Hasil untuk "Infectious and parasitic diseases"

Muhammad Azreen Mat Husin, Adrian Anthony Peirera, Thana Seelan et al.

Economic migrant workers are crucial for a country's development but may also contribute to transboundary transmission of antimicrobial resistance (AMR). This study aimed to investigate the silent carriage of ESBL-producing Escherichia coli (ESBLEC) and Klebsiella pneumoniae (ESBLKP) among economic migrants from Indonesia, Bangladesh and Nepal residing in Klang Valley, Malaysia. Between December 2023 and May 2024, 263 study participants of Indonesian, Bangladeshi, and Nepalese migrant communities were recruited and rectal swabs collected. Swabs were then cultured on CHROMagar™ ESBL; presumptive ESBL-positive strains were confirmed and antimicrobial susceptibility-tested using a VITEK 2 system. ESBL genotyping was also performed on confirmed isolates. A total of 67 and five strains were confirmed as ESBLEC and ESBLKP, respectively. Both ESBLEC and ESBLKP strains showed similar resistance to penicillin and 3rd generation cephalosporins, though more ESBLKP strains were resistant to 4th generation cephalosporins. More ESBLEC strains were resistant to ciprofloxacin. No carbapenem-resistant strains were detected. The blaCTX-M-1 gene family was predominantly found in ESBLEC strains from all three nationalities, while ESBLKP strains frequently harboured blaTEM, blaCTX-M, and blaSHV genes. The prevalence of ESBL-producing strains was highest among Bangladeshi participants (n = 16, 31.4 %), followed by Indonesians (n = 47, 29.7 %) and Nepalis (n = 9, 19.1 %) working in domestic or manufacturing sectors. These findings highlight the public health risks of high ESBLEC and ESBLKP carriage in healthy migrant workers, which may impact recruitment and retention, leading to labour shortages and higher costs. Screening and increased awareness are crucial to limit the spread of these pathogens.

Ahmed Azeez Hasan, Anis Kausar Ghazali, Najib Majdi Yaacob et al.

Objectives This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT). Methods A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity. Results Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors. Conclusion The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.

Chelsea Fauver, Nora Colburn, Justin Smyer et al.

Background: Central line associated bloodstream infections (CLABSIs) are a preventable healthcare-associated infection. Evidence shows implementation of evidence-based bundled infection prevention strategies can reduce CLABSIs. We reviewed the impacts of a CLABSI prevention toolkit on CLABSI rates as well as compliance with key prevention practices. Methods: A CLABSI Prevention Bundle Toolkit was implemented in December 2023 at a quaternary care academic medical center. The toolkit delineated the elements of the bundle, including hand hygiene, daily review of line necessity, daily chlorhexidine gluconate (CHG) topical treatment, aseptic technique for insertion and maintenance, along with the responsible party for each task and educational resources for staff and patients. Additionally, the toolkit required weekly audits of CLABSI bundle by individual units and a multidisciplinary meeting to debrief each CLABSI to identify opportunities and successes. Analysis of compliance with key prevention practices, CLABSI rates and clinical details was completed before (December 2022 – November 2023) and after (December 2023 – November 2024) implantation of the toolkit. Results: Compliance with key prevention practices pre- and post-toolkit implementation is detailed in Table 1. There was a 37% reduction in CLABSI rate pre- and post-toolkit implementation as shown in Table 2. Clinical details including CLABSI classification as preventable, end-of-life or definition-based (Hsueh, Maurice and Uslan, ICHE 2022), organism, dialysis, transplant status and patient race are detailed in Table 2. Conclusions: CLABSI prevention bundles have been shown to reduce CLABSI, but implementation and compliance of the bundle can be challenging. A toolkit which outlines required tasks, responsible parties, regular audits and debriefs after CLABSI can help support healthcare teams in successful implementation of the full CLABSI bundle. Following the bundle toolkit implementation there was improvement in rates of CHG treatment and line necessity review with an overall decrease in CLABSI rates. Not all process measures included in the toolkit are able to be quantified so likely additional factors contributed to the reduction in CLABSI rates. Overall, there did not appear to be a difference in the types of CLABSIs, organisms or patient demographics in the pre and post-toolkit groups although there were more CLABSIs in transplant patients post-toolkit suggesting a complex patient population. A comprehensive toolkit can aide in implementation of a multi-faceted prevention bundle, provide a structure for accountability and help improve patient outcomes.

Wesan Fadhel Khalef, Alaa Oleiwi, Nuha Jabbar Alrikaby

House flies (Musca domestica) are ubiquitous vectors of pathogens, including intestinal parasites, posing significant public health risks. This study aimed to investigate the prevalence of parasitic contamination in house flies collected from various sites in Thi-Qar province, Iraq, using direct microscopic examination and molecular techniques. A total of 500 flies were collected from butchers, fish and chicken shops, garbage sites, vegetable stores, and residential houses. Direct microscopy revealed that 60% (300/500) of flies were contaminated with parasites, while 40% (200/500) were parasite-free. The external surfaces of flies showed higher contamination (41%) compared to internal contents (19%). Molecular detection via conventional PCR targeting the small subunit ribosomal RNA (SSU rRNA) gene was employed for Entamoeba histolytica, Giardiaintestinalis, Microsporidium sp., Cryptosporidium sp., Cyclospora sp., and Cystoisospora sp. The most prevalent parasite was E. histolytica (36%), followed by Microsporidium sp. (24.7%) and Cryptosporidium sp. (17%). This study highlights the role of house flies in transmitting parasitic infections and underscores the need for improved sanitation and vector control measures in urban and periurban environments.

Rumen Harizanov, Violeta Yakimova, Mihaela Videnova et al.

The incidence and number of cases of several parasitic diseases subject to mandatory reporting and registration under the Ministry of Health (MoH) 2005 Regulation 21 increased after the end of the global pandemic of COVID-19 in 2023. In addition, parasitic infections imported from endemic tropical regions are recorded annually in the country. A significant number of people are screened for parasitic diseases each year. The primary indication for screening is prophylactic, followed by epidemiological and clinical indications. This report aims to analyse the dynamics of parasitic diseases in 2023. Data from the periodic and annual reports of the RHI, medical institutions and NCIPD were used as inputs. In 2023, 647 781 people were tested for parasites, of whom 2.0% were diagnosed with various parasitic infections. Cystic echinococcosis increased from 89 cases in 2022 to 117 cases in 2023. The annual incidence of the disease increased from 1.3% in 2022 to 1.81% in 2023. Regarding soil-transmitted parasitic diseases, 447 people were diagnosed with ascariasis and 50 with trichuriasis. Among the 458 764 people tested, the prevalence of enterobiasis was 1.74%. Out of 1 305 suspected cases, 10 individuals were diagnosed with imported malaria. Unfortunately, the disease was fatal for one patient of Bulgarian nationality. Analysis of the data showed no discernible trend in the incidence of parasitic diseases in 2023. However, cases of cystic echinococcosis show an upward trend. For the first time, no epidemic outbreaks of trichinellosis were recorded in 2023.

Vachirapong Charoennitiwat, Kittipong Chaisiri, Sumate Ampawong et al.

The parasitic nematode Paracapillaria (Ophidiocapillaria) najae De, 1998, found in the Indian cobra Naja naja is redescribed and re-illustrated in the present study. The monocled cobra Naja kaouthia was discovered to be a new host for this parasite in central Thailand. A comprehensive description extending the morphological and molecular characteristics of the parasites is provided to aid species recognition in future studies. The morphometric characters of 41 parasites collected from 5 cobra specimens are compared with those described in the original studies. Phylogenetic analyses using mitochondrial cytochrome c oxidase subunit 1 and nuclear 18S ribosomal RNA genes were performed to provide novel information on the systematics of P. najae. Similar characteristics were observed in the examined nematode samples, despite being found in different hosts, confirming their identity as P. najae. The molecular genetic results support the species status of P. najae, indicating P. najae is well defined and separated from other related nematode species in the family Capillariidae. Morphological descriptions, genetic sequences, evolutionary relationships among capillariids and new host and distribution records of P. najae are discussed. Paracapillaria najae specimens found in the Thai cobra had some morphological variation, and sexual size dimorphism was also indicated. Paracapillaria najae was found to infect various cobra host species and appeared to be common throughout the Oriental regions, consistent with its hosts' distribution.

Lourdes Eguiguren, Shirley F. Delair, Archana Chatterjee

Yancheng Yao, Can Imirzalioglu, Linda Falgenhauer et al.

Oliver Razum, Raffaella Ravinetto, Veronika J. Wirtz et al.

Dilu Feng, Sitian Wei, Jun Chen et al.

Abstract Background Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shannan City, Tibet Tibetan Autonomous Region, China. The purpose of this study is to provide reliable data for guiding women in Shannan City in cervical cancer screening and HPV vaccine innoculation. Methods HPV testing was performed on women aged 16–109 years (mean age 44.03 ± 9.25 years) from Shannan City in 2019 and 2020, which was implemented technically by gynecological examination, vaginal discharge smear microscopy, cytology, and HPV detection. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed. Results A total of 48,126 women received HPV testing, of which 3929 were detected human papillomavirus. The HPV-positive rate was 8.16% (3929/48,126), and the highest prevalence was in the ≤ 25-year-old age group (12.68%). After the age of 25, the prevalence rate decreased rapidly, and then slowly increased from 7.49% in the 46–55 age group to 9.82% in the ≥ 66 age group, showing a “U-shaped” pattern. The positive prevalence of HPV 16 or 18-only was 1.43%, that of other HPV genotypes except HPV 16 or 18 was 6.39%, and mixed HPV infections including HPV 16 or 18 was 0.34%. Conclusions The HPV infection rate in Shannan city is rather low, and the age-specific prevalence of HPV infection presents a “U” curve, suggesting the importance of screening among younger women and the necessity of detection among older women.

Ivan Ilic, Marina Zdravkovic, Stefan Timcic et al.

Objectives: The pandemic of coronavirus associated disease (COVID-19) placed the health care workers at high risk. We investigated clinical and treatment characteristics of infected medical professionals in a cardiovascular hospital. Methods: The study was retrospective, conducted in tertiary cardiovascular hospital and included employees with confirmed coronavirus infection. They filled out a questionnaire about health status, symptoms, admission to hospital and treatment. The vaccination status against tuberculosis, hepatitis B and seasonal influenza was assessed. Pneumonia was defined as CT finding of ground glass opacifications (GGO) with consolidations typical for COVID-19. Results: The study included 107 confirmed cases of COVID - 19 out of 726 employees (15%). Most of the infected were from cardiac surgery department (74/107, 69%). Substantial number of employees did not have any symptoms [31 (28.9%)] and 38 patients (35.5%) were admitted to hospital. The average hospital length of stay was 8.1 ± 5.6 days. Seventy-five of 107 (70.1%) received seasonal influenza vaccine. Pneumonia with CT features of GGO and consolidation occurred in 25/107 (23.4%) patients of which 14/107 (13.1%) had bilateral involvement. In multivariate logistic regression analysis including recognized characteristics associated with worse outcomes in COVID-19 (obesity, diabetes mellitus, coronary artery disease, cerebrovascular disease, current smoking, heart failure, influenza immunization), only influenza immunization remained an independent predictor of occurrence of bilateral pneumonia (OR 0.207; 95%CI[0.050 – 0.847]; p = 0.029). Conclusions: The association of influenza immunization and less aggressive form of pneumonia might provide a finding that supports the institution of preventive measures that can be beneficial in reduction of global coronavirus burden.

Regina Rabinovich, Carlos J Chaccour, Achla Marathe et al.

Jun Li, Mingju Ma

In this paper, we formulate a six dimensional drug transmission model to study the effect of family education and public health education. The dynamical behaviors of the model are discussed in terms of the basic reproduction number R0. By constructing Lyapunov functions, we obtain the drug-free equilibrium is globally asymptotically stable if R0≤1 and the drug addiction equilibrium is globally asymptotically stable if R0>1. Sensitivity analyses are performed to seek for effective control measures for drug spread. The analysis show that both the family and public health education can influence the spread of drug transmission. However, the combination of family and public health education is more effective to reduce the prevalence of drugs. Some numerical simulations are given to confirm the obtained theoretical results. Keywords: Drug model, Basic reproduction number, Public health education, Sensitivity, Stability

Yunling Wang

R. E. Kuntz

Hakim AZIZI, Ali FARAHNAK, Iraj MOBEDI et al.

Background: Human Echinostomiasis is an intestinal disease caused by the members of family Echinostomatidae parasites. The aim of present research was to identify echinos­tomatidae cercariae emitted by Lymnaea palustris snails from Mazandaran province in the north of Iran based on the morphological and morphometrical charac­teristics of the different stages of experimental parasite life cycle. Methods: Echinostomatidae cercariae were collected from L. palustris (Gastropoda: Lymnaeidae) of the north of Iran. To collect metacercaria, 50 healthy snails were infected with cercariae experimentally (50 cercariae for each). To obtain the adult stage, 9 laboratory animals (3 ducks, 2 rats, 2 mice and 2 quails) were fed with 60 metacercaria for each. To identify parasite, the different stages of worm were exam­ined using light microscope and then the figures were draw under camera Lucida microscope and measures were determined. Results: Averagely, 15metacercaria were obtained from each snail that had been previously exposed with cercariae. Ducks presented worm eggs in feces after 10-15 days post-infection. Intestinal worms were collected and identified as Hypoderaeum conoideum on the bases of figures and measures of cephalic collar, the number of collar spine, suckers diameter ratio, testes arrangement, etc. Conclusion: H. conoideum cercariae and adult worm are described. This is the first report of the different stages of the experimental life cycle of this parasite in Iran.

Raquel Rodrigues Barbieri, Anna Maria Sales, Ximena Illarramendi et al.

The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.

Karina Hatamoto Kawasato, Léa Campos de Oliveira, Paulo Eduardo Neves Ferreira Velho et al.

Bacteria of the genus Bartonella are emerging pathogens detected in lymph node biopsies and aspirates probably caused by increased concentration of bacteria. Twenty-three samples of 18 patients with clinical, laboratory and/or epidemiological data suggesting bartonellosis were subjected to three nested amplifications targeting a fragment of the 60-kDa heat shock protein (HSP), the internal transcribed spacer 16S-23S rRNA (ITS) and the cell division (FtsZ) of Bartonella henselae, in order to improve detection in clinical samples. In the first amplification 01, 04 and 05 samples, were positive by HSP (4.3%), FtsZ (17.4%) and ITS (21.7%), respectively. After the second round six positive samples were identified by nested-HSP (26%), eight by nested-ITS (34.8%) and 18 by nested-FtsZ (78.2%), corresponding to 10 peripheral blood samples, five lymph node biopsies, two skin biopsies and one lymph node aspirate. The nested-FtsZ was more sensitive than nested-HSP and nested-ITS (p < 0.0001), enabling the detection of Bartonella henselae DNA in 15 of 18 patients (83.3%). In this study, three nested-PCR that should be specific for Bartonella henselae amplification were developed, but only the nested-FtsZ did not amplify DNA from Bartonella quintana. We conclude that nested amplifications increased detection of B. henselae DNA, and that the nested-FtsZ was the most sensitive and the only specific to B. henselae in different biological samples. As all samples detected by nested-HSP and nested-ITS, were also by nested-FtsZ, we infer that in our series infections were caused by Bartonella henselae. The high number of positive blood samples draws attention to the use of this biological material in the investigation of bartonellosis, regardless of the immune status of patients. This fact is important in the case of critically ill patients and young children to avoid more invasive procedures such as lymph nodes biopsies and aspirates.

Ermelindo Tavares, Cândida Fernandes, Maria José Borrego et al.

Introdução: A resistência aos antibióticos em Neisseria gonorrhoeae tem-se revelado um importante problema de saúde pública mundial, estando a levantar grandes dificuldades em termos de opções terapêuticas em alguns países. Objectivo: Rever o panorama (nacional e internacional) da resistência aos antibióticos em Neisseria gonorrhoeae. Material e Métodos: Pesquisa de artigos em revistas nacionais e internacionais (estas últimas com in- dexação na Pubmed/Medline e redigidas em inglês). Utilizaram-se como palavras-chave: “Neisseria gonorrhoeae antibiotic resistance”. Resultados: As cefalosporinas de terceira geração (ceftriaxone e cefixima), associadas ou não à azitromicina, substituíram as fluoroquinolonas como fármacos de primeira linha no tratamento da gonorreia. Os rela- tos de resistência às cefalosporinas são ainda relativamente escassos; contudo, o aumento da concentração inibitória mínima (CIM), traduzido pela diminuição da sensibilidade a esta classe de antibióticos, tem vindo a ser regularmente descrita. Por outro lado, a resistência à azitromicina foi relatada em vários países. Em Portugal, já foram reportados casos de Neisseria gonorrhoeae resistentes à azitromicina mas não às cefalosporinas. Porém, estirpes com diminuição da sensibilidade às cefalosporinas foram já detetadas. Conclusão: Novas alternativas terapêuticas são indispensáveis para o tratamento das infeções por Neisseria gonorrhoeae, bem como condutas adequadas por parte dos médicos e dos doentes e seus contactantes. PALAVRAS-CHAVE – Antibióticos; Resistência antibiótica; Neisseria gonorrhoeae; Guideline.

Griselda Berberian, MD, Verónica Firpo, MD, Adriana Soto, MD et al.

Objectives: The aim of this study was to identify the clinical, radiological, and bacteriological features, risk factors, and outcome of neonates with bone and joint infections. Study design: Observational, retrospective, and analytical study of 77 patients less than 2 months of age, admitted to a tertiary neonatal intensive care unit (NICU) with the diagnosis of bone or joint infection, based on clinical, radiological, and microbiological criteria. Results: Seventy-seven patients with 99 acute osteoarthritis foci in a 16 year period were included in the study. Risk factors for infection could be identified in 69% of the patients. The hip was the most frequent. Staphylococcus aureus was the main isolated microorganism. Twenty-nine infants (38%) had sequelae. Hip involvement, culture positive, and Staphylococcus aureus isolation were risk factors associated with sequelae. Conclusion: Osteoarticular infection is unusual in the neonate; however it is associated with an elevated incidence of sequelae. This mandates for a high degree of suspicion to diagnose this potentially disabling entity. Keywords: osteoarthritis, neonate, Staphylococcus aureus