Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#102289
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101901
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101887
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101869
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101835
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101771
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101738
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101725
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101651
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101596
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101567
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101492
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101367
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101273
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101112
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101075
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#101019
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#100653
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#100655
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#100424
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#100419
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99975
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99895
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99896
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99897
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99869
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99870
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99718
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99658
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99607
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99581
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99354
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99285
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99133
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99074
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99054
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#99018
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98962
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98776
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98763
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98732
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98659
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98414
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98351
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98353
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98341
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#98198
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#97786
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#97794
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://infmed.dk/nyheder-udefra?rss_filter=pseudomonas&setpoint=79983#97796
Søgeord (pseudomonas) valgt.
186 emner vises.
Daniel E. Jacobsen, Makaela M. Montoya, Trent R. Llewellyn, Kaitlyn Martinez, Kristen M. Wilding, Kiersten D. Lenz, Carrie A. Manore, Jessica Z. Kubicek-Sutherland, Harshini Mukundan
PLoS One Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
by Daniel E. Jacobsen, Makaela M. Montoya, Trent R. Llewellyn, Kaitlyn Martinez, Kristen M. Wilding, Kiersten D. Lenz, Carrie A. Manore, Jessica Z. Kubicek-Sutherland, Harshini Mukundan Universal and early recognition of pathogens occurs through recognition of evolutionarily conserved pathogen associated molecular patterns (PAMPs) by innate immune receptors and the consequent secretion of cytokines and chemokines. The intrinsic complexity of innate immune signaling and associated signal transduction challenges our ability to obtain physiologically relevant, reproducible and accurate data from experimental systems. One of the reasons for the discrepancy in observed data is the choice of measurement strategy. Immune signaling is regulated by the interplay between pathogen-derived molecules with host cells resulting in cellular expression changes. However, these cellular processes are often studied by the independent assessment of either the transcriptome or the proteome. Correlation between transcription and protein analysis is lacking in a variety of studies. In order to methodically evaluate the correlation between transcription and protein expression profiles associated with innate immune signaling, we measured cytokine and chemokine levels following exposure of human cells to the PAMP lipopolysaccharide (LPS) from the Gram-negative pathogen Pseudomonas aeruginosa. Expression of 84 messenger RNA (mRNA) transcripts and 69 proteins, including 35 overlapping targets, were measured in human lung epithelial cells. We evaluated 50 biological replicates to determine reproducibility of outcomes. Following pairwise normalization, 16 mRNA transcripts and 6 proteins were significantly upregulated following LPS exposure, while only five (CCL2, CSF3, CXCL5, CXCL8/IL8, and IL6) were upregulated in both transcriptomic and proteomic analysis. This lack of correlation between transcription and protein expression data may contribute to the discrepancy in the immune profiles reported in various studies. The use of multiomic assessments to achieve a systems-level understanding of immune signaling processes can result in the identification of host biomarker profiles for a variety of infectious diseases and facilitate countermeasure design and development.
Læs mere Tjek på PubMedAna D. VegaKailynn DeRondeAdriana JimenezMichael PiazzaChristine VuOctavio MartinezLaura J. RojasSteven MarshallMohamad YasminRobert A. BonomoLilian M. Abbo1Department of Pharmacy, Jackson Health System, Miami, Florida, USA2Department of Epidemiology, Florida International University, Miami, Florida, USA3Department of Medicine, Virtua Medical Group, Medford, New Jersey, USA4Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA5Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA6CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA7Department of Medicine, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA8Departments of Proteomics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA9Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA10Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA, Pranita D. Tamma
Antimicrobial Agents And Chemotherapy, 11.04.2024
Tilføjet 11.04.2024
Bryan K. Lynn, Patrick De Leenheer, Martin Schuster
PLoS One Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
by Bryan K. Lynn, Patrick De Leenheer, Martin Schuster Cooperation via shared public goods is ubiquitous in nature, however, noncontributing social cheaters can exploit the public goods provided by cooperating individuals to gain a fitness advantage. Theory predicts that this dynamic can cause a Tragedy of the Commons, and in particular, a ‘Collapsing’ Tragedy defined as the extinction of the entire population if the public good is essential. However, there is little empirical evidence of the Collapsing Tragedy in evolutionary biology. Here, we experimentally demonstrate this outcome in a microbial model system, the public good-producing bacterium Pseudomonas aeruginosa grown in a continuous-culture chemostat. In a growth medium that requires extracellular protein digestion, we find that P. aeruginosa populations maintain a high density when entirely composed of cooperating, protease-producing cells but completely collapse when non-producing cheater cells are introduced. We formulate a mechanistic mathematical model that recapitulates experimental observations and suggests key parameters, such as the dilution rate and the cost of public good production, that define the stability of cooperative behavior. We combine model prediction with experimental validation to explain striking differences in the long-term cheater trajectories of replicate cocultures through mutational events that increase cheater fitness. Taken together, our integrated empirical and theoretical approach validates and parametrizes the Collapsing Tragedy in a microbial population, and provides a quantitative, mechanistic framework for generating testable predictions of social behavior.
Læs mere Tjek på PubMedInfection, 10.04.2024
Tilføjet 10.04.2024
Abstract Purpose Bronchoalveolar lavage is commonly used in clinical practice for unresolved pneumonia. However, bronchoalveolar lavage is not suitable for all patients as it is an invasive procedure and can worsen oxygenation. The diagnostic value of bronchial wash and sputum has been debated extensively over the years. In this study, we aim to compare the diagnostic value in several pathogens of bronchoalveolar lavage and bronchial wash, and secondarily bronchoalveolar lavage and sputum. Methods We retrospectively included all adult patients in our hospital who underwent bronchoalveolar lavage, bronchial wash, and where sputum sampling was done between January 1st of 2018 and December 31st of 2021. The intraclass correlation coefficient was computed for the three tests. Results In total, 308 patients were included. We found a level of correlation of 0.819 and 0.865, respectively, between bronchoalveolar lavage and bronchial wash for two pathogens: Staphylococcus aureus and Pseudomonas aeruginosa. For Stenotrophomonas maltophilia and Aspergillus fumigatus, we found an intraclass correlation coefficient of 0.568 and 0.624, respectively. Between bronchoalveolar lavage and sputum, we found varying levels of agreement. Conclusion Our study shows reasonably well agreement levels between bronchoalveolar lavage and bronchial wash, suggesting that bronchial wash could potentially be an alternative to bronchoalveolar lavage.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
Abstract Introduction Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022. Methods Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the blaKPC, blaNDM, blaOXA-48, blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened for the blaOXA-23, blaOXA-58 and blaOXA-24/40 genes. Results Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA-48 genes were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa, and blaOXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases. Conclusion The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.
Læs mere Tjek på PubMedInfection, 9.04.2024
Tilføjet 9.04.2024
Abstract Purpose Bronchoalveolar lavage is commonly used in clinical practice for unresolved pneumonia. However, bronchoalveolar lavage is not suitable for all patients as it is an invasive procedure and can worsen oxygenation. The diagnostic value of bronchial wash and sputum has been debated extensively over the years. In this study, we aim to compare the diagnostic value in several pathogens of bronchoalveolar lavage and bronchial wash, and secondarily bronchoalveolar lavage and sputum. Methods We retrospectively included all adult patients in our hospital who underwent bronchoalveolar lavage, bronchial wash, and where sputum sampling was done between January 1st of 2018 and December 31st of 2021. The intraclass correlation coefficient was computed for the three tests. Results In total, 308 patients were included. We found a level of correlation of 0.819 and 0.865, respectively, between bronchoalveolar lavage and bronchial wash for two pathogens: Staphylococcus aureus and Pseudomonas aeruginosa. For Stenotrophomonas maltophilia and Aspergillus fumigatus, we found an intraclass correlation coefficient of 0.568 and 0.624, respectively. Between bronchoalveolar lavage and sputum, we found varying levels of agreement. Conclusion Our study shows reasonably well agreement levels between bronchoalveolar lavage and bronchial wash, suggesting that bronchial wash could potentially be an alternative to bronchoalveolar lavage.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.04.2024
Tilføjet 7.04.2024
Abstract Introduction Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022. Methods Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the blaKPC, blaNDM, blaOXA-48, blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened for the blaOXA-23, blaOXA-58 and blaOXA-24/40 genes. Results Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA-48 genes were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa, and blaOXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases. Conclusion The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.
Læs mere Tjek på PubMedBMC Infectious Diseases, 6.04.2024
Tilføjet 6.04.2024
Abstract Background Bloodstream infections (BSI) are the major cause of morbidity and mortality in children in developing countries. The purpose of the current study was to establish the antimicrobial susceptibility pattern of bacterial isolates from bloodstream infections at Children’s Medical Center Hospital (CMC), Tehran, Iran. Methods We retrospectively recorded all positive blood cultures and antimicrobial susceptibility of all bloodstream isolates among children admitted to CMC, during 5 years. Specimen culture, bacterial identification, and antimicrobial susceptibility testing were performed according to standard laboratory methods. Results From 3,179 pathogens isolated from the blood cultures 2,824 bacteria were cultured, with 1,312 cases being identified as Gram-positive bacteria (46%) and 1,512 cases as Gram-negative bacteria (54%). The most common Gram-negative bacteria isolated were as follows: Pseudomonas spp. (n = 266, 17.6%), Klebsiella pneumoniae (n = 242, 16%), Stenotrophomonas maltophilia (n = 204, 13.5%), Enterobacter spp. (n = 164, 10.8%), Escherichia coli (n = 159, 10.5%), Pseudomonas aeruginosa (n = 126, 8.3%), Serratia marcescens (n = 121, 8%), and Acinetobacter baumannii (n = 73, 4.8%). The most common Gram-positive bacteria isolated were coagulase-negative staphylococci (CONS) (n = 697, 53%), Streptococcus spp. (n = 237, 18%), Staphylococcus aureus (n = 202, 15%) and Enterococcus spp. (n = 167, 12.7%). 34% of bacterial strains were isolated from ICUs. The rates of methicillin resistance in S. aureus and CONS were 34% and 91%, respectively. E. coli isolates showed high resistance to cefotaxime (84%). All isolates of K. pneumoniae were susceptible to colistin and 56% were susceptible to imipenem. P. aeruginosa isolates showed high susceptibility to all antibiotics. Conclusions Our findings emphasize the need of clinicians having access to up-to-date bacterial susceptibility data for routinely prescribed drugs. Continuous monitoring of changes in bacterial resistance will aid in the establishment of national priorities for local intervention initiatives in Iran. The increased risk of BSI caused by antibiotic-resistant organisms, emphasizes the significance of implementing appropriate antibiotic prescribing regulations and developing innovative vaccination techniques in Iran.
Læs mere Tjek på PubMedJirapat Thongchol, Zihao Yu, Laith Harb, Yiruo Lin, Matthias Koch, Matthew Theodore, Utkarsh Narsaria, Joshua Shaevitz, Zemer Gitai, Yinghao Wu, Junjie Zhang, Lanying Zeng
Science, 5.04.2024
Tilføjet 5.04.2024
BMC Infectious Diseases, 4.04.2024
Tilføjet 4.04.2024
Abstract Background Bloodstream infections (BSI) are the major cause of morbidity and mortality in children in developing countries. The purpose of the current study was to establish the antimicrobial susceptibility pattern of bacterial isolates from bloodstream infections at Children’s Medical Center Hospital (CMC), Tehran, Iran. Methods We retrospectively recorded all positive blood cultures and antimicrobial susceptibility of all bloodstream isolates among children admitted to CMC, during 5 years. Specimen culture, bacterial identification, and antimicrobial susceptibility testing were performed according to standard laboratory methods. Results From 3,179 pathogens isolated from the blood cultures 2,824 bacteria were cultured, with 1,312 cases being identified as Gram-positive bacteria (46%) and 1,512 cases as Gram-negative bacteria (54%). The most common Gram-negative bacteria isolated were as follows: Pseudomonas spp. (n = 266, 17.6%), Klebsiella pneumoniae (n = 242, 16%), Stenotrophomonas maltophilia (n = 204, 13.5%), Enterobacter spp. (n = 164, 10.8%), Escherichia coli (n = 159, 10.5%), Pseudomonas aeruginosa (n = 126, 8.3%), Serratia marcescens (n = 121, 8%), and Acinetobacter baumannii (n = 73, 4.8%). The most common Gram-positive bacteria isolated were coagulase-negative staphylococci (CONS) (n = 697, 53%), Streptococcus spp. (n = 237, 18%), Staphylococcus aureus (n = 202, 15%) and Enterococcus spp. (n = 167, 12.7%). 34% of bacterial strains were isolated from ICUs. The rates of methicillin resistance in S. aureus and CONS were 34% and 91%, respectively. E. coli isolates showed high resistance to cefotaxime (84%). All isolates of K. pneumoniae were susceptible to colistin and 56% were susceptible to imipenem. P. aeruginosa isolates showed high susceptibility to all antibiotics. Conclusions Our findings emphasize the need of clinicians having access to up-to-date bacterial susceptibility data for routinely prescribed drugs. Continuous monitoring of changes in bacterial resistance will aid in the establishment of national priorities for local intervention initiatives in Iran. The increased risk of BSI caused by antibiotic-resistant organisms, emphasizes the significance of implementing appropriate antibiotic prescribing regulations and developing innovative vaccination techniques in Iran.
Læs mere Tjek på PubMedHirokazu YanoWataru HayashiSayoko KawakamiSadao AokiEiko AnzaiHui ZuoNorikazu KitamuraAki HirabayashiToshiki KajiharaShizuo KayamaYo SugawaraKoji YaharaMotoyuki Sugai1Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan, Pranita D. Tamma
Antimicrobial Agents And Chemotherapy, 3.04.2024
Tilføjet 3.04.2024
Jiaren LiYouyou LiLiang ZhouHongming LiTengfei WanJin TangLei ZhouHui XieLong Wanga Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, Chinab Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Virulence, 3.04.2024
Tilføjet 3.04.2024
BMC Infectious Diseases, 30.03.2024
Tilføjet 30.03.2024
Abstract Background Vagococcal infections are extremely rare in humans. There are limited studies on the optimal methods for identification, antimicrobial susceptibility testing, and clinical manifestations of vagococcal infections. Herein, we report a patient with a urinary tract infection who had Vagococcus fluvialis in the urine. Case presentation An 84-year-old man presented to our urology department with a fever that had persisted for several days. He previously worked as a zoo clerk. The patient underwent a left nephroureterectomy for ureteral cancer 5 years ago, and total cystectomy and right cutaneous ureterostomy for muscle-invasive bladder cancer 1 year prior. He was empirically treated with 500 mg of levofloxacin intravenously every 24 h for the urinary tract infection. V. fluvialis was detected in his urine samples and Pseudomonas aeruginosa was detected in his urine and blood samples. Two bacterial species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He was administered intravenous levofloxacin for approximately 1 week, followed by oral levofloxacin for another week, after which the infections were eradicated. Conclusions To the best of our knowledge, this is the first report of V. fluvialis detected in human urine in Japan. Vagococcus spp. is commonly isolated from fish or animals, and based on the patient’s work history, it is possible that the patient was a carrier because of transmission from animals.
Læs mere Tjek på PubMedAmruta A. KarbelkarMaria FontT. Jarrod SmithHolger SondermannGeorge A. O’TooleaDepartment of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755bCSSB Centre for Structural Systems Biology, Deutsches Elektronen-Synchrotron DESY, D-22607 Hamburg, Germany
Proceedings of the National Academy of Sciences, 28.03.2024
Tilføjet 28.03.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 13, March 2024.
Læs mere Tjek på PubMedPaulina Guzmán-Guzmán, Eduardo Valencia-Cantero, Gustavo Santoyo
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Paulina Guzmán-Guzmán, Eduardo Valencia-Cantero, Gustavo Santoyo Trichoderma uses different molecules to establish communication during its interactions with other organisms, such as effector proteins. Effectors modulate plant physiology to colonize plant roots or improve Trichoderma’s mycoparasitic capacity. In the soil, these fungi can establish relationships with plant growth–promoting bacteria (PGPBs), thus affecting their overall benefits on the plant or its fungal prey, and possibly, the role of effector proteins. The aim of this study was to determine the induction of Trichoderma atroviride gene expression coding for effector proteins during the interaction with different PGPBs, Arabidopsis or the phytopathogen Fusarium brachygibbosum, and to determine whether PGPBs potentiates the beneficial effects of T. atroviride. During the interaction with F. brachygibbosum and PGPBs, the effector coding genes epl1, tatrx2 and tacfem1 increased their expression, especially during the consortia with the bacteria. During the interaction of T. atroviride with the plant and PGPBs, the expression of epl1 and tatrx2 increased, mainly with the consortium formed with Pseudomonas fluorescens UM270, Bacillus velezensis AF12, or B. halotolerans AF23. Additionally, the consortium formed by T. atroviride and R. badensis SER3 stimulated A. thaliana PR1:GUS and LOX2:GUS for SA- and JA-mediated defence responses. Finally, the consortium of T. atroviride with SER3 was better at inhibiting pathogen growth, but the consortium of T. atroviride with UM270 was better at promoting Arabidopsis growth. These results showed that the biocontrol capacity and plant growth-promoting traits of Trichoderma spp. can be potentiated by PGPBs by stimulating its effector functions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
Abstract Background Vagococcal infections are extremely rare in humans. There are limited studies on the optimal methods for identification, antimicrobial susceptibility testing, and clinical manifestations of vagococcal infections. Herein, we report a patient with a urinary tract infection who had Vagococcus fluvialis in the urine. Case presentation An 84-year-old man presented to our urology department with a fever that had persisted for several days. He previously worked as a zoo clerk. The patient underwent a left nephroureterectomy for ureteral cancer 5 years ago, and total cystectomy and right cutaneous ureterostomy for muscle-invasive bladder cancer 1 year prior. He was empirically treated with 500 mg of levofloxacin intravenously every 24 h for the urinary tract infection. V. fluvialis was detected in his urine samples and Pseudomonas aeruginosa was detected in his urine and blood samples. Two bacterial species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He was administered intravenous levofloxacin for approximately 1 week, followed by oral levofloxacin for another week, after which the infections were eradicated. Conclusions To the best of our knowledge, this is the first report of V. fluvialis detected in human urine in Japan. Vagococcus spp. is commonly isolated from fish or animals, and based on the patient’s work history, it is possible that the patient was a carrier because of transmission from animals.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.03.2024
Tilføjet 21.03.2024
Saima AslamDwayne RoachMikeljon P. NikolichBiswajit BiswasRobert T. SchooleyKimberley A. Lilly-BishopGregory K. RiceRegina Z. CerTheron HamiltonMatthew HenryTiffany LuongAnn-Charlott SalabarriaLaura Sisk-HackworthAndrey A. FilippovFrancois LebretonLindsey HallRan Nir-PazHadil OnallahGilat LivniEran ShostakAnat Wieder-FinesodDafna YahavOrtal YerushalmySivan Alkalay-OrenRon BraunsteinLeron KhalifaAmit RimonDaniel GelmanRonen Hazan1Division of Infectious Diseases and Global Public Health and the Center for Innovative Phage Applications and Therapeutics, University of California San Diego, La Jolla, California, USA2Department of Biology, San Diego State University, San Diego, California, USA3Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA4Naval Medical Research Command – Frederick, Fort Detrick, Maryland, USA5Leidos, Inc, Reston, Virginia, USA6The Geneva Foundation, Tacoma, Washington, USA7Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel8Schneider Children’s Medical Center, Petah Tikva, Israel9The Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel10Institute of Biomedical and Oral Research (IBOR), Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, Cesar A. Arias
Antimicrobial Agents And Chemotherapy, 13.03.2024
Tilføjet 13.03.2024
Xiaoya WeiJiacong GaoDandan ZhouCongjuan XuPing ChenShuiping ChenYanhong ZhangXuehua LiuGuanxian LiGuangbo ZhuHuimin LiuJinjin LiBin GengLinlin GaoZhihui ChengIain L. LamontDaniel PletzerYongxin JinShouguang JinWeihui Wu1State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Department of Microbiology, College of Life Sciences, Nankai University, Tianjin, China2Department of Laboratory Medicine, 5th Medical Center of PLA General Hospital, Beijing, China3Nankai University Affiliated Hospital (Tianjin Forth Hospital), Tianjin, China4Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China5Department of Biochemistry, University of Otago, Dunedin, New Zealand6Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand, Laurent Poirel
Antimicrobial Agents And Chemotherapy, 13.03.2024
Tilføjet 13.03.2024
Journal of Infectious Diseases, 6.03.2024
Tilføjet 6.03.2024
Abstract Background Pseudomonas aeruginosa is a multidrug-resistant pathogen causing recalcitrant pulmonary infections in people with cystic fibrosis (pwCF). Cystic fibrosis transmembrane conductance regulator (CFTR) modulators have been developed that partially correct the defective chloride channel driving disease. Despite the many clinical benefits, studies in adults have demonstrated that while P. aeruginosa sputum load decreases, chronic infection persists. Here, we investigate how P. aeruginosa in pwCF may change in the altered lung environment after CFTR modulation.Methods P. aeruginosa strains (n = 105) were isolated from the sputum of 11 chronically colonized pwCF at baseline and up to 21 months posttreatment with elexacaftor-tezacaftor-ivacaftor or tezacaftor-ivacaftor. Phenotypic characterization and comparative genomics were performed.Results Clonal lineages of P. aeruginosa persisted after therapy, with no evidence of displacement by alternative strains. We identified commonly mutated genes among patient isolates that may be positively selected for in the CFTR-modulated lung. However, classic chronic P. aeruginosa phenotypes such as mucoid morphology were sustained, and isolates remained just as resistant to clinically relevant antibiotics.Conclusions Despite the clinical benefits of CFTR modulators, clonal lineages of P. aeruginosa persist that may prove just as difficult to manage in the future, especially in pwCF with advanced lung disease.
Læs mere Tjek på PubMedLorenzo CarusoMarta MelliniOrtensia Catalano GonzagaAlessandra AstegnoElena ForteAdele Di MatteoAlessandro GiuffrèPaolo ViscaFrancesco ImperiLivia LeoniGiordano Rampioni1Department of Science, University Roma Tre, Rome, Italy2Department of Biotechnology, University of Verona, Verona, Italy3Department of Biochemical Sciences, Sapienza University of Rome, Rome, Italy4CNR Institute of Molecular Biology and Pathology, Rome, Italy5IRCCS Fondazione Santa Lucia, Rome, Italy6NBFC, National Biodiversity Future Center, Palermo, Italy, Boudewijn L. de Jonge
Antimicrobial Agents And Chemotherapy, 6.03.2024
Tilføjet 6.03.2024
B. Sajeewa Amaradasa, Chuansheng Mei, Yimeng He, Robert L. Chretien, Mitchell Doss, Tim Durham, Scott Lowman
PLoS One Infectious Diseases, 26.02.2024
Tilføjet 26.02.2024
by B. Sajeewa Amaradasa, Chuansheng Mei, Yimeng He, Robert L. Chretien, Mitchell Doss, Tim Durham, Scott Lowman The use of fungicides to manage disease has led to multiple environmental externalities, including resistance development, pollution, and non-target mortality. Growers have limited options as legacy chemistry is withdrawn from the market. Moreover, fungicides are generally labeled for traditional soil-based production, and not for liquid culture systems. Biocontrol agents for disease management are a more sustainable and environmentally friendly alternative to conventional agroprotectants. Pythium ultimum is a soil borne oomycete plant pathogen with a broad taxonomic host range exceeding 300 plants. Cucumber seedlings exposed to P. ultimum 1 day after a protective inoculation with bacterial endophyte accession IALR1619 (Pseudomonas sp.) recorded 59% survival; with the control assessed at 18%. When the pathogen was added 5 days post endophyte inoculation, 74% of the seedlings treated survived, compared to 36% of the control, indicating a longer-term effect of IALR1619. Under hydroponic conditions, IALR1619 treated leaf type lettuce cv. ‘Cristabel’ and Romaine cv. ‘Red Rosie’ showed 29% and 42% higher shoot fresh weight compared to their controls, respectively. Similar results with less growth decline were observed for a repeat experiment with IALR1619. Additionally, an experiment on hydroponic lettuce in pots with perlite was carried out with a mixture of P. ultimum and P. dissotocum after IALR1619 inoculation. The endophyte treated ‘Cristabel’ showed fresh weight gain, but the second cultivar ‘Pensacola’ yielded no increase. In summary, the endophyte IALR1619 provided short term as well as medium-term protection against Pythium blight in cucumber seedlings and may be used as an alternative to conventional fungicides in a greenhouse setting. This study also demonstrated the potential of ALR1619 as a biocontrol agent against Pythium blight in hydroponic lettuce.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.02.2024
Tilføjet 24.02.2024
Abstract Background Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy. Methods A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality. Results A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.02.2024
Tilføjet 24.02.2024
Abstract Background Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy. Methods A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality. Results A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.02.2024
Tilføjet 24.02.2024
Abstract Background Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy. Methods A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality. Results A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p
Læs mere Tjek på PubMedMyeongjin ChoiSurekha ShridharHeather FoxKun LuoMohammed AminSharon M. TennantRaphael SimonAlan S. Cross1Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA2Korea Institute of Toxicology, Daejeon, Republic of Korea, Denise M. Monack
Infection and Immunity, 23.02.2024
Tilføjet 23.02.2024
Qi XuDonghoon KangMatthew D. MeyerChristopher L. PenningtonCitrupa GopalJeffrey W. SchertzerNatalia V. Kirienko1Department of BioSciences, Rice University, Houston, Texas, USA2Department of Bioengineering, Rice University, Houston, Texas, USA3Shared Equipment Authority, Rice University, Houston, Texas, USA4Department of Biological Sciences, Binghamton University, Binghamton, New York, USA, Marvin Whiteley
Infection and Immunity, 23.02.2024
Tilføjet 23.02.2024
Jiaren LiYouyou LiLiang ZhouHongming LiTengfei WanJin TangLei ZhouHui XieLong Wanga Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, Chinab Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Virulence, 21.02.2024
Tilføjet 21.02.2024
Journal of Infectious Diseases, 20.02.2024
Tilføjet 20.02.2024
Abstract Background Lysins (cell wall hydrolases) targeting Gram-negative organisms require engineering to permeabilize the outer membrane and access subjacent peptidoglycan to facilitate killing. In the current study, the potential clinical utility for engineered lysin, CF-370, was examined in vitro and in vivo against Gram-negative pathogens important in human infections.Methods MICs and bactericidal activity were determined using standard methods. An in vivo proof-of-concept efficacy study was conducted using a rabbit acute pneumonia model caused by Pseudomonas aeruginosa.Results CF-370 exhibited potent antimicrobial activity, with MIC50/90 values (in µg/mL) for: P. aeruginosa, 1/2; Acinetobacter baumannii, 1/1; Escherichia coli, 0.25/1; Klebsiella pneumoniae, 2/4; Enterobacter cloacae 1/4; and Stenotrophomonas maltophilia 2/8. CF-370 furthermore demonstrated: i) bactericidal activity; (ii) activity in serum; iii) a low propensity for resistance; iv) anti-biofilm activity; and v) synergy with antibiotics. In the pneumonia model, CF-370 alone decreased bacterial densities in lungs, kidneys and spleen vs. vehicle control, and demonstrated significantly increased efficacy when combined with meropenem (vs either agent alone).Conclusions CF-370 is the first engineered lysin described with potent broad spectrum in vitro activity against multiple clinically-relevant Gram-negative pathogens, as well as potent in vivo efficacy in an animal model of severe invasive multi-system infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 17.02.2024
Tilføjet 17.02.2024
Abstract Aims We investigated the antibacterial efficacy of Umonium38 and Virkon® against Burkholderia pseudomallei, Escherichia coli, Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus (MRSA) up to 14 days following treatment. Methods and results Umonium38 was diluted to 0.5%, 1.0%, 1.5%, 2.0%, 2.5% and 3%, tested against the bacterial strains at various contact times (15 min to 24 h), and incubated for up to 14 days. A minimum concentration of 0.5% Umonium38 with a contact time of 15 min effectively killed approximately 108 CFU/ml of all four bacterial species. No growth was observed on agar plates from day 0 until day 14 for all six concentrations. The bacteria were also inactivated by a 30-minute treatment time using Virkon® 1% solution. Conclusions Umonium38 effectively inactivates B. pseudomallei, E. coli, P. aeruginosa and MRSA at a concentration of ≥ 0.5% with a contact time of at least 15 min. The antimicrobial effect of Umonium38 remained for 14 days.
Læs mere Tjek på PubMedBMC Infectious Diseases, 16.02.2024
Tilføjet 16.02.2024
Abstract Aims We investigated the antibacterial efficacy of Umonium38 and Virkon® against Burkholderia pseudomallei, Escherichia coli, Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus (MRSA) up to 14 days following treatment. Methods and results Umonium38 was diluted to 0.5%, 1.0%, 1.5%, 2.0%, 2.5% and 3%, tested against the bacterial strains at various contact times (15 min to 24 h), and incubated for up to 14 days. A minimum concentration of 0.5% Umonium38 with a contact time of 15 min effectively killed approximately 108 CFU/ml of all four bacterial species. No growth was observed on agar plates from day 0 until day 14 for all six concentrations. The bacteria were also inactivated by a 30-minute treatment time using Virkon® 1% solution. Conclusions Umonium38 effectively inactivates B. pseudomallei, E. coli, P. aeruginosa and MRSA at a concentration of ≥ 0.5% with a contact time of at least 15 min. The antimicrobial effect of Umonium38 remained for 14 days.
Læs mere Tjek på PubMedUrszula Wnorowska, Dawid Łysik, Ewelina Piktel, Magdalena Zakrzewska, Sławomir Okła, Agata Lesiak, Jakub Spałek, Joanna Mystkowska, Paul B. Savage, Paul Janmey, Krzysztof Fiedoruk, Robert Bucki
PLoS One Infectious Diseases, 12.02.2024
Tilføjet 12.02.2024
by Urszula Wnorowska, Dawid Łysik, Ewelina Piktel, Magdalena Zakrzewska, Sławomir Okła, Agata Lesiak, Jakub Spałek, Joanna Mystkowska, Paul B. Savage, Paul Janmey, Krzysztof Fiedoruk, Robert Bucki Background Microbial biofilms, as a hallmark of cystic fibrosis (CF) lung disease and other chronic infections, remain a desirable target for antimicrobial therapy. These biopolymer-based viscoelastic structures protect pathogenic organisms from immune responses and antibiotics. Consequently, treatments directed at disrupting biofilms represent a promising strategy for combating biofilm-associated infections. In CF patients, the viscoelasticity of biofilms is determined mainly by their polymicrobial nature and species-specific traits, such as Pseudomonas aeruginosa filamentous (Pf) bacteriophages. Therefore, we examined the impact of microbicidal ceragenins (CSAs) supported by mucolytic agents–DNase I and poly-aspartic acid (pASP), on the viability and viscoelasticity of mono- and bispecies biofilms formed by Pf-positive and Pf-negative P. aeruginosa strains co-cultured with Staphylococcus aureus or Candida albicans. Methods The in vitro antimicrobial activity of ceragenins against P. aeruginosa in mono- and dual-species cultures was assessed by determining minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC). Inhibition of P. aeruginosa mono- and dual-species biofilms formation by ceragenins alone and in combination with DNase I or poly-aspartic acid (pASP) was estimated by the crystal violet assay. Additionally, the viability of the biofilms was measured by colony-forming unit (CFU) counting. Finally, the biofilms’ viscoelastic properties characterized by shear storage (G’) and loss moduli (G”), were analyzed with a rotational rheometer. Results Our results demonstrated that ceragenin CSA-13 inhibits biofilm formation and increases its fluidity regardless of the Pf-profile and species composition; however, the Pf-positive biofilms are characterized by elevated viscosity and elasticity parameters. Conclusion Due to its microbicidal and viscoelasticity-modifying properties, CSA-13 displays therapeutic potential in biofilm-associated infections, especially when combined with mucolytic agents.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
Abstract Background Pseudomonas nitroreducens is a non-fermenting, gram-negative, rod-shaped bacterium commonly inhabiting soil, particularly soil contaminated with oil brine. To our knowledge, no cases of human infection with P. nitroreducens have been previously reported. Here, we present the first documented case of cholangitis caused by P. nitroreducens in a patient with bacteremia. Case presentation A 46-year-old Japanese man with an advanced pancreatic neuroendocrine tumor was hospitalized with fever and chills. Four days before admission, the patient developed right upper abdominal pain. Two days later, he also experienced fever and chills. Endoscopic retrograde cholangiopancreatography was performed on the day of admission, and the patient was diagnosed as having cholangitis associated with stent dysfunction. Gram-negative rods were isolated from blood cultures, but attempts to identify the bacteria using VITEK2 and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with VITEK MS ver. 4.7.1 (bioMérieux Japan Co. Ltd., Tokyo, Japan) were unsuccessful. Finally, the organism was identified as P. nitroreducens using MALDI-TOF MS with a MALDI Biotyper (Bruker Daltonics Co., Ltd., Billerica, MA, USA) and 16 S ribosomal RNA sequencing. Despite thorough interviews with the patient, he denied any exposure to contaminated soil. The patient was treated with intravenous cefepime and oral ciprofloxacin for 16 days based on susceptibility results, achieving a good therapeutic outcome. At the outpatient follow-up on day 28, the patient was in good general condition. Conclusions This is the first reported human case of cholangitis with bloodstream infection caused by P. nitroreducens. This report provides clinicians with novel insights into the clinical manifestations and diagnostic methods necessary for the accurate diagnosis of P. nitroreducens, along with guidance on treatment.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.02.2024
Tilføjet 8.02.2024
Abstract Background Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Streptococcus pneumoniae and Staphylococcus aureus are major bacterial causes of lower respiratory tract infections (LRTIs) globally, leading to substantial morbidity and mortality. The rapid increase of antimicrobial resistance (AMR) in these pathogens poses significant challenges for their effective antibiotic therapy. In low-resourced settings, patients with LRTIs are prescribed antibiotics empirically while awaiting several days for culture results. Rapid pathogen and AMR gene detection could prompt optimal antibiotic use and improve outcomes. Methods Here, we developed multiplex quantitative real-time PCR using EvaGreen dye and melting curve analysis to rapidly identify six major pathogens and fourteen AMR genes directly from respiratory samples. The reproducibility, linearity, limit of detection (LOD) of real-time PCR assays for pathogen detection were evaluated using DNA control mixes and spiked tracheal aspirate. The performance of RT-PCR assays was subsequently compared with the gold standard, conventional culture on 50 tracheal aspirate and sputum specimens of ICU patients. Results The sensitivity of RT-PCR assays was 100% for K. pneumoniae, A. baumannii, P. aeruginosa, E. coli and 63.6% for S. aureus and the specificity ranged from 87.5% to 97.6%. The kappa correlation values of all pathogens between the two methods varied from 0.63 to 0.95. The limit of detection of target bacteria was 1600 CFU/ml. The quantitative results from the PCR assays demonstrated 100% concordance with quantitative culture of tracheal aspirates. Compared to culture, PCR assays exhibited higher sensitivity in detecting mixed infections and S. pneumoniae. There was a high level of concordance between the detection of AMR gene and AMR phenotype in single infections. Conclusions Our multiplex quantitative RT-PCR assays are fast and simple, but sensitive and specific in detecting six bacterial pathogens of LRTIs and their antimicrobial resistance genes and should be further evaluated for clinical utility.
Læs mere Tjek på PubMedClinical Infectious Diseases, 7.02.2024
Tilføjet 7.02.2024
Abstract Background Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak.Methods Cases were defined as a U.S. patient’s first isolation of P. aeruginosa sequence type 1203 with the carbapenemase gene blaVIM-80 and cephalosporinase gene blaGES-9 from any specimen source collected and reported to CDC between January 1, 2022–May 15, 2023. We conducted a 1:1 matched case-control study at the post-acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination.Results We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and four (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears compared to controls (crude matched OR: 5.0, 95% CI: 1.1, 22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. FDA inspection of the manufacturing plant identified likely sources of contamination.Conclusions A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the U.S. The clinical impacts from this outbreak underscore the need for improved requirements for U.S. OTC product importers.
Læs mere Tjek på PubMedXiaonan ZhangYan WangSanwang LiFeifan XieHanxi Yi1Division of Biopharmaceutics and Pharmacokinetics, Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China2Yueyang Inspection and Testing Center, Yueyang, China3Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China4Department of Pathology, School of Basic Medical Science, Central South University, Changsha, China, James E. Leggett
Antimicrobial Agents And Chemotherapy, 6.02.2024
Tilføjet 6.02.2024
Clinical Infectious Diseases, 5.02.2024
Tilføjet 5.02.2024
Abstract Gram-negative antibiotic resistance continues to grow as a global problem due to the evolution and spread of β-lactamases. The early β-lactamase inhibitors (BLIs) are characterized by spectra limited to class A β-lactamases and ineffective against carbapenemases and most extended spectrum β-lactamases. In order to address this therapeutic need, newer BLIs were developed with the goal of treating carbapenemase producing, carbapenem resistant organisms (CRO), specifically targeting the Klebsiella pneumoniae carbapenemase (KPC). These BL/BLI combination drugs, ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam, have proven to be indispensable tools in this effort. However, non-KPC mechanisms of resistance are rising in prevalence and increasingly challenging to treat. It is critical for clinicians to understand the unique spectra of these BL/BLIs with respect to non-KPC CRO. In Part 1of this two-part series, we describe the non-KPC attributes of the newer BL/BLIs with a focus on utility against Enterobacterales and Pseudomonas aeruginosa.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
Abstract Background Healthcare-associated infections (HCAI) place a significant burden on healthcare systems globally. This systematic review and meta-analysis aimed to investigate the prevalence, risk factors, and aetiologic agents of endemic HCAI in Africa. Methods MEDLINE/PubMed, CINAHL, and Global Health databases (EBSCOhost interface) were searched for studies published in English and French describing HCAI in Africa from 2010 to 2022. We extracted data on prevalence of HCAI, risk factors, aetiologic agents, and associated antimicrobial resistance patterns. We used random-effects models to estimate parameter values with 95% confidence intervals for risk factors associated with HCAI. This study was registered in PROSPERO (CRD42022374559) and followed PRISMA 2020 guidelines. Results Of 2541 records screened, 92 were included, comprising data from 81,968 patients. Prevalence of HCAI varied between 1.6 and 90.2% with a median of 15% across studies. Heterogeneity (I2) varied from 93 to 99%. Contaminated wound (OR: 1.75, 95% CI: 1.31–2.19), long hospital stay (OR: 1.39, 95% CI: 0.92–1.80), urinary catheter (OR: 1.57, 95% CI: 0.35–2.78), intubation and ventilation (OR: 1.53, 95% CI: 0.85–2.22), vascular catheters (OR: 1.49, 95% CI: 0.52–2.45) were among risk factors associated with HCAI. Bacteria reported from included studies comprised 6463 isolates, with E. coli (18.3%, n = 1182), S. aureus (17.3%, n = 1118), Klebsiella spp. (17.2%, n = 1115), Pseudomonas spp. (10.3%, n = 671), and Acinetobacter spp. (6.8%, n = 438) being most common. Resistance to multiple antibiotics was common; 70.3% (IQR: 50–100) of Enterobacterales were 3rd -generation cephalosporin resistant, 70.5% (IQR: 58.8–80.3) of S. aureus were methicillin resistant and 55% (IQR: 27.3–81.3) Pseudomonas spp. were resistant to all agents tested. Conclusions HCAI is a greater problem in Africa than other regions, however, there remains a paucity of data to guide local action. There is a clear need to develop and validate sustainable HCAI definitions in Africa to support the implementation of routine HCAI surveillance and inform implementation of context appropriate infection prevention and control strategies.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
Abstract Background Gram-negative bacilli are the most common etiological agents responsible for urinary tract infections. The prevalence of antibiotic resistance in Gram-negative bacilli is increasing at a rapid pace globally, which is constraining the available choices for UTI treatment. The objectives of this study are to identify the most common causal organisms of urinary tract infections (UTIs), and to determine their drug resistance patterns. Materials and methods This was a cross-sectional hospital-based study conducted at El-Amal Hospital, Bahri Teaching Hospital, and Al-Baraha Hospital, Khartoum State, from March to October 2022. Urine samples from patients suspected to have UTI were collected, and patients with confirmed UTI by laboratory investigations and yielded culture growth were enrolled. Antibiotic sensitivity testing and PCR testing of the blaTEM, blaSHV, and blaCTX-M genes were done. Results This study included 50 patients with UTI out of 229 suspected patients (21.8%). The most prominent group of patients was older than 60 years (40%); the majority were females (70%). Escherichia coli was the most prevalent isolated organism (50%), followed by Klebsiella oxytoca (24%), Klebsiella pneumoniae (20%), Pseudomonas aeruginosa (4%), and Citrobacter freundii (2%). A small percentage of organisms were resistant to colistin (17%). However, 77% were resistant to amikacin, 97.6% to cefotaxime, 96.8% to ceftazidime, 97.6% to ceftriaxone, 96.8% to cefixime, 87.6% to ciprofloxacin, 88.4% to gentamycin, 62% to imipenem, 67.6% to meropenem, 87.6% to norfloxacin, and 95.6% to trimethoprim. The overall resistance of isolated gram-negative organisms was 81%. The most prevalent gene for the resistance was blaTEM (100%), followed by blaCTX-M (94%), and then blaSHV (84%). Conclusion Escherichia coli and Klebsiella species were the most commonly isolated uropathogens in this study, and the majority were highly resistant to most of the antimicrobial agents tested. Resistance genes blaTEM, blaCTX-M, and blaSHV are very common in uropathogens.
Læs mere Tjek på PubMedNawaporn Vinayavekhin, Thanyaporn Wattanophas, Mark Francis Murphy, Alisa S. Vangnai, Glyn Hobbs
PLoS One Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
by Nawaporn Vinayavekhin, Thanyaporn Wattanophas, Mark Francis Murphy, Alisa S. Vangnai, Glyn Hobbs Sound has been shown to impact microbial behaviors. However, our understanding of the chemical and molecular mechanisms underlying these microbial responses to acoustic vibration is limited. In this study, we used untargeted metabolomics analysis to investigate the effects of 100-Hz acoustic vibration on the intra- and extracellular hydrophobic metabolites of P. aeruginosa PAO1. Our findings revealed increased levels of fatty acids and their derivatives, quinolones, and N-acylethanolamines upon sound exposure, while rhamnolipids (RLs) showed decreased levels. Further quantitative real-time polymerase chain reaction experiments showed slight downregulation of the rhlA gene (1.3-fold) and upregulation of fabY (1.5-fold), fadE (1.7-fold), and pqsA (1.4-fold) genes, which are associated with RL, fatty acid, and quinolone biosynthesis. However, no alterations in the genes related to the rpoS regulators or quorum-sensing networks were observed. Supplementing sodium oleate to P. aeruginosa cultures to simulate the effects of sound resulted in increased tolerance of P. aeruginosa in the presence of sound at 48 h, suggesting a potential novel response-tolerance correlation. In contrast, adding RL, which went against the response direction, did not affect its growth. Overall, these findings provide potential implications for the control and manipulation of virulence and bacterial characteristics for medical and industrial applications.
Læs mere Tjek på PubMedKim F. H. Hintzen, Lionel Blanchet, Agnieszka Smolinska, Marie-Louise Boumans, Ellen E. Stobberingh, Jan W. Dallinga, Tim Lubbers, Frederik-Jan van Schooten, Agnes W. Boots
PLoS One Infectious Diseases, 27.01.2024
Tilføjet 27.01.2024
by Kim F. H. Hintzen, Lionel Blanchet, Agnieszka Smolinska, Marie-Louise Boumans, Ellen E. Stobberingh, Jan W. Dallinga, Tim Lubbers, Frederik-Jan van Schooten, Agnes W. Boots Introduction Early and reliable determination of bacterial strain specificity and antibiotic resistance is critical to improve sepsis treatment. Previous research demonstrated the potential of headspace analysis of volatile organic compounds (VOCs) to differentiate between various microorganisms associated with pulmonary infections in vitro. This study evaluates whether VOC analysis can also discriminate antibiotic sensitive from resistant bacterial strains when cultured on varying growth media. Methods Both antibiotic-sensitive and -resistant strains of Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella pneumonia were cultured on 4 different growth media, i.e. Brain Heart Infusion, Marine Broth, Müller-Hinton and Trypticase Soy Agar. After overnight incubation at 37°C, the headspace air of the cultures was collected on stainless steel desorption tubes and analyzed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). Statistical analysis was performed using regularized multivariate analysis of variance and cross validation. Results The three bacterial species could be correctly recognized based on the differential presence of 14 VOCs (p
Læs mere Tjek på PubMedEli Fritz McDonald, Kathryn E. Oliver, Jonathan P. Schlebach, Jens Meiler, Lars Plate
PLoS One Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
by Eli Fritz McDonald, Kathryn E. Oliver, Jonathan P. Schlebach, Jens Meiler, Lars Plate Variants in the cystic fibrosis transmembrane conductance regulator gene (CFTR) result in cystic fibrosis–a lethal autosomal recessive disorder. Missense variants that alter a single amino acid in the CFTR protein are among the most common cystic fibrosis variants, yet tools for accurately predicting molecular consequences of missense variants have been limited to date. AlphaMissense (AM) is a new technology that predicts the pathogenicity of missense variants based on dual learned protein structure and evolutionary features. Here, we evaluated the ability of AM to predict the pathogenicity of CFTR missense variants. AM predicted a high pathogenicity for CFTR residues overall, resulting in a high false positive rate and fair classification performance on CF variants from the CFTR2.org database. AM pathogenicity score correlated modestly with pathogenicity metrics from persons with CF including sweat chloride level, pancreatic insufficiency rate, and Pseudomonas aeruginosa infection rate. Correlation was also modest with CFTR trafficking and folding competency in vitro. By contrast, the AM score correlated well with CFTR channel function in vitro–demonstrating the dual structure and evolutionary training approach learns important functional information despite lacking such data during training. Different performance across metrics indicated AM may determine if polymorphisms in CFTR are recessive CF variants yet cannot differentiate mechanistic effects or the nature of pathophysiology. Finally, AM predictions offered limited utility to inform on the pharmacological response of CF variants i.e., theratype. Development of new approaches to differentiate the biochemical and pharmacological properties of CFTR variants is therefore still needed to refine the targeting of emerging precision CF therapeutics.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Pseudomonas aeruginosa is a frequent pathogen isolated from bacterial bloodstream infection (BSI) and is associated with high mortality. To survive in the blood, P aeruginosa must resist the bactericidal action of complement (ie, serum killing). Antibodies usually promote serum killing through the classical complement pathway; however, “cloaking antibodies” (cAbs) have been described, which paradoxically protect bacteria from serum killing. The relevance of cAbs in P aeruginosa BSI is unknown.Methods Serum and P aeruginosa were collected from a cohort of 100 patients with BSI. Isolates were tested for sensitivity to healthy control serum (HCS). cAb prevalence was determined in sera. Patient sera were mixed with HCS to determine if killing of the matched isolate was inhibited.Results Overall, 36 patients had elevated titers of cAbs, and 34 isolates were sensitive to HCS killing. Fifteen patients had cAbs and HCS-sensitive isolates; of these patients, 14 had serum that protected their matched bacteria from HCS killing. Patients with cAbs were less likely to be neutropenic or have comorbidities.Conclusions cAbs are prevalent in patients with P aeruginosa BSI and allow survival of otherwise serum-sensitive bacteria in the bloodstream. Generation of cAbs may be a risk factor for the development of BSI.
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
Clinical Infectious Diseases, 18.01.2024
Tilføjet 18.01.2024
BacteremiaHematologic NeoplasmsFebrile NeutropeniaPseudomonas aeruginosaAntibiotic Prophylaxis
Læs mere Tjek på PubMedQ. C. Truong-BolducL. M. YonkerY. WangB. G. LawtonD. C. Hooper1Infectious Diseases Division and Medical Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA2Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA, Helen Boucher
Antimicrobial Agents And Chemotherapy, 17.01.2024
Tilføjet 17.01.2024
Hiroshi Ishii, Hisako Kushima, Yohei Koide, Yoshiaki Kinoshita
International Journal of Infectious Diseases, 12.01.2024
Tilføjet 12.01.2024
Pseudomonas fluorescens (P. fluorescens) is a Gram-negative rod that is widely distributed in moist environments. P. fluorescens is less virulent than Pseudomonas aeruginosa (P. aeruginosa) and is thought to be non-pathogenic to healthy individuals [1]. Although P. fluorescens can be repeatedly cultured from respiratory specimens [2–5], its pathological significance is unknown. Although there have been reports of opportunistic infections caused by P. fluorescens in immunosuppressed patients, including those with advanced cancer, most of these have been bloodstream infections [1,6,7], with very few reports of pneumonia alone [8,9].
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background In the context of increasing population aging, ongoing drug-resistant pathogens and the COVID-19 epidemic, the changes in the epidemiological and clinical characteristics of patients with pneumonia remain unclear. This study aimed to assess the trends in hospitalization, case fatality, comorbidities, and isolated pathogens of pneumonia-related adult inpatients in Guangzhou during the last decade. Methods We retrospectively enrolled hospitalized adults who had doctor-diagnosed pneumonia in the First Affiliated Hospital of Guangzhou Medical University from January 1, 2013 to December 31, 2022. A natural language processing system was applied to automatically extract the clinical data from electronic health records. We evaluated the proportion of pneumonia-related hospitalizations in total hospitalizations, pneumonia-related in-hospital case fatality, comorbidities, and species of isolated pathogens during the last decade. Binary logistic regression analysis was used to assess predictors for patients with prolonged length of stay (LOS). Results A total of 38,870 cases were finally included in this study, with 70% males, median age of 64 (53, 73) years and median LOS of 7.9 (5.1, 12.8) days. Although the number of pneumonia-related hospitalizations showed an upward trend, the proportion of pneumonia-related hospitalizations decreased from 199.6 per 1000 inpatients in 2013 to 123.4 per 1000 in 2021, and the case fatality decreased from 50.2 per 1000 in 2013 to 23.9 per 1000 in 2022 (all P
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background Nosocomial infections have gradually become an emerging threat to the healthcare system over the past decades and have been attributed to poor decontamination of hospital articles and weak antibacterial stewardship policies. This study sought to investigate the effect of disinfection on the prevalence and resistance profile of bacterial contaminants on oxygen device accessories, and clinical surfaces at the emergency unit of a tertiary health facility in Ghana. Methods The study employed a cross-sectional study design to evaluate the occurrence of bacteria on surfaces in a tertiary hospital. Luminal swabs of the oxygen device accessories and swabs from clinical surfaces used by healthcare providers were collected for isolation and identification of bacteria. The identified bacteria isolates were then tested for their susceptibility to antibacterial agents. Data from this study were analyzed using Excel (Microsoft Office Suite), and GraphPad Prism 8 software programs. Results A quarter of the total 44 bacterial isolates obtained from both post-disinfected and pre-disinfected surfaces were Gram-positive, with the remaining isolates being Gram-negative. Pseudomonas aeruginosa was the most frequent bacteria species isolated (41%) followed by Citrobacter sp. (21%). P. aeruginosa, S. aureus, and S. pneumoniae were found to be highly resistant to Chloramphenicol (36%), and Sulfamethoxazole (100%); whereas Ciprofloxacin (91%) was the most effective antibacterial drug used. Conclusion The almost equal prevalence of multidrug-resistant bacteria from both post-disinfected and pre-disinfected surfaces of inanimate objects, and oxygen device accessories connote an ineffective disinfection process which may influence resistance in bacterial contaminants. This requires the overhaul of disinfection protocol and training of hospital staff, and rational use of antibacterial agents at the hospital to mitigating the burden of nosocomial infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.01.2024
Tilføjet 2.01.2024
Abstract Background Personalized clinical management of spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) is challenging due to limited evidence of microbiologic findings and their clinical impact during the clinical course of the disease. We aimed to characterize clinico-microbiological and imaging phenotypes of SD and ISEE to provide useful insights that could improve outcomes and potentially modify guidelines. Methods We performed chart review and collected data on the following parameters: bacterial antibiogram-resistogram, type of primary spinal infection, location of spinal infection, source of infection, method of detection, clinical complications (sepsis, septic embolism, and endocarditis), length of hospital and intensive care unit (ICU) stay, relapse rate, and disease-related mortality in patients with proven pyogenic SD and ISEE treated surgically in a university hospital in Germany between 2002 and 2022. Results We included data from 187 patients (125 SD, 66.8% and 62 ISEE, 33.2%). Gram-positive bacteria (GPB) were overall more frequently detected than gram-negative bacteria (GNB) (GPB: 162, 86.6% vs. GNB: 25, 13.4%, p
Læs mere Tjek på PubMed