Mycobacterium riyadhense is a newly discovered, slow-growing nontuberculous mycobacterium with an emerging global distribution. We report a case of multifocal osteolytic lesions as the first sign of infection in a previously healthy 39-year-old female. M. riyadhense was detected in this case using next-generation metagenomic sequencing after it failed to be identified with conventional methods. The patient received 12 months of therapy with isoniazid, rifampin, and ethambutol, with the addition of moxifloxacin and clarithromycin in the first four months, and had a full return to health with no detectable disease at the last follow-up.
{"title":"Multifocal osteolytic lesions as an initial presentation of mycobacterium riyadhense: Case report and literature review","authors":"Hassan Almarhabi , Abdulmajeed Sarhan , Aisha Alharbi , Abdulfatah Al-Amri , Mohamed Firoze Ahamed , Sharif Hala","doi":"10.1016/j.jiph.2025.102741","DOIUrl":"10.1016/j.jiph.2025.102741","url":null,"abstract":"<div><div><em>Mycobacterium riyadhense</em> is a newly discovered, slow-growing nontuberculous mycobacterium with an emerging global distribution. We report a case of multifocal osteolytic lesions as the first sign of infection in a previously healthy 39-year-old female. <em>M. riyadhense</em> was detected in this case using next-generation metagenomic sequencing after it failed to be identified with conventional methods. The patient received 12 months of therapy with isoniazid, rifampin, and ethambutol, with the addition of moxifloxacin and clarithromycin in the first four months, and had a full return to health with no detectable disease at the last follow-up.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102741"},"PeriodicalIF":4.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leptospirosis is a zoonotic infection with public health implications and diverse clinical presentations, ranging from mild symptoms to severe, life-threatening disease. In critical cases, it can cause multiorgan failure and death. Diagnosis is typically based on clinical suspicion and confirmed by laboratory testing. However, in acute, life-threatening cases, obtaining a history of exposure and recognizing early symptoms may be challenging. Traditional diagnostic methods for identifying causative pathogens are time-consuming and limited. Next-generation sequencing (NGS) has emerged as a novel diagnostic tool that identifies pathogens using DNA or RNA from bodily fluids, offering more timely, unbiased results, especially for fastidious or non-culturable organisms.
{"title":"Next-generation sequencing for rapid etiologic diagnosis of acute respiratory distress syndrome: A case of life-threatening leptospirosis","authors":"Yu-Ting Weng , Chun-Kai Huang , Aristine Cheng , Sheng-Yuan Ruan , Jann-Tay Wang","doi":"10.1016/j.jiph.2025.102727","DOIUrl":"10.1016/j.jiph.2025.102727","url":null,"abstract":"<div><div>Leptospirosis is a zoonotic infection with public health implications and diverse clinical presentations, ranging from mild symptoms to severe, life-threatening disease. In critical cases, it can cause multiorgan failure and death. Diagnosis is typically based on clinical suspicion and confirmed by laboratory testing. However, in acute, life-threatening cases, obtaining a history of exposure and recognizing early symptoms may be challenging. Traditional diagnostic methods for identifying causative pathogens are time-consuming and limited. Next-generation sequencing (NGS) has emerged as a novel diagnostic tool that identifies pathogens using DNA or RNA from bodily fluids, offering more timely, unbiased results, especially for fastidious or non-culturable organisms.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 6","pages":"Article 102727"},"PeriodicalIF":4.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The diffused and prolonged SARS-CoV-2 transmission lead to high levels of hospitalization. During this period, the focus of sanitary structures was to contain COVID-19 mortality and this may have reduced the application of health associated infection (HAI) and multidrug resistant microorganism (MDRO) prevention programs.
Methods
A search was performed in PubMed, Science Direct, and Google Scholar databases to identify clinical observational studies that reported the impact of COVID-19 pandemic on the prevalence or incidence on HAIs and/or MDROs from December 2019 to August 2024 in Italy. Studies were included if they reported a comparison with pre-pandemic period and had a full-text available. Eligible studies were assessed for risk of bias and quality with NHI Quality Assessment Tool by two researchers independently. Data were represented in tables and a narrative synthesis was made in the text.
Results
Selected studies included 4 studies reporting data on HAI (1497 total patients) and 11 studies reporting data on MDRO (80388 total patients). The majority of the studies reported an increase in HAI prevalence (9–11.1 % range) and MDRO, in particular, gram negative MDRO had an increase range of 0.8 %-45.6 % and gram positive MDRO an increase range of 0.5 %-81.8 % from pre- to post-COVID-19 period in the different studies considered
Conclusion
These findings underscore the critical need for active surveillance in hospital wards, the implementation of antibiotic stewardship and prescribing programs to mitigate the impact of such crises on healthcare-associated infections and antimicrobial resistance. Furthermore, permanent training of healthcare personnel is necessary.
{"title":"Impact of the COVID-19 pandemic on healthcare-associated infections and multidrug-resistant microorganisms in Italy: A systematic review","authors":"Chiara Peconi , Enrica Martini , Donatella Sarti , Emilia Prospero","doi":"10.1016/j.jiph.2025.102729","DOIUrl":"10.1016/j.jiph.2025.102729","url":null,"abstract":"<div><h3>Background</h3><div>The diffused and prolonged SARS-CoV-2 transmission lead to high levels of hospitalization. During this period, the focus of sanitary structures was to contain COVID-19 mortality and this may have reduced the application of health associated infection (HAI) and multidrug resistant microorganism (MDRO) prevention programs.</div></div><div><h3>Methods</h3><div>A search was performed in PubMed, Science Direct, and Google Scholar databases to identify clinical observational studies that reported the impact of COVID-19 pandemic on the prevalence or incidence on HAIs and/or MDROs from December 2019 to August 2024 in Italy. Studies were included if they reported a comparison with pre-pandemic period and had a full-text available. Eligible studies were assessed for risk of bias and quality with NHI Quality Assessment Tool by two researchers independently. Data were represented in tables and a narrative synthesis was made in the text.</div></div><div><h3>Results</h3><div>Selected studies included 4 studies reporting data on HAI (1497 total patients) and 11 studies reporting data on MDRO (80388 total patients). The majority of the studies reported an increase in HAI prevalence (9–11.1 % range) and MDRO, in particular, gram negative MDRO had an increase range of 0.8 %-45.6 % and gram positive MDRO an increase range of 0.5 %-81.8 % from pre- to post-COVID-19 period in the different studies considered</div></div><div><h3>Conclusion</h3><div>These findings underscore the critical need for active surveillance in hospital wards, the implementation of antibiotic stewardship and prescribing programs to mitigate the impact of such crises on healthcare-associated infections and antimicrobial resistance. Furthermore, permanent training of healthcare personnel is necessary.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102729"},"PeriodicalIF":4.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.jiph.2025.102728
Courtney Meilleur , Julianne Kus , Christine Navarro , Vinita Dubey , Jay Lucidarme , Ray Borrow , Raymond S.W. Tsang
Objectives
To characterize the recent trends in serogroup W isolates from invasive meningococcal disease (IMD) cases (MenW) in Ontario, Canada since 2015.
Methods
IMD case isolates in Ontario between January 1, 2015 and June 30, 2024 were examined by phenotypic and genetic methods for possession of vaccine antigen genes and clonal characteristics. MenW ST-11 clonal complex (CC) strains were compared against global MenW isolates by core-genome multi-locus sequence typing (cgMLST).
Results
The percentage of culture-confirmed IMD caused by MenW in Ontario increased from 10 % in 2015–40.9 % in the first half of 2024, consisting entirely of strains belonging to the ST-11 CC. cgMLST comparison of the Ontario invasive MenW isolates versus international MenW ST-11CC strains showed that the Ontario isolates were related to those found globally, with a recent cluster of eight cases from one city due to a strain highly related to international Umrah outbreak strains. Most MenW IMD cases (60 %) occurred in individuals older than 40 years of age and the majority (83.3 %) predicted to express antigens covered by the 4CMenB vaccine.
Conclusions
Multiple different introductions of international MenW strains likely accounted for the recent shift towards invasive MenW disease in Ontario.
{"title":"Genetically distinct Hajj and South American-related strains of serogroup W Neisseria meningitidis causing invasive meningococcal disease in Ontario, Canada, January 1, 2015 to June 30, 2024","authors":"Courtney Meilleur , Julianne Kus , Christine Navarro , Vinita Dubey , Jay Lucidarme , Ray Borrow , Raymond S.W. Tsang","doi":"10.1016/j.jiph.2025.102728","DOIUrl":"10.1016/j.jiph.2025.102728","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize the recent trends in serogroup W isolates from invasive meningococcal disease (IMD) cases (MenW) in Ontario, Canada since 2015.</div></div><div><h3>Methods</h3><div>IMD case isolates in Ontario between January 1, 2015 and June 30, 2024 were examined by phenotypic and genetic methods for possession of vaccine antigen genes and clonal characteristics. MenW ST-11 clonal complex (CC) strains were compared against global MenW isolates by core-genome multi-locus sequence typing (cgMLST).</div></div><div><h3>Results</h3><div>The percentage of culture-confirmed IMD caused by MenW in Ontario increased from 10 % in 2015–40.9 % in the first half of 2024, consisting entirely of strains belonging to the ST-11 CC. cgMLST comparison of the Ontario invasive MenW isolates versus international MenW ST-11CC strains showed that the Ontario isolates were related to those found globally, with a recent cluster of eight cases from one city due to a strain highly related to international Umrah outbreak strains. Most MenW IMD cases (60 %) occurred in individuals older than 40 years of age and the majority (83.3 %) predicted to express antigens covered by the 4CMenB vaccine.</div></div><div><h3>Conclusions</h3><div>Multiple different introductions of international MenW strains likely accounted for the recent shift towards invasive MenW disease in Ontario.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102728"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-antibiotic treatments, such as carbon dots (C-dots), are gaining popularity in the search for effective alternatives. We aimed to evaluate the antibacterial properties of C-dots derived from Lactobacillus acidophilus (L-C-dots) alone and in combination against carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates.
Methods
Seventy clinical isolates of Klebsiella pneumoniae were tested for carbapenem resistance using a modified carbapenem inactivation assay. To determine the presence of fimH and mrkD genes, which are associated with biofilm formation, polymerase chain reaction (PCR) was conducted. L-C-dots were synthesized using a hydrothermal method and characterized. Furthermore, their antibacterial and anti-biofilm activities were evaluated against CRKP isolates. The combination of L-C-dots with the meropenem antibiotics were also tested using a checkerboard assay. Finally, the influence of L-C-dots on the expression levels of fimH and mrkD genes was examined using quantitative PCR (qPCR).
Results
L-C-dots demonstrated significant antibacterial activity against CRKP isolates, with a minimum inhibitory concentration (MIC) of 50 mg/mL and a sub-MIC of 25 mg/mL. L-C-dots effectively inhibited biofilm formation at MIC and sub-MIC concentrations (P ˂ 0.05). Additionally, the L-C-dots had synergistic and additive interactions with the meropenem antibiotics against CRKP isolates, reducing the MIC of both agents. Furthermore, the L-C-dots decreased the expression of the fimH(p< 0.029) and mrkD (p < 0.015) genes.
Conclusions
The findings indicate that L-C-dots may serve as a promising new treatment option for CRKP infections. They show potential as a strong therapeutic choice, especially when used in combination with traditional antibiotics.
{"title":"Synergistic antibacterial effects of carbon dots derived from Lactobacillus acidophilus alone and in combination against carbapenem-resistant Klebsiella pneumoniae","authors":"Leila Shamkhali , Ashraf Mohabati Mobarez , Seyed Davar Siadat , Hamid Pajavand","doi":"10.1016/j.jiph.2025.102724","DOIUrl":"10.1016/j.jiph.2025.102724","url":null,"abstract":"<div><h3>Background</h3><div>Non-antibiotic treatments, such as carbon dots (C-dots), are gaining popularity in the search for effective alternatives. We aimed to evaluate the antibacterial properties of C-dots derived from <em>Lactobacillus acidophilus</em> (L-C-dots) alone and in combination against carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) isolates.</div></div><div><h3>Methods</h3><div>Seventy clinical isolates of <em>Klebsiella pneumoniae</em> were tested for carbapenem resistance using a modified carbapenem inactivation assay. To determine the presence of <em>fimH</em> and <em>mrkD</em> genes, which are associated with biofilm formation, polymerase chain reaction (PCR) was conducted. L-C-dots were synthesized using a hydrothermal method and characterized. Furthermore, their antibacterial and anti-biofilm activities were evaluated against CRKP isolates. The combination of L-C-dots with the meropenem antibiotics were also tested using a checkerboard assay. Finally, the influence of L-C-dots on the expression levels of <em>fimH</em> and <em>mrkD</em> genes was examined using quantitative PCR (qPCR).</div></div><div><h3>Results</h3><div>L-C-dots demonstrated significant antibacterial activity against CRKP isolates, with a minimum inhibitory concentration (MIC) of 50 mg/mL and a sub-MIC of 25 mg/mL. L-C-dots effectively inhibited biofilm formation at MIC and sub-MIC concentrations (P ˂ 0.05). Additionally, the L-C-dots had synergistic and additive interactions with the meropenem antibiotics against CRKP isolates, reducing the MIC of both agents. Furthermore, the L-C-dots decreased the expression of the <em>fimH</em> <strong>(p< 0.029)</strong> and <em>mrkD</em> (<strong>p < 0.015</strong>) genes.</div></div><div><h3>Conclusions</h3><div>The findings indicate that L-C-dots may serve as a promising new treatment option for CRKP infections. They show potential as a strong therapeutic choice, especially when used in combination with traditional antibiotics.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102724"},"PeriodicalIF":4.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1016/j.jiph.2025.102723
Chiwook Chung , Seung Won Lee , Dawoon Jeong , Hongjo Choi , Hojoon Sohn , Doosoo Jeon , Young Ae Kang
Background
Disagreement persists regarding the cause of death in patients with tuberculosis (TB) between the national TB registry and vital registration statistics. This study investigated the disagreement and contributing factors between TB-related and non-TB-related deaths using an integrated national TB database in South Korea.
Methods
We identified a sub-set cohort of 29,033 patients with drug-susceptible TB registered between 2011 and 2020 who died during TB treatment. The cause of death was identified by the Korean National Tuberculosis Surveillance System (KNTSS) and Statistics Korea database. We performed a multinomial logistic regression to identify factors associated with the cause of death.
Results
The participants’ median age was 79 years (interquartile range, 70–85 years), with males comprising 63.2 %. Among the 29,033 deaths, 12,937 (44.6 %) and 6028 (20.8 %) were classified as TB-related deaths in Statistics Korea and KNTSS, respectively. The overall agreement rate for the cause of death between the two databases was 0.72 (95 % confidence interval, 0.71–0.72), increasing from 0.69 in 2011–0.77 in 2020. Among discrepant cases, 92.2 % (7545/8181) were classified as non-TB-related in KNTSS but as TB-related in Statistics Korea. Over the study period, the proportion of individuals classified as non-TB-related deaths in both databases and the agreement rate increased. In the multinomial analysis, age, sputum acid-fast bacilli smear, Charlson comorbidity index, and comorbidities, such as cancer and end-stage renal disease, showed distinguishing features across the cause of death groups.
Conclusions
Substantial disagreement on the cause of death persists between the national TB registry and vital registration statistics, though this decreased during the study period. Most disagreement likely indicates an underestimation of TB-related deaths in the TB registry. Age, sputum smear, and comorbidities were identifiable characteristics across groups that may influence the cause of death coding process.
{"title":"Disagreement on estimating cause of death under tuberculosis treatment between the national tuberculosis registry and statistics data in South Korea, 2011–2020","authors":"Chiwook Chung , Seung Won Lee , Dawoon Jeong , Hongjo Choi , Hojoon Sohn , Doosoo Jeon , Young Ae Kang","doi":"10.1016/j.jiph.2025.102723","DOIUrl":"10.1016/j.jiph.2025.102723","url":null,"abstract":"<div><h3>Background</h3><div>Disagreement persists regarding the cause of death in patients with tuberculosis (TB) between the national TB registry and vital registration statistics. This study investigated the disagreement and contributing factors between TB-related and non-TB-related deaths using an integrated national TB database in South Korea.</div></div><div><h3>Methods</h3><div>We identified a sub-set cohort of 29,033 patients with drug-susceptible TB registered between 2011 and 2020 who died during TB treatment. The cause of death was identified by the Korean National Tuberculosis Surveillance System (KNTSS) and Statistics Korea database. We performed a multinomial logistic regression to identify factors associated with the cause of death.</div></div><div><h3>Results</h3><div>The participants’ median age was 79 years (interquartile range, 70–85 years), with males comprising 63.2 %. Among the 29,033 deaths, 12,937 (44.6 %) and 6028 (20.8 %) were classified as TB-related deaths in Statistics Korea and KNTSS, respectively. The overall agreement rate for the cause of death between the two databases was 0.72 (95 % confidence interval, 0.71–0.72), increasing from 0.69 in 2011–0.77 in 2020. Among discrepant cases, 92.2 % (7545/8181) were classified as non-TB-related in KNTSS but as TB-related in Statistics Korea. Over the study period, the proportion of individuals classified as non-TB-related deaths in both databases and the agreement rate increased. In the multinomial analysis, age, sputum acid-fast bacilli smear, Charlson comorbidity index, and comorbidities, such as cancer and end-stage renal disease, showed distinguishing features across the cause of death groups.</div></div><div><h3>Conclusions</h3><div>Substantial disagreement on the cause of death persists between the national TB registry and vital registration statistics, though this decreased during the study period. Most disagreement likely indicates an underestimation of TB-related deaths in the TB registry. Age, sputum smear, and comorbidities were identifiable characteristics across groups that may influence the cause of death coding process.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102723"},"PeriodicalIF":4.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sporadic cases and rare outbreaks of Zika Virus (ZIKV) have been reported in India since 2016. Between June to early September 2024; the city of Pune in western India was affected with a large outbreak of ZIKV. Here we report the analysis of epidemiological; clinical and genomic characteristics of the outbreak.
Methods
Suspected ZIKV cases and pregnant women within 3 km radius of ZIKV positive cases and household contacts were included in the study. The study area included parts of the Pune metropolitan region. ZIKV RNA in serum and urine samples was detected by a single-plex Realtime RT-PCR assay. Representative samples were characterized by whole-genome sequencing.
Results
Among clinically suspected ZIKV cases 63/433 (14.55 %); and 45/1615 (2.78 %) pregnant women surveyed; were found positive for acute ZIKV infection. Majority of positive cases were asymptomatic or had mild symptoms. Two cases reported complications of pyelonephritis and encephalitis respectively. There was no evidence of microcephaly in the fetuses of the pregnant women surveyed. The ZIKV strains were found to belong to the Asian lineage and clustered close to the Rajasthan strain reported previously in India. Mutation linked with microcephaly was not found in these sequences. Follow-up of pregnant women till October 2024 indicated 22 % (10/45) of women delivered healthy babies.
Conclusion
The ZIKV strain associated with the present outbreak did not have mutations linked with microcephaly; but had mutations linked with enhanced transmission. Symptoms such as thrombocytopenia; bleeding manifestations; retro-orbital-pain; in a small subset of patients were unique; which were not reported in previous outbreaks in India. The findings highlight the urgent need for enhanced surveillance to plan strategies for public health measures to control the disease spread. Study highlights the need for monitoring the mutations and follow up of ZIKV infected pregnant women and their children to confirm absence of congenital anomalies.
{"title":"An outbreak of Zika virus in western India in the metropolis of Pune in the monsoon of 2024","authors":"Gururaj Rao Deshpande , Gajanan N. Sapkal , Asha Salunke , Rashmi Gunjikar , Nitali Tadkalkar , Pradnya Shinde , Nidhi Daga , Manjusha Gopale , Ashwini Ramdasi , Supriya Hundekar , Kavita Lole , Rohan Raj Roy , Jose Antony Jenish , Rashi Srivastava , Shivani Parmar , Pooja Pawara , Kajal Jarande , Shankar Vidhate , Kirtee Khutwad","doi":"10.1016/j.jiph.2025.102720","DOIUrl":"10.1016/j.jiph.2025.102720","url":null,"abstract":"<div><h3>Background</h3><div>Sporadic cases and rare outbreaks of Zika Virus (ZIKV) have been reported in India since 2016. Between June to early September 2024; the city of Pune in western India was affected with a large outbreak of ZIKV. Here we report the analysis of epidemiological; clinical and genomic characteristics of the outbreak.</div></div><div><h3>Methods</h3><div>Suspected ZIKV cases and pregnant women within 3 km radius of ZIKV positive cases and household contacts were included in the study. The study area included parts of the Pune metropolitan region. ZIKV RNA in serum and urine samples was detected by a single-plex Realtime RT-PCR assay. Representative samples were characterized by whole-genome sequencing.</div></div><div><h3>Results</h3><div>Among clinically suspected ZIKV cases 63/433 (14.55 %); and 45/1615 (2.78 %) pregnant women surveyed; were found positive for acute ZIKV infection. Majority of positive cases were asymptomatic or had mild symptoms. Two cases reported complications of pyelonephritis and encephalitis respectively. There was no evidence of microcephaly in the fetuses of the pregnant women surveyed. The ZIKV strains were found to belong to the Asian lineage and clustered close to the Rajasthan strain reported previously in India. Mutation linked with microcephaly was not found in these sequences. Follow-up of pregnant women till October 2024 indicated 22 % (10/45) of women delivered healthy babies.</div></div><div><h3>Conclusion</h3><div>The ZIKV strain associated with the present outbreak did not have mutations linked with microcephaly; but had mutations linked with enhanced transmission. Symptoms such as thrombocytopenia; bleeding manifestations; retro-orbital-pain; in a small subset of patients were unique; which were not reported in previous outbreaks in India. The findings highlight the urgent need for enhanced surveillance to plan strategies for public health measures to control the disease spread. Study highlights the need for monitoring the mutations and follow up of ZIKV infected pregnant women and their children to confirm absence of congenital anomalies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102720"},"PeriodicalIF":4.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-21DOI: 10.1016/j.jiph.2025.102719
Lap Ah Tse , Feng Wang , Phoenix Kit Han Mo , Cherry Choi Miu Wan , Natalie Hiu Yu Tang , Shuyuan Yang , Dong Dong , Kin Fai Ho , Samuel Yang-shan Wong
Background
Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the acceptance of COVID-19 booster shots and reducing breakthrough infections among non-healthcare workers in Hong Kong.
Methods
In this 9-month randomized controlled trial (RCT), workers were randomly allocated to either the intervention or control group. The intervention group received educational sessions at baseline and at 3-month, covering general health and evidence-based information on the efficacy and safety of COVID-19 vaccines and booster shots. The control group received only general health information. All participants were followed up for an additional 6 months. The primary outcomes were intention and acceptance of booster shots, as well as breakthrough infections. The DASS-21 scale was used to evaluate participants’ mental health status, and two-way mixed ANOVA to analyze the group effect. A difference of ≥ 5 % in booster uptake between the intervention and control group indicated a practical significance in infection control.
Results
Among 310 consenting workers, 282 (91.0 %) of them completed the trial. At recruitment, the booster uptake rate was similar between the intervention and control groups (62.0 % vs. 62.1 %). After the educational intervention sessions, the intervention group showed a higher booster uptake rate (76.1 % vs. 67.9 %). A lower rate of breakthrough infection was observed in the intervention group during the latest follow-up period (23.2 % vs. 29.5 %); however, no change in the intention to get booster shots were recorded for all subjects.
Conclusion
This enhanced educational intervention program significantly improves booster uptake rates and reduces COVID-19 breakthrough infection rates among non-healthcare workers. (Trial registration: ClinicalTrials.gov - NCT05197673)
{"title":"Does enhanced educational intervention reduce breakthrough infection and mental health problems via improving acceptance of COVID-19 booster shots in Chinese non-healthcare workers: A randomized controlled trial?","authors":"Lap Ah Tse , Feng Wang , Phoenix Kit Han Mo , Cherry Choi Miu Wan , Natalie Hiu Yu Tang , Shuyuan Yang , Dong Dong , Kin Fai Ho , Samuel Yang-shan Wong","doi":"10.1016/j.jiph.2025.102719","DOIUrl":"10.1016/j.jiph.2025.102719","url":null,"abstract":"<div><h3>Background</h3><div>Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the acceptance of COVID-19 booster shots and reducing breakthrough infections among non-healthcare workers in Hong Kong.</div></div><div><h3>Methods</h3><div>In this 9-month randomized controlled trial (RCT), workers were randomly allocated to either the intervention or control group. The intervention group received educational sessions at baseline and at 3-month, covering general health and evidence-based information on the efficacy and safety of COVID-19 vaccines and booster shots. The control group received only general health information. All participants were followed up for an additional 6 months. The primary outcomes were intention and acceptance of booster shots, as well as breakthrough infections. The DASS-21 scale was used to evaluate participants’ mental health status, and two-way mixed ANOVA to analyze the group effect. A difference of ≥ 5 % in booster uptake between the intervention and control group indicated a practical significance in infection control.</div></div><div><h3>Results</h3><div>Among 310 consenting workers, 282 (91.0 %) of them completed the trial. At recruitment, the booster uptake rate was similar between the intervention and control groups (62.0 % vs. 62.1 %). After the educational intervention sessions, the intervention group showed a higher booster uptake rate (76.1 % vs. 67.9 %). A lower rate of breakthrough infection was observed in the intervention group during the latest follow-up period (23.2 % vs. 29.5 %); however, no change in the intention to get booster shots were recorded for all subjects.</div></div><div><h3>Conclusion</h3><div>This enhanced educational intervention program significantly improves booster uptake rates and reduces COVID-19 breakthrough infection rates among non-healthcare workers. (Trial registration: ClinicalTrials.gov - NCT05197673)</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102719"},"PeriodicalIF":4.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.jiph.2025.102712
Deng-Chi Yang , Jo-Yen Chao , Chih-Yen Hsiao , Chien-Tzu Tseng , Wei-Hung Lin , Te-Hui Kuo , Ming-Cheng Wang
Background
Urinary tract infection (UTI) or acute pyelonephritis can lead to renal scarring and impact the subsequent renal function progression. The aims of this study were to investigate the changes in renal function related to UTI requiring hospital admission (UTI/HA) and the association between UTI/HA and long-term renal outcomes in patients with chronic kidney disease (CKD).
Methods
This was a multicenter, retrospective observational study. Renal events and renal function before and after UTI/HA in CKD patients were analyzed for short-term and mid-term renal outcomes. A case-control study with multivariate logistic regression analysis was used to investigate the association between clinical characteristics and risk of long-term renal outcomes (kidney replacement therapy or death, KRT/death) in adult CKD patients.
Results
This study included 1062 adult CKD patients, with 340 KRT and 76 deaths identified during a median follow-up of 105 months. Among 174 patients with UTI/HA, 59 (33.9 %) had bacteremia, 90 (51.7 %) acute kidney injury (AKI), and one in-hospital mortality. There was a faster decline rate of estimated glomerular filtration rate (eGFR) after UTI/HA compared to the pre-UTI/HA period [median (IQR) 0.37 (0.17–0.72) versus 0.19 (0.06–0.36) ml/min/1.73 m2 per month, P < 0.0001]. The incidence of UTI/HA was similar between the KRT/death and the CKD non-dialysis groups. Multivariate logistic regression analysis showed that baseline eGFR, baseline eGFR decline rate and number of hospital admission were significantly associated with an increased risk of KRT/death.
Conclusions
This study highlights the impact of UTI/HA on renal function and renal outcomes in adult CKD patients. It demonstrates a high incidence of in-hospital AKI but low mortality, and accelerated deterioration of renal function following UTI/HA. Long-term renal outcomes were influenced by the baseline renal function and progression rate, and the frequency of hospital admission. UTI/HA may be regarded as a potentially modifiable factor for CKD progression. However, there is a need for further analysis to isolate the impact of UTI/HA from pre-existing renal function decline on long-term renal outcomes.
{"title":"Impact of urinary tract infection requiring hospital admission on short-term, mid-term and long-term renal outcomes in adult CKD patients – A potentially modifiable factor for CKD progression","authors":"Deng-Chi Yang , Jo-Yen Chao , Chih-Yen Hsiao , Chien-Tzu Tseng , Wei-Hung Lin , Te-Hui Kuo , Ming-Cheng Wang","doi":"10.1016/j.jiph.2025.102712","DOIUrl":"10.1016/j.jiph.2025.102712","url":null,"abstract":"<div><h3>Background</h3><div>Urinary tract infection (UTI) or acute pyelonephritis can lead to renal scarring and impact the subsequent renal function progression. The aims of this study were to investigate the changes in renal function related to UTI requiring hospital admission (UTI/HA) and the association between UTI/HA and long-term renal outcomes in patients with chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>This was a multicenter, retrospective observational study. Renal events and renal function before and after UTI/HA in CKD patients were analyzed for short-term and mid-term renal outcomes. A case-control study with multivariate logistic regression analysis was used to investigate the association between clinical characteristics and risk of long-term renal outcomes (kidney replacement therapy or death, KRT/death) in adult CKD patients.</div></div><div><h3>Results</h3><div>This study included 1062 adult CKD patients, with 340 KRT and 76 deaths identified during a median follow-up of 105 months. Among 174 patients with UTI/HA, 59 (33.9 %) had bacteremia, 90 (51.7 %) acute kidney injury (AKI), and one in-hospital mortality. There was a faster decline rate of estimated glomerular filtration rate (eGFR) after UTI/HA compared to the pre-UTI/HA period [median (IQR) 0.37 (0.17–0.72) versus 0.19 (0.06–0.36) ml/min/1.73 m<sup>2</sup> per month, P < 0.0001]. The incidence of UTI/HA was similar between the KRT/death and the CKD non-dialysis groups. Multivariate logistic regression analysis showed that baseline eGFR, baseline eGFR decline rate and number of hospital admission were significantly associated with an increased risk of KRT/death.</div></div><div><h3>Conclusions</h3><div>This study highlights the impact of UTI/HA on renal function and renal outcomes in adult CKD patients. It demonstrates a high incidence of in-hospital AKI but low mortality, and accelerated deterioration of renal function following UTI/HA. Long-term renal outcomes were influenced by the baseline renal function and progression rate, and the frequency of hospital admission. UTI/HA may be regarded as a potentially modifiable factor for CKD progression. However, there is a need for further analysis to isolate the impact of UTI/HA from pre-existing renal function decline on long-term renal outcomes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102712"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.jiph.2025.102711
Van-Dong Nguyen , Hai Duong , Ming-Chia Lee , Jin-Hua Chen , Wei-Chang Huang , Hsiao-En Chen , Jung-Chun Lin , Jann-Yuan Wang , Chih-Hsin Lee
Background
Mycobacterium avium complex (MAC) infection, requiring prolonged treatment with an antibiotic combination, is an emerging public health concern.
Methods
This meta-analysis compared the efficacy of 2-drug regimens with that of 3-drug regimens in bacteriological responses, acquired macrolide resistance (AMR), and mortality among adult patients with disseminated MAC infection (DMAC) and MAC pulmonary disease (MAC-PD).
Results
Seven randomized controlled trials (RCTs) and 3 non-RCT studies, encompassing 1369 patients, were included. Treating DMAC with 2-drug regimens was associated with comparable bacteriological responses (odds ratio (OR) = 0.76, 95 % confidence interval (CI) = 0.48–1.18, P = .22) and mortality (OR = 1.29, 95 % CI = 0.59–2.83, P = .52), but had a higher risk of AMR (OR = 2.99, 95 % CI = 1.10–8.13, P = .03). For MAC-PD, 2-drug regimens were noninferior to 3-drug regimens in bacteriological responses (OR = 0.82, 95 % CI = 0.53–1.25, P = .35) and AMR (risk differences (RD) = 0.01, −0.02 to 0.05, P = .39), with no observed mortalities. Although not statistically significant compared to the 3-drug regimen, the macrolide–rifamycin regimen resulted in attenuated bacteriological responses (OR = 0.51, 95 % CI = 0.14–1.90, P = .32). However, the proportion of patients with bacteriological response (OR = 1.54, 95 % CI = 0.78–2.93, P = .23) and AMR risk (RD = 0.01, −0.02 to 0.04, P = .50) was not different between those under the macrolide-ethambutol regimen and those under 3-drug regimens.
Conclusions
The macrolide–ethambutol 2-drug regimen may be a viable alternative option for treating MAC-PD, whereas DMAC can be preferably managed with a 3-drug regimen.
{"title":"Two-drug versus three-drug regimens for treating Mycobacterium avium complex infection: A systematic review and meta-analysis","authors":"Van-Dong Nguyen , Hai Duong , Ming-Chia Lee , Jin-Hua Chen , Wei-Chang Huang , Hsiao-En Chen , Jung-Chun Lin , Jann-Yuan Wang , Chih-Hsin Lee","doi":"10.1016/j.jiph.2025.102711","DOIUrl":"10.1016/j.jiph.2025.102711","url":null,"abstract":"<div><h3>Background</h3><div><em>Mycobacterium avium</em> complex (MAC) infection, requiring prolonged treatment with an antibiotic combination, is an emerging public health concern.</div></div><div><h3>Methods</h3><div>This meta-analysis compared the efficacy of 2-drug regimens with that of 3-drug regimens in bacteriological responses, acquired macrolide resistance (AMR), and mortality among adult patients with disseminated MAC infection (DMAC) and MAC pulmonary disease (MAC-PD).</div></div><div><h3>Results</h3><div>Seven randomized controlled trials (RCTs) and 3 non-RCT studies, encompassing 1369 patients, were included. Treating DMAC with 2-drug regimens was associated with comparable bacteriological responses (odds ratio (OR) = 0.76, 95 % confidence interval (CI) = 0.48–1.18, <em>P</em> = .22) and mortality (OR = 1.29, 95 % CI = 0.59–2.83, <em>P</em> = .52), but had a higher risk of AMR (OR = 2.99, 95 % CI = 1.10–8.13, <em>P</em> = .03). For MAC-PD, 2-drug regimens were noninferior to 3-drug regimens in bacteriological responses (OR = 0.82, 95 % CI = 0.53–1.25, <em>P</em> = .35) and AMR (risk differences (RD) = 0.01, −0.02 to 0.05, <em>P</em> = .39), with no observed mortalities. Although not statistically significant compared to the 3-drug regimen, the macrolide–rifamycin regimen resulted in attenuated bacteriological responses (OR = 0.51, 95 % CI = 0.14–1.90, <em>P</em> = .32). However, the proportion of patients with bacteriological response (OR = 1.54, 95 % CI = 0.78–2.93, <em>P</em> = .23) and AMR risk (RD = 0.01, −0.02 to 0.04, <em>P</em> = .50) was not different between those under the macrolide-ethambutol regimen and those under 3-drug regimens.</div></div><div><h3>Conclusions</h3><div>The macrolide–ethambutol 2-drug regimen may be a viable alternative option for treating MAC-PD, whereas DMAC can be preferably managed with a 3-drug regimen.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102711"},"PeriodicalIF":4.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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