Community-acquired Diseases Research Articles

Native valve endocarditis caused by Corynebacterium striatum without underlying structural heart disease or indwelling cardiovascular medical devices: a case report

BackgroundCorynebacterium striatum (C. striatum) is a gram-positive, anaerobic bacillus found both environmentally and in human skin and nasal mucosa flora. It is reportedly the etiologic agent of community-acquired and nosocomial diseases and is significantly associated with bacteremia and medical endovascular devices. This is the rare case of mitral valve native valve endocarditis (NVE) caused by C. striatum occurring in a young adult without underlying structural heart disease or indwelling cardiovascular medical devices successfully treated with multidisciplinary therapy.Case presentationThe patient was a 28-year-old female with no medical history. She was transferred our hospital due to sudden onset of vertigo and vomit. A computed tomography on day 2 revealed the hydrocephalus due to the cerebellar infarction, and she underwent posterior fossa decompression for cerebellar infarction. An angiography on day 8 revealed a left vertebral artery dissection, which was suspected be the etiology. Afterwards, a sudden fever of 39 degrees developed on day 38. She was diagnosed with aspiration pneumonia and treated with ampicillin/sulbactam but was still febrile at the time of transfer for rehabilitation. Treatment continued with levofloxacin, the patient had no fever decline, and she was readmitted to our hospital. Readmission blood cultures (3/3 sets) revealed C. striatum, and an echocardiogram revealed an 11 mm long mitral valve vegetation, leading to NVE diagnosis. On the sixth illness day, cardiac failure symptoms manifested. Echocardiography revealed mitral valve rupture. She was transferred again on the 11th day of illness, during which time her mitral valve was replaced. C. striatum was detected in the vegetation. Following surgery, she returned to our hospital, and vancomycin administration continued. The patient was discharged after 31 total days of postoperative antimicrobial therapy. The patient experienced no exacerbations thereafter.ConclusionsWe report the rare case of C. striatum mitral valve NVE in a young adult without structural heart disease or indwelling cardiovascular devices.Clinical trial numberNot applicable.

The Comparison between the Effect of Probiotics and Antibiotics against Enterotoxin A Produced by Staphylococcus aureus Microbial and Histopathological Study

Abstract Background: Staphylococcus aureus is a significant pathogen that causes nosocomial infections as well as community-acquired diseases; the spectrum of S. aureus infections ranges from pimples and furuncles to toxic shock syndrome and sepsis. Probiotics, which are defined as “live microorganisms that, when taken in suitable proportions, impart a health benefit on the host beyond basic nourishment,” have attracted increasing public and scientific interest in recent years; probiotics are crucial for preserving the integrity of the gut mucosal barrier and preventing the expansion of potentially harmful bacteria. Objectives: The aim of this study was to evaluate the efficiency of probiotics to protect against the Staphylococcal enterotoxin A (SEA) of S. aureus on different organs of rats comparing with the effect of antibiotics. Materials and Methods: Twenty-five isolates were obtained from a variety of clinical locations. The gene sea was detected by using specific primer, 20 rats were used in this study and randomly divided into 5 groups. A complete necropsy was performed for all the animals. Results: The results of the sea gene showed that 16 out of 25 isolates harbored this gene. And the photomicrograph of liver and intestine, after treatment by probiotics (bacteria and yeast), revealed normal hepatocytes and newly formed villi with mild thickness and intact a muscular layer, respectively. At the same time, after treatment with antibiotics, the results showed remarkable reversible changes of hepatic architecture, areas of hepatocytes with normal arrangements and reversible changes, and these were represented by a significant villi length and the areas of necrosis in a muscular layer in liver and intestine, respectively. Conclusion: The conclusion revealed, probiotics of both types (bacteria and yeast) showed curable effect in the organs under study that were altered by SEA and gave efficient effect as much as antibiotics, and also suggested the usage of probiotics instead of antibiotics for better health.

Does the "Obesity Paradox" Have an Expiration Date? A Retrospective Cohort Study.

(1) Background: The "obesity paradox" refers to a protective effect of higher body mass index (BMI) on mortality in acute infectious disease patients. However, the long-term impact of this paradox remains uncertain. (2) Methods: A retrospective study of patients diagnosed with community-acquired acute infectious diseases at Shamir Medical Center, Israel (2010-2020) was conducted. Patients were grouped by BMI: underweight, normal weight, overweight, and obesity classes I-III. Short- and long-term mortality rates were compared across these groups. (3) Results: Of the 25,226 patients, diverse demographics and comorbidities were observed across BMI categories. Short-term (90-day) and long-term (one-year) mortality rates were notably higher in underweight and normal-weight groups compared to others. Specifically, 90-day mortality was 22% and 13.2% for underweight and normal weight respectively, versus 7-9% for others (p < 0.001). Multivariate time series analysis revealed underweight individuals had a significantly higher 5-year mortality risk (HR 1.41 (95% CI 1.27-1.58, p < 0.001)), while overweight and obese categories had a reduced risk (overweight-HR 0.76 (95% CI 0.72-0.80, p < 0.001), obesity class I-HR 0.71 (95% CI 0.66-0.76, p < 0.001), obesity class II-HR 0.77 (95% CI 0.70-0.85, p < 0.001), and obesity class III-HR 0.79 (95% CI 0.67-0.92, p = 0.003)). (4) Conclusions: In this comprehensive study, obesity was independently associated with decreased short- and long-term mortality. These unexpected results prompt further exploration of this counterintuitive phenomenon.

The secreted tyrosine phosphatase PtpA promotes Staphylococcus aureus survival in RAW 264.7 macrophages through decrease of the SUMOylation host response.

Staphylococcus aureus uses numerous strategies to survive and persist in the intracellular environment of professional phagocytes, including modulation of the SUMOylation process. This study aims to understand how S. aureus alters host SUMOylation to enhance its intracellular survival in professional phagocytes. Our results indicate that S. aureus strain Newman utilizes PtpA-driven phosphorylation to decrease the amount of SUMOylated proteins in murine macrophages to facilitate its survival in this immune cell type.

Anti-quorum sensing potential of selenium nanoparticles against LasI/R, RhlI/R, and PQS/MvfR in Pseudomonas aeruginosa: a molecular docking approach.

Pseudomonas aeruginosa is an infectious pathogen which has the ability to cause primary and secondary contagions in the blood, lungs, and other body parts of immunosuppressed individuals, as well as community-acquired diseases, such as folliculitis, osteomyelitis, pneumonia, and others. This opportunistic bacterium displays drug resistance and regulates its pathogenicity via the quorum sensing (QS) mechanism, which includes the LasI/R, RhlI/R, and PQS/MvfR systems. Targeting the QS systems might be an excellent way to treat P. aeruginosa infections. Although a wide array of antibiotics, namely, newer penicillins, cephalosporins, and combination drugs are being used, the use of selenium nanoparticles (SeNPs) to cure P. aeruginosa infections is extremely rare as their mechanistic interactions are weakly understood, which results in carrying out this study. The present study demonstrates a computational approach of binding the interaction pattern between SeNPs and the QS signaling proteins in P. aeruginosa, utilizing multiple bioinformatics approaches. The computational investigation revealed that SeNPs were acutely 'locked' into the active region of the relevant proteins by the abundant residues in their surroundings. The PatchDock-based molecular docking analysis evidently indicated the strong and significant interaction between SeNPs and the catalytic cleft of LasI synthase (Phe105-Se = 2.7Å and Thr121-Se = 3.8Å), RhlI synthase (Leu102-Se = 3.7Å and Val138-Se = 3.2Å), transcriptional receptor protein LasR (Lys42-Se = 3.9Å, Arg122-Se = 3.2Å, and Glu124-Se = 3.9Å), RhlR (Tyr43-Se = 2.9Å, Tyr45-Se = 3.4Å, and His61-Se = 3.5Å), and MvfR (Leu208-Se = 3.2Å and Arg209-Se = 4.0Å). The production of acyl homoserine lactones (AHLs) was inhibited by the use of SeNPs, thereby preventing QS as well. Obstructing the binding affinity of transcriptional regulatory proteins may cause the suppression of LasR, RhlR, and MvfR systems to become inactive, thereby blocking the activation of QS-regulated virulence factors along with their associated gene expression. Our findings clearly showed that SeNPs have anti-QS properties against the established QS systems of P. aeruginosa, which strongly advocated that SeNPs might be a potent solution to tackle drug resistance and a viable alternative to conventional antibiotics along with being helpful in therapeutic development to cure P. aeruginosa infections.

Characterisation of uropathogenic E.coli by detecting the virulence factors and its drug resistance pattern in a tertiary care hospital in India

Urinary tract infections (UTIs) are among the most prevalent nosocomial and community-acquired bacterial diseases in humans, with E.coli being the most typical pathogen isolated. To detect the prevalence of virulence factors like haemolysin, haemagglutination of human erythrocytes with its effect of D-mannose, and cell surface hydrophobicity, the antibiotic sensitivity pattern and ESBL production in urinary isolates of E.coli obtained from clinical samples. We included the E.coli isolates obtained from a midstream urine sample for the study. Virulence factors like haemolysin, hemagglutination and salt aggregation were detected as per standard protocols. Antibiotic sensitivity testing was performed by the Kirby Bauer disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was seen by the combined disc diffusion method on Muller Hinton agar as per CLSI guidelines. A total of 103 E.coli isolates were tested, and among them, 24(23.30%) produced haemolysin, 65(63.10%) produced hemagglutination and 38(36.89%) had salt aggregation properties. Most isolates obtained were resistant to beta-lactam antibiotics but showed high sensitivity towards antibiotics like chloramphenicol, meropenem, amikacin, imipenem and nitrofurantoin. Around 48% of them were ESBL producers. The common virulence factors associated with UTI were P-fimbriae (MRHA), haemolysin production, cell surface hydrophobicity and type-1 fimbriae. Because of the emerging drug resistance among UPEC, therapy should be advocated as far as possible after obtaining the culture and sensitivity results to determine exact aetiology and susceptibility patterns. The sensitivity to nitrofurantoin is very high, suggesting that antibiotic recycling will help clinicians treat UPEC.

Generation of monoclonal antibodies against PBP2a to improve diagnosis and potential treatment of MRSA infections

Background: MRSA is a type of MDR bacterium. All around the world, it leads to significant nosocomial and community-acquired diseases. The discovery of fresh ideas is very important because there are so few effective treatments for MRSA infections. PBP2a is a great candidate for the development of MRSA-specific Mabs. Aim: The purpose of this study was to create murine Mabs against PBP2a in order to enhance MRSA laboratory detection and possibly treatment. Methods: Anti-PBP2a MAb was tested for biodistribution, therapeutic, and preventative effects in comparison to vancomycin. After receiving anti-PBP2a MAb therapy, biodistribution was assessed between 12 and 96 hours later. Results: During the observation timepoints, the majority of the generated MAb stayed in the serum and just a tiny fraction was found in the kidneys, lungs, and spleen. A prophylactic experiment in mice given the lethal dosage 50 (LD50) found that treated animals with anti-PBP2a MAb had a greater survival rate than the control group. In a therapeutic experiment, one dosage of anti-PBP2a MAb reduced bacterial load in the kidneys similarly to the group treated with five doses of vancomycin, and a combination therapy with anti-PBP2a MAb and vancomycin was more effective than either drug used alone. Conclusion: The findings of this study suggested that an anti-PBP2a MAb may be extremely useful in the creation of innovative diagnostic tools and promising treatments for preventative and therapeutic measures against MRSA infections.

Investigation of Biofilm Virulence Genes Prevalence in Klebsiella pneumoniae Isolated from the Urinary Tract Infections.

Klebsiella pneumonia is a pathogen and an agent that causes hospital-acquired infections. Klebsiella pneumonia is the first and most common causative agent in community-acquired infections and urinary tract diseases. This study aimed to detect common genes, (i.e., fimA, mrkA, and mrkD) in the isolates of K. pneumoniae, isolated from urine specimens using the polymerase chain reaction (PCR) method. The isolates of K. pneumoniae were collected from urine specimens in health centers in Wasit Governorate, Iraq, and diagnosed using AnalyticalProfile Index20Eand 16S rRNA techniques. The microtiter plate (MTP) method was used to detect biofilm formation. A total of 56 isolates were identified as K. pneumonia cases. The results led to the detection of biofilms; accordingly, all K. pneumoniae isolates showed biofilm production by MTP, however, at different levels. The PCR method was employed to detect biofilm genes and showed that 49 (87.5%), 26 (46.4%), and 30 (53.6%) of isolates carried fimH, mrkA, and mrkD, respectively. Furthermore, susceptibility tests for different antibiotics revealed that K. pneumoniae isolates were resistant to amoxicillin-clavulanic acid (n=11, 19.5%), ceftazidime (n=13, 22.4%), ofloxacin (n=16, 28.1%), and tobramycin (n=27, 48.4%). It was also found all K. pneumonia isolates were sensitive to polymyxin B (92.6%), imipenem (88.3%), meropenem (79.4%), and amikacin (60.5%).

Microarray Analysis of the Genomic Effect of Eugenol on Methicillin-Resistant Staphylococcus aureus.

Staphylococcus aureus is a highly adaptive human pathogen responsible for serious hospital- and community-acquired infectious diseases, ranging from skin and soft tissue infections, to complicated and life-threatening conditions such as endocarditis and toxic shock syndrome (TSS). The rapid development of resistance of this organism to available antibiotics over the last few decades has necessitated a constant search for more efficacious antibacterial agents. Eugenol (4-allyl-2-methoxyphenol) belongs to the class of chemical compounds called phenylpropanoids. It is a pure-to-pale yellow, oily liquid substance, mostly extracted as an essential oil from natural products such as clove, cinnamon, nutmeg, basil, and bay leaf. Eugenol has previously been shown to have antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA). However, the mechanism of action of eugenol against MRSA has not, as yet, been elucidated; hence, the necessity of this study. Global gene expression patterns in response to challenge from subinhibitory concentrations of eugenol were analysed using the Agilent DNA microarray system to identify genes that can be used as drug targets—most importantly, essential genes involved in unique metabolic pathways elicited for bacterial survival. Transcriptomic analysis of fluctuating genes revealed those involved in amino acid metabolism, fatty acid metabolism, translational, and ribosomal pathways. In amino acid metabolism, for instance, the argC gene encodes for N-acetyl-gamma-glutamyl-phosphate reductase. The argC gene plays an important role in the biosynthesis of arginine from glutamate in the amino acid metabolic pathway. It is the enzyme that catalyses the third step in the latter reaction, and without this process the production of N-acetylglutamate 5-semialdehyde cannot be completed from the NADP-dependent reduction of N-acetyl-5-glutamyl phosphate, which is essential for the survival of some microorganisms and plants. This study enables us to examine complete global transcriptomic responses in MRSA when challenged with eugenol. It reveals novel information with the potential to further benefit the exploratory quest for novel targets against this pathogen, with a view to the development of efficacious antimicrobial agents for the treatment of associated infections.

Health alliance for prudent prescribing and yield of antibiotics in a patient-centred perspective (HAPPY PATIENT): a before-and-after intervention and implementation study protocol

BackgroundExcessive and inappropriate use of antibiotics is the most important driver of antimicrobial resistance. The aim of the HAPPY PATIENT project is to evaluate the adaptation of European Union (EU) recommendations on the prudent use of antimicrobials in human health by evaluating the impact of a multifaceted intervention targeting different categories of healthcare professionals (HCPs) on common community-acquired infectious diseases, especially respiratory and urinary tract infections.Methods/designHAPPY PATIENT was initiated in January 2021 and is planned to end in December 2023. The partners of this project include 15 organizations from 9 countries. Diverse HCPs (doctors, nurses, pharmacists, and pharmacy technicians) will be audited by the Audit Project Odense (APO) method before and after an intervention in four different settings: general practice, out of hours services, nursing homes and community pharmacies in four high antibiotic prescribing countries (France, Poland, Greece, and Spain) and one low prescribing country (Lithuania). About 25 individuals from each professional group will be recruited in each country, who will register at least 25 patients with community-acquired infections during each audit period. Shortly before the second registration participants will undertake a multifaceted intervention and will receive the results from the first registration to allow the identification of possible quality problems. At these meetings participants will receive training courses on enhancement of communication skills, dissemination of clinical guidelines with recommendations for diagnosis and treatment, posters for the waiting rooms, and leaflets for patients. The results of the second registration will be compared with those obtained in the first audit.DiscussionHAPPY PATIENT is an EU-funded project aimed at contributing to the battle against antibiotic resistance through improvement of the quality of management of common community-acquired infections based on interventions by different types of HCPs. It is hypothesized that the use of multifaceted strategies combining active intervention will be effective in reducing inappropriate prescribing and dispensing of antibiotics.Study registrationEU Health programmes project database https://webgate.ec.europa.eu/chafea_pdb/health/projects/900024/summary; date of registration: 1 January 2021.

Trends in Infectious Diseases: A Retrospective 5-Year Study

Background: Although hospital admission is frequently due to the exacerbation of chronic diseases, most often it is caused by an underlying infectious process. Patients often have several admissions per year, making them at risk for recurrent infections, increased morbidity, and the emergence of resistant strains of microorganisms. Methods: This is a retrospective, descriptive study of all patients with an infectious disease diagnosis, who were admitted to the medical ward of a tertiary hospital during a 5-year period. Information was collected from electronic medical files regarding gender, age, autonomy, comorbidities, primary diagnosis, in-hospital length of stay, and mortality as well as microbiological data surveillance. Results: A total of 355 patients fulfilled the inclusion criteria. Amongst the sample analysed, the average age was 78.10+12.47 years years. Of the patients, 57.2% (203) were female, with most patients considered as dependent according to Katz score. The average Charlson Comorbidity Index (CCI) score was 6.28+2.74, increasing with age. The main diagnostic categories were respiratory (191 patients: 137 with pneumonia and 49 with acute bronchitis) and urinary tract (138 patients: 69 with pyelonephritis and 66 with cystitis). Urinary tract infections were more frequent in females and in dependent patients. Only 37.8% of infections had a microbiologic isolate: Escherichia coli (28.4%), Pseudomonas aeruginosa (12.7%), and Klebsiella pneumoniae (8.2%). The overall mortality was 6.77%. Conclusions: The frequent in-hospital admission due to infectious diseases makes it imperative to characterise and follow-up on evolution of the disease itself in order to better know the characteristics of community-acquired diseases, establish routes of transmission and outbreak identification, microbiology patterns, and resistance towards further improving empiric therapy.

Trends in Infectious Diseases: A Retrospective 5-year Study

Background: Although hospital admission is frequently due to the exacerbation of chronic diseases, most often it is caused by an underlying infectious process. Patients often have several admissions per year, making them at risk for recurrent infections, increased morbidity, and the emergence of resistant strains of microorganisms. Methods: This is a retrospective, descriptive study of all patients with an infectious disease diagnosis, who were admitted to the medical ward of a tertiary hospital during a 5-year period. Information was collected from electronic medical files regarding gender, age, autonomy, comorbidities, primary diagnosis, in-hospital length of stay, and mortality as well as microbiological data surveillance. Results: A total of 355 patients fulfilled the inclusion criteria. Amongst the sample analysed, the average age was 78.10±12.47 years. Of the patients, 57.2% (203) were female, with most patients considered as dependent according to Katz score. The average Charlson Comorbidity Index (CCI) score was 6.28±2.74, increasing with age. The main diagnostic categories were respiratory (191 patients: 137 with pneumonia and 49 with acute bronchitis) and urinary tract (138 patients: 69 with pyelonephritis and 66 with cystitis). Urinary tract infections were more frequent in females and in dependent patients. Only 37.8% of infections had a microbiologic isolate: Escherichia coli (28.4%), Pseudomonas aeruginosa (12.7%), and Klebsiella pneumoniae (8.2%). The overall mortality was 6.77%. Conclusions: The frequent in-hospital admission due to infectious diseases makes it imperative to characterise and follow-up on evolution of the disease itself in order to better know the characteristics of community-acquired diseases, establish routes of transmission and outbreak identification, microbiology patterns, and resistance towards further improving empiric therapy.

Changes in Exanthema Subitum Incidence and Patient Age Distribution During the COVID-19 Pandemic in Japan.

Incidences of community-acquired infectious diseases other than COVID-19 decreased during the coronavirus disease 2019 pandemic; however, exanthema subitum incidence before (2016–2019) and during the pandemic (2020) in Niigata, Japan, did not substantially differ, although the proportion of age less than 1-year-old was lower in 2020. These findings suggest that exanthema subitum is transmitted mainly among family members, not in the community.

Outcome and Incidence of Acute Kidney Injury among Hospitalized Children

Background and purpose: Data on the epidemiology of acute kidney injury (ARI) in Asia come primarily from studies conducted in large tertiary hospitals with nephrology departments. Little is known about what happens in primary care settings without nephrology, especially in the paediatric population. The aim of this study is to describe the epidemiology, outcome and risk factors of ARF in children admitted in pediatric department. Place and Duration: In the Pediatric Medicine and Nephrology department of Abbasi Shaheed Hospital for one-year duration from August 2020 to August 2021. Methods: We prospectively examined children aged 2 to 14 whose guardians gave the consent for the study and were admitted in the Pediatric ward. We identified children with risk factors for AKI on admission and then tested them for AKI using the 2012 Creatinine-based Modified General Kidney Disease Improvement (KDIGO) criteria to improve overall outcomes. Participants with AKI were followed up to discharge. The subject of interest was the need and access to dialysis and renal recovery on discharge from the hospital. Results: A total of 74.3% (n = 116) out of the 156 patients admitted during the study period were at risk of ARF. Of the 156 registered participants, 51.9% (n = 81) were males with a mean age of 5 years. Although comorbid conditions were rare, sickle cell anaemia and malnutrition were the most common. Most of the children were hypotensive (n = 89; 57.1%), with mean systolic and diastolic blood pressures of 81 mmHg and 42 mmHg, respectively. The mean urine output was 0.79 ml / kg / hr. Thirteen patients (8.33%) had urine dipstick anomalies. Anaemia was common (n = 72, 46.2%) and 32 (20.5%) had severe anaemia. Leucocytosis was detected in 26.3% of patients, and a platelet count below 100,000 / mm3 in 24 (15.4%) patients. In total, 21 of 156 participants had AKI for an incidence of 13.5%. The only patient with an indication for dialysis (uremic encephalopathy and anuria&gt; 24 hours) died without dialysis due to a delay in transfer to a dialysis centre (due to lack of resources). Of the 20 survivors in the AKI group, 15 (71.4%) had complete improvement in kidney function The median hospitalization time was significantly longer in participants with stage 3 AKI. Conclusions: ARF risk factors are very common in children admitted in the hospitals. At least one in 10 children presenting with AKI risk factors will have AKI. AKI is largely caused by community-acquired diseases that can be prevented, such as diarrheal diseases and malaria. Efforts should be made to educate about risk assessment, prevention, early diagnosis and treatment of AKI in children. Keywords: AKI; epidemiology; risk factors and outcome.

Literature Review: Masalah Kesehatan Anak Jalanan

An increase in the number of street children saved by the world due to several factors such as family problems, poverty, difficulties in the household, parents, challenges, and family assistance are also reasons why children prefer to choose the road. This literature review aims to analyze or find out about health problems in street children. After reviewing the 5 articles, it can be concluded that three problems are often faced by street children, namely physical, psychological and social health problems. The problem of street children is a shared responsibility, the need for the role of cross-sectoral cooperation, both government, community, and educational institutions to solve the problems of street children. From this research, it is concluded that three problems are often faced by street children, namely physical, psychological and social health problems. Physical problems often experienced by street children are growth and nutrition problems, physical injuries, parasites and community-acquired infectious diseases, sexual and reproductive health problems, sexual violence and abuse, drug use and abuse. Meanwhile, the psychological problems of street children include psychiatric disorders such as depression, hopelessness, and suicidal thoughts. The social health problems of street children are economic and social. Street children are also often victims of neglect, psychological, physical, sexual abuse and are susceptible to sexually transmitted infections.

Immunology of Nonhospital and Intrahospital Infections

The ecological factors of infections and their immunotropy are considered in detail, including the immunotropy of medical factors and features of community-acquired and nosocomial infectious diseases. The general patterns and mechanisms of these categories are discussed.

Worldwide survey of Corynebacterium striatum increasingly associated with human invasive infections, nosocomial outbreak, and antimicrobial multidrug-resistance, 1976-2020.

Corynebacterium striatum is part of microbiota of skin and nasal mucosa of humans and has been increasingly reported as the etiologic agent of community-acquired and nosocomial diseases. Antimicrobial multidrug-resistant (MDR) C. striatum strains have been increasingly related to various nosocomial diseases and/or outbreaks worldwide, including fatal invasive infections in immunosuppressed and immunocompetent patients. Although cases of infections by C. striatum still neglected in some countries, the improvement of microbiological techniques and studies led to the increase of survival of patients with C. striatum nosocomial infections at different levels of magnitude. Biofilm formation on abiotic surfaces contributes for the persistence of virulent C. striatum and dissemination of antimicrobial resistance in hospital environment. Besides that, empirical antibiotic therapy can select multi-resistant strains and transfer intra and interspecies genes horizontally. In this study, a worldwide survey of C. striatum human infections and nosocomial outbreaks was accomplished by the analysis of clinical–epidemiological and microbiological features of reported cases from varied countries, during a 44-year period (1976–2020).

A unique population in today's paediatric intensive care unit: Immigrant children presenting with infectious diseases

Despite similar disease severity scores; we found a higher crude death rate in the group of immigrant children compared to the group of native children in a paediatric intensive care unit. Our study aimed to compare descriptive data and standardised mortality ratios (SMR) in order to analyse differences in mortality. We conducted a retrospective study comparing demographic characteristics, diagnostic data, disease severity scores and mortality in immigrant children of Syrian descent and children of Turkish descent. We included data for the medical and surgical patients admitted in 1 year. The sample included 1283 patients. We compared the age and sex distribution, presence of underlying disease, frequency of community-acquired infectious diseases, length of say, PRISM scores, SMR and crude death rates in the 2 groups. There were 1077 patients in the Turkish group and 206 patients in the immigrant group. The proportion of patients with underlying disease was greater in the Turkish group (42% vs. 37.4%). The proportion of patients with a community-acquired infectious disease as the presenting complaint was similar in both groups (52.9% vs. 47.4%). The mortality in patients with infectious disease was higher in the immigrant group (19.3% vs. 9.8%). There was not significant difference in the mean PRISM score between the 2 groups. We found a higher mortality in the immigrant group (16% vs. 11%). The standardised mortality ratio was 0.32 in the total sample group; 0.4 in the immigrant group and 0.24 in the Turkish group. In our study, we found an association between community-acquired infectious disease and increased mortality in the immigrant group. The underlying mechanism for this increase remains to be explained and further research is required to determine whether parameters related to infection should be added to this severity score for its use in this specific population.

Clinical features and natural history of the first 2073 suspected COVID-19 cases in the Corona São Caetano primary care programme: a prospective cohort study

BackgroundDespite most cases not requiring hospital care, there are limited community-based clinical data on COVID-19.MethodsThe Corona São Caetano programme is a primary care initiative providing care to all residents with...

A unique population in today’s paediatric intensive care unit: immigrant children presenting with infectious diseases

IntroductionDespite similar disease severity scores; we found a higher crude death rate in the group of immigrant children compared to the group of native children in a paediatric intensive care unit. Our study aimed to compare descriptive data and standardised mortality ratios (SMR) in order to analyse differences in mortality. Material and MethodsWe conducted a retrospective study comparing demographic characteristics, diagnostic data, disease severity scores and mortality in immigrant children of Syrian descent and children of Turkish descent. We included data for the medical and surgical patients admitted in 1 year. The sample included 1283 patients. ResultsWe compared the age and sex distribution, presence of underlying disease, frequency of community-acquired infectious diseases, length of say, PRISM scores, SMR and crude death rates in the 2 groups.There were 1077 patients in the Turkish group and 206 patients in the immigrant group. The proportion of patients with underlying disease was greater in the Turkish group (42% vs 37.4%). The proportion of patients with a community-acquired infectious disease as the presenting complaint was similar in both groups (52.9% vs 47.4%). The mortality in patients with infectious disease was higher in the immigrant group (19.3% vs 9.8%). There was not significant difference in the mean PRISM score between the 2 groups. We found a higher mortality in the immigrant group (16% vs 11%). The standardised mortality ratio was 0.32 in the total sample, group; 0.4 in the immigrant group and 0.24 in the Turkish group. ConclusionsIn our study, we found an association between community-acquired infectious disease and increased mortality in the immigrant group. The underlying mechanism for this increase remains to be explained and further research is required to determine whether parameters related to infection should be added to this severity score for its use in this specific population.