RESUMEN
OBJECTIVE: To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients. PATIENTS AND METHODS: The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death. RESULTS: The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness. CONCLUSIONS: The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.
Asunto(s)
COVID-19/diagnóstico , Galactosa/análogos & derivados , Aspergilosis Pulmonar Invasiva/diagnóstico , Mananos/sangre , Adulto , Anciano , COVID-19/complicaciones , COVID-19/virología , Ensayo de Inmunoadsorción Enzimática , Femenino , Galactosa/sangre , Humanos , Interleucina-6/metabolismo , Aspergilosis Pulmonar Invasiva/complicaciones , Tiempo de Internación , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , SARS-CoV-2/aislamiento & purificación , Factores SexualesRESUMEN
OBJECTIVE: Tobacco smoking remains a worldwide health issue, and the use of flavored varieties (maassel) embedded in glycerine, molasses, and fruit essence via shisha paraphernalia (waterpipe) is growing globally. 16S rRNA gene pyrosequencing was conducted on 18 different varieties representing 16 flavors and three brands in order to study the microbiota of maassel and find whether it contains pathogenic bacteria. MATERIALS AND METHODS: The samples were selected randomly from the most utilized brands within Albaha, Saudi Arabia as determined through a questionnaire of 253 smokers. In addition, ten-fold serially diluted samples were inoculated on blood agar, MacConkey agar, half-strength trypticase soy agar and malt agar for the enumeration of mesophilic microorganisms, coliforms, Bacillus, thermophilic bacteria, and fungi. RESULTS: A core microbiota was recognized consisting of three phyla (Firmicutes, Proteobacteria and Actinobacteria) and a total of 571 different species were identified including many pathogens, such as Mycobacterium riyadhense, M. chelonae, Shigella sonnei, S. flesneri, Klebsiella pneumoniae, Salmonella bongori, Coxiella burnetii, Acinetobacter spp., Staphylococcus haemolyticus, Streptococcus pseudopneumoniae, and Streptococcus sanguinis, showing the contamination of maassel. CONCLUSIONS: The present study suggests that flavored tobaccos are potentially infectious. However, further risk assessment is required to determine transmission occurrence.