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Life
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Old and New Pandemics: Challenges for Humans
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Old and New Pandemics: Challenges for Humans

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (25 February 2023) | Viewed by 36210

Special Issue Editors

Dr. Anca Oana Docea

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Guest Editor
Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: toxicology; risk assessment; clinical trials; clinical pharmacology; neurotoxicology; pesticides
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Daniela Calina

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Guest Editor
Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: clinical pharmacy; oncology; biomarkers; experimental pharmacology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Last year marks the centenary of the outbreak of the so-called "Spanish" flu, the worst pandemic in history. Over the space of two years, between 40 and 50 million deaths were reported worldwide, more victims than in the Great War. A century later, the scenario of an unknown flu virus continues to frighten experts. Despite the advent of antivirals, antibiotics and early vaccines, two other influenza pandemics, in 1957 and 1968, caused several million deaths. More recent epidemics, such as SARS, Ebola in West Africa, Zika in South America, Dengue hemorrhagic fever, MERS, and now the COVID-19 pandemic, have reminded us that the world remains vulnerable. In addition to the terrible consequences for human health, these viruses also cause economic damage.

The purpose of this Special Issue is to highlight the impact of pandemics on human health, the lifestyle during the lockdown, the presentation of virological, immunological, clinical aspects and emerging therapeutic strategies that could stop the current pandemic and improve prevention of future pandemics.

Therefore, we invite you to send scientific manuscripts, such as original research, reviews, systematic reviews and meta-analyses, mini-reviews, clinical studies, case presentations or letters to the editor, which provide a platform for presenting scientific knowledge about the vehicle and new pandemics, the solutions found by scientists to stop them, comparisons between old and recent pandemics and protective perspectives.

Dr. Anca Oana Docea
Prof. Dr. Daniela Calina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pandemics
  • COVID-19
  • epidemiology
  • virusology
  • immunology
  • clinical aspects
  • pharmacotherapeutic management
  • vaccines
  • preventive measures
  • public health

Published Papers (11 papers)

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Research

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13 pages, 855 KiB  
Article
Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study
by Dušanka Obradović, Milica Popović, Maja Banjac, Jelena Bulajić, Vladimir Đurović, Ivana Urošević and Aleksandra Milovančev
Life 2023, 13(3), 755; https://doi.org/10.3390/life13030755 - 10 Mar 2023
Cited by 1 | Viewed by 1489
Abstract
Background. The aim of the study was to assess the effect of baricitinib on 28-day all-cause mortality and the progression of respiratory failure in patients needing transfer to the intensive care unit (ICU) with COVID-19 pneumonia treated with high-flow oxygen therapy. Methods. This [...] Read more.
Background. The aim of the study was to assess the effect of baricitinib on 28-day all-cause mortality and the progression of respiratory failure in patients needing transfer to the intensive care unit (ICU) with COVID-19 pneumonia treated with high-flow oxygen therapy. Methods. This retrospective study included hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive ventilation receiving standard of care (SOC) or SOC in addition to baricitinib. Data on patients’ characteristics, pro-inflammatory markers, D dimer, and National Early Warning Score 2 (NEWS2) values were collected and compared between groups. The primary endpoint was 28-day all-cause in-hospital mortality and the secondary outcome was transfer to the ICU. Results. The study included 125 patients. The primary outcome was observed in 44.8% of them: 27% in the baricitinib group vs. 62% in the SOC group, p < 0.001. Transfer to the ICU ward was significantly lower in the baricitinib group: 29% vs. 81%, p < 0.001. A significant improvement was observed when the baricitinib group was compared to SOC in procalcitonin, CRP, D-dimer, neutrophil-to-lymphocyte ratio values, and NEWS2. Conclusion. Treatment with baricitinib in addition to SOC was associated with reduced mortality and a lower prevalence of transfer to the ICU in hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive therapy. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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7 pages, 1340 KiB  
Communication
Emerging SARS-CoV-2 Mutational Variants of Concern Should Not Vary in Susceptibility to Microbicidal Actives
by M. Khalid Ijaz, Raymond W. Nims and Julie McKinney
Life 2022, 12(7), 987; https://doi.org/10.3390/life12070987 - 30 Jun 2022
Viewed by 1484
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is evolving, with emergence of mutational variants due to the error-prone replication process of RNA viruses, in general. More recently, the Delta and Omicron variants (including sub-variants BA.1–5) predominate globally, and a Delta–Omicron recombinant termed [...] Read more.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is evolving, with emergence of mutational variants due to the error-prone replication process of RNA viruses, in general. More recently, the Delta and Omicron variants (including sub-variants BA.1–5) predominate globally, and a Delta–Omicron recombinant termed Deltacron has emerged. The emergence of variants of concern (VOC) demonstrating immune evasion and potentially greater transmissibility and virulence naturally raises concern in both the infection control communities and the public at large, as to the continued suitability of interventions intended to mitigate the risk of viral dissemination and acquisition of the associated disease COVID-19. We evaluated the virucidal efficacy of targeted surface hygiene products (an ethanol/quaternary ammonium compound (QAC)-containing disinfectant spray, a QAC disinfectant wipe, a lactic acid disinfectant wipe, and a citric acid disinfectant wipe) through both theoretical arguments and empirical testing using international standard methodologies (ASTM E1053-20 hard surface test and EN14476:2013+A2:2019 suspension test) in the presence of soil loads simulating patients’ bodily secretions/excretions containing shed virus. The results demonstrate, as expected, complete infectious viral inactivation (≥3.0 to ≥4.7 log10 reduction in infectious virus titer after as little as 15 s contact time at room temperature) by these surface hygiene agents of the original SARS-CoV-2 isolate and its Beta and Delta VOC. Through appropriate practices of targeted surface hygiene, it is expected that irrespective of the SARS-CoV-2 VOC encountered as the current pandemic unfolds (and, for that matter, any emerging and/or re-emerging enveloped virus), the chain of infection from virus-contaminated fomites to the hand and mucous membranes of a susceptible person may be disrupted. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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12 pages, 911 KiB  
Article
Liver Function Tests and FIB-4 Score as Predictors of Severity in COVID-19 Patients from the South-West of Romania
by Adina M. Kamal, Florentina Dumitrescu, Adrian Mită, Denisa M. Săbiescu, Dragoș O. Alexandru, Codruța E. Gheorghe, Monalisa M. Filip, Adriana Ionescu-Ciocâlteu, Daniela T. Maria, Diana Kamal and Constantin K. Kamal
Life 2022, 12(7), 934; https://doi.org/10.3390/life12070934 - 22 Jun 2022
Cited by 4 | Viewed by 1904
Abstract
Background: The coronavirus disease 2019 pandemic (COVID-19) is the most important global health crisis to date. In this study, we performed an analysis to find the association between liver damage, FIB-4 score and the severity of COVID-19 disease. Methods: We included a total [...] Read more.
Background: The coronavirus disease 2019 pandemic (COVID-19) is the most important global health crisis to date. In this study, we performed an analysis to find the association between liver damage, FIB-4 score and the severity of COVID-19 disease. Methods: We included a total of 580 patients that tested positive for SARS-CoV-2 infection and were hospitalized. No patient included had any known history of liver disease. Liver function tests were performed, and FIB-4 score was calculated in order to assess their involvement in the disease progression. Results: More than half of the patients had elevated liver function tests. Age, high body mass index, associated heart disease and diabetes were associated with poor outcome. Corticosteroids, antibiotics, and anticoagulants strongly correlated with liver injuries. Liver impairment and injury, as well as a FIB-4 score higher than 3.5, also correlated with higher degrees of disease severity. Conclusion: Liver injury and elevated FIB-4 score were associated with poor clinical outcome and disease severity, as well as being a valuable tool to predict COVID-19-related mortality. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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12 pages, 1376 KiB  
Article
Pediatric Functional Abdominal Pain Disorders following COVID-19
by Mioara Desdemona Stepan, Ramona Cioboata, Ştefăniţa Bianca Vintilescu, Corina Maria Vasile, Andrei Osman, Mircea Sorin Ciolofan, Mihaela Popescu, Ilaria Lorena Petrovici and Andrei Calin Zavate
Life 2022, 12(4), 509; https://doi.org/10.3390/life12040509 - 30 Mar 2022
Cited by 6 | Viewed by 2238
Abstract
Background: Functional abdominal pain disorders (FAPD) are a group of functional gastrointestinal disorders with multifactorial etiology and are subclassified using Rome IV criteria into a series of clinically distinct entities represented by irritable bowel syndrome, functional dyspepsia, abdominal migraine and functional abdominal pain [...] Read more.
Background: Functional abdominal pain disorders (FAPD) are a group of functional gastrointestinal disorders with multifactorial etiology and are subclassified using Rome IV criteria into a series of clinically distinct entities represented by irritable bowel syndrome, functional dyspepsia, abdominal migraine and functional abdominal pain that is not otherwise specified. Digestive functional disorders associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be mediated by the involvement of complex pathogenic mechanisms, which have been under investigation in children since the beginning of the coronavirus disease pandemic (COVID-19). Methods: In this retrospective, observational descriptive and analytical study, we investigated the presence of chronical functional abdominal pain in preschool children (4–6 years old) from the south-west of Romania in the pre-pandemic (18 cases) and COVID-19 pandemic period (34 cases), as well as the association with the COVID-19 positive and COVID-19 negative statuses, gender, environment origin, and viral infection-associated symptoms. Age-specific Rome IV criteria were used to diagnose functional abdominal pain. We performed an integrated statistical analysis of the results utilizing an electronic database in which we compared the data in order to assess the impact of COVID-19 on the clinical-epidemiological parameters analyzed. Results: In the pre-pandemic group, irritable bowel syndrome predominated (77.8%), followed by functional dyspepsia (22.2%), the other types of functional abdominal pain being absent, while for the pandemic group, irritable bowel syndrome was the most common (79.4%), followed by abdominal migraine (11.8%), abdominal dyspepsia (5.9%) and functional abdominal pain not otherwise specified (2.9%). We found a female/male ratio difference of 0.84 and an urban/rural ratio of 1.83 in favor of the pandemic group. These discrepancies were mainly caused by the differences between the COVID-19 positive and negative pandemic groups, where we observed statistical association of the positive pandemic group with IBS and urban environment, and a tendency of FAPDs diagnostic mainly with males. The predominant symptoms associated with COVID-19 positive cases were digestive (60.9%) or respiratory (39.1%). Conclusions: Our study demonstrates viral-mediated sensitivity of the gastrointestinal tract in preschool children, considering different clinical-epidemiological profiles related to the prevalence of FAPD and according to gender and environment origin, while the contribution of the pandemic context remains to be demonstrated in larger studies Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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11 pages, 2030 KiB  
Article
Serology for Borrelia spp. in Northwest Italy: A Climate-Matched 10-Year Trend
by Giacomo Stroffolini, Francesco Vladimiro Segala, Tommaso Lupia, Silvia Faraoni, Luca Rossi, Laura Tomassone, Stefania Zanet, Francesco Giuseppe De Rosa, Giovanni Di Perri and Andrea Calcagno
Life 2021, 11(12), 1310; https://doi.org/10.3390/life11121310 - 27 Nov 2021
Cited by 1 | Viewed by 1789
Abstract
Ticks are hematophagous parasites that can transmit a variety of human pathogens, and their life cycle is dependent on several climatic factors for development and survival. We conducted a study in Piedmont and Aosta Valley, Italy, between 2009 and 2018. The study matched [...] Read more.
Ticks are hematophagous parasites that can transmit a variety of human pathogens, and their life cycle is dependent on several climatic factors for development and survival. We conducted a study in Piedmont and Aosta Valley, Italy, between 2009 and 2018. The study matched human sample serologies for Borrelia spp. with publicly available climatic and meteorological data. A total of 12,928 serological immunofluorescence assays (IFA) and Western blot (WB) tests were analysed. The median number of IFA and WB tests per year was 1236 (range 700–1997), with the highest demand in autumn 2018 (N = 289). In the study period, positive WB showed an increasing trend, peaking in 2018 for both IgM (N = 97) and IgG (N = 61). These results were consistent with a regional climatic variation trending towards an increase in both temperature and humidity. Our results suggest that coupling data from epidemiology and the environment, and the use of a “one health” approach, may provide a powerful tool in understanding disease transmission and strengthen collaboration between specialists in the era of climate instability. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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19 pages, 2880 KiB  
Article
COVID-19 and Artificial Intelligence: An Approach to Forecast the Severity of Diagnosis
by Anca Loredana Udriștoiu, Alice Elena Ghenea, Ștefan Udriștoiu, Manuela Neaga, Ovidiu Mircea Zlatian, Corina Maria Vasile, Mihaela Popescu, Eugen Nicolae Țieranu, Alex-Ioan Salan, Adina Andreea Turcu, Dragos Nicolosu, Daniela Calina and Ramona Cioboata
Life 2021, 11(11), 1281; https://doi.org/10.3390/life11111281 - 22 Nov 2021
Cited by 8 | Viewed by 2433
Abstract
(1) Background: The new SARS-COV-2 pandemic overwhelmed intensive care units, clinicians, and radiologists, so the development of methods to forecast the diagnosis’ severity became a necessity and a helpful tool. (2) Methods: In this paper, we proposed an artificial intelligence-based multimodal approach to [...] Read more.
(1) Background: The new SARS-COV-2 pandemic overwhelmed intensive care units, clinicians, and radiologists, so the development of methods to forecast the diagnosis’ severity became a necessity and a helpful tool. (2) Methods: In this paper, we proposed an artificial intelligence-based multimodal approach to forecast the future diagnosis’ severity of patients with laboratory-confirmed cases of SARS-CoV-2 infection. At hospital admission, we collected 46 clinical and biological variables with chest X-ray scans from 475 COVID-19 positively tested patients. An ensemble of machine learning algorithms (AI-Score) was developed to predict the future severity score as mild, moderate, and severe for COVID-19-infected patients. Additionally, a deep learning module (CXR-Score) was developed to automatically classify the chest X-ray images and integrate them into AI-Score. (3) Results: The AI-Score predicted the COVID-19 diagnosis’ severity on the testing/control dataset (95 patients) with an average accuracy of 98.59%, average specificity of 98.97%, and average sensitivity of 97.93%. The CXR-Score module graded the severity of chest X-ray images with an average accuracy of 99.08% on the testing/control dataset (95 chest X-ray images). (4) Conclusions: Our study demonstrated that the deep learning methods based on the integration of clinical and biological data with chest X-ray images accurately predicted the COVID-19 severity score of positive-tested patients. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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Review

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13 pages, 1644 KiB  
Review
Novel Coronavirus (SARS-CoV-2) in Water and Environment—A Scoping Review
by Taufique Warsi, Tanvi Arora, Syed Shams Rizvi, Ali Raza Moosvi, M. A. Mohammed Aslam, Mohammad Muqtada Ali Khan and Arifullah Mohammed
Life 2022, 12(4), 520; https://doi.org/10.3390/life12040520 - 31 Mar 2022
Cited by 1 | Viewed by 2185
Abstract
A pneumonia outbreak was primarily reported in the fall of 2019 in Wuhan, Hubei province, China, with the identity SARS-CoV-2, a novel coronavirus. It quickly grew from a local epidemic to a global pandemic and was declared a public health emergency by the [...] Read more.
A pneumonia outbreak was primarily reported in the fall of 2019 in Wuhan, Hubei province, China, with the identity SARS-CoV-2, a novel coronavirus. It quickly grew from a local epidemic to a global pandemic and was declared a public health emergency by the WHO. A total of three prominent waves were identified across the globe, with a slight temporal variability as per the geographical locations, and has impacted several sectors which connect the world. By March 2022, the coronavirus had infected 444.12 million people and claimed 6.01 million human lives worldwide, and these numbers have not yet stabilized. Our paper enlightens readers on the seven strains of human coronaviruses, with special emphasis on the three severe deadliest outbreaks (SARS-2002, MERS-2012, and COVID-19). This work attempts a comprehensive understanding of the coronavirus and its impact on the possible sectors that link the world through the economic chain, climate conditions, SDGs, recycling of the event, and mitigations. There are many points that are raised by the authors in the possible sectors, which are emerging or are as yet unnoticed and thus have not been taken into consideration. This comprehension will leave sets of new challenges and opportunities for the researchers in various streams, especially in earth sciences. Science-integrated research may help to prevent upcoming disasters as a by-product of (existing) epidemics in the form of coronavirus. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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12 pages, 415 KiB  
Review
Colorectal Cancer Screening: Impact of COVID-19 Pandemic and Possible Consequences
by Isabelle Harber, Dania Zeidan and Muhammad N. Aslam
Life 2021, 11(12), 1297; https://doi.org/10.3390/life11121297 - 26 Nov 2021
Cited by 20 | Viewed by 6856
Abstract
Colonoscopy procedure has been the key screening method to detect colorectal cancer (CRC). As a fatal disease, CRC needs early detection. The COVID-19 pandemic caused screening tests (colonoscopy) to be halted and delayed. As a result, there could be dire consequences such as [...] Read more.
Colonoscopy procedure has been the key screening method to detect colorectal cancer (CRC). As a fatal disease, CRC needs early detection. The COVID-19 pandemic caused screening tests (colonoscopy) to be halted and delayed. As a result, there could be dire consequences such as later-stage or missed diagnosis or greater mortality. This report will analyze scientific literature pertaining to interrupted CRC screenings due to COVID-19 while drawing historical parallels from the 1918 flu pandemic. We conducted literature searches in the PubMed database as well as in Google Scholar. One of the main lessons learned from the 1918 flu pandemic was to employ social distancing to stop the spread of the virus. So, the global response at the start and peak of the COVID-19 pandemic was decreased hospital visits for any non-emergency cases. That led to a halt and delays in cancer (including CRC) screenings. The Medical community predicted this lag will cause more CRC cases and deaths in the future. However, reorganizing and changing screening method strategies were helpful during the ongoing pandemic. In conclusion, COVID-19 greatly affected CRC screening, including how we view the future of CRC screening. We can learn from this prospect to better prepare for future pandemics or other public health crises. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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11 pages, 804 KiB  
Review
Vaccination against SARS-CoV-2 in Patients with Inflammatory Bowel Diseases: Where Do We Stand?
by Phil-Robin Tepasse, Richard Vollenberg and Tobias Max Nowacki
Life 2021, 11(11), 1220; https://doi.org/10.3390/life11111220 - 11 Nov 2021
Cited by 8 | Viewed by 1975
Abstract
Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBDs). Immunosuppressive medication is the main therapeutic approach to reducing inflammation of the gastrointestinal tract. Immunocompromised patients are more vulnerable to severe courses of illness after infection with common pathogens. The severe acute [...] Read more.
Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBDs). Immunosuppressive medication is the main therapeutic approach to reducing inflammation of the gastrointestinal tract. Immunocompromised patients are more vulnerable to severe courses of illness after infection with common pathogens. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 leads to acute respiratory distress syndrome (ARDS) following severe pulmonal damage in a significant number of cases. The worldwide circulation of SARS-CoV-2 has led to major concerns about the management of IBD patients during the pandemic, as these patients are expected to be at greater risk of complications because of their underlying altered immunological condition and immunosuppressive therapies. Vaccination against SARS-CoV-2 is considered the main approach in containing the pandemic. Today, several vaccines have been shown to be highly effective in the prevention of SARS-CoV-2 infection and severe disease course in subjects without underlying conditions in respective registration studies. Patients with underlying conditions such as IBD and/or immunosuppressive therapies were not included in the registration studies, so little is known about effectiveness and safety of SARS-CoV-2 vaccination in immunocompromised IBD patients. This review provides an overview of the recent knowledge about vaccine response in IBD patients after vaccination against SARS-CoV-2. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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14 pages, 1375 KiB  
Review
Challenges and Scientific Prospects of the Newest Generation of mRNA-Based Vaccines against SARS-CoV-2
by Daniela Calina, Antonio F. Hernández, Thomas Hartung, Alexey M. Egorov, Boris Nikolaevich Izotov, Taxiarchis Konstantinos Nikolouzakis, Aristidis Tsatsakis, Panayiotis G. Vlachoyiannopoulos and Anca Oana Docea
Life 2021, 11(9), 907; https://doi.org/10.3390/life11090907 - 31 Aug 2021
Cited by 19 | Viewed by 6347
Abstract
In the context of the current COVID-19 pandemic, traditional, complex and lengthy methods of vaccine development and production would not have been able to ensure proper management of this global public health crisis. Hence, a number of technologies have been developed for obtaining [...] Read more.
In the context of the current COVID-19 pandemic, traditional, complex and lengthy methods of vaccine development and production would not have been able to ensure proper management of this global public health crisis. Hence, a number of technologies have been developed for obtaining a vaccine quickly and ensuring a large scale production, such as mRNA-based vaccine platforms. The use of mRNA is not a new concept in vaccine development but has leveraged on previous knowledge and technology. The great number of human resources and capital investements for mRNA vaccine development, along with the experience gained from previous studies on infectious diseases, allowed COVID-19 mRNA vaccines to be developed, conditionally approved and commercialy available in less than one year, thanks to decades of basic research. This review critically presents and discusses the COVID-19 mRNA vaccine-induced immunity, and it summarizes the most common anaphylactic and autoimmune adverse effects that have been identified until now after massive vaccination campaigns. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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16 pages, 1466 KiB  
Review
Hypervirulent Klebsiella pneumoniae Endogenous Endophthalmitis—A Global Emerging Disease
by Dragos Serban, Alina Popa Cherecheanu, Ana Maria Dascalu, Bogdan Socea, Geta Vancea, Daniela Stana, Gabriel Catalin Smarandache, Alexandru Dan Sabau and Daniel Ovidiu Costea
Life 2021, 11(7), 676; https://doi.org/10.3390/life11070676 - 10 Jul 2021
Cited by 27 | Viewed by 4563
Abstract
The review aims to document the new emerging hypervirulent Klebsiella pneumoniae (Kp) endogenous endophthalmitis (EKE) in terms of incidence, microbiological characterization of the pathogenic agent, associated risk factors, management, and outcomes. Hypervirulent (hv) strains of KP (hvKp) induce invasive liver abscesses (LA) with [...] Read more.
The review aims to document the new emerging hypervirulent Klebsiella pneumoniae (Kp) endogenous endophthalmitis (EKE) in terms of incidence, microbiological characterization of the pathogenic agent, associated risk factors, management, and outcomes. Hypervirulent (hv) strains of KP (hvKp) induce invasive liver abscesses (LA) with specific clinical features. Up to 80–90% of cases have hepatic liver abscess as a primary focus of infection, followed by renal or lung hvKp infections. However, the incidence of EKE in patients with KPLA varied between 3.4% (19) and 12.6% (13), with a total of 95 cases of endophthalmitis in 1455 cases of KPLA (6.5%). Severe visual loss was encountered in 75% of cases, with 25% bilateral involvement. Intravitreal antibiotics are the mainstay therapeutic approach. Pars plana vitrectomy is a subject of controversy. HvKp strains present mostly natural “wild-type” antibiotic resistance profile suggestive for community-acquired infections, being highly susceptive to the third and fourth generation of cephalosporins and carbapenems. Antimicrobial resistance in hypervirulent strains was recently documented via plasmid transfer and may result in extremely difficult to treat cases. Global dissemination of these strains is a major epidemiologic shift that should be considered in the diagnostic and therapeutic management of patients with endogenous endophthalmitis. Ophthalmologic screening in patients with KPLA and other hvKp infections and a multidisciplinary therapeutic approach is extremely important for early diagnosis and preservation of the visual function. Full article
(This article belongs to the Special Issue Old and New Pandemics: Challenges for Humans)
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