Pub Date : 2024-11-20DOI: 10.1186/s12879-024-10052-5
François Cholette, Lisa Lazarus, Pascal Macharia, Jeffrey Walimbwa, Samuel Kuria, Parinita Bhattacharjee, Helgar Musyoki, Mary Mugambi, Martin K Ongaro, Kennedy Olango, Janet Musimbi, Faran Emmanuel, Shajy Isac, Michael Pickles, Marissa L Becker, Sharmistha Mishra, Lyle R McKinnon, James Blanchard, John Ho, Omari Henry, Rissa Fabia, Paul Sandstrom, Robert Lorway, Souradet Y Shaw
Background: The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.
Methods: Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.
Results: Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).
Conclusions: Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.
背景:肯尼亚的艾滋病疫情仍然是一个重大的公共卫生问题,尤其是在男同性恋、双性恋和其他男男性行为者(GBMSM)中,他们仍然承受着不成比例的疫情负担。本研究旨在描述肯尼亚男同性恋、双性恋和其他男男性行为者(GBMSM)中不同亚群的 HIV 系统发育集群,包括那些使用实体热点、虚拟空间或两者结合来寻找男性性伴侣的人群:方法:分别于 2019 年(基线)和 2020 年(端线)在肯尼亚基苏木、蒙巴萨和基安布县收集了 GBMSM 的干血斑(DBS)。对所有血清反应阳性的 DBS 进行了 HIV pol 测序。使用每个位点的核苷酸替换≤ 0.02 的父系距离截止值推断出 HIV 系统发生群。我们使用描述性统计方法分析了按聚类状况分层的社会人口学特征和危险行为:在 2450 名参与者(基线和终点)中,有 453 人(18.5%)感染了艾滋病毒。只有一小部分血清阳性的 DBS 标本成功测序(n = 36/453;7.9%),这可能是因为大多数研究参与者的病毒得到了抑制(87.4%)。在这些序列中,13 个(36.1%)形成了 8 个不同的群组,包括 7 个二联体和 1 个三联体。这些群组主要由在网上寻找伴侣的 GBMSM(n = 10/13;76.9%)和检测频率低于肯尼亚指南建议的 GBMSM(n = 11/13;84.6%)组成:我们的研究在肯尼亚的 GBMSM 中发现了 HIV 系统发育集群,这些人主要通过网络寻找性伴侣,且检测频率较低。这些发现凸显了这一人群中潜在的未得到满足的 HIV 预防、检测和治疗需求。此外,这些结果还强调了定制 HIV 项目的重要性,以满足肯尼亚 GBMSM 在不同场所(包括实体热点和网络平台)的不同需求,从而确保采取全面的预防和护理策略。
{"title":"HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya.","authors":"François Cholette, Lisa Lazarus, Pascal Macharia, Jeffrey Walimbwa, Samuel Kuria, Parinita Bhattacharjee, Helgar Musyoki, Mary Mugambi, Martin K Ongaro, Kennedy Olango, Janet Musimbi, Faran Emmanuel, Shajy Isac, Michael Pickles, Marissa L Becker, Sharmistha Mishra, Lyle R McKinnon, James Blanchard, John Ho, Omari Henry, Rissa Fabia, Paul Sandstrom, Robert Lorway, Souradet Y Shaw","doi":"10.1186/s12879-024-10052-5","DOIUrl":"https://doi.org/10.1186/s12879-024-10052-5","url":null,"abstract":"<p><strong>Background: </strong>The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.</p><p><strong>Methods: </strong>Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.</p><p><strong>Results: </strong>Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).</p><p><strong>Conclusions: </strong>Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1323"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1186/s12879-024-10212-7
Yining Quan, Xiaomeng Zhang, Guimao Yang, Chunqiang Ma, Mengmeng Liu
Background: Common non-COVID respiratory viruses, such as influenza virus (IFVA/IFVB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), and adenovirus (ADV), often cause acute respiratory infections (ARIs). This study aimed to explore the epidemiological characteristics of these five viruses in patients with ARIs before, during, and after the COVID-19 pandemic from 2018 to 2023.
Methods: A total of 37,139 serum specimens and epidemiological data from all-aged patients who presented with ARIs were collected from January 2018 to December 2023. The IgM antibodies of five non-COVID respiratory viruses were tested by an IgM kit with indirect immunofluorescent assay (lFA).
Results: 12,806 specimens were screened as positive for any one of the targeted viruses, with an overall positivity rate of 34.48%. Among all age groups, the most prevalent respiratory viruses were PIV (21.30%) and influenza virus (17.30% of IFVB and 9.91% of IFVA). Children aged 1-14 years were most vulnerable to lower respiratory viruses, and children aged 4-6 years have the highest prevalence no matter the positivity rate for overall viruses (53.06%) or for each virus. From 2018 to 2023, the annual percentage change (APC) revealed that the prevalence of total viruses have a 13.53% rise (p < 0.05), which increased with statistically significant for all age groups. In addition, both the infection rate and the number of samples detected have decreased significantly in the "first-level response" stage of the COVID-19 pandemic and in the "first three months" after fully lifted. Compared to those in the previous five years, the total infection rate (44.64%) and infection rate (26.93%) of the older adults (> 60 years) were all the highest in 2023, and the number of samples collected in 2023 sharply increased, increasing by 77.10% compared to the average of the number of detected in 2018-2022.
Conclusions: The data from this study indicate that the epidemiological characteristics of five non-COVID respiratory viruses are vulnerability to the environment, age, sex, and epidemics status among AIR patients, and that the detected number and positivity rate of these viruses have increased in the "post-pandemic era", which is critical for the late or retrospective diagnosis and can serve as a useful surveillance tool to inform local public policy in Weifang, China.
{"title":"Epidemiological characteristics of five non-COVID respiratory viruses among 37,139 all-age patients during 2018 - 2023 in Weifang, China: a cross-sectional study.","authors":"Yining Quan, Xiaomeng Zhang, Guimao Yang, Chunqiang Ma, Mengmeng Liu","doi":"10.1186/s12879-024-10212-7","DOIUrl":"https://doi.org/10.1186/s12879-024-10212-7","url":null,"abstract":"<p><strong>Background: </strong>Common non-COVID respiratory viruses, such as influenza virus (IFVA/IFVB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), and adenovirus (ADV), often cause acute respiratory infections (ARIs). This study aimed to explore the epidemiological characteristics of these five viruses in patients with ARIs before, during, and after the COVID-19 pandemic from 2018 to 2023.</p><p><strong>Methods: </strong>A total of 37,139 serum specimens and epidemiological data from all-aged patients who presented with ARIs were collected from January 2018 to December 2023. The IgM antibodies of five non-COVID respiratory viruses were tested by an IgM kit with indirect immunofluorescent assay (lFA).</p><p><strong>Results: </strong>12,806 specimens were screened as positive for any one of the targeted viruses, with an overall positivity rate of 34.48%. Among all age groups, the most prevalent respiratory viruses were PIV (21.30%) and influenza virus (17.30% of IFVB and 9.91% of IFVA). Children aged 1-14 years were most vulnerable to lower respiratory viruses, and children aged 4-6 years have the highest prevalence no matter the positivity rate for overall viruses (53.06%) or for each virus. From 2018 to 2023, the annual percentage change (APC) revealed that the prevalence of total viruses have a 13.53% rise (p < 0.05), which increased with statistically significant for all age groups. In addition, both the infection rate and the number of samples detected have decreased significantly in the \"first-level response\" stage of the COVID-19 pandemic and in the \"first three months\" after fully lifted. Compared to those in the previous five years, the total infection rate (44.64%) and infection rate (26.93%) of the older adults (> 60 years) were all the highest in 2023, and the number of samples collected in 2023 sharply increased, increasing by 77.10% compared to the average of the number of detected in 2018-2022.</p><p><strong>Conclusions: </strong>The data from this study indicate that the epidemiological characteristics of five non-COVID respiratory viruses are vulnerability to the environment, age, sex, and epidemics status among AIR patients, and that the detected number and positivity rate of these viruses have increased in the \"post-pandemic era\", which is critical for the late or retrospective diagnosis and can serve as a useful surveillance tool to inform local public policy in Weifang, China.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1324"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1186/s12879-024-10165-x
Sijia Liu, Sarisak Soontornchai, Somchai Bovornkitti, Xuemei Wang
Background: Brucellosis poses a significant public health challenge in China. Inner Mongolia, characterized by its developed livestock industry, is the most severe endemic area for human brucellosis. This study aims to describe the epidemiology, explore the spatial-temporal distribution patterns, and clustering characteristics of human brucellosis in Inner Mongolia.
Methods: Data on human brucellosis cases from 2010 to 2021 were obtained from the Centers for Disease Control and Prevention in Inner Mongolia. Spatial autocorrelation analysis was used to identify high-risk areas, while spatial-temporal scan statistics were employed to detect changes in clusters over time.
Results: A total of 153,792 brucellosis cases were reported in Inner Mongolia from 2010 to 2021, with an average annual incidence rate of 52.59 per 100,000 persons. The incidence showed a decreasing trend from 2010 to 2016, followed by a significant increase from 2016 to 2021. The disease exhibited distinct seasonality, peaking in spring and summer (March to August). Middle-aged individuals, males, and farmers/herdsmen had higher incidence rates. Spatially, incidence rates decreased from north to south and from the central and eastern regions to the west. Clear spatial clusters were observed during 2010-2013 and 2016-2021 in the global Moran's I test. Local spatial autocorrelation analysis revealed that high-high clusters expanded from the central and eastern regions towards the west over time. Spatio-temporal scan analysis further indicated that high-risk clusters were primarily concentrated in the central and eastern regions, with a continuous expansion towards the west and south, leading to an increasingly broad geographical spread.
Conclusion: Human brucellosis cases in Inner Mongolia exhibit spatio-temporal clustering, with spatial concentration in the central and eastern regions, but also observed expansion towards the western and southern regions. The most of cases occur between March and August each year. For high-risk areas and populations, more timely and effective prevention and control measures should be implemented to mitigate the spread of brucellosis and protect public health.
{"title":"Epidemiological characteristics and spatio-temporal clusters of human brucellosis in Inner Mongolia, 2010-2021.","authors":"Sijia Liu, Sarisak Soontornchai, Somchai Bovornkitti, Xuemei Wang","doi":"10.1186/s12879-024-10165-x","DOIUrl":"https://doi.org/10.1186/s12879-024-10165-x","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis poses a significant public health challenge in China. Inner Mongolia, characterized by its developed livestock industry, is the most severe endemic area for human brucellosis. This study aims to describe the epidemiology, explore the spatial-temporal distribution patterns, and clustering characteristics of human brucellosis in Inner Mongolia.</p><p><strong>Methods: </strong>Data on human brucellosis cases from 2010 to 2021 were obtained from the Centers for Disease Control and Prevention in Inner Mongolia. Spatial autocorrelation analysis was used to identify high-risk areas, while spatial-temporal scan statistics were employed to detect changes in clusters over time.</p><p><strong>Results: </strong>A total of 153,792 brucellosis cases were reported in Inner Mongolia from 2010 to 2021, with an average annual incidence rate of 52.59 per 100,000 persons. The incidence showed a decreasing trend from 2010 to 2016, followed by a significant increase from 2016 to 2021. The disease exhibited distinct seasonality, peaking in spring and summer (March to August). Middle-aged individuals, males, and farmers/herdsmen had higher incidence rates. Spatially, incidence rates decreased from north to south and from the central and eastern regions to the west. Clear spatial clusters were observed during 2010-2013 and 2016-2021 in the global Moran's I test. Local spatial autocorrelation analysis revealed that high-high clusters expanded from the central and eastern regions towards the west over time. Spatio-temporal scan analysis further indicated that high-risk clusters were primarily concentrated in the central and eastern regions, with a continuous expansion towards the west and south, leading to an increasingly broad geographical spread.</p><p><strong>Conclusion: </strong>Human brucellosis cases in Inner Mongolia exhibit spatio-temporal clustering, with spatial concentration in the central and eastern regions, but also observed expansion towards the western and southern regions. The most of cases occur between March and August each year. For high-risk areas and populations, more timely and effective prevention and control measures should be implemented to mitigate the spread of brucellosis and protect public health.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1321"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1186/s12879-024-10195-5
Courtney C Nawrocki, Austin R Earley, Sarah A Hook, Alison F Hinckley, Kiersten J Kugeler
Background: Commercial insurance claims data are a stable and consistent source of information on Lyme disease diagnoses in the United States and can contribute to our understanding of overall disease burden and the tracking of epidemiological trends. Algorithms consisting of diagnosis codes and antimicrobial treatment information have been used to identify Lyme disease diagnoses in claims data, but there might be opportunity to improve their accuracy.
Methods: We developed three modified versions of our existing claims-based Lyme disease algorithm; each reflected refined criteria regarding antimicrobials prescribed and/or maximum days between diagnosis code and qualifying prescription claim. We applied each to a large national commercial claims database to identify Lyme disease diagnoses during 2016-2019. We then compared characteristics of Lyme disease diagnoses identified by each of the modified algorithms to those identified by our original algorithm to assess differences from expected trends in demographics, seasonality, and geography.
Results: Observed differences in characteristics of patients with diagnoses identified by the three modified algorithms and our original algorithm were minimal, and differences in age and sex, in particular, were small enough that they could have been due to chance. However, one modified algorithm resulted in proportionally more diagnoses in men, during peak summer months, and in high-incidence jurisdictions, more closely reflecting epidemiological trends documented through public health surveillance. This algorithm limited treatment to only first-line recommended antimicrobials and shortened the timeframe between a Lyme disease diagnosis code and qualifying prescription claim.
Conclusions: As compared to our original algorithm, a modified algorithm that limits the antimicrobials prescribed and shortens the timeframe between a diagnosis code and a qualifying prescription claim might more accurately identify Lyme disease diagnoses when utilizing insurance claims data for supplementary, routine identification and monitoring of Lyme disease diagnoses.
{"title":"Optimizing identification of Lyme disease diagnoses in commercial insurance claims data, United States, 2016-2019.","authors":"Courtney C Nawrocki, Austin R Earley, Sarah A Hook, Alison F Hinckley, Kiersten J Kugeler","doi":"10.1186/s12879-024-10195-5","DOIUrl":"https://doi.org/10.1186/s12879-024-10195-5","url":null,"abstract":"<p><strong>Background: </strong>Commercial insurance claims data are a stable and consistent source of information on Lyme disease diagnoses in the United States and can contribute to our understanding of overall disease burden and the tracking of epidemiological trends. Algorithms consisting of diagnosis codes and antimicrobial treatment information have been used to identify Lyme disease diagnoses in claims data, but there might be opportunity to improve their accuracy.</p><p><strong>Methods: </strong>We developed three modified versions of our existing claims-based Lyme disease algorithm; each reflected refined criteria regarding antimicrobials prescribed and/or maximum days between diagnosis code and qualifying prescription claim. We applied each to a large national commercial claims database to identify Lyme disease diagnoses during 2016-2019. We then compared characteristics of Lyme disease diagnoses identified by each of the modified algorithms to those identified by our original algorithm to assess differences from expected trends in demographics, seasonality, and geography.</p><p><strong>Results: </strong>Observed differences in characteristics of patients with diagnoses identified by the three modified algorithms and our original algorithm were minimal, and differences in age and sex, in particular, were small enough that they could have been due to chance. However, one modified algorithm resulted in proportionally more diagnoses in men, during peak summer months, and in high-incidence jurisdictions, more closely reflecting epidemiological trends documented through public health surveillance. This algorithm limited treatment to only first-line recommended antimicrobials and shortened the timeframe between a Lyme disease diagnosis code and qualifying prescription claim.</p><p><strong>Conclusions: </strong>As compared to our original algorithm, a modified algorithm that limits the antimicrobials prescribed and shortens the timeframe between a diagnosis code and a qualifying prescription claim might more accurately identify Lyme disease diagnoses when utilizing insurance claims data for supplementary, routine identification and monitoring of Lyme disease diagnoses.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1322"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1186/s12879-024-10209-2
Willy Wirawan Guslianto, Yunialthy Dwia Pertiwi, Mochammad Hatta, Lisa Tenriesa, Ririn Nislawati, Fadhilah Syamsuri, Muhammad Nasrum Massi, Firdaus Hamid
Background: Endophthalmitis is a severe inflammation of the internal ocular structures, usually caused by bacterial or fungal infections, and can lead to rapid, irreversible blindness. Fungal endophthalmitis (FE), primarily due to Candida albicans and Aspergillus, is less common than bacterial endophthalmitis but has shown an increase in prevalence over the past two decades. Diagnosing FE is challenging and often delayed due to the time-consuming nature of traditional culture methods. The timely initiation of targeted antifungal therapy based on the specific fungal pathogen identified by molecular method can improve patient outcomes and reduce the risk of vision loss. This study aims to determine the presence of pathogenic fungal infections in patients with endophthalmitis using molecular methods at Hasanuddin University Hospital Makassar.
Methods: This cross-sectional observational study analyzed 83 intraocular fluid samples from patients with endophthalmitis at Hasanuddin University Hospital, Makassar, Indonesia. Samples were examined using microscopy, culture, and molecular methods, including polymerase chain reaction (PCR) and deoxyribonucleic acid (DNA) sequencing.
Results: The study population comprised 49 males (59%) and 34 females (41%), with an average age of 45.85 years. The distribution of affected eyes was nearly equal, with 50.6% involving the right eye and 49.4% involving the left eye. Exogenous transmission, primarily related to external risk factors such as ocular trauma or surgical procedures, was identified as the most common mode of fungal transmission in this population (97.6%). No fungal elements were detected through microscopy or culture; however, PCR could identify 5 positive samples (6%); 3 were males and 2 were females; all have exogenous transmission, predominantly showing Candida species. Sequencing revealed Candida parapsilosis, Lodderomyces beijingensis, and Trichophyton rubrum among the findings.
Conclusion: Cases of fungal endophthalmitis are rare but increasing, posing diagnostic challenges. Our study concludes that PCR is more effective than traditional culture methods in identifying fungal pathogens, with a predominance of Candida species identified in endophthalmitis. Molecular techniques like PCR offer rapid and accurate diagnosis, improving patient treatment outcomes by enabling earlier initiation of targeted antifungal therapy.
{"title":"Endophthalmitis patients in Makassar City: molecular identification of pathogenic fungal profile.","authors":"Willy Wirawan Guslianto, Yunialthy Dwia Pertiwi, Mochammad Hatta, Lisa Tenriesa, Ririn Nislawati, Fadhilah Syamsuri, Muhammad Nasrum Massi, Firdaus Hamid","doi":"10.1186/s12879-024-10209-2","DOIUrl":"10.1186/s12879-024-10209-2","url":null,"abstract":"<p><strong>Background: </strong>Endophthalmitis is a severe inflammation of the internal ocular structures, usually caused by bacterial or fungal infections, and can lead to rapid, irreversible blindness. Fungal endophthalmitis (FE), primarily due to Candida albicans and Aspergillus, is less common than bacterial endophthalmitis but has shown an increase in prevalence over the past two decades. Diagnosing FE is challenging and often delayed due to the time-consuming nature of traditional culture methods. The timely initiation of targeted antifungal therapy based on the specific fungal pathogen identified by molecular method can improve patient outcomes and reduce the risk of vision loss. This study aims to determine the presence of pathogenic fungal infections in patients with endophthalmitis using molecular methods at Hasanuddin University Hospital Makassar.</p><p><strong>Methods: </strong>This cross-sectional observational study analyzed 83 intraocular fluid samples from patients with endophthalmitis at Hasanuddin University Hospital, Makassar, Indonesia. Samples were examined using microscopy, culture, and molecular methods, including polymerase chain reaction (PCR) and deoxyribonucleic acid (DNA) sequencing.</p><p><strong>Results: </strong>The study population comprised 49 males (59%) and 34 females (41%), with an average age of 45.85 years. The distribution of affected eyes was nearly equal, with 50.6% involving the right eye and 49.4% involving the left eye. Exogenous transmission, primarily related to external risk factors such as ocular trauma or surgical procedures, was identified as the most common mode of fungal transmission in this population (97.6%). No fungal elements were detected through microscopy or culture; however, PCR could identify 5 positive samples (6%); 3 were males and 2 were females; all have exogenous transmission, predominantly showing Candida species. Sequencing revealed Candida parapsilosis, Lodderomyces beijingensis, and Trichophyton rubrum among the findings.</p><p><strong>Conclusion: </strong>Cases of fungal endophthalmitis are rare but increasing, posing diagnostic challenges. Our study concludes that PCR is more effective than traditional culture methods in identifying fungal pathogens, with a predominance of Candida species identified in endophthalmitis. Molecular techniques like PCR offer rapid and accurate diagnosis, improving patient treatment outcomes by enabling earlier initiation of targeted antifungal therapy.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1320"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1186/s12879-024-10161-1
Muhammed Shabil, Shilpa Gaidhane, Suhas Ballal, Sanjay Kumar, Mahakshit Bhat, Shilpa Sharma, M Ravi Kumar, Sarvesh Rustagi, Mahalaqua Nazli Khatib, Nishant Rai, Mohammed Garout, Nabiha A Bouafia, Amer Alshengeti, Hayam A Alrasheed, Nawal A Al Kaabi, Mubarak Alfaresi, Ali Hazazi, Ali A Rabaan, Sanjit Sah, Sorabh Lakhanpal, Ganesh Bushi, Laksmi Thangavelu, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Ashok Kumar Balaraman, Rukshar Syed, Gajendra Sharma
Background: The COVID-19 pandemic has significantly impacted public health, with emerging evidence suggesting substantial effects on maternal and neonatal health. This systematic review and meta-analysis aimed to quantify the prevalence and risk of respiratory distress syndrome (RDS) in newborns born to mothers infected with SARS-CoV-2, the virus responsible for COVID-19.
Methods: We conducted a literature search in Embase, PubMed, and Web of Science up to April 20, without language or date restrictions. Observational studies reporting on the prevalence or risk of RDS among newborns from mothers with confirmed SARS-CoV-2 infection were included. Quality assessment was performed using the JBI tool. Statistical analysis was performed by using R software version 4.3.
Results: Twenty-two studies met the inclusion criteria. The pooled prevalence of RDS among newborns born to COVID-19-infected mothers was 11.5% (95% CI: 7.4-17.3%), with significant heterogeneity (I² = 93%). Newborns from infected mothers had a significantly higher risk of developing RDS, with a pooled risk ratio (RR) of 2.69 (95% CI: 1.77 to 4.17).
Conclusion: Newborns born to mothers with COVID-19 have a substantially increased risk of developing RDS. These findings emphasize the need for vigilant monitoring and appropriate management of pregnant women with COVID-19 to mitigate adverse neonatal outcomes.
{"title":"Maternal COVID-19 infection and risk of respiratory distress syndrome among newborns: a systematic review and meta-analysis.","authors":"Muhammed Shabil, Shilpa Gaidhane, Suhas Ballal, Sanjay Kumar, Mahakshit Bhat, Shilpa Sharma, M Ravi Kumar, Sarvesh Rustagi, Mahalaqua Nazli Khatib, Nishant Rai, Mohammed Garout, Nabiha A Bouafia, Amer Alshengeti, Hayam A Alrasheed, Nawal A Al Kaabi, Mubarak Alfaresi, Ali Hazazi, Ali A Rabaan, Sanjit Sah, Sorabh Lakhanpal, Ganesh Bushi, Laksmi Thangavelu, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Ashok Kumar Balaraman, Rukshar Syed, Gajendra Sharma","doi":"10.1186/s12879-024-10161-1","DOIUrl":"10.1186/s12879-024-10161-1","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has significantly impacted public health, with emerging evidence suggesting substantial effects on maternal and neonatal health. This systematic review and meta-analysis aimed to quantify the prevalence and risk of respiratory distress syndrome (RDS) in newborns born to mothers infected with SARS-CoV-2, the virus responsible for COVID-19.</p><p><strong>Methods: </strong>We conducted a literature search in Embase, PubMed, and Web of Science up to April 20, without language or date restrictions. Observational studies reporting on the prevalence or risk of RDS among newborns from mothers with confirmed SARS-CoV-2 infection were included. Quality assessment was performed using the JBI tool. Statistical analysis was performed by using R software version 4.3.</p><p><strong>Results: </strong>Twenty-two studies met the inclusion criteria. The pooled prevalence of RDS among newborns born to COVID-19-infected mothers was 11.5% (95% CI: 7.4-17.3%), with significant heterogeneity (I² = 93%). Newborns from infected mothers had a significantly higher risk of developing RDS, with a pooled risk ratio (RR) of 2.69 (95% CI: 1.77 to 4.17).</p><p><strong>Conclusion: </strong>Newborns born to mothers with COVID-19 have a substantially increased risk of developing RDS. These findings emphasize the need for vigilant monitoring and appropriate management of pregnant women with COVID-19 to mitigate adverse neonatal outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1318"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1186/s12879-024-10217-2
Siyao Wu, Siqiao Liang, Hanlin Liang, Yan Ning, Xia Li, Zhiyi He
The typical clinical characteristic of patients with anti-IFN-γ autoantibodies (AIGAs) is primarily associated with infection caused by intracellular pathogens. With continued research, additional clinical characteristics have been gradually uncovered. Here, we present a case of multiple pathogen infections accompanied by ocular pathologies in a patient with high titers of AIGAs. The patient, a 53-year-old female patient, was admitted to our hospital after finding a mass in the right supraclavicular fossa. She was successively diagnosed with Talaromyces marneffei, Aspergillus flavus and Nontuberculous mycobacteria (NTM) infections. Then, she received a complete course of antifungal agents for nearly 3.5 years and anti-NTM treatment for nearly 3 years, with discontinuation upon symptom improvement. However, there was a rapid recurrence of the infection upon cessation of the drug despite improvement in the patient's symptoms. Moreover, when the recurrent infection stabilized, the patient exhibited immune conjunctivitis and dry eye, which was successfully treated by tacrolimus eye drops and lubricant. Patients with high-titer AIGAs are more prone to experiencing recurrence and/or persistent infection, as well as immune disorders.
{"title":"Multiple pathogen infections accompanied with ocular pathologies in a patient with high-titer Anti-IFN-γ autoantibodies: a case report.","authors":"Siyao Wu, Siqiao Liang, Hanlin Liang, Yan Ning, Xia Li, Zhiyi He","doi":"10.1186/s12879-024-10217-2","DOIUrl":"https://doi.org/10.1186/s12879-024-10217-2","url":null,"abstract":"<p><p>The typical clinical characteristic of patients with anti-IFN-γ autoantibodies (AIGAs) is primarily associated with infection caused by intracellular pathogens. With continued research, additional clinical characteristics have been gradually uncovered. Here, we present a case of multiple pathogen infections accompanied by ocular pathologies in a patient with high titers of AIGAs. The patient, a 53-year-old female patient, was admitted to our hospital after finding a mass in the right supraclavicular fossa. She was successively diagnosed with Talaromyces marneffei, Aspergillus flavus and Nontuberculous mycobacteria (NTM) infections. Then, she received a complete course of antifungal agents for nearly 3.5 years and anti-NTM treatment for nearly 3 years, with discontinuation upon symptom improvement. However, there was a rapid recurrence of the infection upon cessation of the drug despite improvement in the patient's symptoms. Moreover, when the recurrent infection stabilized, the patient exhibited immune conjunctivitis and dry eye, which was successfully treated by tacrolimus eye drops and lubricant. Patients with high-titer AIGAs are more prone to experiencing recurrence and/or persistent infection, as well as immune disorders.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1319"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1186/s12879-024-10214-5
Lise Lafferty, Tanya L Applegate, Sophie Lewis, Kerryn Drysdale, Robert Monaghan, Angela Kelly-Hanku, Rebecca Guy, Carla Treloar
Background: There exist multiple regulatory layers for point-of-care (POC) testing to be implemented within Australia. This qualitative analysis sought to understand the pre-market barriers and facilitators to scale-up infectious diseases POC testing in primary care settings at the national level.
Methods: Key informant interviews were undertaken with people (n = 30) working in high- level positions relevant to infectious diseases POC testing in Australia. Participants were recruited from federal and state health departments, industry, and nongovernment national peak bodies. The Unitaid scalability framework informed this analysis to understand barriers and enablers to creating access conditions and establishing country readiness for market access of POC tests.
Results: Participants identified regulatory frameworks as significant barriers to market access. National strategies and advocacy were viewed as potential enablers to establishing country readiness. It was recommended that the national system for universal health care should fund infectious disease POC tests to ensure financial sustainability, though the existing pathology infrastructure was regarded as a likely inhibitor.
Conclusions: Current regulatory frameworks inhibit market access for infectious disease POC testing devices for use in the primary care setting. National advocacy is urgently needed to gain government support and align national policies with regulatory frameworks.
{"title":"Pre-market health systems barriers and enablers to infectious diseases point-of-care diagnostics in Australia: qualitative interviews with key informants.","authors":"Lise Lafferty, Tanya L Applegate, Sophie Lewis, Kerryn Drysdale, Robert Monaghan, Angela Kelly-Hanku, Rebecca Guy, Carla Treloar","doi":"10.1186/s12879-024-10214-5","DOIUrl":"10.1186/s12879-024-10214-5","url":null,"abstract":"<p><strong>Background: </strong>There exist multiple regulatory layers for point-of-care (POC) testing to be implemented within Australia. This qualitative analysis sought to understand the pre-market barriers and facilitators to scale-up infectious diseases POC testing in primary care settings at the national level.</p><p><strong>Methods: </strong>Key informant interviews were undertaken with people (n = 30) working in high- level positions relevant to infectious diseases POC testing in Australia. Participants were recruited from federal and state health departments, industry, and nongovernment national peak bodies. The Unitaid scalability framework informed this analysis to understand barriers and enablers to creating access conditions and establishing country readiness for market access of POC tests.</p><p><strong>Results: </strong>Participants identified regulatory frameworks as significant barriers to market access. National strategies and advocacy were viewed as potential enablers to establishing country readiness. It was recommended that the national system for universal health care should fund infectious disease POC tests to ensure financial sustainability, though the existing pathology infrastructure was regarded as a likely inhibitor.</p><p><strong>Conclusions: </strong>Current regulatory frameworks inhibit market access for infectious disease POC testing devices for use in the primary care setting. National advocacy is urgently needed to gain government support and align national policies with regulatory frameworks.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1317"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1186/s12879-024-10226-1
Francesco Di Gennaro, Nicola Veronese, Francesco Vladimiro Segala, Luisa Frallonardo, Giacomo Guido, Mariangela Cormio, Greta Romita, Angela Parisi, Eliana Marrone, Maria Elena Ciuppa, Anna La Carrubba, Luca Carruba, Anna Licata, Giada Cavallaro, Vittorio Pagliuso, Teresa Maino, Silvia Lollo, Lorenzo Latino, Lidia Tina Solimeo, Antonia Ianniello, Domenico Montalbò, Davide Fiore Bavaro, Maria Luisa Fiorella, Mario Barbagallo, Annalisa Saracino
Background: Long COVID, a highly heterogeneous syndrome affecting millions of people worldwide, is emerging as an urgent public health threat, but data on the predictors of specific clinical manifestations over long follow-up periods are limited. The aim of this study is to investigate the role of viral variants and other predictors in long COVID incidence and clinical manifestations.
Methods: All COVID-19 patients aged > 18 years and hospitalized from March 1 2020 to April 2022 in two Italian University Hospitals were enrolled. Incidence and clinical presentation of long COVID were assessed through structured questionnaires delivered by phone calls. The association between possible risk factors collected during hospitalization and long COVID was reported using an adjusted logistic regression and reported as odds ratios (ORs) with their 95% confidence intervals (CIs).
Results: Among 1,012 recruited patients, over a median follow-up of 19 months (IQR: 15-24 months), the cumulative incidence of long COVID was 91.7%, with the most common clinical manifestations involving the respiratory system (80.5%) and the neurological system (77.3%). Among 1,012 recruited patients, over a median follow-up of 19 months (IQR: 15-24 months), the cumulative incidence of long COVID was 91.7%, with the most common clinical manifestations involving the respiratory system (80.5%) and the neurological system (77.3%). Overall, 54% reported long COVID symptomatology between 18 and 24 months. Multivariate analysis suggested that being vaccinated against SARS-CoV-2 was associated with reduced odds of reporting any long COVID symptomatology (OR: 0.34; 95% CI: 0.21-0.58), while infection with the Delta variant was a strong predictor (OR: 9.61, p < 0.0001) for the development of post-COVID conditions characterized by neuropsychiatric symptoms.
Conclusions: In this study long COVID symptoms were still highly prevalent after 18-24 months of follow-up and, when compared to wild-type virus, infection with the Delta variant was associated with a higher risk of developing a neurological post-COVID condition.
{"title":"Protective role of vaccination on the development of long COVID: data from a large, multicenter, prospective cohort study.","authors":"Francesco Di Gennaro, Nicola Veronese, Francesco Vladimiro Segala, Luisa Frallonardo, Giacomo Guido, Mariangela Cormio, Greta Romita, Angela Parisi, Eliana Marrone, Maria Elena Ciuppa, Anna La Carrubba, Luca Carruba, Anna Licata, Giada Cavallaro, Vittorio Pagliuso, Teresa Maino, Silvia Lollo, Lorenzo Latino, Lidia Tina Solimeo, Antonia Ianniello, Domenico Montalbò, Davide Fiore Bavaro, Maria Luisa Fiorella, Mario Barbagallo, Annalisa Saracino","doi":"10.1186/s12879-024-10226-1","DOIUrl":"10.1186/s12879-024-10226-1","url":null,"abstract":"<p><strong>Background: </strong>Long COVID, a highly heterogeneous syndrome affecting millions of people worldwide, is emerging as an urgent public health threat, but data on the predictors of specific clinical manifestations over long follow-up periods are limited. The aim of this study is to investigate the role of viral variants and other predictors in long COVID incidence and clinical manifestations.</p><p><strong>Methods: </strong>All COVID-19 patients aged > 18 years and hospitalized from March 1 2020 to April 2022 in two Italian University Hospitals were enrolled. Incidence and clinical presentation of long COVID were assessed through structured questionnaires delivered by phone calls. The association between possible risk factors collected during hospitalization and long COVID was reported using an adjusted logistic regression and reported as odds ratios (ORs) with their 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 1,012 recruited patients, over a median follow-up of 19 months (IQR: 15-24 months), the cumulative incidence of long COVID was 91.7%, with the most common clinical manifestations involving the respiratory system (80.5%) and the neurological system (77.3%). Among 1,012 recruited patients, over a median follow-up of 19 months (IQR: 15-24 months), the cumulative incidence of long COVID was 91.7%, with the most common clinical manifestations involving the respiratory system (80.5%) and the neurological system (77.3%). Overall, 54% reported long COVID symptomatology between 18 and 24 months. Multivariate analysis suggested that being vaccinated against SARS-CoV-2 was associated with reduced odds of reporting any long COVID symptomatology (OR: 0.34; 95% CI: 0.21-0.58), while infection with the Delta variant was a strong predictor (OR: 9.61, p < 0.0001) for the development of post-COVID conditions characterized by neuropsychiatric symptoms.</p><p><strong>Conclusions: </strong>In this study long COVID symptoms were still highly prevalent after 18-24 months of follow-up and, when compared to wild-type virus, infection with the Delta variant was associated with a higher risk of developing a neurological post-COVID condition.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1313"},"PeriodicalIF":3.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1186/s12879-024-10199-1
Mehdi Fazlalipour, Tahmineh Jalali, Roger Hewson, Mohammad Hassan Pouriayevali, Mostafa Salehi-Vaziri
Background: Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5-50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs.
Methods: From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings.
Results: Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23-53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs.
Conclusions: In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF.
{"title":"Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000-2023, a report of National Reference Laboratory.","authors":"Mehdi Fazlalipour, Tahmineh Jalali, Roger Hewson, Mohammad Hassan Pouriayevali, Mostafa Salehi-Vaziri","doi":"10.1186/s12879-024-10199-1","DOIUrl":"10.1186/s12879-024-10199-1","url":null,"abstract":"<p><strong>Background: </strong>Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5-50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs.</p><p><strong>Methods: </strong>From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings.</p><p><strong>Results: </strong>Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23-53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs.</p><p><strong>Conclusions: </strong>In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1312"},"PeriodicalIF":3.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}