Breast Milk Conferred Immunity to Infants Against COVID-19.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has notably impacted healthcare systems and everyday life worldwide. Regulatory authorities have approved the emergency use of SARS-CoV-2 vaccines due to the rapid spread of the virus. However, during vaccination testing, pregnant and breastfeeding women were initially excluded, leading to a lack of evidence-based recommendations. When taking the COVID-19 pandemic into account, breastfeeding has emerged as a potential defense mechanism against this infection due to its numerous benefits for newborns. Human breast milk contains immunoglobulins (IgA, IgG, and IgM), lactoferrin, and various cells that play an inevitable role in the newborn's protection against respiratory infections and immune system development. Various studies have highlighted that the onset and severity of respiratory infections in infants can be reduced through breastfeeding, and the effects are noticeable during the first six months of life and that breast milk also has the potential to enhance mucosal immunity and promote a diverse microbiome, reducing the risk of asthma, allergies, and enteric diseases through the provision of specific antibodies and immunological factors. Researchers have indicated that breastfeeding mothers who contracted and recovered from COVID-19 or received vaccination passed protective antibodies to their infants through breast milk. Although rare cases of detection of SARS-CoV-2 RNA in breast milk have been reported, the virus has not been cultured from these samples, suggesting a low risk of transmission to the breastfed baby. However, further research is essential to understand the extent of protection provided by breast milk against COVID-19 and the potential effect of distinct phases of lactation. Nonetheless, the current evidence supports the benefits and safety of breastfeeding during the pandemic. With appropriate safety measures, promoting breastfeeding can contribute to the overall health and well-being of infants during the phase of COVID-19.

A Renal Abscess Caused by Nontyphoid Salmonella in an Immunocompetent Adult.

Renal abscesses are uncommon in adults and are typically caused by gram-negative bacteria such as Escherichia coli, Proteus mirabilis, or Staphylococcus aureus. Nontyphoid Salmonella abscesses are infrequent. We discuss the case of a 27-year-old previously healthy female who developed a renal abscess due to Salmonella enterica. Abdominal computed tomography (CT) revealed a left renal abscess (size 11.6 cm × 8.2 cm) and 1.9 cm cyst in the right kidney. The urine and abscess aspirate cultures indicated the presence of gram-negative bacilli and lactose-negative Salmonella. A presumptive diagnosis of the left renal abscess was made. A urologist was consulted, and the patient was prepared for a left-sided nephrectomy. The patient's condition improved following treatment with a combination of piperacillin/tazobactam and moxifloxacin. Based on our experience, prompt recognition of nontyphoidal Salmonella as a potential cause of a renal abscess is important to prevent complications such as the extension of the abscess and the spread of the pathogen to adjacent structures.

The Use of Systemic Inflammatory Markers From Routine Blood Tests in Predicting Preeclampsia and the Impact of Age on Marker Levels.

Our study aimed to investigate the relationship between preeclampsia (PE) and blood levels of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII) in the first trimester of pregnancy. In addition to examining the potential correlation between these inflammatory markers and PE, we aimed to compare the levels based on age to determine whether there are potential age-related differences in marker levels. Over a six-month period, we reviewed the complete blood count (CBC) analysis results of 126 subjects, where 63 patients had a documented history of PE and 63 were healthy pregnant females. We found that age had no statistically significant effect on NLR, MLR, or SII levels, but there was a statistically significant difference in PLR levels between the 18-25 and 26-35 age groups. The study also revealed that the MLR and PLR in the 18-25 age group of preeclampsia patients were statistically significantly lower than those of healthy patients, whereas the PLR and SII in the 26-35 age group of preeclampsia patients were statistically significantly higher than those of healthy patients. The results suggest that systemic inflammatory response (SIR) markers may be able to predict the development of preeclampsia. The study also emphasized the importance of taking age into account, specifically the 18-25 and 26-35 age groups, when assessing the risk of preeclampsia. Further research is needed however to corroborate existing findings and determine the importance of the examined inflammatory markers in the diagnosis of PE.

Salmonella enteritidis Phlegmon in an Elderly Female: A Case Report.

Salmonella enteritidis is an individual serotype of S. enterica which can cause gastroenteritis in humans. In the case of a mild primary infection, bacteremia and phlegmon, as well as other types of extraintestinal Salmonella infection, may go undiagnosed. A 64-year-old female presents with a one-week history of fatigue, fever, and low back pain. She recently noticed a progressively growing mass in her lower back, along with swelling and redness of the surrounding skin. The patient is a nursing home resident who has been immobilized since a fall one month before the presentation. The bacterial culture of discharge from the infected area was found to be positive for S. enteritidis, and the diagnosis of the torso phlegmon was made. The patient underwent surgical removal of the phlegmon and clinically improved after post-operative treatment. After evaluating geographic location, time of the year, and host factors such as relative immobility, extremes of age, and immunosuppressive conditions, S. enteritidis should be considered in a differential diagnosis of torso phlegmon.

The Role of Urinary Nitrite in Predicting Bacterial Resistance in Urine Culture Analysis Among Patients With Uncomplicated Urinary Tract Infection.

Objective This study aims to determine the relationship between the presence of urinary nitrite and bacterial resistance to antimicrobial therapy in patients with uncomplicated urinary tract infections. Methods During a six-month time period (April-October, 2020), we reviewed the urine samples of 59 adult outpatients from the Urology Department of Tbilisi State Medical University the First University Clinic with the diagnosis of urinary tract infection. The infecting microorganisms and the presence of urine nitrite were recorded. Resistance rates to the antibiotics were compared between the positive and negative nitrite groups. Chi-squared test was used to perform the statistical analysis using Prism software version 9.3.1 (GraphPad Software, Inc., San Diego, California). Results We examined the correlation between the nitrite-positive and -negative groups with the resistance pattern to ceftriaxone, trimethoprim/sulfamethoxazole (TMP-SMX), ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin. A total of 59 outpatients with a mean age of 37 years met the inclusion criteria between April and October 2020. In the positive and negative nitrite groups, there were 23 and 36 patients, respectively. Three (17.6%) of the 17 gram-positive organisms and 20 (62.5%) of the 42 gram-negative organisms yielded positive nitrite results. In nitrite-positive group, resistance rates to ceftriaxone, TMP-SMX, ampicillin-sulbactam, fosfomycin, amikacin, doxycycline, cefuroxime, cefotaxime, ceftazidime, and nitrofurantoin were 52.2%, 70.8%, 63.5%, 67.7%, 25.8%, 31.9%, 29.6%, 32.5%, 22.5% and 83.8%, respectively. These values in the nitrite-negative group were 6.5%, 41.3%, 60.7%, 72.9%, 49%, 3%, 2.3%, 3.3%, 4.3% and 81.9%, respectively. Highest relative resistance rate was recorded against cefuroxime (12.9), followed by doxycycline (10.6), cefotaxime (9.8), ceftriaxone (8.03), ceftazidime (5.2), TMP-SMX (1.71), ampicillin-sulbactam (1.05), nitrofurantoin (1.02), fosfomycin (0.93), and amikacin (0.53). The most commonly isolated pathogen was Escherichia coli, which was detected in 35 (71%) isolates. Other bacteria commonly found were Proteus spp in five (12%) isolates, Klebsiella spp in two (5%) isolates, and Enterococcus in five (12%) isolates. Conclusion The findings revealed that out of 10 antibiotics, nitrite-positive groups demonstrated higher resistance only against ceftriaxone, cefuroxime, cefotaxime, and doxycycline. Other antibiotics showed no statistically significant differences in resistance. Furthermore, the highest relative resistance rate was recorded against cefuroxime, whereas amikacin revealed the lowest. Therefore, we suggest physicians to not adjust antibiotic therapy for urinary tract infections (UTIs) based on the presence of nitrite. Urine bacteriology should be ordered.