GERMS最新文献

Introduction: This study aimed to determine the prevalence of multidrug-resistant Gram-negative bacteria (GNB) from blood cultures in a tertiary-care hospital and the multiplex PCR assay's ability to detect resistance genes.

Methods: A total of 388 GNB isolates obtained from hospitalized patients between November 2019 and November 2021 were included in the study. Antimicrobial susceptibility testing was done by VITEK 2 system and broth microdilution method. Beta-lactamase-encoding genes were detected by multiplex PCR assays, BioFire-Blood Culture Identification 2 (BCID2) panel (bioMérieux, France). Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically with VITEK AST-GN71 card (bioMérieux, France). The isolates of GNB were classified into multidrug-resistant, extensively-drug-resistant, and pandrug-resistant categories, and their prevalence and distribution in different wards, including coronavirus diseases 2019 (COVID-19) intensive care units (ICU), were calculated.

Results: Results revealed that all isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were multidrug-resistant as well as 91.6% of Enterobacter cloacae, 80.6% of Proteus mirabilis, and 76.1% of Klebsiella pneumoniae, respectively. In fermentative bacteria, bla_OXA-48-like (58.1%), bla_NDM (16.1%), bla_KPC (9.7%) and bla_VIM (6.5%) genes were detected. More than half of Enterobacter cloacae (58.3%) and Klebsiella pneumoniae (53.7%) produced ESBLs. Among non-fermenters, the bla_NDM gene was carried by 55% of Pseudomonas aeruginosa and 19.5% of Acinetobacter baumannii. In the COVID-19 ICU, Acinetobacter baumannii was the most common isolate (86.1%).

Conclusions: This study revealed high proportions of multidrug-resistant blood isolates and various underlying resistance genes in Gram-negative strains. The BCID2 panel seems to be helpful for the detection of the most prevalent resistance genes of fermentative bacteria.

Introduction: Due to the high load of pathogens in sewage, seeking for effective treatments became a priority. In this regard, testing the sensitivity of microorganisms isolated from sewage against essential oils (EOs) is suggested. In Lebanon, little evidence supports bacteria isolated from sewage reveals a sensitivity to EOs. Due to this fact, the present investigation aims at determining the sensitivity of microbes isolated from sewage sludge to three EOs: lettuce, coconut, and almond.

Methods: Bacterial isolates were identified by VITEK screening. Yeast was identified by germ tube assay. The chemical components of the oils were identified by gas chromatography - mass spectrometry (GC-MS). Susceptibility of the microbial isolates was assessed by the agar well diffusion assay. Bacteriostatic and bactericidal effects of EOs were detected by minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) broth microdilution assay. The activity of EOs on biofilms was detected by antibiofilm screening.

Results: The identified microorganisms include Gram-negative isolates (Escherichia coli, Citrobacter freundii, Citrobacter braakii, Leclercia adecarboxylata, and Stenotrophomonas maltophilia), Gram-positive isolates (Enterococcus faecium, Streptococcus intermedius, Staphylococcus aureus, Staphylococcus capitis, and Staphylococcus haemolyticus), and Candida albicans. Thirty oils' chemical components were identified. Among the antibiotics, doxycycline exhibited the best inhibitory effect. The three EOs were effective against bacterial isolates and yeast at concentrations ranging between 3.125% and 50%. They exhibited a bacteriostatic activity. Lettuce and coconut oils were effective against biofilm formation and the three oils were effective on pre-formed biofilms.

Conclusions: The results reflected the significant antimicrobial and antibiofilm activities of the oils, thus suggesting their potential antimicrobial applications.

Introduction: Rabies remains a significant health problem in many parts of the world. The World Health Organization (WHO) states that rabies is a disease neglected in its management and has become a problem, especially in poor areas. It is estimated that 55,000 rabies deaths occurred worldwide in 2018. From 2015 to 2019, there were 404,306 cases of rabigenic wounds inflicted by animal bites in Indonesia, with 544 deaths. West Kalimantan Province is one of the areas endemic to rabies and one of the five provinces with the highest number of deaths due to rabies.

Methods: This was a case-control study of patients who presented to the health service for potentially-rabigenic wounds inflicted by animal bites and being diagnosed with rabies exposure. The post-mortem examination was carried out to support the diagnosis of exposure to rabies. Cases were defined as those who had experienced dog bites from the health services medical register from 2015 to 2019. Controls were defined as those who lived in the same area as patients from the cases group and were owners of potentially rabigenic animals. The research was performed in Landak and Sanggau Regencies, West Kalimantan.

Results: The results showed an association between the following risk factors and the incidence of rabies: animal care (p=0.033), rabies vaccine (p=0.006), and behavior (p=0.011), while other risk factors were knowledge (p=1.000) and attitude (p=0.840).

Conclusions: The study's findings inform rabies prevention and eradication, particularly in the province of West Kalimantan, which has experienced issues related to the population power of rabies-transmitting animals, as well as the process of vaccinating rabies-transmitting animals and a lack of public awareness. These factors have a significant impact on the prevalence of rabies, as dogs in the province of West Kalimantan have rabies.

Introduction: Although it has long been used as a topical treatment of pityriasis versicolor (PV), the efficacy of topical selenium disulfide as compared to topical ketoconazole in the treatment of PV remains unclear. This study aims to assess the mycological efficacy and safety of SeS₂ 1.8% shampoo and ketoconazole 2% shampoo for the treatment of PV.

Methods: A double-blind randomized controlled trial was performed in patients with PV during September-December 2018, based on block randomization. Physical examinations, scale provocation test, Wood's lamp, and potassium hydroxide examination were conducted. Intention to treat analysis was performed to evaluate the mycological efficacy.

Results: The mycological efficacy and side effect were not significantly different between the ketoconazole group and the selenium group; 94% vs 86% (RR=2.3(95%CI 0.6-8.5), p=0.182), and 22% versus 8%.

Conclusions: SeS2 1.8% has the same mycological efficacy and side effect as compared to ketoconazole 2% in the treatment of PV.

Introduction: Botulinum toxin, the strongest known neurotoxin, is the cause of a rare fatal neuroparalytic disease characterized by the so-called "four Ds": diplopia, dysarthria, dysphagia, dry mouth. If left untreated, botulism may cause paralysis of the respiratory muscles, impairing the respiratory function which can ultimately lead to death.

Case report: We describe the cases of two patients who presented, two years apart, with similar ocular symptoms such as blurred vision due to accommodation palsy, diplopia, accompanied by xerostomia and swallowing disorders, which were further confirmed as botulism. Both cases had a similar clinical presentation of the intoxication and a positive response to treatment with botulinum antitoxin, while only the first case had a laboratory confirmation of the disease.

Conclusions: The key to diagnose botulism correctly is based on high clinical suspicion and requires a medical multidisciplinary approach and urgent specific treatment. Ophthalmology specialists must be aware of the disease, especially in cases in which ophthalmic manifestation appear at the onset.

Introduction: The common target audience of the current guidelines for the prevention of healthcare-associated infections is represented by healthcare workers. Behavioral protocols for visitors and caregivers that aim to prevent healthcare-associated infections are still not available. The aim of this study was to determine the behavior of the visitors and to determine possible behavior that would contribute to the transmission of pathogenic microorganisms, in order to provide suggestions for visitors in the post-pandemic period.

Methods: A survey about visitor behavior was administered to 621 visitors. The survey consisted of questions regarding the demographic features and the behavior of the patient visitors.

Results: Seventy-seven visitors (12.4%) had at least one infection-related symptoms. Overall, 426 (68.6%) visitors stated that they would cancel their visit if they had any infection-related symptoms. The location of the hand washbasin to wash or sanitize the hands at the patient's unit was not known by 142 (22.9%) visitors. The number of visitors performing all hand hygiene steps was 351 (56.5%). Compliance with hand hygiene was not affected by age, gender, living in the same house as the visited patient, or visiting an adult or pediatric patient.

Conclusions: The visitors should be queried about symptoms of infectious disease at the entrance of the hospital. The knowledge level of the visitors about hand hygiene is not sufficient. Clear recommendations about when and how often visitors should practice hand hygiene and providing information at the entrance of the hospital will improve the hand hygiene compliance of the visitors.

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing countries is still poorly understood. Studies indicate significant healthcare disruptions and economic losses attributed to the viruses in resource-poor communities marked by impairment in the performance of daily activities. Arboviruses have reportedly evolved survival strategies to aid their proliferation in favorable niches, further magnifying their public health relevance. However, there is poor knowledge about the viruses in the region. Thus, this review presents a survey of zoonotic arboviruses in SSA, the burden associated with their diseases, management of diseases as well as their prevention and control, mobility and determinants of infections, their vectors, and co-infection with various microorganisms. Lessons learned from the ongoing coronavirus disease 2019 (COVID-19) pandemic coupled with routine surveillance of zoonotic hosts for these viruses will improve our understanding of their evolution, their potential to cause a pandemic, control and prevention measures, and vaccine development.

Introduction: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that mostly result in immunological reactions that affect the skin, peripheral nervous system and mucosa of the upper respiratory tract. This study aimed to evaluate hematological parameters among subjects with leprosy and deduce biomarkers for onset of leprosy reaction.

Methods: This was a cross-sectional study performed from September 1, 2018 to August 1, 2019. Sixty patients with leprosy (30 on multidrug therapy (MDT) and 30 that had completed MDT) and 30 apparently healthy controls were enrolled. Hematology auto-analyzer (Sysmex KX-21N by Sysmex Corporation Kobe, Japan) was used in sample analysis. ANOVA and Kruskal Wallis were used for mean comparison. Eta squared was used to assess effect size. Sensitivity and specificity were assessed using receiver operator characteristic (ROC) curve. Association was checked using bivariate logistics regression.

Results: The majority (68.3%) of the patients with leprosy were males and a larger proportion were either farmers or unemployed. The prevalence of leprosy reaction in the studied population was 40%. The following parameters were significantly (p<0.05) reduced: red cell count, hemoglobin and hematocrit in patients with leprosy compared to controls. Total white cell count, absolute lymphocyte, neutrophil, monocyte and eosinophil counts were significantly elevated in patients with leprosy compared to controls. The hemoglobin and mean corpuscular volume of patients with leprosy on treatment were significantly higher compared to those who had completed treatment, while the mean corpuscular hemoglobin concentration was significantly reduced. Overall, 65% of patients with leprosy were anemic. Eosinophil count showed good biomarker potential for leprosy reaction onset with AUC 0.709. Sex and absolute eosinophil count were associated with leprosy reaction (OR=11.194; 95%CI: 1.775-70.586).

Conclusions: This study has shown a high frequency of anemia in patients with leprosy, both those on treatment and those that had completed MDT, necessitating incorporation of post treatment plan in the management of leprosy. This study has reported absolute eosinophil as potential biomarker of leprosy reaction.

Introduction: Diarrheal diseases have existed since antiquity, resulting in high morbidity and mortality rates, particularly among children in developing countries. To eradicate these diseases, it is crucial to identify the pathogens that cause them and immediately initiate appropriate treatment. This retrospective study aims to investigate the incidence of childhood gastroenteritis and the epidemiological features of its causative agents.

Methods: During an 11-year period (2010-2020), as many as 51159 stool samples were obtained from children aged 0-17 years. These samples were examined for the presence of parasitic, bacterial, and/or viral gastroenteritis agents and evaluated retrospectively. The records obtained from the "ENLIL Hospital Information Management System Modules" were used to collect patient-related information.

Results: The most frequently observed pathogens were rotavirus (22.4%), adenovirus (2.2), Giardia lamblia (1.6%), and Campylobacter spp. (3.0%), considering the number of samples examined for each organism. The total incidence of viruses was about 25%, parasites 5% and the rate of pathogenic bacteria was 2%. In one-way ANOVA analysis, pathogen positivity was found to be significantly higher in children aged 3-5 years compared to those aged 15-17 and 0-2 [F (5, 51153, 17,588, p<0.001)]. The highest demand for the investigation of GE factors from stool samples was made in August, September and July. According to the number of samples examined, the highest pathogen positivity was in February, October, May, December and March, respectively. The most common pathogens involved in coinfections, occurring in 0.04% of the studied cases, were rotavirus and Giardia lamblia.

Conclusions: Parasitic, viral, and bacterial gastroenteritis maintain their current status with a high prevalence in children under 18 years of age, especially in children aged 0-4 years in Erzurum, Turkey.