Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Recycling and photodegradation processes of organic hazardous materials on polyaniline-titanium dioxide quantum dots catalyst

A photo-catalyst with conducting polymers doped with titanium dioxide, known as TiO2 quantum dots (TiO2 QDs), has a high efficiency for photocatalytic usage. The organic hue methyl orange was broken down in the current study using polyaniline (PANI) and polyaniline titanium dioxide quantum dots (PANI-TiO2 QDs) polymers. PANI and PANI-TiO2 QDs have been produced by chemical oxidative polymerization in an aqueous solution. By characterization of PANI-TiO2 QDs nanocomposites using ultraviolet–visible (UV–vis), Fourier transform infrared (FTIR), and X-ray powder diffraction (XRD), it was demonstrated that the chemical structure of polymer composites had not changed after being doped with TiO2 QDs. To determine the form, size, surface area, and thermal analyses of the produced PANI-TiO2 QDs samples, EDX, BET, and TGA were used. The photocatalytic activity of the PANI-TiO2 QDs in the photo-degradation of methyl orange dye as an organic hazardous chemical in an aqueous medium was assessed using a 50-watt xenon lamp light source and direct sunlight. PANI-TiO2 QDs demonstrated high photocatalytic properties, with a 93% efficiency, as opposed to 35% and 60.1%, respectively, for PANI and TiO2 QDs. When PANI, titanium dioxide quantum dots, and PANI-TiO2 QDs are present during the recycling processes in the presence of all created samples up to four times, the photo-degradation rate decreases by about 50.2%, 15.4%, and 17.4%, respectively

A commercial seaweed extract increases growth performance, immune responses, and related gene expressions in whiteleg shrimp (Litopenaeus vannamei)

Seaweed liquid extracts are an attractive source of phytochemicals with high potential applicability in the aquafeed-additive industry. A commercial seaweed liquid extract (True Algae Max, TAM®), which has a marine seaweed odor, also dislplays significant levels of polysaccharides, phytochemicals, phenolic, and flavonoid compounds showing antioxidant activities and DPPH inhibition. This study investigates the impact of diets supplemented with TAM® as a functional additive on the growth, nutrient utilization, immune responses, and immune-related gene expressions of whiteleg shrimp (Litopenaeus vannamei). A total of 750 postlarvae (PL, with an average initial weight of 0.053±0.001 g) were divided into five experimental groups, comprising three replicates per dietary treatment. For an eight-week experimental period, all groups were fed identical diets except for the variation in TAM® inclusion levels. The basal diet (control diet) had no inclusion level of TAM® (TAM0%). Groups 2–5 each contain TAM® inclusion at levels of 1% (10 mL gk− 1 diet TAM1%), 2% (20 mL gk− 1 diet TAM2%), 3% (30 mL gk− 1 diet TAM3%), and 4% (40 mL gk− 1 diet TAM4%), respectively. The results concluded that TAM® has great potential as a feed additive for whiteleg shrimp, compared to the control group. The group TAM2% significantly achieved final weight (4.337 g), weight gain (4.287 g) specific growth rate (3.423% / day), feed conversion ratio (1.970), feed efficiency ratio (0.507), and protein efficiency ratio (1.407), compared to the control group (3.900 g, 3.850 g, 3.347%/day, 2.183, 0.458, and 1.270, respectively). Whole-body composition of protein and lipid contents were significantly improved by all TAM group including TAM2% (51.18% and 4.49%, respectively), compared to the control group (49.38% and 4.15%, respectively). As well as, shrimp in group TAM2% achieved the highest values of lysozyme (3.92 µg mL− 1 ), superoxide dismutase (SOD, 11.92 IU mL− 1 ), catalase (CAT, 13.04 IU g− 1 ), lipase (31.24 IU L− 1 ), and amylase (31.24 IU L− 1 ), compared to the control group (3.19 µg mL− 1 , 8.80 IU mL− 1 , 10.84 IU g− 1 , 17.35 IU L− 1 , 21.65 IU L− 1 , respectively). For gene expressions experiment, four immune-related were performed in this study; Peroxiredoxin (Prx), Prophenoloxidase (PPO1), P53-like protein isoform delta (p53), and Hemocyanin subunit L5 (L5H). The results showed that shrimp in group TAM2% achieved the highest significant P53 gene transcription compared to the control group or the other TAM groups. Compared to other groups, the TAM1% group considerably increased PPO1 gene transcription, while TAM3% displayed the greatest Prx gene transcription. On the other hand, compared to control group, all TAM groups significantly improved L5H gene transcription. In conclusion, the current study revealed that TAM® diet supplementation (20 mL of TAM® per kg diet) represents a promising, eco-friendly, and sustainable feed additive in the shrimp aquadiet industry

The effect of dietary Crataegus Sinaica on the growth performance, immune responses, hemato-biochemical and oxidative stress indices, tissues architecture, and resistance to Aeromonas sobria infection of acrylamide-exposed Clarias gariepinus

This study investigated the effect of using a natural dietary supplement of Crataegus Sinaica (CS) to mitigate the negative impacts of waterborne acrylamide (ACR) on the health and performance of freshwater fish, African catfish (Clarias gariepinus). For this aim, 270 fish were divided into six groups (45 fish/group). Three groups were kept in non-contaminated water and fed a non-fortified basal diet, 1% CS, and 2% CS. The other three groups were exposed to ACR (26.6 mg/L water) and fed a basal diet, 1% CS, and 2% CS. After 60 days, the growth performance, liver and kidney function, stress indicators, oxidative stress indices, immunological response, vital tissue architecture, and resistance to Aeromonas sobria have been evaluated. Results indicated that CS dietary supplementation (1% and 2% CS) significantly counteracted ACR-induced reduced growth and survival. Furthermore, both CS dietary supplementation significantly balanced the ACR-induced leukopenia, anemia, hypoalbuminemia, hypoglobulinemia, and hypoproteinemia. Likewise, 1% and 2% CS addition to the ACR-exposed fish diets significantly reduced the ACR-induced increase in serum enzymes, bilirubin, renal damage products, hyperglycemia, and cortisol. Instead, the ACR-evoked depletion of antioxidant (glutathione peroxidase, superoxide dismutase, catalase, and reduced glutathione) and innate immune (lysozyme, complement3, and nitric oxide) components were significantly restored by both CS dietary supplementation. Besides, the ACR-induced pathological alterations in hepatic, renal, and splenic tissues were considerably lessened by CS. Besides, the reduced disease resistance of ACR-exposed fish was restored when challenged with A.sobria in a fish-fed 1% and 2% CS-fortified diet. Noteworthy, the inclusion of 2% CS produced better results than 1%. Overall, feeding C. gariepinus a diet supplemented with 2% CS significantly improved the fish's overall health, growth, and disease resistance, despite the ACR water pollution that consequently would sustain aquaculture