosis group showed a significant decrease in positive cultures and gram-negative infections and an increase in fungal and gram-positive infections over time. Conclusion(s): Despite matching for demographics and qSOFA, patients with cirrhosis had higher risks of death and organ failures. They were more likely to develop gram-positive and fungal infections with multiple organisms and VRE. Time trends in cirrhosis showed lower rates of positive cultures and gram-negative infections and an increase in fungal and gram-positive infections over time, which should encourage re-evaluation of diagnostic and prophylactic strategies in cirrhosis-related infections. (Figure Presented).

Respiratory microbiological surveillance in people with cystic fibrosis-analysis of respiratory samples before and after elexacaftor/tezacaftor/ivacaftor in a large adult U.K. cystic fibrosis center

Background: Pathogen surveillance is crucial but has become more challenging in the era of highly effective modulator therapy (HEMT), with many people with cystic fibrosis (PwCF) noting a considerable reduction or even absence of sputum on elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA). This challenge has been exacerbated by reduced face-toface contact with patients because of variable COVID-19 government restrictions on travel and social interaction (lockdowns) since March 20, relying on PwCF returning high-quality samples by mail. For those with pre-established bronchiectasis, it is likely that chronic infections and risk of new acquisition of infections remain on ELX/TEZ/IVA, although registry data suggest less prevalence of respiratory microorganisms on IVA [1]. We aimed to examine the impact of ELX/TEZ/IVA on frequency of respiratory pathogen surveillance and microorganism growth in our large, adult CF center. Method(s): A retrospective analysis of pathology results from respiratory samples received from March 19 to December 21, 2020, was completed for all patients commenced on ELX/TEZ/IVA at our CF center. Result(s): Respiratory samples from 216 PwCF who had commenced ELX/ TEZ/IVAwere analyzed. Median start date of ELX/TEZ/IVAwas October 10,2020. Before ELX/TEZ/IVA, the average number of respiratory samples per month was 108. This declined by 55% to an average of 48 per month when the first 50 PwCF commenced on ELX/TEZ/IVA and to 20 per month (82% reduction from pre-ELX/TEZ/IVA) when 100 PwCF had commenced ELX/ TEZ/IVA. The number of positive samples per month decreased from January 20, 2020, correlating with the introduction of ELX/TEZ/IVA and the reduction of respiratory samples received (Figure 1). The proportion of cough swabs and sputum samples remained similar from March 19 to December 21, 2020. (Six-month average showed that 19% of samples were cough swabs and 80% sputum for March to June 2019 and July to December 2021). We found no significant changes in proportion of samples positive for non-Pseudomonas spp. gram-negative organisms, Burkholderia spp., or gram-positive organisms (predominantly S. aureus) isolated over the period. There was a reduction by more than 50% of fungi and Candida spp. and a slight trend toward an increase in Pseudomonas spp. (mainly P. aeruginosa). Forty percent of PwCF who had one respiratory sample after ELX/TEZ/IVA initiation and 20% of those who had two or more samples showed a change in organism growth after ELX/TEZ/IVA initiation. In nearly 50% of these cases, the organism changed from gram negative to gram positive (P. aeruginosa to S. aureus in 69% of cases).(Figure Presented) Figure 1. Number of positive respiratory samples per month and number of people with cystic fibrosis on elexacaftor/tezacaftor/ivacaftor March 19 to December 21, 2020 Conclusion(s): The introduction of ELX/TEZ/IVA and its impact on sputum production has reduced surveillance of our patients' respiratory microbiology. This has been exacerbated by reduced face-to-face contact with patients due to the COVID-19 pandemic. The trends showa reduction in the isolation of fungi and yeasts and a slight increase in isolating Pseudomonas spp. In those who we have seen a change in organism growth, many have gone from gram-negative to gram-positive organisms. These data highlight the challenges of monitoring for new positive cultures and changes in microbiology cultures in the era of HEMT.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Experimental study of the disinfection performance of a 222-nm Far-UVC upper-room system on airborne microorganisms in a full-scale chamber

222-nm Far-UVC light is an emerging and promising tool for rapidly inactivating airborne pathogens. In this study, we experimentally evaluated the performance of a 222-nm Far-UVC upper-room disinfection system with a 15 W Far-UVC lamp in a full-scale chamber (11.9 m3). One gram-positive bacteria, namely Staphylococcus epidermidis and two gram-negative bacteria, namely Escherichia coli and Salmonella enterica were selected for the experiments. The aerosolized bacteria were injected into the chamber and exposed to 222-nm Far-UVC light. The first-order decay rates of indoor bioaerosols concentration with and without Far-UVC treatment were estimated. According to the results, the 222-nm Far-UVC induced decay rates of three bacteria were 0.0611 ± 0.003, 0.409 ± 0.048, and 0.474 ± 0.015 min−1, respectively. Besides, the UV susceptibility constants (Z-values) of these three bacteria were estimated as 0.157, 0.974, and 1.18 m2/J, respectively. The gram-positive bacteria, S. epidermidis, showed higher resistance to Far-UVC light as compared to the gram-negative bacteria, E. coli and S. enterica. In addition, a case study on airborne SARS-CoV-2 indoor transmission was simulated, and the infection risk of SARS-CoV-2 was compared using the Far-UVC and enhanced ventilation approaches. The results showed that both UV inactivation and ventilation approaches can significantly reduce the infection risk. More importantly, the Far-UVC may be a feasible and sustainable solution for reducing infection risk and improving indoor air quality. © 2023 Elsevier Ltd

Complex of Ceftriaxone with Mg(II): Synthesis, Structure, Spectral and Antibacterial Properties

Аннотация. Получен и охарактеризован магниевый комплекс цефтриаксона методами атомно-эмиссионного и элементного анализов, ТГА, ИК- и КР-спектроскопии, РФА и расчетов теории функционала плотности. Цефтриаксон координируется к иону магния через кислород триазинового цикла в шестом положении, азот аминогруппы тиазольного цикла и атомы кислорода карбоксильной и лактамной групп. Динатриевая соль цефтриаксона и комплекс магния были исследованы на антибактериальную активность в отношении Staphylococcus aureus, Escherichia coli и Pseudomonas aeruginosa.Alternate abstract:Magnesium complex of ceftriaxone was obtained and characterized by atomic-emission and elemental analysis, TGA, FTIR and Raman spectroscopy, X-ray diffraction and density functional theory calculations. Ceftriaxone was coordinated to the magnesium ion by the oxygen of the triazine cycle in the 6th position, the nitrogen of the amine group of the thiazole ring, and oxygen atoms of the lactam carbonyl and carboxylate groups. The disodium salt of ceftriaxone and magnesium complex were screened for antibacterial activity against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa.

Evaluation of Dalbavancin Use on Clinical Outcomes, Cost-Savings, and Adherence at a Large Safety Net Hospital.

Dalbavancin is a second-generation lipoglycopeptide antibiotic with activity against Gram-positive organisms. Dalbavancin is Food and Drug Administration (FDA)-approved for acute bacterial skin and soft tissue infections (ABSSTIs). There is a lack of substantial data on dalbavancin in more invasive infections, particularly in high-risk populations (patients with intravenous drug use and unstable living conditions). In this retrospective observational study, we reviewed all patients that received at least one dose of dalbavancin in an inpatient or outpatient setting at Parkland Hospital from February of 2019 to August of 2021. The demographics, type of infection, and rationale for dalbavancin were collected at the baseline. Clinical failure was measured by an avoidance of emergency department (ED) visits or hospital readmission at 30, 60, and 90 days. A separate analysis was conducted to estimate hospital, rehabilitation, or nursing facility days saved based on the projected length of treatment. 40 patients were included, and the majority were uninsured (85%), experiencing homelessness (60%), or had intravenous drug use (IDU) (57.5%). Indications for use included ABSSTIs (45%), bloodstream infection (67.5%), osteomyelitis (40%), infective endocarditis (10%), and septic arthritis (10%). Clinical failure was observed in 5 of the 40 patients (12.5%). Nonadherence to medical recommendations, a lack of source control, and ongoing IDU increased the risk of failure. Dalbavancin saved a total of 566 days of inpatient, rehabilitation, and nursing facility stays. Dalbavancin is a reasonable alternative to the standard of care in an at-risk population, offering decreased lengths of stays and cost savings. The uses of second-generation lipoglycopeptides are desirable alternatives to traditional outpatient parenteral antibiotic therapies for patients who otherwise would not qualify or for patients who desire less hospital contact in light of the COVID-19 pandemic. IMPORTANCE This study contributes additional experience to the literature of dalbavancin use in off-label indications, particularly for patients who do not qualify for outpatient parenteral antimicrobial therapy. The majority of the patient population were people who inject drugs and the uninsured. There is difficulty in tracking outcomes in this patient population, given their outpatient follow-up rates; however, we were able to track emergency room visits and readmissions throughout the majority of the local metroplex. The clinical use of dalbavancin at our institution also increased in the midst of the COVID-19 pandemic in an effort to preserve hospital resources and limit health care exposure. In addition, we are able to provide institution-specific cost-saving data with the use of dalbavancin.

Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: A systematic review.

BACKGROUND: There is paucity of data describing the impact of COVID-19 pandemic on antimicrobial resistance. This review evaluated the changes in the rate of multidrug resistant gram negative and gram positive bacteria during the COVID-19 pandemic. METHODS: A search was conducted in PubMed, Science Direct, and Google Scholar databases to identify eligible studies. Studies that reported the impact of COVID-19 pandemic on carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum beta-lactamase inhibitor (ESBL)-producing Enterobacteriaceae, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Pseudomonas aeruginosa (CPE) were selected. Studies published in English language from the start of COVID-19 pandemic to July 2022 were considered for inclusion. RESULTS: Thirty eligible studies were selected and most of them were from Italy (n = 8), Turkey (n = 3) and Brazil (n = 3). The results indicated changes in the rate of multidrug resistant bacteria, and the changes varied between the studies. Most studies (54.5%) reported increase in MRSA infection/colonization during the pandemic, and the increase ranged from 4.6 to 170.6%. Five studies (55.6%) reported a 6.8-65.1% increase in VRE infection/colonization during the pandemic. A 2.4-58.2% decrease in ESBL E. coli and a 1.8-13.3% reduction in ESBL Klebsiella pneumoniae was observed during the pandemic. For CRAB, most studies (58.3%) reported 1.5-621.6% increase in infection/colonization during the pandemic. Overall, studies showed increase in the rate of CRE infection/colonization during the pandemic. There was a reduction in carbapenem-resistant E. coli during COVID-19 pandemic, and an increase in carbapenem-resistant K. pneumoniae. Most studies (55.6%) showed 10.4 - 40.9% reduction in the rate of CRPA infection during the pandemic. CONCLUSION: There is an increase in the rate of multidrug resistant gram positive and gram negative bacteria during the COVID-19 pandemic. However, the rate of ESBL-producing Enterobacteriaceae and CRPA has decrease during the pandemic. Both infection prevention and control strategies and antimicrobial stewardship should be strengthen to address the increasing rate of multidrug resistant gram positive and gram negative bacteria.

More Than Meets the Eye: Orbital Swelling in an Adolescent with Sickle Cell Disease

Periorbital swelling is a clinical presentation with a broad differential and potentially deleterious consequence. Causes range from benign, including allergic reaction, to vision-and life-threatening, including orbital cellulitis and orbital infarction. The recent climate of SARS-CoV-2 has further complicated this differential, as the virus poses broad clinical presentations with new manifestations reported frequently. Rapid identification of the underlying etiology is crucial, as treatment approaches diverge greatly. Here, we report the case of an African American adolescent male with a history of homozygous sickle cell anemia presenting to an inner city hospital with bilateral periorbital swelling amid the coronavirus pandemic. Differentials including orbital cellulitis, COVID-MIS-C, orbital inflammatory syndrome, Hoagland sign, and orbital infarction secondary to sickle cell crisis are contrasted. We contrast our case with 12 case reports of orbital infarction in the setting of sickle cell crisis within the past 10 years, highlighting how these presentations, along with commonly reported findings of orbital infarction, compare with our patient. Copyright © 2022 Tehran University of Medical Sciences.

Preparation and characterization of antibacterial gels of galactomannan/ZnO nanocomposite in carbopol-based matrix using mesquite seeds as the biopolymer source

Nanocomposite gels are novel materials mainly used in the medical field for the control drug release and distribution. In this study, the effect of the concentration of galactomannan/zinc oxide nanocomposite in a polymeric Carbopol matrix to obtain a functional nanocomposite gel was studied. The swelling, thermogravimetric, rheological, and antibacterial properties against Escherichia coli and Staphylococcus aureus were evaluated. The results indicate that there is a direct effect between the amount of the employed nanocomposite and the properties studied in the gels. In this regard, we present a formulation that demonstrates that the prepared nanocomposite gel has ideal properties to be used in the medical field as an antibacterial agent.

Infections in Patients with Cirrhosis Have a Changing Profile over Time and Are Linked to a Higher Risk of Death Compared to Patients without Cirrhosis

Background: ICU outcomes, especially related to infections, remains unclear in those with and without cirrhosis. With the emergence of resistant and fungal organisms, the changes in infection profiles over time is important to analyze. Method(s): Inpatients admitted to ICUs throughout 2015-2021 were analyzed. Cirrhosis was diagnosed using clinical and radiological features and were matched 1:1 by age, gender, and admission qSOFA to non-cirrhotic patients;COVID positive patients were excluded. Admission demographics and labs, hospital course were obtained for each patient. Comparisons were made between patients with and without cirrhosis and those who died/hospice versus not. Result(s): 1669 patients;833 cirrhosis and 836 non-cirrhosis patients were included, of which 456 (27%) died or were referred to hospice. Cirrhosis versus not comparison: Patients with cirrhosis had a higher rate of infection, positive cultures, abdominal infections, and bacteremia. They also had higher gram-positive and fungal infections with higher rate of VRE. Admission WBC, demographics, altered mental status, nosocomial or second infections or LOS were similar between cirrhosis/not groups.Death and hospice versus not comparison: 74% of patients who died had cirrhosis vs 41% of those who survived. Conversely, 41% out of 1213 patients who survived had cirrhosis (p<0.0001). People who died were more likely to have nosocomial infections, higher UTIs, bacteremia and respiratory infection and those with positive cultures, >1 organisms, VRE and MRSA isolation. Patients who died had higher LOS and all organ failures. On Logistic regression for death/hospice, cirrhosis (OR 4.0, p<0.0001), admission qSOFA (1.60, p<0.0001) and WBC (1.02, p=0.003), reasons for ICU (altered mental status 1.69, hypotension 1.79, renal support 2.77, respiratory failure 1.79 & CVA 1.96, all p<0.0001) with Infection (1.77, p<0.0001, >1 microbe isolated 1.86, p=0.05) were risk factors while skin and soft-tissue infections had a lower risk of death/hospice (0.39, p=0.02). Time trend in cirrhosis for infections: There was a significant decrease over time with positive culture and gram-negative infections and increase in fungal and gram-positive infections. Conclusion(s): Despite matching for demographics and qSOFA, patients with cirrhosis had a higher risk of death and organ failures, and were more likely to develop infections due to gram-positive and fungal infections with > 1 organisms and VRE, compared to those without cirrhosis. Patients who died were more likely to have cirrhosis, infections and higher qSOFA compared to those who survived. Time trends in cirrhosis showed lower rate of positive cultures and gram-negative infections and increase in fungal and gram-positive infections over time, which should encourage re-evaluation of diagnostic and prophylactic strategies in cirrhosis-related infections. (Figure Presented).

A review: The phytochemistry, pharmacology, and pharmacokinetics of Curcumae Longae Rhizoma (Turmeric)

Curcumae Longae Rhizoma (CLR) is the rhizome of Curcuma longa L. Pharmacological studies show that CLR can be used to treat cervical cancer, lung cancer, lupus nephritis, and other conditions. In this paper, we review botany, traditional application, phytochemistry, pharmacological activity, and pharmacokinetics of CLR. The literature from 1981 to date was entirely collected from online databases, such as Web of Science, Google Scholar, China Academic Journals full-text database (CNKI), Wiley, Springer, PubMed, and ScienceDirect. The data were also obtained from ancient books, theses and dissertations, and Flora Reipublicae Popularis Sinicae. There are a total of 275 compounds that have been isolated from CLR, including phenolic compounds, volatile oils, and others. The therapeutic effect of turmeric has been expanded from breaking blood and activating qi in the traditional sense to antitumor, anti-inflammatory, antioxidation, neuroprotection, antibacterial, hypolipidemic effects, and other benefits. However, the active ingredients and mechanisms of action related to relieving disease remain ill defined, which requires more in-depth research and verification at a clinical level.

A CASE OF EGGERTHELLA BACTEREMIA IN A PATIENT WITH COVID-19

SESSION TITLE: COVID-19 Co-Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: We present a case of Eggerthella bacteremia in a patient with COVID-19. CASE PRESENTATION: A 69-year-old woman presented to the emergency room with chief complaint of cough, dyspnea, and malaise. After testing positive with a home COVID-19 test three days earlier, she continued to have worsening respiratory status and was brought in via ambulance. She was found to be tachycardic and hypoxic, requiring high-flow oxygen to maintain saturation in the emergency department. Chest X-ray showed bilateral patchy opacities consistent with multifocal COVID-19 pneumonia, and she was admitted to the intensive care unit for acute hypoxic respiratory failure. COVID-19 drug therapy was initiated, including baricitinib, remdesivir and decadron. Shortly after hospitalization, she began to endorse worsening abdominal pain. Physical exam elicited tenderness to palpation of her right lower quadrant. Abdominal CT scan showed distal ileum fluid collection concerning for possible bowel perforation. She underwent exploratory laparotomy which confirmed perforation, and a small bowel resection with anastomosis was performed. Blood cultures were positive for gram-positive bacilli, which were further identified as Eggerthella species. She required mechanical ventilation for worsening respiratory function post-surgery but remained unresponsive on the ventilator. The patient was administered vancomycin but continued to decline and eventually expired. DISCUSSION: Eggerthella is an anaerobic, gram-positive bacilli present in the gut microflora. Eggerthella infection has most often been reported in intra-abdominal infections. However, cases of bacteremia infection remain sparse. Most infections have been associated with other gastrointestinal processes including Crohn's disease, ulcerative colitis, appendicitis, and diverticulitis abscesses. Our case involved a patient with no significant gastrointestinal history admitted for COVID-19 pneumonia infection on baricitinib complicated by bowel perforation and bacteremia. Bowel perforation is a known risk factor of baricitinib use, and these risks should be discussed with the patient before beginning therapy. Overall mortality for Eggerthella species infection remains high, with some estimates as high as 31%. Much remains unknown about the impact on gut microbiome by SARS-CoV-2, however, early research suggests a higher rate of fungal co-infection in patients with COVID-19. As the literature on COVID-19 expands, more and more unusual pathogens such as Eggerthella may be found to contribute to the morbidity and mortality of patients being treated for COVID-19. CONCLUSIONS: Unusual pathogens such as Eggerthella may complicate a patient's hospital course while undergoing treatment for COVID-19. Reference #1: Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church, Eggerthella lenta Bloodstream Infections Are Associated With Increased Mortality Following Empiric Piperacillin-Tazobactam (TZP) Monotherapy: A Population-based Cohort Study, Clinical Infectious Diseases, Volume 67, Issue 2, 15 July 2018. Reference #2: Gardiner BJ, Tai AY, Kotsanas D, et al. Clinical and microbiological characteristics of Eggerthella lenta bacteremia. J Clin Microbiol. 2015. Reference #3: Lau SK, Woo PC, Fung AM, Chan K-M, Woo GK, Yuen K-Y. Anaerobic, non-sporulating, gram-positive bacilli bacteraemia characterized by 16s rrna gene sequencing. Journal of medical microbiology. 2004. DISCLOSURES: No relevant relationships by Kristin Davis No relevant relationships by Charles Peng

Clinical profile and visual outcome predictors in exogenous endophthalmitis in a referral center in Mexico City

Purpose : Exogenous endophthalmitis (EE) is the most serious complication of penetrating eye surgeries and open globe trauma (OGT). It is crucial to know the associated factors that will determine the final visual prognosis. The aim of the present study was to describe the epidemiological, clinical profile and visual outcomes (VO) predictors in patients with EE in a referral ophthalmology center. Methods : Retrospective, observational clinical study. Patients diagnosed with EE between January 2018 to September 2021 were included. Data collected included demographic characteristics, endophthalmitis origin, culture samples, microbiological diagnosis, initial and final best corrected visual acuity (BCVA), and treatment received. Major outcome was change in BCVA after endophthalmitis treatment and associated factors. T-test and Fisher's exact test for statistical analysis were used. Results : Seventy-three patients with EE were included. Surgery associated (SA) was the most common cause responsible for 39 cases (53.4%), followed by keratitis associated 18 cases (24.6%) and trauma associated (TA) 16 cases (21.9%). Gram-positive bacteria predominated in positive cultures (n= 35 [54.3%]). There was a statistically significant difference at mean age between TA group 41.1 ±18.7 years and SA group 59.9 ±20.9 years (p= 0.002). Final logMAR BCVA in the TA group was 4 ±0.9 (Snellen, light perception [LP]) and in the SA group was 2.7 ±1.7 (Snellen, Hand Motion [HM]). Fourteen (35.8%) patients in the SA group had a final BCVA ≥ 20/400;whereas in the TA group all patients had a final BCVA ≤ CF. Risk factors for non-improving BCVA after EE included OGT (p= 0.007) and initial BCVA of LP or worse (p <0.0001) in the SA group. There was no statistical difference in the final VO in patients that were treated with intravitreal injection (II) and those treated with vitrectomy (VTM) (p =0.40). Although 6 patients (75%) treated with VTM had an improvement in final BCVA compared with 12 (57.1%) of the patients just treated with II, this could be due to the sample number. We observed a tendency of diminishing cases of TA endophthalmitis after covid era, this could be associated with the isolation measures recommended. Conclusions : Surgery associated EE had a better visual prognosis than those with trauma associated EE. The initial BCVA is a meaningful indicator for final VO, being favorable when is better than HM.

5th Interscience Conference of Infection and Chemotherapy (ICIC 2021), Virtual Conference, 4-5 November 2021

These proceedings contain lectures and presentations that discuss invasive fungal infections in severe COVID-19 patients and ongoing battle against gram-positive bacteria.

Multifunctional properties of probiotic strains Lactococcus lactis ssp. lactis

The analysis of the literature of the RSCI and Web of Science on the multifunctionality of useful properties of mesophilic lactic acid bacteria Lactococcus lactis ssp. lactis, which have been used by humans for centuries in the preparation of fermented products as a way to preserve milk and food raw materials. Lactococcus lactis ssp. lactiscan become a resource for various biologically active substances - potential metabiotics, such as: bacteriocins, organic acids, short-chain fatty acids, antioxidants, adhesins, neurotransmitters. New areas of their application as suppliers of bioprotective agents for preventive therapy and the development of oral vaccines are described, which is important for the prevention and control of infections that pose an additional danger to patients during the COVID-19 pandemic.

Antimicrobial resistance patterns of bacterial and fungal isolates in COVID-19

Background: The pattern of bacterial infection in coronavirus disease 2019 (COVID-19) patients differ worldwide. Objectives: This study aimed to determine the patterns of bacterial infections and the antibiotic resistance profile by VITEK 2 (bioMerieux, France) in the culture of blood samples from hospitalized patients with COVID-19.

OUTCOME OF ADULT HEMATOPOIETIC TRANSPLANT RECIPIENTS AFTER ADMISSION TO INTENSIVE CARE UNIT (ICU): SINGLE CENTRE EXPERIENCE

Background: Intensive care unit (ICU) admission during hematopoietic stem cell transplant (HSCT) is associated with poor prognosis1,2. Published series report a range of ICU admission rates from 24-40% of transplant patients, most frequent reasons involving septic shock, respiratory failure and veno-occlusive disease3. In addition, patients undergoing HSCT are at a high risk of severe morbidity and mortality associated with COVID-194. Aims: The aim of this study was to analyze outcome of HSCT patients requiring ICU admission in our center. Methods: We retrospectively analysed outcome of 752 patients who underwent HSCT in our centre from January/2008 to June/2021. Data were collected from patients' clinical histories. Results: 103 (14%) patients required ICU admission (baseline and HSCT characteristics on table). Median time to ICU admission was 42 days (-2-1765). Seven of these patients were admitted to ICU on two occasions giving a total of 110 consecutive ICU admissions available for analysis. Main reason for ICU admission was respiratory distress (74;67%), mainly due to pneumonia (53%) including a 3% caused by COVID19, pulmonary edema (26%) and pulmonary haemorrhage (8%). Septic shock was second most common cause for ICU admission (26;24%) due to gram-negative bacilli (47%), fungal (15%) gram-positive bacteria (13%), virus (10%) and others/idiopathic (16%). Other less frequent causes were veno-occlusive disease (11;10%), hepatic failure/encephalopathy (8;7%), haemorrhagic complications (6;5%), cardiorespiratory arrest (2%), GVHD (2%), cardiogenic shock (2%). Of the 110 ICU admissions, 37 (34%) required hemofiltration, of which 30 (81%) died;and 77 (70%) required orotracheal intubation, of which 59 (77%) died. During the 110 ICU admissions, 67 patients (61%) died in the ICU;of these, 40 (37%) received unrelated donor HSCT, 36 (33%) sibling donor, 16 (15%) haploidentical and 17 (16%) autologous. Median ICU length of stay of these patients was 13 days (range 1-76). The cause of death was the same reason for ICU admission. Eighteen (16%) patients were discharged from ICU and died prior to Hospital discharge and 24 (22%) survived to Hospital discharge and were classified as post-discharge survivors. Of these 24 cases, 19 (79%) remain alive while the others (5;21%) succumbed to underlying disease or complications post-HSCT. Off note, both patients with COVID19 pneumonia (haploidentical and autologous HSCT respectively) were discharged from ICU and remain alive to date, without major complications. Summary/Conclusion: In our study 14% of transplant recipients required ICU admission, slightly lower than previous reports. Most common cause of admission was respiratory failure, consistent with reported. Mortality rate during ICU admission was 61%;higher death rate observed in allogeneic transplantation and those requiring aggressive ICU treatments such as mechanical ventilation or hemofiltration. Although patients with COVID19 pneumoniae who require ICU admission are usually associated with adverse outcome, in our series they responded successfully to intensive treatment. ICU admission following HSCT is associated with poor prognosis, but should not be considered futile. (Table Presented).

Determining the effects of some bacteria on wooden toys treated with antibacterial protective coatings

Several protective coatings enhanced by antimicrobial agents and/or pigments were considered for the wooden toy market: water-based matte varnish, an ultra-hygiene water-based matte varnish (WBV-UH), a polyurethane matte varnish (PUV), and an ultra-hygiene antiviral polyurethane matte varnish (PUV-UH), as well as a water-based dye (WBV 5%K), an ultra-hygiene water-based dye (WBV-UH 5%K), a polyurethane dye (PUV 5%K), and an ultra-hygiene polyurethane dye (PUV-UH 5%K), which contain 5% red nano-pigment (K). By utilizing 7 kinds of bacteria and 2 types of yeast that are commonly detected in routine, daily settings, the efficacy of the different protective coatings on wooden toy surface was investigated. The antibacterial and antimicrobial activities of the tested dye samples were based on the agar-well diffusion method. Ultimately, the study found that the addition of antimicrobial agents to several different protective coatings and dyes resulted in the presence of antimicrobial activity vs. the lack thereof with protective coatings and dyes alone. Additionally, some of the dyes with added antimicrobial agents were found to be effective against biofilm formation. Overall, the addition of pigment into the coating, alongside the addition of antimicrobial agents, proved to be highly effective in inhibiting growth and spread of microorganisms on wooden toy surface.

Structure-Activity Relationship of Anionic and Cationic Polyamidoamine (PAMAM) Dendrimers against Staphylococcus aureus

Dendrimers are potent synergists, carriers, and delivery molecules for natural biological products and pharmaceuticals. Staphylococcus aureus (S. aureus) infection is causing serious diseases in humans and animals. Given the recorded antibacterial and antiviral activity of terminal-charged PAMAM dendrimers, the relation between dendrimer charge type and generation is to be established against S. aureus. Three types of polyanionic dendrimers comprising terminal groups sodium carboxylate (generations 1.5, 2.5, 3.5, and 4.5), hydroxyl (generations 2, 3, 4, and 5), and succinamic acid (generations 2, 3, 4, and 5) and polycationic dendrimers containing primary amine (generations 2, 3, 4, and 5) were in antibacterial assays to determine their zone of inhibition and antibacterial activity. Cationic dendrimers were more potent than anionic dendrimers. The largest inhibition was shown by G(5)-128NH2 followed by G(4)-64NH2 primary amine dendrimers. Carboxylate, hydroxyl, and succinamic acid dendrimers showed weaker effects. Owing to their antibacterial actions, the addition of dendrimers to antibiotic preparations may increase their efficacy by their intrinsic and bacterial action by damaging the bacterial membranes as well as their usage in drug delivery.

Application of an Ultrasonic Nebulizer Closet in the Disinfection of Textiles and Footwear.

The emergence of the coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of disinfection processes in health safety. Textiles and footwear have been identified as vectors for spreading infections. Therefore, their disinfection can be crucial to controlling pathogens' dissemination. The present work aimed to evaluate the effectiveness of a commercial disinfectant aerosolized by an ultrasonic nebulizer closet as an effective method for disinfecting textiles and footwear. The disinfection was evaluated in three steps: suspension tests; nebulization in a 0.08 m3 closet; nebulization in the upscaled 0.58 m3 closet. The disinfection process of textiles and footwear was followed by the use of bacteriophages, bacterial spores, and bacterial cells. The disinfection in the 0.58 m3 closet was efficient for textiles (4 log reduction) when bacteriophage Lambda, Pseudomonas aeruginosa, and Bacillus subtilis were used. The footwear disinfection was achieved (4 log reduction) in the 0.08 m3 closet for Escherichia coli and Staphylococcus aureus. Disinfection in an ultrasonic nebulization closet has advantages such as being quick, not wetting, being efficient on porous surfaces, and is performed at room temperature. Ultrasonic nebulization disinfection in a closet proves to be useful in clothing and footwear stores to prevent pathogen transmission by the items' widespread handling.

Surfaces with instant and persistent antimicrobial efficacy against bacteria and SARS-CoV-2.

Surfaces contaminated with bacteria and viruses contribute to the transmission of infectious diseases and pose a significant threat to global public health. Modern day disinfection either relies on fast-acting (>3-log reduction within a few minutes), yet impermanent, liquid-, vapor-, or radiation-based disinfection techniques, or long-lasting, but slower-acting, passive antimicrobial surfaces based on heavy metal surfaces, or metallic nanoparticles. There is currently no surface that provides instant and persistent antimicrobial efficacy against a broad spectrum of bacteria and viruses. In this work, we describe a class of extremely durable antimicrobial surfaces incorporating different plant secondary metabolites that are capable of rapid disinfection (>4-log reduction) of current and emerging pathogens within minutes, while maintaining persistent efficacy over several months and under significant environmental duress. We also show that these surfaces can be readily applied onto a variety of desired substrates or devices via simple application techniques such as spray, flow, or brush coating.