Journal of Infection in Developing Countries最新文献

Introduction: The purpose of this research was to investigate the outcomes of coronavirus disease 2019 (COVID-19) infection in healthcare workers, assess the incidence of infection among them, and identify factors linked to the severity of the disease.

Methodology: This cross-sectional study was conducted retrospectively in Duhok city, Kurdistan Region of Iraq, from September 2021 to January 2023.

Results: The study included 1,958 participants, of whom 1,338 (68.33%) contracted the infection. Among them, 830 (62.03%) and 372 (27.81%) patients experienced mild and moderate infections, respectively, while 136 (10.1%) had severe infections. The results indicated that several factors, including maintaining a healthy lifestyle, avoiding obesity, having a chronic condition, working consecutive hours, and being in an overwhelmed work environment were significantly associated with a higher severity of infection (p < 0.05). However, factors such as smoking habits, adherence to preventive health guidelines, direct exposure to COVID-19 patients, work days and patterns, family members with COVID-19, and hand/glove sterilization did not appear to have a significant effect on the severity of infection (p > 0.05).

Conclusions: These findings may offer valuable insights for clinicians and public health officials, and aid in the development of effective strategies to manage COVID-19 patients based on their risk factors for infection severity.

Introduction: Urethral catheterization is commonly required in coronavirus disease 2019 (COVID-19) patients hospitalized in intensive care units (ICUs). However, this increases their vulnerability to nosocomial infections such as catheter-associated urinary tract infections (CAUTIs). Existing studies on nosocomial infections in COVID-19 patients usually report CAUTI prevalence but neglect the clinical differences between CAUTI and non-CAUTI patients. This study aimed to assess clinical features, microbiological characteristics, and outcomes of COVID-19 patients with CAUTI vs non-CAUTI patients in an ICU.

Methodology: We analyzed the clinical data from a retrospective cohort study of 527 critically ill COVID-19 patients who required urethral catheterization at the ICU of Bach Mai hospital in Ho Chi Minh City, Vietnam, from August to October 2021. A total of 69 patients (n = 37 CAUTI vs n = 32 non-CAUTI) were selected for urine culture, and their clinical features, microbiological characteristics, and outcomes were recorded for analysis.

Results: COVID-19 patients with CAUTI had a higher mortality rate compared to those without CAUTI (p = 0.02). The length of stay in the ICU was 1.4 times longer for CAUTI patients compared to the non-CAUTI group (p = 0.03). Fungi was the most common microbiological cause of UTI in COVID-19 ICU (91.4%), and Pseudomonas aeruginosa was a significant risk factor of CAUTI. P. aeruginosa, number of antibiotics used, and duration of catheterization had a strong association with the patients' survival time in ICU.

Conclusions: This study provides a better understanding of CAUTI in COVID-19 patients, thus facilitating their future treatment.

Introduction: This study aimed to assess COVID-19 re-infection rates among individuals previously infected between 2020 and November 2022, particularly during the first wave of high-intensity transmission, and to identify the risk factors associated with re-infection in Jiangsu Province, China.

Methodology: Epidemiological investigations were conducted through telephone interviews and face-to-face visits in February and March 2023. Statistical analyses included the Chi-square or Fisher`s exact test for categorical data, Student's t-test for numerical data, Poisson regression for influencing factors, and Kaplan-Meier for cumulative re-infection risk.

Results: Among 12,910 individuals surveyed, 957 (7.4%) cases of re-infection were identified. Re-infection rates varied significantly by initial infection period: 42.5% in January-February 2020, 15.5% in July-August 2021, 6.7% in March-April 2022, and 1.1% in September-October 2022. Females and individuals aged 18-50 years were more susceptible to re-infection. A reduced risk of re-infection was observed in those who received four vaccine doses, with a relative risk of 0.25 (p = 0.019).

Conclusions: For populations prone to COVID-19 re-infections, particularly females and young adults aged 18-50 years, receiving four or more vaccine doses effectively reduces the likelihood of repeated infections. These findings emphasize the need to prioritize vaccination and protect high-risk groups in COVID-19 prevention efforts.

Introduction: Several laboratory parameters may be predictors of coronavirus disease 2019 (COVID-19) mortality. This study aimed to analyze the potential of D-dimer, ferritin, and lactate dehydrogenase (LDH) to predict mortality in severe COVID-19 patients.

Methodology: A retrospective cohort study, including 147 patients, was examined using secondary data from medical records of hospitalized COVID-19 patients. D-dimer, ferritin, and LDH levels were obtained from the patients' blood analysis on first hospitalization. Patients were then categorized into a survival group (97 patients) and a non-survival group (50 patients) based on final outcome. Proportions and means were analyzed using Chi square and Mann-Whitney tests. Further, the correlation and accuracy were analyzed using partial correlations test and receiver operating characteristic curve analysis. The combination of multiple predictors was also analyzed.

Results: The non-survival group had significantly higher levels of D-dimer (32.11 ± 13.05 vs. 9.57 ± 16.65; p < 0.001), ferritin (1719.84 ± 539.52 vs. 808.83 ± 664.81; p < 0.001), and LDH (1782.92 ± 1537.92 vs. 622.848 ± 274.79; p < 0.001) than the survival group. These parameters also had a moderate correlation with mortality (r > 0.500) and robust sensitivity and specificity for predicting mortality, especially ferritin (AUC = 0.906; sensitivity = 92.3%; specificity = 87.5%; p < 0.001), and the combination of ferritin and LDH with or without D-dimer (AUC = 0.959; sensitivity = 100%; specificity = 87.5%; p < 0.001).

Conclusions: The levels of these parameters are significantly higher, have robust sensitivity and specificity, and can be used as predictors of mortality.

Introduction: Cases of human infection with Hymenolepis diminuta are very rare, and only a few hundred cases have been described. We report a rare case of H. diminuta infection in a 16-month-old boy living in a rural area of Bac Giang province, Vietnam.

Case presentation: The patient was admitted to the hospital with mild diarrhea, abdominal pain, and several tapeworm segments in his stool, and no other symptoms. The worm was identified as H. diminuta by morphological examination of eggs in a concentrated stool specimen and genetic sequencing of the 18S rRNA gene of the worm. The patient was successfully treated with single oral dose of praziquantel, and he fully recovered.

Conclusions: This report presents a rare case of human infection with H. diminuta in Vietnam; and contributes to enhancing our understanding of the epidemiology, clinical manifestation, and treatment protocols of human hymenolepiasis.

Objective: To develop a prediction model based on peripheral blood signs to distinguish between infectious mononucleosis and chronic active EBV infection.

Methods: Retrospective data was collected for 60 patients with IM (IM group) and 20 patients with CAEBV infection (CAEBV group) who were hospitalized and diagnosed at the General Hospital of Tianjin Medical University between December 2018 and September 2022. The analyses used were univariate and LASSO (least absolute shrinkage and selection operator) logistic regression.

Results: Univariate analyses revealed that both IM and CAEBV-infected patients displayed overlapping and intersecting clinical manifestations, such as fever, sore throat, enlarged lymph nodes, and enlargement of the liver and spleen, and that in contrast to inflammatory responses in peripheral blood, CAEBV-infected patients had more severe inflammatory responses. Nine biomarkers-HGB, lymphocyte count, percentage of lymphocytes, ALB, fibrinogen, CRP, IFN-, IL-6, and EBV-DNA load-were subsequently selected by LASSO logistic regression modeling to serve as discriminatory models.

Conclusions: Our investigation offers a solid foundation for diagnosing IM and CAEBV infection using the LASSO logistic regression model based on the significance and availability of peripheral blood indicators. Infected patients with CAEBV require early medical attention.

Introduction: Ventilator-associated pneumonia (VAP) causes increased time of mechanical ventilation (MV), prolonged intensive care unit (ICU) stay, and a higher mortality risk. The systematic review and meta-analysis aimed to compare the efficacies between fiberoptic bronchoscopy (FOB) and general sputum suction for the prevention of VAP in patients with invasive MV.

Methodology: Relevant randomized controlled trials (RCTs) were obtained via a search of PubMed, Embase, Cochrane Library, Wanfang, and CNKI databases. A random-effects model was used to pool the results if significant heterogeneity was observed. Otherwise, a fixed-effects model was used.

Results: Sixteen RCTs were included. Compared to general sputum suction, sputum suction with FOB was associated with a significantly reduced risk of VAP (risk ratio [RR]: 0.56, 95% CI: 0.47 to 0.67, p < 0.001; I2 = 0%). Subgroup analyses showed that the combination of FOB-assisted sputum suction with bronchoalveolar lavage (BAL) further reduced the risk of VAP as compared to FOB-assisted sputum suction alone (p for subgroup difference = 0.04). In addition, FOB-assisted treatment was also associated with a reduced MV time (mean difference [MD]: -2.19 days, 95% CI: -2.69 to -1.68, p < 0.001; I2 = 18%), a shorter ICU stay (MD: 2.9 days, 95% CI: -3.68 to -2.13, p < 0.001; I2 = 34%), and a reduced mortality risk (RR: 0.46, 95% CI: 0.24 to 0.90, p = 0.02; I2 = 0%) in patients with invasive MV.

Conclusions: FOB for sputum suction and BAL in patients with invasive MV is effective in reducing the incidence of VAP.

Introduction: Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge.

Methodology: This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT).

Results: Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection.

Conclusions: Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has spread worldwide since 2019. Survey of the antibodies against SARS-CoV-2 is one of the most important measures of immunity since it can give an idea on the effectiveness of administered vaccines and the serologic status of individuals. We determined the concentrations of blood IgM and IgG against three SARS-CoV-2 proteins in vaccinated teachers and students among a university population from Chihuahua, Mexico.

Methodology: Humoral response surveillance against the 3C-like proteinase (3CLpro), nuclear protein (NP), and receptor binding domain (RBD) of SARS-CoV-2 was carried out. A total of 239 samples were analyzed: 67 from teachers who were vaccinated with CanSino and 172 from students (27.9% were vaccinated with AstraZeneca, 32.6% with Sinovac, 24.4% with Pfizer-BioNTech, 15.1% with other vaccines).

Results: Significant differences in the levels of IgG were observed between serum from individuals prior to vaccination (preimmunization serum) and from those that were vaccinated with CanSino. However, samples from asymptomatic individuals did not show differences between the preimmunization and post-immunization serum. The three vaccinated groups (AstraZeneca, Pfizer and Sinovac) did not show significant differences in anti-RBD IgG antibody titers compared to the positive control group, except for a Pfizer non-COVID-19 subgroup where the level of antibodies in the Pfizer group was 1.7 times higher. Neither vaccine group showed significant differences between those individuals who previously had COVID-19 and uninfected individuals.

Conclusions: These results provide a picture of the situation at the time when in-person classes resumed.

Introduction: The World Health Organization declared an end to the global emergency status of COVID-19 in May of 2023. However, the impact of COVID-19 is far from over. Individuals who have recovered from COVID-19 continue to experience physiological, psychological, or cognitive symptoms, such as fatigue, shortness of breath, dizziness, and loss of smell or taste, known as long COVID. This review aims to describe the clinical characteristics of the upper respiratory tract infection (URTI) caused by SARS-CoV-2, and provide evidence for the prevention and treatment of SARS-CoV-2 infection by using nasal irrigation. COVID-19 and nasal irrigation: Nasal irrigation presents a promising adjunct to standard COVID-19 prevention and treatment protocols. This practice is theorized to diminish viral presence in the upper respiratory tract, a region identified as a primary site for SARS-CoV-2 replication and shedding. By facilitating the removal of viral particles and enhancing mucociliary clearance, nasal irrigation could potentially lessen the severity of URTI symptoms and slow transmission rates. The review consolidates current evidence of the efficacy and safety of this approach across various populations, underscoring its practicality in both preventive and therapeutic contexts.

Conclusions: We recommend that saline nasal irrigation is an effective, safe and convenient strategy to prevent the transmission of SARS-CoV-2 and alleviate the symptoms of URTI across various age groups.