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Cytokines, chemokines and growth factors present different expression profiles related to the prognosis of COVID-19. We analyzed clinical parameters and assessed the expression of these biomarkers in patients with different disease severity in a hospitalized Peruvian cohort to determine those associated with worse prognosis. We measured anti-spike IgG antibodies by ELISA and 30 cytokines by quantitative suspension array technology in 123 sera samples. We analyzed differences between patients with moderate, severe and fatal COVID-19 by logistic regression at baseline and in longitudinal samples. Significant differences were found among the clinical parameters: hemoglobin, neutrophils, lymphocytes and C-reactive protein (CRP), creatinine and D-dimer levels. Higher anti-spike IgG antibody concentrations were associated to fatal patient outcomes. At hospitalization, IL-10, IL-6, MIP-1α, GM-CSF, MCP-1, IL-15, IL-5, IL1RA, TNFα and IL-8 levels were already increased in fatal patients´ group. Meanwhile, multivariable analysis revealed that increased GM-CSF, MCP-1, IL-15, and IL-8 values were associated with fatal outcomes. Moreover, longitudinal analysis identified IL-6 and MCP-1 as the main risk factors related to mortality in hospitalized COVID-19 patients. In this Peruvian cohort we identified and validated biomarkers related to COVID-19 outcomes. Further studies are needed to identify novel criteria for stratification of SARS-CoV-2 infected patients at hospital entry.

The COVID-19 pandemic exposed vulnerabilities in health systems and revealed variations in immune responses across populations worldwide. This study examined the kinetics of IgG and IgM antibodies against S1 and receptor-binding domain (RBD) proteins in hospitalized Peruvian patients prior to vaccination. A total of 157 serological samples were collected from 44 hospitalized COVID-19 patients during Peru's first wave (August-October 2020) and stored at -80 °C. Anti-SARS-CoV-2 IgG and IgM antibodies were quantified using an in-house ELISA with recombinant Spike S1 and RBD proteins. Statistical analyses-including linear regression, Kaplan-Meier curves, and receiver operating characteristic (ROC) curves-were conducted to evaluate antibody kinetics, clinical correlations, and predictive accuracy. IgG levels stabilized between days 10 and 15 of hospitalization, while IgM levels declined after day 10, with greater variability observed in severe acute respiratory distress syndrome (ARDS) cases. A significant positive correlation was found between IgG levels and lymphocyte counts (  = 0.37,  < 0.001), and a negative correlation with neutrophil counts (  =  - 0.33,  < 0.01), particularly in severe ARDS non-ICU patients (  =  - 0.34,  < 0.01). Severe ARDS cases also exhibited elevated neutrophil-to-lymphocyte ratios and increased inflammatory biomarkers, such as C-reactive protein and D-dimer, indicating an exacerbated inflammatory response associated with poorer prognosis. Risk factors, including sex and obesity, were linked to higher mortality and increased need for mechanical ventilation. This study contributes to a better understanding of the immune response in COVID-19 and supports the development of predictive models based on immunological and hematological biomarkers.

Multidrug-resistant Escherichia coli ST131 fimH30 responsible for extra-intestinal pathogenic (ExPEC) infections is globally distributed. However, the occurrence of a subclone fimH27 of ST131 harboring both ExPEC and enteroaggregative E. coli (EAEC) related genes and belonging to commonly reported O25:H4 and other serotypes causing bacteremia in African children remain unknown. We characterized 325 E. coli isolates causing bacteremia in Mozambican children between 2001 and 2014 by conventional multiplex polymerase chain reaction and whole genome sequencing. Incidence rate of EAEC bacteremia was calculated among cases from the demographic surveillance study area. Approximately 17.5% (57/325) of isolates were EAEC, yielding an incidence rate of 45.3 episodes/105 children-years-at-risk among infants; and 44 of isolates were sequenced. 72.7% (32/44) of sequenced strains contained simultaneously genes associated with ExPEC (iutA, fyuA and traT); 88.6% (39/44) harbored the aggregative adherence fimbriae type V variant (AAF/V). Sequence type ST-131 accounted for 84.1% (37/44), predominantly belonging to serotype O25:H4 (59% of the 37); 95.6% (35/44) harbored fimH27. Approximately 15% (6/41) of the children died, and five of the six yielded ST131 strains (83.3%) mostly (60%; 3/5) due to serotypes other than O25:H4. We report the emergence of a new subclone of ST-131 E. coli strains belonging to O25:H4 and other serotypes harboring both ExPEC and EAEC virulence genes, including agg5A, associated with poor outcome in bacteremic Mozambican children, suggesting the need for prompt recognition for appropriate management.

[...]other Bartonella spp. have correlated to Carrion's-disease-like presentations. [...]Bartonella rochalimae, which is disseminated worldwide [5], was associated with a mild Oroya-fever-like episode in a tourist after a trip to Peru, whereas Bartonella ancashensis has been isolated from Peruvian warts of children living in an endemic Peruvian area [1]. The illness evolution may vary leading to Oroya fever, Peruvian wart, or asymptomatic infection with different easiness. [...]although no data are available, the natural bacteria clearance may not be ruled out.

Zonulin has previously been related to intestinal permeability in various inflammatory diseases, and more recently to the physiopathology of severe COVID-19 infections. We analysed serum samples from a previous study of a Peruvian cohort of hospitalised COVID-19 patients, for the quantification of zonulin by sandwich ELISA. Comparisons with clinical data, haematological and biochemical parameters and cytokine/chemokine levels were made. We found higher baseline zonulin levels in deceased patients, and zonulin was associated with fatal outcome in multivariable analyses, even after adjustment for age, gender, and obesity. There were also positive correlations between zonulin, creatinine, D-dimer values and prothrombin time, while inverse correlations were found for Sa/FiO 2 ratio and CCL5 (RANTES). Further longitudinal studies are recommended to analyse the variation of zonulin levels over time as well as their relationship with long-COVID.

Evaluating both humoral and cellular immunity is essential for optimizing vaccination strategies and preventing post-pandemic SARS-CoV-2 outbreaks. This cross-sectional study assessed cellular immunity by measuring mRNA expression and humoral immunity through SARS-CoV-2-specific IgG antibodies. Whole blood samples were collected from 40 Peruvian volunteers. expression was evaluated in blood samples stimulated with Spike protein peptides from the Wuhan strain and Omicron BA.5 variant using RT-qPCR. Anti-spike IgG levels were measured with a semi-quantitative ELISA. The median age was 31 years, with 62.5% females. A heterologous vaccination scheme was reported by 73%, but only 25% received their last dose within the past 6 months, and 55% completed three doses. The BNT162b2 vaccine was included in 88% of vaccination schemes, serving as the first and second dose in 48% of cases. All participants had detectable anti-spike IgG antibodies; 90% exhibited cellular responses to Wuhan peptides and 97.5% to Omicron peptides. mRNA expression (2 ) was significantly higher for Omicron (median: 565.97; IQR: 565,148.34) compared to Wuhan (median: 18.55; IQR: 62,898.67). Higher anti-spike IgG levels correlated with age and the number of vaccine doses. Males had significantly higher and anti-spike IgG levels ( < 0.05). Antibody levels were greater in those recently boosted or vaccinated with mRNA-1273 ( = 0.001, = 0.002). Most participants exhibited robust immunity, characterized by elevated levels of and anti-SARS-CoV-2 IgG antibodies. These findings highlight the importance of boosters in enhancing immunity and the need for diverse techniques for measuring immunity.

Pseudomonas aeruginosa is an opportunistic pathogen commonly associated with infections in hospitalized and immunocompromised patients due to its virulence and antimicrobial resistance. In the poultry industry, it has been associated with hatchery mortality. This study aimed to characterize P. aeruginosa isolated from pipped eggs, one-day-old chicks, and broiler carcasses obtained from a slaughterhouse in São Paulo state, Brazil. Nineteen strains of P. aeruginosa were selected and their virulence genes were amplified via PCR. Clonality analysis was performed using BOX-PCR, and three strains were selected for whole-genome sequencing (WGS). All isolates carried aprA, plcH, plcN, lasA, lasB, lasI, lasR, rhlAB, and phzH. The exoA gene was detected in 73.7% of strains, while algD was present in 21.1%. The exoY and exoT genes were present in 94.7% of strains (18/19), whereas exoS was present in 47.4% (9/19). None of the isolates harbored the exoU gene. BOX-PCR and phylogenetic analyses revealed diverse clonal patterns. The sequenced strains were classified as O3 ST116, O2 ST1649, and O3 ST1744. The presence of virulence and antimicrobial resistance determinants in poultry-associated strains underscores the need for surveillance, as these isolates may represent a source for transmission of P. aeruginosa to humans. Our findings highlight the importance of monitoring P. aeruginosa within poultry production and emphasize the value of genomic approaches to understand its diversity, evolution, and public health risks.

Introduction: This study aimed to assess the association between multidrug resistance (MDR) and late-onset sepsis (LOS) among newborns with bloodstream infection (BSI). Methodology: In this cross-sectional study, we routinely tested every newborn with a presumptive diagnosis of sepsis admitted to the largest reference maternity hospital in Lima, Peru for BSI over an 18-month period. We tested every isolate for MDR by using the disk-diffusion method and assessed its associated factors by using a robust Poisson regression analysis with a particular focus on its association with LOS (vs. early-onset sepsis, EOS). Results: We analyzed a total of 489 subjects, including 340 (69%) newborns with LOS, and estimated an MDR rate of 80% (95% confidence interval, CI: 76%-83%), which was significantly higher (p-value < 0.001) among LOS (85%; 95% CI: 81%-89%) than EOS cases (67%; 95% CI: 59%-75%). The primary isolate was coagulase-negative Staphylococci (CoNS) (60%), which exhibited a limited subset of antibiotic MDR patterns, most of which were characterized by their resistance to cefoxitin, gentamicin, and clindamycin and levofloxacin. Overall, the prevalence of MDR was higher among LOS compared to EOS cases (adjusted prevalence ratio [aPR] = 1.28; 95% CI: 1.14-1.45), and among BSI due to CoNS compared to other bacteria (Apr = 1.10; 95% CI: 1.01-1.20). Conclusions: MDR among newborns with sepsis is exceptionally high, being even higher among those with LOS than newborns with EOS, and among those infected with CoNS compared to other bacteria. Furthermore, CoNS exhibited a limited subset of MDR patterns, which could be used to guide therapeutic decisions.

Analysis of immune responses in Bartonella bacilliformis carriers are needed to understand acquisition of immunity to Carrion's disease and may allow identifying biomarkers associated with bacterial infection and disease phases. Serum samples from 144 healthy subjects from 5 villages in the North of Peru collected in 2014 were analyzed. Four villages had a Carrion's disease outbreak in 2013, and the other is a traditionally endemic area. Thirty cytokines, chemokines and growth factors were determined in sera by fluorescent bead-based quantitative suspension array technology, and analyzed in relation to available data on bacteremia quantified by RT-PCR, and IgM and IgG levels measured by ELISA against B. bacilliformis lysates. The presence of bacteremia was associated with low concentrations of HGF (p = 0.005), IL-15 (p = 0.002), IL-6 (p = 0.05), IP-10 (p = 0.008), MIG (p = 0.03) and MIP-1α (p = 0.03). In multi-marker analysis, the same and further TH1-related and pro-inflammatory biomarkers were inversely associated with infection, whereas angiogenic chemokines and IL-10 were positively associated. Only EGF and eotaxin showed a moderate positive correlation with bacteremia. IgM seropositivity, which reflects a recent acute infection, was associated with lower levels of eotaxin (p = 0.05), IL-6 (p = 0.001), and VEGF (p = 0.03). Only GM-CSF and IL-10 concentrations were positively associated with higher levels of IgM (p = 0.01 and p = 0.007). Additionally, IgG seropositivity and levels were associated with high levels of angiogenic markers VEGF (p = 0.047) and eotaxin (p = 0.006), respectively. Our findings suggest that B. bacilliformis infection causes immunosuppression, led in part by overproduction of IL-10. This immunosuppression probably contributes to the chronicity of asymptomatic infections favoring B. bacilliformis persistence in the host, allowing the subsequent transmission to the vector. In addition, angiogenic markers associated with bacteremia and IgG levels may be related to the induction of endothelial cell proliferation in cutaneous lesions during chronic infections, being possible candidate biomarkers of asymptomatic infections.

Introduction: This study aimed to assess the prevalence of multidrug resistance (MDR) and its associated factors among pregnant Peruvian women with bacteremia. Methodology: In an 18-month cross-sectional study, all pregnant women were routinely tested with a presumptive diagnosis of sepsis admitted to the largest reference maternity hospital (Instituto Nacional Materno Perinatal) in Lima, Peru for bacteremia. Every isolate was tested for antimicrobial susceptibility as defined by the Institute of Clinical and Laboratory Standards (CLSI). Additionally, associated factors were assessed with MDR and the number of resistant antimicrobial categories using robust Poisson regression models with link log, especially focused on its association with age and bacterial families or species. Results: A total of 236 blood cultures of pregnant women (33.4 ± 11.4 years old) was analyzed. The prevalence of MDR was 70% (95% confidence interval [CI]: 64%–76%). The main etiological agent was Escherichia coli (65%), showing an MDR rate of 74% (68%–81%). Overall, we observed that the MDR rate was associated with Enterobacteriales (adjusted prevalence rate, (aPR) = 1.29; 95% CI: 1.03–1.61) and age 35 or older (PR = 1.18; 95% CI: 1.01–1.39). However, the number of resistant antimicrobial categories was associated with Enterobacteriales (aPR = 1.44; 95% CI: 1.25–1.67) and hospital-acquired infections (PR = 0.81; 95% CI: 1.01–1.39). Conclusions: The prevalence of MDR among pregnant women with sepsis was alarmingly high, being even higher among women age 35 or older and among those with hospital-acquired infections.