Background. The introduction of combination antiretroviral therapy improves the quality and longevity of people living with HIV/AIDS. However, adverse drug reactions associated with antiretroviral therapy compromise the resulting benefits and have been reported differently worldwide, including Ethiopia. Severe adverse drug reactions are one of the major public health concerns for the reason that they can potentially impede the benefit of antiretroviral therapy and put the patient’s survival at risk. Despite many successes achieved with the introduction of the combined antiretroviral therapy, the majority of the patients on antiretroviral therapy experience adverse drug reactions associated with the drugs. Consequently, little is known about the problem in the current study area. This is, therefore, to study incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in the Harari region, Eastern Ethiopia. The aim of this study was to assess the incidence and predictors of severe adverse drug reactions among patients on antiretroviral therapy from February 25, 2022, to March 25, 2022, in the Harari region, Eastern Ethiopia. Methods. A hospital-based retrospective cohort study was conducted among 449 randomly selected medical records of people living with HIV on first-line antiretroviral therapy. Collected data were entered into EpiData version 3.1 and exported to STATA version 15 for analysis. Kaplan–Meier survival curve with log-rank test was used to compare survival curves for categorical independent variables. A value ≤0.05 was declared as significant, and an adjusted hazard ratio was used to report the effect size using the multivariate Cox proportional hazard model. Result. The overall incidence density of the severe adverse reactions was 7.22 per 1000 months (95% CI: 5.5, 9.6). After adjusting for all potential confounders using multivariable Cox proportional hazard ratio, advanced clinical diseases (AHR = 3.44; 95% CI: 1.54, 7.65), HIV/tuberculosis confections (AHR = 2.38; 95% CI: 1.23, 4.62), and being female (AHR = 3.12; 95% CI: 1.57, 6.18) were significantly associated with the experience of severe adverse drug reactions. Conclusion. In this study, the incidence of severe adverse reactions was consistent with the previous studies, and advanced World Health Organization (WHO) clinical stage, HIV/TB confection, and being female were the independent predictors of the severe adverse drug reactions.
{"title":"Incidence and Predictors of Severe Adverse Drug Reactions among Patients on Antiretroviral Drugs in Harari Regional State, Eastern Ethiopia","authors":"Obsa Anbessa, Behailu Hawulte, Tariku Dingeta, Abdi Birhanu","doi":"10.1155/2024/5580728","DOIUrl":"https://doi.org/10.1155/2024/5580728","url":null,"abstract":"<i>Background</i>. The introduction of combination antiretroviral therapy improves the quality and longevity of people living with HIV/AIDS. However, adverse drug reactions associated with antiretroviral therapy compromise the resulting benefits and have been reported differently worldwide, including Ethiopia. Severe adverse drug reactions are one of the major public health concerns for the reason that they can potentially impede the benefit of antiretroviral therapy and put the patient’s survival at risk. Despite many successes achieved with the introduction of the combined antiretroviral therapy, the majority of the patients on antiretroviral therapy experience adverse drug reactions associated with the drugs. Consequently, little is known about the problem in the current study area. This is, therefore, to study incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in the Harari region, Eastern Ethiopia. The aim of this study was to assess the incidence and predictors of severe adverse drug reactions among patients on antiretroviral therapy from February 25, 2022, to March 25, 2022, in the Harari region, Eastern Ethiopia. <i>Methods</i>. A hospital-based retrospective cohort study was conducted among 449 randomly selected medical records of people living with HIV on first-line antiretroviral therapy. Collected data were entered into EpiData version 3.1 and exported to STATA version 15 for analysis. Kaplan–Meier survival curve with log-rank test was used to compare survival curves for categorical independent variables. A <svg height=\"10.2124pt\" style=\"vertical-align:-3.42943pt\" version=\"1.1\" viewbox=\"-0.0498162 -6.78297 7.83752 10.2124\" width=\"7.83752pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g></svg> value ≤0.05 was declared as significant, and an adjusted hazard ratio was used to report the effect size using the multivariate Cox proportional hazard model. <i>Result</i>. The overall incidence density of the severe adverse reactions was 7.22 per 1000 months (95% CI: 5.5, 9.6). After adjusting for all potential confounders using multivariable Cox proportional hazard ratio, advanced clinical diseases (AHR = 3.44; 95% CI: 1.54, 7.65), HIV/tuberculosis confections (AHR = 2.38; 95% CI: 1.23, 4.62), and being female (AHR = 3.12; 95% CI: 1.57, 6.18) were significantly associated with the experience of severe adverse drug reactions. <i>Conclusion</i>. In this study, the incidence of severe adverse reactions was consistent with the previous studies, and advanced World Health Organization (WHO) clinical stage, HIV/TB confection, and being female were the independent predictors of the severe adverse drug reactions.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139495280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. An increasing number of studies have proved that gut microbiota is involved in the occurrence and development of various lung diseases and can interact with the diseased lung. The concept of the gut-lung axis (GLA) provides a new idea for the subsequent clinical treatment of lung diseases through human microbiota. This review aims to summarize the microbiota in the lung and gut and the interaction between them from the perspectives of traditional Chinese medicine and modern medicine. Method. We conducted a literature search by using the search terms “GLA,” “gut microbiota,” “spleen,” and “Chinese medicine” in the databases PubMed, Web of Science, and CNKI. We then explored the mechanism of action of the gut-lung axis from traditional Chinese medicine and modern medicine. Results. The lung and gut microbiota enable the GLA to function through immune regulation, while metabolites of the gut microbiota also play an important role. The spleen can improve the gut microbiota to achieve the regulation of the GLA. Conclusion. Improving the gut microbiota through qi supplementation and spleen fortification provides a new approach to the clinical treatment of lung diseases by regulating the GLA. Currently, our understanding of the GLA is limited, and more research is needed to explain its working principle.
{"title":"What Makes the Gut-Lung Axis Working? From the Perspective of Microbiota and Traditional Chinese Medicine","authors":"Hui Wang, Ying Wang","doi":"10.1155/2024/8640014","DOIUrl":"https://doi.org/10.1155/2024/8640014","url":null,"abstract":"<i>Background</i>. An increasing number of studies have proved that gut microbiota is involved in the occurrence and development of various lung diseases and can interact with the diseased lung. The concept of the gut-lung axis (GLA) provides a new idea for the subsequent clinical treatment of lung diseases through human microbiota. This review aims to summarize the microbiota in the lung and gut and the interaction between them from the perspectives of traditional Chinese medicine and modern medicine. <i>Method</i>. We conducted a literature search by using the search terms “GLA,” “gut microbiota,” “spleen,” and “Chinese medicine” in the databases PubMed, Web of Science, and CNKI. We then explored the mechanism of action of the gut-lung axis from traditional Chinese medicine and modern medicine. <i>Results</i>. The lung and gut microbiota enable the GLA to function through immune regulation, while metabolites of the gut microbiota also play an important role. The spleen can improve the gut microbiota to achieve the regulation of the GLA. <i>Conclusion</i>. Improving the gut microbiota through qi supplementation and spleen fortification provides a new approach to the clinical treatment of lung diseases by regulating the GLA. Currently, our understanding of the GLA is limited, and more research is needed to explain its working principle.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139500796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Biofilm production and drug resistance phenomenon play a critical role in P. aeruginosa infections. Several genes, including psl, pel, brlR, and mex, are involved in the phenomenon. The aim of this study was to find the relationship between the mentioned genes and the sources of P. aeruginosa infections. Materials and Methods. Fifty-nine P. aeruginosa isolates detected from clinical specimens were used to determine antibiotic susceptibility patterns, prevalence of the genes using PCR, biofilm formation, biofilm eradication concentration assay (MBEC), and epidemiological characteristics using pulsed-field gel electrophoresis (PFGE). Results. The results showed that 35.6% and 16.94% of all the samples were isolated from urine and wounds, 81.33% of the isolates were biofilm producers, 27.11% were multidrug-resistant (MDR), and 100% of the main biofilm former genes belonged to pslA. 94.91% of the isolates possessed brlR and mexA, and 91.5% of them expressed pslA. It was also indicated that neither ciprofloxacin nor imipenem could eradicate the formed biofilms. Moreover, we could identify 81.4% distinctive restriction profiles among the isolates, using an 80% similarity cutoff point; brlR and pel genes were significantly (;
{"title":"Phylogenetic Aspects of Antibiotic Resistance and Biofilm Formation of P. aeruginosa Isolated from Clinical Samples","authors":"Maryam Motevasel, Masoud Haghkhah, Negar Azimzadeh","doi":"10.1155/2024/6213873","DOIUrl":"https://doi.org/10.1155/2024/6213873","url":null,"abstract":"<i>Introduction</i>. Biofilm production and drug resistance phenomenon play a critical role in <i>P. aeruginosa</i> infections. Several genes, including <i>psl</i>, <i>pel</i>, <i>brlR</i>, and <i>mex</i>, are involved in the phenomenon. The aim of this study was to find the relationship between the mentioned genes and the sources of <i>P. aeruginosa</i> infections. <i>Materials and Methods</i>. Fifty-nine <i>P. aeruginosa</i> isolates detected from clinical specimens were used to determine antibiotic susceptibility patterns, prevalence of the genes using PCR, biofilm formation, biofilm eradication concentration assay (MBEC), and epidemiological characteristics using pulsed-field gel electrophoresis (PFGE). <i>Results</i>. The results showed that 35.6% and 16.94% of all the samples were isolated from urine and wounds, 81.33% of the isolates were biofilm producers, 27.11% were multidrug-resistant (MDR), and 100% of the main biofilm former genes belonged to <i>pslA</i>. 94.91% of the isolates possessed <i>brlR</i> and <i>mexA</i>, and 91.5% of them expressed <i>pslA</i>. It was also indicated that neither ciprofloxacin nor imipenem could eradicate the formed biofilms. Moreover, we could identify 81.4% distinctive restriction profiles among the isolates, using an 80% similarity cutoff point; <i>brlR</i> and <i>pel</i> genes were significantly (<span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>;</span></span> <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139460032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
{"title":"Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study","authors":"Rani Kumari Sah, Pragyan Dahal, Ranjana Parajuli, Gorkha Raj Giri, Era Tuladhar","doi":"10.1155/2024/5517662","DOIUrl":"https://doi.org/10.1155/2024/5517662","url":null,"abstract":"Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by <i>Escherichia coli</i> and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) in cephalosporin-resistant <i>E. coli</i>. Altogether, 1050 urine samples were processed to obtain 165 isolates of <i>E. coli</i>. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant <i>E. coli</i>. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as <i>E. coli.</i> The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the <i>E. coli</i> isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the <i>bla</i><sub>CTX-M</sub> gene was 55.26%. The prevalence of MDR <i>E. coli</i> harboring the <i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub> genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139396412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intensive care unit (ICU) patients are prone to develop infections by hospital prevalent organisms. The aim of the study was to determine the bacteriological profiles and their drug resistance pattern among different infections in ICU patients of a tertiary care hospital. The record-based retrospective data of culture reports of the patients admitted to all the ICUs of a tertiary care hospital during the period from January 2020 to May 2022 were analyzed. A total of 3,056 samples were obtained from 2308 patients. The infection rate among ICU patients was found to be 53.40%. Isolates belonged equally to males (50.86%) and females (49.14%). The most common culture-positive clinical specimen received was blood (39.08%) followed by respiratory samples (29.45%). Acinetobacter sp. (33.02%) was the most common organism isolated from various clinical specimens, followed by Klebsiella pneumoniae (20.89%), and Escherichia coli (13.8%). More than 80% of Acinetobacter species were found to be resistant to third-generation cephalosporins, aminoglycosides, and carbapenems, whereas minocycline (56.31% S) and colistin (100% S) were the most effective drugs. Klebsiella sp. was found to be more resistant than E.coli, and the least resistance was observed to be tetracycline (43.97%) and doxycycline (55.84%). Among Staphylococcus aureus, 82.78% of strains were methicillin-resistant (MRSA). Vancomycin-resistant Enterococci (VRE) sp. accounted for 16.67% of the isolates. Evidence-based knowledge regarding the local bacterial organisms and their antimicrobial resistance pattern is pivotal in deciding empirical drug therapy, ultimately leading to the management of antimicrobial resistance (AMR).
{"title":"Insight into the Burden of Antimicrobial Resistance among Bacterial Pathogens Isolated from Patients Admitted in ICUs of a Tertiary Care Hospital in India","authors":"Garima Gautam, Shweta Satija, Ravinder Kaur, Anil Kumar, Divakar Sharma, Megh Singh Dhakad","doi":"10.1155/2024/7403044","DOIUrl":"https://doi.org/10.1155/2024/7403044","url":null,"abstract":"Intensive care unit (ICU) patients are prone to develop infections by hospital prevalent organisms. The aim of the study was to determine the bacteriological profiles and their drug resistance pattern among different infections in ICU patients of a tertiary care hospital. The record-based retrospective data of culture reports of the patients admitted to all the ICUs of a tertiary care hospital during the period from January 2020 to May 2022 were analyzed. A total of 3,056 samples were obtained from 2308 patients. The infection rate among ICU patients was found to be 53.40%. Isolates belonged equally to males (50.86%) and females (49.14%). The most common culture-positive clinical specimen received was blood (39.08%) followed by respiratory samples (29.45%). <i>Acinetobacter</i> sp. (33.02%) was the most common organism isolated from various clinical specimens, followed by <i>Klebsiella pneumoniae</i> (20.89%), and <i>Escherichia coli</i> (13.8%). More than 80% of <i>Acinetobacter species</i> were found to be resistant to third-generation cephalosporins, aminoglycosides, and carbapenems, whereas minocycline (56.31% S) and colistin (100% S) were the most effective drugs. <i>Klebsiella</i> sp<i>.</i> was found to be more resistant than <i>E.coli</i>, and the least resistance was observed to be tetracycline (43.97%) and doxycycline (55.84%). Among <i>Staphylococcus aureus</i>, 82.78% of strains were methicillin-resistant (MRSA). Vancomycin-resistant <i>Enterococci</i> (VRE) sp. accounted for 16.67% of the isolates. Evidence-based knowledge regarding the local bacterial organisms and their antimicrobial resistance pattern is pivotal in deciding empirical drug therapy, ultimately leading to the management of antimicrobial resistance (AMR).","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Q fever is a zoonotic bacterial infection caused by Coxiella burnetii that is reportable in the USA. This infection is often asymptomatic; acute infection usually manifests as a self-limited febrile illness, hepatitis, or pneumonia. Chronic infection (usually infective endocarditis) often affects patients with valvulopathy or immunosuppression. Herein, we study the inpatient frequency of Q fever in the United States. Methods. We used a nationwide inpatient sample (NIS) for our retrospective cohort study to include hospitalizations with a diagnosis of Q fever between 2010 and 2019. Survey procedures were applied to accommodate for complex sampling design of NIS. Chi-square and least-square means were used for categorical and continuous variables, respectively. Jonckheere–Terpstra test was used to study the trends over the years. SAS 9.4 was used for data mining and analysis. Results. A total of 2,685 hospitalizations with a diagnosis of Q fever were included, among which 451 (17%) cases had a concurrent diagnosis of infective endocarditis. The mean age of patients was 58 years, and less than a third was female. Our analysis demonstrated that infective endocarditis was the most common cardiac complication associated with Q fever and was associated with increased inpatient mortality ( value <0.001). There is a trend of an increase in cases of inpatient Q fever with or without endocarditis over the years ( value <0.05). Q fever cases were more common across the Pacific and the South Atlantic divisions. Conclusion. Physicians should be aware of an increasing trend of hospitalized patients with Q fever and the significant association with infective endocarditis. Further studies are needed.
{"title":"Inpatient Q Fever Frequency Is on the Rise","authors":"Mohamad Alhoda Mohamad Alahmad, Kassem A. Hammoud","doi":"10.1155/2023/4243312","DOIUrl":"https://doi.org/10.1155/2023/4243312","url":null,"abstract":"<i>Background</i>. Q fever is a zoonotic bacterial infection caused by Coxiella burnetii that is reportable in the USA. This infection is often asymptomatic; acute infection usually manifests as a self-limited febrile illness, hepatitis, or pneumonia. Chronic infection (usually infective endocarditis) often affects patients with valvulopathy or immunosuppression. Herein, we study the inpatient frequency of Q fever in the United States. <i>Methods</i>. We used a nationwide inpatient sample (NIS) for our retrospective cohort study to include hospitalizations with a diagnosis of Q fever between 2010 and 2019. Survey procedures were applied to accommodate for complex sampling design of NIS. Chi-square and least-square means were used for categorical and continuous variables, respectively. Jonckheere–Terpstra test was used to study the trends over the years. SAS 9.4 was used for data mining and analysis. <i>Results</i>. A total of 2,685 hospitalizations with a diagnosis of Q fever were included, among which 451 (17%) cases had a concurrent diagnosis of infective endocarditis. The mean age of patients was 58 years, and less than a third was female. Our analysis demonstrated that infective endocarditis was the most common cardiac complication associated with Q fever and was associated with increased inpatient mortality (<svg height=\"10.2124pt\" style=\"vertical-align:-3.42943pt\" version=\"1.1\" viewbox=\"-0.0498162 -6.78297 7.83752 10.2124\" width=\"7.83752pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g></svg> value <0.001). There is a trend of an increase in cases of inpatient Q fever with or without endocarditis over the years (<svg height=\"10.2124pt\" style=\"vertical-align:-3.42943pt\" version=\"1.1\" viewbox=\"-0.0498162 -6.78297 7.83752 10.2124\" width=\"7.83752pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-113\"></use></g></svg> value <0.05). Q fever cases were more common across the Pacific and the South Atlantic divisions. <i>Conclusion</i>. Physicians should be aware of an increasing trend of hospitalized patients with Q fever and the significant association with infective endocarditis. Further studies are needed.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Yun Bae, Ina Yun, Kang Il Jun, Chung-Jong Kim, Miae Lee, Hee Jung Choi
We investigated the virulence gene expression of carbapenem-resistant Acinetobacter baumanii (CRAB) isolated from the respiratory samples of patients with CRAB pneumonia and those with CRAB colonization to identify the virulence genes contributing to CRAB pneumonia’s development and mortality. Patients with CRAB identified from respiratory specimens were screened at a tertiary university hospital between January 2018 and January 2019. Patients were classified into CRAB pneumonia or CRAB colonization groups according to predefined clinical criteria. A. baumannii isolated from respiratory specimens was examined for the expression levels of ompA, uspA, hfq, hisF, feoA, and bfnL by quantitative reverse-transcription polymerase chain reaction. Among 156 patients with CRAB from respiratory specimens, 17 and 24 met the criteria for inclusion in the pneumonia and colonization groups, respectively. The expression level of ompA was significantly higher in the pneumonia group than in the colonization group (1.45 vs. 0.63, ). The expression levels of ompA (1.97 vs. 0.86, ),hisF (1.06 vs. 0.10,
{"title":"Association between Pneumonia Development and Virulence Gene Expression in Carbapenem-Resistant Acinetobacter baumannii Isolated from Clinical Specimens","authors":"Ji Yun Bae, Ina Yun, Kang Il Jun, Chung-Jong Kim, Miae Lee, Hee Jung Choi","doi":"10.1155/2023/8265683","DOIUrl":"https://doi.org/10.1155/2023/8265683","url":null,"abstract":"We investigated the virulence gene expression of carbapenem-resistant <i>Acinetobacter baumanii</i> (CRAB) isolated from the respiratory samples of patients with CRAB pneumonia and those with CRAB colonization to identify the virulence genes contributing to CRAB pneumonia’s development and mortality. Patients with CRAB identified from respiratory specimens were screened at a tertiary university hospital between January 2018 and January 2019. Patients were classified into CRAB pneumonia or CRAB colonization groups according to predefined clinical criteria. <i>A. baumannii</i> isolated from respiratory specimens was examined for the expression levels of <i>ompA</i>, <i>uspA</i>, <i>hfq</i>, <i>hisF</i>, <i>feoA</i>, and <i>bfnL</i> by quantitative reverse-transcription polymerase chain reaction. Among 156 patients with CRAB from respiratory specimens, 17 and 24 met the criteria for inclusion in the pneumonia and colonization groups, respectively. The expression level of <i>ompA</i> was significantly higher in the pneumonia group than in the colonization group (1.45 vs. 0.63, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 8.8423\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>).</span></span> The expression levels of <i>ompA</i> (1.97 vs. 0.86, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 8.8423\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>),</span></span> <i>hisF</i> (1.06 vs. 0.10, <span><svg height=\"9.27","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138826037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. Aim. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. Materials and Method. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm2 surface. Results. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2–8) CFU/cm2, the sides of patient tables (1.2–20) CFU/cm2, knee coil (2.4–3) CFU/cm2, and patient leg supports (1.2–8) CFU/cm2. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing Enterobacterales (ESPL) or Carbapenemase-producing Enterobacterales (CPE). On the other hand, methicillin-resistant Staphylococcus (MRS), vancomycin-resistant Staphylococcus (VRS), and vancomycin-resistant Enterococcus (VRE) were detected. Conclusion. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.
导言。在全球范围内，医疗机构都面临着医院感染（HAIs）的巨大挑战。这些疾病除了会导致发病率和死亡率外，还会造成巨大的经济损失。医学领域对感染传播的研究相当多，但放射科的研究却不多。研究目的本研究旨在确定计算机断层扫描（CT）、磁共振成像（MRI）、超声波（US）、普通 X 射线检查室和便携式射线照相术中经常接触的、易受污染的表面上是否存在耐多药（MDR）微生物，并调查患者和医护人员感染耐多药微生物的潜在危险。材料和方法。本研究在 2022 年 5 月和 6 月期间从放射科采集了 160 份拭子样本。样本从 CT 和 MRI 检查室内外的 80 个预定表面采集两次，也从 US 和普通 X 光机以及便携式 X 光机采集两次。样本于早上 7:00 按照常规清洁程序用棉签采集。用棉签拭擦 100 平方厘米的表面后，计算每平方厘米的细菌菌落形成单位 (CFU)。结果显示几乎所有被测表面都有细菌菌落形成单位。污染率最高的是键盘（1.2-8）CFU/cm2、病人桌边（1.2-20）CFU/cm2、膝关节圈（2.4-3）CFU/cm2 和病人腿部支撑（1.2-8）CFU/cm2。与 5 月份相比，6 月份的污染量明显增加，这与医院隔离病人数量、放射科工作量和转诊病人数量的增加是一致的。在我们的研究中，没有一个受检部位出现耐多药革兰氏阴性菌污染，如产广谱β-内酰胺酶肠杆菌（ESPL）或产碳青霉烯酶肠杆菌（CPE）。另一方面，还检测到耐甲氧西林葡萄球菌（MRS）、耐万古霉素葡萄球菌（VRS）和耐万古霉素肠球菌（VRE）。结论放射科的所有设备和部位都可能是细菌感染（包括 MDR）的源头，因此必须修订并在早上和病人之间执行强制性和承诺性消毒协议。
{"title":"Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine","authors":"Zena Odeh, Safaa Abatli, Mohammad Qadi","doi":"10.1155/2023/4441338","DOIUrl":"https://doi.org/10.1155/2023/4441338","url":null,"abstract":"<i>Introduction</i>. Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. <i>Aim</i>. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. <i>Materials and Method</i>. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm<sup>2</sup> surface. <i>Results</i>. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2–8) CFU/cm<sup>2</sup>, the sides of patient tables (1.2–20) CFU/cm<sup>2</sup>, knee coil (2.4–3) CFU/cm<sup>2</sup>, and patient leg supports (1.2–8) CFU/cm<sup>2</sup>. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing <i>Enterobacterales</i> (ESPL) or Carbapenemase-producing <i>Enterobacterales</i> (CPE). On the other hand, methicillin-resistant <i>Staphylococcus</i> (MRS), vancomycin-resistant <i>Staphylococcus</i> (VRS), and vancomycin-resistant <i>Enterococcus</i> (VRE) were detected. <i>Conclusion</i>. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138717165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) is still one of the severe progressive threats in developing countries. There are some limitations to social and economic development among developing nations. The present study forecasts the notified prevalence of TB based on seasonality and trend by applying the SARIMA-NNAR hybrid model. The NIKSHAY database repository provides monthly informed TB cases (2017 to 2022) in India. A time series model was constructed based on the seasonal autoregressive integrated moving averages (SARIMA), neural network autoregressive (NNAR), and, SARIM-NNAR hybrid models. These models were estimated with the help of the Bayesian information criterion (BIC) and Akaike information criterion (AIC). These models were established to compare the estimation. A total of 12,576,746 notified TB cases were reported over the years whereas the average case was observed as 174,677.02. The evaluating parameters values of RMSE, MAE, and MAPE for the hybrid model were found to be (13738.97), (10369.48), and (06.68). SARIMA model was (19104.38), (14304.15), and (09.45) and the NNAR were (11566.83), (9049.27), and (05.37), respectively. Therefore, the NNAR model performs better with time series data for fitting and forecasting compared to other models such as SARIMA as well as the hybrid model. The NNAR model indicated a suitable model for notified TB incidence forecasting. This model can be a good tool for future prediction. This will assist in devising a policy and strategizing for better prevention and control.
{"title":"Time Series Modeling of Tuberculosis Cases in India from 2017 to 2022 Based on the SARIMA-NNAR Hybrid Model","authors":"Baikunth Kumar Yadav, Sunil Kumar Srivastava, Ponnusamy Thillai Arasu, Pranveer Singh","doi":"10.1155/2023/5934552","DOIUrl":"https://doi.org/10.1155/2023/5934552","url":null,"abstract":"Tuberculosis (TB) is still one of the severe progressive threats in developing countries. There are some limitations to social and economic development among developing nations. The present study forecasts the notified prevalence of TB based on seasonality and trend by applying the SARIMA-NNAR hybrid model. The NIKSHAY database repository provides monthly informed TB cases (2017 to 2022) in India. A time series model was constructed based on the seasonal autoregressive integrated moving averages (SARIMA), neural network autoregressive (NNAR), and, SARIM-NNAR hybrid models. These models were estimated with the help of the Bayesian information criterion (BIC) and Akaike information criterion (AIC). These models were established to compare the estimation. A total of 12,576,746 notified TB cases were reported over the years whereas the average case was observed as 174,677.02. The evaluating parameters values of RMSE, MAE, and MAPE for the hybrid model were found to be (13738.97), (10369.48), and (06.68). SARIMA model was (19104.38), (14304.15), and (09.45) and the NNAR were (11566.83), (9049.27), and (05.37), respectively. Therefore, the NNAR model performs better with time series data for fitting and forecasting compared to other models such as SARIMA as well as the hybrid model. The NNAR model indicated a suitable model for notified TB incidence forecasting. This model can be a good tool for future prediction. This will assist in devising a policy and strategizing for better prevention and control.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138680627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. The study aims to investigate the characteristics, comorbidities, laboratory findings, and clinical manifestations of under 18-year-old patients who died with the diagnosis of COVID-19 and determination of the most prevalent risk factors. Method. This case-control study was performed at a referral hospital in Yazd from March 2020 to August 2021. All patients under 18 years who were diagnosed through real-time RT-PCR, chest computed tomography, and the World Health Organization definition were divided into deceased and survived groups. The characteristics (age and sex), disease severity, comorbidities, laboratory findings, and clinical manifestations of the two groups were compared and analyzed using SPSS, version 18 (SPSS Inc., Chicago, III., USA). Results. A total of 24 patients in the deceased group and 167 patients in the survived group were compared. The highest mortality rate was observed in the age group of 1 month to 5 years, although no statistically significant relationship was found between age groups and the risk of mortality. Disease severity, dyspnea, low oxygen saturation on admission, length of hospital stays, and hospitalization history before the last admission were significantly correlated with mortality ( < 0.05). Lymphopenia increased the probability of mortality by more than two times (OR: 2.568; 95% CI (0.962–6.852)), but this was not the case for D-dimer and C-reactive protein. Furthermore, 27.5% of survived patients had normal chest CT scans, which was a statistically significant difference compared to the deceased patients (: 0.031). Conclusion. Based on the findings of this study, dyspnea, low oxygen saturation, and lymphopenia are critical indicators for identifying high-risk children with COVID-19 and triaging them for better care and treatment.
{"title":"Which Groups of Children Are at More Risk of Fatality during COVID-19 Pandemic? A Case-Control Study in Yazd, Iran","authors":"Behnam Shafaei, Zahra Nafei, Mehran Karimi, Nasrin Behniafard, Farimah Shamsi, Masoud Faisal, Amir Pasha Amel Shahbaz, Elahe Akbarian","doi":"10.1155/2023/8838056","DOIUrl":"https://doi.org/10.1155/2023/8838056","url":null,"abstract":"<i>Introduction</i>. The study aims to investigate the characteristics, comorbidities, laboratory findings, and clinical manifestations of under 18-year-old patients who died with the diagnosis of COVID-19 and determination of the most prevalent risk factors. <i>Method</i>. This case-control study was performed at a referral hospital in Yazd from March 2020 to August 2021. All patients under 18 years who were diagnosed through real-time RT-PCR, chest computed tomography, and the World Health Organization definition were divided into deceased and survived groups. The characteristics (age and sex), disease severity, comorbidities, laboratory findings, and clinical manifestations of the two groups were compared and analyzed using SPSS, version 18 (SPSS Inc., Chicago, III., USA). <i>Results</i>. A total of 24 patients in the deceased group and 167 patients in the survived group were compared. The highest mortality rate was observed in the age group of 1 month to 5 years, although no statistically significant relationship was found between age groups and the risk of mortality. Disease severity, dyspnea, low oxygen saturation on admission, length of hospital stays, and hospitalization history before the last admission were significantly correlated with mortality (<svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g></svg> < 0.05). Lymphopenia increased the probability of mortality by more than two times (OR: 2.568; 95% CI (0.962–6.852)), but this was not the case for D-dimer and C-reactive protein. Furthermore, 27.5% of survived patients had normal chest CT scans, which was a statistically significant difference compared to the deceased patients (<span><svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g></svg>:</span> 0.031). <i>Conclusion</i>. Based on the findings of this study, dyspnea, low oxygen saturation, and lymphopenia are critical indicators for identifying high-risk children with COVID-19 and triaging them for better care and treatment.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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