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Clinical Research on Infectious Diseases: State of the Art

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (25 July 2022) | Viewed by 34775

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Prof. Dr. Francisco J. Medrano

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Internal Medicine Service, Virgen del Rocio University Hospital, Institute of Biomedicine of Sevilla (IBiS), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública of Spain (CIBERESP), University of Seville, 41013 Seville, Spain
Interests: epidemiology; infectious diseases; infectious diseases immunity; Pneumocystis; chronic lung diseases; heart failure; Host Microbial Interactions; Microbiota
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Special Issue Information

Dear Colleagues,

Infectious diseases are a major cause of disability and death. Today, infections kill over 10 million people worldwide each year. In 2019, pneumonia and other lower respiratory tract infections were the deadliest group of communicable diseases and together ranked as the fourth leading cause of death. Meanwhile, in recent years, WHO reports have highlighted an overall concerning slow-down or plateauing of the research progress against infectious diseases like HIV, tuberculosis, and malaria. As of today, coronavirus disease 2019 (COVID-19) has tragically claimed more than 1.5 million lives. In addition, some infectious diseases increase the risk of developing specific non-communicable pathologies.

In the last years, due to the rapid development of molecular tools, much has been learned about the epidemiology and biology of infectious diseases. The pathogenesis of infections and new treatment options remain tremendously challenging research areas that need further investigations.

In this Special Issue, we aim to provide a comprehensive up-to-date account on the status of relevant research in the field and highlight the potential of new tools and approaches to solve some longstanding issues regarding infectious diseases, the microbiome, and host–pathogen interactions, including the role of infections in chronic non-infectious diseases.

This Special Issue welcomes contributions in the form of original research articles and reviews that focus on, but are not limited to, the following issues concerning infectious diseases:

Clinical and molecular epidemiology
Modes of transmission
Genomics, transcriptomics, and proteomics
Host–pathogen interactions, pathogenicity, and immunology
New findings related to drug discovery and treatment

Prof. Dr. Francisco J. Medrano
Guest Editor

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Keywords

Infections
infectious disease
chronic disease
epidemiology
molecular biology
immunology
pathogenesis
treatment
Host Microbial Interactions
Microbiota

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Published Papers (8 papers)

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Research

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15 pages, 274 KiB

Open AccessArticle

Comparative Analysis of the Incidence of Selected Sexually Transmitted Viral Infections in Poland in 2010–2015: A Retrospective Cohort Study

by Magda Orzechowska, Mateusz Cybulski, Elzbieta Krajewska-Kulak, Marek Sobolewski, Agnieszka Gniadek and Wiaczeslaw Niczyporuk

J. Clin. Med. 2022, 11(12), 3448; https://doi.org/10.3390/jcm11123448 - 15 Jun 2022

Cited by 1 | Viewed by 1716

Abstract

Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. The main aim of this study was to perform a comparative analysis of the incidence of sexually transmitted viral infections in 2010–2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and the National Institute of Public Health-National Research Institute and constituted information from the epidemiological surveillance system in Poland. We collected data on the incidence of the following diseases: genital herpes (HSV), genital warts, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The key groups with the highest risk of infection were young people between 20 and 29 years of age. The reported data on the incidence of genital herpes in Poland (n = 3378; 1.5/100,000) showed a downward trend, which does not coincide with global trends. Genital warts were the most frequent genital infections in Poland (n = 7980; 3.46/100,000), with significant regional variation. Over the analysed period, the situation of newly detected HIV infections seemed to be stable (n = 7144; 3.1/100,000). The incidence of these infections appeared to be highly correlated with urbanisation rates, which was not confirmed in the case of other analysed infections. The worsening epidemic situation with respect to sexually transmitted infections, the inefficiency of the current surveillance system and the reduction in funding for diagnosis and prevention, combined with inadequate legal solutions, make it necessary to undertake new legal and organisational measures aimed at improving the reproductive health in Poland in terms of sexually transmitted infections. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

10 pages, 460 KiB

Open AccessArticle

Clinical Implications of Multi-Drug Resistant Organisms’ Gastrointestinal Colonization in an Internal Medicine Ward: The Pandora’s Box

by Ombretta Para, Lorenzo Caruso, Eleonora Blasi, Caterina Pestelli, Giulia Pestelli, Stefano Guidi, Giacomo Fedi, Igor Giarretta, Fabrizio Maggi, Tiziana Ciarambino, Carlo Nozzoli and Francesco Dentali

J. Clin. Med. 2022, 11(10), 2770; https://doi.org/10.3390/jcm11102770 - 14 May 2022

Cited by 1 | Viewed by 1644

Abstract

Background: Multi-drug resistant organisms (MDRO) are an emerging health problem with an important impact on clinical outcome in Intensive Care Units (ICUs) and immunocompromised patients. Conversely, the role of MDRO colonization in Internal Medicine is less clear. The objective of our study is to evaluate the clinical impact (namely sepsis development, in-hospital and 30-days mortality, and re-hospitalization) of MDRO colonization in Internal Medicine. Methods: Patients admitted to our Internal Medicine Unit between January 2019 and March 2020 were potentially includible. Outcomes in patients with a positive rectal swab for MDRO (RS+) and in patients without a RS+ were compared. Results of the multivariate analyses were expressed as Odds Ratios (ORs) and the corresponding 95% Confidence Interval (CI). Results: In a cohort of 2147 patients, 77 patients with RS+ were consecutively identified; 377 patients with a rectal swab negative for MDRO were randomly selected from the same cohort (five for each patient with RS+). At the multivariate analysis, RS+ was associated with an increased risk of sepsis development during hospitalization (OR 4.18; 95% CI, 1.99–8.78) and with death or re-hospitalization at 30 days (OR 4.79; 95% CI, 2.79–8.23), whereas RS+ did not appear to be associated with death during hospitalization or need for ICU transfer. Conclusions: Our results suggest for the first time a prognostic role for RS+ in Internal Medicine. Thus, assessment of rectal swab at hospital admission appears useful even in this setting. However, larger prospective studies and a cost–benefit analysis are needed to confirm our preliminary findings. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

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15 pages, 263 KiB

Open AccessArticle

Comparative Analysis of the Incidence of Selected Sexually Transmitted Bacterial Infections in Poland in 2010–2015: A Retrospective Cohort Study

by Magda Orzechowska, Mateusz Cybulski, Elzbieta Krajewska-Kulak, Agnieszka Gniadek and Wiaczeslaw Niczyporuk

J. Clin. Med. 2022, 11(4), 998; https://doi.org/10.3390/jcm11040998 - 14 Feb 2022

Cited by 1 | Viewed by 1887

Abstract

Sexually transmitted infections are common infectious diseases. The main aim of this study was to perform a comparative analysis of the incidence of bacterial sexually transmitted infections in 2010–2015 in Poland, taking into account the administrative division of the country into provinces. This was a retrospective study. The analysed data came from the Centre for Health Information Systems of the Ministry of Health and constituted information being the epidemiological surveillance system in Poland. The analysis included data on the incidence of primary and secondary syphilis, gonorrhoea and non-gonococcal urethritis and genital infections. The overall incidence rates were disproportionately lower than European rates and those presented in studies from other countries. Young people, between 20 and 29 years of age, were the key groups at the highest risk of infection. The incidence rate of primary and secondary syphilis was lower in Poland than in Europe or America, but some regions, such as Mazovia and Lodz provinces, were found to have a higher incidence rate than other European rates. The reported incidence of gonorrhoea in Poland was also significantly lower compared with other countries, with a significantly higher number of infections in males than in females, and this was also one of the highest rates in EU countries. During the study period, the number of non-gonococcal genital infections systematically decreased, while in other countries of the European region, the incidence was among the highest of all sexually transmitted infections. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

10 pages, 849 KiB

Open AccessArticle

Evolution in Real-World Therapeutic Strategies for HIV Treatment: A Retrospective Study in Southern Italy, 2014–2020

by Nunzia Papa, Simona Cammarota, Anna Citarella, Luigi Atripaldi, Francesca F. Bernardi, Marianna Fogliasecca, Nello Giugliano, Ugo Trama and Micaela Spatarella

J. Clin. Med. 2022, 11(1), 161; https://doi.org/10.3390/jcm11010161 - 29 Dec 2021

Cited by 2 | Viewed by 1837

Abstract

Changes in HIV treatment guidelines over the last two decades reflect the evolving challenges in this field. Our study examined treatment change patterns throughout a 7-year period in a large Italian cohort of HIV patients as well as the reasons and direction of changes. Treatment-naïve and -experienced HIV patients managed by Cotugno Hospital of Naples between 2014 and 2020 were analyzed. During the period, the proportion of single-tablet regimen treatment sharply increased for the naïve and experienced patients. Regimens containing integrase strand transfer inhibitors rapidly replaced those containing protease inhibitor and non-nucleoside reverse transcriptase inhibitors. The use of the tenofovir alafenamide fumarate/emtricitabine backbone increased rapidly after its introduction in the Italian pharmaceutical market, making up 63.7 and 54.9% of all treatments in naïve and experienced patients, respectively, in 2020. The main reason for treatment changes was optimization and/or simplification (90.6% in 2018; 85.3% in 2019; 95.5 in 2020) followed by adverse effects and virological failure. Our real-world analysis revealed that the majority of treatment-naïve and treatment-experienced patients received antiretroviral drugs listed as preferred/recommended in current recommendations. Regimen optimization and/or simplification is a leading cause of treatment modification, while virologic failure or adverse effects are less likely reasons for modification in the current treatment landscape. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

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10 pages, 1018 KiB

Open AccessArticle

by Ji Yoon Han and Seung Beom Han

J. Clin. Med. 2021, 10(14), 3088; https://doi.org/10.3390/jcm10143088 - 13 Jul 2021

Cited by 6 | Viewed by 2220

Abstract

Although febrile seizures are the most common neurological complications of influenza, there are few studies comparing seizure characteristics and outcomes between patients with influenza and those with other respiratory virus (RV) infections. Medical records of pediatric patients presenting with seizures accompanied by fever, in whom RV infections were identified, were retrospectively reviewed to compare the characteristics and outcomes of seizures with fever due to influenza (n = 97) to those due to other RV infections (n = 113). Patients with influenza were older than those with other RV infections (p < 0.001), and 22.7% of them were aged ≥5 years. Seizure characteristics of complex febrile seizures were observed more frequently in patients with other RV infections than in those with influenza; however, the frequency of epilepsy was comparable between the two groups. For patients with influenza, children aged <5 years and those aged ≥5 years showed similar seizure characteristics and outcomes. Further neurological evaluations should not be based solely on patient age in children with influenza who experience late-onset seizures at ≥5 years of age. Long-term sequelae should be further investigated in these patients. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

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Review

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29 pages, 1288 KiB

Open AccessReview

An Overview of Healthcare Associated Infections and Their Detection Methods Caused by Pathogen Bacteria in Romania and Europe

by Sándor Szabó, Bogdan Feier, Denisa Capatina, Mihaela Tertis, Cecilia Cristea and Adina Popa

J. Clin. Med. 2022, 11(11), 3204; https://doi.org/10.3390/jcm11113204 - 4 Jun 2022

Cited by 35 | Viewed by 14020

Abstract

Healthcare-associated infections can occur in different care units and can affect both patients and healthcare professionals. Bacteria represent the most common cause of nosocomial infections and, due to the excessive and irrational use of antibiotics, resistant organisms have appeared. The most important healthcare-associated infections are central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site, soft tissue infections, ventilator-associated pneumonia, hospital acquired pneumonia, and Clostridioides difficile colitis. In Europe, some hospitalized patients develop nosocomial infections that lead to increased costs and prolonged hospitalizations. Healthcare-associated infection prevalence in developed countries is lower than in low-income and middle-income countries such as Romania, an Eastern European country, where several factors contribute to the occurrence of many nosocomial infections, but official data show a low reporting rate. For the rapid identification of bacteria that can cause these infections, fast, sensitive, and specific methods are needed, and they should be cost-effective. Therefore, this review focuses on the current situation regarding healthcare-associated infections in Europe and Romania, with discussions regarding the causes and possible solutions. As a possible weapon in the fight against the healthcare-associated infections, the diagnosis methods and tests used to determine the bacteria involved in healthcare-associated infections are evaluated. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

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41 pages, 570 KiB

Open AccessReview

Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)

by Emilio Bouza, Arístides de Alarcón, María Carmen Fariñas, Juan Gálvez, Miguel Ángel Goenaga, Francisco Gutiérrez-Díez, Javier Hortal, José Lasso, Carlos A. Mestres, José M. Miró, Enrique Navas, Mercedes Nieto, Antonio Parra, Enrique Pérez de la Sota, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Jorge Rodríguez-Roda, Gemma Sánchez Espín, Dolores Sousa, Carlos Velasco García de Sierra, Patricia Muñoz and Martha Kestler Show full author list Hide full author list

J. Clin. Med. 2021, 10(23), 5566; https://doi.org/10.3390/jcm10235566 - 26 Nov 2021

Cited by 13 | Viewed by 6018

Abstract

This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

Other

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11 pages, 553 KiB

Open AccessProtocol

Effectiveness of Bubble Continuous Positive Airway Pressure (BCPAP) for Treatment of Children Aged 1–59 Months with Severe Pneumonia and Hypoxemia in Ethiopia: A Pragmatic Cluster Randomized Controlled Clinical Trial

by Meseret Gebre, Kassa Haile, Trevor Duke, Md. Tanveer Faruk, Mehnaz Kamal, Md Farhad Kabir, Md. Fakhar Uddin, Muluye Shimelis, Bethelhem Solomon, Abebe Genetu Bayih, Alemseged Abdissa, Taye Tolera Balcha, Rahel Argaw, Asrat Demtse, Abate Yeshidenber, Abayneh Girma, Bitseat W. Haile, Tahmeed Ahmed, John D. Clemens and Mohammod Jobayer Chisti

J. Clin. Med. 2022, 11(17), 4934; https://doi.org/10.3390/jcm11174934 - 23 Aug 2022

Cited by 2 | Viewed by 2969

Abstract

Despite the beneficial effect of bubble continuous positive airway pressure (BCPAP) oxygen therapy for children with severe pneumonia under the supervision of physicians that has been shown in different studies, effectiveness trials in developing country settings where low-flow oxygen therapy is the standard of care are still needed. Thus, the aim of this study is to assess the effectiveness of bubble CPAP oxygen therapy compared to the WHO standard low-flow oxygen therapy among children hospitalized with severe pneumonia and hypoxemia in Ethiopia. This is a cluster randomized controlled trial where six district hospitals are randomized to BCPAP and six to standard WHO low-flow oxygen therapy. The total sample size is 620 per arm. Currently, recruitment of the patients is still ongoing where the management and follow-up of the enrolled patients are performed by general physicians and nurses under the supervision of pediatricians. The primary outcome is treatment failure and main secondary outcome is death. We anticipate to complete enrollment by September 2022 and data analysis followed by manuscript writing by December 2022. Findings will also be disseminated in December 2022. Our study will provide data on the effectiveness of BCPAP in treating childhood severe pneumonia and hypoxemia in a real-world setting. Full article

(This article belongs to the Special Issue Clinical Research on Infectious Diseases: State of the Art)

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