Yang Li,1 Dongjie Du,2 Fenghua Wen,1 Na Li,1 Yitao Jia1 1The Third Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Vascular Surgery Catheterization Room, Hebei General Hospital, Shijiazhuang, Hebei, 050011, People’s Republic of ChinaCorrespondence: Yitao Jia, The Third Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email jiayitao99@163.comBackground: Infectious arthritis is an uncommon but serious condition in older adults and may be easily misdiagnosed due to atypical clinical presentations. Proteus mirabilis is a rare causative pathogen of infectious arthritis, and its manifestations can resemble reactive arthritis, particularly in elderly patients with malignancy or immunocompromised status.Case Presentation: A 74-year-old woman with advanced endometrial cancer was admitted with fever and urinary tract infection caused by Proteus mirabilis, complicated by septic shock. After initial improvement with intravenous antibiotic therapy, she developed recurrent fever accompanied by bilateral knee swelling and pain. Reactive arthritis was initially suspected, and empiric glucocorticoid therapy resulted in transient symptomatic relief. However, magnetic resonance imaging of both knees demonstrated bone destruction consistent with infectious arthritis. Repeated joint irrigation combined with prolonged antibiotic therapy led to clinical improvement, resolution of fever, and recovery of knee function. Follow-up blood cultures were negative, and the patient remained clinically stable.Conclusion: This case highlights the diagnostic challenges of differentiating infectious arthritis from reactive arthritis in elderly patients with cancer. In older adults with Proteus mirabilis bacteremia who develop acute joint symptoms, infectious arthritis should be carefully considered, even when initial response to glucocorticoids is observed. Early imaging evaluation and repeated microbiological assessment are essential to avoid delayed diagnosis and improve outcomes in the aging population.Keywords: Proteus mirabilis, infectious arthritis, reactive arthritis, urinary tract infection
Dr Eleni Galanis, Dr. Eleni Galanis, Dimitra Panagiotoglou
et al.
Introduction: One in eight Canadians experiences an enteric infection annually. In British Columbia (BC), Canada significant risks of sequelae and death following laboratory-confirmed, reported enteric infections exist, including a 30 times higher risk of acute kidney injury (AKI) and a 4 times higher risk of inflammatory bowel disease (IBD). However, reported infections do not represent everyone who seeks care for these infections. Thus, we aimed to determine whether individuals who sought care for enteric infections, but for whom no laboratory-confirmed infection was reported, were also at risk for kidney, gastrointestinal, and rheumatological sequelae and death, in BC, Canada. Methods: We conducted a retrospective cohort study of everyone registered in BC's health insurance program, 2005-2014 (n=5,819,344). The cohort was followed for ∼7.5 years/person, and included 40,523 individuals with 42,308 laboratory-confirmed, reported enteric infections. Individuals with a physician visit or hospitalization with an International Classification of Disease (ICD) code for enteric infection or non-specific acute gastroenteritis, but without a reported, laboratory-confirmed infection, were our case group. Sequelae and deaths (from all causes) were identified using administrative data and vital statistics. We estimated risks using adjusted hazard ratios (aHRs) from extended Cox regression models, adjusting for age, sex, comorbidities, and neighbourhood income. Our comparison group was those without any evidence of enteric infection, i.e., who never had a laboratory-confirmed reported enteric infection, nor any physician visits or hospitalizations with ICD codes for enteric infections, during the study. Results: From 2005-2014, 238,116 people experienced 298,577 separate episodes where they sought medical care with an ICD code for enteric infection, with no accompanying laboratory-confirmation reported. For these individuals, the risk of AKI was 21.4 times higher (95% confidence interval [CI]: 20.7, 22.1) in the 90 days after seeking care, and the risk of hemolytic-uremic syndrome was 40.9 times higher (95% CI: 20.5, 81.5) in the 1-45 days. Their risks of IBD (aHR: 4.73, 95%CI: 4.44, 5.05), celiac disease (aHR: 3.98; 95%CI: 3.72, 4.26), and irritable bowel syndrome (aHR: 4.91, 95%CI: 4.71, 5.13) in the six months after seeking care were also significantly higher. The risks of ankylosing spondylitis, reactive arthritis, and anterior uveitis were smaller, but also significant. The risk of dying was 8.75 times higher (95% CI: 8.38, 9.14) in the 30 days following a physician visit or hospitalization. Discussion: The risks of sequelae and mortality is comparable regardless of whether individuals had a laboratory-confirmed, reported infection. These findings are consistent with those reported by others, demonstrating the validity of using administrative health data to investigate sequelae of infections. Conclusion: The burden of illness related to enteric infections is greater than that related to the acute infection. Multisectoral public health actions and patient education are therefore important to prevent enteric infections and their sequelae.
Ticks are the second most important vectors of human diseases after mosquitoes. Hard ticks are more abundant and widespread than soft ticks, resulting in their greater involvement in diverse diseases. Consequently, most research on tick-borne pathogens has focused on hard ticks. In contrast, soft ticks, which comprise fewer species, have received less research attention. In this study, we identified a novel single-stranded RNA virus (tentatively named Gagosa Mountain virus) in Ornithodoros lahorensis ticks from the Shigatse region of Tibet. We collected 80 engorged soft ticks from Tibetan sheep, placing each in a separate tube for pathogen analysis. Quantitative real-time PCR (qRT-PCR) and nested PCR techniques were employed to confirm the presence of Gagosa Mountain virus, and subsequent analyses focused on elucidating its genomic features and phylogenetic relationships. Our results demonstrated that Gagosa Mountain virus was present in 15 out of 80 ticks, corresponding to a positivity rate of 19%. The 13,133-nucleotide single-stranded negative-sense RNA genome contained six open reading frames (ORFs) encoding the N protein, RdRp, and four hypothetical proteins. Pairwise distance analysis showed high nucleotide sequence identity among the viral sequences. Phylogenetic analysis indicated that Gagosa Mountain virus is most closely related to Lhasa Rhabd tick virus 1, which is an unclassified member of the family Rhabdoviridae. Further analyses demonstrated that Gagosa Mountain virus represents a novel member of the genus Betanemrhavirus within the family Rhabdoviridae.
Abstract Background Users of intrauterine devices (IUDs) have been found to have a lower incidence of cervical cancer in meta-analyses, but these studies have not been able to examine the influence of IUD type. The aim of this study is to investigate the incidence of de novo high-risk human papillomavirus (HPV) infections in relation to the reported use of contraceptive methods, with special regard to different types of IUDs. Methods A sample of participants in the national screening program for cervical cancer (n = 11,702) with a negative HPV test in 2017–2018 were included. Their subsequent HPV test results in 2020–2023 were analyzed in relation to their reported contraceptive method. Results Participants who reported use of hormonal contraception had higher incidence of a positive HPV screening test (5.6%) compared with women with no reported contraception (4.2%) (OR 1.29; 95% CI 1.01–1.64). There was no significant difference in HPV incidence among women who reported use of hormonal IUD (HIUD) or copper-containing IUD (CU-IUD). Women who reported use of the same contraceptive method in both screening rounds showed no significant differences in HPV incidence, regardless of the contraceptive method they had used. Conclusion The incidence of de novo HPV infections is not significantly different in users of different types of IUD.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Infectious and parasitic diseases
Carlos Alves Pessoa, João Paulo Cola, Thiago Nascimento do Prado
et al.
Justificativa e Objetivos: a população privada de liberdade é classificada como vulnerável à infecção pela COVID-19, pois vive em ambientes suscetíveis à disseminação de infecções. Diante disso, propôs-se descrever o surto de COVID-19 em unidade prisional e analisar as ações de vigilância em saúde para o seu controle. Métodos: trata-se de estudo misto, de caráter quantitativo e qualitativo, de surto de COVID-19 ocorrido entre julho e setembro de 2020 em Centro de Detenção Provisória. Utilizaram-se dados secundários de casos suspeitos da COVID-19, e na análise qualitativa, foram realizadas entrevistas com cinco profissionais de saúde. Resultados: foram registrados 640 casos suspeitos de COVID-19; 477 (74,5%) casos foram confirmados para COVID-19; e somente 91 (14,2%) dos casos apresentaram sintomas característicos. Todos evoluíram para cura. Rastreio de sintomáticos, celas de isolamento, suspensão de visitas e testagem em massa foram estratégias elencadas para o controle do surto. Conclusão: a população privada de liberdade é vulnerável a doenças respiratórias devido ao contexto de superlotação em que vivem.
Objective: Mycobacterium tuberculosis (MTB) is a contagious airborne disease that is spread from person to person via particles in the air which are expelled when speaking or coughing1. This retrospective observational study aims to assess the nosocomial transmission of pulmonary MTB among inpatient roommates in a high-risk oncological population over a 14-year period. With limited studies on the transmissibility of MTB in such environments, the investigation focuses on evaluating the risk of nosocomial transmission and implementation of appropriate infection control measures. Design: A retrospective analysis from 2010 – April 2023 was conducted in an acute care, 500-bed oncological center. Following exposure workups performed by the Department of Infection Prevention and Control, 17 of 57 identified patients with active pulmonary MTB had inpatient stays with roommates. Source infectivity showed 7 AFB smear positive results, 4 MTB PCR positive results, and 14 MTB culture positive results. Some index patients had a combination of AFB, PCR and/or culture positivity. A high-risk exposure is defined as any patient who shared a room with an index patient for >4 cumulative hours during the infectious period. Infectious period was determined for each index patient based on the onset of symptoms and laboratory results. Workups identified 33 exposed roommates who were notified and advised to undergo testing, employing QuantifERON (QFT-GIT) serum test or Tuberculin skin (TST) PPD test at least 8 weeks following their last day of exposure. The overlap between inpatient roommates and index patients ranged from 1 to 4 days, averaging 1.5 days. Results: Of the 33 high-risk roommates, 14 (42%) patients were unable to provide follow-up testing for various reasons including: patient expiration prior to testing, patient transfer to hospice, and being lost to follow up. Nineteen (58%) patients completed post-exposure testing. 12 patients underwent PPD testing (63%) and 7 patients underwent QuantifERON testing (37%). Zero (0%) were found to have a positive QuantifERON or PPD following their exposure. 15.8% (N=3) of exposed patients had hematologic malignancies, and 84.2% (N=16) of exposed patients had solid tumor malignancies. Conclusion: The risk of active pulmonary MTB transmission in an oncological, inpatient setting was determined to be low. The absence of positive conversions among roommates of confirmed MTB patients underscores the effectiveness of infection control measures, emphasizing the importance of isolating confirmed or suspected cases promptly. Ongoing efforts should continue to focus on these preventive measures to mitigate the risk of MTB transmission in similar high-risk settings.
Infectious and parasitic diseases, Public aspects of medicine
Eosinophils are innate immune cells typically associated with allergic and parasitic diseases. However, in recent years, eosinophils have also been ascribed a role in keeping homeostasis and in fighting several infectious diseases. Indeed, these cells circulate as mature cells in the blood and can be quickly recruited to the infected tissue. Moreover, eosinophils have all the necessary cellular equipment such as pattern recognition receptors (PRRs), pro-inflammatory cytokines, anti-bacterial proteins, and DNA traps to fight pathogens and promote an efficient immune response. This review summarizes some of the updated information on the role of eosinophils' direct and indirect mediated interactions with pathogens.
Amir Hossein Hasanpour, Mahdi Sepidarkish, Abolfazl Mollalo
et al.
Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a difficult to treat infection, particularly in residents of elderly care centers (ECCs). Despite the substantial burden of MRSA, an inadequate number of studies have analyzed MRSA prevalence in ECCs. Objectives We conducted a worldwide systematic review and meta-analysis on the prevalence and risk factors of MRSA in ECCs. Methods We searched MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases and the gray literature sources for all studies published between January 1980 and December 2022 on the prevalence of MRSA in ECCs. A random-effects model was utilized to estimate pooled prevalence rates at 95% confidence intervals (CI). Moreover, the data were analyzed based on World Health Organization-defined regions, income, and human development index levels. Results In total, 119 studies, including 164,717 participants from 29 countries, were found eligible for meta-analysis. The pooled global prevalence of MRSA was 14.69% (95% CI 12.39–17.15%; 16,793/164,717). Male gender [prevalence ratio (PR) = 1.55; 95% CI 1.47–1.64], previous MRSA infection (PR = 3.71; 95% CI 3.44–4.01), prior use of antibiotics (PR = 1.97; 95% CI 1.83–2.12), hospitalized within the previous year (PR = 1.32; 95% CI 1.20–1.45), have had any wound (PR = 2.38; 95% CI 2.23–2.55), have used urinary catheter (PR = 2.24; 95% CI 2.06–2.43), have used any medical device (PR = 1.78; 95% CI 1.66–1.91), and those with diabetes (PR = 1.55; CI 1.43–1.67) were more likely to be colonized by MRSA than other patients. Conclusion Screening programs and preventive measures should target MRSA in ECCs due to the high global prevalence rates.
Bruno Samways dos Santos, M. Steiner, A. T. Fenerich
et al.
Abstract The objective of this paper is to present a bibliometric analysis of the applications of Data Mining (DM) and Machine Learning (ML) techniques in the context of public health from 2009 to 2018. A systematic review of the literature was conducted considering three major scientific databases: Scopus, Web of Science and Science Direct. This enabled an analysis of the number of papers by journal, the countries where the applications were carried out, which databases are more commonly used, the most studied topics in public health, and the techniques, programming languages and software applications most frequently used by researchers. Our results showed a slight increase in the number of papers published in 2014 and a significative increase since 2017, focusing mostly on infectious, parasitic and communicable diseases, chronic diseases and risk factors for chronic diseases. The Journal of Medical Internet Research and PLoS ONE published the highest number of papers. Support Vector Machines (SVM) were the most common technique, while R and WEKA were the most common programming language and software application, respectively. The U.S. was the most common country where the studies were conducted. In addition, Twitter was the most frequently used source of data by researchers. Hence, this paper provides an overview of the literature on DM and ML in the field of public health and serves as a starting point for beginner and experienced researchers interested in this topic.
Giardia is the commonest parasitic diarrheal pathogen affecting humans and a frequent cause of waterborne/foodborne parasitic diseases worldwide. Prevalence of giardiasis is higher in children, living in poor, low hygiene settings in developing countries, and in travelers returning from highly endemic areas. The clinical picture of giardiasis is heterogeneous, with high variability in severity of clinical disease. It can become chronic or be followed by post-infectious sequelae. An alarming increase in cases refractory to the conventional treatment with nitroimidazoles (ie, metronidazole) has been reported in low prevalence settings, such as European Union countries, especially in patients returning from Asia. In view of its relevance, we aim in this review to recapitulate present clinical knowledge about Giardia, with a special focus on the challenge of treatment-refractory giardiasis. We propose a working definition of clinically drug-resistant giardiasis, summarize knowledge regarding resistance mechanisms, and discuss its clinical management according to research-based evidence and medical practice. Advances in development and identification of novel drugs and potential non-pharmacological alternatives are also reviewed with the overall aim to define knowledge gaps and suggest future directions for research.
The maternally inherited alpha-proteobacterium Wolbachia has been proposed as a tool to block transmission of devastating mosquito-borne infectious diseases like dengue and malaria. Here we study the reproductive manipulations induced by a recently identified Wolbachia strain that stably infects natural mosquito populations of a major malaria vector, Anopheles coluzzii, in Burkina Faso. We determine that these infections significantly accelerate egg laying but do not induce cytoplasmic incompatibility or sex-ratio distortion, two parasitic reproductive phenotypes that facilitate the spread of other Wolbachia strains within insect hosts. Analysis of 221 blood-fed A. coluzzii females collected from houses shows a negative correlation between the presence of Plasmodium parasites and Wolbachia infection. A mathematical model incorporating these results predicts that infection with these endosymbionts may reduce malaria prevalence in human populations. These data suggest that Wolbachia may be an important player in malaria transmission dynamics in Sub-Saharan Africa. Wolbachia bacteria infect insects and could potentially be used to control populations of malaria-transmitting mosquitoes. Here, the authors provide evidence that natural Wolbachia infections affect the rate of egg laying and are associated with reduced presence of malaria parasites in Anophelesmosquitoes.
A. de-Graft Aikins, N. Unwin, Charles Agyemang
et al.
Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them.
Zyryanov S.K., Chenkurov M.S., Ivzhits M.A.
et al.
Objective.
To investigate the mortality rate, comorbidity prevalence, and etiology of community-acquired pneumonia (CAP) in elderly patient population.
Materials and Methods.
Hospitalized elderly patients with CAP were distributed into the following age groups: 65–74 years (group I), 75–84 years (group II) and 85–94 years (group III). The patients’ medical records were used for determining comorbidities and mortality rate. In order to determine etiology of CAP, sputum or BAL samples were collected. A total of 171 isolates were identified using MALDI-TOF MS.
Results.
The mortality rates were 27.1%, 31.5% and 45.7% in age groups I, II, III, respectively. The most common concomitant diseases in all age groups were arterial hypertension (47.4%, 54.6%, and 62.8% for groups I, II, and III, respectively), chronic heart failure (45.7%, 50.9%, and 60.0%, respectively), and coronary heart disease (15.2%, 25.9%, and 24.3%, respectively). The most frequently isolated bacteria by age group were the following: group I – non-fermenting Gram-negative bacteria (NFGNB) (7.4%), Enterobacterales (6.6%), S. aureus (6.6%); group II – Enterobacterales (13.9%), S. aureus (5.6%), Enterococcus spp. (5.6%), NFGNB (2.8%); group III – NFGNB (15.4%), S. aureus (7.7%), Enterococcus spp. (7.7%), Enerobacterales (7.7%).
Conclusions.
The mortality rates in elderly patients with CAP were high and varied from 27.1% in 65–74 years old patients to 45.7% in 85–94 years old patients. The most common comorbidities in all age groups were arterial hypertension (up to 62.8%), chronic heart failure (up to 60%), and coronary heart disease (up to 25.9%). The main pathogens causing CAP in elderly patient population were Enterobacterales and non-fermenting Gram-negative bacteria.
The connection between our environment and parasitic diseases may not always be straightforward, but it exists nonetheless. This article highlights how climate as a component of our environment, or more specifically climate change, has the capability to drive parasitic disease incidence and prevalence worldwide. There are both direct and indirect implications of climate change on the scope and distribution of parasitic organisms and their associated vectors and host species. We aim to encompass a large body of literature to demonstrate how a changing climate will perpetuate, or perhaps exacerbate, public health issues and economic stagnation due to parasitic diseases. The diseases examined include those caused by ingested protozoa and soil helminths, malaria, lymphatic filariasis, Chagas disease, human African trypanosomiasis, leishmaniasis, babesiosis, schistosomiasis, and echinococcus, as well as parasites affecting livestock. It is our goal to impress on the scientific community the magnitude a changing climate can have on public health in relation to parasitic disease burden. Once impending climate changes are now upon us, and as we see these events unfold, it is critical to create management plans that will protect the health and quality of life of the people living in the communities that will be significantly affected.