Pub Date : 2024-11-16DOI: 10.1016/j.jiph.2024.102595
Nazish Badar, Muhammad Salman, Nadia Nisar, Hamza Ahmed Mirza, Abdul Ahad, Faisal Ahmad, Bisma Daud
Background: The coronavirus pandemic has substantially influenced the transmission pattern of other respiratory viruses. However, screening and detecting other respiratory pathogens was unheeded during this time to combat the COVID-19 pandemic. High virulence and re assortment factors intensify the importance of influenza virus surveillance for effective disease management. Therefore, the present surveillance study was designed to determine the influenza positivity rate from 2008-24. This study will provide integral support in depicting a panoramic representation of two respiratory-pandemic periods, 2010-11 and 2019-2021, for influenza and COVID-19 pandemics, respectively.
Methods: An inferential cross-sectional study was conducted from 2008 to 2024 by collecting influenza surveillance data from twelve sentinel sites in Pakistan. Clinical and demographic data was recorded at sample collection time. Specimens were collected through nasopharyngeal/throat swabs and stored in viral transport medium (VTM) at the sentinel site laboratory at 2-4 °C. Viral RNA was isolated from the samples using KingFisher TM Flex Purification System and MagMAX™ Viral/Pathogen Nucleic Acid Extraction Kit.
Results: Within 16 years, 78118 samples were tested for influenza, of which 7999 (10.2 %) appeared positive. The positivity rate appeared very low in recent years, with only a 3.5 % positivity rate observed in 2020. Influenza A strain H1N1pdm09 seemed to be the prominent strain (n = 3407, 42.6 %), followed by influenza B (n = 2125, 26.6 %).
Conclusion: The positivity of influenza samples was 10.2 % and recorded in patients where typical clinical representation of influenza was absent. Fewer samples were reported during the coronavirus pandemic, which might be because influenza screening was hindered and overlooked to combat the SARS-CoV-2 virus, and the patient threshold was very high for COVID-19 virus screening.
{"title":"Unraveling influenza sentinel surveillance in Pakistan 2008-2024: Epidemiological insights during the pre and post pandemic period of COVID-19.","authors":"Nazish Badar, Muhammad Salman, Nadia Nisar, Hamza Ahmed Mirza, Abdul Ahad, Faisal Ahmad, Bisma Daud","doi":"10.1016/j.jiph.2024.102595","DOIUrl":"https://doi.org/10.1016/j.jiph.2024.102595","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus pandemic has substantially influenced the transmission pattern of other respiratory viruses. However, screening and detecting other respiratory pathogens was unheeded during this time to combat the COVID-19 pandemic. High virulence and re assortment factors intensify the importance of influenza virus surveillance for effective disease management. Therefore, the present surveillance study was designed to determine the influenza positivity rate from 2008-24. This study will provide integral support in depicting a panoramic representation of two respiratory-pandemic periods, 2010-11 and 2019-2021, for influenza and COVID-19 pandemics, respectively.</p><p><strong>Methods: </strong>An inferential cross-sectional study was conducted from 2008 to 2024 by collecting influenza surveillance data from twelve sentinel sites in Pakistan. Clinical and demographic data was recorded at sample collection time. Specimens were collected through nasopharyngeal/throat swabs and stored in viral transport medium (VTM) at the sentinel site laboratory at 2-4 °C. Viral RNA was isolated from the samples using KingFisher TM Flex Purification System and MagMAX™ Viral/Pathogen Nucleic Acid Extraction Kit.</p><p><strong>Results: </strong>Within 16 years, 78118 samples were tested for influenza, of which 7999 (10.2 %) appeared positive. The positivity rate appeared very low in recent years, with only a 3.5 % positivity rate observed in 2020. Influenza A strain H1N1pdm09 seemed to be the prominent strain (n = 3407, 42.6 %), followed by influenza B (n = 2125, 26.6 %).</p><p><strong>Conclusion: </strong>The positivity of influenza samples was 10.2 % and recorded in patients where typical clinical representation of influenza was absent. Fewer samples were reported during the coronavirus pandemic, which might be because influenza screening was hindered and overlooked to combat the SARS-CoV-2 virus, and the patient threshold was very high for COVID-19 virus screening.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"102595"},"PeriodicalIF":4.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: E. coli ST8346 is a unique strain associated with the potential carriage of multiple carbapenemases. Three unique E. coli ST8346 isolates were identified, each concurrently harboring multiple carbapenemases, including blaNDM-5, blaKPC-2, and/or blaOXA-181. This study aimed to characterize the genetic and plasmid structures of these isolates to understand their transmission and resistance mechanisms.
Methods: Antibiotic resistance profiles, genetic relatedness, and plasmid structures were determined using antibiotic susceptibility testing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), S1 nuclease PFGE, and long-read sequencing.
Results: All the strains were carbapenem resistant. PFGE revealed close genetic relationships among the isolates, despite the lack of geographical or epidemiological connections. blaNDM-5, blaKPC-2, and blaOXA-181 were located on separate plasmids. Plasmids harboring blaNDM-5 showed genetic similarities to blaNDM-5-bearing IncF plasmids in the United Kingdom. The IncA/C plasmids harboring blaKPC-2 had identical sequences resembling a plasmid from a K. pneumoniae strain in Taiwan, except for the blaKPC-2 region, which matched a strain from China, indicating a hybrid plasmid.
Conclusion: This study is the first to identify and characterize the coexistence of blaNDM-5, blaKPC-2, and blaOXA-181 in E. coli ST8346 isolates. The spread appears to be due to independent acquisition events. We identified the putative origins of these plasmids and detected a possible recombination event in a novel IncA/C plasmid. These findings emphasize the importance of ongoing surveillance and further investigations.
{"title":"Emergence of multidrug-resistant E. coli ST8346 isolates carrying three distinct plasmids with NDM-5, KPC-2, and OXA-181.","authors":"Ping-Yuan Chen, Yu-Chin Chen, Che-Ming Chiang, Chi-Chung Chen, Chih-Cheng Lai, Chia-Hung Tsai, Chung-Han Ho, Po-Yu Chen, Hung-Jen Tang, Julie Chi Chow, Tu-Hsuan Chang","doi":"10.1016/j.jiph.2024.102596","DOIUrl":"https://doi.org/10.1016/j.jiph.2024.102596","url":null,"abstract":"<p><strong>Background: </strong>E. coli ST8346 is a unique strain associated with the potential carriage of multiple carbapenemases. Three unique E. coli ST8346 isolates were identified, each concurrently harboring multiple carbapenemases, including bla<sub>NDM-5</sub>, bla<sub>KPC-2</sub>, and/or bla<sub>OXA-181</sub>. This study aimed to characterize the genetic and plasmid structures of these isolates to understand their transmission and resistance mechanisms.</p><p><strong>Methods: </strong>Antibiotic resistance profiles, genetic relatedness, and plasmid structures were determined using antibiotic susceptibility testing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), S1 nuclease PFGE, and long-read sequencing.</p><p><strong>Results: </strong>All the strains were carbapenem resistant. PFGE revealed close genetic relationships among the isolates, despite the lack of geographical or epidemiological connections. bla<sub>NDM-5</sub>, bla<sub>KPC-2</sub>, and bla<sub>OXA-181</sub> were located on separate plasmids. Plasmids harboring bla<sub>NDM-5</sub> showed genetic similarities to bla<sub>NDM-5</sub>-bearing IncF plasmids in the United Kingdom. The IncA/C plasmids harboring bla<sub>KPC-2</sub> had identical sequences resembling a plasmid from a K. pneumoniae strain in Taiwan, except for the bla<sub>KPC-2</sub> region, which matched a strain from China, indicating a hybrid plasmid.</p><p><strong>Conclusion: </strong>This study is the first to identify and characterize the coexistence of bla<sub>NDM-5</sub>, bla<sub>KPC-2</sub>, and bla<sub>OXA-181</sub> in E. coli ST8346 isolates. The spread appears to be due to independent acquisition events. We identified the putative origins of these plasmids and detected a possible recombination event in a novel IncA/C plasmid. These findings emphasize the importance of ongoing surveillance and further investigations.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"102596"},"PeriodicalIF":4.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antimicrobial resistance (AMR) is a growing global concern, particularly in poultry farming, where antibiotics are widely used for both disease prevention and growth promotion. This review examines the misuse of antibiotics in poultry production, especially in developing countries, and its contribution to the emergence of antibiotic-resistant bacteria. The findings highlight that factors such as increasing demand for poultry protein, the availability of inexpensive antibiotics, and weak regulatory oversight have led to widespread misuse, accelerating the spread of resistance genes. Although evidence links poultry farming to AMR, significant data gaps remain, especially regarding resistance transmission from poultry to humans. The review underscores the urgent need for stronger regulatory frameworks, phased-out use of antimicrobial growth promoters, and enhanced awareness campaigns to address this issue. Improving the capacity of regulatory bodies and developing more robust national data monitoring systems are essential steps to mitigate the threat of AMR in poultry farming and to protect both animal and human health.
抗生素耐药性（AMR）是一个日益受到全球关注的问题，尤其是在家禽养殖业中，抗生素被广泛用于预防疾病和促进生长。本综述探讨了家禽生产中滥用抗生素的情况，尤其是在发展中国家，以及滥用抗生素导致耐抗生素细菌出现的原因。研究结果强调，对家禽蛋白质需求的增加、廉价抗生素的供应以及监管不力等因素导致了抗生素的广泛滥用，加速了抗药性基因的传播。尽管有证据表明家禽养殖与 AMR 有关，但仍存在巨大的数据缺口，尤其是有关抗药性从家禽传染给人类的数据。审查强调，迫切需要建立更强有力的监管框架、逐步淘汰抗菌剂生长促进剂的使用以及加强宣传活动，以解决这一问题。提高监管机构的能力和开发更强大的国家数据监测系统是减轻家禽养殖业 AMR 威胁、保护动物和人类健康的必要步骤。
{"title":"Antibiotic residues in poultry products and bacterial resistance: A review in developing countries","authors":"Chantal Abou-Jaoudeh , Jeanne Andary , Rony Abou-Khalil","doi":"10.1016/j.jiph.2024.102592","DOIUrl":"10.1016/j.jiph.2024.102592","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) is a growing global concern, particularly in poultry farming, where antibiotics are widely used for both disease prevention and growth promotion. This review examines the misuse of antibiotics in poultry production, especially in developing countries, and its contribution to the emergence of antibiotic-resistant bacteria. The findings highlight that factors such as increasing demand for poultry protein, the availability of inexpensive antibiotics, and weak regulatory oversight have led to widespread misuse, accelerating the spread of resistance genes. Although evidence links poultry farming to AMR, significant data gaps remain, especially regarding resistance transmission from poultry to humans. The review underscores the urgent need for stronger regulatory frameworks, phased-out use of antimicrobial growth promoters, and enhanced awareness campaigns to address this issue. Improving the capacity of regulatory bodies and developing more robust national data monitoring systems are essential steps to mitigate the threat of AMR in poultry farming and to protect both animal and human health.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102592"},"PeriodicalIF":4.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648080","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}
Background: This study aimed to characterize colistin-resistant K. pneumoniae (CoRKp) strains isolated from patients with urinary tract infections and bacteremia between 1999 and 2022 at a tertiary teaching hospital in Taiwan.
Methods: A total of 1966 K. pneumoniae isolates were collected, among which 21 strains were identified as CoRKp. The antimicrobial susceptibility of these CoRKp strains to 19 antibiotics was assessed. The genome characteristics of 21 CoRKp strains were determined by Nanopore-Illumina hybrid whole genome sequencing. Additionally, conjugation assays were conducted to determine the transferability of plasmids carrying mcr genes to K. pneumoniae ATCC BAA-1706 and E. coli C600. The larvae infection model was used to analyze the differences in virulence between transconjugants and recipient strains.
Results: Among the 21 CoRKp, 12 were multidrug-resistant, and four were extensively drug-resistant. The distribution of sequence types (STs) and K types among the CoRKp strains was quite diverse, and ST307 (5 strains) and K64 (3 strains) dominated in CoRKp. The insertion elements IS903B and ISVsa5, were found to inactivate mgrB of 1 and 2 CoRKp isolates, respectively. Moreover, 1, 4, 6, and 1 missense mutations of PhoQ, PmrA, PmrB, and MgrB, were identified in 21 CoRKp. Only two isolates SC-KP169 and SC-KP585 carried mcr-1 and mcr-8, respectively. The plasmid pSC-KP169-1 could be transferred inter- and intra-genus and contributed to the virulence of K. pneumoniae to larvae. In contrast, the plasmid pSC-KP585-1 could be transferred to E. coli but could not affect its virulence to larvae.
Conclusions: We identified 21 CoRKp from 1966 isolates and found a conjugative plasmid carrying mcr-1 gene that contributed to the virulence of K. pneumoniae to larvae.
{"title":"Molecular characterization of colistin-resistant Klebsiella pneumoniae isolates and their conjugative mcr-carrying plasmids.","authors":"Cheng-Yen Kao, Pei-Yun Kuo, Chih-Chieh Lin, Ya-Yu Cheng, Ming-Cheng Wang, Yu-Chen Chen, Wei-Hung Lin","doi":"10.1016/j.jiph.2024.102588","DOIUrl":"https://doi.org/10.1016/j.jiph.2024.102588","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to characterize colistin-resistant K. pneumoniae (CoRKp) strains isolated from patients with urinary tract infections and bacteremia between 1999 and 2022 at a tertiary teaching hospital in Taiwan.</p><p><strong>Methods: </strong>A total of 1966 K. pneumoniae isolates were collected, among which 21 strains were identified as CoRKp. The antimicrobial susceptibility of these CoRKp strains to 19 antibiotics was assessed. The genome characteristics of 21 CoRKp strains were determined by Nanopore-Illumina hybrid whole genome sequencing. Additionally, conjugation assays were conducted to determine the transferability of plasmids carrying mcr genes to K. pneumoniae ATCC BAA-1706 and E. coli C600. The larvae infection model was used to analyze the differences in virulence between transconjugants and recipient strains.</p><p><strong>Results: </strong>Among the 21 CoRKp, 12 were multidrug-resistant, and four were extensively drug-resistant. The distribution of sequence types (STs) and K types among the CoRKp strains was quite diverse, and ST307 (5 strains) and K64 (3 strains) dominated in CoRKp. The insertion elements IS903B and ISVsa5, were found to inactivate mgrB of 1 and 2 CoRKp isolates, respectively. Moreover, 1, 4, 6, and 1 missense mutations of PhoQ, PmrA, PmrB, and MgrB, were identified in 21 CoRKp. Only two isolates SC-KP169 and SC-KP585 carried mcr-1 and mcr-8, respectively. The plasmid pSC-KP169-1 could be transferred inter- and intra-genus and contributed to the virulence of K. pneumoniae to larvae. In contrast, the plasmid pSC-KP585-1 could be transferred to E. coli but could not affect its virulence to larvae.</p><p><strong>Conclusions: </strong>We identified 21 CoRKp from 1966 isolates and found a conjugative plasmid carrying mcr-1 gene that contributed to the virulence of K. pneumoniae to larvae.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"102588"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Recent mpox outbreaks highlight diverse transmission modes, with sexual behavior prominent in China's IIb strain. Nevertheless, despite HPV being a common sexually transmitted pathogen, there is a paucity of research into its coexistence and genotype distribution within this patients population.
Methods: We conducted a study at the Third People's Hospital of Shenzhen from May to September 2023. We collected information on mpox patients, including their sociodemographic and clinical characteristics. Anal swabs were collected for HPV genotyping.
Results: Among 73 MSM mpox cases, HIV positivity was 56.2 % (41/73) and HPV positivity 80.4 % (41/51). Multiple HPV infections were prevalent (56.9 %, 29/51), especially among HIV-positive (93 %, 27/29). HPV16 (29.3 %, 12/41) was the most common high-risk genotype, followed by HPV59 (26.8 %, 10/41), HPV42 (19.5 %, 8/41), HPV6 (14.6 %, 6/41), and HPV54 (14.6 %, 6/41). HPV infection was significantly associated with HIV infection (p = 0.001). Additionally, HIV infection (p = 0.001) and PCR-detected positive sites for mpox (p = 0.047) were associated with high-risk HPV infection.
Conclusions: In this study, most of the mpox patients were found to be infected with HPV, mostly with high-risk types and multiple infections. Therefore, it is strongly recommended that mpox-infected individuals intensify HPV-related screening, prevention, and treatment measures.
{"title":"Epidemiological and typing features of HPV co-infections in MSM with mpox: A hospital-based prospective study.","authors":"Tianyang Liu, Siwei Zhang, Liuqing Yang, Ling Peng, Shanshan Tang, Wanlin Li, Zengchen Liu, Xichao Zhu, Tingdan Gong, Siyu Duan, Yunyan Tang, Yao Wang, Yun Peng, Rui Li, Shiyan Feng, Chuming Chen, Mengli Cao, Siran Huang, Yang Yang, Fuxiang Wang, Hongzhou Lu, Lanlan Wei","doi":"10.1016/j.jiph.2024.102586","DOIUrl":"https://doi.org/10.1016/j.jiph.2024.102586","url":null,"abstract":"<p><strong>Objectives: </strong>Recent mpox outbreaks highlight diverse transmission modes, with sexual behavior prominent in China's IIb strain. Nevertheless, despite HPV being a common sexually transmitted pathogen, there is a paucity of research into its coexistence and genotype distribution within this patients population.</p><p><strong>Methods: </strong>We conducted a study at the Third People's Hospital of Shenzhen from May to September 2023. We collected information on mpox patients, including their sociodemographic and clinical characteristics. Anal swabs were collected for HPV genotyping.</p><p><strong>Results: </strong>Among 73 MSM mpox cases, HIV positivity was 56.2 % (41/73) and HPV positivity 80.4 % (41/51). Multiple HPV infections were prevalent (56.9 %, 29/51), especially among HIV-positive (93 %, 27/29). HPV16 (29.3 %, 12/41) was the most common high-risk genotype, followed by HPV59 (26.8 %, 10/41), HPV42 (19.5 %, 8/41), HPV6 (14.6 %, 6/41), and HPV54 (14.6 %, 6/41). HPV infection was significantly associated with HIV infection (p = 0.001). Additionally, HIV infection (p = 0.001) and PCR-detected positive sites for mpox (p = 0.047) were associated with high-risk HPV infection.</p><p><strong>Conclusions: </strong>In this study, most of the mpox patients were found to be infected with HPV, mostly with high-risk types and multiple infections. Therefore, it is strongly recommended that mpox-infected individuals intensify HPV-related screening, prevention, and treatment measures.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"102586"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.jiph.2024.102590
Hadeel T. Zedan , Alaa Elkhider , Asalet Hicazi , Fathima Amanullah , Duaa W. Al-Sadeq , Parveen B. Nizamuddin , Farah M. Shurrab , Maria K. Smatti , Asmaa A. Althani , Laith J. Abu Raddad , Gheyath K. Nasrallah , Hadi M. Yassine
Background
Human herpesvirus 8 (HHV-8) is a critical causative agent behind Kaposi sarcoma (KS), an oncogenic disease with profound consequences in immunocompromised individuals. Studies suggested HHV-8 seroprevalence in healthy populations is uncommon, but comprehensive investigations within the Middle East region remain scarce. This study aimed to bridge this knowledge gap by meticulously assessing HHV-8 seroprevalence among healthy blood donors in Qatar, leveraging serological methodologies and PCR.
Methods
We used sera samples collected from 621 healthy blood donors (median age = 36 years, IQR 30–43) from different nationalities residing in Qatar, mainly from the MENA region and Southeast Asia. All sera samples were tested for total anti-HHV-8 IgG antibodies using ELISA. The presence of lytic HHV-8 antibodies was confirmed by an immunofluorescence assay (IFA). Further, HHV-8 DNA was tested and quantitated by qRT-PCR.
Results
ELISA detected anti-HHV-8 IgG total antibodies in 6.9 % [43/621, 95 %CI 5.2–9.2] of the tested samples. Subsequent testing by IFA revealed that 14 % [6/43, 95 %CI 3.6–24.3] of these anti-HHV-8 IgG were classified as HHV-8 lytic antibodies. This suggests that 0.97 % [6/621, 95 %CI 0.2–1.7] of these donors had a recent or ongoing active infection and viral replication. Only one seronegative Qatari blood donor had detectable HHV-8 DNA in his blood. No significant difference was observed between HHV-8 seropositivity and the demographic characteristics of the donors.
Conclusion
Our study showed that HHV-8 prevalence in Qatar aligns closely with global reports. Moreover, our findings raise considerations regarding HHV-8’s potential transmission via transfusion, which suggests the value of routine HHV-8 screening, particularly for immunocompromised patients vulnerable to KS.
{"title":"Seroprevalence and detection of Human herpesvirus-8 (HHV-8) among healthy blood donors residing in Qatar","authors":"Hadeel T. Zedan , Alaa Elkhider , Asalet Hicazi , Fathima Amanullah , Duaa W. Al-Sadeq , Parveen B. Nizamuddin , Farah M. Shurrab , Maria K. Smatti , Asmaa A. Althani , Laith J. Abu Raddad , Gheyath K. Nasrallah , Hadi M. Yassine","doi":"10.1016/j.jiph.2024.102590","DOIUrl":"10.1016/j.jiph.2024.102590","url":null,"abstract":"<div><h3>Background</h3><div>Human herpesvirus 8 (HHV-8) is a critical causative agent behind Kaposi sarcoma (KS), an oncogenic disease with profound consequences in immunocompromised individuals. Studies suggested HHV-8 seroprevalence in healthy populations is uncommon, but comprehensive investigations within the Middle East region remain scarce. This study aimed to bridge this knowledge gap by meticulously assessing HHV-8 seroprevalence among healthy blood donors in Qatar, leveraging serological methodologies and PCR.</div></div><div><h3>Methods</h3><div>We used sera samples collected from 621 healthy blood donors (median age = 36 years, IQR 30–43) from different nationalities residing in Qatar, mainly from the MENA region and Southeast Asia. All sera samples were tested for total anti-HHV-8 IgG antibodies using ELISA. The presence of lytic HHV-8 antibodies was confirmed by an immunofluorescence assay (IFA). Further, HHV-8 DNA was tested and quantitated by qRT-PCR.</div></div><div><h3>Results</h3><div>ELISA detected anti-HHV-8 IgG total antibodies in 6.9 % [43/621, 95 %CI 5.2–9.2] of the tested samples. Subsequent testing by IFA revealed that 14 % [6/43, 95 %CI 3.6–24.3] of these anti-HHV-8 IgG were classified as HHV-8 lytic antibodies. This suggests that 0.97 % [6/621, 95 %CI 0.2–1.7] of these donors had a recent or ongoing active infection and viral replication. Only one seronegative Qatari blood donor had detectable HHV-8 DNA in his blood. No significant difference was observed between HHV-8 seropositivity and the demographic characteristics of the donors.</div></div><div><h3>Conclusion</h3><div>Our study showed that HHV-8 prevalence in Qatar aligns closely with global reports. Moreover, our findings raise considerations regarding HHV-8’s potential transmission via transfusion, which suggests the value of routine HHV-8 screening, particularly for immunocompromised patients vulnerable to KS.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102590"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644327","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}
Availability of antibiotics without prescription contributes to the rising threat of antibiotic resistance due to widespread self-medication and improper use. In this study, we aimed to assess the antibiotic market in Bangladesh according to the WHO AWaRe (Access, Watch, Reserve) classification system to better understand how the unregulated access of antibiotics may influence self-medication practices and the emergence of antibiotic resistance in the country.
Methods
Data on AWaRe class antibiotics, their strengths, and dosage forms were collected from Bangladeshi drug indexing smartphone applications, the Bangladesh National Formulary (BDNF), and the Directorate General of Drug Administration (DGDA) website. Sales data were analyzed using IQVIA data to determine the market value and compound annual growth rates (CAGR) of antibiotics. The analysis focused on categorizing antibiotics according to the WHO AWaRe classification and examining their availability in various dosage forms and strengths including child-appropriate formulations.
Results
Of the 81 antibiotics available in Bangladesh, 54.32 % belong to the Watch class, 30.86 % to Access, 8.64 % to Reserve, and 6.17 % were unclassified. In terms of ATC classifcation, the majority (91.35 %) belonged to the J01 class. Most antibiotics were available in multiple dosage forms and strengths, with tablets (54.87 %), injections (48.78 %), and capsules (30.48 %) being the most common. Additionally, 35.8 % of antibiotics were available as child-appropriate formulations. Oral formulations were prevalent, with 88.0 % of Access, 75.0 % of Watch, and 28.57 % of Reserve class antibiotics were available in oral dosage forms. A total of 56 antibiotic combinations were identified, including six WHO-recommended and two WHO-not-recommneded fixed-dose combinations. Watch class antibiotics dominated the market in terms of sales value and CAGR.
Conclusion
The widespread availability of Watch class antibiotics, particularly in oral and child-appropriate formulations suggest a need for stricter regulation and public health interventions to curb self-medication, inappropriate marketing and use of antibiotics to mitigate the risks of resistance.
{"title":"Assessment of the Bangladeshi antibiotic market: Implications of the WHO AWaRe classification and dosage form availability on antimicrobial resistance","authors":"Joya Rani , Sudipta Saha , Fahmi Ferdous , Md. Ajijur Rahman","doi":"10.1016/j.jiph.2024.102587","DOIUrl":"10.1016/j.jiph.2024.102587","url":null,"abstract":"<div><h3>Background</h3><div>Availability of antibiotics without prescription contributes to the rising threat of antibiotic resistance due to widespread self-medication and improper use. In this study, we aimed to assess the antibiotic market in Bangladesh according to the WHO AWaRe (Access, Watch, Reserve) classification system to better understand how the unregulated access of antibiotics may influence self-medication practices and the emergence of antibiotic resistance in the country.</div></div><div><h3>Methods</h3><div>Data on AWaRe class antibiotics, their strengths, and dosage forms were collected from Bangladeshi drug indexing smartphone applications, the Bangladesh National Formulary (BDNF), and the Directorate General of Drug Administration (DGDA) website. Sales data were analyzed using IQVIA data to determine the market value and compound annual growth rates (CAGR) of antibiotics. The analysis focused on categorizing antibiotics according to the WHO AWaRe classification and examining their availability in various dosage forms and strengths including child-appropriate formulations.</div></div><div><h3>Results</h3><div>Of the 81 antibiotics available in Bangladesh, 54.32 % belong to the Watch class, 30.86 % to Access, 8.64 % to Reserve, and 6.17 % were unclassified. In terms of ATC classifcation, the majority (91.35 %) belonged to the J01 class. Most antibiotics were available in multiple dosage forms and strengths, with tablets (54.87 %), injections (48.78 %), and capsules (30.48 %) being the most common. Additionally, 35.8 % of antibiotics were available as child-appropriate formulations. Oral formulations were prevalent, with 88.0 % of Access, 75.0 % of Watch, and 28.57 % of Reserve class antibiotics were available in oral dosage forms. A total of 56 antibiotic combinations were identified, including six WHO-recommended and two WHO-not-recommneded fixed-dose combinations. Watch class antibiotics dominated the market in terms of sales value and CAGR.</div></div><div><h3>Conclusion</h3><div>The widespread availability of Watch class antibiotics, particularly in oral and child-appropriate formulations suggest a need for stricter regulation and public health interventions to curb self-medication, inappropriate marketing and use of antibiotics to mitigate the risks of resistance.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102587"},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644314","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 : 2024-11-06DOI: 10.1016/j.jiph.2024.102585
Ashutosh Pareek, Runjhun Singhal, Aaushi Pareek, Anil Chuturgoon, Alfonso J. Rodriguez-Morales
{"title":"The unprecedented surge of dengue in the Americas: Strategies for effective response","authors":"Ashutosh Pareek, Runjhun Singhal, Aaushi Pareek, Anil Chuturgoon, Alfonso J. Rodriguez-Morales","doi":"10.1016/j.jiph.2024.102585","DOIUrl":"10.1016/j.jiph.2024.102585","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102585"},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644329","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 : 2024-11-06DOI: 10.1016/j.jiph.2024.102589
Barbara Polese , Marie Ernst , Monique Henket , Benoit Ernst , Marie Winandy , Makon-Sébastien Njock , Céline Blockx , Stéphanie Kovacs , Florence Watar , Anna Julie Peired , Sara Tomassetti , Cosimo Nardi , Stéphanie Gofflot , Souad Rahmouni , James PR Schofield , Rebekah Penrice-Randal , Paul J. Skipp , Fabio Strazzeri , Erika Parkinson , Gilles Darcis , Julien Guiot
Background
COVID-19 has put a huge strain on the healthcare systems worldwide, requiring unprecedented intensive care resources. There is still an unmet clinical need for easily available biomarkers capable of predicting the risk for severe disease. The main goal of this prospective multicenter study was to identify biomarkers that could predict ICU admission and in-hospital mortality.
Methods
We prospectively recruited COVID-19 PCR positive patients in two hospitals, in Belgium and Italy. Blood samples were collected at hospital admission and 20 potential biomarkers were measured with the Luminex technology. Logistic regression models were performed to identify the biomarkers that, alone or together, were associated with patient disease severity.
Results
Our study demonstrates that elevated levels of circulating inflammatory cytokines were associated with disease severity in COVID-19 hospitalized patients. CXCL10, IL-4, IL-6 and MCP-1 values were predictive of ICU admission. Elevated levels of IL-6 and MCP-1 were also associated with in hospital death in COVID-19 hospitalized patients.
Conclusion
Altogether, elevated and correlated inflammatory cytokines in the blood of COVID-19 patients at hospital admission are predictive of disease severity and suggest a dysregulated inflammation induced by SARS-CoV-2 infection.
{"title":"Circulating inflammatory cytokines predict severity disease in hospitalized COVID-19 patients: A prospective multicenter study of the European DRAGON consortium","authors":"Barbara Polese , Marie Ernst , Monique Henket , Benoit Ernst , Marie Winandy , Makon-Sébastien Njock , Céline Blockx , Stéphanie Kovacs , Florence Watar , Anna Julie Peired , Sara Tomassetti , Cosimo Nardi , Stéphanie Gofflot , Souad Rahmouni , James PR Schofield , Rebekah Penrice-Randal , Paul J. Skipp , Fabio Strazzeri , Erika Parkinson , Gilles Darcis , Julien Guiot","doi":"10.1016/j.jiph.2024.102589","DOIUrl":"10.1016/j.jiph.2024.102589","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 has put a huge strain on the healthcare systems worldwide, requiring unprecedented intensive care resources. There is still an unmet clinical need for easily available biomarkers capable of predicting the risk for severe disease. The main goal of this prospective multicenter study was to identify biomarkers that could predict ICU admission and in-hospital mortality.</div></div><div><h3>Methods</h3><div>We prospectively recruited COVID-19 PCR positive patients in two hospitals, in Belgium and Italy. Blood samples were collected at hospital admission and 20 potential biomarkers were measured with the Luminex technology. Logistic regression models were performed to identify the biomarkers that, alone or together, were associated with patient disease severity.</div></div><div><h3>Results</h3><div>Our study demonstrates that elevated levels of circulating inflammatory cytokines were associated with disease severity in COVID-19 hospitalized patients. CXCL10, IL-4, IL-6 and MCP-1 values were predictive of ICU admission. Elevated levels of IL-6 and MCP-1 were also associated with in hospital death in COVID-19 hospitalized patients.</div></div><div><h3>Conclusion</h3><div>Altogether, elevated and correlated inflammatory cytokines in the blood of COVID-19 patients at hospital admission are predictive of disease severity and suggest a dysregulated inflammation induced by SARS-CoV-2 infection.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102589"},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639202","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 : 2024-11-05DOI: 10.1016/j.jiph.2024.102584
Abdullah Alhuzaimi , Fatimah S. Alshahrani , Fadi Aljamaan , Fatema H. AL-Ajwad , Ibraheem Altamimi , Abdullah Bukhari , Lama Al-Eyadhy , Sarah Al-Subaie , Nasser S. Alharbi , Mazin Barry , Yamen Shayah , Amr Jamal , Alaa A. Alanteet , Khalid Alhasan , Sameera M. Aljuhani , Jaffar A. Al-Tawfiq , Mohamad-Hani Temsah
Background
The recent unprecedented foodborne botulism outbreak in Saudi Arabia necessitated an assessment of healthcare workers' (HCWs) knowledge, attitudes, and practices (KAP). This study assessed healthcare workers' knowledge regarding the transmission, contagiousness, presentation, and diagnosis of foodborne botulism, as well as their management practices, including contacting public health authorities, administering antitoxin, preparedness to respond to botulism cases and consulting generative Artificial Intelligent (AI)-chatbots, like ChatGPT.
Methods
A cross-sectional online survey targeting Saudi HCWs was conducted from May 6–19, 2024, following the first foodborne botulism outbreak. The survey, developed by infectious disease and public health experts according to the Saudi Public Health Authority (SPHA) botulism guidelines, covered several sections: demographics, knowledge about foodborne botulism, attitudes and perceptions, intended practices, and worry level. Statistical analysis included descriptive statistics, multivariable linear regression to assess factors influencing knowledge, and multivariable logistic binary regression to evaluate factors affecting confidence in handling botulism.
Results
Among the 1058 participants, the knowledge score was 9.69/20 (48.4 % correct ± 18 %), with higher scores among HCWs working in tertiary centers, older than 34 years, reading SPHA botulism protocol, and using scientific journals as main information sources. HCWs consulting ChatGPT had significantly lower knowledge scores (p-value < 0.001). HCWs displayed highly intended practices in managing botulism, with a mean score of 4.10/5. The self-rated management confidence was moderate (2.84 ± 1.05 out of 5-points). Multivariable logistic binary regression showed that previous experience with botulism and reading SPHA protocol were the most significant factors associated with a higher management confidence.
Conclusions
This study highlights significant HCWs’ knowledge gaps during unprecedented foodborne botulism outbreak. Previous experience with botulism cases and reading recent guidelines were associated with higher knowledge and confidence, while reliance on ChatGPT was linked to lower scores. This study emphasizes the importance of timely publishing local guidelines to favorably affect both knowledge and confidence to deal with infectious outbreaks. Future research should evaluate long-term effectiveness of educational interventions.
{"title":"Healthcare workers’ knowledge and preparedness for unprecedented foodborne botulism outbreak in Saudi Arabia","authors":"Abdullah Alhuzaimi , Fatimah S. Alshahrani , Fadi Aljamaan , Fatema H. AL-Ajwad , Ibraheem Altamimi , Abdullah Bukhari , Lama Al-Eyadhy , Sarah Al-Subaie , Nasser S. Alharbi , Mazin Barry , Yamen Shayah , Amr Jamal , Alaa A. Alanteet , Khalid Alhasan , Sameera M. Aljuhani , Jaffar A. Al-Tawfiq , Mohamad-Hani Temsah","doi":"10.1016/j.jiph.2024.102584","DOIUrl":"10.1016/j.jiph.2024.102584","url":null,"abstract":"<div><h3>Background</h3><div>The recent unprecedented foodborne botulism outbreak in Saudi Arabia necessitated an assessment of healthcare workers' (HCWs) knowledge, attitudes, and practices (KAP). This study assessed healthcare workers' knowledge regarding the transmission, contagiousness, presentation, and diagnosis of foodborne botulism, as well as their management practices, including contacting public health authorities, administering antitoxin, preparedness to respond to botulism cases and consulting generative Artificial Intelligent (AI)-chatbots, like ChatGPT.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey targeting Saudi HCWs was conducted from May 6–19, 2024, following the first foodborne botulism outbreak. The survey, developed by infectious disease and public health experts according to the Saudi Public Health Authority (SPHA) botulism guidelines, covered several sections: demographics, knowledge about foodborne botulism, attitudes and perceptions, intended practices, and worry level. Statistical analysis included descriptive statistics, multivariable linear regression to assess factors influencing knowledge, and multivariable logistic binary regression to evaluate factors affecting confidence in handling botulism.</div></div><div><h3>Results</h3><div>Among the 1058 participants, the knowledge score was 9.69/20 (48.4 % correct ± 18 %), with higher scores among HCWs working in tertiary centers, older than 34 years, reading SPHA botulism protocol, and using scientific journals as main information sources. HCWs consulting ChatGPT had significantly lower knowledge scores (p-value < 0.001). HCWs displayed highly intended practices in managing botulism, with a mean score of 4.10/5. The self-rated management confidence was moderate (2.84 ± 1.05 out of 5-points). Multivariable logistic binary regression showed that previous experience with botulism and reading SPHA protocol were the most significant factors associated with a higher management confidence.</div></div><div><h3>Conclusions</h3><div>This study highlights significant HCWs’ knowledge gaps during unprecedented foodborne botulism outbreak. Previous experience with botulism cases and reading recent guidelines were associated with higher knowledge and confidence, while reliance on ChatGPT was linked to lower scores. This study emphasizes the importance of timely publishing local guidelines to favorably affect both knowledge and confidence to deal with infectious outbreaks. Future research should evaluate long-term effectiveness of educational interventions.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"17 12","pages":"Article 102584"},"PeriodicalIF":4.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622030","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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