Infectious Disorders - Drug Targets (Formerly Current Drug Targets - Infectious Disorders) - Volume 23, Issue 3, 2023

Background: Acrophialophora species is an infrequent human opportunistic pathogen. It is widely distributed in temperate as well as tropical regions. Here, we present a rare case of fungal keratitis caused by A. fusispora. Case Presentation: A 26-year male driver presented with pain, watering, redness, whitish discoloration, and blurring of vision in the left eye for the last 3-4 days. Upon examination, he had a dry-looking corneal ulcer with infiltration and satellite lesions. Corneal scrapings were positive for septate fungal hyphae by Gram staining and KOH mount. After five days, the growth observed was presumptively identified as genus Acrophialophora and finally identified as Acrophialophora fusispora by genetic sequencing. The patient failed to respond medically and was planned for therapeutic keratoplasty. Discussion: To date, four cases of ocular involvement due to Acrophialophora have been described. Amongst which one case was associated with an immunocompromised state. Three of the cases were resolved medically, while one required therapeutic keratoplasty, indicating possible strong pathogenicity to the eye. Conclusion: As Acrophialophora seems to have a predilection for eye infections, an early diagnosis with timely appropriate treatment is the best way to restore the normal vision of a patient.

Introduction: Healthcare-associated urinary tract infection (UTI) represents a significant health problem, especially in infants and young children. The most common pathogen associated with this infection is Escherichia coli (E. coli). Objective: The present study aimed to detect the frequency of virulence genes among clinical isolates of E. coli isolated from healthcare-associated urinary tract infections in children and the correlation between these virulence genes and the presence of the blaCTX gene. Methods: The study included one hundred clinical isolates of E. coli isolated from healthcareassociated urinary tract infections in children in intensive care units. The isolates were subjected to antibiotics sensitivity by disc diffusion method and detection of extended-spectrum beta-lactamase by double disc diffusion method. In addition, multiplex polymerase chain reaction (PCR) was used to detect some virulence genes, and PCR was used to detect the blaCTX-M gene. Results: E. coli producing ESBL by double discs method was identified in 74 isolates. blaCTX-M gene detection by PCR was identified among 38 isolates representing 51.4% of ESBL-producing E. coli. There was a significant association between ESBL and blaCTX-M Gene, P = 0.0001. The frequency of the studied virulence genes by multiplex PCR in the isolated E. coli was 66% for the Fim gene, 75% for the Aer gene, 68% for the FliC gene, 53% for each of IucD gene and Usp gene, 40% for pap gene, 35% for each of AFA and ironN genes and 17% for sfa gene. None of the isolated E. coli had the Cdt gene. There was a significant association between the presence of the FimH gene (P = 0.0001), Pap gene (P = 0.05), sfa (P = 0.026), Afa gene (P = 0.018), and aer gene (P = 0.035) and the presence of the blaCTX-M gene in the isolated E. coli. Conclusion: The present study highlights the presence of virulence genes and blaCTX-M gene in uropathogenic E. coli isolated from pediatric patients with healthcare-associated urinary tract infections. There was an association between the blaCTX-M gene and virulence genes FimH, pap, sfa, Afa, and aer. Various distributions of the studied genes with a high frequency of fimbria are flic genes. Moreover, the ESBL had high frequency in E. coli with the presence of blaCTX-M in about one-third of the isolates.

Background: This cross-sectional study was conducted on 232 infants aged <1 month with proven UTI admitted to three major teaching hospitals for the period 2010-2018 to assess clinical, demographic, and laboratory findings of urinary tract infection in this age group. Methods: All information was extracted from the medical records. Urinary tract infection was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from a catheterized or suprapubic aspiration or greater than 100,000 colony-forming units per milliliter from a midstream, clean-catch sample. Results: The most common pathogen isolated was E. coli (78.4%), followed by Enterobacter and Klebsiella, accounting for 12.1 and 4.7% respectively. The main presenting clinical manifestation was jaundice, which was found in 54.7% of cases; it was followed by restlessness (45.6%) and fever (40%). Conclusion: During infancy, the signs and symptoms of UTI are often nonspecific and although urine culture is a gold standard diagnostic tool specimen collection is challenging and urine contamination is common in children, therefore it makes the diagnosis difficult. UTI in infants may indicate underlying genitourinary abnormalities; therefore, appropriate diagnosis and immediate initiation of antibiotic therapy are crucial to decrease long-term complications like renal scarring. According to our study, the most common clinical features were jaundice, restlessness, and fever, therefore it is suggested that urine culture should be performed for all infants presenting with these signs and symptoms.

Objective: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of drugs widely used around the world for their analgesic, antipyretic and anti-inflammatory effect, but still have many limitations due to their side effects. So, these lead to the development of a new approach to search for a new product from natural plants that have similar therapeutic effects without common side effects like gastrointestinal ulcers. Methods: The anti-inflammatory effect of β-amyrin palmitate (1) as triterpene and 1,7-bis (4- hydroxyphenyl) hept-4-en-3-one (2) as diarylheptanoid, isolated from Pellacalyx axillaris was studied by molecular docking to find the probability of binding position and binding strength of new compounds with particular Prostaglandin G/H synthase 2 (PDB ID: 1CX2). In vivo acute anti-inflammatory activity of the isolated compounds (1 and 2) was evaluated in rats using the egg-white induced edema model of inflammation in a dose correspondent to 3 mg/Kg of Diclofenac Sodium. Results: The tested isolated compounds showed a high activity to inhibit the swelling in paw edema and their anti-inflammatory effect began shortly after the injection of the egg white and continued to the end of the experiment in comparison to the reference and control. Conclusion: The isolated compounds show a rapid onset of action and a very potent effect, this may be related to their suitable acidity and may have perfect hydrophilic –lipophilic balance. This is the first study of anti-inflammatory effect using Paw edema model and molecular docking.

Background: Clostridium sporogenes is reported rarely in literature. Reports from the skin and soft tissue infections are even less, more so in immunocompetent patients. Case Presentation: Two skin and soft tissue infections with C. sporogenes in immunocompetent patients have been presented in this study. One of the cases was following an electrical burn wound, and the other was following a bedsore. Both patients expired despite antibacterial treatment and debridement. Discussion and Conclusion: C. sporogenes had usually been reported after trauma particularly after penetrating and deep wound infection. More attention should be given to these patients so that the infection can be treated and diagnosed early in suspected anaerobic infections like Clostridium species.

This review focuses on the applications of chitosan derivatives towards vaccine delivery for their role as adjuvants. Adjuvants have been used as one of the key components in modern-day vaccines to enhance the immune response or as a drug delivery carrier. Generally, vaccines are administered to protect the host against harmful disease-causing infectious pathogens. The area of vaccine delivery is reaching new heights day by day with the evolution of the strategies and tools used for vaccine development. Currently, the vaccines have created a great impact by saving the lives of many human beings. A narrative review of all the relevant papers were conducted across the databases of PubMed and ScienceDirect. Based on the various studies performed in various animal models, the chitosan nanoparticle (CNP) was reported to be a safe and effective adjuvant candidate for a wide range of prophylactic and therapeutic vaccines that require a balanced and potent stimulation of both the cellular and humoral responses, due to its natural origin and good biocompatibility, as well as its lack of lethal toxicity to humans and animals. There was a tremendous shift in the paradigm of vaccine drug delivery from the use of conventional to novel adjuvants. For the development of a promising vaccine delivery system, adjuvant plays an irreplaceable role, but the adjuvants have not been utilized to their full potential because of the limited number of approved adjuvants. Hence the search for novel adjuvants is highly increased. In the list of versatile adjuvants, chitosan derivatives occupy an important place because of their huge benefits. The chitosan derivatives are obtained by the chemical modification of chitosan. The studies performed on various animal models validate the potential use of chitosan dervatives as adjuvants for vaccine delivery.

Background: Tuberculosis (TB) is one of the fatal infectious diseases, making it one of the causes of death in the infectious mortality strata, and it is of prime concern globally. It is spread by a causative agent called Mycobacterium tuberculosis (Mtb) which gets ingressed within the host cells. The current clinical interventions have been associated with various limitations, such as a long treatment regimen (6 months), low lipophilicity of drugs to penetrate the bacterial cell, associated side effects and emerging incidence of multiple drug-resistant strains. Despite these limitations, Isoniazid (INH), a first-line agent, remains a drug of choice to date due to its effectiveness. However, INH is associated with poor penetration into the bacteria cell wall and ultimately leads to the low therapeutic distribution of drugs into the lungs. Methods: Studies have shown that the structural modifications of INH by introducing more lipophilic moiety could lead to its better penetration into the bacterial cell wall resulting in better anti-TB activities. Results: This review updates various studies conducted on INH derivatives as anti-tubercular (Anti-TB) agents, including in silico and preclinical investigations. In addition, updates on clinical investigations of novel anti-TB molecules have also been highlighted. Conclusion: The article focuses on the structural modification of various INH derivatives reported, including the in vitro studies and molecular modelling preclinical and clinical investigations of various INH derivatives.

The perspective of the people of Sub-Saharan Africa (SSA) toward both traditional and western healthcare systems varies. The goal of the current study is to examine the SSA's unique skin disease health care system. This study comprises numerous research that sought to examine how the general public feels about the SSA's current healthcare system. In this review, common skin conditions, such as atopic dermatitis, buruli ulcers, dermatophytosis, and scabies, are addressed. According to this report, government agencies must pay particular attention to skin illnesses in SSA and raise public awareness. Availability of medical care, socioeconomic factors, degree of education, and other factors influence patients’ attitudes toward traditional and western health care differently in different geographic areas. Facts suggest that self-medication is the preference of the majority of patients before seeking dermatological care. The present study concludes that the magnitude of skin diseases is neglected or underestimated in many regions of SSA. Also, western healthcare facilities of many regions of SSA are not up to the mark. The present study recommends that proper access to the health care system and awareness about skin diseases through various government programs can be helpful in the regulation of skin disorders among people of SSA.