Genitourinary Tract Infections Research Articles

Reasons of Hospitalization of Subjects with Type 2 Diabetes Compared to Non-diabetes General People: Experience from a Medical College Hospital of Dhaka City

ABSTRACT Context: Diabetes is one of the most common comorbidities among hospitalized patients; however, reasons of hospitalization among diabetes patients are not well studied in Bangladesh. Aims: The aim of this study was to determine the reasons of hospitalization among subjects with type 2 diabetes. Materials and Methods: This cross-section study was done among the patients who got admitted in the general medicine ward from June 2022 to May 2024. Samples were collected by consecutive convenient sampling. Patients, who got admitted with epidemic diseases, e.g., dengue fever and COVID-19 infections, were excluded from the study. Finally, we used data of 504 patients for analysis using SPSS version 23.0. Results: Infection is the most common cause of hospitalization for both diabetic and nondiabetic patients, though it was a little bit higher in the nondiabetes group (52.6% vs. 65.7%; P = 0.003). Among the infectious causes, genitourinary tract infection (54.9% vs. 29.7%; P < 0.0001) and respiratory tract infection (RTI) (24.8% vs. 21.8%; P < 0.0001) are most common for both groups and significantly more common among diabetes patients. Among the noninfectious causes of hospitalization, diabetes and its complications along with other endocrine diseases was the most common (19.2%), whereas gastrointestinal disease was the most common (30.2%) cause for hospitalization in the nondiabetes group. We also observed a significantly high frequency of hypertension, renal dysfunction, cardiovascular disease, and hypothyroidism in the diabetes group. Conclusion: Infection is the major cause of hospitalization for both diabetes and nondiabetes subjects. Genitourinary tract and RTI are the major forms of infection during hospitalization in diabetes subjects.

Intrauterine Infections and Preterm Birth: Literature Review

Objective: Premature birth is involved in the worldwide health sector problem and an important part challenge. This incidence rate continues to increase and currently, premature births occur in developing countries at 12.5% of all births. Infections within the uterus are associated with at least 40% of births occurring prematurely. Genitourinary tract infections can affect around 41% of women in their reproductive years worldwide may be affected, with 60-80% of these pregnancy-related infections being symptom-free. This article attempts to review the link relating intrauterine infections to premature birth. Data source: This study was taken from six electronic bibliographic databases, namely PubMed, Science Direct. ProQuest, Scopus, EBSCO and DOAJ employing the terms "intrauterine infection", or "premature delivery". Data from all journal articles, summarized according to the categories of the framework of concepts. The following summarization involves the compilation, analysis, and understanding of study data. Results: 10- 12% of intrauterine infections were found in pregnant women, and 20% of premature births were caused by intrauterine infections. The risk factors for this infection are known to be nullipara, lifestyle, and generally women of reproductive age who frequently change partners. There are several types of intrauterine infections, including Bacterial vaginosis, Chlamydia, Asymptomatic bacteriuria, Trihcomonas, and Syphilis. Conclusion: preterm birth has several risk factors, one of which is intrauterine infection that occurs during pregnancy. A quick and accurate diagnosis will help the process of treating intrauterine events in pregnant women to prevent preterm birth.

Association Between Spontaneous Preterm Labor and Genitourinary Tract Infections Among Pregnant Women in a Tertiary Care Hospital in South India: A Cross-Sectional Study.

Introduction and objectives Preterm labor, defined by the WHO as the onset of labor between 20 and 37 weeks of gestation, is a major contributor to neonatal morbidity and mortality, with spontaneous preterm birth accounting for two-thirds of these cases. Genitourinary tract infections, particularly urinary tract infections (UTIs), are a significant risk factor for preterm labor, with studies suggesting that 40% of spontaneous preterm births are associated with genital tract infections. This study aims to determine the association between spontaneous preterm labor and genitourinary tract infections in a sample of antenatal women and evaluate its impact on maternal and neonatal outcomes. Methods This cross-sectional study included 144 antenatal women with spontaneous preterm labor, threatened preterm labor, or preterm premature rupture of membranes (PPROM), presenting between 28 and 37 weeks of gestation at Sri Ramachandra Medical College. Midstream urine samples and vaginal swabs were collected for culture and sensitivity testing. Additional parameters, such as maternal age, body mass index (BMI), parity, socioeconomic status (SES), and history of preterm births, were recorded. Blood tests were performed to measure total counts and C-reactive protein (CRP) levels. Maternal and neonatal outcomes, including birth weight and neonatal sepsis, were analyzed. Results Of the 144 women, 34 (24%) had a positive UTI culture, withEscherichia colibeing the most common organism isolated (35%). The majority of UTI-positive cases were observed in women aged 25-29 years (13, 38%) and those from lower socioeconomic classes (22, 65%). A significant association was found between positive UTI cases and elevated total white blood cell counts and CRP levels. Neonatal outcomes in UTI-positive cases included low birth weight (13, 38%) and neonatal sepsis (3, 9%), while maternal complications were mostly limited to asymptomatic bacteriuria and acute cystitis. Conclusion The study demonstrates a significant association between spontaneous preterm labor and UTIs. Regular screening for genitourinary infections in pregnancy, particularly in high-risk groups such as women from lower socioeconomic backgrounds, could help reduce the incidence of preterm labor and improve neonatal outcomes. Early diagnosis and treatment of UTIs are crucial for preventing complications in both mothers and neonates.

Влияние распространенных бактериальных инфекций на индекс фрагментации ДНК сперматозоидов. Обзор литературы

Sperm DNA fragmentation is an important factor in male infertility, miscarriage and unsuccessful ART cycles. The purpose of thisreview wasto summarize and briefly analyze the available data on the effect of common infections of the male genitourinary tract on sperm DNA fragmentation (SDF), the mechanisms of their influence, efficacy and outcomes of treatment. Based on the results of these studies, it can be said that Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma genitalium have a significant effect and lead to a pronounced increase in SDF. The effect of opportunistic bacteria on SDF depends on the type of microorganisms, their diversity and quantity. The presence of certain bacteria is associated with higher levels of ,some are presumably associated with beneficial effects and lower levels of SDF. Candidiasis can presumably affect SDF, but the available data are insufficient for an accurate answer. Treatment ofsuch infectionsleads to a decrease in sperm DNA fragmentation index, an increase in the effectiveness of ART and spontaneous pregnancy rates. Keywords: sperm DNA fragmentation, infection, male infertility, oxidative stress, fertility, semen analysis, sperm, sperm chromatin.

Clinico-Pathological, Microbiological Profile and Treatment Outcomes of Genitourinary Tract Infections in Patients of Type 2 Diabetes Mellitus Using Sodium-Glucose Co-Transporter 2 Inhibitors

Clinico-Pathological, Microbiological Profile and Treatment Outcomes of Genitourinary Tract Infections in Patients of Type 2 Diabetes Mellitus Using Sodium-Glucose Co-Transporter 2 Inhibitors

Characterization of urethra closure in female neonatal mice at histological and molecular levels.

Female hypospadias is a little-known and poorly studied birth defect. This research establishes an anatomical and molecular foundation for future research to investigate the origins of this defect. Hypospadias is a congenital anomaly of the external genitalia where the urethra does not properly close. In humans, hypospadias is mostly reported in male newborns, whereas in females hypospadias is rare, although it is generally considered to be under-reported. Improper urethra closure in the female genitalia can cause recurrent genitourinary tract infections and infertility. In mice, female hypospadias was induced by exposure to exogenous estrogenic compounds. Aside from the link between estrogen exposure and female hypospadias, the process of female urethra closure is largely unstudied, with the precise timing of urethra closure and associated molecular mechanisms remaining poorly understood. To address this gap, we determined when urethra closure occurs and identified gene expression patterns during the process of urethra closure in female neonatal mice from postnatal day (PND) 5 to 10. Using whole mount imaging and histology, we discovered that the initiation of urethra closure begins at PND7, and urethra closure is fully completed by PND10. To identify the genes associated with urethra closure, we conducted bulk RNA sequencing on female external genitalia prior to and after urethra closure. Gene ontology analyses revealed an increase in steroidogenic gene expression (Star, Hsd3b6, and Cyp17a1) during urethra closure, suggesting that the female genitalia locally produce steroids which could facilitate steroid signaling within the genitalia. With this study, we establish an anatomical timeline of female urethra closure and hypothesize a paracrine steroid signaling mechanism of urethra closure. These observations provide entry points to aid in further understanding external genital abnormalities, like hypospadias, in females.

Dendritic Cells Trained Immunity: A Revolutionary Therapy in Genitourinary Tract infections

Genitourinary Tract infections (GTI), including both vulvovaginal candidiasis (VVC) and urinary tract infections (UTIs), represent a significant burden on public health, affecting millions of women worldwide. These conditions not only impact the quality of life of patients but also incur high healthcare costs due to the need for recurrent treatment and management of complications. The mainstay of treatment for these conditions has traditionally been antibiotics and antifungals. However, overuse of these medications is linked to antibiotic resistance and adverse effects. Dendritic cell trained immunity is an innovative, state-of-the-art reprogramming therapy that offers a revolutionary approach, especially when conventional vaccines are unavailable or for individuals experiencing recurrent infections. Novel studies have demonstrated that these glycoconjugates induce long-lasting epigenetic changes in dendritic cells (DCs), initiating a trained immunity effect that extends protection against subsequent microbial exposures. The aim of this study is to present the latest evidence on the treatment of recurrent genitourinary tract infections, highlighting the potential of dendritic cell trained immunity as a significant breakthrough in gynecological care. This innovative approach not only represents a shift from traditional treatment methods but also offers hope for more effective and sustainable management of recurrent infections, ultimately improving patient outcomes and reducing the burden on healthcare systems.

Electrochemical Detection of Ornidazole Using a WS2 /CNFs Sensor

In recent decades, pharmaceutical compounds, notably antibiotics, have played a significant role in preventing infections and illnesses that affect both animals and humans. However, the utilization of antibiotics in the pharmaceutical industry, farming and other applications has led to environmental concerns 1. Nitroimidazole, an oral drug, is commonly used as an antibacterial agent. An example of a drug in nitroimidazole family is ornidazole (ORZ, (1-(3-chloro-2-hydroxy) propyl-2-methyl- 5-nitroimidazole)), and it is used in treating and preventing various infections, including genitourinary tract, intestinal and protozoal infections. Ornidazole has a heterocyclic structure comprising of an imidazole-based nucleus with a nitro group (NO2)1 and have become a well-established group of antiprotozoan and antibacterial agents. Beyond immediate therapeutic benefits, ornidazole could persist in the environment, posing long-term risks such as potential mutagenic and carcinogenic effects. Moreover, excessive antibiotics such as antibiotics such as ORZ in the environment can lead to the development of antibiotic-resistant pathogens. The widespread use of antibiotics in medical treatment and agriculture contributes to water contamination as these substances find their way into water bodies through various pathways. There is escalating concern over pharmaceutical contaminants therefore highlighting the importance of monitoring and regulating antibiotic levels in the environment. This requires significant research and electrochemical methods portray possibilities for drug detection due to their advantages of high sensitivity, low cost, simplicity and selectivity.Recent developments have brought to the spotlight, two dimensional materials as promising candidates for environmental sensing, due to their unique characteristics and wide-ranging applications. In particular, Transition-metal dichalcogenides (TMDs), comprising of MX2 , with M a transition metal atom e.g. Mo, W etc. and X, a chalcogen atom S, Se or Te 2, have garnered attention for their exceptional features. These materials consist of M atoms closely sandwiched between two layers of X atoms, linked by strong in-plane covalent bonds, and further bonded by weak van der Waals forces between the layers. Among the TMDs, tungsten disulfide (WS2) exhibits exceptional properties, including high electronic conductivity, good chemical stability, large capacitance and surface area. Those inherent properties of WS2, make it a suitable material for various applications, especially in environmental sensing 3.This study explores the detection of ornidazole using a composite material of WS2 with functionalized carbon nanofibers (CNFs). Carbon nanofibers (CNFs) are featured for their equally outstanding electrical and mechanical properties that make them promising candidates for sensor applications. CNFs also provide a unique platform for developing sensitive and selective sensors. Their versatility allows for functionalization, enhancing chemical properties and enabling tailored interactions with target analytes. The study emphasizes how CNFs, with their notable properties, complement WS2 in the creation of innovative sensor structures to create composites with improved sensing capabilities for drug compounds. In this study, the WS2/CNF nanocomposite was synthesized using hydrothermal synthesis and subsequently dispersed in ethanol and water, and then drop casted on a glassy carbon electrode. Prior to synthesis, the CNFs were functionalized using a low cost, environmental friendly method, thus enhancing their chemical properties. Herein, the resulting WS2/CNF composite demonstrates its efficacy in detecting ornidazole, and shows excellent potential for the development of electrochemical sensors. Overall, the work here aims to highlight the ongoing progress of electrochemical sensor technology, emphasizing its crucial role in addressing the growing challenges associated with drug contamination in the environment.References(1) Ettadili, F. E.; Azriouil, M.; Matrouf, M.; Tahiri Alaoui, O.; Laghrib, F.; Farahi, A.; Bakasse, M.; Saqrane, S.; Lahrich, S.; El Mhammedi, M. A. Materials Framework Based Bio/Sensors for the Detection of Ornidazole and Metronidazole Antibiotics in Environment and Foodstuffs. Inorganic Chemistry Communications. 2022. https://doi.org/10.1016/j.inoche.2022.109416.(2) Manzeli, S.; Ovchinnikov, D.; Pasquier, D.; Yazyev, O. V.; Kis, A. 2D Transition Metal Dichalcogenides. Nature Reviews Materials. 2017. https://doi.org/10.1038/natrevmats.2017.33.(3) Santos, B. G.; Gonçalves, J. M.; Rocha, D. P.; Higino, G. S.; Yadav, T. P.; Pedrotti, J. J.; Ajayan, P. M.; Angnes, L. Electrochemical Sensor for Isoniazid Detection by Using a WS2/CNTs Nanocomposite. Sensors and Actuators Reports 2022, 4. https://doi.org/10.1016/j.snr.2021.100073.

Mendelian randomization analysis reveals higher whole body water mass may increase risk of bacterial infections

Background and purposeThe association of water loading with several infections remains unclear. Observational studies are hard to investigate definitively due to potential confounders. In this study, we employed Mendelian randomization (MR) analysis to assess the association between genetically predicted whole body water mass (BWM) and several infections.MethodsBWM levels were predicted among 331,315 Europeans in UK Biobank using 418 SNPs associated with BWM. For outcomes, we used genome-wide association data from the UK Biobank and FinnGen consortium, including sepsis, pneumonia, intestinal infections, urinary tract infections (UTIs) and skin and soft tissue infections (SSTIs). Inverse-variance weighted MR analyses as well as a series of sensitivity analyses were conducted.ResultsGenetic prediction of BWM is associated with an increased risk of sepsis (OR 1.34; 95% CI 1.19 to 1.51; P = 1.57 × 10− 6), pneumonia (OR: 1.17; 95% CI 1.08 to 1.29; P = 3.53 × 10− 4), UTIs (OR: 1.26; 95% CI 1.16 to 1.37; P = 6.29 × 10− 8), and SSTIs (OR: 1.57; 95% CI 1.25 to 1.96; P = 7.35 × 10− 5). In the sepsis and pneumonia subgroup analyses, the relationship between BWM and infection was observed in bacterial but not in viral infections. Suggestive evidence suggests that BWM has an effect on viral intestinal infections (OR: 0.86; 95% CI 0.75 to 0.99; P = 0.03). There is limited evidence of an association between BWM levels and bacteria intestinal infections, and genitourinary tract infection (GUI) in pregnancy. In addition, MR analyses supported the risk of BWM for several edematous diseases. However, multivariable MR analysis shows that the associations of BWM with sepsis, pneumonia, UTIs and SSTIs remains unaffected when accounting for these traits.ConclusionsIn this study, the causal relationship between BWM and infectious diseases was systematically investigated. Further prospective studies are necessary to validate these findings.

Empagliflozin to prevent post-operative atrial fibrillation in patients undergoing coronary artery bypass graft surgery: Rationale and design of the EMPOAF trial.

Postoperative atrial fibrillation (POAF) is one of the most common types of acute AF and can complicate the treatment course of approximately one third of patients undergoing cardiac surgery. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are among the newest antidiabetic drugs which can be therapeutic options for preventing POAF by different mechanisms. Empagliflozin to Prevent POAF (EMPOAF) is an interventional, investigator-initiated, double-blind, placebo-controlled, multicenter, randomized controlled trial which will be conducted in two referral teaching cardiology hospitals in Tehran. Four-hundred ninety-two adult patients who are scheduled for elective isolated coronary artery bypass graft (CABG) surgery will be randomly assigned to one of the groups of intervention (empagliflozin 10mg daily) or placebo starting at least 3 days before surgery until discharge. Key exclusion criteria are a history of diabetes mellitus, AF, ketoacidosis, or recurrent urinary tract infections along with severe renal or hepatic impairment, unstable hemodynamics, and patients receiving SGLT2 inhibitors for another indication. The primary outcome will be the incidence of POAF. Key secondary endpoints will be the composite rate of life-threatening arrhythmias, postoperative acute kidney injury, hospitalization length, in-hospital mortality, stroke, and systemic embolization. Key safety endpoints will be the rate of life-threatening and/or genitourinary tract infections, hypoglycemia, and ketoacidosis. EMPOAF will prospectively evaluate whether empagliflozin 10mg daily can reduce the rate of POAF in patients undergoing elective CABG. Enrolment into this study has started by November 2023 and is expected to be ended before the end of 2025.

Knowledge and Habitual practice Regarding Prevention of Genito-urinary Tract Infection among Adolescent Nursing Girls Students

Knowledge and Habitual practice Regarding Prevention of Genito-urinary Tract Infection among Adolescent Nursing Girls Students

Effect of Ureaplasma/Mycoplasma genital tract infection on preterm labor.

Genitourinary tract infections in pregnant women are one of the causes of abnormal pregnancy development including miscarriages, premature labor or premature rupture of membranes (PPROM). Atypical bacteria responsible for reproductive tract infections include Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum. Identification of pathogens and appropriately selected therapy can improve obstetric outcomes in patients with symptoms of threatened miscarriage or threatened preterm labor. The purpose of our study is to analyze the impact of reproductive tract infections with ureaplasma and mycoplasma bacteria during pregnancy. In the presented study, we retrospectively analyzed the cases of 201 pregnant patients hospitalized in the Obstetrics and Gynecology Department of Poznan Regional Hospital in 2019-2022, who had a swab taken from external os area of the cervix for atypical bacteria - Ureaplasma and Mycoplasma. Only patients with symptoms of threatened miscarriage or threatened preterm labor were included in the study group. Microbiological tests were performed in the hospital laboratory with the Mycoplasma IST 3 test from Biomerieux. We found a higher incidence of preterm labor in patients with symptoms of threatened preterm labor and a genital tract infection with Ureaplasma/Mycoplasma bacteria, compared to patients not infected with Mycoplasma/Ureaplasma - 31.1% vs 20% (p = 0.098). This observation in the case of Ureaplasma/Mycoplasma monoinfection group applied to 6 patients. - 75% of the group. Pregnant patients who had co-infection with other types of bacteria (48 patients in total) gave birth before 37 weeks of pregnancy in 27.1% of cases. We obtained a significant difference (p = 0.007) when comparing groups with positive and negative cultures for Ureaplasma/Mycoplasma by the presence of monoinfection/coinfection and the week of pregnancy in which delivery occurred. We also noted the effect of atypical bacterial infection for PPROM - this complication preceded preterm delivery in 40% of ureaplasma-positive patients, compared to 20% of PPROM without infection. We found a similar rate of preterm labor and pregnancy loss in Ureaplasma/Mycoplasma-positive patients who received antibiotic therapy (35.7%) compared to a group of pregnant women who did not receive treatment (31.6%). Infection of the genital tract with atypical bacteria Ureaplasma and Mycoplasma has a negative impact on the course of pregnancy. Identification of the type of microorganisms in cervical canal secretions of pregnant patients with symptoms of threatened miscarriage or preterm labor seems crucial. The impact of antibiotic therapy though, requires further analysis.

A nationwide study of Stevens–Johnson syndrome and toxic epidermal necrolysis in hospitalized pregnant women in the United States, 2009–2020

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rarely described in the pregnant population, and knowledge of their impact on the mother/fetus is limited. To describe SJS/TEN in pregnant women and to investigate the risk factors for developing SJS/TEN in pregnancy. We utilized hospitalization data from the 2009-2020 National Inpatient Sample. Pregnancy hospitalizations and SJS/TEN involvement were identified by ICD-9/10 codes and analyzed by chi-square and logistic regression. We identified 650 pregnancies complicated by SJS/TEN requiring hospitalization. The median age was 28years, and most were non-Hispanic White (55.2%). There were ≤10 cases associated with mortality. Most SJS/TEN cases (73.9%) occurred during the third trimester. HIV infection (OR=9.49; P=.030), herpes simplex virus infection (OR=2.49; P=.021), genitourinary tract infections (OR=3.80; P<.001), malignant neoplasm (OR=8.67; P=.031), and lupus erythematosus (OR=41.94; P<.001) were associated with increased odds of developing SJS/TEN in pregnancy. Rates of preterm births were higher in the SJS/TEN cohort, 16.9% versus 8.2% (P<.001). Rates of pre-eclampsia, stillbirths, and post-term births were similar between the SJS/TEN versus non-SJS/TEN pregnancy cohorts. Limited cohort size. SJS/TEN in pregnancy appears to be mild and is associated with favorable maternal-fetal outcomes, except for increased preterm birth.

A Systemic Review on Use of Medicinal Plant for Management of Male Infertility

A recent issue with current society is the fall in male infertility. In 50% of instances, couple infertility is caused by the failure in spermatogenesis of the male partner. The male reproductive system is impacted by a variety of factors that lead to infertility, including genitourinary tract infections, endocrine abnormalities, immunological factors, lifestyle, stress, and drug-related damage. There are medications and therapies for male infertility, but they are not very effective, have harmful side effects, and are contraindicated. Plants are among the greatest natural cures for illnesses since they have very few side effects and include a variety of phytoconstituents from different chemical classes. Depending on their concentration, plant bioactive such as flavonoids, polyphenols, glycosides, alkaloids, and terpenoids might have a variable effect on sperm quality - either positively or adversely. These compounds have been suggested as organic reactive oxygen species scavengers for the treatment of male infertility. This review makes an effort to compile the available information and offer perspectives for upcoming investigations on how plants affect male gonads. This review summarizes the most recent research on the use of phytoconstituents to increase testosterone production, support healthy spermatogenesis, and prevent age-related degenerative illnesses linked to low levels of testosterone. This review includes information on about 45 herbal plants that have been published in several papers. The articles have several headings, including plant taxonomy, bioactive components, impacts on fertility, and medical applications. This review provides information on the applications of natural sources for male fertility enhancement and their potential mechanisms of action.

Chronic sexually acquired reactive arthritis secondary to Chlamydiatrachomatis

Reactive arthritis is included in the spectrum of seronegative spondyloarthritides, occurring secondary to triggers of genitourinary and gastrointestinal tract infections. We describe two cases of sexually acquired reactive arthritis secondary to genital infection by Chlamydia trachomatis, diagnosed by in-house polymerase chain reaction performed on the first void urine. Both patients were managed with a combined approach of short course antibiotics, immunosuppressive agents, biologicals and surgical intervention.

Interplay of polygenic liability with birth-related, somatic, and psychosocial factors in anorexia nervosa risk: a nationwide study.

Although several types of risk factors for anorexia nervosa (AN) have been identified, including birth-related factors, somatic, and psychosocial risk factors, their interplay with genetic susceptibility remains unclear. Genetic and epidemiological interplay in AN risk were examined using data from Danish nationwide registers. AN polygenic risk score (PRS) and risk factor associations, confounding from AN PRS and/or parental psychiatric history on the association between the risk factors and AN risk, and interactions between AN PRS and each level of target risk factor on AN risk were estimated. Participants were individuals born in Denmark between 1981 and 2008 including nationwide-representative data from the iPSYCH2015, and Danish AN cases from the Anorexia Nervosa Genetics Initiative and Eating Disorder Genetics Initiative cohorts. A total of 7003 individuals with AN and 45 229 individuals without a registered AN diagnosis were included. We included 22 AN risk factors from Danish registers. Risk factors showing association with PRS for AN included urbanicity, parental ages, genitourinary tract infection, and parental socioeconomic factors. Risk factors showed the expected association to AN risk, and this association was only slightly attenuated when adjusted for parental history of psychiatric disorders or/and for the AN PRS. The interaction analyses revealed a differential effect of AN PRS according to the level of the following risk factors: sex, maternal age, genitourinary tract infection, C-section, parental socioeconomic factors and psychiatric history. Our findings provide evidence for interactions between AN PRS and certain risk-factors, illustrating potential diverse risk pathways to AN diagnosis.

Characterization of Escherichia coli Isolated from Sows Presenting Purulent Vulvar Discharge.

Purulent vulvar discharge is a clinical sign of genitourinary tract infections, which are a significant concern in swine facilities, leading to sow culling and mortality. Escherichia coli is one of the main agents involved in these diseases. This study aimed to characterize the virulence and antimicrobial resistance profiles as well as the phylotype of Escherichia coli strains isolated from sows with purulent vulvar discharge. The results showed that at least 2 of the 29 tested virulence genes related to extraintestinal pathogenic E. coli were present in all strains tested. The most frequent gene was iutA, present in all strains, followed by the genes iucD, csgA, iss2, and irp2. Associations between iron uptake genes, genes related to adhesion, attachment, and serum resistance, as well as genes related to toxin release and bacteriocin, were frequent. The most prevalent phylotype was B1 (40.0%), followed by A (18.5%), D (11.9%), C (9.6%), B2 (7.4%), E (4.4%), F (1.5%), and Clade I (0.7%), with B2 being related to highly virulent traits. The strains presented elevated resistance to antimicrobials such as ciprofloxacin, streptomycin, cephalexin, florfenicol, and ampicillin. More than 90% of the strains were identified as multidrug-resistant, indicating the selection that is induced by the high use of antimicrobials in swine farming.

Maternal Prenatal Infections and Biliary Atresia in Offspring

Investigations into the association of antepartum maternal infections with the pathogenesis of biliary atresia (BA) in human offspring are insufficient. To examine the association between prenatal infections in mothers and the development of BA in their offspring. This population-based case-control study obtained administrative data from the Taiwan National Health Insurance Research Database with linkage to the Taiwan Maternal and Child Health Database, capturing demographic and medical information on nearly all 23 million of the Taiwan population. The cohort comprised 2 905 978 singleton live births among mother-infant dyads between January 1, 2004, and December 31, 2020, in Taiwan. The case group of infants with BA was identified from use of International Classification of Diseases diagnostic codes for BA and subsequent Kasai procedure or liver transplant. The control group was randomly selected from infants without BA, representing approximately 1 in 1000 study population. Data analyses were performed from May 1 to October 31, 2023. Prenatal maternal infections, including intestinal infection, influenza, upper airway infection, pneumonia, soft-tissue infection, and genitourinary tract infection. The main outcome was exposure to prenatal maternal infections. Inverse probability weighting analysis was performed by building a logistic regression model to estimate the probability of the exposure observed for a particular infant and using the estimated probability as a weight in subsequent analyses. The weighted odds ratio (OR) estimated by logistic regressions was then used to assess the risk of BA in offspring after prenatal maternal infections. Among the mother-infant dyads included, 447 infants with BA were cases (232 females [51.9%]) and 2912 infants without BA were controls (1514 males [52.0%]). The mean (SD) maternal age at childbirth was 30.7 (4.9) years. Offspring exposed to prenatal intestinal infection (weighted OR, 1.46; 95% CI, 1.17-1.82) and genitourinary tract infection (weighted OR, 1.22; 95% CI, 1.05-1.41) in mothers exhibited a significantly higher risk of BA. Furthermore, maternal intestinal infection (weighted OR, 6.05; 95% CI, 3.80-9.63) and genitourinary tract infection (weighted OR, 1.55; 95% CI, 1.13-2.11) that occurred during the third trimester were associated with an increased risk of BA in offspring. Results of this case-control study indicate an association between prenatal intestinal infection and genitourinary tract infection in mothers and BA occurrence in their offspring. Further studies are warranted to explore the underlying mechanisms of this association.

A Review on the Use of Third-Generation Cephalosporins on Gram-Positive and Gram-Negative Bacteria Based on its Spectrum of Activity

This review explores the clinical usage of third-generation cephalosporins, a class of broad-spectrum antibiotics that are essential for treating gram-positive and gram-negative bacterial infections in a variety of infectious conditions. These antibiotics have bactericidal action by inhibiting the synthesis of bacterial cell walls. Among the well-known members of this class are cefoperazone, cefpodoxime proxetil, ceftibuten, ceftriaxone, cefotaxime, and ceftazidime. Inhibiting transpeptidase is the mechanism of action, which, in the case of gram-negative bacteria, results in cell lysis and death. Third-generation cephalosporins are used to treat a wide range of conditions, including meningitis, genitourinary tract infections, pneumonia, infections of the skin and soft tissues, and bone and joint infections. Each cephalosporin within this generation exhibits a distinct spectrum of activity. For instance, cefpodoxime proxetil acts against Staphylococcus aureus and Klebsiella pneumoniae, whereas cefixime acts against Streptococcus pneumoniae and Escherichia coli. Neisseria gonorrhoea and Pseudomonas aeruginosa are only two examples of the many gram-positive and gram-negative bacteria that ceftriaxone is active against. This review also highlights the synergistic effects of combining third-generation cephalosporins with other antibiotics, demonstrating their versatility in managing complex infections. Despite their effectiveness, third-generation cephalosporins may not be effective against Chlamydia trachomatis. Furthermore, careful consideration of each antibiotic's spectrum guides their specific use in treating conditions such as urinary tract infections, otitis media, bronchitis, and gynecologic infections. In conclusion, the comprehensive spectrum of action of third-generation cephalosporins makes them valuable in addressing a diverse array of bacterial infections. However, their use should be judicious, considering the evolving landscape of antibiotic resistance and the specific bacterial targets for optimal therapeutic outcomes.

ABDOMINAL WALL DEFECTS: GASTROSCHISIS, DEFINITION, EPIDEMIOLOGY, PATHOGENESIS, TYPES, DIAGNOSIS AND MANAGEMENT

Introduction: Abdominal wall defects are common congenital anomalies, both gastroschisis and omphalocele conform to fetal developmental anomalies that favor multidisciplinary support before and after birth. Outcomes for newborns with gastroschisis usually depend on the distinctive features of the abdominal wall defect and underlying intestinal viability, whereas omphalocele outcomes are determined by the size of the defect and the presence of other related anomalies. Objective: to detail current information related to the two fetal abdominal wall defects, especially gastroschisis definition, epidemiology, pathogenesis, types, diagnosis and management. Methodology: a total of 48 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 36 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: fetal abdominal wall defects, gastroschisis, prenatal anomalies, surgery and prosthetic silo. Results: The incidence of gastroschisis ranges from 0.4 to 3 per 10,000 births and shows an upward pattern, the incidence of omphalocele ranges from 1.5 to 3 per 10,000 births. About 10% of infants with gastroschisis have intestinal stenosis or atresia because of vascular insufficiency due to volvulus or compression of the vascular pedicle by a narrowing abdominal ring. Periconceptional genitourinary tract infections were significantly associated with gastroschisis (OR, 1.5; 95 % CI, 1.3 to 1.9). Other significant associations presented in various studies with gastroschisis pregnancies include smoking (odds ratio (OR), 2.86; 95 % CI, 2.22-3.66), history of pregestational or gestational diabetes (OR, 2.81; 95 % CI, 1.42-5.5), and use of antidepressant medications (OR, 4.4; 95 % CI, 1.38-11.8). Conclusions: Abdominal wall defects are common congenital anomalies, both gastroschisis and omphalocele represent different embryological outcomes, which depend on accurate prenatal diagnosis and referral to a multidisciplinary fetal center. Gastroschisis is a congenital anomaly of the rudimentary umbilical ring, in which there is herniation of a variable portion of viscera through the defect, with no membrane or covering sac, and its prevalence has been steadily increasing. Gastroschisis is classified into simple and complex types. Prenatal ultrasound scans can diagnose gastroschisis as early as 12 weeks of gestation. Routine preterm delivery or elective cesarean section has not been shown to improve outcome. Surgical management after birth is aimed at reduction of the herniated viscera and closure of the abdominal wall. Survival rates are usually high; however, the prognosis depends on the state of the bowel at birth. Those affected with significant intestinal alteration at birth are at higher risk of premature death or later complications. Future fetal surgery could improve the outlook and management of the condition. KEY WORDS: gastroschisis, abdominal wall defect, congenital.