Canadian Journal of Infectious Diseases & Medical Microbiology最新文献

Salmonella entericais one of the most frequent causes of gastroenteritis in humans. The emergence of antimicrobial-resistant strains of the bacterium, especially those which are resistant toward colistin (CST), the latest antibiotic introduced to cure this bacterial disease, has become a severe health problem. Beside pmrA and pmrB genes, CST resistance is determined by mobilized colistin resistance (mcr) genes. Accordingly, in the present study, the expression pattern of these genes and fliC (encoding the flagellin protein) and agfA (encoding the bacterial fimbriae) was evaluated. To this end, a total of 50 S. enterica isolates were collected from two hospitals in Shiraz, Iran, during 2019-2020. The pattern of antimicrobial resistance of the isolates was determined by the disk diffusion method. Then, after the antibiotic sensitivity test, following RNA extraction, the expression of selected genes was evaluated running real-time PCR. Results revealed that the occurrence of CST resistance in Salmonella isolates was 16%. The transcription levels of pmrA and fliC genes were increased in CST-resistant isolates. The results demonstrated the widespread distribution of multidrug-resistant and CST-resistant strains of S. enterica in the hospital setting. To overcome this issue, further actions, such as fast detection and eradication and appropriate preventive measures, should be undertaken to face this challenge.

Background: Electronic device screens can harbor harmful microbes, potentially facilitating the transmission of diseases when users interact with these surfaces. This study aimed to investigate the presence of gram-positive bacterial contamination and identify potentially harmful bacteria in these screens. A total of 200 samples were collected from the screens of devices of healthcare and nonhealthcare workers. Cotton swabs collected samples from device screens, including cellphones and iPads/PCs. These samples were cultured and tested to identify bacterial organisms and then assessed for antibiotic resistance using the disc diffusion method. Statistical analysis was performed using the t-test and ANOVA to compare the data obtained from the two groups.

Results: This study found 12 types of bacteria on device screens used by healthcare and nonhealthcare workers, irrespective of sex. Staphylococcus epidermidis was the most frequently detected bacterium in both groups. However, Staphylococcus aureus and Staphylococcus anaerobes were present in males but absent in females. Devices belonging to male participants exhibited statistically higher levels of bacterial contamination compared to those of the female participants (p < 0.05). Cell phones showed greater bacterial contamination than iPads/PCs. While six bacterial isolates exhibited resistance to antibiotics, Staphylococcus sciuri, S. aureus, Staphylococcus hominis subspecies hominis, and S. epidermidis showed multidrug resistance (MDR).

Conclusion: This research found that all the tested mobile phones harbored microorganisms, indicating they could transmit diseases. This emphasizes the critical need for hand hygiene following use to curtail the propagation of infection and bolster overall public health outcomes.

Background: Azvudine, as an antiviral drug, has been approved for the treatment of COVID-19, and multiple randomized controlled trials (RCTs) and retrospective cohort studies have been conducted. This study aimed to systematically evaluate the efficacy and safety of Azvudine in treating COVID-19 patients. Methods: As of December 1, 2023, we searched databases including PubMed, Web of Science, Ovid, ICTRP, Cochrane Library, Clinical Trials, MedRxiv, and Springer Link for relevant RCTs and retrospective cohort studies. EndNote X9 was used for literature screening and management, and R software was employed for meta-analysis. Results: A total of 1142 COVID-19 patients from five RCTs were included, with 575 patients receiving Azvudine treatment. Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in patients with mild to moderate COVID-19. However, compared to the control group, Azvudine did not significantly reduce the incidence of adverse events (AEs) (risk ratio: 0.89, 95% confidence interval [CI]: 0.80, 1.00). Additionally, eight ongoing clinical trials were included to evaluate the efficacy and safety of Azvudine. In fourteen retrospective cohort studies, a total of 6602 COVID-19 patients were analyzed, with 3118 patients receiving Azvudine treatment. Azvudine significantly reduced all-cause mortality (odds ratio [OR]: 0.49, 95% CI: 0.38, 0.63). The incidence of AEs in the Azvudine group and the Nirmatrelvir/Ritonavir group was 4.13% (60/1453) and 5.08% (67/1319), respectively, indicating that Azvudine significantly reduced the incidence of AEs compared to Nirmatrelvir/Ritonavir (OR: 0.68, 95% CI: 0.47, 0.98). Conclusions: Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in COVID-19 patients and significantly lowered all-cause mortality (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: high-certainty evidence). In terms of safety, Azvudine demonstrated a favorable safety profile (GRADE: moderate-certainty evidence because of suspected publication bias and residual confounding). Further large-scale studies are needed to validate its efficacy and safety.

Background: Antimicrobial resistance (AMR) is a growing public health concern in Ethiopia, marked by high resistance rates among common pathogens and widespread misuse of antimicrobials, particularly among healthcare providers. This study aimed to assess the knowledge, attitudes, practices (KAP), and influencing factors related to AMR among healthcare workers (HCWs) in health centers of Addis Ababa. Methods: A cross-sectional study design was conducted among 485 HCWs in Addis Ababa from July 1, 2023, to November 25, 2023. Participants were HCWs involved in antimicrobial prescribing at randomly selected health centers in three subcities. Data were collected using structured questionnaires and analyzed using SPSS Version 26. Multivariable logistic regression was performed to identify significant associations at p < 0.05, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. Results: A total of 473 HCWs participated, yielding a response rate of 97.5%. While 66.8% of HCWs demonstrated good knowledge about AMR, 61.3% exhibited unfavorable attitudes, and only 43.3% had satisfactory practice scores. Factors significantly associated with poor AMR practices included age (30-39 years; AOR = 0.29, 95% CI: 0.12-0.70), being a general practitioner (AOR = 4.26, 95% CI: 1.52-11.90), holding a degree (AOR = 0.47, 95% CI: 0.26-0.88), working in the outpatient department (AOR = 3.78, 95% CI: 1.82-7.86), lack of training (AOR = 0.16, 95% CI: 0.09-0.29), good knowledge (AOR = 0.45, 95% CI: 0.28-0.72), unfavorable attitudes (AOR = 1.79, 95% CI: 1.17-2.85), and lack of guideline consultation (AOR = 0.34, 95% CI: 0.22-0.52). Conclusions: The study found that younger HCWs, general practitioners, and those working in outpatient departments were more likely to exhibit better AMR practices. Conversely, lack of training and guideline consultation negatively impacted practices. Addressing knowledge gaps, improving attitudes, and reinforcing practices through targeted interventions are essential for effective AMR management in health centers.

Objective: Aimed to analyze the relationship between air pollution and Mycoplasma pneumoniae (MP) infection in children in Chengdu. Method: Data on outpatient and inpatient cases of MP infection among children at Chengdu Women and Children's Central Hospital from 2019 to 2023 were retrospectively collected. Air pollution and meteorological data from the same period were also obtained. A generalized additive model (GAM) was established using R statistical software to examine the impact of different air pollutant concentrations on MP infection incidence in children. The relationship between pollutant concentrations and MP infection rates was further analyzed by stratifying data by age, sex, and season. Results: From 2019 to 2023, a total of 21,075 outpatient and emergency cases and 6964 inpatient cases of MP infection were reported among children at Chengdu Women and Children's Central Hospital. A 10-μg/m³ increase in the daily concentration of particulate pollutants (PM_2.5, PM₁₀) had the most significant delayed effect on outpatient MP infection incidence at a 6-day lag (lag 06), although the cumulative lag effect was not statistically significant. When the average daily concentration of gaseous pollutants (SO₂) increased by 10 μg/m³, the strongest lag effects on outpatient and inpatient MP infections were observed at 7-day lags (lag 07 and lag 7, respectively). In the single air pollutant model, age-stratified analysis showed that SO₂ concentration had the most significant correlation with the incidence of outpatient and inpatient MP infections in children under 6 years of age, while nitrogen dioxide (NO₂) concentration had the most significant correlation in children over six. Sex-stratified analysis indicated that SO₂ levels were most significantly associated with MP infection in males, whereas NO₂ were most strongly correlated in females. Among outpatients, SO₂ had the most substantial effect on MP infection incidence across sexes. Seasonal stratification revealed that the impact of air pollution on MP infection was greater in autumn and winter than in spring and summer. Conclusion: Increased air pollution levels in Chengdu from 2019 to 2023 had a measurable impact on MP infection incidence in both inpatient and outpatient children, with notable lag and cumulative lag effects. These effects were more pronounced in autumn and winter, highlighting the need for targeted early warning systems to monitor air pollutant concentrations. Such efforts could play a crucial role in protecting vulnerable populations and reducing MP infection risks in children.

Background: Emerging scientific evidence suggests a connection between the oral microbiome (OM) and cancer (CA). This paper is designed to delve into the scientific output within this domain, pinpoint highly cited articles, and explore the latest research hotspots and emerging trends in OM/CA studies. Methods: On January 25, 2025, a comprehensive search was conducted to investigate research on the relationship between OM and CA. The search terms pertinent to both OM and CA were utilized. Key information was extracted from WoSCC. A suite of tools including Biblioshiny from R packages, Excel, and VOSviewer were utilized for comprehensive data visualization. Co-citation analysis was conducted to delineate the conceptual landscape of the field and to highlight influential publications. Results: A total of 1663 papers related to OM/CA were retrieved. The number of papers (Np) in OM/CA is proliferated from 2010 to 2024. The United States and China occupied leading positions and made the most significant contributions. Karolinska Institutet and Harvard University were the most productive institutions. The most prolific authors were Tina Dalianis and Anders Naesman. Oral Oncology garnered the most Np, whereas Gut received the highest total citations (TCs). A historical citation analysis traced the evolution of OM/CA research over time. The key topics encompassed the impact of OM on the initiation and progression of CA, the characteristics of OM in CA, the role of OM in screening and prognosis of CA, the effect of OM on CA treatment, and the underlying mechanisms through which OM is involved in CA. Emerging research hotspots in this field may include Mendelian randomization, applications of machine learning, biofilm formation, cytolethal distending toxin, and nanoparticles, along with the roles of Fusobacterium nucleatum and Porphyromonas gingivalis in disease pathogenesis. Conclusion: This study assessed worldwide production in OM/CA research, examining its quantitative characteristics. It pinpointed several pivotal papers and compiled data on the current status, emerging hotspots, and evolving trends within OM/CA research. The findings of this research may offer a fresh perspective for both academics and practitioners in the field.

Background: Hepatitis B virus (HBV) infection remains a major global health challenge, especially among high-risk groups such as hemodialysis (HD) patients. Aim: This study investigated the prevalence of sero-molecular markers and the genetic diversity of HBV in 160 Palestinian HD patients. Blood samples were tested for HBV serological markers (HBsAg, anti-HBc, and anti-HBs) and screened using nested PCR. Whole genome sequencing was conducted on PCR-positive samples to identify HBV genotypes and subgenotypes. Results: The overall HBV prevalence among HD patients was 3.75%, comprising 1.9% with overt infection (HBsAg +ve) and 1.9% with occult HBV infection (OBI). HCV was detected in 1.9% of patients. Evidence of past exposure (anti-HBc positive) was observed in 20% of patients, and 45% showed serological immunity with anti-HBs levels ≥ 10 IU/mL. Although the values of the genetic diversity estimators such as K, S, η, and π were approximately as twice as those for the S-region, the S-region produced a more reasonable phylogenetic tree and haplotype networking but under the condition of accurate sequencing and adequate number of investigated sequences. Phylogenetic trees and haplotype networking of the WGS and S-region revealed a clustering pattern based on genotypes and subgenotypes with two Palestinian WGS clustering in Subgenotype D1, while the other two in Subgenotype D3. Genetic diversity analysis revealed high haplotype diversity (Hd) (0.98-1.00) with high h:n ratio (0.9-1.00) and low nucleotide diversity (π) (0.007-0.027) indicating slight variation between any two given sequences. This is explained by purifying selection, recent population expansion, or constrained evolution as neutrality test values such as Tajima's D were negative (-0.5 to -1.86). Conclusion: HBV infection remains prevalent among HD patients, including both overt and occult forms. Genotype D, specifically Subgenotypes D1 and D3, predominates in the study population. The HBV S-region is a sufficient surrogate for population genetics investigations.

Objective: To investigate if red blood cell distribution width (RDW) is a risk factor for hospital mortality in patients admitted to a public university hospital in Belo Horizonte, Minas Gerais, Brazil. Methods: This observational prospective study included patients over 16 years who had been hospitalized for COVID-19 between May and October 2020. A descriptive and time-to-death analysis was performed using the Cox proportional hazards model. Results: Of the 161 patients included, 39 (24.2%) died during hospitalization. A total of 2227 blood counts were performed, an average of 13.8 tests per patient (standard deviation, SD 2.9). Upon admission, the RDW was normal (11.5% to 14.6%) in 115 patients (71.4%), elevated in 45 (28%), and low in 1 (0.6%). The mean RDW value at admission was 14.5 (SD 2.4), which falls within the normal reference range. Of the patients with normal RDW at admission, 82 (71.3%) maintained normal levels throughout their stay, while 33 (28.7%) showed increased RDW levels over time. Among those with elevated RDW at admission, 40 (88.9%) remained elevated, while 5 (11.1%) returned to normal levels. There was no significant difference in the mean RDW value at admission between survivors and nonsurvivors (14.4 [SD 2.4] for survivors vs. 14.9 [SD 2.4] for nonsurvivors; p=0.2081). The risk for mortality in the group with high RDW upon admission was higher than in the group with normal RDW, but without statistical significance (31.1% vs. 21.7%; RR = 1.43; p=0.413). When performing a multivariate analysis, the following continue to be risk factors for lower survival: age > 70 years, HR 4.8 (95% CI: 2.3; 10.3), p < 0.001; white race, HR 3.2 (95% CI: 1.2; 8.61), p=0.018; and need for invasive MV, HR 3.8 (1.7; 8.7), p=0.001. The presence of a chest X-ray suggestive of COVID-19, HR 3.5 (95% CI: 1.0; 11.5), p=0.044, also appears to be a risk factor in this analysis. Conclusion: Alterations on RDW values on admission were not associated with higher mortality, and further increases in RDW during hospitalization were not linked to a higher risk of mortality across all age groups. Our findings suggest that while RDW may indicate disease severity, it may not serve as a reliable independent predictor of mortality when other factors are accounted for in this cohort.

Background: Limited public knowledge of antimicrobial agents contributes to their misuse and antimicrobial resistance (AMR). Objective: This study aimed to assess the intentions of healthcare students and professionals in promoting public awareness and understanding of AMR. Methods: A 31-item survey based on the theory of planned behavior (TPB) and the health belief model was developed, incorporating intention, attitudes, subjective norms, perceived behavioral control, and perceived benefits. The survey aligned with global and national AMR action plans and was distributed among healthcare professionals and students in Al-Jouf, Saudi Arabia, via Google Forms. Responses were analyzed using frequencies, percentages, correlations between constructs, and ordinal logistic regression to assess significant associations between intention and other variables. Results: A total of 572 participants completed the survey, comprising 59.4% males and 40.6% females. Over one-third were younger individuals, and about one-third were undergraduate students or had less than 5 years of experience. Most respondents (74%) expressed an intention to educate the public on AMR, with a median intention score of 24 (out of 30). Intention showed strong positive correlations with past behavior (r = 0.703), subjective norms (r = 0.695), perceived behavioral control (r = 0.690), and perceived benefits (r = 0.683), while attitudes had a weak correlation (r = 0.122). Attitudes also had low correlations with other constructs (r = 0.137-0.278). Among predictors, subjective norms significantly influenced intention (p < 0.001), while other factors showed no significant predictive relationship. Conclusion: Healthcare students and professionals exhibited a strong inclination toward educating the public on responsible antimicrobial use and AMR. The findings underscore the complex interplay of factors influencing this intention, with subjective norms playing a key role, highlighting the impact of social pressure. Identifying these contributing factors can inform targeted strategies for healthcare professionals and students, enabling broader educational outreach and strengthening AMR control efforts.