All Articles

Attinsounon Cossi Angelo^1,2,3*, Dovonou Comlan Albert^2,3, Alidjinou Kazali⁴, Kanninkpo Fabius^1,2, Alassani Adébayo^2,3, Vodounou Amos^1,2, Saké khadidjatou^2,3, Serge Adé^2,3

¹Infectious Diseases and Tropical Medicine Unit, University of Parakou, R. Benin.

²Faculty of Medicine, University of Parakou, R. Benin.

³Departmental and Teaching Hospital of Borgou-Alibori (DTH-BA), Parakou, R. Benin.

⁴Laboratoire de virologie, Centre Hospitalier Universitaire de Lille, Faculté de médecine de Lille, France.

Introduction: Literature data suggest that people living with the human immunodeficiency virus (PLHIV) are at increased risk of severe forms of Coronavirus 2019 (COVID-19) infection and related mortality. The aim of this study was to investigate the anti-SARS-CoV-2 serological profile in adults living with HIV followed at the Departmental and Teaching Hospital of Borgou (DTH-B) in 2022 and to identify factors associated with anti-SARS-CoV-2 seropositivity in the latter.

Methods: This was a descriptive and analytical cross-sectional study conducted in the Internal Medicine Department at DTH-B, from June 27, 2022 to July 27, 2022. PLHIV were systematically recruited after informed consent. A survey form was used to collect epidemiological, clinical, paraclinical and therapeutic data. Anti-SARS-CoV-2 antibodies (IgG and IgM) were tested using the BIOSYNEX COVID-19 BSS rapid test (Biosynex SA, France). Data were analyzed using STATA/MP14.1 software. The significance level was 5%.

Results: A total of 135 adults living with HIV were included in the study. The sex ratio was 0.34 and the mean age 45 ± 11.03 years. Anti-SARS-CoV-2 seroprevalence was 50.37%. Only one respondent reported a confirmed COVID-19, while vaccination coverage was 37.78%. Anti-SARS-CoV-2 seroprevalence in unvaccinated patients was 40.48%. Factors significantly associated with anti-SARS-CoV-2 seropositivity in multivariate analysis were vaccination status (p=0.02) and viral load (p=0.001).

Conclusion: Anti-SARS-CoV-2 antibodies were detectable in more than half the PLHIV. Their presence was associated with the notion of vaccination and an undetectable viral load. This study therefore suggests the need to promote COVID-19 vaccination among PLHIV followed up at DTH-B, as well as the continuation of adequate management of HIV infection in order to reduce COVID-19-related morbidity and mortality in this so-called vulnerable population.

Edward Goldstein Senior Biostatistician

Harvard Medical School, Boston, MA 02114, USA

During the 2022-2023 season, influenza circulation levels in the European Union (EU) have increased substantially compared to the 2021-2022 season but were still generally somewhat lower compared to pre-pandemic influenza seasons. Studies have shown that influenza epidemics in the EU countries were associated with a heavy toll of mortality for different principal causes of death including respiratory, cardiac and other causes. Mortality data also suggest that residents of long-term care facilities represent a sizeable share of all cases of death in the EU, and an even higher share among deaths stemming from infections with respiratory viruses, including influenza. Influenza vaccination coverage for healthcare workers in nursing homes in many EU countries is moderate to low, whereas evidence in the literature suggests that higher influenza vaccination coverage levels for healthcare workers result in a significant reduction in all-cause mortality during influenza seasons, both in nursing home residents as well as in hospital patients, though the magnitude of that effect varies with influenza season. Here, we review the above evidence, and as well as the effect of different strategies for boosting influenza vaccination coverage in healthcare workers, such as mandatory vaccination, educational initiatives/outreach activities and availability of on-sight vaccination.

Dr. Gyanshankar P. Mishra

Associate Professor, Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, C.A. Road, Nagpur, Maharashtra, India– 440018;

Linezolid is an effective second-line anti-tuberculosis drug. However, the use of linezolid has been associated with rare adverse drug reactions (ADRs), one of which is the linezolid-associated black hairy tongue (BHT). This reaction is characterized by a black or dark brown discoloration of the tongue, which may be accompanied by a metallic or bitter taste. In this case report, we present a 19-year-old male patient who developed linezolid-associated black tongue while receiving linezolid as part of an all-oral, longer-course treatment regime for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB). The patient's BHT was only cosmetic and resolved upon discontinuation of linezolid. This case report aims to raise awareness of this rare ADR and the importance of close monitoring and potential withdrawal of linezolid to optimize treatment outcomes.

Eva Deveze^*, Damien Raimondeau, Myriam Ammi

Department of Vascular and Thoracic surgery, University hospital of Angers, France

Case report of a 73-year-old man with Mycobacterium bovis BCG supra renal saccular aortic aneurysm eight months after intravesical BCG therapy.

Eman EL-Sawalhy¹, Priscila Bercea², Mohammad Alkheder¹, Maher Khadra¹, Wehbi Hanayni¹, Muna Shaaeli¹, Hanady Daas³

¹Department of Internal Medicine, Beaumont Hospital, Dearborn, Michigan, USA

²Department of infection Prevention & Control, Beaumont Hospital, Dearborn, Michigan, USA

³Division of Infectious Disease, Department of Internal Medicine, Beaumont Hospital, Dearborn, Michigan, USA

COVID-19 infection can lead to severe consequences, especially among ethnic minorities. Data about COVID-19 infection outcomes in the Arab American population as a minority ethnic group compared to other racial and ethnic minorities are lacking. We conducted a retrospective observational cohort study that included 1,740 hospitalized adult patients with confirmed COVID-19 infection from March 12^th, 2020, to January 30^th, 2021, at a single center to compare baseline characteristics and outcomes in Arabs hospitalized with COVID-19 to patients from other ethnic groups during the same study period. Of those, we identified 320 Arab patients. We found that Arab American population suffered similar odds of complications and adverse outcomes despite having fewer risk factors for severe illness.

MAHAMANE SANI Mahamane Aminou¹, GBAGUIDI Aichatou Diawara², MIGITABA Hassane Moctar¹, SANI Rabiou¹, EMOUD TCHOLI Idrissa³, SALIFOU ALKASSOUM Ibrahim³, FOUMAKOYE GADO Adamou⁴, BATOURE Oumarou², OCQUET Sakina⁵, BRAH Souleymane⁶, MOUSSA SALIA Amadou⁶, OUMARA Maman⁶, TAMBWE Didier², ANYA Blanche², Ngozi Idemili-Aronu⁷, IGWEONU Obianuju⁷, DANGOU Jean-marie⁸, ADEHOSSI Eric⁶, OKEIBUNOR Joseph Chukwudi⁸, TALISUNA Ambrose⁸

¹Service Endocrinologie, Diabétologie et Nutrition de l’Hôpital Général de référence de Niamey ; BP: 12674, Niamey

²Bureau de la Représentation de l’OMS au Niger, BP: 10739 Niamey, Niger

³Service Surveillance Épidémiologique et Recherche de l’Hôpital Général de référence de Niamey, BP: 12674, Niamey, Niger

⁴Departement d’Anesthésie réanimation et Urgences de l’Hôpital Général de référence de Niamey, BP: 12674, Niamey, Niger

⁵Direction des Études et la programmation; Ministère de la santé Publique, Niamey, Niger

⁶ Service de Médecine Interne Hôpital Général de référence de Niamey, BP: 12674, Niamey

⁷University of Nigeria, Nsukka, Enugu State, Nigeria

⁸Bureau Régional de l’OMS pour l’Afrique, PO Box 06, Brazzaville, Congo

The COVID-19 infection has highlighted the most vulnerable patients. Indeed, COVID-19 patients suffering from another pathology including NCDs such as Arterial Hypertension (Hypertension), diabetes, cancers and respiratory diseases are paying a heavy price for this pandemic. We undertook a study in Niger to better document this comorbidity in a cross-sectional study that brought together patients hospitalized at the Niamey General Reference Hospital for COVID-19 infection and suffering from one or more NCDs. Among 273 patients hospitalized from March 19 to June 03, 2020, 34.8% had a non-communicable disease associated with COVID-19. The average age of the patients was 55 years (22 years to 94 years) and the sex ratio was 2.64 (72.5 % men and 27.5% women). Hypertension was the most represented NCD with 24.5%, followed by diabetes in 17.9% of cases, respiratory diseases 3.66% and other diseases (Heart disease, Obesity, Dyslipidemia, Gout, Chronic renal failure) with 3%. Health workers were the most affected by the disease with 38.6% of cases. The average consultation time was 3.77 days with extremes ranging from 1 to 8 days. The clinical symptoms characterizing the two main groups of patients (hypertensive and diabetic) were almost identical. It consisted mainly of cough, fever, chills, sore throat and rhinorrhea. According to the WHO clinical criteria for the severity of COVID-19, 34 patients or 16.11% were severe and 177 patients or 83% moderate. The clinical severity of the disease is significantly correlated with the patient's age (over 50 years) and the presence of an NCD associated with COVID-19. A total of 35.8% were hospitalized in intensive care in the NCD and COVID-19 group and 14.6% in the NCD group (p <0.001). The average length of patient hospitalization was 6.87 days overall, it was 7 days in intensive care. In 61.7% of cases the length of hospitalization was greater than 4 days. There was 22.1% in the NCD group and 7.3% in the just COVID-19 group (p <0.001). A total of 90.6% of registered deaths occurred in intensive care.

Farizan Tajudin, Nik Azlan Nik Muhamad^*

Emergency Department, Medical Centre, National University of Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia

Introduction: Mortality from syncope may not be apparent on initial evaluation in emergency department (ED). No reliable tools or clinical decision rule was established risk stratify mortality or morbidity from syncope. This study relates blood parameters with short term serious outcome of syncope. Methods: This was a single centre case control study of adults presenting to emergency department with syncope (n = 98), over 3 months’ duration. Patients particulars, contact profile and blood investigation results were recorded. Patients were called up to ascertain development of serious outcome of syncope within 7 days. Blood parameters such as hemoglobin, hematocrit, serum urea, serum sodium and Troponin I were compared between serious outcome and non-serious outcome group. Result: There was significant difference (p < 0.05) in hemoglobin, hematocrit, serum urea and Troponin I level between the 2 groups of syncope patients. Lower hemoglobin (11.5 ±3.4 g/dL vs. 13.0 ±2.1 g/dL) and lower hematocrit level (34.5 ±9.1 % vs. 38.8 ±5.8 %) were associated with development of short-term serious outcome after syncope. Higher serum urea (9.3 ±8.0 mmol/L vs. 4.3 ±1.2 mmol/L) and abnormally elevated Troponin I (x2 = 15.77; p < .001) were associated with development of short-term serious outcome after syncope. Conclusion: The parameters studied can be a baseline guide for disposition of syncope patient in ED. Further interventional prospective studies are required.

Paolo Lissoni^1*, Franco Rovelli¹, Alejandra Monzon¹, Giusy Messina¹, Enrica Porta¹, Giorgio Porro¹, Sonia Pensato¹, Elio Martin¹, Andrea Sassola¹, Alberto Caddeo¹, Carla Galli¹, Nicoletta Merli¹, Agnese Valentini¹, Giuseppe Di Fede¹

¹Institute of Biological Medicine, Milan, Italy

COVID-19 disease is characterized by severe and acute immune alterations, consisting of an abnormal secretion of inflammatory cytokines, mainly IL-17, IL-6 and TNF-alpha, in association with decline in lymphocyte and increase in monocyte counts. ACE2 is the key for COVID19 entry into the cells. However, the link of viral spike protein to ACE2 receptor on cell surface would also block the ACE2 enzymatic activity itself, with a consequent diminished production of angiotensin 1-7 (Ang 1-7), which is provided by fundamental anti-inflammatory and anti-coagulant properties. Then, the severe and acute Ang 1-7 deficiency would allow an exaggerated cytokine-induced inflammatory response, endothelial damage, leak capillary syndrome and acute respiratory distress syndrome (ARDS). Moreover, because of the documented connections occurring among ACE2, cannabinoid system and melatonin (MLT) secretion from the pineal gland, the block of ACE2 activity would also allow a concomitant deficiency of pineal-cannabinoid system axis, which plays a fundamental anti-inflammatory role by inhibiting IL-17 secretion, one of the main cytokine involved in COVID19 infection. Therefore, COVID19-induced exaggerated inflammatory response could be controlled at least in part by correcting Ang 1-7, MLT and cannabinoid deficiency through their exogenous administration. On these bases, a study was planned in 30 COVID19-infected patients with initial or important symptomatology, 16 of whom orally treated by MLT (20 mg/day in the evening) plus cannabidiol (CBD) (10 mg x 2/day) only, while the other 14 patients received also Ang 1-7 (0.5 mg 2/day orally). The results were compared to those observed in a control group of 30 COVID-19 infected patient, who received the only supportive therapy. No hospitalisation for initial respiratory failure was required in the group of patients treated by the neuroimmune regimen. In addition, most patients referred a rapid disappearance of fever and myalgia, as well as a relief of asthenia, particularly in those concomitantly treated with Ang 1-7. On the contrary, 5/30 (17%) control patients required hospitalisation. The difference was statistically significant (0/30 vs 5/30, P< 0.05). This preliminary study would suggest that a neuroimmune approach consisting of MLT and CBD in association with Ang 1-7 is an effective and non-toxic regimen in the therapy of COVID19-related symptoms, which could also control the clinical evolution of disease and reduce the need of hospitalisation.

Biyu^1†, Pang Zheng^2†, Shao Lijun¹, Tang Yunfeng¹, Niu Guoyu¹*

¹School of Public Health, WeiFang Medical University, China

²Tianjin International Joint Academy of Biomedicine, Tianjin, China

Objective: To investigate the frequency of influenza A and influenza B infections in people entering China at Tianjin port during 2019, so as to provide the basis for preventing the spread and control of influenza A and influenza B virus in China, and preliminarily assess the risk of entry passengers.

Methods: The throat swabs of entry personnel at Tianjin port in 2019 were collected, and influenza A and influenza B virus in the samples were detected by quantitative RT-PCR. According to the collected passenger information, combined with the experimental results, classification was carried out, and the related factors influencing the positive of influenza A and influenza B virus were analyzed.

Results: A total of 1605 throat swabs were collected. The results of quantitative RT-PCR showed that there were 40 (2.5%) cases of influenza A virus positive. No significant differences were found in gender, age and country distribution. However, in terms of entry time, the positive rate of influenza A virus was the highest in the first quarter compared with other quarters, and the difference was statistically significant. At the same time, there were 13 (0.8%) cases of influenza B virus positive in this survey. No significant differences were found in gender, country distribution and entry time, but in terms of the age of entry personnel, the positive detection rate of children and young people with influenza B infection was higher, and the difference between different age groups was statistically significant.

Conclusions: In 2019, Chinese accounted for the majority of the entry personnel at Tianjin port. The detection rates of influenza A and influenza B virus were low, while the total number of foreign immigrants was small, and the detection rate was high. The positive rate of influenza A and influenza B among different genders was similar. The positive detection rate of influenza A virus in the first quarter and influenza B virus in adolescents were relatively high. These two groups of people posed a threat to public health safety in China. Therefore, Therefore, we should focus on prevention and monitoring of key population at ports.

Patindoilba Marcel Sawadogo^1,2*, Kiswendsida Thierry Guiguemdé^2,4, Adama Zida^1,2, Nina korsaga/Somé^2,3, Ibrahim Sangaré^5,6, Sanata Bamba^5,6, Salimata Kiemdé¹, Rasmata Ouédraogo/Traoré^2,4

¹Parasitology-Mycology Service, Yalgado Ouédraogo University Hospital Center, Ouaga, Burkina Faso

²Training and Research Unit in Health Sciences, Ouaga University 1 Professor Joseph Ki-Zerbo (UO1 / PrZKZ), Ouagadougou, Burkina Faso

³Dermatology-Venereology service, Yalgado Ouédraogo University Hospital Center, Ouaga, Burkina Faso

⁴Parasitology-Mycology Service, Charles de Gaulle University Hospital Center, Ouagadougou, Burkina Faso

⁵Institute of Health Sciences, Nazi Boni University, Bobo Dioulasso, Burkina Faso

⁶Parasitology-Mycology Service, Souro Sanou University Hospital Center, Bobo Dioulasso, Burkina Faso

Background: In Burkina Faso, the first cases of tegumentary leismaniasis were reported in 1960. But it was not until the 1990s that the disease was really known by the Burkinabè with the epidemic that Ouagadougou experienced at that time. Since 2000, the disease has become neglected. However, the frequency of cases diagnosed in hospitals suggests that tegumentary leismaniasis is still endemic in Ouagadougou. Hence the present study whose purpose and assess the current state of the disease in the city of Ouagadougou from 2012 to 2016.

Methods: We conducted a descriptive study on retrospective data collected from January 2012 to December 2016 in different hospitals in the city of Ouagadougou. Data were collected from clinical and laboratory registers.

Results: a total of 96 parasitologically-confirmed cases were identified. Clinical forms were mentioned in 43 patients. Localized cutaneous leishmaniasis was the most common form 25/43 (58.14%), followed by mucocutaneous leishmaniasis 8/43 (18.60%), diffuse cutaneous leishmaniasis 7/43 (16.28%) and finally pseudo-leprosy Leishmaniasis 3/43 (6.98%). The Leishmaniasis / HIV association was found in 15 patients/96 (15.63%). The parasitological examination in search of amastigote forms had a positivity rate of 92/209 (44.02%). Meglumine antimoniate (Glucantime®), the WHO reference drug, was the most prescribed 35/42 (83.33%).

Conclusion: Tegumentary Leishmaniasis still exists in Ouagadougou. Thus, precautions must be taken to avoid an upsurge of cutaneous Leishmaniasis in Ouagadougou.

Mohadeseh Nemati¹, Elmira Roshani Asl¹, Fahima Danesh Pouya¹, Yousef Rasmi^1,2*

¹Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

²Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran

Zisheng Shang¹, Valentina L. Kouznetsova^2,3, Igor F Tsigelny^2-5*

¹MAP Program UC San Diego, La Jolla, California, USA

²Moores Cancer Center UC San Diego, La Jolla, California, USA

³San Diego Supercomputer Center, UC San Diego, La Jolla, California, USA

⁴Department of Neurosciences, UC San Diego, La Jolla, California, USA

⁵CureMatch Inc. San Diego, California, USA

Purpose: Although a strong association between human papillomavirus (HPV) and a variety of cancers has long been established, infection by HPV alone has been shown to be insufficient for the induction of cancer, with a large number of HPV infections regressing without causing cancer. Additionally, HPV-negative cases have worse prognosis rates than HPV-positive ones across a multitude of cancer types. The reasons behind these phenomena are poorly understood. We try to explain it.

Methods: In this meta-analysis study, we first compared the mutation sets of HPV-positive and HPV-negative cancers using data from the Cancer Genome Atlas (TCGA) and from open published sources. Then, focusing on the genes that are exclusively mutated in HPV-negative head and neck cancer, we used KEGG pathways and reviewed literature to investigate how HPV can mimic the effects of mutations in those genes and thereby trigger carcinogenesis despite the absence of those mutations.

Results: Using TCGA mutation frequencies of significantly mutated genes stratified by HPV status, we extracted 17 genes exclusively mutated in HPV-negative cancers and detailed the HPV infection mechanisms that are largely able to mimic the effects of mutations in 13 of these genes. Through our literature searches and pathway analyses, we also presented antitumor effects caused by HPV infection that reduce carcinogenic efficiency and could contribute to the prognosis difference.

Conclusion: Our findings confirm that HPV infection substitutes for some, but not all, somatic driver mutations required for the induction of cancer by mimicking the effects of those mutations through various virus–host interaction mechanisms, thereby accelerating the cancer-related pathways.

Paolo Lissoni¹*, Giusy Messina¹, Francesco Pelizzoni², Franco Rovelli¹, Fernando Brivio¹, Alejandra Monzon¹, Nadal Crivelli¹, Arianna Lissoni¹, Simonetta Tassoni³, Andrea Sassola¹, Sonja Pensato¹, Giuseppe Di Fede¹

¹Institute of Biological Medicine, Milan, Italy

²Cardiological Surgery Division, Niguarda Hospital, Milan, Italy

³Effata Institute, Lucca, Italy

Today, it is known that all human biological functions are under two fundamental regulatory systems, consisting of the endocrine system and the cytokine network. Moreover, it has been shown that the cytokines released from the activated immune cells do not influence only immune functions, but also the whole biological system, including the various metabolic activities, the cardiovascular system, and the functionless of the neuroendocrine system itself. Unfortunately, despite the well-demonstrated importance of cytokines in maintaining the status of health, from a clinical point of view the routine evaluation of the cytokine system still remains unconsidered to establish the status of health, since it is investigated only in severe conditions, such as septic shock, disseminated intravascular coagulation and respiratory distress, which have been demonstrated to be due to an abnormal endogenous production of inflammatory cytokines, namely IL-6, TNF-alpha, and IL-1 beta. This clinical deficiency was depended on several factors, particularly on the complexity of cytokine interactions themselves, but also on the decision to use artificial molecules, such as monoclonal antibodies against the various cytokines, to counteract their eventual abnormally enhanced endogenous production, rather than to investigate the mechanisms responsible for their altered production and to correct eventual alterations. The main reason of the complexity of the cytokine network is related to the fact that the interactions occurring among the different cytokines are often founded on positive feedback mechanisms, then on reciprocal stimulatory actions, while the endocrine system is substantially based on negative feedback circuits. The aim of the present review is to propose a synthetic knowledge regarding the main effects and the source of origin of each single interleukin discovered up to now, to elaborate a first preliminary fundamental physiology of the cytokine network.

Piryani Rano Mal¹*, Piryani Suneel², Bhandary Shital³

¹Department of Internal Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal

²Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

³School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal

Gyanshankar P. Mishra¹*, Ninu P. Babu²

¹Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

²Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Tubercular pleural effusion is one of the extrapulmonary forms of tuberculosis. We herein report the case of a thirty-five-year-old female diagnosed with Tubercular pleural effusion who inadvertently took steroid monotherapy for four weeks sans antitubercular chemotherapy. On follow up she showed clinico radiological improvement. The case report discusses the potential role of steroids in current management of tubercular pleural effusion.

Zachary Sitton*, Daniel Crawford, Eric vanSonnenberg, Paul Kang

The University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA

Joseph Yoon¹*, Claire Maree O’Bryan³, Michael Redmond^1,2

¹Department of Neurosurgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia

²Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia

³Flinders University, Darwin, Northern Territory, Australia

Intracranial subdural empyema is a rare but devastating infection of the brain. With improvements in investigations and treatment, the previously seen mortality of 100% has now been reduced to 4-9%. The underlying factor in this improvement is the reduction in time to treat. To achieve this, the first barrier is identifying the possibility of the condition. There have been multiple case reports, series, and retrospective studies on the matter, but over time the clinical epidemiology has changed. In this report, we give a up to date review of the infection and highlight the important features clinicians should consider when assessing patients with possible intracranial subdural empyema.

Daiane Flores Dalla Lana¹*, Paula Reginatto², William Lopes³, Marilene Henning Vainstein³, Alexandre Meneghello Fuentefria^1,2

¹Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil

²Programa de Pós-graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Brazil

³Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Brazil

We report the invasion of the human nail plate by the dermatophytic species Microsporum canis, which was recently described as a biofilm former, in Scanning Electron Microscopy (SEM) images. With the images it was possible to evidence the propagation and aggregation of hyphae on the nails and also the formation of biofilm, as a pathogenicity and virulence factor of the species in cases of onychomycosis.

Franz Bracher*

Ludwig-Maximilians University, Department of Pharmacy - Center for Drug Research, Butenandtstr., Munich, Germany

The development of anti-infective drugs has been one of the most impressive progresses in drug therapy in the past century. However, some of the promising antibacterial and antiviral drugs lost activity after being used in therapy for some time. Typically, this is due to the development of resistance phenomena, among which the expression of drug-degrading enzymes is one major aspect. In other cases, enzymatic degradation of anti-infective drugs by mammalian enzymes in the liver (or kidney) can limit the efficacy of the drugs. In all of these cases, selection of a drug from a different class is a therapeutic opportunity. Alternatively, the original drug can be used further in combination with other compounds named boosters, pharmacokinetic enhancers or antibiotic adjuvants. These compounds are used in combination with the primary anti-infective agent, but not for their direct effects on the infection itself, but since they enhance or restore the activity of the drug. This mini-review gives an overview on the therapeutically most important classes of boosters/antibiotic enhancers, like β-lactamase inhibitors, inhibitors of CYP enzymes in HIV therapy and hepatitis C. Inhibitors of efflux pumps in pathogenic bacteria and fungi will be addressed shortly.

Angel Ramos-Ligonio¹, Aracely López-Monteon¹*

¹LADISER Inmunología y Biología Molecular, Universidad Veracruzana, Orizaba, Veracruz, México

Dhanashree Lokesh¹, Kammara Rajagopal^1,2, Jae Ho Shin²*

¹Department of Protein Chemistry and Technology, CSIR-CFTRI, Mysore, India

²School of Applied Biosciences, Kyungpook National University, Daegu, Korea

Drug-resistance is a major problem globally, the number of drug-resistant bacteria has increased substantially through horizontal gene transfer. Even Mycobacterium tuberculosis are reported to have acquired antitubercular drug-resistance and named as MDR Mtb. The acquisition of immunity has not given up, here; it is needed to be a continuous procedure. Further causing the microbial adapting to a very high and larger number of drugs recognized as extreme drug and total drug-resistance. The mechanistic aspects of MDR Mtb are well understood. Nevertheless, this is not the case with Probiotic microbes such as Bifidobacterium adolescentis. Herein, we report the mechanistic aspects of antitubercular drug-resistance in this organism for the first time. This review discusses the report by a mutation that confers multi drug-resistance in Bifidobacteria.

Gerges Rizkallah¹, Renaud Mahieux², Hélène Dutartre²

¹Faculty of Public Health, Sagesse University, Beirut, Lebanon

²Équipe oncogenèse rétrovirale, équipe labellisée «FRM», CIRI – Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR, ENS Lyon, Lyon, France

Two retroviruses emerged in the 1980s : HTLV-1 and HIV-1^1,2,3. HTLV-1 infects 5-10 million people worldwide and is detected in highly endemic areas, such as Japan, sub-Saharan Africa, the Caribbean region, South America⁴ as well as in Australian indigenous⁵. According to the UNAIDS’s 2018 fact sheet, HIV-1 is endemic worldwide, infects 37.9 million people and is particularly prevalent in central and South Africa, the Caribbean region, Latin America, South-East Asia and Eastern Europe⁶. HTLV-1 or HIV-1 infected individuals develop chronic infections. Only in 1-10% of infected carriers, HTLV-1 leads either to the development of Adult T-cell Leukemia/Lymphoma (ATLL), or of Tropical Spastic Paraparesis/HTLV-1 Associated Myelopathy (TSP/HAM)⁷. In most chronically infected people, HIV-1 infection leads to an Acquired Immunodeficiency Syndrome (AIDS), and around 22% of the death causes among HIV-infected patients remains AIDS-related⁶. The aim of this mini-review is to highlight some of the points discussed in the review ‘’HTLV-1, the Other Pathogenic Yet Neglected Human Retrovirus: From Transmission to Therapeutic Treatment’’⁸. First, it will focus on the similarities regarding transmission mechanisms and cellular tropism between these retroviruses. Then, starting from the therapeutic protocols currently used in the treatment of each of these retroviral infections, this mini-review will summarize the therapeutic protocols used for co-infections management.

Caridad Rosette, Alessandro Mazzetti, Roberto Camerini, Luigi Moro, Mara Gerloni*

Cosmo Pharmaceuticals, Riverside II. Sir John Rogerson’s Quay, Dublin, Ireland

Rifamycin SV (rifamycin), is a member of the ansamycin family of antimicrobial compounds which kills bacteria commonly associated with infectious diarrhea and other enteric infections. For colonic diseases like diverticulitis, inflammatory bowel syndrome (IBS) or inflammatory bowel disease (IBD), bacterial proliferation or microbial dysbiosis is associated with a strong inflammatory component. This inflammation has a profound influence on the liver via the gut-liver axis. This review summarizes the anti-inflammatory activities of rifamycin based on analyses of its impact on two key regulators of inflammation: PXR and NFκB. Rifamycin was found to activate PXR and two of its downstream targets, CYP3A4 and PgP, in liver and intestinal cell lines. Rifamycin also directly inhibited NFκB in a cell line which lacks PXR expression. These dual activities likely explain the inhibition of pro-inflammatory cytokine secretion from human colonic cells lines and activated CD4⁺ T cells. These experimental data define the immune regulatory characteristics of rifamycin and an emerging role in the treatment of both gastrointestinal (GI) and liver disorders.

Pascal Bezel¹, Sandro F. Fucentese², Jan Burkhard^1,3, Dominique Holy^1,3, Arend J. Nieuwland², Marco Burkhard², Ilker Uçkay^1,2,3,4*

¹Internal Medicine, Balgrist University Hospital, Zurich, Switzerland

²Department of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland

³Infectiology, Balgrist University Hospital, Zurich, Switzerland

⁴Unit for Clinical and Applied Research, Balgrist University Hospital, Zurich, Switzerland

A prosthetic joint infection (PJI) requires a combined approach (infectiology and surgery). The therapeutic DAIR approach (debridement, antibiotics, irrigation, and retention) is an option for acute and stable PJI yielding remission incidences that oscillate between 70% and 90%; in a literature mostly composed of retrospective single-center trials. DAIR can be performed with or without mobile part’s exchange during debridement. Scientific data proving the necessity of mobile part exchanges (by leaving other infected components in situ) remain scarce. In this narrative mini review, we evaluate the existing literature that analyses the benefit of exchanging mobile parts with at least ten own cases. We moreover discuss the optimal duration of concomitant targeted systemic antibiotic therapy and reveal some insights in the surgical difficulties in performing DAIR. Our conclusion tends to favor of the mobile part’s exchange whenever feasible.

PM Sawadogo^1,2, A Zida^1,2, I Sangaré^5,6, TK Guiguemdé^2,3, A. Sanfo¹, M. Idani¹, H Nacanabo¹, S Bamba^5,6, R Ouédraogo/Traoré^2,3, TR Guiguemdé^2,4

¹Parasitology-Mycology Department, Yalgado Ouedraogo University Hospital Center, Ouagadougou, Burkina Faso

²Training and Research Unit in Health Sciences, Ouaga University 1 Professor Joseph Ki-Zerbo (UO1 / PrZKZ), Ouagadougou, Burkina Faso

³Parasitology-Mycology Department, Charles de Gaulle University Hospital Center, sector 28 Ouagadougou, Burkina Faso

⁴Muraz Research Center, Bobo-Dioulasso, Burkina Faso

⁵Parasitology-Mycology Department, Souro Sanou University Hospital, Bobo Dioulasso, Burkina Faso

⁶Institut de Reccherche en Sciences de la Santé, Université Nazi Boni (UNB), Bobo Diuolasssa, Burkina Faso

This article aims to summarize the results of works from January 2013 to December 2017, on the molecular mechanisms of Candida albicans resistance to antifungal drugs. It is a prelude to a study on the molecular mechanisms of these resistances in Burkina Faso, with the aim of exploring new therapeutic solutions. Almost all studies have focused on the ERG11 gene as the most involved in azoles resistance. Mutations have also been demonstrated on other genes conferring resistance to other molecules such as CDR1 and 2, MRR1 and 2, TAC1 and ERG for polyenes, allylamines and azoles, FKS1 for echinocandins, FCA1 and FCY1 for pyrimidine analogues. Genetic mutations conferring the resistance of C. albicans to antifungals drugs worldwide are regularly reported, but in Burkina Faso we have no data on this subject. As a perspective therefore, a study on the molecular mechanisms of resistance of C. albicans to antifungals will be of great help in the fight against the resistance of this frequent yeast to antifungals drugs.