Bacterial biofilms predominate in both acute and chronic human lung infections

BackgroundA basic paradigm of human infection is that acute bacterial disease is caused by fast growing planktonic bacteria while chronic infections are caused by slow-growing, aggregated bacteria, a phenomenon known as a biofilm. For lung infections, this paradigm has been thought to be supported by observations of how bacteria proliferate in well-established growth media in the laboratory—the gold standard of microbiology.ObjectiveTo investigate the bacterial architecture in sputum from patients with acute and chronic lung infections.MethodsAdvanced imaging technology was used for quantification and direct comparison of infection types on fresh sputum samples, thereby directly testing the acute versus chronic paradigm.ResultsIn this study, we compared the bacterial lifestyle (planktonic or biofilm), growth rate and inflammatory response of bacteria in freshly collected sputum (n=43) from patient groups presenting with acute or chronic lung infections. We found that both acute and chronic lung infections are dominated by biofilms (aggregates of bacteria within an extracellular matrix), although planktonic cells were observed in both sample types. Bacteria grew faster in sputum from acute infections, but these fast-growing bacteria were enriched in biofilms similar to the architecture thought to be reserved for chronic infections. Cellular inflammation in the lungs was also similar across patient groups, but systemic inflammatory markers were only elevated in acute infections.ConclusionsOur findings indicate that the current paradigm of equating planktonic with acute and biofilm with chronic infection needs to be revisited as the difference lies primarily in metabolic rates, not bacterial architecture.

Citizen-science surveillance of triazole-resistant Aspergillus fumigatus in UK residential garden soils

Compost is an ecological niche for Aspergillus fumigatus due to its role as a decomposer of organic matter and its ability to survive the high temperatures associated with the composting process. Subsequently, composting facilities are associated with high levels of A. fumigatus spores that are aerosolised from compost and cause respiratory illness in workers. In the UK, gardening is an activity enjoyed by individuals of all ages and it is likely that they are being exposed to A. fumigatus spores when handling commercial compost or compost they have produced themselves. In this study, 246 citizen scientists collected 509 soil samples from locations in their garden in the UK, from which were cultured 5,174 A. fumigatus isolates. Of these isolates, 736 (14%) were resistant to tebuconazole: the third most-sprayed triazole fungicide in the UK, which confers cross-resistance to the medical triazoles used to treat A. fumigatus lung infections in humans. These isolates were found to contain the common resistance mechanisms in the A. fumigatus cyp51A gene TR 34 /L98H or TR 46 /Y121F/T289A, and less common resistance mechanisms TR 34 , TR 53 , TR 46 /Y121F/T289A/S363P/I364V/G448S and (TR 46 ) 2 /Y121F/M172I/T289A/G448S. Regression analyses found that soil samples containing compost were significantly more likely to grow susceptible and tebuconazole-resistant A. fumigatus than those that did not, and that compost samples grew significantly higher numbers of A. fumigatus than other samples. Importance These findings highlight compost as a potential health hazard to individuals with pre-disposing factors to A. fumigatus lung infections, and a potential health hazard to immunocompetent individuals who could be exposed to sufficiently high numbers of spores to develop infection. Furthermore, this study found that 14% of A. fumigatus isolates in garden soils were resistant to an agricultural triazole, which confers cross-resistance to medical triazoles used to treat A. fumigatus lung infections. This raises the question of whether compost bags should carry additional health warnings regarding inhalation of A. fumigatus spores, whether individuals should be advised to wear facemasks whilst handling compost or whether commercial producers should be responsible for sterilising compost before shipping. The findings support increasing public awareness of the hazard posed by compost and investigating measures that can be taken to reduce the exposure risk.

Implementation Of Clean and Healthy Living Behavior Efforts to Prevent the Spread of Covid 19 Padang Sambian Kelod Village

COVID-19 is a disease caused by a new type of coronavirus (SARS-CoV-2), which has now become a global health problem that can cause respiratory system disorders, ranging from mild symptoms such as flu to lung infections. The most effective effort currently being made is to create community awareness starting from the household level, namely through the implementation of Clean and Healthy Life Behavior (PHBS). PHBS culture is very influential in preventing the transmission of the COVID-19 virus. Through this KKN activity, it will be practiced as well as empowered by the community in implementing PHBS efforts. The data collection technique in this community service activity is in the form of socialization using interview and documentation techniques. This activity is expected to be entrenched in the community so that it can become a new habit that is not only valid during the COVID-19 pandemic but will be sustainable in the order of daily life. Increased community participation in PHBS, where people are able/empowered to make cloth masks to avoid splashing droplets when talking/coughing/sneezing and making natural hand sanitizers made from betel leaf and lime, so that they can suppress/control cases of illness and death due to COVID-19.

SD-UNet: A Novel Segmentation Framework for CT Images of Lung Infections

Due to the outbreak of lung infections caused by the coronavirus disease (COVID-19), humans have to face an unprecedented and devastating global health crisis. Since chest computed tomography (CT) images of COVID-19 patients contain abundant pathological features closely related to this disease, rapid detection and diagnosis based on CT images is of great significance for the treatment of patients and blocking the spread of the disease. In particular, the segmentation of the COVID-19 CT lung-infected area can quantify and evaluate the severity of the disease. However, due to the blurred boundaries and low contrast between the infected and the non-infected areas in COVID-19 CT images, the manual segmentation of the COVID-19 lesion is laborious and places high demands on the operator. Quick and accurate segmentation of COVID-19 lesions from CT images based on deep learning has drawn increasing attention. To effectively improve the segmentation effect of COVID-19 lung infection, a modified UNet network that combines the squeeze-and-attention (SA) and dense atrous spatial pyramid pooling (Dense ASPP) modules) (SD-UNet) is proposed, fusing global context and multi-scale information. Specifically, the SA module is introduced to strengthen the attention of pixel grouping and fully exploit the global context information, allowing the network to better mine the differences and connections between pixels. The Dense ASPP module is utilized to capture multi-scale information of COVID-19 lesions. Moreover, to eliminate the interference of background noise outside the lungs and highlight the texture features of the lung lesion area, we extract in advance the lung area from the CT images in the pre-processing stage. Finally, we evaluate our method using the binary-class and multi-class COVID-19 lung infection segmentation datasets. The experimental results show that the metrics of Sensitivity, Dice Similarity Coefficient, Accuracy, Specificity, and Jaccard Similarity are 0.8988 (0.6169), 0.8696 (0.5936), 0.9906 (0.9821), 0.9932 (0.9907), and 0.7702 (0.4788), respectively, for the binary-class (multi-class) segmentation task in the proposed SD-UNet. The result of the COVID-19 lung infection area segmented by SD-UNet is closer to the ground truth compared to several existing models such as CE-Net, DeepLab v3+, UNet++, and other models, which further proves that a more accurate segmentation effect can be achieved by our method. It has the potential to assist doctors in making more accurate and rapid diagnosis and quantitative assessment of COVID-19.

Combining Ivacaftor and Intensive Antibiotics Achieves Limited Clearance of Cystic Fibrosis Infections

Recent work shows that people with cystic fibrosis (CF) and chronic lung infections generally remain persistently infected after treatment with drugs that target the CF physiological defect (called CFTR modulators). However, changes produced by modulators could increase antibiotic efficacy.

PENGABDIAN MASYARAKAT STIKES WIDYAGAMA HUSADA MALANG DALAM PERCEPATAN VAKSINASI COVID-19 DENGAN KUNJUNGAN RUMAH DI WILAYAH KERJA PUSKESMAS KARANGPLOSO KABUPATEN MALANG

ABSTRAKVirus Corona atau severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) adalah virus yang menyerang sistem pernapasan. Penyakit karena infeksi virus ini disebut COVID-19. Virus Corona bisa menyebabkan gangguan ringan pada sistem pernapasan, infeksi paru-paru yang berat, hingga kematian. Pandemi COVID-19 telah berdampak merugikan masyarakat, tidak hanya kesakitan dan kematian tetapi juga pada berbagai bidang sosial dan ekonomi. Vaksinasi atau imunisasi bertujuan untuk membuat sistem kekebalan tubuh seseorang mampu mengenali dan dengan cepat melawan bakteri atau virus penyebab infeksi. Tujuan yang ingin dicapai dengan pemberian vaksin COVID-19 adalah menurunnya angka kesakitan dan angka kematian akibat virus ini. Pengabdian masyarakat yang dilakukan oleh relawan Pengabdian Masyarakat STIKES Widyagama Husada ini memiliki tujuan yaitu untuk membantu percepatan vaksinasi di seluruh wilayah di Kabupaten Malang khususnya vaksinasi pada masyarakat cakupan wilayah Puskesmas Karangploso. Kegiatan Pengabdian Masyarakat ini dilakukan dengan pemberian dosis pertama dan dosis kedua. Pemberian vaksinasi dilakukan dengan kunjungan rumah dan sasarannya adalah lansia. Kolaborasi Abdimas STIKES Widyagama Husada Malang dengan tenaga medis di Puskesmas dan kader terjalin dengan baik, dengan indikator pelaksanaan kegiatan berjalan lancar dan tertib. Rangkaian prosedur kegiatan vaksinasi sebagai upaya percepatan vaksin covid-19 berjalan sesuai prosedur. Kata kunci: covid 19; vaksinasi; pengabdian masyarakat. ABSTRACTCorona virus or severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) is a virus that attacks the respiratory system. The disease caused by this viral infection is called COVID-19. Corona virus can cause mild disorders of the respiratory system, severe lung infections, and even death. The COVID-19 pandemic has had a detrimental impact on society, not only in illness and death but also in various social and economic fields. Vaccination or immunization aims to make a person's immune system able to recognize and quickly fight bacteria or viruses that cause infection. The goal to be achieved by giving the COVID-19 vaccine is to reduce morbidity and mortality due to this virus. This community service carried out by the STIKES Widyagama Husada Community Service volunteer has a goal, namely to help accelerate vaccination in all areas in Malang Regency, especially vaccinations in the community coverage of the Karangploso Health Center area. This Community Service activity is carried out by giving the first dose and the second dose. Vaccination is carried out by home visits and the target is the elderly. The collaboration of Abdimas STIKES Widyagama Husada Malang with medical personnel at the Puskesmas and cadres is well established, with indicators that the implementation of activities runs smoothly and in an orderly manner. The series of procedures for vaccination activities as an effort to accelerate the Covid-19 vaccine run according to the procedure. Keywords: covid 19; vaccination; community service

Immunometabolites Drive Bacterial Adaptation to the Airway

Pseudomonas aeruginosa and Staphylococcus aureus are both opportunistic pathogens that are frequently associated with chronic lung infections. While bacterial virulence determinants are critical in initiating infection, the metabolic flexibility of these bacteria promotes their persistence in the airway. Upon infection, these pathogens induce host immunometabolic reprogramming, resulting in an airway milieu replete with immune-signaling metabolites. These metabolites are often toxic to the bacteria and create a steep selection pressure for the emergence of bacterial isolates adapted for long-term survival in the inflamed lung. In this review, we discuss the main differences in the host immunometabolic response to P. aeruginosa and S. aureus, as well as how these pathogens alter their own metabolism to adapt to airway metabolites and cause persistent lung infections.

The Pro-Inflammatory Effect of Staphylokinase Contributes to Community-Associated Staphylococcus Aureus Pneumonia

Pneumonia caused by community-associated Staphylococcus aureus (CA-SA) has high morbidity and mortality. Pathogens can express a variety of virulence factors to promote infection. The game between the host immune system and pathogens determines the degree of infection and tissue damage, but its mechanism has not been well explored. In this study, we found that staphylokinase (SAK) is highly expressed in CA-SA lineage ST398 and promotes lung infection in both wild-type and cathelicidins-related antimicrobial peptide CRAMP knockout (CRAMP−/−) mice. Furthermore, our results showed that SAK can activate the host's innate immune inflammatory response. Importantly, SAK can promote the activation of NLRP3 inflammasome by increasing the production of ROS. This may be one of the important mechanisms of SAK aggravating CA-SA pneumonia after excluding its function of promoting fibrinolysis and neutralizing CRAMP. Our results emphasize the importance of controlling inflammation in acute lung infections, and also provides new insights into the pathogenesis of highly virulent CA-SA.