We reviewed medical records of cases of liver abscesses (LA) registered in Rīga East University Hospital clinical centre “Gaiïezers” from January 2012 to October 2018 to assess sociodemo-graphic factors, clinical, laboratory, microbiological and radiological findings, as well as therapeutic modalities and their efficacy associated with LA. A total of 95, including five recurrent, cases were included in this study. No statistically significant differences in gender distribution were found. Mean patient’s age was 64.5 ± 15.9. The most common documented risk factors for the development of LA were underlying biliary tract abnormalities (37.9% of cases), and diabetes mellitus (12.7%), while in 21.1% of cases, LA were defined as cryptogenic. Most patients presented with fever (70.5%); right upper abdominal pain was reported in 61.1%, while vomiting and / or nausea — in 25.3% of cases. The most common isolates identified from LA were Klebsiella pneumonia (40.3% of cases), mainly in monomicrobial LA, and Escherichia coli (22.6% of cases), predominantly in polymicrobial LA. Ceftriaxone and metronidazole intravenous formulations were used in 35.5% cases as the principal antimicrobial combination at hospital. Median overall expected duration of antimicrobial treatment was 15 days. LA drainage was performed in 87.4% of cases for the median duration of seven days. In 86.3% of cases both approaches were combined.
Cytokeratin 18 (CK18) is a specific marker of hepatocellular apoptosis, which is a useful noninvasive indicator of liver fibrosis in the HIV/HCV group. However, data on the CK18 level in serum are limited for this group. This study demonstrated CK18 levels in serum in HIV/HCV co-infected and HIV mono-infected patients; investigated the association of CK18 levels with other non-invasive markers of liver fibrosis; and presents CK18 dynamics in a four-month-long period. The sample included 273 patients with HIV infection (128 of them were with HIV/HCV co-infection) aged from 23 to 65 (35% females). Levels of hyaluronic acid, CK18, ALT, and AST were determined in serum, and the FIB4 index was calculated. All markers had higher levels in the HIV/HCV group than in the HIV mono-infection group. The HIV/HCV group demonstrated coherent correlations among the markers and their associations with the level of CK18 than the HIV mono-infection group. During the four-month-long period, the CK18 level in serum showed no significant changes.
Legionella pneumophila is an environmental pathogen of engineered water systems that can cause different forms of legionellosis - from mild fever to potentially lethal pneumonia. Low concentrations of legionellae in natural habitats can increase markedly in engineered hot water systems where water temperatures are below 55 °C. In the current study, we aimed to investigate the influence of sampling season, hot water temperature and sampling protocol on occurrence of L. pneumophila. A total of 120 hot water samples from 20 apartment buildings were collected in two sampling periods - winter 2014 (n = 60) and summer 2015 (n = 60). Significantly higher occurrence of L. pneumophila was observed in summer 2015. Significant differences in temperature for negative and positive samples were not observed, which can be explained by low water temperatures at the point of water consumption. Temperature above 55 °C was observed only once, for all other sampling events it ranged from 14 °C to 53 °C.
Toxoplasmosis is an important infection caused by the single-celled parasite Toxoplasma gondii, which is a zoonotic parasite causing widespread human and animal diseases, mostly involving the central nervous system. Humans can acquire toxoplasmosis by ingestion of raw or undercooked meat containing T. gondii tissue cysts, ingestion of oocysts shed by infected felids via contaminated food or water, and by vertical transmission to the fetus through the placenta from the mother during pregnancy. The aim of the present study was to determine the seroprevalence of specific anti-T. gondii IgG and IgM antibodies using a large set of clinical diagnostic laboratory data obtained over a 14-year period. In total, 25 069 unique patients were included in the present study. The overall specific anti-T. gondii IgG prevalence were 36.3%, which was significantly (p < 0.01) higher than IgM prevalence (2.4%). Mean age for IgG antibody-positive patients was 33.7 ± 12.2 years. A significant positive correlation (r = 0.99; p < 0.01) was observed between age group and anti-T. gondii IgG antibody prevalence, which ranged from 4.2% to 66.7%. The most prevalent (69.9%; 95% CI 69.2–70.7) comorbidities of patients tested for presence of anti-T. gondii IgG and IgM antibodies were classified as factors affecting health status which includes also monitoring of normal pregnancy.
The aim of this study was to assess the relationship between HLA Class II alleles in two groups of patients in Latvia: patients with cystic and alveolar echinococcosis. The study included 37 patients from the Rīga East Clinical University Hospital with echinococcosis (29 patients with cystic echinococcosis and eight patients with alveolar echinococcosis) and 100 healthy control persons without echinococcosis. HLA Class II allele genotyping was performed using Real-time polymerase chain reaction–sequence specific primer (RT-PCR-SSP). The odds ratios (OR), with 95% confidence intervals (95% CI), were calculated using statistical analysis performed with IBM SPSS Statistics for Windows, Version 22.0, to evaluate the risk of developing the disease in an individual having a particular HLA genotype. In the case of cystic echinococcosis a more severe course of a disease can be anticipated in the presence of HLA-DRB1 alleles *17:01 and *07:01, -DQB1 *03:02, and *03:01, -DQA1*04:01 and haplotypes HLA-DRB1*04:01/-DQB1*03:01/ -DQA1*03:01, HLADRB1*11:01/ -DQB1*03:01 /-DQA1*05:01. However, in the group with alveolar echinococcosis it was associated with the HLA-DRB1 alleles *17:01 and *07:01, -DQB1 *05:01 and haplotypes HLA- DRB1*17:01/-DQB1*02:01-2/-DQA1*01:01, HLA-DRB1*11:01/ -DQB1*03:01/-DQA1*01:03 and HLA-DRB1*11:01/-DQB1*03:01/-DQA1*03:01. HLADRB1*15:01/-DQÂ1*06:02-8/-DQA1*05:01 and HLA-DRB1*13:01/-DQB1*02:01-2/-DQA1*05:01 haplotypes were protective in all patient groups. The limitations of this exploratory study indicate that a broader study needs to be conducted for revealing specific risk and protective HLA Class II haplotypes for patients with cystic and alveolar echinococcosis in Latvia.
In this study, we sought to identify human leukocyte antigen (HLA) DRB1 alleles that might be associated with Lyme borreliosis in Latvian patients. Case patients and control subjects were similar in age, sex, and ethnic heritage and differed only in the presence of Borrelia burgdorferi infection. The frequency of HLA-DRB1*07 (OR 3.52; p = 0.001), HLA-DRB1*15 (OR 3.02; p = 0.001) and HLA-DRB1 *17 (03) (OR 2.63; p = 0.001) were significantly increased in the Lyme disease patients compared with the control groups. The frequency of the alleles -DRB1*11(OR 0.37; p = 0.005) and -DRB1*13 (OR 0.34; p = 0.002) was smaller in Borreliosis patients and significantly higher in the control group.
Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary “Gaiļezers” of the Rīga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients - 34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.
Kefir is a fermented dairy product, created by fermentation of milk by bacteria and yeasts. Kefir is the most common traditional non-sweetened fermented dairy beverage in the Baltic countries. Whole kefir and specific fractions and individual organisms isolated from kefir provide a multitude of health benefits, including regulation of composition of the gut microbiome. This review aims to summarise the available data about influence of kefir consumption on the gut microbiome in healthy individuals and to highlight the effects that kefir consumption as well as separated fractions of kefir can have in disease states via modulation of the host microbiome.
Ready-to-eat (RTE) foods are challenging for food business operators as they need to remain qualitative and safe for consumers. However, consumers tend to choose them more and more often because of fast and easy handling. The highest risk from RTE foods is microbiological contamination, particularly for vulnerable groups like children, elderly, and pregnant women. The aim of the research was to assess the microbiological quality of RTE meat and fish products to highlight possible risks for consumers. A total of 15 984 analyses performed on RTE meat and fish products were included in this study. It was found that RTE meat and fish product samples representative of the market in Latvia in the period 2012-2015 had high microbiological quality and only in rare cases was contamination with hygiene indicatororganisms (coliforms and Escherichia coli) and pathogens (Salmonella spp., Listeria monocytogenes, Staphylococcus aureus, and sulphite-reducing clostridia) detected. However, it is important to pay attention to customer habits of cooking and preparing RTE foods as well - thermal processing for products intended to be used cooked, use before expiration date and adequate storage rules for products, as these have important regarding microbiological risks for health.
Undeniably, sepsis is still a profoundly damaging and life-threatening condition for many individuals. With multiple changes in sepsis patients it is difficult to precisely classify an individual’s response in sepsis as proinflammatory or immunosuppressed. The aim of this study was to investigate genetically determined predisposition to developed sepsis by analysis of distribution of human leukocyte antigen (HLA) class II genes. Samples from patients with sepsis were collected at Pauls Stradiņš Clinical University Hospital, Latvia, in an intensive care unit between October 2016 and May 2017. The study group included 62 patients with sepsis, who were genotyped for HLA-DR; DQ using real time polymerase chain reaction – sequence specific primer (RT PCR-SSP). As a control group, data of 100 individuals were taken from the genetic bank of RSU Joint Laboratory of Clinical Immunology and Immunogenetics. The summarised results showed that the frequency of alleles DRB1*04:01 (OR = 5.54; 95% CI = 1.88–16.29); DRB1*07:01 (OR = 19.03; 95% CI = 2/37–152.82); DQA1*05:01 (OR = 14.17; 95% CI = 5.67–35.4); and DQB1*02:01 (OR = 50.00; 95% CI = 2.90–861.81) were significantly increased in patients with sepsis compared to the control group patients. The frequency of DRB1*16:01 (OR = 0.17, 95% CI = 0.04–0.59); DRB1*17:01 (OR = 0.04; 95% CI = 0.00–0.69); DQA1*01:01 (OR = 0.04; 95% CI = 0.00–0.31); DQA1*01:02 (OR = 0.03; 95% CI = 0.00–0.23); DQB1*02:02 (OR = 0.12; 95% CI = 0.03–0.42) alleles was lower in sepsis patients than in control subjects. The most frequent HLA-DRB1/DQA1/DQB1 haplotypes that was significantly increased in patients with sepsis were: DRB1*01:01/DQA1*05:01/DQB1*03:01 (OR = 12.6; 95% CI = 1.51–105.0; p < 0.003). Sepsis patients with pneumonia and alleles and DRB1 04:01; 07:01, DQB1 02:01 had the highest mortality rate. Undoubtedly, our preliminary data showed that development of sepsis can be associated with alleles and haplotypes of HLA class II genes. For more precise conclusion the research should be continued to include a larger patient group.