Infectious Disease Reports

18 pages, 1377 KiB

Open AccessReview

Atherosclerosis and Cardiovascular Complications in People Living with HIV: A Focused Review

by Michele Salvatore Paternò Raddusa, Andrea Marino, Benedetto Maurizio Celesia, Serena Spampinato, Carmen Giarratana, Emmanuele Venanzi Rullo, Bruno Cacopardo and Giuseppe Nunnari

Infect. Dis. Rep. 2024, 16(5), 846-863; https://doi.org/10.3390/idr16050066 (registering DOI) - 1 Sep 2024

Abstract

The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such [...] Read more.

The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such as CVD. This paper explores the multifaceted relationship between HIV infection, ART, and cardiovascular health, focusing on the mechanisms by which HIV and ART contribute to increased cardiovascular risk, including the promotion of endothelial dysfunction, inflammation, immune activation, and metabolic disturbances. We highlight the critical roles of HIV-associated proteins—Tat, Nef, and gp120—in accelerating atherosclerosis through direct and indirect pathways that exacerbate endothelial damage and inflammation. Additionally, we address the persistent challenge of chronic inflammation and immune activation in PLWH, factors that are strongly predictive of non-AIDS-related diseases, including CVD, even in the context of effective viral suppression. The impact of ART on cardiovascular risk is examined, with particular attention to the metabolic implications of specific ART regimens, which can influence lipid profiles and body composition, thereby modifying CVD risk. The therapeutic potential of statins, aspirin, and emerging treatments such as PCSK9 inhibitors in mitigating cardiovascular morbidity and mortality among PLWH is discussed, alongside considerations for their use in conjunction with ART. Our review underscores the necessity for a comprehensive, multidisciplinary approach to cardiovascular care in PLWH, which integrates vigilant cardiovascular risk assessment and management with HIV treatment. As we navigate the evolving landscape of HIV care, the goal remains to optimize treatment outcomes while minimizing cardiovascular risk, ensuring that the gains in longevity afforded by ART translate into improved overall health and quality of life for PLWH. Full article

(This article belongs to the Section HIV-AIDS)

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10 pages, 591 KiB

Open AccessBrief Report

Wastewater Surveillance of Mpox during the Summer Season of 2023 in Slovenia

by Jan Rožanec, Natalija Kranjec, Ivana Obid, Andrej Steyer, Tjaša Cerar Kišek, Tom Koritnik, Mario Fafangel and An Galičič

Infect. Dis. Rep. 2024, 16(5), 836-845; https://doi.org/10.3390/idr16050065 - 29 Aug 2024

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Abstract

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS [...] Read more.

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation. Full article

(This article belongs to the Topic Human Monkeypox Research)

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8 pages, 226 KiB

Open AccessArticle

Bloodstream Infections Due to Wild-Type Pseudomonas aeruginosa: Carbapenems and Ceftazidime/Avibactam Prescription Rate and Impact on Outcomes

by Carlo Pallotto, Andrea Tommasi, Elisabetta Svizzeretto, Giovanni Genga, Giulia Gamboni, Anna Gidari and Daniela Francisci

Infect. Dis. Rep. 2024, 16(5), 828-835; https://doi.org/10.3390/idr16050064 - 27 Aug 2024

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Abstract

Background. Pseudomonas aeruginosa is one of the major concerns among bacterial diseases even when it shows a wild-type susceptibility pattern. In 2020, EUCAST reconsidered antibiogram interpretation shifting “I” from “intermediate” to “sensible, increased exposure” with possible significant impact on antibiotic prescription. The aim [...] Read more.

Background. Pseudomonas aeruginosa is one of the major concerns among bacterial diseases even when it shows a wild-type susceptibility pattern. In 2020, EUCAST reconsidered antibiogram interpretation shifting “I” from “intermediate” to “sensible, increased exposure” with possible significant impact on antibiotic prescription. The aim of this study was to evaluate mortality in patients with P. aeruginosa bloodstream infections treated with antipseudomonal penicillins or cephalosporins vs. carbapenems and ceftazidime/avibactam. Methods. This is a retrospective observational study. All the patients with a bloodstream infection due to P. aeruginosa admitted to our hospital were enrolled. Exclusion criteria were as follows: extremely critical conditions, age <18 years, pregnancy, isolation of a strain non-susceptible to piperacillin/tazobactam and antipseudomonal cephalosporins. Patients were divided into group A (treatment with carbapenems or ceftazidime/tazobactam) and group B (treatment with antipseudomonal penicillin or cephalosporins). Results. We enrolled 77 patients, 56 and 21 in groups A and B, respectively. The two groups were homogeneous for age, sex, and biochemical and clinical characteristics at admission. All-cause in-hospital mortality was 17/56 (30.4%) and 3/21 (14.3%) in groups A and B, respectively (p > 0.1). In group A, in-hospital BSI-related mortality was 23.2% (13/56), while it was 14.3% (3/21) in group B (p > 0.1). After multivariate analysis, only the PITT score represented a risk factor for BSI-related mortality (OR 2.917, 95% CI 1.381–6.163). Conclusions. Both all-cause and BSI-related mortality were comparable between the two groups. Treatment with carbapenem or ceftazidime/avibactam did not represent a protective factor for mortality in wild-type P. aeruginosa BSI. Full article

(This article belongs to the Section Antimicrobial Stewardship)

8 pages, 645 KiB

Open AccessArticle

Uncovering Gaps in Knowledge: A Survey of Belgian General Practitioners’ Awareness of Legionnaires’ Disease Diagnostic Testing

by Marco Moretti, Julien Van Nedervelde, Robin Vanstokstraeten, Lucie Seyler, Fedoua Echahidi, Benoit Prevost, Delphine Martiny, Ingrid Wybo and Charlotte Michel

Infect. Dis. Rep. 2024, 16(5), 820-827; https://doi.org/10.3390/idr16050063 - 27 Aug 2024

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Abstract

Background: The incidence of Legionnaires’ disease (LD) is increasing steadily in Europe. Its early diagnosis by general practitioners (GPs) is crucial for better patient outcomes. Study objectives: This study assessed Belgian GPs’ knowledge about LD and the accessibility of diagnostic tests [...] Read more.

Background: The incidence of Legionnaires’ disease (LD) is increasing steadily in Europe. Its early diagnosis by general practitioners (GPs) is crucial for better patient outcomes. Study objectives: This study assessed Belgian GPs’ knowledge about LD and the accessibility of diagnostic tests in their practices. Methods: A specifically designed questionnaire was distributed to actively practicing GPs, including primary care trainees, between 31 January 2022 and 13 March 2022. This survey targeted approximately 4200 GPs with an estimated population catchment of 30% of the actively working Belgian GPs. Results: The response rate was estimated at 3%. Over 70% of the GPs correctly identified the LD occurrence peak, major risk factors, and clinical manifestations. While 62% of participants preferred the Legionella pneumophila urinary antigen test (UAT) as a primary diagnostic method, 75% were unsure about its availability within their laboratories and 82% had not prescribed it in the last year. Finally, 76% expressed a desire for additional information on this topic. Conclusions: Belgian GPs should evaluate the possibility of conducting UAT testing in their laboratories to enhance LD case management and improve their preparedness. Furthermore, initiatives should be implemented to improve communication between specialists and GPs and develop educational programs directed at Belgian GPs. Full article

(This article belongs to the Section Bacterial Diseases)

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14 pages, 2031 KiB

Open AccessArticle

Lipid Metabolism Disorders as Diagnostic Biosignatures in Sepsis

by Charlotte Birner, Patricia Mester, Gerhard Liebisch, Marcus Höring, Stephan Schmid, Martina Müller, Vlad Pavel and Christa Buechler

Infect. Dis. Rep. 2024, 16(5), 806-819; https://doi.org/10.3390/idr16050062 - 26 Aug 2024

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Abstract

Critical illness causes disturbances in lipid metabolism. Here, we investigated the levels of apolipoprotein A-IV (apoA-IV), a regulator of triglyceride and cholesterol metabolism, in human sepsis. ApoA-IV (analyzed in 156 patients with systemic inflammatory response syndrome (SIRS)/sepsis) and cholesteryl ester (CE) (analyzed in [...] Read more.

Critical illness causes disturbances in lipid metabolism. Here, we investigated the levels of apolipoprotein A-IV (apoA-IV), a regulator of triglyceride and cholesterol metabolism, in human sepsis. ApoA-IV (analyzed in 156 patients with systemic inflammatory response syndrome (SIRS)/sepsis) and cholesteryl ester (CE) (analyzed in 121 of these patients) were lower in patients compared to 43 healthy controls. In contrast, triglyceride (TG) levels were elevated in patients. ApoA-IV levels in plasma of the patients did not correlate with these lipids. Patients with SIRS, sepsis or septic shock had comparable apoA-IV, TG, CE and free cholesterol (FC) levels. Patients on dialysis had significantly lower CE levels, whereas apoA-IV levels did not change much. CE levels were elevated in patients with viral sepsis due to SARS-CoV-2 infection in comparison to SIRS/sepsis patients not infected by this virus. CE levels correlated negatively with procalcitonin, interleukin-6 and bilirubin, while TGs were positively associated with bilirubin and C-reactive protein. ApoA-IV, TG, CE and FC levels were not associated with bacterial infection or survival. In conclusion, this analysis suggests that CE levels decline in sepsis-related renal failure and also shows that plasma apoA-IV and CE levels are early biomarkers of sepsis. Full article

(This article belongs to the Section Bacterial Diseases)

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12 pages, 649 KiB

Open AccessArticle

First Insight into the Prevalence of Coxiella burnetii Infection among Veterinary Medicine Students in Bulgaria

by Petia Genova-Kalou, Yordan Hodzhev, Ilia Tsachev, Roman Pepovich, Stefan Panaiotov, Veselin Dobrinov, Stefka Krumova, Betina Boneva-Marutsova, Borislava Chakarova, Keytlin Todorova, Konstantin Simeonov, Magdalena Baymakova and Pierre-Edouard Fournier

Infect. Dis. Rep. 2024, 16(5), 794-805; https://doi.org/10.3390/idr16050061 - 26 Aug 2024

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Abstract

The aim of this study was to assess the prevalence of Coxiella burnetii infection among veterinary medicine students from two Bulgarian Universities, located in Sofia and Stara Zagora. Blood samples were collected from a total of 185 veterinary students for the detection of [...] Read more.

The aim of this study was to assess the prevalence of Coxiella burnetii infection among veterinary medicine students from two Bulgarian Universities, located in Sofia and Stara Zagora. Blood samples were collected from a total of 185 veterinary students for the detection of C. burnetii phase II antibodies and presence of DNA using an enzyme-linked immunosorbent assay (ELISA) and end-point PCR test. Out of all samples, 29.7% were positive for at least one C. burnetii phase II antibody marker or by the result of the PCR test. Veterinary students from Stara Zagora showed a significantly high seropositivity for Q fever (33.6%), as compared to the students in Sofia (23%; p < 0.05). Evidence of recent exposure with detection of anti-C. burnetii phase II IgM (+) antibodies was observed in 14.6% of the students under study. Seroprevalence among students in Stara Zagora was higher (15.3%). Anti-C. burnetii phase II IgG antibodies were detected in 21.6% of examined samples. Our study revealed a higher seropositivity among the male students (32.8%) as compared to females (16.0%; p < 0.05). The end-point PCR assay detected 5.9% blood samples as positive. The relative risk (RR) of Q fever exposure for male students was 40.7%, whereas it was 24.6% in females (p < 0.05). The findings from this study indicate that the C. burnetii infection is widely distributed amongst veterinary students in Bulgaria. This study emphasizes the need for improved safety protocols and infection control measures in veterinary training programs. Full article

(This article belongs to the Special Issue Emerging Infections: Epidemiology, Diagnostics, Clinics and Evolution)

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11 pages, 629 KiB

Open AccessArticle

Comparative Epidemiological and Clinical Outcomes on COVID-19 and Seasonal Influenza Hospitalized Patients during 2023

by Constantin-Marinel Vlase, Mariana Stuparu Cretu, Mihaela-Camelia Vasile, George-Cosmin Popovici and Manuela Arbune

Infect. Dis. Rep. 2024, 16(5), 783-793; https://doi.org/10.3390/idr16050060 - 23 Aug 2024

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Abstract

COVID-19 and influenza are highly contagious respiratory viral diseases and priority global public health concerns. We conducted a retrospective observational study of COVID-19 and/or influenza hospitalized cases, during 2023. We identified 170 influenza cases, 150 COVID-19 cases and 3 co-infections. Overall, 29.10% of [...] Read more.

COVID-19 and influenza are highly contagious respiratory viral diseases and priority global public health concerns. We conducted a retrospective observational study of COVID-19 and/or influenza hospitalized cases, during 2023. We identified 170 influenza cases, 150 COVID-19 cases and 3 co-infections. Overall, 29.10% of patients had at least one COVID-19 vaccine dose and 4.6% received the seasonal Flu vaccine. The demographic data found older patients in the COVID-19 group and a higher index of the comorbidities, mainly due to chronic heart diseases, hypertension, and diabetes. Fever, chills, and rhinorrhea were more frequently related to influenza, while cough was prevalent in COVID-19. Antibiotics were more used in influenza than COVID-19, either pre-hospital or in-hospital. The mortality rate within the first 30 days from the onset of the respiratory infection was higher in influenza compared to COVID-19. We concluded that the COVID-19 clinical picture in hospitalized patients is changing to influenza-like symptoms. The evolution is variable, related to chronic comorbidities, but influenza had more frequent severe forms. All through 2023, due to poor vaccination rates, COVID-19 and influenza have continued to cause numerous hospitalizations, and a new strategy for efficient vaccinations is required. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention through Vaccination)

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Infect. Dis. Rep., Volume 16, Issue 5 (October 2024) – 7 articles

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