Journal of Infection in Developing Countries最新文献

Introduction: African Swine Fever (ASF) poses a significant threat to swine populations and the global pork industry. Effective surveillance is critical for early detection and control of the disease. However, active surveillance programs may face challenges in sensitivity, particularly in regions like Serbia, where ASF is an emerging concern.

Methodology: This study evaluated the sensitivity of active surveillance efforts for ASF in Serbia, focusing on sampling strategies, diagnostic methods, and data analysis. Surveillance activities included field sampling in high-risk areas, testing of domestic pigs and wild boars, and assessment of diagnostic accuracy for early detection.

Results: The analysis revealed low sensitivity in the current active surveillance framework, attributed to suboptimal sampling density, limited diagnostic reliability, and logistical constraints in high-risk regions. These limitations potentially delay ASF detection, increasing the risk of disease spread and complicating control measures.

Conclusions: Enhancing ASF surveillance in Serbia requires improving sampling strategies, deploying advanced diagnostic tools, and addressing logistical challenges to increase detection sensitivity and safeguard the swine industry.

Introduction: Mycoplasma hominis (M. hominis) is a commensal that mainly colonizes in the microflora of the genitourinary tracts and is associated with urogenital tract infections. There are reports of central nervous system (CNS) infections in neonates caused by M. hominis. Nevertheless, M. hominis CNS infections in non-neonatal patients are extremely rare. Herein, we have reported a case of a man who suffered from intracranial infection secondary to M. hominis after neurosurgical operation. Additionally, we reviewed the relevant published literature to raise awareness on such infections and highlight the importance of proper treatments.

Case presentation: A 68-year-old man underwent emergence craniotomy for intracerebellar hemorrhage. He presented with a moderate fever unresponsive to piperacillin-tazobactam on the seventh day after the surgery. His body temperature continued to increase, and he presented with signs of CNS infection. The antimicrobial therapy was switched to meropenem and vancomycin. No obvious reduction in the body temperature was observed. The cerebrospinal fluid (CSF) obtained previously revealed tiny point colonies which were morphologically consistent with M. hominis and subsequently confirmed by metagenomic next-generation sequencing (mNGS). Thus, M. hominis induced intracranial infection was diagnosed, and a combination therapy with moxifloxacin and minocycline was implemented. Fortunately, the patient's body temperature decreased to normal range after effective antibiotic therapy.

Conclusions: Based on the lesson of our case and a thorough review of published literature, the possibility of M. hominis induced CNS infections after neurosurgical intervention should not be ignored, especially when there is no response to standard antimicrobial therapy.

Introduction: Annually, scabies affects more than 400 million people worldwide and is an important public health problem. This study investigated the socio-demographic and clinical characteristics of patients with scabies at a major dermatologic clinic in Turkiye in the context of the COVID-19 pandemic.

Methodology: A retrospective evaluation was performed on outpatients diagnosed with scabies between 2014 and 2022. Statistical analyses were performed using IBM SPSS Statistics 22.0.

Results: In total, 759 of the 48,381 patients (1.6%) who visited the dermatology outpatient clinic were diagnosed with scabies. The incidence rate of scabies was 0.5-0.9% before the pandemic, which increased to 3.1-4.4% in 2020-2022. Cases were more common in October-December (36.5%), and 57.9% of patients were 18-44 years old. Those aged 1-6 years showed an increased rate of scabies from 3% to 7.8% during the pandemic. There was no significant difference according to gender or nationality. All patients complained of itching, and 35% had a history of contact with individuals who were diagnosed with scabies. The recurrence rate was 27.3%. Lesions of 73.1% of patients showed a generalized distribution, as well as local lesions on the hands (7.9%), genital area (6.4%), trunk (4.0%), arms (3.0%), legs (2.8%), feet (1.6%), and head (1.2%).

Conclusions: The results emphasize that scabies can develop regardless of age, gender, and ethnicity, and periods such as pandemics may delay diagnosis and treatment, leading to a higher occurrence of the disease.

Introduction: Wound infections, particularly diabetic foot infections (DFIs), are major clinical challenges, often exacerbated by polymicrobial colonization and rising antibiotic resistance. This study evaluates the pathogens isolated from DFIs in a Turkish hospital and their antibiotic susceptibility profiles to guide empirical treatment.

Methodology: A retrospective study was conducted in the orthopaedic wound care unit of Pamukkale University Hospital. Data from 478 wound cultures of 136 patients treated between 11/02/2021 and 02/03/2023 were analyzed. Pathogens were identified using microbiological methods and the VITEK 2 system, with antibiotic susceptibility testing performed via the Kirby-Bauer disc diffusion method, following Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: Among the 478 clinical samples, 66.9% displayed monomicrobial growth, and 32.1% were polymicrobial. Gram-negative bacteria were more prevalent, found in 85.7% of samples, with Escherichia coli (21.5%) and Pseudomonas aeruginosa (14%) being the dominant isolates. Gram-positive organisms were identified in 50.6% of cases, with Staphylococcus aureus (11.7%) as the most common, of which 8.9% were methicillin-resistant (MRSA). Multidrug-resistant (MDR) strains were detected in 320 Gram-negative isolates, including E. coli (89 isolates), P. aeruginosa (40), and Proteus spp. (50). Extended-spectrum beta-lactamase (ESBL) production was observed in 27.1% of the isolates, and carbapenem resistance in 2.3%. Notably, MDR pathogens were more frequent in patients with osteomyelitis, amputations, or HbA1c levels > 8%.

Conclusions: Gram-negative bacteria, particularly E. coli and P. aeruginosa, were the predominant pathogens in DFIs in Turkey. The increasing prevalence of MDR strains necessitates careful selection of empirical antibiotics, favoring coverage of Enterobacteriaceae and P. aeruginosa over MRSA until culture results are available.

Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that emerged shortly after the coronavirus disease 2019 (COVID-19) pandemic began have altered epidemiological and clinical findings; and these variants changed the course of this health crisis.

Methodology: Whole-genome sequencing was performed on SARS-CoV-2 strains isolated from 21 patients with COVID-19. The frequency of structural changes in the virus and their effects on clinical findings of the disease were analyzed.

Results: The spike Q493R mutation was detected more frequently in patients who had received four or more doses of a COVID-19 vaccine (p = 0.043). The clinical effect of the spike R346K and A263T mutations (reported in Türkiye for the first time) detected in a patient who had received four doses of the vaccine in the 3 months prior to being infected with COVID-19 could be related to escape from the antibody response. The spike R21T mutation may increase the virus's entry into intestinal cells; and, as a result it may be responsible for severe clinical course and gastrointestinal symptoms. The patient infected with the Omicron BA.2 subvariant with the spike L452M mutation exhibited a significant increase in inflammatory parameters; suggesting that this mutation may trigger an excessive immune response and hyperinflammation.

Conclusions: This is the first study based in Türkiye that evaluated the clinical impact of variations in the sequences of SARS-CoV-2 variants. There is a need for further investigation into the clinical impact of these results in a larger population spread over more centers, and more sequencing studies.

Introduction: This meta-analysis evaluates the correlation between carbapenem antibiotic use and the incidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA).

Methodology: A comprehensive literature search conducted across multiple databases yielded seven clinical experimental studies involving 4,417 patients. The primary outcomes assessed were the risk factors associated with CRPA infection, drug resistance rates, and the comparison of resistance rates between meropenem (MEM) and imipenem (IPM). The Newcastle-Ottawa Scale (NOS) was used to assess study quality, and Egger's test and funnel plots were used to assess publication bias.

Results: The NOS scores for the included studies ranged between 6 and 8, indicating their generally high quality. The analysis indicated that prior carbapenem use significantly increased the risk of CRPA infection (OR = 1.866, 95% confidence interval [CI]: 1.164-2.993, p = 0.010). The drug resistance rates of P. aeruginosa to carbapenems ranged between 21.07% and 37.90%. There was no significant difference in drug resistance rates between MEM and IPM (risk ratio = 1.09, 95% CI: 0.99-1.21, p = 0.517).

Conclusions: With drug resistance rates between 21.07% and 37.90%, these findings suggest that carbapenem use is associated with an increased risk of CRPA infection, highlighting the need for the judicious use of these antibiotics in clinical practice.

Introduction: This study aimed to investigate the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among health care workers in Zonguldak Gynecology and Pediatrics Hospital.

Methodology: The records of healthcare personnel working in the hospital between 2023 and 2024 were retrospectively analyzed through the hospital information management system (HIMS) and periodic examination forms. Age, gender, job, and test results for Hepatitis B surface antigen (HBsAg), Hepatitis C antibody (anti-HCV), Hepatitis B surface antibody (anti-HBs), and HIV antibodies (anti-HIV/1-2) were all recorded.

Results: A total of 364 healthcare personnel, including 25 doctors, 135 nurses, 14 technicians, 39 cleaning staff, and 151 other personnel, were included in the study. The staff comprised 266 (73%) female and 98 (27%) male workers, and the mean age was 37.69 ± 9.95 years. The HBsAg positivity rate was found to be 0.8%, and the anti-HBs positivity rate was noted to be 82.9%. Significant differences were determined for age, gender, and anti-HBs among occupational groups (p < 0.001). The prevalence of anti-HBs was markedly elevated in the group of doctors (p < 0.001). The anti-HBs value was statistically significantly different between occupational groups (p < 0.001). No staff members tested positive for anti-HCV or anti-HIV.

Conclusions: Differences in infection rates and immunological responses were seen among various occupational groups, emphasizing the necessity for targeted medical attention within this population. Healthcare personnel should have screening for HBV, HCV, and HIV, and individuals susceptible to HBV should receive vaccination.

Introduction: Nosocomial pneumonia includes hospital-acquired pneumonia without association with mechanical ventilation (HAP) and ventilator-associated pneumonia (VAP). The prevalence and microbial etiology of HAP/VAP in Shandong Province were evaluated to provide a reference for hospital infection control.

Methodology: Data was obtained from patients with HAP/VAP admitted to hospitals within the network of Shandong Provincial Hospital infection management and monitoring from 2019 to 2023.

Results: The prevalence of HAP/VAP showed an overall downward trend across the 5-year period, with range of 0.68-0.43% and 0.067-0.04%, respectively. A total of 83,533 HAP and 7,205 VAP cases were diagnosed (male-to-female ratio of 1.89:1 and 2.13:1; and median age of 67.7 and 64.2 years), among which 47,862 and 9,806 strains were isolated from patients with HAP/VAP, respectively. The primary pathogens in HAP/VAP were similar, and included Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. The antimicrobial susceptibility was low, with lesser susceptibility in VAP. The major multidrug resistant microorganisms (MDROs) were identical in HAP/VAP; and MDR-A. baumannii had the highest detection rate, followed by MDR-Staphylococcus. aureus and MDR-P. aeruginosa. The Mantel-Haenszel χ2 test suggested that there was a linear relationship between the detection rate of MDR-P. aeruginosa and MDR-S. aureus and time (p < 0.001 for MDR-P. aeruginosa in HAP/VAP and MDR-S. aureus in HAP; p = 0.023 for MDR-S. aureus in VAP).

Conclusions: The infection rates of HAP and VAP displayed a declining trend. The major pathogens were similar in HAP and VAP, but with low antimicrobial susceptibility and high detection rate of MDROs.

Introduction: Measles is highly contagious and transmitted via droplets, leading to complications such as encephalitis, pneumonia, diarrhea, and death. Although global vaccination efforts have reduced cases, gaps in vaccination coverage and vaccine hesitancy continue to cause outbreaks. This study aims to evaluate measles cases reported in Kayseri, Türkiye, from 2019 to 2023.

Methodology: The study analysed measles cases reported to the Kayseri Provincial Health Directorate's İZCİ system from 1 January 2019 to 31 December 2023. Demographic characteristics, vaccination status, symptoms, complications, and case classifications were recorded. Annual incidence rates were calculated using data from the Turkish Statistical Institute.

Results: A total of 137 measles cases were reported, of which 126 were included in the analysis. Among confirmed cases, 48.2% were children aged 0-4 years. The most common symptoms were rash (89.7%) and fever (81.0%). Among confirmed cases, 17.9% developed complications, including pneumonia (12.5%) and diarrhea (1.8%). The incidence of measles peaked in 2019 and 2023.

Conclusions: The resurgence of measles is driven by factors such as inadequate vaccination coverage, with 35.7% of the population remaining unvaccinated. Strengthening immunization programs and primary healthcare services is essential for the elimination of measles.