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Foreword

BackgroundInfection with nontuberculous mycobacteria (NTM) is of growing clinical concern in people with cystic fibrosis (CF). The epidemiology of infection in children and young people remains poorly understood. Our goal was to investigate the epidemiology of NTM infection in the pediatric age group using data from the UK CF Registry.MethodsData from 2010–2015 for individuals aged <16 years (23200 observations from 5333 unique individuals) were obtained. Univariate analysis of unique individuals comparing all key clinical factors and health outcomes to NTM status was performed. The significant factors that were identified were used to generate a multivariate logistic regression model that, following step-wise removal, generated a final parsimonious model.ResultsThe prevalence of individuals with a NTM-positive respiratory culture increased every year from 2010 (45 [1.3%]) to 2015 (156 [3.8%]). Allergic bronchopulmonary aspergillosis (odds ratio [OR], 2.66; P = 5.0 × 10−8), age (OR, 1.08; P = 3.4 × 10−10), and intermittent Pseudomonas aeruginosa infection (OR, 1.51; P = .004) were significantly associated with NTM infection.ConclusionsNTM infection is of increasing prevalence in the UK pediatric CF population. This study highlights the urgent need for work to establish effective treatment and prevention strategies for NTM infection in young people with CF.

Climate change may cause profound and complex changes in the prevalence of infectious diseases. Obligate pathogenic fungi causing endemic mycoses and the agents of cryptococcosis are environmental pathogens adapted to environmental niches. They may be exposed to changing climatic conditions, which may change the epidemiology of human infections. To review documented changes in the epidemiology of endemic fungal infections and cryptococcosis. To review evidence that changing climate is apotential mechanism for changes in the epidemiology of these infections. Aselective literature review focusing on endemic mycoses and cryptococcosis. Changes in endemic regions of infections caused by C.gattii and selected endemic mycoses have been well documented. Significant increases in the incidence of infections have been demonstrated for some areas. Climatic factors (temperature, precipitation, and extreme weather events), changes in land use, distribution of potential host animals, and global trade routes are discussed as contributory factors. Improved surveillance of fungal infections of humans and animals including molecular typing of clinical and environmental isolates is necessary to understand the epidemiology of these infections. The characterization of environmental niches, mechanisms of distribution of fungi, and fungal adaptation mechanisms are needed to guide prevention strategies.

Bloodstream infections (BSI) pose a substantial threat to the well-being and survival of patients undergoing hematopoietic stem cell transplantation (HSCT). Risk factors for these infections vary across the different post-HSCT phases. In the pre-engraftment period, patients are particularly susceptible to infection due to prolonged neutropenia, mucosal damage, and extensive use of central venous line (CVL). In the post-engraftment phase, the emergence of graft versus host diseases further compounds the risk. The epidemiology of these infections has undergone notable changes over the years due to multifactorial reasons, including the evolution of protocols that intensify immunosuppression. In this context, the emergence of multi-drug resistance (MDR) microorganisms can be a challenge due to the elevated risk of mortality in these vulnerable patients. Unfortunately, there is a lack of comprehensive data on this topic, particularly in pediatrics. This article aims to provide a summary of the epidemiology of BSI in the different post-transplant phases and the impact of MDR pathogens. Having knowledge about the local epidemiology of BSI can be instrumental in tailoring targeted therapies, leading to improved survival rates in HSCT recipients.

A simple model is used to explore the extent to which the uniquely comprehensive studies of western equine encephalomyelitis in Kern County, California, by Reeves and his colleagues over many years, explain the dynamics and epidemiology of the infection. It is concluded that not only does this series of integrated field and laboratory studies successfully account for these phenomena, to an extent which is unlikely to be substantially improved upon, not least because of the inherent difficulties in measuring the key factors with greater precision; but it also provides a unique model of the dedication and ingenuity required if comparable levels of understanding of the ecology and epidemiology of other arbovirus infections are to be achieved.

The risk for infection after solid organ transplantation is determined by interactions between the net state of immunosuppression, the organ transplanted, the preventive measures implemented, and the epidemiology of pre-existing infections in both the donor and recipient and any environmental exposure to endemic and epidemic community infections. Clinical experience and observational studies have revealed some common patterns of posttransplant infections that may be considered in developing a differential diagnosis for infectious syndromes. However, any proposed timeline must be interpreted in the context of the clinical course of the specific recipient and the local epidemiology. This chapter provides an overview of common patterns of infectious risk in transplantation. Detailed considerations of the equation of infectious risk, including pretransplant assessments, donor-derived infections, and early and late posttransplant infections, are presented in subsequent chapters.

Review of the past and present status of respiratory syncytial virus and rotavirus infections that commonly affect children

This review focuses on the anatomy of the Swedish new variant of Chlamydia trachomatis (nvCT). This information provides an interesting insight into the emergence of new strains (how, where, and when), and the important lessons learned are discussed. In late 2006, the nvCT was first reported in Sweden; it carries a 377 bp deletion within its plasmid which covers the single targets originally used by Roche and Abbott diagnostic systems. The nvCT spread rapidly with thousands of falsely negative diagnoses. Genome sequencing and phenotypic characterization showed that the biological fitness of nvCT when compared with wild-type CT in vitro is unaltered. Therefore, the rapid transmission of nvCT was due to the selective advantage gained from failed diagnosis and the introduction of nvCT into a high-frequency transmitting population. The proportions of nvCT cases are now converging toward equilibrium with the wild-type CT strains. Interestingly, the nvCT remains rarely reported beyond the Nordic countries. The spread of nvCT had a substantial impact on C. trachomatis identification, epidemiology, and public health in Sweden. Lessons learned from this experience include the importance of investigating the incidence and epidemiology of infection in detail, the frequent participation in appropriate quality assurance schemes, and the careful design of diagnostic assays. The nvCT presents a unique opportunity to study the spread of a single C. trachomatis strain within both the human and bacterial populations; this may substantially increase our knowledge of epidemiology and transmission of chlamydial infections, and other sexually transmitted infections.

The epidemiology of parasitic infections in sheep is a significant problem in the fields of meat production and human health. Coccidiosis in sheep is one of the major problems caused by protozoan parasites from the genus Eimeria. This study aims to determine the prevalence of Coccidian in the Sawakni sheep breed (Linnaeus, 1758) and the epidemiology of the infection in Saudi Arabia. We used morphological characteristics to identify Eimeria spp. We collected a total of 1000 fecal samples of Ovis aries, representing different ages and genders, from cattle markets and slaughterhouses in Riyadh city. The results showed 5 species of Eimeria that infect sheep: E. ahsata (length 37±0.34 µm; width 25±0.62 µm), E. crandallis (length 22±0.81µm; width 18±0.62µm), E. marsica (length 19±0.18µm; width 12±0.56µm), E. weybridgensis (length 23±0.37µm; width 17±0.50µm), and E. ovinoidalis (length 23±0.37µm; width 17±0.50µm). Moreover, the results showed that the infection rate was 35.6%. Summer recorded the highest percentage at 46.8%, while winter recorded the lowest at 26.4%. The species Eimeria crandallis recorded the highest infection rate of 8.9%, while the species Eimeria intericata represented the lowest infection rate of 0.30%. The current study provides relevant information to assess potential infections and future defenses against sheep coccidiosis, thereby minimizing financial losses for Saudi Arabia's sheep industry.

Changes in health care delivery systems over the last decade have resulted in a major increase in outpatient surgery and a higher severity of illness for inpatients. We sought to determine the effects of this change on the epidemiology of postoperative surgical infections. Historical data on incidence and epidemiology of infection were obtained from peer-reviewed articles published between 1960 and 1999 (MEDLINE). All nosocomial infections in 5035 patients admitted to a tertiary-care university hospital surgical intensive care unit between January 1994 and December 1997 were prospectively identified and classified as wound, urinary tract, bloodstream, or pneumonia. Incidence of bacterial isolates at each site was also recorded. From these data we determined infection rates per 100 admissions. We also identified all device-related nosocomial infections and calculated infection rates. Comparisons between time periods were made. In the 1960s wound infections constituted the predominant postoperative infection at 46 per cent. This was replaced by urinary tract infection in the 1970s (44%) and 1980s (32%) and closely followed by bloodstream infections (25%). In the 1990s nosocomial pneumonia became the most common postoperative infection, comprising 43 per cent of surgical intensive care unit infections. Analysis of the bacteriology also revealed changing trends with primarily gram-positive organisms in the 1960s followed by an increase in methicillin-resistant Staphylococcus in the 1970 to 1980s, and currently resistant gram-negative bacteria predominate. The incidence of fungal infections has steadily increased. This survey identified a new epidemiology for postoperative surgical infections. Over the last several decades the reported wound infections have been markedly decreased and there is little change in urinary tract infection. Nosocomial pneumonia with resistant gram-negative bacteria now predominates along with increased incidence of fungal infections. Currently, postoperative infections are now more severe, involve critical organs, and require close monitoring of the changing patterns of pathogens.

IntroductionUnlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due attention in French Guiana. The main objective of the current study was to define the incidence of these PNTM infections: NTM pulmonary diseases (NTM-PD) and casual PNTM isolation (responsible of latent infection or simple colonization). The secondary objectives were to determine species diversity and geographic distribution of these atypical mycobacteria.MethodsA retrospective observational study (2008–2018) of French Guiana patients with at least one PNTM positive respiratory sample in culture was conducted. Patients were then classified into two groups: casual PNTM isolation or pulmonary disease (NTM-PD), according to clinical, radiological and microbiological criteria defined by the American Thoracic Society / Infectious Disease Society of America (ATS / IDSA) in 2007.Results178 patients were included, out of which 147 had casual PNTM isolation and 31 had NTM-PD. Estimated annual incidence rate of respiratory isolates was 6.17 / 100,000 inhabitants per year while that of NTM-PD was 1.07 / 100,000 inhabitants per year. Among the 178 patients, M. avium complex (MAC) was the most frequently isolated pathogen (38%), followed by M. fortuitum then M. abscessus (19% and 6% of cases respectively), the latter two mycobacteria being mainly found in the coastal center region. Concerning NTM-PD, two species were mainly involved: MAC (81%) and M. abscessus (16%).Discussion/ConclusionThis is the first study on the epidemiology of PNTM infections in French Guiana. PNTM’s incidence looks similar to other contries and metropolitan France and NTM-PD is mostly due to MAC and M.abscessus. Although French Guiana is the French territory with the highest tuberculosis incidence, NTM should not be overlooked.

The study of Helicobacter pylori in Malaysia has given several important insights into the epidemiology of the infection and pathogenesis of disease. Malaysia has a multiracial Asian population with three major Asian races living together-Malay, Chinese, and Indian. Races remain fairly distinct because of a paucity of interracial marriages. The "Racial Cohort Hypothesis" proposes that the infection occurs within racial groups rather than between. As such, the high prevalence among Indians (>50%) and Chinese (40-50%) reflects the high prevalence in their countries of origin even though migration had taken place more than two generations before. The Malays have a comparatively low prevalence of about 10-20%. Despite the high prevalence of H.pylori, the Indians have a low gastric cancer incidence of less than 10 per 100000 per year. This is in contrast to the Chinese who has an incidence in excess of 20 per 100000 per year. We have called this the "Indian Enigma." The reason for this enigma is unclear and is the result of interaction between bacterial virulence factors, host susceptibility, and environmental factors. Phylogenetically, Chinese bacterial strains are distinct from Indians and Malays and are predominantly hpEastAsia/hsp EAsia. CagA EPIYA motifs among Chinese belong predominantly to the more virulent ABD motif. There is no clear distinguishing profile among host genetic factors. Environmental factors particularly diet may play an important role. Indians consume chilies and curries, which may be gastro protective, whereas Chinese consume more preserved and salted foods, which are thought to be carcinogenic.

Epidemiology of infection in mechanical circulatory support: A global analysis from the ISHLT Mechanically Assisted Circulatory Support Registry.

The epidemiology of parasite infection in local and imported breeds is quite an essential topic in the meat industry and human health. This study aims to determine the prevalence of Dicrocoelium dendriticum in local sheep breeds (Naemi, Najdi, and Harri) and imported breeds from Romania (Romani breed) and the epidemiology of the infection in Saudi Arabia. Morphological description, the relationship between dicrocoeliasis and sex, age, and histological changes were also presented. A total of 6845 slaughtered sheep at Riyadh Automated slaughterhouse were investigated and followed up for 4 months between 2020-2021. It included 4,680 local breeds and 2,165 imported Romanian breeds. Fecal samples and livers and gallbladders from slaughtered animals were examined for apparent pathological lesions. The results indicated that the infection rate in slaughtered animals was 10.6% in imported Romani sheep and 0.9% in the local Naeimi breed. After identifying the parasite morphologically, negative results were obtained from examining feces, gallbladders, and livers of Najdi and Harry sheep breeds. The mean number of eggs per 20 µL/gallbladder was low (72.78 ± 17.8: 76.11 ± 5.07), medium (334.59 ± 90.6: 292.91 ± 26.63), and high (1113.2 ± 22.3: 1004 ± 143.4) in imported and Naeime sheep, respectively. Significant differences were found between gender and age (males and females were 3.67% and 6.31%; > 2 years 4.39%, 1-2 years 4.22%, and 1 year 3.53%) respectively. Histopathological lesions in the liver were more pronounced. Our survey confirmed the presence of D. dendriticum in imported Romani and local Naeimi sheep, and the potential role of imported sheep in the epidemiology of dicrocoeliasis in Saudi Arabia.

The epidemiology of infections after living donor liver transplantation (LDLT) is limited. We aimed to study the epidemiology and risk factors of infections after LDLT. The medical records of 223 adult patients who underwent LDLT from January 1, 2000 to August 31, 2015 were reviewed for all infections occurring up to 1 year. We estimated the cumulative incidence of infection using the Kaplan-Meier product limit method. Risk factors were analyzed with time-dependent Cox regression modeling. The majority of patients were Caucasian (94.6%) and male (64.6%), and the median age at transplantation was 55 years. The most common indication for transplantation was primary sclerosing cholangitis (37.7%). A total of 122 patients developed an infection during the follow-up period (1-year cumulative event rate of 56%), with the majority (66%) of these occurring within 30 days after transplantation. Enterococcus sp. was the most frequent pathogen identified. Multivariate analysis showed that increased Model for End-Stage Liver Disease (MELD) score (per 10-point change: hazard ratio [HR], 1.59), history of recurrent infections prior to transplant (HR, 2.01), Roux-en-Y anastomosis (HR, 2.37), increased log-number of packed red blood cell transfusions (HR, 1.39), and biliary complications (HR, 4.26) were independently associated with a higher risk of infection. Infections occur commonly after LDLT, with most infections occurring early and being related to the hepatobiliary system. Higher MELD scores, the type of biliary anastomosis, presence of biliary complications, and prior pretransplant infections are independently associated with a higher risk for infections. Liver Transplantation 23 465-477 2017 AASLD.