Mikrobiyol Bul
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In spite of the improvements in the clinical management of solid organ transplant (SOT) recipients provided by immunosuppresion and universal prophylaxis, human cytomegalovirus (CMV) infections continue to be one of the most leading causes of morbidity and mortality. Cell-mediated immunity specific to CMV (CMV-CMI) plays an important role in the control of CMV replication. Therefore, monitoring of CMV-specific T-cell response can be used to predict individuals at increased risk of CMV disease. ⋯ In this patient the level of CMV-CMI in the 6th month (CD4(+)T + CD8(+)T= 0.9%), have reached higher values than the values obtained before the transplantation (CD4(+) T + CD8(+) T= 0.5%). The viremia was cleared spontaneously in this patient and no antiviral therapy was required. In conclusion, our results suggested that pretransplant and posttransplant monitoring of CMV-specific T-cell responses might be helpful as well as viral load in the clinical management of CMV infection in SOT patients.
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Zika virus (ZIKV) is an enveloped RNA virus that belongs to the Flaviviridae family. Although more than 60 years have passed since the discovery and first reported human cases of the virus, only a small number (< 10) of cases had been encountered in the literature until the last 10 years. Zika virus was known as a virus which caused sporadic infections and was confined to Africa and Asia along a narrow equatorial line. ⋯ In addition, concurrent with outbreaks in 2013 in French Polynesia and in 2015 in Brazil, there have been significant rises reported in the incidence of some autoimmune and neurodevelopmental disorders, including Guillain-Barre syndrome and microcephaly; these reports have caused considerable international concern. There are many points that are still unclear about ZIKV, including: (1) intrauterine transmission risk, frequency, and effects of the infection on fetal development; (2) the probability of perinatal transmission and if so the possible risks; (3) association with autoimmune and neurological diseases, and presence of long-term sequelae risks after infection; (4) possible routes of transmission other than mosquito bites, such as sexual contact, blood transfusion, and other body fluids (saliva, semen, or urine); (5) presence of reservoir(s) and different mosquito vectors; (6) diagnostic difficulties including cross reactivity in serological tests and standardization of testing procedures; (7) severity of the infection in immunocompromised patients; and (8) the potential effectiveness of antiviral therapy or preventive vaccines. In this review, updated information and recommendations regarding ZIKV outbreaks and risks, and the epidemiology, diagnosis and characteristics of ZIKV infections, are summarized in light of the most recent literature.
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Skin and soft tissue infections (SSTIs) may represent a wide clinical spectrum from cellulitis to high-mortality associated necrotizing fasciitis. Limitations in therapy due to the multiple drug resistance, leads to increase in the morbidity and mortality rates, especially in complicated SSTIs such as diabetic foot, decubitus, and surgical wound infections. Therefore, alternative treatment strategies other than antibiotics are needed in appropriate clinical conditions. "Bacteriophage therapy", which is an old method and has been used as part of standard treatment in some countries such as Georgia and Russia, has again become popular worldwide. ⋯ All MRSA (3/3) strains were susceptible to ENKO, SES, Fersisi and Sb phage cocktails, while all A.baumannii isolates (9/9) were susceptible to Φ5 and Φ7 phages. However, two E.coli, one K. pneumoniae and one P.aeruginosa strains were resistant to the all phage preparations tested. Although the clinical use of phages has not been approved yet, except a few Eastern European countries, this study exhibits the potential use of the topical bacteriophage therapy in the treatment of complicated SSTIs caused by MDR pathogens with limited treatment options, such as diabetic foot, decubitus, and surgical wound infections.