Population analysis of Legionella pneumophila reveals a basis for resistance to complement-mediated killing

Legionella pneumophila is the most common cause of the severe respiratory infection known as Legionnaires’ disease. However, the microorganism is typically a symbiont of free-living amoeba, and our understanding of the bacterial factors that determine human pathogenicity is limited. Here we carried out a population genomic study of 902 L. pneumophila isolates from human clinical and environmental samples to examine their genetic diversity, global distribution and the basis for human pathogenicity. We find that the capacity for human disease is representative of the breadth of species diversity although some clones are more commonly associated with clinical infections. We identified a single gene (lag-1) to be most strongly associated with clinical isolates. lag-1, which encodes an O-acetyltransferase for lipopolysaccharide modification, has been distributed horizontally across all major phylogenetic clades of L. pneumophila by frequent recent recombination events. The gene confers resistance to complement-mediated killing in human serum by inhibiting deposition of classical pathway molecules on the bacterial surface. Furthermore, acquisition of lag-1 inhibits complement-dependent phagocytosis by human neutrophils, and promoted survival in a mouse model of pulmonary legionellosis. Thus, our results reveal L. pneumophila genetic traits linked to disease and provide a molecular basis for resistance to complement-mediated killing.

COVID-19 as a concomitant diagnosis and the emergencies behind COVID-19 mask – a real challenge that requires a multidisciplinary view of the patient

The etiological cause of Coronavirus infection, which has captured the attention of almost the whole world at the moment, is SARS-CoV2. The clinical picture of coronavirus infection varies from asymptomatic to severe respiratory infection with manifestations of respiratory failure, the development of respiratory distress syndrome and even death. Already in the first months of the coronavirus pandemic in the United States there was a serious decline in the number of patients seeking medical care in the Emergency Department (49.3%) compared to 2019. There is evidence of increased mortality during the pandemic, which causality cannot be directly or associated with coronavirus infection. Even in the context of a global pandemic, we must not forget all other diagnoses and conditions that exist as comorbidity, and emergency care must be provided without delay and delay.

Surveillance of Antibacterial Usage during the COVID-19 Pandemic in England, 2020

Changes in antibacterial prescribing during the COVID-19 pandemic were anticipated given that the clinical features of severe respiratory infection syndrome caused by SARS-CoV-2 mirror bacterial respiratory tract infections. Antibacterial consumption was measured in items/1000 population for primary care and in Defined Daily Doses (DDDs)/1000 admissions for secondary care in England from 2015 to October 2020. Interrupted time-series analyses were conducted to evaluate the effects of the pandemic on antibacterial consumption. In the community, the rate of antibacterial items prescribed decreased further in 2020 (by an extra 1.4% per month, 95% CI: −2.3 to −0.5) compared to before COVID-19. In hospitals, the volume of antibacterial use decreased during COVID-19 overall (−12.1% compared to pre-COVID, 95% CI: −19.1 to −4.4), although the rate of usage in hospitals increased steeply in April 2020. Use of antibacterials prescribed for respiratory infections and broad-spectrum antibacterials (predominately ‘Watch’ antibacterials in hospitals) increased in both settings. Overall volumes of antibacterial use at the beginning of the COVID-19 pandemic decreased in both primary and secondary settings, although there were increases in the rate of usage in hospitals in April 2020 and in specific antibacterials. This highlights the importance of antimicrobial stewardship during pandemics to ensure appropriate prescribing and avoid negative consequences on patient outcomes and antimicrobial resistance.

Mesenchymal Stem Cell Therapy For COVID-19; Is A New Challenge Review

"Coronavirus" is the word that absolutely isn't forgotten by everybody who lives in the first half of the twenty-first century. COVID19, as a pandemic, has driven numerous researchers from various biomedical fields to discover arrangements or therapies to deal with the pandemic. Nonetheless, no standard treatment for this infection has been found to date. Presumably, preventing the acute severe respiratory infection type of COVID-19 as the most risky period of this disease can be useful for the therapy and decrease of the death rate. In such manner, mesenchymal stem cells (MSCs)-based immunomodulation treatment has been proposed as a reasonable restorative methodology and a several clinical studies have started. Recently, MSCs as indicated by their immunomodulatory and regenerative properties stand out in clinical trials. After the intravenous transplantation of MSCs, a large population of cells gathers in the lung, which they close by immunomodulatory impact could protect alveolar epithelial cells, recover the respiratory microenvironment, prevent pneumonic fibrosis, and cure lung dysfunction. Given the vulnerabilities here, we checked on detailed clinical preliminaries and theories to give helpful data to scientists and those keen on stem cell therapy.In this study, we considered this new way to deal with improve patient's immunological reactions to COVID-19 utilizing MSCs and talked about the parts of this proposed treatment. Nonetheless, right now, there are no affirmed MSC-based methodologies for the anticipation or potentially treatment of COVID-19 patients however clinical preliminaries progressing.

Lessons learned from COVID-19 outbreaks profile in combination with pathology, diagnosis, treatment and vaccines

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which may lead to severe respiratory infection. Since December 2019, the first COVID-19 case was detected in Wuhan, Hubei Province, China. The virus has been spread worldwide, and many countries are still struggling with disease control. Therefore, this revision would provide experience accumulated and the lessons learned by China in the pandemic. The current work reviewed the basic information about COVID-19 in the aspects of pathology, diagnosis, treatment, prevention, and the major pandemic outbreaks in China. By summarizing and analyzing the measurements taken by the Chinese government and their corresponding outcomes on public health, it determined the progress made on the policies and their efficiency in the control of pandemics. With the sharing of these lessons, other countries can learn from establishing the COVID-19 surveillance system in China that would support their struggle on domestic public health.

Treatment of COVID-19 patients using plasma therapy: Letter to Editor

The symptoms of COVID-19, caused by the newly known type of coronavirus, vary widely from asymptomatic, mild to severe respiratory infection leading to hospitalization or death of patients. To date, no specific drug has been reported for the treatment of patients affected by this virus. One of the approaches adopted for the treatment of this disease is the use of plasma therapy, which contains antibodies against the virus. Following of the plasma therapy have not been reported any serious side effects. Currently, the numbers of these studies are limited, and evaluation of the larger population studies can provide stronger evidence for treating physicians about the effectiveness of this therapeutic approach.

Severe respiratory disease caused by human respiratory syncytial virus impairs language learning during early infancy

Human respiratory syncytial virus infection is a leading cause of pediatric morbidity and mortality. A previous murine study showed that during severe acute respiratory infections the virus invades the central nervous system, and that infected animals evolve with long-lasting learning difficulties associated with long-term potentiation impairment in their hippocampus. We hypothesized here that human infants who presented a severe episode of respiratory syncytial virus infection before 6 months of age would develop long-term learning difficulties. We measured the acquisition of the native phoneme repertoire during the first year, a milestone in early human development, comprising a reduction in the sensitivity to the irrelevant nonnative phonetic information and an increase in the sensitivity to the information relevant for the native one. We found that infants with a history of severe respiratory infection by the human respiratory syncytial virus presented poor distinction of native and nonnative phonetic contrasts at 6 months of age, and remained atypically sensitive to nonnative contrasts at 12 months, which associated with weak communicative abilities. Our results uncover previously unknown long-term language learning difficulties associated with a single episode of severe respiratory infection by the human respiratory syncytial virus, which could relate to memory impairments.

In silico trial to test COVID-19 candidate vaccines: a case study with UISS platform

Background SARS-CoV-2 is a severe respiratory infection that infects humans. Its outburst entitled it as a pandemic emergence. To get a grip on this outbreak, specific preventive and therapeutic interventions are urgently needed. It must be said that, until now, there are no existing vaccines for coronaviruses. To promptly and rapidly respond to pandemic events, the application of in silico trials can be used for designing and testing medicines against SARS-CoV-2 and speed-up the vaccine discovery pipeline, predicting any therapeutic failure and minimizing undesired effects. Results We present an in silico platform that showed to be in very good agreement with the latest literature in predicting SARS-CoV-2 dynamics and related immune system host response. Moreover, it has been used to predict the outcome of one of the latest suggested approach to design an effective vaccine, based on monoclonal antibody. Universal Immune System Simulator (UISS) in silico platform is potentially ready to be used as an in silico trial platform to predict the outcome of vaccination strategy against SARS-CoV-2. Conclusions In silico trials are showing to be powerful weapons in predicting immune responses of potential candidate vaccines. Here, UISS has been extended to be used as an in silico trial platform to speed-up and drive the discovery pipeline of vaccine against SARS-CoV-2.

Extracorporeal life support

Using the narrative about a child with severe respiratory infection and septic shock, this chapter illustrates important learning points around both veno-arterial and veno-venous extracorporeal life support (ECLS) in children. Several important considerations such as patient selection, anticoagulation, management of bleeding complications, and respiratory rehabilitation on ECLS are discussed. The chapter includes a brief discussion of other forms of mechanical circulatory support (e.g. ventricular assist device) and early mobilization while on ECLS. The chapter highlights difficulties with prognostication, ethical decision-making dilemmas in patients on longer-term ECLS support, and provides a useful framework for decision-making.