Search

Healthcare associated infections are the potential cause of morbidity and mortality amongst paediatric population. Widespread antimicrobial use amongst paediatric population leads to the antimicrobial resistance. Bloodstream infections amongst the paediatric population are the leading cause of death. The objective of the study was to determine the general trend of antimicrobial susceptibility pattern in the paediatric and neonatal age group in the ICU setting. Retrospective analysis was done of all the patients of paediatric and neonatal age group who were admitted in ICU including patients on ventilators, and whose blood samples were sent to the lab for culture and sensitivity testing. The sample profile from PICU and NICU shows the total numbers of 3056 samples (including blood, ET secretion, pus, urine, pleural fluid, etc.) were received in the laboratory from paediatric and Neonatal ICU during the study period. Total blood samples received from PICU and NICU were 1310 (sample size). Out of these, blood samples received from PICU were 618 (33.76%), of which 173 (28%) were positive, whereas, 692 (56.52%) blood samples were received from NICU, of which 242 (35%) were positive. The blood samples showed that in PICU, CONS (20.75%), and Staphylococcus aureus (16.98%) were found in maximum numbers. In NICU, Klebsiella pneumoniae were obtained in maximum numbers (30.77%), followed by Acinetobacter baumanii (21.98%). CONS (Methicillin resistant) were found 100% susceptible against Linezolid, followed by Vancomycin and Clindamycin (83% each). Staphylococcus aureus showed 100% sensitivity for Teicoplanin. Klebsiella pneumoniae, were found to be most susceptible to Tigecycline (74.07%) and Colistin (70.37%). Acinetobacter in blood of PICU patients showed high level of resistance with only 37.5% sensitivity for Colistin and Minocycline each, 12.5% sensitivity for Amikacin. To our conclusion, Linezolid was found to be the best Antimicrobial agent against MRCONS, whereas, Linezolid, Teicoplanin, Tetracyclines were found to have good efficacy against Staphylococcus aureus. The best antimicrobial agents against Klebsiella pneumoniae and E. coli were Colistin and Tigecycline. [ABSTRACT FROM AUTHOR]

Neonatal sepsis is a severe medical condition that contributes significantly to neonatal mortality. However, early diagnosis and treatment can help manage the condition effectively. Predictive analytics can assist neonatal sepsis diagnosis and treatment and offer a reassuring solution. This study presents a systematic literature review of various predictive analytics methods for neonatal sepsis diagnosis and treatment. It thoroughly reviews 16 studies between 2014 and 2024, including retrospective and prospective data and utilizing various predictive modeling techniques, such as Machine Learning (ML) and Deep Learning (DL). The review unveils that the Predictive analytics models can rapidly detect early and late-onset neonatal sepsis. This detection aids clinicians in decision-making and improves healthcare management for neonates, especially in low-resource settings. This study lays the groundwork for utilizing advanced analytics technologies to address challenges in this domain. It inspires further research in innovative and unexplored methods for neonatal sepsis diagnosis. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is an infectious disease of global public health importance caused by the Mycobacterium tuberculosis complex. Despite advances in diagnosis and treatment, this disease has worsened with the emergence of multidrug-resistant strains of tuberculosis. We aim to present and review the history, progress, and future directions in the diagnosis of tuberculosis by evaluating the current methods of laboratory diagnosis of tuberculosis, with a special emphasis on microscopic examination and cultivation on solid and liquid media, as well as an approach to molecular assays. The microscopic method, although widely used, has its limitations, and the use and evaluation of other techniques are essential for a complete and accurate diagnosis. Bacterial cultures, both in solid and liquid media, are essential methods in the diagnosis of TB. Culture on a solid medium provides specificity and accuracy, while culture on a liquid medium brings rapidity and increased sensitivity. Molecular tests such as LPA and Xpert MTB/RIF have been found to offer significant benefits in the rapid and accurate diagnosis of TB, including drug-resistant forms. These tests allow the identification of resistance mutations and provide essential information for choosing the right treatment. We conclude that combined diagnostic methods, using several techniques and approaches, provide the best result in the laboratory diagnosis of TB. Improving the quality and accessibility of tests, as well as the implementation of advanced technologies, is essential to help improve the sensitivity, efficiency, and accuracy of TB diagnosis. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is accountable for considerable global morbidity and mortality. Effective TB therapy with multiple drugs completes in about six months. The longer duration of TB therapy challenges patient compliance and contributes to treatment collapse and drug resistance (DR) progress. Therefore, new medications with an innovative mechanism of action are desperately required to shorten the TB therapy's duration and effective TB control. The mycobacterial membrane protein Large 3 (MmpL3) is a novel, mycobacteria-conserved and recognized promiscuous drug target used in the development of better treatments for multi-drug resistance TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). This article spotlights MmpL3, the clinical studies of its inhibitor (SQ109), and the patent literature. The literature on MmpL3 inhibitors was searched on PubMed and freely available patent databases (Espacenet, USPTO, and PatentScope). SQ109, an analog of ethambutol (EMB), is an established MmpL3 inhibitor and has completed Phase 2b-3 clinical trials. Infectex and Sequella are developing orally active SQ109 in partnership to treat MDR pulmonary TB. SQ109 has demonstrated activity against drug-sensitive (DS) and drug-resistant (DR) Mycobacterium tuberculosis (Mtb) and a synergistic effect with isoniazid (INH), rifampicin (RIF), clofazimine (CFZ), and bedaquiline (BNQ). The combination of SQ109, clofazimine, bedaquiline, and pyrazinamide (PZA) has been patented due to its excellent anti-TB activity against MDR-TB, XDR-TB, and latent-TB. The combinations of SQ109 with other anti-TB drugs (chloroquine, hydroxychloroquine, and sutezolid) have also been claimed in the patent literature. SQ109 is more potent than EMB and could substitute EMB in the intensive stage of TB treatment with the three- or four-drug combination. Developing MmpL3 inhibitors is a promising approach to fighting the challenges associated with DS-TB and DR-TB. The authors foresee MmpL3 inhibitors such as SQ109 as future drugs for TB treatment. [ABSTRACT FROM AUTHOR]

Diagnosis of tuberculosis, and especially the diagnosis of extrapulmonary tuberculosis, still faces challenges in clinical practice. There are several reasons for this. Methods based on the detection of Mycobacterium tuberculosis (Mtb) are insufficiently sensitive, methods based on the detection of Mtb-specific immune responses cannot always differentiate active disease from latent infection, and some of the serological markers of infection with Mtb are insufficiently specific to differentiate tuberculosis from other inflammatory diseases. New tools based on technologies such as flow cytometry, mass spectrometry, high-throughput sequencing, and artificial intelligence have the potential to solve this dilemma. The aim of this review was to provide an updated overview of current efforts to optimize classical diagnostic methods, as well as new molecular and other methodologies, for accurate diagnosis of patients with Mtb infection. [ABSTRACT FROM AUTHOR]

Female genital tuberculosis (TB) is a common form of extrapulmonary TB (EPTB) with varied clinical presentations, i.e. infertility, pelvic pain, and menstrual irregularities. Diagnosis of female genital TB is challenging predominantly due to paucibacillary nature of specimens and inconclusive results obtained by most of the routine laboratory tests. This review has briefly summarized the epidemiology, clinical features, and transmission of female genital TB. Commonly used laboratory tests include bacteriological examination (smear/culture), tuberculin skin testing, interferon-γ release assays, imaging, laparoscopy/hysteroscopy, and histopathological/cytological observations. Furthermore, utility of nucleic acid amplification tests (NAATs), like loop-mediated isothermal amplification, PCR, multiplex-PCR, nested PCR, real-time PCR, and GeneXpert® could significantly improve the detection of female genital TB. Currently, there is no single test available for the efficient diagnosis of female genital TB, rather a combination of tests is being employed, which yields moderate diagnostic accuracy. The latest modalities developed for diagnosing pulmonary TB and other clinical EPTB forms, i.e. aptamer-linked immobilized sorbent assay, immuno-PCR (I-PCR), analysis of circulating cell-free DNA by NAATs, and identification of Mycobacterium tuberculosis biomarkers within extracellular vesicles of bodily fluids by I-PCR/nanoparticle-based I-PCR, may also be exploited to further improve the diagnosis of female genital TB. [ABSTRACT FROM AUTHOR]

Background: Blood transcriptomics can be used for confirmation of tuberculosis diagnosis or sputumless triage, and a comparison of their practical diagnostic accuracy is needed to assess their usefulness. In this study, we investigated potential biomarkers to improve our understanding of the pathogenesis of active pulmonary tuberculosis (PTB) using bioinformatics methods.Methods: Differentially expressed genes (DEGs) were analyzed between PTB and healthy controls (HCs) based on two microarray datasets. Pathways and functional annotation of DEGs were identified and ten hub genes were selected. They were further analyzed and selected, then verified with an independent sample set. Finally, their diagnostic power was further evaluated between PTB and HCs or other diseases.Results: 62 DEGs mostly related to type I IFN pathway, IFN-γ-mediated pathway, etc. in GO term and immune process, and especially RIG-I-like receptor pathway were acquired. Among them, OAS1, IFIT1 and IFIT3 were upregulated and were the main risk factors for predicting PTB, with adjusted risk ratios of 1.36, 3.10, and 1.32, respectively. These results further verified that peripheral blood mRNA expression levels of OAS1, IFIT1 and IFIT3 were significantly higher in PTB patients than HCs (all P < 0.01). The performance of a combination of these three genes (three-gene set) had exceeded that of all pairwise combinations of them in discriminating TB from HCs, with mean AUC reaching as high as 0.975 with a sensitivity of 94.4% and a specificity of 100%. The good discernibility capacity was evaluated d via 7 independent datasets with an AUC of 0.902, as well as mean sensitivity of 87.9% and mean specificity of 90.2%. In regards to discriminating PTB from other diseases (i.e., initially considered to be possible TB, but rejected in differential diagnosis), the three-gene set equally exhibited an overall strong ability to separate PTB from other diseases with an AUC of 0.999 (sensitivity: 99.0%; specificity: 100%) in the training set, and 0.974 with a sensitivity of 96.4% and a specificity of 98.6% in the test set.Conclusion: The described commonalities and unique signatures in the blood profiles of PTB and the other control samples have considerable implications for PTB biosignature design and future diagnosis, and provide insights into the biological processes underlying PTB. [ABSTRACT FROM AUTHOR]

Objective: The purpose is to discuss abdominal tuberculosis mimicking malignancy involving the lymph nodes, peritoneum, and the GI tract. Conclusion: Awareness of the pathophysiology and imaging appearance on various modalities of abdominal tuberculosis involving the lymph nodes, peritoneum, and the GI tract that may simulate malignancy can aid differentiation, diagnosis, and therapy, particularly in areas where tuberculosis is endemic. [ABSTRACT FROM AUTHOR]

An editorial is presented on the challenges raised by the Enteric fever by Salmonella enteric serotype tophi and paratyphoid A, B and C and rarely, choleras is. It outlines the endemic in the Indian population and is more commonly seen in urban compared to rural areas. An overview of the hypertrophy and may even undergo necrosis due to recruitment of monocytes and lymphocytes.