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Early antibiotics administration reduces mortality in sepsis patients in tertiary care hospital
(2025-12-01)
Isaranuwatchai, Suramath
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Buppanharun, Jirawat
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Thongbun, Thamonwan
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Thavornwattana, Kaewklao
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Harnphadungkit, Monprach
Introduction: Early antibiotic administration is one of the core treatments of sepsis which associated with reduced mortality rate. However, the appropriate timing of antibiotics remains a controversial issue, especially in patients without septic shock. Here, we reported the outcomes of early antibiotic administration within one hour from the time of infection suspicion in a tertiary care hospital. Methods: We reviewed the medical records and sepsis protocols in Chulabhorn Hospital, Bangkok, Thailand, from January 2021 to December 2023 for patients presenting with sepsis. We had our own sepsis protocol which we used for early detection and treatment of sepsis patients. We compared the 28-day mortality, 90-day mortality, and the length of stay between patients with time-to-antibiotics (TTA) within one hour and patients with TTA more than one hour. Results: We recruited 1,506 patients into our study. The mean age is 68 years and 49.40% of patients is female. 90.97% of the patients have comorbidities. The most common comorbidities were cancer (68.66%), and hypertension (33.40%). The 28-day mortality rate and the 90-day mortality rate were significantly lower in the patients with TTA within one hour compared to those with TTA more than one hour (P = 0.009 and P = 0.042, respectively). Nonetheless, adjusted mortality rate was significantly lower in only 28-day mortality rate but not 90-day mortality rate. Subgroup analysis showed that the mortality rate was significantly lower in patients with ICD-10 diagnosis of infections (15.35% vs. 21.51%, P = 0.029), patients with cancer (17.29% vs. 24.11%, P = 0.016), and patients with solid cancer (20.86% vs. 28.18%, P = 0.036). However, subgroup analysis for the mortality rate at 90 days were not statistically significant. Conclusion: Antibiotic administration within one hour from the time of infection suspicion is associated with lower mortality rates at 28 days but not at 90 days after adjusted analysis. Cancer patients, especially patients with solid cancer, will benefit more with time-to-antibiotics less than one hour.
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Infection density, diversity, and distribution of Wolbachia bacteria in moths (Order Lepidoptera): First systematic report from Thailand
(2021-08-01)
Boonsit, Panukorn
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Wiwatanaratanabutr, Itsanun
Members of the genus Wolbachia are a group of Rickettsia-like, intracellular, maternally inherited bacterial endosymbionts that infect a diverse range of insects and cause reproductive changes in their hosts. Although Wolbachia's role in many insects has been extensively studied, only a little of their effects on host's reproduction and their infection frequencies were reported in Lepidopteran which is one of the most diverse insects. Here, we present the first systematic survey of the Wolbachia infection status in different species of moths from three different geographic regions of Thailand, which was carried out during January to December in 2019 with the screening of 1,235 specimens in total of 58 moth species from 13 families. Specimens were collected from Khao Yai National Park (the Central and the Northeast regions), and Kaeng Krachan National Park (the West region). Infections of Wolbachia were screened by using polymerase chain reaction with 16S rRNA, ftsZ and wsp gene primers which the results indicated high rates of Wolbachia infection in moth populations from Thailand. Wolbachia was found in all different geographically populations in total of 625 individuals in total of 28 moth species from 9 families, including 144 individuals (46 males and 98 females) from the Central, 156 individuals (49 males and 107 females) from the Northeast, and 325 individuals (114 males and 211 females) from the West. The highest infection rate was 90.47% in the West populations and the average infection rate was 61.90%. The detection of Wolbachia in different moth populations from all regions was identical when all primers were used to screen for Wolbachia. The relative densities of Wolbachia within each individual were determined using quantitative real-time PCR and the result showed that there was a low Wolbachia infection density in these moth populations. These findings indicated that Wolbachia are distributed throughout the moth populations from Thailand.
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Presence of viral pathogens amongst wild Penaeus monodon in Thailand
(2017-05-01)
Hamano, Kaoru
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Maeno, Yukio
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Klomkling, Sirimas
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Aue-Umneoy, Dusit
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Tsutsui, Isao
An epizootiological study of 230 wild Penaues monodon collected from a set net in the seashore of Klong Khone, Samut Songkhram, Thailand was conducted from December 2012 to November 2013. Each month approximately 20 wild P. monodon were tested for the following five pathogenic shrimp viruses: yellow head virus (YHV), white spot syndrome virus, infectious hypodermal and hematopoietic necrosis virus, taura syndrome virus, and infectious myonecrosis virus (IMNV). Among all P. monodon individuals, 45.7% were positive for YHV, which causes yellow head disease that is commonly encountered in Thai shrimp cultivation. Overall, pathogenic viruses were detected in 80.9% of all the shrimp; however, IMNV, which has yet to be identified in Thailand, was not detected in any shrimp. This finding suggests that there is a link between the prevalence of pathogenic viruses in wild shrimp and the outbreaks of viral diseases in farmed shrimp.
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Waterborne and cannibalism-mediated transmission of the Yellow head virus in Penaeus monodon
(2015-02-01)
Hamano, K.
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Miyoshi, T.
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Aue-umneoy, D.
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Srisapoome, P.
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Maeno, Y.
Disease outbreaks caused by yellow head virus (YHV) can result in significant economic losses for shrimp aquaculture; however, little is known about how YHV is transmitted. Here we evaluate the role of direct and indirect contact with YHV among Penaeus monodon. One in 3 specimens released into 5 experimental tanks was inoculated with the virus, and 100. μm-filtered water from each tank was allowed to circulate through another tank containing an additional set of 3 naive P. monodon. All of the injected shrimps died within 4. d; 9 of the 10 shrimps cohabitating with them died within 10. d. Only 5 of the 15 shrimps in the water-exposed tanks died within 14. d. As determined by RT-nested PCR, YHV infection was also lower among shrimp exposed to water. To assess the potential of moribund shrimp to transmit disease, gill samples from individuals inoculated with YHV at either 12. h or 24. h after the onset of the first obvious signs of morbidity were injected into naïve P. monodon housed in individual tanks. Over a 30-d period following inoculation, the mortality rate was higher among shrimps injected with 12. h gill extracts than in those injected with 24. h gill extracts. Taken together, these data suggest that cannibalism of moribund shrimps presents a far greater potential to transmit the yellow head disease than does water exposure alone. Removing moribund shrimps as soon as morbidity becomes evident could represent an efficient measure to reduce YHV transmission and disease outbreaks.

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