Oral Infection Caused by Stenotrophomonas maltophilia: A Rare Presentation of an Emerging Opportunistic Pathogen

Stenotrophomonas maltophilia is an emerging multidrug-resistant opportunistic pathogen with an increasing incidence of nosocomial and community-acquired infection cases, mainly in immunocompromised individuals. Oral cavity infections are rare. To learn more about this infection, a case of oral cavity infection caused by S. maltophilia in an immunosuppressed patient under ventilatory therapy has been presented. The patient presented with multiple nonpainful erosive lesions of the tongue, palate, and oral mucosa. A smear of the oral lesions was performed that revealed the presence of S. maltophilia and Candida albicans, and the patient was treated with fluconazole and sulfamethoxazole associated with trimethoprim in accordance with the antimicrobial susceptibility testing. After 14 days of antibiotic therapy, there were almost no signs of the previous lesions.info:eu-repo/semantics/publishedVersio

Dentes Verdes: a Propósito de Três Casos Clínicos

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Infeção da Cavidade Oral Associada a Ventilação Não Invasiva

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Mucosal and systemic immune responses after a single intranasal dose of nanoparticle and spore-based subunit vaccines in mice with pre-existing lung mycobacterial immunity.

Tuberculosis (TB) is a major global health threat that claims more than one million lives annually. With a quarter of the global population harbouring latent TB, post-exposure vaccination aimed at high-risk populations that could develop active TB disease would be of great public health benefit. Mucosal vaccination is an attractive approach for a predominantly lung disease like TB because it elicits both local and systemic immunity. However, the immunological consequence of mucosal immunisation in the presence of existing lung immunity remains largely unexplored. Using a mycobacterial pre-exposure mouse model, we assessed whether pre-existing mucosal and systemic immune responses can be boosted and/or qualitatively altered by intranasal administration of spore- and nanoparticle-based subunit vaccines. Analysis of lung T cell responses revealed an increasing trend in the frequency of important CD4 and CD8 T cell subsets, and T effector memory cells with a Th1 cytokine (IFNγ and TNFα) signature among immunised mice. Additionally, significantly greater antigen specific Th1, Th17 and IL-10 responses, and antigen-induced T cell proliferation were seen from the spleens of immunised mice. Measurement of antigen-specific IgG and IgA from blood and bronchoalveolar lavage fluid also revealed enhanced systemic and local humoral immune responses among immunised animals. Lastly, peripheral blood mononuclear cells (PBMCs) obtained from the TB-endemic country of Mozambique show that individuals with LTBI showed significantly greater CD4 T cell reactivity to the vaccine candidate as compared to healthy controls. These results support further testing of Spore-FP1 and Nano-FP1 as post-exposure TB vaccines

Global respiratory syncytial virus–related infant community deaths

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines

Iatrogenia num Caso de 6º Impactados nos 5ª Decíduos

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Groundwater as an emergency source for drought mitigation in the Crocodile River catchment, South Africa

Global climate change has received much attention worldwide in the scientific as well as in the political community, indicating that changes in precipitation, extreme droughts and floods may increasingly threaten many regions. Drought is a natural phenomenon that causes social, economical and environmental damage to society. In this study, we assess the drought intensity and severity and the groundwater potential to be used as a supplementary source of water to mitigate drought impacts in the Crocodile River catchment, a water-stressed sub-catchment of the Incomati River catchment in South Africa. The research methodology consists of three parts. First, the spatial and temporal variation of the meteorological and hydrological drought severity and intensity over the catchment were evaluated. The Standardized Precipitation Index (SPI) was used to analyse the meteorological drought and the Standardized Runoff Index (SRI) was used for the hydrological drought. Second, the water deficit in the catchment during the drought period was computed using a simple water balance method. Finally, a groundwater model was constructed in order to assess the feasibility of using groundwater as an emergency source for drought impact mitigation. Results show that the low-rainfall areas are more vulnerable to severe meteorological droughts (lower and upper crocodile). Moreover, the most water stressed sub-catchments with high level of water uses but limited storage, such as the Kaap located in the middle catchment and the Lower Crocodile sub-catchments, are more vulnerable to severe hydrological droughts. The analysis of the potential groundwater use during droughts showed that a deficit of 97 Mm³ yr⁻¹ could be supplied from groundwater without considerable adverse impacts on the river base flow and groundwater storage. Abstraction simulations for different scenarios of extremely severe droughts reveal that it is possible to use groundwater to cope with the droughts in the catchment. However, local groundwater exploitation in Nelspruit and White River sub-catchment will cause large drawdowns (> 10 m) and high base flow reduction (> 20%). This case study shows that conjunctive water management of groundwater and surface water resources is necessary to mitigate the impacts of droughts

Groundwater as an emergency source for drought mitigation in the Crocodile River catchment, South Africa

Global climate change has received much attention worldwide in the scientific as well as in the political community, indicating that changes in precipitation, extreme droughts and floods may increasingly threaten many regions. Drought is a natural phenomenon that causes social, economical and environmental damage to society. In this study, we assess the drought intensity and severity and the groundwater potential to be used as a supplementary source ofwater to mitigate drought impacts in the Crocodile River catchment, a water-stressed sub-catchment of the Incomati River catchment in South Africa. The research methodology consists of three parts. First, the spatial and temporal variation ofthe meteorological and hydrological drought severity and intensity over the catchment were evaluated. The Standardized Precipitation Index (SPI) was used to analyse the meteorological drought and the Standardized Runoff Index (SRI) was used for the hydrological drought. Second, the water deficit in the catchment during the drought period was computed using a simple water balance method. Finally, a groundwater model was constructed in order to assess the feasibility of using groundwater as an emergency source for drought impact mitigation. Results show that the low-rainfall areas are more vulnerable to severe meteorological droughts (lower and upper crocodile). Moreover, the most water stressed subcatchments with high level of water uses but limited storage, such as the Kaap located in the middle catchment and the Lower Crocodile sub-catchments, are more vulnerable to severe hydrological droughts. The analysis of the potential groundwater use during droughts showed that a deficit of 97Mm3 yr−1 could be supplied from groundwater without considerable adverse impacts on the river base flow and groundwater storage. Abstraction simulations for different scenarios ofextremely severe droughts reveal that it is possible to use groundwater to cope with the droughts in the catchment. However, local groundwater exploitation in Nelspruit and White River sub-catchment will cause large drawdowns (> 10 m) and high base flow reduction (> 20 %). This case study shows that conjunctive water management of groundwater and surface water resources is necessary to mitigate the impacts of droughts

Serological analysis reveals differential antibody responses between TB patients and latently infected individuals from the TB endemic country of Mozambique.

Serological antibody profiling of tuberculosis (TB) patients and household contacts with latent TB infection (LTBI) could identify risk indicators of disease progression, and potentially also serve as an easily accessible diagnostic tool to discriminate between these two stages of Mycobacterium tuberculosis (Mtb) infection. Yet, despite significant efforts over many decades, neither application has yet fully materialised, and this is at least in part due to inconsistent and varying antibody profiles from different TB endemic regions. In this study, we conducted a retrospective exploratory analysis of serum antibodies in a cohort of active TB patients (ATB) and their interferon-gamma release assay (IGRA) positive household contacts (LTBI), as well as healthy controls (HC) from Mozambique, a country with a high TB burden from the Sub-Saharan region. Using several Mtb antigens as well as crude preparations of culture filtrate proteins (CFP) from Mtb and Bacille Calmette Guérin (BCG), we report that the most discriminatory response for TB and LTBI was observed for serum IgA antibodies to the MPT64 antigen, followed by IgG antibodies to Ag85B and CFP, with ATB patients having significantly higher levels than LTBI or BCG-vaccinated healthy controls. Conversely, sera from LTBI individuals had higher levels of IgG antibodies to the HBHA antigen than ATB. While our sample size (n = 21 for ATB, 18 for LTBI and 17 for HC) was too small to fully evaluate the diagnostic potential of these differing serological profiles, our study however preliminarily indicated high level of sensitivity (95%) and specificity (97%) of an ELISA MPT64-IgA test for discriminating TB from LTBI and healthy controls, supporting the notion that it alone, or possibly in combination with other antigens such as Ag85B or CFP could lead to development of an easily accessible diagnostic tool for TB