Background Urinary tract infections (UTI) are the most common bacterial infections worldwide, and Klebsiella pneumoniae (K. pneumoniae) UTI are a notable issue worldwide, especially in Taiwan. This is not only because of the association with immunocompromised patients, but also because of the issue of antibiotic resistance caused by K. pneumoniae. Therefore, the aim of this study was to identify possible risk factors in the genomes of Taiwanese patients with K. pneumoniae UTI using genome-wide association studies (GWASs). Methods Genotyping results were collected from participants recruited from Tri-Service General Hospital who had a medical history of urinary tract infection and joined the Taiwan Precision Medicine Initiative (TPMI). A case-control study was designed using GWAS to identify possible susceptibility single-nucleotide polymorphisms (SNPs) in patients with K. pneumoniae infected UTI. The corresponding genes were identified using the genome browser, and their expression profiles were confirmed using the GTEx database. To determine the relationship between these genes and biological function, molecular pathway and diseases, we also searched the GO, Rectome, DisGeNET, and MalacCards databases. Results The GWAS analysis identified 11 variants with a higher odds ratio than the control groups. These variants are involved in adhesion, protein depolymerization, Ca2+-activated potassium channels, SUMOylation, and protein ubiquitination, which might further impact the host immune response. Disease association analysis based on these risk variants also revealed several diseases that were compatible with the medical histories of the included patients. Conclusion This GWAS study based on the Taiwanese population suggests the idea that some risk variants may be associated with K. pneumoniae infection by affecting various molecular functions that could impact host immunity. Further studies and follow-up are required to clarify the impact of these risk variants on infectious diseases.

Purpose Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major healthcare threat worldwide. Since it was first identified in November 2021, the Omicron (B.1.1.529) variant of SARS-CoV-2 has evolved into several lineages, including BA.1, BA.2–BA.4, and BA.5. SARS-CoV-2 variants might increase transmissibility, pathogenicity, and resistance to vaccine-induced immunity. Thus, the epidemiological surveillance of circulating lineages using variant phenotyping is essential. The aim of the current study was to characterize the clinical outcome of Omicron BA.2 infections among hospitalized COVID-19 patients and to perform an immunological assessment of such cases against SARS-CoV-2. Patients and Methods We evaluated the analytical and clinical performance of the BioIC SARS-CoV-2 immunoglobulin (Ig)M/IgG detection kit, which was used for detecting antibodies against SARS-CoV-2 in 257 patients infected with the Omicron variant. Results Poor prognosis was noted in 38 patients, including eight deaths in patients characterized by comorbidities predisposing them to severe COVID-19. The variant-of-concern (VOC) typing and serological analysis identified time-dependent epidemic trends of BA.2 variants emerging in the outbreak of the fourth wave in Taiwan. Of the 257 specimens analyzed, 108 (42%) and 24 (9.3%) were positive for anti-N IgM and IgG respectively. Conclusion The VOC typing of these samples allowed for the identification of epidemic trends by time intervals, including the B.1.1.529 variant replacing the B.1.617.2 variant. Moreover, antibody testing might serve as a complementary method for COVID-19 diagnosis. The combination of serological testing results with the reverse transcription-polymerase chain reaction cycle threshold value has potential value in disease prognosis, thereby aiding in epidemic investigations conducted by clinicians or the healthcare department.

No abstract

Paraproteins have been reported to cause interference in a sort of chemistry assays conducted by current automated chemistry analyzers. However, the nature of interference differs across different methodologies and reactions. Total bilirubin and direct bilirubin assays might yield spurious result when the sample contains excess amounts of paraproteins, which are neither reliable nor reproducible when repeated tests are applied once the interference occurs. Herein, we present the case of a 78-year-old female diagnosed with kappa light chain multiple myeloma with disease progression. On admission, she had acute hepatitis and a bizarre result with direct bilirubin level higher than total bilirubin level was noted. After further investigation, excess amounts of immunoglobulin G (IgG) were the most likely cause which led to the interference of direct bilirubin assay and caused unreliable results. This case highlights the significance of the fact that patients with excess IgG might have unreliable results of direct bilirubin assay which could mislead clinical judgment. Moreover, clinicians should be more careful and should base therapeutic decisions on the patient's clinical condition when faced with patients in a similar condition.