Department Of Infectious Diseases Research Articles

Effects of sputum bacillary load and age on GeneXpert and traditional methods in pulmonary tuberculosis: a 4-year retrospective comparative study

BackgroundThe purpose of this study was to evaluate the diagnostic value of the GeneXpert® MTB/RIF (Xpert®), Auramine O staining method, and Lowenstein-Jensen medium for bacteriologically confirmed pulmonary tuberculosis and explore the effects of the sputum bacillary load (SBL) and qRT‒PCR threshold cycle (Ct) value on the detection methods.MethodsWe retrospectively analysed the results in the Department of Infectious Disease for 49 months. The χ2 test was used to compare the performances of each method, receiver operating characteristic curve analysis was used to determine the optimal cut-off values, and the factors associated with a false-negative result from Xpert® were analysed by logistic regression.ResultsSimultaneous analysis of 980 sputum specimens showed that the positive detection rate of Xpert® did not increase with increasing SBL, and there were differences between the three when SBL ≤ 1 + (all P < 0.05). There was a good negative correlation between the Ct value and the SBL (P < 0.0001). Age was an independent risk factor for false-negative Xpert® results (P = 0.029), and when Ct < 16, the diagnostic sensitivity and specificity were both 100.00%. The optimal cut-off Ct values for resegmentation based on the drug resistance classification were < 18.6, 18.6–34.1, and > 34.1 cycles.ConclusionsXpert® was not affected by SBL but it was by age, and it is more advantageous when SBL ≤ 1 + . The results regarding rifampicin resistance were reliable, and the novel Ct segmentation was a practical and more clinically meaningful classification method for diagnosing rifampicin resistance. These findings will help improve physicians’ ability to accurately diagnose TB.

Characteristics of hematological parameters on admission in COVID-19 Omicron variant infected in Chinese population: a large-scale retrospective study

BackgroundThe Omicron variant of SARS-CoV-2, currently the most prevalent strain, has rapidly spread in Jingzhou, China, due to changes in the country’s epidemic prevention policy, resulting in an unprecedented increase in cases. Previous studies reported hematological parameters’ predictive value in COVID-19 severity and prognosis, but their relevance for early diagnosis in patients infected by the Omicron variant, particularly in high-risk pneumonia cases, remains unclear. Our study aimed to evaluate these parameters as early warning indicators for Omicron-infected patients in fever clinics and those with pulmonary infections (PI).MethodsA total of 2,021 COVID-19 patients admitted to the fever clinic and infectious disease department of Jingzhou Hospital Affiliated to Yangtze University from November 1, 2022, to December 31, 2022, were retrospectively recruited. Demographic and hematological parameters were obtained from the electronic medical records of eligible patients. These hematological parameters were analyzed by receiver operating characteristic (ROC) curves to determine whether they can be used for early diagnosis of COVID-19 patients in fever clinics and the presence of PI in COVID-19 patients.ResultsStatistical differences in hematological parameters were observed between COVID-19 patients with fever and PI and control groups (P < 0.01). The ROC curve further demonstrated that lymphocyte (LYM) counts, neutrophil (NEU) counts, monocyte-to-lymphocyte ratios (MLR), platelet-to-lymphocyte ratios (PLR), white blood cell counts (WBC), and mean corpuscular hemoglobin concentration (MCHC) were the top 6 indicators in diagnosing Omicron infection with fever, with area under the curve (AUC) values of 0.738, 0.718, 0.713, 0.702, 0.700, and 0.687, respectively (P < 0.01). Furthermore, the mean platelet volume (MPV) with an AUC of 0.764, red blood cell count (RBC) with 0.753, hematocrit (HCT) with 0.698, MLR with 0.694, mean corpuscular hemoglobin (MCH) with 0.676, and systemic inflammation response indexes (SIRI) with 0.673 were the top 6 indicators for the diagnosis of COVID-19 patients with PI (P < 0.01).ConclusionsLYM, NEU, MLR, PLR, WBC, and MCHC can serve as potential prescreening indicators for Omicron infection in fever clinics. Additionally, MPV, RBC, HCT, MLR, MCH, and SIRI can predict the presence of PI in COVID-19 patients infected by the Omicron variant.

80 years of protecting children's health (to the anniversary of the formation and development of the Department of Children's Infectious Diseases named after Professor S. D. Nosov of the Ivanovo State Medical Academy)

The article presents the history of the development of the Department of Children's Infectious Diseases named after Professor S.D. Nosov of the Ivanovo State Medical Academy. The department was created in 1943 on the basis of the 2nd infectious diseases building of the First City Clinical Hospital in Ivanovo. For 80 years, the staff of the department has preserved and continued the scientific and pedagogical traditions in training qualified personnel for Russian healthcare and preserving the health of children.

Clinical and laboratory aspects of the new coronavirus infection in newborns and infants

Purpose: to identify clinical and laboratory aspects of a new coronavirus infection in newborns and infants. Materials and methods: a retrospective analysis of 131 observations of newborns and infants infected with SARS-CoV-2 treated in children's infectious diseases departments of Izhevsk was carried out. Results. The course of coronavirus infection in newborns and infants who became ill on an outpatient basis and were hospitalized did not have significant specific clinical and laboratory features and was similar to the symptoms of major respiratory infections. Among the hospitalized, 80.9% of children had a mild severity of coronavirus infection, the rest of the children had a moderate course. The clinical picture was dominated by cough (86.3%), nasal congestion (74%) and fever (71.8%). Significant clinical differences were obtained in newborns in the form of predominance of nasal obstruction, and in infants in the predominance of fever and dry cough. Pneumonia was diagnosed in 19.1% in the form of a mild, mainly bilateral lesion.

Epidemiological Profile of Acute Typical Bacterial Pneumonia at The National Reference University Hospital Center of N’Djamena: Risk Factors and Antibiotic Resistance

Acute bacterial pneumonias are non-tuberculous bacterial infections of the lung. They constitute a common pathology in children and adults. The objective of this study was to promote microbiological diagnosis for optimal treatment in terms of antibiotic therapy. This is a prospective observational and analytical study running from June 2022 to February 2023 based on cytobacteriological examinations of sputum from patients of all genders and ages admitted to the pulmonology and infectious diseases department of the National Reference University Hospital Center (CHURN) from N’Djamena. The isolation, identification and antibiogram of the bacteria responsible for acute pneumonia were carried out according to standard clinical microbiology techniques. Of the 207 patients receiving sputum cytobacteriological screening, 121 bacterial agents were isolated, representing a prevalence of bacterial pneumonia of 58.45%. The most isolated bacterial strains were Staphylococcus (45.25%) followed by Streptococcus pneumoniae (34%) and Escherichia coli (10%). Significant differences were observed in terms of predominance of participation of men in the survey compared to women, the origin of patients from N’Djamena and Provinces, schooled and non-schooled patients and Gram-positive and Gram-negative bacteria with the probabilities of 0.01, 0.001, 0.01 and 0.001 respectively. The average age of the patients was 40.9 years with a sex ratio of 1.9. The antecedents associated with pneumonia were HIV infection, respiratory diseases, diabetes, smoking, alcoholism and cough with the proportions of 8.7%, 7.7%, 4.8%, 11.1% and 72.5 % respectively. The sensitivity of isolated bacterial strains gradually decreases from aminopenicillins to 3rd generation cephalosporin. The proportions of resistance were completely variable. Among Staphylococcus, resistance was very remarkable with erythromycin (68%), oxacillin (64.51%), ciprofloxacin (60%) and 96.15% of Staphylococcus were sensitive to fusidic acid. Oxacillin and amoxicillin clavulanic acid were almost inactive. Resistance of Escherichia coli remains high with amoxicillin clavulanic acid (66.7%) and ceftazidime (83.3%). Pseudomonas aeruginosa was 100% susceptible to ceftazidime. This study not only revealed the high prevalence of bacterial pneumonia and high resistance of the antibiotics tested. The importance of the sensitivity test allows the adaptation of antibiotic therapy to microbiological results.

In memory of Alexander Markusovich Bronshtein

On August 11, 2023, at the age of 79 years, Alexander Markusovich Bronstein, Doctor of Medical Sciences, Professor of the Department of Infectious Diseases and Epidemiology of the Faculty of Medicine of the Russian National Research Medical University named after N.I. Pirogov, who worked on the editorial board of our magazine for more than a quarter of a century.

Viral lumbosacral radiculitis (Elsberg syndrome) in Denmark.

To describe clinical features and outcomes of viral lumbosacral radiculitis (Elsberg syndrome). Nationwide population-based cohort study of all adults hospitalised for viral lumbosacral radiculitis at departments of infectious diseases in Denmark from 2015 to 2020. Twenty-eight patients with viral lumbosacral radiculitis were included (mean annual incidence: 1.2/1,000,000 adults). The median age was 35years (IQR 27-43), and 22/28 (79%) were female. All patients had urinary retention, with 17/28 (61%) needing a catheter. On admission, at least one sign or symptom of meningitis (headache, neck stiffness, photophobia/hyperacusis) was present in 18/22 (82%). Concurrent genital herpetic lesions were present in 11/24 (46%). The median cerebrospinal fluid leukocyte count was 153 cells/µL (IQR 31-514). Magnetic resonance imaging showed radiculitis/myelitis in 5/19 (26%). The microbiological diagnosis was herpes simplex virus type 2 in 19/28 (68%), varicella-zoster virus in 2/28 (7%), and unidentified in 7/28 (25%). Aciclovir/valaciclovir was administered in 27/28 (96%). At 30days after discharge, 3/27 (11%) had persistent urinary retention with need of catheter. At 180days after discharge, moderate disabilities (Glasgow Outcome Scale score of 4) were observed in 5/25 (20%). Urinary retention resolved within weeks in most patients with viral lumbosacral radiculitis, but moderate disabilities according to the Glasgow Outcome Scale were common at the end of follow-up.

Quality of Life of People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Monastir, Tunisia.

Despite the benefits of an efficient antiretroviral therapy (ART), HIV/AIDS epidemic still represents the most seriousaffection worldwide that negatively impacts people's quality of life (QoL). As no studies exist on QoL in Tunisia, the aim of the present work was i: to assess, based on WHOQOL-HIV BREF tool, the perception of QoL of people living with HIV (PLHIV) receiving ART and ii: to investigate the relationship between socio-demographic features, disease-related variables and QoL domains' mean scores. This cross-sectional study was conducted at the department of infectious diseases of F. Bourguiba Teaching Hospital in Monastir, Tunisia. One hundred and five participants receiving ART were involved. QoL assessment was based on the WHOQOL-HIV Bref including six domains with 29 items with scores ranged from the lowest (4) to the highest (20). Results were reported as frequencies and means (±SD). The Student's t-test for independent samples and the one-way ANOVA were performed to assess differences in QoL mean scores. Linear regression analysis was used to investigate predictors of QoL. The confidence interval was set at 95%. Clients' mean age was 39.20±10.18 years old with a male to female sex ratio of 3.12. Low mean scores were seen with the environment (12.34±2.90), social relations (12.58±3.94) and psychological domains (12.76±3.31), and moderate mean scores were noted for the physical (14.11±3.52), the spiritual (14.05±3.78) and the level of independence (13.98±3.57) domains. Regression analysis showed that health status and feeling healthy were related to all QoL domains and that profession, marital status and the presence of a confident person were related to environment and spiritual domains. QoL of PLHIV on ART is affected. Concrete measures and strategies should be undertaken by healthcare stakeholders to improve QoL determinants.

A Predictive Model for Identifying Low Medication Adherence Among Patients with Cirrhosis.

This study aims to identify the novel risk predictors of low medication adherence of cirrhosis patients in a large cohort and construct an applicable predictive model to provide clinicians with a simple and precise personalized prediction tool. Patients with cirrhosis were recruited from the inpatient populations at the Department of Infectious Diseases of Tangdu Hospital. Patients who did not meet the inclusion criteria were excluded. The primary outcome was medication adherence, which was analyzed by the medication possession ratio (MPR). Potential predictive factors, including demographics, the severity of cirrhosis, knowledge of disease and medical treatment, social support, self-care agency and pill burdens, were collected by questionnaires. Predictive factors were selected by univariable and multivariable logistic regression analysis. Then, a nomogram was constructed. The decision curve analysis (DCA), clinical application curve analysis, ROC curve analysis, Brier score and mean squared error (MSE) score were utilized to assess the performance of the model. In addition, the bootstrapping method was used for internal validation. Among the enrolled patients (460), most had good or moderate (344, 74.78%) medical adherence. The main risk factors for non-adherence include young age (≤50 years), low education level, low income, short duration of disease (<10 years), low Child-Plush class, poor knowledge of disease and medical treatment, poor social support, low self-care agency and high pill burden. The nomogram comprised these factors showed good calibration and good discrimination (AUC = 0.938, 95% CI = 0.918-0.956; Brier score = 0.14). In addition, the MSE value was 0.03, indicating no overfitting. This study identified predictive factors regarding low medication adherence among patients with cirrhosis, and a predictive nomogram was constructed. This model could help clinicians identify patients with a high risk of low medication adherence and intervention measures can be taken in time.

CORRELATION BETWEEN INTRAHEPATIC cccDNA AND SERUM HBV pgRNA IN TREATMENT-NAÏVE CHRONIC HEPATITIS B PATIENTS

Objectives: To evaluate the correlation between intrahepatic covalently closed circular DNA (cccDNA) and serum HBV pregenomic Ribo nucleic acid (pgRNA) in treatment-naïve chronic hepatitis B (CHB) patients. Methods: A total of 105 treatment-naïve CHB patients from the Department of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, were enrolled from 2017 to 2020. Real-time RT-PCR methods were used to quantify serum HBV pgRNA and intrahepatic cccDNA. Clinical and histopathological assessments were also performed. The patients were categorized into two groups: HBeAg-positive CHB (n = 59) and HBeAg-negative CHB (n = 46). Statistical analyses were conducted using Medcalc 20.019. Results: In treatment-naïve patients, the average concentration of cccDNA and HBV RNA were 1.61 ± 0.40 log10 copies/cell and 4.88 ± 1.65 log10 copies/mL, respectively. A positive linear correlation was observed between HBV pgRNA and cccDNA, especially in the overall group and the HBeAg-negative subgroup, as well as in patients with HAI score ≥ 9 and Fibrosis score ≥ 3 (r = 0.49, r = 0.56, and r = 0.57; p &lt; 0.01, respectively). Conclusion: The study findings indicate a positive linear correlation between intrahepatic cccDNA and serum HBV pgRNA in CHB patients. HBV pgRNA can serve as a reliable marker in the management of CHB patients.

Association of HLA-DRB1*11 and HLA-DRB1*12 gene polymorphism with COVID-19 in Burkina Faso

BackgroundThe clinical manifestations of coronavirus disease (COVID-19) can vary widely, ranging from asymptomatic to severe, and may be influenced by the host genetic background. The aim of the present study was to determine the frequencies of HLA-DRB1*11 and HLA-DRB1*12 allele polymorphisms and their associations with COVID-19.MethodsIn this cross-sectional study, 198 subjects were enrolled, including 150 COVID-19 positive cases and 48 subjects who tested negative for COVID-19. Participants were recruited from the emergency, intensive care, and infectious diseases departments of the Bogodogo Centre University Hospital (CHU-B) or the routine laboratory of Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA). Genomic DNA was extracted from nasopharyngeal swabs samples and multiplex PCR-SSP was used to detect the HLA-DRB1*11 and HLA-DRB1*12 alleles. The study was approved by CERS (№ 2021-02-033).ResultsThe positive cases were categorized into 38 asymptomatic (CC+), 60 symptomatic (NC+), and 52 severe cases (SC+). Females were more frequent in the overall study population (53.0%, 105/198) as well as in the negative group’s CC- (68.75%, 33/48) and SC+ (57.69%, 30/52 negative groups, whereas males were more frequent in the CC+ (63.16%, 24/38) and NC+ (53.33%, 32/60) groups. The highest mean age was observed in the SC + group. A frequency of 19.19% (38/198) and 14.65% (29/198) was found for the HLA-DRB1*11 and HLA-DRB1*12 alleles, respectively. Individuals carrying the HLA-DRB1*11 allele had an approximately sixfold higher risk of asymptomatic SARS-CoV-2 infection (OR = 5.72 [1.683–19.442], p = 0.005) based on the association analysis.ConclusionsAltogether, the present study reports high frequency of HLA-DRB1*11 and HLA-DRB1*12 alleles within a population from Ouagadougou, Burkina Faso. The results suggest that individuals carrying the HLA-DRB1*11 allele are more susceptible to COVID-19 infection but may not display symptoms.

Steroid use in measles: A retrospective cohort study during the 2017 outbreak in tertiary referral center, Rome and Latina, Italy

IntroductionSince early January 2017, a new measles outbreak in Italy has been observed. The aim of the study was to compare features between adults and children measles cases and evaluate the effect of steroid treatment on the above parameters. MethodsA retrospective multicenter, descriptive study was performed. We analyzed all patients admitted to the Department of Public Health and Infectious Diseases, Sapienza University, Rome and Latina, from January 2017 to December 2017 and discharged with diagnosis of measles. ResultsWe identified 113 patients discharged with the diagnosis of measles infection cases of which 59 adults and 54 children (≤16 years). In adult population 32 patients (54 %) were males, with a median age of 30.5 years old and all unvaccinated (100 %). Keratoconjunctivitis 30 (50 %) was the most frequent complication. In pediatric population 27 (50 %) patients were males, with a median age of 3 years old. Information on measles vaccination status was available for only 21 (38.8 %) of cases. Keratoconjunctivitis 40 (74 %) was the most frequent complication. Analyzing the differences between adult and pediatric patients we found that children were significantly more likely to have keratoconjunctivitis and diarrhea as complications than adults in which the rate of thrombocytopenia and hepatitis was highest. Thirty-nine adult subjects (66 %) have been treated with systemic corticosteroids. ConclusionsPediatric patients differ from adults in complications and liver involvement. Regarding steroids use, although there is no clear indication of steroid use during measles, there is no evidence of a worse outcome in our cases series.

Benign recurrent lymphocytic meningitis (Mollaret's meningitis) in Denmark: a nationwide cohort study.

Data on clinical features and outcomes of benign recurrent lymphocytic meningitis (BRLM) are limited. This was a nationwide population-based cohort study of all adults hospitalized for BRLM associated with herpes simplex virus type 2 (HSV-2) at the departments of infectious diseases in Denmark from 2015 to 2020. Patients with single-episode HSV-2 meningitis were included for comparison. Forty-seven patients with BRLM (mean annual incidence 1.2/1,000,000 adults) and 118 with single-episode HSV-2 meningitis were included. The progression risk from HSV-2 meningitis to BRLM was 22% (95% confidence interval [CI] 15%-30%). The proportion of patients with the triad of headache, neck stiffness and photophobia/hyperacusis was similar between BRLM and single-episode HSV-2 meningitis (16/43 [37%] vs. 46/103 [45%]; p = 0.41), whilst the median cerebrospinal fluid leukocyte count was lower in BRLM (221 cells vs. 398 cells; p = 0.02). Unfavourable functional outcomes (Glasgow Outcome Scale score of 1-4) were less frequent in BRLM at all post-discharge follow-up visits. During the study period, 10 (21%) patients with BRLM were hospitalized for an additional recurrence (annual rate 6%, 95% CI 3%-12%). The hazard ratio for an additional recurrence was 3.93 (95% CI 1.02-15.3) for patients with three or more previous episodes of meningitis. Clinical features of BRLM were similar to those of single-episode HSV-2 meningitis, whilst post-discharge outcomes were more favourable. Patients with three or more previous episodes of meningitis had higher risk of an additional recurrence.

Knowledge and Attitudes towards HIV and HCV among the Population Attending the Fast-Track Cities Mobile Unit in Brescia, Italy.

The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18-40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations.

Targeted Pharmaceutical Analysis of Antibiotic Use by Risk Criteria in Patients Hospitalized in the Infectious and Tropical Diseases Department at Treichville Teaching Hospital (Abidjan, Côte d'Ivoire)

Introduction: Most pharmacotherapeutic problems in hospitals are caused by anti-infectives. Audit of prescriptions by a clinical pharmacist is a control and prevention element for iatrogenic risks. Objective: The main aim of our study was to assess the use of antibiotics according to risk criteria in patients hospitalized in the infectious diseases Unit of the Treichville Teaching Hospital (Abidjan, Ivory Coast). Methods: This cross-sectional descriptive study conducted from August to December 2022 in the Infectious and Tropical Diseases department of the Treichville University Hospital aimed to analyze the use of antibiotics in patients with risk criteria. The tools for detecting pharmacotherapeutic problems allowed us to evaluate the frequency and nature of pharmaceutical interventions, highlighting the role of the pharmacist in patient management. Data were analyzed using SPSS version 20.0 software (IBM, USA). Results: A total of 88 patients were included in the study, with a majority of singles (54.5%) and a predominance of subjects under 45 years of age (87.6%) and HIV-positive (93.2%). Antibiotics were the most frequent treatment (75.1%), followed by beta-lactams (36.7%). The main drug interactions were precautions for use (53.6%) and contraindicated associations (45.6%), especially the combination of Ofloxacin with bivalent cations or didanosine. The main pharmaceutical interventions proposed were monitoring of biological parameters in at-risk patients (68.8%) and drug substitution (14.8%). All proposed pharmaceutical interventions were accepted by prescribers. Risk criteria associated with the use of antibiotics were significantly associated with the nature of proposed pharmaceutical interventions. Conclusion: In conclusion, the use of antibiotics in patients with risk criteria is common in the Infectious and Tropical Diseases department of the Treichville University Hospital. The results emphasize the importance of prescription audit by a clinical pharmacist in detecting pharmacotherapeutic problems and preventing iatrogenic risks. The proposed pharmaceutical interventions were accepted by prescribers and were tailored to the risk criteria associated with the use of antibiotics.

Characteristics, Management, and Outcomes of Bacterial Dermohypodermatitis at the Infectious and Tropical Diseases Department of Fann University Hospital, 2016-2020

Recent trends show a clear increase in cases of bacterial dermohypodermatitis (BDH) worldwide. According to some authors, this upsurge is linked to an increase in risk factors, particularly depigmentation. In Senegal, all data relating to BDH come from dermatology departments. The objective of this study was to describe the characteristics, management, and outcomes of dermohypodermatitis at the Infectious and Tropical Diseases Department (SMIT) of Fann hospital. This was a retrospective study conducted at the SMIT. The study population consisted of all patients hospitalized in the department for BDH from 2016 to 2020. We recorded 54 cases of BDH, representing a hospital frequency of 1.29%. The sex ratio (M/F) was 0.42. The median age was 46.5 years [17-85 years]. The most factor of BDH, was depigmentation (31.48%). BDH was localized to the lower limbs in 81.48%. Pain (96.30%), inflammatory swelling (92.59%), and erythematous placard (85.19%) were the main physical symptoms. Blood cultures were positive for Staphylococcus aureus, and Staphylococcus saprophyticus. Cytobacteriological examinations of fluid from ruptured phlyctens isolated Staphylococcus aureus, Klebsiella pneumoniae, Enterobacter spp, Escherichia Coli, and Acinetobacter Spp. Deep vein thrombosis (DVT) was found in 4 patients (13.79%). Complications were present in 18 patients (33.33%). We recorded 5 deaths, representing a lethality rate of 9.26%. Depigmentation has become a major risk factor. Women need to be educated about the harmful effects associated with this practice.

Tetanus, an infectious disease still topical in Lome (Togo)

Tetanus still remains a public health problem in Togo despite the existence of the Expanded Program on Immunization. A retrospective and descriptive cohort study was performed from January 1, 2008 to December 31, 2018 in the infectious and tropical diseases department of Sylvanus Olympio teaching hospital of Lome (Togo) on tetanus cases. We included 208 tetanus cases accounting for 6.5% of the whole hospitalizations in the infectious and tropical diseases department at this hospital. The median age of the patients was 23 [13-38 years] with male predominance (81.2%). The patients were workers (63.5%) and came mainly from urban areas (65.9%). Tetanus vaccination was only up to date in 9.3% of patients. Gateways were dominated by skin wounds (66.8%). Antitetanus serum was administered in 191 patients (91.8%) mainly through intrathecal route (189 patients (91.1%)). Complications were marked by superinfection of the wound (n=8), septic shock (n=3), acute respiratory failure and skin necrosis in 1 case respectively. The lethality was 27.4%. The morbidity of tetanus, in particular juvenile morbidity, remains high with significant lethality. It is therefore important to place particular emphasis on the vaccine booster component.

INFLUENCE OF OBESITY ON DIFFICULTY OF RUNNING CORONAVIRUS DISEASE (COVID-19) (clinical case)

Aim: To conduct a retrospective analysis of the influence of obesity on the severity of the course of COVID-19 based on the analysis of the chart of an inpatient who was treated in the infectious department of the Chernivtsi Regional Clinical Hospital.&#x0D; Materials and methods. "Medical card of an inpatient" of a patient who was undergoing inpatient treatment in the infectious department of the Chernivtsi Regional Clinical Hospital.&#x0D; Results. A 42-year-old obese patient (BMI 40.0 kg/m2) was admitted to the inpatient ward of the infectious disease department of the Chernivtsi Regional Clinical Hospital on the 5th day of her illness. In hospital conditions, oxygen therapy was immediately started (flow 3 l/min), antibiotic therapy (cefepime - 1 g 3 r/day), hormone therapy (dexamethasone - 8 mg 1 r/day) was prescribed. On the 26th day of intensive treatment, the patient's condition significantly worsened. The state of consciousness was disturbed to the level of sopor, and then came a coma. Hemodynamic instability was noted, which required medical support (dopamine). The patient underwent endotracheal intubation and mechanical ventilation. Despite all the measures applied, cardiac arrest occurred. The resuscitation measures that were carried out did not have the desired effect, and the death of the patient was confirmed.&#x0D; Conclusion. In patients with obesity (BMI &gt; 40), the course of COVID-19 is much more severe, compared to patients whose body weight is within acceptable norms. Also, excess body weight significantly increases the risk of complications in patients with COVID-19 caused by Sars-Cov2, and more often leads to a fatal outcome.

Features of COVID-19 in teenagers. Clinical cases

Coronavirus infection in childhood is a common disease and has a number of features of the clinical course. There remain quite a lot of problems related to the variety of clinical symptoms, the severity of the course and treatment tactics in different age categories. Purpose - to study the epidemiological and clinical features of the coronavirus disease COVID-19 in adolescents compared to the younger age group in order to predict the severity of the course and determine treatment tactics. Materials and methods. A single-center retrospective open cohort study of 188 patients under the age of 18 hospitalized in the infectious disease department of the Chernivtsi Regional Children’s Clinical Hospital with a confirmed respiratory infection caused by SARS-CоV-2 was conducted. This cohort of patients is divided into 2 clinical groups. The Group I consisted of children aged 12 to 18 years (43 children), the Group II included children aged 0 to 11 years (145 patients). Results. Epidemiologically, extrafamilial sources of infection prevail in adolescence in the range of 44.2% (n=19), which is explained by greater social activity compared to children from birth to 11 years of age. For the 1st observation group, symptoms of damage to the lower respiratory tract are more characteristic, in particular, cough 81.4% (n=23), shortness of breath 51.1% (n=22), hypoxemia 14.2% (n=6) and symptoms of associated with intoxication syndrome (general weakness, asthenia 97.6% (n=42), decreased appetite, refusal to eat 74.4% (n=32), myalgia 11.6% (n=5), headache 14,2% (n=6)). The severity of the course of the coronavirus infection in adolescence is due to the dominance of lower respiratory tract lesions with the development of pneumonia in 58.2% (n=25) of cases, which required longer and more intensive treatment. Conclusions. The share of adolescents hospitalized due to COVID-19 was 22.9% (n=43), among them with a severe degree of impairment of the general condition - 16.4% (n=7), which is due to the predominance of damage to the lower respiratory tract with the development of pneumonia in 58.2% (n=25) of cases. This cohort of patients is characterized by a longer intoxication syndrome, the epidemiological role of family contacts with regard to COVID-19 decreases, and the value of unidentified non-familial sources of infection increases - 44.2% (n=19). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the authors.

Retracted: Analysis of the Demand for Continuing Education of Nurses in the Department of Infectious Diseases and Its Influencing Factors.

[This retracts the article DOI: 10.1155/2022/3743588.].